六例人感染H7N9禽流感伴肺部感染患者的影像学表现

Imaging analysis of 6 cases of human infection with avian influenza A(H7N9) virus and pulmonary infection

目的探讨人感染H7N9禽流感伴肺部感染患者的影像学表现,为临床诊断提供参考。方法回顾性分析安庆市立医院2015年3月至2017年3月收治的6例经确诊的H7N9禽流感病毒性肺炎患者的影像学及临床资料,6例患者均采用X线/CT检查,扫描电压:120 k V,电流:80 m A,扫描螺距:1.25 mm,层厚:1.25 mm,范围由肺叶尖至膈角,进行不间断扫描。结果 6例患者均以咳嗽、咳痰、发热为首发症状,血常规显示CRP显著升高。6例患者病灶呈多灶叶分布,以两下叶病变居多;其中有6例影像学表现为磨玻璃密度影(GGO),3例伴有大面积肺实变;3例小叶间隔增厚、2例支气管血管影增粗、4例肺部实变组织内可见充气支气管征,此外合并4例胸腔积液及1例纵膈淋巴结肿大钙化灶。结论影像学检查有助于诊断人感染H7N9禽流感并且利于监测病情转归。

Objective To investigate the imaging findings of human infection with avian influenza H7 N9 virus and pulmonary infection, and to provide reference for clinical diagnosis. Methods The imaging and clinical data of 6 patients with avian influenza H7 N9 virus pneumonia treated in our hospital from March 2015 to March 2017 were retrospectively analyzed. X-ray/CT was used in 6 patients, scanning voltage： 120 k V, current： 80 m A, scan pitch： 1.25 mm, layer thickness： 1.25 mm, range from the tip of the lung to the diaphragm angle, continuous scanning. Results Cough, sputum,fever were the first symptoms of 6 cases. Routine blood test showed a significant increase in C-reactive protein（CRP）. 6 cases of lesions showed multi-stove distribution, mostly with two leaves. There were 6 cases of imaging performance for the ground glass density（GGO）, 3 cases associated with large area of lung consolidation. There were 3 cases of lobular interval thickening, 2 cases of bronchial vascular thickening, 4 cases of pulmonary solid tissue visible inflamed bronchial sign, in addition to 4 cases of pleural effusion and 1 case of mediastinal lymph node enlargement calcification. Conclusion Imaging studies can help diagnose human infection with avian influenza H7 N9 virus and facilitate the surveillance of disease outcomes.