甲型H1N1流感肺炎CT演变特点  

CT findings during the evolvement of influenza A(H1N1) pneumonia

作　　者：齐战元[1,2] 袁涛[1] 全冠民[1] 王颖杰[1] 

机构地区：[1]河北医科大学第二医院影像科,石家庄050000 [2]河北省井陉县中医院

出　　处：《放射学实践》2012年第4期386-389,共4页Radiologic Practice

摘　　要：目的:探讨甲型H1N1流感肺炎近中期CT演变特点。方法:回顾性分析35例临床确诊的甲型H1N1流感肺炎患者发热后1个月内86次CT资料,分析其肺部病变出现、进展及吸收时间和影像特点。结果:肺部病变发生时CT表现主要为肺部磨玻璃密度影或实变,胸腔积液等。CT复查表现分为3组:完全吸收组4例,表现为肺部磨玻璃密度影或实变在6～13d(平均11.25d)吸收;明显减轻组29例,表现为磨玻璃密度影及实变减轻或缩小,胸腔积液减少或消失;进展组2例,1例发热后第10天进展为ARDS,另1例合并真菌感染,复查后表现为实变及空洞扩大。2例远期复查中1例第73天仍浅淡磨玻璃密度影,1例第90d遗留少许磨玻璃密度影、小叶间隔增厚、小叶性结节及少许索条影。结论:甲型H1N1流感肺炎肺部病变多在发热后3天内出现,2周左右完全或部分吸收,部分病例中期复查可见间质性病变,危重症患者早中期CT即可见病变迅速进展。Objects：To evaluate the CT findings of pneumonia caused by influenza A（H1N1） during the evolvement from early to middle phase.Methods：The CT materials of 35 patients with clinically diagnosed pneumonia caused by H1N1 influenza virus were analyzed retrospectively.Altogether there were 86 times of CT examination within 1 month.The onset,development and absorption CT features of the pulmonary lesions were analyzed.Results：The early CT findings of pulmonary lesions included ground-glass opacity（GGO）,patchy consolidation and pleural effusion.Follow-up CT findings of 35 patients were divided into 3 groups：complete absorption group（4 cases） with GGO and patchy consolidation disappeared at 6~13 days（average 11.25d）;obviously improved group（29 cases） with patchy GGO and consolidation abated,pleural effusion reduced or disappeared;progressive group（2 cases）,1 case developed ARDS with patchy GGO and consolidation at 10th day after onset of fever,1 case had complicated fungus infection with consolidation and enlargement of cavity.2 cases had long-term follow-up CT,one case showed faint GGO at 73th day,the other showed mild GGO,thickening of interlobular septa,intralobular nodules and pulmonary linear shadows at 90th day.Conclusion：Most of the pulmonary abnormalities caused by H1N1 influenza virus developed within 3 days after the onset of fever,improved or disappeared in about 2 weeks.Part of the patients showed mild interstitial abnormalities during follow-up.Rapid deterioration of CT findings can be found at severe cases during early/middle phase of the disease.

关 键 词：流感 人 肺炎 病毒性 体层摄影术 X线计算机 

分 类 号：R816.4[医药卫生—放射医学]