重症甲型H1N1流感急性肺损伤的高分辨率CT影像学分析  

HRCT imaging analysis of influenza A H1N1 complicated with severe lung injury

作　　者：谢正平[1] 戴峰[1] 蒋燕[1] 袁莉莉[1] 

机构地区：[1]东南大学附属第二医院放射科,江苏南京210003

出　　处：《现代医学》2012年第3期276-280,共5页Modern Medical Journal

摘　　要：目的:探讨重症甲型H1N1流感急性肺损伤的高分辨率CT(HRCT)影像学特征。方法:对65例重症甲型H1N1流感急性肺损伤患者的常规CT和HRCT影像学表现进行回顾性分析。结果:重症甲型H1N1流感急诊肺损伤的HRCT主要有以下表现:(1)肺实质改变。呈均匀肺实变影20例,其内可见充气支气管征伴部分腺泡结节影;呈斑片状模糊影36例,单侧或双侧分布,以中下肺为主;胸膜下实变影44例,呈紧贴胸膜下的斑片状或类圆形渗出性病变,密度均匀,边缘模糊;磨玻璃样改变43例,其中肺实质内磨玻璃影21例,胸膜下磨玻璃影22例,呈大片或斑片状分布,密度淡而均匀,内见网格状或结节状改变。(2)肺间质性改变。肺纹理增粗、紊乱35例;小叶间隔增厚23例;星芒状或结节状影24例;网格状影32例。结论:HRCT能客观反映重症甲型H1N1流感并发急性肺损伤的影像特征,有助于指导临床治疗和疗效评估。Objective： To discuss the high resolution computer technique（HRCT）imaging feature of influenza A H1N1 complicated with severe lung injury.Methods： Conventional CT and HRCT imaging of 65 patients with influenza A H1N1 complicated severe lung injury were analyzed retrospectively.Results：（1） Lung parenchyma imaging feature： imaging of uniformity lung consolidation was found in 20 patients,with inflatable bronchus and gland alveolus nodules;patching and blurred imaging could be found in 36 patients,which distribute to half or bilateral lungs and in middle and lower lung;consolidation imaging in subpleuralis was found in 44 patients with patches or spherical exudation with uniformity density and edge unsharpness;43 ground-glass-like change imaging was found in 43 patients,21 of them the changs was in lung parenchyma and 22 was in subpleural,which displayed large or patching distribution,and grid or nodosity changing.（2） Lung mesenchyma imaging feature： thickening and derangement lung marking imaging was found in 35 cases,thickening interlobular septum in 23 cases;cases of aristiform or nodosity shadows in 24 cases,grid shadows in 32 cases.Conclusions： HRCT imaging not only objectively evaluate influenza A H1N1 complicated with severe lung injury,but also help to guide and assess the clinical efficacy.

关 键 词：甲型H1N1流感 急性肺损伤 高分辨率CT 

分 类 号：R816.41[医药卫生—放射医学]