人感染H7N9禽流感胸部影像学表现:2例报告并文献复习  

Appearances of chest imaging on patients infected with H7N9 bird flu(report of two cases and literrature review)

作　　者：宋传涛[1] 王兆华[1] 

机构地区：[1]山东省枣庄市立医院放射科,山东枣庄277102

出　　处：《医学影像学杂志》2013年第9期1399-1402,共4页Journal of Medical Imaging

摘　　要：目的分析人感染H7N9禽流感患者的胸部影像学特点,为临床合理诊断和评价病情提供依据。方法回顾性分析人感染H7N9禽流感确诊2例患者的胸部影像学资料及特点。结果病例1为极危重患者,首次CR胸片,表现为侵及右肺上中下3叶的节段性、局灶性随机分布的磨玻璃样渗出性病变和肺实变,此后的2h、9h余追踪CT复查,病灶迅速进展扩散,累及的肺叶增多,面积扩大,病灶融合,短时间内进展为ARDS,呈典型的"白肺"征;病例2为临床轻症患者,初次胸部CT表现为累及双下肺叶及右肺上叶的多发斑片状、片状磨玻璃样渗出性病变。出院前复查胸部DR及CT片,2例患者均显示肺间质及小叶间隔增厚。结论人感染H7N9禽流感患者的胸部影像学表现颇具特征性,结合症状、体征及实验室检查,对临床诊断有较好的提示作用。Objective To analyze the chest imaging features of H7N9 bird flu so as to provide the basis for clinical diag nosis and evaluation. Methods The chest imaging data and characteristics of 2 patients infected with H7N9 bird flu were analyzed retrospectively. Results One case was a critical ill patient whose first CR chest radiograph showed ground-glass exudative lesions and pulmonary consolidation invading the right there lobes and distributing randomly. After two and nine hours, the CT scans showed that the lesions developed and diffused quickly and the area of the involved lobes enlarged and merged. In short time, the lesions progressed to ARDS which showed typical ＂white lung＂ sign. Another case was a mild clinical patient and his dual lower lobes and right upper lobe were involved with groung-glass exudative lesions with multi ple patchy shadows. In the imaging of the chest DR and CT before leaving hospital, the thickening of both interstitical lung and interlobular septum were demonstrated in two cases. ConcLusion The chest imaging of the patients infected with H7N9 bird flu is quite characteristic and it is helpful to clinical course and laboratory results.

关 键 词：X线摄影术 体层摄影术 X线计算机 流感病毒 

分 类 号：R511[医药卫生—内科学]