甲型H7N9病毒性肺炎的胸部影像学表现  

Roentgenography and CT appearance in patients with influenza A(H7N9)virus pneumonia

作　　者：辛小燕[1] 常莹[1] 孙晓敏[1] 朱斌[1] 高凤娟[2] 刘宝瑞[3] 

机构地区：[1]南京大学医学院附属鼓楼医院医学影像科,江苏南京210008 [2]南京大学医学院附属鼓楼医院急诊科,江苏南京210008 [3]南京大学医学院附属鼓楼医院肿瘤科,江苏南京210008

出　　处：《医学影像学杂志》2015年第4期637-640,共4页Journal of Medical Imaging

摘　　要：目的探讨甲型H7N9病毒性肺炎的胸部影像学表现及变化规律。方法回顾性分析确诊的6例甲型H7N9病毒性肺炎患者,对发病后的一系列X-线胸片和CT进行征象观察并统计分析。结果 6例患者均以发热为最早起病症状,发病初期的影像学主要表现为单侧或双侧肺野的大片斑片影;斑片状影并间质改变;病程进展期,6例均以出现磨玻璃密度影为特征向周围浸润,肺实质和肺间质病灶共存,病灶范围增大,累及肺野增多。2例出现气胸、纵隔气肿并发症,病程延长。转归期,5例肺部阴影不同程度吸收,但遗留纤维化病灶。1例死亡。结论 H7N9病毒性肺炎发病早期出现肺部炎症,发展迅速,进展期以出现磨玻璃密度影为特征,病情严重;转归期易残留肺纤维化。CT扫描检查能较准确地评估H7N9病毒性肺炎病程进展期疾病的浸润发展规律。Objective To evaluate the appearance and dynamic change of chest roentgenography and CT in patients with influenza A （H7N9） virus pneumonia .Methods Serial roentgenography and CT of 6 confirmed patients with influenza A （H7N9） virus pneumonia were analyzed .Results The onset symptom was fever in all patients .In the early phase of H7N9 pneumonia ,the main abnormal appearance was single or bilateral localized large consolidation and patchy clouding opacity with interstitial changes .In the progressive phase ,new characteristic ground‐glass opacity appeared and infiltra‐ted .The boundary of lesions larged and progressed rapidly .Lungs complicated pneumothorax and pneumomediastinum were found in 2 patients with a prolonged duration of the illness .In the recovery phase .The opacity disappeared gradually in 5 patients but lung fibrosis was residues and 1 patient was dead .Conclusion In H7N9 pneumonia ,lung consolidation was the main abnormal appearance in early phase and new characteristic ground‐glass opacity appeared in advanced phase and develops rapidly .Lungs fibrosis was found in patients in the recovery phase .CT examination can provide more accu‐rate assessment of the progressed regularity of the lungs .

关 键 词：体层摄影术 X线计算机 甲型H7N9病毒性肺炎 

分 类 号：R561[医药卫生—呼吸系统] R814.42[医药卫生—内科学]