成人重症腺病毒肺炎胸部CT动态变化  

Dynamic changes of chest CT in adult patients with severe adenovirus pneumonia

作　　者：曹玉书[1] 张志良 王施[1] 杜嘉琪[1] 石剑波[1] 

机构地区：[1]解放军411医院呼吸科,上海200081 [2]解放军411医院影像科,上海200081

出　　处：《实用放射学杂志》2015年第9期1447-1449,共3页Journal of Practical Radiology

摘　　要：目的：探讨成人重症腺病毒肺炎的胸部 CT 影像学特征。方法收集呼吸道腺病毒感染聚集性发病中的6例重症肺炎的患者,回顾性分析病程不同时期的临床与胸部 CT 影像表现,以及激素治疗的影响。结果6例胸部 CT 首次检查为发热后平均（2.22±0.75）d,表现为段性实变伴磨玻璃样影（GGO）1例,斑片状实变伴 GGO 3例,斑片状间质性病灶1例,小结节影1例。6例达到重症肺炎标准的平均热程（6.17±0.37）d,CT 表现为叶、段性实变1例,叶、段性实变伴 GGO 4例,斑片状实变伴 GGO 1例,其中单发病灶4例,多发2例,均以两下肺叶分布为主。激素治疗后,病灶进展均表现为原病灶的扩大,未见新发病灶。病灶吸收的最初2～4 d 内,GGO 完全吸收6例,实变完全吸收1例,大部分吸收5例。结论成人重症腺病毒肺炎主要表现为两下肺为主的单发或多发的叶段性实变伴或不伴 GGO。Objective To explore the characteristics of chest multislice spiral CT and dynamic changes in adult patients with severe adenovirus pneumonia.Methods Clinical and CT data of 6 patients with severe pneumonia in an epidemic of the respiratory adenovirus infection were retrospectively analyzed.The impact of hormone therapy was also studied.Results The first chest CT examinations in 6 patients were performed 2.22 ± 0.75 days after fever.CT showed segmental consolidation with groundglass opacity （GGO）in one case,patchy consolidation with GGO in 3 cases,patchy interstitial changes in one case and small nodules in one case. The duration reaching the standards of severe pneumonia was 6.1 7 ± 0.37 days from the onset.During severe phase chest CT showed a range of lobar consolidation in one case,lobar in 2 cases,segmental in 2 cases or patchy in one case,consolidation with GGO in 5 cases.In all cases the lesions were commonly seen in the lower lobes of bilateral lungs.Multiple lobes were involved in 2 cases.After methylprednisolone treatment,no new lesion was showed but the early lesion was enlarged.During the first 2 to 4 days GGO absorbed completely in 6 cases,consolidation absorbed completely in one case and mostly in 5 cases.Conclusion Chest CT findings of severe adenovirus pneumonia in adult are single or multiple lobar or segmental consolidations with or without GGO which distribute mainly at lower lobes.

关 键 词：腺病毒肺炎 重症 计算机体层成像 甲泼尼龙 成人 

分 类 号：R563.1[医药卫生—呼吸系统] R814.42[医药卫生—内科学]