H7N9病毒性肺炎胸部CT随访分析  

Follow up analysis of high-resolution chest CT in H7N9 viral pneumonia

作　　者：云永兴 王立非[1] 杨根东[1] 陆普选[1] 曾政[1] 李晶晶[1] 

机构地区：[1]广东省深圳市第三人民医院放射科,广东深圳518112

出　　处：《中国中西医结合影像学杂志》2017年第3期277-279,共3页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:追踪观察人感染H7N9禽流感病毒性肺炎恢复期的影像学改变。方法:应用肺部HRCT对治愈出院后的8例人感染H7N9禽流感病毒性肺炎患者进行3~12个月的随访追踪观察。结果:肺部HRCT随访特点:(1)主要表现为位于肺外围低垂位置的肺实变、磨玻璃影长期(>3个月)存在;(2)追踪动态观察,患者存在肺部基础病变合并的实变、磨玻璃影相对无肺部基础病变吸收缓慢;(3)3例6~12个月仍存在明显的肺间质性病变(蜂窝状影、牵引性支气管扩张、马赛克灌注征)。结论:人感染H7N9禽流感病毒性肺炎部分患者肺部HRCT表现为不可逆的肺间质性病变,病灶以两肺下叶周围肺部为主。长期存在的肺间质性病变可能反映肺功能的降低。肺部HRCT对人感染H7N9禽流感患者肺功能的判断、指导临床诊疗有一定价值。Objective：Analysis of the imaging features of recovery stage of human infection with H7N9 avian influenza virus pneumonia. Methods：By high-resolution CT scan,8 cases＂ lungs of human infection with the HTN9 avian influenza virus which recovering from pneumonia were tracked for 3 months to 12 months,observed and analyzed their imaging. Results：The high-resolution CT features of pulmonary were ：（1）Mainly manifested as the lung consolidation shadow and ground grass like shadow persisted over three months. （2）Tracking dynamic observation,the presence of other lung disease combined with the consolidation and ground glass like shadow was relatively slowly absorbed without lung disease based. （3）Three cases still had significant in- terstitial lung disease 6--12 months later,such as line-like and reticular opacities,honeycomb shadow,traction bronchiectasis and mosaic perfusion. Conelusion：HRCT of the patients with H7N9 pneumonia shows irreversible pulmonary interstitial lesions, which is mainly found in the area around the lower lobe. The persistence of interstitial lung disease might reflect a decrease in lung function. Application of high-resolution CT observed on lung lesions might be value of estimating of lung function and guiding clinical diagnosis and treatment.

关 键 词：肺炎 流感病毒A型 H7N9亚型 体层摄影术 X线计算机 

分 类 号：R563.1[医药卫生—呼吸系统] R816.41[医药卫生—内科学]