Department of Radiology, The Second Affiliated Hospital of Harbin Medical University, 246 Xue Fu Road, Harbin 150086, China.
Eur J Radiol. 2011 Nov;80(2):e146-52. doi: 10.1016/j.ejrad.2010.05.029. Epub 2010 Jun 20.
The purpose of our study was to review the initial high-resolution CT (HRCT) findings in pneumonia patients with presumed/laboratory-confirmed novel swine-origin influenza A (H1N1) virus (S-OIV) infection and detect pneumonia earlier.
High-resolution CT (HRCT) findings of 106 patients with presumed/laboratory-confirmed novel S-OIV (H1N1) infection were reviewed. The 106 patients were divided into two groups according to the serious condition of the diseases. The pattern (consolidation, ground-glass, nodules, and reticulation), distribution, and extent of abnormality on the HRCT were evaluated in both groups. The dates of the onset of symptoms of the patients were recorded.
The predominant CT findings in the patients at presentation were unilateral or bilateral multifocal asymmetric ground-glass opacities alone (n=29, 27.4%), with unilateral or bilateral consolidation (n=50, 47.2%). The consolidation had peribronchovascular and subpleural predominance. The areas of consolidation were found mainly in the posterior, middle and lower regions of the lungs. Reticular opacities were found in 6 cases of the initial MDCT scan. The extent of disease was greater in group 1 patients requiring advanced mechanical ventilation, with diffuse involvement in 19 patients (63.3%) of group 1 patients, and only 15/76 (19.7%) of group 2 patients (p<0.01, χ2 test). 20 cases (19%) of the 106 patients had small bilateral or unilateral pleural effusions. None had evidence of hilar or mediastinal lymph node enlargement on CT performed at admission or later.
The most common radiographic and CT findings in patients with S-OIV infection are unilateral or bilateral ground-glass opacities with or without associated focal or multifocal areas of consolidation. On HRCT, the ground-glass opacities had a predominant peribronchovascular and subpleural distribution. CT plays an important role in the early recognition of severe S-OIV (H1N1).
本研究旨在回顾疑似/实验室确诊新型猪源流感 A（H1N1）病毒（S-OIV）感染肺炎患者的初始高分辨率 CT（HRCT）表现，以便更早地发现肺炎。
回顾了 106 例疑似/实验室确诊新型 S-OIV（H1N1）感染患者的 HRCT 表现。根据疾病的严重程度，将 106 例患者分为两组。评估两组患者 HRCT 上病变的形态（实变、磨玻璃影、结节和网状影）、分布和程度。记录患者症状发作的日期。
患者就诊时的主要 CT 表现为单侧或双侧多灶性不对称磨玻璃影（n=29，27.4%），单侧或双侧实变（n=50，47.2%）。实变呈支气管血管周围和胸膜下分布为主。实变区主要位于肺的后、中、下叶。6 例患者在初次 MDCT 扫描时发现网状影。需要高级机械通气的 1 组患者的疾病范围更大，19 例（63.3%）患者弥漫性受累，而 2 组 76 例患者中仅 15 例（19.7%）（p<0.01，χ2 检验）。106 例患者中有 20 例（19%）有双侧或单侧小量胸腔积液。入院时或之后的 CT 均未见肺门或纵隔淋巴结肿大。
S-OIV 感染患者最常见的放射学和 CT 表现是单侧或双侧磨玻璃影，伴或不伴局灶或多灶性实变区。HRCT 上磨玻璃影呈支气管血管周围和胸膜下分布为主。CT 在早期识别严重 S-OIV（H1N1）方面发挥着重要作用。
