Fluminense Federal University, Rio de Janeiro, Brazil.
Eur J Radiol. 2011 Dec;80(3):e500-4. doi: 10.1016/j.ejrad.2010.10.003. Epub 2010 Oct 30.
The purpose of this study was to describe the high-resolution computed tomography (HRCT) features of fatal cases of Influenza A (H1N1) virus-associated pneumonia and to correlate them with pathologic findings.
The study included six adult patients who died following Influenza A (H1N1) virus-associated pneumonia. All patients had undergone HRCT, and the images were retrospectively analyzed by two chest radiologists, who reached decisions by consensus. Two experienced lung pathologists reviewed all pathological specimens. The HRCT findings were correlated with the histopathologic data.
The predominant HRCT findings included areas of airspace consolidation (n=6) and ground-glass opacities (n=3). The main pathological features consisted of diffuse alveolar damage with hyaline membrane formation (n=5), associated with various degrees of pulmonary congestion, edema, hemorrhage, inflammatory infiltration and bronchiolitis. A patient who survived longer showed findings of organizing pneumonia.
Fatal cases of Influenza A (H1N1) virus-associated pneumonia can present as areas of consolidation on CT, with or without ground-glass opacities. These abnormalities can be pathologically correlated with diffuse alveolar damage. Patients with longer survival may present with findings of organizing pneumonia.
本研究旨在描述甲型 H1N1 流感病毒相关性肺炎致死病例的高分辨率 CT（HRCT）特征，并将其与病理发现相关联。
本研究纳入了 6 例因甲型 H1N1 流感病毒相关性肺炎死亡的成年患者。所有患者均接受了 HRCT 检查，由 2 位胸部放射科医生对图像进行回顾性分析，达成共识。2 位经验丰富的肺病理学家对所有病理标本进行了复查。将 HRCT 结果与组织病理学数据相关联。
主要的 HRCT 发现包括气腔实变区（n=6）和磨玻璃影（n=3）。主要的病理特征包括弥漫性肺泡损伤伴透明膜形成（n=5），伴有不同程度的肺充血、水肿、出血、炎症浸润和细支气管炎。存活时间较长的患者表现为机化性肺炎的发现。
甲型 H1N1 流感病毒相关性肺炎致死病例的 CT 表现可为实变区，伴或不伴磨玻璃影。这些异常可与弥漫性肺泡损伤相关联。存活时间较长的患者可能表现为机化性肺炎的发现。
