Department of Diagnostic Radiology, Dankook University College of Medicine, Dankook University Hospital, Chungnam, Korea.
Korean J Radiol. 2010 Nov-Dec;11(6):656-64. doi: 10.3348/kjr.2010.11.6.656. Epub 2010 Oct 29.
The purpose of this study was to evaluate the chest radiographic and CT findings of novel influenza A (H1N1) virus infection in children, the population that is more vulnerable to respiratory infection than adults.
The study population comprised 410 children who were diagnosed with an H1N1 infection from August 24, 2009 to November 11, 2009 and underwent chest radiography at Dankook University Hospital in Korea. Six of these patients also underwent chest CT. The initial chest radiographs were classified as normal or abnormal. The abnormal chest radiographs and high resolution CT scans were assessed for the pattern and distribution of parenchymal lesions, and the presence of complications such as atelectasis, pleural effusion, and pneumomediastinum.
The initial chest radiograph was normal in 384 of 410 (94%) patients and abnormal in 26 of 410 (6%) patients. Parenchymal abnormalities seen on the initial chest radiographs included prominent peribronchial marking (25 of 26, 96%), consolidation (22 of 26, 85%), and ground-glass opacities without consolidation (2 of 26, 8%). The involvement was usually bilateral (19 of 26, 73%) with the lower lung zone predominance (22 of 26, 85%). Atelectasis was observed in 12 (46%) and pleural effusion in 11 (42%) patients. CT (n = 6) scans showed peribronchovascular interstitial thickening (n = 6), ground-glass opacities (n = 5), centrilobular nodules (n = 4), consolidation (n = 3), mediastinal lymph node enlargement (n = 5), pleural effusion (n = 3), and pneumomediastinum (n = 3).
Abnormal chest radiographs were uncommon in children with a swine-origin influenza A (H1N1) virus (S-OIV) infection. In children, H1N1 virus infection can be included in the differential diagnosis, when chest radiographs and CT scans show prominent peribronchial markings and ill-defined patchy consolidation with mediastinal lymph node enlargement, pleural effusion and pneumomediastinum.
本研究旨在评估儿童新型甲型流感（H1N1）病毒感染的胸部 X 线和 CT 表现，儿童比成人更容易受到呼吸道感染。
研究人群包括 2009 年 8 月 24 日至 2009 年 11 月 11 日期间在韩国 Dankook 大学医院诊断为 H1N1 感染的 410 名儿童，其中 6 名患儿还接受了胸部 CT 检查。最初的胸部 X 射线被分为正常或异常。异常的胸部 X 射线和高分辨率 CT 扫描评估了实质病变的模式和分布，以及是否存在并发症，如肺不张、胸腔积液和气胸。
410 名患儿中，384 名（94%）患儿的初始胸部 X 射线正常，26 名（6%）患儿异常。最初的胸部 X 射线显示的实质异常包括明显的支气管周围标记（26 例中的 25 例，96%）、实变（26 例中的 22 例，85%）和无实变的磨玻璃样混浊（26 例中的 2 例，8%）。病变通常是双侧的（26 例中的 19 例，73%），下肺区为主（26 例中的 22 例，85%）。12 例（46%）患儿出现肺不张，11 例（42%）患儿出现胸腔积液。CT（n=6）扫描显示支气管血管周围间质增厚（n=6）、磨玻璃样混浊（n=5）、小叶中心结节（n=4）、实变（n=3）、纵隔淋巴结肿大（n=5）、胸腔积液（n=3）和气胸（n=3）。
儿童感染猪源甲型流感（H1N1）病毒（S-OIV）时，异常胸部 X 射线并不常见。当胸部 X 射线和 CT 扫描显示明显的支气管周围标记和边界不清的斑片状实变，伴纵隔淋巴结肿大、胸腔积液和气胸时，可将 H1N1 病毒感染纳入鉴别诊断。
