El-Badrawy Adel, Zeidan Amany, Ebrahim Mohamed A
Department of Radiology, Mansoura Faculty of Medicine, Mansoura, Egypt.
Acta Radiol. 2012 Jul;53(6):662-7. doi: 10.1258/ar.2012.120038. Epub 2012 Jun 25.
The pandemic of swine-origin H1N1 influenza that began in early 2009 has provided evidence that radiology can assist in the early diagnosis of severe cases. Immunocompromised patients are at increased risk for morbidity and mortality. MDCT is superior to radiography in showing the distribution of the disease.
To review the 64 multidetector CT thoracic findings of novel swine-origin influenza A (H1N1) virus in patients with hematologic malignancies.
This study included 12 patients (3 women, 9 men; mean age, 32.2 years). All patients proved to be infected with influenza A (H1N1) virus. The hematologic malignancies were acute myeloid leukemia (n = 8), chronic lymphocytic leukemia (n = 2), multiple myeloma (n = 1), and myelodysplastic syndrome (n = 1). All the patients underwent CT scanning using a 64 multidetector CT scanner. Chest CT scans were reviewed for ground-glass opacities (GGOs), consolidation, airway thickening/dilatation, nodules, mediastinal lymphadenopathy, and pleural effusion.
More than one CT finding was detected in every patient. Pulmonary affection was bilateral, more on the left side. The affections were mainly peribronchial. Airway wall thickening and dilatation were detected in all 12 patients, GGO in 9/12 patients, nodules in 6/12 patients, consolidation in 6/12 patients, hilar lymphadenopathy in 3/12 patients, and pleural effusion in 2/12 patients.
Acute myeloid leukemia is the most common hematologic malignancy affected by influenza A (H1N1) virus. The left lung is affected more than the right one. The most common multidetector CT findings are unilateral or bilateral airway thickening and dilatation. Multidetector CT can be used for early and accurate assessment of pulmonary affection with influenza A H1N1 virus infection.
2009年初开始的甲型H1N1流感大流行证明，放射学有助于重症病例的早期诊断。免疫功能低下患者的发病和死亡风险增加。在显示疾病分布方面，MDCT优于X线摄影。
回顾血液系统恶性肿瘤患者中新型甲型H1N1流感病毒的64层螺旋CT胸部表现。
本研究纳入12例患者（3例女性，9例男性；平均年龄32.2岁）。所有患者均被证实感染甲型H1N1流感病毒。血液系统恶性肿瘤包括急性髓系白血病（8例）、慢性淋巴细胞白血病（2例）、多发性骨髓瘤（1例）和骨髓增生异常综合征（1例）。所有患者均使用64层螺旋CT扫描仪进行CT扫描。对胸部CT扫描进行磨玻璃影（GGO）、实变、气道增厚/扩张、结节、纵隔淋巴结肿大及胸腔积液的评估。
每位患者均检测到不止一项CT表现。肺部病变为双侧性，左侧更多见。病变主要位于支气管周围。12例患者均检测到气道壁增厚及扩张，9/12例患者出现GGO，6/12例患者出现结节，6/12例患者出现实变，3/12例患者出现肺门淋巴结肿大，2/12例患者出现胸腔积液。
急性髓系白血病是受甲型H1N1流感病毒影响最常见的血液系统恶性肿瘤。左肺受累多于右肺。最常见的多层螺旋CT表现是单侧或双侧气道增厚及扩张。多层螺旋CT可用于甲型H1N1流感病毒感染肺部病变的早期准确评估。
