Lin Zhi Qian, Xu Xue Qin, Zhang Ke Bei, Zhuang Zhi Guo, Liu Xiao Sheng, Zhao Li Qun, Lin Chang Yang, Li Yang, Hua Xiao Lan, Zhao Hui Lin, Hua Jia, Xu Jian Rong
Department of Radiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, PR China.
Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, PR China.
Acta Radiol. 2015 May;56(5):552-6. doi: 10.1177/0284185114535209. Epub 2014 Jun 10.
The H7N9 strain of bird flu is a new type of avian flu that was identified at the end of March 2013. The disease is concerning because most patients have become severely ill.
To study the X-ray and computed tomography (CT) findings of early H7N9 avian influenza cases.
Chest radiography and CT were performed in six patients with H7N9 avian influenza within 1-20 days after onset. The CT examinations included conventional spiral CT and high-resolution CT. The findings on the radiography and CT images were analyzed.
Abnormal X-ray and CT findings were present in all of the patients. All of the cases had acute onset. In the early stage, the right lung was more commonly affected (particularly in the right upper and middle lobes). The lesions rapidly expanded to the entire lungs and were characterized primarily by ground-glass opacities (GGOs) combined with consolidation. Diffuse GGO was observed in all six cases (1 was symmetric, and 5 were non-symmetric). Local consolidation was found in four cases, and lobar consolidation was found in two cases. Normal lung tissue was observed between the lesions. Pleural thickening was common and was combined with pleural/pericardial effusion or mediastinal lymph node enlargement. Reticular changes, centrilobular nodules, and the tree-in-bud sign were observed in some cases, but reticular changes, bronchial wall thickening, and hyperinflation were not found.
Radiological changes associated with both acute pneumonia and acute interstitial inflammation were observed in early H7N9 avian influenza cases. Serial chest X-rays were useful for the diagnosis and severity assessment of the disease. CT may provide a more accurate assessment of the lung pathology.
H7N9禽流感病毒株是2013年3月底发现的一种新型禽流感。该疾病令人担忧，因为大多数患者病情严重。
研究早期H7N9禽流感病例的X线和计算机断层扫描（CT）表现。
对6例H7N9禽流感患者在发病后1 - 20天内进行胸部X线摄影和CT检查。CT检查包括常规螺旋CT和高分辨率CT。分析X线和CT图像上的表现。
所有患者均有异常的X线和CT表现。所有病例均急性起病。早期，右肺更常受累（尤其是右上叶和中叶）。病变迅速扩展至全肺，主要表现为磨玻璃影（GGO）合并实变。6例均观察到弥漫性GGO（1例对称，5例不对称）。4例发现局部实变，2例发现大叶实变。病变之间可见正常肺组织。胸膜增厚常见，并伴有胸腔/心包积液或纵隔淋巴结肿大。部分病例观察到网状改变、小叶中心结节和树芽征，但未发现网状改变、支气管壁增厚和肺过度充气。
早期H7N9禽流感病例观察到与急性肺炎和急性间质性炎症相关的影像学改变。系列胸部X线检查对该疾病的诊断和严重程度评估有用。CT可能对肺部病理提供更准确的评估。
