Hilmes Melissa A, Daniel Dunnavant F, Singh Sudha P, Ellis Wendy D, Payne Daniel C, Zhu Yuwei, Griffin Marie R, Edwards Kathryn M, Williams John V
Department of Radiology, Vanderbilt University School of Medicine, Nashville, TN, USA.
Centers for Disease Control and Prevention, Atlanta, GA, USA.
Pediatr Radiol. 2017 Dec;47(13):1745-1750. doi: 10.1007/s00247-017-3943-5. Epub 2017 Aug 22.
Human metapneumovirus (HMPV) was identified in 2001 and is a common cause of acute respiratory illness in young children. The radiologic characteristics of laboratory-confirmed HMPV acute respiratory illness in young children have not been systematically assessed.
We systematically evaluated the radiographic characteristics of acute respiratory illness associated with HMPV in a prospective cohort of pediatric patients.
We included chest radiographs from children <5 years old with acute respiratory illness who were enrolled in the prospective New Vaccine Surveillance Network (NVSN) study from 2003 to 2009 and were diagnosed with HMPV by reverse transcription-polymerase chain reaction (RT-PCR). Of 215 HMPV-positive subjects enrolled at our tertiary care children's hospital, 68 had chest radiographs obtained by the treating clinician that were available for review. Two fellowship-trained pediatric radiologists, independently and then in consensus, retrospectively evaluated these chest radiographs for their radiographic features.
Parahilar opacities were the most commonly observed abnormality, occurring in 87% of children with HMPV. Hyperinflation also occurred frequently (69%). Atelectasis (40%) and consolidation (18%) appeared less frequently. Pleural effusion and pneumothorax were not seen on any radiographs.
The clinical presentations of HMPV include bronchiolitis, croup and pneumonia. Dominant chest radiographic abnormalities include parahilar opacities and hyperinflation, with occasional consolidation. Recognition of the imaging patterns seen with common viral illnesses like respiratory syncytial virus (RSV) and HMPV might facilitate diagnosis and limit unnecessary antibiotic treatment.
人偏肺病毒（HMPV）于2001年被发现，是幼儿急性呼吸道疾病的常见病因。尚未对实验室确诊的幼儿HMPV急性呼吸道疾病的放射学特征进行系统评估。
我们在前瞻性儿科患者队列中系统评估了与HMPV相关的急性呼吸道疾病的影像学特征。
我们纳入了2003年至2009年参加前瞻性新疫苗监测网络（NVSN）研究的5岁以下急性呼吸道疾病儿童的胸部X光片，这些儿童通过逆转录聚合酶链反应（RT-PCR）被诊断为HMPV。在我们三级护理儿童医院登记的215名HMPV阳性受试者中，有68名受试者的治疗医生获取了可供审查的胸部X光片。两名经过专科培训的儿科放射科医生先独立然后共同回顾性评估这些胸部X光片的影像学特征。
肺门周围阴影是最常见的异常表现，在87%的HMPV患儿中出现。肺过度充气也很常见（69%）。肺不张（40%）和实变（18%）出现频率较低。所有X光片均未发现胸腔积液和气胸。
HMPV的临床表现包括细支气管炎、哮吼和肺炎。主要的胸部X光异常包括肺门周围阴影和肺过度充气，偶尔有实变。认识呼吸道合胞病毒（RSV）和HMPV等常见病毒性疾病的影像学表现可能有助于诊断并限制不必要的抗生素治疗。
