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人偏肺病毒感染:影像学诊断的影响。

Human metapneumovirus infection: Diagnostic impact of radiologic imaging.

机构信息

Department of Infectious Diseases, American Hospital, Istanbul, Turkey.

Department of Radiology, Klinikum Bremen-Mitte, Gesundheit Nord Hospital Group, Bremen, Germany.

出版信息

J Med Virol. 2019 Jun;91(6):958-962. doi: 10.1002/jmv.25402. Epub 2019 Feb 1.

Abstract

BACKGROUND

Human metapneumovirus (hMPV) is a recently detected virus, which can cause mild to severe respiratory tract infections. Through this study, we aimed to detail the outcomes of hMPV infections.

MATERIALS/METHODS: Between January 2012 and November 2017, patients who had hMPV detected in nasopharyngeal or bronchoalveolar lavage by molecular respiratory pathogen tests were evaluated. The Food and Drug Administration cleared multiplexed-polymerase chain reaction system (Idaho Technology, Salt Lake City, UT) was used for diagnosis. Chest radiography (CR) and computed tomography (CT) were evaluated by an expert radiologist.

RESULTS

In total 100 patients were included, the mean age was 22.9 (0-87) years, and 50% were male. The hospitalization rate was 52%. Lower respiratory system infection (LRTI) was diagnosed in 44 patients with clinical findings, and in 31 patients out of 44 the radiological findings supported the diagnosis. The LRTI rate was significantly higher in adults than children (66.7%-32.8%; P = 0.001). In CR, peribronchovascular infiltration (PI) was the most common feature seen in 14 out of 18 patients and was generally bilateral (13 out of 18 patients). In CT imaging, ground-glass opacity was the most common finding seen in 11 out of 16 patients and nodular consolidation in five patients. Ribavirin was given to four patients, three of whom were severe and required respiratory support. None of the patients died of hMPV infection.

CONCLUSIONS

The ground-glass opacity in CT was similar to other respiratory virus infections, and PI in CR was very common and typical; however, nodular consolidation that may mimic bacterial infection was seen in one-fourth of CT.

摘要

背景

人偏肺病毒(hMPV)是一种新近发现的病毒,可引起轻度至重度呼吸道感染。通过本研究,我们旨在详细描述 hMPV 感染的结果。

材料/方法:2012 年 1 月至 2017 年 11 月,通过分子呼吸道病原体检测在鼻咽或支气管肺泡灌洗液中检测到 hMPV 的患者接受了评估。食药监局批准的多重聚合酶链反应系统(爱达荷技术,盐湖城,犹他州)用于诊断。胸部 X 线摄影(CR)和计算机断层扫描(CT)由专家放射科医生进行评估。

结果

共纳入 100 例患者,平均年龄为 22.9(0-87)岁,50%为男性。住院率为 52%。有 44 例患者根据临床发现诊断为下呼吸道感染(LRTI),其中 31 例患者的影像学发现支持该诊断。成人的 LRTI 发生率明显高于儿童(66.7%-32.8%;P=0.001)。在 CR 中,支气管血管周围浸润(PI)是最常见的特征,在 18 例患者中有 14 例,通常为双侧(18 例患者中有 13 例)。在 CT 成像中,磨玻璃影是最常见的表现,在 16 例患者中有 11 例,结节性实变见于 5 例患者。有 4 例患者给予利巴韦林,其中 3 例病情严重,需要呼吸支持。没有患者因 hMPV 感染死亡。

结论

CT 中的磨玻璃影与其他呼吸道病毒感染相似,CR 中的 PI 非常常见且典型;然而,CT 中也有四分之一的患者可见可能模拟细菌感染的结节性实变。

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