Adôrno Isa Félix, Tibana Tiago Kojun, Santos Rômulo Florêncio Tristão, Leão Victor Machado Mendes, Brustoloni Yvone Maia, Silva Pedro Augusto Ignácio, Ferreira Marco Antônio, Nunes Thiago Franchi
Hospital Universitário Maria Aparecida Pedrossian da Universidade Federal de Mato Grosso do Sul (HUMAP-UFMS), Campo Grande, MS, Brazil.
Radiol Bras. 2019 Mar-Apr;52(2):78-84. doi: 10.1590/0100-3984.2018.0030.
To evaluate chest X-ray findings in pediatric patients diagnosed with influenza A (H1N1) virus infection.
We retrospectively reviewed chest X-ray findings in 17 cases of pulmonary infection with the H1N1 virus (in 7 males and 10 females) examined between 2012 and 2016. The mean age of the patients was 14 months (range, 2-89 months). The diagnosis was established on the basis of clinical and radiographic criteria, and the virus was detected by polymerase chain reaction. The radiographic findings were categorized by type/pattern of opacity and by lung zone. The patients were divided into two groups: those not requiring ventilatory support; and those requiring ventilatory support or evolving to death.
The abnormality most often seen on chest X-rays was that of peribronchovascular opacities, the majority of which affected less than 25% of the lung, the involvement being bilateral and asymmetric. The lung zone most frequently involved was the middle third, with central and peripheral distribution, without pleural effusion. There was a statistically significant difference between the groups in terms of the symmetry of pulmonary involvement, asymmetric findings predominating in the group that required ventilatory support ( = 0.029).
In pediatric patients with H1N1 virus infection, the main alterations on the initial chest X-rays are peribronchovascular opacities, nonspecific alveolar opacities, and consolidations. Although the definitive diagnosis of H1N1 virus infection cannot be made on the basis of imaging characteristics alone, using a combination of clinical and radiographic findings can substantially improve the diagnostic accuracy.
评估确诊为甲型H1N1流感病毒感染的儿科患者的胸部X线表现。
我们回顾性分析了2012年至2016年间检查的17例甲型H1N1流感病毒肺部感染患者（7例男性，10例女性）的胸部X线表现。患者的平均年龄为14个月（范围2 - 89个月）。诊断依据临床和影像学标准确定，病毒通过聚合酶链反应检测。影像学表现根据不透明度类型/模式和肺区进行分类。患者分为两组：不需要通气支持的患者；需要通气支持或进展至死亡的患者。
胸部X线最常出现的异常是支气管血管周围不透明度，其中大多数累及不到25%的肺，累及双侧且不对称。最常受累的肺区是中三分之一，呈中央和外周分布，无胸腔积液。两组在肺部受累的对称性方面存在统计学显著差异，不对称表现主要见于需要通气支持的组（P = 0.029）。
在甲型H1N1流感病毒感染的儿科患者中，初始胸部X线的主要改变是支气管血管周围不透明度、非特异性肺泡不透明度和实变。虽然仅根据影像学特征不能确诊甲型H1N1流感病毒感染，但结合临床和影像学表现可显著提高诊断准确性。
