儿童重症甲型H1N1流感病毒性肺炎的胸部X线及CT表现

目的 初步探讨儿童重症甲型H1N1流感病毒性肺炎的胸部X线及CT表现特点.方法 回顾性分析6例经病毒核酸检测确诊的重症甲型H1N1流感病毒性肺炎的胸部影像资料,病初6例摄胸部X线片,其中4例复查,1例行胸部CT检查.结果 6例病初胸部X线表现为肺纹理增多、增粗,均有不同程度的肺实质浸润和间质改变,其中实质浸润累及双肺3例,左肺3例;肺门增大3例.病程中复查4例,影像表现变化较快,与临床表现一致.CT检查表现为双肺中内带实变和磨玻璃密度影、胸膜下小结节影,肺门和纵隔淋巴结增大,右侧胸腔积液.结论 儿童重症甲型H1N1流感病毒性肺炎的胸部X线及CT表现有一定特点.最终诊断需结合流行病学和实验室检查.

Influenza A H1N1 pneumonia: radiograph and CT features of children

Objective To explore the imaging features on chest radiograph and CT in children with Influenza A H1N1 pneumonia. Methods The imaging data of chest radiograph and CT in six children with Influenza A H1N1 pneumonia confirmed by real-time RT-PCR assay was retrospectively analysis. All patients had chest radiograph at first examination and 4 of them re-examed. One children took CT. Results All cases showed thick lung markings with varied degrees of pulmonary infiltration and interstitial changes on chest radiograph. Among them, 3 cases showed bilateral pulmonary infiltration and 3 cases showed infiltration in left lung; enlarged hilar was observed in 3 cases. The imaging findings of the pneumonia changed quickly during the follow-up accompanied with the improvement of clinical symptoms. The only one chest CT examination showed bilateral infiltration, multiple ground-glass opacities,small subpleural nodulars, right pleural effusion and lymphadenopathy of lung hila and mediastinum. Conclusions Chest radiograph and CT revealed certain typical imaging features in the children with influenza A H1N1 pneumonia. However, the final diagnosis of influenza A H1N1 pneumonia still should be made based on epidemiology and laboratory examination.