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目的探讨重症型甲型H1N1流感的X线平片与CT特征。方法回顾性分析9例临床确诊的重症型甲型H1N1流感的X线与CT表现。结果首次X线胸部平片示双肺受累8例,单肺受累1例,8例行CT检查两肺均受累,1例死亡未行CT检查。受累肺叶3~5叶,受累肺段5~8个。9例均表现在两肺多叶,以中外带及下叶为甚,2例病变进展迅速,1例死亡。结论重症型甲型H1N1流感的主要影像学表现为:(1)病变主要发生在肺的外周;(2)两肺多叶受累,下肺野多于上肺野;(3)病变变化迅速;(4)两肺出现磨玻璃影、大片实变影,可见支气管气相,伴有胸膜增厚或少量胸水;(5)CT比胸片能更好地显示肺内病变特征。熟悉其影像学表现,密切结合临床和实验室检查可以做出明确诊断。
Objective To investigate the X-ray and CT features of severe type A (H1N1) influenza. Methods Retrospective analysis of 9 cases of clinically diagnosed severe type A (H1N1) influenza X-ray and CT findings. Results The first X-ray showed 8 cases of bilateral lung involvement, 1 case of single lung involvement, 8 cases of both lung involvement and 1 case of death without CT examination. Affected lobes 3 to 5 leaves, affected lung segment 5 to 8. 9 cases were manifested in more than two lobes, to the middle and the band and the lower lobe is very rapid, 2 cases of rapid progress, 1 case of death. Conclusions The major imaging findings of severe type A (H1N1) influenza are as follows: (1) the lesion mainly occurs in the periphery of the lung; (2) the multiple lung involvement in both lungs is more than in the upper lung field; (3) the pathological changes are rapid; (4) ground glass appeared in both lungs, large solidified shadow, showing bronchial vapor phase, with pleural thickening or a small amount of pleural effusion; (5) CT than chest X-ray can better display lesions in the lungs. Familiar with the imaging findings, combined with clinical and laboratory tests can make a clear diagnosis.