CAJ | 학술논문

目的探讨重症甲型H1N1流行性感冒(流感)肺炎高分辨率计算机X线断层扫描(HRCT)表现及动态变化.方法回顾性分析36例临床确诊的重症甲型H1N1流感肺炎1个月内100次HRCT资料,分析其肺部病变出现、进展及吸收时间和影像学特点.结果发病初期行HRCT检查(3d内)6例,小片磨玻璃密度影3例,小片实变影3例.病变进展期(发病3d后)36例患者均表现为双肺多发弥漫分布的磨玻璃密度影伴或不伴实变,其中主要呈弥漫磨玻璃密度影9例,占25.0％；弥漫磨玻璃密度影伴实变影20例,占55.6％;主要呈肺实变影7例,占19.4％；合并胸膜病变10例,占27.8％.在发病(8.0±2.6)d内病变进展最为明显,发病(16.0±4.8)d后为吸收期,36例病变均明显吸收,23例出现肺间质增生,占63.9％.病灶的动态变化分三型,包括先进展后吸收型、进展和吸收并存后吸收型和逐渐吸收型,以先进展后吸收型为主,占41.7％.结论 HRCT可准确显示重症甲型H1N1流感肺炎的病变形态和范围,监测其动态变化.
목적 탐토중증갑형H1N1류행성감모(류감)폐염고분변솔계산궤X선단층소묘(HRCT)표현급동태변화.방법 회고성분석36례림상학진적중증갑형H1N1류감폐염1개월내100차HRCT자료,분석기폐부병변출현、진전급흡수시간화영상학특점.결과 발병초기행HRCT검사(3d내)6례,소편마파리밀도영3례,소편실변영3례.병변진전기(발병3d후)36례환자균표현위쌍폐다발미만분포적마파리밀도영반혹불반실변,기중주요정미만마파리밀도영9례,점25.0％；미만마파리밀도영반실변영20례,점55.6％;주요정폐실변영7례,점19.4％；합병흉막병변10례,점27.8％.재발병(8.0±2.6)d내병변진전최위명현,발병(16.0±4.8)d후위흡수기,36례병변균명현흡수,23례출현폐간질증생,점63.9％.병조적동태변화분삼형,포괄선진전후흡수형、진전화흡수병존후흡수형화축점흡수형,이선진전후흡수형위주,점41.7％.결론 HRCT가준학현시중증갑형H1N1류감폐염적병변형태화범위,감측기동태변화.
Objective To study the appearances and dynamic changes of chest high resolution computed tomography (HRCT) in clinically diagnosed critical influenza A (H1N1) pneumonia.Methods One hundred chest HRCT scanning examinations were performed in 36 cases of influenza A (H1N1) pneumonia who were diagnosed by the clinical manifestations in one month.The onset,progress and resolve of pulmonary manifestations were analyzed.Results Chest HRCT was performed in six patients,and small patchy opacity presented in three cases and ground-glass opacities presented in the other three cases within 3 days after onset when the disease was at the initial stage.Multiple larger opacities were visualized in all cases at the progressive stage (3 days later after onset),which included the pure ground-glass opacities (9 cases,25.0％ ),ground-glass opacities accompanied by consolidations (20 cases,55.6％),prominent consolidations (7 cases,19.4％),and accompanied pleural lesions (10,27.8％).The lesions strongly progressed within (8.0± 2.6) d and distinctly absorption in all cases (100.0％,36/36) within (16.0±4.8) d after onset of the disease.The pulmonary interstitial hyperplasia was found in 23 cases (63.9％).Dynamic change types of the lesions include absorption after progression,absorption and progression coexistence then absorption and gradually absorption,and absorption after progression was the major type (41.7％).Conclusion HRCT could distinctly demonstrate the shape,range and dynamic changes of pulmonary lesions of critical influenza A (H1 N1) pneumonia.