目的探讨人感染H7N9禽流感的临床和胸部影像学特征。方法5例H7N9的患者行前后位X线胸片和薄层CT检查,2名影像学专家回顾性分析5例患者的临床、影像资料,并对胸部影像特征进行了鉴别诊断。结果5例患者就诊时,全部以右肺大片实变影为主要影像特征,内含有明显的空气支气管征,两下肺实变较上肺严重。进展期的肺部病变均为双肺多发,散在分布;大片肺呈均匀一致的实变、磨玻璃样改变,多发小病灶与大片实变病灶同时并存。恢复期,左肺病变较右肺吸收更为迅速;两肺残留的索条影较少。结论H7N9禽流感肺部感染在起病期、进展期、恢复期均有一定的影像学规律。
Objective To discuss the clinical presentations and imaging features of a novel avianorigin influenza (H7N9). Methods Anteroposterior chest radiographs and serial thin-section CT images in 5 patients with H7N9 were reviewed retrospectively by two radiologists, the predominant imaging patterns of lung abnormalities and clinical data were recorded and analyzed. Results The large consolidation of the right lung with air bronchograms was the most common radiographic appearance in all patients with H7N9 at admission, and the abnormalities were more severe in the bilateral lower lobes. Both lungs developed large, scattered consolidations and ground-glass opacities with the progression of disease. The lesions in the left lung were more rapidly absorbed than those in the right lung. Conclusion Influenza H7N9 has certain chest imaging characteristics in the onset, progression and recovery of disease.