Prachi P Agarwal1, Sandro Cinti, Ella A Kazerooni. 1. Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan Health Service, Ann Arbor, MI 48109, USA. prachia@med.umich.edu
Abstract
OBJECTIVE: This article reviews the chest radiographic and CT findings in patients with presumed/laboratory-confirmed novel swine-origin influenza A (H1N1) virus (S-OIV) infection. MATERIALS AND METHODS: Of 222 patients with novel S-OIV (H1N1) infection seen from May 2009 to July 2009, 66 patients (30%) who underwent chest radiographs formed the study population. Group 1 patients (n = 14) required ICU admission and advanced mechanical ventilation, and group 2 (n = 52) did not. The initial radiographs were evaluated for the pattern (consolidation, ground-glass, nodules, and reticulation), distribution, and extent of abnormality. Chest CT scans (n = 15) were reviewed for the same findings and for pulmonary embolism (PE) when performed using IV contrast medium. RESULTS: Group 1 patients were predominantly male with a higher mean age (43.5 years versus 22.1 years in group 2; p < 0.001). The initial radiograph was abnormal in 28 of 66 (42%) subjects. The predominant radiographic finding was patchy consolidation (14/28; 50%) most commonly in the lower (20/28; 71%) and central lung zones (20/28; 71%). All group 1 patients had abnormal initial radiographs; extensive disease involving > or = 3 lung zones was seen in 93% (13/14) versus 9.6% (5/52) in group 2 (p < 0.001). No group 2 patients had > 20% overall lung involvement on initial radiographs compared with 93% of group 1 patients (13/14). PEs were seen on CT in 5/14 (36%) of group 1 patients. CONCLUSION: Chest radiographs are normal in more than half of patients with S-OIV (H1N1) and progress to bilateral extensive air-space disease in severely ill patients, who are at a high risk for PE.
OBJECTIVE: This article reviews the chest radiographic and CT findings in patients with presumed/laboratory-confirmed novel swine-origin influenza A (H1N1) virus (S-OIV) infection. MATERIALS AND METHODS: Of 222 patients with novel S-OIV (H1N1) infection seen from May 2009 to July 2009, 66 patients (30%) who underwent chest radiographs formed the study population. Group 1 patients (n = 14) required ICU admission and advanced mechanical ventilation, and group 2 (n = 52) did not. The initial radiographs were evaluated for the pattern (consolidation, ground-glass, nodules, and reticulation), distribution, and extent of abnormality. Chest CT scans (n = 15) were reviewed for the same findings and for pulmonary embolism (PE) when performed using IV contrast medium. RESULTS: Group 1 patients were predominantly male with a higher mean age (43.5 years versus 22.1 years in group 2; p < 0.001). The initial radiograph was abnormal in 28 of 66 (42%) subjects. The predominant radiographic finding was patchy consolidation (14/28; 50%) most commonly in the lower (20/28; 71%) and central lung zones (20/28; 71%). All group 1 patients had abnormal initial radiographs; extensive disease involving > or = 3 lung zones was seen in 93% (13/14) versus 9.6% (5/52) in group 2 (p < 0.001). No group 2 patients had > 20% overall lung involvement on initial radiographs compared with 93% of group 1 patients (13/14). PEs were seen on CT in 5/14 (36%) of group 1 patients. CONCLUSION: Chest radiographs are normal in more than half of patients with S-OIV (H1N1) and progress to bilateral extensive air-space disease in severely ill patients, who are at a high risk for PE.
Authors: Cristian Cilloniz; Mary J Pantin-Jackwood; Chester Ni; Alan G Goodman; Xinxia Peng; Sean C Proll; Victoria S Carter; Elizabeth R Rosenzweig; Kristy J Szretter; Jacqueline M Katz; Marcus J Korth; David E Swayne; Terrence M Tumpey; Michael G Katze Journal: J Virol Date: 2010-05-26 Impact factor: 5.103
Authors: Brett M Elicker; Brian S Schwartz; Catherine Liu; Eunice C Chen; Steve A Miller; Charles Y Chiu; W Richard Webb Journal: Emerg Radiol Date: 2010-01-29
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