Ces radiol. 2011, 65(1):25-34

Radiological imaging of pulmonary affection at so called swine influenza (H₁N₁)Original article

Boris Kreuzberg¹, Renata Vondráková¹, Eduard Kasal², Jiří Kobr³, Jiří Ferda¹

¹ Klinika zobrazovacích metod LF UK a FN, Plzeň

² Anesteziologicko-resuscitační klinika LF UK a FN, Plzeň

³ Dětská klinika LF UK a FN, Plzeň

Aim: The aim of the article is to conclude the experience with the examination of lung of severe ill patients with lung inflammation during the epidemy of so called swine influenza (H₁N₁).

Method: Five patients hospitalized at the Department of Anaesteziology and Resuscitation and 10 children at Intensive Care unit of Paediatric Department. The patients were repeatedly examined since October 2009 till January 2010 with mobile equipment Mobilett X Digital Siemens with direct digitalisation of X-ray images and with multidetector CT equipment SOMATOM SENSATION 64, Siemens, Forchheim, Germany and SOMATOM DEFINITION DSCT, Siemens, Forchheim, Germany. CT images were acquired in 1 or 1,5 or 2 mm slices to depict lung parenchyma and in mediastinal window in 5 mm slices. Most of CT examinations were performed after i.v. administration of non-ionic iodine contrast material in average dose 80-100 ml (Iomeron Bracco 350, Milano, Italy). Complex analysis of findings with detailed assessment of lung parenchyma, mediastinal structures with regard to the presence of pleural effusion and other pathological changes was accomplished.

Results: At four patients with H₁N₁ pneumonia bilateral more to periphery of lung localised interstitial infiltration prevailed with later change to dense consolidation of parenchyma. Typical finding in HRCT were "ground glass" pattern with negative bronchogram up to atelectatic changes. None of the patients had pleural effusion. Only one of the patients included due to differential diagnostic reasons with proved herpetic pneumonia had predominant unilateral infiltration and pleural effusion. Our children patients had analogous interstitial infiltration with higher tendency to atelectasis with lobar extent. In contrast to adult patients pleural effusions among our children patients were not rare. The regression of the findings was relatively rapid. None of the affected children died. Part of our children had relevant primary disease. In both groups no nodular foci and lymphnodes enlargment were visible.

Conclusion: Our experience is consistend with results of other authors. Swine influenza is very serious disease though severe lung inflammation is relatively rare. The monitoring of possible complications with correct early diagnosis anticipating specific serological and PCR diagnosis is the contribution of radiological imaging.

Keywords: swine influenza (H₁N₁), H₁N₁ pneumonia, complications of lung inflammation at H₁N₁ influenza, radiological diagnosis of lung inflammation at influenza

Accepted: November 15, 2010; Published: March 1, 2011  Show citation