Friday 20 February 2015

IMAGING FOR SWINE FLU

IMAGING FOR SWINE FLU

CXR is usually the first imaging test performed for the assessment of acute respiratory symptoms.
The predominant findings are bilateral consolidation and reticular opacities .

INDICATION OF CHEST CT -----

1. high clinical suspicion of pneumonia in the presence of normal or questionable radiological findings. 

2.Chest CT is also helpful in assessing complication or evidence of mixed infection.



A 40-year-old man with influenza A (H1N1) virus pneumonia and severe respiratory failure (paO<sub>2</sub>/FIO<sub>2</sub> at admission 180) who underwent non-invasive mechanical ventilation: chest computed tomography demonstrates patchy bilateral interstitial infiltrates and peripheral focal ground-glass opacities in the middle and lower lung zones.




A 28-year-old man with severe obesity and sleep apnea with influenza A (H1N1) virus pneumonia and not severe respiratory failure (PaO<sub>2</sub>/FIO<sub>2</sub> at admission 340): chest computed tomography exhibits bilateral, patchy, confluent areas of consolidation in all lung zones.




A 39-year-old man with Influenza A (H1N1) virus pneumonia and severe respiratory failure (PaO<sub>2</sub>/FIO<sub>2</sub> at admission 170) respiratory underwent non-invasive mechanical ventilation: chest computed tomography shows alveolar consolidation, peripheral ground-glass opacities in both middle and lower lung zones and small bilateral pleural effusions.

The predominant CT findings at presentation of illness are unilateral or more often bilateral multi-focal asymmetric ground-glass opacities, either alone or associated with areas of consolidation.

The abnormalities have a predominantly peripheral and subpleural distribution:

Patients who exhibit consolidation on chest CT have a more severe clinical course compared with those who present with ground-glass opacities.

The crazy-paving pattern is a common finding on chest CT of the lungs: Some authors presume that crazy-paving pattern is also closely related to an adverse course,

Multifocal bilateral distribution and Opravil CXR score are directly correlated with the severity of the illness:








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