Radiographic study of severe Influenza-A (H1N1) disease in children.
OBJECTIVE
To characterize the radiographic findings of pediatric patients with severe Influenza-A (H1N1) disease.


METHODS
A retrospective study of data from chest X-ray, CT and MRI exam of 29 pediatric patients treated in intensive care unit for severe Influenza-A (H1N1) disease.


RESULTS
Disease developed quickly at early stage. Here are four types of radiographic findings. The disease continued to progress for 2-3 days and X-ray showed that all 29 patients had increased solid lesions with the existence of interstitial lesions. Four days later, all lung lesions showed absorption to certain degree. Fifteen days later, X-ray and CT showed complete or significant absorption in 19 cases (85.5%); delayed recovery was identified in 8 cases (27.6%), pulmonary fibrosis was found in 3 cases (10.3%), and 3 patients (10.3%) died. But the latter identified more lesions. Cranial CT and MRI were performed for 8 patients who had neurological symptoms. Of them, 3 cases (10.3%) were abnormal, showed symmetrical long T1 and T2 signal shadow in bilateral thalamus and longer T1 and T2 signals in the between. 3 cases had autopsy completed.


CONCLUSIONS
The severe Influenza-A (H1N1) among children progression was generally rapid in the first 3 days. The overall radiographic findings are similar to acute respiratory distress syndrome (ARDS). A small portion of the patients occurred acute necrotizing encephalopathy and plastic bronchitis.
Department of Radiology, Shenzhen Children's Hospital, Futian District, Shenzhen 518026, China.
Cailei
C
Zhao
Yungen
Y
Gan
Jie
J
Sun
D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis* / Q000453:epidemiology / Q000821:virology; D015278:Intensive Care Units, Pediatric; D008279:Magnetic Resonance Imaging; D008297:Male; D013902:Radiography, Thoracic; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed