成年水痘肺炎患者抗病毒治疗前后CT影像学变化及其预后分析OA

Objective:To comparatively analyze the difference of the performance of computed tomography(CT)imaging of the lung of adult patients with primary varicella pneumonia(PVP)between before and after antiviral therapy,and evaluate the effect of that.Methods:A retrospective analysis was conducted on the clinical data of 112 adult patients who were confirmed as varicella-zoster virus(VZV)infection complicated with pneumonia at Peking University Third Hospital from January 2020 to December 2024.The changes of the number,size,distribution and imaging characteristics of intrapulmonary nodular lesions were statistically analyzed,and paired t-test was used to assess the differences of nodule diameters.Among them,23 followed-up patients underwent re-examination of CT examination at the 3rd month after antiviral therapy.Results:In the initial inspection of CT examination,112 patients appeared shadow of multiple intrapulmonary small nodules,and typical halo sign were observed around these nodules(approximately 85%),and some of them accompanied with ground-glass opacities,pleural thickening and other manifestations.In the 23 followed-up patients,the mean diameter of nodules was 5.21 mm before treatment,which decreased to 0.69 mm after treatment,and the difference was statistically significant(t=14.918,P<0.001).In the results of re-examined CT on chest of 23 patients,the lesions of 12 cases(52.2%)were fully absorbed,and the striped shadows or nodules of residual fibers of 11 cases(47.8%)obviously reduced,and the overall prognosis was favorable.Conclusions:The multiple small nodules with halo sign are the characteristic of CT manifestations of the chest of adult patients with varicella pneumonia,which can find multiple pathological signs of pulmonary parenchyma and interstitium.The CT on chest can clearly show the lesion scope of varicella pneumonia,which can be used to assess therapeutic effect.