Pulmonary measles disease: old and new imaging tools

Radiol Med. 2018 Dec;123(12):935-943. doi: 10.1007/s11547-018-0919-y. Epub 2018 Jul 30.

Abstract

Background: Measles virus can cause lower respiratory tract infection, so that chest radiography is necessary to investigate lung involvement in patients with respiratory distress.

Purpose: To assess measles pneumonia imaging during the measles outbreak occurred in 2016-2017 in Italy.

Material and methods: We retrospectively observed adult patients with a serological diagnosis of measles, who underwent chest-X rays for suspected pneumonia. If a normal radiography resulted, the patient underwent unenhanced CT. A CT post processing software package was used for an additional quantitative lung and airway involvement analysis .

Results: Among 290 patients affected by measles, 150 underwent chest-X ray. Traditional imaging allowed the pneumonia diagnosis in 114 patients (76%). The most frequent abnormality at chest X-rays was bronchial wall thickening, observed in 88.5% of the cases; radiological findings are faint in the 25% of the cases (29/114 patients). In nine subjects with a normal chest X-ray, unenhanced CT with a quantitative analysis was performed, and depicted features consistent with constrictive bronchiolitis.

Conclusion: Measles may produce bronchiolitis and pneumonia. In the cases in which involvement of pulmonary parenchyma is not sufficient to result in radiological abnormalities, CT used with a dedicated postprocessing software package, provides an accurate lungs and airways analysis, also determining the percentage of lung involvement.

Keywords: Bronchiolitis; Computer tomography; Computer tomography quantitative airway analysis; Conventional radiography; Measles; Pneumonia.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Disease Outbreaks
  • Female
  • Humans
  • Italy / epidemiology
  • Male
  • Measles / diagnostic imaging*
  • Measles / epidemiology
  • Middle Aged
  • Pneumonia, Viral / diagnostic imaging*
  • Pneumonia, Viral / epidemiology
  • Radiographic Image Interpretation, Computer-Assisted
  • Radiography, Thoracic
  • Retrospective Studies
  • Tomography, X-Ray Computed / methods*