Lower Respiratory Tract Infection with Human Metapneumovirus: Chest CT Imaging Features and Comparison with Other...

Area of Science:

• Medical Imaging
• Infectious Diseases
• Pulmonology

Background:

• Human metapneumovirus (hMPV) is an emerging cause of lower respiratory tract infections in adults globally.
• CT imaging characteristics of hMPV in adult populations remain underexplored.

Purpose of the Study:

• To define the CT imaging features of hMPV in adults.
• To compare these features with those associated with other viral respiratory pathogens.

Main Methods:

• Retrospective review of 104 adult patients with hMPV lower respiratory tract infection.
• Analysis of CT scans by two chest radiologists for specific imaging findings and dominant patterns.
• Comparison of hMPV imaging results with previously reported data for other viruses.

Main Results:

• hMPV predominantly presented with an airway-centric pattern (71-81%), including bronchial wall thickening, tree-in-bud opacities, and peribronchial consolidation/ground-glass opacities.
• hMPV was significantly more likely to cause bronchopneumonia (46-55%) compared to parainfluenza virus (17%) and respiratory syncytial virus (21%).
• Follow-up CT scans showed resolution of findings in 91% of patients.

Conclusions:

• Paramyxoviridae, including hMPV, exhibit a propensity to cause bronchitis, bronchiolitis, and bronchopneumonia, as evidenced by CT findings.
• hMPV is particularly associated with bronchopneumonia among this viral family.
• Healthcare providers should consider hMPV in the differential diagnosis of pneumonia on chest CT.