Abstract: Human infection with H10N3 avian virus pneumonia is a rare respiratory infectious disease caused by H10N3 subtype avian influenza virus. While demonstrating low pathogenicity in avian populations, cross-species infection in humans may manifest as severe viral pneumonia, potentially progressing to life-threatening complications including acute respiratory distress syndrome (ARDS) and multi-organ failure. The first confirmed case of human infection with H10N3 avian influenza virus iwas reported in Jiangsu Province in 2021, followed by three more cases in China. This study conducted comprehensive analyses of imaging manifestations and underlying pathological mechanisms based on clinical data from confirmed cases in Yunnan and Guangxi regions, aiming to elucidate the characteristic imaging features of human H10N3 avian influenza virus pneumonia. The investigation revealed a triphasic temporal pattern in radiological evolution, demonstrating distinct stage-specific radiological characteristics that can be categorized into three progressive phases: ① Early stage (day 1-7 of disease progression): ground glass density with patchy consolidation appeared in both lungs. ② Progression period (day 8-20 of disease progression): enlargement and fusion of consolidation areas, thickening of interlobular septa, and air bronchogram sign. ③ Recovery period (day ≥ 21 of disease progression): tractional bronchiectasis and reticular fibrosis lesions. his study provides certain guiding significance for people in understanding the imaging manifestations, clinical diagnosis, differential diagnosis, efficacy evaluation, and prognosis judgment of human infection with H10N3 avian influenza virus pneumonia.

Key words: H10N3 avian influenza, Imaging characteristics, Pathological mechanisms, Imaging follow-up, Pulmonary fibrosis