【作者】 赵振军； 梁长虹； 张金娥； 张汝绵； 何晖；

【Author】 ZHAO Zhen-jun, LIANG Chang-hong, ZHANG Jin-e, ZHANG Ru-mian, HE Hui. Department of Radiology, Imaging Institute of Guangdong Provincial People’s Hospital, Guangzhou 510080, China

【机构】 广东省人民医院影像医学部放射科；

【摘要】 目的探讨严重急性呼吸综合征(SARS)的临床表现和影像学特征及其关系。方法回顾性分析46例符合《广东省医院收治非典型肺炎病人工作指引》诊断标准的SARS临床和影像学资料。所有病例均有全胸站立后前位和侧位片;6例行胸部CT扫描。结果97.8%(45/46)的SARS患者以发热为首发表现,其体征较轻,与影像学改变不符。X线表现:(1)病变分布:两侧肺17例(37%);一侧肺29例(63%),其中右肺14例(14/29)。左肺15例(15/29)。病变局限于1个肺叶者28例(60.9%),分布于2个肺叶者9例(19.6%),3个肺叶者4例,4个肺叶者4例,5个肺叶者1例。多肺叶分布中,局限于一侧肺者1例(1/18),两侧肺分布者17例(17/18)。(2)病灶类型:以肺间质性改变为主,表现为密度不均的斑片状阴影,其内可见增粗和紊乱的肺纹理结构;肺纹理改变型3例(6.5%);间质型18例(39.1%);实质型9例(19.6%),混合型16例(34.8%)。此外还可见肺门模糊1例,少量胸水1例,轻度胸膜反应1例。6例CT扫描,3例急性期表现为磨玻璃样高密度灶或大片状渗出和实变,3例吸收期可见条索状残留灶。结论SARS的临床与影像学表现有一定的特征,其预后与病变的严重程度相关。更多还原

【Abstract】 Objective To investigate the clinical and imaging characteristics of the severe acute respiratory syndrome (SARS) , and to study the relationship between imaging and clinical findings. Methods Forty-six patients with SARS verified by imaging and clinical data were reviewed. X-ray examination data were available in all cases and chest CT scanning was acquired in 6 cases. The X-ray and CT findings were analyzed retrospectively. Results Fever was found in 97. 8% (45/46) of the patients. The clinical symptoms were mild, but findings on X-ray film and CT were distinct. Pulmonary interstitial infiltration was demonstrated on X-ray films at the onset, and then the lesion could involve the pulmonary parenchyma. (1) Location; bilateral lung involvement was revealed in 17 cases (37%), and unilateral involvement in 29 (63% ). In the unilateral lung involvement group, right lung involvement was found in 14 cases (147 29) , and left in 15 (15/29). The lesion was confined within one lobe in 28 cases (60.9% ), two lobes in 9 (19. 6% ) , three lobes in 4, four lobes in 4 , and five lobes in 1, respectively. In cases with multiple lobe involvement, the lesion was limited to one side of the lung in 1 case (1/18) , and bilateral lung involvement in 17 (17/18). (2) Type: change of lung markings in 3 cases (6. 5% ) , interstitial type in 18 (39. 1% ) , consolidation type in 9 (19. 6% ) , and mixed type in 16 (34. 8% ). Besides, blurred hilum in 1 case, small amount of pleural effusion in 1 case, and mild pleural reaction in 1 case was detected, respectively. CT scanning demonstrated ground-glass hyperdense lesions or large patchy exudation and consolidation at the early stage in 3 cases. The different findings on X-ray and CT were related to the different phase of the disease. After treatment, most lesions were absorbed completely, but the lesions were absorbed slowly for 3 patients with multi-lobe consolidation or/and extensive interstitial infiltration. Conclusion SARS had characteristic clinical and imaging lindings. The prognosis oi AP was related to the degree of lesions on X-ray and CT film.更多还原