严重急性呼吸综合征的影像学表现  

Radiographic and CT appearances of severe acute respiratory syndrome

作　　者：张琳[1] 任俊杰[1] 许晓矛[1] 谢榜昆[1] 梁碧玲[1] 

机构地区：[1]中山大学附属第二医院放射科,广州510120

出　　处：《放射学实践》2004年第1期46-49,共4页Radiologic Practice

摘　　要：目的 :分析严重急性呼吸综合征 (SARS)的X线及CT表现。方法 :回顾性分析 110例SARS患者的影像学表现。所有病例均有较完整的胸片资料 ,其中 5例同时进行了CT检查。结果 :SARS的影像学表现形式多样 ,主要表现为肺实质渗出性病变和肺间质渗出性病变两大类型。根据病变早期表现及进展情况 ,将其分为 5型 :①单纯局限型 3 4例 ,早期为肺内单一局限病灶 ,其后病变扩大或无明显增大 ;②局限 广泛型 2 0例 ,早期为肺内单一局限病灶迅速发展为病灶广泛分布 ;③多发型 2 8例 :早期即见肺内多发片状和 /或结节状病灶 ;④间质 实质型 2 2例 :早期为肺部间质性渗出 ,其后出现肺实质渗出性病变 ;⑤单纯间质型 6例 ,主要表现为肺间质渗出性病变。结论 :X线检查是发现SARS的最基本的影像学检查方法 ,CT能更好地显示病变。在SARS的诊治过程中 ,了解该病的影像学分型和分期有助于判断病情 ,指导治疗 ,估计预后。Objective:To study radiographic and CT appearances of severe acute respiratory syndrome (SARS).Methods:The imaging appearances of 110 patients with SARS were retrospectively analyzed.All the patients had comparatively complete chest film data and additional CT was performed in 5 cases. Results:The appearances on plain film were variable, and present mainly with two types of the changes:parenchymal and interstitial exudation. According to their initial radiographic appearances and progression,the patterns of lesions were categorized to five subtypes:①pure focal lesion(n=34) as the single focal lesion in early stage,which expanded or did not obviously enlarge in the series radiography.②focal extensive lesion(n=20),which initially appeared as single focal consolidation and progressed quickly and extensively.③multiple lesions(n=28),which showed multiple patchy or/and nodular lesions on the initial radiograph.④interstitial parenchymal lesion (n=22),which showed mainly interstitial changes on the initial radiograph,and followed by parenchymal exudation.⑤pure interstitial lesion(n=6), which showed predominantly interstitial exudation.Conclusion:Plain radiography is the elementary means to detect this disease,but CT is superior to plain radiography in displaying the lesions. It is necessary to study the radiological types and stages of SARS during the diagnostic and therapeutic procedure,which are useful in assessment of the condition of SARS,conduction of its therapy and evaluation of the outcome.

关 键 词：严重急性呼吸综合征 影像学表现 临床分型 间质性炎症 

分 类 号：R511.9[医药卫生—内科学] R816.4[医药卫生—临床医学]