SARS死亡病例影像表现及病理对照  

The radiological manifestation and radiological-pathologic correlation in dead SARS cases

作　　者：许东海[1] 贾翠宇[2] 李常青[1] 王薇[2] 石晓红[3] 张世杰[4] 孟欣[4] 张伟[1] 李洪璐[1] 任刚[1] 李新民[1] 闫会文[1] 

机构地区：[1]北京地坛医院放射科,100011 [2]北京佑安医院放射科 [3]北京地坛医院病理科,100011 [4]北京佑安医院病理科

出　　处：《中华放射学杂志》2004年第5期455-458,共4页Chinese Journal of Radiology

摘　　要：目的　探讨SARS死亡病例的影像学表现及其病理基础。方法　搜集 31例SARS死亡病例的影像资料 ,其中 2 7例摄床旁X线胸片 ,8例行高分辨率CT(HRCT)扫描 ,并对其中 9例尸检病例进行影像 病理对照研究。结果　SARS病人临终前胸部X线表现以大片状和多片融合阴影多见(19例 ) ,白肺 8例。病变呈多发、弥漫分布 ,密度高低混合 ,支气管气像常见 (16例 )。CT表现为多发的大片状磨玻璃样密度阴影 (5例 ) ,可合并其他部位的肺实变 (3例 ) ,病灶有融合趋势。病理对照研究提示影像表现的病理基础是肺组织广泛实变、淤血、出血 ,镜下可见肺泡内透明膜形成及支气管内膜脱落。结论　SARS病人临终前病变进展迅速 ,范围广 ,影像检查能够为评价病情、观察动态变化提供有价值的帮助。Objective To evaluate the radiological manifestation in dead severe acute respiratory syndrome (SARS) cases,and to correlate the radiologic findings with pathologic specimen.Methods Thirty-one dead SARS cases were collected.In these cases,27 had a series of bedside chest films and 8 had HRCT scan.Three radiologists analyzed the images,and disagreement among them was discussed and a consensus was reached.9 cases had autopsy.The radiological manifestations of dead SARS cases were evaluated,and radiological-pathologic correlation of 4 dead cases was studied.Results In the late stage of SARS,patches (12 cases) and white lung (8 cases) were the main manifestations in plain film.Multiple,diffuse diseases in the lung (26 cases),air-bronchogram and reticular shallow could be seen.On CT scan,multiple patchy ground-glass attenuation was detected in the field,while consolidations could be in other field.The pathologic basis of the radiological manifestation was diffuse consolidation and hemorrhage in the lung.In the microscope there were hyaline-membrane formation and pneumocyte desquamation.Conclusion In the late stage of SARS,the disease is diffusely distributed,the lesion in the lung progresses rapidly, and the radiological examination is useful in diagnosing and observing the disease.

关 键 词：SARS 死亡病例 影像表现 病理对照 严重急性呼吸综合征 

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