严重急性呼吸综合症(SARS)影像学表现的初步探讨

Plain X-ray film and CT manifestations of severe acute respiratory syndrome

目的 认识严重急性呼吸综合症(SARS)的影像学表现特征并探讨适宜的检查方法。 方法 回顾性分析6例确诊为(SARS)影像学表现。其中:男4例,女2例,年龄25～65岁。使用TOSHIBA 800mA X线机和床旁机以及TOSHIBA Xvision螺旋CT机扫描。所有患者自入院起,每1-2天复查一次胸片和3天复查一次低剂量螺旋CT扫描。比较初次影像学表现,动态记录肺内病变的变化情况,由两位资深放射科医师进行统计分析。 结果 6例病人中3例初次胸部平片检查为阴性,CT扫描见胸膜下灶性渗出,伴有磨玻璃样改变和支气管充气征象。3例初次胸部平片见局限性肺纹理增重且边缘模糊,肺野透光度下降,CT扫描见团片状磨玻璃样改变,内有小斑片实变灶。2周左右影像学表现达到高峰,随后开始逐渐吸收好转。 结论 SARS影像学表现虽不典型,但早期征象以胸膜下灶性渗出为主,逐步由渗出、浸润范围扩大,病灶中央向灶性实变发展,变化仍具有特殊性。发病初期胸部平片检查易漏诊,CT扫描可以为临床诊断提供重要依据。

Objective To recognize the characteristics manifestations of severe acute respiratory syndrome (SARS) on plain X-ray film and CT in order to find a suitable way of examination. Methods The imaging manifestations of 6 (male 4, female 2) SARS patient were analyzed retrospectively. Their aged were between 25-65. Both TOSHIBA 800mA X-ray machine and TOSHIBA Xvision spiral CT were used for examination once every 1-2 days. Dynamically observe pathological changes in the lungs. The imaging were assessed by two skilled radiologist. Results Normal initial chest film were seen in 3 of the 6 patient , while CT imaging showed exudation near the pleura region with 'ground-glass opacity' and 'air bronchogram'. Local areas of blurred lung markings with opacity were found in the other 3 cases initially ,while CT imaging showed areas of 'ground-glass opacity' with consolidation. Gradually diffused consolidation could be seen bilaterally with the worst condition in the 2nd week. After that gradual absorption could be seen. Conclusion No typical manifestation in SARS , the rapid development from initial exudation near the pleura region to bilateral consolidation is typical. Normal plain X-ray film could be seen in early stage, while CT imaging can give a big help to diagnosing SARS.