严重急性呼吸系统综合征的影像学表现及临床特点

Imaging Manifestations and Clinical Characteristics of Severe Acute Respiratory

目的 :探讨急性呼吸系统综合征的胸部影像学表现及临床特点。方法 :对经确诊的 30例严重急性呼吸综合征患者的胸部影像学表现和临床特点进行回顾性分析。结果 :此 30例SARS患者的胸部影像学表现由肺实质的渗出或 /和间质的渗出程度所决定 ,根据病变早期及进展期的表现分为 4型 :(1 )局限小片型 :8例 ,早期为一片状局限灶性实变 ,随后病灶可增大 ,然后渐次吸收。(2 )广泛大片型 :6例 ,由早期单一局限片状病灶迅速发展为广泛大片状影(范围≥ 2个肺野 )。(3)间质肺纹型 :1 0例 ,主要表现为肺间质渗出性炎症 ,可有“粗网”、“细网”、“网点”之分。(4)多发混合型 :6例 ,早期即见肺内多发(病灶数目≥ 2个 )片状及结节状病灶或 /和与其它肺野的“网格状”及“网 -点状”阴影共在。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 ,影像学的“三有”与“三无”和实验室检查的“三高”与“三低”对诊断分型、分期有益 ,并有助于判断病情 ,指导治疗 。

Objective: To study chest imaging manifestations and clinical characteristics of Severe Acute Respiratory Syndrome (SARS). Methods: Chest imaging manifestations of 30 patients with SARS were analyzed retrospectively. Results: Chest imaging manifestations of SARS depended on the degree of parenchyma exudation and/or interstitial exudation. According to their initial and progressive imaging manifestations, we categorized SARS into 4 subtypes: (1) Focal small patchy lesion (n=5): The focal patchy consolidation expanded.And it subsequently will be absorbed little by little. (2) Extensive large patchy lesion (n=7) The single and focal consolidation quickly progressed to diffusive large lesions (Consolidation exceeds 2 lung fields.) (3) Lung marking-interstitial lesion (n=6) The predominant abnormality was interstitial exudation. There were the thicken reticular consolidation, the thin reticular consolidation and the punctual reticular consolidation. (4) Multiple mixed lesion (n=12) The initial image showed multiple patchy and nodular lesions or/and reticular consolidation and reticular consolidation and punctual reticular consolidation. Conclusion: Plain radiogaphy is an elementary imaging means of choice for detecting the disease. CT is superior to plain radiography in displaying lesion.During the diagnostic and therapeutic procedure, 'Three Existence' and 'Three Inexistence' of medical image and ' Three High' and 'Three Low' of laboratory tests are beneficial to studying radiological types and states and helpful to assessing the disease condition, planning the therapy and evaluating the prognosis.