50例SARS患者的X线分析

Radiologic analysis of SARS: report of 50 cases

目的 分析总结SARS的X线表现。方法 回顾性分析 50例确诊为SARS患者的X线表现及其发展过程。结果 (1)SARS的X线主要表现为早期即可出现大小不一、边界模糊的片状阴影 ,以下肺及肺野外周多见。可单发或多发 ,可单侧肺受累或双侧同时受累 ,形态多样 ,变化迅速。随病情进展 ,单发病灶多发展为单侧多发或双侧多发病灶。空洞 (1例 )、结节状病灶 (1例 )、胸腔积液 (2例 )及胸膜肥厚粘连 (1例 )改变少见 ,未见有钙化灶。X线的进展情况可分为 4种 :X线改变严重程度加重 ,出现 1个高峰后 ,病灶逐渐改善 ,共 3 2例 (占 64% ) ;X线改变波动 ,共 9例 (占 18% ) ;X线改变较平稳 ,共 7例 (占 14 % ) ;X线表现进行性恶化 ,共 2例 (4% )。 (2 ) 50例SARS患者的肺部X线表现可初步分为三型 :实质型 3 6例 (占 72 % ) ,间质型 4例 (占 8% ) ,混合型 10例 (占 2 0 % )。 (3 )转归 48例X线胸片有明显吸收 ,多在接受治疗后 6～ 3 9d吸收消散 (平均为 15.9d) ,1例治疗期间死亡 ,1例病危 ,其X线表现加重。结论 胸部X线检查可以协助临床早期发现SARS ,并可了解其进展及转归 。

Objective To evaluate and summ arize the radiographic features of severe acute respiratory syndrome (SARS). Methods The radiographic appearance and the patterns of radiological progression in 50 patients with confirmed SARS were retrospectively reviewed at the author's hospital. Results (1) The main radiographic appearance of SARS was air-space opacities with various size and ill-defined margins, predominantly located in the lower lobes and peripheral lung zone with focal or multifocal, unilateral or bilateral involvement. The lesion was featured by diverse appearance and quick changes. As the disease progressed, unilateral focal air-space opacity mostly changed into unilateral multifocal or bilateral multifocal air-space opacities. Among these cases, cavitation (1 case), lymphadenopathy (1 case), pleural effusion (2 case), and pleural thickening (1 case) were uncommon. Calcification was not found. Radiographic progression had four conditions: initial radiographic deterioration to a peak level, followed by radiographic improvement in 32 cases (64%); fluctuating radiographic changes in 9 cases (18%); static radiographic changes in 7 cases (14%); progressive radiographic deterioration in 2 cases (4%). (2) The radiographic appearance in 50 patients was classified into three patterns: consolidation pattern in 36 cases (72%); interstitial pattern in 4 cases (8%); and mixed pattern in 10 cases (20%). (3) After the treatment, abnormal X-ray appearance in 48 cases dissipated markedly, which mostly changed in 6-39 d (average 15 9 d), One case died during treatment in hospital. One case got worse and her radiographic appearance was deteriorating. Conclusion X-ray examination can not only find the SARS-related changes at early stage, but also judge the progress and outcome of the disease. It can provide important information for the clinical diagnosis and treatment.