胸片和CT诊断SARS价值的对比研究

目的 :评价CT对胸片正常严重急性呼吸综合征 (SARS)患者的诊断价值。材料和方法 :对临床疑似SARS而X线胸片正常的 2 1例患者进行了胸部螺旋CT扫描及系列床边X线胸片复查。分析肺部病变的CT表现特征。结果 :2 1例疑似SARS患者中CT显示 12例有肺部病变 ( 5 7.1% )。根据系列复查胸片结果将 12例患者分成 2组 :第一组 ,复查胸片异常组 ,共 7例。其中单发磨玻璃样影 3例、多发磨玻璃样影 4例 ;第二组 ,复查胸片正常组 ,共 5例。其中单发磨玻璃样影 1例、多发磨玻璃样影 3例和左下叶实变影 1例。磨玻璃样影多位于肺周边部 ( 2 7/ 3 5 ) ,均为圆形 ,直径小于 3cm。结论 :胸片阴性SARS患者肺部病变的CT特点是以周围性分布为主的磨玻璃样影。CT可早于胸片发现肺部病变 ,并可提高SARS的肺部病变检出率。

Comparative Study between X-ray Film and CT of the Chest in Diagnosis of SARS

Purpose:To evaluate CT in diagnosis of severe acute respiratory syndrome (SARS) in patients with a normal chest film. Materials and Methods: Twenty one cases of suspicious patients of SARS whose chest films were normal underwent chest spiral CT Scan and serial follow-up chest films. The CT Features of chest lesions were analyzed. Results: Spiral CT could display the lesions in 12/21 patients with clinical suspected SARS including group 1 (n=7): follow-up chest radiograph were abnormal,3/7 cases had single ground-glass opacification, 4/7 cases had multi-ground-glass opacifications; group 2(n=5): follow-up chest radiograph were normal ,1/5 case had single ground-glass opacification, 3/5 cases had multi-ground-glass opacifications, 1/5case had a consolidation in left lower lobe. Ground-glass opacifications were all round and <3cm diameter. A majority of ground-glass opacifications(27 of 35) were located in peripheral lung. Conclusion: CT features of SARS in patients with a normal chest film are ground-glass opacification and peripheral distribution. CT scan could display lung lesions early and increase positive rate of lung lesions in SARS.