SARS的胸部影像学特点探讨

目的：探讨SARS肺部影像学特点。方法：临床确诊为传染性非典型肺炎患51例，年龄9～75岁；X线检查用DR摄取胸部正、侧位像。结果：51例患中，呈两肺多发病灶或单侧广泛分布共30例(58．8％)。病灶位于周边肺野较多见42例(82．4％)。病灶形态早期多为局限片状、扇形或椭圆形43例(84．3％)；密度低且均匀32例(62．7％)；随病情进展；病灶扩大27例(51．9％)；同时病灶中央密度增高，病灶之间互相融合2例(3．9％)，病灶吸收后残留索条状纤维化5例(9．8％)。结论：SARS以急性肺损伤为其病理基础，病程发展迅速。胸部影像学主要表现为间质性炎症过程，按其病情进展可分为①充血期；②间质渗出期；③进展期；④肺泡浸润期；病灶吸收后常残留间质纤维化。数字化成像技术有助于对病变进行更准确的分析及诊断。

The Discussion of Thoracic Imaging Manifestations of SARS

Objective:To discuss the thoracic imaging features of Severe Acute Respiratory Syndrome (SARS). Method : 51 patients (age 9 to 75) of SARS diagnosed clinically were reviewed. All cases had a history of close contacting with infected persons. Anteroposterior and lateral chest direct digitalized radiography (DR) were performed in each case. Results:Of 51 cases reviewed, widespread multilobar involvement in one side or both sides of lungs were observed in a proportion of 58. 8% (30/51). Lesions tended to distribute in the peripheral zone of lung fields, which were found in a proportion of 82. 4% (42/51). Focal lesion showed patchy, fan-shaped or elliptical at early stage in 43 cases (84. 3%), A low density homogeneous ground-glass consolidation was seen in 32 cases (62. 7%). With disease progress, opacity scope enlargement was showed in 27 cases (51. 9%), and the consolidation became central dense and confluent in 2 cases (3. 9%). Post resolution fibrosis was recorded in 5 cases (9. 8%). Conclusions:The SARS developed rapidly upon a basic pathology of acute pulmonary damage. Pulmonary interstitial inflammation mostly contributeedto the thorax imaging findings. The disease would be classified into four stages according to progress: congestion,interstitial exudation, evolution and alveolus infiltration. Fibrosis remained after resolution. Digitalized radiogram was helpful for more accurate analysis and diagnosis of the disease.