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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 understand the imaging features of Severe Acute Respiratory Syndrome (SARS) and to explore suitable methods of examination. Methods Retrospective analysis of 6 cases diagnosed as (SARS) imaging findings. Of which: 4 males and 2 females, aged 25 to 65 years. Scan with TOSHIBA 800mA X-ray machine and bedside machine and TOSHIBA Xvision Spiral CT machine. All patients were admitted to hospital, and chest radiographs were reviewed every 1-2 days and low-dose spiral CT scans were performed on the 3rd day. Compared with the primary imaging findings, dynamic changes of lung lesions were recorded and analyzed by two senior radiologists. Results Of the 6 patients, 3 had a negative initial chest radiograph, and had a subpleural pleural exudation on CT scans accompanied by ground-glass-like changes and bronchial inflation signs. 3 cases of primary chest plain film see the limitations of lung weight gain and fuzzy edges, lung field transmittance decreased, CT scan see the glass mill-like changes, there are small patches of consolidation lesions. Imaging performance peaked at about 2 weeks, and then began to gradually absorb the improvement. Conclusion Although the manifestations of SARS are not typical, the early signs are mainly subpleural exudate and gradually exudate, the scope of infiltration is enlarged, and the focus of the lesion develops to the focal consolidation. The changes are still distinctive. Early diagnosis of chest plain film easy to missed diagnosis, CT scan can provide an important basis for clinical diagnosis.