SARS的胸部CT表现

目的 探讨SARS的胸部CT表现。方法 搜集6例临床确诊为SARS的患者共9次胸部CT扫描(复查3例)资料，采用标准肺窗、纵隔窗、宽窗宽条件分别摄片。分析胸部CT影像。结果 6例中双肺多叶、多段实变灶5例，无明显肺叶、肺段或特定体位分布趋势；双肺病变均为大片肺实变与多发小实变灶并存；大片肺实变表现为一侧或双侧2～4片沿支气管树分布的肺段实变；内有明显的空气支气管征；相邻肺段实变融合或在叶间裂处相邻的肺叶实变扩展，于影像接触部位融合，形成更大片实变影，未观察到病变越过叶间裂蔓延至邻近肺叶的现象；肺内小病灶均为双肺多发，呈类圆形或棉球状，沿肺纹理分布最多见；大片肺实变可呈均匀致密实变、磨玻璃样变、蜂窝状实变，小病灶与大片实变灶一致，磨玻璃样变可出现在初诊和吸收期病例；胸膜反应性增厚常见，胸腔积液罕见；无纵隔、肺门淋巴结肿大。结论 CT改变提示：SARS在病程发展阶段，病变有经支气管肺泡系播散的特点。

The chest CT appearance of SARS

Objective To report the CT app earances in SARS (severe acute respiratory syndrome). Methods Nine chest CT scanning examinations were performed in 6 cases of SARS that were verified by the clinic. CT films were acquired with standard pulmonary window, mediastinal window, and wide window, respectively.CT imaging appearances were summarized. Results In 5 of the 6 cases, multi-lobar or multi-segmental consolidations of bilateral lungs were detected. There was no distribution tendency for any specific pulmonary lobes or segments. The big consolidation and small multiple consolidations existed simultaneously. The big range of consolidation manifested as the bilateral or unilateral pulmonary segment consolidation that distributing along the bronchi tree. There was the air bronchogram in the consolidation. Each consolidation expanded along the pulmonary segment and mixed together to form a pulmonary segment consolidation, or even a whole pulmonary lobe consolidation. The foci that crossed the interlobar fissure were not observed. The small foci manifested as the bilateral multiple oval foci, which distributed along the lung markings. The big consolidation could appear as homogeneous densification, ground-glass appearance, or honeycomb consolidation. The ground-glass appearance could appear in cases of first visiting and in cases of recovery period. The pleural thickened was common and hydrothorax was rare. The mediastinal lymph node enlargement was not observed. Conclusion The limited SARS cases show a tendency that the pathological changes disseminate along broncho-alveolar system when SARS is developing.