54例SARS患者胸部影像学表现分析

目的：探讨SARS的影像学表现、分型与诊断。方法：54例临床诊断的SARS患者均有系列胸片，23例有CT资料，进行回顾分析。胸片分型为：单纯型(Ⅰ)、进展型(Ⅱ)、迁延型(Ⅲ)。对18例临床治愈出院后胸片、CT复查结果进行对比分析。结果：54例中，15例以肺实质渗出、实变为主，5例以肺问质浸润为主，34例兼有肺实质、间质病变。Ⅰ型(n=12)胸片表现多不具特征性，预后好；Ⅱ型(n=25)胸片表现具有相对特征性，病死率高(16％)；Ⅲ型(n=17)残留病变最多(100％)。CT显示残留病变比胸片更清楚。结论：SARS影像学表现仅具有相对特征性，诊断必须结合临床、流行病学和实验室检查。

The Chest Radiological Appearances of Severe Acute Respiratory Syndrome (SARS) in 54 Patients

Objective:To investigate the chest radiological characteristics, classification and diagnosis of SARS.Methods: Data of chest plain films and chest CT scan were retrospectively analyzed in 54 patients with SARS. The basic classification on the chest plain films included simple type (I), progressive type (II), and prolonged type (III).The results of chest plain films and CT scans were analyzed comparatively in 18 patients who recovered after the treatment.Results: Of 54 cases,pulmonary parenchymal exudation and consolidation were in 15 cases,interstitial infiltration was in 5 cases, and parenchymal and interstitial lesions were in 34 cases.The radiological appearances were nonspecific and the patients had well prognosis in type I(n=12).The radiological appearances were relative specific and the patients had high fatality rate (16%) in type II(n=25). In type III(n=17),the residual lesions were the most(100%).CT was superior to the chest plain film on detecting residual lesions.Conclusions: The radiological appearances of SARS were relative specific. The diagnosis of SARS must be combined with radiological appearances, clinical epidemiological, and laboratory findings.