严重急性呼吸综合征的影像表现的探讨

目的 :探讨典型的严重急性呼吸综合征 (SARS)的X线表现及变化规律 ,有助于与其他类似疾病的鉴别诊断。方法 :收集我院有明显传染源的 18例SARS患者的一系列胸片进行回顾性分析。结果 :患者均以发热为首发症状(10 0 % ) ;从发病到第 1次拍胸片时间为 1d～ 7d ;第 1次胸片单侧肺出现病灶者 6例 (33% ) ,双侧肺出现病灶者 7例(39% ) ,双肺纹理明显增粗、紊乱者 5例 (2 8% ) ;从发病到X线胸片出现双肺病灶的时间平均 (4 .7± 1.8)d ,病情进展迅速 ;从发病到X线胸片病灶最重的时间平均 (12 .3± 5 .2 )d ,即 2周之内病灶达高峰 ;病灶部位以右上肺及双下肺多见 ;形态以斑片状及磨玻璃样阴影为多见。从发病到病灶明显吸收的时间平均 (2 0 .6± 6 .3)d ,即 3周左右病灶明显吸收 ;3例SARS患者病灶恶化而死亡 ;5例出院前做胸部CT ,3例留有纤维索条样阴影。结论 :SARS的X线特点为 :右上肺及双下肺为好发部位 ,以斑片状及磨玻璃样阴影为主要表现 ,病灶出现早 ,进展迅速 ,易累及双侧肺野 ;一旦出现发热症状 ,积极地动态观察胸片变化情况很有必要

Exploration of image manifestations of SARS

Objective:Exploration of the manifestations of X-ray chest films and their change of typical SARS helps to make a differential diagnosis of SARS from other similar diseases.Method:The author made a retrospective analysis by collecting a series of chest films of 18 patients with SARS who had obvious source of infection.Results:Fever appear as the first symptom in all the patients(100 %).The time from the attack to the first chest film taken was 1～7 days.The first chest film showed lesion of one lung in 6 patients(33 %),both the lungs in 7 patients(39 %).The lung markings became increased or disturbed in 5 patients(28 %).The average time from the attack to the appearance of the lesion of two lungs was (4.7+1.8) days.The change the disease took place quickly.The time from the attack to appearance of the most serious lesions on the X-ray chest film was on average (12.3+5.2) days,that is the lesion became the most serious at the end of two weeks.The location of the lesion was often found in the right upper lung and two lungs.Morphologically,the strip and ground-glass-like sha-dows were often seen.The time from the attack to appearance of obvious absorption of the lesion was on average(20.6+5.2) days,that is the lesion obviously improved needed about 3 Weeks.3 patients with SARS died due to exacerbation of the lesion.3 of 5 patients still had strip-like shadows on CT chest scan before they were discharged from our hospital.Conclusion:The X-ray chest film of the cases with SARS revealed that the right upper lung and two lungs were easily affected.These chest films showed strip and ground-glass-like shadows as major manifestations.The earlier the lesion emerged,the faster the course of disease developed and both the lungs were easily affected.Once a sick man had fever,it was necessary to observe the change of his or her chest film carefully.