严重急性呼吸综合征的临床与影像学表现

目的　研究SARS患者不同阶段的临床与影像学改变。方法　对 12 3例住院患者进行影像与临床分析。结果　影像改变 :早期 ,病灶多发或单发 ,表现多种多样 ,肺实质改变不明显 ;进展期 ,病变迅速发展 ,范围扩大 ,病灶数目明显增多 ,影像表现呈多样性 ;吸收期 ,病灶明显缩小、变淡 ,部分有纤维化表现。胸部CR、DR与HRCT影像学表现相似 ,但HRCT更敏感。临床表现 :早期 ,发热、全身及关节酸痛 ,咳嗽 ,白细胞正常或偏低 ;进展期 ,在上述症状加重的基础上出现血氧饱和度下降 ,有 2 0 %的患者发展为ARDS ;恢复期 ,80 %的患者好转康复出院。结论　SARS的影像表现与其它肺炎相似 ,特异性不强 ,肺部病变的变化与临床表现无明显相关性。但是影像学仍是作为治疗、了解病变的重要依据。

Clinical and Imaging Manifestations of Severe Acute Respiratory Syndrome

Objective To reseach variation of clinical and imaging in different stages of patients with SARS.Methods The author reviewed imaging findings and the clinical manifestations of 123 cases of SARS.Results Imaging changes (1)Early stage lesions were singular focus and multifocuses.Focuses exihibited multiform and multishape.The lung parenchyma not change evidently.(2)Progressive stage focuses developed rapidly,the extent enlarged,the number of focuses increased rapidly,multiform and multishape in imaging manifestations.(3)Absorb stage focuses evidently shruink,less dense and focal fibrosis.Clinical manifestation (1)Early stage the clinical manifestations were characterized by the onset of fever,associated with systemic and joint aching pains and dry coughs.Leucocyte counts showed normal or lower than normal. (2)Progressive stage these symptoms worsened and saturation degree of blood oxygen declined.20% patients developed ARDS.80% patients recoveried and leaved from hospital.Conclusion Imaging changes in patients with SARS took after the other pneumonia and may be indistinguishable from other conditions that result in airspace disease.But imaging findings offers an important diagnostic clue to SARS,and it is valuable in showing response to therapy and understanding state of an illness.