重症SARS的X线影像表现

目的探讨重症严重急性呼吸综合征(SARS)的X线表现.方法回顾性分析37例重症SARS患者的一系列X线胸片变化规律.结果重症SARS患者胸片表现为两肺阴影迅速进展,大部分区域受累.有3种表现类型:①19例表现为弥漫大片云雾状影,病灶无明显分界,肺纹理显示不清;②13例表现为弥漫棉团状密影,边缘模糊,肺纹理增粗;③5例表现为多发大团块密影,边缘模糊,可见支气管气相.如无合并症发生,对症治疗有效,1个月左右肺部阴影消失.6例肺部合并G-杆菌感染,5例合并纵隔气肿,出现合并症时,肺部阴影延迟吸收.结论重症SARS患者的X线影像为肺部密影快速进展至两肺大部分区域,易合并纵隔气肿及肺部感染.

Chest radiographic appearance in critical severe acute respiratory syndrome

Objective To evaluate the appearance of chest roentgenography in critical cases of severe acute respiratory syn-drome(SARS) . Methods Serial roentgenography of 37 confirmed critical SARS patients were analyzed retrospectively in order to elucidate the pattern of progress in those critical cases. Results The characteristics of radiographic appearance on chest roentgenography in critical SARS were rapid progression of bilateral lung infiltration, involving most area of the lung. The appearance could be classified into three patterns:(1)In 19 cases, the main appearance was diffuse large cloudy opacity with dim margin and lung markings.(2)In 13 cases, the main appearance was diffuse cotton- like opacity with obscure margin and increased lung markings. (3)In 5 cases, there were multiple large masses opacity with obscure margin and bronchial air contrast. In case of no complication and good response to treatment, the opacity of the lung disappeared gradually in about 1 month. Complication with G- bacillus infection in 6 cases and pneumomediastinum in 5 cases were found, which was accompanied with delayed resolution of the lung opacity. Conclusion The characteristics of radiographic appearance on chest roentgenography of critical SARS are rapid progression of bilateral lung infiltration, involving most area of the lung and complication with pneumomediastinum and lungs infection are common.