严重急性呼吸综合征的影像学分析

目的探讨严重急性呼吸综合征(SARS)的X线及CT表现。资料与方法回顾性分析108例SAPS患者的影像学表现。所有病例均有较完整的胸片资料，其中5例同时行CT检查。结果SARS的影像学表现形式多样，主要表现为肺实质渗出性病变和肺间质渗出性病变两大类型，根据病变早期及进展期表现，又可将其分为5型：(1)单纯局限型：32例，为肺内单一局限病灶，随后病变扩大或无明显增大；(2)局限-广泛型：20例，为肺内单一局限病灶迅速发展为弥漫分布；(3)多发型：28例，为早期即见肺内多发片状和／或结节状病灶；(4)间质-实质型：22例，早期为肺部间质性渗出，随后发展为肺实质渗出性病变；(5)单纯间质型：6例，主要表现为肺间质渗出性病变。结论X线检查是发现SARS的最基本的影像学检查方法，CT能更好地显示病变。在SARS的诊治过程中，有必要了解本病的影像学分型和分期，这有助于判断病情，指导治疗，估计预后。

Imaging Analysis of Severe Acute Respiratory Syndrome

Objective To explore chest radiograph and CT appearances of Severe Acute Respiratory Syndrome (SARS). Materials and Methods The imaging findings of 108 patients with SARS were retrospectively analyzed. All the patients had a complete set of chest film and clinical data. 5 patients underwent additional chest CT.Results Imaging findings of SARS were various and appeared dominantly as two types of the parenchymal and interstitial exudation. According to their initial and progressive radiographic appearances, the patterns of lesions were categorized to five subtypes: (1) Pure focal lesion(n=32): the single and focal lesion expanded or did not change obviously in the series radiography; (2) Focal extensive lesion (n=20): the single and focal consolidation quickly progressed to diffusive lesions; (3) Multiple lesions (n=28): the initial radiography showed multiple patchy or/and nodular lesions; (4) Interstitial parenchymal lesion (n=22): the major appearance on the initial radiogram was interstitial abnormality, and subsequent parenchymal exudation occurred; (5) Pure interstitial lesion (n=6): the predominant abnormality was interstitial exudation.Conclusion Plain radiography was an elementary imaging means of choice for detecting the disease. CT is superior to plain radiography in displaying lesion. It is necessary to study radiological types and stages of SARS in the diagnostic and therapeutic procedure, which is helpful to assessing the disease condition, planning the therapy and evaluating the prognosis.