SARS的胸部X线表现及动态观察

目的 研究严重急性呼吸综合征(SARS)患者胸部X线影像及变化规律。方法临床诊断为SARS者46例，每间隔2～4d摄胸片复查，分析全部胸片的影像表现和动态变化。结果 首次胸片正常但不能排除SARS，在拍摄病变初期X线胸片的30例中，4例在发病10d后才发现胸部异常。病变早期胸片表现以单发小片状阴影为主(66．7％，20／30)。动态观察病变的影像变化快，而且病程中严重程度有反复，8例患者肺内病变吸收缓慢。死亡患者肺内有多发弥漫病变及病变逐渐减轻者各3例。结论 胸部X线检查可用于SARS的早期发现及显示病程的变化。但对于早期诊断和判断预后需结合临床及实验室检查。

X-ray appearances and dynamic changes of the chest in SARS

Objective To study the X-ray appearances and dynamic imaging changes of the chest in severe acute respiratory syndrome diagnosed clinically. Methods The sequential X-ray examinations of the chest at 2-4 days intervals were performed in 46 patients with severe acute respiratory syndrome. The X-ray findings were analyzed retrospectively. Results The initial chest normal X-ray finding did not exclude severe acute respiratory syndrome. The abnormal X-ray findings were not seen until 10 days later after onset in 4 of 30 cases who had initial pulmonary radiograms. The small patchy shadows were found in 20 out of 30 cases (66.7%) on the initial stage Dynamic observations indicated that rapid changes and repeated severing of X-ray appearances were common The disease course in 8 patients was longer The multiple or spread opacities and lessened abnormalities on X-ray films were found in 3 death cases, respectively Conclusion The chest radiogram can be used to display early appearances and dynamic change in severe acute respiratory syndrome Chest X-ray should combine with clinical examination and laboratory results because radiogram is limited in the early diagnosis and predicting prognosis