SARS患者康复过程中的胸部CT表现

目的　探讨严重急性呼吸综合征 (SARS)患者康复期的CT表现。方法　随访观察 6 5例确诊为SARS的康复者 ,根据病史分为重症 2 1例 ,轻症 4 4例 ,进行多层螺旋CT和高分辨率CT扫描、肺功能等检查。结果　 2 8例CT扫描未见异常。其余CT表现为 :(1)磨玻璃样密度灶 35例 ,包括 :局限斑片状磨玻璃样密度病灶 11例 ;多叶多段磨玻璃样密度灶 19例 ;双肺弥漫磨玻璃样密度病灶 5例。 (2 )小叶内间质及小叶间隔增厚 30例。 (3)胸膜下弧线影 9例。 (4 )不规则纤维索条影 19例。(5 )牵拉性细支气管扩张 3例。 (6 )结节状气腔实变病灶 2例。 (7)空洞病灶 1例。未见明显纵隔淋巴结肿大和胸腔积液。多次复查肺内影像及肺功能均有好转。比较重症组和轻症组CT表现及肺功能指标差异有显著意义 (P <0 0 5 )。结论　部分SARS康复期患者肺部表现基本正常 (2 8/ 6 5 ,占 4 3 1% )。磨玻璃样密度病灶为康复期的主要CT表现 (35 / 6 5 ,占 5 3 8% ) ,并伴有程度不等的肺间质增生。重症组较轻症组患者肺内表现严重 ,肺功能差。随着时间的延长 ,肺内病变及肺功能逐渐好转。

Chest CT manifestations of SARS patients in the recovery phase

Objective To study the chest CT manifestations of the severe acute respiratory syndrome (SARS) patients in the recovery phase.Methods Sixty-five diagnosed SARS patients performed CT and HRCT, pulmonary functions, and so on. They were classified into 2 groups.Results 28 cases were normal on CT scan. Ground-glass opacities were found in 35 cases. Among them, 11 cases showed small focal patchy ground-glass opacities, 19 cases had multiple ground-glass opacities, and 5 cases showed diffuse ground-glass opacities. Thickening of interlobular and intralobular septa was revealed in 30 cases. Subpleural lines were found in 9 cases. Irregular lines were found in 19 cases. Bronchiolectasis was found in 3 cases. Nodular consolidation was found in 2 cases. They were lack of lymphadenopathy and pleural effusion. The CT manifestations and pulmonary functions had statistically significant differences between the two groups.Conclusion During the early recovery phase, some patients were normal on CT scan (28/65, 43.1%). The main manifestations were ground-glass opacities (35/65, 53.8%) and interstitial hyperplasia. The severe patients had worse CT manifestations and lung function than others. The CT manifestations and pulmonary functions tend to become better over the time.