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目的 探讨传染性非典型肺炎的CT表现特点 ,以期提高临床诊断水平。方法 回顾性分析临床诊断的 46例传染性非典型肺炎的临床和CT资料。结果 17例表现为单肺叶单个病灶 ,以两肺下叶 (10 / 17)及右肺上叶 (5 / 17)多见 ,2 9例表现为多肺叶多个病灶 ,以两肺中下叶 (14 / 2 9)多见 ,其次部位是 :两肺广泛分布 (5 / 2 9) ,右肺上叶为主 (4 / 2 9) ,左肺上叶为主 (2 / 2 9) ,右肺下叶为主 (2 / 2 9) ,左肺下叶为主 (2 / 2 9)。病灶分布于胸膜下 (3 1/ 46)或胸膜下并中央区 (15 / 46) ,胸膜面范围较大。形态分为二种 :球形 (13 / 46) ,片状或类似扇形 (2 1/ 46) ,多球形并片状或类似扇形 12例。密度分为二种 :磨玻璃样高密度 (3 6/ 46)和实变样高密度 (10 / 46)。 1～ 2周复查 ,病变范围扩大 ,密度减低 ,病灶增多 (6/ 7) ,病变缩小 ,密度减低(1/ 7)。 1月左右复查 ,病变完全吸收消失 (9/ 16) ,病变范围扩大 ,密度减低 ,病灶增多 (4 / 16) ,病变范围扩大 ,密度减低 (1/16) ,局部遗留少许纤维条索影 (2 / 16)。结论 以下CT征象应为传染性非典型肺炎较可靠的诊断依据 :①病灶多发 ,胸膜下分布或合并中央区病灶 ;②球形 ,片状或扇形形态 ;③磨玻璃样密度 ;④病灶的CT动态变化。
Objective To investigate the CT features of SARS in order to improve the clinical diagnosis. Methods The clinical and CT findings of 46 cases of SARS were retrospectively analyzed. Results Seventeen patients showed a single lesion with single lobe, which was more common in lower lobes (10/17) and upper right lobe (5/17), with multiple lesions in multiple lobe in 29 cases. (14/29) were more common, followed by the following: widespread lungs (5/29), upper right lung (4/29), upper left lung (2/29) Right lower lobe mainly (2/29), left lower lobe mainly (2/29). Lesions were located in the subpleural (31/46) or subpleural and central (15/46), pleural surface larger. The morphology is divided into two types: spherical (13/46), flake or similar sector (21/46), multi-spherical and flake-like or fan-like 12 cases. The density is divided into two types: ground glass-like high-density (36/46) and real-like high-density (10/46). 1 ~ 2 weeks review, the lesion expanded, the density decreased, the lesion increased (6/7), lesion shrinkage, reduced density (1/7). In January, the lesions were completely disappeared (9/16). The lesions were enlarged, the density was reduced, the number of lesions was increased (4/16), the lesion size was expanded, the density was reduced (1/16) 2/16). Conclusion The following CT signs should be more reliable diagnosis of SARS based on: ① multiple lesions, subpleural distribution or lesions in the central area; ② spherical, lamellar or fan-shaped morphology; ③ ground glass-like density; ④ CT lesions dynamic Variety.