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目的 评价X线平片和CT检查在严重急性呼吸综合征 (SARS)的诊断价值。方法回顾性分析 2 9例临床诊断SARS的患者 ,对发病后的一系列胸片和CT影像进行分析。结果 X线表现 :发热后 1周内胸片显示单侧或双侧肺局灶性斑片状模糊影 ,然后迅速扩大到其他肺野 ,部分呈片团状弥漫分布 ,部分融合呈大片状 ,中心密度高 ,周边密度低 ,可见支气管气像。按病变高峰期侵犯肺的范围将病变分为轻、中、重度 ,轻度 5例 ,中度 10例 ,重度 14例。CT表现 :发病 1～ 10d有 4例CT扫描显示两肺多发斑片状实变影 ,边缘模糊 ,部分融合成大片状 ,可见支气管气像。发病 10～ 30d有 9例进行CT检查 ,表现为两肺大部或弥漫磨玻璃样改变 ,肺间质增厚 ,呈粗大网状 ,夹杂斑块状肺实变影 ,胸膜下区可见小叶过度充气征象 ;发病 30d后 ,有 19例进行检查 ,2例CT表现正常 ,17例主要表现为两肺局灶或广泛性不同程度的肺间质增厚影像。结论 SARS同时存在急性肺炎和急性间质性肺炎的影像改变 ,在治疗过程中 ,一系列胸片检查有助于掌握病情的变化 ,CT检查能较准确地评价肺部病变。
Objective To evaluate the diagnostic value of X-ray and CT in the diagnosis of severe acute respiratory syndrome (SARS). Methods A retrospective analysis of 29 cases of clinically diagnosed patients with SARS, the incidence of a series of chest X-ray and CT images were analyzed. X-ray findings: 1 week after fever, chest radiograph showed unilateral or bilateral focal patchy blurry shadow, and then rapidly expanded to other lung fields, some were diffuse patchy distribution, part of the fusion was large , The center of high density, low peripheral density, bronchial gas seen. Lesions at the peak of the range of violations of the lung lesions will be divided into mild, moderate, severe, mild in 5 cases, moderate in 10 cases, severe in 14 cases. CT manifestations: the incidence of 1 ~ 10d 4 cases of CT scan showed multiple lung lesions patchy consolidation, blurred edges, part of the fusion into a large flake, bronchial gas seen. The onset of 10 ~ 30d in 9 cases of CT examination, manifested as most of the two lungs or diffuse glass-like changes, interstitial thickening, was coarse mesh, inclusion of plaque-like lung consolidation shadow, pleural area visible lobular over After 30 days of onset, 19 cases were examined, 2 cases had normal CT findings, and 17 cases mainly showed focal or extensive pulmonary interstitial thickening in two lungs. Conclusion SARS has both acute pneumonia and acute interstitial pneumonia. During the course of treatment, a series of chest radiographs can help to grasp the changes of the disease. The CT examination can accurately evaluate the lung lesion.