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目的 探讨严重急性呼吸综合征 (SARS)的临床表现和影像学特征及其关系。方法回顾性分析 4 6例符合《广东省医院收治非典型肺炎病人工作指引》诊断标准的SARS患者的临床和影像学资料。所有病例均有全胸站立后前位和侧位片 ;6例行胸部CT扫描。结果 97.8% (45 /4 6 )的SARS患者以发热为首发表现 ,其体征较轻 ,与影像学改变不符。X线表现 :(1)病变分布 :两侧肺 17例 (37 0 % ) ;一侧肺 2 9例 (6 3 0 % ) ,其中右肺 14例 (14 /2 9) ,左肺 15例 (15 /2 9)。病变局限于 1个肺叶者 2 8例 (6 0 9% ) ,分布于 2个肺叶者 9例 (19 6 % ) ,3个肺叶者 4例 ,4个肺叶者 4例 ,5个肺叶者 1例。多肺叶分布中 ,局限于一侧肺者 1例 (1/18) ,两侧肺分布者 17例 (17/18)。 (2 )病灶类型 :以肺间质性改变为主 ,表现为密度不均的斑片状阴影 ,其内可见增粗和紊乱的肺纹理结构 ;肺纹理改变型 3例(6 5 % ) ;间质型 18例 (39 1% ) ;实质型 9例 (19 6 % ) ,混合型 16例 (34 8% )。此外还可见肺门模糊 1例 ,少量胸水 1例 ,轻度胸膜反应 1例。 6例CT扫描 ,3例急性期表现为磨玻璃样高密度灶或大片状渗出和实变 ,3例吸收期可见条索状残留灶。结论 SARS的临床与影像学表现有一定的特征 ,其预后与病变的严重程度相关。
Objective To investigate the clinical manifestations and imaging features of Severe Acute Respiratory Syndrome (SARS) and their relationship. Methods Retrospective analysis of clinical and imaging data of 46 cases of SARS patients meeting the diagnostic criteria of “Guangdong Provincial Hospital for SARS patients”. All cases had a full chest before posterior and lateral radiographs; 6 cases of chest CT scan. Results 97.8% (45/46) of SARS patients with fever as the first performance, the signs of light, and imaging changes do not match. X-ray findings: (1) The distribution of lesions: 17 cases (37 0%) on both sides of the lung and 29 cases (63 0%) on the side of the lung, including 14 cases (14/29) of the right lung and 15 cases of the left lung (15/29). Lesions were localized in 28 cases (69%) in one lobe, 9 cases (19.6%) in 2 lobes, 4 cases in 3 lobes, 4 cases in 4 lobes and 1 in 5 lobes example. Multi-lobe distribution, confined to one side of the lung in 1 case (1/18), both sides of the lung distribution in 17 cases (17/18). (2) The types of the lesions were mainly pulmonary interstitial changes, patchy shadows with uneven density, thickening and disordered lung texture were seen in the lesions. Three lung cancers (65%) were changed. 18 (39.1%) were interstitial, 9 (19.6%) were substantial, and 16 (34.8%) were mixed. In addition, one can also see the hilar ambiguity, a small amount of pleural effusion in 1 case, mild pleural reaction in 1 case. 6 cases of CT scan, 3 cases of acute phase showed ground glass-like high-density lesions or lamellar oozing and solidification, 3 cases of absorption of visible cord-like residual foci. Conclusion The clinical and radiological manifestations of SARS have certain characteristics, and their prognosis is related to the severity of the disease.