| 李永忠,李坤成,苏壮志,梁志刚,于春水,刘树良,卢洁,王志群,姚新宇,彭靖.20例严重急性呼吸综合征(SARS)死亡患者的影像研究[J].中国医学影像技术,2003,19(10):1288~1291 |
| 20例严重急性呼吸综合征(SARS)死亡患者的影像研究 |
| Study of Imaging Findings in 20 Death Cases of Severe Acute Respiratory Syndrome |
| 投稿时间：2003-08-08 |
| DOI： |
| 中文关键词: 严重急性呼吸综合征 体层摄影术,X线计算机 X 线平片 |
| 英文关键词:Severe acute respiratory syndrome Tomography, X-ray computer X-ray plain radiography |
| 基金项目: |
| 作者 | 单位 | | 李永忠 | 首都医科大学宣武医院医学影像学部放射科,北京 100053 | | 李坤成 | 首都医科大学宣武医院医学影像学部放射科,北京 100053 | | 苏壮志 | 首都医科大学宣武医院医学影像学部放射科,北京 100053 | | 梁志刚 | 首都医科大学宣武医院医学影像学部放射科,北京 100053 | | 于春水 | 首都医科大学宣武医院医学影像学部放射科,北京 100053 | | 刘树良 | 首都医科大学宣武医院医学影像学部放射科,北京 100053 | | 卢洁 | 首都医科大学宣武医院医学影像学部放射科,北京 100053 | | 王志群 | 首都医科大学宣武医院医学影像学部放射科,北京 100053 | | 姚新宇 | 首都医科大学宣武医院医学影像学部放射科,北京 100053 | | 彭靖 | 首都医科大学宣武医院医学影像学部放射科,北京 100053 |
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| 中文摘要: |
| 目的 回顾性分析一组(20例)严重急性呼吸综合征(SARS)死亡患者的影像表现,探讨特征性影像表现及其与临床进展的关系。方法 评价20例死亡SARS患者的动态胸部平片和CT影像,分析病变分布、形式、面积和密度的特点,探讨死亡患者胸部平片进展类型,分析影像变化和临床病程关系。结果 20例患者入院时胸片均可见明显的肺部病灶,表现为边缘不清的渗出影,病灶面积占全肺的百分比平均值为49.6%(1.4%~85.4%),病灶相对密度比平均值为0.79(0.60~1.10);患者死亡前胸片显示病灶明显扩大,均累及双肺,病灶面积占全肺的百分比上升为77.8%(52.2%~100%),与入院时胸片面积相比,差异有显著性(P＜0.01);死亡前密度增高,病变相对密度比平均值为0.88(0.60~1.10),与入院时病灶密度相比,差异有显著性(P＜0.01),8例患者胸片显示空洞、胸腔积液、纵隔气肿等征象;胸片进展状况可分为两种类型,Ⅰ型表现为病变面积扩展但无继发改变,Ⅱ型表现为病变面积扩展伴密度增高、空洞、胸腔积液等继发改变征象。结论 SARS病灶迅速进展,面积占据全肺组织75%以上,为死亡患者的影像特征;病灶密度明显升高,出现空洞和胸腔积液为病变出现继发改变的影像特点,可加重SARS疾病状态,导致死亡。对于SARS重症患者,动态影像检查(胸部平片和CT)为监测疾病发展的有效手段。 |
| 英文摘要: |
| Objective To retrospectively analyze the imaging findings in 20 death cases of SARS, and to probe into the probable relationship between clinical progress and radiographic appearances. Methods A serial of chest films and CT images in 20 SARS patients were evaluated according to the location, appearance, size and density of lesions. The radiographic types of 20 patients were summed up. Results All patients showed local or multiple lesions in chest films; the mean proportion of lesion area to the whole lung was 49.6%(1.4%-85.4%), and the mean relative density of lesion was 0.79(0.60-1.10) when admission. Whereas, the lesions were in bigger size to 77.8%(52.2%-100%), and a higher density to 0.88(0.60-1.10) before death. Two kinds of progress could be seen: type Ⅰ showed a bigger lesion size without secondary changes; type Ⅱ showed a bigger lesion size with higher density, cavity or pleural effusion. Conclusion The radiographic features of 20 death case were that: the lesions were growing progressively and the size of lesions were more than 50% of whole lung; higher density of lesion, cavity in lesion and pleural effusion which would worsen outcomes were secondary characteristics in SARS death cases. Dynamic examinations were good methods to monitor severe SARS cases. |
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