Severe acute respiratory syndrome: Radiographic appearances and pattern of progression in 138 patients
Severe acute respiratory syndrome: Radiographic appearances and pattern of progression in 138 patients
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DOI：
10.1148/radiol.2282030593
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发表时间：
2003-08-01
期刊：
影响因子：
19.7
通讯作者：
Ahuja, AT
中科院分区：
文献类型：
--
作者：
Wong, KT;Antonio, GE;Ahuja, AT
目的：回顾分析严重急性呼吸综合征(SARS)的X线表现和发展规律。材料和方法：对138例确诊SARS患者的临床表现和治疗过程中的胸部X线片进行分析。在最初的胸片上记录肺实质异常的X线表现、分布和受累程度。结果：138例患者中，108例(78.3%)初始胸片异常，表现为空隙混浊。多累及下肺区(70/108，64.8%)和右肺(82/108，75.9%)。在大多数患者中，周围肺受累更为常见(81/108，75.0%)。单灶性受累(59/108，54.6%)比多灶性受累或双侧受累更为常见。未发现空洞、淋巴结病或胸腔积液。X线进展分为四种类型：第1型(先恶化到峰值，再好转)97例(70.3%)，第2型(波动改变)24例(17.4%)，第3型(静态X线表现)10例(7.3%)，第4型(进行性恶化)7例(5.1%)。在59例患者中，44例(74.6%)在治疗过程中进展为单侧多灶性或双侧受累。结论：SARS以周围部位为主，治疗过程中常见的从单侧局灶性空洞到单侧多灶性或双侧受累的进展模式，以及缺乏空洞、淋巴结肿大和胸腔积液是SARS较典型的X线表现。(C)RSNA，2003年。
PURPOSE: To retrospectively evaluate the radiographic appearances and pattern of progression of severe acute respiratory syndrome (SARS).MATERIALS AND METHODS: Chest radiographs obtained at clinical presentation and during treatment in 138 patients with confirmed SARS (66 men, 72 women; mean age, 39 years; age range, 20-83 years) were assessed. Radiographic appearances of pulmonary parenchymal abnormality, distribution, and extent of involvement on initial chest radiographs were documented. Recognizable patterns of radiographic progression were determined by comparing the overall mean percentage of lung involvement for each patient on serial radiographs.RESULTS: Initial chest radiographs were abnormal in 108 of 138 (78.3%) patients and showed air-space opacity. Lower lung zone (70 of 108, 64.8%) and right lung (82 of 108, 75.9%) were more commonly involved. In most patients, peripheral lung involvement was more common (81 of 108, 75.0%). Unifocal involvement (59 of 108, 54.6%) was more common than multifocal or bilateral involvement. No cavitation, lymphadenopathy, or pleural effusion was demonstrated. Four patterns of radiographic progression were recognized: type 1 (initial radiographic deterioration to peak level followed by radiographic improvement) in 97 of 138 patients (70.3%), type 2 (fluctuating radiographic changes) in 24 patients (17.4%), type 3 (static radiographic appearance) in 10 patients (7.3%), and type 4 (progressive radiographic deterioration) in seven patients (5.1%). Initial focal air-space opacity in 44 of 59 patients (74.6%) progressed to unilateral multifocal or bilateral involvement during treatment.CONCLUSION: Predominant peripheral location; common progression pattern from unilateral focal air-space opacity to unilateral multifocal or bilateral involvement during treatment; and lack of cavitation, lymphadenopathy, and pleural effusion are the more distinctive radiographic findings of SARS. (C) RSNA, 2003 .