Thin-section CT in patients with severe acute respiratory syndrome following hospital discharge: Preliminary experience
Thin-section CT in patients with severe acute respiratory syndrome following hospital discharge: Preliminary experience
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DOI：
10.1148/radiol.2283030726
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发表时间：
2003-09-01
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：
Antonio, GE;Wong, KT;Ahuja, AT
目得：报告的初步经验，关于薄切片计算机断层扫描（CT）的结果，在严重急性呼吸综合征（SARS）的患者临床治疗后改善。材料和方法：24例（10名男性，14名女性;平均年龄，39岁;年龄范围，23-70岁）确诊SARS进行了后续的胸部薄切片CT。平均在入院后36.5天获得扫描结果，并分析实质异常（磨玻璃样混浊、实变或间质增厚）和纤维化证据（实质带、牵引性支气管扩张、不规则界面）。患者被分配到第I组（有纤维化的CT证据）和第2组（没有纤维化的CT证据）进行分析。比较两组患者的人口统计学资料、住院时间、重症监护室入院率、峰值乳酸脱氢酶水平、静脉内甲基强的松龙冲击治疗和胸片峰值混浊。96%的患者有脑实质异常（23/24）例患者，范围为第2组中残留的磨玻璃样混浊和间质增厚（9/24，38%）至纤维化（15/24，62%）。I组患者年龄较大（平均年龄45岁对30.3岁），入住重症监护室的比例较高（27% [4/15] vs 11% [1/9]），更需要脉冲静脉注射甲泼尼龙（87%，[13/15] vs 67% [6/9]），乳酸脱氢酶峰值水平较高（438.9 vs 355.6 U/L），胸片峰值浑浊更高结论：SARS患者经治疗后出院，肺纤维化可能发生较早。年龄较大且在治疗期间病情较重的患者更有可能出现纤维化的薄层CT结果。
PURPOSE: To report the initial experience regarding thin-section computed tomographic (CT) findings in patients with severe acute respiratory syndrome (SARS) who improved clinically after treatment.MATERIALS AND METHODS: Twenty-four patients (10 men, 14 women; mean age, 39 years; age range, 23-70 years) with confirmed SARS underwent follow-up thin-section CT of the thorax. The scans were obtained on average 36.5 days after hospital admission and were analyzed for parenchymal abnormality (ground-glass opacification, consolidation, or interstitial thickening) and evidence of fibrosis (parenchymal band, traction bronchiectasis, irregular interfaces). Patients were assigned to group I (with CT evidence of fibrosis) and group 2 (without CT evidence of fibrosis) for analysis. Patient demographics, length of hospital stay, rate of intensive care unit admission, peak lactate dehydrogenase level, pulsed intravenous methylprednisolone therapy, and peak opacification on chest radiographs were compared between the two groups.RESULTS: Parenchymal abnormality was found in 96% (23 of 24) of patients and ranged from residual ground-glass opacification and interstitial thickening in group 2 (nine of 24, 38%) to fibrosis in group 1 (15 of 24, 62%). Patients in group I were older (mean age, 45 vs 30.3 years), had a higher rate of intensive care unit admission (27% [four of 15] vs 11% [one of nine]), more requirement for pulsed intravenous methylprednisolone (87%, [13 of 15] vs 67% [six of nine]), higher peak lactate dehydrogenase level (438.9 vs 355.6 U/L), and higher peak opacification on chest radiographs (estimated area, 14% vs 11%) than patients in group 2.CONCLUSION: Pulmonary fibrosis may develop early in patients with SARS who have been discharged after treatment. Patients who are older and have more severe disease during treatment are more likely to develop thin-section CT findings of fibrosis.