Severe Acute Respiratory Syndrome: Radiographic Features of 36 Probable Cases

嚴重急性呼吸道症候群：36位可能病例之胸部X光特徵

高鴻文(Hung-Wen Kao) ； 徐先和(Hsian-He Hsu) ； 許居誠(Giu-Cheng Hsu) ； 鄭煒東(Wei-Tung Cheng) ； 陳震宇(Cheng-Yu Chen)

《中華放射線醫學雜誌》 29卷1期 (2004/02) Pp. 1-6

摘要

本研究目的在評估嚴重急性呼吸道症候群（SARS）之胸部X光表現及其病程變化。我們回溯性地分析36位SARS可能病例之X光特徵，包括型態、分布及範圍，並經由比較一系列X光病灶之影像緻密度、範圍、及數目，評估病程變化。在所有36位病人當中，第一張X光片就有異常者為30位（83%），並呈現肺實質陰影，其中單一病灶（13位，44%）或雙側多發病灶（15位，50%）較為常見，在這30位病人中共有49個病灶，最常見於下肺區（28個，58%）及同時出現於肺中央與邊緣區（26個，53%）。在所有異常的X光片中，都沒有出現開洞、淋巴結腫大或肺積水的情形。除了2位病人沒有出現明顯的X光異常外，其餘34位的X光系列變化可歸納為4型：第一型（逐漸好轉）有4位，佔12%；第二型（起初先惡化再逐漸好轉）有14位，佔41%；第三型（好好壞壞的波動型變化）有13位，佔38%；第四型（持續惡化）有3位，佔9%。
雖然SARS有不同的X光表現，但其典型的特徵為單一病灶或多發肺實質陰影，且以下肺區為多，不合併開洞、淋巴結腫大或肺積水的情形。

關鍵字

胸部X光 ； 冠狀病毒 ； 嚴重急性呼吸道症候群

並列摘要

The purpose of this study is to evaluate the radiographic manifestations and sequential changes of severe acute respiratory syndrome (SARS). The chest radiographs obtained in 36 patients with probable SARS were retrospectively reviewed. Radiographic features, including the patterns, distribution, and extent of involvement, were documented and sequential radiographic changes were evaluated through comparisons of the evolving density, extent, and number of lesions. Initial chest radiographs were abnormal in 30 of 36 (83%) patients and showed air-space opacity. Unifocal (13 of 30, 44%) or bilateral multifocal involvement (15 of 30, 50%) was more commonly observed. Of the total 49 lesions in 30 patients, it appeared more frequently in the lower lung zone (28 of 49, 58%), as well as in the mixed central and peripheral regions (26 of 49, 53%). There was no evidence of cavitation, adenopathy, or pleural effusion on any of the initial chest radiographs. Except for two patients without significant abnormality, four patterns of sequential radiographic changes were recognized: type 1 (progressive improvement) in 4 of 34 patients (12%), type 2 (initial worsening followed by progressive improvement) in 14 patients (41%), type 3 (fluctuating changes) in 13 patients (38%), and type 4 (progressive worsening) in 3 patients (9%).
Although SARS had a variety of radiographic appearances, typical findings were predominantly unifocal or multifocal air-space opacity, lower lobe predominance, and lack of cavitation, adenopathy, and pleural effusion.

並列關鍵字

Chest radiography ； Coronavirus ； Severe acute respiratory syndrome