Wong Ka-tak, Antonio Gregory E, Hui David S C, Ho Catherine, Chan Po-nin, Ng Wing-hung, Shing Kwok-kuen, Wu Alan, Lee Nelson, Yap Florence, Joynt Gavin M, Sung Joseph J Y, Ahuja Anil T
Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, Hong Kong, China.
J Comput Assist Tomogr. 2004 Nov-Dec;28(6):790-5. doi: 10.1097/00004728-200411000-00010.
To evaluate thin-section computed tomography findings of patients with severe acute respiratory syndrome (SARS) in the convalescent period and to correlate the results with clinical parameters and lung function tests.
Ninety-nine severe acute respiratory syndrome patients with persistent changes on follow-up chest radiography were included. One hundred seventy computed tomography examinations at baseline (n=70), 3 months (n=56), and 6 months (n=44) were retrospectively evaluated to determine the extent of ground-glass opacification, reticulation, and total parenchymal involvement. Patients' demographic information, clinical information during treatment, and results of lung function tests at 3 and 6 months were correlated with computed tomography findings.
A significant serial improvement in the extent of overall ground-glass opacification, overall reticulation, and total parenchymal involvement was observed (P <0.01). Advanced age, previous intensive care unit admission, mechanical ventilation, alternative treatment, higher peak lactate dehydrogenase, and peak radiographic involvement during treatment showed a positive correlation with overall reticulation and total parenchymal involvement at 6 months. There was a significant negative correlation between overall reticulation and total parenchymal involvement with diffusion capacity adjusted for hemoglobin at 3 and 6 months (P <0.01).
Lung changes on thin-section computed tomography of severe acute respiratory syndrome patients improved with time during the convalescent period and showed a significant correlation with advanced age, parameters indicating severe illness, and diffusion capacity adjusted for hemoglobin on follow-up.
评估重症急性呼吸综合征(SARS)患者恢复期的薄层计算机断层扫描结果,并将结果与临床参数和肺功能测试相关联。
纳入99例胸部X线随访有持续改变的重症急性呼吸综合征患者。回顾性评估170次计算机断层扫描检查,包括基线时(n = 70)、3个月时(n = 56)和6个月时(n = 44)的检查,以确定磨玻璃样混浊、网状改变及实质受累的范围。将患者的人口统计学信息、治疗期间的临床信息以及3个月和6个月时的肺功能测试结果与计算机断层扫描结果相关联。
观察到总体磨玻璃样混浊、总体网状改变及实质受累范围有显著的系列改善(P <0.01)。高龄、既往入住重症监护病房、机械通气、替代治疗、较高的乳酸脱氢酶峰值以及治疗期间的影像学受累高峰与6个月时的总体网状改变及实质受累呈正相关。3个月和6个月时,总体网状改变及实质受累与经血红蛋白校正的弥散能力之间存在显著负相关(P <0.01)。
重症急性呼吸综合征患者恢复期薄层计算机断层扫描显示的肺部改变随时间改善,且与高龄、提示病情严重的参数以及随访时经血红蛋白校正的弥散能力显著相关。