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目的 探讨SARS死亡病例的影像学表现及其病理基础。方法 搜集 31例SARS死亡病例的影像资料 ,其中 2 7例摄床旁X线胸片 ,8例行高分辨率CT(HRCT)扫描 ,并对其中 9例尸检病例进行影像 病理对照研究。结果 SARS病人临终前胸部X线表现以大片状和多片融合阴影多见(19例 ) ,白肺 8例。病变呈多发、弥漫分布 ,密度高低混合 ,支气管气像常见 (16例 )。CT表现为多发的大片状磨玻璃样密度阴影 (5例 ) ,可合并其他部位的肺实变 (3例 ) ,病灶有融合趋势。病理对照研究提示影像表现的病理基础是肺组织广泛实变、淤血、出血 ,镜下可见肺泡内透明膜形成及支气管内膜脱落。结论 SARS病人临终前病变进展迅速 ,范围广 ,影像检查能够为评价病情、观察动态变化提供有价值的帮助。
Objective To investigate the imaging findings and pathological basis of SARS death. Methods The data of 31 cases of SARS death were collected. Among them, 27 cases were taken by bedside X-ray and 8 cases were diagnosed by high-resolution CT (HRCT). Nine cases of autopsy were studied by pathology. Results The X-ray findings of the anterior chest of the SARS patients were more common in large and multiple fusion shadows (19 cases) and white lung in 8 cases. Lesions were multiple, diffuse distribution, the density of mixed, bronchial common (16 cases). CT showed multiple large pieces of ground glass-like density shadow (5 cases), may be combined with other parts of the lung consolidation (3 cases), the fusion trend. Pathological control studies suggest that the pathological basis of imaging performance is extensive consolidation of lung tissue, congestion, bleeding, microscopic alveolar visible transparent membrane formation and bronchial membrane detachment. Conclusion SARS patients progressed rapidly and had a wide range of preneoplastic lesions. Image examination can provide valuable help in evaluating the condition and observing the dynamic changes.