论文部分内容阅读
目的探讨严重急性呼吸综合征(SARS)患者临床治疗后,CT复查肺内残留病变的动态变化情况。方法对124例治疗后的SARS患者进行CT复查随访,失访13例,资料完整111例,对平均病程第3、6、12及18个月行螺旋CT检查的结果进行对比分析,总结其影像动态变化的特征。结果病程18个月内,相继有70例(占63.1%)患者肺内CT表现恢复正常。6、12、18个月时CT主要征象:(1)磨玻璃样病变残留率分别为33.3%(37/111)、24.3%(27/111)、20.7%(23/111)。(2)小叶间隔或小叶内间质增厚残留率分别为37.8%(42/111)、28.8%(32/111)、25.2%(28/111)。以上2种主要病变在随访期内的总体变化经对比分析χ2检验,差异有统计学意义(P<0.01)。(3)胸膜下弧线影15例,随访期内病变有不同程度的吸收,但无一例病变消失。(4)不规则纤维条索影18个月时残留率17.1%(19/111)。少见征象:(1)实变病灶1例,病程第12个月完全吸收。(2)空洞病灶2例,1例于病程第12个月基本吸收,1例随访期内未完全吸收。(3)牵拉性支气管扩张1例,随访期内无明显变化。(4)小结节灶3例,1例病程第12个月基本吸收,2例无明显变化。结论病程第18个月SARS患者肺内磨玻璃样病变残留率为20.7%。17.1%的患者残留局限性肺间质纤维化改变。对肺内残留磨玻璃样病变的患者继续定期随访间隔6～12个月为宜,其他患者可以延长随访间隔时间至12个月以上。
Objective To investigate the dynamic changes of residual lung lesions after CT examination in patients with severe acute respiratory syndrome (SARS). Methods A total of 124 patients with SARS were followed up for CT, 13 patients were lost to follow-up, and 111 were complete. The results of spiral CT examination at 3, 6, 12 and 18 months were compared and analyzed. Dynamic characteristics. Results Within 18 months, 70 cases (63.1%) had normal pulmonary CT findings. The main signs of CT at 6, 12 and 18 months: (1) The residual rates of ground vitreous lesions were 33.3% (37/111), 24.3% (27/111) and 20.7% (23/111) respectively. (2) The residual rate of interlobular septa or interlobular septa was 37.8% (42/111), 28.8% (32/111) and 25.2% (28/111), respectively. The above two main changes in the follow-up of the overall changes in the comparative analysis of χ2 test, the difference was statistically significant (P <0.01). (3) 15 cases of subpleural arc, the lesions were different degrees of absorption during the follow-up period, but no case of lesions disappeared. (4) irregular fiber strip shadow 18 months, the residual rate of 17.1% (19/111). Rare signs: (1) 1 case of consolidation lesions, the first 12 months of course completely absorbed. (2) 2 cases of empty lesions, 1 case basically absorbed in the 12th month of disease course, and 1 case was not completely absorbed in the follow-up period. (3) 1 case of traction bronchiectasis, no significant changes during the follow-up period. (4) Summary 3 cases of focal lesions, 1 case of basic absorption of the 12th month, 2 cases no significant change. Conclusion In the 18th month, the residual rate of ground vitreous lesions in SARS patients was 20.7%. 17.1% of patients with residual pulmonary interstitial fibrosis changes. Pulmonary residual glassy lesions of patients with regular follow-up interval of 6 to 12 months is appropriate, other patients can extend the follow-up interval to 12 months or more.