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題名 | 嚴重急性呼吸道症候群(SARS)的影像學表徵:馬偕醫院53例病例分析=Radiographic Manifestation of SARS--53 Cases Analysis at Mackay Memorial Hospital during a Major out Break in Taipei |
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作者 | 許清寅; 惲純和; 劉景隆; 郭許達; 施焄鏻; | 書刊名 | 中華放射線醫學雜誌 |
卷期 | 29:2 2004.04[民93.04] |
頁次 | 頁73-80 |
分類號 | 415.463 |
關鍵詞 | 非典型肺炎; 胸部X光攝影; 電腦斷層攝影; 嚴重急性呼吸道症候群; Atypical pneumonia; Chest radiography; Computed tomography; Severe acute respiratory syndrome; SARS; |
語文 | 中文(Chinese) |
中文摘要 | 本文以2003年春,台北發生嚴重急性呼吸道症候群(SARS)大流行期間,馬偕紀念醫院53例SARS病例,以胸部X光素片在急性期的表徵作分析,98%(52/53)病例其X光呈現典型肺炎(air-space pneumonic consolidation),X光病灶出現的時機約在發燒後4.5±2.1天出現。肺炎的最初形態:73%(34/52)好發於下肺野。48%(25/52)為單一局部肺炎浸潤,52%(27/52)為多發性病灶,但單一部病灶一半以上60%(15/25)在3~5天內即快速變為多發性病灶,此意味SARS肺炎有相當快速演變的行為特質佔81%(42/52),此亦可作為與一般非典型肺炎的鑑別方法,然而在癒後的病例中,有19例以高解析度電腦斷層掃描(HRCT)追蹤肺部變化,得知大多數在急性期有嚴重浸潤的病患,於渡過危險期後肺部纖維化的情形漸漸趨緩,幾乎所有HRCT追蹤的病例都能在出院後3~6個月康復至輕微纖維化,此為對SARS病患癒後之重大發現。 |
英文摘要 | The purpose of our study was to demonstrate the radiographic manifestation of 53 SARS patients at Mackay Memorial Hospital during a major outbreak in Taipei. Chest radiographs obtained at clinical presentation and during treatment in 53 patients with confirmed SARS (18 men,35 women, mean age 39; age range,5~91 years) were assessed. Initial abnormal chest films revealed the typical pattern with air-space pneumonic consolidation in either unifocal (25 of 52, 48%) or multifocal infiltrate (27 of 52, 52%). In most patients, peripheral lung involvement was more common (36 of 52, 68%), and lower lung field involvement was predominant (45 of 52, 86.5%). Over half of the cases with initial unifocal lesion had rapid progression into bilateral multifocal lesions within 3~5 days, representing the special behavior for SARS. Therefore, it is able to differentiate SARS from the other atypical pneumonias. However, chest HRCT serves the role as follow-up monitoring the imaging change of pulmonary fibrosis for severe SARS patients. Nearly all follow-up HRCT cases had satisfied outcome in recovery from severe diffuse fibrosing alveolitis to mild fibrotic change within 3~6 months. It is a very important discovery for the disease process of SARS. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。