Published online before print May 20, 2003, 10.1148/radiol.2282030593
Severe Acute Respiratory Syndrome: Radiographic Appearances and Pattern of Progression in 138 Patients1
K. T. Wong, FRCR,
Gregory E. Antonio, FRANZCR,
David S. C. Hui, MD,
Nelson Lee, MD,
Edmund H. Y. Yuen, FRCR,
Alan Wu, MD,
C. B. Leung, MD,
T. H. Rainer, MD,
Peter Cameron, MD,
Sydney S. C. Chung, MD,
Joseph J. Y. Sung, MD and
Anil T. Ahuja, FRCR
1 From the Departments of Diagnostic Radiology and Organ Imaging (K.T.W., G.E.A., E.H.Y.Y., A.T.A.), Medicine and Therapeutics (D.S.C.H., N.L., A.W., C.B.L., J.J.Y.S.), Accident and Emergency Medicine (T.H.R., P.C.), and Surgery (S.S.C.C.), Prince of Wales Hospital, Chinese University of Hong Kong, 30-32 Ngan Shing St, Shatin, Hong Kong SAR. Received April 15, 2003; revision requested April 17; revision received April 22; accepted April 29. Address correspondence to K.T.W. (e-mail: wongkatakjeffrey@hotmail.com).
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Figure 1. Frontal chest radiograph in a 23-year-old man with SARS shows a focal ill-defined air-space opacity predominantly involving the periphery of right lower zone. Note lack of cavitation, lymphadenopathy, and pleural effusion.
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Figure 2. Schematic depicts the four patterns of radiographic progression determined from serial chest radiographs. See Table 4 for time to peak(s).
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Figure 3a. Serial radiographic appearances in a 23-year-old woman with SARS, type 1 pattern. (a) Frontal chest radiograph obtained at clinical presentation shows unilateral focal air-space opacity in the right middle zone. (b) Follow-up frontal chest radiograph obtained 5 days later shows progression of radiographic changes, with multifocal bilateral air-space opacities in both lungs. (c) Subsequent follow-up chest radiograph obtained after another 7 days shows radiographic improvement in extent of pulmonary parenchymal air-space opacities after successful medical therapy with a combination of oral ribavirin and corticosteroids.
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Figure 3b. Serial radiographic appearances in a 23-year-old woman with SARS, type 1 pattern. (a) Frontal chest radiograph obtained at clinical presentation shows unilateral focal air-space opacity in the right middle zone. (b) Follow-up frontal chest radiograph obtained 5 days later shows progression of radiographic changes, with multifocal bilateral air-space opacities in both lungs. (c) Subsequent follow-up chest radiograph obtained after another 7 days shows radiographic improvement in extent of pulmonary parenchymal air-space opacities after successful medical therapy with a combination of oral ribavirin and corticosteroids.
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Figure 3c. Serial radiographic appearances in a 23-year-old woman with SARS, type 1 pattern. (a) Frontal chest radiograph obtained at clinical presentation shows unilateral focal air-space opacity in the right middle zone. (b) Follow-up frontal chest radiograph obtained 5 days later shows progression of radiographic changes, with multifocal bilateral air-space opacities in both lungs. (c) Subsequent follow-up chest radiograph obtained after another 7 days shows radiographic improvement in extent of pulmonary parenchymal air-space opacities after successful medical therapy with a combination of oral ribavirin and corticosteroids.
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Figure 4. Frontal chest radiograph in a 76-year-old man with SARS who was undergoing medical treatment shows diffuse confluent air-space opacities involving both lungs and normal heart size. These findings are compatible with radiologic features of acute respiratory distress syndrome.
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Copyright © 2003 by the Radiological Society of North America.
