Article: Severe Acute Respiratory Syndrome: temporal lung changes at thin-section CT in 30 patients

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TitleSevere Acute Respiratory Syndrome: temporal lung changes at thin-section CT in 30 patients
AuthorsOoi, GC
Khong, PL1
Müller, NL
Yiu, WC
Zhou, LJ
Ho, JCM1
Lam, B
Nicolaou, S
Tsang, KWT
KeywordsLung, CT
Lung, infection
Severe acute respiratory syndrome (SARS)
Issue Date2004
PublisherRadiological Society of North America, Inc. The Journal's web site is located at http://radiology.rsnajnls.org
CitationRadiology, 2004, v. 230 n. 3, p. 836-844 [How to Cite?]
DOI: http://dx.doi.org/10.1148/radiol.2303030853
AbstractPURPOSE: To evaluate lung abnormalities on serial thin-section computed tomographic (CT) scans in patients with severe acute respiratory syndrome (SARS) during acute and convalescent periods. MATERIALS AND METHODS: Serial thin-section CT scans in 30 patients (17 men, aged 42.5 years ± 12.2 [SD]) with SARS were reviewed by two radiologists together for predominant patterns of lung abnormalities: ground-glass opacities, ground-glass opacities with superimposed linear opacities, consolidation, reticular pattern, and mixed pattern (consolidation, ground-glass opacities, and reticular pattern). Scans were classified according to duration in weeks after symptom onset. Longitudinal changes of specific abnormalities were documented in 17 patients with serial scans obtained during 3 weeks. Each lung was divided into three zones; each zone was evaluated for percentage of lung involvement. Summation of scores from all six lung zones provided overall CT score (maximal CT score, 24). RESULTS: Median CT scores increased from 1 in the 1st week to 12.5 in the 2nd week. Ground-glass opacities with or without smooth interlobular septal thickening and consolidation were predominant patterns found during the 1st week. Ground-glass opacities with superimposed irregular reticular opacities, mixed pattern, and reticular opacities were noted from the 2nd week and peaked at or after the 4th week. After the 4th week, 12 (55%) of 22 patients had irregular linear opacities with or without associated ground-glass opacities and CT scores greater than 5; five of these patients had bronchial dilatation. When specific opacities were analyzed in 17 patients, consolidation generally resolved completely (n = 4) or to minimal residual opacities; six (55%) of 11 patients with ground-glass opacities had substantial residual disease (CT scores > 5) on final scans. CONCLUSION: There is a temporal pattern of lung abnormalities at thin-section CT in SARS. Predominant findings at presentation are ground-glass opacities and consolidation. Reticulation is evident after the 2nd week and persists in half of all patients evaluated after 4 weeks. Long-term follow-up is required to determine whether the reticulation represents irreversible fibrosis. © RSNA, 2004.
ISSN0033-8419
2011 Impact Factor: 5.726
2011 SCImago Journal Rankings: 0.475
DOIhttp://dx.doi.org/10.1148/radiol.2303030853
ISI Accession Number IDWOS:000189186500035
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorOoi, GC
dc.contributor.authorKhong, PL
dc.contributor.authorMüller, NL
dc.contributor.authorYiu, WC
dc.contributor.authorZhou, LJ
dc.contributor.authorHo, JCM
dc.contributor.authorLam, B
dc.contributor.authorNicolaou, S
dc.contributor.authorTsang, KWT
dc.date.accessioned2012-06-26T06:13:54Z
dc.date.available2012-06-26T06:13:54Z
dc.date.issued2004
dc.description.abstractPURPOSE: To evaluate lung abnormalities on serial thin-section computed tomographic (CT) scans in patients with severe acute respiratory syndrome (SARS) during acute and convalescent periods. MATERIALS AND METHODS: Serial thin-section CT scans in 30 patients (17 men, aged 42.5 years ± 12.2 [SD]) with SARS were reviewed by two radiologists together for predominant patterns of lung abnormalities: ground-glass opacities, ground-glass opacities with superimposed linear opacities, consolidation, reticular pattern, and mixed pattern (consolidation, ground-glass opacities, and reticular pattern). Scans were classified according to duration in weeks after symptom onset. Longitudinal changes of specific abnormalities were documented in 17 patients with serial scans obtained during 3 weeks. Each lung was divided into three zones; each zone was evaluated for percentage of lung involvement. Summation of scores from all six lung zones provided overall CT score (maximal CT score, 24). RESULTS: Median CT scores increased from 1 in the 1st week to 12.5 in the 2nd week. Ground-glass opacities with or without smooth interlobular septal thickening and consolidation were predominant patterns found during the 1st week. Ground-glass opacities with superimposed irregular reticular opacities, mixed pattern, and reticular opacities were noted from the 2nd week and peaked at or after the 4th week. After the 4th week, 12 (55%) of 22 patients had irregular linear opacities with or without associated ground-glass opacities and CT scores greater than 5; five of these patients had bronchial dilatation. When specific opacities were analyzed in 17 patients, consolidation generally resolved completely (n = 4) or to minimal residual opacities; six (55%) of 11 patients with ground-glass opacities had substantial residual disease (CT scores > 5) on final scans. CONCLUSION: There is a temporal pattern of lung abnormalities at thin-section CT in SARS. Predominant findings at presentation are ground-glass opacities and consolidation. Reticulation is evident after the 2nd week and persists in half of all patients evaluated after 4 weeks. Long-term follow-up is required to determine whether the reticulation represents irreversible fibrosis. © RSNA, 2004.
dc.description.natureLink_to_OA_fulltext
dc.identifier.citationRadiology, 2004, v. 230 n. 3, p. 836-844 [How to Cite?]
DOI: http://dx.doi.org/10.1148/radiol.2303030853
dc.identifier.doihttp://dx.doi.org/10.1148/radiol.2303030853
dc.identifier.epage844
dc.identifier.hkuros87699
dc.identifier.isiWOS:000189186500035
dc.identifier.issn0033-8419
2011 Impact Factor: 5.726
2011 SCImago Journal Rankings: 0.475
dc.identifier.issue3
dc.identifier.pmid14990845
dc.identifier.scopuseid_2-s2.0-1342329986
dc.identifier.spage836
dc.identifier.urihttp://hdl.handle.net/10722/150886
dc.identifier.volume230
dc.languageeng
dc.publisherRadiological Society of North America, Inc. The Journal's web site is located at http://radiology.rsnajnls.org
dc.publisher.placeUnited States
dc.relation.ispartofRadiology
dc.relation.referencesReferences in Scopus
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshFemale
dc.subject.meshHong Kong
dc.subject.meshHumans
dc.subject.meshLongitudinal Studies
dc.subject.meshLung - Radiography
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshPulmonary Fibrosis - Radiography
dc.subject.meshRemission, Spontaneous
dc.subject.meshSevere Acute Respiratory Syndrome - Radiography
dc.subject.meshTomography, Spiral Computed
dc.subjectLung, CT
dc.subjectLung, infection
dc.subjectSevere acute respiratory syndrome (SARS)
dc.titleSevere Acute Respiratory Syndrome: temporal lung changes at thin-section CT in 30 patients
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong
  2. Queen Mary Hospital Hong Kong
  3. The University of British Columbia