Imaging of Severe Acute Respiratory Syndrome in Hong Kong
Gregory E. Antonio1,
K. T. Wong1,
David S. C. Hui2,
Nelson Lee2,
Edmund H. Y. Yuen1,
Alan Wu2,
Sydney S. C. Chung3,
Joseph J. Y. Sung2 and
Anil T. Ahuja1
1 Department of Diagnostic Radiology and Organ Imaging, Prince of Wales
Hospital, Chinese University of Hong Kong, 30-32 Ngan Shing St., Shatin, Hong
Kong Special Administrative Region, Republic of China.
2 Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese
University of Hong Kong, Shatin, Hong Kong Special Administrative Region,
Republic of China.
3 Department of Surgery, Prince of Wales Hospital, Chinese University of Hong
Kong, Shatin, Hong Kong Special Administrative Region, Republic of
China.
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Fig. 1A. —Type 1 progression shown on serial chest radiographs of
38-year-old woman with 2-day history of fever and chills. Frontal chest
radiograph obtained at presentation shows ill-defined air-space opacity in
periphery of right lower zone.
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Fig. 1B. —Type 1 progression shown on serial chest radiographs of
38-year-old woman with 2-day history of fever and chills. Frontal chest
radiograph obtained on day 2 shows increase in extent of pulmonary opacity in
right lower zone.
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Fig. 1C. —Type 1 progression shown on serial chest radiographs of
38-year-old woman with 2-day history of fever and chills. Frontal chest
radiograph obtained on day 7 shows further radiographic progression with
additional ill-defined air-space opacity in left lower zone.
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Fig. 1D. —Type 1 progression shown on serial chest radiographs of
38-year-old woman with 2-day history of fever and chills. Frontal chest
radiograph obtained on day 12 shows resolution of pulmonary opacities in both
lower zones.
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Fig. 2A. —Type 2 progression shown on serial chest radiographs of
37-year-old man with 1-day history of high fever and cough. Frontal chest
radiograph obtained at presentation shows subtle increased opacity in
periphery of right lower zone.
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Fig. 2B. —Type 2 progression shown on serial chest radiographs of
37-year-old man with 1-day history of high fever and cough. Frontal chest
radiograph obtained on day 3 shows confluent air-space opacity in periphery of
right lower zone that is more obvious than on previous radiograph
(A).
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Fig. 2C. —Type 2 progression shown on serial chest radiographs of
37-year-old man with 1-day history of high fever and cough. Frontal chest
radiograph obtained on day 5 shows worsening of airspace opacities in right
lower zone and involvement of left lower zone.
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Fig. 2D. —Type 2 progression shown on serial chest radiographs of
37-year-old man with 1-day history of high fever and cough. Frontal chest
radiograph obtained on day 12 shows resolution of bilateral lower zone
pulmonary opacities.
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Fig. 2E. —Type 2 progression shown on serial chest radiographs of
37-year-old man with 1-day history of high fever and cough. Frontal chest
radiograph obtained on day 16 shows reappearance of multifocal ill-defined
air-space opacities in mid and lower zones of both lungs. Subsequent follow-up
radiograph obtained at discharge (not shown) revealed resolution of pulmonary
opacities.
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Fig. 3A. —Type 4 progression shown on serial chest radiographs of
83-year-old woman with 3-day history of fever, chills, and rigor. Frontal
chest radiograph obtained at presentation shows area of ill-defined air-space
opacity in right middle lobe obscuring part of right heart border.
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Fig. 3B. —Type 4 progression shown on serial chest radiographs of
83-year-old woman with 3-day history of fever, chills, and rigor. Frontal
chest radiograph obtained on day 2 shows increased area of pulmonary opacities
in right lower zone. Subtle air-space opacities appear in perihilar regions of
both upper zones.
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Fig. 3C. —Type 4 progression shown on serial chest radiographs of
83-year-old woman with 3-day history of fever, chills, and rigor. Frontal
chest radiograph obtained on day 5 shows progressive patchy areas of pulmonary
opacities in both lungs.
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Fig. 3D. —Type 4 progression shown on serial chest radiographs of
83-year-old woman with 3-day history of fever, chills, and rigor. Frontal
chest radiograph obtained on day 10 shows further radiographic progression
with adult respiratory distress syndrome—type of confluent
opacification. Patient died 1 day after last radiograph.
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Fig. 4A. —High-resolution CT scans show ground-glass opacification in
two patients. CT scan of 33-year-old man shows large area of ground-glass
opacification. Note that underlying pulmonary vasculature (arrow) is
not obscured.
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Fig. 4B. —High-resolution CT scans show ground-glass opacification in
two patients. CT scan of 51-year-old woman shows multiple small areas of
ground-glass opacification.
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Fig. 5. —High-resolution CT scan of 52-year-old woman shows
consolidation. Vascular architecture is obscured and air bronchograms are
seen.
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Fig. 6. —High-resolution CT scan of 61-year-old man shows mixed
ground-glass and consolidated opacification. Air bronchogram (arrow)
runs through center of consolidation (vascular architecture obscured). Note
ground-glass opacification present at edges of consolidation.
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Fig. 7. —High-resolution CT scan of 56-year-old man shows thickened
interlobular septa and intralobular interstitium superimposed on ground-glass
opacification.
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Fig. 8A. —High-resolution CT scans and radiograph of 27-year-old woman
with strong clinical suspicion of severe acute respiratory syndrome. CT scan
shows crazy paving pattern (arrow) with markedly thickened
interlobular septa superimposed on ground-glass opacification.
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Fig. 8B. —High-resolution CT scans and radiograph of 27-year-old woman
with strong clinical suspicion of severe acute respiratory syndrome. Chest
radiograph shows no obvious abnormality.
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Fig. 8C. —High-resolution CT scans and radiograph of 27-year-old woman
with strong clinical suspicion of severe acute respiratory syndrome. CT scan
obtained within 24 hr of initial CT scan shows left paraspinal opacity in left
upper lobe posterior segment behind aortic arch.
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Copyright © 2003 by the American Roentgen Ray Society.
