A correlation between the severity of lung lesions on radiographs and clinical findings in patients with severe acute respiratory syndrome.
OBJECTIVE
The purpose of this study was to quantify lesions on chest radiographs in patients with severe acute respiratory syndrome (SARS) and analyze the severity of the lesions with clinical parameters.


METHODS
Two experienced radiologists reviewed chest radiographs of 28 patients with SARS. Each lung was divided into upper, middle, and lower zones. A SARS-related lesion in each zone was scored using a four-point scale: zero to three. The mean and maximal radiographic scores were analyzed statistically to determine if the scorings were related to the laboratory data and clinical course.


RESULTS
Forward stepwise multiple linear regression showed that the mean radiographic score correlated most significantly with the number of hospitalized days (p < 0.001). The second most significant factor was the absolute lymphocyte count (p < 0.001) and the third most significant factor was the number of days of intubation (p = 0.025). The maximal radiographic score correlated best with the percentage of lymphocytes in a leukocyte count (p < 0.001), while the second most significant factor was the number of hospitalized days (p < 0.001) and the third most significant factor was the absolute lymphocyte count (p = 0.013). The mean radiographic scores of the patients who died, with comorbidities and without a comorbidity were 11.1, 6.3 and 2.9, respectively (p = 0.032). The corresponding value for maximal radiographic scores were 17.7, 9.7 and 6.0, respectively (p = 0.033).


CONCLUSIONS
The severity of abnormalities quantified on chest radiographs in patients with SARS correlates with the clinical parameters.
Wan
Yung-Liang
YL
Department of Medical Imaging and Intervention, Chang Gung Memorial at Linkou, College of Medicine, Chang Gung University, 5 Fuhsing Rd., Kweishan, Taoyuan, Taiwan. ylw0518@adm.cgmh.org.tw
Tsay
Pei-Kwei
PK
Cheung
Yun-Chung
YC
Chiang
Ping-Cherng
PC
Wang
Chun-Hua
CH
Tsai
Ying-Huang
YH
Kuo
Han-Ping
HP
Tsao
Kuo-Chien
KC
Lin
Tzou-Yien
TY
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001784:Blood Gas Analysis / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data; D007902:Length of Stay; D008168:Lung / Q000000981:diagnostic imaging*; D018655:Lymphocyte Count / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D011379:Prognosis; D011859:Radiography; D012189:Retrospective Studies; D045169:Severe Acute Respiratory Syndrome / Q000097:blood / Q000175:diagnosis* / Q000401:mortality; D012720:Severity of Illness Index; D016019:Survival Analysis
D015415:Biomarkers