HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lai, E. K. Y. Articles by Loutfy, M. R. Search for Related Content PubMed PubMed Citation Articles by Lai, E. K. Y. Articles by Loutfy, M. R. Social Bookmarking                      What's this?

Severe Acute Respiratory Syndrome: Quantitative Assessment from Chest Radiographs with Clinical and Prognostic Correlation

¹ Department of Medical Imaging, North York General Hospital, 4001 Leslie St., Toronto, ON M2K 1E1, Canada.
² Department of Medicine, North York General Hospital, Toronto, ON M2K 1E1, Canada.
³ Toronto General Research Institute, University Health Network, 200 Elizabeth St., Toronto, ON M5G 2C4, Canada.

OBJECTIVE. This study examined findings of severe acute respiratory syndrome (SARS) on chest radiographs and presented a classification scheme using quantitative radiographic data supported by clinical parameters.

MATERIALS AND METHODS. Three radiologists who were blinded to the identity, diagnosis, treatment protocol, and outcome of each patient independently evaluated serial chest radiographs from 67 patients with confirmed SARS. In addition to the chest radiographic abnormalities and percentage of involvement, several quantitative improvement parameters, including the peak to 50% improvement time (PIT₅₀), were collected. Correlation between PIT₅₀ and clinical parameters (duration of fever, cough, dyspnea, oxygen supplementation, intubation, and death) were evaluated using Wilcoxon's rank sum testing and Spearman's correlation.

RESULTS. The most common initial findings were unifocal air-space disease in the periphery of the lower lungs occurring a mean of 3.6 ± 2.4 (SD) days from symptoms onset. Peak abnormalities were seen at 10.4 ± 2.9 days. PIT₅₀ was dependent on disease severity, showing a strong linear correlation with the clinical parameter duration of oxygen supplementation (r = 0.44, p = 0.0015). Three patterns of disease were recognized: pattern A (severe, 29.9%) with PIT₅₀ of more than 10 days, pattern B (typical, 44.8%) with PIT₅₀ of 10 or fewer days, and pattern C (mild, 25.4%) with minimal findings throughout the course of the disease. This classification was supported by collaborative clinical parameters.

CONCLUSION. The quantitative radiographic parameter PIT₅₀ has strong clinical correlation and can be used to differentiate severity of disease into severe, typical, and mild types.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

				V. C. C. Cheng, S. K. P. Lau, P. C. Y. Woo, and K. Y. Yuen Severe Acute Respiratory Syndrome Coronavirus as an Agent of Emerging and Reemerging Infection Clin. Microbiol. Rev., October 1, 2007; 20(4): 660 - 694. [Abstract] [Full Text] [PDF]

				B. J. Cowling, M. P. Muller, I. O. L. Wong, L.-M. Ho, S.-V. Lo, T. Tsang, T. H. Lam, M. Louie, and G. M. Leung Clinical prognostic rules for severe acute respiratory syndrome in low- and high-resource settings. Arch Intern Med, July 24, 2006; 166(14): 1505 - 1511. [Abstract] [Full Text] [PDF]

				A. C. Arroliga, E. Diaz-Guzman, and H. P. Wiedemann Severe Acute Respiratory Syndrome, Pulmonary Function Tests, and Quality of Life: Lessons Learned Chest, September 1, 2005; 128(3): 1088 - 1089. [Full Text] [PDF]