非典型肺炎 - 嚴重急性呼吸道綜合症 (SARS)

香港發生嚴重非典型肺炎的個案所呈現的放射學徵狀

本網頁由 區皓智醫生 及 黃嘉德醫生 負責籌辦。
本網頁由 高士進醫生 及 安　邦醫生 負責維護。

本網頁建於公元二零零三年三月二十一日。
瀏覽人次︰ 125691 / 本網頁曾於 2005年12月12日，香港時間15時32分54秒更新。

[ BOOK ON SARS [NEW!] ] [ 引言 ][ FOLLOW-UP IMAGING FINDINGS IN SARS [NEW!] ]
[ ACUTE IMAGING FINDINGS IN SARS ] [ CXR WITH CORRESPONDING HRCT ]
[ CXR WITH CORRESPONDING HRCT ] [ PROGRESS CXR ]
[ IMAGES FROM OTHER CENTERS ] [ IMAGE GALLERY ]
[ PAEDIATRICS ] [ 成像常規指引 ]
[ MANAGEMENT AND INFECTION CONTROL IN A RADIOLOGY DEPARTMENT DURING THE SARS OUTBREAK ] [ 病者出院時的成像方針 ]
[ DROID SARS ACTIVITIES [NEW!] ] [ ARTICLES ON SARS ]
[ USEFUL LINKS ] [ FAQs ]

13th July 2004

A message to our visitors

A year has passed since the end of the SARS outbreak in Hong Kong and it appears that we (the world community in general) have been spared of a massive recurrence of this infection this year. Nonetheless, research on this disease is on-going and we would like to congratulate all who have contributed to furthering our knowledge of this disease.

The convalescent period of this disease has not been uneventful. Complications of the disease such as Lung fibrosis resulting in limitations to respiratory function, post-traumatic stress disorder like psychological trauma, side-effects of corticosteroid therapy (adrenal insufficiency and osteonecrosis) continue to surface. We have included some of the relevant images and references with this update.

With the help of many co-workers from Hong Kong and other countries, we are pleased to announce that we have compiled a book documenting our collective knowledge and experience on SARS. This book is titled "Imaging in SARS", published by Cambridge University Press (http://www.cambridge.org/uk/catalogue/catalogue.asp?isbn=1841102199). Despite its title, this book contains extensive information on the epidemiology, clinical diagnosis and treatment, emergency medicine, intensive care medicine and infection control related to SARS.

On another front, a different viral infection has re-surfaced this past winter, the Avian Influenza. We have created a webpage similar to this SARS webpage for sharing images of that infection with all. The address of the Avian Influenza webpage is: http://www.droid.cuhk.edu.hk/web/specials/avian_flu/avian_flu.htm

If you come across something interesting in your management of SARS or Avian Influenza patients and would like to share this with the rest of the medical community, we would be more than happy to post it on our website. Acknowledgement and copyright will obviously be granted to the contributor and institution.

Again we like to thank our support staff for the great work they have done and the personal sacrifices they have made to get both webpages up and running. We would also like to thank the numerous visitors who have given us very valuable feed back to help us improve our website.

With our sincere thanks,

The Department of Diagnostic Radiology and Organ Imaging,
The Chinese University of Hong Kong.

INTRODUCTION

The beginning of 2004 saw the confirmation of the first community acquired case of SARS since the end of the 2003 epidemic. We now know much more about this novo disease and the United States Centers of Disease Control and prevention has issued an updated case definition in December 2003. Radiology continues to be an integral part of the diagnosis and management of patients with SARS.

The following are the radiological and CT features of this disease based on our experience (336 patients imaged during after the epidemic) at the Department of Diagnostic Radiology and Organ Imaging, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong.

These are presented here to facilitate early diagnosis and management should it be encountered in other centres.

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FOLLOW-UP IMAGING FINDINGS IN SARS

9 MAY 2003

5 AUGUST 2003

3 JULY 2003

2 OCTOBER 2003

Patient One

55 year old male admitted on 17th March 2003 with SARS Co-V infection.Serial follow up HRCT of the same level demonstrate evolution of lesions.There is significant clearing of most changes on 3rd and 6th month follow-up. Some residual abnormalities may represent fibrosis.

(a) T1W coronal

(b) T2W fat-saturated coronal

Patient Two

32 year old male previous treated for SARS Co-V infection. MRI of the right hip shows abnormal subchondral areas bound by geographic borders in the femoral head: (a) T1W coronal (b) T2W fat-saturated coronal (c) PD sagittal. The appearances are consistent with avascular necrosis.

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ACUTE IMAGING FINDINGS IN SARS

Radiographs:

In the early stage of the disease, a peripheral / pleural-based opacity may be the only abnormality. This may range from ground-glass to consolidation in appearance. A particular area to review is the paraspinal region behind the heart. In our experience, this is frequently where lung lesions are detected on HRCT in suspected SARS patients with normal radiographs.

In the more advanced cases, there is widespread opacification which may be ground-glass or consolidative affecting large areas. This tends to affect the lower zones first and is not uncommonly bilateral. Calcification, cavitation, pleural effusion or lymphadenopathy are not features of this disease.

HRCT:

Solitary or multiple patchy area(s) of

Ground-glass opacification with or without thickening of the intra-lobular interstitium or interlobular interstitium.

Consolidation

A combination of 1 & 2

These tend to occupy a sub-pleural position rather than axial. Again, calcification, cavitation, pleural effusion or lymphadenopathy are not features of this disease

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CXR WITH CORRESPONDING HRCT

Patient Three

Patient Four

24 year old symptomatic female. Frontal view shows vague paraspinal opacity in the left lower zone

Click here to view corresponding HRCT

29 year old symptomatic female with normal radiographic appearance

Click here to view corresponding HRCT

Patient One

27 year old symptomatic female with subtle left lower zone opacity

Click here to view corresponding HRCT

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PROGRESS CXR

Case 1: A 31-year-old health-care worker presented with 2-day history of fever, chills and myalgia.

Figure 1 - CXR at the time of diagnosis showed ill-defined air space opacification in right lower zone

Figure 2 - CXR after 3 days showed partial resoulation of consolidatve changes in right lower zone. There is a new finding of ill-defined air space opacification in left lower zone

Figure 3 - CXR after another 4 days showed progressive resolution of the changes in both lower zones

Case 2: A 34-year-old presented with 3-day history of fever, chills and malaise.

Figure 1 - CXR (7 days after admission) showed ill-defined air space opacification in periphery of right lower zone

Figure 2 - CXR (2 days later) showed progression of air space opacification in right lower zone and a new finding of similar changes in left mid and lower zones after initial treatment

Figure 3 - CXR (after another 4 days) showed marked resolution of the consolidative changes in both lungs after treatment

Case 3: A 34-year-old health care worker presented with fever, chills and myalgia for 2 days.

Figure 1 - CXR showed ill-defined air-space opacity in periphery of left upper and mid zones

Figure 2 - CXR (after 5 days) showed progressive air-space opacities in both lungs

Figure 3 - CXR (after another 7 days) showed resolution of radiographic changes after successful treatment

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IMAGES FROM OTHER CENTERS

Boca Raton, Florida, USA

Courtesy of Dr. Michael E. Katz M D

52-year-old symptomatic female from Virginia

15 MARCH 2003
(On presentation to A&E)

19 MARCH 2003

20 MARCH 2003

Changi General Hospital, Singapore

Courtesy of Dr Augustine Tee

24-year-old Filipino nursing aid from nursing home with one week history of fever, dry cough and myalgia.

Day 1 - CXR showed subtle left lower zone airspace infiltrates.

Day 5 - CXR showed left lower zone consolidation became more obvious.

Day 7 - Patient became hypoxic & required subsequent intubation. CXR showed bilateral widespread airspace infiltrates.

最新加入! 壢新醫院 ( 台灣 )

嗚謝：盧業球醫生

16 years old male c/o swinging but persisted fever above 38 degree Celius for a few days with dry cough CXR taken on the 10th day in our OPD department. No fever at that time.

CXR PA : bronchitis ?

Repeated CXR PA another 10 days later.

Repeated CXR PA on the 20th day.

Please send us your images to share with the rest of the medical community.
E-mail address: gregantonio@cuhk.edu.hk

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IMAGE GALLERY

CHEST RADIOGRAPHS

Fig 1: (day 3 after onset of symptoms)

Ill-defined air-space opacification in right lower zone

Fig 2: (day 4 after onset of symptoms)

Confluent air-space opacification in left lower zone

Fig 3: (day 5 after onset of symptoms)

Air-space opacification in the periphery of middle lobe abutting the superior aspect of the horizontal fissure

Fig 4: (day 3 after onset of symptoms)

Ill-defined opacity in left lower zone

Fig 5: (day 4 after onset of symptoms)

Bilateral lower zones air-space opacities in para-cardiac areas

Fig 6: (day 2 after onset of symptoms)

Middle lobe air-space opacity obscuring part of right heart border

Fig 7: (day 4 after onset of symptoms)

Peripheral segmental air-space opacification in right upper lobe

Fig 8: (day 5 after onset of symptoms)

Patchy peripheral opacities involving both lower lobes

Fig 9: (day 6 after onset of symptoms)

Multi-focal ill-defined air-space opacities in both lower and right upper zones

Fig 10: (day 5 after onset of symptoms)

Patchy air-space opacification in both mid and lower zones

Fig 11: (day 4 after onset of symptoms)

Peripheral patchy opacification in right upper and left lower zones

Fig 12: (day 7 after onset of symptoms)

Multi-focal diffuse air-space opacities in both lungs

Fig 13: (day 5 after onset of symptoms)

Multi-focal confluent areas of air-space opacities in both lungs

Fig 14: (day 6 after onset of symptoms)

Diffuse and widespread consolidative changes in both lungs (patient is intubated)

Note: ARDS (Adult Respiratory Distress Syndrome) may be a feature in severe disease

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PAEDIATRICS

2-year-old boy presented with febrile convulsion and cough. CXR on admission showed air-space opacities in left mid and lower zones.

6-year-old girl presented with fever, running nose and cough. CXR on admission showed focal air-space consolidation in left upper zone.

5-year-old girl presented with fever for 4 days. CXR showed air-space opacity in left lower zone.

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Fig 1: (day 3 after onset of symptoms)

Peripheral ill-defined consolidation in the lateral basal segment of left lower lobe

Fig 2: (day 2 after onset of symptoms)

Peripheral ground-glass opacification in middle lobe

Fig 3: (day 2 after onset of symptoms)

Patchy ground-glass opacification in periphery of both lower lobes (R>L)

Fig 4: (day 3 after onset of symptoms)

Ill-defined consolidation with air-bronchogram in apical segment of right lower lobe

Fig 5: (day 5 after onset of symptoms)

Multi-focal peripheral consolidation in posterior basal segments of both lower lobes and an area of ground-glass opacification in left lingular segment

Fig 6: (day 5 after onset of symptoms)

Patchy, multi-focal, ground-glass opacification and consolidation in both upper lobes

Fig 7: (day 4 after onset of symptoms)

Multiple confluent areas of consolidation in the middle lower and both lower lobes

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成像常規指引

目前我們的成像常規指引是：

臨床上懷疑SARS個案，應進行胸部X光平片檢查。
如胸部平片異常，則無須作進一步檢查(跟進病況除外)。

如胸部平片正常，則應進行高解像電腦掃描(HRCT)，因HRCT可比胸部X光平片早一至兩天顯示異常變化

現時所有住院的SARS病人都有異常的胸部成像影像。
由於此病的傳染性高，當值人員必須嚴格執行防疫措施，並徹底清潔有關儀器。

注意：初時，我們為病者進行常規和高解像的胸部電腦掃描，以比較兩者成效，當累積一定經驗後，因發現病者皆無肺積水或淋巴結節病變情況，故現選擇只進行HRCT，以減低病者接受的幅射劑量。

嚴格防疫措施

詳情請參閱「感染控制措施」。

檢查後，清潔X光及CT的檢查床架，以及檢查室的地板。

檢查後，更換床單。

所有當值人員須配戴口罩、手套及保護衣。

所有放射部門人員必須清楚並嚴格遵行防疫措施守則。

對SARS的成像檢查建議流程：

*為要提防HRCT過於敏感，應用時過份診斷，以假作真，故請只在下列情況下方可應用。

有接觸SARS病者的病歷
有清楚的臨床徵狀，包括連續發熱發燒，低白血球數量等
初步胸部X光平片正常

故此我們必須為成像檢查訂出清楚的臨床指引。

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MANAGEMENT AND INFECTION CONTROL IN A RADIOLOGY DEPARTMENT DURING THE SARS OUTBREAK

1.	Basic consideration regarding the spread of SARS

2.	Problems related to Radiology

3.	Infection control measures

	A)	Specific personal infection control guidelines for staff and patients

	B)	General infection control guidelines for staff

	C)	Main areas of attention when re-organising the Radiology department

	D)	Practical checklist for running the department

	E)	Specific problems related to individual imaging modalities

	F)	Update on new measures (15.5.03)

4.	Final comment

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病者出院時的成像方針

由於這是SARS的首次爆發。我們沒法從醫學文獻取得前人經驗可作參考，以訂立在病者出院時的成像檢查方針。經結合其他在處理SARS個案之醫療中心同仁的意見，我們初步提出以下的成像指引。這個指引因經驗所限，或許尚有改善的空間。我們訂立過程中有考慮過資源調配，病者數量，幅射劑量，個別成像檢查的敏感度，以及指引的可行性等因素。因應臨床需要，病者出院時的成像檢查指引如下：

對於病者在進院時，胸部X光平片有明確異常，並在治療時其X光徵狀有分解減退情?，我們初步?定為這類病者在出院及覆診時進行胸部X光平片，以監察其康復進展。
對於病者在進院時，胸部X光平片無異常，而只從其HRCT發現肺部有肺炎病變，我們初步?定為這類病者在出院及覆診時進行HRCT，以監察其康復進展。

我們醫療界同仁務須同舟共濟，協力同心對抗SARS，在此我們極歡迎各位對本頁的資科作出回應和建議。

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DROID SARS ACTIVITIES

Indexed Publications on SARS:

1.	Lee N, Hui D, Wu A, Chan P, Cameron P, Joynt GM, Ahuja A, Yung MY, Leung CB, To KF, Lui SF, Szeto CC, Chung SSC and Sung JJY. A Major Outbreak of Severe Acute Respiratory Syndrome in Hong Kong. N Engl J Med. 2003 May 15;348(20):1986-94. Epub 2003 Apr 07.

2.	Wong KT, Antonio GE, Hui DSC, Lee N, Yuen EHY, Wu A, Leung CB, Rainer TH, Cameron P, Chung SSC, Sung JJY, Ahuja AT. Radiographic Appearances and Pattern of Progression of Severe Acute Respiratory Syndrome (SARS): A Study of 138 Patients.Radiology 2003; 228:401-406.

3.	Wong KT, Antonio GE, Hui DSC, Lee N, Yuen EHY, Wu A, Leung CB, Rainer TH, Cameron P, Chung SSC, Sung JJY, Ahuja AT. Radiological Appearances of Severe Acute Respiratory Syndrome. Journal of the Hong Kong College of Radiologists 2003;6:4-6.

4.	Wong KT, Antonio GE, Hui DSC, Lee N, Yuen EHY, Wu A, Leung CB, Rainer TH, Cameron P, Chung SSC, Sung JJY, Ahuja AT. Thin-Section CT of Severe Acute Respiratory Syndrome: Evaluation of 73 Patients Exposed to or with the Disease. Radiology 2003;228:395-400.

5.	Ahuja AT. Letter to Editor, Severe Acute Respiratory Syndrome in Hong Kong. Clin Radiol. 2003 Jun;58(6):496.

6.	Antonio GE, Wong KT, Hui DSC Lee N, Yuen EHY, Wu A, Leung CB, Rainer TH, Cameron P, Chung SSC, Sung JJY, Ahuja AT. Pictorial Essay: Imaging of Severe Acute Respiratory Syndrome in Hong Kong. AJR Am J Roentgenol 2003;181:11-7.

7.	Antonio GE, Wong KT, Hui DSC Lee N, Yuen EHY, Wu A, Leung CB, Rainer TH, Cameron P, Chung SSC, Sung JJY, Ahuja AT. Thin-section Computed Tomography in Severe Acute Respiratory Syndrome (SARS) Patients Following Hospital Discharge: Radiology. 2003 Sep;228(3):810-5. Epub 2003 Jun 12.

8.	King AD, Ching ASC, Chan PL, Cheng AYH, Wong PK, Ho SSY, Griffith JF, Lyon DJ, Fung KSC, Choi P, Li CK, Cheng AFB, Ahuja AT. Severe Acute Respiratory Syndrome: Avoiding the Spread of Infection in a Radiology Department. AJR Am J Roentgenol. 2003 Jul;181(1):25-7.

9.	Ho SSY, Chan PL, Wong, PK Antonio GE, Wong KT, Lyon DJ, Fung KSC, Li CK, Cheng AFB, Ahuja AT. Eye of the Storm: The Roles of a Radiology Department in the Outbreak of Severe Acute Respiratory Syndrome. AJR Am J Roentgenol. 2003 Jul;181(1):19-24.

10.	Griffith JF, Antonio GE, Ahuja AT. SARS and the Modern Day Pony Express (the World Wide Web). American Journal of Roentgenology 2003;180:1736.

11.	Hon KLE, Leung CW, Cheng WTF, Chan PKS, Chu WCW, Kwan YW, Li AM, Fong NC, Ng PC, Chiu MC, Li CK, Tam JS, Fok TF. Clinical presentations and outcome of severe acute respiratory syndrome in childern. Lancet. 2003 May 17;361(9370):1701-3.

12.	Antonio GE, Wong KT, Chu WC, et al. Imaging in severe acute respiratory syndrome (SARS). Clin Radiol. 2003 Nov;58(11):825-32.

13.	Gomersall CD, Joynt GM, Lam P, et al. Short-term outcome of critically ill patients with severe acute respiratory syndrome. Intensive Care Med. 2004 Mar;30(3):381-7. Epub 2004 Jan 23.

14.	Hui DSC, Wong KT, Antonio GE et al. Severe Acute Respiratory Syndrome (SARS): Correlation of Clinical Outcome and Radiological Features. Radiology in press.

15.	Joynt GM, Antonio GE, Lam P, et al. Late-stage adult respiratory distress syndrome caused by severe acute respiratory syndrome: abnormal findings at thin-section CT. Radiology. 2004 Feb;230(2):339-46

16.	Griffith JF, Antonio GE, Kumta SM, et al. Osteonecrosis of the hip and knee in SARS patients treated with steroids. Radiology in press.

Conference Lectures/ Presentations on SARS:

1.	Hong Kong College of Radiologists, Hong Kong Academy of Medicine and Hong Kong Hospital Authority. SARS Imaging Symposium. Hong Kong, China. 7th June 2003 Pneumonia, atypical pneumonia and pneumonia-like conditions "Pneumonia in children including SARS" Dr. Winnie Chu

2.	Hong Kong College of Radiologists, Hong Kong Academy of Medicine and Hong Kong Hospital Authority. SARS Imaging Symposium. Hong Kong, China. 7th June 2003 Pneumonia, atypical pneumonia and pneumonia-like conditions "Application & Imaging Features of SARS on HRCT" Dr. KT Wong

3.	World Health Organization, SARS Clinical Management Workshop, Hong Kong, China, 13th June 2003. "Imaging in SARS: The Hong Kong Experience" Dr. Ahuja

4.	The Second Chinese Medical Association Medical Forum, Beijing, China. 9th September 2003. "Imaging of Severe Acute Respiratory Syndrome (SARS)" Dr. Antonio

5.	Radiological Society of North America Scientific Assembly and Annual Meeting. 1st December 2003. "Computed Tomography of Severe Acute respiratory Syndrome: Initial Experience" Dr. Antonio

6.	16th European Congress of Radiology, 8 March, 2004 "Steroid-induced AVN in patients treated for SARS: Early observations." (abstract B-702) Dr. Antonio

7.	16th European Congress of Radiology, 9 March, 2004 "Radiographic appearances and pattern of progression of Severe Acute Respiratory Syndrome (SARS)." (abstract B-862). Dr. Antonio

8.	Hong Kong SARS Forum and Hospital Authority Convention 2004. 8 May 2004. "Magnetic Resonance Screening for Skeletal Abnormalities in post-SARS patients" Dr. Antonio

Scientific Exhibits on SARS:

1.	SARS Imaging - What do we need to know? Shetty S, Burney K, Hopkins R, Antonio GE, Ahuja AT Annual Meeting of The Royal College of Radiologists UK September 2003

2.	Severe Acute Respiratory Syndrome (SARS): Correlation of Clinical Outcome and Radiological Features. Wong KT, Hui DSC, Antonio GE, Wu A, Wong V, Lau W, Wu, JC, Tam LS, Yu LM, Joynt, GM, Chung SSC, Ahuja AT. Hong Kong College of Radiologists 11th Annual Scientific Meeting, Hong Kong, 18th -19th October 2003.

3.	Computerised tomography (CT) in severe acute respiratory syndrome 9SARS): late-stage acute respiratory disease syndrome (ARDS) and follow-up findings. Joynt G, Antonio G, Wong K, Lam P, Gomersall C, Li T. 24th International Symposium on Intensive Care and Emergency Medicine Brussels, Belgium, 30 March - 2 April 2004

4.	Texture Classification of SARS Infected Region in Radiographic Image Xiaoou Tang, Dacheng Tao, Gregory E Antonio Institute of Electrical and Electronics Engineers, 11th International Conference on Image Processing, Singapore October 2004

Books on SARS:

Imaging in SARS
Editors: Anil T Ahuja and Clara GC Ooi
2004 Greenwich Medical Media Limited, London, UK.

Book Chapters:

1.	SARS. Editor: Joseph JY Sung Imaging in Severe Acute Respiratory Syndrome (SARS) KT Wong, Gregory E Antonio, Anil T Ahuja,

2.	Imaging in SARS. Editors: Anil T Ahuja and Clara GC Ooi 2004 Greenwich Medical Media Limited, London, UK. Chapter 5 The Role of Chest Radiographs in the Diagnosis of SARS KT Wong, Gregory E Antonio, Anil T Ahuja

3.	Imaging in SARS. Editors: Anil T Ahuja and Clara GC Ooi 2004 Greenwich Medical Media Limited, London, UK. Chapter 6 Chest radiography: Clinical correlation and its role in the management of Severe Acute Respiratory Syndrome (SARS) David SC Hui, KT Wong, Gregory E Antonio, Anil T Ahuja, Joseph JY Sung

4.	Imaging in SARS. Editors: Anil T Ahuja and Clara GC Ooi 2004 Greenwich Medical Media Limited, London, UK. Chapter 7 The Role of High-resolution Computed Tomography (HRCT) in Diagnosis of SARS Gregory E Antonio, KT Wong, Anil T Ahuja

5.	Imaging in SARS. Editors: Anil T Ahuja and Clara GC Ooi 2004 Greenwich Medical Media Limited, London, UK. Chapter 8 The Role of Imaging in the Follow up of SARS Gregory E Antonio, KT Wong, Anil T Ahuja

6.	Imaging in SARS. Editors: Anil T Ahuja and Clara GC Ooi 2004 Greenwich Medical Media Limited, London, UK. Chapter 9 Treatment of Severe Acute Respiratory Syndrome Joseph JY Sung, Alan Wu

7.	Imaging in SARS. Editors: Anil T Ahuja and Clara GC Ooi 2004 Greenwich Medical Media Limited, London, UK. Chapter 10 SARS in the Intensive Care Unit Gavin M Joynt, Gregory E Antonio, Charles D Gomersall.

8.	Imaging in SARS. Editors: Anil T Ahuja and Clara GC Ooi 2004 Greenwich Medical Media Limited, London, UK. Chapter 11 Imaging of Pneumonia in Children Winnie CW Chu

9.	Imaging in SARS. Editors: Anil T Ahuja and Clara GC Ooi 2004 Greenwich Medical Media Limited, London, UK. Chapter 12 Imaging and Clinical Management of Paediatric SARS Winnie CW Chu, Ellis KL Hon, Frankie WT Cheng, TF Fok

10.	Imaging in SARS. Editors: Anil T Ahuja and Clara GC Ooi 2004 Greenwich Medical Media Limited, London, UK. Chapter 14 Radiographers' Perspective in the Outbreak of SARS Stella SY Ho

11.	Imaging in SARS. Editors: Anil T Ahuja and Clara GC Ooi 2004 Greenwich Medical Media Limited, London, UK. Chapter 15 Implementation of Measures to Prevent the Spread of SARS in a Radiology Department Anne D King and Alex SC Ching

12.	Imaging in SARS. Editors: Anil T Ahuja and Clara GC Ooi 2004 Greenwich Medical Media Limited, London, UK. Chapter 16 Post-mortem of SARS Gregory E Antonio, James F Griffith, Anil T Ahuja

13.	Imaging in SARS. Editors: Anil T Ahuja and Clara GC Ooi 2004 Greenwich Medical Media Limited, London, UK. Chapter 17 The Future of Severe Acute Respiratory Syndrome Anil T Ahuja, Gregory E Antonio