Background: SARS is an acute infectious pulmonary disease caused by a so-called coronavirus. The aim of this study was to assess the characteristics of clinical images of severe acute respiratory syndrome (SARS) in children for further understanding of the disease.

Methods: Clinical data and radiographic findings in 38 patients with clinically confirmed SARS in the period of January 2003-April 2003 were retrospectively analyzed. Chest radiography was performed in all the patients, and additional chest HRCT was given in a few of these patients.

Results: The radiological features of SARS in these patients were divided into three patterns: 1) massive consolidation (n=27, 71.1%) marked by patchy and segment air-space consolidations; 2) pulmonary interstitial infiltration (n=8, 21.0%) shown by coarse lung markings, and enhanced or inordinated reticular and drop shadows; 3) mixed pattern (n=3, 7.9%) characterized by marked lung markings with patchy opacity and reticular shadows. Radiographically the foci of lesions appeared early, progressed rapidly and were absorbed slowly. They could be grouped into early, progressive and convalescent stages, in which the median days were 4, 6 and 9 respectively.

Conclusions: The lung lesions of pediatric SARS patients appear early, and present bilateral or unilateral single or multiple patchy shadows predominantly. It is necessary to differentiate SARS from other pulmonary diseases through combined use of clinical and laboratory examinations.