目的 探讨高分辨率多层螺旋CT 在重症肺炎诊断中的应用价值。方法 回 顾性分析我院2013年12月-2015年12月期 间接收诊治的83例重症肺炎患者的临床资 料和高分辨率多层螺旋CT影像学资料，综 合分析重症肺炎的高分辨率多层螺旋CT影 像特征及病理特点。结果 本组83例重症 肺炎患者中并发症包括有心肌梗死、肺外 感染、COPD等共92例，此外患者中1-2个 器官受累48例(57.8%)，3个及以上器官受 累35例(42.1%)，器官中又以心脏和肾脏 受累为主。通过CT扫描结果及病理学确诊 本组83例患者中单个及双个肺叶受累有54 例占65.1%，三个及三个以上肺叶受累有 29例，占34.9%。社区获得性肺炎(CAP)有 52例，占62.6%，医院获得性肺炎(HAP)患 者有31例，占37.4%。结论 高分辨率多层 螺旋CT具有多角度、宽方位、高分辨率的 特点，在对重症肺炎患者的临床诊断中， 不仅能够清楚地显示出肺炎感染的部位、 形态及其与邻近组织的关系，还能够清晰 的表现出重症肺炎的影像特异性，再结合 患者的临床表现能快速的确定患者为重症 肺炎，这对重症肺炎的定位、定性诊断具 有十分重要的临床意义，值得进一步推广 和应用。

Objective To investigate the clinical value of high resolution multi-slice spiral CT in the diagnosis of severe pneumonia. Methods Retrospective analysis of CT data of 83 patients with severe pneumonia in our hospital from January 2013 to December 2015, and comprehensive analysis of high-resolution multi-slice spiral CT imaging features and pathological features. Results Among 83 patients, a total of 92 cases of complications including myocardial infarction, pulmonary infections, COPD, 48 cases(57.8%) are 1-2 organs involved, 35 cases(42.1%) are over 3 organs involved, and heart and kidney organs are mainly involved. Through CT scan and pathological diagnosis, among 83 patients, 54 cases accounted for 65.1% in the single and double lobes involved, 29 cases accounted for 34.9% more than three and three lung involved. 52 cases of community-acquired pneumonia (CAP), accounting for 62.6%, and 31 cases of hospital-acquired pneumonia (HAP), accounting for 37.4%. Conclusion High-resolution multi-slice spiral CT with multi-angle, wide-azimuth, high-resolution features, in the clinical diagnosis of patients with severe pneumonia, it is not only able to clearly show the relationship between pneumonia location, shape and the adjacent tissues, also clearly showed images of specific severe pneumonia, combined with clinical manifestations, which can quickly identify patients with severe pneumonia, which has significance clinical value in localization and qualitative of severe pneumonia, worthy of further promotion and application.