【摘要】 目的 分析成人慢性移植物抗宿主病（c GVHD）患者肺部CT异常的影像学表现，并结合临床资料，得到有助于对c GVHD肺部异常诊断及鉴别信息。资料与方法 回顾性收集2018年10月—2020年10月北京大学人民医院行异基因造血干细胞移植术后出现cGVHD临床表现的患者162例，分析其胸部CT征象，包括病变部位、分布、磨玻璃结节、实变、网格影、结节影、支气管扩张、胸腔积液、气体潴留、气胸或纵隔积气，并比较c GVHD肺部异常与肺部感染的影像差异。结果 50例真菌感染中43例单发结节影，7例病毒感染中4例弥漫分布磨玻璃结节、2例弥漫分布网格影，5例细菌感染中1例局限实变影；36例非感染性肺部并发症均为闭塞性细支气管炎，CT征象气体潴留32例、支气管扩张22例、支气管壁增厚27例。结论 cGVHD患者绝大多数有肺部异常征像，以感染为主要病因，肺部CT表现为结节、磨玻璃结节、实变及网格影。部分患者具有闭塞性细支气管炎的影像表现，影像结合临床有助于肺部并发症的诊断与鉴别。更多还原

【Abstract】 Purpose To analyze the abnormal CT imaging features of the lungs of adult patients with chronic graft-versus-host disease(cGVHD) and to improve the ability of diagnosis and differentiation of abnormal cGVHD lungs via combining with clinical data. Materials and Methods A retrospective study of 162 patients with clinical manifestations of c GVHD after allogeneic hematopoietic stem cell transplantation in Peking University People’s Hospital from October 2018 to October 2020 was conducted. The chest CT images(including lesion location, distribution, ground glass density, consolidation, mesh image, nodule image, bronchiectasis, pleural effusion, gas retention, pneumothorax or mediastinal air) were summarized and the differences of imaging features between pulmonary cGVHD and pulmonary infection were compared.Results Of the 50 fungal infections, 43 had single nodules; of the 7 viral infections, 4 had diffuse ground glass nodules; 2 had diffuse grid shadows, and of the 5 bacterial infections, 1 had limited solid shadows. The 36 cases of non-infectious pulmonary complications were all oblusive bronchiolitis, and the CT signs showed gas retention in 32 cases, bronchiectasis in 22 cases, and thickening of the bronchial wall in 27 cases.Conclusion The vast majority of cGVHD patients have abnormal lung imaging, with the main cause of infection. Some patients have imaging manifestations of obliterated bronchiolitis, and imaging combined with clinical practice may be helpful for the diagnosis and differentiation of lung complications.更多还原