Lung Imaging Evaluation in Chronic Graft-Versus-Host Disease After Allogeneic Hematopoietic Stem Cell Transplantation / 中国医学影像学杂志

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 cGVHD 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.