Byrne Danielle, Nador Roland G, English John C, Yee John, Levy Robert, Bergeron Celine, Swiston John R, Mets Onno M, Muller Nestor L, Bilawich Ana-Maria
Department of Radiology, Division of Cardiothoracic Radiology (D.B., O.M.M., N.L.M., A.M.B.), Department of Medicine, Division of Respirology (R.G.N., R.D.L., C.B., J.R.S.), Department of Pathology (J.C.E.), and Department of Thoracic Surgery (J.Y.), Vancouver General Hospital, University of British Columbia, 899 W 12th Ave, Vancouver, BC, Canada V5Z 1L5; and British Columbia Lung Transplant Program, Vancouver, Canada (R.G.N., J.Y., R.D.L., C.B., J.R.S.).
Radiol Cardiothorac Imaging. 2021 Feb 11;3(1):e200314. doi: 10.1148/ryct.2021200314. eCollection 2021 Feb.
Chronic lung allograft dysfunction (CLAD) is the most common cause of mortality in lung transplant recipients after the 1st year of transplantation. CLAD has traditionally been classified into two distinct obstructive and restrictive forms: bronchiolitis obliterans syndrome and restrictive allograft syndrome. However, CLAD may manifest with a spectrum of imaging and pathologic findings and a combination of obstructive and restrictive physiologic abnormalities. Although the initial CT manifestations of CLAD may be nonspecific, the progression of findings at follow-up should signal the possibility of CLAD and may be present on imaging studies prior to the development of functional abnormalities of the lung allograft. This review encompasses the evolution of CT findings in CLAD, with emphasis on the underlying pathogenesis and pathologic condition, to enhance understanding of imaging findings. The purpose of this article is to familiarize the radiologist with the initial and follow-up CT findings of the obstructive, restrictive, and mixed forms of CLAD, for which early diagnosis and treatment may result in improved survival. © RSNA, 2021.
慢性肺移植功能障碍（CLAD）是肺移植受者移植后第1年最常见的死亡原因。传统上，CLAD分为两种不同的阻塞性和限制性形式：闭塞性细支气管炎综合征和限制性移植综合征。然而，CLAD可能表现出一系列影像学和病理学表现，以及阻塞性和限制性生理异常的组合。虽然CLAD的初始CT表现可能不具有特异性，但随访时发现的进展应提示CLAD的可能性，并且可能在肺移植功能异常出现之前的影像学研究中就已存在。本综述涵盖了CLAD中CT表现的演变，重点关注潜在的发病机制和病理状况，以增进对影像学表现的理解。本文的目的是使放射科医生熟悉CLAD阻塞性、限制性和混合性形式的初始和随访CT表现，早期诊断和治疗可能会提高生存率。©RSNA，2021。
