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Purpose: To evaluate chest computed tomography(CT)findings in patients with systemic lupus erythematosus(SLE),delineate the characteristic CT features in various subsets of SLE,and investigate the prognostic factors.Materials and methods: Retrospectively identified 89 SLE patients who underwent chest CT from 2010 through 2012(median follow-up period,16 months; range,2–30 months)were included in this study.ChestCTfindings were qualitatively and semiquantitatively analyzed at the initial and follow-up CT scans,and correlation with anti-Sm antibodies,anti-double-stranded DNA antibodies,and antiphospholipid antibodies.Overall changes in disease extent at the follow-up CT findings were classified as improved(i.e.,≥ 10%decrease in extent),Stable,or progressed(i.e.,≥ 10%increase in extent),we evaluated the change of the chest CT findings with logistic regression in 89 SLE patients to determine the prognostic factors.Results: Chest CT abnormalities were identified in 77(87%)patients,the most frequent CT findings at the initial CT scans was axillary lymphadenopathy(60%),followed by interlobular septal thickening(45%),ground-glass opacities(39%),subpleural curvilinear line(35%),reticulation(35%).No correlation was found between the presence of anti-Sm antibodies and the initial chest CT findings.It showed a significant association between axillary,lymphadenopathy and the presence of anti-doublestranded DNA antibodies,independent and significant associations between ground-glass opacities or ill-defined centrilobular nodules and the presence of antiphospholipid antibodies were observed.The presence of anti-double-stranded DNA antibodies and the extent of axillary lymphadenopathy were significant association with the progression of chest CT abnormalities at the follow-up CT findings.Conclusion:The presence of anti-double-stranded DNA antibodies and the extent of axillary lymphadenopathy were significant association with the progression of chest CT abnormalities,anti-double-stranded DNA antibodies seropositive and axillary lymphadenopathy might be poor prognostic factors in SLE patients with pulmonary involvement.