Objectives Thin-section chest CT manifestations and blood oxygen indexes were quantitatively analyzed to predict the prognosis in patients infected wth cytomegalovirus(CMV)pneumonia patients after renal transplant and complicated with acute respiratory distress syndrome. Methods Thirty-four patients with ARDS and their thin-section chest CT images were included in this study.Thin-section CT images were quantitatively analyzed and the total volume percentages of the four patterns including hyperinflation,normal,GGO and consolidation were calculated. Differences in CT calculations in patients with different mechanical ventilation time(≥8 days versus<8 days),different ventilator free time(≥15 days versus<15 days),different prognosis(survivors versus nonsurvivors),and for different right heart function(RA/LA≥1.474 versus<1.474)were statistically analyzed using Wilcoxon rank-sum test. Results The differences in normal%(P=0.0002),GGO%(P=0.0447),consolidation%(P=0.0001),ventilation days(P=0.0189)and ventilator free days(P=0.0549)were statistically significant between the survival group and nonsurvival group.The differences in RA/LA(P=0.1018)and hyperinflated%(P=0.1862)did not show a statistical significance. Conclusion This study demonstrated that the longer of the ventilation time,the poorer of the prognosis.Mechanical ventilation could affect the prognosis of the patients due to lung tissue consolidation and hyperinflation and could affect the function of the right heart.At the same time,the ventilation free time would be longer if long ventilation time was applied before.