High-Resolution CT Findings of Mycobacterium avium-intracellulare Complex Pulmonary Disease: Correlation with Pulmonary Function Test Results

Abstract

The purpose of our study was to analyze the high-resolution CT findings of the nodular bronchiectatic form of Mycobacterium avium-intracellulare complex (MAC) pulmonary disease and to correlate the extent of high-resolution CT findings with pulmonary function test (PFT) results. From January 2005 through December 2005, we identified 47 patients (mean age, 58 +/- 13 years; age range, 24-72 years; male-female ratio, 11:36) with the nodular bronchiectatic form of MAC pulmonary disease who underwent both high-resolution CT and PFTs. High-resolution CT findings were reviewed retrospectively in terms of the presence and extent of bronchiectasis, cellular or inflammatory bronchiolitis (centrilobular small nodules and tree-in-bud signs), cavity, nodule, and other findings. The extent of the abnormalities seen on high-resolution CT was scored by modifying the cystic fibrosis scoring system proposed by Helbich and coworkers. The scores were correlated with PFT results using Spearman's correlation coefficient. On high-resolution CT, the three most frequently observed patterns of parenchymal abnormalities were, in decreasing order of frequency, cellular bronchiolitis (n = 47, 100%), bronchiectasis (n = 46, 98%), and consolidation (n = 27, 57%). The total CT score showed a significant correlation with the residual volume-total lung capacity (RV/TLC) ratio (r = 0.572, p < 0.001), forced expiratory volume in 1 second (FEV(1)) value (r = -0.426, p = 0.003), forced vital capacity (FVC) value (r = -0.360, p = 0.013), peak expiratory flow value (r = -0.352, p = 0.015), and peak expiratory flow between 25% and 75% of the forced vital capacity (FEF(25-75%)) (r = -0.289, p = 0.049). CT scoring of pulmonary abnormalities correlates with measures of functional impairment in patients with MAC pulmonary disease.