High Resolution CT Findings of Nontuberculous Mycobacterial Pulmonary Disease: Comparison between the First Treatment and the Re-Treatment Group

Abstract

Copyrights © 2012 The Korean Society of Radiology Purpose: To analyze and compare the thin section CT findings of first and re-treatment nontuberculous mycobacterial (NTM) pulmonary disease. Materials and Methods: Between January 2005 and April 2010, 121 patients with positive sputum culture for NTM were recruited. We included only 32 patients underwent high resolution chest CT and were confirmed by American Thoracic Society criteria NTM pulmonary infection (first treatment 15, re-treatment 17 patients). CT images of 32 patients were reviewed retrospectively. We evaluated the frequency and laterality of the followings; nodule, increased density, bronchial change, parenchymal change. Results: The significantly frequent CT findings of the re-treatment NTM group were well defined nodules (retreatment-82.4%, first treatment-33.3%, p = 0.00), consolidations (retreatment-88.2%, first treatment-53.3%, p = 0.03), bronchial changes (bronchiectasis; retreatment-100%, first treatment-66.6%, p = 0.01, bronchial narrowing; retreatment-23.5%, first treatment-0%, p = 0.04 and mucoid impaction; retreatment-58.8%, first treatment-20.0%, p = 0.03) and atelectasis with bronchiectasis (retreatment-88.2%, first treatment-26.7%, p = 0.00). However, most of the evaluated thin-section CT findings, such as centrilobular and ill-defined nodules, lobular, segmental and subpleural consolidations, ground glass attenuation, bronchial wall thickening, cavities, pleural lesions, fibrotic band, emphysema and laterality of lesions, have not shown significant differences between first treatment and the re-treatment group. Conclusion: Thin section CT findings of well defined nodules, consolidations, bronchial changes (bronchiectasis, bronchial narrowing and mucoid impaction) and atelectasis with bronchiectasis are highly suggestive of re-treatment NTM pulmonary disease. Index terms Lung Nontuberculous Mycobacteria Multidetector Computed Tomography High Resolution CT Findings of Nontuberculous Mycobacterial Pulmonary Disease: Comparison between the First Treatment and the Re-Treatment Group 비결핵 항산균 폐질환의 고해상도 전산화단층촬영 소견: 초치료군과 재치료군의 비교