Comparison of CT Findings of Non-Tuberculous Mycobacterial Pulmonary Infection: Disease Stable versus Progressed Group

Go Eun Yang; Heon Han; Ji Young Hong; Taek Geun Ohk

doi:10.3348/jksr.2018.79.2.57

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Yang, Han, Hong, and Ohk: Comparison of CT Findings of Non-Tuberculous Mycobacterial Pulmonary Infection: Disease Stable versus Progressed Group

Original Article

J Korean Soc Radiol 2018;79(2):57-62.

Published online: 19 January 2018

DOI: https://doi.org/10.3348/jksr.2018.79.2.57

Comparison of CT Findings of Non-Tuberculous Mycobacterial Pulmonary Infection: Disease Stable versus Progressed Group

Go Eun Yang, MD¹, Heon Han, MD^1,, Ji Young Hong, MD², Taek Geun Ohk, MD³

¹Department of Radiology, Kangwon National University Hospital, Chuncheon, Korea

³Department of Emergency Medicine, Kangwon National University Hospital, Chuncheon, Korea

²Department of Medicine, Hallym University Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea

^∗Corresponding author: Heon Han, MD Department of Radiology, Kangwon National University Hospital, 156 Baengnyeong-ro, Chuncheon 24289, Korea. Tel. 82-33-258-2329 Fax. 82-33-258-2221 E-mail: hanheon@kangwon.ac.kr

Received 7 August 2017 Revised 1 November 2017 Accepted 7 November 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose:

To compare initial CT findings of non-tuberculous mycobacteria (NTM) pulmonary infection between stable and progressed groups and determine whether they could be used to predict disease prognosis and treatment response.

Materials and Methods:

From July 2006 to October 2013, 71 patients with NTM infection were retrospectively reviewed. Lung lesion pattern of CT finding, specific species, disease duration, and follow-up period were analyzed. These patients were classified into NTM stable (n = 46) and progressed (n = 25) groups.

Results:

The most common CT findings of NTM infection were small nodules (n = 71, 100%) and bronchiectasis (n = 67, 94%). Large consolidation (> 2 cm, n = 34, 48%) and involvement of more than four lobes (n = 49, 69%) were also commonly observed. According to disease prognosis, large consolidation (n = 18, 72%, p = 0.003), cavitary lesion (n = 17, p = 0.002), and involvement of four or more lobes (n = 21, p = 0.044) on CT were significantly more frequent in disease progressed group than that in the stable group.

Conclusion:

Among common CT findings of NTM disease, some CT findings such as large consolidation, cavitary lesion, and disease extent are good predictors of response to treatment in NTM pulmonary disease.

Keywords: Lung, Nontuberculous Mycobacteria, Computed Tomography, X-ray

REFERENCES

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Fig. 1.

A 76-year-old man with non-tuberculous mycobacteria disease, classified as progressed group. A, B. Axial CT scan shows cavitary lesion (arrow) in left upper lobe (A), and bronchiectasis with peribronchial nodules in both upper lobes (A, B). C, D. Axial CT scan with lung setting image (C) and mediastinal setting image (D) show large consolidation (arrowheads) in left lower lobe.

Fig. 2

A 68-year-old man with non-tuberculous mycobacteria disease, classified as stable group. A. Normal both upper lobes. B. Mild bronchiectasis in right middle lobe (arrow) and small peribronchial nodules in right middle lobe and left lingular division. C. Small peribronchial nodules in right middle lobe and right lower lobe. D. Mild bronchiectasis in left lingular division (arrow) and peribronchial nodules in both basal lung.

Table 1.

General Charateristics of Contral Group and NTM Patients with Stable and Progressed Group

	NTM Patients (n = 71)	Stable (n = 46)	Progressed (n = 25)	p-Value
Age (years)∗	68 (58–77)	68 (58–79)	68 (58–76)
Females, n (%)	42 (59.2)	27 (58.7)	15 (60)	0.826
Species, n (%)
M. avium/M. intracellulare	49 (69.0)	34 (73.9)	15 (60.0)
MAC + M. abscessus	5 (7.0)	2 (4.3)	3 (12.0)
M. abscessus	11 (15.5)	5 (10.9)	6 (24.0)
M. kansasii	2 (2.8)	2 (4.3)	0 (0)
M. fortuitum	2 (2.8)	2 (4.3)	0 (0)
Unknown	2 (2.8)	1 (2.2)	1 (4.0)
Disease duration (month)∗	36 (24–48)	30 (24–48)	36 (24–48)
Follow-up period (month)∗	24 (16–38)	24 (16–38.3)	25 (16–34.5)
Tuberculosis history (%)	36 (50.1)	18 (39.1)	18 (72.0)	0.008
Treatment history (%)	40 (56.3)	27 (58.7)	13 (52.0)	0.587
ESR (mm/hr)	50 ± 26.67	49.69 ± 26.88	50.44 ± 27.99	0.950
CRP (mg/dL)	60.69 ± 65.83	67.98 ± 70.50	50.48 ± 60.81	0.533

Percentages are in parentheses.

∗median.

CRP = C-reactive protein, ESR = erythrocyte sedimentation rate, M. = mycobacterium, NTM = non-tuberculous mycobacteria

Table 2.

Common CT Findings of NTM Patients

	Stable (n = 46, %)	Progressed (n = 25, %)	p-Value
Large consolidation	16 (34.8)	18 (72.0)	0.003
Cavitary lesion	14 (30.4)	17 (68.0)	0.002
Bronchiectasis	42 (91.3)	25 (100.0)	0.290
Disease extension more than 4 lobes	28 (60.9)	21 (84.0)	0.044

NTM = non-tuberculous mycobacteria

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