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KMID : 0390320130230020001
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Chungbuk Medical Journal
2013 Volume.23 No. 2 p.1 ~ p.10
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Non-treated Nontuberculous Mycobacterial Pulmonary Disease: Analysis of Serial Changes of HRCT Findings
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Kim Eun-Young
Kim Sung-Jin
Lee Kee-Man
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Abstract
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Purpose: This study was to analyze the serial changes of high-resolution CT (HRCT) findings in non-treated
nontuberculous mycobacterial (NTM) pulmonary disease, by comparing the exactly matches images.
Materials and Methods: Between January 2005 and April 2010, 32 patients were confirmed NTM pulmonary infection and underwent HRCT. Among the these, 10 patients was not treated by NTM or tuberculous medicine and underwent following HRCT. The 10 patients were five men and five women. The mean age were 72 years old (men) and 64.4 years old (women). The mean interval period of initial and following chest CT was 8.2 months.
The 20 chest CT images in 10 patients were reviewed retrospectively by the radiologists unaware of patients’ clinical information. Each patient’s lung were divided into six lobes and the changes of lung lesions (nodule, increased density, cavity, bronchial change and parenchymal changes) were evaluated on following HRCT in each lobe. The predominant changes of each finding were classified into the following four categories (progression, no change, improvement, mixed response). The two radiologists evaluated the most common overall changes of HRCT findings in each patient, by consensus.
Results: Most of evaluated following HRCT findings have shown various changes. Ill defined nodules and centrilobular nodules have shown the changes of progression in one half of cases (46.1%, 51.7%). The finding of cavity have shown the change of progression in many cases (85.7%). Some lesions such as bronchiectasis and atelectasis with bronchiectasis have not shown the change in most cases (97.1%, 88.8%). The most common overall changes of HRCT findings in 10 patients with non-treated NTM infection were mixed response (50%) or progression (40%).
Conclusion: The serial changes of each HRCT findings in patients with non-treated NTM infection were variable. The progression of some findings such as ill-defined nodule, centrilobular nodule and cavity were observed in many cases. Bronchiectasis and atelectasis with bronchiectasis did not show serial change in most cases. The most common overall changes of HRCT findings in patients with non-treated NTM infection were mixed response or progression. The change of HRCT findings will be helpful to determine the time of treatment when following the examination.
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KEYWORD
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Mycobacteria, Pulmonary disease, Computed tomography, High-resolution
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