High-resolution CT of nontuberculous mycobacterium infection in adult CF patients: diagnostic accuracy.

Autor: McEvoy S, Lavelle L, Kilcoyne A, McCarthy C, Dejong PA, Loeve M, Tiddens HA, McKone E, Gallagher CG, Dodd JD, McEvoy, Sinead, Lavelle, Lisa, Kilcoyne, Aoife, McCarthy, Colin, deJong, Pim A, Loeve, Martine, Tiddens, Harm A W M, McKone, Edward, Gallagher, Charles G, Dodd, Jonathan D
Zdroj: European Radiology; Dec2012, Vol. 22 Issue 12, p2736-2742, 7p
Abstrakt: Objectives: To determine the diagnostic accuracy of high-resolution computed tomography (HRCT) for the detection of nontuberculous mycobacterium infection (NTM) in adult cystic fibrosis (CF) patients.Methods: Twenty-seven CF patients with sputum-culture-proven NTM (NTM+) underwent HRCT. An age, gender and spirometrically matched group of 27 CF patients without NTM (NTM-) was included as controls. Images were randomly and blindly analysed by two readers in consensus and scored using a modified Bhalla scoring system.Results: Significant differences were seen between NTM (+) and NTM (-) patients in the severity of the bronchiectasis subscore [45 % (1.8/4) vs. 35 % (1.4/4), P = 0.029], collapse/consolidation subscore [33 % (1.3/3 vs. 15 % (0.6/3)], tree-in-bud/centrilobular nodules subscore [43 % (1.7/3) vs. 25 % (1.0/3), P = 0.002] and the total CT score [56 % (18.4/33) vs. 46 % (15.2/33), P = 0.002]. Binary logistic regression revealed BMI, peribronchial thickening, collapse/consolidation and tree-in-bud/centrilobular nodules to be predictors of NTM status (R(2 )= 0.43). Receiver-operator curve analysis of the regression model showed an area under the curve of 0.89, P < 0.0001.Conclusion: In adults with CF, seven or more bronchopulmonary segments showing tree-in-bud/centrilobular nodules on HRCT is highly suggestive of NTM colonisation.Key Points: Lung function declines rapidly in cystic fibrosis patients with nontuberculous mycobacterium infection. High-resolution computed tomography can help identify nontuberculous mycobacterium in CF patients. Extensive collapse/consolidation and tree-in-bud/centrilobular nodules are predictive of NTM infection. Multiple bronchopulmonary segments showing tree-in-bud/centrilobular nodules strongly suggest nontuberculous mycobacterium infection. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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