title: Analysis of chest CT in patients with Mycobacterium avium complex pulmonary disease.
abstract: BACKGROUND
  The radiographic changes of Mycobacterium avium complex (MAC) pulmonary disease during therapy have not been studied well.
  
  
  OBJECTIVE
  To assess the efficacy of antituberculous drug therapy against MAC pulmonary disease using computed tomography (CT).
  
  
  METHODS
  We analyzed chest CT scans before and after antituberculous therapy in 30 patients (21 women, 9 men) with MAC pulmonary disease. To evaluate radiographic changes during therapy, we defined a 'degree of improvement' (DI) that is calculated according to the CT appearance.
  
  
  RESULTS
  DI was better (1.35 +/- 0.21) in patients who had converted sputum culture than in those who had not (0.44 +/- 0.25) (p < 0.05). In patients who were diagnosed by bronchial washing, DI was better (1.60 +/- 0.22) than in patients who were diagnosed by sputum (0.67 +/- 0.20) (p < 0.01). We categorized the CT appearance into 6 types: small nodules, cavities, bronchial wall thickening, infiltration, pleural thickening and atelectasis. Patients who showed pleural thickening had a significantly worse DI (0.12 +/- 0.40) than those who did not (1.23 +/- 0.18) (p < 0.01). Most of the lesions that disappeared after therapy were small nodules.
  
  
  CONCLUSIONS
  These results indicate that chest CT might be a useful tool for the prediction or assessment of drug therapy for MAC pulmonary disease.
authors.affiliation: Department of Respiratory Medicine, National Dohoku Hospital, Asahikawa, Japan. fujiuchi@douhoku.hosp.go.jp
authors.forename: Satoru
authors.initials: S
authors.lastname: Fujiuchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Matsumoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: Shoko
authors.initials: S
authors.lastname: Nakao
authors.forename: Masaaki
authors.initials: M
authors.lastname: Takahashi
authors.forename: Kazue
authors.initials: K
authors.lastname: Satoh
authors.forename: Akinori
authors.initials: A
authors.lastname: Takeda
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Okamoto
authors.forename: Yuka
authors.initials: Y
authors.lastname: Fujita
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Fujikane
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Shimizu
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000627:therapeutic use; D017291:Clarithromycin / Q000627:therapeutic use; D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D016015:Logistic Models; D008171:Lung Diseases / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D015269:Mycobacterium avium Complex; D015270:Mycobacterium avium-intracellulare Infection / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D011237:Predictive Value of Tests; D012293:Rifampin / Q000627:therapeutic use; D013307:Streptomycin / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D004977:Ethambutol; D017291:Clarithromycin; D012293:Rifampin; D013307:Streptomycin