Analysis of chest CT in patients with Mycobacterium avium complex pulmonary disease.
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.
Fujiuchi
Satoru
S
Department of Respiratory Medicine, National Dohoku Hospital, Asahikawa, Japan. fujiuchi@douhoku.hosp.go.jp
Matsumoto
Hiroyuki
H
Yamazaki
Yasuhiro
Y
Nakao
Shoko
S
Takahashi
Masaaki
M
Satoh
Kazue
K
Takeda
Akinori
A
Okamoto
Kiyotaka
K
Fujita
Yuka
Y
Fujikane
Toshiaki
T
Shimizu
Tetsuo
T
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
D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D004977:Ethambutol; D017291:Clarithromycin; D012293:Rifampin; D013307:Streptomycin