title: High-resolution CT of nontuberculous mycobacterium infection in adult CF patients: diagnostic accuracy.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  In adults with CF, seven or more bronchopulmonary segments showing tree-in-bud/centrilobular nodules on HRCT is highly suggestive of NTM colonisation.
  
  
  CONCLUSIONS
  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.
authors: Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland.
authors: Sinead
authors: S
authors: McEvoy
authors: Lisa
authors: L
authors: Lavelle
authors: Aoife
authors: A
authors: Kilcoyne
authors: Colin
authors: C
authors: McCarthy
authors: Pim A
authors: PA
authors: deJong
authors: Martine
authors: M
authors: Loeve
authors: Harm A W M
authors: HA
authors: Tiddens
authors: Edward
authors: E
authors: McKone
authors: Charles G
authors: CG
authors: Gallagher
authors: Jonathan D
authors: JD
authors: Dodd
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009165:Mycobacterium Infections, Nontuberculous / Q000000981:diagnostic imaging*; D012372:ROC Curve; D012720:Severity of Illness Index; D013147:Spirometry; D013183:Sputum / Q000382:microbiology; D014057:Tomography, X-Ray Computed / Q000379:methods*