Chu Haiqing, Li Bing, Zhao Lan, Huang Dongdong, Xu Jinfu, Zhang Jingbo, Gui Tao, Xu Liyun, Luo Liulin, Zhang Zhemin, Sun Xiwen
Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine Shanghai 200433, China.
Department of Medicine, Tongji University School of Medicine Shanghai 200092, China.
Int J Clin Exp Med. 2015 Oct 15;8(10):18705-12. eCollection 2015.
Changes of chest CT images in Mycobacterium and non-Mycobacterium abscesses in patients with lung disease were with a view to making an early diagnosis.
124 primary patients diagnosed with non-tuberculosis Mycobacterium infections with a positive sputum acid-fast smear were enrolled in this retrospective study. CT images and clinical data of these patients were analyzed.
The 52 Mycobacterium abscess lung disease cases included bronchiectasis 82.7% (43/52), which was more easily detected bilaterally than unilaterally (29/52 vs. 14/52), lung consolidation 44.2% (23/52), nodules 44.2% (22/52), cavities 32.7% (17/52), tree-in-bud pattern 42.3% (22/52) and patchy shadow 63.5% (33/52) in CT images. Tree-in-bud pattern was more common in Mycobacterium abscess compared with non-Mycobacterium abscess lung disease (42.3% vs. 18.1%, P = 0.004). A significant difference of the lung area involved by tree-in-bud in CT was found between non-Mycobacteria abscess and Mycobacterium abscess lung disease (17.0% vs. 7.2%, P < 0.001), and tree-in-bud occurred more readily unilaterally (21.2% vs. 6.9%, P = 0.029), and in the inferior lobe of the right lung (3.2% vs. 0.2%, P = 0.029) in Mycobacterium abscess lung disease. Patchy shadow was more common in non-Mycobacterium abscess lung disease (63.5% vs. 80.1%, P = 0.041). Further multi-factor analysis confirmed that tree-in-bud was an independent predictor of Mycobacterium abscess lung disease.
Different CT results existed between non-Mycobacterium abscess and Mycobacterium abscess lung diseases. The tree-in-bud pattern might be helpful to choose a suitable therapy in patients, with an acid-fast bacilli smear-positive diagnosis of lung disease.
观察肺部疾病患者中分枝杆菌和非分枝杆菌肺脓肿胸部CT图像的变化，以便早期诊断。
本回顾性研究纳入124例痰涂片抗酸染色阳性的原发性非结核分枝杆菌感染患者。分析这些患者的CT图像和临床资料。
52例分枝杆菌肺脓肿患者中，CT图像表现为支气管扩张82.7%（43/52），双侧比单侧更易出现（29/52比14/52），肺实变44.2%（23/52），结节44.2%（22/52），空洞32.7%（17/52），树芽征42.3%（22/52），斑片状阴影63.5%（33/52）。与非分枝杆菌肺脓肿相比，分枝杆菌肺脓肿中树芽征更常见（42.3%比18.1%，P = 0.004）。非分枝杆菌肺脓肿和分枝杆菌肺脓肿在CT上树芽征累及的肺面积存在显著差异（17.0%比7.2%，P < 0.001），且树芽征在分枝杆菌肺脓肿中更易单侧出现（21.2%比6.9%，P = 0.029），并多见于右肺下叶（3.2%比0.2%，P = 0.029）。斑片状阴影在非分枝杆菌肺脓肿中更常见（63.5%比80.1%，P = 0.041）。进一步多因素分析证实树芽征是分枝杆菌肺脓肿的独立预测因素。
非分枝杆菌肺脓肿和分枝杆菌肺脓肿的CT表现不同。对于痰涂片抗酸杆菌阳性的肺部疾病患者，树芽征可能有助于选择合适的治疗方案。
