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感染或定植缓慢生长非结核分枝杆菌患者的放射影像学特征差异。

Differential radiological features of patients infected or colonised with slow-growing non-tuberculous mycobacteria.

机构信息

Department of Radiology, Goethe University, University Hospital Frankfurt, Frankfurt am Main, Germany.

Department of Internal Medicine, Infectious Diseases, Goethe University, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany.

出版信息

Sci Rep. 2024 Jun 10;14(1):13295. doi: 10.1038/s41598-024-64029-0.

Abstract

Non-tuberculous mycobacterial pulmonary disease (NTM-PD) is considered a growing health concern. The majority of NTM-PD cases in Europe are caused by slow-growing mycobacteria (SGM). However, distinct radiological features of different SGM remain largely uninvestigated. We applied a previously described radiological score to a patient cohort consisting of individuals with isolation of different SGM. Correlations between clinical data, species and computed tomography (CT) features were examined by logistic and linear regression analyses, as well as over the course of time. Overall, 135 pulmonary CT scans from 84 patients were included. The isolated NTM-species were mainly Mycobacterium avium complex (MAC, n = 49), as well as 35 patients with non-MAC-species. Patients with isolation of M. intracellulare had more extensive CT findings compared to all other SGM species (coefficient 3.53, 95% Cl - 0.37 to 7.52, p = 0.075) while patients meeting the ATS criteria and not undergoing therapy exhibited an increase in CT scores over time. This study provides insights into differential radiological features of slow-growing NTM. While M. intracellulare exhibited a tendency towards higher overall CT scores, the radiological features were similar across different SGM. The applied CT score might be a useful instrument for monitoring patients and could help to guide antimycobacterial therapy.

摘要

非结核分枝杆菌肺病(NTM-PD)被认为是一个日益严重的健康问题。欧洲大多数 NTM-PD 病例是由缓慢生长的分枝杆菌(SGM)引起的。然而,不同 SGM 的不同放射学特征在很大程度上仍未得到研究。我们将先前描述的放射评分应用于由不同 SGM 分离的患者队列中。通过逻辑回归和线性回归分析以及随时间的推移,检查了临床数据、物种和计算机断层扫描(CT)特征之间的相关性。总体而言,纳入了 84 名患者的 135 例肺部 CT 扫描。分离的 NTM 物种主要是鸟分枝杆菌复合群(MAC,n=49),以及 35 名非 MAC 物种患者。与所有其他 SGM 物种相比,分离出 M. intracellulare 的患者的 CT 发现更广泛(系数 3.53,95%置信区间 -0.37 至 7.52,p=0.075),而符合 ATS 标准且未接受治疗的患者的 CT 评分随时间增加。本研究提供了关于缓慢生长的 NTM 的不同放射学特征的见解。虽然 M. intracellulare 表现出更高的总体 CT 评分趋势,但不同 SGM 的放射学特征相似。应用的 CT 评分可能是监测患者的有用工具,并有助于指导抗分枝杆菌治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51a5/11164953/d20fa56d7beb/41598_2024_64029_Fig1_HTML.jpg

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