Kasahara T, Nakajima Y, Niimi H, Kurihara Y, Arakawa H, Ishikawa T, Nakamura T, Kumagai M, Miyairi A
Department of Radiology, St. Marianna University School of Medicine, Kanagawa-ken.
Nihon Kokyuki Gakkai Zasshi. 1998 Feb;36(2):122-7.
Computed tomographic (CT) findings of 70 patients with Mycobacterium avium complex (MAC) disease were analyzed by two chest radiologists and compared with those of 37 patients with Mycobacterium tuberculosis infection. Common CT findings in patients with MAC, included bronchiectasis (97%), small nodules (89%), parenchymal distortion (60%), bronchial wall thickening (56%), consolidation (50%) and cavity formation (49%) and small nodules (86%), bronchiectasis (70%), consolidation (57%) and bronchial wall thickening (51%) in patients with Mycobacterium tuberculosis. Bronchiectasis and parenchymal distortion were significant in patients with MAC compared with Mycobacterium tuberculosis patients. Bronchiectasis involving the RUL, RML, lingula and LLL and small nodules involving the RML were often seen in patients with MAC. Both bronchiectasis and small nodules were commonly observed in multiple lobes in both types of patients. Cavities in MAC infection tended to be thin and smooth walled, and less commonly associated with consolidation. We conclude that CT findings of MAC infection were characterized by widely distributed bronchiectasis and small nodules and/or cavities with thin, smooth walls. These CT findings are one of the keys in differentiating MAC from Mycobacterium tuberculosis.
两名胸部放射科医生分析了70例鸟分枝杆菌复合群（MAC）病患者的计算机断层扫描（CT）结果，并与37例结核分枝杆菌感染患者的结果进行了比较。MAC病患者常见的CT表现包括支气管扩张（97%）、小结节（89%）、实质扭曲（60%）、支气管壁增厚（56%）、实变（50%）和空洞形成（49%）；结核分枝杆菌感染患者的常见表现为小结节（86%）、支气管扩张（70%）、实变（57%）和支气管壁增厚（51%）。与结核分枝杆菌感染患者相比，MAC病患者的支气管扩张和实质扭曲更为显著。MAC病患者常可见右肺上叶（RUL）、右肺中叶（RML）、舌叶和左肺下叶（LLL）的支气管扩张以及右肺中叶的小结节。两种类型的患者中，支气管扩张和小结节均常见于多个肺叶。MAC感染的空洞往往壁薄且光滑，较少与实变相关。我们得出结论，MAC感染的CT表现特征为广泛分布的支气管扩张、小结节和/或薄壁光滑的空洞。这些CT表现是鉴别MAC与结核分枝杆菌的关键之一。
