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High-Resolution CT Findings of Mycobacterium avium-intracellulare Complex Pulmonary Disease: Correlation with Pulmonary Function Test Results

¹ Department of Radiology and Center for Imaging Science, Sungkyunkwan University School of Medicine, Samsung Medical Center, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
² Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

OBJECTIVE. The purpose of our study was to analyze the high-resolution CT findings of the nodular bronchiectatic form of Mycobacterium avium-intracellulare complex (MAC) pulmonary disease and to correlate the extent of high-resolution CT findings with pulmonary function test (PFT) results.

MATERIALS AND METHODS. From January 2005 through December 2005, we identified 47 patients (mean age, 58 ± 13 years; age range, 24–72 years; male–female ratio, 11:36) with the nodular bronchiectatic form of MAC pulmonary disease who underwent both high-resolution CT and PFTs. High-resolution CT findings were reviewed retrospectively in terms of the presence and extent of bronchiectasis, cellular or inflammatory bronchiolitis (centrilobular small nodules and tree-in-bud signs), cavity, nodule, and other findings. The extent of the abnormalities seen on high-resolution CT was scored by modifying the cystic fibrosis scoring system proposed by Helbich and coworkers. The scores were correlated with PFT results using Spearman's correlation coefficient.

RESULTS. On high-resolution CT, the three most frequently observed patterns of parenchymal abnormalities were, in decreasing order of frequency, cellular bronchiolitis (n = 47, 100%), bronchiectasis (n = 46, 98%), and consolidation (n = 27, 57%). The total CT score showed a significant correlation with the residual volume–total lung capacity (RV/TLC) ratio (r = 0.572, p < 0.001), forced expiratory volume in 1 second (FEV₁) value (r = –0.426, p = 0.003), forced vital capacity (FVC) value (r = –0.360, p = 0.013), peak expiratory flow value (r = –0.352, p = 0.015), and peak expiratory flow between 25% and 75% of the forced vital capacity (FEF_25–75%) (r = –0.289, p = 0.049).

CONCLUSION. CT scoring of pulmonary abnormalities correlates with measures of functional impairment in patients with MAC pulmonary disease.

Keywords: bronchiectasis • bronchiolitis • CT • high-resolution CT • lung infections • Mycobacterium avium-intracellulare complex • pulmonary function tests

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