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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.

View larger version (101K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —Representative figures show how extent of bronchiectasis was estimated on high-resolution CT scans in patients with Mycobacterium avium-intracellulare complex pulmonary disease. Bronchiectasis, scored as 1 in terms of severity, in superior segment of right lower lobe of 72-year-old man. Also note tree-in-bud sign (arrows).

View larger version (111K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —Representative figures show how extent of bronchiectasis was estimated on high-resolution CT scans in patients with Mycobacterium avium-intracellulare complex pulmonary disease. Bronchiectasis, scored as 3 in terms of severity and as 2 in terms of bronchial wall thickening (arrows), in anteromedial and posterior basal segments of left lower lobe of 63-year-old woman.

View larger version (101K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —Representative figures show how extent of bronchiolitis was estimated on high-resolution CT scans in patients with Mycobacterium avium-intracellulare complex pulmonary disease. Bronchiolitis in 48-year-old woman. This case was scored as 1 (mild) in terms of severity, with identifiable centrilobular small nodules and tree-in-bud sign within 2 cm from pleura, in lateral basal segment of left lower lobe.

View larger version (122K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —Representative figures show how extent of bronchiolitis was estimated on high-resolution CT scans in patients with Mycobacterium avium-intracellulare complex pulmonary disease. Bronchiolitis in 56-year-old woman. This case was scored as 2 (moderate) in terms of severity, with centrilobular small nodules and tree-in-bud signs extending more than 2 cm from pleura, in superior segment of right lower lobe. Bronchiolitis in right middle lobe was scored as 1 (mild).

View larger version (101K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —Representative figures show how extent of bronchiolitis was estimated on high-resolution CT scans in patients with Mycobacterium avium-intracellulare complex pulmonary disease. Bronchiolitis in 24-year-old woman. This case was scored as 3 (severe) in terms of severity, with centrilobular small nodules and tree-in-bud sign extending to central lung, in right lower lobe.

View larger version (98K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —Mycobacterium avium-intracellulare complex pulmonary disease in 64-year-old woman. High-resolution CT scans obtained at levels of bronchus intermedius (A) and right middle lobar bronchus (B) show bronchiolitis of tree-in-bud signs mainly in right middle lobe and lingular division of left upper lobe and also in both lower lobes. Bronchiectasis is associated in lingular division. Total CT score was 18 with scores of bronchiectasis, bronchiolitis, consolidation, cavity, nodules, and lobar volume loss of 6, 6, 2, 2, 1, and 1, respectively. Pulmonary function test results were as follows: forced vital capacity (FVC), 111%; forced expiratory volume in 1 second (FEV1), 104%; FEV1/FVC, 67%; peak expiratory flow between 25% and 75% of the forced vital capacity (FEF25–75%), 48%; total lung capacity (TLC), 111%; and residual volume (RV)/TLC, 41% of predicted value.

View larger version (102K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —Mycobacterium avium-intracellulare complex pulmonary disease in 64-year-old woman. High-resolution CT scans obtained at levels of bronchus intermedius (A) and right middle lobar bronchus (B) show bronchiolitis of tree-in-bud signs mainly in right middle lobe and lingular division of left upper lobe and also in both lower lobes. Bronchiectasis is associated in lingular division. Total CT score was 18 with scores of bronchiectasis, bronchiolitis, consolidation, cavity, nodules, and lobar volume loss of 6, 6, 2, 2, 1, and 1, respectively. Pulmonary function test results were as follows: forced vital capacity (FVC), 111%; forced expiratory volume in 1 second (FEV1), 104%; FEV1/FVC, 67%; peak expiratory flow between 25% and 75% of the forced vital capacity (FEF25–75%), 48%; total lung capacity (TLC), 111%; and residual volume (RV)/TLC, 41% of predicted value.

View larger version (108K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —Mycobacterium avium-intracellulare complex pulmonary disease in 69-year-old woman. High-resolution CT scans obtained at levels of right middle lobar bronchus (A) and inferior pulmonary vein (B) show extensive bronchiectasis, large areas of mosaic perfusion (arrows), and several small centrilobular nodules and cavitating nodules (arrowheads) in both lungs. Total CT score was 23 with scores of bronchiectasis, bronchiolitis, cavity, nodules, volume loss, emphysema, and bullae 6, 7, 4, 1, 1, 2, and 2, respectively. Pulmonary function test results were as follows: forced vital capacity (FVC), 61%; forced expiratory volume in 1 second (FEV1), 70%; FEV1/FVC, 81%; peak expiratory flow between 25% and 75% of the forced vital capacity (FEF25–75%), 56%; total lung capacity (TLC), 91%; and residual volume (RV)/TLC, 60% of predicted value.

View larger version (101K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —Mycobacterium avium-intracellulare complex pulmonary disease in 69-year-old woman. High-resolution CT scans obtained at levels of right middle lobar bronchus (A) and inferior pulmonary vein (B) show extensive bronchiectasis, large areas of mosaic perfusion (arrows), and several small centrilobular nodules and cavitating nodules (arrowheads) in both lungs. Total CT score was 23 with scores of bronchiectasis, bronchiolitis, cavity, nodules, volume loss, emphysema, and bullae 6, 7, 4, 1, 1, 2, and 2, respectively. Pulmonary function test results were as follows: forced vital capacity (FVC), 61%; forced expiratory volume in 1 second (FEV1), 70%; FEV1/FVC, 81%; peak expiratory flow between 25% and 75% of the forced vital capacity (FEF25–75%), 56%; total lung capacity (TLC), 91%; and residual volume (RV)/TLC, 60% of predicted value.

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