High-resolution CT of nontuberculous mycobacterium infection in adult CF patients: diagnostic accuracy
High-resolution CT of nontuberculous mycobacterium infection in adult CF patients: diagnostic accuracy
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成人 CF 患者非结核分枝杆菌感染的高分辨率 CT：诊断准确性
DOI：
10.1007/s00330-012-2558-3
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发表时间：
2012
影响因子：
5.9
通讯作者：
J. Dodd
中科院分区：
文献类型：
--
作者：
S. McEvoy;L. Lavelle;A. Kilcoyne;C. McCarthy;P. deJong;M. Loeve;H. Tiddens;E. McKone;C. Gallagher;J. Dodd
摘要 目的确定高分辨率计算机断层扫描（HRCT）对成人囊性纤维化（CF）患者非结核分枝杆菌感染（NTM）的诊断准确性。方法对27例痰培养证实NTM（NTM+）的CF患者进行HRCT。年龄、性别和肺量计匹配的 27 名无 NTM (NTM-) 的 CF 患者被纳入对照组。图像由两名读者一致随机盲法分析，并使用改良的 Bhalla 评分系统进行评分。 结果 NTM (+) 和 NTM (-) 患者之间支气管扩张子评分的严重程度存在显着差异 [45 % (1.8/4) vs. 35 % (1.4/4)，P = 0.029]，塌陷/巩固子评分 [33 % （1.3/3 vs. 15% (0.6/3)]，树芽/小叶中心结节子评分 [43% (1.7/3) vs. 25% (1.0/3)，P = 0.002] 和总 CT 评分 [56% (18.4/33) vs. 46% (15.2/33)，二元 Logistic 回归显示 BMI、支气管周围增厚、塌陷/实变和树芽/小叶中央结节是 NTM 状态的预测因子（R2= 0.43）回归模型的接受者-操作曲线分析显示曲线下面积为 0.89，P< 0.0001。结论在成人中。患有 CF 的患者，HRCT 上显示七个或更多支气管肺段显示树芽/小叶中心结节，高度提示 NTM 定植。要点• 非结核分枝杆菌感染的囊性纤维化患者肺功能迅速下降
• 高分辨率计算机断层扫描有助于识别 CF 患者中的非结核分枝杆菌
• 广泛的塌陷/实变和树芽/小叶中心结节是 NTM 感染的预测因素
• 多个支气管肺段显示树芽/小叶中心结节，强烈提示非结核分枝杆菌感染
AbstractObjectivesTo determine the diagnostic accuracy of high-resolution computed tomography (HRCT) for the detection of nontuberculous mycobacterium infection (NTM) in adult cystic fibrosis (CF) patients.MethodsTwenty-seven CF patients with sputum-culture-proven NTM (NTM+) underwent HRCT. An age, gender and spirometrically matched group of 27 CF patients without NTM (NTM-) was included as controls. Images were randomly and blindly analysed by two readers in consensus and scored using a modified Bhalla scoring system.ResultsSignificant differences were seen between NTM (+) and NTM (-) patients in the severity of the bronchiectasis subscore [45 % (1.8/4) vs. 35 % (1.4/4), P = 0.029], collapse/consolidation subscore [33 % (1.3/3 vs. 15 % (0.6/3)], tree-in-bud/centrilobular nodules subscore [43 % (1.7/3) vs. 25 % (1.0/3), P = 0.002] and the total CT score [56 % (18.4/33) vs. 46 % (15.2/33), P = 0.002]. Binary logistic regression revealed BMI, peribronchial thickening, collapse/consolidation and tree-in-bud/centrilobular nodules to be predictors of NTM status (R2 = 0.43). Receiver-operator curve analysis of the regression model showed an area under the curve of 0.89, P < 0.0001.ConclusionIn adults with CF, seven or more bronchopulmonary segments showing tree-in-bud/centrilobular nodules on HRCT is highly suggestive of NTM colonisation.Key Points• Lung function declines rapidly in cystic fibrosis patients with nontuberculous mycobacterium infection
• High-resolution computed tomography can help identify nontuberculous mycobacterium in CF patients
• Extensive collapse/consolidation and tree-in-bud/centrilobular nodules are predictive of NTM infection
• Multiple bronchopulmonary segments showing tree-in-bud/centrilobular nodules strongly suggest nontuberculous mycobacterium infection
DOI：
10.1164/rccm.200207-678oc
发表时间：
2003-03-15
影响因子：
24.7
作者：
Olivier, KN;Weber, DJ;Knowles, MR
通讯作者：
Knowles, MR