Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Nontuberculous Mycobacterial (NTM) Disease in Immunocompetent Patients: Expanding Image Findings on Chest CT

면역적합성 환자에서 비결핵 항산균 폐질환: 흉부 전산화단층촬영에서의 다양한 영상 소견

  • Shin, Hyo-Hyun (Department of Radiology, Chonnam National University, Medical School, Chonnam National University Hospital) ;
  • Seon, Hyun-Ju (Department of Radiology, Chonnam National University, Medical School, Chonnam National University Hospital) ;
  • Kim, Mok-Hee (Department of Radiology, Chonnam National University, Medical School, Chonnam National University Hospital) ;
  • Choi, Song (Department of Radiology, Chonnam National University, Medical School, Chonnam National University Hospital) ;
  • Song, Sang-Gook (Department of Radiology, Chonnam National University, Medical School, Chonnam National University Hospital) ;
  • Shin, Sang-Soo (Department of Radiology, Chonnam National University, Medical School, Chonnam National University Hospital) ;
  • Kim, Yun-Hyeon (Department of Radiology, Chonnam National University, Medical School, Chonnam National University Hospital) ;
  • Park, Jin-Gyoon (Department of Radiology, Chonnam National University, Medical School, Chonnam National University Hospital)
  • 신효현 (전남대학교병원 영상의학과) ;
  • 선현주 (전남대학교병원 영상의학과) ;
  • 김목희 (전남대학교병원 영상의학과) ;
  • 최송 (전남대학교병원 영상의학과) ;
  • 송상국 (전남대학교병원 영상의학과) ;
  • 신상수 (전남대학교병원 영상의학과) ;
  • 김윤현 (전남대학교병원 영상의학과) ;
  • 박진균 (전남대학교병원 영상의학과)
  • Received : 2010.02.02
  • Accepted : 2010.03.15
  • Published : 2010.08.01
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Abstract

Purpose: The aim of this study was to evaluate the chest CT features of nontuberculous mycobacterial (NTM) disease regardless of the specific organisms. Materials and Methods: This study included 74 consecutive patients (35 men, 39 women; mean age, 63 years; age range, 25-89 years) who were diagnosed with NTM disease according to the American Thoracic Society Guidelines (1997 and 2007) between January 2005 and July 2007. Chest CT images were randomly reviewed by two radiologists with consensus. Results: The most common organism associated with NTM disease is M. avium-intracellulare complex (87.8%), followed by M. abscessus, M. kansasii, and M. chelonae. The most common chest CT finding was a nodular bronchiectatic lesion (n = 35, 46.7%), followed by a cavitary lesion of the upper lobe (n = 21, 28.0%), combined lesions of two prior subtypes (n = 6, 8.0%), consolidative lesion (s) (n = 5, 6.7%), a bronchogenic spreading pulmonary tuberculosis-like lesion (n = 5, 6.7%), a cavitary mass lesion with small satellite nodules (n = 2, 2.7%), and a miliary nodular lesion (n = 1, 1.3%). More than 5 segments were involved in 60 cases (81.1%). Conclusion: The nodular bronchiectatic lesion or cavitary lesion of upper lobe presents with multi-segmental involvement and the occurrence of combined consolidation is indicative of NTM disease.

목적: 비결핵 항산균 폐질환의 흉부 전산화단층촬영에서의 영상 소견을 균주에 관계없이 알아 보고자 했다. 대상과 방법: 2005년 1월부터 2007년 7월까지 비결핵 항산균 폐질환으로 진단되고 흉부 전산화단층촬영을 시행한 74명(남:여 = 35:39)을 대상으로, 영상소견을 후향적으로 분석했다. 결과: 가장 흔한 균주는 M. avium-intracellulare complex (87.8%)이었고, 이외 M. abscessus, M. kansasii, 그리고 M. chelonae 가 있었다. 흉부 전산화단층촬영에서 주된 소견들은 결절성기관지확장증(46.7%), 상엽에 공동성 질환(28.0%), 그리고 두 소견의 병합(8.0%)이었다. 이 외에도 주로 경화성 병변 만을 보인 예, 주변의 위성 소결절과 동반된 공동성 종괴를 보인 예, 기관지 내 파급만을 보인 예 그리고 속립성 질환을 보인 예가 있었다. 81.1%에서 5분절 이상의 침범이 이었다. 결론: 다 분절을 침범하면서 결절성기관지확장증과 동반된 기관지주변 경화성 병변이 있거나 상엽의 파괴성 또는 비파괴성 공동성 병변이 있는 경우 비결핵 항산균 폐질환을 시사하는 소견이라 할 수 있다.

Keywords

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