Jp. Laissy et al., MYCOBACTERIUM-TUBERCULOSIS VERSUS NONTUBERCULOUS MYCOBACTERIAL INFECTION OF THE LUNG IN AIDS PATIENTS - CT AND HRCT PATTERNS, Journal of computer assisted tomography, 21(2), 1997, pp. 312-317
Purpose: The aim of this study was to determine discriminating CT and
HRCT features between mycobacterial pulmonary tuberculosis and nontube
rculous mycobacterial (NTMB) pulmonary infections in patients with AID
S. Method: CT and HRCT scans of 52 AIDS patients with culture-proven m
ycobacterial infection [29 with Mycobacterium tuberculosis (MTB) and 2
3 with NTMB] without concomitant pulmonary infection were reviewed by
two observers. Results: Nodular opacities, mainly centrilobular in dis
tribution, were the most common finding, seen in 21 (72%) and 15 (65%)
of patients with MTB and NTMB, respectively. A lower lobe predominanc
e of centrilobular nodules was seen more commonly in NTMB (p < 0.03).
Ground-glass attenuation was seen in 5 (17%) and 11 (48%) of patients
with MTB and NTMB, respectively (p = 0.03). Ground-glass opacities and
bronchial wall thickening affected a larger number of lobes in NTMB (
p < 0.01), while centrilobular nodules involved more lobes in MTB (p <
0.01). A higher prevalence of unilateral lung involvement was seen in
MTB (12 patients, 44%) than NTMB (1 patient, 5%) (p < 0.01). Enlarged
lymph nodes were more frequent in patients with MTB than in those wit
h NTMB (22, 76% vs. 10, 43%, respectively) (p < 0.02). Conclusion: NTM
B infection and pulmonary tuberculosis display different CT and HRCT p
atterns in AIDS patients, but there is considerable overlap in CT find
ings.