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Bilateral Bronchiectasis and Bronchiolitis at Thin-Section CT: Diagnostic Implications in Nontuberculous Mycobacterial Pulmonary Infection¹

¹ From the Division of Pulmonary and Critical Care Medicine, Department of Medicine (W.J.K., O.J.K.) and Department of Radiology and Center for Imaging Science (K.S.L., Y.J.J., S.H.K., T.S.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135–710, Korea. From the 2003 RSNA Annual Meeting. Received February 28, 2004; revision requested May 5; revision received May 10; accepted June 15. Supported in part by Samsung Biomedical Research Institute grant SBRI C-A4–113-1. Address correspondence to K.S.L. (e-mail: kslee@smc.samsung.co.kr).

View larger version (114K): [in a new window]   Figure 1a. Transverse thin-section (2.5-mm section thickness) CT scans obtained in 58-year-old woman with NTM pulmonary infection caused by M intracellulare show centrilobular small nodules and branching nodular structures (tree-in-bud pattern) (arrowhead), bronchiectasis (solid arrows), and mosaic low-attenuation areas, features consistent with air trapping (open arrow), in both lungs. (a) Image obtained at level of middle lobe bronchus of the right lung. (b) Image obtained at level of inferior pulmonary veins.

View larger version (114K): [in a new window]   Figure 1b. Transverse thin-section (2.5-mm section thickness) CT scans obtained in 58-year-old woman with NTM pulmonary infection caused by M intracellulare show centrilobular small nodules and branching nodular structures (tree-in-bud pattern) (arrowhead), bronchiectasis (solid arrows), and mosaic low-attenuation areas, features consistent with air trapping (open arrow), in both lungs. (a) Image obtained at level of middle lobe bronchus of the right lung. (b) Image obtained at level of inferior pulmonary veins.

View larger version (113K): [in a new window]   Figure 2a. Transverse thin-section (2.5-mm section thickness) CT scans obtained in 59-year-old woman with NTM pulmonary infection caused by M abscessus show centrilobular small nodules and branching nodular structures (tree-in-bud pattern) (arrowhead) and mosaic low-attenuation areas, features consistent with air trapping (open arrow), in both lungs. Also note bronchiectasis (solid arrows) and volume decrease in middle lobe of right lung. (a) Image obtained at level of proximal basal arteries. (b) Image obtained at level of inferior pulmonary veins.

View larger version (114K): [in a new window]   Figure 2b. Transverse thin-section (2.5-mm section thickness) CT scans obtained in 59-year-old woman with NTM pulmonary infection caused by M abscessus show centrilobular small nodules and branching nodular structures (tree-in-bud pattern) (arrowhead) and mosaic low-attenuation areas, features consistent with air trapping (open arrow), in both lungs. Also note bronchiectasis (solid arrows) and volume decrease in middle lobe of right lung. (a) Image obtained at level of proximal basal arteries. (b) Image obtained at level of inferior pulmonary veins.

View larger version (108K): [in a new window]   Figure 3a. Transverse thin-section (2.5-mm section thickness) CT scans obtained in 41-year-old woman show diffuse panbronchiolitis. Centrilobular small nodules, branching nodular structures (tree-in-bud pattern) (arrowheads), and mosaic low-attenuation areas, features consistent with air trapping (open arrow), were observed in both lungs. Also note bronchiectasis (solid arrows) and volume decrease in middle lobe of right lung. (a) Image obtained at level of proximal basal arteries. (b) Image obtained at level of subsegmental bronchi.

View larger version (107K): [in a new window]   Figure 3b. Transverse thin-section (2.5-mm section thickness) CT scans obtained in 41-year-old woman show diffuse panbronchiolitis. Centrilobular small nodules, branching nodular structures (tree-in-bud pattern) (arrowheads), and mosaic low-attenuation areas, features consistent with air trapping (open arrow), were observed in both lungs. Also note bronchiectasis (solid arrows) and volume decrease in middle lobe of right lung. (a) Image obtained at level of proximal basal arteries. (b) Image obtained at level of subsegmental bronchi.