3-D computed tomographic airway analysis detects mild bronchiectasis in mycobacterium avium complex pulmonary disease

Purpose: Mycobacterium avium complex pulmonary disease (MACPD) causes respiratory tract lesions, and it is often difficult to recognize bronchiectasis macroscopically on CT when only mild bronchodilation occurs. The aim of this study was to evaluate such normally appearing bronchi, and quantify bronchial changes in patients with MACPD by 3-D airway analysis. Methods: Thirty-one women bacteriologically diagnosed with mycobacterium avium complex (MAC group) and 20 healthy women (control group) were enrolled. We measured the area of the inner lumen (Ai) of the bronchi from the third to sixth generations of the right apical bronchus (B1) and the right basal bronchus (B8) using computed tomography data. We also analyzed Ai values of both the MAC group and the control group. Additionally, we examined the correlation between Ai values and the CT scores (cellular bronchiolitis, nodules, bronchiectasis, air spaces, and cavities) assigned by radiologists in MAC group. Results: The Ai values indicate that bronchodilation at each of the 4th to 6th generations of the right B1 was significantly greater in the MAC group than in the control group (P < 0.05). The Ai values and the CT scores were significantly correlated at each of the 5th to 6th generations of right B1 (r = 0.58, P < 0.001; r = 0.67, P < 0.0001, respectively). Conclusions: The study suggests that the mild bronchiectasis of peripheral bronchus in patients with MACPD could be detected by 3-D airway analysis, even in normally appearing bronchi.