Non-tuberculous mycobacterial lung disease: a brief review focusing on radiological findings

Abstract The incidence and prevalence of lung disease caused by non-tuberculous mycobacteria (NTM-LD) has increased worldwide and its diagnosis represents a complex challenge. This article aims to review the tomographic findings of NTM-LD in order to facilitate their definitive diagnosis. The search for publications on the subject was performed in PMC and Scielo using the keywords ‘non-tuberculous mycobacteria’, ‘lung disease and computed tomography (CT)’ and ‘radiological findings’. The radiological findings described by 18 articles on mycobacteriosis were reviewed. In addition, CT images of patients diagnosed with NTM-LD were considered to represent radiological findings. Eighteen publications were used whose main findings were pulmonary cavitation (88.9%), bronchiectasis (77.8%), and pulmonary nodules (55.6%). Despite the overlaps in imaging-related analysis of myocobacterioses with other pulmonary infections, such as tuberculosis, the predominant involvement of the middle lobe and lingula should raise suspicion for NTM-LD.

摘要 非结核分枝杆菌肺病（non-tuberculous mycobacteria lung disease, NTM-LD）的发病率与患病率在全球范围内逐年攀升，其临床诊断是一项极具挑战性的复杂任务。本文旨在系统综述非结核分枝杆菌肺病的断层影像学表现，以助力其精准明确诊断。本研究以“非结核分枝杆菌”“肺病与计算机断层扫描（CT）”“影像学表现”为检索关键词，在PMC与Scielo数据库中开展文献检索。本研究对18篇涉及分枝杆菌病的文献所描述的影像学表现进行了系统梳理，并纳入确诊为非结核分枝杆菌肺病患者的CT影像以作为影像学表现的佐证。最终纳入的18篇文献显示，其核心影像学特征包括肺空洞（88.9%）、支气管扩张（77.8%）与肺结节（55.6%）。尽管分枝杆菌病的影像学分析结果与肺结核等其他肺部感染存在诸多重叠表现，但当病变主要累及肺中叶与舌叶时，应高度怀疑为非结核分枝杆菌肺病。