BACKGROUND Although cavities are an important finding in Mycobacterium avium complex pulmonary disease (MAC-PD), there is little information regarding the types of cavities that indicate disease progression. This study was performed to identify cavity characteristics that were associated with disease progression in patients with MAC-PD. METHODS This retrospective cohort study included 97 patients presenting with MAC-PD with cavities between December 2006 and June 2016. We compared initial and final computed tomography (CT) findings, classified 52 and 45 patients in the progressive and non-progressive cavity groups, respectively, and examined the progression-related imaging features in initial CT images. A progressive cavity was defined by more than two-fold increase in internal diameter or emergence of a new cavity around the initial cavity. RESULTS Patients in the progressive group were older (p < 0.001), had a lower body mass index (p = 0.043), and showed higher diabetes complication rates (p = 0.005). The initial CT in the progressive group showed a longer maximum internal diameter of the cavity (p < 0.001) and higher rates of cavities close to the chest wall (p < 0.001), multiple cavities (p = 0.023), consolidation around the cavity (p < 0.001), atelectasis (p = 0.011), and pleural thickening (p < 0.001). Multivariable logistic regression analysis revealed that the maximum internal diameter of the cavity (odds ratio [OR]: 1.11, 95% confidence interval [CI]: 1.02-1.21; p=0.012) and consolidation around the cavity (OR: 16.15, 95% CI: 4.05-64.46; p < 0.001) were significantly associated with progressive cavities. In cavities with a maximum internal diameter of ≥10 mm and simultaneous consolidation, the probability of progression was as high as 96.2%. The 10-year mortality rates in the progressive and non-progressive cavity groups were 46.7 and 9.8% (p < 0.001), respectively, while the 10-year respiratory failure rates were 28.1 and 0%, respectively (p < 0.001). CONCLUSIONS Large cavity size and consolidation on CT showed strong relationships with disease progression, which led to respiratory failure and high mortality rate.

中文翻译：

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鸟分枝杆菌复杂性肺疾病进行性腔的特征性胸部CT表现：一项回顾性队列研究。

背景技术虽然在鸟分枝杆菌复杂性肺病（MAC-PD）中发现空洞是一个重要发现，但是关于指示疾病进展的空洞类型的信息很少。进行这项研究是为了确定与MAC-PD患者疾病进展相关的腔特征。方法这项回顾性队列研究包括2006年12月至2016年6月期间97例患有MAC-PD并伴有腔的患者。我们比较了最初和最终的计算机体层摄影（CT）结果，分别将52例和45例患者分为渐进型和非渐进型腔组，并检查了初始CT图像中与进展相关的影像学特征。渐进型腔的定义是内径增加两倍以上或围绕初始腔出现新腔。结果进行性组患者年龄较大（p <0.001），体重指数较低（p = 0.043），糖尿病并发症发生率较高（p = 0.005）。进行性组的初始CT显示腔的最大内径更长（p <0.001），靠近胸壁的腔的发生率更高（p <0.001），多个腔（p = 0.023），腔周围固结（ p <0.001），肺不张（p = 0.011）和胸膜增厚（p <0.001）。多变量logistic回归分析显示，空腔的最大内径（比值[OR]：1.11，95％置信区间[CI]：1.02-1.21； p = 0.012）和空腔周围的固结（OR：16.15，95％ CI：4.05-64.46； p ＜0.001）与进行性腔显着相关。在最大内径≥10 mm且同时固结的腔中，进展的可能性高达96.2％。进行性和非进行性腔组的10年死亡率分别为46.7和9.8％（p <0.001），而10年呼吸衰竭率分别为28.1和0％（p <0.001）。结论CT上的大腔和巩固显示与疾病进展密切相关，这导致呼吸衰竭和高死亡率。