Seo Hyun Kwak MD, PRESENTER: Nothing to Disclose

Abstract: HTML Purpose: Bronchiectasis and bronchiolitis involving four or more lobes with the preconditional involvement of the right middle lobe and lingular segmental of the left upper lobe at thin-section CT have been regarded diagnostic of Lady Windermere syndrome. The aim of this study was to validate prospectively how these findings on CT are important in the diagnosis of non-tuberculous mycobacterial (NTM) pulmonary infection. Methods and Materials: During the period of recent two and half years (from July 2000 to December 2002), 190 patients with symptoms and signs of bronchiectasis were diagnosed prospectively to have a possibility of Lady Windermere syndrome at thin-section CT (helical technique of 120 kVp, 70 mA, 2.5-mm collimation, pitch of 6 [total active detector length pitch of 1.5]; reconstructed with both axial and coronal planes) with the findings of bilateral bronchiectasis and bronchiolitis (with centrilobular nodules and branching centrilobular nodules; tree-in-bud pattern) regardless of the presence of upper lobe cavity. Of these, 20 patients did not undergo appropriate study for the diagnosis of NTM infection including sputum study or were lost for further follow-up studies. In this study, we included 170 patients who underwent adequate and complete study for the diagnosis of NTM pulmonary infection or other definitive diagnoses. Medical records were reviewed for the final diagnoses of these 170 patients. Results: Of 170 patients, 32 (19%) patients had definitive (MAC in 16 patients, M. abscessus in 14, M. kansasii in one, and unspecified in one) diagnosis of NTM pulmonary infection and additional 17 (10%, total 49 patients, 29%) patients had highly suggestive (MAC in five patients, M. abscessus in three, M. fortuitum in one, and unspecified in eight) diagnoses of the disease. Others turned out to have Mycobacterium tuberculosis in nine, diffuse panbronchiolitis in six, X-linked agammaglobulinemia in one, immotile cilia syndrome in one, bronchiectasis associated with lung cancer in one and bronchiectasis without specific underlying causes in the remaining 103 patients. Conclusion: About 30% of patients turn out to have NTM pulmonary infection when they present with thin-section CT findings of multi-lobar bronchiectasis and bronchiolitis suggestive of Lady Windermere syndrome.       Questions about this event email: melon2@samsung.co.kr

Kwak MD, S, Effectiveness of Thin-Section CT in the Diagnosis of Non-tuberculous Mycobacterial Pulmonary Infection: A Prospective Study.  Radiological Society of North America 2003 Scientific Assembly and Annual Meeting, November 30 - December 5, 2003 ,Chicago IL. http://archive.rsna.org/2003/3102204.html