CT findings of Mycobacterium abscessus lung disease and its application value in differential diagnosis

LI Chenghai; JI Yuanfei; YU Xia; WANG Jue; SUN Mengyan; HE Wei; LÜ Yan; HOU Dailun

doi:10.20258/j.cnki.1006-9011.2025.12.010

Abstract：Objective To analyze the CT findings of Mycobacterium abscessus lung disease and to explore its application value in the differential diagnosis between mycobacterium abscessus lung disease and other mycobacterium lung diseases.Methods A total of 259 patients with nontuberculous mycobacteria(NTM)were selected.According to the results of bacterial species identification,they were divided into 77 cases of Mycobacterium abscessus lung disease(Mycobacterium abscessus group)and 182 cases of other mycobacterium lung disease(other mycobacterium group).All the research subjects underwent routine chest plain scans,and the CT findings of patients with NTM lung disease were observed and recorded.Binary Logistic re-gression analysis was used to screen the risk factors of Mycobacterium abscessus lung disease.The receiver operating characteris-tic(ROC)curve was used to evaluate the diagnostic value of CT findings for Mycobacterium abscessus lung disease.Results Uni-variate analysis revealed that the proportion of females in the Mycobacterium abscessus group was higher than that in the other mycobacterium groups,and the age was younger than that in the other mycobacterium groups(all P<0.05).The proportions of in-terstitial changes,lung consolidation,single or multiple nodules,spherical lesions and mass shadows,cavity features,bronchi-ectasis,pleural thickening and emphysema in the other mycobacterium groups were all higher than those in the Mycobacterium abscessus group(all P<0.05),while,the proportion of bronchiectasis was lower than that in the Mycobacterium abscessus group(P<0.05).However,there were no statistically significant differences between the two groups in terms of patchy shadows,sheet-like ground-glass shadows,thickening of the bronchial wall,tree bud sign,lobular central nodules,pulmonary cord-like shad-ows,concurrent lobar atosis,lung damage,lymph node enlargement,lymph node calcification,pleural effusion,and the pro-portion of calcification(all P>0.05).Binary Logistic regression analysis revealed that bronchiectasis was a risk factor for Myco-bacterium abscessus lung disease(P<0.05),while,thick-walled cavity was a protective factor(P<0.05).ROC curve analysis re-vealed that the area under the curve(AUC)for CT findings such as bronchiectasis and thick-walled cavities in the individual di-agnosis of Mycobacterium abscess lung disease was 0.559(95%CI:0.485-0.633,P<0.05)and 0.292(95%CI:0.224-0.360,P>0.05),respectively.The AUC of the combined diagnosis of Mycobacterium abscess lung disease was 0.735(95%CI:0.671-0.798,P<0.05),and the efficacy of CT findings such as bronchiectasis and thick-walled cavities in the combined diagnosis of my-cobacterium abscess lung disease was superior to that of the two alone(Z=1.50,5.30,all P<0.05).Conclusion Bronchiecta-sis and thick-walled cavities are typical CT findings of Mycobacterium abscessus lung disease.CT findings such as bronchiectasis and thick-walled cavities both have certain differential diagnostic value for Mycobacterium abscessus lung disease,and the com-bined differential diagnostic value of the two is even higher.