Computed Tomography Comparative Analysis of Nontuberculous Mycobacterial Lung Disease in the Elderly and Secondary Pulmonary Tuberculosis.

OBJECTIVES: The study aimed to explore the key points of computed tomography (CT) differential diagnosis of nontuberculous mycobacteria (NTM) and secondary pulmonary tuberculosis in elderly patients. METHODS: We retrospectively analyzed 45 patients with NTM pulmonary disease and 65 patients with secondary pulmonary tuberculosis. All patients were older than 60 years. The diseases were confirmed by laboratory examination. The general data and CT images of the 2 groups were compared and analyzed using χ 2 tests, single-factor analysis, and multivariate logistic regression analysis. RESULTS: Single-factor analysis showed significant differences between the 2 groups in 9 factors: bronchiectasis of the left upper lobe lingual segment, bronchiectasis of the right middle lobe, small nodules, large nodules, thin-walled cavities, thick-walled cavities, nonsubpleural hollows, strip opacity, and mediastinal lymph node enlargement ( P < 0.05). Multivariate logistic regression analysis showed that thin-walled cavities, bronchiectasis of the right middle lobe, small nodules, and large nodules were important factors in the differential diagnosis of the two groups. CONCLUSIONS: Nontuberculous mycobacteria show certain characteristics on CT, which are helpful for differential diagnosis when coupled with clinical and sputum smear examinations.