Regular CT vs HRCT

@cwal The radiologist typically compares each scan to the most recent previous one. So perhaps your MAC and whatever else is in your lungs is stable for now. If so that is very good news.

What does the doctor say? Remember that the radiologist only has the scans to evaluate. The doctor has your whole history.
Sue

Thank you Sue.
Yes, the Radiologist had the previous "regular" CT to compare to. I just don't understand how it would show on the Regular CT but the HRCT, which as I understand gives a higher quality image, did not show it? Can tree in bud "disappear"?

I have not seen my doctor yet since the scan but she tends to blow me off anyway so I try not to ask her much.

Maybe your are misinterpreting? I read "No tree in bud changes" [when compared to the previous scan] not "No tree in bud" [exists]. I would say that means nothing changed and it looks the same as before. What do you think?
Sue

Maybe? Here is the direct quote- ....."No characteristically tree in bud pattern to suggest mycobacterial infection"
It is a confusing picture from previous regular CT reports to the statement in the HRCT. I was Dx with MAC per bronch specimen a couple of years ago.

MAC can go away spontaneously, especially if you do airway clearance.
For example, I had tree-in-bud nodules and a positive sputum culture in late 2019, but elected to stop the antibiotics in December of that year due to increasingly severe side effects from the daily regimen. I continued daily airway clearance with 7% saline and an Aerobika. I also use Mucinex and NAC to thin my mucus, and an inhaler to control my asthma.
One year later, my CT scan looked better than the day I stopped. It has remained stable ever since.
Also, a HRCT may show the exact lung condition more clearly, making it possible for the radiologist to recognize that what were reported as tree in bud previously was perhaps scar tissue or other artifacts of a previous infection. Again, for example, I have one area in my lungs that always shows "some opacity" on scans but in 5 years, it has never developed into something identifiable.
What does the doctor say?
Sue

Sue
Good points about the HRCT showing exact conditions more clearly in that context. I was confused and surprised about that part of my report since I had just had 2 recent exacerbations only about 5 months apart.

I will see what the doc says next appt. Also, what is NAC?

N Acetyl Cysteine - It is a precursor of glutathione, and is commonly thought to be useful both for thinning mucus and against inflammation. You can read about it here:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458826/
https://bronchiectasisnewstoday.com/2019/05/09/n-acetylcysteine-potentially-beneficial-bronchiectasis-patients/

There are also numerous discussions about it in this group. If you go to the main MAC & Bronchiectasis group page and put NAC in the search box for Search this Group, you will find many discussions and posts.

I was a little hesitant at first, but tried it to clamp down on exacerbations. In the past 2 years, I have only had two - only one of which required treatment. Previously, I had 4-5 episodes a year.
Sue

I think brand is important with NAC. Have you researched that Sue and found a good one? I may try it again. Last time gave me insomnia.

Hello Irene, Since I have been unable to get the Jarrow brand I prefer, I have switched to NOW brand with good results. Fortunately, I was recently in Canada where Jarrow is available, and I stocked up.
I have not noticed any side effects from NAC, but when I accidentally ran out last winter, I sure noticed a difference in my cough after only 3 days.
Sue

If you feel that way, I'd look for a new pulminologist. Why did they order a HRCT?