Learning objectives
Determine the significance of MDCT in detection and narrowing differential diagnosis of tree-in-bud sign.
Background
Tree-in-bud (TIB) sign represents centrilobular,
well-defined,
soft-tissue micronodules in linear,
branching distribution,
resembling a tree in bud.
The finding indicates disease of the peripheral airways that develops due to plugging of small airways with fluid,
dilated bronchioles,
bronchiolar wall thickening and peribronchiolar inflammation.[1] TIB sign is not visible on chest radiographs,
whereas is well depicted by thin-section multi-detector computed tomography (MDCT).
The smallest portion of lung visible on MDCT is the secondary pulmonary lobule,
measuring 10-25 mm in diameter.
It is surrounded by connective tissue...
Findings and procedure details
In this five-year retrospective study we analyzed patient with TIB sign at MDCT chest imaging.
41 patients were included in study,
19 males and 22 females,
the average age at the time of examination was 57±17.
We analyzed presence and localization of TIB sign,
presence of ancillary findings and potential diagnosis.
The most common localisation of tree-in-bud sign was upper right lobe (28 patient or 68%) and its anterior segment (15 patients/36.5%),
after that lower right and upper left lobe 16 (39%).
Two or more...
Conclusion
TIB sign is well depicted on chest MDCT.
Although causes are frequently radiologically indistinguishable,
presence of additional findings,
along with history and clinical presentation,
can often be useful in suggesting the appropriate diagnosis.
References
Muller NL,
Miller RR.
Diseases of the bronchioles: CT and histopathologic findings.
Radiology 1995; 196:3–12.
2. Rossi SE,
Franquet T.
Volpacchio M,
et al.
Tree-in-bud pattern at thin-section CT of the lungs: radologic-pathologic overview.
RadioGraphics,
2005; 25: 789-801
3. Attaya M,
Attaya E,
Islam E ( 2014) Tree-in-bud.
Soutwest Respir Crit Care Chron 2(8):42-43
4. Santiago Enrique Rossi,
MD,
Tomas Franquet,
MD,
mariano Volpacchio,
MD ,
Ana Gimenez,
MD,
Gabriel Aguilar,
MD: Tree-in-Bud Patten at Thin-Section CT of the Lungs: Radiologic-Pathologic Overview
5. Theresa C....