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The "Tree-in-Bud" Pattern on Chest CT: Radiologic and Microbiologic Correlation.

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The tree-in-bud (TIB) pattern on chest CT, seen in 1.8% of patients, primarily indicates infectious endobronchiolar inflammation. Its microbiologic causes mirror those found in general community and hospital-acquired infections.

Keywords:
Chest CTEndobronchiolar inflammationPulmonary infectionTree-in-bud

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Area of Science:

  • Radiology
  • Pulmonology
  • Infectious Diseases

Background:

  • The tree-in-bud (TIB) pattern on high-resolution chest CT signifies bronchiolar mucoid impaction.
  • The clinical and microbiologic significance of the TIB pattern requires further investigation.

Purpose of the Study:

  • To determine the incidence of the TIB pattern in patients undergoing chest CT.
  • To identify the etiologies associated with the TIB pattern.

Main Methods:

  • A retrospective review of chest CT scans from January 2007 to June 2012 was conducted.
  • Patients with the TIB pattern were identified, and their microbiologic data were analyzed.

Main Results:

  • The TIB pattern was observed in 326 patients (1.8% of all chest CTs).
  • Infectious etiologies were identified in 67.5% of cases, with aspiration pneumonia in 10.4%.
  • The distribution of isolated organisms was consistent with community- and hospital-acquired infections, irrespective of TIB pattern or immune status.

Conclusions:

  • The TIB pattern is predominantly associated with infectious endobronchiolar inflammation.
  • The microbiologic profile of patients with the TIB pattern is similar to the general population regarding infection sources.