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Causes and imaging patterns of tree-in-bud opacities.
[allergic bronchopulmonary aspergillosis]
Multiple
causes
for
tree-
in
-
bud
(
TIB
)
opacities
have
been
reported
.
However
,
to
our
knowledge
the
relative
frequencies
of
the
causes
have
not
been
evaluated
.
The
purpose
of
this
study
was
to
determine
the
relative
frequency
of
causes
of
TIB
opacities
and
identify
patterns
of
disease
associated
with
TIB
opacities
.
Cases
with
TIB
opacities
in
the
radiology
report
in
2010
were
identified
by
searching
the
Radiology
Information
System
.
Medical
records
and
CT
scan
examinations
were
reviewed
for
the
causes
of
TIB
opacities
.
Patterns
of
disease
associated
with
TIB
opacities
were
evaluated
.
Causes
for
TIB
opacities
were
established
in
166
of
406
(
40
.
9
%
)
cases
.
Respiratory
infections
(
119
of
166
,
72
%
)
with
mycobacteria
(
65
of
166
,
39
%
)
,
bacteria
(
44
of
166
,
27
%
)
,
viruses
(
four
of
166
,
3
%
)
,
or
multiple
organisms
(
six
of
166
,
4
%
)
were
most
common
.
Aspiration
was
the
cause
in
42
of
166
(
25
%
)
.
Alternating
areas
of
normal
lung
with
regions
of
small
airways
disease
(
TIB
opacities
,
bronchiectasis
)
(
random
small
airways
pattern
)
was
specific
(
0
.
92
)
for
Mycobacterium
avium
complex
infection
.
Nearly
uniform
distribution
of
bronchiectasis
(
widespread
bronchiectasis
pattern
)
was
specific
for
"
diseases
predisposing
to
airway
infection
"
(
specificity
0
.
92
)
,
such
as
cystic
fibrosis
,
primary
ciliary
dyskinesia
,
allergic
bronchopulmonary
aspergillosis
,
and
immunodeficiency
states
.
Consolidation
and
TIB
opacities
(
bronchopneumonia
pattern
)
were
usually
due
to
bacterial
infection
or
aspiration
.
Dependent
distribution
(
specificity
0
.
79
)
and
esophageal
abnormality
(
specificity
0
.
86
)
with
TIB
opacities
were
associated
with
aspiration
.
Chronicity
of
findings
was
associated
with
mycobacterial
infection
(
P
&
lt
;
.
0001
,
sensitivity
0
.
96
)
.
Acuteness
of
findings
was
associated
with
bacterial
infection
(
P
&
lt
;
.
001
,
specificity
0
.
87
)
.
TIB
opacities
are
most
often
a
manifestation
of
infections
or
aspiration
.
Patterns
of
disease
can
provide
clues
to
the
most
likely
diagnosis
.
Diseases
Validation
Diseases presenting
"bronchiectasis"
symptom
allergic bronchopulmonary aspergillosis
lymphangioleiomyomatosis
severe combined immunodeficiency
wiskott-aldrich syndrome
This symptom has already been validated
