The Common Vein Copyright 2008

Ashley Davidoff MD

is a radiological sign that characterises abnormal filling and stretching of the bronchioles best seen in the periphery of the lung AND and localises the disease to the centrilobular bronchioles.  There is lack of tapering at the tip of their branches giving the appearnce of knobby/bulbous branches and hence the “budding” reference . The bronchioles are 2-3 mm structures that are not usually resolved by CT scanning since the walls are to thin to be differentiated. (Zompatori) When they are filled with fluid, mucus, pus, granulomas or inflammatory cells they are visualised as as branching structures.  They may cause subsegmental obstruction of the distal airways visible on expiratory sections.

They may appearas branching and budding or just as a focal clustered collection of buds in the centrilobular region

CAUSES

Most commonly infectious and associated with acute bronchitis, pneumonia and bronchiectasis.  Also seen in active cases of TB and atypical TB and Asian panbronchiolitis.

The TIB pattern on CT scan is mostly associated with pulmonary infections that commonly involve the large airways. This pattern was present in 17.6% of cases with acute bronchitis or pneumonia and 25.6% of cases with bronchiectasis.(Aquino) Also seen in patients with cystic fibrosis , allergic bronchopulmonary aspergillosis bronchoalveolar carcinoma  Rarely in sarcoidosis and collagen vascular diseases.

Not seen in patients with emphysema, respiratory bronchiolitis, bronchiolitis obliteransBOOP, hypersensitivity pneumonitis.(Aquino)

UCSF

AJR AJR

 UCSF

Mevis

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