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The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
The fourth pattern ... on the basis of HRCT ... #Diagnosis #Radiology ... Differential #Diagram #Comparison ... Emphysema #SignetRing #RadiologyAssistant
High Attenuation pattern (2) 
1. Non specific interstitial pneumonitis (NSIP): ground glass with traction bronchiectasis, no
bronchiectasis, no honeycombing ... #Clinical #Radiology ... #HRCT #CTChest ... #Comparison #Table ... #RadiologyAssistant
Chronic hypersensitivity pneumonitis
The key findings in chronic hypersensitivity pneumonitis are:
Mosaic pattern with areas of ground-glass atenuation
pattern with areas ... The HRCT shows a ... mosaic pattern ... #Clinical #Radiology ... #Fibrosis #RadiologyAssistant
Low Attenuation pattern 
1. Lymphangiomyomatosis (LAM): uniform cysts in woman of child-bearing age; no history of
Honeycombing 4. ... #Clinical #Radiology ... #HRCT #CTChest ... #Comparison #Table ... #RadiologyAssistant
Low Attenuation pattern (2) 
1. Centrilobular emphysema: low attenuation areas without walls. Notice the centrilobular artery
Honeycombing. 4. ... #Clinical #Radiology ... #HRCT #CTChest ... #Comparison #Table ... #RadiologyAssistant
High Attenuation pattern 
1. Chronic eosinophilic pneumonia with peripheral areas of ground glass opacity.
2. Sarcoid end-stage
High Attenuation pattern ... Chronic eosinophilic ... #HRCT #CTChest ... #Comparison #Table ... #RadiologyAssistant
Nodular pattern(2)
1. Sarcoidosis: nodules with perilymphatic distribution, along fissures, adenopathy.
2. TB: Tree-in-bud appearance in a patient
bronchiolitis in infection ... #Clinical #Radiology ... #HRCT #CTChest ... #Comparison #Table ... #RadiologyAssistant
UIP
UIP is a histologic pattern of pulmonary fibrosis.
On a chest X-ray UIP manifests as a reticular
A HRCT is needed ... attributed to chronic ... HRCT demonstrated ... #Clinical #Radiology ... RadiologyAssistant
UIP with honeycombing (left) and chronic HP (right)
Differential diagnosis of Hypersensitivity Pneumonitis.
Subacute stage:
- RB-ILD: seen in
UIP with honeycombing ... show very similar HRCT ... Clinical #Diagnosis #Radiology ... #CTChest #UIP #Comparison ... Fibrosis #Mimic #ILD #RadiologyAssistant
It can be difficult to distinguish these three entities.
There are two diagnostic hints for further differentiation:
-
bronchiolitis or chronic ... seen in: - (post) infection ... MosaicAttenuation #Mosaic ... #Attenuation #Comparison ... #RadiologyAssistant