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The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
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- Lung cysts (LAM ... on the basis of HRCT ... #Diagnosis #Radiology ... #Pulmonary #CTChest ... #SignetRing #RadiologyAssistant
Low Attenuation pattern 
1. Lymphangiomyomatosis (LAM): uniform cysts in woman of child-bearing age; no history of
Lymphangiomyomatosis (LAM ... #Clinical #Radiology ... #HRCT #CTChest ... #Comparison #Table ... #RadiologyAssistant
Low Attenuation pattern (2) 
1. Centrilobular emphysema: low attenuation areas without walls. Notice the centrilobular artery
Centrilobular emphysema ... #Clinical #Radiology ... #HRCT #CTChest ... #Comparison #Table ... #RadiologyAssistant
Differential diagnosis on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
, high and low attenuation ... in many cases UIP ... #Diagnosis #Radiology ... #Pulmonary #CXR ... #Differential #RadiologyAssistant
Ground-glass opacity
Ground-glass opacity (GGO) represents:
- Filling of the alveolar spaces with pus, edema, hemorrhage, inflammation or
resolution of the HRCT ... or interstitial lung ... predominance: UIP ... #Radiology #Pulmonary ... #CTChest #GGO #
UIP
UIP is a histologic pattern of pulmonary fibrosis.
On a chest X-ray UIP manifests as a reticular
pattern of pulmonary ... On a chest X-ray ... to confirm the diagnosis ... #Clinical #Radiology ... #Honeycombing #RadiologyAssistant
UIP with honeycombing (left) and chronic HP (right)
Differential diagnosis of Hypersensitivity Pneumonitis.
Subacute stage:
- RB-ILD: seen in
centrilobular emphysema ... show very similar HRCT ... #Clinical #Diagnosis ... #Radiology #CTChest ... #UIP #Comparison
Cavities frequently arise within a mass or an area of consolidation as a result of necrosis.
We
the surrounding lung ... without associated pulmonary ... #Clinical #Diagnosis ... #Radiology #CTChest ... #Comparison #RadiologyAssistant
On the left a smoker with RB-ILD with subtle HRCT-findings.
The dominant pattern is ground glass opacification.
Additional
The dominant pattern ... are paraseptal emphysema ... these non-specific CT ... #Clinical #Radiology ... #CTChest #RBILD
It can be difficult to distinguish these three entities.
There are two diagnostic hints for further differentiation:
-
There are two diagnostic ... penicillamine) #Clinical ... #Radiology #CTChest ... #Attenuation #Comparison ... #RadiologyAssistant