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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 ... findings. ... #Diagnosis #Radiology ... #SignetRing #RadiologyAssistant
Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
Upper lung zone ... (centrilobular emphysema ... bronchiolitis (RB-ILD ... #Pulmonary #HRCT ... #Differential #Table
Differential diagnosis on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
about imaging findings ... in interstitial lung ... low attenuation (table ... #Diagnosis #Radiology ... #Differential #RadiologyAssistant
The idiopathic interstitial pneumonias (IIPs) comprise a heterogenous group of disorders. 
They represent fundamental responses of
listed in the table ... on HRCT and histology ... #Diagnosis #Radiology ... IdiopathicInterstitialPneumonia #ILD ... #Findings #RadiologyAssistant
Figure 3 HRCT-LUS correlation in normal lung, pulmonary congestion, rheumatoid lung disease, idiopathic pulmonary fibrosis.
Notes: (A)
Figure 3 HRCT-LUS ... artifact); (G) UIP pattern ... Clinical #Diagnosis #HRCT ... #POCUS #Lung #Correlation ... #Table #ILD #Findings
Basic Interpretation
A structured approach to interpretation of HRCT involves the following questions:
What is the dominant HR-pattern:
reticular
nodular
high
the dominant HR-pattern ... low attenuation (emphysema ... there additional findings ... Interpretation #Algorithm #ILD ... #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 ... findings ... throughout the whole lung ... #RadiologyAssistant
On the left a smoker with RB-ILD with subtle HRCT-findings.
The dominant pattern is ground glass opacification.
Additional
with subtle HRCT-findings ... The dominant pattern ... are paraseptal emphysema ... #Clinical #Radiology ... #RadiologyAssistant
Acute interstitial pneumonia (AIP, earlier named Hamman Rich Pneumonitis) is a rare idiopathic lung disease characterized
rare idiopathic lung ... The histologic pattern ... #Clinical #Radiology ... AcuteInterstitialPneumonia #ILD ... #RadiologyAssistant
Septal thickening
Thickening of the lung interstitium by fluid, fibrous tissue, or infiltration by cells results in
cells results in a pattern ... a predominant finding ... differential diagnosis (Table ... #Pulmonary #HRCT ... #Differential #RadiologyAssistant