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Diagnostic algorithm for idiopathic pulmonary fibrosis, in part adapted from the ATS/ERS consensus statement. HRCT =
fibrosis, in part ... HRCT = high-resolution ... computerised tomography; ILD ... fibrosis; UIP = ... pneumonitis #IPF #UIP
Differential diagnosis on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
on HRCT Most of ... disease comes from HRCT ... On HRCT there are ... low attenuation (table ... #Pattern #Differential
UIP
UIP is a histologic pattern of pulmonary fibrosis.
On a chest X-ray UIP manifests as a reticular
pattern of pulmonary ... fibrosis. ... on the CXR. ... A HRCT is needed ... HRCT demonstrated
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 ... Clinical #Diagnosis #HRCT ... #Correlation #Table ... #ILD #Findings
Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
bronchiolitis (RB-ILD ... is seen in: - UIP ... - Aspiration - Pulmonary ... #HRCT #ChestCT ... #Differential #Table
Central distribution is seen in sarcoidosis and cardiogenic pulmonary edema.
Peripheral distribution is mainly seen in cryptogenic
and cardiogenic pulmonary ... pneumonia and UIP ... Diagnosis #Radiology #Pulmonary ... #HRCT #ChestCT ... #Differential #Table
Ground-glass opacity
Ground-glass opacity (GGO) represents:
- Filling of the alveolar spaces with pus, edema, hemorrhage, inflammation or
resolution of the HRCT ... as seen in fibrosis ... in ground glass pattern ... Diagnosis #Radiology #Pulmonary ... #GroundGlass #Differential
The idiopathic interstitial pneumonias (IIPs) comprise a heterogenous group of disorders. 
They represent fundamental responses of
combinations of fibrosis ... listed in the table ... morphologic findings on HRCT ... findings of NSIP, UIP ... Diagnosis #Radiology #Pulmonary
The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
The fourth pattern ... Lung cysts (LAM, LIP ... on the basis of HRCT ... Diagnosis #Radiology #Pulmonary ... LowAttenuation #Differential
UIP with honeycombing (left) and chronic HP (right)
Differential diagnosis of Hypersensitivity Pneumonitis.
Subacute stage:
- RB-ILD: seen in
chronic HP (right) Differential ... Subacute stage: - RB-ILD ... show very similar HRCT ... In chronic HP fibrotic ... #Mimic #ILD #RadiologyAssistant