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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 ... #Pulmonary #CTChest ... Differential #Diagram #Comparison
Differential diagnosis on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
Differential diagnosis ... on HRCT Most of ... histiocytosis or honeycombing ... #Diagnosis #Radiology ... #Pulmonary #CXR
UIP
UIP is a histologic pattern of pulmonary fibrosis.
On a chest X-ray UIP manifests as a reticular
of pulmonary fibrosis ... On a chest X-ray ... A HRCT is needed ... to confirm the diagnosis ... #Clinical #Radiology
On the left some diseases with a nodular pattern.
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary
with a nodular pattern ... #Clinical #Diagnosis ... #Radiology #Pulmonary ... #CTChest #Nodular ... #Differential #Comparison
The idiopathic interstitial pneumonias (IIPs) comprise a heterogenous group of disorders. 
They represent fundamental responses of
have specific patterns ... morphologic findings on HRCT ... #Diagnosis #Radiology ... #Pulmonary #CTChest ... IdiopathicInterstitialPneumonia #ILD
UIP with honeycombing (left) and chronic HP (right)
Differential diagnosis of Hypersensitivity Pneumonitis.
Subacute stage:
- RB-ILD: seen in
UIP with honeycombing ... ) Differential diagnosis ... show very similar HRCT ... #Radiology #CTChest ... #UIP #Comparison
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 ... bronchiectasis) #Diagnosis ... #Radiology #Pulmonary ... #HRCT #CTChest ... Interpretation #Algorithm #ILD
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 ... broad differential diagnosis ... #Clinical #Radiology ... #CTChest #RBILD
In the images on your left you can appreciate again the spectrum of findings seen in
(dark bronchus sign ... fine reticular pattern ... excluding UIP as diagnosis ... #Clinical #Radiology ... #CTChest #NSIP
Authors: Mark M. Ramzy, DO, EMT-P (@MarkRamzyDO, EM Resident Physician, Drexel University, Department of Emergency Medicine)
Vital signs: BP ... Several of the diagnoses ... trauma are diagnosed ... radiograph pattern ... #Radiology #CTChest