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Basic Interpretation
A structured approach to interpretation of HRCT involves the following questions:
What is the dominant HR-pattern:
reticular
nodular
high

perilymphatic or random ... Interpretation #Algorithm #ILD ... #RadiologyAssistant

The distribution of nodules shown on HRCT is the most important factor in making an accurate

centrilobular or random ... Random refers to ... Random distribution ... Nodules are randomly ... Comparison #Diagram #RadiologyAssistant

Nodular pattern
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary TB: random nodules
3. Sarcoidosis: nodules with perilymphatic

Hypersensitivity pneumonitis: ill ... Miliary TB: random ... Comparison #Table #RadiologyAssistant

Algorithm for nodular pattern
The algorithm to distinguish perilymphatic, random and centrilobular nodules is the following:
- Look

perilymphatic, random ... pattern is either random ... it is likely a random ... Differential #Algorithm #RadiologyAssistant

Lung Nodules - Differential Diagnosis by Distribution
• Centrilobular: Hypersensitivity Pneumonitis, RB-ILD, Pneumoconiosis, Infectious Bronchiolitis, Vasculitis,

Pneumonitis, RB-ILD ... Carcinomatosis • Random

On the left some diseases with a nodular pattern.
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary

Hypersensitivity pneumonitis: ill ... Miliary TB: random ... bronchiolitis: ill ... Comparison #Table #RadiologyAssistant

$Scaphoid fracture - Proximal Pole - Wrist XRay Proximal pole scaphoid fractures have poor healing potential If an$

wks in cast - Random ... Handom, MD https

Differential diagnosis of Langerhans cell histiocytosis.
Nodular LCH:
- Sarcoidosis: perilymphatic distribution.
- Metastases: random distribution.
Cystic LCH:
- LAM: round

- Metastases: random ... Comparison #Table #RadiologyAssistant

Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases

bronchiolitis (RB-ILD ... #Upper #Lower #RadiologyAssistant

Interstitial Lung Diseases (ILD)
Exposure-Related ILD (a.k.a. extrinsic allergic alveolitis):
• Hypersensitivity pneumonitis, Farmer's lung, Bird

Lung Diseases (ILD ... Exposure-Related ILD ... ILD caused by inhalation ... Medication-induced ILD ... Methotrexate ILD

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