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The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
- Lung cysts (LAM ... on the basis of HRCT ... Diagnosis #Radiology #Pulmonary ... #CTChest #LowAttenuation ... Differential #Diagram #Comparison
Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
Upper lung zone ... (centrilobular emphysema ... bronchiolitis (RB-ILD ... #HRCT #ChestCT ... #Differential #Table
Low Attenuation pattern 
1. Lymphangiomyomatosis (LAM): uniform cysts in woman of child-bearing age; no history of
Centrilobular emphysema ... Clinical #Radiology #HRCT ... #CTChest #LowAttenuation ... Cystic #Pattern #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 #LowAttenuation ... Cystic #Pattern #Comparison ... #Table #RadiologyAssistant
Figure 3 HRCT-LUS correlation in normal lung, pulmonary congestion, rheumatoid lung disease, idiopathic pulmonary fibrosis.
Notes: (A)
Figure 3 HRCT-LUS ... , pulmonary congestion ... disease, idiopathic pulmonary ... Clinical #Diagnosis #HRCT ... #Table #ILD #Findings
Nodular pattern
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary TB: random nodules
3. Sarcoidosis: nodules with perilymphatic
Hypersensitivity pneumonitis: ill ... Clinical #Radiology #HRCT ... #CTChest #Nodular ... #Pattern #Comparison ... #Table #RadiologyAssistant
The idiopathic interstitial pneumonias (IIPs) comprise a heterogenous group of disorders. 
They represent fundamental responses of
listed in the table ... morphologic findings on HRCT ... Diagnosis #Radiology #Pulmonary ... #CTChest #Idiopathic ... IdiopathicInterstitialPneumonia #ILD
On the left a typical case of panlobular emphysema.
There is uniform destruction of the underlying architecture
the secondary pulmonary ... Pulmonary vessels ... the other hand, mild ... difficult to detect on HRCT ... Clinical #Radiology #CTChest
Differential diagnosis on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
in interstitial lung ... On HRCT there are ... low attenuation (table ... is interstitial lung ... Diagnosis #Radiology #Pulmonary
Radiologists use many terms to describe areas of decreased density or lucencies within the lung, like
pneumatocele, emphysema ... we describe a chest ... with a thin wall Emphysema ... #Differential #Table ... #Pulmonary #Diagnosis