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The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
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These include: - Emphysema ... on the basis of HRCT ... Diagnosis #Radiology #Pulmonary ... TractionBronchiectasis #Cysts #Emphysema ... #SignetRing #RadiologyAssistant
Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
(centrilobular emphysema ... - Aspiration - Pulmonary ... Diagnosis #Radiology #Pulmonary ... #HRCT #ChestCT ... #Upper #Lower #RadiologyAssistant
Low Attenuation pattern 
1. Lymphangiomyomatosis (LAM): uniform cysts in woman of child-bearing age; no history of
child-bearing age ... Centrilobular emphysema ... Clinical #Radiology #HRCT ... Comparison #Table #RadiologyAssistant
Low Attenuation pattern (2) 
1. Centrilobular emphysema: low attenuation areas without walls. Notice the centrilobular artery
Centrilobular emphysema ... child-bearing age ... Clinical #Radiology #HRCT ... Comparison #Table #RadiologyAssistant
Central distribution is seen in sarcoidosis and cardiogenic pulmonary edema.
Peripheral distribution is mainly seen in cryptogenic
and cardiogenic pulmonary ... Diagnosis #Radiology #Pulmonary ... #HRCT #ChestCT ... Central #Peripheral #RadiologyAssistant
Perilymphatic distribution
Perilymphatic nodules are most commonly seen in sarcoidosis.
They also occur in silicosis, coal-worker's pneumoconiosis and
Perilymphatic nodules are ... Diagnosis #Radiology #Pulmonary ... #HRCT #CTChest ... #Differential #RadiologyAssistant
Differential diagnosis on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
Differential diagnosis on HRCT ... disease comes from HRCT ... On HRCT there are ... Diagnosis #Radiology #Pulmonary ... #Differential #RadiologyAssistant
More than 100 entities manifest as diffuse lung disease.
Fortunately only about 10 of these account for
diseases, that are ... also uncommon HRCT-presentations ... Diagnosis #Radiology #Pulmonary ... SHITFACED #Mnemonic #HRCT ... #RadiologyAssistant
Algorithm for nodular pattern
The algorithm to distinguish perilymphatic, random and centrilobular nodules is the following:
- Look
These are often ... pleural nodules are ... Diagnosis #Radiology #Pulmonary ... #HRCT #CTChest ... Differential #Algorithm #RadiologyAssistant
On the left a typical case of panlobular emphysema.
There is uniform destruction of the underlying architecture
the secondary pulmonary ... Pulmonary vessels ... vascular markings are ... difficult to detect on HRCT ... PanlobularEmphysema #RadiologyAssistant