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The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
These include: - Emphysema ... #Diagnosis #Radiology ... #Pulmonary #CTChest ... Differential #Diagram #Comparison ... #SignetRing #RadiologyAssistant
Low Attenuation pattern 
1. Lymphangiomyomatosis (LAM): uniform cysts in woman of child-bearing age; no history of
Centrilobular emphysema ... low attenuation areas ... #Clinical #Radiology ... Cystic #Pattern #Comparison ... #Table #RadiologyAssistant
Low Attenuation pattern (2) 
1. Centrilobular emphysema: low attenuation areas without walls. Notice the centrilobular artery
Centrilobular emphysema ... low attenuation areas ... #Clinical #Radiology ... Cystic #Pattern #Comparison ... #Table #RadiologyAssistant
Mosaic attenuation
The term 'mosaic attenuation' is used to describe density differences between affected and non-affected lung
non-affected lung areas ... There are patchy areas ... disease #Diagnosis #Radiology ... #Pulmonary #CTChest ... #Differential #RadiologyAssistant
On the left a patient with ground glass pattern in a mosaic distribution.
The clue here is
glass pattern in a mosaic ... enlargement of pulmonary ... (arrow) in the areas ... #Clinical #Radiology ... Thromboembolism #RadiologyAssistant
Cavities frequently arise within a mass or an area of consolidation as a result of necrosis.
We
without associated pulmonary ... emphysema. ... Clinical #Diagnosis #Radiology ... #Cavity #Cyst #Emphysema ... #Comparison #RadiologyAssistant
On the left a typical case of panlobular emphysema.
There is uniform destruction of the underlying architecture
the secondary pulmonary ... to widespread areas ... Pulmonary vessels ... #Clinical #Radiology ... PanlobularEmphysema #RadiologyAssistant
Basic Interpretation
A structured approach to interpretation of HRCT involves the following questions:
What is the dominant HR-pattern:
reticular
nodular
high
low attenuation (emphysema ... bronchiectasis) #Diagnosis #Radiology ... #Pulmonary #HRCT ... Interpretation #Algorithm ... #ILD #RadiologyAssistant
It can be difficult to distinguish these three entities.
There are two diagnostic hints for further differentiation:
-
bronchiolitis or chronic pulmonary ... right with the pulmonary ... MosaicAttenuation #Mosaic ... #Attenuation #Comparison ... #RadiologyAssistant