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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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- Lung cysts (LAM ... on the basis of HRCT ... #Diagnosis #Radiology ... #Pulmonary #CTChest ... #SignetRing #RadiologyAssistant
Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
Upper lung zone ... (centrilobular emphysema ... edema #Diagnosis #Radiology ... #Pulmonary #HRCT ... #Upper #Lower #RadiologyAssistant
Low Attenuation pattern 
1. Lymphangiomyomatosis (LAM): uniform cysts in woman of child-bearing age; no history of
Centrilobular emphysema ... #Clinical #Radiology ... #HRCT #CTChest ... 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 ... Comparison #Table #RadiologyAssistant
On the left a typical case of panlobular emphysema.
There is uniform destruction of the underlying architecture
Pulmonary vessels ... difficult to detect on HRCT ... #Clinical #Radiology ... #CTChest #Panlobular ... #RadiologyAssistant
Perilymphatic distribution
Perilymphatic nodules are most commonly seen in sarcoidosis.
They also occur in silicosis, coal-worker's pneumoconiosis and
#Diagnosis #Radiology ... #Pulmonary #HRCT ... #CTChest #Perilymphatic ... #Differential #RadiologyAssistant
Differential diagnosis on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
in interstitial lung ... is interstitial lung ... #Diagnosis #Radiology ... #Pulmonary #CXR ... #Differential #RadiologyAssistant
More than 100 entities manifest as diffuse lung disease.
Fortunately only about 10 of these account for
also uncommon HRCT-presentations ... #Diagnosis #Radiology ... #Pulmonary #SHITFACED ... #Mnemonic #HRCT ... #RadiologyAssistant
Ground-glass opacity
Ground-glass opacity (GGO) represents:
- Filling of the alveolar spaces with pus, edema, hemorrhage, inflammation or
resolution of the HRCT ... or interstitial lung ... bronchiolitis #Diagnosis #Radiology ... #Pulmonary #CTChest ... #Differential #RadiologyAssistant
Centrilobular emphysema due to smoking. The periphery of the lung is spared (blue arrows). Centrilobular artery
Centrilobular emphysema ... periphery of the lung ... #Clinical #Radiology ... #CTChest #Centrilobular ... #RadiologyAssistant