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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, LIP ... 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
(centrilobular emphysema ... is seen in: - UIP ... edema #Diagnosis #Radiology ... #Pulmonary #HRCT ... #Upper #Lower #RadiologyAssistant
On the left a patient who had a CT to rule out pulmonary embolism.
There is a
patient who had a CT ... to rule out pulmonary ... #Clinical #Radiology ... #CTChest #SeptalThickening ... #CHF #RadiologyAssistant
Ground-glass opacity
Ground-glass opacity (GGO) represents:
- Filling of the alveolar spaces with pus, edema, hemorrhage, inflammation or
resolution of the HRCT ... predominance: UIP ... bronchiolitis #Diagnosis #Radiology ... #Pulmonary #CTChest ... #Differential #RadiologyAssistant
Differential diagnosis on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
On HRCT there are ... in many cases UIP ... #Diagnosis #Radiology ... #Pulmonary #CXR ... #Differential #RadiologyAssistant
HRCT findings in Chronic eosinophilic pneumonia
Peripheral consolidations with upper lobe predominance (photo negative of pulmonary edema).
On
HRCT findings in ... photo negative of pulmonary ... contrast enhanced CT ... #Clinical #Radiology ... #CTChest #Chronic
UIP with honeycombing (left) and chronic HP (right)
Differential diagnosis of Hypersensitivity Pneumonitis.
Subacute stage:
- RB-ILD: seen in
centrilobular emphysema ... show very similar HRCT ... Clinical #Diagnosis #Radiology ... #CTChest #UIP # ... Fibrosis #Mimic #ILD #RadiologyAssistant
The idiopathic interstitial pneumonias (IIPs) comprise a heterogenous group of disorders. 
They represent fundamental responses of
morphologic findings on HRCT ... findings of NSIP, UIP ... #Diagnosis #Radiology ... #Pulmonary #CTChest ... ILD #Findings #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 ... #CTChest #Interpretation ... Algorithm #ILD #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