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The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
on the basis of HRCT ... #Diagnosis #Radiology ... #Pulmonary #CTChest ... LowAttenuation #Differential ... #Diagram #Comparison
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 ... cysts; smoking history ... #Clinical #Radiology ... #HRCT #CTChest ... #Comparison #Table
Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
(centrilobular emphysema ... bronchiolitis (RB-ILD ... edema #Diagnosis ... #Radiology #Pulmonary ... #HRCT #ChestCT
UIP with honeycombing (left) and chronic HP (right)
Differential diagnosis of Hypersensitivity Pneumonitis.
Subacute stage:
- RB-ILD: seen in
HP (right) Differential ... In chronic HP fibrotic ... #Clinical #Diagnosis ... #Radiology #CTChest ... #ILD #RadiologyAssistant
High Attenuation pattern 
1. Chronic eosinophilic pneumonia with peripheral areas of ground glass opacity.
2. Sarcoid end-stage
end-stage with massive fibrosis ... consolidation #Clinical ... #Radiology #HRCT ... #Comparison #Table ... #RadiologyAssistant
High-Res Chest CT Patterns - Differential Diagnosis Framework
Reticular:
 • Septal Thickening: Lymphangitic Carcinoma, Interstitial Edema, Alveolar
- Differential ... Diagnosis Framework ... Attenuation: • Emphysema ... Diagnosis #pulmonary ... #radiology
Ground-glass opacity
Ground-glass opacity (GGO) represents:
- Filling of the alveolar spaces with pus, edema, hemorrhage, inflammation or
resolution of the HRCT ... in ground glass pattern ... bronchiolitis #Diagnosis ... #Radiology #Pulmonary ... #RadiologyAssistant
UIP
UIP is a histologic pattern of pulmonary fibrosis.
On a chest X-ray UIP manifests as a reticular
of pulmonary fibrosis ... to confirm the diagnosis ... attributed to chronic ... #Clinical #Radiology ... #Honeycombing #RadiologyAssistant
Basic Interpretation
A structured approach to interpretation of HRCT involves the following questions:
What is the dominant HR-pattern:
reticular
nodular
high
the dominant HR-pattern ... low attenuation (emphysema ... bronchiectasis) #Diagnosis ... #Radiology #Pulmonary ... #RadiologyAssistant