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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 ... 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 ... bronchiolitis (RB-ILD ... edema #Diagnosis ... #HRCT #ChestCT ... #Upper #Lower #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 ... #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 #Perilymphatic ... #Differential #RadiologyAssistant
On the left a typical case of panlobular emphysema.
There is uniform destruction of the underlying architecture
Pulmonary vessels ... the other hand, mild ... difficult to detect on HRCT ... Clinical #Radiology #CTChest ... PanlobularEmphysema #RadiologyAssistant
More than 100 entities manifest as diffuse lung disease.
Fortunately only about 10 of these account for
also uncommon HRCT-presentations ... some of them the old ... #Pulmonary #SHITFACED ... #Mnemonic #HRCT ... #RadiologyAssistant
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 ... fibrotic changes are ... #Radiology #CTChest ... #RadiologyAssistant
Differential diagnosis on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
Differential diagnosis ... On HRCT there are ... #Diagnosis #Radiology ... #Pulmonary #CXR ... #Differential #RadiologyAssistant
Algorithm for nodular pattern
The algorithm to distinguish perilymphatic, random and centrilobular nodules is the following:
- Look
These are often ... #Diagnosis #Radiology ... #Pulmonary #HRCT ... #CTChest #NodularPattern ... Differential #Algorithm #RadiologyAssistant
The idiopathic interstitial pneumonias (IIPs) comprise a heterogenous group of disorders. 
They represent fundamental responses of
morphologic findings on HRCT ... #Diagnosis #Radiology ... #Pulmonary #CTChest ... IdiopathicInterstitialPneumonia #ILD ... #Findings #RadiologyAssistant