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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 #LowAttenuation ... #Differential #
Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
(centrilobular emphysema ... bronchiolitis (RB-ILD ... #HRCT #ChestCT ... #Differential #Table ... #Upper #Lower #RadiologyAssistant
Perilymphatic distribution
Perilymphatic nodules are most commonly seen in sarcoidosis.
They also occur in silicosis, coal-worker's pneumoconiosis and
Perilymphatic nodules are ... the overlap in differential ... Diagnosis #Radiology #Pulmonary ... #HRCT #CTChest ... #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 ... 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 ... the other hand, mild ... difficult to detect on HRCT ... Clinical #Radiology #CTChest ... PanlobularEmphysema #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 ... Interstitial #Pattern #Differential ... #RadiologyAssistant
UIP with honeycombing (left) and chronic HP (right)
Differential diagnosis of Hypersensitivity Pneumonitis.
Subacute stage:
- RB-ILD: seen in
chronic HP (right) Differential ... centrilobular emphysema ... show very similar HRCT ... Diagnosis #Radiology #CTChest ... #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 ... MultipleNodules #Nodules #Differential ... #Algorithm #RadiologyAssistant
On the left a smoker with RB-ILD with subtle HRCT-findings.
The dominant pattern is ground glass opacification.
Additional
in this patient are ... paraseptal emphysema ... there is a broad differential ... Clinical #Radiology #CTChest ... #RadiologyAssistant
Differential diagnosis of Lymphangiomyomatosis:
Langerhans cell histiocytosis: > 90% are smokers, cysts have irregular shapes and the
Differential diagnosis ... Centrilobular emphysema ... of LAM. ... Clinical #Radiology #CTChest ... #Cystic #RadiologyAssistant