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The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
Honeycombing Most diseases ... on the basis of HRCT ... #Diagnosis #Radiology ... #Pulmonary #CTChest ... #Diagram #Comparison
Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
Smoking related diseases ... (centrilobular emphysema ... bronchiolitis (RB-ILD ... edema #Diagnosis #Radiology ... #Pulmonary #HRCT
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 ... #Algorithm #ILD ... #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 ... Clinical #Diagnosis #Radiology ... #CTChest #UIP # ... Comparison #Chronic
On the left some diseases with a nodular pattern.
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary
the left some diseases ... Clinical #Diagnosis #Radiology ... #Pulmonary #CTChest ... #Comparison #Table ... #RadiologyAssistant
On the left a smoker with RB-ILD with subtle HRCT-findings.
The dominant pattern is ground glass opacification.
Additional
are paraseptal emphysema ... there is a broad differential ... #Clinical #Radiology ... #CTChest #RBILD ... #RadiologyAssistant