Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief πŸ‡΅πŸ‡­ πŸ‡ΊπŸ‡Έ - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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Upper lung zone preference is seen in:
- Inhaled particles: pneumoconiosis (silica or coal)
- Smoking related diseases
is seen in: - UIP ... Radiology #Pulmonary #HRCT ... #ChestCT #Differential ... #Table #Distribution ... RadiologyAssistant
Differential diagnosis on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
Differential diagnosis ... low attenuation (table ... in many cases UIP ... #Differential # ... RadiologyAssistant
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 ... LowAttenuation #Differential ... #Diagram #Comparison ... Emphysema #SignetRing #RadiologyAssistant
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, PCP. - Lower ... #GroundGlass #Differential ... #RadiologyAssistant
The idiopathic interstitial pneumonias (IIPs) comprise a heterogenous group of disorders. 
They represent fundamental responses of
listed in the table ... have specific patterns ... morphologic findings on HRCT ... findings of NSIP, UIP ... #Findings #RadiologyAssistant
UIP with honeycombing (left) and chronic HP (right)
Differential diagnosis of Hypersensitivity Pneumonitis.
Subacute stage:
- RB-ILD: seen in
chronic HP (right) Differential ... show very similar HRCT ... lower zone distribution ... #Comparison #Chronic ... #RadiologyAssistant
On the left a patient with DIP.
The HRCT shows diffuse areas of ground-glass density in the
The HRCT shows diffuse ... density in the lower ... and some mosaic pattern ... DesquamativeInterstitialPneumonia #ILD ... #RadiologyAssistant
Basic Interpretation
A structured approach to interpretation of HRCT involves the following questions:
What is the dominant HR-pattern:
reticular
nodular
high
interpretation of HRCT ... the dominant HR-pattern ... an upper versus lower ... Interpretation #Algorithm ... #ILD #RadiologyAssistant
On the left a smoker with RB-ILD with subtle HRCT-findings.
The dominant pattern is ground glass opacification.
Additional
with subtle HRCT-findings ... The dominant pattern ... there is a broad differential ... patient was coughing up ... #RadiologyAssistant