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
(centrilobular emphysema ... bronchiolitis (RB-ILD ... #HRCT #ChestCT ... #Differential #Table ... #Upper #Lower #RadiologyAssistant
The fourth pattern includes abnormalities that result in decreased lung attenuation or air-filled lesions.
These include:
- Emphysema
-
on the basis of HRCT ... findings. ... Diagnosis #Radiology #Pulmonary ... #CTChest #LowAttenuation ... #Differential #
Differential diagnosis on HRCT
Most of our knowledge about imaging findings in interstitial lung disease comes from
Differential diagnosis ... about imaging findings ... low attenuation (table ... Diagnosis #Radiology #Pulmonary ... #RadiologyAssistant
The idiopathic interstitial pneumonias (IIPs) comprise a heterogenous group of disorders. 
They represent fundamental responses of
listed in the table ... on HRCT and histology ... Diagnosis #Radiology #Pulmonary ... #CTChest #Idiopathic ... #Findings #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 ... there additional findings ... #HRCT #CTChest ... 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 ... are paraseptal emphysema ... there is a broad differential ... Clinical #Radiology #CTChest ... #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 ... findings ... #RadiologyAssistant
Radiologists use many terms to describe areas of decreased density or lucencies within the lung, like
we describe a chest ... visible wall #CXR ... #Lucency #Differential ... #Table #CavitaryLesion ... Cavity #Cyst #Lung #Pulmonary
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
On the left some diseases with a nodular pattern.
1. Hypersensitivity pneumonitis: ill defined centrilobular nodules.
2. Miliary
Diagnosis #Radiology #Pulmonary ... #CTChest #Nodular ... NodularPattern #Differential ... #Comparison #Table ... #RadiologyAssistant