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. 2019 May 14;92(1099):20181003. doi: 10.1259/bjr.20181003

Table 3.

Radiographic patterns of IPF (Reproduced with permission from Raghu et al. 2018)

HRCT patterns
UIP Probable UIP Indeterminate for UIP Alternative diagnosis
Subpleural and basal predominant; distribution is often heterogeneousa Subpleural and basal predominant; distribution is often heterogeneous Subpleural and basal predominant Findings suggestive of another diagnosis, including:
Honeycombing with or without peripheral traction bronchiectasis or bronchiolectasisb Reticular pattern with peripheral traction bronchiectasis or bronchiolectasis Subtle reticulation; may have mild GGO or distortion (“early UIP pattern”) CT features:

  • Cysts

  • Marked mosaic attenuation

  • Predominant GGO

  • Profuse micronodules

  • Centrilobular nodules

  • Nodules

  • Consolidation
May have mild GGO CT features and/or distribution of lung fibrosis that do not suggest any specific etiology (“truly indeterminate for UIP”) Predominant distribution
Peribronchovascular
Perilymphatic
Upper or mid-lung
Other:

  • Pleural plaques (consider asbestosis)

  • Dilated esophagus (consider CTD)

  • Distal clavicular erosions (consider RA)

  • Extensive lymph node enlargement (consider other etiologies)

  • Pleural effusions, pleural thickening (consider CTD/drugs)

CTD, connective tissue disease; GGO, ground-glass opacity; HRCT, high-resolution computed tomography; IPF, idiopathic pulmonary fibrosis; RA, rheumatoid arthritis; UIP, usual interstitial pneumonia.

Reprinted with permission of the American Thoracic Society.Copyright © 2018 American Thoracic Society. Raghu G, et al. 2018 Diagnosis of idiopathic pulmonary fibrosis. An Official ATS/ERS/JRS/ALAT clinical practice guideline. American Journal of Respiratory and Critical Care Medicine 198:e44-e68. The American Journal of Respiratory and Critical Care Medicine is an official journal of the American Thoracic Society.

a

Variants of distribution: occasionally diffuse, may be asymmetrical.

b

Superimposed CT features: mild GGO, reticular pattern, pulmonary ossification.