Thank you so much, amazing video and succinct too, much more confident calling these now, especially traction bronchiectasis which I struggled with, love the corkscrew description. Where's the follow up video? Keep up the good work Rishi
Near the end, some of the findings that you indicated as reticular opacities or bronchiectasis looked more like honeycombing. It's tough to really delineate the difference when there's so much overlap. - Medical Student
Sir , if a hrct CT reports findings mentioned as..... 1.post kocchs sequel. Seen upper lobe. 2.Signaficcant fibrotic changes noted. 3.traction bronchiectasis noted. If this above mentioned g Findings in CT report are not to be worried or are not good sign.Patient is having short of breath on climbing staircase.
sounds like there is fibrosis in the lungs. If it is significant, it is probably contributing to the shortness of breath. I would have that person see a lung doctor.
What is a consolidated Ground glass opacity 8mm ? Is this just an opacity or a nodule? I have alot more going on in my lungs and now have to go to pulmonologist to rule out atypical infection vs inflammatory less likely neoplastic process. Trying to learn what I can. My xray from 10 months ago tells them it grew. I know your teaching future radiologist but I'm greatful for your videos and piece of mind.
Hello there, do you think it could be possible to understand what's going on when we see Ground glass opacity during a Covid-19 infection ? Thank you for your explaination.
Hi, I would recommend taking a look at the resources on COVID-19 from the RSNA: www.rsna.org/covid-19 The imaging patterns of COVID-19 can range from nonspecific to mildly specific. However, much more important are the symptoms, prevalence in your community, and lab testing.
What would these CT findings mean: Multiple irregular streaky linear densities, fibrosis, atelectasis, and subpleural reticulation? ( In the bulibasal and basal region.) I just received the CT results ( the CT was taken for another issue - not my lungs) so that specialist couldn't elaborate, I am waiting to see my PCP and a referral to a pulmonologist. I am a 60 year old woman, never smoked, don't have a cough, and this is very alarming to me - trying to figure it out.
CT report of 61 yrs male. Sir is this normal and self limiting findings or require medical treatment is must. "Area of consolidation noted in basal segment of left lower lobe as superior segment of right lower lobe with multiple tiny noduls giving tree in bud appearance.. # Minimal left plural effusion noted . #Traction bronchiactisis changes noted in upper bilateral and middle lobe. #Signaficant fibrotic changes with interstitial changes noted along bilateral upper lobe. Rest of the bilateral parenchyma appears normal in attenuation. Rrachea and major bronchi appwars normal. No signaficant medisstinal lymhodanopathy seen. The heart and medistinal vessel seems normal. Thoracic vertebrae sternym, ribs ,chest wall normal. Post kochs sequel in upper lobe. Moderate size consolidations and tree in bud nodules in bilateral lower lobe" Pl seeking yiur valuable opinion.
Thanks to military service 86-97 ZERO PPE provided during all handling asbestos, grinding metal, cutting concrete etc etc etc welding Diesel and jet fuel exhaust and second hand smoke
it looks the same on the sagittal as it does on the axials. traction bronchiectasis will look different, on the coronal and sagittals, traction bronchiectasis can look like elongated tubes which helps differentiate traction bronchiectasis from honeycombing.
What would be your differential for the last case? With the combination of GGO, reticulations and traction bronchiectasis, would that fulfill the criteria of fibrotic NSIP?
yeah, the distinction between the two may not be as important as once thought. If there aren't any features that suggest otherwise, peripheral and basilar fibrosis without much ground glass is often UIP.
Hello... thanks for the great explanation! Does reticulation AND traction bronchiectasis definitively mean fibrosis, or is there still room for other diagnoses?
Usually air trapping is very well demarcated as opposed to ggo which usually has ill-defined borders. Also, in air trapping, the lung will look hyperlucent to normal lung and the vessels may be smaller in caliber.
Hi, a few different ways: 1) apical-basilar distribution. emphysema will be more apical and honeycombing usually basilar. 2) look at the septations. emphysema will usually be thin vs honeycombing is thick. 3) are they rows stacked on each other? prob is honeycombing. 4) are they a smoker? if not, prob not emphysema. In the end, it can still be hard, and to make matters worse, it is not uncommon to see both honeycombing and emphysema in the same patient.
It means no hope at all ! Treatment doesn’t make any difference,suffering longer and in short time you be going 😃 Simply you can behave yourself all your life,worked hard and expect to have a reasonable life when you retired ! Still no cure,might be another 50-100 years ! Godbless us all🙏🙏
I wish every part of radiology had videos like you. 🎉
you should start a channel and make them :)
Crystal clear explanation of ILD features, extremely useful, thank you so much Dr. Rishi Agarwal 👌👏👍❤️
GOATT. Greatest Of All Time Teacher . Thank you ❤❤❤❤❤❤
Thanks from a potential ILD patient! This was super easy to understand.
Good luck to you
Wow! Such a great video! I'm a night hospitalist and found this extremely useful. Thanks again!
Thank you!
Wow, what a great video! Extremely thorough explanation throughout the whole video, thank you so much for the upload my friend.
Glad it was helpful!
Another fantastic video. I'm gonna dominate this thoracic rotation.
💪😤👍
this is a great video, thank you from algeria
Please do more videos like this. Very well explained. To the point.
Where's the next video on ILD?
Thanks Jiju, still working on it. Such a big topic, trying to figure out how to chop it up into less than 10 min videos.
excellent grand merci from Algeria
Thank you for this great video!
Thank you so much, amazing video and succinct too, much more confident calling these now, especially traction bronchiectasis which I struggled with, love the corkscrew description. Where's the follow up video? Keep up the good work Rishi
Thanks very much hoped to post a while back but been so busy with regular work. Thanks for your kind feedback.
excellent , thank you very much .
A simple and beautiful explanation... really helpful sir... 👍
Explained well. Thank you.
super duper helpful. thank you for posting this Doc!
Thank you for this great crystal clear video! Would be great if you had a video of several cases.
Great suggestion!
You are amazing, I wish you all luck and health good sir♥️
Your videos are great!! Wish I would've came across them earlier
Near the end, some of the findings that you indicated as reticular opacities or bronchiectasis looked more like honeycombing. It's tough to really delineate the difference when there's so much overlap. - Medical Student
Oookooomooooomom
I love this explanation. Much appreciated!
Thank you sir❤
Nicely expained
Thank you.
Please upload more videos like this :)
I plan on it
@@ThoracicRadiologythis video is probably the best video explaining basic knowledge of intersticial lung disease. Top notch content. Congratulations.
Excellent 👌
Great. Thank you very much.
Thank you
Excellent!
Thank you.
very well explained. Thank you so much!
thank you , this helped me a lot
Very helpful . Thank you
excellent presentation
Thank you so much. Amazing
Thank u dr ❤
VERY GOOD TEACHING
Great lecture ,very much helpful
Thank you Sir
Thanks sir for the detailed info .👌🏻💐
Great video, thank you
Sir , if a hrct CT reports findings mentioned as.....
1.post kocchs sequel. Seen upper lobe.
2.Signaficcant fibrotic changes noted.
3.traction bronchiectasis noted.
If this above mentioned g
Findings in CT report are not to be worried or are not good sign.Patient is having short of breath on climbing staircase.
sounds like there is fibrosis in the lungs. If it is significant, it is probably contributing to the shortness of breath. I would have that person see a lung doctor.
Very helpful. Thank you 😊
What is a consolidated Ground glass opacity 8mm ? Is this just an opacity or a nodule? I have alot more going on in my lungs and now have to go to pulmonologist to rule out atypical infection vs inflammatory less likely neoplastic process. Trying to learn what I can. My xray from 10 months ago tells them it grew. I know your teaching future radiologist but I'm greatful for your videos and piece of mind.
How r u feel now mam
Superb. Thanks
thank you, this was really pragmatic useful
This was great! I couldn’t find the follow up talk for building a differential based on these - anyone?
hi yeah it is still in the works. sorry I'm slow with these videos lately bc of work
very good
Excellent
Really Great lecture!😁
Hi Dr Agarwal could you please explain the difference between fine and coarse reticulation? This always confuses me! Thank you!
Sir can u describe various bronchiectasis changes in lung hrct
Very helpful!
Thank you for yout excellent video.What was the diagnosis of the last patient?
Hello there,
do you think it could be possible to understand what's going on when we see Ground glass opacity
during a Covid-19 infection ?
Thank you for your explaination.
Hi, I would recommend taking a look at the resources on COVID-19 from the RSNA: www.rsna.org/covid-19
The imaging patterns of COVID-19 can range from nonspecific to mildly specific. However, much more important are the symptoms, prevalence in your community, and lab testing.
What would these CT findings mean: Multiple irregular streaky linear densities, fibrosis, atelectasis, and subpleural reticulation? ( In the bulibasal and basal region.) I just received the CT results ( the CT was taken for another issue - not my lungs) so that specialist couldn't elaborate, I am waiting to see my PCP and a referral to a pulmonologist. I am a 60 year old woman, never smoked, don't have a cough, and this is very alarming to me - trying to figure it out.
CT report of 61 yrs male.
Sir is this normal and self limiting findings or require medical treatment is must.
"Area of consolidation noted in basal segment of left lower lobe as superior segment of right lower lobe with multiple tiny noduls giving tree in bud appearance..
# Minimal left plural effusion noted .
#Traction bronchiactisis changes noted in upper bilateral and middle lobe.
#Signaficant fibrotic changes with interstitial changes noted
along bilateral upper lobe.
Rest of the bilateral parenchyma appears normal in attenuation.
Rrachea and major bronchi appwars normal.
No signaficant medisstinal lymhodanopathy seen.
The heart and medistinal vessel seems normal.
Thoracic vertebrae sternym, ribs ,chest wall normal.
Post kochs sequel in upper lobe.
Moderate size consolidations and tree in bud nodules in bilateral lower lobe"
Pl seeking yiur valuable opinion.
Thank you for your time and effort.
Is there a software with cases available for learning chest CT's ?
Thanks to military service 86-97
ZERO PPE provided during all handling asbestos, grinding metal, cutting concrete etc etc etc welding Diesel and jet fuel exhaust and second hand smoke
That really Cool Video!
Thanks pls also tell us how can we report
Nd more examples of acute nd chronic infection pattern
Brilliant thanks lot, could you tell me please what called characteristic sign of traction bronchiectasis?
How does honeycombing look on saggital image ?
it looks the same on the sagittal as it does on the axials. traction bronchiectasis will look different, on the coronal and sagittals, traction bronchiectasis can look like elongated tubes which helps differentiate traction bronchiectasis from honeycombing.
What would be your differential for the last case? With the combination of GGO, reticulations and traction bronchiectasis, would that fulfill the criteria of fibrotic NSIP?
Yeah I would say nsip for that one.
Clarity wow,but i m still feeling difficulty between broniectasis and honeycombing at pleural regions .
yeah, the distinction between the two may not be as important as once thought. If there aren't any features that suggest otherwise, peripheral and basilar fibrosis without much ground glass is often UIP.
🙏
Hello... thanks for the great explanation! Does reticulation AND traction bronchiectasis definitively mean fibrosis, or is there still room for other diagnoses?
It definitely means fibrosis but the reason why the fibrosis developed can be for a number of reasons.
Shouldn't a single layer of honeycombing be called paraseptal emphysema?
They are different processes. One is lung destruction and one is lung fibrosis. They can be hard to tell apart sometimes.
Pls add time codes ;)
great suggestion, thank you
Daymeee________ has had junk in the lung [thick opaque mucus] for a decade now and is affraid to get a CT scan
Hi sir. How to differentiate between GGO and air trapping, other than doing expiratory scan.
Usually air trapping is very well demarcated as opposed to ggo which usually has ill-defined borders. Also, in air trapping, the lung will look hyperlucent to normal lung and the vessels may be smaller in caliber.
Thank you for your explaination，i want to know what system do you use to watch CT? 3KS
Do you mean the software I use? It is called OsiriX
@@ThoracicRadiology yeah，thank you a lot.
Hi, how do you differentiate honeycombing with emphysema ?
Hi, a few different ways: 1) apical-basilar distribution. emphysema will be more apical and honeycombing usually basilar. 2) look at the septations. emphysema will usually be thin vs honeycombing is thick. 3) are they rows stacked on each other? prob is honeycombing. 4) are they a smoker? if not, prob not emphysema. In the end, it can still be hard, and to make matters worse, it is not uncommon to see both honeycombing and emphysema in the same patient.
😍
is there a treatment?
The treatment will depend on what the underlying cause of fibrosis is
It means no hope at all ! Treatment doesn’t make any difference,suffering longer and in short time you be going 😃 Simply you can behave yourself all your life,worked hard and expect to have a reasonable life when you retired ! Still no cure,might be another 50-100 years ! Godbless us all🙏🙏
g.o.a.t
Ok
Thank you