Changes in high-resolution computed tomography (HRCT) pattern over time. a) Idiopathic pulmonary fibrosis (IPF), increased specificity over time. Changes.

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Changes in high-resolution computed tomography (HRCT) pattern over time. a) Idiopathic pulmonary fibrosis (IPF), increased specificity over time. Changes in high-resolution computed tomography (HRCT) pattern over time. a) Idiopathic pulmonary fibrosis (IPF), increased specificity over time. Initial HRCT in a patient with early IPF (left) shows mild subpleural reticulation without honeycombing. 3 years later (right) honeycombing has developed. While the initial study is nonspecific, the follow-up HRCT would be considered a “definite usual interstitial pneumonia” pattern and diagnostic of IPF in the appropriate clinical setting. b) Nonspecific interstitial pneumonia (NSIP), change in pattern over time. Baseline prone HRCT image (left) in a patient with rheumatoid arthritis demonstrates reticulation and traction bronchiectasis with subpleural sparing compatible with NSIP. 8 years later (right) there is diffuse honeycombing that would be compatible with a usual interstitial pneumonia pattern. Brett M. Elicker et al. Eur Respir Rev 2017;26:170008 ©2017 by European Respiratory Society