0:01

So here's another example of someone

0:03

with diffuse pulmonary fibrosis

0:05

and we'll, let's just scroll through quickly.

0:06

I think those of you guys who do a lot of imaging,

0:08

this is pretty classic.

0:09

This sort of slaps you upside the head.

0:12

This is a, obviously does not feel like UIP.

0:15

This feels like something else. Ton of mosaic attenuation.

0:17

These areas of hypodensity within the lungs.

0:20

And the distribution here clearly is gonna be diffused both

0:24

in the axial plane and within the zonal plane.

0:27

And so this is someone who has fibrotic hp.

0:31

Beautiful example here with areas of reticulation.

0:33

Oftentimes these patients have concoct areas

0:36

of ground glass opacity in addition to the fibrosis

0:40

and that likely represents some residual

0:42

inflammation within the lungs.

0:44

Remember this starts out as more of a non fibrotic phenotype

0:48

and then eventually through recurrent inflammation can

0:51

develop into pulmonary fibrosis as we see here.

0:53

So beautiful example here, we pull up the expiratory images.

0:57

Look at that beautiful air trapping.

0:59

Those areas that were mosaic attenuation

1:02

of inspiratory image, they stay equally

1:04

as black on expiration as on inspiration.

1:07

And so because these areas of hypo density don't change

1:11

during expiration, while the rest of the

1:14

non-air trap lung turns more gray, more hyperdense,

1:18

we can be highly sure there's air trapping.

1:20

There's by my guesstimate, maybe like 50% air trapping,

1:23

a ton of air trapping in this patient.

1:26

So pretty classic example, not even pretty classic,

1:29

a textbook example of fibrotic hypersensitivity pneumonitis.