Making a confident diagnosis is a complex task for a specific form of interstitial lung disease and\nproviding appropriate management in an attempt to achieve normalization of the disease can put\nup an alarming process for the clinicians. A set of diffuse and restrictive lung diseases incorporate\nwith idiopathic interstitial pneumonias, showing inflammation and fibrosis of the interstitium due\nto parenchymal damage. High-resolution computed tomography (HRCT) has magnified the diagnostic\nstandpoint in stepwise identification and classified various patterns in the evaluation of interstitial\nlung disease. The aim of our review is to elaborate clinical, radiographic and typical and\natypical HRCT findings of idiopathic interstitial pneumonias by correlating with its differential\ndiagnosis. Idiopathic pulmonary fibrosis is the most predominant idiopathic interstitial pneumonias\nand its diagnosis needs to omit all other well-known causes of interstitial lung diseases. According\nto the 2011 evidence-based guidelines, usual interstitial pneumonia can be diagnosed by\nHRCT when all criteria are fulfilled. Non-specific interstitial pneumonia is distinguished by bilateral\npatchy ground-glass opacities and irregular linear/reticular opacities. Respiratory bronchiolitis\nassociated-interstitial lung disease and desquamative interstitial pneumonia show centrolobular\nnodules and ground-glass opacities as imaging patterns. Cryptogenic organizing pneumonia\nconsists of patchy peripheral or peribronchial consolidations, while ground-glass opacities\nwith tendency for migration, which is evolving to fibrosis, in acute interstitial pneumonia. Lymphoid\ninterstitial pneumonia and idiopathic pleuro-parenchymal fibroelastosis are classified under\nrare idiopathic interstitial pneumonias. HRCT images help radiologists in diagnosis and mapping\nspecific patterns of idiopathic interstitial pneumonias. This article reviews the stages of evolution\nin HRCT features for idiopathic interstitial pneumonias.
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