1. Which of the following imaging findings is most indicative of fibrotic changes within ground-glass opacities (GGOs)?
A. Presence of air bronchograms
B. Smooth interlobular septal thickening
C. Traction bronchiectasis
D. Centrilobular nodules
Answer: C. Traction bronchiectasis
?Traction bronchiectasis is a hallmark of fibrotic changes seen in ILD, often accompanying ground-glass opacities that reflect fibrotic remodeling.?
Reference: PubMed: Fibrosis Imaging
2. According to the Fleischner Society guidelines, what is the recommended follow-up for a solitary pure ground-glass nodule measuring less than 6 mm in diameter?
A. No routine follow-up required
B. CT at 6-12 months to confirm persistence
C. Immediate biopsy
D. PET-CT scan
Answer: A. No routine follow-up required
?The Fleischner Society recommends that solitary pure ground-glass nodules smaller than 6 mm do not require routine follow-up.?
Reference: Fleischner Society Guidelines
3. Which high-resolution CT (HRCT) feature is least likely to be associated with pulmonary fibrosis?
A. Honeycombing
B. Ground-glass opacity without architectural distortion
C. Reticular pattern
D. Traction bronchiolectasis
Answer: B. Ground-glass opacity without architectural distortion
?GGOs without accompanying architectural distortion are less specific for fibrosis and may indicate reversible processes.?
Reference: PubMed: ILD Features
4. In the context of interstitial lung disease (ILD), which statement best describes the significance of ground-glass opacities (GGOs) on HRCT?
A. GGOs always indicate irreversible fibrosis.
B. GGOs are specific to idiopathic pulmonary fibrosis (IPF).
C. GGOs can represent both inflammatory changes and early fibrosis.
D. GGOs are synonymous with pulmonary consolidation.
Answer: C. GGOs can represent both inflammatory changes and early fibrosis.
?Ground-glass opacities on HRCT are non-specific and can indicate reversible inflammatory changes, edema, or early fibrotic processes.?
Reference: Radiographics: GGOs
5. Which of the following is NOT a typical feature of usual interstitial pneumonia (UIP) pattern on HRCT?
A. Subpleural basal predominance
B. Honeycombing
C. Ground-glass opacities without reticulation
D. Absence of significant lymphadenopathy
Answer: C. Ground-glass opacities without reticulation
?In UIP, GGOs are usually accompanied by reticulation, architectural distortion, or honeycombing.?
Reference: Thoracic Society Guidelines
6. What feature distinguishes fibrotic ground-glass opacity (GGO) from non-fibrotic GGO on HRCT?
A. Smooth interlobular septal thickening
B. Traction bronchiectasis or bronchiolectasis
C. Centrilobular nodules
D. Consolidation
Answer: B. Traction bronchiectasis or bronchiolectasis
?Traction bronchiectasis is a hallmark of fibrotic changes seen in ILD, often accompanying ground-glass opacities that reflect fibrotic remodeling.?
Reference: PubMed: Fibrosis Imaging
7. Which of the following is most characteristic of advanced fibrotic interstitial lung disease on HRCT?
A. Ground-glass opacity without architectural distortion
B. Honeycombing with subpleural and basal predominance
C. Centrilobular nodules in the mid-zones
D. Pleural effusion
Answer: B. Honeycombing with subpleural and basal predominance
?Honeycombing consists of clustered cystic spaces and is a key imaging feature of UIP, located in the subpleural basal areas of the lung.?
Reference: Fleischner Society: UIP Pattern
8. Which of the following diseases is LEAST likely to present with traction bronchiectasis or bronchiolectasis?
A. Idiopathic pulmonary fibrosis (IPF)
B. Non-specific interstitial pneumonia (NSIP)
C. Sarcoidosis
D. Pneumocystis pneumonia
Answer: D. Pneumocystis pneumonia
?Pneumocystis pneumonia primarily manifests as diffuse ground-glass opacities and may lack significant fibrotic components seen in traction bronchiectasis.?
Reference: PubMed: Pneumocystis Imaging
9. What is the significance of reticulation superimposed on ground-glass opacity (GGO) in interstitial lung disease?
A. Indicates chronic inflammation
B. Suggests irreversible fibrosis
C. Reflects alveolar hemorrhage
D. Implies pulmonary edema
Answer: B. Suggests irreversible fibrosis
?Reticulation combined with ground-glass opacity strongly supports the presence of fibrotic changes rather than acute or reversible conditions.?
Reference: Radiographics: Fibrotic GGO
10. According to the Fleischner Society, what is the most appropriate follow-up for a patient with suspected fibrotic interstitial lung disease on HRCT?
A. Repeat CT in 3-6 months
B. Immediate biopsy
C. PET-CT to confirm fibrosis
D. Multidisciplinary discussion (MDD)
Answer: D. Multidisciplinary discussion (MDD)
?MDD ensures a comprehensive approach to ILD diagnosis, integrating radiologic, clinical, and histopathologic data.?
Reference: Fleischner Society: MDD Recommendations