Differentiating Between UIP and NSIP | IPF Radiology Rounds

Differentiating UIP and NSIP

Several key features can help to distinguish NSIP from UIP. While helpful, the differences between UIP and NSIP are often not as obvious as this figure suggests, and the difficulty lies in distinguishing the cases that lie toward the middle. NSIP is temporally and spatially homogeneous, while UIP is typically heterogeneous, patchy, and irregular in size.³⁶ The extent of honeycombing and traction bronchiectasis is greater in UIP than the extent of ground glass opacity or micronodules, which are more commonly associated with an NSIP pattern.^5,36

NSIP Subpleural Sparing

Cryptogenic Organizing Pneumonia

Idiopathic Pulmonary Fibrosis (an Update) and Progressive Pulmonary Fibrosis in Adults: An Official ATS/ERS/JRS/ALAT Clinical Practice Guideline

Reference

5. Raghu G, Collard HR, Egan JJ, et al. An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med. 2011;183:788-824.

36. Mueller-Mang C, Grosse C, Schmid K, Stiebellehner L, Bankier AA. What every radiologist should know about idiopathic interstitial pneumonias. Radiographics. 2007;27:595-615.