Der Radiologe
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Areas with reduced density are a common finding with thin-slice computed tomography (CT) examinations of lung parenchyma. Diffuse and localized patterns can be differentiated. The most frequent cause for a diffuse decrease in density is pulmonary emphysema which can be classified into centrilobular, panlobular and paraseptal emphysema based on the distinct anatomical features. ⋯ Langerhans cell histiocytosis and lymphangioleiomyomatosis are the most frequent cystic diseases of the lung parenchyma. Based on the geometry and anatomical distribution of the cysts a differentiation is mostly possible. Rare diseases leading to a reduced lung density include the Birt-Hogg-Dubé syndrome, lymphoid interstitial pneumonia as well as congenital diseases or diseases which are acquired during early childhood, such as cystic adenomatoid malformation or Swyer-James syndrome.
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A quality certification is nowadays an important competitive factor for clinics and other institutions in Germany. The best known procedures are certification according to the norm DIN EN ISO, the German certification procedure in the healthcare system KTQ (Cooperation for Quality and Transparency in Healthcare) and the procedures of the German Cancer Society or medical professional societies. The majority of German clinics, centers, practices and nursing institutions are certified according to one of these procedures. ⋯ In most cases the certificate can be successfully obtained at least by the second attempt. Appropriate regulations are made by all procedures. Basically a thorough cost-benefit analysis should be carried out before deciding to apply for certification.