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Interlobular septal thickening (Kerley B lines) in the lung apex is a specific sign for pulmonary congestion, although not exclusive (since in ILD there may be apical reticulation). In combination with peribronchial cuffing and increased cardiothoracic ratio, it allows differentiation between cardiac/renal insufficiency and pulmonary ILD.

Kerley B lines in the lung apex – a distinct CT sign for pulmonary congestion