O slideshow foi denunciado.
Utilizamos seu perfil e dados de atividades no LinkedIn para personalizar e exibir anúncios mais relevantes. Altere suas preferências de anúncios quando desejar.
Aunt Minnie signsAunt Minnie signs
Dr Nitin JainDr Nitin Jain
Senior ResidentSenior Resident
PGIMSPGIMS
RohtakRohtak
1.The Cord1.The Cord SignSign
 The cord sign is a
homogeneous,
hyperattenuating,cord
like appearance on a
unenhanced
tran...
 The cord sign is one of the important clues in
the diagnosis of CVTCVT on an unenhanced CT
scan.
 The cord sign demonst...
 CECT may help illustrate
further clues toward the
diagnosis of CVT, such as
venous filling defects (empty
delta sign), a...
2.The Fat Halo Sign
 The fat halo sign is seen
on CT scans of the
abdomen and appears as
a thickened bowel wall
demonstra...
 The inner layer of soft-
tissue attenuationrepresents
the bowel (small and/or
large) mucosa, while the
layer of low atte...
 The fat halo sign is seen in various
diseases of the bowel in which fatty
infiltration of the submucosa is present .
The...
3.The Cupola Sign
 The cupola sign is
seen at supine
radiography as an
arcuate lucency
overlying the lower
thoracic spine...
 When the patient is in the
supine position,air within the
peritoneal cavity
(pneumoperitoneum) will
preferentially accum...
4.The Split Pleura Sign
 The split pleura sign is
seen on contrast
material–enhanced chest
CT images. There is
enhancemen...
 The split pleura sign refers to thickening
and increased contrast enhancement of
the visceral and the parietal pleura
se...
5.The Reversal Sign
The reversal sign is seen on unenhanced CT images of
the brain as an inversion of the normal
attenuation relationship betw...
 The reversal sign indicates diffuse cerebral injury in a
patient who has suffered an anoxic insult
 Causes of the rever...
6.The Polka-Dot Sign
 The polka-dot sign
is seen on transverse
CT images of
vertebral bodies. The
medullary cavity of
the...
 The polka-dot sign on CT images is produced by
thickened trabeculae in a vertebral body
hemangioma, seen in cross sectio...
7.The Ivory Vertebra Sign
 The ivory vertebra sign
is seen at conventional
radiography and refers to
an increase in opaci...
The ivory vertebra sign can be seen in both adults and
children.
In children, typically the result of lymphoma, usually
...
8.The Crazy-paving Sign
 The crazy-paving sign is a
pattern seen on thin-section
CT images of the lungs. It is
characteri...
 In the crazy-paving sign, ground-glass opacity may reflect the
presence of airspace or interstitial abnormalities.
 The...
9.The Spoke Wheel Sign: Bowel
 At CT, the spoke
wheel sign appears as
fluid-filled, dilated
bowel loops that are
radially...
 In small-bowel volvulus ,the shortening and tightening of the
mesentery causes the fluid-filled, dilated bowel loops tha...
10.The Antral Pad Sign
 The antral pad sign is
seen on a radiograph
of the upper GIT
obtained with orally
administered co...
 The impression is typically caused by a
lesion in the region of the head or body of
the pancreas.
 However, it has been...
11.The Boot-shaped Heart
Sign
 The boot-shaped
heart sign is seen on
the frontal chest
radiograph of children
with decrea...
 The boot-shaped heart or coeur en sabot is often seen in
patients with TOF, which is the most common cause (75%) of
cyan...
12.The Air Crescent Sign
 The air crescent sign
can be visualized
both on radiographs
and CT scans of the
chest . It is
r...
 The air crescent sign is
characteristic of invasive
pulmonary aspergillosis.
 During the neutropenic
period, CT may dem...
 Patients with neutropenia do not develop cavitary lesions.
Visualization of the air crescent sign is an indicator that m...
13.Naclerio’s V Sign
 Naclerio’s V sign can
be seen on frontal
radiographs of the
chest as a V- shaped
air lucency in the...
 This V-shaped air
collection occurs in the
setting of
pneumomediastinum.
 Mediastinal air at this
location is frequentl...
14.The Deep Sulcus Sign
 The deep sulcus sign is
seen on chest radiographs
obtained with the patient in the
supine positi...
 It is important that the lateral costophrenic angles are included on
the radiograph, as failure to diagnose pneumothorax...
15.The Dependent Viscera Sign
 The dependent viscera sign is seen at supine computed
tomography (CT) in the thoracoabdomi...
 The dependent viscera sign is seen with diaphragmatic rupture.
 The absence of posterior support by the diaphragm allow...
16.The CT Arrowhead Sign
 The arrowhead sign, which is
obtained after the administration
of oral and/or rectal contrast
m...
 In primary sign most
specific is depiction of an
abnormal appendix
(maximum diameter
between outer walls greater
than 6 ...
17.The Cobra Head Sign
 The cobra head sign is
characterized by bulbous
dilatation of the distal end
of the ureter with a...
 The cobra head sign is classically seen with an intravesical
ureterocele.
 The term ureterocele denotes a cystic balloo...
18.The Bridging Vascular Sign
 The presence of multiple vessels along the interface between the
uterus and a juxtauterine...
 Juxtauterine masses include subserosal myomas, adnexal
masses, bowel masses, and other pelvic lesions.
 The bridging va...
19.The Molar Tooth Sign
 The molar tooth sign is seen on
transverse computed tomographic
(CT) and magnetic resonance
(MR)...
The sign is caused by a lack of normal decussation of superior
cerebellar peduncular fiber tracts in patients with Jouber...
20.The Mount Fuji Sign
 The Mount Fuji sign is a finding that
can be observed on computed
tomographic (CT) scans of the b...
 The Mount Fuji sign on CT scans of the
brain is useful indiscriminating tension
pneumocephalus from nontension
Pneumocep...
21.The Rigler Sign
 In the Rigler sign, which is also
known as the double-wall sign
or the bas-relief sign , both sides o...
22.The Sandwich Sign
 The sandwich sign refers to
the cross-sectional imaging
appearance of mesenteric fat
and tubular st...
 The CT appearance of the mesenteric fat and vessels resembles
sandwich filling, while the soft-tissue adenopathy represe...
23.The Goblet Sign
 The Goblet sign is a cup-shaped
collection of contrast material
that is seen just distal to an
intral...
 The slow expansion of a polypoid
intraluminal tumorous mass from a
uroepithelial carcinoma causes
dilatation of the uret...
24.The Golf Ball– on-Tee Sign
 The golf ball– on-tee sign is seen during excretory urography and
appears as a contrast ag...
 The golf ball– on-tee sign is part of the spectrum of
papillary necrosis and is distinguished by a papillary cavity
that...
25.The Tree-in-Bud Sign
 The tree-in-bud sign is a finding seen on thin-section CT
images of the lung . Peripheral (within approximately 3–5 mm
o...
THANKSTHANKS
Radiology signs
Próximos SlideShares
Carregando em…5
×

Radiology signs

28.668 visualizações

Publicada em

Radiology signs-cvt, inflammatory bowel disease,Crohn disease, ulcerative colitis, pneumoperitoneum, empyema or an exudative effusion,. diffuse cerebral injury, hypoxia, Polka-Dot Sign , hemangioma, ivory vertebra,metastasis prostate, crazy paving sign, pulmonary alveolar proteinosis, small-bowel volvulus, boot shaped heart, air creascent sign, .Naclerio’s V Sign, Deep sulcus sign, pneumothorax, The Dependent Viscera Sign, appendicites, cobra head sign, molar tooth sign, mount fuji sign, rigler sign, sandwithch sign, goblet sign, tree in bud appearance , tuberculosis

Publicada em: Saúde e medicina

Radiology signs

  1. 1. Aunt Minnie signsAunt Minnie signs Dr Nitin JainDr Nitin Jain Senior ResidentSenior Resident PGIMSPGIMS RohtakRohtak
  2. 2. 1.The Cord1.The Cord SignSign  The cord sign is a homogeneous, hyperattenuating,cord like appearance on a unenhanced transverse computed tomographic (CT) scan of the brain
  3. 3.  The cord sign is one of the important clues in the diagnosis of CVTCVT on an unenhanced CT scan.  The cord sign demonstrates a newly formed thrombus.  Appearance of a strongly hyperintense triangle in the area of the sinus on nonenhanced CT images (dense triangle sign).
  4. 4.  CECT may help illustrate further clues toward the diagnosis of CVT, such as venous filling defects (empty delta sign), and venous collateral flow with gyral and tentorial enhancement.
  5. 5. 2.The Fat Halo Sign  The fat halo sign is seen on CT scans of the abdomen and appears as a thickened bowel wall demonstrating three layers: an inner and an outer layer of soft-tissue attenuation, between which lies a third layer of fatty attenuation.
  6. 6.  The inner layer of soft- tissue attenuationrepresents the bowel (small and/or large) mucosa, while the layer of low attenuation (-18 to -64 HU) results from widening and fatty infiltration of the submucosa. The outer soft-tissue attenuation layer represents the muscularis propria and serosa.
  7. 7.  The fat halo sign is seen in various diseases of the bowel in which fatty infiltration of the submucosa is present . The sign has been described as typically appearing in patients with chronic inflammatory bowel disease (Crohn disease and ulcerative colitis).
  8. 8. 3.The Cupola Sign  The cupola sign is seen at supine radiography as an arcuate lucency overlying the lower thoracic spine and projecting caudad to the heart
  9. 9.  When the patient is in the supine position,air within the peritoneal cavity (pneumoperitoneum) will preferentially accumulate in the anterior portion of the cavity, beneath the central tendon of the diaphragm and within the median subphrenic space
  10. 10. 4.The Split Pleura Sign  The split pleura sign is seen on contrast material–enhanced chest CT images. There is enhancement of the thickened inner visceral and outer parietal pleura, with separation by a collection of pleural fluid.
  11. 11.  The split pleura sign refers to thickening and increased contrast enhancement of the visceral and the parietal pleura separated by empyema or an exudative effusion.
  12. 12. 5.The Reversal Sign
  13. 13. The reversal sign is seen on unenhanced CT images of the brain as an inversion of the normal attenuation relationship between gray and white matter; gray matter is of relatively lower attenuation than adjacent white matter Attenuation of the thalami, brainstem, and cerebellum is increased.
  14. 14.  The reversal sign indicates diffuse cerebral injury in a patient who has suffered an anoxic insult  Causes of the reversal sign include head trauma, hypoxia, birth asphyxia, drowning, status epilepticus, hypothermia, bacterial meningitis, strangulation, nonaccidental trauma, and other causes of global cerebral ischemia  Pathogenesis of the reversal sign is complex and not yet fully understood  The reversal sign is associated with a poor prognosis and indicates irreversible brain damage
  15. 15. 6.The Polka-Dot Sign  The polka-dot sign is seen on transverse CT images of vertebral bodies. The medullary cavity of the vertebral body shows numerous high attenuation dots simulating the polka- dot pattern on clothing.
  16. 16.  The polka-dot sign on CT images is produced by thickened trabeculae in a vertebral body hemangioma, seen in cross section as small punctate areas of high attenuation  The trabecular thickening occurs due to reinforcement of the osseous network adjacent to the vascular channels of the lesion that have caused bone resorption. This process occurs within the fatty marrow  D/D-chondrosarcoma and intraosseous meningioma
  17. 17. 7.The Ivory Vertebra Sign  The ivory vertebra sign is seen at conventional radiography and refers to an increase in opacity of a vertebral body that retains its size and contours, with no change in the opacity and size of adjacent intervertebral disks.,giving it a white appearance as opposed to the normal or possibly osteoporotic appearance of the rest of the vertebral column.
  18. 18. The ivory vertebra sign can be seen in both adults and children. In children, typically the result of lymphoma, usually Hodgkin lymphoma In adults, the ivory vertebra sign has been associated with metastatic disease, especially carcinoma of the prostate or breast, and occasionally with osteosarcoma, carcinoid, Paget disease, and lymphoma, particularly Hodgkin lymphoma. Paget disease can give the appearance of an ivory vertebral body, but, more often, the disease is characterized by the “picture frame” vertebral body Lymphoma is particularly characteristic when there is an accompanying paraspinal soft-tissue mass.
  19. 19. 8.The Crazy-paving Sign  The crazy-paving sign is a pattern seen on thin-section CT images of the lungs. It is characterized by a reticular pattern superimposed on ground- glass opacity.  The term crazy-paving is used because thesign resembles the appearance of paths made with broken pieces of stone or concrete.
  20. 20.  In the crazy-paving sign, ground-glass opacity may reflect the presence of airspace or interstitial abnormalities.  The lines of reticular opacities may represent interlobular septal thickening, thickening of the intralobular interstitium.  The crazy-paving sign was initially recognized in patients who had pulmonary alveolar proteinosis.  The differential diagnosis of crazy-paving sign includes Pneumocystis carinii pneumonia, mucinous bronchioloalveolar carcinoma , sarcoidosis, lipoid pneumonia , adult respiratory distress syndrome , and pulmonary hemorrhage syndromes.  The highest prevalence of crazy-paving sign in this study was seen in pulmonary alveolar proteinosis (100%), diffuse alveolar damage (67%), acute interstitial pneumonia (31%), and adult respiratory distress syndrome (21%).
  21. 21. 9.The Spoke Wheel Sign: Bowel  At CT, the spoke wheel sign appears as fluid-filled, dilated bowel loops that are radially arranged around converging mesenteric vessels that are thickened & stretched.
  22. 22.  In small-bowel volvulus ,the shortening and tightening of the mesentery causes the fluid-filled, dilated bowel loops that are attached to the twisted mesentery to lie in a concentric, more peripheral location, with the engorged and thickened mesenteric vascular structures occupying the center.  The most common causes of small-bowel volvulus (ie, the so-called secondary small-bowel volvulus) are adhesive bands and internal and external hernias.  The most valuable CT finding for the detection of strangulating small-bowel obstruction is poor or no enhancement of the bowel wall after intravenous contrast material injection.
  23. 23. 10.The Antral Pad Sign  The antral pad sign is seen on a radiograph of the upper GIT obtained with orally administered contrast material. The sign refers to an extrinsic impression or indentation on the posteroinferior aspect of the antrum.
  24. 24.  The impression is typically caused by a lesion in the region of the head or body of the pancreas.  However, it has been shown that the antral pad sign can be caused by a normal gallbladder or by pancreatitis, pseudocyst of the pancreas, or neoplasms of the head and body of the pancreas.
  25. 25. 11.The Boot-shaped Heart Sign  The boot-shaped heart sign is seen on the frontal chest radiograph of children with decreased pulmonary vasculature. The left cardiac border resembles the shape of a wooden boot
  26. 26.  The boot-shaped heart or coeur en sabot is often seen in patients with TOF, which is the most common cause (75%) of cyanotic heart disease.  The toe of the boot is formed by the upward pointing cardiac apex, which makes an acute angle with the diaphragm. The upturned cardiac apex is ascribed to right ventricular hypertrophy.  The narrower upper part of the boot results from a small or absent main pulmonary artery.  When TOF is also associated with an atrial septal defect, it is called the pentalogy of Fallot.  Right aortic arch occurs in 20%–30% of patients with cyanotic TOF.
  27. 27. 12.The Air Crescent Sign  The air crescent sign can be visualized both on radiographs and CT scans of the chest . It is recognized as a crescent-shaped or circumferential area of radiolucency within a parenchymal consolidation or nodular opacity.
  28. 28.  The air crescent sign is characteristic of invasive pulmonary aspergillosis.  During the neutropenic period, CT may demonstrate areas of ground-glass attenuation surrounding these nodular opacities,termed the “CT halo sign,” this represents pulmonary hemorrhage, and in the correct clinical setting, it is highly specific for invasive aspergillosis.
  29. 29.  Patients with neutropenia do not develop cavitary lesions. Visualization of the air crescent sign is an indicator that marks the recovery phase of the infection.  A cavitating neoplasm,infections such as tuberculosis, nocardiosis, or a bacterial lung abscess may also give rise to an air crescent sign.  Not to mistake the Monad sign of aspergilloma with the air crescent sign of invasive aspergillosis. The former develops in immunologically competent patients with structural lung disease. The radiographic appearance is that of a gravity dependent mass within a preexisting cavity.
  30. 30. 13.Naclerio’s V Sign  Naclerio’s V sign can be seen on frontal radiographs of the chest as a V- shaped air lucency in the left lower mediastinal area.
  31. 31.  This V-shaped air collection occurs in the setting of pneumomediastinum.  Mediastinal air at this location is frequently seen in the presence of esophageal perforation.  One limb of the V is produced by mediastinal air outlining the left lower lateral mediastinal border. The other limb is produced by air between the parietal pleura and medial left hemidiaphragm.
  32. 32. 14.The Deep Sulcus Sign  The deep sulcus sign is seen on chest radiographs obtained with the patient in the supine position. It represents lucency of the lateral costophrenic angle extending toward the hypochondrium.
  33. 33.  It is important that the lateral costophrenic angles are included on the radiograph, as failure to diagnose pneumothorax may be life- threatening because of the risk of tension.  False-positive cases of the deep sulcus sign have been described in patients with chronic obstructive pulmonary disease, in which hyperaeration of the lungs deepens the lateral costophrenic angle.  Further evaluation with lateral decubitus radiography may be helpful, but computed tomography is more sensitive for confirming the presence of a pneumothorax in supine patients.
  34. 34. 15.The Dependent Viscera Sign  The dependent viscera sign is seen at supine computed tomography (CT) in the thoracoabdominal area. The viscera (ie, the bowel or solid organs) are positioned against the posterior ribs, with obliteration of the posterior costophrenic recess
  35. 35.  The dependent viscera sign is seen with diaphragmatic rupture.  The absence of posterior support by the diaphragm allows viscera to “fall” against the posterior ribs to a dependent position.  The dependent viscera sign is up to 100% sensitive as a sign of diaphragmatic rupture and 83% sensitive for right-sided injury.
  36. 36. 16.The CT Arrowhead Sign  The arrowhead sign, which is obtained after the administration of oral and/or rectal contrast material, is seen on computed tomographic (CT) images as an arrowhead-shaped collection of contrast medium localized to the upper part of the cecum near the orifice of the appendix
  37. 37.  In primary sign most specific is depiction of an abnormal appendix (maximum diameter between outer walls greater than 6 mm without contrast medium distending the lumen).  Secondary signs are the presence of an appendicolith and fat stranding, gas outside the lumen of the appendix, periappendiceal fluid, thickening of the terminal ileal or sigmoid wall, and lymphadenopathy.
  38. 38. 17.The Cobra Head Sign  The cobra head sign is characterized by bulbous dilatation of the distal end of the ureter with a surrounding radiolucent halo, seen within the contrast material– enhanced bladder on intravenous urograms
  39. 39.  The cobra head sign is classically seen with an intravesical ureterocele.  The term ureterocele denotes a cystic ballooning of the distal end of the ureter.  This type of ureterocele is also termed orthotopic, since it arises from a ureter with a normal insertion into the Trigone.  Most intravesical ureteroceles are incidental findings in asymptomatic adult patients. When large, ureteroceles can cause obstruction of the bladder neck, along with obstruction of the ipsilateral ureter. This results in an increased frequency of calculus formation, as well as infection.
  40. 40. 18.The Bridging Vascular Sign  The presence of multiple vessels along the interface between the uterus and a juxtauterine mass (ie, a pelvic mass adjacent to the uterus) at color and power Doppler ultrasonogaphy (US) imaging is known as the bridging vascular sign
  41. 41.  Juxtauterine masses include subserosal myomas, adnexal masses, bowel masses, and other pelvic lesions.  The bridging vascular sign indicates the uterine origin of a juxtauterine mass.  Solid ovarian masses, such as fibromas, granulosa cell tumors, germ cell tumors (dysgerminomas, mixed germ cell tumors, or terato-sarcomas), metastatic tumors, and lymphomas, may be confused with subserous myomas owing to their similar imaging findings.
  42. 42. 19.The Molar Tooth Sign  The molar tooth sign is seen on transverse computed tomographic (CT) and magnetic resonance (MR) images obtained at the level of the midbrain in patients with Joubert syndrome  The term molar tooth refers to the characteristic appearance of an enlarged and horizontally directed tubular structure on each side of the midline emerging from the midbrain.
  43. 43. The sign is caused by a lack of normal decussation of superior cerebellar peduncular fiber tracts in patients with Joubert syndrome.  Joubert syndrome is an autosomal recessive disorder with characteristic pathologic findings of cerebellar vermian hypoplasia with a midline cleft.  Joubert syndrome has also been associated with a constellation of other findings, including microcephaly, dysmorphic facies, retinal dystrophy, tongue protrusion, multicystic kidney disease, congenital heart disease, unsegmented midbrain tectum, and agenesis of the corpus callosum.
  44. 44. 20.The Mount Fuji Sign  The Mount Fuji sign is a finding that can be observed on computed tomographic (CT) scans of the brain in which bilateral subdural hypoattenuating collections cause compression and separation of the frontal lobes.
  45. 45.  The Mount Fuji sign on CT scans of the brain is useful indiscriminating tension pneumocephalus from nontension Pneumocephalus.  Tension pneumocephalus occurs most commonly after the neurosurgical evacuation of a subdural hematoma.  Treatment options for tension pneumocephalus include drilling of burr holes, craniotomy, needle aspiration, ventriculostomy placement, administration of 100% oxygen, and closure of dural defects.
  46. 46. 21.The Rigler Sign  In the Rigler sign, which is also known as the double-wall sign or the bas-relief sign , both sides of the bowel wall can be visualized on a radiograph of the abdomen obtained with the patient in the supine position.  The Rigler sign is the second most common sign of pneumoperitoneum on supine radiographs, with a prevalence of 32% in the studied cases of pneumoperitoneum.
  47. 47. 22.The Sandwich Sign  The sandwich sign refers to the cross-sectional imaging appearance of mesenteric fat and tubular structures as the sandwich filling and the homogeneous soft-tissue masses as the two halves of a sandwich bun.
  48. 48.  The CT appearance of the mesenteric fat and vessels resembles sandwich filling, while the soft-tissue adenopathy represents the bun.  There are numerous causes of mesenteric denopathy.,carcinoma,, carcinoid tumor, lymphadenopathy syndrome associated with acquired immunodeficiency syndrome (AIDS), tuberculosis, Whipple disease, and inflammatory bowel disease are among the most common causes. These diseases, however, do not produce the large bulky adenopathy that results in the sandwich sign.  This sign is specific to mesenteric lymphomas, most mesenteric lymphomas are NHLs.
  49. 49. 23.The Goblet Sign  The Goblet sign is a cup-shaped collection of contrast material that is seen just distal to an intraluminal filling defect of the Ureter  The Goblet sign is a clue that the ureteral filling defect is a mass rather than a calculus
  50. 50.  The slow expansion of a polypoid intraluminal tumorous mass from a uroepithelial carcinoma causes dilatation of the ureter distal as well as proximal to the mass ,thus causes the cup-shaped collection of contrast material . On the other hand, the ureteral lumen just distal to a mechanical obstruction caused by a calculus will have a narrowed appearance due to wall spasm, edema, or both.
  51. 51. 24.The Golf Ball– on-Tee Sign  The golf ball– on-tee sign is seen during excretory urography and appears as a contrast agent–filled cavity (the golf ball) that lies adjacent to a blunted calyx (the tee).
  52. 52.  The golf ball– on-tee sign is part of the spectrum of papillary necrosis and is distinguished by a papillary cavity that lies adjacent to a blunted Calyx.  The common etiology of papillary necrosis can be conveniently remembered with mnemonic NSAID: nonsteroidal anti-inflammatory medications, sickle cell hemoglobinopathies, analgesic nephropathy (specifically aspirin and phenacetin), infection (specifically tuberculosis), and diabetes.  Papillary necrosis can be bilateral or unilateral. Bilateral disease usually indicates a systemic or disseminated cause and often results from analgesic nephropathy, diabetes, and sickle cell trait or disease. Unilateral disease is associated with severe unilateral acute pyelonephritis, obstruction, and renal vein thrombosis.
  53. 53. 25.The Tree-in-Bud Sign
  54. 54.  The tree-in-bud sign is a finding seen on thin-section CT images of the lung . Peripheral (within approximately 3–5 mm of the pleural surface), small (2–4 mm in diameter), centrilobular, and well-defined nodules of soft-tissue attenuation are connected to linear, branching opacities that have more than one contiguous branching site, thus resembling a tree in bud.  The tree-in-bud pattern represents bronchiolar luminal impaction with mucus, pus, or fluid, which demarcates the normally invisible branching course of the peripheral airways  The tree-in-bud sign has primarily been used as a descriptive term for abnormalities found on CT scans of the lung in patients with endobronchial spread of Mycobacterium tuberculosis.
  55. 55. THANKSTHANKS

×