The banana and egg sign is a sign for the diagnosis of pulmonary arterial hypertension (PAH) on axial CT/MR images. It refers to the appearance of the aortic arch (banana) next to a distorted main pulmonary artery (egg). Like an egg, the main pulmonary artery is preferentially dilated in the PA plane, taking on an oval-shape at the level of the aortic arch.
This sign has been described as having a high specificity and PPV for PAH, especially when found in the setting of additional classic signs of PAH 1, such as the carina crossover sign. Some have raised the concern that the high PPV is a function of the subset of patients the sign was described in (patients undergoing right heart catheterization) and that the specificity and PPV of the sign would not be as high in a general population 2.
- 1. Chris L. Scelsi, William B. Bates, Yulia V. Melenevsky, Gyanendra K. Sharma, Norman B. Thomson, Jayanth H. Keshavamurthy. Egg-and-Banana Sign: A Novel Diagnostic CT Marker for Pulmonary Hypertension. (2018) American Journal of Roentgenology. 210 (6): 1235-1239. doi:10.2214/AJR.17.19208 - Pubmed
- 2. Deng F. Reporting Predictive Values for Diagnostic Tests. (2018) AJR. American journal of roentgenology. 211 (5): W278. doi:10.2214/AJR.18.20142 - Pubmed