Fleischner sign (enlarged pulmonary artery)
Citation, DOI & article data
The Fleischner sign refers to a prominent central pulmonary artery that can be commonly caused either by pulmonary hypertension or by distension of the vessel by a large pulmonary embolus. It can be seen on chest radiographs, CT pulmonary angiography (CTPA), and MR pulmonary angiography (MRPA).
It is seen most commonly in the setting of massive pulmonary embolism (defined angiographically as involving 50% or more of the major pulmonary artery branches). It has a low sensitivity but high specificity.
It is one of several described signs of pulmonary embolus on chest radiographs.
History and etymology
It is named after Felix George Fleischner (1893-1969), an Austrian-American radiologist, who first described it in 1961 7. Pre-World War II, Fleischner was a Professor of Radiology in Vienna, before moving to Boston where he eventually became a Professor at Harvard College.
- 1. Plain Film Signs in Pulmonary Embolism (with CT correlate), Kirwadi A, Bickle IC. http://www.eurorad.org/eurorad/case.php?id=7735 Eurorad case 7735
- 2. Worsley DF, Alavi A, Aronchick JM et-al. Chest radiographic findings in patients with acute pulmonary embolism: observations from the PIOPED Study. Radiology. 1993;189 (1): 133-6. Radiology (abstract) - Pubmed citation
- 3. Abbas A, St Joseph EV, Mansour OM et-al. Radiographic features of pulmonary embolism: Westermark and Palla signs. Postgrad Med J. 2014;90 (1065): 422-3. doi:10.1136/postgradmedj-2013-132000 - Pubmed citation
- 4. Hansell DM, Bankier AA, Macmahon H et-al. Fleischner Society: glossary of terms for thoracic imaging. Radiology. 2008;246 (3): 697-722. Radiology (full text) - doi:10.1148/radiol.2462070712 - Pubmed citation
- 5. Stein PD, Athanasoulis C, Greenspan RH, Henry JW. Relation of plain chest radiographic findings to pulmonary arterial pressure and arterial blood oxygen levels in patients with acute pulmonary embolism. (1992) The American journal of cardiology. 69 (4): 394-6. doi:10.1016/0002-9149(92)90240-y - Pubmed
- 6. Fleischner FG. Roentgen diagnosis of pulmonary embolism. The Heart bulletin. 10: 104-7. Pubmed
- 7. Maizlin ZV, Cooperberg PL, Clement JJ, Vos PM, Coblentz CL. People behind exclusive eponyms of radiologic signs (Part II). Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes. 61 (1): 44-53. doi:10.1016/j.carj.2009.10.011 - Pubmed