Mistletoe sign

Last revised by Patrick J Rock on 2 Aug 2021

Citation, DOI, disclosures and article data

Citation:

Suhai F, Rock P, Baba Y, et al. Mistletoe sign. Reference article, Radiopaedia.org (Accessed on 19 Apr 2024) https://doi.org/10.53347/rID-85300

DOI:

https://doi.org/10.53347/rID-85300

Permalink:

https://radiopaedia.org/articles/85300

rID:

85300

Article created:

22 Dec 2020, Ferenc Imre Suhai

Disclosures:

At the time the article was created Ferenc Imre Suhai had no recorded disclosures.

View Ferenc Imre Suhai's current disclosures

Last revised:

2 Aug 2021, Patrick J Rock

Disclosures:

At the time the article was last revised Patrick J Rock had no recorded disclosures.

View Patrick J Rock's current disclosures

Revisions:

7 times, by 6 contributors - see full revision history and disclosures

Systems:

Cardiac

Sections:

Signs

Synonyms:

Mistletoe signs

The mistletoe sign refers to solid enhancing perivascular masses around the coronary arteries in the presence of idiopathic retroperitoneal fibrosis (Ormond's disease).

The presence of the mistletoe sign on cardiac MRI and coronary CT angiography is relatively rare, but it might be a characteristic manifestation of retroperitoneal fibrosis. With the increasing number of non-invasive cardiac imaging tests performed worldwide, the recognition of this imaging sign could aid the diagnosis of retroperitoneal fibrosis.

History and etymology

The sign was first described by Pál Maurovich-Horvat and colleagues in 2017 ³.

The appearance of the soft tissue around the coronary arteries invokes the appearance of mistletoe, a hemiparasitic plant, around the branches of a tree that it has invaded (see Figure 1).