Periwinkle sign (supratentorial ependymoma)

Last revised by Frank Gaillard on 16 May 2022

The periwinkle sign has been coined to describe what has been claimed to be a characteristic appearance of intraparenchymal supratentorial ependymomas on non-enhanced CT axial images.

The central solid component sometimes demonstrates centripetal calcification surrounding the central necrotic core. This appearance is reminiscent of a periwinkle flower. More fanciful still, the often present surrounding peripheral cyst has been likened to a leaf 1.


For reasons that are not immediately apparent a particular flower, the periwinkle, also known as myrtle herb (Vinca minor) is chosen, although in fairness many flowers would appear similar. 

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Cases and figures

  • Periwinkle flower (photo)
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  • Case 1
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