Citation, DOI, disclosures and article data
Citation:
Gaillard F, Verikios N, Silverstone L, et al. Split pleura sign (empyema). Reference article, Radiopaedia.org (Accessed on 06 Oct 2024) https://doi.org/10.53347/rID-8597
The split pleura sign is seen with pleural empyemas and is considered the most reliable CT sign helping to distinguish an empyema from a peripheral pulmonary abscess (see empyema vs pulmonary abscess) 1,2.
The sign results from fibrin coating both the parietal and visceral surfaces of the pleura with resulting ingrowth of blood vessels and contrast enhancement. Both layers of the pleura can then be visualized as linear regions of enhancement that come together at the margins of the collection 1. Extrapleural fat hypertrophy develops between the parietal pleura and ribs and is a marker of chronicity 4.
Other causes of split pleura sign include 3:
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1. Stark DD, Federle MP, Goodman PC et-al. Differentiating lung abscess and empyema: radiography and computed tomography. AJR Am J Roentgenol. 1983;141 (1): 163-7. doi:10.2214/ajr.141.1.163 - Pubmed citation
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2. Kazerooni Ella A and Barry H Gross. The Core Curriculum: Cardiopulmonary Imaging. 1st ed. Lippincott Williams & Wilkins, 2003. ISBN: 0781736552.
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3. Kraus G. The Split Pleura Sign. Radiology. 2007;243(1):297-8. doi:10.1148/radiol.2431041658 - Pubmed
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4. Santamarina M, Beddings I, Lermanda Holmgren G, Opazo Sanchez H, Volpacchio M. Multidetector CT for Evaluation of the Extrapleural Space. Radiographics. 2017;37(5):1352-70. doi:10.1148/rg.2017160180 - Pubmed
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