Spoke wheel sign (focal nodular hyperplasia)

Last revised by Bouhouche Abdeldjalil on 6 Jun 2023

The spoke wheel sign is described in focal nodular hyperplasia (FNH) and describes the pattern of internal vasculature of FNHs seen on color Doppler ultrasound when multiple arteries radiate peripherally from the center of the lesion.

This sign was classically applied to the color/power Doppler ultrasound but contrast-enhanced ultrasonography (CEUS), being a real-time imaging modality, is more sensitive than Doppler ultrasound , dynamic CT, and MRI in the detection of the spoke wheel sign typically 1.

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