Wheel within a wheel sign (hepatic candidiasis)

The wheel within a wheel sign describes one of several possible ultrasound findings of hepatic candidiasis. The finding consists of a round lesion with three layers corresponding to the following histopathological changes 2:

  • peripheral hypoechoic area (fibrosis)
  • middle hyperechoic area (inflammatory cells)
  • central hypoechoic area (necrosis)

The histopathologic correlates were shown via an animal model.

This appearance is in contrast to the more common bull’s-eye sign ultrasound finding, which consists of a central echogenic nidus surrounded by a hypoechoic rim.

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Article information

rID: 16489
Section: Signs
Synonyms or Alternate Spellings:
  • Wheel within a wheel sign in hepatic candidiasis

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