Wheel within a wheel sign (diagram)

Case contributed by Dr Brian Gilcrease-Garcia

This is one of several appearances of a lesion caused by hepatic candidiasis on ultrasound. The outer hypoechoic "wheel" corresponds to fibrosis, which surrounds a middle hyperechoic "wheel" of inflammation. The central hypoechoic focus represents an area of central necrosis.

Of note, this appearance is not reported by CT imaging.

Case Discussion

Author: Brian Gilcrease-Garcia

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