Wheel within a wheel sign (diagram)
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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.
Author: Brian Gilcrease-Garcia
- 1. Pastakia B, Shawker TH, Thaler M, O'leary T, Pizzo PA. Hepatosplenic candidiasis: wheels within wheels. (1988) Radiology. 166 (2): 417-21. doi:10.1148/radiology.166.2.3275982 - Pubmed
- 2. Lawrence PH, Holt SC, Levi CS, Gough JC. Ultrasound case of the day. Hepatosplenic candidiasis. (1994) Radiographics : a review publication of the Radiological Society of North America, Inc. 14 (5): 1147-9. doi:10.1148/radiographics.14.5.7991822 - Pubmed