Wheel within a wheel sign (diagram)

Case contributed by Dr Brian Gilcrease-Garcia
Diagram

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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Case information

rID: 58743
Published: 4th Mar 2018
Last edited: 14th Aug 2019
Inclusion in quiz mode: Excluded
Institution: Washington University in Saint Louis

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