radiological signs ( shënja radiologjike )-9

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    Sllavko K. Kallfa

    Radiological Signs

    Shnja Radiologjike)

    Prmbledhje Artikujsh nga

    Radiopaedia.org

    9

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    weapon and munition inspired signs

    cannonball metastases..........................f.3

    dagger sign........................................................... f.7

    panzerherz(armour heart)..f.19

    saber-sheath trachea............................ .f.20

    Scimitar syndrome.................................. f.23

    target sign............................................................ f.35

    http://radiopaedia.org/articles/weapon-and-munition-inspired-signshttp://radiopaedia.org/articles/cannonball-metastases-1http://radiopaedia.org/articles/cannonball-metastases-1http://radiopaedia.org/articles/dagger-signhttp://radiopaedia.org/articles/dagger-signhttp://radiopaedia.org/articles/panzerherz-1http://radiopaedia.org/articles/panzerherz-1http://radiopaedia.org/articles/saber-sheath-tracheahttp://radiopaedia.org/articles/saber-sheath-tracheahttp://radiopaedia.org/articles/scimitar-syndromehttp://radiopaedia.org/articles/scimitar-syndromehttp://radiopaedia.org/articles/bulls-eye-sign-generalhttp://radiopaedia.org/articles/bulls-eye-sign-generalhttp://radiopaedia.org/articles/bulls-eye-sign-generalhttp://radiopaedia.org/articles/scimitar-syndromehttp://radiopaedia.org/articles/saber-sheath-tracheahttp://radiopaedia.org/articles/panzerherz-1http://radiopaedia.org/articles/dagger-signhttp://radiopaedia.org/articles/cannonball-metastases-1http://radiopaedia.org/articles/weapon-and-munition-inspired-signs
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    Cannonball metastases

    Dr Henry KnipeandDr Ian Bickleet al.

    Cannonball metastasesrefer to large, well circumscribed, round metastases to the lung thatappear like cannonballs.

    Metastases with such an appearance are classically fromrenal cell carcinomaorchoriocarcinoma,and less commonly from an alternative primary tumour, such as prostate

    cancer,synovial sarcomaorendometrial carcinoma.

    The French term "envole de ballons" which translates to "balloons release" is also used to

    describe this same appearance.

    References

    1. Arkless R. RENAL CARCINOMA: HOW IT METASTASIZES. Radiology. 1996;84:

    496-501.Pubmed citation

    Synonyms & Alternative Spellings

    Synonyms or Alternative Spelling Include in Listings?

    Cannonball pulmonary metastases

    Cannonball metastasis

    Cannonball lung metastases

    Cannon-ball metastases

    Balloons release appearance

    http://radiopaedia.org/users/henryknipehttp://radiopaedia.org/users/henryknipehttp://radiopaedia.org/users/clonvarahttp://radiopaedia.org/users/clonvarahttp://radiopaedia.org/users/clonvarahttp://radiopaedia.org/articles/renal-cell-carcinoma-1http://radiopaedia.org/articles/renal-cell-carcinoma-1http://radiopaedia.org/articles/renal-cell-carcinoma-1http://radiopaedia.org/articles/choriocarcinomahttp://radiopaedia.org/articles/choriocarcinomahttp://radiopaedia.org/articles/synovial-sarcomahttp://radiopaedia.org/articles/synovial-sarcomahttp://radiopaedia.org/articles/synovial-sarcomahttp://radiopaedia.org/articles/endometrial-carcinomahttp://radiopaedia.org/articles/endometrial-carcinomahttp://radiopaedia.org/articles/endometrial-carcinomahttp://www.ncbi.nlm.nih.gov/pubmed/14280724http://www.ncbi.nlm.nih.gov/pubmed/14280724http://www.ncbi.nlm.nih.gov/pubmed/14280724http://www.ncbi.nlm.nih.gov/pubmed/14280724http://radiopaedia.org/articles/endometrial-carcinomahttp://radiopaedia.org/articles/synovial-sarcomahttp://radiopaedia.org/articles/choriocarcinomahttp://radiopaedia.org/articles/renal-cell-carcinoma-1http://radiopaedia.org/users/clonvarahttp://radiopaedia.org/users/henryknipe
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    From the case:Renal cell carcinoma with pulmonary metastases

    Modality: X-ray

    http://radiopaedia.org/cases/renal-cell-carcinoma-with-pulmonary-metastaseshttp://radiopaedia.org/cases/renal-cell-carcinoma-with-pulmonary-metastaseshttp://radiopaedia.org/cases/renal-cell-carcinoma-with-pulmonary-metastaseshttp://radiopaedia.org/cases/renal-cell-carcinoma-with-pulmonary-metastases
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    From the case:Cannon ball metastases - from synovial sarcoma

    Modality: CT

    http://radiopaedia.org/cases/cannon-ball-metastases-from-synovial-sarcomahttp://radiopaedia.org/cases/cannon-ball-metastases-from-synovial-sarcomahttp://radiopaedia.org/cases/cannon-ball-metastases-from-synovial-sarcomahttp://radiopaedia.org/cases/cannon-ball-metastases-from-synovial-sarcoma
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    Frontal

    Cannon-ball metastasis From the case:Lung metastases

    Modality: X-ray

    http://radiopaedia.org/cases/lung-metastaseshttp://radiopaedia.org/cases/lung-metastaseshttp://radiopaedia.org/cases/lung-metastaseshttp://radiopaedia.org/cases/lung-metastases
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    Dagger sign

    Dr Henry KnipeandDr Frank Gaillardet al.

    The dagger signis a radiographic feature seen inankylosing spondylitisas single centralradiodense line on frontal radiographs related to ossification of supraspinous and interspinousligaments.

    o

    References

    1. Bone and joint imaging. Donald Resnick, Mark J. Kransdorf. Philadelphia, Pa. :

    Elsevier Saunders, c2005.ISBN:0721602703(find it at amazon.com)

    Synonyms & Alternative Spellings

    Synonyms or Alternative Spelling Include in Listings?

    The dagger sign

    http://radiopaedia.org/users/henryknipehttp://radiopaedia.org/users/henryknipehttp://radiopaedia.org/users/frankhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/articles/ankylosing-spondylitishttp://radiopaedia.org/articles/ankylosing-spondylitishttp://radiopaedia.org/articles/ankylosing-spondylitishttp://www.worldcat.org/wcpa/isbn/0721602703http://www.worldcat.org/wcpa/isbn/0721602703http://www.amazon.com/gp/product/0721602703?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0721602703http://www.amazon.com/gp/product/0721602703?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0721602703http://www.amazon.com/gp/product/0721602703?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0721602703http://www.amazon.com/gp/product/0721602703?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=0721602703http://www.worldcat.org/wcpa/isbn/0721602703http://radiopaedia.org/articles/missing?article%5Btitle%5D=missinghttp://radiopaedia.org/articles/missing?article%5Btitle%5D=missinghttp://radiopaedia.org/articles/ankylosing-spondylitishttp://radiopaedia.org/users/frankhttp://radiopaedia.org/users/henryknipe
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    Dagger Photo by Jrgen Adam Holen. This file is licensed under Creative Commons Attribution 1.0

    license

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    Dagger sign of ankylosing spondylitis

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    From the case:Ankylosing spondylitis of the

    lumbar spine

    Modality: X-ray

    http://radiopaedia.org/cases/ank-spond-lumbarjpghttp://radiopaedia.org/cases/ank-spond-lumbarjpghttp://radiopaedia.org/cases/ank-spond-lumbarjpghttp://radiopaedia.org/cases/ank-spond-lumbarjpghttp://radiopaedia.org/cases/ank-spond-lumbarjpghttp://radiopaedia.org/cases/ank-spond-lumbarjpg
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    From the case:

    Dagger sign in ankylosing spondylitis

    Modality: X-ray

    http://radiopaedia.org/cases/dagger-sign-in-ankylosing-spondylitishttp://radiopaedia.org/cases/dagger-sign-in-ankylosing-spondylitishttp://radiopaedia.org/cases/dagger-sign-in-ankylosing-spondylitis
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    From the case:

    Ankylosing spondylitis with bamboo spine and dagger sign

    Modality: X-r

    http://radiopaedia.org/cases/ankylosing-spondylitis-with-bamboo-spine-and-dagger-signhttp://radiopaedia.org/cases/ankylosing-spondylitis-with-bamboo-spine-and-dagger-signhttp://radiopaedia.org/cases/ankylosing-spondylitis-with-bamboo-spine-and-dagger-sign
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    From the case:

    Ankylosing spondylitis - with dagger sign

    Modality: CT

    http://radiopaedia.org/cases/ankylosing-spondylitis-with-dagger-signhttp://radiopaedia.org/cases/ankylosing-spondylitis-with-dagger-signhttp://radiopaedia.org/cases/ankylosing-spondylitis-with-dagger-sign
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    From the case:

    Ankylosing spondylitis

    Modality: X-ray

    http://radiopaedia.org/cases/ankylosing-spondylitis-19http://radiopaedia.org/cases/ankylosing-spondylitis-19http://radiopaedia.org/cases/ankylosing-spondylitis-19
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    From the case:

    Ankylosing spondylitis

    Modality: X-ray

    http://radiopaedia.org/cases/ankylosing-spondylitis-19http://radiopaedia.org/cases/ankylosing-spondylitis-19http://radiopaedia.org/cases/ankylosing-spondylitis-19
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    From the case:Ankylosing spondilitis

    Modality: Annotated image

    http://radiopaedia.org/cases/ankylosing-spondilitishttp://radiopaedia.org/cases/ankylosing-spondilitishttp://radiopaedia.org/cases/ankylosing-spondilitishttp://radiopaedia.org/cases/ankylosing-spondilitis
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    From the case:Ankylosing spondilitis

    Modality: Annotated image

    http://radiopaedia.org/cases/ankylosing-spondilitishttp://radiopaedia.org/cases/ankylosing-spondilitishttp://radiopaedia.org/cases/ankylosing-spondilitishttp://radiopaedia.org/cases/ankylosing-spondilitis
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    Panzerherz

    Dr Yuranga WeerakkodyandDr Ian Bickleet al.

    Panzerherz(or armoured heart) is a term used to describe the appearance of the heart incalcified constrictivepericarditis.

    Thepericardiumbecomes circumferentially thickened with calcification, limiting the ability ofthe heart to contract. The rim of dense calcification describes how the heart is "armoured", in the

    manner a military vehicle is.

    The calcification is a generic response to a number of potential insults causingconstrictive

    pericarditisincluding:

    tuberculosis

    viral infections trauma

    radiation treatment

    References

    1. Dewey M, Eddicks S, Hamm B. Images in cardiology: Armoured heart. Heart. 2005;91

    (10): 1256.doi:10.1136/hrt.2005.060616-Free text at pubmed-Pubmed citation 2. Eastman G, Wald C. Getting Started in Clinical Radiology: From Image to Diagnosis.

    TIS. ISBN:B005NA3D1U.Read it at Google Books-Find it at Amazon

    Synonyms & Alternative Spellings

    Synonyms or Alternative Spelling Include in Listings?

    Porcelin heart

    Armoured heart

    Armored heart Armour-plated heart

    Armor-plated heart

    http://radiopaedia.org/users/weer06http://radiopaedia.org/users/weer06http://radiopaedia.org/users/clonvarahttp://radiopaedia.org/users/clonvarahttp://radiopaedia.org/users/clonvarahttp://radiopaedia.org/articles/constrictive-pericarditishttp://radiopaedia.org/articles/constrictive-pericarditishttp://radiopaedia.org/articles/constrictive-pericarditishttp://radiopaedia.org/articles/pericardiumhttp://radiopaedia.org/articles/pericardiumhttp://radiopaedia.org/articles/pericardiumhttp://radiopaedia.org/articles/constrictive-pericarditishttp://radiopaedia.org/articles/constrictive-pericarditishttp://radiopaedia.org/articles/constrictive-pericarditishttp://radiopaedia.org/articles/constrictive-pericarditishttp://radiopaedia.org/articles/tuberculosishttp://radiopaedia.org/articles/tuberculosishttp://dx.doi.org/10.1136/hrt.2005.060616http://dx.doi.org/10.1136/hrt.2005.060616http://dx.doi.org/10.1136/hrt.2005.060616http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769117http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769117http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769117http://www.ncbi.nlm.nih.gov/pubmed/16162604http://www.ncbi.nlm.nih.gov/pubmed/16162604http://www.ncbi.nlm.nih.gov/pubmed/16162604http://books.google.com/books?vid=ISBNB005NA3D1Uhttp://books.google.com/books?vid=ISBNB005NA3D1Uhttp://books.google.com/books?vid=ISBNB005NA3D1Uhttp://www.amazon.com/gp/product/B005NA3D1Uhttp://www.amazon.com/gp/product/B005NA3D1Uhttp://www.amazon.com/gp/product/B005NA3D1Uhttp://www.amazon.com/gp/product/B005NA3D1Uhttp://books.google.com/books?vid=ISBNB005NA3D1Uhttp://www.ncbi.nlm.nih.gov/pubmed/16162604http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1769117http://dx.doi.org/10.1136/hrt.2005.060616http://radiopaedia.org/articles/tuberculosishttp://radiopaedia.org/articles/constrictive-pericarditishttp://radiopaedia.org/articles/constrictive-pericarditishttp://radiopaedia.org/articles/pericardiumhttp://radiopaedia.org/articles/constrictive-pericarditishttp://radiopaedia.org/users/clonvarahttp://radiopaedia.org/users/weer06
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    Saber sheath trachea

    Dr Henry KnipeandDr Frank Gaillardet al.

    Saber-sheath trachea refers to diffuse coronal narrowing of the intra-thoracic portion of thetrachea with concomitant widening of the sagittal diameter. It is not uncommon and ispathognomonic forchronic obstructive pulmonary disease (COPD)

    1.

    The sagittal:coronal diameter is over 2:12and the extra-thoracic portion of the trachea is not

    narrowed.

    Radiographic features

    Marked decrease in the coronal diameter of the intra-thoracic trachea associated with an increase

    in its sagittal diameter.

    CT

    Additional features may include:

    inward bowing or displacement of the lateral tracheal walls as a result of cartilageweakness

    mild intra-thoracic tracheal wall thickening

    ossification of tracheal rings

    during forceful expiration, there may be further inward bowing

    References

    1. Marom EM, Goodman PC, Mcadams HP. Diffuse abnormalities of the trachea and

    main bronchi. AJR Am J Roentgenol. 2001;176 (3): 713-7.AJR Am J Roentgenol (fulltext)-Pubmed citation

    2. Webb EM, Elicker BM, Webb WR. Using CT to diagnose nonneoplastic tracheal

    abnormalities: appearance of the tracheal wall. AJR Am J Roentgenol. 2000;174 (5):

    1315-21.AJR Am J Roentgenol (full text)-Pubmed citation

    3. Ciccarese F, Poerio A, Stagni S et -al. Saber-sheath trachea as a marker of severe

    airflow obstruction in chronic obstructive pulmonary disease. Radiol Med. 2014;119 (2):90-6.doi:10.1007/s11547-013-0318-3-Pubmed citation

    Synonyms & Alternative Spellings

    Synonyms or Alternative Spelling Include in Listings?

    Saber sheath trachea

    http://radiopaedia.org/users/henryknipehttp://radiopaedia.org/users/henryknipehttp://radiopaedia.org/users/frankhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/articles/chronic-obstructive-pulmonary-disease-1http://radiopaedia.org/articles/chronic-obstructive-pulmonary-disease-1http://radiopaedia.org/articles/chronic-obstructive-pulmonary-disease-1http://www.ajronline.org/content/176/3/713.fullhttp://www.ajronline.org/content/176/3/713.fullhttp://www.ajronline.org/content/176/3/713.fullhttp://www.ajronline.org/content/176/3/713.fullhttp://www.ncbi.nlm.nih.gov/pubmed/11222211http://www.ncbi.nlm.nih.gov/pubmed/11222211http://www.ncbi.nlm.nih.gov/pubmed/11222211http://www.ajronline.org/content/174/5/1315.fullhttp://www.ajronline.org/content/174/5/1315.fullhttp://www.ajronline.org/content/174/5/1315.fullhttp://www.ncbi.nlm.nih.gov/pubmed/10789785http://www.ncbi.nlm.nih.gov/pubmed/10789785http://www.ncbi.nlm.nih.gov/pubmed/10789785http://dx.doi.org/10.1007/s11547-013-0318-3http://dx.doi.org/10.1007/s11547-013-0318-3http://dx.doi.org/10.1007/s11547-013-0318-3http://www.ncbi.nlm.nih.gov/pubmed/24297576http://www.ncbi.nlm.nih.gov/pubmed/24297576http://www.ncbi.nlm.nih.gov/pubmed/24297576http://www.ncbi.nlm.nih.gov/pubmed/24297576http://dx.doi.org/10.1007/s11547-013-0318-3http://www.ncbi.nlm.nih.gov/pubmed/10789785http://www.ajronline.org/content/174/5/1315.fullhttp://www.ncbi.nlm.nih.gov/pubmed/11222211http://www.ajronline.org/content/176/3/713.fullhttp://www.ajronline.org/content/176/3/713.fullhttp://radiopaedia.org/articles/chronic-obstructive-pulmonary-disease-1http://radiopaedia.org/users/frankhttp://radiopaedia.org/users/henryknipe
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    From

    the case:Saber sheath trachea

    Modality: X-ray

    http://radiopaedia.org/cases/saber-sheath-tracheahttp://radiopaedia.org/cases/saber-sheath-tracheahttp://radiopaedia.org/cases/saber-sheath-tracheahttp://radiopaedia.org/cases/saber-sheath-trachea
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    Scimitar syndrome

    Dr Yuranga WeerakkodyandDr Frank Gaillardet al.

    Scimitar syndrome(also known as pulmonary venolobar syndrome orhypogenetic lungsyndrome)4

    is characterised by a hypoplastic lung that is drained by an anomalous vein into thesystemic venous system. It is a type ofpartial anomalous pulmonary venous return.

    Pathology

    It is essentially a combination ofpulmonary hypoplasiaandpartial anomalous pulmonary venous

    return(PAPVR).It almost exclusively occurs on the right side.

    Haemodynamically, there is an acyanotic left to right shunt. The anomalous vein usually drains

    into

    inferior vena cava -most common

    right atrium

    portal vein

    The lung is frequently perfused by theaorta,but thebronchial treeis still connected and thus the

    lung is not sequestered.

    Associations

    congenital heart disease (e.g.ASD,VSD,tetralogy of Fallot,PDA)

    ipsilateral diaphragmatic anomalies (e.g. accessory diaphragm,diaphragmatic hernia)

    localised bronchiectasis

    horseshoe lung

    vertebral anomalies (e.g.hemivertebrae4)

    genitourinary tract abnormalities4

    Radiographic features

    The diagnosis is made by transthoracic or transesophageal echocardiography, angiography, or by

    CT or MR angiography.

    Plain film

    Chest radiographic findings are that of a small lung with ipsilateral mediastinal shift, and in one

    third of cases the anomalous draining vein may be seen as a tubular structure paralleling the right

    heart border in the shape of a Turkish sword (scimitar). The right heart border maybe blurred.

    Complications

    http://radiopaedia.org/users/weer06http://radiopaedia.org/users/weer06http://radiopaedia.org/users/frankhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/articles/pulmonary-anomalous-pulmonary-venous-connectionhttp://radiopaedia.org/articles/pulmonary-anomalous-pulmonary-venous-connectionhttp://radiopaedia.org/articles/pulmonary-anomalous-pulmonary-venous-connectionhttp://radiopaedia.org/articles/pulmonary-hypoplasiahttp://radiopaedia.org/articles/pulmonary-hypoplasiahttp://radiopaedia.org/articles/pulmonary-hypoplasiahttp://radiopaedia.org/articles/pulmonary-anomalous-pulmonary-venous-connectionhttp://radiopaedia.org/articles/pulmonary-anomalous-pulmonary-venous-connectionhttp://radiopaedia.org/articles/pulmonary-anomalous-pulmonary-venous-connectionhttp://radiopaedia.org/articles/pulmonary-anomalous-pulmonary-venous-connectionhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=partial-anomalous-pulmonary-venous-returnhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=partial-anomalous-pulmonary-venous-returnhttp://radiopaedia.org/articles/inferior-vena-cava-1http://radiopaedia.org/articles/inferior-vena-cava-1http://radiopaedia.org/articles/missing?article%5Btitle%5D=right-atriumhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=right-atriumhttp://radiopaedia.org/articles/portal-veinhttp://radiopaedia.org/articles/portal-veinhttp://radiopaedia.org/articles/aortahttp://radiopaedia.org/articles/aortahttp://radiopaedia.org/articles/aortahttp://radiopaedia.org/articles/missing?article%5Btitle%5D=bronchial-treehttp://radiopaedia.org/articles/missing?article%5Btitle%5D=bronchial-treehttp://radiopaedia.org/articles/missing?article%5Btitle%5D=bronchial-treehttp://radiopaedia.org/articles/congenital-cardiovascular-anomalieshttp://radiopaedia.org/articles/congenital-cardiovascular-anomalieshttp://radiopaedia.org/articles/atrial-septal-defect-2http://radiopaedia.org/articles/atrial-septal-defect-2http://radiopaedia.org/articles/atrial-septal-defect-2http://radiopaedia.org/articles/ventricular-septal-defect-1http://radiopaedia.org/articles/ventricular-septal-defect-1http://radiopaedia.org/articles/ventricular-septal-defect-1http://radiopaedia.org/articles/tetralogy-of-fallothttp://radiopaedia.org/articles/tetralogy-of-fallothttp://radiopaedia.org/articles/tetralogy-of-fallothttp://radiopaedia.org/articles/patent-ductus-arteriosushttp://radiopaedia.org/articles/patent-ductus-arteriosushttp://radiopaedia.org/articles/patent-ductus-arteriosushttp://radiopaedia.org/articles/diaphragmatic-herniahttp://radiopaedia.org/articles/diaphragmatic-herniahttp://radiopaedia.org/articles/diaphragmatic-herniahttp://radiopaedia.org/articles/horseshoe-lunghttp://radiopaedia.org/articles/horseshoe-lunghttp://radiopaedia.org/articles/hemivertebrahttp://radiopaedia.org/articles/hemivertebrahttp://radiopaedia.org/articles/hemivertebrahttp://radiopaedia.org/articles/hemivertebrahttp://radiopaedia.org/articles/horseshoe-lunghttp://radiopaedia.org/articles/diaphragmatic-herniahttp://radiopaedia.org/articles/patent-ductus-arteriosushttp://radiopaedia.org/articles/tetralogy-of-fallothttp://radiopaedia.org/articles/ventricular-septal-defect-1http://radiopaedia.org/articles/atrial-septal-defect-2http://radiopaedia.org/articles/congenital-cardiovascular-anomalieshttp://radiopaedia.org/articles/missing?article%5Btitle%5D=bronchial-treehttp://radiopaedia.org/articles/aortahttp://radiopaedia.org/articles/portal-veinhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=right-atriumhttp://radiopaedia.org/articles/inferior-vena-cava-1http://radiopaedia.org/articles/missing?article%5Btitle%5D=partial-anomalous-pulmonary-venous-returnhttp://radiopaedia.org/articles/pulmonary-anomalous-pulmonary-venous-connectionhttp://radiopaedia.org/articles/pulmonary-anomalous-pulmonary-venous-connectionhttp://radiopaedia.org/articles/pulmonary-hypoplasiahttp://radiopaedia.org/articles/pulmonary-anomalous-pulmonary-venous-connectionhttp://radiopaedia.org/users/frankhttp://radiopaedia.org/users/weer06
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    A potential complication that could develop is development or pulmonary hypertension an

    Eisenmenger physiology.

    Treatment

    Surgical correction should be considered in the presence of significant left to right shunting andpulmonary hypertension.This involves creation of an inter-atrial baffle to redirect the pulmonaryvenous return into theleft atrium.Alternatively, the anomalous vein can be re-implanted directly

    into the left atrium.

    Etymology

    The term was first given by C A Neillet al in 19605.

    Differential diagnosis

    General imaging differential considerations include

    pulmonary sequestration

    right middle lobe atelectasis(on AP plain film)

    unilateral absence of pulmonary artery (UAPA)

    References

    1. Dahnert WF. Radiology Review Manual. (2011) ISBN:1609139437.Read it at Google

    Books-Find it at Amazon 2. Melduni RM, Mookadam F, Mulligan ME. Scimitar syndrome: another one for the

    radiologists. Radiology. 2006;241 (2): 629.doi:10.1148/radiol.2412051952-Pubmed

    citation

    2. Olson MA, Becker GJ. The Scimitar syndrome: CT findings in partial anomalouspulmonary venous return. Radiology. 1986;159 (1): 25-6.Radiology (citation)-Pubmed

    citation

    4. Berrocal T, Madrid C, Novo S et-al. Congenital anomalies of the tracheobronchial tree,lung, and mediastinum: embryology, radiology, and pathology. Radiographics. 24 (1):

    e17.doi:10.1148/rg.e17-Pubmed citation

    5. Schramel FM, Westermann CJ, Knaepen PJ et-al. The scimitar syndrome: clinical

    spectrum and surgical treatment. Eur. Respir. J. 1995;8 (2): 196-201.Eur. Respir. J. (link)-Pubmed citation

    6. Baskar karthekeyan R, Saldanha R, Sahadevan MR et-al. Scimitar syndrome:

    experience with 6 patients. Asian Cardiovasc Thorac Ann. 2009;17 (3): 266-71.doi:10.1177/0218492309104750-Pubmed citation

    7. Woodring JH, Howard TA, Kanga JF. Congenital pulmonary venolobar syndrome

    revisited. Radiographics. 1994;14 (2): 349-69.doi:10.1148/radiographics.14.2.8190958-

    Pubmed citation

    http://radiopaedia.org/articles/missing?article%5Btitle%5D=eisenmenger-syndromehttp://radiopaedia.org/articles/missing?article%5Btitle%5D=eisenmenger-syndromehttp://radiopaedia.org/articles/pulmonary-hypertensionhttp://radiopaedia.org/articles/pulmonary-hypertensionhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=left-atriumhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=left-atriumhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=left-atriumhttp://radiopaedia.org/articles/pulmonary_sequestrationhttp://radiopaedia.org/articles/pulmonary_sequestrationhttp://radiopaedia.org/articles/right-middle-lobe-atelectasishttp://radiopaedia.org/articles/right-middle-lobe-atelectasishttp://radiopaedia.org/articles/missing?article%5Btitle%5D=unilateral-absence-of-pulmonary-artery-uapahttp://radiopaedia.org/articles/missing?article%5Btitle%5D=unilateral-absence-of-pulmonary-artery-uapahttp://books.google.com/books?vid=ISBN1609139437http://books.google.com/books?vid=ISBN1609139437http://books.google.com/books?vid=ISBN1609139437http://books.google.com/books?vid=ISBN1609139437http://www.amazon.com/gp/product/1609139437?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=1609139437http://www.amazon.com/gp/product/1609139437?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=1609139437http://www.amazon.com/gp/product/1609139437?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=1609139437http://dx.doi.org/10.1148/radiol.2412051952http://dx.doi.org/10.1148/radiol.2412051952http://dx.doi.org/10.1148/radiol.2412051952http://www.ncbi.nlm.nih.gov/pubmed/17057083http://www.ncbi.nlm.nih.gov/pubmed/17057083http://www.ncbi.nlm.nih.gov/pubmed/17057083http://www.ncbi.nlm.nih.gov/pubmed/17057083http://radiology.rsna.org/content/159/1/25.citationhttp://radiology.rsna.org/content/159/1/25.citationhttp://radiology.rsna.org/content/159/1/25.citationhttp://www.ncbi.nlm.nih.gov/pubmed/3952313http://www.ncbi.nlm.nih.gov/pubmed/3952313http://www.ncbi.nlm.nih.gov/pubmed/3952313http://www.ncbi.nlm.nih.gov/pubmed/3952313http://dx.doi.org/10.1148/rg.e17http://dx.doi.org/10.1148/rg.e17http://dx.doi.org/10.1148/rg.e17http://www.ncbi.nlm.nih.gov/pubmed/14610245http://www.ncbi.nlm.nih.gov/pubmed/14610245http://www.ncbi.nlm.nih.gov/pubmed/14610245http://erj.ersjournals.com/cgi/pmidlookup?view=long&pmid=7758551http://erj.ersjournals.com/cgi/pmidlookup?view=long&pmid=7758551http://erj.ersjournals.com/cgi/pmidlookup?view=long&pmid=7758551http://www.ncbi.nlm.nih.gov/pubmed/7758551http://www.ncbi.nlm.nih.gov/pubmed/7758551http://www.ncbi.nlm.nih.gov/pubmed/7758551http://dx.doi.org/10.1177/0218492309104750http://dx.doi.org/10.1177/0218492309104750http://www.ncbi.nlm.nih.gov/pubmed/19643850http://www.ncbi.nlm.nih.gov/pubmed/19643850http://www.ncbi.nlm.nih.gov/pubmed/19643850http://dx.doi.org/10.1148/radiographics.14.2.8190958http://dx.doi.org/10.1148/radiographics.14.2.8190958http://dx.doi.org/10.1148/radiographics.14.2.8190958http://www.ncbi.nlm.nih.gov/pubmed/8190958http://www.ncbi.nlm.nih.gov/pubmed/8190958http://www.ncbi.nlm.nih.gov/pubmed/8190958http://dx.doi.org/10.1148/radiographics.14.2.8190958http://www.ncbi.nlm.nih.gov/pubmed/19643850http://dx.doi.org/10.1177/0218492309104750http://www.ncbi.nlm.nih.gov/pubmed/7758551http://erj.ersjournals.com/cgi/pmidlookup?view=long&pmid=7758551http://www.ncbi.nlm.nih.gov/pubmed/14610245http://dx.doi.org/10.1148/rg.e17http://www.ncbi.nlm.nih.gov/pubmed/3952313http://www.ncbi.nlm.nih.gov/pubmed/3952313http://radiology.rsna.org/content/159/1/25.citationhttp://www.ncbi.nlm.nih.gov/pubmed/17057083http://www.ncbi.nlm.nih.gov/pubmed/17057083http://dx.doi.org/10.1148/radiol.2412051952http://www.amazon.com/gp/product/1609139437?ie=UTF8&tag=radiopaediaor-20&linkCode=as2&camp=1789&creative=9325&creativeASIN=1609139437http://books.google.com/books?vid=ISBN1609139437http://books.google.com/books?vid=ISBN1609139437http://radiopaedia.org/articles/missing?article%5Btitle%5D=unilateral-absence-of-pulmonary-artery-uapahttp://radiopaedia.org/articles/right-middle-lobe-atelectasishttp://radiopaedia.org/articles/pulmonary_sequestrationhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=left-atriumhttp://radiopaedia.org/articles/pulmonary-hypertensionhttp://radiopaedia.org/articles/missing?article%5Btitle%5D=eisenmenger-syndrome
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    8. Konen E, Raviv-Zilka L, Cohen RA et-al. Congenital pulmonary venolobar syndrome:

    spectrum of helical CT findings with emphasis on computerized reformatting.

    Radiographics. 2003;23 (5): 1175-84.doi:10.1148/rg.235035004-Pubmed citation

    Synonyms & Alternative Spellings

    Synonyms or Alternative Spelling Include in Listings?

    Pulmonary venolobar syndrome

    Congenital pulmonary venolobar syndrome (CVLS)

    Scimitar's syndrome

    Hypogenetic lung syndrome

    http://dx.doi.org/10.1148/rg.235035004http://dx.doi.org/10.1148/rg.235035004http://dx.doi.org/10.1148/rg.235035004http://www.ncbi.nlm.nih.gov/pubmed/12975508http://www.ncbi.nlm.nih.gov/pubmed/12975508http://www.ncbi.nlm.nih.gov/pubmed/12975508http://www.ncbi.nlm.nih.gov/pubmed/12975508http://dx.doi.org/10.1148/rg.235035004
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    Scimitar Syndrome A tubular

    lesion in in the right lower zone with increasing diameter inferiorly.This is classic apperance of the

    scimitar syndrome. It can be associated with hypoplasia of the right middle/ lower lobe.

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    From the case:Scimitar syndrome

    Modality: MRI

    http://radiopaedia.org/cases/scimitar-syndrome-3http://radiopaedia.org/cases/scimitar-syndrome-3http://radiopaedia.org/cases/scimitar-syndrome-3http://radiopaedia.org/cases/scimitar-syndrome-3
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    From the case:

    Scimitar syndrome

    http://radiopaedia.org/cases/scimitar-syndrome-1http://radiopaedia.org/cases/scimitar-syndrome-1http://radiopaedia.org/cases/scimitar-syndrome-1
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    From the case:Scimitar syndrome

    http://radiopaedia.org/cases/scimitar-syndrome-1http://radiopaedia.org/cases/scimitar-syndrome-1http://radiopaedia.org/cases/scimitar-syndrome-1http://radiopaedia.org/cases/scimitar-syndrome-1
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    From the case:Scimitar syndrome

    Modality: X-ray

    http://radiopaedia.org/cases/scimitar-syndrome-8http://radiopaedia.org/cases/scimitar-syndrome-8http://radiopaedia.org/cases/scimitar-syndrome-8http://radiopaedia.org/cases/scimitar-syndrome-8
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    Abnormal curvilnear shadow

    overlying the heart in the right hemithorax - characteristic Scimitar finding.From the case:Scimitar

    syndrome

    Modality: X-ray

    http://radiopaedia.org/cases/scimitar-syndrome-6http://radiopaedia.org/cases/scimitar-syndrome-6http://radiopaedia.org/cases/scimitar-syndrome-6http://radiopaedia.org/cases/scimitar-syndrome-6http://radiopaedia.org/cases/scimitar-syndrome-6http://radiopaedia.org/cases/scimitar-syndrome-6
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    From the case:Scimitar syndrome

    Modality: CT

    http://radiopaedia.org/cases/scimitar-syndrome-7http://radiopaedia.org/cases/scimitar-syndrome-7http://radiopaedia.org/cases/scimitar-syndrome-7http://radiopaedia.org/cases/scimitar-syndrome-7
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    Archery target Archery target

    for use in target sign articles. target sign of intussesceptionPermission is granted to copy, distribute

    and/or modify this document under the terms of the GNU Free Documentation License, Version 1.2 or

    any later version published by the Free Software Foundation; with no Invariant Sections, no Front-Cover

    Texts, and no Back-Cover Texts. A copy of the license is included in the section entitled "GNU Free

    Documentation License".Original file:

    http://commons.wikimedia.org/wiki/File:Archery_target.jpgAuthor: Casito

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    From the case:

    Bull's eye sign (from cerebral metastasis)

    Modality: MRI

    http://radiopaedia.org/cases/bulls-eye-sign-from-cerebral-metastasishttp://radiopaedia.org/cases/bulls-eye-sign-from-cerebral-metastasishttp://radiopaedia.org/cases/bulls-eye-sign-from-cerebral-metastasis
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    From the case:Intussusception

    Modality: Ultrasound

    http://radiopaedia.org/cases/intussusception-3http://radiopaedia.org/cases/intussusception-3http://radiopaedia.org/cases/intussusception-3http://radiopaedia.org/cases/intussusception-3
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    From the case:Bull's eye sign

    Modality: MR

    http://radiopaedia.org/cases/bulls-eye-sign-1http://radiopaedia.org/cases/bulls-eye-sign-1http://radiopaedia.org/cases/bulls-eye-sign-1http://radiopaedia.org/cases/bulls-eye-sign-1
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    A

    small 'pit' of barium contained within an ulcer cavity in the body of the stomachFrom the case:

    Gastric ulcer - a bull's eye

    Modality: Fluoroscopy

    http://radiopaedia.org/cases/gastric-ulcer-a-bulls-eyehttp://radiopaedia.org/cases/gastric-ulcer-a-bulls-eyehttp://radiopaedia.org/cases/gastric-ulcer-a-bulls-eye
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