Reversed halo sign in invasive pulmonary fungal infections.
ABSTRACT Computed tomography scans of documented pulmonary mold infections were reviewed for the presence of the reversed halo sign, a focus of ground-glass attenuation surrounded by a solid ring. The reversed halo sign was an early sign, seen in approximately 4% of patients with pulmonary mold infections, usually with zygomycosis.
Article: Signs in chest imaging.[show abstract] [hide abstract]
ABSTRACT: A radiological sign can sometimes resemble a particular object or pattern and is often highly suggestive of a group of similar pathologies. Awareness of such similarities can shorten the differential diagnosis list. Many such signs have been described for X-ray and computed tomography (CT) images. In this article, we present the most frequently encountered plain film and CT signs in chest imaging. These signs include for plain films the air bronchogram sign, silhouette sign, deep sulcus sign, Continuous diaphragm sign, air crescent ("meniscus") sign, Golden S sign, cervicothoracic sign, Luftsichel sign, scimitar sign, doughnut sign, Hampton hump sign, Westermark sign, and juxtaphrenic peak sign, and for CT the gloved finger sign, CT halo sign, signet ring sign, comet tail sign, CT angiogram sign, crazy paving pattern, tree-in-bud sign, feeding vessel sign, split pleura sign, and reversed halo sign.Diagnostic and interventional radiology (Ankara, Turkey) 03/2011; 17(1):18-29. · 1.10 Impact Factor
Article: The diagnostic value of halo and reversed halo signs for invasive mold infections in compromised hosts.[show abstract] [hide abstract]
ABSTRACT: The halo sign is a CT finding of ground-glass opacity surrounding a pulmonary nodule or mass. The reversed halo sign is a focal rounded area of ground-glass opacity surrounded by a crescent or complete ring of consolidation. In severely immunocompromised patients, these signs are highly suggestive of early infection by an angioinvasive fungus. The halo sign and reversed halo sign are most commonly associated with invasive pulmonary aspergillosis and pulmonary mucormycosis, respectively. Many other infections and noninfectious conditions, such as neoplastic and inflammatory processes, may also manifest with pulmonary nodules associated with either sign. Although nonspecific, both signs can be useful for preemptive initiation of antifungal therapy in the appropriate clinical setting. This review aims to evaluate the diagnostic value of the halo sign and reversed halo sign in immunocompromised hosts and describes the wide spectrum of diseases associated with them.Clinical Infectious Diseases 05/2011; 52(9):1144-55. · 9.15 Impact Factor
Article: Computed tomography findings in invasive pulmonary aspergillosis in non-neutropenic transplant recipients and neutropenic patients, and their prognostic value.[show abstract] [hide abstract]
ABSTRACT: We evaluated CT findings and their prognostic value in non-neutropenic transplant recipients with invasive pulmonary aspergillosis (IPA) compared with neutropenic patients with IPA. All adult patients during a 27-month who met the criteria for proven or probable IPA according to the 2008 EORTC/MSG criteria were retrospectively enrolled. Initial CT findings were reviewed by two radiologists blinded to the patients' demographics and clinical outcomes. A total of 50 non-neutropenic transplant recipients and 60 neutropenic patients were enrolled. Consolidation-or-mass, halo signs, and angio-invasive form were observed less often in non-neutropenic transplant recipients than in neutropenic patients: (56%, 26%, and 32%) versus (78%, 55%, and 60%, p = 0.01, p = 0.002, and p = 0.003, respectively). Multivariate analysis revealed that macronodules (HR 0.31, p = 0.001), multiple infarct-shaped consolidations (HR 4.26, p < 0.001), renal replacement therapy (HR 5.62, p < 0.001) and persistence of a positive serum galactomannan (HR 7.14, p < 0.001) were independently associated with 90-day mortality. Our data indicate that CT findings in non-neutropenic transplant recipients with IPA are similar to those in neutropenic patients with IPA except that consolidation-or-mass, halo sings, and angio-invasive form are less frequent, and certain CT findings such as macronodules and multiple infarct-shaped consolidations have prognostic implications in IPA.The Journal of infection 08/2011; 63(6):447-56. · 4.13 Impact Factor