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British Journal of Radiology (2003) 76, 437-443
© 2003 British Institute of Radiology
doi: 10.1259/bjr/16438547
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The aurora sign: an ultrasonographic sign suggesting parenchymal lung disease

S Kohzaki, MD1, K Tsurusaki, MD2, M Uetani, MD2, K Nakanishi, MD2 and K Hayashi, MD2

1 Department of Radiology, Kitakyushu City Yahata Hospital, 4-18-1 Nishihon-machi, Yahatahigashi, Kitakyushu 850-8534 and 2 Department of Radiology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan



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  		Figure 1. Hepatic ultrasounds obtained from a patient without pulmonary disease. (a) Subcostal and (b) intercostal ultrasound of the liver show some ring-down artefacts that originate from the right diaphragm with perpendicular orientation.

 


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  		Figure 2. A 71-year-old man with idiopathic pulmonary fibrosis. (a) Subcostal ultrasound of the liver shows numerous ring-down artefacts. (b) Chest CT scan shows honeycomb changes of the right lung base.

 


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  		Figure 3. A 65-year-old woman with collagen lung. (a) Intercostal ultrasound of the liver shows numerous ring-down artefacts. (b) Chest CT scan did not show any honeycomb changes but did show increased interstitial changes of the parenchyma of the right lung base.

 


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  		Figure 4. (a) Scout image of the oblique axial scan. (b) Oblique axial CT of the lung base performed by slanting the gantry 25 degrees in the caudal direction clearly showed honeycomb changes extending along the right hemidiaphragm.

 


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  		Figure 5. (a) Three-dimensional CT of the right lung base obtained from a healthy subject showed smooth surfaces except for the interlobar fissure and the region surrounding the inferior vena cava. (b) Three-dimensional CT of the right lung base obtained from an aurora sign-positive patient showed marked irregularity or cobble stone appearance of the lung surface.

 


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  		Figure 6. (a) The schema of an experimental model and an "aurora sign". (b) Experimental ultrasound. The scanner is submerged in the water and a sheet of vinyl packing material is attached outside the water bag, displaying an "aurora-like" image.

 




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