Aroosa Kanwal, Khurram Bhinder, Amna Mehboob, Arsalla Naveed, Usama Shafiq, Nasir Khan


Objective: The objective of this article is to present astronomical inspired signs seen in radiology, which will eventually help in imaging based diagnosis.

Study Design: Retrospective study

Place and Duration of Study: Radiology Department, Shifa International Hospital, from 2020 to 2023.

Methodology: We compiled all the cases with interesting astronomical signs manifested on various radiological modalities including radiograph, ultrasound and CT.

-       Comet tail artifact seen on grey scale ultrasound is noted in gallbladder adenomyomatosis and thyroid colloid cyst.

-       Comet tail artifact seen on color doppler ultrasound is noted in renal/ureteric calculus.

-        Comet tail sign seen on CT chest is noted in round atelectasis.

-       Galaxy sign seen on CT chest is noted in sarcoidosis or pulmonary TB.

-       Loss of half-moon sign seen on shoulder radiograph is noted in posterior shoulder dislocation.

-       Starry sky appearance seen on grey scale ultrasound is noted in acute hepatitis.

-       Starry sky appearance seen on MR is noted in multiple biliary hamartomas.

-       Sunburst appearance seen on radiograph is noted in osteosarcoma.

-       Sunburst sign seen on MR brain is noted in meningioma.

-       Sunburst sign seen on DSA is noted in renal angiomyolipoma.

-       Sunset eye sign seen on CT brain in obstructive hydrocephalus.

-       Twinkling artifact seen on color Doppler ultrasound is noted in calculi.

-       Earth heart sign seen on radiograph chest is noted in tension pneumomediastinum.

-       Milky sign seen on MR brain is noted in multifocal leukoencephalopathy.

-       Star-field pattern seen on MR brain is noted in fat embolism.

Result: Imaging features in various modalities of aforementioned diseases are explained narrowing down the differentials.

Conclusion: Understanding of these clearly discernible astronomy-based signs is crucial since it aids in cutting down the lengthy range of differentials and also aids in imaging-based diagnosis.

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