Prominent upper lobe vessels on CXR

UL Vessels

Prominent upper lobe vessels on CXR

Prominent upper lobe vessels on X-ray chest (CXR) PA view suggests pulmonary venous hypertension. Actually they are dilated pulmonary veins, though it is not easy to differentiate between veins and arteries on CXR, hence the term prominent upper lobe vessels.

There are various other names for this sign:

  1. Antler sign
  2. Inverted moustache sign
  3. Cephalization
  4. Redistribution

Antler sign and inverted moustache sign are self explanatory as the appearance of the upper lobe vessels seen together on both sides resemble them. Cephalization suggests the prominence of upper lobe vessels more than the lower zone vessels, which the inverse of normal. Redistribution also indicates the redistribution of pulmonary flow to the upper lobes than the lower lobes, different from the normal situation.