Dr Aadil Ibn Saja | Radiologist on Instagram: "Split pleura sign Split pleura sign is seen in CT scan in cases of empyema which most commonly occurs due to bacterial pneumonia. There occurs fluid accumulation in the pleural space, which causes fibrin coating of the inner visceral and outer parietal layers of pleura. This results in separation, thickening, and increased enhancement of pleural layers, producing split pleura sign Empyema causes extrapleural fat stranding and thickening of extrapleu