Harisinghani Mukesh G, Wittenberg Jack, Lee Winnie, Chen Steven, Gutierrez Ana Luiza, Mueller Peter R
Division of Abdominal Imaging and Intervention, Massachusetts General Hospital, White 270, 55 Fruit St., Boston MA 02114, USA.
AJR Am J Roentgenol. 2003 Sep;181(3):781-4. doi: 10.2214/ajr.181.3.1810781.
Stratification with a fat layer in the intestinal wall is thought to be a reliable marker for inflammatory bowel disease. We evaluated the presence and frequency of the bowel wall fat halo sign in patients undergoing abdominal CT for clinical indications unrelated to the gastrointestinal tract.
We performed a retrospective review of 100 consecutive abdominal and pelvic CT examinations in 61 men and 39 women (mean age, 56 years) with clinical suspicion of renal stone disease. Two radiologists experienced in abdominal imaging performed qualitative and quantifiable assessment of the images. Five segments of the colon (ascending colon, transverse colon, descending colon, sigmoid colon, and rectum) and the terminal ileum (for approximately 1 ft [30 cm]) were evaluated for the presence of the fat halo sign. If the fat halo sign was present, fat density and total wall-thickness assessments were made. Presence or absence of clinical and radiologic signs of inflammatory bowel disease was determined. The Student's t test was used to evaluate the statistical significance, correlating body weight and presence of the halo sign.
The fat halo sign was seen in 21 (21%) of 100 patients. Of the 21 patients with the fat halo sign, six (29%) had renal stone disease and 15 (71%) had no stone disease. The density value of the halo sign ranged from -18 to -64 H (mean, -41 H). The distribution of the fat halo sign was as follows: the terminal ileum, 4%; the ascending colon, 28%; the transverse colon, 34%; the descending colon, 36%; the sigmoid colon, 14%; and rectum, 10%. No patient with this sign had any remote, recent, or subsequently recorded history of inflammatory bowel disease. A statistically significant relationship (p < 0.001) was seen between the presence of the fat halo sign and body weight distribution, with 16 of 21 patients weighing over 200 lb (90 kg).
In the absence of clinical or radiologic evidence of inflammatory bowel disease, the presence of the fat halo sign may represent a normal finding that is possibly related to obesity.
肠壁脂肪层分层被认为是炎症性肠病的可靠标志物。我们评估了因与胃肠道无关的临床指征而接受腹部CT检查的患者中肠壁脂肪晕征的存在情况及发生率。
我们对61名男性和39名女性（平均年龄56岁）连续进行的100次腹部和盆腔CT检查进行了回顾性研究，这些患者临床上怀疑患有肾结石病。两名有腹部影像诊断经验的放射科医生对图像进行了定性和定量评估。对结肠的五个节段（升结肠、横结肠、降结肠、乙状结肠和直肠）以及末段回肠（约1英尺[30厘米]）进行脂肪晕征检查。如果存在脂肪晕征，则进行脂肪密度和肠壁总厚度评估。确定是否存在炎症性肠病的临床和影像学征象。采用Student's t检验评估统计学意义，将体重与晕征的存在情况进行相关性分析。
100名患者中有21名（21%）出现脂肪晕征。在这21名有脂肪晕征的患者中，6名（29%）患有肾结石病，15名（71%）没有结石病。晕征的密度值范围为-18至-64 H（平均-41 H）。脂肪晕征的分布如下：末段回肠4%；升结肠28%；横结肠34%；降结肠36%；乙状结肠14%；直肠10%。有此征象的患者均无炎症性肠病的既往、近期或后续记录病史。脂肪晕征的存在与体重分布之间存在统计学显著相关性（p < 0.001），21名患者中有16名体重超过200磅（90千克）。
在没有炎症性肠病的临床或影像学证据的情况下，脂肪晕征的存在可能是一种与肥胖相关的正常表现。
