Department of Radiology, Ankara Ataturk Training and Research Hospital, Bilkent, Ankara 06800, Turkey.
Jpn J Radiol. 2011 Aug;29(7):495-502. doi: 10.1007/s11604-011-0587-5. Epub 2011 Sep 1.
Our aim was to report the multidetector-row computed tomography (MDCT) findings of sclerosing mesenteritis, which is a rare disease characterized by chronic nonspecific inflammation of mesenteric adipose tissue. It has associated diseases, and we explored its prevalence.
A total of 2100 patients were evaluated retrospectively for sclerosing mesenteritis between December 2007 and May 2009. Signs and symptoms, associated diseases, laboratory data, surgical histories, and related findings of a misty mesentery, which corresponds to sclerosing mesenteritis on MDCT, were recorded.
Misty mesentery findings were seen in 51 (2.43%; 35 men) patients. Their ages ranged between 33 and 78 years (mean 56.2 years). The most frequent complaint of patients was abdominal pain (n = 19; 37.2%). The most prominent possible causative and/or associated factors in our study were malignancy (n = 9; 17.6%), previous surgery (n = 17; 33.3%), smoking (n = 20; 39.2%), coronary artery disease (n = 9; 17.6%), urolithiasis (n = 10; 19.6%), hypertension (n = 18; 35.2%), hyperlipidemia (n = 13; 25.5%), and diabetes mellitus (n = 11; 21.5%). On MDCT, density values in mesenteric fat (-62.8 ± 18.6 HU) were significantly higher than the values for subcutaneous (-103.9 ± 5.8 HU) and retroperitoneal (-105 ± 6 HU) fatty tissues (both P < 0.0001). A partially hyperdense stripe (n = 37; 72.6%), well-defined soft tissue nodules (100%), hypodense fatty halo enclosing vessels (n = 1; 1.9%), and nodules (n = 12; 23.5%) were demonstrated in most of the patients.
The diagnosis of sclerosing mesenteritis has increased with the more frequent use of MDCT and the popularization of the DICOM viewer. Defined hallmarks on MDCT can be helpful for differentiating sclerosing mesenteritis from other pathologies.
本研究旨在报告肠系膜纤维硬化症的多排螺旋 CT(MDCT)表现。肠系膜纤维硬化症是一种以肠系膜脂肪组织慢性非特异性炎症为特征的罕见疾病,它与多种疾病相关,我们探讨了其患病率。
2007 年 12 月至 2009 年 5 月期间,我们对 2100 例患者进行了肠系膜纤维硬化症的回顾性评估。记录了肠系膜模糊征(相当于 MDCT 上的肠系膜纤维硬化症)的体征和症状、相关疾病、实验室数据、手术史和相关发现。
51 例(2.43%;35 例男性)患者存在肠系膜模糊征。其年龄在 33 至 78 岁之间(平均 56.2 岁)。患者最常见的主诉是腹痛(19 例;37.2%)。我们研究中最常见的可能病因和/或相关因素是恶性肿瘤(9 例;17.6%)、既往手术史(17 例;33.3%)、吸烟(20 例;39.2%)、冠状动脉疾病(9 例;17.6%)、尿路结石(10 例;19.6%)、高血压(18 例;35.2%)、高脂血症(13 例;25.5%)和糖尿病(11 例;21.5%)。在 MDCT 上,肠系膜脂肪的密度值(-62.8 ± 18.6 HU)明显高于皮下脂肪(-103.9 ± 5.8 HU)和腹膜后脂肪(-105 ± 6 HU)(均 P < 0.0001)。大多数患者显示部分高密度条纹(37 例;72.6%)、边界清楚的软组织结节(100%)、血管周围低密脂肪晕(1 例;1.9%)和结节(12 例;23.5%)。
随着 MDCT 的广泛应用和 DICOM 浏览器的普及,肠系膜纤维硬化症的诊断有所增加。MDCT 上的明确特征有助于将肠系膜纤维硬化症与其他病变区分开来。