Scheer F, Spunar P, Wiggermann P, Wissgott C, Andresen R
Institute of Diagnostic and Interventional Radiology/Neuroradiology, Westkuestenklinikum Heide, Academic Teaching Hospital of the Universities of Kiel, Luebeck and Hamburg, Heide, Germany.
Radiology Center Peine, Germany.
Rofo. 2016 Oct;188(10):926-32. doi: 10.1055/s-0042-110100. Epub 2016 Aug 16.
The exact etiology of mesenteric panniculitis (MP) is still unknown and has been discussed in relation to different causes. The aim of this retrospective study was to evaluate a coherence between MP and malignancy.
Retrospective analysis of consecutive CT abdomen examinations of 5595 patients in terms of MP over a period of 3 years was performed. To make the diagnosis of MP, three of five typical signs were obligatory: hyperdense mass lesion with intercalated nodules, a "fat-ring sign" or halo sign, a hyperdense pseudocapsule and displacement of bowel loops. The patient cohort (mean age: 64.7 years) consisted of 1974 (35.2 %) patients with histologically confirmed cancer and 3621 patients (64.8 %) without known underlying oncological disease.
A total of 143 cases were diagnosed with MP (2.55 %). The average age of patients was 69.9 years with a male to female ratio of 2:1. In this group oncological disease was confirmed in 107 patients (74.8 %). In 36 patients with MP (25.2 %), no malignancy was present. In the group of patients with an underlying oncological disease, the prevalence of MP was 5.42 % and was significantly higher (p < 0.005) than in the patients with MP and without an oncological disease. The highest prevalence of MP (29 cases) was observed in non-Hodgkin lymphoma (22.6 %). The statistically calculated risk of a tumor disease in this collective is about 5 times higher if MP was demonstrated (p < 0.001).
Based on the data of the collective, the risk of malignancy is five times higher in the presence of MP than in an inconspicuous mesentery. MP seems to frequently occur with non-Hodgkin lymphoma. MP can be seen on the basis of typical morphological features on the CT image. MP must be differentiated from a wide range of benign and malignant diseases of the mesentery.
• Mesenteric panniculitis can be diagnosed with CT.• In the case of accidentally diagnosed mesenteric panniculitis, a possible malignant cause should be ruled out in the differential diagnosis. Citation Format: • Scheer F, Spunar P, Wiggermann P et al. Mesenteric Panniculitis (MP) in CT - A Predictor of Malignancy?. Fortschr Röntgenstr 2016; 188: 926 - 932.
肠系膜脂膜炎（MP）的确切病因尚不清楚，且已针对不同病因进行了讨论。本回顾性研究的目的是评估MP与恶性肿瘤之间的相关性。
对5595例患者连续3年的腹部CT检查进行回顾性分析，以确定MP情况。诊断MP时，五个典型征象中必须出现三个：伴有插入结节的高密度肿块病变、“脂肪环征”或晕征、高密度假包膜以及肠袢移位。患者队列（平均年龄：64.7岁）包括1974例（35.2%）经组织学确诊患有癌症的患者和3621例（64.8%）无已知潜在肿瘤疾病的患者。
共诊断出143例MP（2.55%）。患者的平均年龄为69.9岁，男女比例为2:1。在该组中，107例（74.8%）患者确诊患有肿瘤疾病。36例MP患者（25.2%）未发现恶性肿瘤。在有潜在肿瘤疾病的患者组中，MP的患病率为5.42%，显著高于（p<0.005）无肿瘤疾病的MP患者。MP患病率最高的是在非霍奇金淋巴瘤中（29例，22.6%）。经统计计算，如果发现有MP，该群体中患肿瘤疾病的风险约高5倍（p<0.001）。
基于该群体的数据，存在MP时发生恶性肿瘤的风险比肠系膜无异常时高5倍。MP似乎经常与非霍奇金淋巴瘤同时出现。MP可根据CT图像上的典型形态特征进行诊断。MP必须与多种肠系膜的良性和恶性疾病相鉴别。
• 肠系膜脂膜炎可用CT诊断。• 对于偶然诊断出的肠系膜脂膜炎，在鉴别诊断中应排除可能的恶性病因。引用格式：• Scheer F, Spunar P, Wiggermann P等。CT中的肠系膜脂膜炎（MP）——恶性肿瘤的预测指标？。Fortschr Röntgenstr 2016; 188: 926 - 932。
