Université Paris Cité, 75006 Paris, France; Department of Radiology, Beaujon Hospital, APHP.Nord, 92110 Clichy, France; INSERM, UMR1153, Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), METHODS team, Hôpital Hôtel Dieu, F-75004, Paris, France; Department of Radiology, McGill University, Montreal H3G 1A4, QC, Canada.
Department of Radiology, McGill University, Montreal H3G 1A4, QC, Canada; Institut National de la Santé et de la Recherche Médicale (Inserm), U1110, Institut de Recherche sur les Maladies Virales et Hépatiques, Strasbourg, France; Institut Hospitalo-Universitaire (IHU), 67000 Strasbourg, France; Université de Strasbourg, 67000 Strasbourg, France.
Diagn Interv Imaging. 2022 Sep;103(9):394-400. doi: 10.1016/j.diii.2022.06.009. Epub 2022 Jul 15.
The purpose of this study was to identify abdominal computed tomography (CT) features associated with underlying malignancy in patients with mesenteric panniculitis (MP).
This single-institution retrospective longitudinal cohort study included patients with MP and a minimum 1-year abdominopelvic CT follow-up or 2-year clinical follow-up after initial abdominopelvic CT examination. Two radiologists, blinded to patients' medical records, conjointly reviewed CT-based features of MP. Electronic medical records were reviewed for newly diagnosed malignancies with the following specific details: type (lymphoproliferative disease or solid malignancy), location (possible mesenteric drainage or distant), stage, time to diagnosis. An expert panel of three radiologists and one hemato-oncologist, who were blinded to the initial CT-based MP features, assessed the probability of association between MP and malignancy based on the malignancy characteristics.
From 2006 to 2016, 444 patients with MP were included. There were 272 men and 172 women, with a median age of 64 years (age range: 25-89); the median overall follow-up was 36 months (IQR: 22, 60; range: 12-170). A total of 34 (8%) patients had a diagnosis of a new malignancy; 5 (1%) were considered possibly related to the MP, all being low-grade B-cell non-Hodgkin lymphomas. CT features associated with the presence of an underlying malignancy were the presence of an MP soft-tissue nodule with a short axis >10 mm (P < 0.0001) or lymphadenopathy in another abdominopelvic region (P < 0.0001). Associating these two features resulted in high diagnostic performance (sensitivity 100%; [95% CI: 57-100]; specificity 99% [95% CI: 98-100]). All related malignancies were identified.
Further workup to rule out an underlying malignancy is only necessary in the presence of an MP soft-tissue nodule >10 mm or associated abdominopelvic lymphadenopathy.
本研究旨在确定肠系膜脂膜炎（MP）患者中与潜在恶性肿瘤相关的腹部计算机断层扫描（CT）特征。
这是一项单中心回顾性纵向队列研究，纳入了 MP 患者，这些患者至少有 1 年的腹盆腔 CT 随访或初始腹盆腔 CT 检查后 2 年的临床随访。两位放射科医生在不了解患者病历的情况下共同审查了 MP 的 CT 特征。电子病历回顾了新发恶性肿瘤的详细信息，包括类型（淋巴增生性疾病或实体恶性肿瘤）、位置（可能的肠系膜引流或远处）、分期、诊断时间。由三位放射科医生和一位血液肿瘤科医生组成的专家小组，在不了解初始 CT 基础上 MP 特征的情况下，根据恶性肿瘤特征评估 MP 与恶性肿瘤之间关联的可能性。
2006 年至 2016 年，共纳入 444 例 MP 患者。其中男性 272 例，女性 172 例，中位年龄 64 岁（年龄范围：25-89 岁）；中位总随访时间为 36 个月（IQR：22，60；范围：12-170）。共有 34 例（8%）患者诊断出新发恶性肿瘤；5 例（1%）被认为与 MP 可能相关，均为低级别 B 细胞非霍奇金淋巴瘤。与潜在恶性肿瘤存在相关的 CT 特征是存在短轴 >10mm 的 MP 软组织结节（P<0.0001）或另一个腹盆腔区域的淋巴结病（P<0.0001）。联合这两个特征具有较高的诊断性能（灵敏度 100%[95%CI：57-100]；特异性 99%[95%CI：98-100]）。所有相关的恶性肿瘤均被识别。
仅在存在 >10mm 的 MP 软组织结节或相关的腹盆腔淋巴结病时，才需要进一步检查以排除潜在的恶性肿瘤。
