Features of multi-slice spiral computed tomography examination of mesenteric panniculitis / 中华消化外科杂志

ABSTRACT

Objective To summarize the features of multi-slice spiral computed tomography (MSCT) examination of mesenteric panniculitis (MP).Methods The retrospective cross-sectional study was conducted.The clinical data of 105 patients with MP who were admitted to the Yangzhou NO.1 People's Hospital between September 2009 and September 2015 were collected.All the patients were diagnosed by MSCT and multiplanar reconstruction (MPR).Observation indicators(1) imaging features of computed tomography (CT)location,number,shape,size,density,mesenteric vessels and surrounding intestine of the lesions,with or without pseudotumor sign,enlarged fibrous nodules or lymph nodes,pseudocapsule sign,fatring sign,cystolization and calcification;(2) follow-up results.Follow-up using outpatient examination was performed by plain and/or enhanced scans of abdominal CT up to April 2017.Results (1) Imaging features of CTof 105 patients,77,14 and 14 received respectively plain scans of abdominal CT,plain and enhanced scans of abdominal CT and enhanced scans of abdominal CT.Lesions of 105 patients were located at the mesentery.The single lesion was detected in 79 patients and multiple lesions in 26 patients,with number of lesions of 5-12 per case and total number of 213.All the 105 patients had pseudotumor sign,which showed different size of patchy or mass shadows with clear edge extended from mesentery root to mesenteric vessels;most long axes extended from mesentery root to jejunum in the left lumbar region;the homogeneous or heterogeneous mesenteric fat density was increased,and CT value was higher than that of normal retroperitoneal adipose tissues;fog-like mesentery showed less obvious enhancement by enhanced scan and mesenteric vessels were wrapped around.The cord-like,round or oval fibrous tissue nodules and/or enlarged lymph nodes were found in 100 patients.All the 105 patients had pseudocapsule sign.The density ring of soft tissues of different thickness was found,with a clear boundary between leading-and trail-edges and normal abdominal and retroperitoneal adipose tissues;most membranes extended to left lumbar region,thicker and thinner membranes were respectively located at the anterior and posterior areas and right side,and parts of membranes were absence.The fatring sign was detected in 71 patients,there were ring-like hypodense shadows around the mesenteric vessels and fibrous tissue nodules or lymph nodes.Cystolization and calcification were found in 2 and 2 patients.Thirty-eight patients had surrounding intestinal canal translocation.(2) Follow-up results:55 patients were followed up for 1.0-57.0 months,with an average time of 14.7 months.Of 55 patients,26 had stable lesions and no obvious changes;4 returned to normal due to complete absorption of lesions;19 were improved due to partial absorption of lesions;6 had lesions progressions.Conclusion The features of MSCT examination of MP include pseudotumor sign,pseudocapsule sign and fatring sign.