Keywords:
Abdomen, Gastrointestinal tract, Small bowel, CT, Diagnostic procedure, Tropical diseases
Authors:
E. Kuznetsova, A. L. Yudin, E. Yumatova, G. F. Sologubova, M. M. Aliev, I. Lisachenko; Moscow/RU
DOI:
10.1594/ecr2013/C-0816
Results
Clinical manifestations of SM are unspecific.
As a rule,
there are also no any changes in blood tests,
or their results are unspecific.
The most distinctive features of SM were provided by CT images.
CT features varied from an inconspicuous increase in the density of adipose tissue surrounding the mesenteric vessels (mainly due to chronic inflammation),
to the formation of soft tissue in the projection of the root of the mesentery (prevalence of fibrosis).
In the initial phase SM CT revealed increased density of mesenteric fat – "misty mesentery" sign (n=61,
80.3%) without displacement of vessels,
which were surrounded by a rim of normal adipose tissue – "fat halo" sign (n=52,
68.4%).
It’s possible to detect pseudocapsules (n=31,
40.8%),
enlarged lymph nodes in the mesentery (n=15,
19.7%) and retroperitoneum (n=4,
5.3%).
A type of SM with the predominance of fibrosis (n=15,
19.7%) revealed soft tissue formation at the root of mesentery surrounding mesenteric vessels,
and a slight increase of fat density.
The Symptom of "fat halo" sign was detected less frequently (n=5,
6.6%).
By results of CT examinations it was established that the most sensitive (75%) and specific (100%) pattern of SM was "fat halo" sign,
positive predictive value (PPV) = 100%.
The sensitivity of "misty mesentery" sign was 80.3%,
but specificity was lower than the specificity of the previous sign (79.4%),
PPV was 40.1%.
The specificity of pseudocapsules presentation was 97.6%,
sensitivity just 45%,
PPV = 73.8%.
The less sensitivity soft tissue formation at the root of mesentery (19.7%),
but it’s specificity was sufficient (79.4%),
PPV = 14.2%.
The prevalence of SM among patients in our group was 14.7%.
This value is 25 times larger than data/literature,
and be the reason why this phenomenon is commonly detected in aged and senile patients.