Multidetector-row computed tomography findings of sclerosing mesenteritis with associated diseases and its prevalence

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.