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CT Findings in Sclerosing Mesenteritis (Panniculitis): Spectrum of Disease¹

¹ From the Department of Radiology, Johns Hopkins Medical Institutions, 601 N Caroline St, Rm 3251, Baltimore, MD 21287. Presented as an education exhibit at the 2002 RSNA scientific assembly. Received January 22, 2003; revision requested March 10; revision received April 4; accepted April 25. Address correspondence to E.K.F. (e-mail: efishman@jhmi.edu).

View larger version (135K): [in a new window]   Figure 1.  Sclerosing mesenteritis. Coronal multiplanar reformatted image from CT demonstrates subtle increased attenuation within the mesentery (arrowheads). Adenopathy is also noted (arrows).

View larger version (140K): [in a new window]   Figure 2.  Sclerosing mesenteritis. Axial CT scan shows an irregular soft-tissue mass in the root of the mesentery (arrowheads).

View larger version (167K): [in a new window]   Figure 3a.  Sclerosing mesenteritis. Axial CT scan (a) and coronal multiplanar reformatted image (b) demonstrate irregular soft-tissue masses in the root of the mesentery (arrowheads).

View larger version (177K): [in a new window]   Figure 3b.  Sclerosing mesenteritis. Axial CT scan (a) and coronal multiplanar reformatted image (b) demonstrate irregular soft-tissue masses in the root of the mesentery (arrowheads).

View larger version (144K): [in a new window]   Figure 4a.  Sclerosing mesenteritis. (a) Axial CT scan demonstrates a necrotic-cystic mass (arrowheads) in the region of the porta hepatis. (b) Sagittal multiplanar reformatted image shows a low-attenuation soft-tissue mass (M) in the region of the porta hepatis located superior to the hepatic artery (arrowhead), portal vein (arrow), and pancreas (P). (c) Coronal volume-rendered image shows soft tissue (black arrowheads) infiltrating the area around the hepatic artery (white arrowhead), portal vein (long arrow), and bile duct (short arrow), which contains a stent.

View larger version (125K): [in a new window]   Figure 4b.  Sclerosing mesenteritis. (a) Axial CT scan demonstrates a necrotic-cystic mass (arrowheads) in the region of the porta hepatis. (b) Sagittal multiplanar reformatted image shows a low-attenuation soft-tissue mass (M) in the region of the porta hepatis located superior to the hepatic artery (arrowhead), portal vein (arrow), and pancreas (P). (c) Coronal volume-rendered image shows soft tissue (black arrowheads) infiltrating the area around the hepatic artery (white arrowhead), portal vein (long arrow), and bile duct (short arrow), which contains a stent.

View larger version (97K): [in a new window]   Figure 4c.  Sclerosing mesenteritis. (a) Axial CT scan demonstrates a necrotic-cystic mass (arrowheads) in the region of the porta hepatis. (b) Sagittal multiplanar reformatted image shows a low-attenuation soft-tissue mass (M) in the region of the porta hepatis located superior to the hepatic artery (arrowhead), portal vein (arrow), and pancreas (P). (c) Coronal volume-rendered image shows soft tissue (black arrowheads) infiltrating the area around the hepatic artery (white arrowhead), portal vein (long arrow), and bile duct (short arrow), which contains a stent.

View larger version (169K): [in a new window]   Figure 5.  Fat ring sign. On an axial CT scan, a halo of fat (arrowhead) is preserved around the superior pulmonary artery despite the presence of an infiltrating soft-tissue mass (short arrow). The patient had bowel ischemia due to progressive arterial compromise, resulting in small bowel thickening (long arrow) and ascites (A).

View larger version (132K): [in a new window]   Figure 6a.  Sclerosing mesenteritis. (a) Coronal volume-rendered image shows a soft-tissue mass (arrowheads) with calcification (white arrow) in the mesentery along the distribution of the superior mesenteric artery (black arrow). (b) On a sagittal volume-rendered image, the soft-tissue mass (arrowheads) encases the superior mesenteric artery (long arrow) in the root of the small bowel mesentery. Short arrow indicates the celiac axis.

View larger version (125K): [in a new window]   Figure 6b.  Sclerosing mesenteritis. (a) Coronal volume-rendered image shows a soft-tissue mass (arrowheads) with calcification (white arrow) in the mesentery along the distribution of the superior mesenteric artery (black arrow). (b) On a sagittal volume-rendered image, the soft-tissue mass (arrowheads) encases the superior mesenteric artery (long arrow) in the root of the small bowel mesentery. Short arrow indicates the celiac axis.

View larger version (165K): [in a new window]   Figure 7.  Lymphoma. Coronal multiplanar reformatted image demonstrates soft-tissue masses in the mesentery (arrowheads) along the distribution of the superior mesenteric vein (arrow).

View larger version (125K): [in a new window]   Figure 8.  Lymphoma. Axial CT scan shows lymphadenopathy (arrows) and stranding (arrowheads) of the mesentery.

View larger version (155K): [in a new window]   Figure 9.  Carcinoid tumor. Coronal multiplanar reformatted image shows a calcified soft-tissue mass (arrowhead) with desmoplastic reaction (arrows) in the root of the mesentery.