PICTORIAL ESSAY   

Il Giornale Italiano di Radiologia Medica 2019 Gennaio-Febbraio;6(1):71-83

DOI: 10.23736/S2283-8376.19.00161-X

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

The sign of misty mesentery: differential diagnosis on multi-detector computed tomography

Ginevra DANTI, Noemi MORELLI, Gloria ADDEO, Diletta COZZI ✉, Monica LANZETTA, Gianluca FREZZETTI, Antonella MASSERELLI, Vittorio MIELE

Unit of Emergency Radiodiagnostics, Department of Services, Careggi University Hospital, Florence, Italy

The term “misty mesentery” indicates a pathological increase in the attenuation of mesenteric adipose tissue on multidetector computed tomography (MDCT). Normally mesenteric fat has a similar density (-100 to -160 HU) to subcutaneous and retroperitoneal fat. Due to the infiltration of the mesentery by fluids or cells, the average density of this fat increases from -40 to -60 HU, and the arteries and veins of the mesentery often lose their clear interfaces. This sign can be frequently seen in MDCT performed daily and can be the expression of various pathological conditions, including edema, inflammation, hemorrhage, mesenteric panniculitis or neoplasms. This pictorial essay describes the different MDCT aspects of misty mesentery in various diseases in order to provide a rational approach to differential diagnosis.

KEY WORDS: Diagnostic imaging - Mesentery - Anatomy - X-ray computed tomography