Dados do Trabalho

Título

Fat Stranding in Abdominal and Pelvic CT: A Pictorial Essay

Introdução e objetivo(s)

Computed tomography (CT) has become an essential diagnostic tool in assessing abdominal pain, both acute and chronic. Fat stranding is defined as an abnormal increase in the attenuation of fat within structures such as the mesentery, omentum, retroperitoneum, and subcutaneous tissue, linked to alterations in vascular permeability due to inflammation, edema, and lymphatic congestion. Our aim is to provide a concise and comparative review of the various patterns of fat stranding observed in CT scans, focusing on non-traumatic intraabdominal pathologies and excluding those resulting from postoperative complications.

Método(s)

We will adopt a pictorial review approach, with a particular emphasis on abdominal anatomy and the peritoneal and retroperitoneal spaces. This review will include clinical examples from our institution that illustrate variations in fat attenuation in abdominopelvic CT studies, allowing a detailed understanding of how fat stranding can indicate various pathological conditions.

Discussão

Fat stranding is crucial for diagnosing inflammatory and infectious conditions, such as cholecystitis, epiploic appendagitis, diverticulitis, colitis, and pelvic pathologies, extending its relevance to vascular disorders like mesenteric vascular dissections and omental infarcts. In the case of complicated acute appendicitis, its 94% sensitivity underlines its diagnostic utility. Mesenteric fat stranding is identified in 89.8% of intestinal ischemia cases, and periarterial stranding in 86.4% of vascular dissections. In contexts of ischemic colitis, it is observed in approximately 71% of instances. This phenomenon also serves as a severity marker in acute pancreatitis and as a suggestive sign of lymphoma, besides its role in identifying and delineating intraabdominal neoplasias, particularly colon and pancreatic cancer. Despite this, the predominant literature includes mainly individual reports or series, highlighting the urgency for more prospective studies.

Conclusões

This review emphasizes the relevance of fat stranding in CT as a precise indicator for evaluating intraabdominal pathologies. The variety of its patterns and its notable sensitivity for certain conditions emphasize its diagnostic and prognostic value, urgently calling for further prospective investigations for clinical application.

Palavras Chave

Fat Stranding; Abdominal CT

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