Published in:
01-03-2017 | Classics in Abdominal Imaging
Misty mesentery: a CT sign of mesenteric infiltration
Published in: Abdominal Radiology | Issue 3/2017
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The normal small bowel mesentery is rich in fat which has the same attenuation as subcutaneous fat on CT (−100 to −160 HU) (Fig. 1). However, if there is cellular or acellular infiltration of the mesentery, the attenuation value increases (−40 to −60 HU) (Fig. 2). [1] This increased attenuation of the fat is referred to as the misty mesentery sign. It was first described by Mindelzun in 1996. [1] In such cases, the mesenteric vessels, which normally appear distinct from the fat, may sometimes become indistinct or effaced like a tree in the mist (Fig. 3).
Fig. 1
Axial (A) and coronal (B) reformatted CT images showing the normal appearance of the mesentery fat
Fig. 2
Axial (A) and coronal (B) reformatted CECT images showing diffuse inhomogeneous attenuation of mesenteric fat, displacement of small bowel loops laterally
Fig. 3
Image showing tree in the mist with obscured details
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