Patterns of Fat Stranding

Thornton, Eavan; Mendiratta‐Lala, Mishal; Siewert, Bettina; Eisenberg, Ronald L.

doi:10.2214/ajr.10.4375

Cited by 63 publications

(71 citation statements)

References 3 publications

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“…Usually, a short (<5 cm [4,11,14,15]) discrete segment of asymmetric thickening with abrupt transition to normal bowel helps differentiate CRC from benign conditions [4,15,16]. Benign inflammatory conditions may demonstrate a target appearance (mural stratification), which is rarely seen in cancers, with the exception being infiltrating scirrhous carcinomas [4,12,[15][16][17]. Benign conditions also tend to circumferentially and symmetrically involve longer segments of bowel, typically causing <2 cm of wall thickening and demonstrating tapered rather than heaped up edges as seen in malignancy [15][16][17][18][19].…”

Section: Wall Thickeningmentioning

confidence: 99%

“…Pericolic tumor infiltration represents invasion beyond the muscularis propria into the adjacent fat and is an important staging feature of CRC [16,17].…”

Section: Pericolic Changesmentioning

confidence: 99%

“…Typical findings include a loss of the normal homogenous low-density attenuation of the pericolic fat and loss of a clearly defined bowel wall (serosal irregularity) due to pericolic fat stranding and spiculation; described as having a reticulonodular appearance (Figs. 5,9) [14,[16][17][18][19]. Critically in CRC this increased pericolic attenuation is localized to an area of focal bowel wall thickening.…”

Section: Pericolic Changesmentioning

confidence: 99%

“…The sensitivity of CT for detecting tumor spread beyond the muscularis propria in CRC has improved over the past 30 years with initial studies demonstrating a sensitivity of 60% and more recent studies reporting a sensitivity of 86% [12,14,[16][17][18][19][20]. A meta-analysis has attributed this to the use of thinner slices with spiral and multi-detector CT with the ability for multiplanar reconstruction [12,14,16,17,20,21].…”

Section: Pericolic Changesmentioning

confidence: 99%

“…A meta-analysis has attributed this to the use of thinner slices with spiral and multi-detector CT with the ability for multiplanar reconstruction [12,14,16,17,20,21]. However, it should be noted that the best results are obtained with additional rectal air or water insufflation [14,16,17,[20][21][22].…”

Section: Pericolic Changesmentioning

confidence: 99%

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Revisiting the potential signs of colorectal cancer on contrast-enhanced computed tomography without bowel preparation

2015

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Colorectal cancer (CRC) is the second most common cause of cancer death in the US. Earlier detection can allow treatment with curative intent and improve prognosis. Optical and virtual colonoscopy are widely used in screening for colonic polyps and in the investigation of suspected CRC. However, contrast-enhanced computed tomography (CT) is still performed to investigate various non-specific abdominal complaints. Hence, a significant number of CRC are identified on contrast-enhanced CT without bowel preparation. We describe several signs, which when present in tandem, raise suspicion of CRC, and may warrant further investigation with optical colonoscopy. These include an intraluminal mass, eccentric or circumferential wall thickening >3 mm, focal wall enhancement, pericolic fat stranding, a cluster of >3 local lymph nodes, and enlarged lymph nodes >10 mm in short axis. Multiplanar evaluation of the bowel should be performed on all CT abdominal studies, including those without bowel preparation, to identify subtle features of CRC.

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Section: Wall Thickeningmentioning

confidence: 99%

“…Pericolic tumor infiltration represents invasion beyond the muscularis propria into the adjacent fat and is an important staging feature of CRC [16,17].…”

Section: Pericolic Changesmentioning

confidence: 99%