Contrast-enhanced ultrasound of epiploic appendagitis

C Görg, J Egbring, T Bert
Ultraschall in der Medizin 2009, 30 (2): 163-7

PURPOSE: To present our experience with contrast-enhanced ultrasound (CEUS) in patients with epiploic appendagitis (EA).

PATIENTS AND METHODS: From May 2005 to December 2007, 15 patients with the clinical and B-mode sonographic diagnosis of EA (13 men and 2 women, aged 11 - 78 years) were included in the study. All patients were examined by CEUS. The extent of contrast enhancement of the fatty tissue masses was measured using the normal surrounding fat tissue enhancement as an in vivo reference (no, hyperechoic, mixed enhancement). B-mode sonographic follow-up examinations were performed in all cases. As additional diagnostic procedures, computed tomography (n = 8), colonoscopy (n = 5), and surgery (n = 1) were used.

RESULTS: With CEUS all 15 masses showed a central area of no enhancement. Masses with a central unenhanced area and with broad perilesional enhancement (> 1 mm) were classified as mixed enhancement (n = 11). In the 4 cases classified as no enhancement the central unenhanced area was demarcated by only a marginal hyperechoic rim (< or = 1 mm).

CONCLUSION: EA is diagnosed by clinical, laboratory and B-mode sonographic patterns. EA shows a fairly characteristic CEUS feature. CEUS may therefore be helpful to confirm the diagnosis of EA in equivocal cases.

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