Errors in Radiology by Luigia Romano & Antonio Pinto

Author:Luigia Romano & Antonio Pinto
Language: eng
Format: epub
Publisher: Springer Milan, Milano

14.2.4 Perceptual Errors

Regular soft-tissue windows apply a window width of 350 HU and window level 50 HU. The use of additional windows settings, particularly in evaluating the intra-abdominal fat, is very helpful. In patients with acute abdominal pain, the observation of intra-abdominal fat stranding is a helpful CT sign. According to some authors [14], it suggests that the pathologic process is centered in the mesentery, thus narrowing the differential diagnosis of gastrointestinal disorders to four main entities: diverticulitis, epiploic appendagitis, omental infarction, and appendicitis. The characteristic CT findings of each of these entities often allow a final diagnosis (Fig. 14.4).

Fig. 14.4 a Acute right flank pain in a 46-year-old man. The heterogeneous fatty mass in the greater omentum and the peritoneal thickening are better appreciated by applying a wider window for image interpretation (b). The finding of extensive fat stranding without significant changes of the adjacent colon allows omental infarction to be diagnosed with confidence

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