CT findings at lupus mesenteric vasculitis.
OBJECTIVE
To describe the spectrum of early CT findings of lupus mesenteric vasculitis (LMV) and to assess the utility of CT in the management of this uncommon entity.


METHODS
Abdominal CT was performed within 1-4 days (average 2.2 days) of the onset of severe abdominal pain and tenderness in 15 women with systemic lupus erythematosus. Prompt high-dose i.v. corticosteroid was administered in 11 patients after the CT diagnosis of LMV was made. CT was performed after abdominal symptoms subsided.


RESULTS
Eleven cases revealed CT features suggestive of LMV including conspicuous prominence of mesenteric vessels with palisade pattern or comb-like appearance (CT comb sign) supplying focal or diffuse dilated bowel loops (n = 11), ascites with slightly increased peritoneal enhancement (n = 11), small bowel wall thickening (n = 10) with double halo or target sign (n = 8). Follow-up CT before high-dose steroid therapy revealed complete or marked resolution of the abnormal CT findings.


CONCLUSIONS
CT is helpful for confirming the diagnosis of LMV, especially the comb sign which may be an early sign. Bowel ischemia due to LMV is less ominous than previously expected, and the abnormal CT findings were reversible when early diagnosis and prompt i.v. steroid therapy could be achieved.
Ko
S F
SF
Department of Radiology, Chang Gung Medical College and Memorial Hospital, Kaohsiung Hsien, Taiwan.
Lee
T Y
TY
Cheng
T T
TT
Ng
S H
SH
Lai
H M
HM
Cheng
Y F
YF
Tsai
C C
CC
D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology; D000293:Adolescent; D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging; D008642:Mesenteric Veins / Q000000981:diagnostic imaging; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed / Q000379:methods; D014657:Vasculitis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000209:etiology
D005938:Glucocorticoids; D011241:Prednisone; D006854:Hydrocortisone