Fat stranding (CT)
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Fat stranding is a common sign seen on CT wherever fat can be found. It is most commonly seen in abdomen/pelvis, but can also be seen in retroperitoneum, thorax, neck and subcutaneous tissues. It can be helpful in localizing both acute and chronic pathology.
Fat stranding is increased attenuation which can be ill-defined, reticular, linear, or in some malignancies, reticulonodular 1. Fat stranding is a non-specific sign in itself and can be seen in infectious, inflammatory, malignant, or traumatic conditions.
There are several patterns of fat stranding in the abdomen which can occur within the mesentery or surrounding solid organs 1,2:
mesenteric fat stranding (misty mesentery)
pericolonic fat stranding with bowel wall thickening
pericolonic fat stranding disproportionate to bowel wall thickening
peripancreatic fat stranding: acute pancreatitis
pericholecystic fat stranding: acute cholecystitis
Fat stranding can also be seen in the thorax, and is mainly indicative of mediastinal pathology:
- 1. Thornton E, Mendiratta-Lala M, Siewert B et-al. Patterns of fat stranding. AJR Am J Roentgenol. 2011;197 (1): W1-14. doi:10.2214/AJR.10.4375 - Pubmed citation
- 2. Pereira JM, Sirlin CB, Pinto PS et-al. Disproportionate fat stranding: a helpful CT sign in patients with acute abdominal pain. Radiographics. 2004;24 (3): 703-15. Radiographics (full text) - doi:10.1148/rg.243035084 - Pubmed citation