Abnormal bowel wall attenuation patterns
Updates to Article Attributes
Abnormal bowel wall attenuation patterns on CT scan can be grouped under five categories:
- white enhancement
- gray enhancement
- water halo sign
- fat halo sign
- black attenuation
The first three patterns are seen on contrast studies.
White enhancement
It is defined as uniform enhancement of thickened bowel wall which is greater than or equal to the venous opacification.
Common differentials include:
- idiopathic inflammatory bowel disease
- vascular disorder
Gray enhancement
It is defined as homogenous enhancement of thickened bowel wall that equals to the muscle enhancement. It is useful in differentiating benign with malignant diseases.
Water halo sign
It corresponds to edema in the submucosa (c.f fat halo sign where there is fat infiltrating the submucosa). It may be seen in three forms
- outer hyperattenuating layer with inner edematous layer
- inner hyperattenuating layer with outer edematous layer
- edematous submucosa between two hyperattenuating layers (target sign)
Common differentials include:
- idiopathic inflammatory bowel disease
- vascular disorder
- infectious diseases
- radiation damage
Fat halo sign
It represents infiltration of the submucosa with fat, between the muscularis and the mucosa.
It is considered pathognomonic forinflammatory bowel disease.
Black attenuation
It is synonymous to pneumatosis and the causes include
- trauma
- ischemia
- infection
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-</ul><p> </p>- +</ul>