CT FINDINGS AT LUPUS MESENTERIC VASCULITIS

Purpose: To describe the spectrum of early CT findings of lupus mesent eric vasculitis (LMV) and to assess the utility of CT in the managemen t 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 s ubsided. Results: Eleven cases revealed CT features suggestive of LMV including conspicuous prominence of mesenteric vessels with palisade p attern or comb-like appearance (CT comb sign) supplying focal or diffu se dilated bowel loops (n=11), ascites with slightly increased periton eal enhancement (n=11), small bowel wall thickening (n=10) with double halo or target sign (n=8). Follow-up CT before high-dose steroid ther apy revealed complete or marked resolution of the abnormal CT findings . Conclusion: CT is helpful for confirming the diagnosis of LMV, espec ially the comb sign which may be an early sign. Bowel ischemia due to LMV is less ominous than previously expected, and the abnormal CT find ings were reversible when early diagnosis and prompt i.v. steroid ther apy could be achieved.