A study of multi-detector row CT scan on greater omentum in 50 individuals: correlating with anatomical basis and clinical application.

Background: In view of the descriptions of the CT manifestations on the greater omentum (GO) were not precise and detailed enough in the previous literature, we tried to evaluate the radiologic-anatomical features of the GO and to address the related clinical implications for the radiologic diagnosis and surgical application.

Methods: We evaluated the GO by using multi-detector row CT (MDCT) scanning in 50 individuals correlating with anatomical basis and clinical application. Emphasis was placed on the following items: the anatomical distribution and location of the GO; the CT manifestations of the vasculature, fatty tissue and lymph nodes.

Results: The gastro-epiploic vessel, the landmark for delineating the GO, was visualized in 50/50 cases (100%). The gastro-colic vein was detected in 34/50 cases (68%). The free-hanging portion, 48 cases revealed, seemed to have the capability of 'migration': it is located in the subphrenic spaces in 9/48 cases (19%) and distributed in the right lower quadrant predominantly in 10/48 cases (21%). Three-dimensional reformatted images, obtained in five cases, demonstrated the return of the gastro-epiploic vein distinctly. Lymph nodes were rarely detected within the GO.

Conclusion: The depicted omental vessels, visualized by using multi-planar reconstruction images together with three-dimensional reformatted images, played a crucial role in delineating the GO comprehensively. It can provide the valuable data for the radiologic diagnosis and surgical therapy planning including surgery of reconstruction, pancreas, portal hypertension as well as infections and neoplastic diseases.