Epiploic appendagitis is a rare cause of acute abdominal pain, determined by a benign self-limiting inflammation of the epiploic appendages. It may manifest with heterogeneous clinical presentations, mimicking other more severe entities responsible of acute abdominal pain, such as acute diverticulitis or appendicitis. Given its importance as clinical mimicker, imaging plays a crucial role to avoid inaccurate diagnosis that may lead to unnecessary hospitalization, antibiotic therapy, and surgery. CT represents the gold standard technique for the evaluation of patients with indeterminate acute abdominal pain. Imaging findings include the presence of an oval lesion with fat-attenuation surrounded by a thin hyperdense rim on CT (“hyperattenuating ring sign”) abutting anteriorly the large bowel, usually associated with inflammation of the adjacent mesentery. A central high-attenuation focus within the fatty lesion (“central dot sign”) can sometimes be observed and is indicative of a central thrombosed vein within the inflamed epiploic appendage. Rarely, epiploic appendagitis may be located within a hernia sac or attached to the vermiform appendix. Chronically infarcted epiploic appendage may detach, appearing as an intraperitoneal loose calcified body in the abdominal cavity. In this review, we aim to provide an overview of the clinical presentation and key imaging features that may help the radiologist to make an accurate diagnosis and guide the clinical management of those patients.

Objectives:The aim of the study was to compare epicardial adipose tissue (EAT) characteristics assessed with coronary calcium score (CS) and CT coronary angiography (CTCA) image datasets.Methods:In 76 patients (mean age 59±13 years) who underwent CS and CTCA due to suspected coronary artery disease (CAD), EAT was quantified in terms of density (HU), thickness, and volume. The EAT volume was extracted with a semiautomatic software.Results:A moderate correlation was found between EAT density in CS and CTCA image datasets (-100±19HU vs. -70±24HU, p0.05, r=0.76). The EAT volume resulted 122±50 cm3 in CS and 86±40 cm3 in CTCA (Δ=30%, p<0.05, r=0.92). After adjustment for post-contrast EAT attenuation difference (Δ=30HU), the volume was 101±47 cm3 (Δ=17%, p<0.05, r=0.92). Based on EAT volume median values, no differences were found between groups with...