Misty Mesentery in Patients with Ureterolithiasis: Just Coincidence?

Abstract

Objective: The purpose of this study is to evaluate the misty mesentery sign on computed tomography in patients with ureterolithiasis.Methods: This retrospective study enrolled all consecutive patients with ureteral stone diagnosed in abdominal computed tomography in the 3-year study period. Computed tomography scans were reviewed to assess the presence and interrelations between misty mesentery, ureteral diameter, volume and location of stones, presence of periureteral and perinephric stranding, thickening of the perirenal fascia, nephromegaly, and grade of hydronephrosis.Results: Four hundred thirty-four patients were included in the analysis. Misty mesentery was identified in 62 (14.2%) patients. Patients with misty mesentery were significantly older (mean age=45.2±12.2) than those without (mean age=37.3±10.9) (p=0.022). Perirenal fascial thickening was identified in 101 (23.2%) patients and found to be significantly associated with misty mesentery (c2=7.74, p=0.005). Two hundred patients (46%) were noted to exhibit periureteral stranding which was noted to be significantly related with misty mesentery (c2=13.6, p=0.000).The relationship between misty mesentery and pelvicalyceal ectasia, perinephric stranding, ureteral location of the stone, and nephromegaly were not found statistically significant.Conclusions: Ureterolithiasis can be accompanied by misty mesentery at computed tomography examination. There may be a potential association between ureterolithiasis and misty mesentery.