Skip to main content

Advertisement

SpringerLink
Log in

CT and MR imaging of the properitoneal fat pad: a pictorial essay

  • Review
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

The properitoneal fat pad is a distinctive anatomical structure located in the midline of anterior abdominal wall between the transversalis fascia and parietal peritoneum. It has variable size and configuration depending on the gender and nutritional status of individuals, but CT and MR images of the upper abdomen can readily depict its shape and adipose composition. The purpose of this essay is to illustrate the CT and MRI features of normal properitoneal fat pad, and the spectrum of pathological processes that affect it among patients. This information can be relevant to the practicing radiologists and clinicians for the correct diagnosis and management of such conditions because most lesions of this fat pad produce nonspecific symptoms.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12

Similar content being viewed by others

References

  1. Klopfenstein BJ, Kim MS, Krisky CM, et al (2012) Comparison of 3 T MRI and CT for the measurement of visceral and subcutaneous adipose tissue in humans. Br J Radiol 85(1018):e826-830.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Pereira JM, Sirlin CB, Pinto PS, Casola G (2005) CT and MR imaging of extrahepatic fatty masses of the abdomen and pelvis: techniques, diagnosis, differential diagnosis, and pitfalls. RadioGraphics 25: 69-85.

    Article  PubMed  Google Scholar 

  3. Merklin RJ (1971) The anterior abdominal fat body. Am J Anat 132: 33-44.

    Article  CAS  PubMed  Google Scholar 

  4. Feldberg MA, van Leeuwen MS (1990) The properitoneal fat pad associated with the falciform ligament. Imaging of extent and clinical relevance. Surg Radiol Anat 12: 193-202.

    Article  CAS  PubMed  Google Scholar 

  5. Vlachos IS, Hatziioannou A, Perelas A, Perrea DN (2007) Sonographic assessment of regional adiposity. AJR 189: 1545-1553.

    Article  PubMed  Google Scholar 

  6. Tadokoro N, Murano S, Nishide T, et al (2000) Preperitoneal fat thickness determined by ultrasonography is correlated with coronary stenosis and lipid disorders in non-obese male subjects. Int J Obes 24: 502-507.

    Article  CAS  Google Scholar 

  7. Sones PJ, Thomas BM, Masand PP (1981) Falciform ligament abscess: appearance on computed tomography and sonography. AJR 137: 161-162.

    Article  PubMed  Google Scholar 

  8. Bhatt A, Robinson E, Cunningham SC (2020) Spontaneous inflammation and necrosis of the falciform and round ligaments: a case report and review of the literature. J Med Case Rep 14:17.doi.10.1186.

  9. Parente DB, Neto JAO, Americano Brasil PEA, et al (2018) Preperitoneal fat as a non-invasive marker of increased risk of severe non-alcoholic fatty liver disease in patients with type 2 diabetes. J Gastroenterol Hepatol 23: 511-517.

    Article  Google Scholar 

  10. Tayama K, Inukai T, Shimomura Y. ( 1999) Preperitoneal fat deposition estimated by ultrasonography in patients with non-insulin-dependent diabetes mellitus. Diabetes Res Clin Pract 43: 49-58.

    Article  CAS  PubMed  Google Scholar 

  11. Merlotti C, Ceriani V, Morabito A, Pontiroli AE (2017) Subcutaneous fat loss is greater than visceral fat loss with diet and exercise, weight-loss promoting drugs and bariatric surgery: a critical review and meta-analysis. Int J Obes 41: 672-682.

    Article  CAS  Google Scholar 

  12. Hong SS, Kim TK, Sung KB, et al (2003) Extrahepatic spread of hepatocellular carcinoma: a pictorial review. Eur Radiol 13: 874-882.

    Article  PubMed  Google Scholar 

  13. Arora S, Harmath C, Catania R, et al (2021) Hepatocellular carcinoma: metastatic pathways and extra-hepatic findings. Abdom Radiol 46: 3698-3707.

    Article  Google Scholar 

  14. Casullo J, Zeng H, Belley G, Artho G (2018) CT of the paraumbilical and ensiform veins in patients with superior vena cava or left brachiocephalic vein obstruction. PLoS One 13(4):e 0196093.

  15. Ibukuro K, Tsukiyama T, Mori K, Inoue Y (1998) Hepatic falciform ligament artery: angiographic anatomy and clinical importance. Surg Radiol Anat 20: 367-371.

    Article  CAS  PubMed  Google Scholar 

  16. Wong E, Sayed-Hassen A (2021) Grey Turner’s sign in acute pancreatitis. Clin Case Rep 9(5): e04313.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Chung H, Jacks T, Lilien LD (2011) Properitoneal fat mimicking free air in an infant of a diabetic mother. J Perinatol 31: 687-688.

    Article  CAS  PubMed  Google Scholar 

  18. Mackey RA, Brody FJ, Berber E, et al (2005) Subxiphoid incisional hernias after median sternotomy. J Am Coll Surg 201: 71-76.

    Article  PubMed  Google Scholar 

  19. Mori H, Aikawa H, Hirao K, et al (1989) Exophytic spread of hepatobiliary disease via perihepatic ligaments: demonstration with CT and US. Radiology 172: 41-46.

    Article  CAS  PubMed  Google Scholar 

  20. Agarwal A, Yeh BM, Breiman RS, et al (2004) Peritoneal calcification: causes and distinguishing features on CT. AJR 182: 441-445.

    Article  PubMed  Google Scholar 

  21. Al-Ali MHM, Salih AM, Ahmed OF, et al (2019) Retroperitoneal lipoma; a benign condition with frightening presentation. Int J Case Rep 57: 63-66.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, University of California-San Diego Medical Center, 200 West Arbor Drive, San Diego, CA, 92103, USA

    Gary G. Ghahremani

Authors
  1. Gary G. Ghahremani
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gary G. Ghahremani.

Ethics declarations

Conflict of interest

The author declares no conflict of interest and has no disclosure relevant to the subject matter of this article.

Ethical approval

Due to the retrospective review of the already performed and medically warranted examinations, the patients consent, and IRB approval were waived.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ghahremani, G.G. CT and MR imaging of the properitoneal fat pad: a pictorial essay. Abdom Radiol 48, 3512–3519 (2023). https://doi.org/10.1007/s00261-023-04005-w

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-023-04005-w

Keywords

Search

Navigation