Computed tomography of omental pathology.

Computed tomographic scans were reviewed in 46 patients with documented omental pathology to analyze the radiographic characteristics of benign and malignant disease. The normal omentum is identified on CT of the abdomen as a homogeneous fat density anterior to the transverse colon. Four distinct patterns of omental pathology were identified: (a) omental caking, (b) finely infiltrated fat with a "smudged" appearance, (c) cystic masses, and (d) discrete nodules. The smudged pattern of omental pathology was identified most frequently; it was present in 20 to 39 patients with malignant disease and in five of seven patients with inflammatory disease. Omental caking was present in 17 of 46 patients but was only identified in malignant disease. Computed tomography provides the most reliable radiographic technique to routinely evaluate omental pathology. A thorough understanding of the variable appearance of omental disease is important in identifying omental pathology.