Classification of CT bowel wall enhancement

Classification of CT bowel wall enhancement .

:black_small_square:︎WHITE:if bowel wall enhancement is equal to or greater than venous opacification(IVC or adjacent veins enhancement )in same scan.

Acute Inflammatory bowel disease

vascular disorders

:black_small_square:︎GREY:If thickened bowel wall show little enhancement comparable to that of enhanced muscle.

differentiate between benign

and malignant disease

Uniform,symmetric ,less thickness with tapered edges and presence of valvulae conniventes indicate benign disease

Variable,asymmetric ,more thickness with heaped up margims and absence of valvulae conniventes indicate malignant disease

:black_small_square:︎WATER HALO

three pattern

halo sign with Two layers .

•High attenuation (white )outer ring (muscularis propria) surrounding gray attenuation inner ring .

• grey attenuation outer ring with high attenuation inner ring .

•three layered target sign

Outer white attenuation muscularis propria .

Middle grey attenuation submucosal ring

Inner high attenuation mucosa ring



Vascular disorders

Infectious disorders

Radiation damage.

Rarely malignancy

:black_small_square:︎FAT HALO

Three layered target sign of thickened bowel in which middle sub mucosa layer has fat attenuation. HU<-10.

Indicates chronic changes of Crohns and ulcerative colitis


Indicating pneumatosis.




Iatrogenic injury.