多层螺旋CT对成人活体肾筋膜向上附着的解剖研究  

Superior Attachment of Renal Fascia:a Study with Multidetector Computed Tomography and Three Dimensional Reconstruction

作　　者：漆锐[1] 周翔平[1] 陈卫霞[1] 余建群[1] 李真林[1] 廖凯[1] 

机构地区：[1]四川大学华西医院放射科,成都610041

出　　处：《四川大学学报（医学版）》2012年第2期196-199,共4页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技厅科技攻关项目(2006Z09-016)资助

摘　　要：目的通过对成人活体肾筋膜和肾周间隙的多层螺旋CT扫描及三维重建,探讨肾筋膜向上的附着关系以及肾周间隙向上的通连关系。方法收集2010年10～12月于我院接受腹部CT增强扫描检查的病例121例,采用飞利浦Brilliance 64及西门子双源多层螺旋CT机进行双期增强扫描,在飞利浦及西门子图像工作站进行图像后处理及三维重建,观察肾筋膜的显示情况、肾筋膜向上的附着情况及肾周间隙的上方通连关系。结果肾筋膜的上方附着:右侧肾筋膜前层与腹膜的融合位置均在肾上极以下。左侧肾筋膜前层在肾上极以上与腹膜融合,占27.3%(33/121),左侧肾筋膜前层在肾上极以上外侧与脾脏表面腹膜融合,内侧与膈下筋膜融合,占19.8%(24/121),左侧肾筋膜前层在肾上极以下与腹膜融合,占52.9%(64/121),在总体上呈内高外低趋势。肾筋膜后层与膈下筋膜的融合位置均位于肾上极以下,表现为外高内低。肾周间隙向上的通连关系:双侧肾筋膜前后层在肾脏上方均未见融合。肾周间隙在右侧向上与肝裸区通连,在左侧约80.2%(97/121)向上与腹膜外间隙通连,约19.8%(24/121)左侧肾周间隙外侧与腹膜外间隙通连,而内侧止于膈下。结论多层螺旋CT及三维重建能较好的观察肾筋膜向上的附着情况,以及肾周间隙向上的通连关系。Objective To observe the superior attachment of renal fascia（RF） and the perirenal space（PS） in order to identify the spreading pathway of inflammatory and malignant tumors.Methods Multidetector computed tomography（MDCT）,with double phase enhancement scanning and three dimensional reconstruction of images were performed on 121 healthy adults.The RF attachments upward were observed and their connections with the PS were evaluated.Results The left anterior renal fascia（ARF） fusing with peritoneum accounted for 27.3%（33/121） and the left ARF fusing with peritoneum of the spleen laterally and with the subdiaphragmatic fascia interiorly accounted for 19.8%（24/121） of the upper attachments of the RF above the upper renal pole（URP）.Under the URP,the left ARF fusing with peritoneum accounted for 52.9%（64/121） of the upper attachments of the RF.The right ARF fusing with peritoneum did not display above the URP. The posterior renal fascia（PRF） of both side fused with subdiaphragmatic fascia under the URP.The ARF and PRF of the left and right kidney showed no upward integration.The right PS communicated with the subdiaphragmatic retroperitoneal space（SDRS） that is a bare area of the liver.The left PS communicating with the SDRS accounted for 80.2%（97/121） and the left PS communicating with the SDRS laterally but separating from the SDRS interiorly accounted for 19.8%（24/121） of the SDRS communication.Conclusion MDCT and three-dimensional reconstruction can remarkably display RF and its superior attachment,as well as the connection between the PS and SDRS.

关 键 词：肾筋膜 肾周间隙 多层螺旋CT 

分 类 号：R816.7[医药卫生—放射医学]