多层螺旋CT对成人肾筋膜外侧附着的解剖研究  

Study of Anatomy of the Lateral Attachment of the Renal Fascia in Adult with Multidetector Computed Tomography

作　　者：漆锐[1] 周翔平[1] 余建群[1] 陈卫霞[1] 李真林[1] 张春乐[2] 

机构地区：[1]四川大学华西医院放射科,成都610041 [2]四川大学华西医院消化科,成都610041

出　　处：《生物医学工程学杂志》2012年第4期658-662,共5页Journal of Biomedical Engineering

基　　金：四川省科技厅-攻关项目资助(2006Z09-016)

摘　　要：通过对正常成人肾筋膜(RF)的多层螺旋CT(MDCT)薄层扫描,探讨RF在外侧的附着关系,以及其诊断价值。收集2010年10月-2010年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,观察RF向外侧的附着情况。另新鲜尸体横断面薄层标本一具,作为解剖观察基础。观察发现在肾门以上平面,RF的外侧延伸与附着表现为RF前层与肝肾隐窝、脾肾隐窝的腹膜融合,RF后层与膈下筋膜融合。在肾门及以下平面,RF的外侧附着分为三型,Ⅰ型,肾门平面左侧约占47.9%(58/121),右侧约占33.9%(41/121)。肾下极平面左侧约占55.3%(67/121),右侧约占42.1%(51/121)。Ⅱ型,肾门平面左侧约占38.8%(47/121),右侧约占26.4%(32/121)。肾下极平面左侧约占27.3%(33/121),右侧约占13.3%(16/121)。Ⅲ型,肾门平面左侧约占13.3%(16/121),右侧约占39.7%(48/121)。肾下极平面左侧约占17.4%(21/121),右侧约占44.6%(54/121)。MDCT薄层扫描能较好地观察RF在外侧的显示及其附着情况,以及腹膜后间隙向外侧的通连关系。The present paper is aimed to observe the lateral attachment of the renal fascia （RF） in vivo with multide- rector computed tomography （MDCT） scanning, and to discuss its diagnostic value. 121 healthy adults were adopted into this experiment. All images were obtained with MDCT and double phase enhancement scanning. Then we ob- served the lateral attachment of RF. In addition,we mad a fresh body specimen as anatomical basis. The study found that above the renal hilar plane （RHP） ,the anterior renal fascia laterally fused with the peritoneum of the liver on the right and the peritoneum of the spleen on the left,and the posterior renal fascia fused with the subdiaphragmatie fas- cia. The lateral attachment of the RF at the RHP and the lower renal pole（LRP）is divided into three types. The RF in Typel is about 47.9%（58/121） at the left RHP, while about 33.9% （41/121） at the right RHP. At the LRP of the kidney is about 55.3% （67/121） on the left, and about 42.1%（51/121） on the right. The RF in Type ]1 is a- bout 38. 8% （47/121） on the left side at the RHP, about 26.4% （32/121） on the right side. At the LRP, left side about 27. 3% （33/121）, right side about 13.3%（16/121）. The RF in Type lit at the RHP is 13.3%（16/121） on the left side, and on the right side is about 39.7% （48/121）. At the LRP, it is about 17, 4% （21/121） on the left side, and about 44.6 % （54/121） on the right side. MDCT can display the lateral attachment of the RF better as well as the outside connection of the retroperitoneal space.

关 键 词：肾筋膜 多层螺旋CT 腹膜后间隙 

分 类 号：R816.7[医药卫生—放射医学]