右肾周间隙上份源于脏器肿块CT表现特征探讨  

CT features of masses originating from parenchymal organs in upper part of right perirenal space

作　　者：伍兵[1] 闵鹏秋[1] 何之彦[2] 杨开清[3] 宋彬[1] 刘荣波[1] 

机构地区：[1]四川大学华西医院放射科,成都610041 [2]上海市第一人民医院放射科 [3]四川大学基础医学院解剖教研室

出　　处：《放射学实践》2002年第6期477-480,共4页Radiologic Practice

摘　　要：目的 :探讨右肾周间隙上份不同脏器来源肿块的CT表现特征。方法 :观察和分析 76例经手术、病理和临床证实 ,位于右肾周间隙上份 ,源于不同脏器 ,直径≥ 4cm肿块的增强扫描CT表现特征。结果 :肿块直径 <8cm的 2 2例中 ,其优势平面在肝门平面以上的 3例均来源于肝脏 ,在肝门平面以下的 19例中 ,18例 (94.7% )来源于右肾上腺和右肾 ;下腔静脉肝内段 (IVC Ⅰ段 )和肝门至右肾门平面段 (IVC Ⅱ段 )同时向左前方推移多见于肝脏肿块 (2 4/2 7,88.9% ) ,IVC Ⅱ段向前移的 7例全为右肾上腺肿块 ;门静脉右支后移 (3例 )和门静脉癌栓 (12例 )全部见于肝脏肿瘤 ;造成某脏器实质缺损常为来源于该脏器的肿块 ,而脏器受压推移征则常为邻近脏器肿块推压所致 ;肾筋膜显示的 3 3例中 ,11例位于肾筋膜囊外的肿块均来源于肝脏 ,而 2 2例位于肾筋膜囊内的肿块均来源于右肾上腺和右肾 ;13例侵犯右膈脚的恶性肿瘤中 ,9例 (69.2 % )来源于右肾上腺。结论 :肿块优势平面的位置 ,对邻近大血管和脏器的影响 ,对右膈脚的侵犯以及与肾筋膜囊的关系等CT征象 。Objective:To investigate the CT features of masses originating from parenchymal organs in upper part of right perirenal space (UPRPS).Methods:The CT features of 76 cases with mass of more than 4 cm in diameter originating from parenchymal organs in UPRPS were analysed.All cases underwent CT scanning before operations and were confirmed by surgery,pathology and clinical data.Results:There were 22 cases with mass diameter less than 8cm,of which 3 cases with mass dominant plane above the level of hepatic portal originated from the liver (3/3,100%),and 18 of 19 cases with dominant plane below the level of hepatic portal from the right adrenal gland or kidney (18/19,94.7%).The cases with the left anterior displacement of both segment Ⅰ (from second to first hepatic portal) and segment Ⅱ (from first hepatic portal to renal hilus) of inferior vena cava resulted from liver masses (24/27,88.9%),and all the 7 cases with anterior displacement of the only segment Ⅱ resulted from right adrenal masses.In the 33 cases with renal fascia visualization,masses out of the renal capsule (n=11) and within the renal capsule (n=22) were from the liver and the right adrenal or kidney,respectively.In 13 cases with invasion of right diaphragmatic crus,9 (69.2%) originated from the right adrenal gland.Conclusion:CT findings such as the location of mass dominant plane,the involvement of adjacent vessels and organs,invasion of right diaphragmatic crus,and the correlation with renal capsule may be helpful for differentiating the organ originations of masses in UPRPS.

关 键 词：右肾周间隙上份肿块 CT表现 UPRPS 

分 类 号：R816.7[医药卫生—放射医学]