基于影像学视角的腹膜下间隙与腹部盆腔肿瘤转移途径  

Subperitoneal space and pathways of abdominal and pelvic tumor spread from the perspective of imaging

作　　者：王屹[1] 冯彩珍 Wang Yi;Feng Caizhen(Department of Radiology,People's Hospital,Peking University,Beijing 100044,China)

机构地区：[1]北京大学人民医院放射科,100044

出　　处：《中华胃肠外科杂志》2020年第8期810-816,共7页Chinese Journal of Gastrointestinal Surgery

摘　　要：腹膜腔和腹膜下间隙由腹膜或称为浆膜分隔为解剖学上相对独立的间隙。腹膜下间隙由疏松结缔组织构成呈线状位于腹膜和肌层的内层。器官表面覆盖腹膜,因此所有器官均位于腹膜下间隙内;位于背侧腹膜后的器官成为腹膜后器官。腹膜反折构成韧带或系膜,其内含位于腹膜下间隙内的、供应脏器的血管、淋巴管和神经分支供应相应的脏器。根据典型位置和器官关系或其包含的主要血管,我们可以在横断面影像中识别韧带或系膜。腹部和盆腔经韧带或系膜连接成连续的统一的解剖间隙,不仅提供了连续解剖平面,也为病变的播散提供了路径。理解腹膜下间隙的解剖将提升临床上识别炎性病变、恶性肿瘤和创伤播散途径的能力。The abdomen and pelvis have been divided anatomically and clinically into peritoneal cavity and subperitoneal space by peritoneum.The subserosal areolar tissue which lines the inner surfaces of the peritoneum and the musculature of the abdomen and pelvis form the subperitoneal space.The surfaces of organs are covered by peritoneum,therefore,organs are located within subperitoneal space.Those organs that are deep to the posterior peritoneum are called extraperitoneal.Peritoneal reflections comprise the abdominal major ligaments and mesenteries.They contain the branches of the vascular,lymphatic,and nervous systems within subperitoneal space to supply the corresponding organs.Either the relationships of typical location and organ or the landmarks provided by major constituent vessels give a help to recognize ligaments and mesenteries on computed tomographic scans.The abdomen and pelvis may be visualized as unifying,anatomically continuous potential space by ligaments and mesenteries,which provide continuity of anatomic planes and permit the spread of diseases between intraperitoneal compartments,between extraperitoneal spaces,and between intraperitoneal and extraperitoneal localized sites.Understanding the anatomy of subperitoneal space would increase the capabilities to detect pathways of spread and localizing features of infections,malignancies,and traumas.

关 键 词：腹膜腔 腹膜下间隙 韧带 系膜 

分 类 号：R737.3[医药卫生—肿瘤]