肾周间隙CT扫描的临床意义

Clinical Significance of CT Scanning of the Perirenal Space

本文总结了１８例肾周间隙内积血、２８例积脓和３７例肾癌累及肾周间隙共８３例的ＣＴ征象。ＣＴ主要表现为不同程度的肾周筋膜增厚；肾周间隙内纤维间隔线增粗；肾周间隙内积血积脓呈局限或包囊性分布；腰大肌受累等。根据肾周间隙解剖，认为肾周间隙内纤维间隔线有限制积液的扩散作用，并因腹主动脉和下腔静脉的阻挡，血或脓液等较稠的液体不进入对侧肾周间隙。

This paper is to review the CT findings of 83 cases with a limited spectrum of disorders that affect the perirenal space, including perirenal hematoma(18 cases). perirenal abscess (28 cases) and renal cell carcinoma with perirenal invasion (37 cases) The main CT features were:1) Various degrees of thickening of the Gerota fascia;2)Swelling of the bridging septa in the cases with perirenal hernotomas and abscesses, but very slight in renal cancer;3)Tendency of encapsulation of blood or pus collection within the perirenal compartment. and 4)High incidence of psoas muscle involvement. Authors’ study showed that viscous fluid such as blood or pus could not traverrse the midline probably due to the reactive inflammatory thickening of the bridging septa in the perirenal space and abdominal aorta and cava interposition. Authors suggest that the familiarity with the normal anatomy will prompt the proper CT localization and determine the route of spreading of the renal as well as the perirenal disorders.