急性胰腺炎致肾前筋膜间平面积液的CT表现及解剖

CT features and anatomy of fluid collection in the retromesenteric plane caused by acute pancreatitis

目的研究急性胰腺炎所致的肾前筋膜间平面(retromesenteric plane,RMP)积液的CT表现。方法收集39例急性胰腺炎致RMP积液的患者的CT和临床资料,结合RMP的解剖回顾性分析双侧RMP积液情况。结果 1左侧和右侧RMP积液分别为28例和38例;双侧RMP积液27例;239例中,24例显示双侧RMP均为单层积液,表现为肾前筋膜内厚薄不一的梭形或弧形液体密度影,其走行方向与增厚的肾前筋膜相一致;315例显示RMP积液呈多层状,表现为肾前筋膜内走行与增厚的肾前筋膜一致的多层的厚薄不一的梭形或弧形液体密度影;层状积液相互交叉或部分融合,之间可见脂肪间隙。15例中,左侧RMP显示多层积液2例,右侧RMP显示多层积液5例,双侧RMP多层积液8例。结论 CT可良好显示急性胰腺炎时肾前筋膜间平面积液的解剖细节。

Objective To study the CT features of fluid collection in the retromesenteric plane（RMP）by the acute pancreatitis.Methods Thirty-nine cases with fluid collection in the RMP resulting from acute pancreatitis were reviewed retrospectively,which were proved by surgery or clinical and laboratory findings.Emphasis was placed on the CT findings of fluid collection in the RMP.Results ① Fluid collections were shown in the left RMP（28cases）,right RMP（38cases）and bilateral showed（27cases）;②In the 39 cases,twenty-four cases were detected single layer fluid collections,showing as spindle-shaped or curved fluid density with different thickness.The courses were in concordance with the anterior renal fascia;③ Fifteen were cases detected multiple layers of fluid collections,showing as spindle-shaped or curved fluid density with different thickness.The courses of the fluid collections were in concordance with the anterior renal fascia.The multiple layers of fluid collections were reciprocal chiasmata or fusion,with fat tissue showing between the fluid collections.Among fifteen cases,the multiple layers of fluid collection located in the left RMP（2cases）,right RMP（5cases）and bilateral RMP（8cases）.Conclusion CT can show the fluid collections in the RMP in detail.