肾筋膜间平面在急性胰腺炎中CT表现.doc

肾筋膜间平面在急性胰腺炎中CT表现 　［摘要］ 目的：通过观察急性胰腺炎（AP）在腹膜后间隙内扩散的CT表现来认识肾筋膜间平面的解剖形态。方法：回顾分析41例AP病例的CT增强表现，着重观察肾筋膜间平面及其毗邻间隙受累的CT表现。结果：AP发生在全胰腺21例，在胰头5例，在胰腺体尾15例。AP均累及左侧肾旁前间隙，累及右旁前间隙35例，双侧肾旁前间隙同时受累32例；累及右肾前筋膜间平面32例，右锥侧筋膜间平面16例，右肾后筋膜间平面7例，右肾周间隙23例，右肾旁后间隙2例；累及左肾前筋膜间平面41例，左锥侧筋膜间平面26例，左肾后筋膜间平面12例，左肾周间隙33例，左肾旁后间隙7例。结论：AP在肾筋膜间平面的扩散支持了肾筋膜分层学说；AP所致肾筋膜间平面的炎性积液主要通过扩散或破坏肾筋膜进入毗邻间隙。　　［关键词］ 胰腺炎；腹膜后间隙；解剖；体层摄影术；X线计算机 　　Renal Interfascial Plane:Its CT Features in Acute Pancreatitis 　　Abstract：Objective To recognize the anatomy of renal interfascial plane through observation of the CT features in acute pancreatitis(AP) with involvement of the retroperitoneal space.Methods CT images of 41 cases with AP were studied,with focus on CT features of renal interfascial plane and the correlative space and their internal contact. Results Of the total 41 AP cases, the whole pancreas(21 cases),the head of pancreas(5 cases),the body and tail of pancreas(15 cases) were involved. Of the retroperitoneal space involvement, left anterior pararenal space(41 cases) ,right anterior pararenal space(35 cases),both sides(32 cases);right anterior renal interfascial plane(32 cases), right lateroconal interfascial plane(16 cases),right posterior renal interfascial plane(7 cases), right perirenal space(23 cases),right posterior pararenal space(2 cases);left anterior renal interfascial plane(41 cases), left lateroconal interfascial plane(26 cases),left posterior renal interfascial plane(12 cases), left perirenal space(33 cases), left posterior pararenal space(7 cases) were involved.Conclusion The delamination theory of renal fascia was sustained by the involvement of the renal interfascial plane in AP.Fluid within renal interfascial plane in AP follows into the correlative space by two routes. 　　Key words： Pancreatitis;Retroperitoneal space;Anatomy;Tomography; X-ray computed 　　胰腺是腹膜后器官，居于腹膜后间隙的肾旁前间隙内。急性胰腺炎（acute pancreatitis，AP）是常见的急腹症，AP胰液渗漏到胰腺间质内，这些含有激活蛋白水解酶的液体进而漏到胰腺周围的组织间隙内，重症AP早期往往在胰腺周围形成急性积液，并且向胰外远处区域扩散，病变在肾旁前间隙内向上、下及双侧扩散，