正常左侧肾旁后间隙的CT解剖学研究

目的 研究正常左侧肾旁后间隙（left posterior pararenal space，LPPrS）的CT表现。 方法 对1具尸体标本行左侧肾旁前间隙乳胶灌注制作断面标本，观察双侧肾旁后间隙的解剖学特点并记录灌注剂在LPPrS的弥散情况；分析50例正常成人腹部CT资料，观察LPPrS的形态及脂肪厚度、LPPrS血管显示情况及其与左侧肾后筋膜的关系；测量左侧肾静脉水平LPPrS脂肪厚度的最大值以及第2腰椎体水平腹壁皮下脂肪面积，并分析二者的相关性。 结果 （1）标本轴位断层灌注剂进入左侧肾后筋膜间平面后沿LPPrS的纤维分隔蔓延。肾旁后间隙呈弯月状，见多条血管。（2）轴位CT图像上LPPrS可见多条血管影，主要位于左肾外侧、后方；血管可穿过肾后筋膜。LPPrS可见纤细的分隔，显示欠清。LPPrS的形态呈弯月状；左侧肾静脉水平，LPPrS脂肪最厚处位于左肾外侧、后方，平均厚度为0.77 cm。第2腰椎体水平皮下脂肪面积平均为112.37 cm2，二者具有正相关性（r=0.283，P<0.05）。 结论 LPPrS具有特殊的解剖学特点。关注LPPrS的CT表现有助于LPPrS病变及其邻近脏器病变的影像学诊断和治疗。

CT anatomic study of normal left posterior pararenal space

Objective To study the computed tomography (CT) manifestations of normal left posterior pararenal space (LPPrS). Methods (1) One cadaver was perfused with latex into the left anterior pararenal space. The anatomical characteristics of the bilateral posterior pararenal space was observed and the diffusion of perfusion agent in the LPPrS was recorded. (2) The abdominal CT data of 50 normal adult were analyzed to observe the morphology and fat thickness of LPPrS, the vascular display of LPPrS and its relationship with the left posterior renal fascia. The maximal fat thickness of LPPrS at the level of left renal vein and the subcutaneous fat area at the level of the second lumbar vertebra were measured, and their correlation was analyzed. Results (1) After entering into the interfacial planes of the left posterior renal fascia, the axial tomography perfusion agent spread along the fiber separation of LPPrS. The posterior pararenal space was menisus in shape with multiple vessels. (2) On the axial CT images, multiple vascular shadows were detected in the LPPrS and mainly located in the lateral and posterior left kidney. The blood vessels passed through the left posterior renal fascia. CT images showed slender separation in the LPPrS. The average maximal fat thickness at the left renal vein level and the subcutaneous fat area at the second lumbar vertebra level were 0.77 cm and 112.37 cm2. The relationship of them was positive (r=0.283, P<0.05). Conclusions The LPPrS has its own anatomical features. Paying attention to the CT manifestation of the LPPrS is helpful to the imaging diagnosis and treatment of LPPrS lesions and adjacent organs.