急性胰腺炎扩散至肾周间隙的螺旋CT表现及其解剖基础

目的探讨急性胰腺炎(AP)扩散至肾周间隙的螺旋CT表现及其解剖学基础。方法回顾分析87例连续AP病例的螺旋CT增强扫描表现,着重观察肾周间隙是否受累以及其CT特征,并进行CT分级评分,观察肾周间隙受累与肾筋膜的毗邻关系。结果肾周间隙总的受累率为75%(65/87),其中B级50%(44/87),C级25%(21/87)。本组轻症AP24例,其中9例出现了肾周间隙受累;63例重症AP,56例出现了肾周间隙受累。肾周间隙内出现的水肿或积液通过肾周间隙内的桥隔与同侧水肿或积液的肾筋膜相连。结论AP累及肾周间隙时,轻者CT表现为肾周间隙内桥隔或脂肪水肿,重者可见蜂窝组织炎或积液。AP所致的炎性水肿或积液主要通过肾周间隙内的桥隔扩散或者破坏肾筋膜而进入肾周间隙。

Spiral CT Features and Anatomic Basis of Involvement of Perirenal Space in Acute Pancreatitis

Objective To evaluate the spiral CT features and anatomic basis of involvement of the perirenal space(PRS) in acute pancreatitis (AP).Methods CT images of 87 cases with AP were retrospectively studied, with focused on spiral CT features and incidence of the PRS involvement, and its correlations with the renal fasciae. Results The incidence of the PRS involvement was 75% with Grade B in 50%,Grade C in 25%. PRS involvement were detected in 9 of 24 cases of mild pancreatitis and in 56 of 63 of severe pancreatitis.The pancreatitis fluid collection in the PRS was continuous with that fluid within the interfascial plain by the bridging septa . Conclusion Spiral CT features of the PRS involvement varies from mild inflammatory changes to fluid collection or phlegmonous mass. Fluid within PRS in acute pancreatitis follows into the PRS by two routes.