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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。
Objective To investigate the manifestation and anatomical basis of spiral CT in the diffusence of acute pancreatitis (AP) into the perirenal space. Methods Retrospective analysis of 87 cases of continuous AP spiral CT enhanced scan performance, focusing on the observation of whether the perirenal space involvement and CT features, and CT grading, observe the relationship between renal peritoneal space involvement and renal fascia. Results The total perirenal space involvement rate was 75% (65/87), with 50% (44/87) in grade B and 25% (21/87) in grade C. This group of mild AP24 cases, of which 9 cases of renal perineal involvement; 63 cases of severe AP, 56 cases of renal interstitial involvement. Perirephric space appears within the edema or effusion through the perirenal space within the bridge and ipsilateral edema or fluid connected to the renal fascia. Conclusion AP involving the perirenal space, the performance of the light of the cytoplasm of the perirenal gap or fat edema, severe cases of cellulitis or effusion. AP caused by inflammatory edema or fluid mainly through the peritubal space within the bridge to diffuse or destroy the renal fascia into the perirenal space.