The perinephric space and renal fascia: review of normal anatomy, pathology, and pathways of disease spread.
The perinephric space and renal fascia: review of normal anatomy, pathology, and pathways of disease spread.
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肾周间隙和肾筋膜：正常解剖学、病理学和疾病传播途径的回顾。
DOI：
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发表时间：
1997
期刊：
影响因子：
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通讯作者：
H. O'Neil
中科院分区：
文献类型：
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作者：
R. Aizenstein;C. Owens;S. Sabnis;A. Wilbur;J. Hibbeln;H. O'Neil
肾周间隙是一个圆锥形的腹膜后腔室，包含肾脏、肾上腺、肾周脂肪、纤维桥接隔以及丰富的肾周血管和神经网络。肾周间隙病变可能起源于肾周筋膜的范围内或外。大多数内在性肾周间隙疾病起源于肾脏或肾上腺，其次累及肾周间隙。起源于肾筋膜锥外的疾病可通过毛细血管扩散到肾周空间（即，转移扩散）或直接越过肾周筋膜平面（例如，侵袭性肿瘤或感染）。此外，浸润的软组织或快速积聚的腹膜后液体可通过肾周桥接隔和肾筋膜进入或流出肾周间隙。在这篇文章中，我们回顾了肾周间隙和肾筋膜的正常解剖，强调腹膜后筋膜间平面和肾周桥接隔作为腹膜后疾病传播的潜在管道的意义。本文回顾了正常解剖结构和疾病传播途径，作为讨论各种可能涉及肾周间隙和腹膜后筋膜的特定病理条件的背景，包括胰腺炎、腹膜后血肿、尿瘤、转移性疾病和肾周静脉曲张。
The perinephric space is a cone-shaped retroperitoneal compartment containing the kidney, adrenal gland, perinephric fat, fibrous bridging septa, and a rich network of perirenal vessel and lymphatics. Perinephric space pathology may originate from within or outside the confines of the perirenal fascia. Most intrinsic perinephric space disease arises from the kidney or adrenal gland, and secondarily involves the perinephric space. Disease originating outside the cone of renal fascia may spread to the perinephric space via lymphatics (i.e., metastatic spread) or by directly transgressing perirenal fascial planes (e.g., invasive tumor or infections). Additionally, infiltrating soft tissue or rapidly accumulating retroperitoneal fluid may travel into or out of the perinephric space via perinephric bridging septa and renal fascia. In this article, we review the normal anatomy of the perinephric space and renal fascia, emphasizing the significance of retroperitoneal interfascial planes and perinephric bridging septa as a potential conduit for retroperitoneal disease spread. This review of normal anatomy and pathways of disease spread serves as background for a discussion of a variety of specific pathologic conditions that may involve the perinephric space and retroperitoneal fascia, including pancreatitis, retroperitoneal hematoma, urinoma, metastatic disease, and perirenal varices.