健康男性直肠周围筋膜的CT和MRI影像学观察

摘要

目的 阐明健康男性直肠周围筋膜和神经的CT和MRI影像特点.方法 观察健康成年男性的CT和MRI影像资料各10例、男性尸体骨盆标本MRI扫描影像5例.结果 直肠固有筋膜和骶前筋膜显示为环形直肠系膜后外侧的联合层;此联合层于S5椎体水平增厚为直肠骶骨筋膜.Denonvilliers筋膜是联合层在直肠系膜前面的延续.下腹下丛为联合层后外侧,联系直肠、膀胱和盆侧壁的网孔结构.直肠周围筋膜的MRI T2影像较T1和CT影像更清晰.结论 直肠固有筋膜和骶前筋膜在MRI T2影像中为连续、清晰的联合层,在指导直肠癌的影像学评估方面具有潜在的临床价值.%Objective To explore iconography of computed tomography( CT )and magnetic resonance imaging( MRI )of perirectal fasciae and autonomic nerves of healthy subjects. Methods CT and MRI images of 10 healthy male were collected. Five healthy male cadaveric pelvises underwent MRI examination. Images were reviewed. Results Rectal proper fascia and presacral fascia were combined single layer covering annular mesorectum from posterolateral aspect. The combined layer was bolded at the level of the fifth sacral vertebra that indicated rectosacral fascia. Denonvilliers fascia was continuation of the combined layer and covered the mesorectum from anterior aspect. Inferior hypogastric plexus was a mesh posterolateral to the combined layer and linked rectum and bladder to lateral wall of pelvis. Perirectal fasciae were observed more clearly on T2 weighed MRI images than on Tl images or CT images. Conclusion Rectal proper fascia and presacral fascia were continued and clear combined layer on T2 MRI images, which may play potential roles on iconographic evaluation of rectal caner. .