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With the advent of CT we entered a new area of radiological imaging. Structures which rarely if ever were seen became apparent. In no part of the body was the impact of CT as profound as it was in the retroperitoneum. In the pre-CT area this region of the body could not be directly studied and only when gross abnormalities were present could they be appreciated. The best we could do was to try to identify a suspected process by studying its effect on surrounding organs whose position might have been affected by the growth. Urography, barium studies or angiography were employed in the hope that variation in the position of the vessels, ureter or bowel would lead us to the correct diagnosis. With computed tomography all this changed. Modern scanners, available to all today, permit us to appreciate details undreamed of only few years ago. The abundance of fat in this region helps to clearly show even the smallest of structures. We now have the ability to recognize small vessels, lymph nodes and fascial planes. We had a tool which permitted us to study structures which hitherto were only seen by the anatomist or during surgical dissection.
Table des matières
1. Case Material and Methods.- 1.1. Case materials.- 1.2. CT techniques.- 1.3. Patient preparation and contrast enhancement.- 2. Review of the literature. Anatomic considerations. Identification by CT.- 2.1. Introduction.- 2.2. History.- 2.3. Compartments of the retroperitoneum.- 2.4. Arrangements of the renal fascia.- 3. Gerota's Fascia And Intraabdominal Fluid.- 3.1. Hemorrhage in retroperitoneum.- 3.2. Urinary extravasation in retroperitoneum.- 3.3. Acute and chronic inflammation of organs and structures in the retroperitoneal subspaces.- 3.4. Intraperitoneal fluid.- 4. Gerota's Fascia And Infiltrating Malignancies.- 4.1. Primary retroperitoneal tumors.- 4.2. Renal cell carcinoma.- 4.3. Renal pelvis carcinoma.- 4.4. Wilms' tumor (nephroblastoma).- 4.5. Adrenal tumors.- 4.6. Pancreatic tumor.- 4.7. Duodenum and ascending or descending colon tumor.- 5. Gerota's Fascia Associated With LYMPH Node Disease of the Retrope- Ritoneum.- 5.1. General considerations.- 5.2. CT findings and illustrative cases.- Discussion of the Results.- Summary.- List of References.
Commentaire
`By mixing the text with superb CT images, Dr Feldberg has beautifully demonstrated this new dimension in retroperitoneal imaging. The extensive literature on the subject has been investigated and incorporated in the text. It is undoubtedly the most complete reference book on the subject. The study of this area - which in the past has been the domain reserved for the anatomist and surgeon - has now been opened to all. Because our studies are in the living patient, understanding of the spread of disease is now possible. Old and new techniques are combined and the result is a most thorough study of the retroperitoneal fascial planes.'
P.R. Koehler, Salt Lake City, UT, USA (from the Foreword)
`The text is concise and contains pertinent observations from the author's experience and a review of the literature. The atlas is adequately illustrated. The figures are clearly marked with appropriate arrows and symbols to aid the reader in identifying the important anatomic and pathologic features shown on the CT (Computed tomography) scans. The strength of the atlas lies in the cross-sectional and direct coronal CT illustrations. These illustrations provide a good method of studying the anatomy and pathology of the retroperitoneum and they also serve as an excellent reference.'
Journal of Computer Assisted Tomography, June 1984
