Computed Tomography of the Retroperitoneum

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.

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.