Department of Radiology, Xuan-Wu Hospital, Capital University of Medical Sciences, 45 Chang-Chun St., Xuanwu District, Beijing 100053, People's Republic of China.
AJR Am J Roentgenol. 2010 Mar;194(3):642-52. doi: 10.2214/AJR.09.3003.
The objective of our study was to clarify the anatomic and radiologic features of the extraperitoneal fasciae and fascial spaces associated with the rectum.
Fourteen embalmed cadavers were studied: two for gross anatomy; six for sectional anatomy, of which two underwent histologic study; and six for space perfusion study. These examinations were followed by CT and cross dissection to observe the pelvic extraperitoneal fasciae and the role of the fasciae in the anatomic subdivision and communication of the fascial spaces. Eighty healthy subjects underwent CT or MRI to identify the imaging characteristics of the pelvic fasciae.
Cadaver dissection and histologic study revealed a distinct sheath consisting of dense connective tissue encasing the rectum and surrounding adipose tissue like a sleeve that divided the rectal extraperitoneal space into the perirectal space and pararectal space. Perfusion studies showed communication between the pararectal spaces and the vesical extraperitoneal space anteriorly and the anterior pararenal space superiorly, but not with the perirectal space. In healthy subjects, both CT (95.0%) and MRI (97.5%) showed a circular or linear structure representing the rectal fascia outside the rectum encasing the rectum and its surrounding adipose tissue.
The extraperitoneal segment of the rectum and its surrounding adipose tissue are encased by a fascia, like a sleeve, that can be seen on CT and MRI in healthy populations. The fascia divides the rectal extraperitoneal space into the perirectal space and pararectal space, and it may prevent lesions of the rectum from spreading to other pelvic extraperitoneal spaces.
本研究旨在阐明与直肠相关的腹膜外筋膜和筋膜间隙的解剖和影像学特征。
对 14 具防腐尸体进行了研究：2 具用于大体解剖；6 具用于断面解剖，其中 2 具进行了组织学研究；6 具用于空间灌注研究。随后进行 CT 和交叉解剖，观察盆腔腹膜外筋膜及其在筋膜间隙解剖细分和连通中的作用。80 例健康受试者接受 CT 或 MRI 检查，以识别盆腔筋膜的影像学特征。
尸体解剖和组织学研究显示，致密结缔组织构成的明显鞘包裹直肠和周围脂肪组织，就像一个套管将直肠腹膜外间隙分为直肠旁间隙和直肠旁间隙。灌注研究显示，直肠旁间隙与膀胱腹膜外间隙前部和前肾旁间隙上部之间存在连通，但与直肠旁间隙无连通。在健康受试者中，CT（95.0%）和 MRI（97.5%）均显示出圆形或线性结构，代表直肠外的直肠筋膜，包裹直肠及其周围脂肪组织。
直肠的腹膜外段及其周围的脂肪组织被一层筋膜包裹，就像一个套管，可以在健康人群的 CT 和 MRI 上看到。筋膜将直肠腹膜外间隙分为直肠旁间隙和直肠旁间隙，它可能防止直肠病变扩散到其他盆腔腹膜外间隙。
