[Superior attachment of renal fascia: a study with multidetector computed tomography and three dimensional reconstruction].

Objective: To observe the superior attachment of renal fascia (RF) and the perirenal space (PS) in order to identify the spreading pathway of inflammatory and malignant tumors.
Methods: Multidetector computed tomography (MDCT), with double phase enhancement scanning and three dimensional reconstruction of images were performed on 121 healthy adults. The RF attachments upward were observed and their connections with the PS were evaluated.
Results: The left anterior renal fascia (ARF) fusing with peritoneum accounted for 27.3% (33/121) and the left ARF fusing with peritoneum of the spleen laterally and with the subdiaphragmatic fascia interiorly accounted for 19.8% (24/121) of the upper attachments of the RF above the upper renal pole (URP). Under the URP, the left ARF fusing with peritoneum accounted for 52.9% (64/121) of the upper attachments of the RF. The right ARF fusing with peritoneum did not display above the URP. The posterior renal fascia (PRF) of both side fused with subdiaphragmatic fascia under the URP. The ARF and PRF of the left and right kidney showed no upward integration. The right PS communicated with the subdiaphragmatic retroperitoneal space (SDRS) that is a bare area of the liver. The left PS communicating with the SDRS accounted for 80.2% (97/121) and the left PS communicating with the SDRS laterally but separating from the SDRS interiorly accounted for 19.8% (24/121) of the SDRS communication.
Conclusion: MDCT and three-dimensional reconstruction can remarkably display RF and its superior attachment, as well as the connection between the PS and SDRS.