Spectrum of lesions in the perirrenal space: a pictorial review
Number:28ESURABS0088
Type:Educational Electronic Presentation
Authors: Andreu Antolin, Richard Mast, Manuel Perez Toran, Josep Salvador, Sarai Roche, David Armario, Xavi Merino, Nuria Roson
Keywords:Perirrenal space, CT, MRI
SECTIONS
Educational objective

The aim of this pictorial review is to illustrate the anatomy and radiological findings of lesions located in the perirenal space in CT, MRI and US. 

Topic Review

BACKGROUND 

The perirenal space is a retroperitoneal space located between the anterior and posterior renal fasciae. It contains the kidneys, proximal ureters, adrenal glands, fat, bridging septa (Kunin’s septa), vessels and lymphatics [1]. A wide spectrum of diseases/entities are found in this retroperitoneal space. An understanding of common and uncommon conditions and their imaging findings can help narrowing the likely diagnosis [1].  

The etiology of disorders can be attributed to solid tumors (benign or malignant), collections, inflammatory masses and proliferative syndromes (Figure 1) [1].  

 

PERIRRENAL SPACE LESIONS

ANATOMICAL LANDMARKS 

The perirenal space is a retroperitoneal space that sits between the...

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Figure 1. Classification of the main entities found in the perirenal space, both benign and malignant. ​ ​ © Department of Radiology, Hospital Universitari Vall d’Hebron, Barcelona, Spain 2022. ​
Figure 2. Schematic representation (*) of the retroperitoneal spaces in the renal area with its radiological correlation. Retromesenteric plane (RMP), perivascular space (1), perirenal space (PS, 2, limited by the Gerota's and Zuckerkandl's fascia), anterior pararenal space (APS, 3), posterior pararenal space (PPS, 4), retrorenal plane (RRP, 5), lateroconal plane (LP, 6). ​ * Tirkes T, Sandrasegaran K, Patel AA, et al. Peritoneal and retroperitoneal anatomy and its relevance for cross-sectional imaging [published correction appears in Radiographics. 2019 May-Jun;39(3):912]. Radiographics. 2012;32(2):437-451.​ ​ © Department of Radiology, Hospital Universitari Vall d’Hebron, Barcelona, Spain 2022.
Conclusions

The perirenal space is a retroperitoneal compartment that can be affected by a great variety of benign and pathological conditions. A good understanding of the anatomy of this region and the different conditions that can arise within or extent from other regions is crucial for an accurate diagnosis. A good use of the different radiological techniques (CT, MRI and US) helps narrowing the diagnosis, although sometimes the final diagnosis can only be made through histological analysis, enhancing the role of interventional radiologists. ...read more

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