To clarify the anatomy of the peritoneal reflections of the left perihepatic region, the authors examined 95 cadavers. Thirty-eight were studied radiographieally, 37 with sagittal dissection, and 2O with transverse dissection. In over 80% of the cadavers, the left triangular ligament of the liver separated the left suprahepatic-space into anterior and posterior selions. The lesser omentum extended to the diaphragm, where its anterior layer reflected and continued as the posterior layer of the left triangular ligament. Thus, the posterior left suprahepatic space and the lesser sac were clearly separated by the lesser omentum and the stomach and overlapped each other in three dimensions. The posterior left suprahepatic-space was located anterosuperior to the lesser sac and in turn was continuous with the gastrohepatic space inferfurly. Carefully researched diagrams of both the mldline sagittal and left parasagittal perihepatic spaces were developed. This informarion has clinical value when the radiologist is called on to drain a left perthepatic abscess.

OBJECTIVE. Yuberculosis in the abbuminal lymph nodes may be difficult to distrngfinlsh from lympbunmas, Tnis study evaluated specithc CT bnaging criteria for differetiating these entides. MATERIALS AND METHODS. We retrospacfively reviewed the anatomic distribution and CT enhancement patterns o1' disease in 69 pabuupa 26 (38%) wdh tuberculosis and 43 (62%) with untreated lymphomas invnlving abdominal lymph nodes. Of the patients with tuberculosis, five (19%) had disseminated disease and 21 (81%) bad noodissemninated disease, Of the patients with lympbumas. 16 (37%) had Hodgkin's thsease and 27 (63%) had non-Hodgkin's [ympbuma, RESULTS. Disseminated and nondisseminated tuberculosis involved predominantly lesser omemah mesenteric, anterior prarenah and upper paraaordc lymph nodes. Lower paraaortic lymph nodes were involved more often in Hodgkin's disease (15 patients [94%]). non-Hodgkin's lymphoma (24 patients [89%]), and disseminated tuberculosis (five patients [100%]) than in noodisseminatod tubercnlosis (one patient [5%]). Mesenteric lymph nodes were involved more often in dissemthaled lubereulosis (four pabunls [80%11 and nondisseminatod tuberculosis (11 patients [52%]) than in Hodgkin's disease (one patient [6%]) (p<.01). Anatomic distribution was not different belween disseminated tuberculosis and non-Hodgkin's lymphoma, Tuberculous lymphadenopathy commonly showed peripheral en fianeement, frequently with a multilocular appeance, whereas lympbumatous adenopathy characteristically showed fiomofieneous attenuation (14 patients [87.5%] with Hodgkin's disease and 19 patients [7O%] with non-Hodgknl's lympbuma [p<.01]). CONCLUSION. Our findings indicate that the anatomic distribution and specific en-hancement pettems of lymphadenopathy seen on contrast-enhanced crf can be useful in differeodafing between tuberculosis and untreated lymphomas of the abdominal lymph nodes.

Background: We investigated the constituting collateral vessels in cavernous transformation of the portal vein (CTPV) caused by tumor thromboals of hepatocellalar carcinoma (HCC) by using contrast-enhanced spiral computed tomographie (CT) examination. Methods: Fifty-four histopathothgically proven HCC patients with tumor thrombosis-induced CTPV were retrospectively included and assigned to cirrhosis negative (n=31) and positive (n=23) groups. Another 15 cirrhotic patients with portal hypertension but no HCC and CTPV were used for comparison. Standardized dualphase contrast-enhanced spiral CT was perfornned for all patients. CT appearances of the collateral vessels of CTPV were observed, and their visualization rates were analyzed. Results: Biliary (cystic and paracholedochal veins) and gastric (left and right gaslric veins) branches of the portal vein were the most frequently visualized collateral vessels of CTPV. There was a marked difference in CT visualizetion rates for billary branches between patients with and without CTPV (83-94% vs. 0). No difference existed in visualization rates for gastric branehes across the three groups (77-87% for left gastric, 58-61% for rigbt gastric vein). Conclusion; Biliary and gastric branches of the portal vein are tile major collateral vessels of CTPV. The intergroup differences in CT visualization rates may provide clues to the roles that they migbt play in the hemody namic adaptation process of CTPV.

目的 探究左脯下脂肪浸润（left sulibphrenic fat infiltratiom, LSFI）与急性胰腺炎（acute aqncreatitis, AP）病情严重程度的相关性。方法 对能用Ranson，Balthuzar标准进行升级的连续性AP病例（分别为144例、188例）进行了回顾性的研究，对每例进行分级，井观测记录各病例的LSFI厚度，将3mm内的定为lsfi阴性，厚垭记为0。然后分别作每一例LSFI厚度与Ranson及Balthazar分级的等级资料的相关丹析，结果 Ranson临床分级1～3级中LS出现率分州为30.86%，54.90%及75.00%，LSFI厚度与Ranson分级的等级相关系数为0.4179，P<0.01；Balthazar CT分级A-E级中LSPI出现率分别为0，0，31.52%，71.05%及80.76%，LSFI厚度与Balthazar分级的等级相关系数为0.6301，P<0.01。结论 LSFI厚度与Ranson评分及Balthazar巩分级均吴显著正相关关系，可一定程度反映临床病变的严重程度及其扩展的范围。

目的 探索生膈下脂肪浸润（1eft subphrenic fat infiltration）是否为急性胰腺炎的1种CT表现发其形态学特祉和出现率。方法 回顾性分析188例连续性急性胰腺炎病侧的CT资料，观察LSFI的密度、厚度及其CT表现特征，同时对照观寨了正常腹部50例及胸。腹腔祝液各30侧左膈下区域的CT表现。结果 LSFI出现率为40.96%。表现对左侧肾上腺上方左膈肌下表面前方呈现组织密度浸润或的或局限性的新月形水肿、侵润带，其前方存在或不存在1层正常脂肪组织投影；KSFI的厚度为3-50mm，中位数厚废为8mm，车组资料对照组110例中。仅1例出现相似象。结论 LSFI是急性胰腺炎CI表现中的1个新征象，随急性胰腺炎病情的转目而变化。大部分最终可以吸收消散。小部分则表现为慢性机化过程。