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Montanarella M, Gonzalez Baerga CI, Menendez Santos MJ, Elsherif S, Boldig K, Kumar S, Virarkar M, Gopireddy DR. Retroperitoneal anatomy with the aid of pathologic fluid: An imaging pictorial review. J Clin Imaging Sci 2023; 13:36. [PMID: 38205277 PMCID: PMC10778072 DOI: 10.25259/jcis_79_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/24/2023] [Indexed: 01/12/2024] Open
Abstract
The retroperitoneum, a complex anatomical space within the abdominopelvic region, encompasses various vital abdominal organs. It is compartmentalized by fascial planes and contains potential spaces critical in multiple disease processes, including inflammatory effusions, hematomas, and neoplastic conditions. A comprehensive understanding of the retroperitoneum and its potential spaces is essential for radiologists in identifying and accurately describing the extent of abdominopelvic disease. This pictorial review aims to describe the anatomy of the retroperitoneum while discussing commonly encountered pathologies within this region. Through a collection of illustrative images, this review will provide radiologists with valuable insights into the retroperitoneum, facilitating their diagnostic proficiency to aid in appropriate patient clinical management.
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Affiliation(s)
- Matthew Montanarella
- Department of Radiology, University of Florida-Jacksonville, Jacksonville, Florida, United States
| | | | | | - Sherif Elsherif
- Department of Radiology, University of Florida-Jacksonville, Jacksonville, Florida, United States
| | - Kimberly Boldig
- Department of Internal Medicine, University of Florida-Jacksonville, Jacksonville, Florida, United States
| | - Sidhu Kumar
- Department of Radiology, University of Florida-Jacksonville, Jacksonville, Florida, United States
| | - Mayur Virarkar
- Department of Radiology, University of Florida-Jacksonville, Jacksonville, Florida, United States
| | - Dheeraj Reddy Gopireddy
- Department of Radiology, University of Florida-Jacksonville, Jacksonville, Florida, United States
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Chaurasia A, Singh S, Homayounieh F, Gopal N, Jones EC, Linehan WM, Shyn PB, Ball MW, Malayeri AA. Complications after Nephron-sparing Interventions for Renal Tumors: Imaging Findings and Management. Radiographics 2023; 43:e220196. [PMID: 37384546 PMCID: PMC10323228 DOI: 10.1148/rg.220196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/20/2022] [Accepted: 01/10/2023] [Indexed: 07/01/2023]
Abstract
The two primary nephron-sparing interventions for treating renal masses such as renal cell carcinoma are surgical partial nephrectomy (PN) and image-guided percutaneous thermal ablation. Nephron-sparing surgery, such as PN, has been the standard of care for treating many localized renal masses. Although uncommon, complications resulting from PN can range from asymptomatic and mild to symptomatic and life-threatening. These complications include vascular injuries such as hematoma, pseudoaneurysm, arteriovenous fistula, and/or renal ischemia; injury to the collecting system causing urinary leak; infection; and tumor recurrence. The incidence of complications after any nephron-sparing surgery depends on many factors, such as the proximity of the tumor to blood vessels or the collecting system, the skill or experience of the surgeon, and patient-specific factors. More recently, image-guided percutaneous renal ablation has emerged as a safe and effective treatment option for small renal tumors, with comparable oncologic outcomes to those of PN and a low incidence of major complications. Radiologists must be familiar with the imaging findings encountered after these surgical and image-guided procedures, especially those indicative of complications. The authors review cross-sectional imaging characteristics of complications after PN and image-guided thermal ablation of kidney tumors and highlight the respective management strategies, ranging from clinical observation to interventions such as angioembolization or repeat surgery. Work of the U.S. Government published under an exclusive license with the RSNA. Online supplemental material and the slide presentation from the RSNA Annual Meeting are available for this article. Quiz questions for this article are available in the Online Learning Center. See the invited commentary by Chung and Raman in this issue.
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Affiliation(s)
- Aditi Chaurasia
- From the Urologic Oncology Branch, National Cancer Institute,
National Institutes of Health, Bethesda, Md (A.C., N.G., W.M.L., M.W.B.);
Department of Radiology and Imaging Sciences, Clinical Center, National
Institutes of Health, 10 Center Dr 1C352, Bethesda, MD 20892 (S.S., F.H.,
E.C.J., A.A.M.); and Division of Abdominal Imaging and Intervention, Department
of Radiology, Brigham and Women’s Hospital, Harvard Medical School,
Boston, Mass (P.B.S.)
| | - Shiva Singh
- From the Urologic Oncology Branch, National Cancer Institute,
National Institutes of Health, Bethesda, Md (A.C., N.G., W.M.L., M.W.B.);
Department of Radiology and Imaging Sciences, Clinical Center, National
Institutes of Health, 10 Center Dr 1C352, Bethesda, MD 20892 (S.S., F.H.,
E.C.J., A.A.M.); and Division of Abdominal Imaging and Intervention, Department
of Radiology, Brigham and Women’s Hospital, Harvard Medical School,
Boston, Mass (P.B.S.)
| | - Fatemeh Homayounieh
- From the Urologic Oncology Branch, National Cancer Institute,
National Institutes of Health, Bethesda, Md (A.C., N.G., W.M.L., M.W.B.);
Department of Radiology and Imaging Sciences, Clinical Center, National
Institutes of Health, 10 Center Dr 1C352, Bethesda, MD 20892 (S.S., F.H.,
E.C.J., A.A.M.); and Division of Abdominal Imaging and Intervention, Department
of Radiology, Brigham and Women’s Hospital, Harvard Medical School,
Boston, Mass (P.B.S.)
| | - Nikhil Gopal
- From the Urologic Oncology Branch, National Cancer Institute,
National Institutes of Health, Bethesda, Md (A.C., N.G., W.M.L., M.W.B.);
Department of Radiology and Imaging Sciences, Clinical Center, National
Institutes of Health, 10 Center Dr 1C352, Bethesda, MD 20892 (S.S., F.H.,
E.C.J., A.A.M.); and Division of Abdominal Imaging and Intervention, Department
of Radiology, Brigham and Women’s Hospital, Harvard Medical School,
Boston, Mass (P.B.S.)
| | - Elizabeth C. Jones
- From the Urologic Oncology Branch, National Cancer Institute,
National Institutes of Health, Bethesda, Md (A.C., N.G., W.M.L., M.W.B.);
Department of Radiology and Imaging Sciences, Clinical Center, National
Institutes of Health, 10 Center Dr 1C352, Bethesda, MD 20892 (S.S., F.H.,
E.C.J., A.A.M.); and Division of Abdominal Imaging and Intervention, Department
of Radiology, Brigham and Women’s Hospital, Harvard Medical School,
Boston, Mass (P.B.S.)
| | - W. Marston Linehan
- From the Urologic Oncology Branch, National Cancer Institute,
National Institutes of Health, Bethesda, Md (A.C., N.G., W.M.L., M.W.B.);
Department of Radiology and Imaging Sciences, Clinical Center, National
Institutes of Health, 10 Center Dr 1C352, Bethesda, MD 20892 (S.S., F.H.,
E.C.J., A.A.M.); and Division of Abdominal Imaging and Intervention, Department
of Radiology, Brigham and Women’s Hospital, Harvard Medical School,
Boston, Mass (P.B.S.)
| | - Paul B. Shyn
- From the Urologic Oncology Branch, National Cancer Institute,
National Institutes of Health, Bethesda, Md (A.C., N.G., W.M.L., M.W.B.);
Department of Radiology and Imaging Sciences, Clinical Center, National
Institutes of Health, 10 Center Dr 1C352, Bethesda, MD 20892 (S.S., F.H.,
E.C.J., A.A.M.); and Division of Abdominal Imaging and Intervention, Department
of Radiology, Brigham and Women’s Hospital, Harvard Medical School,
Boston, Mass (P.B.S.)
| | - Mark W. Ball
- From the Urologic Oncology Branch, National Cancer Institute,
National Institutes of Health, Bethesda, Md (A.C., N.G., W.M.L., M.W.B.);
Department of Radiology and Imaging Sciences, Clinical Center, National
Institutes of Health, 10 Center Dr 1C352, Bethesda, MD 20892 (S.S., F.H.,
E.C.J., A.A.M.); and Division of Abdominal Imaging and Intervention, Department
of Radiology, Brigham and Women’s Hospital, Harvard Medical School,
Boston, Mass (P.B.S.)
| | - Ashkan A. Malayeri
- From the Urologic Oncology Branch, National Cancer Institute,
National Institutes of Health, Bethesda, Md (A.C., N.G., W.M.L., M.W.B.);
Department of Radiology and Imaging Sciences, Clinical Center, National
Institutes of Health, 10 Center Dr 1C352, Bethesda, MD 20892 (S.S., F.H.,
E.C.J., A.A.M.); and Division of Abdominal Imaging and Intervention, Department
of Radiology, Brigham and Women’s Hospital, Harvard Medical School,
Boston, Mass (P.B.S.)
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Stein R, Bashir S, Kee-Sampson J. Interventional radiology in renal emergencies: a pictorial essay. Emerg Radiol 2022; 29:409-424. [PMID: 35001206 DOI: 10.1007/s10140-021-02004-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/28/2021] [Indexed: 11/25/2022]
Abstract
Renal emergencies necessitate prompt diagnosis and management to stop active bleeding and retain kidney function. Causes of renal emergencies can be classified into traumatic, atraumatic, iatrogenic, and obstructive etiologies. Interventional radiology (IR) has emerged as an acceptable alternative to surgical treatment in the management of renal emergencies due to its minimally invasive nature. With the rise of interventional procedures, there is a need for further discussion of angiographic and fluoroscopic imaging in the setting of renal emergencies.
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Affiliation(s)
- Rachel Stein
- Department of Radiology, University of FL School of Medicine - Jacksonville, 655 West 8th Street, C90, 2nd Floor, Clinical Center, Jacksonville, FL, 32209, USA.
| | - Saeed Bashir
- Department of Radiology, University of FL School of Medicine - Jacksonville, 655 West 8th Street, C90, 2nd Floor, Clinical Center, Jacksonville, FL, 32209, USA
| | - Joanna Kee-Sampson
- Department of Radiology, University of FL School of Medicine - Jacksonville, 655 West 8th Street, C90, 2nd Floor, Clinical Center, Jacksonville, FL, 32209, USA
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