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1、The Diaphragmatic Crura and Retrocrural SpaceNormal Imaging Appearance, Variants, and Pathologic ConditionsGuo Xiaochao2010.7.22RadioGraphics 2008;28:1289-1305The retrocrural space (RCS) is a small triangular region within the most inferior posterior mediastinum bordered by the two diaphragmatic cru
2、ra. Multiplanar imaging modalities allow evaluation of the RCS as part of routine examinations. Normal structures within the retrocrural region include the aorta, nerves, the azygos and hemiazygos veins, the cisterna chyli with the thoracic duct, fat, and lymph nodes.Anatomic ConsiderationsDiaphragm
3、 and Diaphragmatic CruraLymph Nodes, Cisterna Chyli, and Thoracic Duct 52% at lymphangiography; 1.7% at CT; 15%96% at MRAortaAzygos and Hemiazygos VeinsParavertebral Venous Plexus valvelessSympathetic Trunk and Splanchnic NervesCisterna Chyli & Thoracic DuctParavertebral Venous PlexusCongenital diap
4、hragmatic hernia Bochdalek hernia(95%) Morgagnis hernia(2%) Partial duplication of the diaphragmDiscontinuity of the diaphragmCongenital Anomalies of the IVCAnatomic Variants and AnomaliesAbnormalities of the CruraLymphadenopathy NeoplasmsForegut MalformationsVascular DisordersInfammatory Conditions
5、InfectionsOther AbnormalitiesAbnormalities of the RCSLymphadenopathy (6mm)NeoplasmsThese can be categorized according to their cell of origin into neurogenic, mesenchymal, germ cell, and lymphoid tumors.Neurogenic tumorsganglion cell tumorsnerve sheath tumorsparagangliaVascular DisordersInfammatory
6、ConditionsRetroperitoneal fbrosisSteroid-induced retrocrural lipomatosisSpondylosis deformansPancreatic pseudocystsInfectionsDiabetes, immunosuppression, intravenous drug abuse, anemia, and urinary tract infections ConclusionsDespite the small area that encompasses the RCS, there is a wide variety o
7、f pathologic conditions within this region, which is located at the posterior confnes of the inferior thorax and upper abdomen. An understanding of the anatomy, the normal variants, and the multiple pathologic conditions affecting the diaphragmatic crura and retrocrural structures facilitates the diagnosis of disease.