Download Clinical Anatomy

Radiological anatomy
thoracic imaging
Grzegorz Staskiewicz MD, PhD
Human Anatomy Department, Medical University of Lublin
•  Methods of thoracic imaging
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X-ray (PA, AP and lateral projections), fluoroscopy
Computed Tomography
Magnetic Resonance Imaging
Ultrasonography
Computed Tomography
•  Advantages
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TimeSoft
tissueRepeatability
DepthAvailability
Procedures
•  Disadvantages
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Radiation
High dose
Contrast medium
Patient weight
Ultrasound
•  Advantages
•  Disadvantages
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QuicklyCheaplyEveryw
hereReal timeBlood
flow: DopplerTreatments
procedures
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Limited range
Obstacles: air, gases,
bones
Dependence on operator
MRI
•  Advantages
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No ionizing radiation
multi-planar imaging
Excellent resolution of
soft tissue
•  Disadvantages
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Cost
Availability
Claustrophobia
Time
Contraindications
Anatomia radiologiczna klatki piersiowej
Ao
PT
Hilum
Pulmonary
vessels
LA
RA
LV
cardiophrenic angle
costophrenic angle
KPŻ
Anatomia radiologiczna klatki piersiowej
Thoracic imaging
•  Native scanning
•  Chest CT with contrast medium
•  High Resolution CT (HRCT)
•  Computed Tomography angiography (CTA)
•  Cardiac CT examinations (ECG-gating)
•  Low dose screening chest CT
Pulmonary segments
Pulmonary segments - Left Lung
Pulmonary segments - Right Lung
•  Thoracic lymph nodes classification
•  pulmonary arteries - embolism extent
•  Qanadli score
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Qanadli SD et al. AJR (176)2001
•  10 segmental arteries
in both lungs
•  extent: 0/1/2
•  The heart
•  Norm values for echocardiography
Female
Male
LP
2.7-3.8 cm
3.0-4.0 cm
LV
3.9-5.3 cm
4.2-5.9 cm
LV (volume)
56-104 cm3
67-155 cm3
Ejection Fraction
≥ 55%
≥ 55%
LV wall
0.6-0.9 cm
0.6 – 1.0 cm
Halpern E. Clinical Cardiac CT: Anatomy and Function. Thieme.
•  Aorta
Hager et al. Diameters of the thoracic aorta throughout life as
measured with helical computed tomography. JTCS, 2008
•  Pulmonary trunk
29 mm
Karazincir et al. CT assessment of main pulmonary artery
diameter. Diagn Interv Radiol, 2008
•  Coronary arteries
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RCA: 1-4
LCA: 5
LAD: 6-10
LCx: 11-15
Radiological anatomy
head imaging
Grzegorz Staskiewicz MD, PhD
Human Anatomy Department, Medical University of Lublin
•  Non-­‐contrast study •  Contrast study •  Angio CT •  Perfusion CT Head CT in ER pa-ent
Anatomy Falx cerebri
Longitudinal
fissure
Anatomy Lateral ventricle,
Frontal horn
Caudate nucleus,
Head
Fornix
Lateral ventricle,
Occipital horn
Choroid plexus
Thalamus
Anatomy Internal capsule,
Anterior crus
Putamen
Internal capsule,
Posterior crus
Lateral ventricle,
Frontal horn
Head of caudate
nucleus
3rd ventricle
Pineal gland
Thalamus
Lateral ventricle,
Occipital horn
Anatomy Cistern of lateral fossa
Quadrigeminal lamina
Qadrigeminal cistern
Anatomy 3rd ventricle
Interpeduncular cistern
Cisterna ambiens
Cerebral aqeduct
Quadrigeminal cistern
Anatomy Lateral ventricle,
Temporal horn
Basal cistern
4th ventricle
Anatomy Pontine cistern
4th ventricle
Anatomy Cerebello-pontine angle
4th ventricle
Increased intracranial pressure? Hirsch W. et al. Reliability of cranial CT versus intracerebral pressure measurement for the evaluation of generalised cerebral
oedema in children. Pediatr Radiol (2000) 30: 439-443
Objec-ve assessment A
B
D
C
E
F
(A) Frontal horns distance; (B) Caudate nuclei distance
(C) 3rd ventricle width; (D) Minimal lateral ventricles width;
(E) Internal cranial width; (F) External cranial width
Objec-ve assessment A
B
D
C
E
(A)/(E) = Evans score
(C)/(E) = 3rd ventricle score
(D)/(F)= cella media score
F
Aging LeMay M. Radiologic changes of the aging brain and skull. AJR, 1984; 143: 383-­‐9. Trauma Trauma Intracranial hemorrhages Intracranial hemorrhage: mass effect Hemorrhagic stroke:
evolution
•  Hyperdense ICA sign •  Up to 50% cases •  Very high specificity •  Low sensitivity •  White/gray matter homogeneity: first 3 hrs •  Lentiform nucleus •  Insula •  Hypodensity •  Swelling of gyri – flatening of sulci Ischemic stroke