Download cross-sectional anatomy

Section III
CROSS-SECTIONAL
ANATOMY
CHAPTER 15 • Neuro Anatomy
INTRODUCTION
CHAPTER 16 • Thoracic Anatomy
A radiologic technologist practicing in any field of radiology
must understand basic human anatomy and physiology in
order to perform his or her duties. Those working in CT or
MRI must also be able to identify normal anatomic structures on cross-sectional images. This requires an adaptation
in thinking; special attention must be paid to the relationships among structures. There are many excellent resources
available that provide comprehensive images from the
entire head and body, allowing readers to learn, identify,
and recall anatomic structures in cross section. Some of
these resources are listed here.
CHAPTER 17 • Abdominopelvic Anatomy
CHAPTER 18 • Musculoskeletal Anatomy
The aim of this section is to provide an introduction to cross-sectional anatomy by presenting
just a few representative slices from some of the
most common examinations performed in the
CT department. Each cross-sectional image is
accompanied by a drawing, in shades of gray, to
help identify structures. All the drawings have
been done according to the same gray scale. Regardless of where they are found in the body, air
is depicted as black; bone is white. Within these
extremes, shading varies for tissues, organs, and
abnormalities. Each cross-sectional image is also
accompanied by a reference image to help the
reader imagine its location in the body.
181
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Because only representative slices are included,
the slices displayed are not adjacent. Compared
with an actual CT examination that includes
contiguous slices, the reader is at a considerable
disadvantage in accurately identifying specific
structures from a single image. (Note: questions
contained in the certification examination
for CT asking the examinee to identify anatomic structures most often provide only a
single cross-sectional image. Therefore, this
format, although not reflecting actual practice,
Chap15.indd 182
does mirror that commonly used for the CT
examination.) In actual practice, whenever
there is doubt the viewer should analyze adjacent superior and inferior images and compare
the structures in question.
Resources:
Madden ME. Introduction to Sectional Anatomy. Philadelphia: Lippincott Williams & Wilkins, 2001.
Kelley LL, Peterson C. Sectional Imaging for Imaging
Professionals. St. Louis: Mosby/Elsevier, 2006.
Dean D, Herbener TE. Cross-Sectional Human Anatomy.
Philadelphia: Lippincott Williams & Wilkins, 2000.
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NEURO ANATOMY
HEAD
A
Brain
Routine scans of the brain usually begin at the base of the
skull and continue superiorly. Depending on the clinical
indication, the scans may be done without IV contrast
enhancement, with IV contrast enhancement, or without
and with IV contrast enhancement. The images included
below include IV contrast enhancement.
B
12
1
2
11
3
10
4
5
6
9
8
Chap15.indd 183
7
1.
2.
3.
4.
5.
6.
Nasal bones
Eye, lens
Maxillary sinus
Vomer
Sphenoid bone
Medulla oblongata
7. Occipital bone
8. Vertebral artery
9. Mastoid air cells
10. Zygoma
11. Eye, globe
12. Ethmoid sinus
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A
1
14
2
2
3
13
4
5
12
6
8
11
9
9
7
10
B
1.
2.
3.
4.
5.
6.
Chap15.indd 184
1. Medial rectus m.
2. Globe of eye
3.Medial
Optic n.
rectus m.
4.Globe
Sphenoid
bone,
of eye
greater wing of
Optic n.
5. Mandibular condyle
Sphenoid bone,
6. Mastoid air cells
greater wing of
in left temporal bone
Mandibular condyle
7. Sigmoid sinus
Mastoid air cells
in left temporal bone
8. Pons
9. Cerebellum
10.
auditory
7.Internal
Sigmoid
sinus canal
11.
8.Auricle
Pons
12.
auditory meatus
9.External
Cerebellum
13.
rectus
m. canal
10.Lateral
Internal
auditory
14.
11.Zygoma
Auricle
12. External auditory meatus
13. Lateral rectus m.
14. Zygoma
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A
1
2
16
3
15
15
4
14
5
13
5
1
9
12
11
6
9
10
7
8
1.
Frontalsinus
sinus
1. Frontal
2.
Pituitary
2. Pituitary
3.
Sphenoidbone
bone
3. Sphenoid
4.
Middle
cerebral
4. Middle cerebral a.a.
5.
Temporallobe
lobe
5. Temporal
6.
Mastoid
air
cells
6. Mastoid air cells
lefttemporal
temporalbone
bone
ininleft
7.
Sigmoidsinus
sinus
7. Sigmoid
8.
Occipitalbone
bone
8. Occipital
Chap15.indd 185
B
9. Cerebellar
peduncles
9. Cerebellar
peduncles
10.
Cerebellum
10. Cerebellum
lamboid
suture
11.11.
RightRight
lamboid
suture
12.
Fourth
ventricle
12. Fourth ventricle
Basilar
13.13.
Basilar
a. a.
14.
Sella
tursica
14. Sella tursica
15.
Temporalis
15. Temporalis m. m.
Frontal
bone,
orbital
16.16.
Frontal
bone,
orbital
roof roof
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A
1
2
12
3
11
4
10
5
9
6
7
8
B
1.
2.
3.
4.
5.
Frontal bone
cerebri
1.Falx
Frontal
bone
cerebral a.
2.Anterior
Falx cerebri
cerebral
a. a.
3.Middle
Anterior
cerebral
4.Lateral
Middleventricle,
cerebral a.
5.temporal
Lateral ventricle,
ho
rn
temporal horn
6. Parietal bone
6. Parietal bone
Chap15.indd 186
7. Cerebellum, tentorium
Internal occipital
7.8.
Cerebellum,
tentorium
protuberance
8. Internal
occipital
9.protuberance
Fourth ventricle
9.
Fourth
ventricle
10.
Posterior
cerebral a.
10.
Posterior
cerebral a.
11. Basilar a.
11.
a. bone
12.Basilar
Temporal
12. Temporal bone
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A
1
12
2
14
13
3
5
4
4
5
6
12 12
11
7
10
8
B
9
1. Superior sagittal sinus
Frontalsagittal
bone sinus
1.2.Superior
3.
Lateral
ventricle,
2. Frontal bone
anterior
ho
rn
3. Lateral
ventricle,
4.
Caudate
anterior
hornnucleus, head
Putamen/Globus
p
allidus
4.5.Caudate
nucleus, head
Third ventricle pallidus
5.6.Putamen/Globus
Choroid
plexus
6.7.Third
ventricle
8. Parietal bone
9.Parietal
Internal
occipital
8.
bone
protuberence
9. Internal occipital
10.protuberence
Cerebellar vermis
11.
Pineal body
10. Cerebellar
vermis
12.
Thalamus
11. Pineal
body
13.
Internal capsule
12. Thalamus
14.
Temporal
bone
13. Internal
capsule
7. Choroid plexus
14. Temporal bone
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A
1
2
11
10
3
9
4
3
8
7
B
7
5
12
6
1. Falx cerebri
7. Occipital lobe
1. Falx cerebri
6. Superior sagittal sinus
2. Frontal bone
8. Choroid plexus
2. Frontal bone
7. Occipital lobe
3. Corpous callosum
9. Lateral ventricle, body
3. Corpous callosum
8. Choroid plexus
4. Caudate nucleus, body
10. Temporal bone
4. Caudate nucleus, body
9. Lateral ventricle, body
5. Parietal bone
11. Corona radiata
5. Parietal bone
10. Temporal bone
6. Confluence of sinuses (torcula)
12. Straight sinus
11. Corona radiata
12. Straight sinus
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189
A
10
2
9
8
3
1
1
4
6
7
1. Frontal lobe
Frontal lobe
2. 1.Superior
sagittal sinus
2.
Superior sagittal
3. Precentral
gyrus sinus
3.
Precentral
gyrus
4. Central suicus
4.
Central
suicus
5. Falx cerebri
5. Falx cerebri
6. Parietal lobe
Chap15.indd 189
6
5
B
6. Parietal lobe
7.7.
Parietal
bone
Parietal
bone
8.8.
Temporal
bone
Temporal
bone
9.9.
Scalp
Scalp
10.
bone
10.Frontal
Frontal
bone
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Sinuses
Sinus screening is intended as an inexpensive, accurate,
and low radiation dose method for confirming the presence of inflammatory sinonasal disease. If confirmed and
the patient will then have endoscopic sinus surgery, the
coronal images provide a “roadmap” for the surgeon.
When the clinical indication is recurrent or chronic sinusitis, the study is done without IV contrast enhancement
and scanning is done in the coronal plane. Other clinical
indications may require the administration of IV contrast
or additional scans in the axial plane.
Sinuses (Coronal)
1
A
3
1
4
2
4
1
5
5
9
6
6
11
12
12
11
7
8
10
B
1.
2.
3.
4.
5.
6.
Chap15.indd 190
Sphenoid bone
1.Sphenoid
bone
Sphenoid sinus
2.Sella
Sphenoid
sinus
tursica,
floor
3.Zygoma
Sella tursica, floor
4.Medial
Zygoma
pterygoid m.
5.Masseter
Medial pterygoid
m.
m.
6. Masseter m.
7. Mandible
7. Mandible
8.8.Aryepiglottic
foldfold
Aryepiglottic
9.9.Pharynx
Pharynx
10.
bone
10. Hyoid
Hyoid
bone
11.
m.m.
11. Lateral
Lateralpterygoid
pterygoid
12.
12. Pharyngeal
Pharyngealconstrictor
constrictor
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A
2
15
3
1
14
13
6
8
19
5
16
16
12
4
7
6
8
18
19
17
11
10
10
9
B
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Chap15.indd 191
Frontal lobe
1. Frontal lobe
Medial rectus m.
2. Medial rectus m.
Superior rectus m.
3. Superior rectus m.
Infraorbital fissure
4. Infraorbital fissure
Nasal conchae
5. Nasal conchae
Maxillary sinus
6. Maxillary sinus
Zygoma
7. Zygoma
Maxillary bone
8. Maxillary bone
Hard palate
9. Hard palate
Mandible
11. Tooth
10. Mandible
12. Nasal bone (nasal septum)
11. Tooth
13. Inferior rectus m.
12. Nasal bone (nasal septum)
14. Lateral rectus m.
13. Inferior rectus m.
15. Optic nerve/ canal
14. Lateral rectus
16. Sphenoid sinus
15. Optic nerve/ canal
17. Tongue
16. Sphenoid sinus
18. Oral vestibule
17. Tongue
19. Masseter m.
18. Oral vestibule
19. Masseter m.
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A
14
13
1
3
12
4
4
2
15
2
15
5
6
7
B
11
7
9
8
9
10
1.
2.
3.
4.
5.
6.
7.
8.
Chap15.indd 192
Crista
galli galli
9.
1. Crista
Ethmoid
sinus sinus
10.
2. Ethmoid
Medial
rectusrectus
m.
3. Medial
m.
Frontal
bone bone
11.
4. Frontal
Inferior
rectusrectus
m.
12.
5. Inferior
m.
Middle
nasal turbinate
6. Middle
nasal turbinate 13.
Maxillary
sinus sinus
14.
7. Maxillary
Inferior
nasal turbinate
8. Inferior
nasal turbinate 15.
Mandible
9.
Mandible
Maxillary
bone,
hard
10.
Maxillary
bone,
hard
palate
palate
11.
Dental
filling
(spray
Dental
filling
(spray
artifact)
artifact)gland
Lacrimal
12.
Lacrimal
gland
Superior
rectus
m.
13.
Superior
rectus
Superior oblique
m.m.
14.
Superior
oblique
m.
Eye, globe
15. Eye, globe
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A
14
1
1
3
13
2
2
4
12
6
11
5
5
6
9
6
6
7
7
8
10
1.
2.
3.
4.
5.
6.
7.
Chap15.indd 193
Frontal lobe
1. Frontal lobe
Eye, globe
2. Eye, globe
Lacrimal gland
3. Lacrimal gland
Inferior rectus m.
4. Inferior rectus m.
Maxillary sinus
5. Maxillary sinus
Maxillary bone
6. Maxillary bone
Tooth
7. Tooth
8. Tongue
10
B
8. Tongue
9. Oral vestibule
9. Oral vestibule
10. Mandible
10. Mandible
11. Inferior nasal chonchae
11. Inferior nasal chonchae
12. Nasal bone (nasal septum)
12. Nasal bone (nasal septum)
13. Middle nasal chonchae
13. Middle nasal chonchae
14. Ethmoid sinus
14. Ethmoid sinus
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Temporal Bones
The organs of hearing and balance are located in the petrous ridge of the temporal bone. Because these organs are
tiny, thin slices are used. Once the scan data are acquired,
the two petrosal bones are reconstructed separately so
that the display field of view can be reduced to ensure
optimal resolution. Most protocols include scans in both
the coronal and axial planes; the use of IV contrast varies
according to the clinical indication.
Temporal Bones (Coronal)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Epitympanum
Malleus
Facial canal
Cochlea
Internal auditory canal
Tympanic cavity
Mastoid air cells
Temporal bone
Semicircular canals
Hypoglossalc anal
Occipitalc ondyle
Jugularf ossa
15-12
15-13
15-12
8
1
7
4
3
2
5
6
15-13
8
9
7
12
10
11
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195
1. Internal auditory canal
1. Internal auditory canal
2. Superior semicircular canal
2. Superior semicircular
3. canal
Lateral semicircular canal
4. 3.Epitympanum
Lateral semicircular canal
5. 4.Incus
Epitympanum
6. 5.External
Incus auditory canal
7. 6.Styloid
process
External
auditory canal
8. 7.Tympanic
cavity
Styloid process
9. 8.Oval
window
Tympanic cavity
9. Oval window
4
3
5
2
9
1
6
8
7
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Temporal Bones (Axial)
1.
2.
3.
4.
5.
6.
7.
8.
Mandible, condyle
Sphenoid
sinus
1. Mandible,
condyle
Clivus
2. Sphenoid sinus
Carotid
canal
3. Clivus
Sigmoid
nus
4. Carotidsi
canal
Mastoid
air cells
5. Sigmoid
sinus
External
auditory
canal
6. Mastoid
air cells
Jugular
foramen
7. External
auditory canal
9. Auditory ossicle: malleus
10.
Auditory
ossicle: incus
8. Jugular
foramen
11.
Carotid ossicle:
a
cnal malleus
9. Auditory
12.
10.Internal
Auditoryauditory
ossicle: canal
incus
13.
11.Vestibule
Carotid canal
14.
canalcanal
12.Semicircular
Internal auditory
15.
Cochlea
13.Vestibule
14. Semicircular canal
15. Cochlea
15-16
15-15
15-15
2
3
1
4
7
8
6
5
15-16
9
10
11
15
12
13
5
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14
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15-18
1.
2.
3.
4.
5.
6.
7.
197
Temporal lobe
1. Temporal lobe
Superior semicircular canal
2. Superior semicircular canal
Mastoid antrum
3. Mastoid antrum
Posterior semicircular canal
4. Posterior semicircular canal
Sigmoid sinus
5. Sigmoid sinus
Temporal bone
6. Temporal bone
Occipital bone
7. Occipital bone
15-17
1
2
6
3
4
5
7
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NECK
Unless contraindicated, CT examinations of the neck are
done with the IV administration of contrast media. Artifacts caused by dental work often obscure surrounding
structures at some levels. Some facilities split the data acquisition into two groups so that the gantry can be angled
to reduce artifact. However, many MDCT systems do not
allow the gantry to be angled in the helical mode, so this
is not always possible.
15-18
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
Maxillary bone
Oral vestibule
Masseter m.
Mandible, ramus
Atlas, anterior arch
Dens
Spinal cord
Internal jugular v.
Mastoid tip
Parotidg land
Retromandibularv .
Internal carotid a.
Pharynx
Genioglossusm.
Vertebrala .
Vertebra, spinous process
Longus colli muscles
15-18
15-19
18. Rectus/oblique capitus m.
19. Splenius capitus m.
20. Pterygoid m.
1
12
1
2
4
3
3
11
20
20
13
5
6
10
10
7
9
8
19
15-19
4
14
17
3
12
3
20
20
11
13
10
10
8
18
7
15
18
16
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1. 1.Genioglossus
Genioglossusm.
m.
2. 2.Tongue
Tongue
3. 3.Mandible
Mandible
4. 4.Pharynx
Pharynx
5. 5.Left
Leftexternal
externalcarotid
carotid a.
a.
6. 6.Internal
Internaljugular
jugularvv.
v.
199
7.9. Vertebral
Left internal
a. carotid a.
8.10.Vertebral
body
Sternocleidomastoid
m.
9.11.Right
vertebral a.gland
Submandibular
10. Sternocleidomastoid m.
11. Submandibular gland
7. Left internal carotid a.
8. Vertebral body
1
3
5
3
11
2
11
7
4
10
6
6
8
10
9
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2
12
1
4
5
6
1
3
4
13
6
7
5
8
7
12
11
9
10
1. Sternohyoid/Sternothyroid mm.
1. Sternohyoid/Sternothyroid mm.
2. Thyroid cartilage
2. Thyroid cartilage
3. Cricoid cartilage
3. Cricoid cartilage
4. Sternocleidomastoid m.
4. Sternocleidomastoid m.
5. Jugular vv.
5. Jugular v.
6. Thyroid g
land
6. Thyroid gland
7. Esophagus
Chap15.indd 200
9
10
8. Vertebral body
7. Esophagus
9. Erector spinae m.
8. Vertebral body
10. Trapezius m.
9. Erector spinae m.
11. Right vertebral a.
10. Trapezius m.
12. Right common carotid a.
11. Vertebral a.
13. Pharynx
12. Common carotid a.
13. Pharynx
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SPINE
CT of the spine is most often performed without IV contrast media administration. However, scans of the spine
are often obtained after intrathecal contrast material is
given for a myelography study.
A
1
12
5
2
2
4
11
B
9
3
10
11
4
10
6
7
8
1.
2.
3.
4.
5.
6.
Chap15.indd 201
Aorta
1. Aorta
Psoas
m.
2. Psoas
Dural
sac m.
3. Dural sac
Pedicle
4. Pedicle
Lumbar
vertebra 2
5. Lumbar
Articular
facetvertebra 2
6. Articular facet
7. Ligamenta flava
8.7.Ligamenta
L1, spinousflava
process
L1, transverse
spinous process
9.8.L2,
process
L2, transverse
process
10.9.Erector
spinae m.
Erector spinae m.
11.10.
Kidneys
Kidneys
12.11.
Jejunum/ileum
12. Jejunum/ileum
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A
13
12
2
1
3
4
11
4
5
6
8
9
10
8
7
9
B
1.
2.
3.
4.
5.
6.
7.
Chap15.indd 202
Inferior vena cava
1.Aorta
Inferior vena cava
2.L2,
Aorta
vertebral body
3.Psoas
L2, vertebral
body
m.
4.Dural
Psoas
m.
sac
5.L2,
Dural
sac
lamina
6.L2,
L2,spinous
lamina process
7. L2, spinous process
8. Multifidus m.
8. Multifidus
m.
9.
Erector spinae
m.
9.
Erector
spinae
10. Cauda equina m.
(in dural sac)
10. Right
Caudakidney
equina (in dural sac)
11.
11.
Right
kidney
12. Nerve root (exiting)
12. Posterior
Nerve rootlongitudinal
(exiting) lig.
13.
13. Posterior longitudinal lig.
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A
2
1
3
4
9
8
8
11
5
12
7
B
1.
2.
3.
4.
5.
6.
Chap15.indd 203
5
5
10
6
Inferior vena cava
7.
Aorta
8.
1. Inferior
vena cava
Anulus
fibrosus
9.
2. Aorta
Intervertebral
disk L2/L3
10.
3. Anulus
fibrosus
Articular
processes
11.
Intervertebral
disk L2/L312.
L2,4.spinous
process
5. Articular processes
6. L2, spinous process
12
5
7
Erector spinae m.
Psoas m.
7. Erector
spinae m.
Right
kidney
8. Psoas m.
Ligamenta
flava
9. Right
Dural
sackidney
10. Ligamenta
flava m.
Quadratus
lumbrum
11. Dural sac
12. Quadratus lumbrum m.
10/9/2009 2:37:37 PM