Normal Cortical Anatomy
MGH Massachusetts General Hospital Harvard Medical School NORMAL CORTICAL ANATOMY
• Sagittal • Axial • Coronal • The Central Sulcus
NP/MGH Sagittal Neuroanatomy
NP/MGH Superior frontal gyrus Cingulate sulcus Marginal ramus of Cingulate sulcus Cingulate gyrus Paracentral lobule
Superior parietal lobule
Parietooccipital sulcus
Cuneus
Calcarine sulcus
Lingual gyrus
Subcallosal gyrus Gyrus rectus Fastigium, fourth ventricle NP/MGH Superior frontal gyrus Cingulate sulcus Precentral gyrus Marginal ramus of Cingulate gyrus Central sulcus Cingulate sulcus
Superior parietal lobule
Precuneus
Parietooccipital sulcus
Cuneus
Calcarine sulcus
Frontomarginal gyrus Lingual gyrus Caudothallamic groove Gyrus rectus NP/MGH Precentral sulcus Central sulcus Superior frontal gyrus Marginal ramus of Corona radiata Cingulate sulcus
Superior parietal lobule
Precuneus
Parietooccipital sulcus
Calcarine sulcus
Lingual gyrus Inferior occipital gyrus NP/MGH Central sulcus
Superior parietal lobule
Parietooccipital sulcus
Frontopolar gyrus
Frontomarginal gyrus Superior occipital gyrus
Middle occipital gyrus Medial orbital gyrus
Posterior orbital gyrus Lingual gyrus Inferior occipital gyrus
Inferior temporal gyrus Temporal horn, lateral ventricle NP/MGH Central sulcus
Superior Temporal gyrus
Middle Temporal gyrus
Inferior Temporal gyrus
NP/MGH Central sulcus Superior parietal Inferior frontal gyrus gyrus
Frontomarginal gyrus
Anterior orbital gyrus Superior occipital gyrus
Posterior orbital gyrus Middle occipital gyrus
Superior Temporal gyrus Inferior occipital gyrus Middle Temporal gyrus Inferior Temporal gyrus Lingual gyrus NP/MGH Precentral sulcus
Superior frontal sulcus Central sulcus Postcentral sulcus Lateral fissure, Inferior frontal gyrus, posterior segment pars triangularis
Inferior frontal gyrus, Angular gyrus pars orbitalis
Superior Temporal gyrus Superior Temporal sulcus Middle occipital gyrus Middle Temporal gyrus Inferior Temporal gyrus Anterior occipital sulcus
Inferior occipital gyrus
NP/MGH Axial Neuroanatomy
NP/MGH Fusiform gyrus Superior Temporal gyrus
Middle Temporal gyrus
Inferior Temporal gyrus
NP/MGH Parahippocampal gyrus
Superior Temporal gyrus
Middle Temporal gyrus Inferior Temporal gyrus
Hippocampal gyrus
NP/MGH Amygdala Hippocampus
Superior Temporal gyrus
Middle Temporal gyrus Temporo-occipital fissure
Inferior occipital gyrus Inferior Temporal gyrus
Gyrus descendens Lingual gyrus NP/MGH Gyrus rectus
Medial orbital gyrus Olfactory sulcus Subcallosal gyrus Posterior orbital gyrus
Superior Temporal gyrus Amygdala
Middle Temporal gyrus Hippocampus
Inferior Temporal gyrus
Temporo-occipital fissure
Middle occipital gyrus Gyrus descendens Lingual gyrus NP/MGH Gyrus rectus Olfactory sulcus Medial orbital gyrus
Anterior orbital gyrus Superior Temporal gyrus Posterior orbital gyrus
Middle Temporal gyrus Parahippocampal gyrus
Lingual gyrus Temporo-occipital fissure
Calcarine sulcus Middle occipital gyrus Gyrus descendens Cuneus Intra-occipital sulcus NP/MGH Frontomarginal gyrus Superior frontal gyrus
Anterior orbital gyrus
Posterior orbital gyrus
Cingulate gyrus
Middle occipital gyrus Intra-occipital sulcus Superior occipital gyrus NP/MGH Superior frontal gyrus Middle frontal gyrus
Inferior frontal gyrus, pars orbitalis Lateral fissure
Inferior frontal gyrus, pars opercularis
Inferior parietal gyrus Insula Lateral fissure Cingulate gyrus Superior temporal gyrus Parieto-occipital fissure Superior temporal sulcus
Middle temporal gyrus Calcarine sulcus
Middle occipital gyrus Cuneus Superior occipital gyrus Intra-occipital sulcus NP/MGH Superior frontal gyrus Middle frontal gyrus
Inferior frontal gyrus
Central sulcus Postcentral gyrus
Lateral fissure Inferior parietal gyrus
Superior temporal gyrus Lateral fissure
Superior temporal sulcus
Middle occipital gyrus
Parieto-occipital sulcus Intra-occipital sulcus Superior occipital gyrus NP/MGH Precentral sulcus
Precentral gyrus
Central sulcus Central sulcus
Middle occipital gyrus Cuneus Intra-occipital sulcus Superior occipital gyrus NP/MGH Superior frontal gyrus
Middle frontal gyrus
Superior frontal sulcus Inferior frontal gyrus
Centrum semiovale
Central sulcus Central sulcus
Postcentral sulcus Postcentral sulcus
Supramarginal gyrus Intraparietal sulcus
Angular gyrus Parietooccipital sulcus Superior parietal gyrus
Precuneus NP/MGH Superior frontal gyrus
Middle frontal gyrus
Superior frontal sulcus
Central sulcus Central sulcus
Supramarginal gyrus Postcentral sulcus
Intraparietal sulcus Angular gyrus
Pars marginalis Intraparietal sulcus Superior parietal gyrus
NP/MGH Superior frontal gyrus
Middle frontal gyrus
Superior frontal sulcus
Precentral gyrus Precentral sulcus
Central sulcus Postcentral gyrus
Postcentral sulcus
Supramarginal gyrus Intraparietal sulcus
Angular gyrus Pars marginalis Superior parietal gyrus NP/MGH Superior frontal gyrus Superior frontal sulcus Middle frontal gyrus
Precentral sulcus
Central sulcus Precuneus Postcentral sulcus
Paracentral lobule
Superior parietal gyrus Intraparietal sulcus Pars marginalis
NP/MGH Coronal Neuroanatomy
NP/MGH Interhemispheric Fissure Superior Frontal gyrus Inferior Frontal gyrus
Middle Frontal gyrus
Inferior Frontal gyrus
Gyrus rectus Medial Orbital gyrus
Olfactory bulb
NP/MGH Superior Frontal gyrus Forceps Superior Frontal sulcus minor
Middle Frontal gyrus
Inferior Frontal gyrus
Lateral orbital sulcus
Gyrus rectus Medial Orbital gyrus Anterior Orbital gyrus Lateral orbital gyrus Olfactory Sulcus NP/MGH Circular insular sulcus Cingulate gyrus Superior Frontal gyrus Middle Frontal gyrus
short insular gyrus Inferior Frontal sulcus
Inferior Frontal gyrus pars opercularis
Sylvian Fissure
Posterior Orbital gyrus
Middle Temporal gyrus Olfactory Sulcus
Superior Temporal gyrus Medial Orbital gyrus Inferior Temporal gyrus Gyrus rectus NP/MGH Superior Frontal gyrus Superior Frontal sulcus Cingulate sulcus
Middle Frontal gyrus Precentral sulcus
Precentral gyrus
Sylvian Fissure
Superior Temporal gyrus
Superior Temporal Sulcus
Middle Temporal gyrus
Amygdala Inferior Temporal gyrus Anterior commissure NP/MGH Superior Frontal Superior Frontal gyrus sulcus Cingulate gyrus Middle Frontal gyrus Precentral sulcus
Precentral gyrus
Sylvian Fissure
Superior Temporal gyrus
Superior Temporal Sulcus
Heschl’s gyrus Middle Temporal gyrus
Inferior Temporal sulcus Ambient gyrus Entorhinal area Amygdala Inferior Temporal gyrus NP/MGH Superior Frontal gyrus
Middle Frontal gyrus
Central Sulcus
Superior Temporal gyrus
Hippocampus
Middle Temporal gyrus
Inferior Temporal gyrus
Parahippocampal gyrus CA1, cornu ammonis Fusiform gyrus NP/MGH Postcentral gyrus Paracentral lobule Intraparietal sulcus Intraparietal sulcus Central Sulcus Cingulate gyrus
Supramarginal gyrus
Superior Temporal gyrus
Middle Temporal gyrus
Inferior Temporal gyrus
Fusiform gyrus Collateral sulcus Parahippocampal gyrus NP/MGH Paracentral lobule Central sulcus
Superior Temporal gyrus
Middle Temporal gyrus
Inferior temporal gyrus
Fusiform gyrus NP/MGH Paracentral lobule
Postcentral gyrus Central sulcus Intraparietal sulcus
Supramarginal gyrus
Middle temporal gyrus
Inferior temporal gyrus
Fusiform gyrus Calcarine sulcus Cingulate gyrus Lingual gyrus NP/MGH Superior parietal lobule precuneus
Cingulate gyrus Inferior parietal lobule
Lingual gyrus Middle occipital gyrus Calcarine sulcus
Collateral sulcus
Fusiform gyrus Inferior occipital gyrus
Lingual gyrus Tentorium cerebelli NP/MGH The Central Sulcus
NP/MGH The Central Sulcus (CS)*
• superior frontal sulcus - pre CS sign • sigmoidal Hook sign • pars bracket sign • Bifid post-CS sign • thin postcentral gyrus sign • intraparital sulcus - post-CS • midline sulcus sign
*Naidich & Brightbill. Int J Neurorad 1996;2:313-338 NP/MGH The Central Sulcus (CS) • Superior frontal sulcus - preCS sign – the posterior end of the superior frontal sulcus joins the precentral sulcus in 85% Superior frontal gyrus
Superior frontal sulcus Superior frontal sulcus
Precentral sulcus
Precentral sulcus
Precentral gyrus Precentral gyrus Central sulcus NP/MGH The Central Sulcus (CS)
• Sigmoid “Hook” – hooklike configuration of the posterior surface of the Precentral sulcus precentral gyrus – the “hook” corresponds to the motor hand area. – The “hook” is well seen on CT (89%) and MRI (98%).
Central sulcus NP/MGH The Central Sulcus (CS)
Precentral gyrus • pars bracket sign Superior frontal – The paired pars sulcus marginalis form a
“bracket” to each Precentral sulcus side of the interhemispheric fissure at or behind the central sulcus Central sulcus (96%).
Pars bracket Paracentral lobule NP/MGH The Central Sulcus (CS)
Precentral gyrus • pars bracket sign Superior frontal sulcus
Precentral sulcus
Central sulcus
Pars bracket Pars bracket NP/MGH The Central Sulcus (CS)
• Bifid post-CS sign – the post-CS is bifid (85%). – The bifid post-CS encloses the lateral end of the pars marginalis (88%).
Precentral sulcus
Central sulcus
Precentral gyrus Postcentral sulcus
Pars bracket NP/MGH Central sulcus Central sulcus Central sulcus
Postcentral sulcus Postcentral sulcus Postcentral sulcus
Pars bracket Pars bracket NP/MGH The Central Sulcus (CS) Precentral gyrus • Thin post-CG sign – the postcentral gyrus is thinner than the precentral gyrus (98%).
Postcentral gyrus
NP/MGH The Central Sulcus (CS)
• Intraparietal Sulcus (IPS) and the post-CS – in axial MRI, the IPS intersects the post-CS (99%).
Postcentral sulcus
IPS IPS
Pars bracket Pars bracket NP/MGH IPS IPS IPS Postcentral sulcus Postcentral sulcus Postcentral sulcus
NP/MGH The Central Sulcus (CS)
Superior frontal gyrus
• Midline Sulcus sign – the most prominent Superior frontal sulcus convexity sulcus that reaches the midline interhemispheric fissure is the CS (70%).
Precentral sulcus
Precentral gyrus Central sulcus NP/MGH The Central Sulcus (CS)
NP/MGH The Central Sulcus (CS)
SFS-preCS sign
Hook sign Thin postcentral gyrus sign
Bifid post-CS sign IPS - postCS sign Pars bracket sign NP/MGH