1 Part I Sectional Anatomy of the Body (Chest Abdomen Pelvis)
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Outline 11.1 Body Imaging Part I Part I • Planes of the Chest, Abdomen & Pelvis Sectional Anatomy of the Body (Chest, Abdomen, Pelvis) • Sectional Anatomy of the Chest & Heart • MR imaging of the Chest • Sectional Anatomy of the Abdomen & Pelvis Carolyn Kaut Roth, RT (R)(MR)(CT)(M)(CV) FSMRT • MR imaging of the Abdomen & Pelvis CEO Imaging Education Associates www.imaginged.com [email protected] Slide # 1 Slide # 2 Imaging Planes Median Line Frontal or Chest Coronal, Heart & Lungs Mid-sagittal Plane Coronal Plane CT Images Parasagittal Planes MRI Images Transverse MRA Or Axial Plane Axial CTA Axial Heart Coronal Reformat Coronal Lungs Enhanced Coronal CT Sagittal Reformat Sagittal Coronal MRI SagittalSlide # 3 Axial Coronal Slide # 4 Chest Coronal, Vasculature Chest Coronal, Lungs & Airway Upper Lobe of the right lung MRA Upper Lobe of the left lung CTA Bronchi - carina Middle lobe of the right lung *remember there is no middle left because of the heart! Pulmonary Arteries Lower lobe of the right lung Pulmonary Veins Lower lobe of the left lung Diaphragm Coronal MRI Coronal CT Enhanced Coronal CT Coronal MRI Slide # 5 Slide # 6 1 Chest Coronal Muscles of the Chest Sagittal Chest – “Candy Cane Shot” Pectoralis muscles Heart Muscle Aortic Arch Axial MRI Axial CT Trapezius Ascending Aorta Descending Aorta Latissimus Intercostal Muscles Heart Sagittal MRI Diaphragm Sagittal CT Coronal CT Coronal MRI Slide # 7 Slide # 8 CTA CORONAL Axial chest Heart anatomy MRI CORONAL Axial slice #1 Axial slice #2 Axial slice #1 Axial slice #3 Axial slice #2 Axial slice #3 Heart flow Pectoralis Muscle IVC & SVC (Inferior & Superior vena cava) Aortic Arch RA (right atrium) Tri Latissimus Muscle Axial slice #1 Rv Axial slice #1 Spine (vertebral body) P valve Pa Ascending Aorta Lungs Pulmonary arteries Pv Pulmonary veins La Axial slice #2 Bi Axial slice #2 Descending Aorta Lv Heart Aortic valve Aorta – coronary CT AXIAL MRI AXIAL arch Slide # 9 Axial slice #3 Slide # 10 Axial slice #3 CTA CORONAL Heart Anatomy Heart Anatomy MRI CORONAL Heart flow Heart flow SVC (superior vena cava) CTA CORONAL IVC & SVC (Inferior & Superior vena cava) RA (right atrium) MRI CORONAL RA (right atrium) Tri cuspid valve Tri cuspid valve Rv RV (right ventricle) P valve P valve Pa Pa Lungs Lungs Pv P-S v La La Bi Bi Lv Lv Aortic valve Aortic valve Aorta – coronary CT AXIAL MRI AXIAL Aorta – coronary CT AXIAL MRI AXIAL arch arch Slide # 11 Slide # 12 2 CTA CORONAL CTA CORONAL Heart Anatomy MRI CORONAL Heart Anatomy MRI CORONAL Heart flow Heart flow IVC & SVC (Inferior & Superior vena cava) IVC & SVC (Inferior & Superior vena cava) RA (right atrium) RA (right atrium) Tri cuspid valve Tri cuspid valve RV (right ventricle) RV (right ventricle) Pulmonary valve Pulmonary valve PA (Pulmonary artery) PA (Pulmonary artery) Lungs Lungs Pv PV (pulmonary veins) La LA Bi Bi Lv LV Aortic valve Aortic valve Aorta – coronary CT AXIAL MRI AXIAL Aorta – coronary CT AXIAL MRI AXIAL arch Arch Slide # 13 Slide # 14 CTA CORONAL CTA CORONAL Heart anatomy MRI CORONAL Heart anatomy MRI CORONAL Heart flow Heart flow IVC & SVC (Inferior & Superior vena cava) IVC & SVC (Inferior & Superior vena cava) RA (right atrium) RA (right atrium) Tri cuspid valve Tri cuspid valve RV (right ventricle) RV (right ventricle) Pulmonary valve Pulmonary valve PA (Pulmonary artery) PA (Pulmonary artery) Lungs Lungs PV (pulmonary veins) PV (pulmonary veins) LA (Left Atrium) LA (Left Atrium) Bi Bi cuspid valve LV LV Aortic valve Aortic valve Aorta – coronary CT AXIAL MRI AXIAL Aorta – coronary CT AXIAL MRI AXIAL Arch Arch Slide # 15 Slide # 16 CTA CORONAL CTA CORONAL Heart anatomy MRI CORONAL Heart anatomy MRI CORONAL Heart flow Heart flow IVC & SVC (Inferior & Superior vena cava) IVC & SVC (Inferior & Superior vena cava) RA (right atrium) RA (right atrium) Tri cuspid valve Tri cuspid valve RV (right ventricle) RV (right ventricle) Pulmonary valve Pulmonary valve PA (Pulmonary artery) PA (Pulmonary artery) Lungs Lungs PV (pulmonary veins) PV (pulmonary veins) LA (Left Atrium) LA (Left Atrium) Bi cuspid valve Bi cuspid valve LV (Left Ventricle) LV (Left Ventricle) Aortic valve Aortic valve Aorta – coronary CT AXIAL MRI AXIAL Aorta – coronary CT AXIAL MRI AXIAL Arch Arch Slide # 17 Slide # 18 3 Aortic Arch – the “ A, B, C’s” Aortic Arch – the “ A, B, C’s” Ascending aorta Ascending aorta Coronaries Coronaries Brachiocephalic (aka Innominate) Brachiocephalic (aka Innominate) right common carotid right common carotid right subclavian right subclavian right vertebral right vertebral Left common carotid Left common carotid Left Subclavian Left Subclavian Left vertebral Left vertebral MRA CORONAL MRA CORONAL CTA CORONAL CTA CORONAL Slide # 19 Slide # 20 Aortic Arch – the “ A, B, C’s” Aortic Arch – the “ A, B, C’s” Ascending aorta Ascending aorta Coronaries Coronaries Brachiocephalic (aka Innominate) Brachiocephalic (aka Innominate) right common carotid right common carotid right subclavian right subclavian right vertebral right vertebral Left common carotid Left common carotid Left Subclavian Left Subclavian Left vertebral Left vertebral MRA CORONAL MRA CORONAL CTA CORONAL CTA CORONAL Slide # 21 Slide # 22 Frontal or Frontal or Coronal Plane Coronal Plane Imaging Planes Median Line Imaging Planes Median Line Mid-sagittal Plane Mid-sagittal Plane Parasagittal Planes Parasagittal Planes Transverse Transverse Or Axial Or Axial Plane Plane Sagittal Axial Coronal Sagittal Axial Coronal CT Images CT Images Axial Coronal Sagittal Axial Coronal Sagittal reformat reformatSlide # 23 Slide # 24 4 Coronal Abdomen Coronal Abdomen Approximate Approximate Approximate Slice location Slice location Slice location Spleen Approximate Slice location Liver Spleen Kidneys Stomach Adrenals Liver Mass Spleen Liver Bowel Psoas Small Bowel Muscles Structures of the Small bowel Duodenum Gleuteus Jejunem Muscles Ileum Coronal MR image Coronal CT image Coronal CT image Coronal MR image Slide # 25 Slide # 26 body anatomy Slide 2b Coronal Abdomen Axial Abdomen Diaphragm Diaphragm Approximate Approximate Slice location Slice location Lesser curvature Liver Spleen Stomach Approximate Approximate Structures of the stomach: Slice location Slice location Lesser curvature umor Fundus Pylorus Liver Greater curvature Spleen Small Bowel Stomach Structures of the Small bowel Duodenum Aorta Jejunem Ileum Vertebral body Large bowel (colon) Axial MR image Ascending colon Axial CT image Transverse colon Coronal MR image Coronal CT image Descending colon Slide # 27 Slide # 28 Sigmoid colon Axial Abdomen Axial Abdomen Approximate Approximate Approximate Approximate Slice location Slice location Slice location Slice location Liver Liver Spleen Spleen Stomach Pancreas Aorta Vena cava Kidneys Axial CT image Vertebral Axial MR image Axial CT image Axial MR image body Slide # 29 Slide # 30 5 Axial Abdomen Sagittal Abdomen Approximate Approximate Slice location Slice location Thoracic Approximate Rectus abdominus muscles Spine Slice location Approximate Slice location Liver Liver Pancreas Gall bladder Lumbar Spine Aorta Pancreas Bowel Kidneys Sacrum Coccyx Bladder Axial CT image Axial MR image Sagittal CT image Symphysis Pubis Sagittal MR image Slide # 31 Slide # 32 Abdominal Vasculature Abdominal Vasculature “See Spot Run In..” “See Spot Run In..” (“C” not see) Celiac, SMA, Renals (right & Left), IMA (“C” not see) Celiac, SMA, Renals (right & Left), IMA SMA “C”=Celiac superior gastric mesenteric hepatic artery splenic Arises anteriorly Arises the from the aorta aorta at the at the level of level of L1 L2-3 Provides Provides blood blood supply supply to the to the stomach, small stomach, bowel and part spleen and of the colon liver Coronal CTA Image Coronal MRA image Coronal CTA Image Coronal MRA image Slide # 33 Slide # 34 Abdominal Vasculature Abdominal Vasculature “See Spot Run In..” “See Spot Run In..” (“C” not see) Celiac, SMA, Renals (right & Left), IMA (“C” not see) Celiac, SMA, Renals (right & Left), IMA IMA Infererior Renal arteries Mesenteric right Artery left Arises anter ior ly & Arises inferiorly Bilaterally and from the posteriorly from aorta at the the aorta at the level of L 4-5 level of L3-4 Provides Provides blood blood supply supply to the to the inferior right & left colon, kidney Coronal CTA Image Coronal MRA image sigmoid and Coronal CTA Imagerectum Coronal MRA image Slide # 35 Slide # 36 6 Abdominal Vasculature Abdominal Veins “See Spot Run In..” (IVC) (“C” not see) Celiac, SMA, Renals (right & Left), IMA Review Vasculature… Inferior vena cava Almost ALL Arteries: Portal vein – Carry oxygenated blood away from Splenic vein the heart (AAA) Left renal ve Abdominal – Carry oxyhemaglobin blood to organs Almost ALL Veins: (SMV) Aortic Superior Aneurysm – Carry deoxygenated blood to the mesenteric heart Abdominal Vein – Carry deoxyhemaglobin away from Aorta organs (IVC) Inferior Exceptions: vena cava Iliac – Portal vein- arteries • Carries deoxyhemaglobin to the liver Right iliac – Pulmonary veins- vein • Carries deoxyhemaglobin to the Coronal abdominal venogram lungs – Pulmonary arteries- Coronal CTA Image Coronal MRA image • Carries oxyhemaglobin to the heart Slide # 37 Slide # 38 Peripheral Vasculature “Run-off’s Female Pelvis Anatomy Fundus Abdominal Aorta Endometrium Iliac arteries (at the level of the Ileum) Approximate Slice locations Femoral Arteries Sagittal ultrasound image Superficial femoral & Uterus common femoral (at the level of the Femur) Fundus Junctional Zone Popliteal Arteries Endometrium (at the level of the Knee) Cervix Trifurcation