1 Part I Sectional Anatomy of the Body (Chest Abdomen Pelvis)

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]

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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

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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

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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

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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

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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

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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

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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

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Aortic Arch – the “ A, B, C’s” Aortic Arch – the “ A, B, C’s”

Left Subclavian Left Subclavian Left vertebral Left vertebral

MRA CORONAL MRA CORONAL

CTA CORONAL CTA CORONAL

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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

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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

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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

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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

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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 (Lower Leg) Vagina *Anterior Tibeal Bladder *Posterior Tibealis Symphysis pubis *Peroneus Brevis Coronal CTA Image Coronal MRA image (at the level of the Foot) Dorsalis Pedis Sagittal Reformatted CT Sagittal MRI (T2 image) Medial Malalear

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Female Pelvis Anatomy Female Pelvis Anatomy Approximate Approximate Approximate Slice locations Slice locations Slice locations CT #1 MR #1 CT #2 MR #2

Uterus Junctional Zone Rectus abdominus muscles Endometrium Uterus endometrium Ovary Gleuteal muscles Fallopian tube rectum Bladd er Axial CT #1 Axial MR #1

Bladder Muscles Ovary Coronal Reformatted CT Gleuteal Muscles Ileum Femoral head Acetabulum Coronal MRI (T2 image) Obturator Internus muscles

Cervix Obturator internus muscles Vagina Obturator extermus muscles

Axial CT #2 Axial MR #2 Slide # 41 Slide # 42

7 Male Pelvis Anatomy Male Pelvis Anatomy

Approximate Approximate Approximate Slice locations Slice locations Slice locations

Approximate Slice locations NAVEL

Symphysis Pubis Psoas Muscles Bladder Prostate Central gland Prostate (base) Peripheral zone Seminal vessicles (normal) Vas defferens Peripheral zone Urethra (cancer) Apex of the Prostate Axial CT Neuro vascular Pubic bone bundle Axial MR Coronal Oblique MRI (T2 image) Gleuteal High resolution (small FOV) High resolution (small FOV) Obtuaturator Coronal Reformatted CT Internus Muscles Rectum Muscles Slide # 43 Slide # 44

Male Pelvis Anatomy Outline

Approximate Slice locations Part I • Planes of the Chest, Abdomen & Pelvis

Seminal vessicles • Sectional Anatomy of the Chest & Heart Urinary Bladder

Prostate Base • MR imaging of the Chest Peripheral zone

Prostate Apex • Sectional Anatomy of the Abdomen & Pelvis

Rectum Sagittal MRI (T2 image) • MR imaging of the Abdomen & Pelvis High resolution (small FOV) Rectus abdominus Sagittal Reformatted CT Muscles

Symphysis Pubis

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11.1 Body Imaging Part I – Anatomy of the Chest, Abdomen & Pelvis

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Carolyn Kaut Roth, RT (R)(MR)(CT)(M)(CV) FSMRT CEO Imaging Education Associates www.imaginged.com [email protected]

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