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Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. Color Atlas of Ultrasound Anatomy Berthold Block, M.D. Private Practice Braunschweig Germany 544 illustrations Thieme Stuttgart · New York Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. IV Library of Congress Cataloging-inPublication Data is available from the publisher. This book is an authorized translation of the German edition published and copyrighted 2003 by Georg Thieme Verlag, Stuttgart, Germany. Title of the German edition: Der Sono-Guide: Taschenatlas der sonographischen Schnittbilddiagnostik Translator: Terry C. Telger, Fort Worth, TX, USA Illustrator: Gay & Sender, Bremen, Germany © 2004 Georg Thieme Verlag, Rüdigerstrasse 14, 70469 Stuttgart, Germany http://www.thieme.de Thieme New York, 333 Seventh Avenue, New York, NY 10001 USA http://www.thieme.com Cover design: Cyclus, Stuttgart Typesetting by Gay & Sender, Bremen Printed in Germany by Druckhaus Götz ISBN 3-13-139051- 4 (GTV) ISBN 1-58890-281-1 (TNY) 1 2 3 4 5 Important note: Medicine is an ever-changing science undergoing continual development. Research and clinical experience are continually expanding our knowledge, in particular our knowledge of proper treatment and drug therapy. Insofar as this book mentions any dosage or application, readers may rest assured that the authors, editors, and publishers have made every effort to ensure that such references are in accordance with the state of knowledge at the time of production of the book. Nevertheless, this does not involve, imply, or express any guarantee or responsibility on the part of the publishers in respect to any dosage instructions and forms of applications stated in the book. Every user is requested to examine carefully the manufacturers’ leaflets accompanying each drug and to check, if necessary in consultation with a physician or specialist, whether the dosage schedules mentioned therein or the contraindications stated by the manufacturers differ from the statements made in the present book. Such examination is particularly important with drugs that are either rarely used or have been newly released on the market. Every dosage schedule or every form of application used is entirely at the user’s own risk and responsibility. The authors and publishers request every user to report to the publishers any discrepancies or inaccuracies noticed. Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain. This book, including all parts thereof, is legally protected by copyright. Any use, exploitation, or commercialization outside the narrow limits set by copyright legislation, without the publisher’s consent, is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing, preparation of microfilms, and electronic data processing and storage. Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. V Preface Ultrasound scanning yields a series of sectional images. The basis for interpreting the examination is the individual sectional image. At first sight, it is easy to be confused by the variable appearance of an ultrasound scan of the same region in different patients. This has numerous causes, including differences in density, body fat, age-related differences, overlying gas, and artifacts. In most cases the apparent discrepancies are not based on true anatomical differences. When a systematic scanning routine is closely followed, series of sectional images can be obtained in every patient with remarkable consistency. Even if the images themselves vary, the anatomical relationships that are demonstrated remain constant. While some excellent atlases have been published on computed tomography and magnetic resonance imaging, it is curious that no one (to the author’s knowledge) has taken the trouble to create a similar atlas of sectional anatomy for abdominal ultrasound. The present atlas attempts to fill this gap. In particular, the author hopes to provide the beginner with a comprehensive guide to the initially confusing world of sonographic anatomy. Many have helped in the creation of this book. I wish to thank Dr. Hartwig Schöndube and Dr. Matthias Geist, who gave me some scans. I also thank Mrs. Stephanie Gay and Mr. Bert Sender of Bremen for their superb rendering of the illustrations. I am also grateful to the staff at Thieme Medical Publishers for enabling me to make this book a reality, with special thanks to Dr. Antje Schönpflug, Mrs. Marion Holzer, and, of course, Dr. Markus Becker. Braunschweig, Spring 2004 Berthold Block Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. VII Table of Contents Standard Sectional Planes for Abdominal Scanning 1 Adrenal Glands 202 Vessels 14 Stomach 218 Liver 72 Bladder 242 Gallbladder 118 Prostate 250 Pancreas 134 Uterus 260 Spleen 168 Thyroid Gland 272 Kidneys 180 Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. VIII Table of Contents The numbers shown on the scanning paths refer to the corresponding figure numbers Vessels (1–56) Liver (57–100) 31–34 47–52 53–56 1–24 35–38 71–78 25–30 57–70 43–46 79–96 97–100 39–42 Gallbladder (101–114) Pancreas (115–146) 135–138 101– 106 115–126 139– 142 127–130 107–112 131–134 Spleen (147–156) 143–144 Kidney (157–176) 151–154 163–166 147–150 157–160 167– 168 161–162 Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. 173–174 169–172 Organs and Scanning Paths in this book. Adrenal gland (177–190) Stomach (191–212) 195–198 205–208 191–194 181– 184 177–180 Bladder (213–218) 185–188 199–204 Prostate (219–226) 223–226 213– 216 Uterus (227–236) 233–236 219– 222 Thyroid gland (237–244) 241– 244 237–240 227– 232 Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. IX