Nội dung

III Pocket Atlas of Sectional Anatomy Computed Tomography and Magnetic Resonance Imaging Volume II Thorax, Heart, Abdomen, and Pelvis Torsten B. Moeller, MD Department of Radiology Caritas Hospital Dillingen, Germany Emil Reif, MD Department of Radiology Caritas Hospital Dillingen, Germany Third edition, revised and updated 443 Illustrations Thieme Stuttgart · New York Moeller, Sectional Anatomy © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. IV Library of Congress Cataloging-in Publication Data is available from the publisher Translation of heart section: Barbara Herzberger, MD, Munich, Germany Illustrator: Gay & Sender, Bremen This book is an authorized revised new edition based on the 2nd German edition published and copyrighted 2000 by Georg Thieme Verlag, Stuttgart, Germany. Title of the German Edition: Taschenatlas der Schnittbildanatomie 1st German edition 1993 1st English edition 1994 1st Japanese edition 1994 1st Spanish edition 1995 1st Greek edition 1995 1st French edition 1996 2nd German edition 2000 2nd English edition 2001 © 1994, 2007 Georg Thieme Verlag Rüdigerstrasse 14, 70469 Stuttgart, Germany Thieme New York, 333 Seventh Avenue, New York, N.Y. 10001, USA Typesetting by primustype Robert Hurler GmbH, Notzingen, Germany Printed in Germany by Appl Aprinta Druck, Wemding ISBN ISBN ISBN ISBN 10: 13: 10: 13: 3-13-125603-6 (GTV) 978-3-13-125603-4 (GTV) 1-58890-577-2 (TNY) 978-1-58890-577-2 (TNY) Important Note: Medicine is an everchanging 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 application stated in the book. Every user is requested to examine carefully the manufacturer’s 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 or duplication of any kind, translating, preparation of microfilms, and electronic data processing and storage. 12345 Moeller, Sectional Anatomy © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. V Dedicated to our parents, Alfred and Friedel Möller and Emil and Edith Reif, in love and gratitude. Moeller, Sectional Anatomy © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. VI Preface to the Third Edition Medicine is, fortunately, constantly evolving. Imaging diagnosis is no exception. Technical improvements guarantee further developments in diagnosis. Computed tomography (CT) and magnetic resonance imaging (MRI) have attained a recognized value in the diagnosis of the heart, which is continuing to increase. For this reason, we have now provided a separate chapter on diagnostic imaging of the heart. We have placed sectional CT images next to MR images of the heart to facilitate classification. We have limited ourselves to scans which are presently recognized as standard. In the CT images of the coronary vessels of the heart we have diverged from the conventional designations and numbered the vessels as suggested by the American Heart Association in 1975. Other procedures in MRI and CT visualization of the vascular system have also further improved. For example, stepwise shifts of the table top have become standard procedures in angiography of the pelvis and leg. Like earlier editions, this edition contains current original images complemented by color illustrations on the opposite page. We have continued to follow our successful method, which combines great clarity with a high level of detail. For the production of images we are especially grateful to our radiology assistants, Silke Köhl, Sabine Mattil, Stefanie Müller, Heike Philippi, Brigitte Schild, Petra Weber, and Tanja Breunig, and also to Birgit Reuter and Marion Hellinger of the Siemens Manufacturing Center. We owe the good coronary CTs on our 64-line CT to our colleagues Christoph Buntru and Heike Ringling. We express our heartfelt gratitude for intensive discussions and helpful suggestions to our colleagues Sigrid Roth and Simone Zenner. Torsten B. Moeller, Emil Reif Moeller, Sectional Anatomy © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. VII Contents Thorax CT of the Thorax—Axial . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MRI of the Thorax—Sagittal . . . . . . . . . . . . . . . . . . . . . . . . . MRI of the Thorax—Coronal . . . . . . . . . . . . . . . . . . . . . . . . . CT of the Heart—CT Angiography . . . . . . . . . . . . . . . . . . . . MRT of the Heart—Two Chamber View of the Left Ventricle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MRT of the Heart—Four Chamber View of the Left Ventricle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MRT of the Heart—Short Axis View . . . . . . . . . . . . . . . . . . . MRT of the Heart—Left Ventricular Inflow and Outflow Tract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MRT of the Heart—Left Ventricular Outflow Tract . . . . . . . MRT of the Heart—Two Chamber View of the Right Ventricle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MRT of the Heart—Right Ventricular Outflow Tract . . . . . . Aorta—MR Angiography . . . . . . . . . . . . . . . . . . . . . . . . . . . . Pulmonary Vessels—MR Angiography . . . . . . . . . . . . . . . . . MR Mammography—Axial . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 30 46 58 64 66 68 70 72 74 76 78 80 82 Abdomen CT of the Abdomen—Axial . . . . . . . . . . . . . . . . . . . . . . . . . . MRI of the Abdomen—Sagittal . . . . . . . . . . . . . . . . . . . . . . . MRI of the Abdomen—Coronal . . . . . . . . . . . . . . . . . . . . . . . Renal Artery—MR Angiography . . . . . . . . . . . . . . . . . . . . . . . MR Angiography of the Coeliac Trunk—MR Angiography . . MR Angiography of the Splenic and Portal Veins— MR Angiography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . MR Cholangiopancreatography . . . . . . . . . . . . . . . . . . . . . . Moeller, Sectional Anatomy © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. 84 132 150 162 164 166 168 Contents VIII Pelvis MRI MRI MRI MRI MRI MRI MRI of of of of of of of the the the the the the the Female Pelvis—Axial . . . . . . . . . . . . . . . . . . . . . . Female Pelvis—Sagittal . . . . . . . . . . . . . . . . . . . . Female Pelvis—Coronal . . . . . . . . . . . . . . . . . . . . Male Pelvis—Sagittal . . . . . . . . . . . . . . . . . . . . . . Male Pelvis—Coronal . . . . . . . . . . . . . . . . . . . . . . Prostate—Axial . . . . . . . . . . . . . . . . . . . . . . . . . . Testes—Sagittal . . . . . . . . . . . . . . . . . . . . . . . . . . 170 182 192 208 216 226 230 Lower Extremity MR Angiography of the Lower Extremity— MR Angiography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232 Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 234 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235 Moeller, Sectional Anatomy © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. 1 Thorax Abdomen Pelvis Lower Extremity Moeller, Sectional Anatomy © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. 2 CT of the Thorax 33 34 35 36 37 38 Segments of the lungs Right Lung 1. Apical segment of upper lobe 2. Posterior segment of upper lobe 3. Anterior segment of upper lobe 4. Lateral segment of middle lobe 5. Medial segment of middle lobe 6. Superior segment of lower lobe 7. Medial basal (cardiac) segment of lower lobe 8. Anterior basal segment of lower lobe 9. Lateral basal segment of lower lobe 10. Posterior basal segment of lower lobe Left Lung 1+2 Apicoposterior segment of upper lobe 3. Anterior segment of upper lobe 4. Superior lingular segment 5. Inferior lingular segment 6. Superior segment of lower lobe 7. Medial basal (cardiac) segment of lower lobe 8. Anterior basal segment of lower lobe 9. Lateral basal segment of lower lobe 10. Posterior basal segment of lower lobe Moeller, Sectional Anatomy © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. Axial 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 1 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 1. Deltoid muscle 2. Head of humerus (head of humerus) 3. Pectoralis major muscle 4. Pectoralis minor muscle 5. Sternothyroid muscle 6. Internal jugular vein 7. Internal carotid artery 8. Longus colli muscle 9. Thyroid gland 10. Trachea 11. Esophagus 12. Sternocleidomastoid muscle 13. Vagus nerve (ramus) 14. Anterior scalene muscle 15. Brachial plexus 16. Subclavian artery 17. Joint capsule with capsular ligaments 18. Infraspinatus muscle 19. Spine of scapula 20. Coracoid process 21. Trapezius muscle 22. Medial and posterior scalene muscles 23. Costovertebral joint (Rib 1) 24. Thoracic vertebra 1 25. Vertebral arch (lamina) 26. Supraspinous ligament 27. Spinal cord 28. Erector spinae muscle 29. Serratus anterior muscle 30. Rhomboid muscle 31. Clavicle 32. Supraspinatus muscle 33. Supraclavicular lymph nodes 34. Subclavicular lymph nodes 35. Jugular lymph nodes 36. Paratracheal lymph nodes 37. Anterior cervical lymph nodes 38. Paraesophageal lymph nodes Moeller, Sectional Anatomy © 2007 Thieme All rights reserved. Usage subject to terms and conditions of license. 3