Abdominal CT scan

http://info.med.yale.edu/surgery/anatomy/radiology/abdomen_ct_content.php

TOPICS
SLIDE 1
Goals
1. To understand vascular anatomy of the liver and how the vessels define the segmental anatomy of the liver
2. To review and understand the developmental anatomy and fetal circulation of the liver and what remnants are still present in the adult liver
3. To review colonic and small bowel anatomy and be able to predict where you may visualize different segments of bowel and axial CT
4. To understand the anatomy, relationships and orientation of the pancreas
5. To review and understand the relationships of major arterial and venous structures in the abdomen and pelvis and how they can be seen on axial CT

SLIDE 2
Questions
2. What is this high attenuation structure in the liver?
- this is the left portal vein.
1a. Do the portal veins divide the liver into segments?
- No. the hepatic veins do.
4a. What is this black line that runs through the liver?
- this is the fissure for the ligamentum teres
4b. What structure ran through this region?
- the umbilical vein
4c. What is this fissure anterior to the caudate lobe?
- this is the fissure for the ligamentum venosum
5a. what part of the colon is this?
- this is the distal transverse extending to the splenic flexure
5b. Why does the colon look white?
- the patient was given oral contrast
6. what portion of the pancreas is this?
- this is the tail
9. what portion of the colon is this?
- hepatic flexure
10. what is this venous structure extending from the left kidney to the IVC?
- this is the left renal vein
13. what portion of the colon is labeled by each arrow?
- ascending colon (black)
- descending colon (white)
14. What vessel is coming off the aorta?
- hint: it is colonic supply and below the level of the SMA
- inferior mesenteric artery
15. Look at the small bowel without contrast (white arrows) and the colon with contrast (black arrows) and note that the bowel wall is extremely thin. Normally it is approximately 3mm.
18. What is this small tubular structure partially filled with contrast on this and the subsequent image.
19. This is the appendix. Note this is normal; thin walled, filled with contrast and no inflammatory changes in the adjacent fat.
23. What portion of the colon is labeled with arrows?
- sigmoid colon
24. What vascular structures are marked by the arrows?
- the external iliac arteries and veins
26a. What is this fluid filled structure?
- the bladder
26b. What portion of bowel is this located posterior to the bladder and anterior to the sacrum?
- the rectum
26c. What is the significance of the space between the bladder and the sacrum?
- this is the most dependent portion of the peritoneal cavity in a male.

SLIDE 3
SUMMARY
- You will need to be able to navigate your way through CT and MRI images of the abdomen. This exercise focuses on important structures and represents an appropriate level of detail.
- You should become skilled at tracing structures superiorly and inferiorly to appreciate their relations in three dimensions.

CT reconstruction of the kidneys and renal arteries and 3-D reconstruction of kidneys and SMA vasculature

http://info.med.yale.edu/surgery/anatomy/radiology/CT_kidney_content.php

TOPICS

SLIDE 1
Goals
1. Be able to identify the renal vessels, aorta and ureters as these structures are rotated in 3-D
2. Be able to explain the relative position of important nearby structures that are not shown such as the 12th rib and IVC

SLIDE 2
- CT reconstruction of the kidneys and renal arteries
- Rib 12 is colored blue, the abdominal aorta is pink and the renal arteries are red
- Transpyloric plane
- Subcostal plane

SLIDE 3
[...]

SLIDE 4
3-D reconstruction of kidneys and SMA vasculature
- aorta
- left renal artery
- left renal vein
- right renal artery
- left ureter
(and questions)
- right ureter
- SMA (superior mesenteric artery)
- IMA (inferior mesenteric artery)

SLIDE 5
- lumbar segmental arteries
(question)

SUMMARY
1. The renal vessels are at the subcostal plane
2. The left renal artery is posterior to the left renal vein
3. The kidneys are posterior to the aorta and IVC, so the vessels course posteriorly from the midline to reach their targets

Abdominal cross section anatomy at L2 <– Click on this link to view the image

Terms:

Left side: greater omentum, pancreas with uncinate process, transverse colon, junction of 2nd and 3rd parts of duodenum, ascending colon, liver, right renal vein (entering inferior vena cava), right kidney, inferior vena cava, right crus of diaphragm, psoas major muscle, L1-L2 intervertebral disc

Right side: superior mesenteric vein, superior mesenteric artery, transverse colon, ileum, jejunum, perirenal fat, ureteropelvic junction, descending colon, renal fascia, left kidney, minor calyx and renal pelvis, pararenal fat, left renal artery, left renal vein (entering inferior vena cava), left crus of diaphragm, abdominal aorta

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Source:
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