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.
