256 shades of gray: exploring your body with...

256 shades of gray: Exploring your body with medical imaging

A. Kyle Jones, Ph.D.

MD Anderson Cancer Center

Learning objectives

1. Review radiologic imaging planes and projections.

2. Identify major structures in medical images of the human body.

3. Examine how disease processes affect normal anatomy and their impact on medical images.

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 2

ANATOMIC PLANES AND PROJECTIONS

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 3

Anatomic planes

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 4

Axial Coronal Sagittal

Radiographic projections

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 5

Posteroanterior (PA) Left lateral (LL)

Radiographic projections

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 6

Anteroposterior (AP) Right posterior oblique (RPO)

Left posterior oblique (LPO)

Radiographic projections

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 7

Left decubitus Right decubitus AP

Cross-sectional conventions

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 8

R L

P

A

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 9

THE CHEST

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 10

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 11

• Apex • Cardiac shadow • Aortic arch • Hilum • Carina • Costophrenic angle • Mediastinum • Thoracic inlet

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 12

• Apex • Aortic arch • Trachea • Retrosternal space • Retrocardiac space • Raider’s triangle • Hilum • Mediastinum

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 13

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 14

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 15

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 16

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 17

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 18

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 19

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 20

SKELETAL ANATOMY

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 21

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 22

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 23

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 24

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 25

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 26

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 27

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 28

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 29

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 30

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 31

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 33

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 34

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 35

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 36

VASCULAR ANATOMY

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 37

Coronary arteries

• Left main trunk (LCA) • Left anterior descending • Circumflex • Right coronary artery (RCA) • Posterior descending artery (PDA) • Coronary sinus • Tricuspid valve • Mitral valve • Aortic valve • Papillary muscles

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 38

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 39

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 40

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 41

• Aortic arch • Brachiocephalic a.

• R common carotid a. • R subclavian a.

• L common carotid a. • L subclavian a.

• L vertebral a.

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 42

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 43

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 44

• Celiac a. • L. gastric a. • Common hepatic a. • GDA • Proper hepatic a. • Splenic a.

Gray’s Anatomy

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 45

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 46

• Ileocolic a. • Right colic a. • Middle colic a. • Intestinal a. • Inferior pancreaticoduodenal a.

Gray’s Anatomy

Stroeder J et al. Angiographic findings in non-occlusive mesenteric ischemia: an attempt of standardization. C-2114 ECR 2011

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 47

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 48

ABDOMINOPELVIC ANATOMY

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 49

MO-D-201-1 A. Kyle Jones, Ph.D.

• Liver • Spleen • Stomach • Pancreas • Colon • Small intestine • Kidneys • Portal vein • IVC

7/13/2015 50

Corticomedullary

Nephrographic

Excretory (delayed)

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 51

0%

34%

21%

45%

What radiographic projection is this?

R L

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 53

1. Left decubitus

2. Right decubitus

3. AP

4. PA

What radiographic projection is this?

1. Left decubitus

2. Right decubitus

3. AP

4. PA

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 54

R L

71%

4%

18%

0%

7%

What structure is identified?

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 55

1. Olecranon

2. Greater tuberosity

3. Greater trochanter

4. Diaphysis

5. Lesser trochanter

What structure is identified?

1. Olecranon

2. Greater tuberosity

3. Greater trochanter

4. Diaphysis

5. Lesser trochanter

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 56

52%

8%

20%

16%

4%

What vessel is identified?

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 57

1. Celiac a.

2. Jugular v.

3. Portal v.

4. Brachiocephalic a.

5. L common carotid a.

What vessel is identified?

1. Celiac a.

2. Jugular v.

3. Portal v.

4. Brachiocephalic a.

5. L common carotid a.

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 58

0%

7%

3%

27%

63%

What region of the kidneys is enhanced in this image?

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 59

1. Cortex

2. Medulla

3. Renal pelvis

4. Capsule

5. Pole

What region of the kidneys is enhanced in this image?

1. Cortex

2. Medulla

3. Renal pelvis

4. Capsule

5. Pole

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 60

Bonus: What is depicted in this image?

7/13/2015 MO-D-201-1 A. Kyle Jones, Ph.D. 61