Head MR The MedPixMan James G. Smirniotopoulos, M.D.

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Presentation transcript:

Head MR The MedPixMan James G. Smirniotopoulos, M.D. Basic Axial Anatomy James G. Smirniotopoulos, M.D. Professor of Radiology, Neurology, and Biomedical Informatics Center for Neuroscience and Regenerative Medicine Radiology and Radiological Sciences Uniformed Services University Bethesda, MD http://rad.usuhs.edu The MedPixMan james.smirnio@usuhs.edu

Myelin is fat … fat is bright on T1-weighted MR Head – Axial – MR – T1W Myelin is fat … fat is bright on T1-weighted MR

Image File Name: i00001.jpg Smirniotopoulos 2014

Maxilla Maxillary Sinus Hard Palate Lateral mass C1 C2 Odontoid Image File Name: i00001.jpg Cx Spinal Cord Smirniotopoulos 2014

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Maxilla Maxillary Sinus Hard Palate Occipital Condyle Clivus Image File Name: i00002.jpg Cx Spinal Cord Smirniotopoulos 2014

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Nose Maxillary Sinus Vomer Occipital Condyle Clivus Medulla oblongata Image File Name: i00003.jpg Medulla oblongata Cerebellar Tonsil Smirniotopoulos 2014

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Nose Maxillary Sinus Vomer Clivus Medulla oblongata Cerebellar Tonsil Image File Name: i00004.jpg Medulla oblongata Cerebellar Tonsil Smirniotopoulos 2014

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Nose Maxillary Sinus Vomer Clivus Medulla oblongata Cerebellar Tonsil Image File Name: i00005.jpg Medulla oblongata Cerebellar Tonsil Smirniotopoulos 2014

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Nose Maxillary Sinus Vomer Clivus Medulla oblongata Cerebellar Tonsil Image File Name: i00006.jpg Medulla oblongata Cerebellar Tonsil Smirniotopoulos 2014

Internal Auditory Canal w/ CNN 7 & 8 Temporal lobe Petrous apex marrow Internal Auditory Canal w/ CNN 7 & 8 Image File Name: i00007.jpg Brachium pontis (middle cerebellar peduncle) Vermis Smirniotopoulos 2014

Nose Orbit Sphenoid sinus Clivus Pons Vermis (nodulus) Image File Name: i00007.jpg Pons Vermis (nodulus) Smirniotopoulos 2014

Internal Auditory Canal w/ CNN 7 & 8 Nose Orbit Temporal lobe Sphenoid sinus Petrous apex marrow Internal Auditory Canal w/ CNN 7 & 8 Clivus Image File Name: i00007.jpg Pons Brachium pontis (middle cerebellar peduncle) Vermis (nodulus) Vermis Smirniotopoulos 2014

Cerebello-pontine angle & cistern CNN 7 & 8 Temporal lobe Petrous apex marrow Cerebello-pontine angle & cistern CNN 7 & 8 Image File Name: i00007.jpg Brachium pontis (middle cerebellar peduncle) Vermis Smirniotopoulos 2014

Nose Orbit Sphenoid sinus Clivus Pons Vermis (nodulus) Image File Name: i00007.jpg Pons Vermis (nodulus) Smirniotopoulos 2014

Cerebello-pontine angle & cistern CNN 7 & 8 Nose Orbit Temporal lobe Sphenoid sinus Petrous apex marrow Cerebello-pontine angle & cistern CNN 7 & 8 Clivus Image File Name: i00007.jpg Pons Brachium pontis (middle cerebellar peduncle) Vermis (nodulus) Vermis Smirniotopoulos 2014

T1 --- T2 Temporal lobe Petrous apex marrow Internal Auditory Canal w/ CNN 7 & 8 Image File Name: i00007.jpg Brachium pontis (middle cerebellar peduncle) Vermis Smirniotopoulos 2014

T1 --- T2 Nose Orbit Sphenoid sinus Clivus Pons Vermis (nodulus) Image File Name: i00007.jpg Pons Vermis (nodulus) Smirniotopoulos 2014

T1 --- T2 Nose Orbit Temporal lobe Sphenoid sinus Petrous apex marrow Internal Auditory Canal w/ CNN 7 & 8 Clivus Image File Name: i00007.jpg Pons Brachium pontis (middle cerebellar peduncle) Vermis (nodulus) Vermis Smirniotopoulos 2014

Cerebello-pontine angle & cistern CNN 7 & 8 Temporal lobe Petrous apex marrow Cerebello-pontine angle & cistern CNN 7 & 8 Image File Name: i00008.jpg Brachium pontis (middle cerebellar peduncle) Vermis Smirniotopoulos 2014

Nose Orbit Sphenoid sinus Clivus Pons 4th Ventricle Image File Name: i00008.jpg Pons 4th Ventricle Smirniotopoulos 2014

Cerebello-pontine angle & cistern CNN 7 & 8 Nose Orbit Temporal lobe Sphenoid sinus Petrous apex marrow Cerebello-pontine angle & cistern CNN 7 & 8 Clivus Image File Name: i00008.jpg Pons Brachium pontis (middle cerebellar peduncle) 4th Ventricle Vermis Smirniotopoulos 2014

Cerebello-pontine angle & cistern CNN 7 & 8 Ethmoid sinus Uncus of Temporal lobe Cerebello-pontine angle & cistern CNN 7 & 8 Image File Name: i00009.jpg Brachium conjunctivum (superior cerebellar peduncle) Vermis Smirniotopoulos 2014

Nose Eyeball Sphenoid sinus Pre-pontine cistern Pons 4th Ventricle Image File Name: i00009.jpg Pons 4th Ventricle Smirniotopoulos 2014

Cerebello-pontine angle & cistern CNN 7 & 8 Nose Eyeball Ethmoid sinus Sphenoid sinus Uncus of Temporal lobe Cerebello-pontine angle & cistern CNN 7 & 8 Pre-pontine cistern Image File Name: i00009.jpg Pons Brachium conjunctivum (superior cerebellar peduncle) 4th Ventricle Vermis Smirniotopoulos 2014

Brachium conjunctivum (superior cerebellar peduncle) Ethmoid sinus Uncus of Temporal lobe Ambient cistern Image File Name: i00010.jpg Brachium conjunctivum (superior cerebellar peduncle) Vermis Smirniotopoulos 2014

Nose Eyeball Pituitary fossa Pre-pontine cistern Upper Pons Image File Name: i00010.jpg Upper Pons 4th Ventricle Smirniotopoulos 2014

Brachium conjunctivum (superior cerebellar peduncle) Nose Eyeball Ethmoid sinus Pituitary fossa Uncus of Temporal lobe Ambient cistern Pre-pontine cistern Image File Name: i00010.jpg Upper Pons Brachium conjunctivum (superior cerebellar peduncle) 4th Ventricle Vermis Smirniotopoulos 2014

Cerebral peduncle and midbrain (mesencephalon) Optic nerve Uncus of Temporal lobe Ambient cistern Cerebral peduncle and midbrain (mesencephalon) Image File Name: i00011.jpg Superior Sagittal sinus Smirniotopoulos 2014

Interpeduncular cistern Crista galli Eyeball Optic chiasm Interpeduncular cistern Image File Name: i00011.jpg Cerebral aqueduct Vermis of Cerebellum Smirniotopoulos 2014

Interpeduncular cistern Cerebral peduncle and midbrain (mesencephalon) Crista galli Eyeball Optic nerve Optic chiasm Uncus of Temporal lobe Ambient cistern Interpeduncular cistern Cerebral peduncle and midbrain (mesencephalon) Image File Name: i00011.jpg Cerebral aqueduct Vermis of Cerebellum Superior Sagittal sinus Smirniotopoulos 2014

T1 --- T2 Crista galli Eyeball Optic nerve Optic chiasm Uncus of Temporal lobe Ambient cistern & PCA Interpeduncular cistern Cerebral peduncle and midbrain (mesencephalon) Cerebral aqueduct Vermis of Cerebellum Superior Sagittal sinus Smirniotopoulos 2014

Temporal horn, lateral ventricle eye L. Sylvian fissure Hippocampus Temporal horn, lateral ventricle Image File Name: i00012.jpg Quadrigeminal plate cistern Occipital lobe Smirniotopoulos 2014

Cerebral peduncle (corticospinal tracts) eye R. Sylvian fissure 3rd ventricle Cerebral peduncle (corticospinal tracts) mid Image File Name: i00012.jpg vermis Inf. sagittal sinus Sup. sagittal sinus Smirniotopoulos 2014

Temporal horn, lateral ventricle eye L. Sylvian fissure Hippocampus Temporal horn, lateral ventricle Image File Name: i00012.jpg Quadrigeminal plate cistern Occipital lobe Smirniotopoulos 2014

Tectal (quadrigeminal) plate Optic tracts eye L. Temporal lobe hypothalamus L. Mammillary body Image File Name: i00012.jpg Tectal (quadrigeminal) plate Occipital lobe Smirniotopoulos 2014

Cerebral peduncle (corticospinal tracts) L. Mammillary body mid Optic tracts eye L. Temporal lobe R. Temporal lobe hypothalamus Cerebral peduncle (corticospinal tracts) L. Mammillary body mid Image File Name: i00012.jpg Tectal (quadrigeminal) plate vermis Occipital lobe Inf. sagittal sinus Sup. sagittal sinus Smirniotopoulos 2014

Cerebral peduncle (corticospinal tracts) L. Mammillary body mid Optic tracts eye L. Temporal lobe R. Temporal lobe hypothalamus Cerebral peduncle (corticospinal tracts) L. Mammillary body mid Image File Name: i00012.jpg Tectal (quadrigeminal) plate vermis Occipital lobe Inf. sagittal sinus Sup. sagittal sinus Smirniotopoulos 2014

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Quadrigeminal Cistern Gyrus rectus Frontal lobe Anterior Commissure Thalamus Image File Name: i00013.jpg 3rd ventricle Quadrigeminal Cistern Sup Sagittal Sinus Smirniotopoulos 2014

Lat Vent – atrium (trigone) Sylvian Fissures Image File Name: i00013.jpg Lat Vent – atrium (trigone) Smirniotopoulos 2014

Quadrigeminal Cistern Caudate nucleus Frontal lobe Anterior Commissure Thalamus Image File Name: i00014.jpg 3rd ventricle Quadrigeminal Cistern Sup Sagittal Sinus Smirniotopoulos 2014

2 - Sulcus centralis insulae 3 - Gyrus longus insulae 1 - Gyri breves insulae 2 - Sulcus centralis insulae 3 - Gyrus longus insulae 4 - Gyri temporales transversum (Heschl’s Gyri) Description Human brain view on transverse temporal and insular gyri Date 30 November 2005 Source http://www.healcentral.org/healapp/showMetadata?metadataId=40566 Author John A Beal, PhD Dep't. of Cellular Biology & Anatomy, Louisiana State University Health Sciences Center Shreveport Permission (Reusing this file) CC-BY Smirniotopoulos 2011-2013

Lat Vent – atrium (trigone) Sylvian Fissures Heschl's Gyri Heschl's Gyri Image File Name: i00014.jpg Lat Vent – atrium (trigone) Smirniotopoulos 2014

Putamen Lenticular Nucleus Caudate Head Putamen Lenticular Nucleus Lateral Geniculate Body Column of Fornix (post-commissural) Image File Name: i00014.jpg Occipital lobe calcarine cortex Smirniotopoulos 2014

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Heschl's Gyri Heschl's Gyri Image File Name: i00015.jpg Smirniotopoulos 2014

Putamen Lenticular Nucleus Caudate Head Putamen Lenticular Nucleus Lateral Geniculate Body Column of Fornix Image File Name: i00015.jpg Occipital lobe calcarine cortex Smirniotopoulos 2014

Corpus Callosum Splenium Caudate nucleus Frontal lobe Putamen Internal Capsule Thalamus Image File Name: i00015.jpg Corpus Callosum Splenium Quadrigeminal Cistern Sup Sagittal Sinus Smirniotopoulos 2014

Corpus Callosum Splenium Caudate nucleus head Frontal lobe Putamen Internal Capsule Thalamus Image File Name: i00016.jpg Corpus Callosum Splenium Quadrigeminal Cistern Sup Sagittal Sinus Smirniotopoulos 2014

Putamen Lenticular Nucleus Frontal horn Putamen Lenticular Nucleus Lateral ventricle choroid plexus Column of Fornix Image File Name: i00016.jpg Occipital lobe calcarine cortex Smirniotopoulos 2014

T1 --- T2 Caudate nucleus head Frontal lobe Putamen Internal Capsule Thalamus Corpus Callosum Splenium Inferior Sagittal Sinus Interhemispheric fissure Sup Sagittal Sinus Smirniotopoulos 2014

T1 --- T2 Frontal horn Putamen Lenticular Nucleus Lateral ventricle choroid plexus Column of Fornix Occipital lobe calcarine cortex Internal Cerebral Veins Smirniotopoulos 2014

T1 --- T2 Smirniotopoulos 2014

T1 --- T2 Heschl's Gyri Heschl's Gyri Smirniotopoulos 2014

Occipital lobe calcarine cortex Genu Corpus callosum Corona Radiata Lateral ventricle Arch (body) of Fornix Image File Name: i00017.jpg Occipital lobe calcarine cortex Smirniotopoulos 2014

Corpus Callosum Splenium Caudate nucleus head Frontal lobe Forceps minor Corona radiata Forceps major Image File Name: i00017.jpg Corpus Callosum Splenium Interhemispheric fissure Sup Sagittal Sinus Smirniotopoulos 2014

Lateral Ventricle body Caudate nucleus body Forceps minor Lateral Ventricle body Forceps major Image File Name: i00018.jpg Interhemispheric fissure Sup Sagittal Sinus Smirniotopoulos 2014

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Intehemispheric fisure Forceps minor Lateral Ventricle body Forceps major Image File Name: i00019.jpg Interhemispheric fissure Sup Sagittal Sinus Smirniotopoulos 2014

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Intehemispheric fisure Forceps minor Centrum Semiovale (white matter) Forceps major Image File Name: i00020.jpg Interhemispheric fissure Sup Sagittal Sinus Smirniotopoulos 2014

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Central Sulcus Image File Name: i00021.jpg NOTE: the “omega” of the pre-central gyrus (on the pt’s LEFT) this is the motor hand area of activation Smirniotopoulos 2014

Central Sulcus Image File Name: i00022.jpg NOTE: the “omega” of the pre-central gyrus (on the pt’s LEFT) this is the motor hand area of activation Smirniotopoulos 2014

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CSF is water, water is bright on T2-weighted MR Head – Axial – MR – T2W CSF is water, water is bright on T2-weighted MR

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Cerebral peduncle (corticospinal tracts) Ant. Cerebral Arteries L. MCA flow-void eye R. MCA flow-void Suprasellar cistern Hippocampus Cerebral peduncle (corticospinal tracts) Temporal horn, lateral ventricle mid Image File Name: i00012.jpg Quadrigeminal plate cistern vermis Inf. sagittal sinus Occipital lobe Sup. sagittal sinus Smirniotopoulos 2014

Cerebral peduncle (corticospinal tracts) Ant. Cerebral Arteries L. MCA flow-void eye R. MCA flow-void Suprasellar cistern Hippocampus Cerebral peduncle (corticospinal tracts) Temporal horn, lateral ventricle mid Image File Name: i00012.jpg Quadrigeminal plate cistern vermis Inf. sagittal sinus Occipital lobe Sup. sagittal sinus Smirniotopoulos 2014

Cerebral peduncle (corticospinal tracts) L. Mammillary body mid Optic tracts L. MCA flow-void eye R. MCA flow-void hypothalamus Cerebral peduncle (corticospinal tracts) L. Mammillary body mid Image File Name: i00012.jpg Tectal (quadrigeminal) plate vermis Inf. sagittal sinus Occipital lobe Sup. sagittal sinus Smirniotopoulos 2014

Cerebral peduncle (corticospinal tracts) L. Mammillary body mid Optic tracts L. MCA flow-void eye R. MCA flow-void hypothalamus Cerebral peduncle (corticospinal tracts) L. Mammillary body mid Image File Name: i00012.jpg Tectal (quadrigeminal) plate vermis Inf. sagittal sinus Occipital lobe Sup. sagittal sinus Smirniotopoulos 2014

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