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Sectional Anatomy by MRI and CT
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Sectional Anatomy by MRI and CT
Fourth Edition
Mark W. Anderson, MDHarrison Distinguished Teaching Professor of Radiology
Chief, Musculoskeletal ImagingProfessor of Orthopaedic Surgery
University of VirginiaCharlottesville, Virginia
Michael G. Fox, MDAssociate Professor of Radiology and Medical Imaging
Associate Professor of Orthopaedic SurgeryUniversity of Virginia
Charlottesville, Virginia
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treat-ment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in eval-uating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and du-ration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products li-ability, negligence or otherwise, or from any use or operation of any methods, products, instruc-tions, or ideas contained in the material herein.
Previous editions copyrighted 2007, 1995, and 1990.
Library of Congress Cataloging-in-Publication Data
Names: Anderson, Mark W., 1957- , author. | Fox, Michael G., author. | El-Khoury, Georges Y. Sectional anatomy by MRI and CT. Preceded by (work):Title: Sectional anatomy by MRI and CT / Mark W. Anderson, Michael G. Fox.Description: Fourth edition. | Philadelphia, PA : Elsevier, [2017] | Includes index. | Preceded by Sectional anatomy by MRI and CT / Georges Y. El-Khoury, William J. Montgomery, Ronald A. Bergman. 3rd ed. 2007.Identifiers: LCCN 2015049199 | ISBN 9780323394192 (hardcover : alk. paper)Subjects: | MESH: Anatomy, Regional | Magnetic Resonance Imaging | Tomography, X-Ray Computed | AtlasesClassification: LCC QM25 | NLM QS 17 | DDC 611/.90222--dc23 LC record available at http://lccn.loc.gov/2015049199
SECTIONAL ANATOMY BY MRI AND CT, FOURTH EDITION ISBN: 978-0-323-39419-2
Copyright © 2017 by Elsevier, Inc. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further informa-tion about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
1600 John F. Kennedy Blvd.Ste 1800Philadelphia, PA 19103-2899
Content Strategist: Robin CarterContent Development Specialist: Kathryn DeFrancescoPublishing Services Manager: Catherine JacksonSenior Project Manager: Daniel FitzgeraldDesigner: Paula Catalano
With the explosion of cross-sectional imaging, the accessibility of a high quality anatomic atlas has become essential and it is with great pleasure
that we introduce the fourth edition of this classic atlas.
Since it was first published in 1990, it has become a standard anatomic reference source. The first three edi-tions were masterfully edited by Drs. Georges El-Khoury, Ronald Bergman, and William Montgomery, and we are honored to be able to continue the tradition of excellence that they established.
New features in this fourth edition include color-coded labeling and a corresponding online version that allows for easy access anytime/anywhere and provides features such as scroll, zoom, and search functions that should further enhance the user’s experience.
We hope that you will find this new edition to be an integral and valuable addition to your practice.
Mark W. Anderson, MDMichael G. Fox, MD
Preface
We are indebted to Drs. El-Khoury and Bergman for their prior efforts in producing and improv-ing this text and for allowing us to continue
along the path of excellence they established. We also thank Robin Carter, Katie DeFrancesco, and Dan Fitzgerald
from Elsevier for helping to bring this project to fruition. Without their invaluable assistance, it wouldn’t have happened!
Mark W. Anderson, MDMichael G. Fox, MD
Acknowledgments
SECTION I UPPER EXTREMITYChapter 1 MRI of the Pectoral Girdle and Chest
Wall, 3
Axial, 4Sagittal, 14Coronal, 24
Chapter 2 MRI of the Shoulder, 34
Axial, 36Oblique Sagittal, 46Oblique Coronal, 56
Chapter 3 MR Arthrography of the Shoulder, 66
Axial, 67Oblique Sagittal, 72Oblique Coronal, 78ABER (Abduction and External Rotation), 84
Chapter 4 MRI of the Arm, 90
Axial, 92Sagittal, 98Coronal, 105
Chapter 5 MRI of the Elbow, 114
Axial, 115Oblique Sagittal, 125Oblique Coronal, 134
Chapter 6 MRI of the Forearm, 143
Axial, 146Sagittal, 156Coronal, 162
Chapter 7 MRI of the Wrist, 170
Axial, 171Sagittal, 180Coronal, 189
Chapter 8 MRI of the Hand, 196
Axial, 198Sagittal, 205Coronal, 214
SECTION II LOWER EXTREMITYChapter 9 MRI of the Hip, 221
Axial, 224Sagittal, 233Coronal, 243
Chapter 10 MR Arthrography of the Hip, 250
Axial, 251Sagittal, 257Coronal, 262
Chapter 11 MRI of the Thigh, 267
Axial, 269Sagittal, 277Coronal, 286
Chapter 12 MRI of the Knee, 294
Axial, 295Sagittal, 302Coronal, 311
Chapter 13 MRI of the Leg, 321
Axial, 324Sagittal, 334Coronal, 342
Chapter 14 MRI of the Ankle, 348
Axial, 349Oblique Axial, 359Sagittal, 365Coronal, 372
Chapter 15 MRI of the Foot, 381
Axial, 385Sagittal, 391Coronal, 399
Contents
viii CONTENTS
SECTION III SPINE AND BACKChapter 16 MRI of the Thoracic Spine, 411
Axial, 415Sagittal, 417Coronal, 420
Chapter 17 MRI of the Lumbar Spine, 424
Axial, 425Sagittal, 429Coronal, 432
SECTION IV THORAXChapter 18 CT of the Thorax, 441
Axial, 442Sagittal, 449Coronal, 453
Chapter 19 MRI of the Heart, 459
Axial, 460Sagittal, 464Coronal, 467
SECTION V ABDOMENChapter 20 CT of the Abdomen, 473
Axial, 475Sagittal, 481Coronal, 487
Chapter 21 MRI of the Abdomen, 493
Axial, 494Sagittal, 502Coronal, 510
SECTION VI PELVISChapter 22 CT of the Male Pelvis, 521
Axial, 522Sagittal, 528Coronal, 531
Chapter 23 CT of the Female Pelvis, 537
Axial, 538Sagittal, 543Coronal, 546
Chapter 24 MRI of the Male Pelvis, 552
Axial, 553Sagittal, 559Coronal, 565
Chapter 25 MRI of the Female Pelvis, 571
Axial, 572Sagittal, 576Coronal, 580
Index, 585
Upper Extremity
ISection
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MRI of the Pectoral Girdle and Chest Wall
1Chapter
4 UPPER EXTREMITY: MRI OF THE PECTORAL GIRDLE AND CHEST WALL
AXIALFigure 1.1.1 Infrahyoid m Thyroid cartilagePlatysma mInternal jugular v
Sternocleidomastoid m
Anterior scalene m
Middle scalene m
Posterior scalene m
Levator scapulae m
Trapezius m
Splenius cervicisand splenius capitis mm
Semispinalis cervicisand semispinalis capitis mm
Multifidus m
Vertebral aC5-6 disc level
Carotid a
Inferior constrictor m
arteryarteries
veinveins
musclemuscles
tendontendons
nervenerves
ligamentligaments
nerve &vessels
bone
aaavvvmmmtttnnnligligs
============
Figure 1.1.2Infrahyoid mPlatysma m
Internaljugular v
Sternocleido-mastoid m
Anteriorscalene m
Middlescalene m
Posteriorscalene m
Trapezius m
Levatorscapulae m
Splenius cervicisand splenius capitis mm
Semispinaliscervicis andsemispinaliscapitis mm
Multifidus m
C6-7disc level
Longuscolli m
Internalcarotid a
Trachea
UPPER EXTREMITY: MRI OF THE PECTORAL GIRDLE AND CHEST WALL 5
Figure 1.1.3
Figure 1.1.4
Transverse cervicalvessels
Trachea
Esophagus
C7 vertebralbody
Rhomboidminor m
Splenius m
Thyroidgland
Sternocleido-mastoid m
Anteriorscalene m
Distalclavicle
Middlescalene mSupraspinatus m
Anteriorjugular v
Posteriorscalene m
Trapezius m Levatorscapulae m
Longuscolli m
Trachea
Acromion
Sternocleido-mastoid m
Anteriorscalene m
Middle scalene m
Acromioclavicularjoint
Clavicle
Thyroid
Commoncarotid a
Externa jugular v
Internal jugular v
Serratusanterior m
Posteriorscalene m
Trapezius m Levatorscapulae m
Scapularspine
Supraspinatus m
Spleniuscapitis andspleniuscervicis mm
Serratus posteriorsuperior m
Semispinaliscapitis m
Longuscolli m
Multifidus m
6 UPPER EXTREMITY: MRI OF THE PECTORAL GIRDLE AND CHEST WALL
Figure 1.1.5
Figure 1.1.6
Splenius capitisand spleniuscervicis mm
Rhomboidminor m
Anterior scalene m
Sternocleidomastoid m,clavicular head
Sternocleidomastoid m,sternal head
Middlescalene m
Clavicle
Commoncarotid a
Externaljugular v
Internal jugular v
Anteriorjugular v
Serratusanterior m
Trapezius m Trapezius mLevatorscapulae m
Scapularspine
Supraspinatus mAnteriordeltoid m
Middledeltoid m
Posteriordeltoid m
Supraspinatus t
Semispinaliscapitis m
Longuscolli m
Costovertebraljoint
Costotransversejoint
Rib
Commoncarotid a
Subclavian a
Sternohyoid m
Anteriorjugular v
Internaljugular v
ClavicleSerratus
anterior m
Anteriorscalene mSubclavius m
Subscapularis m
Semispinaliscapitis m
Splenius capitisand splenius cervicis mm
Rhomboidminor m
Trapezius m
Humeralhead
Deltoid m
Glenoid
Infraspinatus m
Scapularspine
Supraspinatus m
Thoracoacromial a,acromial branch
Deltoid m,anterior head
Greatertuberosity
of humerus
CoracoidSternocleidomastoid m,sternal head
Sternocleidomastoid m,clavicular head
UPPER EXTREMITY: MRI OF THE PECTORAL GIRDLE AND CHEST WALL 7
Figure 1.1.7
Figure 1.1.8
Humeralhead
Greatertuberosity
of humerus
Bicepsbrachii t,
long head
Deltoid m,anterior head
Conjoined t ofcoracobrachialis m
and biceps brachii m,short head
Coracoidprocess
Pectoralisminor t
Cephalic v Cephalic v
Anteriorscalene m
Anterior jugular v
Sternohyoid m
Sternothyroid m
Commoncarotid aSubclavian a
Semispinalisthoracis m
Semispinaliscapitis m
Splenius capitisand spleniuscervicis mm
Rhomboid major m
Trapezius m
Thoracoacromial a
Scapularbody
Infraspinatus mSuprascapular neurovascularbundle in suprascapular notch
Glenoid
Posteriordeltoid m
Serratusanterior m
Sternocleidomastoid m,sternal head
Subscapularis m
Subclavius m
Clavicle
Biceps brachii t,long head
Glenohumeraljoint
Infraspinatus m Infraspinatus m Subscapularis m Serratusanterior m
Trapezius m
Trapezius m
Rhomboidmajor m
Deltoid m
Glenoid
Right lung
Trachea
Brachiocephalic a
Brachiocephalic v
Subclavius m
Subclavian v
Pectoralismajor m,clavicular
headPectoralisminor mCephalic v
Bicepsbrachii t,
short head Clavicle
Axillary a
Axillary v
Sternohyoid m
Anterior jugular v
Sternocleidomastoid m,sternal head
Semispinalisthoracis m
Suprascapulara and n in
spinoglenoid notch
Coracobrachialis tHumeralhead
8 UPPER EXTREMITY: MRI OF THE PECTORAL GIRDLE AND CHEST WALL
Figure 1.1.9
Figure 1.1.10
Infraspinatus m Glenoid Serratusanterior m
Rhomboidmajor m
Deltoid
Greatertuberosity
of humerus
Bicepsbrachii t,
long head
Lessertuberosity
of humerus
Pectoralis major m,clavicular head Axillary vAxillary a
Biceps brachii t,short head Coracobrachialis m
Pectoralis minor mSubscapularis m
Scapular body,medial border
Serratusanterior m
Trapezius m
Brachiocephalic a
Sternohyoid mSternothyroid m
Brachiocephalic v
Sternocleidomastoid m,sternal head
Clavicle
Trapezius m
Splenius capitisand spleniuscervicis mm
Erector spinae m
Semispinalisthoracis m
Right lung
Rib
Costovertebraljoint
Surgical neckof humerus
Deltoid m
Quadrangularspace
Rib
Posteriorcircumflex
humeral a andbranches
and axillary nand branches
Semispinalisthoracis m
Trachea
Brachiocephalic a
Rightbrachiocephalic v
Leftbrachiocephalic v
Sternoclavicularjoint
Pectoralismajor m,
clavicular headPectoralisminor m
Axillary v
Axillary aBiceps
brachii t,long head
Deltoid m,anterior head Biceps brachii t,
short head
Coracobrachialis m andbiceps brachii m,
short head
Splenius capitisand spleniuscervicis mm
Rhomboidmajor m
Trapezius mSerratusanterior m
Infraspinatus mSubscapularis mTeresminor m
Triceps brachii m,long head
UPPER EXTREMITY: MRI OF THE PECTORAL GIRDLE AND CHEST WALL 9
Figure 1.1.11
Figure 1.1.12
Serratusanterior m
Scapular bodyInfraspinatus mTriceps brachii m,long head
Teresminor m
Teresmajor m
Rib
Humerus
Quadrangularspace
Deltoid m
Axillary n andposterior
circumflexhumeral a
Costochondralcartilage,first rib
Pectoralisminor mAxillary v
Pectoralis major m,clavicular head
Biceps brachii t,long head
Biceps brachii t,short head
Coracobrachialis m
Axillary a
Trapezius m
Trachea
Rightbrachiocephalic v
Leftbrachiocephalic v
Sternum
Brachiocephalic a
Rhomboidmajor m
Subscapularis m
Thoracicvertebral body
Right lung
Subscapular aCircumflexscapular a
Superior venacava
Ascending aorta
Trachea
Sternum
Pectoralis major m,sternoclavicular head
Pectoralis minor m
Coracobrachialis mBiceps brachii m,
short headBiceps brachii t,
long head
Deltoid m
Triceps m,lateral head
Tricepsbrachii m,long head
Teres major m
Superiorportion of t of
latissimusdorsi m
Latissimusdorsi m
Teresminor m
Rhomboidmajor m
Trapezius m
Serratus anterior m
Infraspinatus m
Subscapularis m
Axillary a
10 UPPER EXTREMITY: MRI OF THE PECTORAL GIRDLE AND CHEST WALL
Figure 1.1.13
Figure 1.1.14
Vertebral body
Rib
Right mainstembronchus
Superiorvena cava
Ascending aorta
Sternum
Pectoralisminor m
Pectoralismajor m,
sternocostal head
Axillaryneurovascular
bundleCoracobrachialis mBiceps brachii m,
short head
Bicepsbrachii m,long head
Pectoralismajor t
Trapezius m
Rhomboidmajor m
Serratusanterior m
Subscapularis m
Infraspinatus m
Inferiorscapula
Teresminor m
Latissimusdorsi m
Teresmajor m
Latissimusdorsi and
teres major tt
Axillary n,posterior branch
Tricepsbrachii m,long head
Deltoid m
Tricepsbrachii m,
lateral head
Ascendingaorta
Superiorvena cava
Right lung
Semispinalisthoracis m
Erector spinae m
Trapezius m
Rhomboidmajor m
Serratusanterior m
Infraspinatus mScapula
Subscapularis m
Teres major m
Axillaryneurovascular
bundle
Latissimus dorsi t
and teresmajor m
Latissimusdorsi m
Axillary n,posterior branch
Tricepsbrachii m,long head
Tricepsbrachii m,
lateral head
Humeraldiaphysis
Deltoid m
Cephalic v Sternum
Internal thoracica and v
Pectoralis major m,costosternal head
Pectoralisminor mCoracobrachialis m
Biceps brachii m,short head
Bicepsbrachii m,long head
Pectoralismajor t
UPPER EXTREMITY: MRI OF THE PECTORAL GIRDLE AND CHEST WALL 11
Figure 1.1.15
Figure 1.1.16
Ascendingaorta
Superiorvena cava
Right mainpulmonary a
Thoracicvertebral body
Rib
Semispinalisthoracis m
Erectorspinae m
Trapezius mRhomboidmajor m
Serratusanterior m
Inferiorscapular body
Teresmajor m
Subscapularis m
Latissimusdorsi m
Brachialneurovascular
bundle
Tricepsbrachii m,long head
Tricepsbrachii m,
lateral head
Deltoid m
Pectoralismajor t
Cephalic v
Bicepsbrachii m,long head
Biceps brachii m,short head Coracobrachialis m
Pectoralisminor m
Pectoralis major m,costosternal head
Internal thoracica and v
Sternum
Sternum
Ascendingaorta
Superiorvena cava
Semispinalisthoracis m
Trapezius m
Erectorspinae m
Rhomboidmajor m
Serratusanterior m
Inferiorscapula
Teresmajor m
Latissimusdorsi m
Radial n anddeep brachial a
Cephalic v
Deltoid m
Humeraldiaphysis
Tricepsbrachii m,
lateral head
Tricepsbrachii m,long head
Internalthoracica and v
Pectoralis major m,costosternal head
Pectoralisminor mCoracobrachialis m
Bicepsbrachii m,
short head
Bicepsbrachii m,long head
12 UPPER EXTREMITY: MRI OF THE PECTORAL GIRDLE AND CHEST WALL
Figure 1.1.17
Figure 1.1.18
Sternum
Internal thoracica and v
Pectoralis major m,costosternal head
Pectoralisminor mCoracobrachialis m
Biceps brachii m,short head
Bicepsbrachii m,long head
Cephalic v
Humeraldiaphysis
Tricepsbrachii m,
lateral head
Tricepsbrachii m,long head
Semispinalisthoracis m
Trapezius m
Erectorspinae m
Rhomboidmajor m
Inferior medialscapula
Serratusanterior m
Teresmajor m
Latissimusdorsi m
Neurovascularbundle
Tricepsbrachii m,
medial head
Radial n
Deltoid m
Cephalic v
Deltoid m
Tricepsbrachii m,
lateral head
Tricepsbrachii m,long head
Tricepsbrachii m,
medial headRadial n
Brachialneurovascular
bundle
Latissimusdorsi m
Long thoracicn and a
Serratusanterior m
Sternum
Pectoralismajor m
Internalthoracica and v
Right lung
Pectoralisminor mCoracobrachialis m
Bicepsbrachii m,long head
Biceps brachii m,short head
Trapezius m
Erectorspinae m
Intercostal m
Inferior medialscapula
UPPER EXTREMITY: MRI OF THE PECTORAL GIRDLE AND CHEST WALL 13
Figure 1.1.19
Trapezius m
Vertebralbody
Costovertebraljoint
Erectorspinae m
RibLatissimusdorsi m
Latissimusdorsi m
Serratusanterior m
Radial n anddeep brachial a
Triceps brachii m,medial head
Brachialneurovascular
bundle
Sternum
Internal thoracica and v
Pectoralis major m,costosternal head
Pectoralisminor m
Cephalic v
Deltoid m
Tricepsbrachii m,long head
Tricepsbrachii m,
lateral head
Coracobrachialis m
Biceps brachii m,short head
Bicepsbrachii m,long head
14 UPPER EXTREMITY: MRI OF THE PECTORAL GIRDLE AND CHEST WALL
Figure 1.2.2 Deltoid mInfraspinatus t
Triceps brachii m,long head
Deltoid m
Humeral head
Greatertuberosity
of humerus
Deltoidtuberosity
Cephalic v
Triceps brachii m,lateral head
SAGITTALFigure 1.2.1
arteryarteries
veinveins
musclemuscles
tendontendons
nervenerves
ligamentligaments
nerve &vessels
bone
aaavvvmmmtttnnnligligs
============
Deltoid m
Triceps brachii m,long head
Deltoid m
Cephalic v
Triceps brachii m,lateral head
UPPER EXTREMITY: MRI OF THE PECTORAL GIRDLE AND CHEST WALL 15
Figure 1.2.3
Biceps brachii m,long head
Biceps brachii t,long head
Supraspinatus t
Lateral edgeof acromion
Posterior circumflexhumeral a and axillary n
Teres major m
Humeral diaphysis
Teres minor m and t
Deltoid m
Infraspinatus t
Triceps brachii m,long head
Triceps brachii m,medial head
Deltoid m
Humeral head
Deltoid tuberosity
Cephalic v Triceps brachii m,lateral head
Figure 1.2.4
Anterior circumflexhumeral a
Posterior circumflex aand axillary n
Biceps brachii m,long head
Biceps brachii m,short head
Subscapularis t
Lesser tuberosityof humerus
Supraspinatus t
Teres major m
Radial n anddeep brachial a
Teres minor m
Deltoid m
Infraspinatus t
Acromion
Triceps brachii m
Humeral diaphysis
Triceps brachii m,medial head
Pectoralis major t
Humeral head
Deltoid m
Cephalic v