Abdominal Cross-sectional Cross sectional Imaging

Department of Radiology, p gy, Vancouver General Hospital

Dr. Savvas Nicolaou Director of ER/Trauma Radiology savvas.nicolaou@vch.ca

Learning Objectives
Be able to identify which abdominal organs are intraperitoneal and retroperitoneal Be able to identify the following gastrointestinal anatomy on Abdomen CT Abdominal part of esophagus Stomach:
Cardia Fundus Body Greater and lesser curvatures Antrum Pylorus

Appendix Large intestine

Ascending Transverse T Descending Sigmoid Left & right hepatic ducts Cystic duct Common bile duct

Liver & Gallbladder

Spleen Pancreas
Head Neck Body y Tail

Duodenum: 4 parts Small intestine Ileocecal junction

Learning Objectives Contd Cont d

Be able to identify the following posterior abdominal wall structures on Abdomen CT : Lumbar vertebrae Iliac crest Iliac fossa Quadratus lumborum Iliacus Psoas major Transversus abdominis Diaphragm Abdominal aorta
Bifurcation t common ili arteries Bif ti to iliac t i Internal/external iliac arteries Common iliac veins Internal/external iliac veins

Ureters Adrenal glands

Inferior vena cava

Kidneys

Anatomy R i A Review

Basic Abdominal Anatomy

Abdomen extends from inferior margin of g thorax to the superior margin of pelvis and lower limb Peritoneum lines the abdominal cavity Forms the mesenteries that suspends viscera d i

Basic Abdominal Anatomy

Intraperitoneal
Suspended from abdominal wall p by mesenteries
Stomach Duodenum (1st & 4th part) Jejunum Ileum Cecum Appendix Transverse colon Sigmoid colon

Retroperitoneal
Lie between parietal peritoneum and posterior abdominal wall Urinary system Pancreas Duodenum (2nd & 3rd part) Ascending colon Descending colon Large vessels, nerves and lymphatics

Basic Abdominal Anatomy

Stomach

Pancreas

Liver

Large Intestine

Pelvis Bone

1: Ischiopubic rami 1 I hi bi i 2: Obturator Foramen 3: Anterior superior Iliac Spine 4: Iliac Crest 5: Iliac Fossa 6: Ischial Spine 7: Pubic Tubercle 8: Pubic Crest 8 P bi C t 9: Pubic Symphysis 10. Sacro-iliac joints 11. Ala of sacrum

Anterior

Abdominal Muscles

Vasculature

Kidneys & Ureter

CT Atlas

Upper abdomen axial view level of the pancreas and L1

12 2 3 8 7 11 5 4 6 1 10

12 2 4 5 9 8 3 11
8. Abdominal aorta 9. Inferior vena cava 10. Right crus 11. 11 Left adrenal gland 12. Rectus abdominus

1 10

6 7

1. 2. 3. 4. 4 5. 6. 7.

Liver Stomach Pancreas Small intestine Large intestine Intra-abdominal fat Spleen

Mid-abdomen axial view level of kidneys and L3

10 3 2 1 8 7 9 5 6 2

10 3

8 7 9

5 4 6

1. 2. 3. 4. 5. 6.

Liver Ascending colon Transverse colon Descending colon Small intestine Left kidney

7. Abdominal aorta 8. Inferior vena cava 9. Psoas muscle 10. Rectus Abdominus

Lower abdomen - axial view level of L5

4 8 10 9 7 5 6 23 1 8 7 10

4 3 12 9 5 6

1. Transversus abdominus muscle 2. 2 Internal oblique muscle 3. External oblique muscle 4. Rectus abdominus 5. Psoas muscle

6. Quadratus lumborum muscle 7. Lumbar vertebral body 8. 8 Ascending Colon 9. Descending Colon 10. Small Intestine

Mid-Sagittal view

2 2 1 1 3 3

1. Abdominal aorta 2. Liver 3. Small intestine

Right Para-Sagittal view

6 6 5 5 4 4

4. Kidney 5. Quadratus lumborum muscle 6. Liver

Left Para-Sagittal view

8 4 5

8 4 5

4. Kidney 5. Quadratus lumborum muscle 7. Stomach 8. Spleen

Vascular Review
1. 1 Aorta 2. Left Common Iliac Artery 3. Right Common Iliac Artery 4. Left External Iliac Artery 5. 5 Left Internal Iliac Artery 6. Inferior Vena Cava

1 6 2 3 5 4

Coronal view

1 2

3 4 2 7 6 5

3 4

7 5 6
5. Descending colon 6. Rectum 7. Ascending colon 7 A di l

1. 2. 3. 3 4.

Liver Gallbladder Stomach St h Small intestine

Coronal view

4 3 2

1 2

5 6 6 5

1. Fundus f t 1 F d of stomach h 4. Cardial t h 4 C di l notch 2. Body of stomach 5. Psoas muscles 3. Pyloric antrum of stomach 6. Iliacus muscle

Coronal view

1 3 4

1 3 4

5 6 6

1. 2. 3. 4.

Liver Spleen Left kidney y Psoas muscle

5. Gluteal muscles 6. Rectum