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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


Chapter 5 MRI of the Elbow, 114

Axial, 115Oblique Sagittal, 125Oblique Coronal, 134

Chapter 6 MRI of the Forearm, 143


Chapter 7 MRI of the Wrist, 170


Chapter 8 MRI of the Hand, 196


SECTION II LOWER EXTREMITYChapter 9 MRI of the Hip, 221


Chapter 10 MR Arthrography of the Hip, 250


Chapter 11 MRI of the Thigh, 267


Chapter 12 MRI of the Knee, 294


Chapter 13 MRI of the Leg, 321


Chapter 14 MRI of the Ankle, 348

Axial, 349Oblique Axial, 359Sagittal, 365Coronal, 372

Chapter 15 MRI of the Foot, 381


Contents

viii CONTENTS

SECTION III SPINE AND BACKChapter 16 MRI of the Thoracic Spine, 411


Chapter 17 MRI of the Lumbar Spine, 424


SECTION IV THORAXChapter 18 CT of the Thorax, 441


Chapter 19 MRI of the Heart, 459


SECTION V ABDOMENChapter 20 CT of the Abdomen, 473


Chapter 21 MRI of the Abdomen, 493


SECTION VI PELVISChapter 22 CT of the Male Pelvis, 521


Chapter 23 CT of the Female Pelvis, 537


Chapter 24 MRI of the Male Pelvis, 552


Chapter 25 MRI of the Female Pelvis, 571


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


Anteriorscalene m

Distalclavicle

Middlescalene mSupraspinatus m

Anteriorjugular v

Posteriorscalene m

Trapezius m Levatorscapulae m

Longuscolli m

Trachea

Acromion


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


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


Longuscolli m

Costovertebraljoint

Costotransversejoint

Rib

Commoncarotid a

Subclavian a

Sternohyoid m

Anteriorjugular v

Internaljugular v

ClavicleSerratus

anterior m

Anteriorscalene mSubclavius m

Subscapularis 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


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



Rhomboid major m

Trapezius m

Thoracoacromial a

Scapularbody

Infraspinatus mSuprascapular neurovascularbundle in suprascapular notch

Glenoid

Posteriordeltoid m

Serratusanterior m


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



Suprascapulara and n in

spinoglenoid notch

Coracobrachialis tHumeralhead


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


Clavicle

Trapezius m


Erector spinae m


Right lung

Rib

Costovertebraljoint

Surgical neckof humerus

Deltoid m

Quadrangularspace

Rib

Posteriorcircumflex

humeral a andbranches

and axillary nand branches


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


Rhomboidmajor m

Trapezius mSerratusanterior m

Infraspinatus mSubscapularis mTeresminor m

Triceps brachii m,long head


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,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


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


Deltoid m

Tricepsbrachii m,

lateral head

Ascendingaorta

Superiorvena cava

Right lung


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,

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


Pectoralismajor t


Figure 1.1.15

Figure 1.1.16

Ascendingaorta

Superiorvena cava

Right mainpulmonary a

Thoracicvertebral body

Rib


Erectorspinae m

Trapezius mRhomboidmajor m

Serratusanterior m

Inferiorscapular body

Teresmajor m

Subscapularis m

Latissimusdorsi m

Brachialneurovascular

bundle


Tricepsbrachii m,

lateral head

Deltoid m

Pectoralismajor t

Cephalic v


Biceps brachii m,short head Coracobrachialis m

Pectoralisminor m



Sternum

Sternum

Ascendingaorta

Superiorvena cava


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


Internalthoracica and v



Bicepsbrachii m,

short head



Figure 1.1.17

Figure 1.1.18

Sternum






Cephalic v

Humeraldiaphysis

Tricepsbrachii m,

lateral head



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,

medial headRadial n


bundle

Latissimusdorsi m

Long thoracicn and a

Serratusanterior m

Sternum

Pectoralismajor m

Internalthoracica and v

Right lung




Trapezius m

Erectorspinae m

Intercostal m

Inferior medialscapula


Figure 1.1.19

Trapezius m

Vertebralbody

Costovertebraljoint

Erectorspinae m

RibLatissimusdorsi m

Latissimusdorsi m

Serratusanterior m


Triceps brachii m,medial head


bundle

Sternum



Pectoralisminor m

Cephalic v

Deltoid m


Tricepsbrachii m,

lateral head

Coracobrachialis m




Figure 1.2.2 Deltoid mInfraspinatus t


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


Deltoid m

Cephalic v

Triceps brachii m,lateral head


Figure 1.2.3

Biceps brachii m,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



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


Subscapularis t

Lesser tuberosityof humerus

Supraspinatus t

Teres major m


Teres minor m

Deltoid m

Infraspinatus t

Acromion

Triceps brachii m

Humeral diaphysis


Pectoralis major t

Humeral head

Deltoid m

Cephalic v

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