Head MR
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
The MedPixMan
http://rad.usuhs.edu
james.smirnio@usuhs.edu
Head – Axial – MR – T1W Myelin is fat … fat is bright on T1weighted MR
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Maxilla Maxillary Sinus
Hard Palate
Lateral mass C1 C2 Odontoid Cx Spinal Cord
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Maxilla Maxillary Sinus
Hard Palate
Occipital Condyle Clivus Cx Spinal Cord
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Maxillary Sinus
Vomer
Occipital Condyle Clivus Medulla oblongata Cerebellar Tonsil
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Maxillary Sinus
Vomer
Clivus Medulla oblongata Cerebellar Tonsil
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Maxillary Sinus
Vomer
Clivus Medulla oblongata Cerebellar Tonsil
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Maxillary Sinus
Vomer
Clivus Medulla oblongata Cerebellar Tonsil
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Temporal lobe Petrous apex marrow Internal Auditory Canal w/ CNN 7 & 8
Brachium pontis (middle cerebellar peduncle) Vermis
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Orbit
Sphenoid sinus
Clivus Pons Vermis (nodulus)
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Orbit Temporal lobe Sphenoid sinus
Petrous apex marrow Internal Auditory Canal w/ CNN 7 & 8
Clivus Pons
Brachium pontis (middle cerebellar peduncle)
Vermis (nodulus)
Vermis
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Temporal lobe Petrous apex marrow Cerebello-pontine angle & cistern CNN 7 & 8 Brachium pontis (middle cerebellar peduncle) Vermis
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Orbit
Sphenoid sinus
Clivus Pons Vermis (nodulus)
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Orbit Temporal lobe Sphenoid sinus
Petrous apex marrow Cerebello-pontine angle & cistern CNN 7 & 8
Clivus Pons
Brachium pontis (middle cerebellar peduncle)
Vermis (nodulus)
Vermis
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
T1 --- T2 Temporal lobe Petrous apex marrow Internal Auditory Canal w/ CNN 7 & 8
Brachium pontis (middle cerebellar peduncle) Vermis
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose
T1 --- T2
Orbit
Sphenoid sinus
Clivus Pons Vermis (nodulus)
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose
T1 --- T2
Orbit Temporal lobe Sphenoid sinus
Petrous apex marrow Internal Auditory Canal w/ CNN 7 & 8
Clivus Pons
Brachium pontis (middle cerebellar peduncle)
Vermis (nodulus)
Vermis
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Temporal lobe Petrous apex marrow Cerebello-pontine angle & cistern CNN 7 & 8 Brachium pontis (middle cerebellar peduncle) Vermis
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Orbit
Sphenoid sinus
Clivus Pons 4th Ventricle
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Orbit Temporal lobe Sphenoid sinus
Petrous apex marrow Cerebello-pontine angle & cistern CNN 7 & 8
Clivus Pons
Brachium pontis (middle cerebellar peduncle)
4th Ventricle
Vermis
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Ethmoid sinus Uncus of Temporal lobe Cerebello-pontine angle & cistern CNN 7 & 8 Brachium conjunctivum (superior cerebellar peduncle) Vermis
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Eyeball
Sphenoid sinus
Pre-pontine cistern Pons 4th Ventricle
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Eyeball Ethmoid sinus Sphenoid sinus
Uncus of Temporal lobe Cerebello-pontine angle & cistern CNN 7 & 8
Pre-pontine cistern Pons
Brachium conjunctivum (superior cerebellar peduncle)
4th Ventricle
Vermis
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Ethmoid sinus Uncus of Temporal lobe
Ambient cistern
Brachium conjunctivum (superior cerebellar peduncle) Vermis
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Eyeball
Pituitary fossa
Pre-pontine cistern Upper Pons 4th Ventricle
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Nose Eyeball Ethmoid sinus Pituitary fossa
Uncus of Temporal lobe
Ambient cistern Pre-pontine cistern Upper Pons
Brachium conjunctivum (superior cerebellar peduncle)
4th Ventricle
Vermis
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Optic nerve Uncus of Temporal lobe
Ambient cistern Cerebral peduncle and midbrain (mesencephalon)
Superior Sagittal sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Crista galli Eyeball
Optic chiasm
Interpeduncular cistern Cerebral aqueduct Vermis of Cerebellum
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Crista galli Eyeball Optic nerve Optic chiasm
Uncus of Temporal lobe
Ambient cistern
Interpeduncular cistern
Cerebral peduncle and midbrain (mesencephalon)
Cerebral aqueduct Vermis of Cerebellum
Superior Sagittal sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Crista galli
T1 --- T2
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
Uniformed Services University - America’s Medical School
eye L. Sylvian fissure Hippocampus Temporal horn, lateral ventricle Quadrigeminal plate cistern
Occipital lobe
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
eye
R. Sylvian fissure 3rd ventricle Cerebral peduncle (corticospinal tracts)
mid
vermis Inf. sagittal sinus Sup. sagittal sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
eye L. Sylvian fissure Hippocampus Temporal horn, lateral ventricle Quadrigeminal plate cistern
Occipital lobe
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Optic tracts
eye L. Temporal lobe
hypothalamus L. Mammillary body
Tectal (quadrigeminal) plate
Occipital lobe
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Optic tracts
eye L. Temporal lobe
R. Temporal lobe
hypothalamus Cerebral peduncle (corticospinal tracts)
mid
L. Mammillary body
Tectal (quadrigeminal) plate vermis Occipital lobe
Inf. sagittal sinus Sup. sagittal sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Optic tracts
eye L. Temporal lobe
R. Temporal lobe
hypothalamus Cerebral peduncle (corticospinal tracts)
mid
L. Mammillary body
Tectal (quadrigeminal) plate vermis Occipital lobe
Inf. sagittal sinus Sup. sagittal sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Gyrus rectus
Frontal lobe
Anterior Commissure
Thalamus 3rd ventricle Quadrigeminal Cistern
Sup Sagittal Sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Sylvian Fissures
Lat Vent – atrium (trigone) Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Caudate nucleus
Frontal lobe
Anterior Commissure
Thalamus 3rd ventricle
Quadrigeminal Cistern Sup Sagittal Sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
1 - Gyri breves insulae 2 - Sulcus centralis insulae 3 - Gyrus longus insulae 4 - Gyri temporales transversum (Heschl’s Gyri)
Smirniotopoulos 2011-2013
Uniformed Services University - America’s Medical School
Sylvian Fissures
Heschl's Gyri Heschl's Gyri
Lat Vent – atrium (trigone) Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Caudate Head Putamen Lenticular Nucleus Lateral Geniculate Body Column of Fornix (post-commissural) Occipital lobe calcarine cortex
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Heschl's Gyri Uniformed Services University - America’s Medical School
Heschl's Gyri
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Caudate Head Putamen Lenticular Nucleus Lateral Geniculate Body Column of Fornix
Occipital lobe calcarine cortex
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Caudate nucleus
Frontal lobe Putamen
Internal Capsule Thalamus Corpus Callosum Splenium Quadrigeminal Cistern Sup Sagittal Sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Caudate nucleus head
Frontal lobe Putamen
Internal Capsule Thalamus Corpus Callosum Splenium Quadrigeminal Cistern Sup Sagittal Sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Frontal horn Putamen Lenticular Nucleus Lateral ventricle choroid plexus Column of Fornix
Occipital lobe calcarine cortex
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Caudate nucleus head
T1 --- T2
Frontal lobe Putamen
Internal Capsule Thalamus Corpus Callosum Splenium Inferior Sagittal Sinus Interhemispheric fissure Sup Sagittal Sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
T1 --- T2 Frontal horn Putamen Lenticular Nucleus Lateral ventricle choroid plexus Column of Fornix
Occipital lobe calcarine cortex
Internal Cerebral Veins
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
T1 --- T2
Smirniotopoulos 2014
Heschl's Gyri Heschl's Gyri Uniformed Services University - America’s Medical School
T1 --- T2
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Genu Corpus callosum
Corona Radiata
Lateral ventricle Arch (body) of Fornix
Occipital lobe calcarine cortex
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Caudate nucleus head
Frontal lobe Forceps minor Corona radiata
Forceps major Corpus Callosum Splenium Interhemispheric fissure Sup Sagittal Sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Caudate nucleus body
Forceps minor Lateral Ventricle body
Forceps major
Interhemispheric fissure Sup Sagittal Sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Intehemispheric fisure
Forceps minor Lateral Ventricle body
Forceps major
Interhemispheric fissure Sup Sagittal Sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Intehemispheric fisure
Forceps minor
Centrum Semiovale (white matter) Forceps major
Interhemispheric fissure Sup Sagittal Sinus Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Central Sulcus
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Central Sulcus
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Central Sulcus
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Central Sulcus
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Central Sulcus
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Central Sulcus
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Head – Axial – MR – T2W CSF is water, water is bright on T2-weighted MR
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Ant. Cerebral Arteries
eye
L. MCA flow-void
R. MCA flow-void Suprasellar cistern
Hippocampus
Cerebral peduncle (corticospinal tracts)
mid
Temporal horn, lateral ventricle Quadrigeminal plate cistern
vermis Inf. sagittal sinus Sup. sagittal sinus
Occipital lobe
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Ant. Cerebral Arteries
eye
L. MCA flow-void
R. MCA flow-void Suprasellar cistern
Hippocampus
Cerebral peduncle (corticospinal tracts)
mid
Temporal horn, lateral ventricle Quadrigeminal plate cistern
vermis Inf. sagittal sinus Sup. sagittal sinus
Occipital lobe
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Optic tracts
eye
L. MCA flow-void
R. MCA flow-void hypothalamus Cerebral peduncle (corticospinal tracts)
mid
L. Mammillary body
Tectal (quadrigeminal) plate vermis Inf. sagittal sinus Sup. sagittal sinus
Occipital lobe
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Optic tracts
eye
L. MCA flow-void
R. MCA flow-void hypothalamus Cerebral peduncle (corticospinal tracts)
mid
L. Mammillary body
Tectal (quadrigeminal) plate vermis Inf. sagittal sinus Sup. sagittal sinus
Occipital lobe
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014
Uniformed Services University - America’s Medical School
Smirniotopoulos 2014