1. „SelectedChaptersfromtheCross-SectionalAnatomy ofthe Human Body”András Jakab MD, Levente István Lánczi MD

2. Why to choose this elective? Images support the everyday medical practice. Medical students should become familiar with images(radiography, CT, MRI, US, NM). Theoretical knowledge -> clinical use Medical students have strong anatomy background Clinical correlations

3. Why to choose this elective? Support clinical and imaging education Imagesareimportantonexams, suchasStateexam (lastexambeforegraduation), USMLE Step 1,2 & 3 and others „Every picture tells a story”

4. Structure of the Lectures Background information Macroscopic anatomy revision Clinical anatomy – „Why is this region important?” Cross-sectional demonstration using www.imaios.com and other sources Selected clinical cases (www.eurorad.com) Sources

5. About medical imaging Methods using X-ray ”Classical” two-directionalx-ray CT Ultrasound (US) Magnetic Resonance Imaging (MRI) Nuclear Medicine imaging and hybrid technologies SPECT, PET PET-CT, PET-MR Image fusion

6. On a CT scan/radiography… White bone, contrastagent (vessels, bowels, masses, etc.), implants/foreign body (metalic) Grey parenchymalorgans (liver, brain, etc.) Black air (gas), water, liquor

7. On a T1 MRI scan… White fat Black water, liquor Good graymatter/whitemattercontrastinthebrain

8. On a T2 MRI scan… White water, liquor Black Fat Edemaimaging

9. „ Selected Chapters from the Cross-Sectional Anatomy ” –Head and neck anatomy: pharynx, larynx, oral cavityAndrásJakab MD, LeventeIstvánLánczi MD

11. Whatcan be seenontheaxial MR images of theneck? Bones hyoidbone vertebrae Neckmuscles Vessels commoncarotidartery Inferior/superiorthyroidartery vertebralartery Internal/external/anteriorjugularveins Larynx: cartilages, muscles, cavities Esophagus, pharynx Spinalcord

12. Bones – cervicalvertebrae spinousprocess vertebralarch vertebralforamen sup./inf. articularprocess Transverseprocess vertebral body

13. C1: atlas, C2: axis densof axis posteriorarch lateralmass transverseprocess articularsurface arcus anterior

14. Hyoidbone greaterhorn lesserhorn body

15. Muscles of theneck Platysma Sternocleidomastoidmuscle (SCM) Suprahyoid – infrahyoidmuscles Triangles of theneck carotid, submandibular, supraclavicular (omoclavicular, omotrapezoid) submental Scalenimuscles anterior, medius, posterior

16. Superficialneckmuscles sternocleidomastoidmuscle (SCM) manubrium of sternum mastoidprocess platysma

17. Infrahyoidmuscles sternohyoidmuscle thyrohyoidmuscle sternothyroidmuscle omohyoidmuscle omohyoidmuscle

18. Suprahyoidmuscles mylohyoidmuscle digastricmuscle stylohyoidmuscle geniohyoidmuscle

19. Triangles of theneck Submandibular Carotid Submental Supraclavicular omoclavicular omotrapezoid

20. Deep neck & scalenusmuscles spleniuscapitis, semispinaliscapitis m. levatorscapulae m. scalenusanterior m. scalenusmedius m. trapeziusmuscle scalenusposterior m.

22. T2 MRI, Level Th1

23. Axialis metszet a Th1 magasságában (T2 MRI) T2 MRI, Level Th1

24. Axialis metszet a Th1 magasságában (T2 MRI) T2 MRI, Level Th1

25. Axialis metszet a Th1 magasságában (T2 MRI) T2 MRI, Level Th1

26. T2 MRI, Level Th1

27. T2 MRI, Level C7

28. T2 MRI, Level C7

29. T2 MRI, Level C7

30. T2 MRI, Level C7

31. Larynx Respiratorysystem Hyalinecartilage, ligaments, muscles, mucosa Hyoidbone -> trachea Cartilages Thyroidcartilage(Prominentialaryngea – Pomum Adami) Cricoidcartilage Arytenoidcartilage Epiglottis Smallcartilages: cuneiform, corniculate

32. medianthyrohyoid ligament epiglottis hyoidbone thyroidmembrane corniculatecartilage thyroidcartilage arytenoidcartilage cricoidcartilage trachea mediancricothyroid ligament

33. epiglottis thyroid membrane hyoidbone thyroidcartilage cricoidcart. - lamina cricoidcartilage - arcus

34. T2 MRI, Level C6

35. T2 MRI, Level C6

36. T2 MRI, Level C6

37. T2 MRI, Level C6

38. T2 MRI, Level C6

39. T2 MRI, Level C6

40. T2 MRI, Level C6

41. Internalstructure of pharynx thyroidcartilage vocalmuscle vocallig. arytenoidcart. Cricoidcart. pharynx constrictorpharyngisinferior m.

42. T2 MRI, Level C5

43. T2 MRI, Level C5

44. T2 MRI, Level C5

45. T2 MRI, Level C5

46. T2 MRI, Level C5

47. T2 MRI, Level C5

48. T2 MRI, Level C4

49. T2 MRI, Level C4

50. T2 MRI, Level C4

51. T2 MRI, Level C4

52. T2 MRI, Level C4

53. Larynx– coronalplane epiglottis vestibule thyroidcartilage vocalis m., vocallig. cricoidcartilage thyroidgland trachea

54. T2 MRI, laryngealcavities, coronal plane

55. T2 MRI, laryngealcavities, coronal plane

56. T2 MRI, Level C3

57. T2 MRI, Level C3

58. T2 MRI, Level C3

59. T2 MRI, Level C3

60. Head – face & masticatorymuscles buccinator m. parotidglandule zygomaticus major m. orbicularisoris m. SCM ramusof manibule m. masseter

61. pterygoideusmed & lat m. buccinator m. occipitalis a. externalcarotid a. facial a. facial a.

62. T2 MRI, Level C1-2

63. Axialis metszet a C1-C2 magasságában (T2 MRI) T2 MRI, Level C1-2

64. Axialis metszet a C1-C2 magasságában (T2 MRI) T2 MRI, Level C1-2

65. Axialis metszet a C1-C2 magasságában (T2 MRI) T2 MRI, Level C1-2

66. Axialis metszet a C1-C2 magasságában (T2 MRI) T2 MRI, Level C1-2

67. Axialis metszet a C1-C2 magasságában (T2 MRI) T2 MRI, Level C1-2

68. T2 MRI saggital plane

69. Sagittalis metszet a fej-nyak régióról (T2 MRI) T2 MRI saggital plane

70. Sagittalis metszet a fej-nyak régióról (T2 MRI) T2 MRI saggital plane

71. Sagittalis metszet a fej-nyak régióról (T2 MRI) T2 MRI saggital plane

72. Sagittalis metszet a fej-nyak régióról (T2 MRI)

73. Sagittalis metszet a fej-nyak régióról (T2 MRI)

74. Sagittalis metszet a fej-nyak régióról (T2 MRI)

75. Sagittalis metszet a fej-nyak régióról (T2 MRI)

76. Sinuses Frontal sinus Maxillary sinus

77. Selectedclinicalcase #1 48 y old man forfistulography thyreoglossalcystincision 5 yearsbefore Fistulography thyroglossaltract, sinus dilatation; taste of contrastagent Ultrasound ovoidhypoechoiclesion, subtle flow CT cysticcomponents MRI cysticsuprahyoidlesion Thyroglossalductfistula http://www.eurorad.org/case.php?id=8884

78. Selectedclinicalcase #2 50 y old female History: dry eyes & mouth 1 yduration; foreign body sensation, enlargement of parotids US: mildlyenlargedparotidglandsdemonstratingechotextureheterogeneity MR sialographyimaging: bilateraldiffuseintra-glandularductectasia no sialolith PositiveSchirmer’s test Sjogren’ssyndrome http://www.eurorad.org/case.php?id=8515

79. Selectedclinicalcase #3 21 y old male History: caraccident CT examination Air bubblesbetweenmuscles Linearband of negativedensity Surgicalintervention: 10 cm piece of wood http://www.eurorad.org/case.php?id=5072

80. Selectedclinicalcase #4 Sinus piriformiscarcinomahttp://www.eurorad.org/case.php?id=4930