МР Анатомия головного мозга МРТ

1. МРТ анатомия головного мозга

НИИ нейрохирургии им. акад. Н.Н. Бурденко РАМН
Отделение рентгенохирургических методов диагностики и лечения
МРТ анатомия головного мозга

2. NOMINA ANATOMICA

• Базельская - BNA (1895), 5629
терминов
• Йенская (1935) “анималистическая”
• Парижская PNA (1955) свыше 6000
терминов Parisiana Nomina Anatomica
• VIII Всесоюзный съезд анатомов
(Ташкент, 1974)
• Лондонский список XII Международный
конгресс (1985)

3.

Corpus callosum
Septum pellucidum
Rostrum corporis callosi
Ventriculus tertius
Cisterna chiasmatis
Lamina cribrosa
Cisterna suprasellaris
Corpus mamillare
Diploae
Gyrus cinguli
Massa intermedia
Corpus pineale
Lamina quadrigemina
Sinus rectus
Vermis cerebelli
Ventriculus quartus
Fossa interpeduncularis
Pons (Varoli)
Cisterna cerebellomedularis

4.

Truncus corporis callosi
Genu corporis callosi
Rostrum corporis callosi
Gyrus rectus
Crista galli
Cellulae ethmoidales post.
Clivus
Tonsilla pharyngea
Arcus atlantis anter.
Dens epistrophei
Sinus sagittalis super.
Gyrus cinguli
Thalamus
Splenium corporis callosi
Lamina quadrigemina
Tentorium cerebelli
Vermis cerebelli
Pons (Varoli)
Medulla oblongata
Arcus atlantis post.

5.

6.

Lobulus centralis vermis
Monticulus, culmen
Velum medullare anterius
Monticulus, declive
Lingula cerebelli
Fastigium
Nodulus vermis
Uvula vermis
Folium vermis
Tuber vermis
Pyramis vermis
Tonsilla cerebelli

7.

Pedunculi cerebelli sup.
Fissura cerebri lat. (Silvii)
Fossa interpeduncularis
Gyrus temporalis sup.
Flocculus cerebelli
Tonsilla cerebelli
Vermis cerebelli
Pons (Varoli)
Medulla oblongata
Pyramis medullae oblongatae
Gyrus temporalis med.
Gyrus temporalis inf.
Gyrus orbitalis transv.
Gyrus rectus
Tractus opticus
Uncus

8.

9.

Sinus sagittalis sup.
Gyrus frontalis sup.
Gyrus frontalis med.
Gyrus centralis ant.
Sulcus frontalis sup.
Sulcus centralis (Rolandi)
Gyrus centralis post.
Fiss. longitudinaliscerebri
Pars marginalis sulci cinguli
Falx cerebri
Lobulus parietalis sup.
Diploae

10.

Gyrus frontalis sup.
Gyrus centralis ant..
Sulc. centralis (Rolandi)
Gyrus centralis post.
Diploae
Sinus sagittalis sup.
Gyrus frontalis medius
Centrum semiovale
Sulc. centralis (Rolandi)
Lobulus parietalis sup.
Sulcus interparietalis
Lobulus parietalis inf.

11.

Sulcus cinguli
Gyrus cinguli
Gyrus frontalis sup.
Gyrus frontalis medius
Gyrus centralis ant.
Ventriculus later.
Gyrus centralis post.
Corpus callosum
Falx cerebri
Sinus sagittalis sup.
Gyrus supramarginalis
Gyrus angularis

12.

Gyrus frontalis sup.
Gyrus frontalis med.
Sulcus cinguli
Corpus callosum
Gyrus cinguli
Nucleus caudatus
Sulc. corporis callosi
Gyrus cinguli
Lobulus parietalis inf.
Septum pellucidum
Ventriculus later.
Sulcus subparietalis

13.

Sulcus cinguli
Genu corporis callosi
Capsula interna, genu
Putamen
Capsula interna,
pars occipit.
Ventriculus lateralis
Splenium corporis callosi
Lobus parietalis
Forceps minor
Ventriculus lat.,
cornu ant.
Nucleus caudatus
Septum pellucidum
Thalamus
Forceps major
Fissura parietooocipitalis
Lobus occipitalis

14.

Sulcus cinguli
Sulc. corporis callosi
Capsula externa
Claustrum
Globus pallidus
Putamen
Ventriculus lat., trigonum
Lobus occipitalis
Lobus frontalis
Gyrus cinguli
Capsula interna,
pars frontalis
Septum pellucidum
Foramen Monroi
Gyrus longus insulae
Thalamus
Fiss. parietooccipitalis

15.

Gyrus frontalis med.
Gyrus frontalis sup.
Nucleus caudatus
Gyrus frontalis inf.,
pars opercularis
Putamen
Insula
Commissura cerebri ant.
Gyrus temporalis med
Massa intermedia
Gyrus temporalis sup.
Pulvinar
Corpus pineale
Ventriculus lat, cornu post.
Ventriculus tertius
Habenula
Calcar avis

16.

A. cerebri anterior
Nucleus amygdalae
Gyrus orbitalis
longitudinalis externus
Gyrus orbitalis
transversus
Columna fornicis
Trigonum olfactorium
Sulcus circularis
Tractus
mamillothalamicus
Corpus geniculatum later.
Aquaeductus cerebri
Hippocampus
Ventriculus lat.,
trigonum
Colliculus sup.
Calcar avis
Vermis cerebelli
Sinus rectus

17.

Gyrus rectus
A. cerebri media
Gyrus orbitalis
longitudinalis internus
Tuber cinereum
Tractus opticus
A. communicans ant.
Corpus mamillare
Gyrus parahippocampi
Substantia nigra
Cisterna ambiens
Colliculus inf.
Lingula cerebelli
Gyrus hippocampi
Nucl. ruber tegmenti
Gyrus occipitotemporalis lat.
Gyrus occipitotemporalis med.

18.

Sulcus olfactorius
Cisterna interpeduncularis
Pedunculus cerebri
A. cerebri post.
Tentorium cerebelli
Cisterna fossae
cerebri lat.
Gyrus temporalis inf.
Uncus
Ventriculus lat., cornu inf.
Formatio reticularis
Lingula cerebelli
Lobulus centralis vermis
Monticulus, culmen
Sulcus occipitotemporalis lat.
Confluens sinuum
Sulcus collateralis

19.

N. opticus
Hipophysis
Ventriculus lat., cornu inf.
Pons (Varoli)
Tentorium cerebelli
Lobulus centralis vermis
Monticulus, declive
Sulcus horizontalis cerebelli
A. carotis interna
Gyrus temporalis med.
A. cerebelli sup.
Sulc. occipitotemporalis lat.
Pedunculi cerebelli
conjunctivi
Monticulus, culmen
Folium vermis
Sinus transversus

20.

M. rectus medialis
Cellulae ethmoidales ant.
M. rectus lateralis
Cellulae ethmoidales post.
Orbit, apex
Lobus temporalis
Cisterna pontocerebellaris
Sinus sphenoidalis
A. carotis interna
A. basilaris
Pedunculi cerebelli
conjunctivi
N. trigeminus
Ventriculus quartus
Pons (Varoli)
Vermis cerebelli
Hemisphaerum cerebelli

21.

Sinus sphenoidalis
Cavum Meckeli
Lobus temporalis
A. basilaris
A. carotis interna
Cisterna
pontocerebellaris
Cochlea
Pons (Varoli)
Canalis semicircularis
post., pars superior
Canalis semicircularis post.
Corpus medullare
N. acusticus
Flocculus cerebelli
Pedunculi pontis cerebelli
Ventriculus quartus
Vermis cerebelli

22.

Lobus temporalis
Pons (Varoli)
Cochlea
Sulcus pontomedullaris
N. acusticus
Sinus sphenoidalis
A. basilaris
A. cerebelli infer. ant.
Pedunculi cerebelli inf.
Canalis semicircularis post.
Apertura lateralis
ventriculi quarti (Luschka)
Pedunculus flocculi
Ventriculus quartus
Corpus medullare
Uvula vermis
Pyramis vermis

23.

M. masseter
Clivus
M. temporalis
Cisterna medullaris ant.
Processus condyloideus
mandibulae, capitulum
A. Carotis interna
A. vertebralis
Meatus acusticus exter.
Processus mastoideus
Lobulus biventer (cerebelli)
Tonsilla cerebelli
Hemisphaerum cerebelli
N.n. Glossopharyngeus
et vagus
Pyramis medullae oblongatae
Velum posterius
Protuberantia occipitalis int.

24.

Os. sphenoidale, corpus
A. vertebralis
Processus mastoideus
Hemisphaerum cerebelli
Sinus maxillaris
Cisterna medullaris ant.
Medulla oblongata
Lobulus biventer (cerebelli)
Cisterna cerebellomedularis
Vallecula cerebelli
Protuberantia occipitalis int.
Tonsilla cerebelli

25.

Septum nasi
Pars nasalis pharyngis
Tonsilla pharyngea
Pyramis medullae oblongatae
A. cerebelli inf. post.
Tonsilla cerebelli
M. masseter
M. pterygoideus ext.
M. pterygoideus int.
Processus condyloideus
mandibulae, collum
V. Jugularis int.
Medulla oblongata

26.

Анатомия височной кости

27.

NeuroImaging
МРТ 3D антомия

28.

Fossa cranii medium
Canalis semicircularis
superior, pars ant.
Pyramis, pars petrosa
Cellulae mastoideae
Fossa cranii posterior
Canalis semicircularis
superior, pars post.

29.

Canalis facialis
Pyramis, pars petrosa
Crista falciformis
Recessus epitympanicus
Porus acusticus int.
Antrum tympanicum
Crus commune
Canalis semicircularis
posterior., pars sup.

30.

Canalis facialis
Cochlea
Porus acusticus int.
Foramen vestibuli
Canalis semicircularis post.
Crista falciformis
Recessus epitympanicus
Aditus ad antrum
Canalis semicircularis lat.
Antrum tympanicum

31.

Ganglion geniculi
Cochlea
Area cochlea
Capitulum mallei
Corpus incudis
Canalis facialis,
pars horizontalis
Meatus acusticus int.
Aditus ad antrum
Canalis semicircularis
posterior
Canalis semicircularis
lateralis

32.

Mesotympanum
Modiolus
Area cochlea
Vestibulum
Canalis semicircularis
posterior
Capitulum mallei
Corpus incudis
Crus breve incudis
Articulatio
incudostapedia
Antrum tympanicum

33.

Mesotympanum
Collum mallei
Cochlea
Processus lenticularis
incudis
Cochlea
Recessus facialis
Vestibulum
Canalis semicircularis
posterior
Canalis facialis,
genu posterior
Sinus tympani

34.

M. tensor tympani
Collum mallei
Cochlea
Articulatio
incudostapedia
Cochlea
Recessus facialis
Fenestra vestibuli
Eminentia pyramidalis
Sinus tympani
Cellulae mastoideae

35.

M. mensor tympani
Pyramis, pars petrosa
Cochlea
Fenestra vestibuli
Sinus tympani
Manubrium mallei
Capitulum stapedis
Recessus facialis
Eminentia pyramidalis
Cellulae mastoideae

36.

A. carotis interna
Cochlea
Apex pyramidis
Apertura externa
aquaeductus vestibuli
Canalis facialis,
pars mastoideus
M. tensor tympani
Pars ossea tubae
auditivae (Eustachii)
Hypotympanum
Manubrium mallei
Cellulae mastoideae

37.

Canalis facialis,
pars distalis
Cochlea
Cochlea
Canalis semicircularis
superior
Recesus epitympanicus
Corpu incudis
Canalis caroticus
Capitulum mallei
Hypotympanum
Canalis facialis,
pars tympanicus
Annulus tympanicus
Processus cochleariformis

38.

Canalis facialis,
pars distalis
Canalis simicircularis
superior
Cochlea
Canalis simicircularis
lateralis
Cochlea
Canalis facialis,
pars tympanicus
Manubrium mallei
Canalis caroticus
Hypotympanum
Recessus epitympanicus
lateralis
Scutum
Articulatio mandibularis

39.

Vestibulum
Meatus acusticus int.
Fenestra vedtibuli
Cochlea
Hypotympanum
Annulus tympanicus
Tegmen tympani
Canalis semicircularis
lateralis
Canalis facialis,
pars tympanicus
Scutum
Crus anterius stapedis
Articulatio mandibularis

40.

Canalis petromastoideus
Tegmen tympani
Porus acusticus int.
Canalis semicircularis
superior
Apertura externa
aquaeductus vestibuli
Canalis semicircularis
lateralis
Foramen jugulare
Clivus
Sutura occipitomastoidea
Antrum tympanicum
Canalis semicircularis
posterior
Meatus acusticus externus

41.

Lamina cribrosa
A. carotis interna
Fissura orbitalis sup.
Foramen rotundum
Foramen ovale
Foramen spinosum
Meatus acusticus internus
Sinus petrosus superior
Sinus petrosus inferior
Canalis hypoglossus
A. vertebralis
A. Spinalis anterior
Sinus sigmoideus
Sinus transversus
Confluens sinuum

42.

NeuroImaging

43.

3D FIESTA versus 3D FSE
3D FIESTA
Acq time :3 min 53
3D FSE
Acq time : 6 min 02
Images courtesy of Pr Heuck, Munich Pasing

44.

Neuro : Cranial nerves
Trijeminal nerve
Maxillary nerve
(branche of trijeminal)
Frontal nerve
(branche of trijeminal)
Maxillary nerve (branche of trijeminal)
Trijeminal nerve
Mandibular nerve
(branche of trijeminal)
Mandibular nerve
(branche of trijeminal)
Images courtesy of Pr Heuck, Munich Pasing

45.

Neuro-vascular conflict
Sup Cerebelar artery
Sup Cerebelar
artery
Trijeminal Nerve
Trijeminal Nerve
Images courtesy of Dr Appel, Middleheim

46.

Neuro-vascular conflict
Conflict between the basilar artery and the
origine of the facial nerve
Images courtesy of Dr Guichard, Lariboisiere Hospital

47.

L-Spine Myelography
FA°45 , TR 4.9, TE 1.4, Bw 62.5, Acq time 2min43
Images courtesy of Pr Heuck, Munich Pasing

48.

Sagital FSE T2
L-Spine
Nerve root
Discal Hernia
Sagital reformat view
Images courtesy of Pr Laredo, Lariboisiere Hospital
3DFiesta Coronal view

49.

L-Spine
Nerve
root
Axial reformat view
Discal
Hernia
3d FIESTA
2d FSE
3d FIESTA
2d FSE
Images courtesy of Pr Laredo, Lariboisiere Hospital

50.

C-Spine Myelography
Axial acquisition
Nerve
roots
Ax/ob Reformation
Ax/ob reformation
Parallel to the foramen
Images courtesy of Pr Laredo, Lariboisiere Hospital
Curvilgne reformation

51.

Neuro : Cranial nerves
IAC
Images courtesy of Pr Heuck, Munich Pasing

52.

Neuro : Cranial nerves
IAC
Cochleo-vestibular
nerve
Images courtesy of Pr Heuck, Munich Pasing

53.

Neuro : Cranial nerves
IAC
Cochleo-vestibular
nerve
Facial nerve
Navigator
reconstruction
Images courtesy of Pr Heuck, Munich Pasing

54.

Neuro : Semi-circular canals & Cochlea
MIP
Volume Rendering
Images courtesy of Pr Heuck, Munich Pasing

55.

Neuro : Semi-circular canals & Cochlea
Nerve in transparency
Volume Rendering
Images courtesy of Pr Heuck, Munich Pasing

56.

a. communicans anterior
a. cerebri anterior
a. ophtalmica
a. carotis interna
a. communicans posterior
a. cerebri media
gang. n. trigemini (Gasseri)
a. choroidea anterior
n. oculomotorius
n. trochlearis
a. cerebri posterior
n. oculomotorius
a. cerebelli anterior inferior
a. cerebellaris superior
n. facialis et n. acusticus
tentorium cerebelli
n. glossopharingeus, n. vagus
a. cerebelli posterior inferior
n. hypoglossus
(canalis n. hypoglossi)
a. vertebralis
a. spinalis anterior

57.

falx cerebri
bulbus olfactorius
lamina cribrosa
scala anterior
n. opticus
sinus intercavernosus anterior
sinus sphenoparietalis
infundibulim hypophisi
a. carotis interna
sinus intercavernosus post.
sinus cavernosus
n. oculomotorius
plexus venosus basilaris
sinus petrosus inferior
sinus petrosus superior
scala media
plexus venosus vertebralis interna
sinus sigmoideus
tentorium cerebelli
foramen occipitale magnum
sinus occipitalis
sinus rectus
sinus transversus
sinus sagittalis superior

58. Методы определения s.centralis

Pars marginalis sulci cinguli (sag)
“Bracket” sign, “скобки”
(axial)
Признак Kido
(axial)
Признак Yousry
(axial)
Толщина коры
(axial)

59.

NeuroImaging
МРТ в планировании операционного доступа

60.

NeuroImaging
МРТ 3D антомия

61.

NeuroImaging

62.

63.

NeuroImaging
Роль КТ, МРТ и Аг
5.Планирование леченияСТБ,
навигация,
хирургия,
лучевое,
химиотерапия

64.

NeuroImaging
Vol. rendering

65.

NeuroImaging

66.

n. Opticus right
Программа прицельного МРТ-исследования
орбиты и n. Opticus (T2-ВИ)
n. Opticus left

67.

3.0T fMRI
Language Paradigm
Images courtesy of Brain Imaging Research Institute, Australia

68.

3.0T fMRI
fMRI - Patient navigating
through a maze
Images courtesy of Brain Imaging Research Institute, Australia

69.

Diffusion Tensor Imaging
fMRI Left hand
fMRI Right hand
DTI FA
Small FA signal drop was shown in edema around low FA area, which corresponds to tumor. fMRI result showed activation area
in both hemisphere and that means degree of neuro Dysfunction is not so severe. This patient had a slight clinical symptom.
Image courtesy of Iwate Medical Univ.

70.

Diffusion Tensor Imaging
Cortico-Spinal Tract Mapping
Images courtesy of University of Wisconsin, Madison
Works in progress

71.

Diffusion Tensor Imaging
Diffusion Tensor Imaging Tractography
Images courtesy of University of Wisconsin, Madison
Works in progress

72. High resolution brain Images

FOV 16cm, 3mm thickness
FSE , 11 slices 5:20 mm

73.

3D FIESTA versus 3D FRFSE
3D FIESTA
3D FRFSE
Neurinoma
Neurinoma
Same
pixel
size
Scan time 3’40
Scan time 6’45
Images courtesy of Dr Guichard, Lariboisiere Hospital

74.

Neurinoma of Acoustic nerve
Facial nerve
Neurinoma
Acoustic nerve
& Neurinoma
3d Fiesta + Contrast
Facial nerve
SE T1 + Contrast
Facial nerve
Acoustic nerve
& Neurinoma
Images courtesy of Dr Appel
Acoustic nerve
& Neurinoma

75.

Neurinoma of Acoustic nerve
Facial nerve
Facial nerve
Neurinoma
Acoustic nerve
Neurinoma
Neurinoma
Images courtesy of Dr Appel, Middleheim

76.

IAC Neurinoma
(Recurrence after surgery)
Neurinoma
3D FIESTA
Images courtesy of Dr Guichard, Lariboisiere Hospital
Neurinoma
3D FRFSE
SE T1 after contrast agent injection

77.

Pineal glande
cyst
Images courtesy of Dr Appel, Middleheim

78.

Intra cisternal lesion
Epidermoid Cyst
Images courtesy of Dr Appel, Middleheim

79. Release 9.0 TwinSpeed Images:

•Edison

80. Схема получения стереотаксической проекции (AC-PC)

Commissura cerebri anterior
Commissura cerebri posterior

81.

Curved reformat
C-Spine
Canal
Stenosis
Nerve
roots
Sagittal Acquisition
Images courtesy of Pr Laredo, Lariboisiere Hospital