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Ultrasound of the liver demonstrates it to be relatively larger than
that of the adult. It often visualized well across the midline to the
spleen, requiring careful technique to separately identify the two
organs. The gall bladder is readily seen in the fasting state along with
the biliary tree.


Genitourinary anatomy
In babies and children, as in adults, ultrasound forms the mainstay of
renal morphological imaging. The widespread use of fetal anomaly
scanning means that many children with antenatally detected renal
abnormalities are seen for follow-up in the ¬rst few weeks of life.
During the ¬rst few days of life the kidneys produce little urine. Unless
Fig. 15.5. Chest radiograph showing the sail like thymus extending into the
a severe abnormality is suspected, imaging should be delayed until the
right lung.
child is approximately 7 days of age. Before this time, dehydration my
lead to an underestimation of the degree of any hydronephrosis.
bubbles may indicate duodenal atresia but more distal obstruction The neonatal kidney is of signi¬cantly higher re¬‚ectivity than in
may require other imaging for its localization. adults. The medullary pyramids are of very low re¬‚ectivity. If the gain
The swallowing mechanism in infants differs from that of adults in controls are not correctly set, they may be mistaken for hydronephro-
that a number of small milk boluses may be retained in the pharynx sis. The adrenals are also more conspicuous than in adults and are
before triggering the swallow re¬‚ex. Milk may leak up into the usually visualized. (Fig. 15.6) The bladder is always examined both full
nasopharynx (nasopharyngeal escape) or aspiration may occur. and empty. The thickness of the bladder wall may give indirect evi-
Detailed examination of babies with severe feeding dif¬culties may dence of bladder out¬‚ow obstruction. The maximum thickness is
require video¬‚uoroscopy with the combined disciplines of radiology 2 mm when fully distended and 4 mm when contracted.
and speech therapy. Functional imaging of kidneys often complements ultrasound exam-
The appearance of the esophagus is similar to that of the adult. The ination. When obstructive uropathy is suspected, e.g., pelviureteric
stomach may often appear relatively large as it is distended readily by junction obstruction, dynamic renal imaging with DTPA or Mag3 is
the crying, which may accompany radiological investigation. All used. Mag 3 is both ¬ltered and secreted and is therefore more useful
barium studies of the upper GI tract should include an image, demon- with the low glomerular ¬ltration rates found in infants. In the follow-
strating the position of the duodeno-jejunal ¬‚exure. This should be to up of childhood urinary tract infection, renal parenchymal imaging
the left of the left pedicles of the upper lumbar spine. Malrotation with DMSA provides the most sensitive estimation of renal scarring,
of the intestines is a cause of intermittent acute abdominal symptoms provided at least 6 months has elapsed since the infection. Imaging
as the small bowel is unusually mobile and prone to twisting with before this time may give false-positive or false-negative results owing
closed loop obstruction (small bowel volvulus). to the renal perfustion changes that occur during acute infection.
Ultrasound of the stomach may demonstrate gastroesophageal
re¬‚ux but it is most commonly used in the diagnosis or exclusion of
pyloric stenosis. The normal pylorus is a low re¬‚ectivity, tubular struc- Right
kidney
ture with relatively thin walls less than 2 mm. In hypertrophic pyloric
Fig. 15.6. Longitudinal
stenosis (HPS) the wall thickens to greater than 4 mm and the length
Liver ultrasound of the upper
of the canal increases to greater than 16 mm. These measurements are
part of the right kidney
only guidelines as there is some overlap between early HPS and
demonstrating the low
normal values, particularly in low birthweight infants.
re¬‚ectivity of the
Imaging of the colon in infants and children is for very different Diaphragm medullary pyramids and
indications from that in adults. Most imaging is performed in the Right the relatively large right
Spine Suprarenal
neonatal period for the examination of symptoms suggestive of large adrenal gland.


156
Pediatric imaging ruth williamson

Ultrasound forms the mainstay of imaging sex organs in children.
Fig. 15.7. Sagittal
In boys, it is frequently used to locate undescended testes. Eighty to
ultrasound of the female
90% lie within the inguinal canal and are readily seen on ultrasound,
pelvis demonstrating
10“20% lie within the abdomen and may be extremely dif¬cult to
the tubular infantile
uterus. locate. In girls, the sex organs are seen fairly easily. The neonatal
Bladder ovaries are of low re¬‚ectivity and can be mistaken for dilated ureters.
The uterus involutes in size during the ¬rst year as the effects of
maternal hormones are withdrawn. It remains tubular in shape until
the menarche when thickening of the fundus occurs (Fig. 15.7).

Musculoskeletal anatomy
Tubular uterus
As cartilage is relatively radiolucent, the appearance of unossi¬ed and
partially ossi¬ed bones in childhood differs signi¬cantly from adult
bony appearances. These differences are exploited in radiology in two
main ways. Ultrasound may be used in the evaluation of unossi¬ed
structures, for example, in the assessment of the neonatal hip for evi-
dence of developmental dysplasia or dislocation (Fig. 15.8) Plain ¬lms
of speci¬c structures (most commonly the left hand) may be used to




Labrum
Head Foot


Gluteus



Femoral head




Calcified
femoral
neck

Ilium



Gap of triradiate cartilage
Fig. 15.9. Isotope bone
Acetabulum scan of the knee
showing increased
Fig. 15.8. Coronal ultrasound of the neonatal hip demonstrating the stippled tracer uptake at the
femoral epiphysis held within the acetabulum by the cartilagenous labrum. growth plates.


157
Pediatric imaging ruth williamson


provide a skeletal age by comparison with reference images. This tech- During childhood, a gradual transformation to adult marrow occurs,
nique is useful in congenital and metabolic conditions that alter skele- beginning peripherally in the appendicular skeleton. The axial skele-
tal maturation. ton, including sternum spine and pelvis, retains hematopoietic marrow
Knowledge of the appearances of epiphyseal ossi¬cation centers is into adulthood. Longitudinal growth occurs at the physes or growth
useful in trauma, particularly around the elbow where an entrapped plates. These are highly vascular. Isotope bone scanning demonstrates
avulsed medial epicondyle may lie in the position of the trochlear markedly increased tracer uptake at these sites. When using these scans
ossi¬cation center. to look for bony metastases, osteomyelitis, or occult fractures, compari-
Infantile bone marrow is hematopoietic and is of low signal intensity son with age-de¬ned normal scans is essential (Fig. 15.9).
on MRI compared with the high signal fatty type seen in adulthood.




158
Index internal carotid artery 78, 80, 85
Note: page numbers in italics refer to
¬gures and tables kidneys 51
lower limb 129
abdomen 36“46 MR 13
shoulder 128
blood supply 60“2
circumference measurement 147, upper limb 113, 125
vertebral artery 103
148
fetal 149“50, 151 ankle joint 138
layers 36 imaging 141
lymphatics 62“3 annular ligament 118
muscle layer 36 anode 1“2
radiograph image interpretation antecubital fossa 125
aorta
18
super¬cial fascia 36 abdominal 60“1
transabdominal scanning 55, 146, fetal 149
147 intrathoracic 28
see also gastrointestinal tract primitive 27
abdominal sympathetic trunk 63 aortic arch 28
abdominal wall, posterior 59“60 aortic plexus 30
abducent (sixth) cranial nerve 72, aortic valve 27
aortogram, ¬‚ush 61
83“4
acetabular teardrop 131, 132 appendix 40
acetabulum 131, 132 aqueduct of Sylvius, pediatric
acoustic enhancement 7 imaging 154
acoustic shadowing 7 arachnoid mater 76, 112
acromioclavicular joint 115 areola 31
acromioclavicular ligament 115 arm 117“22
acromion 114, 115 arterial supply 124“5
acromiothoracic artery 125 musculature 117“18
adductor brevis muscle 134 venous drainage 125
adductor longus muscle 134 arteriography, spleen 43
adductor magnus muscle 134 artery of Adamkiewicz 112
adrenal glands 51“2 arthrography
imaging 48, 52 hip joint 132
airway, anatomy 24“5 pelvis 132
ampulla of Vater 44 shoulder 116“17
anal canal 40, 41“2 upper limb 113
arytenoid cartilage 99, 100
anal ¬stulae 42
anal sphincter 41 atlanto-occipital joints 108
atlas 108, 109
damage 42
anal triangle 60 atria 27
angiography 4, 5 axilla 117
axillary artery 125, 127
abdominal aorta 61
colonic bleeding 41 axillary lymph nodes 32, 117, 128
digital subtraction 4, 28 ultrasound imaging 34
¬‚uoroscopy 3 axillary nerve 126
hand 127 axillary vessels 117

159
Index


axis 108, 109 pregnancy 32 chest wall 23“30 pelvis 62, 132
CT 23, 24 peritoneal cavity 45
azygos vein 37 sentinel node 32
tissue underdevelopment 31 muscles 30 PET 16
barium studies 4, 18, 20 ultrasound 34 nerve supply 30 pituitary gland 73
colon 41 Bremsstrahlung 2 radiography 23 prostate gland 55
pterygopalatine fossa 91, 92“3
duodenum 39 bronchial circulation 29 sympathetic ganglia 30
bronchial tree 25, 26
esophagus 37 children 153“8 radiation dose 10
¬‚uoroscopy 3 bronchopulmonary segments 25 neuroanatomy 153“4 renal tract 47
small bowel 39 bronchus 25 choroid 83 scanners 8
stomach 38 Buck™s fascia 56 ciliary body 83 seminal vesicles 55
skull 69, 70
barium sulphate 4 circle of Willis 73, 78
calcaneum 138, 139, 140
basilar artery 78“9 cisterna chyli 29, 63 skull base 91
capitulum 119, 119“20
basilic vein 125 clavicle 114, 115 slice thickness 22
cleft lip and palate 148, 150 small bowel 39, 40
biceps femoris muscle 134 cardiac chambers 27
fetal 148“9, 151
biceps muscle 117, 118 coccygeus muscle 60 spermatic cord 56
coccyx 129, 130
attachment 114 cardiac defects 155 spiral (helical) 8
cochlea 86, 87, 88
bile duct, common 44 cardiac plexus 30 spleen 43
cardiac pulsations 146, 147 streak artifact 10, 11
biliary tree imaging 42 coeliac artery 44
cardiothoracic ratio 23, 27
biparietal diameter measurement collateral ligaments three-dimensional
carotid artery 64 ankle 138 reconstructions 8“9
147, 148
bladder 52“3 cannulation 67 knee 135 thyroid gland 101
see also intravenous urography common 28, 102 ulnar 121 upper limb 113, 125
vertebral column 105, 106
blood circulation 27, 28 external 84, 102“3 collimator 2
internal 77“8, 80
bone colon volume averaging 10
window width/level 8, 9
age estimation 123“4, 158 carotid bifurcation 102 anatomy 40“1
pediatric imaging 157“8 carpal bones 122 pediatric imaging 156 computed tomography
see also ossi¬cation; ossi¬cation ossi¬cation 123 common bile duct 44 angiography (CTA) 67
centers carpometacarpal joints 122, 124 Compton scattering 2, 8 contrast enhancing agents
bone marrow, infant 158 catheter angiography 67 computed radiology 3 biliary tree imaging 42
bowel preparation, gastrointestinal cathode 1 computed tomography (CT) 7“10 CT 8, 20“1
tract studies 20 caudate nucleus 73 abdominal aorta 61 gastrointestinal tract studies 18,
brachial artery 125, 127 caudothalamic groove 153, 154 abdominal lymphatic system 63 20
brachial plexus 104, 117, 126, 127 cavernous sinuses 73, 82 adrenal glands 52 liver imaging 42
brachial vein 125, 128 celiac artery 38, 39, 60, 61 advanced image reconstructions MRI 22
cephalic vein 125, 128
brachialis muscle 118 neuroimaging 67
8“9
brain 64“80 cerebellar arteries 78, 90 advantages 10 pituitary gland imaging 73
abnormal density 68 cerebellar peduncles 71 artifacts 10 renal studies 20
anatomy 64 cerebellopontine angle cistern 90 beam hardening 10 ultrasound 7
cavities 64 cerebellum 70, 71 cardiac imaging 28 urinary tract 47
chest 23, 24
cerebral blood circulation 77“9, pediatric imaging 154 X-rays 4, 18, 20
80 contrast medium 4, 5
cerebral aqueduct 70 collimation 8
cerebral envelope 76 cerebral arteries 76, 77, 78 colon 41 contrast studies, urinary tract
cerebral hemispheres 74, 75 cerebral blood circulation 77“9, contrast agents 8 20
fetal 148, 149 80 duodenum 39 conventional tomography 4“5
cerebral envelope 76, 77
limbic system 74“6 facial skeleton 91 coracobrachialis muscle 117, 118
motor tracts 73“4 cerebral hemispheres 71, 74 female genital tract 58 coracoclavicular ligament 114
neuroimaging 64, 64“7, 67 cerebral veins 64, 76, 79, 80 foot 141 coracoid process 114
pediatric imaging 153“4 cerebral ventricles 64, 68, 77 gray-scale 6, 7, 21 coronary angiogram 28
sensory tracts 73“4 pediatric imaging 154 high-resolution 10 coronary arteries 27
signal intensity 68 cerebrospinal ¬‚uid 64 hip joint 132 coronary ligaments 46
vascular territories 79 cerebral ventricular system image interpretation 20“2 coronary sinus 27
brainstem 70“1 spaces 77 image reconstruction 8 corpora albicantia 58
pediatric imaging 154 cisterns 68, 77, 90 inferior vena cava 62 corpora cavernosa 56
infratemporal fossa 91, 92“3
breast subarachnoid space 76, 112 corpora spongiosum 56
acini 32 cervical lymph nodes 102 intensity 8 corpus callosum 74
anatomy 31“5 cervical nerves 125 interpretation of neuroimaging corpus luteum 58
cervical spine 108, 109
arterial supply 32 cortical gyri 74
68
congenital malformations 31 pediatric imaging 154 kidneys 50“1 costoclavicular ligament 114
ducts 31, 34 cervical vasculature 102“4 knee joint 135 costophrenic recess 30
embryology 31 charged couple device (CCD) limitations 10 costotransverse joint 110
glandular tissue 31“2 technology 3 liver imaging 42 cranial nerves 64, 71“3
imaging 32“5 chest lower limb 129 craniocervical junction 108
motion artifact 10, 11
implants 35 anatomy 24“9 craniocervical lymphatic system
imaging techniques 23, 24
lobes 31 multi-detector 8 102
chest radiographs 3, 23 multiplanar reformats 8, 10 craniovertebral ligaments 109
lymphatics 32, 34
malignancy 32 image interpretation 17“18 neuroimaging 64, 67, 68 cribriform plate 94
cricoid cartilage 99, 100
MRI 35 pediatric imaging 155 pancreas 44
nerve supply 32 projection 17“18, 23 pelvimetry 132 cricopharyngeus 98

160
Index


esophagus 25, 27
crown rump length of embryo 146, gastroesophageal junction 38 hypothalamus 72, 73
anatomy 37 gastroesophageal re¬‚ux 156 hysterosalpingography 47, 58“9
147
cruciate ligaments 135 pediatric imaging 156 gastrograf¬n 20
ethmoid sinuses 92
cuboid bone 140 gastrointestinal tract ileocecal valve 41
ileum 39, 40
cuneiform bones 138, 140 ethmoidal bone 69, 94 anatomy 37
iliac arteries 62, 141, 142, 143
Eustachian tube 87 bowel preparation 20
deltoid muscle 116 external jugular vein 104 contrast studies 18, 20 internal 49
deltopectoral lymph node 128 eye 81“5 CT studies 20, 37 iliac lymph nodes 62
extraocular muscles 81, 83
diaphragm 30, 59 MRI 37 iliacus muscle 59
ilium 129, 130
diencephalon 72 nuclear medicine 37
diffusion-weighted imaging 13 facet joints 29, 107 pediatric imaging 155“6 image intensi¬ers 3
facial (seventh) cranial nerve 72, 86,
digital radiology 3 radiography 37 image interpretation 17
image interpretation 17 gastrosplenic ligament 43 CT 20“2
89, 90, 96
digital subtraction angiography 4, facial structure genital tract MRI 22
fetal 148, 149, 150 female 56“9 nuclear medicine 22
28
skeletal imaging 92 X-rays 17“18, 19, 20
digitorum longus muscle male 54“6
extensor 137 falciform ligament 46 Gerota™s fascia 47, 48, 51 incisura angularis 37
¬‚exor 138 Fallopian tubes 57“9 gestational age determination 146, incus 87, 88
Doppler ultrasound 6“7 falx cerebri 76 infants
147
penis/testis 56 fascia lata muscle, tensor 132 glans penis 56 feeding dif¬culties 156
femoral arteries 142, 143
dorsal root ganglion 111 glenohumeral joint 115“16 neuroimaging 153“4
double contrast studies 4, 20 femoral nerve 145 bursae 116 swallowing mechanism 156
femoral vein, common 143, 144
colon 41 glenoid fossa 114, 115 see also neonates
femur 132, 133
esophagus 37 glenoid labrum 115 inferior mesenteric artery 41, 61
stomach 38 length measurement 148 glossopharyngeal (ninth) cranial inferior vena cava 27, 43, 48, 61“2
ossi¬cation 133
ductus arteriosus nerve 72 in¬‚ammatory bowel disease 39
fetal 149 fetal anomaly scanning 156 gluteus maximus muscle 131 infratemporal fossa, imaging 91,
92“3
neonatal 155 fetus gonadal artery 49
abdomen 149“50, 151
duodenal cap 38 gracilis muscle 133 inguinal canal 36
duodenocolic ligament 45 anatomy 148 gradient recalled echo sequences 13 inguinal lymph nodes 56
brain 148, 149 innominate bones 129, 130
duodenum 38“9 gray-scale imaging 6, 7, 21
facial structure 148, 149, 150 great vein of Galen 79, 80 insula 74, 75
pancreatic duct opening 44
heart 148“9, 151 greater omentum 45
duplex scan 7 intercostal space, blood vessels 30
testis 56 size 148 internal auditory canal (meatus) 89
spine examination 148, 150
dura mater 76, 111“12 hallucis longus muscle internal iliac artery 49
dural venous sinuses 77, 79 thorax 148“9, 151 extensor 137 internal jugular vein 64, 102
transvaginal scanning 146, 147 ¬‚exor 138 interosseous membrane 119
¬bula 136, 137 interspinous ligament 107, 108
ear 86“90 hamstrings 134, 144
external 86 ¬‚uid attenuated inversion-recover hand 122“4 intervertebral canal 107
(FLAIR) sequences 12“13, 14
inner 88“9 bone age estimation 123“4 intervertebral discs 106“7
middle 86“8 ¬‚uoro-deoxy-glucose (FDG) 16 imaging 124 intestines, malrotation 156
echo-planar imaging 13 ¬‚uoroscopy 3 veins 125 intravenous contrast 8
effective dose 5, 6 intravenous urography 4, 5, 20, 47,
barium studies 4 hard palate 94
¬‚uoroscopy machine 1
ejaculatory ducts 54, 55, 56 head circumference measurement 52“3
foot 138, 139, 140“1
elbow 115, 121 inversion recovery (IR) sequences
147, 148
imaging 121 imaging 141 heart 12“13
ossi¬cation centers 119, 119“20, foramen of Magendie 77 anatomy 27“8 iodinated contrast agents 4
foramen of Monro 76, 77 blood circulation 27“8 iris 83
158
diameter ratio to thorax 23, 27
trauma 158 pediatric imaging 153 ischiorectal fossae 42
fetal 148“9, 151 ischium 129, 130
embryo foramen ovale 155
crown rump length 146, 147 foramina of Luschka 77 venous drainage 27 isotopes, PET scanning 15“16
forearm 118“19, 120, 121“2
limb bud formation 146 hemiazygos vein 37
jejunum 39, 40
endoluminal ultrasound, anal canal musculature 121“2 hepatic artery 43, 44
fractures, plain radiographs 18, 19 hepatoduodenal ligament 43 jugular vein
42
endolymphatic sac 89 frontal bones 68“9 hiatus semilunaris 94 external 104
endometrium 57 orbital plates 69 hilar point 27 internal 64, 102
endoscopic retrograde frontal lobe 74 hilum 26“7, 29
cholangiopancreatography pediatric imaging 153 hindbrain 70 kidneys 47“51
frontal sinuses 92, 94
(ERCP) 44 hip joint 131“2 circulation 48
endoscopy imaging 131“2 contrast studies 20
duodenum 39 gadolinium DTPA 22 neonatal imaging 157 crossed fused ectopia 50
pancreatic duct 44 neuroimaging 67 hippocampus 75“6 fascial spaces 48
fetal 150, 151
virtual 9 gall bladder 43 Hirschsprung™s disease 156
epididymis 56 fetal 150 horseshoe kidney 50 imaging 50“1
epiglottis 98, 99 gamma camera 15 Houns¬eld units 8 intravenous urography 50
epiphyseal ossi¬cation centers 158 gastric emptying 38 humerus 115 lymphatic drainage 48
episcleral membrane 83 gastrocnemius muscle 138 hypoglossal (twelfth) cranial nerve migration abnormalities 49, 50
epitympanum 86, 87 gastroduodenal artery 44 nerve supply 48
72

161
Index


seminal vesicles 53, 55
kidneys (cont.) pediatric vascular pattern 155 myelography, vertebral column
shoulder 116“17, 118
nuclear medicine 22 venous drainage 29 105
pediatric imaging 156 signal intensity 12 mylohyoid muscles 96
pelvic 50 magnetic resonance angiography 13 signal localization 11 myometrium 57
relations 49 neuroimaging 67 small bowel 39
structure 47“8 magnetic resonance spin echo sequence 12 nasal cavity 94, 103
knee joint 134“6 cholangiopancreaticogram spinal pediatric imaging 154 nasopharyngeal carcinoma 97
bursae 134 (MRCP) 14 spleen 43 nasopharynx 94, 97
navicular bone 138, 139
imaging 135“6 magnetic resonance imaging (MRI) STIR sequences 12, 13
neck, fascial layers 97“8, 98
ligaments 135 susceptibility artifact 14
10“15
menisci 134 abdominal aorta 61 T1 11, 12 necrotizing enterocolitis 156
pediatric imaging 157 abdominal lymphatic system 63 T1 weighted scans 12, 22 neonates
adrenal glands 48, 52
knot of Henry 138 T2 11, 12 circulatory changes 155
kyphoses 106 advantages 15 T2 weighted scans 12, 22 colon imaging 156
aliasing 14“15 testis 56 neuroimaging 153“4
neuroimaging 64, 64“7, 67
labia majora 56 anal canal 42 thyroid gland 101
labyrinth 86, 88 ankle 141 transverse relaxation 11 MRI 22
lacrimal gland 84 artifacts 14“15 turbo spin echo 13 pediatric 153“4
large bowel 40“1 brachial plexus 104 upper limb 113 nipples 31
laryngopharynx 98 breast 35 uterus 58 nuchal translucency 146
larynx 98, 98“100, 100 cardiac imaging 28 vertebral column 105“7 nuclear medicine 15“16
leg 132“45 chemical shift artifact 14 malleoli 138 advantages 16
arteries 141, 142, 143 colon 41 malleus 87, 88 image interpretation 22
lower 136“8, 139, 140“1 contrast agents 22 mamillary bodies 73 liver imaging 42
muscles 132“4 cranial nerves 71, 72 mammograms, viewing 34 lower limb 129
thigh 132“4 diffusion-weighted imaging 13 mammography 32“4 pancreas 44
venous drainage 143, 144 normal patterns 33, 33
echo-planar imaging 13 renal tract 47
mandible 91, 92“4, 94
lens 83 fat suppression 13 thyroid gland 101
lentiform nucleus 73 female genital tract 58 mandibular canal 91
oblique muscles of eye 81, 83
lesser omentum 45 ferromagnetic artifact 14 manubrium 29
FLAIR sequences 12“13, 14
lesser sac 45 mastication muscles 91 obstetric imaging 146“52
levator ani muscle 60 foot 141 mastoid air cells 87 20-week scan 147“8
levator scapulae muscle 116 gradient recalled echo sequences maxillary artery 103 obturator externus muscle 131
ligamentum ¬‚avum 107, 108 maxillary sinus 94, 95 obturator internus muscle 59“60,
13
limb, lower 129“45 hip joint 132 Meckel™s diverticulum 39 131
imaging methods 129“45 image interpretation 22 meconium ileus 156 occipital bone 68, 69“70
muscles 132“4, 137“8 inferior vena cava 62 median nerve 127 occipital condyles 108
mediastinum 25, 26
nerve supply 144“5 interpretation of neuroimaging occipital cortex 79
vascular supply 141, 142, 143, 144 medulla 70 occipital lobe 74
68
see also hip joint; leg; pelvis inversion recovery sequences membranous urethra 53 pediatric imaging 154
limb, upper 113“28 meningeal artery, middle 103 occiput 108
12“13
imaging methods 113 kidneys 51 meninges 64, 76, 111“12 oculomotor (third) cranial nerve 71,
knee joint 135, 136
lymphatic drainage 128 menisci of knee 134 84
olecranon 119, 119“20
nerve supply 125“8 liver 42 mental foramen 91
vascular supply 124“5 longitudinal recovery 11 mesenteric artery olecranon fossa 115, 118
see also arm; hand; shoulder; wrist lower limb 129 inferior 41, 61 olfactory (¬rst) cranial nerve 71,
superior 39, 40, 41, 44, 60, 61
joint motion artifact 14 94
neuroimaging 64, 64“7, 67, 68,
limbic gyrus mesenteric vein, superior 44 omentum, greater/lesser 45
ophthalmic artery 82, 84, 85
inner 75“6 mesentery 39, 45
154
small bowel 45, 46
outer 75 ovaries 58 ophthalmic veins 85
limbic lobe 76 mesocolon, transverse 45, 46
pancreas 44 optic canal 82, 85
optic chiasm 73, 74, 85
limbic system 74“6 pediatric imaging 154 metacarpal bones 122
lipohemarthrosis 135 pelvic vasculature 62 metatarsal bones 140 optic (second) cranial nerve 71, 82,
83, 84, 85
liver 42“3 pelvimetry 132 microbubbles 7
blood supply 43 pelvis 132 micturating cystourethrogram optic pathways 85
fetal 149“50, 151 penis 56 (MCUG) 47, 53 oral cavity 96
pituitary gland 73, 74
pediatric imaging 156 midbrain 70“1 orbit
longitudinal ligaments 107, 108, 109 principles 11“12 midcarpal joint 124 bony 81“2
lordotic curves 106 prostate gland 55 mirror image artifact 7 cavity 81“2
lumbar lymphatic trunks 63 proton density scans 12 mitral valve 27 infections 82
Morison™s pouch 45
lumbar plexus 144 pulse sequence 12 lacrimal gland 84
lumbar spine 110 rectal tumors 41 mucosal folds 39 nerves 83“4
pediatric imaging 154 rectouterine pouch 46 multiplanar reformats (MPR) 8, 10 soft tissues 82“3
lumbosacral plexus 63, 144 relaxation times 11“12 musculocutaneous nerve 126“7 vasculature 84“5
lungs renal tract 47 musculoskeletal system orbital ¬ssures 82
anatomy 24“5 safety 15 MRI 22 oropharynx 98
scanner 10, 11 plain radiographs 18, 19 orthopantomography 91, 94
¬ssures 24
high-resolution CT 10 scanning parameters 12 myelination abnormalities 154 ossicular chain 87

162
Index


ossi¬cation ligaments 45“6 quadratus lumborum muscle 59 single photon emission
carpal bones 123 malignancy 45 quadriceps femoris muscle 132 tomography (SPECT) 15
femur 133 recesses 45“6 sinuses of Valsalva 27
pelvis 130 peroneal artery 142, 143 radial artery 125, 127 sinusitis 96
ossi¬cation centers peroneal nerves 144, 145 radial collateral ligament 121 skeleton
elbow 119, 119“20, 158 radial head 119, 119“20
peroneus brevis muscle 138 maturity 123“4
epiphyseal 158 peroneus longus muscle 137“8 radial nerve 115, 126 see also ossi¬cation; ossi¬cation
ostiomeatal complex 94, 95, 96 persistent fetal lobulation 49 radiation centers
oval window 86, 87, 89 petrosal vein of Dandy 90 characteristic 2 skull 64“80
ovarian artery 57, 58 phalanges 140 damage 5 anatomy 64, 68“70
pharyngeal recesses 97 dose 4“5, 6
ovaries 58“9 anterior fossa 69
pharyngotympanic tube 87 radiocarpal joint 124 base 68“9
pampiniform plexus 58 pharynx 97 radiopharmaceuticals 15 foramina 69
pancreas 44 photoelectric absorption 2 thyroid gland 101 imaging 91
pancreatic duct 44 photographic ¬lm 2 radioulnar joint 119 middle fossa 69
pancreatica magna 44 photo-multiplier tube 3 radius 118, 119 posterior fossa 69
para-aortic lymph nodes 62, 63 photons, X-ray 2, 3 rectal arteries 41 radiograph 70
rectouterine pouch 45, 46
parahippocampal gyrus 76 phrenocolic ligament 40 sutures 68
paranasal sinuses 94, 95, 96 pia mater 76, 112 rectum 40“1 vault 68
parapharyngeal space 97“8, 98 rectus muscles of eye 81, 83 small bowel 39, 40
piezoelectric materials 6
small bowel mesentery 45, 46
parathyroid glands 101 pineal gland 72 renal artery 48
parietal lobe 74 piriform fossa 98 renal cortex 47 soft tissues, radiodensity 20“1
pediatric imaging 154 piriformis muscle 59, 131 renal duplication 49, 50 soleus muscle 138
pituitary gland 73, 74, 85
parotid gland 96, 103 renal medulla 47 spectral Doppler ultrasound 7
patella 134, 135, 136 placenta 150, 151, 152 renal pelvis 47“8 spermatic cord 56
patello-femoral joint space 135 plain radiography 3 renal tract 47“52 sphenoid bone 69, 73
pectineus muscle 133“4 ankle 141 anatomical variants 49“50 sphenopalatine artery 103
facial skeleton 91, 92
pectoralis major muscle 116 stones 50 spinal accessory (eleventh) cranial
pectoralis minor muscle 116 foot 141 renal vein 48 nerve 72
pediatric imaging 153“8 image interpretation 17“18, retina 83 spinal arteries 103, 112
19
chest 155 retroperitoneum 47“52 spinal cord 107, 110“11
knee joint 135, 136
gastrointestinal tract 155“6 reverberation artifact 7 blood supply 112
neuroimaging of infants 153“4 liver imaging 42 rhomboid muscles 116 meninges 111“12
spinal anatomy 154 lower limb 129 ribs 29 spinal nerves 107, 111
pelvic brim 129“30 pediatric abdomen 155“6 attachment 109“10 spine
fetal examination 148, 150
pelvic ¬‚oor 60 pediatric bone 157“8 ring down artifact 7
shoulder 116, 117
pelvic outlet 130 rotator cuff 114, 115 pediatric anatomy 154
pelvic recesses 45 upper limb 113 muscle innervation 126 see also vertebral column
pelvic ring 130 vertebral column 105 splanchnic plexus 52
spleen, fetal 150, 151
pelvic viscera 52“9 pleura 24“5 sacral canal 129
pelvicalyceal systems 47 polythelia 31 sacral plexus 63 splenic ¬‚exure 40, 41
pelvimetry 132 pons 70 sacroiliac joints 130 splenic vessels 43
popliteal artery 142, 143
pelvis sacroiliac ligament 130 spongy urethra 53
popliteal vein 143, 144 sacrum 129, 130, 132
arteriogram 62 stapedius muscle 88
blood supply 62 portal vein 43 salivary glands 96 stapes 87, 88
bony 129“30 portosystemic anastomoses 43 saphenous nerve 145 sternoclavicular joint 114“15
saphenous veins 143, 144
imaging 131“2 positron emission tomography sternum 29
lymphatics 62“3 (PET) 15“16 sartorius muscle 132 stomach
scaphoid bone 126
muscles 59“60 CT 16 anatomy 37“8
ossi¬cation 130 pouch of Douglas 45, 46 scapula 113“14, 115 fetal 150
pediatric imaging 157 power Doppler ultrasound 7 sciatic nerve 63, 144 pediatric imaging 156
pelviureteric junction (PUJ) 49, 50 pre-aortic lymph nodes 63 sclera 83 styloid process 118
penis 56 pregnancy, breast 32 scoliosis, spinal pediatric imaging 154 subacromial“subdeltoid bursa 116
percutaneous transhepatic primitive aortae 27 scrotum 55, 56 subarachnoid space 76, 112
profunda femoris artery 142,
cholangiogram (PTC) 42 sella turcica 73 subclavian artery 37
semicircular canals 86, 88, 89
perforating arteries 78 subclavian vein 28, 102, 104
143
prostate gland 53, 54“5
perianal abscess 42 semimembranosus muscle 134 subhepatic space 45
seminal vesicles 53, 55
pericardium 27 prostatic urethra 53 subiculum 76
perilymph 88 protons, MRI 11, 12 semitendinosus muscle 134 sublingual gland 96
perinephric fascia 47, 48 psoas muscle 59, 63 serratus anterior muscle 116 submandibular gland 96
perinephric fat 47, 48 pterygopalatine fossa 82 sex organs, pediatric imaging 157 subphrenic space 45
imaging 91, 92“3
perineum 60 short tau inversion time (STIR) subtalar joint 140“1
pubis 129, 130 superior mesenteric artery 39, 40,
periorbita 82 sequences 12, 13
41, 44, 60, 61
periosteum 68 pulmonary arteries 28“9 shoulder 113“17
perisellar region 73 fetal 149 bursae 116 superior mesenteric vein 44
peritoneal cavity 44“5 pulmonary veins 29 girdle 113 superior vena cava 27
imaging 115, 116“17, 128
peritoneal spaces 44“5 pyloric stenosis 156 suprapatellar bursa 135
musculature 116 suprasellar cistern 73, 74
peritoneum 38, 40, 43, 44“5, 57 pylorus 38

163
Index


supraspinatus tendon 115 triceps muscle 118 pelvis 132 vertebral bodies 106
Sylvian ¬ssure 74 attachment 114 penis 56 vertebral canal 107
sympathetic plexus 63 trigeminal (¬fth) cranial nerve 72, prostate gland 55 vertebral column 105“10
cervical 108, 109
symphysis pubis 56, 130, 132 re¬‚ection 6
84, 90
trochlea 119, 119“20 renal tract 47 curves 106
fetal examination 148, 150
talocalcaneal joint 140 trochlear (fourth) cranial nerve 72, 83 shoulder 115
talo¬bular ligament 138 tunica albuginea 55, 56 small bowel 39 imaging 105“7
talus 138, 139 ligaments 107, 108
turbo spin echo imaging 13 spinal anatomy of neonates
technetium 99m 15, 16, 129 tympani muscle, tensor 88 lumbar 110
154
technology of imaging 1“16 tympanic cavity 86“8 spleen 43 pediatric anatomy 154
tectum 71 tympanic membrane 86, 87 testis 56 thoracic 109“10
temporal bone 69 tissue harmonics 6 vesico-ureteric junction 49, 50
temporal lobe 74, 76 transabdominal 55, 146, 147
ulna 118“19 vestibular aqueduct 88
ulnar artery 125, 127
temporomandibular joint (TMJ) 94 transrectal 55 vestibule 88
transvaginal 146, 147
Tenon™s capsule 83 ulnar collateral ligament 121 vestibulocochlear (eighth) cranial
tensor fascia lata muscle 132 ulnar nerve 127“8 upper limb 113 nerve 72, 89, 90
tensor tympani muscle 88 ultrasound 5“7 uterus 58 vestibulocochlear organ 88“9
vidian canal 97
tentorium cerebelli 76 abdominal aorta 61 vagina 58
teres major muscle 116 abdominal lymphatic system 63 wrist 124 virtual endoscopy 9
vocal cords/folds 99, 100
terminal ductal lobular unit (TDLU) absorption 6 ultrasound transducers 6
umbilical arteries 151, 152, 155
adrenal glands 52
31
testicular vessels 56 advantages 7 catheter 155 windowing 17, 21
umbilical cord 150, 151, 152
testis 55“6 anal canal 42 wrist joint 119, 124
umbilical vein 150, 151, 155 imaging 122, 124, 125
thalamus 72 ankle 141
pediatric imaging 154 artifacts 7 catheter 155 median nerve 127
thigh 132“4 attenuation 6 ureters 47, 49 radial nerve 126
thin ¬lm transistor (TFT) detectors bladder 53 fetal 150 ulnar nerve 128
breast 34 intravenous urography 50
3
thoracic arteries 125 carotid bifurcation 102 urethra xiphoid process 29
thoracic cage 29“30 colon 41 female 53 X-ray tube 1“2
sympathetic ganglia 30 contrast enhancing agents 7 fetal 150 X-rays 1“5
thoracic duct 29, 37, 63, 102 epididymis 56 male 53 contrast enhancing agents 4, 18,
thoracic nerves 30, 125 esophagus 37 urinary tract 47 20
thoracic spine 109“10 female genital tract 58 contrast studies 20 conventional tomography 4“5
thoracic vertebrae 29“30 foot 141 see also intravenous urography detection 2
thorax, fetal 148“9, 151 gall bladder 43 urogenital triangle, anterior 60 elbow 121
thyroid cartilage 98, 99 hand 124 uterine artery 57, 58 ¬lm 2
thyroid gland 101 hip joint 132 uterine ligaments 57 generation 1“2
tibia 136, 137 image display 6 uterus 57“9 hand 124
plafond 138 image formation 6 hip joint 131“2
tibial arteries 142, 143 image interpretation 17“18, 19, 20
inferior vena cava 62 vagina 56“7
kidneys 50, 51 transvaginal scanning 146, 147
tibial nerve 144“5 image production 2
tibialis anterior muscle 137 knee joint 136 vaginal vessels 57 interaction 2
tibialis posterior muscle 138 limitations 7 vagus (tenth) cranial nerve 72 liver imaging 42
tibio-femoral joint space 135 liver 42 vas deferens 56 pelvis 131“2
tibio¬bular joints 136“7 lower limb 129 venography, upper limb 113 production 2
tissue harmonics 6 neuroimaging of infants 153“4 ventricles 27 spinal pediatric imaging 154
obstetric 146, 147
trachea 25 vertebrae 106, 107 technology 1“2
cervical 108, 109, 154 wrist 122, 124, 125
transabdominal scanning 55, 146, ovaries 58
147 lumbar 110, 154
pancreas 44 see also chest radiographs;
transvaginal scanning 146, 147 pediatric bone 157 thoracic 29“30, 109“10 computed tomography (CT);
transversus abdominis muscle 59 pediatric liver 156 vertebral arteries 64, 78, 103, 108, plain radiography
109
trapezius muscle 116 pediatric sex organs 157
yolk sac visualization 146, 147
triangular ¬brocartilage 124 pediatric stomach 156 cannulation 67




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