This document provides an overview of topographic anatomy and its correlation with MRI/CT imaging. It begins with introductory sections on relevant anatomy. The majority of the document consists of clinical cases presented with accompanying MRI/CT images and diagnoses. Cases include a variety of pulmonary, cardiac, hepatic, pancreatic and splenic pathologies such as lung cancer, empyema, liver abscess, hepatocellular carcinoma, pancreatic cancer and splenic lymphoma. Each case provides brief patient history and physical exam findings along with labeled MRI/CT images and diagnoses. The document concludes with references.
12. A 58-year-old man presents with a 2-week
history of progressive dyspnea on exertion,
neck swelling, decreased appetite, and
fatigue.
There is no history of syncope or dysphagia.
He smoked cigarettes until 5 years ago.
The physical examination reveals superficial
vascular distention over the neck.
12
15. Contrast enhanced axial CT thorax showing
the right lobe tumor together with
paratracheal lymphadenopathy. There is
tumor which has invaded into the superior
vena cava (arrow)
15
17. Axial CT of the lung
showing a left
pulmonary nodule
(arrow) with
spiculated margins
indicating its
infiltrative malignant
nature.
17
18. A 65-year-old man presents with history of
prolonged fever and left-sided chest pain
He has past history of productive cough,
acute dyspnea and acute fever over a month
ago
The physical examination reveals decrease
breath sound of left lung, increase tractile left
right lung.
18
25. Oval or spherical
discrete nodules
Solitary or multiple
Well-defined, smooth
or irregular outlines
Soft-tissue density
Pulmonary vessels
leading to
metastases (“afferent
vessel sign”)
25
27. A 30-year-old women presents at emergency
room with sudden severe retrosternal chest
pain after forceful vomiting
Physical examination reveals dyspnea,
subcutaneous emphysema.
27
30. Axial NECT
through the root
of the thoracic
inlet shows gas
(arrows)
insinuating
between the neck
vessels.
T=trachea,
A=common
carotid artery,
V=jugular vein,
E=esophagus.
30
32. A 48-year-old man presents with a history of
progressive dysphagia, hoarseness of voice,
weight loss and shortness of breath.
He heavily smoked cigarettes until 1 years
ago.
The physical examination reveals cachectic
appearance, supraclavicular lymph nodes
enlargement.
32
35. Contrast enhanced axial CT images show a
large circumferential tumor in the esophagus
(arrows) with narrowing of the lumen at the
aortopulmonary (b) and subcarinal (c) level.
The tumour compresses on the posterior
aspect of the trachea and carina with
narrowing of the right and left main bronchi
(arrowheads).
35
49. A 45-year-old man presents with a 2-week
history of prolonged fever, loss of appetite,
RUQ abdominal pain
The physical examination reveals tender
hepatomegaly
49
52. Contrast enhanced
axial computed
tomography (CT)
shows a large left
lobe hepatic
abscess (arrows) as
a multiloculated
hypodense lesion
with septations.
52
54. A 55-year-old man presents with decreased
appetite, weight loss, and fatigue.
History of heavy alcohol drinking
The physical examination reveals jaundice
and abdominal distension
54
57. Contrast enhanced axial
computed tomography
shows enhancement of
a small hepatocellular
carcinoma (arrows). It
shows increased
enhancement
(hypervascular) on the
arterial phase and
decreased enhancement
(compared with the rest
of the liver) on the
portal venous phase.
57
59. axial enhanced CT in
the portal phase
demonstrates
1. peripheral
nodularity of hepatic
parenchyma
2. splenomegaly
3. spontaneous shunt
between the left portal
(arrow) and
paraumbilical veins
(arrowhead)
59
60. Contrast enhanced axial
computed tomography
showing multiple hepatic
metastases as
hypodense, poorly
enhancing lesions
(arrowheads). Note the
right pleural effusion
(asterisk) and ascites
(arrows). Mass lesion in
the right adrenal gland
(open arrow) represents
another site of
metastasis.
60
61. A 55-year-old man presents with progressive
jaundice.
He also has past history of anorexia, malaise
and significant weight loss
The physical examination reveals jaundice.
Laboratory results reveals direct
hyperbilirubinemia and high level of CA19-9.
61
64. Contrast enhanced axial
computed tomography
(CT) shows a hypodense
tumour in pancreatic
head (arrow). The rest of
the pancreas appears
normal (open arrows).
Note the presence of
biliary stent (arrowhead)
which was inserted to
relieve common bile
duct obstruction by the
tumour. However, the
gallbladder (asterisk)
remains distended.
64
67. A 50-year-old man presents with abdominal
discomfort.
He also has past history of anemia, malaise
and weight loss
The physical examination reveals
splenomegaly.
67