CT Chest and Abdomen for Beginners

Arcot Chandrasekhar, M.D.

Hema Chandrasekhar, M.D.

Recommended way to use presentation:

• Use it as a slide show.• Decide on one structure and follow the sequence,

example aorta.• Next attempt to see its relationship to other structures.• Study it multiple times until you are comfortable in

identifying each structure.• When in doubt, follow the structure above and below and

it will become evident.

Exercises: First go through the entire sequence.

1. Follow axillary vein to superior vena cava entering right atrium.

2. Follow iliac veins to inferior vena cava entering right atrium.

3. Follow splenic vein to portal vein.

4. Follow aorta originating from LV to bifurcation to common iliac arteries.

5. Follow esophagus to rectum.

6. Follow trachea to RUL bronchus.

7. Follow SVC to RA to RV to main pulmonary artery and branches.

Focus on one structure and use the pg up/pg down option to follow it.

At the level of

Trachea

Contrast in axillary vein

Thyroid cartilage

Contrast is injected in the right antecubital vein.Follow the contrast in the next few slides.

Clavicle

Humerus

Scapula

Cervical spine

Pectoralis major

Supraspinatus

AC joint

Thyroid Gland

Thyroid gland

First rib

First rib

Apex of lung

Medial end of clavicle

Left

Rt common carotid artery

Rt subclavian artery

Subclavian vein

Right

The subclavian vein joins the internal jugular vein to form the brachiocephalic vein behind the medial end of clavicle.

Left common carotid arteryLeft subclavian artery

The brachiocephalic vein is also called the innominate vein.

Sternum

Left brachiocephalic vein

Innominate vein

Because contrast was injected on the right side there is no visible contrast in left brachiocephalic vein.

Brachiocephalic artery

Left

ABC

A: Brachiocephalic arteryB: Left common carotid arteryC: Left subclavian artery

See how the left brachiocephalic vein is joining the right brachiocephalic vein to become the superior vena cava.

Contrast in the right brachiocephalic vein has been diluted by blood from the left brachiocephalic vein as they combine to form the SVC.

Arch of aortaAortic arch

SVC

Mediastinal fat

Scapula

Ascending aorta

Descending aorta

Main pulmonary artery

Esophagus

Azygous vein

Contrast in SVC is diluted by blood from the azygous vein.

Left pulmonary artery

Carina

Right pulmonary artery

RUL bronchus

Main pulmonary artery

Left pulmonary artery

Left main bronchus

LUL divisionIntermediate bronchus

SVC

Ascending aorta

Rt atrium

Rt ventricle

Lt atrium

Pulmonary vein

RA

RV

LVLA

A

A: Aortic root

Aortic valve

Lt ventricle

Rt ventricle

Interventricular septum

Osteophyte

IVC

Liver

Heart

Esophagus

GE junction

Stomach

Liver

Spleen

Stomach

Lt lobe

Rt lobe

Fissure for ligamentum teres

Fissure for ligamentum venosum

Caudate lobe

Diaphragm

Caudate lobe

Diaphragm

Portal vein

Lt adrenal

Rt adrenal

Portal vein

Surgical clips in gallbladder fossa.

Coeliac trunk

Pancreas

Splenic vein

The splenic vein lies in the posterior pancreatic grove and joins the superior mesenteric vein to form the portal vein.

Duodenal bulb

Pancreas

Rt renal artery

IVC

The right renal artery is retrocaval.

Small cyst in the left kidney.

Lt renal vein

IVC

Left renal vein emptying into the IVC.

Transverse colon

Ileum

KidneyKidney

Right

Descending colon

Right

Renal pelvis

Ascending colon

Right colon with fecal material.

Abdominal aorta about to bifurcate.

Psoas

Rt common iliac artery

Lt common iliac arteryIVC

L5

Left

Arrows are pointing to the common iliac veins joining to form the IVC.

Sacrum

Ilium

Arrows are pointing to the internal and external iliac veins joining to form the common iliac vein.

Sacrum

Ilium

Rectosigmoid

Sacroiliac joint

Diverticula in recto sigmoid

Rectosigmoid

Arrows are pointing to air filled diverticulum and the second one is filled with residual barium from an old GI study.

Gluteus

Seminal vesicle Rectum

Bladder

Femoral artery

Femoral vein

Bladder

ProstateRectum

Femoral head

Acetabulum

Feces in the rectum

Pubic symphysis

Ischiorectal fossa

Shaft of penis

Femur