Imaging of

gastrointestinal tract

MUDr. Jiří Beneš, Ph.D.

Main imaging modalities

• X-ray

– plain abdominal x-ray

– x-ray with contrast matter (fluoroscopy)

– CT

• non-X-ray

– ultrasound

– magnetic resonance

• Optical

– endoscopy (gastroscopy, coloscopy, laparscopy)

Plain abdominal x-ray

Caudal end

of the liver

Caekum

Colon transversumLienal flexure

Colon descendens

Three layers of

abdominal wall

muscles

Psoas line

Rim of the liver

Cékum

Caudal polus

of right kidney

Lienal flexure

Colon descendens

Psoas line

Pozitiv vs. negativ contrast

Esophagus x-ray

Hypofarynx

Esoph.

Trachea

Valecula

epiglotica

Piriform.

recesus

Epiglotis

Esophagus

Laryngeal dyphagia

Stomach

Small intestine

Cékum

Ascendens

Hepatal

flexure

Lienal

flexure

Descendens

Sigmoid

Rektum

Transversum

Irrigography

Practical example, what CT can do

+ a bit of anatomy

Right hepatic lobe

Left hepatic lobeLig. teres hepatis

Branching of v.portae

Vena cava inf. Aorta abdominalis

Crus (diaphragm) Suprarenal gl. sin.

Upper pole of left kidney

Spleen

Vena lienalis

Lienal flexure

Stomach

Right hepatic lobe

Left hepatic lobeLig. teres hepatis

V.portae

Vena cava inf. Aorta abdominalis

Crus (diaphragm) Suprarenal gl. sin.

Left kidney

Lienal flexure

Stomach

Spleen

Pankreas (cauda)

ductus

choledochus

Right hepatic lobe

Left hepatic lobe

Upper pole of

right kidney

Suprarenal gl. dx.

Vena cava inf. Aorta abdominalis

Left kidney

Lienal flexure

Pylorus

Spleen

Pankreas (cauda)

Gallblader

Bulbus duodeni

Pankreas (corpus)

V.portae

Right hepatic lobe

Left hepatic lobe

Right kidney

Suprarenal gl.dx

Vena cava inferiorAorta abdominalis

Levá ledvina

Lienal flexure

Pylorus

Slezina

Pankreas (cauda)

Žlučník

Bulbus duodeni

Pankreas (corpus)

v.portae

Right hepatic lobe

Caput pancreatis

A.mesenterica sup.

Left kidney

colon

descendens

Pylorus

Spleen

Jejunum

Gallblader

V. lienalis

V.mesenterica

superior

Right kidney Vena cava inf. Aorta abdominalis

Right hepatic lobe

Pancreas

(proc.uncinatus)

Left kidney

Colon

descendens

Colon transversum

v.renalis sin.

Jejunum

Hepatal

flexure

A.mesenterica sup

V.mesenterica

superior

Right kidney Vena cava inf. Aorta abdominalis

Pars descendens

duodeni

Left kidney

Colon

descendens

M.psoas major

Colon

ascendens

Right kidney Vena cava inferiorAorta abdominalis

Small intestine

Colon

descendens

Cekum

M.psoas major Vena cava inferioraa.iliacae communes

Small intest.

Colon

sigmoideumRight ovary

Left ovary

M.iliopsoas Vasa iliaca

externa

Rectum

Ligamentum

teres uteriUterus

M.iliopsoas Vasa iliaca

externa

Douglas space (small

amount of fluid here)

Rectum

Vagina

Bladder

M.psoas

major

Cékum

Right

hepatic lobe

Vena portae

Tenké střevo

Vena cava

inferior

Right ovary

Uterus

Bladder

Stomach

Pankreas

Jejunum

Aorta

abdominalis

Colon

descendens

Colon

sigmoideum

A.hepatica

comm.

A.hepatica

propria

A.gastroduodenali

s

A. lienalis

AMS

AMI

A.hepatica

propria

A.gastroduodenali

s

A. lienalis

AMS

AMI

A.lumbalis

Endoskopical methods

Gastroscopy

Endoscopical retrograde

cholangiopankreatikography (ERCP)

Koloscopy

In the hands of gastroenterologists

(internal medicine)

Gastroscopy

https://www.youtube.com/watch?v=DUVDKoKSEk

U

ERCP

Endoskopical retrograde

cholangiopankreatikography

Kolo(no)scopy

https://www.youtube.com/watch?v=6kg5wZQfA

DQ

Laparoscopy

In the hands of surgeons

Abdominal surgery using endoscopical methods

Anatomy of abdominal cavity via

laparoscopy

https://www.youtube.com/watch?v=4MttrlyaxUE