Physical Address

304 North Cardinal St.
Dorchester Center, MA 02124

Anatomic and Physiologic Relationships Within the Abdominopelvic Cavity

Objectives On completion of this chapter, you should be able to : Define and use terms for anatomic directions Discuss the body systems and their functions Know the terms for the body planes Describe and locate the abdominal quadrants and regions List the organs located in each major body cavity Identify and locate the abdominal viscera and other abdominal structures and spaces Key Terms Acidic Acidosis…

Ergonomics and Musculoskeletal Issues in Sonography

Objectives On completion of this chapter, you should be able to: Discuss the history of work-related musculoskeletal disorders in sonography Define Occupational Safety and Health Administration and discuss its role in sonography Define common types of work-related injury for sonographers and know what causes them Describe and apply “best practices” in sonography Outline the costs of occupational injury to yourself and your employer Discuss the ultrasound…

Essentials of Patient Care for the Sonographer

Objectives On completion of this chapter, the reader should be able to: Discuss nonscanning aspects of being a sonographer Define patient-centered care Describe patient transfer techniques Demonstrate proper placement of a blood pressure cuff on the arm Discuss the importance of proper disinfection of the transducer and ultrasound equipment Discuss Spaulding’s classification system and how it relates to ultrasound List various types of patient isolation Key…

Foundations of Clinical Sonography

Objectives On completion of this chapter, you should be able to: Describe the role of the sonographer and the career path Know the historical developments in medical ultrasound List the basic principles and terminology of medical ultrasound Identify the transducers necessary for specific ultrasound applications Explain the multiple display modes on ultrasound instrumentation State the Doppler effect Key Terms AbsorptionAcoustic impedance Aliasing Amplitude Angle of incidence…

Neurointerventional Radiology for Skull Base Lesions

In this chapter, we discuss the embolization of the most common hypervascular tumors and vascular lesions occurring at the skull base (i.e., the juvenile angiofibromas [JAFs], paragangliomas [PGLs], dural arteriovenous fistula [DAVF], and traumatic carotid-cavernous fistula [CCF]). Other rare diseases such as orbital arteriovenous malformation and aneurysm at the foramen magnum are not included. We provide an introduction to the pathogenesis of these diseases, the current…

Skull Base Bone Lesions II: Benign and Malignant Tumors

Introduction Most tumors affecting the skull base result from hematogenous spread of primary malignancies outside the skull base (hematogenous bone metastases) or from direct invasion or perineural spread of neoplasms arising from neighboring structures of the suprahyoid neck. As the skull base provides a frontier between the intracranial compartment and the extracranial head and neck, the first and most important issue in the differential diagnosis of…

Skull Base Bone Lesions I: Imaging Technique, Developmental and Diffuse Bone Lesions

Introduction The skull base is a bony-cartilaginous structure, oriented in the axial plane, providing a barrier between the intracranial compartment and the extracranial head and neck. It is pierced by several neurovascular foramina, which provide a crossroad for disease to spread between these two compartments. Most tumors affecting the skull base have their origin outside the skull base proper, mainly from the suprahyoid neck, and secondarily…

Imaging of the Craniovertebral Junction

The craniovertebral junction (CVJ) supports the head and enables its flexion and rotation in three dimensions. It has a complex anatomic structure consisting of the vertebral column, paraspinal soft tissue, ligaments, and joints between the clivus, occipital bone, foramen magnum, atlas (C1), and axis (C2). In this chapter, we emphasize and discuss mainly on CVJ disorders with clinical significance. Embryology and Congenital Anomalies Embryonic development of…

Jugular Foramen

The jugular foramen is a complex bony canal containing neurovascular structures deep in the skull base. It is inaccessible to direct clinical examination and difficult to access surgically because of the surrounding critical structures. Radiology plays a central role in the diagnostic evaluation and management planning of jugular foramen lesions. Consequently, it is important to comprehend the normal anatomy of the jugular foramen, as well as…

Imaging of the Cerebellopontine Angle

Introduction The cerebellopontine angle (CPA) cistern is a subarachnoid space within the posterior cranial fossa. About 6%–10% of all intracranial masses are found in this location. Vestibular schwannomas (VSs) are the most commonly encountered lesion in the CPA, followed by meningiomas. Together these masses account for 85%–90% of all CPA tumors. Other less common entities comprise the remaining 15% of lesions, and although encountered less frequently,…

Petrous Apex

Introduction The petrous apex is the most medial portion of the temporal bone. Its deep location precludes direct clinical examination and safe percutaneous biopsy. In addition, many of the petrous apex lesions are asymptomatic or present with nonspecific symptoms such as headache, making it harder to justify an invasive procedure for diagnostic purposes. Therefore, the referring physician primarily relies upon imaging for the evaluation of petrous…

Imaging of the Postoperative Middle Ear, Mastoid, and Internal Auditory Canal

Introduction Interpretation of CT or MR imaging examinations performed on patients with a history of middle ear (ME), mastoid, or neurotologic surgery can be challenging. This is greatly simplified by knowing the surgical procedures used and the expected postoperative appearance. Knowledge of the normal postoperative appearance and the current clinical situation is the key to recognizing recurrent disease. The goal of surgery in the ME, mastoid,…

Imaging of the Facial Nerve

Anatomy The facial nerve comprises motor, sensory, and parasympathetic fibers. The dominant motor component comprises 70% of the total axons. The sensory component makes up much of the remaining portion of the nerve and includes the nervus intermedius (nerve of Wrisberg). The motor division supplies somatic motor fibers to the muscles of the face, scalp, and auricle; the buccinators; the platysma; the stapedius; the stylohyoideus; and…

Update on Imaging of Hearing Loss

Disclosure Disclosure of any relationship with a commercial company that has a direct financial interest in subject matter or materials discussed in article or with a company making a competing product. Introduction In the imaging evaluation of hearing loss, the radiologic examination is complementary to the physical examination. The clinical evaluation includes not only an accurate history of the hearing loss itself (unilateral or bilateral, slow…

Temporal Bone Trauma

Temporal Bone Pseudofractures—Fracture Mimics An important challenge in detecting and classifying temporal bone fractures is the inherent complexity of the temporal bone anatomy. Although the evaluation of symmetry is helpful to distinguish normal anatomy from acute injury, temporal bone sutures or fissures and canals can still be wrongly interpreted as fractures. The temporal bone has a complex structure. It is a part of the lateral wall…

Temporal Bone Tumors

Introduction This chapter presents an overview of tumoral lesions of the temporal bone. These lesions can be considered to be rather rare. Imaging plays a crucial role in describing the exact extent of these tumors and can be helpful in specifying some of these lesions. Classification of temporal bone tumors can be done in various ways. It can be based on the location and origin, age…

Temporal Bone Inflammatory and Infectious Diseases

Acknowledgments I thank Nancy Verpoort who spent a considerable amount of time editing the figures and texts. Introduction In a wide variety of inflammatory and infectious diseases of the temporal bone, imaging studies are used to determine the extent of the disease and to visualize eventual complications. Imaging protocols for the evaluation of infections in the external ear, the middle ear (and mastoid), and the inner…

Imaging in Endoscopic Endonasal Skull Base Surgery

Introduction The endoscopic endonasal approach has become the preferred surgical approach to many tumors of the ventral skull base, both benign and malignant. Although advances in surgical equipment and technique have played a role in the development, imaging remains one of the cornerstones to the endoscopic endonasal approach, playing an important role in the diagnosis from the preoperative planning stage to intraoperative navigation, postoperative complications, and…

The Sphenoid Bone

The sphenoid bone is located at the central skull base and is commonly considered the most complex bone in the human body. Although the sphenoid bone is often neglected in relation to the adjacent temporal bone, it forms the major boundary between the intra- and extracranial structures. The various sphenoid foramina to the orbits anteriorly and neck spaces inferiorly are pathways for transmission of disease. This…

Imaging of the Paranasal Sinuses and Their Surgical Relevance

One of the earliest computed tomography (CT) evaluations of the paranasal sinuses was published by Hesselink et al. in 1978 as a two-part series: describing both normal and pathologic anatomy. Early CT studies were performed only in the axial and coronal planes, but with the availability of multiplanar high-resolution CT, more complex imaging anatomy and anatomic variations have been documented. As such, preoperative CT has gained favor…