CT of The Abdomen

Chapter
20
CT of the Abdomen
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CT OF THE ABDOMEN: AXIAL
AXIAL
Figure 20.1.1
Left
hepatic v
Esophagus
Rectus
abdominis m Heart
Costal
cartilage
Middle
hepatic v
Aorta
Inferior
vena cava
Stomach
Rib
Spleen
Right
hepatic v
Serratus
anterior m
Right lung
Latissimus
dorsi m
Iliocostalis m
Longissimus Multifidus m Intercostal

dorsi m
vessels
Figure 20.1.2
Liver, left
medial superior
subsegment
(segment IVa)
Left portal v,
umbilical
Left
portion
hepatic a
Left lung
artery =
arteries =
vein =
veins =
muscle =
muscles =
tendon =
tendons =
nerve =
nerves =
ligament =
ligaments =
a
aa
v
vv
m
mm
t
tt
n
nn
lig
ligs
Liver, left
lateral inferior
subsegment
(segment III)
Left portal v
(p III)
Left hepatic v
Middle
hepatic v
Liver, right
portal v
(p VIII)
Liver, left lateral

superior
subsegment
(segment II)
Right anterior
superior
subsegment
(segment VIII)
Left portal v
(p II)
Stomach
Right
hepatic v
Ligamentum
venosum,
fissure
Inferior vena
cava
Liver caudate
lobe (segment I)
Right posterior
superior
subsegment
(segment VII)
Spleen
Left lung
Right
portal v
(p VII)
Right
lung
Right Right crus of

adrenal diaphragm
gland
Aorta
487
488
Figure 20.1.3
Liver, left
medial
segment
(segment IV)
Ligamentum
teres, fissure
Liver, left
lateral inferior
subsegment
(segment III)
Left
hepatic v
Portal v,
bifurcation
Left
hepatic a
Middle hepatic v
Ligamentum
venosum,
fissure
Right portal v
(p VIII)
Stomach
Right portal v
Right hepatic v
Spleen
Liver, right
posterior
superior
subsegment
(segment VII)
Inferior vena cava
Right
adrenal
gland
Left
Crus of
Caudate Aorta
adrenal
diaphragm
lobe
gland
(segment I)
Right
portal v,
bifurcation
Figure 20.1.4
Ligamentum
Right
teres, fissure hepatic a
Left
hepatic a
Left gastric v
and
gastrohepatic lig
Middle
hepatic v
Stomach
Right portal v,
anterior branch
Right hepatic v
Origin of
celiac trunk
Spleen
Splenic v
Right portal v,
posterior branch
Left
adrenal v
Left adrenal
gland
Main portal v
Inferior
vena cava
Right
kidney,
superior
pole
Left
Right Right crus of Aorta
kidney,
adrenal diaphragm
superior
gland
pole
Figure 20.1.5
External
oblique m
Ligamentum
teres, fissure
Rectus
Linea abdominis
m
alba
Common
hepatic a
Celiac
trunk
Stomach
Right crus of
diaphragm
Main portal v
Right portal v,
anterior branch
Splenic v
Portacaval
space
Intercostal mm
Right hepatic v
Splenic v
Right portal v,
posterior
branch
Inferior vena
cava
Spleen
Left kidney,
superior pole
Right kidney,
superior pole
Iliocostalis Longissimus Multifidus Right
m
dorsi m
m
adrenal
gland
Figure 20.1.6
Falciform
ligament
Duodenum
Common
bile duct
Left
adrenal
gland
Liver, left
lateral segment
Pancreas
neck
Portal v
Stomach
body
Spleen
Gallbladder
Portal v
(p V)
Superior
mesenteric a
Right hepatic v,
branch
Stomach
fundus
Splenic v
Portal v
(p VI)
Inferior vena
cava
Right
kidney
Right crus of
diaphragm
Lumbar v
Aorta
Left
kidney
489
490
Figure 20.1.7
Splenoportal confluence
Main
Duodenum pancreatic
duct
bulb
Liver, left
medial inferior
subsegment
(segment IVb)
Liver, left lateral

inferior
subsegment Pancreas
(segment III)
body
Stomach
Gallbladder
Superior
mesenteric a
Liver, right
anterior inferior
subsegment
(segment V)
Duodenum,
second portion
Spleen
Left renal v
Splenic v
Pancreas tail
Liver, right
posterior inferior
subsegment
(segment V)
Left renal a
Left kidney
Right kidney,
renal pelvis
Right kidney,
renal cortex
Figure 20.1.8
Stomach
antrum
Inferior
vena cava
Right kidney,
renal medulla
Aorta
Quadratus
lumborum m
Right crus of
diaphragm
Superior
Superior
mesenteric mesenteric
v
a
Rectus Transversus
Stomach abdominis abdominis
m
m
body
Pancreas,
head
External
oblique m
Internal
oblique m
Spleen
Gallbladder
Colon,
hepatic flexure
Colon,
splenic flexure
Duodenum,
second portion
Small bowel,
jejunum
Right kidney
Right
renal v
Inferior
vena cava
Aorta
Lumbar v
Left
renal v
Left
kidney
Figure 20.1.9
Liver, lateral segment

Superior
mesenteric
v
Stomach Gastrocolic
trunk
antrum
Superior
Stomach mesenteric
a
body
Gallbladder
fundus
Colon,
splenic
flexure
Pancreas,
uncinate
process
Duodenum,
second portion
Jejunum
Spleen
Left renal v
Hepatic flexure
Inferior vena
cava
Left kidney
Right kidney,
renal pelvis
Figure 20.1.10
Psoas m
Aorta
Duodenum,
third portion
Left
gonadal v
Quadratus
lumborum m
Mesentery and
mesenteric
vessels
Stomach
Left gonadal v
Transverse
colon
Small bowel,
ileum
Small bowel,
jejunum
Liver
Inferior vena
cava
Descending
colon
Left kidney,
inferior pole
Ascending
colon
Latissimus
dorsi m
Right kidney,
inferior pole
Superior
lumbar
triangle
Right
gonadal v
Aorta
Iliocostalis
and
longissimus
dorsi mm
Psoas m
Quadratus
lumborum m
491
492
Figure 20.1.11
Umbilicus
Inferior mesenteric a
Transverse
colon
Small bowel,
ileum
Small bowel,
jejunum
Ascending
colon
Descending
colon
Small bowel
mesentery and
mesenteric
vessels
Right gonadal v
Latissimus
dorsi m
Inferior
vena cava
Figure 20.1.12
Aortic
bifurcation
Left
gonadal v
Left common iliac a

Rectus
abdominis m
Quadratus
lumborum m
Left gonadal v
Inferior
mesenteric a
Small bowel,
mesentery
External
oblique m
Small bowel,
ileum
Right common
iliac a
Internal
oblique m
Right gonadal v
Ascending colon
Transversus
abdominis m
Inferior
lumbar triangle
Descending
colon
Iliac crest
Small bowel,
jejunum
Psoas m
Right
common
iliac v
Multifidus m
Left
common
iliac v
Iliocostalis and
longissimus
dorsi mm
Quadratus
lumborum m
CT OF THE ABDOMEN: SAGITTAL
SAGITTAL
Figure 20.2.1
Right
ventricle
Pericardium
Left
ventricle
Stomach
Left lung
Splenic
hilum,
splenic a,
and
splenic v
Pericardial
fat
Diaphragm
Costal
cartilage
Spleen
Internal
oblique m
Pancreas,
tail
Transversus
abdominis m
Left kidney
Descending
colon
Small bowel
Small bowel
mesentery
and vessels
Quadratus
lumborum m
Rectus
abdominis m
Gluteus
medius m
Iliacus m
Figure 20.2.2
Splenic v
Right
ventricle
Ilium
Left
ventricle
Left
lung
Stomach
fundus
Rib
Pancreas,
tail
Costal
cartilage
Liver,
lateral
segment
Intercostal
vessels
and mm
Spleen
Splenic a
Latissimus
dorsi m
Stomach
body
Small bowel,
jejunum
Longissimus
dorsi m
Small bowel
mesentery
and
mesenteric
vessels
Iliocostalis m
Transverse
colon
Renal hilum, Psoas m Left Ilium

Quadratus
renal a, and renal v
kidney
lumborum m
493
494
Figure 20.2.3
Right
ventricle
Stomach
Left
ventricle
Descending
aorta
Left
lung
Gastrohepatic
lig
Intercostal
a and v
Spleen
Splenic a
Left adrenal
gland
Pancreas,
body
Splenic v
Left kidney,
superior pole
Liver,
lateral
segment
Left renal v
Stomach
antrum
Transverse
colon
Latissimus
dorsi m
Inferior
mesenteric v
Duodenum,
third portion
Iliocostalis
and
longissimus
dorsi mm
Sigmoid
colon
Psoas m
Figure 20.2.4
Gastroesophageal
junction
Descending
aorta
Accessory
hemiazygos v
Left kidney,
superior pole
Left gastric
a and v
Left renal v
Liver,
lateral
segment
Left renal a
Pancreas,
body
Stomach
antrum
Lumbar v
Left
gonadal v
Splenic
a and v
Iliocostalis
and
longissimus
dorsi mm
Transverse
colon
Psoas m
Sigmoid
colon
Rectus
abdominis m
Left common
iliac a
Duodenum,
third portion
Figure 20.2.5
Left gastric a
Splenic v
Splenic a
Right
ventricle
Median arcuate lig
Left
atrium
Diaphragm
Liver,
lateral
segment
Esophagus
Aorta
Celiac trunk
Pancreas,
body
Superior
mesenteric a
Stomach
antrum
Left renal a
Gastroepiploic
a and v
Gastrocolic
lig
Duodenum,
third portion
Transverse
colon
Iliocostalis
and
longissimus
dorsi mm
Umbilicus
Inferior
mesenteric a
Small
bowel
Figure 20.2.6
Sigmoid
Sigmoid
colon
mesocolon
Left common
iliac v
Splenic a
Left common
iliac a
Left ventricle
Sternum
Esophagus
Liver,
caudate lobe
Splenoportal
confluence
Ligamentum
venosum
Liver,
lateral
segment
Pancreas,
neck
Stomach
Gastroepiploic
a and v
Crus of
diaphragm
Left renal v
Duodenum,
third portion
Gastrocolic
lig
Aorta
Superior
mesenteric v
Iliocostalis and
longissimus
dorsi mm
Omentum and
omental
vessels
Transverse
colon
Left common
iliac v
Small
bowel
Sigmoid Small bowel

colon mesentery and
mesenteric
vessels
495
496
Figure 20.2.7
Liver, caudate lobe
Right atrium
Right lung
Left portal v
Inferior vena
cava,
suprahepatic
portion
Diaphragm
Liver,
lateral
segment
Inferior vena
cava,
hepatic portion
Common
hepatic a
Main
portal v
Crus of
diaphragm
Pancreas,
head
Common
bile duct
Right renal a
Multifidus m
Pancreas,
uncinate
process
Inferior vena
cava
Transverse
colon
Duodenum,
third portion
Small bowel
Figure 20.2.8
Right common iliac a,

bifurcation
Proper
hepatic a
Left
portal v
Main
portal v
Liver,
caudate lobe
Superior
pancreaticoduodenal v
Crus of diaphragm
Diaphragm
Left portal v,
umbilical portion
Right renal a
Left hepatic a
Longissimus
dorsi m
Gastroduodenal a
Duodenum,
third portion
Pancreas, head
Multifidus m
Rectus
abdominis m
Lumbar
vessels
Omentum and
omental vessels
Inferior vena cava
Transverse
colon
Small
bowel
Right
Right
external common
iliac v
iliac a
Figure 20.2.9
Right internal
mammary a
Left
portal v
Liver, right
anterior
segment
Right
portal v
Proper
hepatic a
Liver,
posterior
segment
Diaphragm
Right adrenal
gland
Liver,
medial
segment
Crus of
diaphragm
Ligamentum
teres
Right kidney,
superior pole
Liver,
lateral
segment
Right renal a
Pancreas,
head
Rectus
abdominis m
Right renal v
Iliocostalis m
Transverse
colon
Duodenum,
second
portion
Psoas m
Small bowel
Longissimus
dorsi m
Right
gonadal v
Figure 20.2.10
Right
lung
Liver, anterior
superior subsegment
(segment VIII)
Right portal v
Liver,
medial
segment
(segment IV)
Liver, right
posterior
superior
subsegment
(segment VII)
Right
hepatic a
Common
hepatic
duct
Crus of
diaphragm
Liver,
caudate lobe
Falciform
lig
Right kidney
Diaphragm
Right renal v
Gallbladder
neck
Renal pelvis
Duodenum,
second
portion
Iliocostalis and
longissimus
dorsi mm
Rectus
abdominis m
Small bowel
Psoas m
Inferior
epigastric
vessels
Transverse
colon
497
498
Figure 20.2.11
Liver, right anterior

superior subsegment
(segment VIII)
Right
lung
Liver, right posterior

superior subsegment
(segment VII)
Right
portal v,
posterior
branch
Gallbladder
body
Liver, right
anterior
inferior
subsegment
(segment V)
Right kidney,
renal cortex
Renal
medulla
Colon,
hepatic
flexure
Iliocostalis m
Rectus
abdominis m
Longissimus
dorsi m
Psoas m
Small bowel
Figure 20.2.12
Right portal v,
anterior branch
Liver, right anterior

superior subsegment
(segment VIII)
Right
lung
Liver, right
anterior
inferior
subsegment
(segment V)
Gallbladder
body
Liver, right
posterior
superior
subsegment
(segment VII)
Liver, right
posterior
inferior
subsegment
(segment VI)
Gallbladder
fundus
Latissimus
dorsi m
Transversus
abdominis m
Right kidney
Ascending
colon
Rectus
abdominis m
Quadratus
lumborum m
Iliac crest
CT OF THE ABDOMEN: CORONAL
CORONAL
Figure 20.3.1
Liver,
Sternum,
lateral segment xiphoid process
Costal
cartilage
Left diaphragm
Liver,
medial
segment
Right
gastroepiploic
a and v
Left gastroepiploic
a and v
Gallbladder
fundus
Falciform
lig
Omental
vessels
Small bowel
loop
Abdominal wall
(rectus
abdominis m)
and inferior
epigastric a and v
Figure 20.3.2
Liver, left portal v,

subsegmental
branches
(p IVa and p IVb)
Liver, left portal v,

subsegmental
branch
Ligamentum
Right
(p III)
teres
ventricle
Stomach
antrum
Left
gastroepiploic
a and v
Stomach body
Gallbladder
body
Gastrocolic lig
Transverse
colon
Duodenal
bulb
Small bowel,
jejunum
Omentum
External
oblique m
Sigmoid colon
Internal
oblique m
Small bowel,
ileum
Transversus
abdominis m
Small bowel mesentery
499
500
Figure 20.3.3
Liver, right lobe,
anterior superior
subsegment
(segment VIII)
Liver, left lobe,

lateral superior
Left
Left
Liver, left lobe,
subsegment
medial segment hepatic portal Right
Left
v
a
(segment IV)
ventricle (segment II) ventricle
Liver, left lobe,

lateral inferior
subsegment
(segment III)
Stomach
Liver, right lobe,

anterior inferior
subsegment
(segment IV)
Left gastric a
Transverse
colon
Gallbladder
body
Gastrocolic
trunk
Gastroduodenal a
Superior
mesenteric v
Pancreas, neck
Small bowel,
jejunum
Small bowel,
ileum
Inferior
mesenteric a
Cecum
Aortic
bifurcation
Inferior
vena cava
Figure 20.3.4
Left hepatic a
Hepatoduodenal
lig
Left
Right
Right
common common common
iliac v
iliac a
iliac v
Left common
iliac a
Liver, right lobe,

anterior superior Middle Liver, left lobe,
Left
subsegment
hepatic medial segment Right portal
(segment VIII)
v
v
(segment IV) ventricle
Left hepatic v
Left ventricle
Liver, left lobe,
lateral superior
subsegment
(segment II)
Liver, right lobe,

anterior inferior
subsegment
(segment V)
Stomach
Colon,
splenic flexure
Gallbladder
neck
Liver, left lobe,

lateral inferior
subsegment
(segment III)
Common
bile duct
Colon,
hepatic flexure
Pancreas,
body
Main portal v
Splenic a
Pancreas, head
Splenoportal
confluence
Ileocecal
valve
Small
bowel,
ileum
Pancreas, Superior
Inferior Aorta Inferior
vena cava
mesenteric uncinate mesenteric
a
process
v
Figure 20.3.5
Liver, right lobe,

anterior superior Liver, left lobe,
subsegment
medial segment
(segment VIII)
(segment IV)
Left
portal v
Common
hepatic a
Celiac trunk
Liver,
left lobe,
lateral segment
Stomach
Main portal v
Pancreas,
body
Right portal v,
anterior branch
Colon,
splenic flexure
Proper
hepatic a
Splenic a
Splenic v
Gallbladder
neck
Superior
mesenteric a
Duodenum,
second portion
Duodenum,
third portion
Pancreas, head,
and main
pancreatic duct
External
oblique m
Small bowel
Internal
oblique m
Inferior
mesenteric v
Ascending
colon
Psoas m
Figure 20.3.6
Liver, right lobe,

anterior superior
subsegment
(segment VIII)
Inferior
vena cava
Liver, left lobe,

medial segment
(segment IV)
Aorta
Descending
colon
Transversus
abdominis m
Liver,
left lobe,
lateral segment
Left diaphragm
Left gastric
a and v, and
gastrohepatic
lig
Right portal v,
anterior branch
Main portal v
Liver, right lobe,
anterior inferior
subsegment
(segment V)
Stomach
Colon,
splenic flexure
Duodenum,
second portion
Pancreas,
body
Colon,
hepatic flexure
Splenic a
Splenic v
Small bowel,
jejunum
Ascending
colon
Left renal v
Celiac
trunk
Psoas m
Inferior Superior
vena mesenteric a
cava
Aorta
Inferior
mesenteric v
501
502
Figure 20.3.7
Common
hepatic a
Superior Celiac Left

Right
mesenteric a trunk gastric a ventricle
Ligamentum
venosum
Left
ventricle
Liver,
lateral
segment
Left gastric v
Stomach
Colon,
splenic flexure
Right portal v
Duodenum,
second portion
Pancreas,
body
Splenic a
Splenic v
Colon,
hepatic flexure
Inferior
mesenteric v
Ascending
colon
External
oblique m
Internal
oblique m
Right kidney,
inferior pole
Inferior Right Aorta Left
renal v
vena renal a
cava
Figure 20.3.8
Liver, right
anterior
superior
subsegment
(segment VIII)
Middle
hepatic v
Left
Small
gonadal v bowel,
jejunum
Transversus
abdominis m
Crus of diaphragm
Liver,
caudate Right
Left
lobe
atrium
Aorta ventricle
Gastroesophageal
junction
Colon,
splenic flexure
Right portal v
(p VIII)
Pancreas,
body and tail
Inferior
vena cava
Small bowel,
jejunum
Right renal v
Left renal v
Colon,
hepatic
flexure
Left renal a
Ascending
colon
Right kidney,
inferior pole
Iliacus m
Right
renal a
L2 vertebral
body
Psoas m
Figure 20.3.9
Splenic v Splenic a
Inferior
vena cava,
suprahepatic Gastroesophageal
portion
junction
Stomach
fundus
Right portal v
(p VIII)
Short gastric
a and v
Right
hepatic v
Colon,
splenic
flexure
Liver,
posterior
segment
Small bowel,
jejunum
Right portal v,
posterior
branch
Crus of
diaphragm
Left renal v
Right kidney,
renal pelvis
Left kidney,
inferior pole
Aorta
Quadratus Pancreas,
lumborum m
tail
Figure 20.3.10
Right
adrenal
gland
L3 vertebral
body
Aorta
Left
adrenal
gland
Psoas m
Stomach
fundus
Splenic v
Short
gastric a
Liver, right
posterior superior
subsegment
(segment VII)
Splenic a
Spleen
Liver, right
posterior inferior
subsegment
(segment VI)
Pancreas, tail
Left kidney
Descending
colon
Perirenal fascia
Psoas m
Right kidney
Quadratus
lumborum m
Right crus of
diaphragm
Left crus of
diaphragm
503
504
Figure 20.3.11
Right
lung
Left
adrenal
gland
Aorta
Left
lung
Stomach
fundus
Short
gastric v
Right crus of
diaphragm
Spleen
Liver,
right lobe,
posterior
segment
Splenic v
Splenic a
Pancreas,
tail
Right adrenal
gland
Descending
colon
Right kidney
Quadratus
lumborum m
Left crus of
diaphragm
Figure 20.3.12
Left kidney,
renal medulla
Left kidney,
renal cortex
Ilium
Gluteus
medius m
Left lung
Right lung
Liver,
right lobe,
posterior
segment
Spleen
Left kidney
External
oblique m
Twelfth rib
Iliocostalis m
Spinous
process
Multifidus m
Longissimus
dorsi m

CT of The Abdomen

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Chapter

CT OF THE ABDOMEN: AXIAL

Longissimus Multifidus m Intercostal

Liver, left lateral

Right Right crus of

CT OF THE ABDOMEN: AXIAL

CT OF THE ABDOMEN: AXIAL

CT OF THE ABDOMEN: AXIAL

Liver, left lateral

CT OF THE ABDOMEN: AXIAL

Liver, lateral segment

CT OF THE ABDOMEN: AXIAL

Left common iliac a

CT OF THE ABDOMEN: SAGITTAL

Renal hilum, Psoas m Left Ilium

CT OF THE ABDOMEN: SAGITTAL

CT OF THE ABDOMEN: SAGITTAL

Median arcuate lig

Sigmoid Small bowel

CT OF THE ABDOMEN: SAGITTAL

Liver, caudate lobe

Right common iliac a,

Inferior vena cava

CT OF THE ABDOMEN: SAGITTAL

CT OF THE ABDOMEN: SAGITTAL

Liver, right anterior

Liver, right posterior

Liver, right anterior

CT OF THE ABDOMEN: CORONAL

Liver, left portal v,

Liver, left portal v,

CT OF THE ABDOMEN: CORONAL

Liver, left lobe,

Liver, left lobe,

Liver, right lobe,

Liver, right lobe,

Liver, right lobe,

Liver, left lobe,

CT OF THE ABDOMEN: CORONAL

Liver, right lobe,

Liver, right lobe,

Liver, left lobe,

CT OF THE ABDOMEN: CORONAL

Superior Celiac Left

CT OF THE ABDOMEN: CORONAL

CT OF THE ABDOMEN: CORONAL

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