Contents

Foreword to the First Edition by R.H. Marshak xi

Foreword to the First Edition by L.M. Nyhus xiii

1 General Considerations: Dynamics of Image Analysis 1

Normal Anatomic Relationships and Dynamic Principles of Pathways of Spread and Localization of Disease 1

2 Clinical Embryology of the Abdomen: Normal and Pathologic Anatomy 9

Bruce R. Javors, M.D., Hiromu Mori, M.D., Morton A. Meyers, M.D., and Ronald H. Wachsberg, M.D.

Early Development of the Embryo, 9

Embryologic Rotation and Fixation of Gut 13

Ectopic and Accessory Gallbladders 23

Hepatic Duct Diverticulum 25

Aneurysmal Dilation of the Portal Vein 31

Pancreatic Arteriovenous Malformation 36

3 Intraperitoneal Spread of Infections 57

Detailed Anatomy of the Right Upper Quadrant 59

The Spread and Localization of Intraperitoneal Abscesses 79

The Sectional and Isotopic Imaging Modalities 118

4 Intraperitoneal Spread of Malignancies 131

Direct Invasion from Noncontiguous Primary Tumors 132

Invasion Along Mesenteric Reflections 132

Invasion by Lymphatic Permeation 166

Developments and Advances in Imaging 233

Bronchogenic Carcinoma 245

5 Staging of Gastrointestinal Cancers 265

Delineation of Normal Mural Components by Sectional Imaging 270

6 Pathways of Lymph Node Metastases in Cancer of the Gastrointestinal and

Chusilp Charnsangavej, M.D.

Peritoneal Ligaments of the Liver 288

Peritoneal Ligaments of the Stomach 288

Lymphatic Drainage of the Liver and Pathways of Lymph Node Metastasis 289

Lymphatic Drainage of the Stomach and Pathways of Lymph Node Metastasis 292

Lymphatic Drainage of the Colon and Pathways of Lymph Node Metastasis 300

7 Manifestations of Intraperitoneal Air 309

Depiction of Ligaments Protruding into the Peritoneal Cavity 310

Visualization of the Peritoneal Surface of Intraabdominal Organs 316

Detection of Free Air Confined in Specific Peritoneal Recesses 319

Recognition of Free Air Superimposed on the Liver 326

References 330

8 The Extraperitoneal Spaces: Normal and Pathologic Anatomy 333

The Three Extraperitoneal Compartments and Perirenal Fasciae 334

Roentgen Anatomy of Distribution and Localization of Collections 356

Sources of Effusions 357

Compartmentalization of the Anterior Pararenal Space 396

Maarten S. van Leeuwen, M.D., and Michiel A.M. Feldberg, M.D.

Normal Imaging Features 402

Roentgen Anatomy of Distribution and Localization of Collections 409

Roentgen Anatomy of Distribution and Localization of Collections 451

Extraperitoneal Gas of Supradiaphragmatic Origin 467

Differential Diagnosis of Small Amounts of Supradiaphragmatic Gas 471

The Extraperitoneal Paravesical Pelvic Spaces 477

Catherine Roy, M.D.

Abnormal Imaging Features 480

9 The Renointestinal Relationships: Normal and Pathologic Anatomy 493

Characteristic Mass Displacements 496

Invasive Renal Cell Carcinoma 505

Perinephritis and Renointestinal Fistulas 505

Direct Intestinal Effects Unique to Renal Ectopia 532

10 The Duodenocolic Relationships: Normal and Pathologic Anatomy 539

Anatomic and Normal Radiologic Features 539

Defect of Mesocolon with Internal Herniation into Lesser Sac 544

Masses Within the Mesocolic Leaves 544

Effect upon the Descending Duodenum by Carcinoma of the Hepatic Flexure 546

Effect of Gallbladder Disease on the Duodenocolic Relationships 549

Duodenocolic Displacements from Right Renal Masses 560

Effect on Colon of Mass Arising in Descending Duodenum 560

Inframesocolic Extension of Neoplasm of Third Duodenum 560

Duodenojejunal Junction: Relation to Colon 561

11 Intestinal Effects of Pancreatitis: Spread Along Mesenteric Planes 565

Effects of Pancreatitis on the Colon: Spread Along the Transverse Mesocolon 569

Transverse Colon and Splenic Flexure 569

Effects of Pancreatitis on the Duodenum, Small Bowel, and Cecum: Spread Along Small Bowel Mesentery 584

12 Pathways of Regional Spread in Pancreatic Cancer 595

Chusilp Charnsangavej, M.D.

CT Anatomy of the Pancreatic Head 598

Pathways of Regional Spread in Pancreatic Cancer 599

13 The Subperitoneal Space: Normal and Pathologic Anatomy 607

Michael Oliphant, M.D., Alfred S. Berne, M.D., and Morton A. Meyers, M.D.

Dorsal Mesentery Derivatives 612

14 The Small Bowel: Normal and Pathologic Anatomy 635

Axis of the Root of the Small Bowel Mesentery 636

Undulating Changeable Nature of Coils of Bowel Loops 636

Identification of Mesenteric and Antimesenteric Borders of Small Bowel Loops 640

Diverticulosis of the Small Intestine 644

Intramural and Mesenteric Bleeding 657

15 The Colon: Normal and Pathologic Anatomy 665

Classification of Organization of Haustral Rows 669

Lesions Within the Gastrocolic Ligament 675

Lesions Within the Transverse Mesocolon 681

Distinction Between Intraperitoneal and Extraperitoneal Processes 683

Diverticulosis and Diverticulitis 692

16 Internal Abdominal Hernias 711

Anatomic Considerations 712

Radiologic and Arteriographic Features 713

Internal Hernias Through the Foramen of Winslow 731

Transmesenteric and Transmesocolic Hernias 739

Hernias Through the Falciform Ligament 744

17 Pathways of Extrapelvic Spread of Disease 749

Index 763

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