Imaging Approach to Abdominal Manifestations of Systemic Conditions

(Left) Coronal volume-rendered CTA shows the entire common hepatic artery

arising from the superior mesenteric artery. The left gastric artery also has a separate origin from the aorta, though difficult to perceive on this image. The “celiac trunk” in this patient consists only of the splenic artery. Congenital variations of vascular anatomy are very common.

(Right) Oblique view of CTA clearly shows the origin of the accessory right hepatic artery from the superior mesenteric artery.

(Right) Oblique view of CTA clearly shows the origin of the accessory right hepatic artery from the superior mesenteric artery.

Inferior phrenic veins
Inferior vena cava (IVC)
Renal veins
Right gonadal vein
Ascending lumbar vein
Middle sacral vein
Adrenal veins
Ascending lumbar vein
External iliac vein
Internal iliac (hypogastric) vein
(Top) The inferior vena cava (IVC) is formed by the confluence of the common iliac veins, which are formed by the confluence of the internal and external iliac veins. Note the ascending lumbar veins, which anastomose freely between the IVC and azygous, hemiazygos, and renal veins. These form a pathway for collateral flow in the event of IVC obstruction and play an important role in the systemic spread of pelvic tumors and infection.

Thoracic duct
Cisterna chyli
Lumbar trunks (of cisterna chyli)
Right lumbar (retrocaval) node
Aortocaval nodes
Celiac nodes
Superior mesenteric nodes
Intestinal trunk (of cisterna chyli)
Lumbar (paraaortic) nodes
Inferior mesenteric nodes
Common iliac nodes
External iliac node
Internal iliac (hypogastric) nodes
(Bottom) The major lymphatics and lymph nodes of the abdomen are located along, and share the same name as, the major blood vessels.

(Left) Axial CT in a 50-year-old woman with non-Hodgkin lymphoma (NHL) shows splenomegaly and marked enlargement of multiple upper abdominal and retrocrural lymph nodes.

(Left) Axial CT in a 50-year-old woman with non-Hodgkin lymphoma (NHL) shows splenomegaly and marked enlargement of multiple upper abdominal and retrocrural lymph nodes.

(Right) On this CT section in the same case, the duodenum is displaced by large retroperitoneal nodes; the mesenteric vessels are surrounded or “sandwiched” by mesenteric nodes . The lumbar nodes are often referred to as para- or retroaortic (or -caval) , indicating their position relative to the great vessels.

(Right) On this CT section in the same case, the duodenum is displaced by large retroperitoneal nodes; the mesenteric vessels are surrounded or “sandwiched” by mesenteric nodes . The lumbar nodes are often referred to as para- or retroaortic (or -caval) , indicating their position relative to the great vessels.

(Left) This 33-year-old African American woman presented with dyspnea and general weakness. CT shows bilateral hilar and subcarinal lymphadenopathy .

(Left) This 33-year-old African American woman presented with dyspnea and general weakness. CT shows bilateral hilar and subcarinal lymphadenopathy .

(Right) CT at lung windows in the same patient shows diffuse pulmonary nodules predominantly in a peribronchial distribution.

(Left) CT in the same patient shows massive splenomegaly with innumerable small, poorly defined, hypodense nodules. Similar lesions were present in the liver, better seen on narrow window-width images (not shown). There are innumerable focal hypodense nodules in both kidneys, as well as upper abdominal lymphadenopathy .

(Left) CT in the same patient shows massive splenomegaly with innumerable small, poorly defined, hypodense nodules. Similar lesions were present in the liver, better seen on narrow window-width images (not shown). There are innumerable focal hypodense nodules in both kidneys, as well as upper abdominal lymphadenopathy .

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Tags: Diagnostic Imaging Gastrointestinal

Nov 16, 2016 | Posted by admin in GASTROINTESTINAL IMAGING | Comments Off

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