Color Atlas of Ultrasound Anatomy Berthold Block, M.D. Private Practice Braunschweig Germany 544 illustrations Thieme Stuttgart·New York Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. IV Library of Congress Cataloging-in- Important note: Medicine is an ever-chang- Publication Data is available from the ing science undergoing continual develop- publisher. ment. Research and clinical experience are continually expanding our knowledge, in par- ticular our knowledge of proper treatment and drug therapy. Insofar as this book men- tions any dosage or application, readers may rest assured that the authors, editors, and publishers have made every effort to ensure that such references are in accordance with the state of knowledge at the time of pro- duction of the book. This book is an authorized translation Nevertheless, this does not involve, imply, or of the German edition published and express any guarantee or responsibility on copyrighted 2003 by Georg Thieme the part of the publishers in respect to any Verlag, Stuttgart, Germany. Title of the dosage instructions and forms of applications German edition: Der Sono-Guide: stated in the book. Every user is requested to Taschenatlas der sonographischen examine carefully the manufacturers’ leaf- Schnittbilddiagnostik lets accompanying each drug and to check, if necessary in consultation with a physician or specialist, whether the dosage schedules mentioned therein or the contraindications Translator: Terry C.Telger, Fort Worth, stated by the manufacturers differ from the TX, USA statements made in the present book. Such examination is particularly important with Illustrator: Gay&Sender, Bremen, drugs that are either rarely used or have been Germany newly released on the market. Every dosage schedule or every form of application used is entirely at the user’s own risk and responsi- bility. The authors and publishers request every user to report to the publishers any dis- crepancies or inaccuracies noticed. Some of the product names, patents, and reg- istered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this © 2004 Georg Thieme Verlag, fact is not always made in the text. Therefore, Rüdigerstrasse14, 70469Stuttgart, the appearance of a name without designa- Germany tion as proprietary is not to be construed as a http://www.thieme.de representation by the publisher that it is in Thieme New York, 333Seventh Avenue, the public domain. New York, NY10001 USA http://www.thieme.com This book, including all parts thereof, is legal- ly protected by copyright. Any use, exploita- Cover design: Cyclus, Stuttgart tion, or commercialization outside the nar- Typesetting by Gay&Sender, Bremen row limits set by copyright legislation, with- out the publisher’s consent, is illegal and lia- Printed in Germany by Druckhaus Götz ble to prosecution. This applies in particular to photostat reproduction, copying, mimeo- ISBN 3-13-139051-4 (GTV) graphing, preparation of microfilms, and ISBN 1-58890-281-1 (TNY) 1 2 3 4 5 electronic data processing and storage. Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. V Preface Ultrasound scanning yields a series of sectional images. The basis for in- terpreting the examination is the individual sectional image. At first sight, it is easy to be confused by the variable appearance of an ultra- sound scan of the same region in different patients. This has numerous causes, including differences in density, body fat, age-related differ- ences, overlying gas, and artifacts. In most cases the apparent discrepan- cies are not based on true anatomical differences. When a systematic scanning routine is closely followed, series of sectional images can be obtained in every patient with remarkable consistency. Even if the images themselves vary, the anatomical relationships that are demon- strated remain constant. While some excellent atlases have been published on computed tomo- graphy and magnetic resonance imaging, it is curious that no one (to the author’s knowledge) has taken the trouble to create a similar atlas of sectional anatomy for abdominal ultrasound. The present atlas attempts to fill this gap. In particular, the author hopes to provide the beginner with a comprehensive guide to the initially confusing world of sonogra- phic anatomy. Many have helped in the creation of this book. I wish to thank Dr. Hart- wig Schöndube and Dr. Matthias Geist, who gave me some scans. I also thank Mrs. Stephanie Gay and Mr. Bert Sender of Bremen for their superb rendering of the illustrations. I am also grateful to the staff at Thieme Medical Publishers for enabling me to make this book a reality, with spe- cial thanks to Dr. Antje Schönpflug, Mrs. Marion Holzer, and, of course, Dr. Markus Becker. Braunschweig, Spring 2004 Berthold Block Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. VII Table of Contents Standard Sectional Planes for Abdominal Scanning 1 Adrenal Glands 202 Vessels 14 Stomach 218 Liver 72 Bladder 242 Gallbladder 118 Prostate 250 Pancreas 134 Uterus 260 Spleen 168 Thyroid Gland 272 Kidneys 180 Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. VIII Table of Contents The numbers shown on the scanning paths refer to the corresponding figure numbers Vessels (1–56) Liver (57–100) 31–34 53–56 1–24 71–78 47–52 25–30 5577––7700 35–38 43–46 7799––9966 39–42 9977––110000 Gallbladder (101–114) Pancreas (115–146) 135–138 101– 106 139– 115–126 142 127–130 107–112 131–134 143–144 Spleen (147–156) Kidney (157–176) 151–154 173–174 163–166 147–150 157–160 167– 169–172 168 161–162 Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. Organs and Scanning Paths IX in this book. Adrenal gland (177–190) Stomach (191–212) 195–198 205–208 191–194 181– 177–180 184 185–188 199–204 Bladder (213–218) Prostate (219–226) 223–226 213– 219– 216 222 Uterus (227–236) Thyroid gland (237–244) 241– 233–236 244 237–240 227– 232 Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. Standard Planes for Abdominal Scanning p. 2/3 Upper abdominal longitudinal scan, center Lower abdominal longitudinal scan, center p. 4/5 Upper abdominal longitudinal scan, right side Lower abdominal longitudinal scan, left side p. 6/7 Upper abdominal transverse scan, center Lower abdominal transverse scan, center p. 8/9 Upper abdominal transverse scan, right side Upper abdominal transverse scan, left side p. 10/11 Longitudinal flank scan, right side Longitudinal flank scan, left side p. 12/13 Transverse flank scan, right side Transverse flank scan, left side Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. 2 s e n a Pl g n ni n a c S Upper abdominal longitudinal scan, center Lower abdominal longitudinal scan, center Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license. Standard Planes for Abdominal Scanning 3 40 73 2200 55 77 1 8800 8855 8899 Block, Color Atlas of Ultrasound Anatomy © 2004 Thieme All rights reserved. Usage subject to terms and conditions of license.