ll6mn.temporal.bone.ct.and.mri.anatomy.a.guide.to.3d.volumetric.acquisitions

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Temporal Bone CT

and MRI Anatomy

Jan KopivaJan ika

A Guide to3D VolumetricAcquisitions

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Temporal Bone CT and MRI Anatomy


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Jan Kopiva Jan ika

Temporal Bone CTand MRI Anatomy

A Guide to 3D Volumetric Acquisitions


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ISBN 978-3-319-08241-7 ISBN 978-3-319-08242-4 (eBook)DOI 10.1007/978-3-319-08242-4Springer Cham Heidelberg New York Dordrecht London

Library of Congress Control Number: 2014954745

Springer International Publishing Switzerland 2015This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part ofthe material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation,broadcasting, reproduction on microfilms or in any other physical way, and transmission or informationstorage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodologynow known or hereafter developed. Exempted from this legal reservation are brief excerpts in connectionwith reviews or scholarly analysis or material supplied specifically for the purpose of being entered andexecuted on a computer system, for exclusive use by the purchaser of the work. Duplication of thispublication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher'slocation, in its current version, and permission for use must always be obtained from Springer.Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violationsare liable to prosecution under the respective Copyright Law.The use of general descriptive names, registered names, trademarks, service marks, etc. in this publicationdoes not imply, even in the absence of a specific statement, that such names are exempt from the relevantprotective laws and regulations and therefore free for general use.While the advice and information in this book are believed to be true and accurate at the date ofpublication, neither the authors nor the editors nor the publisher can accept any legal responsibility for

any errors or omissions that may be made. The publisher makes no warranty, express or implied, withrespect to the material contained herein.

Printed on acid-free paper

Springer is part of Springer Science+Business Media (www.springer.com)

Jan Kopiva, MDDepartment of RadiologyUniversity Hospital Hradec KrlovHradec Krlov

Czech RepublicJan ika, MD, PhDDepartment of RadiologyUniversity Hospital Hradec KrlovCharles University in PragueFaculty of Medicine in Hradec KrlovHradec KrlovCzech Republic
http://www.springer.com/http://www.springer.com/


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Foreword

Understanding the anatomy of the temporal bone has always been, is and will be adifficult task for doctors of various specialities: radiology, otorhinolaryngology,neurosurgery or anatomy.

Temporal Bone CT and MRI Anatomyby Jan Kopiva and Jan ika is a compre-hensive atlas of radiological anatomy of the temporal bone. All important anatomi-cal structures of the temporal bone are didactically and precisely labeled in threestandard planes of view.

I personally recommend a thorough survey of the black-and-white images within

this CT and MRI atlas to every doctor who is interested in the given field. The pre-sented knowledge forms a mere basic cornerstone in gradually acquired experiencein clinical CT and MRI of the temporal bone.

This atlas may aid in promoting consultations and discussions between radiolo-gists and otologists, as only two pairs of eyes and two individual brains lead to trueunderstanding of the complicated beauty of the temporal bone where the black-and-white radiologists view turns into a colourful clinical picture of the correctly diag-nosed disorder.

Hradec Krlov, Czech Republic Viktor Chrobok, MD, PhD


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Preface

A few years ago, I was asked by Professor Viktor Chrobok, the head of theDepartment of Head and Neck Surgery, University Hospital Hradec Krlov, toprepare an educational material on temporal bone anatomy. At that time, I couldhardly anticipate how much the temporal bone will influence my life. The temporalbone feared by so many students of anatomy as well as residents of radiology orhead and neck surgery; their companion during sleepless nights spent over theanatomy textbooks; the most complex and difficult to understand bone of the humanbody.

There is no doubt that knowledge of anatomy is the fundamental prerequisite toproper diagnosis making. I was happy enough to gain my applied anatomy skillsduring my professional 2-year fellowship at the Department of Anatomy at theCharles University Medical School in Hradec Krlov. I took the opportunity todeepen my knowledge of the spatial arrangement of the middle ear during the tem-poral bone preparative courses led by Prof. Viktor Chrobok. Later on when I (alreadyas a radiology resident) focused my professional interest on the details of the tem-poral bone CT anatomy, I simply did not find a textbook which would cover thistopic in its full complexity. And this, in fact, turned out to be the key issue in the

inception of this atlas.

Hradec Krlov, Czech Republic Jan Kopiva, MD


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Scope

It is an indisputable fact that knowledge of anatomy is one of the cornerstones ofclinical medicine. Nowadays, with the advancement of microsurgical techniquesand state-of-the-art imaging modalities, this applies to surgical specialities as wellas to radiology more than ever. Familiarity with the key anatomical structures andtheir basic topographic relationships is necessary for the effective use of this atlas,which does not aspire to be a fundamental source of information for medical stu-dents. That is, among other things, why we have not included currently so popularand visually impressive 3D reconstructions, mostly suitable for demonstration of

the surface anatomy of the temporal bone: this topic is extensively covered byrespective textbooks and atlases.

Our major goal is to provide the reader with the detailed temporal bone imaginganatomy in the same way as it is routinely displayed on contemporary DICOMviewing consoles, i.e. as a series of consecutive sub-millimetre sections in standard-ized orientation.


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Acknowledgements

Our sincere thanks belong to Prof. Viktor Chrobok, MD, PhD, who stood at the veryroots of this atlas, and to our colleagues Zdenk Blobrdek, MD, PhD, and JiVasek, MD, for their technical support. Our special thanks belong to Olgaermkov for her diligent assistance with the graphic layout of the book.


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Abbreviations

AA anterior ampullaAAA aditus ad antrum

entrance to the mastoid antrumACN accessory nerve

n.XIACP air cell of the pyramidAE anterior epitympanumAICA anterior inferior cerebellar artery

AN abducens nerven.VI

AOA anterior osseous ampullaASC anterior semicircular canal

also called superior semicircular canalBA basilar arteryBI body of incus

also called corpus incudisBSL bony spiral lamina

also called lamina spiralis osseaCA cochlear areaentry of cochlear nerve, portion of n.VIII

CAC carotid canalcontains internal carotid artery

CAQ cochlear aqueductalso called perilymphatic duct or aquaeductus cochleae

CAT cochlea apical turnCBT cochlea basilar turn

CCR common crusCE cerebellumCJS caroticojugular spine


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CMT cochlea middle turnCN cochlear nerve

portion of n.VIIICOC common osseous crusCOCA condylar canal

communication between extra- and intracranial veinsCP cochleariform processCPC cerebellopontine cisternCTAT crista transversa anterior epitympanumE epitympanum

also called atticEAC external auditory canalEACA external aperture of the cochlear aqueduct

EOVA external opening of the vestibular aqueductET Eustachian tubeFAC falx cerebelliFC flocculusFL foramen lacerumFN facial nerve

n.VIIFNA facial nerve area

entry of the facial nerve

FNCLS facial nerve canal labyrinthine segmentcontains labyrinthine segment of the facial nerve

FNCMS facial nerve canal mastoid segmentcontains mastoid segment of the facial nerve

FNCTS facial nerve canal tympanic segmentcontains tympanic segment of the facial nerve

FNES facial nerve extracranial segmentFNFG facial nerve first genuFNSG facial nerve second genu

FO foramen ovalecontains mandibular nerveFP foramen petrosum

contains lesser petrosal nerveFR facial recessFS foramen spinosum

contains middle meningeal arteryFV fourth ventricleGF geniculate fossa

contains geniculate ganglionGIPS groove of the inferior petrosal sinuscontains inferior petrosal sinus

GN glossopharyngeal nerven.IX

Abbreviations


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GSS groove of the sigmoid sinusGWS greater wing of sphenoidHC hypoglossal canal

contains twelfth cranial nerve and venous plexusHN hypoglossal nerve

n.XIIHT hypotympanumI incusIAC internal auditory canalIACF internal auditory canal fundusIAM internal auditory canal meatusILP incus long processIMJ incudomallear joint

ISJ incudostapedial jointISP incus short process

also called short crus or limbIVA inferior vestibular area

entry of the saccular nerveJB jugular bulbJF jugular foramenJFPN jugular foramen pars nervosaJFPV jugular foramen pars vascularis

JS jugular spineKS Koerners septumLA lateral ampullaLOA lateral osseous ampullaLP lenticular processLPE lateral posterior epitympanumLSC lateral semicircular canal

also called horizontal or external semicircular canalMA mastoid antrum

MAC mastoid air cellsMACA mastoid canaliculuscontains auricular branch of the vagus nerve

MAN mastoid notchMAP malleus anterior processMCBS mastoid cells bony septaMCF middle cranial fossaMCP middle cerebellar pedunculeMET mesotympanum

MF mandibular fossaMH malleus headMHA malleus handleMHE mandible headMLP malleus lateral process

Abbreviations


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MN malleus neckMNE mandible neckMO medulla oblongataMOD modiolusMP mastoid processMPE medial posterior epitympanumOB occipital boneOMS occipitomastoid sutureOW oval windowOWN oval window nicheP promontoryPC petromastoid canal

contains subarcuate artery and vein

PCF posterior cranial fossaPCP posterior clinoid processPE petrous part of the temporal bonePLSC prominence of the lateral semicircular canalPMC premedullary cistern

also called perimedullary cisternPMSTB posteromedial surface of the temporal bonePNS ponsPO ponticulus

POA posterior osseous ampullaPOF petrooccipital fissurePOT posterior tympanumPPC prepontine cisternPS Prussaks spacePSC posterior semicircular canalPT protympanumPTF petrotympanic fissure

also called glaserian, an exit route for the chorda tympani

PYE pyramidal eminenceRW round windowRWN round window nicheSAC stapes anterior crusSAF subarcuate fossa

entry to the petromastoid canalSC simple crusSCT scutumSIC singular canal

entry of the posterior ampullar nerveSIT sinus tympaniSM stapedius muscleSMF stylomastoid foramen

Abbreviations


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SN saccular nerveportion of n.VIII, also called inferior branch of the vestibularnerve

SOC simple osseous crusSP styloid processSPC stapes posterior crusSPF sphenopetrosal fissureSPS sphenoidal sinusSQP squamous part of the temporal bone

also called squama temporalisSQT squama temporalis

also called squamous part of the temporal boneSSS sphenosquamosal suture

STH stapes headSU subiculumSVA superior vestibular area

entry of the utriculo-ampullar nerveTC tympanic canaliculus

contains tympanic nerve and inferior tympanic arteryTCR transverse crest

also called crista transversaTL temporal lobe

TM tympanic membraneTMF tympanomastoid fissureTN trigeminal nerve

n.VTSF tympanosquamous fissureTTM tensor tympani muscleTTMT tensor tympani muscle tendonUAN utriculo-ampullar nerve

portion of n.VIII, also called superior branch of the vestibular

nerveV vestibuleVA vertebral arteryVAQ vestibular aqueductVCN vestibulocochlear nerve

n.VIIIVER vestibule elliptical recessVN vagus nerve

n.X

VSR vestibule spherical recessZP zygomatic process

Abbreviations


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Contents

Part I Imaging Issues

1 Image Quality and Radiation Dose Aspects . . . . . . . . . . . . . . . . . . . . . 31.1 MDCT. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31.2 MRI. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Part II The Atlas

2 HRCT Axial Reformat. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93 HRCT Coronal Reformat. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61

4 HRCT Stenvers Reformat . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113

5 MRI Axial Sections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157

Suggested Reading . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195


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Dear Reader,

There were two major reasons why this book came into existence, eventually: exten-sive progress and spread of multidetector CT technology (MDCT) and the absenceof similarly focused publications on the market. The major aim of this book is toprovide the reader with a comprehensive, systematic and topical view of the anat-omy of the temporal bone from the perspective of advanced imaging methods,namely MDCT and MRI. We have intended to provide the reader with complete

image datasets comprising consecutive high-spatial-resolution CT and MRI slicesof sub-millimetre thickness, presented in the same way as they emanate from con-temporary MDCT and MRI scanners, with all anatomical structures labelled. Thisis why we have not included any histological sections, developmental variants orpathologic conditions which are discussed elsewhere.

The book addresses primarily radiologists, although we hope that it may offervaluable information also to head and neck surgeons, neurosurgeons as well asanatomists.

The Authors

Introduction


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Part I

Imaging Issues


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3 Springer International Publishing Switzerland 2015J. Kopiva, J. ika, Temporal Bone CT and MRI Anatomy:

A Guide to 3D Volumetric Acquisitions, DOI 10.1007/978-3-319-08242-4_1

Chapter 1

Image Quality and Radiation Dose Aspects

As the anatomy of the temporal bone comprises of very small structures, high spa-tial resolution imaging techniques are a prerequisite for adequate diagnostic results.For several decades, the effort has been aimed at maximizing the spatial resolutionas well as minimizing the image noise.

1.1 MDCT

In case of high-resolution CT (HRCT) of the pyramids, the scanning protocols weretraditionally associated with relatively high radiation doses (e.g. effective tube cur-renttime product of 320 mAs and peak tube voltage of 120 kVp), yielding up to75 mGy of volume CT dose index (CTDIvol). These scanning parameters were com-parable or even exceeding those of routine CT head scanning protocols. Moreover,protocols based on 140 kVp tube voltage settings commonly exceeded CTDIvolval-ues of 90 mGy, thus further increasing the radiation load near/in the area of the eyelens which is the most endangered organ in terms of radiation damage in adult head

CT scans. It should also be noted that the vast majority of current helical MDCThead scanning protocols do not employ or even do not allow gantry tilt. The eye lensis therefore regularly exposed to the primary beam in both head and temporal boneMDCT scanning procedures. Furthermore, on conventional as well as multidetectorCT scanners equipped with less than 16 rows of detectors, head CT scans wereroutinely acquired separately from HRCT studies of the temporal bones, thus virtu-ally doubling the radiation dose to the eye lens.

According to the latest statement on tissue reactions issued by the InternationalCommission on Radiological Protection (ICRP), the threshold in absorbed dose for

the eye lens was lowered from 2.0 to 0.5 Gy in order to minimize the risk ofradiation-induced cataract development.Whereas the radiation protection measures and ALARA (as low as reasonably

achievable) principles urge us on minimizing the radiation dose, the abovementioned


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scanning strategies and continuously increasing numbers of CT procedures world-wide act in contradiction.

Fortunately, the state-of-the-art MDCT scanners offer numerous options on howto effectively reduce the radiation dose without sacrificing spatial resolution anddiagnostic performance. First, their detector arrays of submillimetre (0.50.6 mm)width allow for acquiring high spatial resolution 3D volumetric datasets: the sub-millimetre collimation necessary for HRCT is thus automatically available in everyMDCT acquisition. Second, increased quantum efficiency of current detectorsallows for lowering kVp and mAs settings in all acquisitions without significantincrease in image noise. Third, novel techniques of iterative CT image reconstruc-tion benefit from inherent low image noise levels and have already proved theirabilities to decrease radiation exposure by tens of percent when compared to stan-dard filtered back projection which dominated CT technology for more than three

decades.Current MDCT systems are therefore routinely capable of reconstructing HRCT

images of the skull base and pyramids with isotropic submillimetre resolution fromevery routine head CT scan, with markedly reduced dose compared to conventional(CTDIvol60 mGy) standards and without additional radiation burden, as both thincollimation raw data and high spatial resolution reconstructive algorithm (sharpor bone kernel) are readily available.

We aimed to demonstrate that with the adoption of adequate precautions focusedon radiation dose reduction, it is feasible to obtain 3D volumetric datasets offering

both high spatial resolution and sufficient diagnostic image quality. We would liketo encourage the users of state-of-the-art MDCT scanners to acquire image data forboth cerebral and temporal bone studies from a single helical acquisition, thusavoiding the need for any additional scanning of the temporal bones in routine headMDCT scans and minimizing the radiation dose impact.

The protocol we routinely use in our institution for non-emergency helical headMDCT scans combines iterative reconstruction algorithm with automatic tube cur-rent modulation and carefully reduced reference mAs settings in order to reduceboth the effective and particularly the organ dose to the eye lens. When compared to

the European Commission Quality Criteria for MDCT which set CTDIvolof 60 mGyas a reference standard for head scans, our protocol yields a 53 % dose reductionwhen compared to the reference standard (28.2 mGy versus 60 mGy).

All HRCT scans showed in this book were acquired in a helical mode, with nogantry tilt, on a single source MDCT scanner with the following parameters: colli-mation 2 64 0.6 mm, tube voltage of 120 kV, pitch factor of 0.55, rotation time of1 s, and quality reference mAs values set to 240 mAs. The iterative reconstructionkernel was set to J70s for HRCT of the pyramids (or alternatively to J30s for cere-bral scans, not shown). Slice thickness of all HRCT scans shown in the book is

0.6 mm with the reconstruction interval of 0.4 mm. The average effective dose ofthis protocol is 1.18 mSv. The average organ dose to the eye lens yields 31.9 mGy.It is an unfavourable fact that the average medical radiation dose to the popula-

tion of the most developed countries showed an increase of several hundred percentin a single generation. The authors hereby want to demonstrate that a proper use of

1 Image Quality and Radiation Dose Aspects


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dose-reducing strategies is capable of significant radiation dose reduction, namely,in terms of organ dose delivered to the eye lens, which is more radiosensitive thanpreviously thought. The synergic effect of the utilized advanced techniques allowedus to routinely obtain helical head MDCT scans with only 47 % of the radiationdose set as a reference standard for head scans, with the additional bonus of obtain-ing high-quality HRCT of the pyramids in every routine head MDCT examinationfor free.

1.2 MRI

MRI offers a complementary information to HRCT, with excellent visualization of

cranial nerves and inner ear fluid containing structures, thus completing the skel-etal type of information obtained from MDCT with the neural component avail-able from MRI.

Principally, there are two types of MRI sequences suitable for high spatial reso-lution imaging of the cranial nerves and inner ear anatomy: either balanced steady-state 3D gradient echo (CISS, FIESTA, bFFE) or 3D fast/turbo spin echo (SPACE,VISTA, CUBE, VFA) with artificially restored longitudinal magnetization whichhelps keep the acquisition time within acceptable ranges (Restore, DRIVE,FRFSE-XL, FIESTA). Both approaches yield similar results with comparable

acquisition times; nonetheless, 3D FSE/TSE techniques are less prone to inherentsusceptibility artefacts which might degrade the image quality in the proximity ofbony structures.

It is feasible to obtain the submillimetre spatial resolution fully comparable withthat of MDCT in all three planes using current MRI systems. MRI scans presentedin this book were acquired on a clinical 1.5 T MRI system with the following param-eters: TR = 1,400 ms, effective TE = 259 ms, turbo factor (ETL) = 85, PAT factor = 2,voxel size of 0.6 0.6 0.6 mm, and acquisition time of 6:00 mins.

1.2 MRI


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Structure

Despite the fact that interactive online anatomical applications are widely popular at

present, we have chosen a printed issue of this topic. Not only just because books

last for ages. The interactivity is substituted here by means of complexity of the

data: complete sets of source axial MDCT and MR images are accompanied by

reformatted CT sections in coronal and Stenverse planes (i.e. in the plane perpen-

dicular to the course of the superior semicircular canal). The anatomy is listed here

step-by-stepwise or, if you wish, slice-by-slice, resembling the way you scroll

through the images on a diagnostic workstation. Therefore, the motto of this book

might read what I can see on the screen is what I get in the book.

The image atlas is divided into four chapters: (1) axial HRCT sections listed in

craniocaudal direction, (2) coronal HRCT sections in anteroposterior direction, (3)

Stenverse HRCT sections in lateromedial direction, and (4) axial MRI sections in

craniocaudal direction. For readers convenience, all anatomical structures are

labelled in each image. The total number of anatomical structures identified in this

atlas exceeds 150.Histological sections have been intentionally omitted in this book because this

topic had been extensively covered by other literary sources. Similarly, pathologic

conditions of the temporal bone have not been included in this issue as these are

extensively discussed in other sources likeImaging of the Temporal Boneby Swartz

and Loevner.

Part II

The Atlas


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Chapter 2

HRCT Axial Reformat

A00: HRCT axial reformatAxial plane:

Using an MPR (multi-planar reformat) 3D viewer, anterior and posterior aspects of the lateralsemicircular canal are identified. Their connecting line defines the axial plane.


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ACP air cell of the pyramidGSS groove of the sigmoid sinusMAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossaOB occipital bone

OMS occipitomastoid suturePCF posterior cranial fossaPMSTB posteromedial surface of the

temporal boneSQP squamous part of the temporal

bone

A01: HRCT axial reformat

2 HRCT Axial Reformat


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ACP air cell of the pyramidASC anterior semicircular canalGSS groove of the sigmoid sinusMAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossaOB occipital bone



bone




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bone




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bone




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ACP air cell of the pyramidASC anterior semicircular canalGSS groove of the sigmoid sinusMA mastoid antrumMAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossaOB occipital bone

OMS occipitomastoid suturePC petromastoid canalPCF posterior cranial fossaPMSTB posteromedial surface of the


bone

A05:HRCT axial reformat



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ASC anterior semicircular canalGSS groove of the sigmoid sinusMA mastoid antrumMAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossaOB occipital boneOMS occipitomastoid suture

PC petromastoid canalPCF posterior cranial fossaPMSTB posteromedial surface of the

temporal bonePSC posterior semicircular canalSAF subarcuate fossaSQP squamous part of the temporal

bone




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AAA aditus ad antrumASC anterior semicircular canalGSS groove of the sigmoid sinusMA mastoid antrumMAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossaOB occipital bone

OMS occipitomastoid suturePC petromastoid canalPCF posterior cranial fossaPMSTB posteromedial surface of the

temporal bonePSC posterior semicircular canalSQP squamous part of the temporal

bone




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AAA aditus ad antrumASC anterior semicircular canalCOC common osseous crusE epitympanumGSS groove of the sigmoid sinusMA mastoid antrumMAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossa

OB occipital boneOMS occipitomastoid suturePCF posterior cranial fossaPCP posterior clinoid processPE petrous part of the temporal

bonePSC posterior semicircular canalSQP squamous part of the temporal

bone




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AAA aditus ad antrumASC anterior semicircular canalCOC common osseous crusE epitympanumGSS groove of the sigmoid sinusMA mastoid antrumMAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossa



bone




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AAA aditus ad antrumASC anterior semicircular canalCOC common osseous crusE epitympanumEOVA external opening of the vestibular

aqueductGSS groove of the sigmoid sinusMA mastoid antrumMAC mastoid air cellsMCBS mastoid cells bony septa

MCF middle cranial fossa



boneVAQ vestibular aqueduct




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AAA aditus ad antrumAOA anterior osseous ampullaCOC common osseous crusE epitympanumEOVA external opening of the vestibular

aqueductGSS groove of the sigmoid sinusMA mastoid antrumMAC mastoid air cellsMCBS mastoid cells bony septa

MCF middle cranial fossaPCF posterior cranial fossaPCP posterior clinoid processPE petrous part of the temporal






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aqueductGSS groove of the sigmoid sinusIAC internal auditory canalMA mastoid antrumMAC mastoid air cells

MCBS mastoid cells bony septaMCF middle cranial fossaPCF posterior cranial fossaPCP posterior clinoid processPE petrous part of the temporal






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aqueductGSS groove of the sigmoid sinusIAC internal auditory canalIAM internal auditory canal meatusLOA lateral osseous ampulla

LSC lateral semicircular canalMA mastoid antrum

MAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossaPCF posterior cranial fossaPCP posterior clinoid processPE petrous part of the temporal

bonePSC posterior semicircular canalSOC simple osseous crusSQP squamous part of the temporal





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AAA aditus ad antrumCOC common osseous crusE epitympanumEOVA external opening of the vestibular

aqueductGSS groove of the sigmoid sinusIAC internal auditory canalIAM internal auditory canal meatusLOA lateral osseous ampullaLSC lateral semicircular canal

MA mastoid antrumMAC mastoid air cellsMCBS mastoid cells bony septa

MCF middle cranial fossaPCF posterior cranial fossaPCP posterior clinoid processPLSC prominence of the lateral

semicircular canalPE petrous part of the temporal

bonePSC posterior semicircular canalSOC simple osseous crusSQP squamous part of the temporal

boneVAQ vestibular aqueductVER vestibule elliptical recess




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AAA aditus ad antrumCOC common osseous crusE epitympanumEOVA external opening of the vestibular

aqueductGSS groove of the sigmoid sinusIAC internal auditory canalIACF internal auditory canal fundusKS Koerners septumLOA lateral osseous ampulla

LSC lateral semicircular canalMA mastoid antrumMAC mastoid air cells

MCBS mastoid cells bony septaMCF middle cranial fossaPCF posterior cranial fossaPCP posterior clinoid processPLSC prominence of the lateral

semicircular canalPE petrous part of the temporal bonePSC posterior semicircular canalSOC simple osseous crusSQP squamous part of the temporal

boneVAQ vestibular aqueductVER vestibule elliptical recess




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BI body of incusEOVA external opening of the vestibular

aqueductFNA facial nerve areaFNCLS facial nerve canal labyrinthine

segmentGSS groove of the sigmoid sinusIAC internal auditory canalIMJ incudomallear jointISP incus short process

KS Koerners septumLPE lateral posterior

epitympanumMA mastoid antrumMAC mastoid air cells

MCBS mastoid cells bony septaMCF middle cranial fossaMH malleus headMPE medial posterior epitympanumPCF posterior cranial fossaPCP posterior clinoid processPE petrous part of the temporal

bonePSC posterior semicircular canalSOC simple osseous crus

SQP squamous part of the temporalbone

SVA superior vestibular areaVAQ vestibular aqueductVER vestibule elliptical recess




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AE anterior epitympanumBI body of incusEOVA external opening of the vestibular

aqueductFNA facial nerve areaFNCLS facial nerve canal labyrinthine

segmentGSS groove of the sigmoid sinusIAC internal auditory canalIMJ incudomallear joint

ISP incus short processKS Koerners septumLPE lateral posterior

epitympanumMA mastoid antrumMAC mastoid air cells

MCBS mastoid cells bony septaMCF middle cranial fossaMH malleus headMPE medial posterior

epitympanumPCF posterior cranial fossaPCP posterior clinoid processPE petrous part of the temporal

bonePSC posterior semicircular canal

SQP squamous part of thetemporal bone

SVA superior vestibular areaVAQ vestibular aqueductVER vestibule elliptical recess




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AE anterior epitympanumBI body of incusCMT cochlea middle turnFNCLS facial nerve canal labyrinthine

segmentFNCTS facial nerve canal tympanic

segmentGSS groove of the sigmoid sinusIAC internal auditory canalIMJ incudomallear joint

ISP incus short processKS Koerners septumLPE lateral posterior

epitympanum

MAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossaMH malleus headMPE medial posterior epitympanumPCF posterior cranial fossaPSC posterior semicircular canalSQP squamous part of the temporal

boneSVA superior vestibular area

VER vestibule elliptical recessVSR vestibule spherical recess




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AE anterior epitympanumBI body of incusCMT cochlea middle turnFNCTS facial nerve canal tympanic

segmentFNFG facial nerve first genuFNSG facial nerve second genuGF geniculate fossaGSS groove of the sigmoid sinusIAC internal auditory canal

IMJ incudomallear jointISP incus short processLPE lateral posterior

epitympanum

MAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossaMH malleus headMPE medial posterior

epitympanumPCF posterior cranial fossaPSC posterior semicircular canalSIC singular canalSQP squamous part of the temporal

boneVSR vestibule spherical recess




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BI body of incusCMT cochlea middle turnFNCMS facial nerve canal mastoid

segmentFNCTS facial nerve canal

tympanic segmentGF geniculate fossaGSS groove of the sigmoid sinusIAC internal auditory canalIMJ incudomallear joint

LPE lateral posteriorepitympanum

MAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossa

MH malleus headMPE medial posterior

epitympanumOW oval windowOWN oval window nichePCF posterior cranial fossaPO ponticulusPOA posterior osseous ampullaPSC posterior semicircular canalPYE pyramidal eminence

SIC singular canalSIT sinus tympaniSQP squamous part of the

temporal boneVSR vestibule spherical recess




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BI body of incusCA cochlear areaCMT cochlea middle turnFNCMS facial nerve canal mastoid


segmentFR facial recessGSS groove of the sigmoid sinusIAC internal auditory canal

IMJ incudomallear jointIVA inferior vestibular areaMAC mastoid air cells

MCBS mastoid cells bony septaMCF middle cranial fossaMH malleus headPCF posterior cranial fossaPOA posterior osseous ampullaPSC posterior semicircular canalPYE pyramidal eminenceSIC singular canalSIT sinus tympaniSQP squamous part of the

temporal boneVSR vestibule spherical recess




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CA cochlear areaCAT cochlea apical turnCMT cochlea middle turnCP cochleariform processFNCMS facial nerve canal mastoid

segmentFR facial recessGSS groove of the sigmoid sinusIAC internal auditory canalILP incus long process

MAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossa

MH malleus headMOD modiolusPCF posterior cranial fossaPOA posterior osseous ampullaPYE pyramidal eminenceSAC stapes anterior crusSIC singular canalSIT sinus tympaniSPC stapes posterior crusSQP squamous part of the temporal

boneTTM tensor tympani muscleVSR vestibule spherical recess




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CA cochlear areaCAT cochlea apical turnCMT cochlea middle turnFNCMS facial nerve canal mastoid

segmentFR facial recessGSS groove of the sigmoid sinusIACF internal auditory canal

fundusILP incus long process

ISJ incudostapedial jointMAC mastoid air cellsMAN mastoid notchMCBS mastoid cells bony septaMCF middle cranial fossa

MN malleus neckMOD modiolusPCF posterior cranial fossaPOT posterior tympanumPSC posterior semicircular canalPYE pyramidal eminenceSAC stapes anterior crusSIT sinus tympaniSM stapedius muscleSPC stapes posterior crus

SQP squamous part of the temporalbone

STH stapes headTTM tensor tympani muscleVSR vestibule spherical recess




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CBT cochlea basilar turnCMT cochlea middle turnFNCMS facial nerve canal mastoid

segmentGSS groove of the sigmoid sinusIACF internal auditory canal

fundusISJ incudostapedial jointLP lenticular processMAC mastoid air cells

MAN mastoid notchMAP malleus anterior processMCBS mastoid cells bony septaMCF middle cranial fossa

MN malleus neckMOD modiolusP promontoryPCF posterior cranial fossaPOT posterior tympanumPYE pyramidal eminenceSIT sinus tympaniSQP squamous part of the

temporal boneSTH stapes head

TTM tensor tympani muscleTTMT tensor tympani muscle

tendonVSR vestibule spherical recess




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CBT cochlea basilar turnCMT cochlea middle turnEAC external auditory canalFNCMS facial nerve canal mastoid

segmentGSS groove of the sigmoid sinusLP lenticular processMAC mastoid air cellsMAN mastoid notchMCBS mastoid cells bony septa

MCF middle cranial fossa

MN malleus neckP promontoryPCF posterior cranial fossaPYE pyramidal eminenceSIT sinus tympaniSQP squamous part of the

temporal boneTTM tensor tympani muscleTTMT tensor tympani muscle

tendon

VSR vestibule spherical recess




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CBT cochlea basilar turnCMT cochlea middle turnEAC external auditory canalET Eustachian tubeFNCMS facial nerve canal mastoid

segmentGSS groove of the sigmoid sinusLP lenticular processMAC mastoid air cellsMAN mastoid notch

MCBS mastoid cells bony septaMCF middle cranial fossa

MET mesotympanumMHA malleus handleP promontoryPCF posterior cranial fossaRW round windowRWN round window nicheSIT sinus tympaniSQP squamous part of the

temporal boneSU subiculum

TM tympanic membraneTTM tensor tympani muscle




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CAQ cochlear aqueductCBT cochlea basilar turnCMT cochlea middle turnEAC external auditory canalET Eustachian tubeFNCMS facial nerve canal mastoid

segmentGSS groove of the sigmoid sinusMAC mastoid air cellsMAN mastoid notch

MCBS mastoid cells bony septa

MCF middle cranial fossaMET mesotympanumMHA malleus handleMLP malleus lateral processP promontoryPCF posterior cranial fossaRWN round window nicheSIT sinus tympaniSU subiculumTM tympanic membrane

TTM tensor tympani muscle




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CAQ cochlear aqueductCBT cochlea basilar turnCMT cochlea middle turnEAC external auditory canalET Eustachian tubeFNCMS facial nerve canal mastoid

segmentGSS groove of the sigmoid sinusMAC mastoid air cells

MAN mastoid notchMCBS mastoid cells bony septaMCF middle cranial fossaMET mesotympanumMHA malleus handlePCF posterior cranial fossaPTF petrotympanic fissureTM tympanic membraneTTM tensor tympani muscle




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CAC carotid canalCAQ cochlear aqueductCBT cochlea basilar turnEAC external auditory canalET Eustachian tubeFNCMS facial nerve canal mastoid

segmentGSS groove of the sigmoid sinus

MAC mastoid air cellsMAN mastoid notchMCBS mastoid cells bony septaMCF middle cranial fossaMHA malleus handlePCF posterior cranial fossaPTF petrotympanic fissureTTM tensor tympani muscle




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CAC carotid canalCAQ cochlear aqueductCBT cochlea basilar turnEAC external auditory canalET Eustachian tubeFNCMS facial nerve canal mastoid

segmentGSS groove of the sigmoid sinusHT hypotympanum

MAC mastoid air cellsMAN mastoid notchMCBS mastoid cells bony septaMCF middle cranial fossaMHA malleus handlePCF posterior cranial fossaPTF petrotympanic fissureTTM tensor tympani muscle




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CAC carotid canalCAQ cochlear aqueductCBT cochlea basilar turnEAC external auditory canalEACA external aperture of the

cochlear aqueductET Eustachian tubeFNCMS facial nerve canal mastoid

segmentGSS groove of the sigmoid sinus

HT hypotympanumMAC mastoid air cellsMAN mastoid notchMCBS mastoid cells bony septaMCF middle cranial fossaMHA malleus handleOB occipital bonePCF posterior cranial fossaPTF petrotympanic fissureTTM tensor tympani muscle




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CAC carotid canalCAQ cochlear aqueductCBT cochlea basilar turnEAC external auditory canalEACA external aperture of the


segmentGIPS groove of the inferior petrosal

sinusGSS groove of the sigmoid sinus

HT hypotympanumMAC mastoid air cellsMAN mastoid notchMCBS mastoid cells bony septaMCF middle cranial fossaOB occipital bonePCF posterior cranial fossaPOF petrooccipital fissurePT protympanumPTF petrotympanic fissure





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CAC carotid canalCAQ cochlear aqueductEAC external auditory canalEACA external aperture of the



sinus

GSS groove of the sigmoid sinusHT hypotympanum

JF jugular foramenMAC mastoid air cellsMAN mastoid notchMCBS mastoid cells bony septaMCF middle cranial fossaOB occipital bonePCF posterior cranial fossaPOF petrooccipital fissurePT protympanumPTF petrotympanic fissure

TSF tympanosquamous fissureTTM tensor tympani muscle




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CAC carotid canalCAQ cochlear aqueductEAC external auditory canalET Eustachian tubeFNCMS facial nerve canal mastoid


sinusGSS groove of the sigmoid sinusHT hypotympanum

JF jugular foramen

MAC mastoid air cellsMAN mastoid notchMCBS mastoid cells bony septaMCF middle cranial fossaMF mandibular fossaOB occipital bonePOF petrooccipital fissurePT protympanumPTF petrotympanic fissureTSF tympanosquamous fissure





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CAC carotid canalCAQ cochlear aqueductEAC external auditory canalET Eustachian tubeFNCMS facial nerve canal mastoid


sinusGSS groove of the sigmoid sinusHT hypotympanum

JF jugular foramen

MAC mastoid air cellsMAN mastoid notchMCBS mastoid cells bony septaMCF middle cranial fossaMF mandibular fossaOB occipital bonePOF petrooccipital fissurePT protympanumPTF petrotympanic fissureTSF tympanosquamous fissure





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CAC carotid canalCOCA condylar canalEAC external auditory canalET Eustachian tubeFNCMS facial nerve canal mastoid

segmentHT hypotympanumJFPN jugular foramen pars

nervosaJFPV jugular foramen pars

vascularis

JS jugular spineMAC mastoid air cellsMAN mastoid notchMCBS mastoid cells bony septaMCF middle cranial fossaMF mandibular fossaMHE mandible headOB occipital bonePOF petrooccipital fissureSSS sphenosquamosal suture





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segmentHT hypotympanumJFPN jugular foramen pars


vascularisJS jugular spine

MAC mastoid air cellsMAN mastoid notchMCBS mastoid cells bony septaMCF middle cranial fossaMF mandibular fossaMHE mandible headOB occipital bonePOF petrooccipital fissureSSS sphenosquamosal sutureTC tympanic canaliculus

TTM tensor tympani muscleZP zygomatic process




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segmentJFPN jugular foramen pars


vascularis

JS jugular spineMAC mastoid air cells

MAN mastoid notchMCBS mastoid cells bony septaMCF middle cranial fossaMF mandibular fossaMHE mandible headOB occipital bonePOF petrooccipital fissureSSS sphenosquamosal sutureTC tympanic canaliculusTMF tympanomastoid fissure





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vascularis

JS jugular spineMAC mastoid air cells

MAN mastoid notchMCBS mastoid cells bony septaMCF middle cranial fossaMF mandibular fossaMHE mandible headOB occipital bonePOF petrooccipital fissureSSS sphenosquamosal sutureTC tympanic canaliculusTMF tympanomastoid fissure





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vascularis

JS jugular spineMAC mastoid air cellsMAN mastoid notch

MCBS mastoid cells bony septaMCF middle cranial fossaMF mandibular fossaMHE mandible headOB occipital bonePOF petrooccipital fissureSPF sphenopetrosal fissureSPS sphenoidal sinusSSS sphenosquamosal sutureTC tympanic canaliculus

TMF tympanomastoid fissureTTM tensor tympani muscleZP zygomatic process




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CAC carotid canalEAC external auditory canalET Eustachian tubeJFPN jugular foramen pars


vascularisJS jugular spineMAC mastoid air cellsMAN mastoid notch

MCBS mastoid cells bony septaMCF middle cranial fossa

MF mandibular fossaMHE mandible headOB occipital bonePOF petrooccipital fissureSMF stylomastoid foramenSPF sphenopetrosal fissureSPS sphenoidal sinusSSS sphenosquamosal sutureTC tympanic canaliculusTMF tympanomastoid fissure





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CAC carotid canalEAC external auditory canalET Eustachian tubeFO foramen ovaleFS foramen spinosumJFPN jugular foramen pars


vascularisJS jugular spine

MAC mastoid air cellsMAN mastoid notch

MCBS mastoid cells bony septaMCF middle cranial fossaMF mandibular fossaMHE mandible headOB occipital bonePOF petrooccipital fissureSMF stylomastoid foramenSPF sphenopetrosal fissureSPS sphenoidal sinusSSS sphenosquamosal suture

TC tympanic canaliculusZP zygomatic process




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CAC carotid canalEAC external auditory canalET Eustachian tubeFNES facial nerve extracranial

segmentFO foramen ovaleFS foramen spinosumHC hypoglossal canalJFPN jugular foramen pars

nervosa

JFPV jugular foramen parsvascularis

JS jugular spine

MAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossaMF mandibular fossaMHE mandible headOB occipital bonePOF petrooccipital fissureSPF sphenopetrosal fissureSPS sphenoidal sinusSSS sphenosquamosal suture

TC tympanic canaliculusZP zygomatic process




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CAC carotid canalEAC external auditory canalET Eustachian tubeFO foramen ovaleFS foramen spinosumHC hypoglossal canalJFPN jugular foramen pars


vascularis

JS jugular spine

MAC mastoid air cellsMCBS mastoid cells bony septaMCF middle cranial fossaMF mandibular fossaMHE mandible headOB occipital bonePOF petrooccipital fissureSPF sphenopetrosal fissureSPS sphenoidal sinusTC tympanic canaliculus

ZP zygomatic process




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CAC carotid canalEAC external auditory canalET Eustachian tubeFO foramen ovaleFS foramen spinosumHC hypoglossal canalJB jugular bulbJFPV jugular foramen pars

vascularis

JS jugular spineMF mandibular fossaMHE mandible headOB occipital bonePOF petrooccipital fissureSPF sphenopetrosal fissureSPS sphenoidal sinusSSS sphenosquamosal sutureZP zygomatic process




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CAC carotid canalCJS caroticojugular spineEAC external auditory canalET Eustachian tubeFO foramen ovaleFS foramen spinosumGWS greater wing of sphenoidHC hypoglossal canalJB jugular bulbJFPV jugular foramen pars

vascularis

MACA mastoid canaliculusMF mandibular fossaMHE mandible headOB occipital bonePOF petrooccipital fissureSPF sphenopetrosal fissureSPS sphenoidal sinusSSS sphenosquamosal sutureZP zygomatic process




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CAC carotid canalCJS caroticojugular spineEAC external auditory canalET Eustachian tubeFL foramen lacerumFO foramen ovaleFP foramen petrosumFS foramen spinosumGWS greater wing of sphenoidHC hypoglossal canal

JB jugular bulb


MF mandibular fossaMHE mandible headOB occipital bonePOF petrooccipital fissureSPF sphenopetrosal fissureSPS sphenoidal sinusSSS sphenosquamosal sutureZP zygomatic process




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CAC carotid canalEAC external auditory canalET Eustachian tubeFL foramen lacerumFO foramen ovaleFS foramen spinosumGWS greater wing of sphenoidHC hypoglossal canalJB jugular bulbJFPV jugular foramen pars

vascularis

CJS caroticojugular spineMF mandibular fossaMHE mandible headOB occipital bonePOF petrooccipital fissureSPF sphenopetrosal fissureSPS sphenoidal sinusSSS sphenosquamosal sutureZP zygomatic process




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Chapter 3

HRCT Coronal Reformat

Coronal planeUsing an MPR 3D viewer, anterior and posterior aspects of the lateral semicircu-

lar canal (which define the axial plane) are identified. The coronal plane is perpen-dicular to the axial plane.

C00: HRCT coronal reformat


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CAC carotid canalET Eustachian tubeGIPS groove of the inferior petrosal

sinusMF mandibular fossaMHE mandible headMNE mandible neck

POF petrooccipital fissurePTF petrotympanic fissureSPF sphenopetrosal fissureSQT squama temporalisSSS sphenosquamosal sutureTTM tensor tympani muscle


3 HRCT Coronal Reformat


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sinusMF mandibular fossaMHE mandible head

MNE mandible neckPOF petrooccipital fissurePTF petrotympanic fissureSPF sphenopetrosal fissureSQT squama temporalisTTM tensor tympani muscle




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MNE mandible neckPOF petrooccipital fissurePTF petrotympanic fissureSPF sphenopetrosal fissureSQT squama temporalisTTM tensor tympani muscle




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MNE mandible neckPOF petrooccipital fissureSPF sphenopetrosal fissureSQT squama temporalisTTM tensor tympani muscle




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sinusMF mandibular fossaMH malleus head

MHE mandible headMNE mandible neckPOF petrooccipital fissureSPF sphenopetrosal fissureSQT squama temporalisTTM tensor tympani muscle




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CAC carotid canalET Eustachian tubeFNCTS facial nerve canal tympanic

segmentGF geniculate fossaGIPS groove of the inferior

petrosal sinusLPE lateral posterior

epitympanum

MF mandibular fossaMH malleus headMHE mandible headMNE mandible neckPOF petrooccipital fissureSQT squama temporalisTTM tensor tympani muscle




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CAC carotid canalFNCTS facial nerve canal tympanic


petrosal sinusI incusIMJ incudomallear jointLPE lateral posterior

epitympanum

MAP malleus anterior processMF mandibular fossaMH malleus headMHE mandible headMNE mandible neckPOF petrooccipital fissurePT protympanumSQT squama temporalisTTM tensor tympani muscle




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CAC carotid canalCMT cochlea middle turnFNCTS facial nerve canal tympanic


petrosal sinusI incusIMJ incudomallear jointLPE lateral posterior

epitympanum

MAP malleus anterior processMF mandibular fossaMH malleus headMHE mandible headMNE mandible neckPOF petrooccipital fissurePT protympanumSQT squama temporalisTTM tensor tympani muscle




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BI body of incusCAC carotid canalCMT cochlea middle turnCTAT crista transversa anterior

epitympanumEAC external auditory canalFNCLS facial nerve canal labyrinthine


segment

GIPS groove of the inferiorpetrosal sinus

IMJ incudomallear jointLPE lateral posterior

epitympanum

MF mandibular fossaMH malleus headMHE mandible headMLP malleus lateral processMN malleus neckMNE mandible neckPOF petrooccipital fissurePS Prussaks spaceSCT scutumSQT squama temporalis

TM tympanic membraneTTM tensor tympani muscle




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BI body of incusCAC carotid canalCAT cochlea apical turnCMT cochlea middle turnEAC external auditory canalFNCLS facial nerve canal labyrinthine


segmentGIPS groove of the inferior

petrosal sinusIMJ incudomallear jointLPE lateral posterior

epitympanumMF mandibular fossa

MHE mandible headMLP malleus lateral processMN malleus neckMNE mandible neckMPE medial posterior

epitympanumPOF petrooccipital fissurePS Prussaks spaceSCT scutumSQT squama temporalis

TM tympanic membraneTTM tensor tympani muscleTTMT tensor tympani muscle

tendon




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BI body of incusCAC carotid canalCAT cochlea apical turnCMT cochlea middle turnEAC external auditory canalFNCLS facial nerve canal labyrinthine



petrosal sinusLPE lateral posterior

epitympanumMF mandibular fossa

MHE mandible headMN malleus neckMNE mandible neckMPE medial posterior

epitympanumPOF petrooccipital fissurePS Prussaks spaceSCT scutumSQT squama temporalisTM tympanic membrane

TTM tensor tympani muscleTTMT tensor tympani muscle

tendon




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BI body of incusBSL bony spiral laminaCAC carotid canalCMT cochlea middle turnCP cochleariform processEAC external auditory canalFNCLS facial nerve canal labyrinthine


segment


IAC internal auditory canalISP incus short process

LPE lateral posterior epitympanumMF mandibular fossaMHE mandible headMN malleus neckMNE mandible neckMPE medial posterior epitympanumPOF petrooccipital fissurePS Prussaks spaceSCT scutumSQT squama temporalis

TM tympanic membraneTTM tensor tympani muscleTTMT tensor tympani muscle

tendon




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ASC anterior semicircular canalBI body of incusBSL bony spiral laminaCAC carotid canalCMT cochlea middle turnEAC external auditory canalFNCLS facial nerve canal labyrinthine


segment

GIPS groove of the inferior petrosalsinus

IAC internal auditory canal

IAM internal auditory canal meatusISP incus short processLPE lateral posterior epitympanumMF mandibular fossaMHA malleus handleMHE mandible headMNE mandible neckMPE medial posterior epitympanumPOF petrooccipital fissurePS Prussaks space

SCT scutumSQT squama temporalisTM tympanic membrane




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AOA anterior osseous ampullaASC anterior semicircular canalBSL bony spiral laminaCAC carotid canalCMT cochlea middle turnEAC external auditory canalFNCLS facial nerve canal labyrinthine


segment


HT hypotympanumIAC internal auditory canal

IAM internal auditory canal meatusILP incus long processISP incus short processLOA lateral osseous ampullaLPE lateral posterior epitympanumMF mandibular fossaMHA malleus handleMNE mandible neckMPE medial posterior epitympanumPOF petrooccipital fissure

SCT scutumSQT squama temporalisTM tympanic membrane




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AAA aditus ad antrumAOA anterior osseous ampullaASC anterior semicircular canalBSL bony spiral laminaCA cochlear areaCAC carotid canalCBT cochlea basilar turnCMT cochlea middle turnEAC external auditory canalFNA facial nerve area

FNCTS facial nerve canal tympanicsegment


HT hypotympanum

IAC internal auditory canalIAM internal auditory canal meatusILP incus long processISP incus short processLOA lateral osseous ampullaMF mandibular fossaMNE mandible neckPLSC prominence of lateral

semicircular canalPOF petrooccipital fissure

SCT scutumSQT squama temporalisSVA superior vestibular areaTM tympanic membraneVER vestibule elliptical recess




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AAA aditus ad antrumAOA anterior osseous ampullaASC anterior semicircular canalCA cochlear areaCAC carotid canalCBT cochlea basilar turnEAC external auditory canalFNCTS facial nerve canal tympanic


petrosal sinusHT hypotympanumIAC internal auditory canalILP incus long process

ISJ incudostapedial jointISP incus short processLOA lateral osseous ampullaLP lenticular processLSC lateral semicircular canalPLSC prominence of lateral

semicircular canalPOF petrooccipital fissureSAC stapes anterior crusSPC stapes posterior crus

SQT squama temporalisSVA superior vestibular areaVER vestibule elliptical recess




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AAA aditus ad antrumACP air cell of the pyramidAOA anterior osseous ampullaASC anterior semicircular canalCA cochlear areaCAC carotid canalCBT cochlea basilar turnEAC external auditory canalFNCTS facial nerve canal tympanic

segment


HT hypotympanumIAC internal auditory canalISP incus short process

LOA lateral osseous ampullaLP lenticular processLSC lateral semicircular canalOW oval windowOWN oval window nicheP promontoryPLSC prominence of lateral

semicircular canalPOF petrooccipital fissureSQT squama temporalis

STH stapes headSVA superior vestibular areaVER vestibule elliptical recessVSR vestibule spherical recess




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AAA aditus ad antrumACP air cell of the pyramidASC anterior semicircular canalCAC carotid canalCBT cochlea basilar turnEAC external auditory canalFNCTS facial nerve canal tympanic


petrosal sinus

HT hypotympanumIAC internal auditory canalIVA inferior vestibular areaLOA lateral osseous ampulla

LSC lateral semicircular canalMET mesotympanumOW oval windowOWN oval window nicheP promontoryPLSC prominence of lateral

semicircular canalPOF petrooccipital fissureSQT squama temporalisSTH stapes head

SVA superior vestibular areaTCR transverse crestVER vestibule elliptical recessVSR vestibule spherical recess




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petrosal sinus


IVA inferior vestibular areaLSC lateral semicircular canalMET mesotympanumOWN oval window nicheP promontoryPLSC prominence of lateral

semicircular canalPOF petrooccipital fissureSTH stapes headTCR transverse crest





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petrosal sinus


KS Koerners septumLSC lateral semicircular canalMET mesotympanumOWN oval window nicheP promontoryPC petromastoid canalPLSC prominence of lateral

semicircular canalPOF petrooccipital fissureSPC stapes posterior crus





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AAA aditus ad antrumASC anterior semicircular canalCAC carotid canalCBT cochlea basilar turnEAC external auditory canalFNCTS facial nerve canal tympanic

segmentFR facial recessGIPS groove of the inferior

petrosal sinus


KS Koerners septumLSC lateral semicircular canalMET mesotympanumPC petromastoid canalPOF petrooccipital fissurePYE pyramidal eminenceRW round windowSIT sinus tympaniTM tympanic membraneVER vestibule elliptical recess

VSR vestibule spherical recess




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ASC anterior semicircular canalCAC carotid canalEAC external auditory canalFNCTS facial nerve canal tympanic


petrosal sinusHT hypotympanumIAC internal auditory canal

KS Koerners septumLSC lateral semicircular canal

MA mastoid antrumMET mesotympanumPC petromastoid canalPOF petrooccipital fissurePYE pyramidal eminenceRW round windowRWN round window nicheSIC singular canalSIT sinus tympaniTM tympanic membrane

V vestibule




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ASC anterior semicircular canalCAC carotid canalEAC external auditory canalFNCTS facial nerve canal tympanic


petrosal sinusHT hypotympanumIAC internal auditory canal

KS Koerners septum

LSC lateral semicircular canalMA mastoid antrumMET mesotympanumPC petromastoid canalPYE pyramidal eminenceRW round windowRWN round window nicheSIC singular canalSIT sinus tympaniV vestibule




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ASC anterior semicircular canalEAC external auditory canalFNSG facial nerve canal second

genuFR facial recessGIPS groove of the inferior petrosal

sinusHT hypotympanum

IAC internal auditory canalKS Koerners septumLSC lateral semicircular canalMA mastoid antrumRWN round window nicheSIT sinus tympaniV vestibule




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ASC anterior semicircular canalEAC external auditory canalFNSG facial nerve canal second

genuGIPS groove of the inferior petrosal

sinus

HT hypotympanumKS Koerners septumLSC lateral semicircular canalMA mastoid antrumSIT sinus tympaniV vestibule




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ASC anterior semicircular canalCOC common osseous crusEAC external auditory canalFNCMS facial nerve canal mastoid


petrosal sinus

KS Koerners septumLSC lateral semicircular canalMA mastoid antrumPOA posterior osseous ampullaSIT sinus tympaniTC tympanic canaliculusV vestibule




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ASC anterior semicircular canalCAQ cochlear aqueductCOC common osseous crusEAC external auditory canalFNCMS facial nerve canal mastoid


petrosal sinus

KS Koerners septumLSC lateral semicircular canalMA mastoid antrumPOA posterior osseous ampullaSOC simple osseous crusSP styloid process




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CAQ cochlear aqueductCOC common osseous crusEAC external auditory canalFNCMS facial nerve canal mastoid

segmentKS Koerners septum

LSC lateral semicircular canalMA mastoid antrumPOA posterior osseous ampullaSOC simple osseous crusSP styloid process




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CAQ cochlear aqueductCJS caroticojugular spineCOC common osseous crusFNCMS facial nerve canal mastoid

segmentJF jugular foramen

KS Koerners septumLSC lateral semicircular canalMA mastoid antrumPOA posterior osseous ampullaSP styloid process




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CAQ cochlear aqueductCJS caroticojugular spineFNCMS facial nerve canal mastoid



vascularis

JS jugular spineKS Koerners septumMA mastoid antrumPSC posterior semicircular canalSP styloid process




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CAQ cochlear aqueductFNCMS facial nerve canal mastoid



vascularis

JS jugular spineKS Koerners septumMA mastoid antrumPSC posterior semicircular canalSP styloid processVAQ vestibular aqueduct




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CAQ cochlear aqueductFNCMS facial nerve canal mastoid



vascularis

KS Koerners septumMA mastoid antrumPSC posterior semicircular canalSP styloid processVAQ vestibular aqueduct




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FNCMS facial nerve canal mastoidsegment


KS Koerners septumMA mastoid antrumPSC posterior semicircular canalVAQ vestibular aqueduct




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HC hypoglossal canalJFPV jugular foramen pars

vascularis





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vascularis





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vascularis

KS Koerners septumMA mastoid antrumVAQ vestibular aqueduct




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vascularis





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vascularis





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vascularis

KS Koerners septumMA mastoid antrumSMF stylomastoid foramenVAQ vestibular aqueduct




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104



vascularis

MA mastoid antrumSMF stylomastoid foramenVAQ vestibular aqueduct




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105



vascularis

MA mastoid antrumSMF stylomastoid foramenVAQ vestibular aqueduct




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vascularis

MA mastoid antrum




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vascularis




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vascularis




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vascularis




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Chapter 4

HRCT Stenvers Reformat

Stenvers plane (oblique coronal, i.e. long axis of the pyramid)Using an MPR 3D viewer, anterior semicircular canal is identified on reformat-ted axial sections. The Stenvers reformat runs perpendicular to the plane defined bythe anterior semicircular canal.

S00: HRCT Stenvers reformat


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EAC external auditory canalFS foramen spinosumMAC mastoid air cells

MCBS mastoid cells bony septa

MF mandibular fossaMHE mandible headMP mastoid process

SSS sphenosquamosal suture

S01: HRCT Stenvers reformat

4 HRCT Stenvers Reformat


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EA

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