Normal Cortical Anatomy
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Transcript of Normal Cortical Anatomy
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Normal CorticalAnatomy
MGH
Massachusetts General HospitalHarvard Medical School
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NORMAL CORTICAL ANATOMY
• Sagittal• Axial• Coronal• The Central Sulcus
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Sagittal Neuroanatomy
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Subcallosal gyrusGyrus rectus
Parietooccipital sulcus
Fastigium, fourth ventricle
Cingulate gyrus
Calcarine sulcus
Marginal ramus of Cingulate sulcus
Superior parietal lobule
Paracentral lobule
Cingulate sulcusSuperior frontal gyrus
Cuneus
Lingual gyrus
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Gyrus rectus
Parietooccipital sulcus
Cingulate gyrus
Calcarine sulcus
Lingual gyrus
Marginal ramus of Cingulate sulcus
Superior parietal lobule
Cingulate sulcus
Caudothallamic groove
Precuneus
Central sulcus
Cuneus
Precentral gyrus
Frontomarginal gyrus
Superior frontal gyrus
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Parietooccipital sulcus
Calcarine sulcus
Superior parietal lobule
Marginal ramus of Cingulate sulcus
Central sulcusPrecentral
sulcus
Precuneus
Corona radiataSuperior frontal
gyrus
Lingual gyrus Inferior occipital gyrus
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Inferior temporal gyrus Temporal horn, lateral ventricle
Central sulcus
Posterior orbital gyrus
Frontomarginal gyrus
Medial orbital gyrus
Frontopolar gyrus
Parietooccipital sulcus
Lingual gyrusInferior occipital gyrus
Superior occipital gyrus
Middle occipital gyrus
Superior parietal lobule
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Central sulcus
Inferior Temporal gyrus
Middle Temporal gyrus
Superior Temporal gyrus
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Central sulcus
Lingual gyrus
Inferior occipital gyrus
Superior parietal gyrus
Middle occipital gyrus
Superior occipital gyrus
Inferior Temporal gyrusMiddle Temporal gyrus
Superior Temporal gyrus
Posterior orbital gyrus
Anterior orbital gyrus
Frontomarginal gyrus
Inferior frontal gyrus
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Inferior Temporal gyrus
Superior Temporal sulcusSuperior Temporal gyrus
Anterior occipital sulcus
Superior frontal sulcus
Precentral sulcus
Central sulcusPostcentral sulcus
Angular gyrus
Lateral fissure, posterior segment
Inferior frontal gyrus,pars orbitalis
Middle Temporal gyrus
Inferior occipital gyrus
Middle occipital gyrus
Inferior frontal gyrus,pars triangularis
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Axial Neuroanatomy
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Superior Temporal gyrus
Middle Temporal gyrus
Inferior Temporal gyrus
Fusiform gyrus
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Superior Temporal gyrus
Middle Temporal gyrus
Inferior Temporal gyrus
Parahippocampal gyrus
Hippocampal gyrus
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Temporo-occipital fissure
Inferior occipital gyrus
Lingual gyrusGyrus descendens
Superior Temporal gyrus
Middle Temporal gyrus
Inferior Temporal gyrus
Amygdala Hippocampus
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Gyrus rectus
Olfactory sulcusMedial orbital gyrusSubcallosal gyrus
Posterior orbital gyrus
Temporo-occipital fissure
Middle occipital gyrus
Lingual gyrus
Amygdala
Hippocampus
Superior Temporal gyrus
Middle Temporal gyrus
Inferior Temporal gyrus
Gyrus descendens
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Superior Temporal gyrus
Middle Temporal gyrus
Gyrus rectus
Olfactory sulcus Medial orbital gyrus
Anterior orbital gyrus
Posterior orbital gyrus
Lingual gyrus
Parahippocampal gyrus
Calcarine sulcus
CuneusGyrus descendens
Temporo-occipital fissure
Middle occipital gyrusIntra-occipital sulcus
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Superior frontal gyrus
Anterior orbital gyrus
Posterior orbital gyrus
Frontomarginal gyrus
Cingulate gyrus
Superior occipital gyrusIntra-occipital sulcusMiddle occipital gyrus
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Superior occipital gyrusIntra-occipital sulcus
Middle occipital gyrus
Cingulate gyrus
Parieto-occipital fissure
Calcarine sulcus
Cuneus
Middle temporal gyrus
Superior temporal sulcus
Superior temporal gyrus
Insula
Inferior frontal gyrus,pars orbitalis
Superior frontal gyrus Middle frontal gyrus
Inferior frontal gyrus,pars opercularis
Lateral fissure
Lateral fissure
Inferior parietal gyrus
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Middle occipital gyrus
Superior temporal gyrus
Intra-occipital sulcus
Superior frontal gyrus
Central sulcus
Superior occipital gyrusParieto-occipital sulcus
Superior temporal sulcus
Lateral fissure
Inferior parietal gyrus
Postcentral gyrus
Lateral fissure
Middle frontal gyrus
Inferior frontal gyrus
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Superior occipital gyrus
CuneusIntra-occipital sulcus
Middle occipital gyrus
Central sulcus
Precentral sulcus
Precentral gyrus
Central sulcus
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Postcentral sulcus
Superior frontal sulcus
Central sulcus
Intraparietal sulcus
Superior frontal gyrus
Middle frontal gyrus
Superior parietal gyrus
Centrum semiovale
Parietooccipital sulcus
Precuneus
Angular gyrus
Central sulcus
Inferior frontal gyrus
Supramarginal gyrus
Postcentral sulcus
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Postcentral sulcus
Central sulcus
Superior frontal sulcus
Pars marginalis
Intraparietal sulcus
Superior frontal gyrus
Middle frontal gyrus
Superior parietal gyrus
Angular gyrus
Supramarginal gyrus
Intraparietal sulcus
Central sulcus
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Central sulcus
Postcentral sulcus
Superior frontal sulcus
Precentral sulcus
Pars marginalis
Intraparietal sulcus
Superior frontal gyrus
Middle frontal gyrus
Superior parietal gyrus
Angular gyrus
Postcentral gyrus
Supramarginal gyrus
Precentral gyrus
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Central sulcus
Postcentral sulcus
Superior frontal sulcus
Precentral sulcus
Pars marginalisIntraparietal sulcus
Superior frontal gyrus
Middle frontal gyrus
Precuneus
Paracentral lobule
Superior parietal gyrus
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Coronal Neuroanatomy
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Olfactory bulb
Gyrus rectusMedial Orbital gyrus
Inferior Frontal gyrusSuperior Frontal gyrus
Middle Frontal gyrus
Interhemispheric Fissure
Inferior Frontal gyrus
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Forceps
minor
Olfactory SulcusLateral orbital gyrus
Inferior Frontal gyrus
Superior Frontal gyrusSuperior Frontal sulcus
Middle Frontal gyrus
Medial Orbital gyrus Gyrus rectusAnterior Orbital gyrus
Lateral orbital sulcus
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Inferior Frontal gyruspars opercularis
Superior Frontal gyrus Middle Frontal gyrus
Sylvian Fissure
Posterior Orbital gyrus
Inferior Temporal gyrus
Cingulate gyrusCircular insular sulcus
Olfactory Sulcus
Superior Temporal gyrus
Middle Temporal gyrus
Inferior Frontal sulcusshort insular gyrus
Gyrus rectusMedial Orbital gyrus
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Superior Frontal gyrusSuperior Frontal sulcus
Middle Frontal gyrus
Superior Temporal Sulcus
Sylvian Fissure
Amygdala
Precentral sulcus
Anterior commissure
Cingulate sulcus
Superior Temporal gyrus
Middle Temporal gyrus
Inferior Temporal gyrus
Precentral gyrus
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Superior Frontal gyrus
Middle Frontal gyrus
Superior Temporal gyrus
Middle Temporal gyrus
Superior Temporal Sulcus
Sylvian Fissure
Heschl’s gyrus
Inferior Temporal sulcus
Inferior Temporal gyrusAmygdala
Ambient gyrus
Entorhinal area
Cingulate gyrus
Superior Frontal sulcus
Precentral sulcus
Precentral gyrus
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Superior Frontal gyrus
Middle Frontal gyrus
Superior Temporal gyrus
Middle Temporal gyrus
Inferior Temporal gyrus
Fusiform gyrus
Hippocampus
CA1, cornu ammonisParahippocampal gyrus
Central Sulcus
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Paracentral lobule
Superior Temporal gyrus
Middle Temporal gyrus
Inferior Temporal gyrus
Central Sulcus
Postcentral gyrus
Cingulate gyrusIntraparietal sulcus
Fusiform gyrusCollateral sulcus
Parahippocampal gyrus
Supramarginal gyrus
Intraparietal sulcus
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Superior Temporal gyrus
Middle Temporal gyrus
Inferior temporal gyrus
Fusiform gyrus
Central sulcusParacentral lobule
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Fusiform gyrusLingual gyrus
Calcarine sulcus Cingulate gyrus
Inferior temporal gyrus
Middle temporal gyrus
Supramarginal gyrus
Intraparietal sulcus
Central sulcus
Paracentral lobule
Postcentral gyrus
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Lingual gyrus
Calcarine sulcus
Superior parietal lobuleprecuneus
Cingulate gyrus
Tentorium cerebelli
Fusiform gyrus
Inferior parietal lobule
Middle occipital gyrus
Inferior occipital
gyrus
Lingual gyrus
Collateral sulcus
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The Central Sulcus
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• superior frontal sulcus - pre CS sign
• sigmoidal Hook sign• pars bracket sign• Bifid post-CS sign• thin postcentral gyrus sign• intraparital sulcus - post-CS• midline sulcus sign
The Central Sulcus (CS)*
*Naidich & Brightbill. Int J Neurorad 1996;2:313-338
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• Superior frontal sulcus - preCS sign– the posterior end of the superior frontal
sulcus joins the precentral sulcus in 85%
The Central Sulcus (CS)
Precentral sulcus
Superior frontal sulcus
Precentral gyrus
Central sulcus
Superior frontal gyrus
Superior frontal sulcus
Precentral sulcus
Precentral gyrus
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• Sigmoid “Hook”– hooklike
configuration of the posterior surface of the precentral gyrus
– the “hook” corresponds to the motor hand area.
– The “hook” is well seen on CT (89%) and MRI (98%).
The Central Sulcus (CS)
Precentral sulcus
Central sulcus
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• pars bracket sign– The paired pars
marginalis form a “bracket” to each side of the interhemispheric fissure at or behind the central sulcus (96%).
The Central Sulcus (CS)
Precentral sulcus
Superior frontal sulcus
Precentral gyrus
Central sulcus
Pars bracket Paracentral lobule
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• pars bracket sign
The Central Sulcus (CS)
Precentral sulcus
Superior frontal sulcus
Precentral gyrus
Central sulcus
Pars bracketPars bracket
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• Bifid post-CS sign– the post-CS is bifid (85%).– The bifid post-CS encloses the lateral end of
the pars marginalis (88%).
The Central Sulcus (CS)
Precentral sulcus
Precentral gyrus
Central sulcus
Postcentral sulcus
Pars bracket
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Central sulcus
Postcentral sulcus
Central sulcus Central sulcus
Postcentral sulcus
Postcentral sulcus
Pars bracketPars bracket
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• Thin post-CG sign– the postcentral gyrus is
thinner than the precentral gyrus (98%).
The Central Sulcus (CS)Precentral
gyrus
Postcentral gyrus
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• Intraparietal Sulcus (IPS) and the post-CS– in axial MRI, the IPS intersects the post-CS
(99%).
The Central Sulcus (CS)
Pars bracket
IPS
Postcentral sulcus
IPS
Pars bracket
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Postcentral sulcus
IPS
Postcentral sulcus
IPS
Postcentral sulcus
IPS
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Precentral sulcus
Superior frontal sulcus
Precentral gyrus Central sulcus
Superior frontal gyrus
• Midline Sulcus sign– the most prominent
convexity sulcus that reaches the midline interhemispheric fissure is the CS (70%).
The Central Sulcus (CS)
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The Central Sulcus (CS)
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SFS-preCS sign
Hook sign
Pars bracket sign
Bifid post-CS sign
Thin postcentral gyrus sign
IPS - postCS sign
The Central Sulcus (CS)