Computer Tomographic Imaging and Anatomic Correlation of the Human Brain: A comparative atlas of thin CT-scan sections and correlated neuro-anatomic preparations

108 Pages·1986·19.3 MB·English

by  C. Plets

COMPUTER TOMOGRAPHIC IMAGING AND ANATOMIC CORRELATION
OF THE HUMAN BRAIN
SERIES IN RADIOLOGY
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C. Plets, A.L. Baert, G.L. Nijs and G. Wilms, Computer Tomographic Imaging and Anatomic Correla
tion of the Human Brain.
1987. ISBN 0 89838 811 2
COMPUTER TOMOGRAPHIC IMAGING
AND ANATOMIC CORRELATION
OF THE HUMAN BRAIN
A comparative atlas of thin CT-scan sections and
correlated neuro-anatomic preparations
C. PLETS
Departments of Neurosurgery & Anatomy
A.L. BAERT
Department of Radiology
G.L. NIJS
Departments of Neurology & Neurosurgery
and
G. WILMS
Department of Radiology
Catholic University of Leuven, Belgium
1987 MARTINUS NIJHOFF PUBLISHERS
a member of the KLUWER ACADEMIC PUBLISHERS GROUP
DORDRECHT / BOSTON / LANCASTER
Distributors
for the United States and Canada: Kluwer Academic Publishers, P.O. Box 358,
Accord Station, Hingham, MA 02018-0358, USA
for the UK and Ireland: Kluwer Academic Publishers, MTP Press Limited,
Falcon House, Queen Square, Lancaster LAI lRN, UK
for all other countries: Kluwer Academic Publishers Group, Distribution Center,
P.O. Box 322, 3300 AH Dordrecht, The Netherlands
Library of Congress Cataloging in Publication Data
Computer tomographic imaging and anatomic correlation
of the human brain.
(Series in radiology; 13)
Includes index.
1. Brain--Anatomy--Atlases. 2. Tomography--Atlases.
3. Brain--Radiography--Atlases. I. Plets, C.
II. Series.
QM455. C586 1986 611 ' .81 86-8525
ISBN ·13: 978·94·0 10·M07·9 e·ISBN ·13: 978·94·009·4291·2
DOl: 10.1007/978·94·009·4291·2
Copyright
©
1987 by Martinus Nijhoff Publishers, Dordrecht.
Softcover reprint of the hardcover 1s t edition 1987
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted in any form or by any means, mechanical,
photocopying, recording, or otherwise, without the prior written permission of
the publishe~s,
Martinus Nijhoff Publishers, P.O. Box 163, 3300 AD Dordrecht,
The Netherlands.
ACKNOWLEDGEMENTS
Appreciation is expressed to the Department of Anatomy of the Catholic University of Leuven and to the
Department of Radiology of the Academic University of Leuven. The former provided two dead bodies
which we used in our work and the latter took care of the radiology of pictures.
With gratitude we would like to acknowledge the assistance of Mr. J. Sente, Mr. L. Brants, and Mr. H.
Govaerts who were most helpfu.1.
The photographic specimens in this book were produced through the efforts of Mr. Frenay .
. We also wish to express our thanks to the Technical Department of the Catholic University of Leuven and
to Dr. G. Hoorens, Ir. P. Rosias, Lic. J. Honinx, Lic. P. Boon, Lic. H. Thonnon and Lic. N. Claes for their
valuable contributions to this work.
Sincere thanks are due to Mrs. Lenaerts who skillfully typed much of this manuscript.
Lastly we would be negligent if we did not express thanks to our publishers and to the many friends and
colleagues who have been most gracious by sharing their knowledge with us and who urged us on in the
preparation of this textbook.
CONTENTS
Acknowledgements V
Materials, Technique and Methodology 1
Note to the reader 9
Frontal Sections 11
Part one 11
Part two 49
Horizontal Sections 61
Part one 61
Part two 95
Literature 107
Subject Index 109
MATERIALS, TECHNIQUE AND METHODOLOGY
Anatomical Specimen First, the heads were laid in such a way that at
least three reference holes could be visualised on
The heads of two cadavers were removed within 12 the screen (see Fig. 3). As soon as the reference
hours after death; one to achieve the frontal sec plane was found, a scali was taken at every two
tions, and the other to prepare the horizontal sec millimeter distance in either an anterior-posterior
tions of the skull and brain which we are to discuss or an inferior-superior sequence. Following the
in our atlas. radiological part of the experiment the examiners
The sectioI?- plane used for the horizontal sec went back to the refence plane step by step in order
tions was defined by the right and left orbito to controle the position and to check whether the
meatal line. The orbito-meatalline taken as a basis examined leads had stayed in a position during the
for the sections was determined by two points: scanning procedure.
firstly the outer angle of the orbit, and secondly the
inferior-posterior side of the external acoustic
meatus. The Head Position Box (Fig. 4)
The section plane for the frontal sections was
defined by the plane vertical to the aforesaid plane A 3 mm thick plate, made out of austerretic chro
going through the identical points of the external miumnickel stainless steel was used to build the
acoustic meatus. head position box. The material is taken up in the
The heads were placed in a freezer at - 20° C and catalogues under the AISI-type numbers 302,304,
were completely frozen after 48 hours. 309 or 310.
A 3 mm hole was drilled at the four reference The head position box consists of following plat
points with a conventional electric drill. The depth ing:
of these holes varied from 5 to 15 mm. 1. the bottom with two upward walls (835 x
The holes were drilled as far as the inner side of 300mm)
the skull and at the points without hard tissue there 2. two singular upward walls (280 x 300mm)
was chosen for a drill-depth of approximately 3. two inlay plates (18 x 250 mm)
15 mm. Later on, four 3 mm headless screws were 4. one fixation plate (70 x 300mm)
inserted in the holes and the contents of the speci Before folding the walls in their upward position
men in order to achieve two parallel lines going by means of a trimming-press, a groove of 2 mm
through the top side of the screws. width and 0,5 mm depth is milled in the middle of
these walls.
This groove has a double function:
CT scanning 1. it functions as a casting-mould to produce a
positioning rib on the paraffin block
The froozen he_ads were put into a plastic log in 2. later on, the fixation plate will be shaven in
order to prevent' the CT scan from getting stained. these grooves
We scanned the specimens with a Somatom DR3 To assure a quick removal of the paraffin block
scan of Siemens, which is operational in the Aca out of the head position box, the lower part of the
demic Hospital of Leuven since 1983. two upward walls will be lightly bent towards the
2
middle of the box. Therefore, the trimming press to
fold plates will be adjusted as follows:
on 210 mm, caunted on 12°
on 281,6mm, caunted on 78°
on 551,6 mm, caunted on 78°
on 623,2 mm, caunted on 78°
All plate borders will further be splayed to
achieve correct welding joints of the different
plates. Before welding the head position box
plates it is necessary to fix the inlay plates on to the
bottom of the head position box. To avoid redun
dant welding seams, 5 holes should be drilled in
each inlay plate, corresponding with ten holes dril
led in the bottom plates. Meanwhile, a slit of 3 mm
width must be kept between the two inlay plates in
the middle of the Head Position Box bottom plate.
To fix the inlay-plates on the bottom of the Head
Position Box, the holes should only be filled up
with by melting welding wire. The Tungsten Inert
Gas welding technique is the obvious method to
weld the Head Position Box. The produced heat
causes melting of a welding wire.
The melting bath is seperated from the atmo
sphere during welding by adding an inert gas via
the welding head.
The inert gas used is Argon.
Fig. 1. Anatomical Theatre Leuven Beginning of the eight The welding wire is made of the same kind of
teenth century. steal as used for the head position box plates.
Fig. 2. Vesalius Institute Leuven (1870).
3
4
In order to reach a higher rust resistance, the metal. The total hight of the paraffin block with the
welding seams are then stained and passivated. head requires an increased draught.
During this staining process, the slay remainders of The head position box, the mitrebox and the saw
the welding will dissolve on an acid bath. Is is also were manufactured at the Technical Department
possible to polish the welding seams. Finally the of the Catholic University of Leuven.
welding seams are passivated in a 10% nitric acid
solution by which the acid shine of the stainless
steal is restored. Fixation of the heads
The head is to be fixed in position as follows: two
Mitrebox and saw (fig. 5) screws (for example on the left side) should be
inserted in the groove at the bottom of the head
A plywooden mitre-box is made in such a way that position box.
a paraffin block out from head position box fits into Afterwards the fixation plate is shoven in the two
it tightly. grooves of the vertical walls in such a way that the
A seam of 2 mm width is sawn in the middle of sharpened edge of the fixation plate fits in the small
the mitrebox, perpendicularly to the bottom. At grooves of the two upper screws. In this way, the
12 mm of this seam a 8 mm hole is drilled in the two head is completely fixed in the head position box.
vertical walls of the mitrebox. Through these walls The contemplated section plane is exactly situ
a 8 mm thick stainless steel bar is placed, which ated in the middle plane of the box (see fig. 6).
makes it possible to push the paraffin block with We heated paraffin blocks at 60° C. The liquid
the head to the right over a length of 8 mm. In this paraffin was poured onto the periphery of the head
way it is possible to produce slices which are exactly up to a height of 70 mm.
8mm thick. The head position box was immediately put in
The saw should be a fine-toothed universal saw. the freezer till the next day.
The used saw was 2 mm thick and consisted of hard As soon as the specimen is well froozen it can
Fig. 5. The Mitrebox.