High-Resolution MRI in Evaluation of the Surgical Anatomy of the Esophagus and Posterior Mediastinum
A. M. Riddell1,
D. C. Davies2,
W. H. Allum1,
A. C. Wotherspoon1,
C. Richardson1 and
G. Brown1
1 Department of Diagnostic Radiology, Royal Marsden Hospital Foundation Trust,
Downs Rd., Sutton, Surrey, SM2 5PT, United Kingdom.
2 Department of Anatomy, St. George's Hospital Medical School, London SW17 0RE,
United Kingdom.
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Fig. 1A —Cadaver of 86-year-old woman. Images show layers of
esophageal wall: mucosa (thin arrow), submucosa (arrowhead),
and muscularis propria (thick arrow). Nearby structures are azygos
vein (A), vertebral body (V), and descending thoracic aorta (TA).
High-resolution T2-weighted axial MR image.
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Fig. 1B —Cadaver of 86-year-old woman. Images show layers of
esophageal wall: mucosa (thin arrow), submucosa (arrowhead),
and muscularis propria (thick arrow). Nearby structures are azygos
vein (A), vertebral body (V), and descending thoracic aorta (TA). Photograph
shows anatomic section.
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Fig. 1C —Cadaver of 86-year-old woman. Images show layers of
esophageal wall: mucosa (thin arrow), submucosa (arrowhead),
and muscularis propria (thick arrow). Nearby structures are azygos
vein (A), vertebral body (V), and descending thoracic aorta (TA). Photograph
shows whole-mount histologic section. (H and E)
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Fig. 3A —Cadaver of 72-year-old woman. Images show right pleural space
(arrow) extending to esophageal wall. RL = right lung, V = vertebral
body, TA = descending thoracic aorta. Axial MR image.
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Fig. 3B —Cadaver of 72-year-old woman. Images show right pleural space
(arrow) extending to esophageal wall. RL = right lung, V = vertebral
body, TA = descending thoracic aorta. Photograph shows anatomic section.
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Fig. 4A —Cadaver of 72-year-old woman. Line drawing shows site of
folds of parietal serous pericardium forming oblique sinus posterior to left
atrium and transverse sinus posterior to ascending aorta.
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Fig. 4B —Cadaver of 72-year-old woman. MR image shows pericardium
(arrows) as low signal intensity, oblique sinus (double
asterisk) posterior to left atrium, and transverse sinus
(asterisk) posterior to ascending aorta.
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Fig. 4C —Cadaver of 72-year-old woman. Photograph of anatomic section
shows pericardium (arrows) as shimmering fibrous tissue layer,
oblique sinus (double asterisk) posterior to left atrium, and
transverse sinus (asterisk) posterior to ascending aorta.
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Fig. 5A —Cadaver of 86-year-old woman. Close anatomic structures are
left atrium (LA), vertebral body (V), and descending thoracic aorta (TA). MR
image shows thoracic duct (arrow) as small structure of low signal
intensity posterolateral to aorta. Azygos vein (arrowhead) is to
right of duct.
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Fig. 5B —Cadaver of 86-year-old woman. Close anatomic structures are
left atrium (LA), vertebral body (V), and descending thoracic aorta (TA).
Photograph of histologic whole-mount section shows thoracic duct
(arrow) as fine endothelial-lined vessel. Azygos vein
(arrowhead) is to right of duct. (H and E)
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Fig. 6A —Cadaver of 86-year-old woman. Images show fascial attachment
to aorta. Nearby anatomic structures are left atrium (LA), azygos vein (A),
vertebral body (V), and descending thoracic aorta (TA). MR image shows fascial
plane (arrow) as linear band of low signal intensity passing to
aortic adventitia and extending posterior to esophagus toward right parietal
pleura (arrowheads).
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Fig. 6B —Cadaver of 86-year-old woman. Images show fascial attachment
to aorta. Nearby anatomic structures are left atrium (LA), azygos vein (A),
vertebral body (V), and descending thoracic aorta (TA). Photograph of
histologic whole-mount section confirms findings in A. Fascial plane
passes to aortic adventitia (arrow) and posterior to esophagus toward
right parietal pleura (arrowheads). (Elastin-Van Gieson)
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Fig. 7A —Cadaver of 86-year-old woman. RL = right lung, A = azygos
vein, V = vertebral body, TA = descending thoracic aorta. Axial MR image shows
fine line (arrow) of high signal intensity interposed between
esophagus and left main bronchus at level of carina.
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Fig. 7B —Cadaver of 86-year-old woman. RL = right lung, A = azygos
vein, V = vertebral body, TA = descending thoracic aorta. Photograph of
histologic whole-mount section confirms presence of narrow layer of connective
tissue (arrow) between esophagus and left main bronchus at level of
carina. (Elastin-van Gieson)
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Copyright © 2007 by the American Roentgen Ray Society.
