e-Anatomy funktioniert besser in der Mobile App!
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Normales Thorax-CT (Lunge, Pleura, Mediastinum und Herz)
Preamble
The present document contains important information on the conditions (hereinafter "Conditions") of subscription to the paid services available on the site, accessible at www.imaios.com (hereinafter "Site") or offered in the applications, available on the Apple Store and Google Play platforms (hereinafter "Applications") and published by the company IMAIOS (hereinafter "Publisher" or "Licensor"). In this respect, as the Applications are available on these platforms, the Customer using the Applications shall also be required to accept the terms of use of the Apple Store or Google Play platform. The Conditions are reserved solely for consumers, as defined by law and jurisprudence, acting exclusively on their own behalf. In accordance with Articles L. 111-1 to L. 111-3 of the French Consumer Code, the essential characteristics and prices of the Paid Services are available on the Site and the Applications.
The Conditions are accessible, before any order and before its completion on the Site and on the Applications.
Publisher identification
Company name: IMAIOS
Corporate form: SAS
Registered office: 2 Allée Charles Darwin, 34170 Castelnau-le-Lez
Registered at the RCS of Montpellier under the number 505 111 716
VAT number: FR 93 505 111 716
Holder of a professional civil liability policy with AXA France IARS SA, for the year 2021 and tacitly renewable, covering certain damages occurring throughout the world.
Represented for the purposes hereof by Denis HOA, acting as President and duly authorized to sign the present, domiciled at the said head office.
Address: 2 Allée Charles Darwin, 34170 Castelnau-le-Lez
Email: contact@imaios.com
1. Purpose of the contract
1.1 Definitions
For the purposes of this contract, the terms below are defined as follow:
"License" refers to this License agreement defining the conditions of access and use of the Products imposed by the Publisher that the Customer accepts in order to place an order. According to the terms of this License, the Editor grants the Customer a license to use the Software for internal purposes as well as for its own needs. This term refers to the present contract, its annexes and its successive modifications.
"Licensee" or "Customer" or "User": means the natural person wishing to access and use the Paid Services offered by IMAIOS under the conditions set forth in this license, acting in his or her own name.
"Software" or “Solution” means original Software (including but not limited to, e-Anatomy, vet-Anatomy, QEVLAR Radiology, QEVLAR Quiz, IDV Dicom Viewer, Anatomy Ninja Lower Limb and Anatomy Ninja Upper Limb) pursuant to Article L112-2 13° of the Intellectual Property Code published and distributed by IMAIOS and for which the Licensee wishes to have access to paying functionalities. This original Software is based on intangible elements and components such as the development of a source code, a set of instructions, programs ( such as graphic interface, databases, etc.), processes and rules which are the result of specific and creative choices and above all of intellectual contribution. It also means the documentation associated with said products and their accessories (images, texts, etc.), i.e. any element attached to or associated with the Software that allows their functioning and use.
"Paid Services": refers to paid access to features of the Software, available on the Site or within the Applications. The Licensor hereby grants the Licensee, who accepts it, a non-exclusive, non-transferable, non-assignable, revocable license to use the paid-for software features ordered for the entire duration of this License, in accordance with its intended purpose and for its personal needs only.
1.2 Purpose
The purpose of this contract is thus to determine the conditions of subscription by the Customer allowing him to use the Paid Services of the Products, accessible from the Site or the Applications, within the limits of use defined in the License.
1.3 Scope
The Licensee declares that he has read the documentation freely accessible on the IMAIOS website, which presents the characteristics of the Software, as well as the terms and conditions of the License granted by the Publisher to the Customer for the Software and, in the event of an order placed on the Apple Store or Google Play platform, the related terms of use.
The Licensee acknowledges that the granted use only allows the Software to be consulted on the Website or within the Applications downloaded onto the mobile device (tablet, telephone) belonging to the Licensee. The Licensee agrees that this License does not include any additional services other than the Paid Services "defined" in Article 1.1 "Definitions". This License does not authorize the Licensee to grant sub-licenses.
This License does not include user support for the Licensee.
Licensee hereby agrees that the Software contains proprietary content, information and materials that are protected by applicable intellectual property and other laws, including but not limited to copyright, and that Licensee shall not use such proprietary content, information or materials in any manner whatsoever, except for the permitted use of the Software under the terms of this Agreement.
The Licensor's intellectual property rights in trademarks, designs and models are not within the scope of this License.
2. Terms of order
In order to subscribe to Paid Services, the Customer must follow the steps below:
2.1. On the Site
a. The Customer will type in the address of the Site.
b. The Customer will follow the instructions of the Site and in particular, the instructions necessary for the registration of the Customer, reflected by the creation of a User account if he does not already have one: in this case, the Customer will have, in particular, to provide information relating to his title, his name, his first name, his billing address and his e-mail address. The Customer agrees to provide true and accurate information. The Customer may, at any time, modify his personal information, his login and password, by accessing his account. The Customer is the only one responsible for the use of his login and password, which he agrees to keep secret. In case of loss or unauthorized use of his account, it is up to the Customer to inform the Publisher without delay, by using the tab "Contact" present on all the pages of the Site. In the event of a possible loss of the password, when opening the session and entering the username and password, the Customer can click on a link that will allow him to ask the Publisher to grant him a new password that will be sent to the address indicated in his personal information.
c. From then on, the Customer will read the present on the link "Subscription Terms & Conditions" as well as the conditions of access and use of the site and the applications. The Customer will then check the box "I accept the Subscription Terms & Conditions and Conditions of access & use".
d. It is then up to the Customer who wishes to access the Paid Services to fill in the order form. In the event of prolonged inactivity during the connection, it is possible that the selection of the Paid Services chosen by the Customer before this inactivity is no longer guaranteed. The Customer is then invited to restart the selection of the Paid Services from the beginning. The Customer will check the elements of the order and, if necessary, identify and correct any errors; it is always possible to abandon the order until confirmation.
e. The Customer will confirm the order and follow the instructions of the online payment server to pay the Total Price.
f. The Customer will be redirected to the "My Order" page. At the same time, the Customer will receive an electronic order confirmation, showing the order number and the price paid. The Customer will be able to access an invoice in electronic format on his account. It is recommended to print the order confirmation page, in order to keep the elements of the order, as well as the order number. This number must be remembered for any claim.
2.2 On Applications
a. The Customer shall go to the Application, or, if he does not already have it, to the Application download platform, Apple Store or Google Play in order to download the Application, in accordance with the terms and conditions applicable to the relevant platform and agreeing to abide by the conditions of access and use of the site and the Applications.
b. If he wishes, the Customer may create a User account within the Application, in order to be able to benefit from the Paid Services on other devices, such as on the Site or the same application on another platform. To this end, he must provide information on his title, surname, first name and e-mail address. The Customer agrees to provide true and accurate information. The Customer may, at any time, modify his personal information, his login and password, by accessing his account. The Customer is the only one responsible for the use of his login and password, which he agrees to keep secret. In case of loss or unauthorized use of his account, it is the Customer's responsibility to notify the Publisher without delay, using the "Contact" tab in the Applications. In the event of a lost password, when logging in and entering the username and password, the Customer may click on a link that will lead the Publisher to grant a new password which will be sent to the Customer at the address indicated in his personal information.
c. In any case, the subscription to the Paid Services is made with the platform. Therefore, in addition to reading these terms and conditions on the "Subscription Terms" link, as well as the terms and conditions of access and use of the website and applications, and checking the box "I accept the Subscription Terms & Conditions and Conditions of access & use", the Customer will also be bound by the general terms and conditions of the platform, Google Play or Apple Store, which he will have already read when downloading the Application and which he will be required to accept again.
d. It is then up to the Customer who wishes to access the Paid Services to order the desired services by selecting the services, clicking on "Subscribe" and then on the desired subscription and on "Subscribe". The Customer will then validate his order, according to the terms retained by the platform and will follow the platform's instructions to pay the price.
e. The Customer shall receive an electronic order confirmation without delay, showing the order number and the price paid. The Customer will be able to access an invoice in electronic format on his account within the platform. It is recommended to keep the order confirmation page, in order to keep the elements composing the order, as well as the order number. This number must be mentioned for any claim.
3. Access to Paid Services and Withdrawal
3.1 Access and Limitation
Access to the Paid Services on the Site will be activated after validation and payment of the order, by providing a username and password. The Customer will be able to access, by logging in on the Site, the Paid Services ordered and paid for. Access to the Paid Services on the Applications occurs after payment has been made on the Application, on the Customer's Google Play or Apple Store account, but can also be done by linking, within the Application, to the account opened on the Site in order to benefit from the paid services that have been subscribed to on the Site. Indeed, while the use of the Customer's account is strictly individual, no account sharing being accepted, the Customer is entitled to use, in a non-simultaneous manner, the Paid Services on several devices, on the basis of a single subscription.
The Licensee acknowledges that the use of the Paid Services does not include any installation, adaptation, customization, or training services: such services, if required, will be billed separately upon request by the Licensee to the Licensor.
3.2 Withdrawal
Concerning the orders made on the Site, the Customer benefits, beyond even the legal prescriptions, from a right of retraction of 30 (thirty) days from the day his order has been completed. The Customer can thus during this period, without attesting to any reason, go back on his commitment by sending to the Publisher, ideally with acknowledgement of receipt, a letter or an e-mail in that sense and without any ambiguity. A standard withdrawal form, which is only an example, is communicated to the Customer in the appendix. The refund will then take place within 14 (fourteen) days.With respect to orders for Paid Services placed on the Applications, the Google Play or Apple Store terms of use apply.
In this respect, the Customer ordering services on the Apple Store as well as on Google Play expressly acknowledges, due to the nature of the subject matter of the contract (access to and use of Products requested by the Customer prior to any exercise of a right of withdrawal), and by virtue of Article L.221-28 of the French Consumer Code, that withdrawal is excluded when the download of the Paid Services takes place at the time of the order on the Apple Store and that the services ordered on Google Play are also immediately available. He therefore waives the fourteen-day withdrawal period provided for in Article L221-18 of the same code, for the services offered by the Publisher under these conditions, on Google Play or Apple Store.
During the realization of the various stages mentioned above of the order, the Customer commits himself to respect the present contractual conditions.
In accordance with article L. 121-11 of the French Consumer Code, the Publisher reserves the right to refuse the order for any legitimate reason and in particular if it is abnormal, placed in bad faith or when there is a dispute with the Customer concerning the payment of a previous order.
4. Price and payment
4.1 Price
To access and use the Paid Services, the Customer must pay the price corresponding to the service in question and to the duration of the subscription chosen.
The price of the subscription allowing access to and use of the Paid Services is specified on the current price list available on the Site or on the Application and mentioned again at the time of the order; it includes all taxes.
The Paid Services correspond to:
· the cost of granting this License for the use of the Site and Applications;
· if applicable, the cost of support, usage statistics, hosting, and bandwidth for the use of the Software.
All other services are not included in the Price, including any potential installation, adaptation, customization or training fees: such services, if required, will be billed separately upon request by the Licensee to the Licensor. In this regard, the telecommunication fees related to access to the Site or the Application shall remain the sole responsibility of the Client. The validity period of the offers and prices is determined by the updating of the Site and the Applications.
4.2 Payment
On the Site, the payment of the total price by the Customer is carried out by credit card, Apple Pay, Google Pay, WeChat Pay or Alipay via the third party service Stripe, or by Paypal. The accepted credit cards are those of the VISA, MASTERCARD and AMERICAN EXPRESS networks issued and payable in France and the EURO zone.
Where applicable, the transaction is immediately debited from the Customer's bank card after verification of the card's data, upon receipt of the debit authorization from the company issuing the bank card used by the Customer.
The commitment to pay by means of a payment card is irrevocable. By providing his credit card information, the Customer authorizes the payment provider to debit his credit card for the amount corresponding to the total price.
To this end, the Customer confirms that he is the holder of the bank card to be debited and that the name on the bank card is indeed his. The Customer communicates the sixteen digits and the expiry date of his credit card as well as, if necessary, the numbers of the visual cryptogram.
In the event that it is impossible to debit the total price, the order will be immediately canceled by right.
The Licensor makes every effort to ensure the confidentiality and security of data transmitted on the Site. The Customer is informed that when paying by credit card, the Licensor uses the services of a service provider who is responsible for ensuring the safety of the payment transaction; the Publisher does not have access to the Customer's credit card numbers which are not stored at the Publisher but at the payment provider. Moreover, when subscribing to paid Services on the Applications, the Publisher does not handle the payment operations, which depend on the platforms.
5. Duration of access and renewal
Access to the Paid Services begins on the day of payment of the order for the duration chosen by the Customer when ordering. For certain Paid Services, individual subscriptions are automatically renewed on the expiration date; the user may at any time, up to and including the day before the renewal, disable this renewal from the interface of his profile, under the section "Subscriptions", or, in the context of the Applications, on the page for managing purchases and/or subscriptions provided by Apple Store (Settings > Apple ID) or Google Play, grouping together all the purchases made through them in the Applications.
The User will be informed of the deadline for objecting to the renewal of the subscription by e-mail, at the earliest 3 months and at the latest 1 month before the annual subscription renewal date.
It is expressly agreed between the Parties that IMAIOS reserves the right to modify its rates and access conditions from one period to another.
In addition, certain Paid Services may be subscribed to for an indefinite period: IMAIOS may not request a new paid subscription for these services, but does not commit to ensuring that these services, or the Application on which they are located, remain available.
6. Applicable contract documents
By using the IMAIOS’ Site and the Applications, the Licensee accepts, without reservation, the Conditions of access and use of the Site and Applications available on the IMAIOS site in free access and on each Application, as well as the Licensor's Privacy Policy. In the event of a conflict between the general terms of use and the present contract, the latter shall prevail. Furthermore, the Customer using the Applications is subject to the terms of use of the platform used, namely Google Play or Apple Store. In the event of a conflict between those conditions and the present terms and conditions, the latter shall prevail.
7. Termination
In the event of a breach by either party of any of its contractual obligations, this agreement may be terminated, ipso jure and without judicial formality, at the request of the injured party, in the absence of an amicable agreement, after formal notice to perform has been served by registered letter with acknowledgement of receipt which has remained unsuccessful for a period of thirty days, simply by sending a registered letter with acknowledgement of receipt notifying said termination. In the event that the Licensee fails to comply with its obligations, no refund of the price paid, corresponding to the remaining period of the subscription, will be granted.
8. Miscellaneous provisions
Unless proven otherwise, the data recorded on the page "My Account" of the Site constitutes proof of all Orders placed on the Site, and the Customer may thus access the history of orders placed at any time. Similarly, orders placed on the Applications are visible on the Apple Store or Google Play platforms.
The Customer may access the contracts binding the parties at the time of the order (Subscription Conditions, Privacy Policy, Terms and conditions of access and use of the Site and Applications) on the Site and via links within the Applications. The Customer may download these contracts and keep them in a durable manner on any other medium of his choice.
This Agreement shall be binding upon and inure to the benefit of the parties and their respective successors in interest. Licensee may not assign its rights, obligations or privileges hereunder or under any law, except with the prior written consent of Licensor.
The translation of the Conditions into any other language is provided for information purposes only. In the event of any inconsistency between the translated version and the French version, the French version shall prevail and be the only version that is binding on both parties and governs the relationship with the Publisher.
This contract and its interpretation are subject to French law and the parties acknowledge the exclusive jurisdiction of the French courts. Any dispute shall be referred to the competent French courts. The present clause will be applicable, even in case of summary proceedings, appeal in guarantee or plurality of defendants.
Cancellation form template
(for Orders placed on the Site)
To: IMAIOS SAS
2 Allée Charles Darwin, 34170 Castelnau-le-Lez, France / contact@imaios.com
I hereby inform you of my decision to exercise my right of withdrawal for:
the order n°XXXX, concerning the service XXXX, made on XX/XX/202X.
Consequently, I would like to ask you to return to me as soon as possible and at the latest within 14 days following the reception of the present, the sum of .... euros that I paid to you at the time of my order, this in accordance with the provisions of the articles L. 221-24 and L.221-25 of the French Consumer Code.
Name of the consumer
Address and, if necessary, email address of the consumer
Date
Warning to be read carefully
1. This document contains important information about the terms and conditions (hereinafter "Conditions") for accessing and using the site accessible at www.imaios.com (hereinafter "Site") and the applications, including but not limited to, e-Anatomy, vet-Anatomy, QEVLAR Radiology, IDV Dicom Viewer, Anatomy Ninja Lower Limb and Anatomy Ninja Upper Limb available on Google Play and Apple Store (hereinafter "Applications"), which apply between the company that publishes the Site and the Applications and all the users of the Site and Applications (hereinafter referred to as the "User").
2. The Site and the Applications may only be used for informational purposes. With the exception of certain applications, such as Anatomy Ninja Lower Limb and Anatomy Ninja Upper Limb, which are intended to be educational and entertaining, the Site and the Applications are intended only for use by knowledgeable healthcare professionals and those who are already engaged in a training process, independent of the Site and the Applications, to become professionals. Therefore, if you are not in this situation, with the exception of the Anatomy Ninja Lower Limb and Anatomy Ninja Upper Limb applications, please leave the Site and the Applications, which are not intended for you.
The Site and the Applications can in no way answer the public's medical questions. They are not intended to replace the relationship between the patient and his health care professional or to replace his medical advice. The Site and the Applications have not been tested or approved for clinical use. They are not medical devices and are not certified as such. They may not be used as diagnostic tools.
In general, we recommend that you systematically seek the advice of your usual doctor before consulting any Internet sites and applications with medical content.
3. By accessing the Site or the Applications and their content, or by using any of the services offered on the Site and within the Applications, you fully and unreservedly accept these Conditions as defined below and you declare that you are bound by these Conditions for an indefinite period of time, whether or not you are a healthcare professional. They include various limitations and exclusions of liability, as well as a jurisdictional clause governing the handling of any dispute.
By accessing the Site or downloading one of the Applications, you acknowledge that you are aware of the Privacy and Data Protection Policy practiced by the Editor and accessible at https://www.imaios.com/en/privacy-policy, on any page of the Site and within each Application. You declare that you do not object to this Privacy and Data Protection Policy implemented by the Editor.
4. These terms are subject to change at any time and without notice; they are systematically brought to the attention of any person accessing the Site or an Application by a link accessible on all pages of the Site and within each Application. We therefore thank you for regularly consulting these terms and their update.
If you do not accept all or part of the Conditions, you are requested to renounce all use of the Site and the Applications and to leave them.
5. These terms apply exclusively to your access to and use of the Site and the Applications; they do not alter the terms or conditions of any other agreement you may have with the Editor.
1 PRESENTATION OF THE SITE AND THE APPLICATIONS
1.1 Description and objectives of the Site and the Applications
Both the Site and the Applications are intended exclusively for an audience of knowledgeable healthcare professionals, with the exception of the Anatomy Ninja Lower Limb and Anatomy Ninja Upper Limb applications, which are intended for a broader audience (hereinafter "User(s)"). They are designed for educational purposes and contain medical information (articles, illustrations, tools and other resources, etc.).
1.2 Origin of the Site and the Applications
The Site and the Applications are published by the company IMAIOS, SAS, with a capital of 37000 €, whose registered office is IMAIOS SAS, 2 Allee Charles Darwin, 34170 Castelnau-Le-Lez, France, registered under the identification number 505 111 716 with the trade and company register of Montpellier (hereinafter referred to as the "Editor").
The director of the publication is Mr Denis Hoa.
1.3 Hosting of the Site
The Site is hosted by Amazon Web Services, Inc. whose registered office is 410 Terry Ave North, Seattle, WA 98109-5210, United States.
1.4 Regular contributors
All members of the IMAIOS team contribute regularly to the provision of medical information on the Site and the Applications, and in particular its managers:
Denis Hoa, Doctor of Medicine, graduate of the Faculty of Medicine of Montpellier, DES Radiodiagnostic et Imagerie médicale, Laureate of the Faculty of Medicine of Montpellier, Holder of a Master 2 Recherche en Radiophysique et Imagerie médicales, and
Antoine Micheau, Doctor of Medicine, graduate of the Faculty of Medicine of Montpellier, DES Radiodiagnostic et Imagerie médicale.
1.5 Financing of the Site and the Applications
The Site is financed by the Editor and the Users' subscriptions. The Applications are financed by the Editor and by the integrated purchases made by the Users, the Applications being of freemium type.
The shareholders of the Editor have no direct or indirect link with the pharmaceutical industry.
2. ACCESS TO THE SITE AND APPLICATIONS
2.1. Open access and registration
2.1.1 The Site
The Site is free and in free access. However, the Editor reserves the right to make access to all or part of the Site subject to payment, unilaterally and without prior notice.
Access to certain areas of the Site may be subject to prior registration according to a procedure explained on this occasion. If necessary, the Editor reserves the right to suspend, limit or refuse access to the Site, unilaterally and without prior notice, to any registered User (hereinafter "Registered User") who does not respect the Conditions.
2.1.2 The Applications
The Applications (including but not limited to e-Anatomy, vet-Anatomy, QEVLAR, IDV Dicom Viewer, Anatomy Ninja Lower Limb et Anatomy Ninja Upper Limb) each and individually are based on a set of instructions, programs, and rules. They are the expression of a unique source code created by the Editor.
Each of these Applications is an original software in accordance with the provisions of Article L112-2 13° of the French Intellectual Property Code.
These Applications are more than the simple implementation of an automatic logic.
Each one has lines of programming, codes, a structure and language of development which are the reflection of creative choices and an intellectual contribution of the Editor.
The Applications are free and freely downloadable on the Google Play and Apple Store platforms. However, some options are not free and the Editor reserves the right to charge for access to functions that are initially free, unilaterally and without notice.
2.2 Updating, interruption and availability of the Site and the Applications and their content
The Editor may, at any time, modify or delete information made available on the Site and/or any Application. It reserves the right to interrupt, temporarily or permanently suspend or modify access to all or part of the Site and the Applications, in order to ensure maintenance, or for any other reason, without this interruption giving rise to any obligation or compensation. Access to the Applications may also be interrupted or suspended due to unilateral decisions by Google Play or Apple Store.
Product and service specifications are subject to change without notice. Furthermore, IMAIOS does not guarantee that the products or services that are listed online or on the Applications will be available at the time of your order.
2.3 Scope
It is hereby expressly agreed that the granted access only allows the User to visit the Site and the Applications.
The User acknowledges that these Terms do not confer to the User any title of intellectual property rights (in particular as trademarks, designs or models) on the Site and the Applications.
3 SPECIFIC COMMITMENTS OF USERS
By using the Site and the Applications, the User agrees in particular not to:
- share his credentials with another user, each account being for strictly individual use;
- disrupt or interfere with the security of the Site and the Applications and their Content, resources (servers or networks connected to or accessible through the Site);
- disrupt or interfere with the enjoyment of any other User;
- upload, post or otherwise transmit through or on any site any virus or other harmful file;
- transmit through or on the Site or the Applications any type of unsolicited mass email to persons or entities who have not agreed to be part of such mailings;
- attempt to gain unauthorized access to the Site or the Applications or portions of the Site or the Applications that are restricted;
- use the Site or the Applications to seek, provide or obtain specific medical advice, medical opinion or diagnosis;
- use the Site or the Applications to seek, provide or obtain answers and/or specific lessons applied to a specific health-related examination;
- re-use the content of the Site or Applications outside the conditions set out in article 7.2.
4 QUALITY AND USE OF THE INFORMATION PROVIDED
4.1 Quality
The Editor endeavors to take the greatest care in the quality of the information provided on the Site and the Applications and in their regular updating. However, the Site and the Applications may contain erroneous or inaccurate information, omissions or data published independently of the Editor’s wish.
The Editor assumes no obligation to update the information available on the Site and the Applications.
The source of the data published on the Site and the Applications is explicitly mentioned with, if necessary, a hyperlink to this source. The date of the last modification appears clearly on the page of the Site or the Application concerned.
4.2 Usage
The Editor particularly draws the attention to the fact that the information published on the Site and on the Applications remains only indicative and for educational purposes without any express or tacit guarantee of any kind, for the exclusive use of health professionals duly authorized to practice in France or in their country of origin and health students, with the exception of the Applications which may be intended for a wider public.
This information shall in no way replace the opinion of health professionals or be considered or interpreted as advice or a recommendation of any kind.
The User shall not under any circumstances use the Site or the Applications to describe a condition, make a diagnosis, decide on a treatment or make any medical decision in the treatment of patients.
The User is in any case the only one responsible for the use of the information made available to him. He is invited to use it with discernment and to use his own professional judgment to evaluate it. The Editor further advises the systematic consultation of other sources of information.
5 AVAILABILITY OF PRODUCTS OR SERVICES
Any reference to an Editor product, application or service on the Site or the Applications does not imply that such product or service is or will be available in your country, where it may be subject to different regulations and conditions of use. This reference does not imply any intention on the part of the Editor to sell such product, application or service in the User's country. The Site and the Applications contain information on products and services that may or may not be available in all countries of the world. The User must ensure, prior to any use of the Site, the Applications or the products/services accessible via the Site and the Applications, that such use does not violate the laws of his country of residence.
The User is solely responsible for verifying whether the content of the Site, the Applications (or the products/services accessible from the Site or the Applications) complies with the legislation of the country from which he accesses the Site or the Application. The User is thus prohibited from using the Site or the Applications in a manner contrary to the legal, regulatory or ethical provisions applicable under the law of the country from which he accesses the Site or the Applications. The responsibility of the Editor or any other party involved in the creation and operation of the Site or the Applications shall not be engaged in case of non-compliance with the legislation of the country where the Site or the Applications are used.
6 LIABILITY AND WARRANTY
6.1 Exclusion of liability and warranty of the Editor
The use of the Site, the Applications and their information is the sole and entire responsibility of the Users.
Consequently, the responsibility of the Editor, its partners, its employees or any other party involved in the creation and operation of the Site and the Applications shall not be engaged because of any prejudice or damage, direct or indirect, of any nature whatsoever, resulting from access, use, even partial, or interpretation of the information on the Site or the Applications.
6.2 Liability and warranty of the User
The User guarantees and indemnifies the Editor, its partners, its employees or any other party involved in the creation and operation of the Site or the Applications against any action or claim from a third party due to the use of the Site or the Applications by the User or any harmful consequences directly or indirectly related to the use he makes of the Site or the Applications.
The User thus takes in charge the entirety of the damages to which the Editor, its partners, its employees or any other party implied in the creation and the exploitation of the Site and the Applications could be condemned as well as the legal expenses and the exposed fees.
Finally, the Editor cannot be held responsible for the content of the messages left on the discussion forums of the Site and, where applicable, of the Applications, which are only moderated a posteriori and which are only binding on their authors.
6.3 Hyperlinks to third-party sites
The Site and the Applications are likely to contain hypertext links to other Internet sites managed by third parties. However, the Editor cannot proceed to the regular verification of the quality of these linked sites. The Editor cannot be held responsible for the content of these sites, nor for the services offered on these sites.
In addition, a summary and/or a link to a third party site does not imply that the Editor approves the site or the products or services on these third party sites. It does not guarantee the accuracy of any content referenced in such third party sites and will not be liable for any damages or injury resulting from access to or inability to access such sites.
7 OWNERSHIP OF THE SITE, APPLICATIONS AND THEIR CONTENT
7.1 Protection of the content of the Site and the Applications
All intellectual property rights on the Site, the Applications and their content (hereinafter "Content") including texts, databases, software, applications, slideshows, logos, images, drawings, graphics, animated sequences, sounds, videos are the property of the Editor or third parties having authorized the Editor to use them.
The whole of this Content is thus protected by the French and international legislations in particular on the copyright, the designs and models law, the trademark law, the database law.
The names and brands mentioned on the Site and the Applications are registered trademarks of the Editor or its beneficiaries.
It is explicitly agreed that the granted access to the Site and the Applications shall not be interpreted as a license granted to the User on the intellectual property rights held by the Editor. Therefore, any reproduction, imitation and more generally any exploitation of these trademarks are prohibited, with the exception of the use of the Editor's trademarks to specify the origin of content reproduced by the User, in accordance with 7.2.
7.2 Use of the Site and the Applications - License granted
The Site and the Applications are intended exclusively for the personal and private use of the User.
The Editor grants the User a worldwide, non-exclusive, non-transferable, non-assignable, revocable license to use the Site and Applications for the duration of this Agreement and under the conditions set forth. The User acknowledges that the Site and Applications contain exclusive content, information, and materials that are protected by applicable intellectual property laws, in particular, copyright law. IMAIOS holds the intellectual property rights, including copyright, to the Site and Applications. The User acquires only a grant of rights, without any transfer of ownership.
The User is authorized to print or download the pages of the Site or print or take screenshots of the pages of the Applications under the following cumulative conditions:
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10. Date of update
This privacy policy was updated on December 6th, 2021.
Normales Thorax-CT (Lunge, Pleura, Mediastinum und Herz)
- Antoine MICHEAU, MD , Denis HOA, MD
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- Antoine MICHEAU, MD : 2 Allée Charles Darwin, 34170 Castelnau-le-lez
- Denis HOA, MD : 2 Allée Charles Darwin, 34170 Castelnau-le-lez
- Datum der veröffentlichung: 26.05.2021 | Letzte aktualisierung: 02.10.2024
- https://doi.org/10.37019/e-anatomy/826053.de ISSN 2534-5079
Einleitung
Dieses e-Anatomie-Modul beschäftigt sich mit der Anatomie des Thorax (Lunge, Pleura, Herz, Aorta, thorakale Lymphknoten und andere relevante anatomische Strukturen) unter Verwendung einer CT-Aufnahme des normalen Thorax.
Es wurde entwickelt, um Radiologen und Radiologinnen im Praxisalltag zu unterstützen (einen besonderen Schwerpunkt bilden beispielsweise Themen wie die segmentale Anatomie der Lunge, die Lymphknotenstationen nach IASLC zur Stadieneinteilung des Lungenkarzinoms vor Behandlungsbeginn, die Vermessung der Aorta thoracica für die TAVI-Planung oder Nachuntersuchungen nach Aneurysmen der Aorta thoracica). Dieses Modul ist aber auch ein Tool zum Erlernen der radiologischen Anatomie des Thorax, insbesondere für Studierende der Medizin oder Assistenzärztinnen und -ärzte in den Fachbereichen Radiologie, Pneumologie, Radioonkologie oder Thoraxchirurgie.
Material und Methoden
Die Thorax-Computertomografie wurde von Antoine Micheau MD (Radiologe), Imaios Frankreich, an einem gesunden 43-jährigen männlichen Probanden mit einem Siemens Somatom Definition Edge mit den folgenden technischen Spezifikationen durchgeführt:
| Collimation: 128 x 0.6 mm | Tube settings: 100 kV, 70 eff. mAs | |
| Pitch: 1.7 | DLP: 172 mGy cm | |
| Scan time: 2.5 s |
| |
| Scan length: 580 mm | Eff. dose: 2.49 mSv | |
| Rotation time: 0.28 s | Heart rate: 64 bpm |
Es wurde ein jodhaltiges Kontrastmittel (Omnipaque [Iohexol] 350 mg I/ ml) injiziert und ein Elektrokardiogramm-(EKG-)Gating eingesetzt.
Wir verwendeten Aufnahmen im Parenchym- und Mediastinalfenster mit multiplanaren Rekonstruktionen (MPR) in frontaler (koronarer) und sagittaler Ebene.
Wir erstellten Thoraxbilder mittels 3D-Volumen-Rendering, einschließlich der allgemeinen Anatomie, der Oberflächenanatomie, der Knochen des Thorax, der Muskeln des Thorax, der Luftröhre und Bronchien, der Lungen, der thorakalen Gefäße, der Aorta thoracica, der Lungenarterien, der Lungenvenen und der Vena cava superior.
Die anatomische Beschriftung erfolgte durch Dr. Antoine Micheau unter Verwendung der Terminologia Anatomica 2.
Bei der Beschriftung stellten wir einige unvermeidliche anatomische Abweichungen fest, die nachfolgend aufgeführt sind.
Anatomical variants and notes from the author about the anatomical labeling of the thorax CT:
- In the lower lobe of the left lung, there is an inconstant subsuperior pulmonary segment that is seen in approximately 30% of individuals, located between the superior and basal segments of the lower lobe. For pedagogical purposes, we included it in the superior segment of right lower lung, but we termed his bronchus as subpsuperior bronchus (S*), and his artery as subsuperior artery (A*).
- The lower lobe of the right lung has two superior segmental bronchi, with separate origins from the right inferior lobar bronchus.
- In the lower left lobe, it is not clear if there is a common basal anteromedial segment, or if these segments are separated (this is the option we chose for labeling, but consequently, the anterior segment appears to be slightly lateral and the lateral segment appears to be slightly posterior….).
- Segmental and subsegmental pulmonary arteries are generally parallel to segmental and subsegmental bronchi and run alongside them. This is in contrast to the course of most pulmonary veins, which run independently of bronchi within interlobular septa. In this module, the segmental arteries were named according to the bronchopulmonary segments that they feed, following the Terminologia Anatomica 2 (we just added the terms interlobar arteries, used in daily practice). However, the proximal portions of the arteries can run independently of their respective bronchi for short segments. Frequently, there are also accessory arteries from neighboring segments, particularly in the right upper lobe. Segmental and subsegmental pulmonary arteries vary considerably in the location of their origins, in whether they arise as common trunks with other arteries or as separate arteries, and in their number. Here are the variations encountered in this e-Anatomy module:
- There is an additional segmental middle lobar artery, draining the upper lateral part of middle lobe, and connected directly to the left lower lobe artery.
- There are two separate superior and subsuperior segmental arteries in the right lung.
- There are at least 3 separate superior segmental arteries in the left lung. - In our case, the brachiocephalic artery shares a common origin with the left common carotid artery forming a bovine arch, most common variant of the aortic arch (near 15% population).
- For the measurements of aortic diameters, we put colored lines as overlay on axial, coronal, sagittal and 3VR, however these landmarks are inevitably imprecise because the measurements of the diameters of the aorta must imperatively be measured on multiplanar reconstructions perpendicular to the aorta (blood flow) and not directly on axial, coronal or frontal images.
- Some structures like the phrenic nerve along with the pericardiacophrenic artery and vein, or some lymph nodes of the thorax cannot be clearly seen on this CT. But for educational purposes, we put anatomical labels on the presumed place of these structures.
- The IASLC lymph node map provides a reproducible and consistent set of definitions for the discussion of regional lymphadenopathy in patients with lung cancer. However, because of its comprehensiveness and text-based presentation, it may be challenging to grasp, remember, and apply during daily practice especially on thorax CTs. More importantly, ambiguities may emerge when its definitions are rigorously applied during interpretation of CT images. That’s why we used the article of El-Sherief et al. (Radiographics) for the delimitations of the thoracic lymph node area. The main changes concern the lower boundary of station 1 (thoracic inlet with sagittal oblique plane preferred to the clavicles) and the lower boundary of the station 4 (it should be on the right side of the inferior border of the azygos vein, and on the left side of the superior border of the left main pulmonary artery, but the result is unclear for the precarinal space that is included in station 4 during daily practice.
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- Kandathil A, Chamarthy M. Pulmonary vascular anatomy & anatomical variants. Cardiovasc Diagn Ther. 2018;8(3):201-207. doi:10.21037/cdt.2018.01.04
- https://www.med-ed.virginia.edu/courses/rad/CTPA/02anat/anat-02-02.html
- El-Sherief AH, Lau CT, Wu CC, Drake RL, Abbott GF, Rice TW. International association for the study of lung cancer (IASLC) lymph node map: radiologic review with CT illustration. Radiographics. 2014 Oct;34(6):1680-91. doi: 10.1148/rg.346130097. PMID: 25310423.
- Terminologia anatomica: international anatomical terminology By the Federative Committee on Anatomical Terminology (FCAT). Stuttgart: Georg Thieme Verlag. ISBN-10: 3-13-114361-4. ISBN-13: 978-3-13-114361-7
- Netter, Frank H. (2011) Atlas of human anatomy /Philadelphia, PA: Saunders/Elsevier
- Pocket Atlas of Human Anatomy: 5th edition - W. Dauber, Founded by Heinz Fene
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