Antoine Micheau, MD , Denis Hoa, MD
Wednesday 12 April 2017Limbs
This part of the interactive anatomic atlas of the human body is devoted to the arterial vasculature of the pelvic girdle, pelvis, thigh, knee, leg and foot and to the study of bones and joints. It includes a 3D reconstruction of bones and arteries from angioCT with injection of a contrast agent (iodine), an angiographic view correlated with the 3D view and digital radiography of the skeleton of the lower limb.
Procedure details of this interactive atlas of the lower limb anatomy:
We have selected a normal angioCT (Computed Tomography) exam of lower limbs: acquisition was made with helical multidetector CT (MDCT) after injection of iodized contrast. The axial images were post-processed using software post-treatment on a workstation for a multimodal reconstruction and a three-dimensional visualization of bone and blood vessels, then a similar angiographic view was created.
The DICOM images were exported and then integrated into the software Adobe CS3 Professional Flash to create this anatomic module. The anatomical structures were labelled on the 3D view.
We also selected non pathologic digital X-rays: pelvis, hip, knee, ankle and foot, labelling the skeletal structures and joints.
All anatomical structures of the Terminologia Anatomica are translated in French, English, Spanish, Portuguese, Russian, Czech, Japanese and Chinese. This module may be used as a medical dictionary.
Peripheral vascular imaging of the lower limb:
We preferred to use an angioCT of the lower limb rather than a digital arteriography because it allowed the user to make a correlation between angiographic views of arteries with three-dimensional structures.
The 3D/angiographies tab can be used to select these two kinds of view.
The fields of view are the ones routinely used for angiography: a global vision of the entire arterial vasculature (from the aorta to the foot) and then 3 specific fields of view: iliac, femoral and tripod arteries
We have segmented the legends of the arteries into different groups: aorta and its branches, internal iliac artery and its branches, external iliac artery and its branches. This decreases the number of labels shown on each image and provides a better educational approach.
Only the arteries visible on the 3D view were labelled, this explains why on the angiographic view some arteries are visible only under particular rotation angles.
This module is designed for teachers in anatomy, including vascular disease, medical students and paramedical students (nurses, radiology technicians), but also practitioners in vascular medicine, ultrasound and Doppler examination, vascular surgery, interventional radiology, cardiology, angiology and endocrinology. It facilitates the study of arterial diseases of the lower limbs (atheroma, atherosclerosis), embolizations in emergencies, balloon angioplasties or stents, vascular bypass, gynaecologic embolizations (uterine fibroids, Primary Post-Partum Haemorrhages (note: the patient is male so there are some differences with the female pelvis vasculature).
Skeletal imaging of the lower limb
Joints and bones of the skeleton pelvis, thigh, hip, knee, leg, ankle and foot were also labelled. At the end this module please note that anatomical conventional radiology could be useful for usual practice, which is why you may find some labelled digital radiographies at the end of this module.
The left side menu provides access to various exams.
Long bones and joints are featured so that each structure can be followed throughout its extent.
We had to use groups of anatomical structures: sacrum, coxal bone, femur, patella, tibia, fibula, bones of the feet (tarsus and metatarsus). For technical reasons, the legends of the bone structures appear on the angiographic views and some bones do not appear; please forgive us for this problem.
The joints have also been labelled, although their study is easier on such exams as CT or MR arthrography.
This module is less specific than slice imaging modules, so it is helpful for all who are curious about skeletal and vascular anatomy and pathology of the lower limb: