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NORMAL CORTICAL ANATOMY

NORMAL CORTICAL ANATOMY. MGH Massachusetts General Hospital Harvard Medical School. Nicola Petitti MD, PhD. NORMAL CORTICAL ANATOMY. Sagittal Axial Coronal The Central Sulcus. Sagittal Neuroanatomy. Cingulate sulcus. Superior frontal gyrus. Marginal ramus of Cingulate sulcus.

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NORMAL CORTICAL ANATOMY

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  1. NORMAL CORTICALANATOMY MGH Massachusetts General Hospital Harvard Medical School Nicola Petitti MD, PhD

  2. NORMAL CORTICAL ANATOMY • Sagittal • Axial • Coronal • The Central Sulcus NP/MGH

  3. Sagittal Neuroanatomy NP/MGH

  4. Cingulate sulcus Superior frontal gyrus Marginal ramus of Cingulate sulcus Cingulate gyrus Paracentral lobule Superior parietal lobule Parietooccipital sulcus Cuneus Calcarine sulcus Lingual gyrus Subcallosal gyrus Gyrus rectus Fastigium, fourth ventricle NP/MGH

  5. Superior frontal gyrus Cingulate sulcus Precentral gyrus Marginal ramus of Cingulate sulcus Central sulcus Cingulate gyrus Superior parietal lobule Precuneus Parietooccipital sulcus Cuneus Calcarine sulcus Frontomarginal gyrus Lingual gyrus Caudothallamic groove Gyrus rectus NP/MGH

  6. Precentral sulcus Central sulcus Superior frontal gyrus Marginal ramus of Cingulate sulcus Corona radiata Superior parietal lobule Precuneus Parietooccipital sulcus Calcarine sulcus Inferior occipital gyrus Lingual gyrus NP/MGH

  7. Central sulcus Superior parietal lobule Parietooccipital sulcus Frontopolar gyrus Frontomarginal gyrus Superior occipital gyrus Middle occipital gyrus Medial orbital gyrus Lingual gyrus Posterior orbital gyrus Inferior occipital gyrus Inferior temporal gyrus Temporal horn, lateral ventricle NP/MGH

  8. Central sulcus Superior Temporal gyrus Middle Temporal gyrus Inferior Temporal gyrus NP/MGH

  9. Central sulcus Superior parietal gyrus Inferior frontal gyrus Frontomarginal gyrus Anterior orbital gyrus Superior occipital gyrus Middle occipital gyrus Posterior orbital gyrus Superior Temporal gyrus Inferior occipital gyrus Middle Temporal gyrus Inferior Temporal gyrus Lingual gyrus NP/MGH

  10. Precentral sulcus Superior frontal sulcus Central sulcus Postcentral sulcus Lateral fissure, posterior segment Inferior frontal gyrus, pars triangularis Angular gyrus Inferior frontal gyrus, pars orbitalis Superior Temporal gyrus Superior Temporal sulcus Middle occipital gyrus Middle Temporal gyrus Anterior occipital sulcus Inferior Temporal gyrus Inferior occipital gyrus NP/MGH

  11. Axial Neuroanatomy NP/MGH

  12. Fusiform gyrus Superior Temporal gyrus Middle Temporal gyrus Inferior Temporal gyrus NP/MGH

  13. Parahippocampal gyrus Superior Temporal gyrus Middle Temporal gyrus Inferior Temporal gyrus Hippocampal gyrus NP/MGH

  14. Amygdala Hippocampus Superior Temporal gyrus Middle Temporal gyrus Temporo-occipital fissure Inferior occipital gyrus Inferior Temporal gyrus Gyrus descendens Lingual gyrus NP/MGH

  15. Gyrus rectus Medial orbital gyrus Olfactory sulcus Subcallosal gyrus Posterior orbital gyrus Superior Temporal gyrus Amygdala Middle Temporal gyrus Hippocampus Inferior Temporal gyrus Temporo-occipital fissure Middle occipital gyrus Gyrus descendens Lingual gyrus NP/MGH

  16. Gyrus rectus Olfactory sulcus Medial orbital gyrus Anterior orbital gyrus Superior Temporal gyrus Posterior orbital gyrus Middle Temporal gyrus Parahippocampal gyrus Lingual gyrus Temporo-occipital fissure Calcarine sulcus Middle occipital gyrus Gyrus descendens Cuneus Intra-occipital sulcus NP/MGH

  17. Frontomarginal gyrus Superior frontal gyrus Anterior orbital gyrus Posterior orbital gyrus Cingulate gyrus Middle occipital gyrus Intra-occipital sulcus Superior occipital gyrus NP/MGH

  18. Superior frontal gyrus Middle frontal gyrus Inferior frontal gyrus, pars orbitalis Lateral fissure Inferior frontal gyrus, pars opercularis Inferior parietal gyrus Insula Lateral fissure Cingulate gyrus Superior temporal gyrus Parieto-occipital fissure Superior temporal sulcus Middle temporal gyrus Calcarine sulcus Middle occipital gyrus Cuneus Superior occipital gyrus Intra-occipital sulcus NP/MGH

  19. Superior frontal gyrus Middle frontal gyrus Inferior frontal gyrus Central sulcus Postcentral gyrus Lateral fissure Inferior parietal gyrus Superior temporal gyrus Lateral fissure Superior temporal sulcus Middle occipital gyrus Parieto-occipital sulcus Intra-occipital sulcus Superior occipital gyrus NP/MGH

  20. Precentral sulcus Precentral gyrus Central sulcus Central sulcus Cuneus Middle occipital gyrus Intra-occipital sulcus Superior occipital gyrus NP/MGH

  21. Superior frontal gyrus Middle frontal gyrus Superior frontal sulcus Inferior frontal gyrus Centrum semiovale Central sulcus Central sulcus Postcentral sulcus Postcentral sulcus Supramarginal gyrus Intraparietal sulcus Angular gyrus Parietooccipital sulcus Superior parietal gyrus Precuneus NP/MGH

  22. Superior frontal gyrus Middle frontal gyrus Superior frontal sulcus Central sulcus Central sulcus Supramarginal gyrus Postcentral sulcus Intraparietal sulcus Angular gyrus Pars marginalis Intraparietal sulcus Superior parietal gyrus NP/MGH

  23. Superior frontal gyrus Middle frontal gyrus Superior frontal sulcus Precentral gyrus Precentral sulcus Central sulcus Postcentral gyrus Postcentral sulcus Supramarginal gyrus Intraparietal sulcus Angular gyrus Pars marginalis Superior parietal gyrus NP/MGH

  24. Superior frontal gyrus Superior frontal sulcus Middle frontal gyrus Precentral sulcus Central sulcus Precuneus Postcentral sulcus Paracentral lobule Superior parietal gyrus Intraparietal sulcus Pars marginalis NP/MGH

  25. Coronal Neuroanatomy NP/MGH

  26. Interhemispheric Fissure Superior Frontal gyrus Inferior Frontal gyrus Middle Frontal gyrus Inferior Frontal gyrus Gyrus rectus Medial Orbital gyrus Olfactory bulb NP/MGH

  27. Superior Frontal gyrus Forceps minor Superior Frontal sulcus Middle Frontal gyrus Inferior Frontal gyrus Lateral orbital sulcus Gyrus rectus Medial Orbital gyrus Anterior Orbital gyrus Lateral orbital gyrus Olfactory Sulcus NP/MGH

  28. Circular insular sulcus Cingulate gyrus Superior Frontal gyrus Middle Frontal gyrus short insular gyrus Inferior Frontal sulcus Inferior Frontal gyrus pars opercularis Sylvian Fissure Posterior Orbital gyrus Middle Temporal gyrus Olfactory Sulcus Superior Temporal gyrus Medial Orbital gyrus Inferior Temporal gyrus Gyrus rectus NP/MGH

  29. Superior Frontal gyrus Superior Frontal sulcus Cingulate sulcus Middle Frontal gyrus Precentral sulcus Precentral gyrus Sylvian Fissure Superior Temporal gyrus Superior Temporal Sulcus Middle Temporal gyrus Amygdala Inferior Temporal gyrus Anterior commissure NP/MGH

  30. Superior Frontal gyrus Superior Frontal sulcus Cingulate gyrus Middle Frontal gyrus Precentral sulcus Precentral gyrus Sylvian Fissure Superior Temporal gyrus Superior Temporal Sulcus Middle Temporal gyrus Heschl’s gyrus Inferior Temporal sulcus Ambient gyrus Entorhinal area Amygdala Inferior Temporal gyrus NP/MGH

  31. Superior Frontal gyrus Middle Frontal gyrus Central Sulcus Superior Temporal gyrus Hippocampus Middle Temporal gyrus Inferior Temporal gyrus Parahippocampal gyrus CA1, cornu ammonis Fusiform gyrus NP/MGH

  32. Postcentral gyrus Paracentral lobule Intraparietal sulcus Central Sulcus Cingulate gyrus Intraparietal sulcus Supramarginal gyrus Superior Temporal gyrus Middle Temporal gyrus Inferior Temporal gyrus Fusiform gyrus Collateral sulcus Parahippocampal gyrus NP/MGH

  33. Paracentral lobule Central sulcus Superior Temporal gyrus Middle Temporal gyrus Inferior temporal gyrus Fusiform gyrus NP/MGH

  34. Paracentral lobule Postcentral gyrus Central sulcus Intraparietal sulcus Supramarginal gyrus Middle temporal gyrus Inferior temporal gyrus Fusiform gyrus Calcarine sulcus Cingulate gyrus Lingual gyrus NP/MGH

  35. Superior parietal lobule precuneus Inferior parietal lobule Cingulate gyrus Lingual gyrus Middle occipital gyrus Calcarine sulcus Collateral sulcus Fusiform gyrus Inferior occipital gyrus Lingual gyrus Tentorium cerebelli NP/MGH

  36. The Central Sulcus NP/MGH

  37. The Central Sulcus (CS)* • 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 *Naidich & Brightbill. Int J Neurorad 1996;2:313-338 NP/MGH

  38. The Central Sulcus (CS) • Superior frontal sulcus - preCS sign • the posterior end of the superior frontal sulcus joins the precentral sulcus in 85% Superior frontal gyrus Superior frontal sulcus Superior frontal sulcus Precentral sulcus Precentral sulcus Precentral gyrus Precentral gyrus Central sulcus NP/MGH

  39. The Central Sulcus (CS) • 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%). Precentral sulcus Central sulcus NP/MGH

  40. The Central Sulcus (CS) Precentral gyrus Superior frontal sulcus • pars bracket sign • The paired pars marginalis form a “bracket” to each side of the interhemispheric fissure at or behind the central sulcus (96%). Precentral sulcus Central sulcus Pars bracket Paracentral lobule NP/MGH

  41. The Central Sulcus (CS) Precentral gyrus • pars bracket sign Superior frontal sulcus Precentral sulcus Central sulcus Pars bracket Pars bracket NP/MGH

  42. The Central Sulcus (CS) • Bifid post-CS sign • the post-CS is bifid (85%). • The bifid post-CS encloses the lateral end of the pars marginalis (88%). Precentral sulcus Central sulcus Precentral gyrus Postcentral sulcus Pars bracket NP/MGH

  43. Central sulcus Central sulcus Central sulcus Postcentral sulcus Postcentral sulcus Postcentral sulcus Pars bracket Pars bracket NP/MGH

  44. The Central Sulcus (CS) Precentral gyrus • Thin post-CG sign • the postcentral gyrus is thinner than the precentral gyrus (98%). Postcentral gyrus NP/MGH

  45. The Central Sulcus (CS) • Intraparietal Sulcus (IPS) and the post-CS • in axial MRI, the IPS intersects the post-CS (99%). Postcentral sulcus IPS IPS Pars bracket Pars bracket NP/MGH

  46. IPS IPS IPS Postcentral sulcus Postcentral sulcus Postcentral sulcus NP/MGH

  47. The Central Sulcus (CS) Superior frontal gyrus • Midline Sulcus sign • the most prominent convexity sulcus that reaches the midline interhemispheric fissure is the CS (70%). Superior frontal sulcus Precentral sulcus Precentral gyrus Central sulcus NP/MGH

  48. The Central Sulcus (CS) NP/MGH

  49. The Central Sulcus (CS) SFS-preCS sign Hook sign Thin postcentral gyrus sign Bifid post-CS sign IPS - postCS sign Pars bracket sign NP/MGH

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