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Realistic two-dimensional (2D) and three-dimensional (3D) applications for anatomical studies are being developed from true-colored sectioned images. We generated advanced-sectioned images of the entire male body and verified that anatomical structures of both normal and abnormal shapes could be visualized in them. The cadaver was serially sectioned at constant intervals using a cryomacrotome. The sectioned surfaces were photographed using a digital camera to generate horizontal advanced-sectioned images in which normal and abnormal structures were classified. Advanced-sectioned images of the entire male body were generated. The image resolution was 3.3 × 3.3 fold better than that of the first sectioned images obtained in 2002. In the advanced-sectioned images, normal and abnormal structures ranging from microscopic (≥0.06 mm × 0.06 mm; pixel size) to macroscopic (≤473.1 mm × 202 mm; body size) could be identified. Furthermore, the real shapes and actual sites of lung cancer and lymph node enlargement were ascertained in them. Such images will be useful because of their true color and high resolution in digital 2D and 3D applications for gross anatomy and clinical anatomy. In future, we plan to generate new advanced-sectioned images of abnormal cadavers with different diseases for clinical anatomy studies., (© 2021 American Association of Clinical Anatomists.)

Three-dimensional (3D) models of the brain made from magnetic resonance images (MRI) are used in various medical fields. 3D models assembled from grayscale color and low-resolution can be complemented with true color sectioned images of the Visible Korean. The purpose of this study is to apply the MRI automatic segmentation technique to the sectioned images. 3D models of the sectioned images, which have true color and high resolution, can be produced without manual segmentation. The Brain Extraction Tool and the Automated Segmentation Tool of the FMRIB Software Library (FSL) were chosen for automatic segmentation. Using those tools, true color sectioned images were reconstructed from gray 3D models of brain, gray matter, and white matter. Color 3D models of those structures were generated from the gray 3D models using MRIcroGL. The color 3D models made from the sectioned images revealed details of brain anatomy that could not be observed on the 3D models from MRI. This trial suggests that convergence of the MRI segmentation technique with color sectioned images is a time-efficient method for producing color 3D models of various structures. In future, the method of this study will be used for various sectioned images of cadavers. The resulting color sectioned images and 3D models will be made available to other researchers., (© 2020 Wiley Periodicals, Inc.)

The anatomy of the pallidothalamic tracts, including the ansa lenticularis, lenticular fasciculus, and thalamic fasciculus (field H1 of Forel), should be elucidated by neurosurgeons and neuroscientists who study deep brain stimulation. In this study, serially sectioned images of a human cadaver head were employed to overcome the limitations of existing methods to observe the pallidothalamic tracts. Owing to the high resolution and real color of the sectioned images, 28 structures, including the pallidothalamic tracts and mammillothalamic fasciculus, were identified. The structures were segmented and made into surface models, which are helpful in improving the stereoscopic understanding. Observing the sectioned images and surface models may help in understanding the detailed anatomy of the pallidothalamic tracts. The new findings, such as the spatial relationship of the tracts, were summarized in a schematic figure. Moreover, to elucidate the anatomical structures along the course of deep brain stimulation, virtual electrodes were inserted into the surface models. The sectioned images and surface models of this study are expected to enhance the understanding of the pallidothalamic tract anatomy. A portable document format file containing the surface models and the sectioned images can be freely downloaded from the authors' homepage. Clin. Anat. 32:66-76, 2019. © 2019 Wiley Periodicals, Inc., (© 2019 Wiley Periodicals, Inc.)

Our objective was to define the positions of the nerves around the brachial artery and, secondarily, to assess the risk of intraneural injection during dual guided axillary block. Sixty ultrasound-guided axillary blocks were performed. The locations of the musculocutaneous, median, ulnar, and radial nerves relative to the brachial artery were determined. The position of the ulnar nerve was defined in relation to that of the brachial vein, and the position of the musculocutaneous nerve in relation to the coracobrachialis muscle. The locations were confirmed by neurostimulation and injection of local anesthetic was avoided when the current intensities were below 0.3 mA. The incidences of intraneural injection and postblock neurological injury were recorded. The median nerve was located in the upper external quadrant in 89% of cases and the ulnar nerve in the upper internal quadrant (95%), superficial (19%), or deep (81%) to the brachial vein. The radial nerve was located in the lower internal quadrant in 97% of cases, and the musculocutaneous nerve in the lower external quadrant in 85%. Its disposition differed depending on its proximity to the artery (106 ± 26°) or whether it was inside the coracobrachialis muscle (119 ± 15°; P = 0.023). Three intraneural injections were observed (0.5%, one in the median and two in the radial nerves) and no patient had postblock neuropathy. Our study evidences slight anatomical variability among the neural structures in the axillary region and confirms the safety of the axillary technique with double monitoring, using ultrasound to monitor the approach of the needle to the nerve and nerve stimulation at currents > 0.3 mA to reduce the incidence of intraneural injection. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc. 2018., (© 2018 Wiley Periodicals, Inc.)

To compare the projectional surface anatomy of healthy individuals in an adult population with those with a thyroid mass, using computed tomography (CT). Sixteen slice CT images of 101 individuals were analyzed using a 32-bit Radiant DICOM viewer to establish the relationships among major anatomical landmarks in the neck and their vertebral levels. The structures investigated included: hard palate (HP), hyoid bone (HB) including body and lesser horns, soft palate (SP), thyroid gland (TG) (both superior and inferior poles), thyroid gland anteroposterior (APD) and superoinferior (SID) diameters, thyroid isthmus (TI) superoinferior dimension, epiglottis, vertebral arteries (right and left), and both right and left parotid glands (superior and inferior extents). The vertebral levels noted most frequently were: body of hyoid bone (C4, 42.71%); lesser horns of hyoid bone (C3, 36.46%); thyroid gland superior pole (C6, 31.25%); and thyroid gland inferior pole (T2, 30.2%). TG-ID, TG-APD, and TG-SID were not significantly different between males and females in the healthy group; however, there was a significant gender difference in thyroid gland inferior diameter in the pathology group [males 2.16(±1.16) vs. females 3.37(±1.30), P = 0.01, paired sample t-test]. Further studies are needed to determine whether neck pathology in those with a thyroid mass affects the dimensions of the thyroid gland. Moreover, the surface anatomy of the neck should be revisited using modern imaging techniques to address inconsistencies in anatomy and clinical reference texts. Clin. Anat. 30:781-787, 2017. © 2017Wiley Periodicals, Inc., (© 2017 Wiley Periodicals, Inc.)

To compare key thoracic anatomical surface landmarks between healthy and patient adult populations using Computed Tomography (CT). Sixteen slice CT images of 250 age and gender matched healthy individuals and 99 patients with lung parenchymal disease were analyzed to determine the relationship of 17 thoracic structures and their vertebral levels using a 32-bit Radiant DICOM viewer. The structures studied were: aortic hiatus, azygos vein, brachiocephalic artery, gastroesophageal junction (GEJ), left and right common carotid arteries, left and right subclavian arteries, pulmonary trunk bifurcation, superior vena cava junction with the right atrium, carina, cardiac apex, manubriosternal junction, xiphisternal joint, inferior vena cava (IVC) crossing the diaphragm, aortic arch and junction of brachiocephalic veins. The surface anatomy of all structures varied among individuals with no significant effect of age. Binary logistic regression analysis showed a significant association between individual health status and vertebral level for brachiocephalic artery (P = 0.049), GEJ (P = 0.020), right common carotid (P = 0.009) and subclavian arteries (P = 0.009), pulmonary trunk bifurcation (P = 0.049), carina (P = 0.004), and IVC crossing the diaphragm (P = 0.025). These observations differ from those reported in a healthy white Caucasian population and from the vertebral levels of the IVC, esophagus, and aorta crossing the diaphragm in an Iranian population. The differences observed in this study provide insight into the effect of lung pathology on specific thoracic structures and their vertebral levels. Further studies are needed to determine whether these are general changes or pathology-specific. Clin. Anat. 30:227-236, 2017. © 2017 Wiley Periodicals, Inc., (© 2017 Wiley Periodicals, Inc.)

Surface anatomy is a core component of human anatomy in clinical practice. It allows clinicians to assess patients accurately and quickly; however, recent studies have revealed variability among individuals and ethnicities. The aim of this study is to investigate possible variations in adult thoracic and abdominal surface anatomy landmarks in an Iranian population. This study used 100 thoracoabdominal CT scans (mean age: 47 ± 17 years, age range: 20-77 years, 47% females), noted the most common locations of clinically relevant surface markings, and analyzed correlations between these variables and age or gender. While many common surface markings in Iranians were consistent with the evidence-based literature, there were some differences. In relation to the corresponding segments of the vertebral column, the superior vena cava formation and the lower border of the pleura adjacent to the vertebral column and right kidney tended to be at higher levels in adult Iranians than a Caucasian population. There were also discrepancies between the Iranian population and commonly-referenced medical textbooks and recent evidence-based literature concerning the vertebral levels of the diaphragmatic openings of the esophagus, aorta, and inferior vena cava. This study emphasizes the need to consider evidence-based reappraisals of surface anatomy to guide clinical practice. Much of our current knowledge of surface anatomy is based on older studies of cadavers rather than living people, and does not take ethnic and individual variations into consideration., (© 2015 Wiley Periodicals, Inc.)