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![Radiology for Radiation Oncologists
Skull base radiology
Dr Kanhu Charan Patro
MD,DNB[RADIATION ONCOLOGY],MBA,CEPC,PDCR
HOD, Radiation Oncology
MGCHRI, Visakhapatnam, INDIA
1](https://image.slidesharecdn.com/skullbaseradiology-200709161512/85/Skull-base-radiology-FOR-RADIATION-ONCOLOGISTS-1-320.jpg)
![Radiology for Radiation Oncologists
Skull base radiology
Dr Kanhu Charan Patro
MD,DNB[RADIATION ONCOLOGY],MBA,CEPC,PDCR
HOD, Radiation Oncology
MGCHRI, Visakhapatnam, INDIA
1](https://image.slidesharecdn.com/skullbaseradiology-200709161512/75/Skull-base-radiology-FOR-RADIATION-ONCOLOGISTS-1-2048.jpg)
Uploaded byKanhu Charan
#Skull base radiology FOR #RADIATION ONCOLOGISTS
This document provides an overview of skull base radiology for radiation oncologists. It discusses the complex anatomy of the skull base area and lists the important structures and contents, including bones, foramina, fissures, canals, ganglia, nerves, vessels, and more. It highlights key areas like the anterior, middle, and posterior cranial fossae and provides labeled images to illustrate important structures like foramina, canals, and the origins and paths of cranial nerves. Slice-by-slice views from different skull base levels are also included to demonstrate the anatomy in detail.
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#Skull base radiology FOR #RADIATION ONCOLOGISTS
- 1. Radiology for RadiationOncologists Skull base radiology Dr Kanhu Charan Patro MD,DNB[RADIATION ONCOLOGY],MBA,CEPC,PDCR HOD, Radiation Oncology MGCHRI, Visakhapatnam, INDIA 1
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- 3. Why a radiationoncologist need it? • Some head and neck cancers having perineural spread • Para nasal sinus • Nasopharynx • Salivary gland • Buccal mucosa • Complex nature of skull base area • Some tumors like schwannoma arise from cranial nerves • Some functional issues like trigeminal neuralgia need SRS 3
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- 5. Buccal mucosa withintracranial extension 5
- 6. Parotid with intracranialspread 6
- 7. Nasopharynx with sphenopalatineforamen (SPf) left 7
- 8. Maxilla with Pterygopalatine fossa invasion 8
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- 10. Normal skull base •Extend – root of nose anteriorly to the superior nuchal line posteriorly 10
- 11. Structures and contents •BONES • Fossa • Foramen • Fissure • Canal • CONTENTS • Ganglion • Nerve • Vessel • Vein • Artery 11
- 12. What to see? •FORAMINA • SUTURES • CANALS • FISSURES • FOSSES 12
- 13. Normal skull base •5 bones: – Frontal – Ethmoid – Sphenoid – Temporal – Occipital 13
- 14.
- 15. Two ridges Sphenoidridge 15
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- 17. Ethmoid bone • Cribriformplate is perforated by approx 20 holes on each side of the crista galli • Nerve fibres of olfactory nerve (CN I) pass from nasal mucosa to olfactory bulb • Crista galli serves as the anchor for anterior margin of the falx cerebri 17
- 18. Normal skull base •Most important part: – Basisphenoid (anterior aspect of sella) – Basiocciput (posterior lip of the foramen magnum) 18
- 19. Sphenoid bone • 3compartments: – Basisphenoid: • Dorsum sella, posterior clinoids, sella turcica, tuberculum sella, sphenoid sinus • Fused to clivus in adult – Greater wing of sphenoid • Medial two-thirds and anterior wall of the middle cranialfossa floor – Lesser wing of sphenoid • Medial and superior aspects of the anterior wall of the middle cranial fossa and the anterior clinoids • Superior and medial edgesof the superior orbital fissure 19
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- 27.
- 28. Anterior fossa foramina •Foramen cecum • ANTERIOR ETHMOIDAL FORAMEN • Foramen cribriform • POSTERIOR ETHMOIDAL FORAMEN • ORBITO MENINGEAL FORAMEN 28
- 29.
- 30. Foramen cecum Content • Emissaryveins to superior sagittal sinus from the upper part of the nose 30
- 31. Cribriform foramen Content • Olfactorynerve bundles (I) 31
- 32. Anterior and posteriorethmoidal foramen Content • Anterior ethmoidal foramen • Anterior ethmoidal artery • Anterior ethmoidal vein • Posterior ethmoidal foramen • Posterior ethmoidal artery • Posterior ethmoidal vein 32
- 33. Supraorbital foramen Content • Supraorbitalartery supraorbital vein • Supraorbital nerve 33
- 34. Middle cranial fossaforamina • Superior orbital fissure • Inferior orbital fissure • Optic canal • Foramen rotundum • Foramen ovale • Foramen lacerum • Foramen spinosum 34
- 35.
- 36. Superior orbital fissure Content •Superior ophthalmic vein • Inferior ophthalmic veins • Oculomotor nerve (III) • Trochlear nerve (IV) lacrimal, frontal • Nasociliary branches of ophthalmic nerve (V1) • Abducent nerve (VI) 36
- 37. Inferior orbital fissure Content •Inferior ophthalmic veins infraorbital artery infraorbital vein, • Tributary of pterygoid plexus • Zygomatic nerve and infraorbital nerve of maxillary nerve (V2) • Orbital branches of pterygopalatine ganglion 37
- 38. Optic canal Content • Ophthalmicartery • Optic nerve (II) 38
- 39. Foramen rotundum Content • Maxillarynerve (V2) 39
- 40. Foramen ovale Content • Accessorymeningeal artery, • Emissary vein connecting cavernous sinus with pterygoid plexus • Mandibular nerve (V3) • Lesser petrosal nerve 40
- 41. Foramen lacerum Content • Arteryof pterygoid canal, • Meningeal branch of ascending pharyngeal artery, • Emissary vein • Nerve of pterygoid canal through its anterior wall 41
- 42. Foramen spinosum Content • Middlemeningeal artery • Meningeal branch of the mandibular nerve (V3) 42
- 43. Posterior cranial fossaforamina • Internal auditory meatus • Jugular Foramen • Hypoglossal canal • Foramen magnum 43
- 44. Internal auditory meatus Content •Labyrinthine artery • Facial nerve (VII), • Vestibulocochlear nerve (VIII) 44
- 45. Jugular foramen Content • Internaljugular vein, • Inferior petrosal sinus, • Sigmoid sinus • Glossopharyngeal nerve (IX), • Vagus nerve (X), • Accessory nerve (XI) 45
- 46.
- 47. Foramen magnum Content 1. Anteriorand posterior spinal arteries, vertebral arteries 2. Lowest part of medulla oblongata, three meninges, ascending spinal fibers of accessory nerve (XI) 47
- 48. OVALE OVAL MAGNUM MAGNA ROTUNDUMROUND LACERUM LARGE SPINOSUM SMALL SUPERIOR ORBITAL FISSURE SUPERIOR INFERIOR ORBITAL FISSURE INFERIOR OPTIC CANAL CANAL VIDIAN CANAL CANAL SOFTWARERadiAnt DICOM Viewer (64-bit).lnk 48
- 49. Pterygomaxillary area • Pterygopalatinefossa • Pterygomaxillary fissure • Sphenopalatine foramen • Sphenopalatine ganglion 49
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- 61.
- 62.
- 63. Sphenopalatine foramen opensto nasal cavity 63
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- 65.
- 66. Inferior opthalmic vein Drainsvia: Sphenoparietal sinus Petrosal sinuses Basilar plexus Connection: Contains: Pterygoid plexus Circular sinus CN III, IV, V1, V2, VI Skull Base Anatomy Cavernous Sinus Receives: Superior opthalmic vein Meckel’s Cave • Posterior aspect of cavernous sinus • Gasserian ganglion (sensory root ganglion of CN V) 66
- 67. Origin of cranialnerves 1. Magnetic resonance imaging (MRI) is the gold standard technique in the study of the cranial nerves 2. Steady-state free procession (SSFP) images are the best sequences for the visualization of the cisternal segments showing dark cranial nerves against a background of bright cerebrospinal fluid (CSF) 3. Computed tomography (CT) can be useful to evaluate intraosseous segments of cranial nerves, skull base foramina, and bony traumatic lesions https://mrimaster.com/anatomy%20brain%20cranial%20nerves .html for cranial nerve 67
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- 74. 7th and 8thcranial nerve 74
- 75. 9th ,10th and11th cranial nerve 75
- 76. 12th cranial nerve 76 softwareRadiAntDICOM Viewer (32-bit).lnk
- 77. SLICE BY SLICEDOWN TO UP 77
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- 107.
- 108. Articular tubercle (at anteriorroot of zygomatic arch) 108
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- 115.
- 116. Occipital bone (squamouspart) 116
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- 122.
- 123. Zygomaticofacial foramen /canal 123
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- 128.
- 129. Occipital bone (squamousportion) 129
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- 136. Temporal bone, tympanic andpetrous portions 136
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- 144. Sphenoid bone, greaterwing 144
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- 148. Occipital bone, squamouspart 148
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- 157. PETROUS PART OFTEMPORAL BONE 157
- 158. . Temporal bone,squamous part 158
- 159. Temporal bone, tympanicpart 159
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- 167. Jugular foramen becomingsigmoid sinus 167
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- 169. Jugular tubercle ofoccipital bone (roof of hypoglossal canal) 169
- 170. Occipital bone, squamouspart 170
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- 180. TYMPANIC PART OFTEMPORAL 180
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- 185. JUGULAR TUBERCULE OFOCCIPITAL BONE 185
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- 200. BASAL TURN OFCOCHLEA 200
- 201. Groove in bodyof sphenoid bone for internal carotid artery 201
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- 205. Space connecting superiorand inferior orbital fissures 205
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- 210. TEMPORAL BONE, SQUAMOUSPART 210
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- 214. MIDDLE EAR WITHMALLEUS AND INCUS 214
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- 219. Space connecting superiorand inferior orbital fissures 219
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- 224. Middle ear withmalleus and incus 224
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- 232. VESTIBULE WITH SEMICIRCULARCANAL 232
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