2/On axial temporal bone CT, you cannot see the whole cochlea at once. So let’s start at the bottom. The first thing you come to is the basal turn of the cochlea (makes sense, basal=bottom). On axial images, it looks like a banana. I remember both Basal and Banana start w/B.
3/As you move up to the next slice, you start to see the upper turns of the cochlea coming in above the basal turn. They look like a stack of pancakes. Pancakes are the heart of any breakfast, so they are at the heart or middle of the cochlea on imaging.
4/On this slice showing pancakes, you can see the round window and the round window niche. I remember that this slice is where you can see the round window bc pancakes are ROUND.
5/As you move up, you leave the basal turn behind & see only the upper turns. These no longer look like pancakes bc cochlear scala separate them. Instead they look like a bunch of cherries. I know I’m at the cochlea top when I see cherries bc you always put a cherry on top!
6/Here’s an easy way to remember the order of the appearance of the cochlea. Starting at the basal turn, B is for banana & basal. Bananas can make banana pancakes, so the next slice is pancakes. Finally, you put a cherry on top of the pancakes, so top of the cochlea is cherries.
7/On the coronal plane, you get a sense of the spiral nature of the cochlea. It looks like the spiral of a snail’s shell.
8/Looking closely, you can see eyes of the snail on coronal images.Eyes are right in front of the cochlear snail shell—canal of labyrinthine facial nerve segment going anterior & canal of the tympanic segment coming back. Makes sense that the FACIAL nerve canal would be the EYES
9/So now you know the anatomy of the cochlea, so it won’t just look like the layered rolls of Jabba the Hutt to you. May the force of this knowledge be with you!
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1/The 90s called & wants its carotid imaging back!
It’s been 30 years--why are you still just quoting NASCET?
Do you feel vulnerable when it comes to identifying plaque vulnerability?
Here’s a thread to help you identify high risk plaques with carotid plaque imaging
2/Everyone knows the NASCET criteria:
If the patient is symptomatic & the greatest stenosis from the plaque is >70% of the diameter of normal distal lumen, patient will likely benefit from carotid endarterectomy.
But that doesn’t mean the remaining patients are just fine!
3/Yes, carotid plaques resulting in high grade stenosis are high risk.
But assuming that stenosis is the only mechanism by which a carotid plaque is high risk is like assuming that the only way to kill someone is by strangulation.
1/I always say you can tell a bad read on a spine MR if it doesn’t talk about lateral recesses.
What will I think when I see your read? Do you rate lateral recess stenosis?
Here’s a thread on lateral recess anatomy & a grading system for lateral recess stenosis
2/First anatomy.
Thecal sac is like a highway, carrying the nerve roots down the lumbar spine.
Lateral recess is part of the lateral lumbar canal, which is essentially the exit for spinal nerve roots to get off the thecal sac highway & head out into the rest of the body
3/Exits have 3 main parts.
First is the deceleration lane, where the car slows down as it starts the process of exiting.
Then there is the off ramp itself, and this leads into the service road which takes the car to the roads that it needs to get to its destination
3/At its most basic, you can think of the PPF as a room with 4 doors opening to each of these regions: one posteriorly to the skullbase, one medially to the nasal cavity, one laterally to the infratemporal fossa, and one anteriorly to the orbit