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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

NORMAL CORTICALANATOMY

MGH

Massachusetts General Hospital

Harvard Medical School

Nicola Petitti MD, PhD

normal cortical anatomy2
NORMAL CORTICAL ANATOMY
  • Sagittal
  • Axial
  • Coronal
  • The Central Sulcus

NP/MGH

slide4

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

slide5

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

slide6

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

slide7

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

slide8

Central sulcus

Superior Temporal gyrus

Middle Temporal gyrus

Inferior Temporal gyrus

NP/MGH

slide9

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

slide10

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

slide12

Fusiform gyrus

Superior Temporal gyrus

Middle Temporal gyrus

Inferior Temporal gyrus

NP/MGH

slide13

Parahippocampal gyrus

Superior Temporal gyrus

Middle Temporal gyrus

Inferior Temporal gyrus

Hippocampal gyrus

NP/MGH

slide14

Amygdala

Hippocampus

Superior Temporal gyrus

Middle Temporal gyrus

Temporo-occipital fissure

Inferior occipital gyrus

Inferior Temporal gyrus

Gyrus descendens

Lingual gyrus

NP/MGH

slide15

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

slide16

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

slide17

Frontomarginal gyrus

Superior frontal gyrus

Anterior orbital gyrus

Posterior orbital gyrus

Cingulate gyrus

Middle occipital gyrus

Intra-occipital sulcus

Superior occipital gyrus

NP/MGH

slide18

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

slide19

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

slide20

Precentral sulcus

Precentral gyrus

Central sulcus

Central sulcus

Cuneus

Middle occipital gyrus

Intra-occipital sulcus

Superior occipital gyrus

NP/MGH

slide21

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

slide22

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

slide23

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

slide24

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

slide26

Interhemispheric Fissure

Superior Frontal gyrus

Inferior Frontal gyrus

Middle Frontal gyrus

Inferior Frontal gyrus

Gyrus rectus

Medial Orbital gyrus

Olfactory bulb

NP/MGH

slide27

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

slide28

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

slide29

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

slide30

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

slide31

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

slide32

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

slide33

Paracentral lobule

Central sulcus

Superior Temporal gyrus

Middle Temporal gyrus

Inferior temporal gyrus

Fusiform gyrus

NP/MGH

slide34

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

slide35

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

the central sulcus cs
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

the central sulcus cs38
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

slide39

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

the central sulcus cs40
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

slide41

The Central Sulcus (CS)

Precentral gyrus

  • pars bracket sign

Superior frontal sulcus

Precentral sulcus

Central sulcus

Pars bracket

Pars bracket

NP/MGH

the central sulcus cs42
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

slide43

Central sulcus

Central sulcus

Central sulcus

Postcentral sulcus

Postcentral sulcus

Postcentral sulcus

Pars bracket

Pars bracket

NP/MGH

slide44

The Central Sulcus (CS)

Precentral gyrus

  • Thin post-CG sign
    • the postcentral gyrus is thinner than the precentral gyrus (98%).

Postcentral gyrus

NP/MGH

slide45

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

slide46

IPS

IPS

IPS

Postcentral sulcus

Postcentral sulcus

Postcentral sulcus

NP/MGH

slide47

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

slide49

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