label the planes of the sectioned cut body part

The anatomist has long been interested in sectional anatomy which is the study of cut surfaces of the human organs. The sectional human body is based on four imaginary planes, i.e., axial (flat), median (midsagittal), sagittal, and coronal planes that pass through the body. The sectional anatomy is in particular important in the brain where functional topography is of far sake. This sectional fles of mental capacity becomes increasingly important atomic number 3 a response to giant strides in neuroimaging engineering.

Traditionally triad standard anatomical planes, namely axial, mesial, and coronal birth been practiced in the brain. Totally these planes are based happening the median plane in near anatomy books ( 1 - 3). The sagittal plane has been defined as any rearing sheet parallel of latitude to the median plane. And the coronal plane is a vertical flat perpendicular to the sagittal airplane, whereas stem plane is a planer perpendicular to some sagittal and coronal planes. However, these are all imaginary planes without specific landmarks operating room reference points. Therefore, the cutting directions of the brain have been decided by the examiner's need and intention.

After additive Visible Korean project ( 4 , 5), we realized the axial sections of the trunk displayed by different authors birth non been standardised ( 6 - 8). It was particularly true in head and neck. Therefore, we thought that anatomical landmarks should atomic number 4 explored to set a standard for the guidance of the cutting plane in human mind.

In Holocene epoch year advance of neuroimaging applied science with drastically increased resolution, the sectional images of the central nervous system became the main source of neurological information. Perhaps more than tens of thousands images of magnetic resonance images (MRIs) and computed tomographs (CTs) are organism examined and interpreted daily in all parts of the ma. In these MRIs and CTs, orbitomeatal line and canthomeatal line have been used for axial radiological images. These radiographic radica lines have been selected because they allow the comparatively pursuant brain images without excessive bony variations. However, in that location is none universal standard reference point to guide the cutting direction for axial, mesial, and coronal brain images. Therefore, the sharp centering of neuroimaging has been indiscriminately compulsive past the radiologists or by the postulation of the physicians in charge of the patients.

Considering all these uncertainties and lack of intracerebral landmarks, we thought process it is necessary to sic a reference organization to East the central systema nervosum precisely. To reach this object, we unsuccessful 0.1 mm serial sectioning of cadaver head including unit brain based on the proposed reference points victimisation the anterior commissure (AC) and posterior commissure (PC), and obtained a complete set of axial, mesial, and coronal images that could be used for the standardization of surface area anatomy of the human brain.

MATERIALS AND METHODS

A donated cadaver was a 67-yr-old, Korean male with the height of 162 cm and the weight of 45 kg. He was a known patient of myasthenia gravis gravis, for which he was treated for the last several years. Recently individual bouts of acute upper respiratory infection were experienced. He died suddenly of cardiorespiratory contain.

Quadruplet hours after death the cadaver was moved to Neuroscience Research Institute to take necropsy MRIs. The clay head was placed on the bed of 7 Tesla Mister scanner (Siemens Medical Solutions, Erlangen, Germany) and the way of the cadaver head was familiarized. Median MRI of the cadaver brain was acquired to identify centers of AC and PC. The cadaver brain was 7 Tesla MR rescanned (TR, 39 ms; TE, 17 ms; BW, 60; interchange angle, 30°; matrix size up, 480×576×312) along the axial plane passing the both Alternating current revolve around and PC center of median MRI. Exploitation laser indicator of MR machine, stem line was drawn on the face of the cadaver parallel to the line that passed both AC and PC centers. Sagittal channel was also worn on the chee on the cerebral falx and longitudinal intellectual fissure (Fig. 1A).

The cadaver was then stirred to department of anatomy for the serial sectioning procedure. The cadaver was put into a deep freezer and rooted to -70℃. After a workweek, the channelise was apart from the main body to make a head block. The head block was put into the embedding box and the direction of the block was adjusted referring to the axial and sagittal indicator lines on the face. The embedding box was filled with the embedding federal agent (1,000 mL of water, 30 g of gelatin, and 0.5 g of methylthionine chloride) which was hard icy (Fig. 1B) ( 4).

On the specially-made cryomacrotome, the head cylinder block was serially divided from vertex to chin at 0.1 mm intervals to make sectioned surfaces (Fig. 1C). After each sectioning, the frost on the divided surface was cleaned exploitation ethyl alcohol ( 4 , 5).

The Canon™ EOS 5D digital photographic camera (resolution 4,368×2,912) with Canon™ 50 mm micro lens was installed in front of sectioned surfaces. The locating of the digital camera was adjusted to photograph the sectioned surface with 436.8×291.2 mm sized (Ficus carica. 1C). Ii Elinchrom™ Digital S strobes were installed around digital tv camera. The put away of the strobes was adjusted to save changeless brightness of the serial divided surfaces ( 4 , 5).

The sectioned surface was photographed using the digital camera and was saved every bit tag image register format (TIFF) file (0.1 millimetre pixel size; 48 bit coloration). Aft cautious verification of for each one image on the computer monitor away anatomists, next footprint of serial sectioning was continuing. The serially-sectioned images were flipped over to orient the right side of the head to the left side to coincide with the radiological convention on Adobe Photoshop™ CS3 extended version 10 (Photoshop program). Other details of the procedures were cookie-cutter as those in Visible Korean ( 4 , 5). Whole procedures took the States one calendar month in winter years to develop 2,343 serially-divided images from the head block.

Stem serially-sectioned images were converted from 48 spot color to 24 bit color because the in-theatre developed software for fashioning sagittal and coronal images could handle only 24 bit color images. On the software, every column of completely lengthwise serially-sectioned images was stacked to make a sagittal epitome. Different columns were stacked to generate else mesial images. Victimisation the similar method, rows of all axial serially-sectioned images were cumulated to produce coronal images.

A the preliminary step of volume reconstruction on uncommitted software, both intervals and pixel size of the serially-sectional images were enhanced from 0.1 mm to 1 mm; fleck depth was changed from 48 bit colouration to 8 bit gray; outside of cerebrum was erased on Photoshop program. The cerebrum images were stacked and reconstructed by book modeling on MRIcro version 1.4 (MRIcro program) to gain a blocky (3D) fancy of the cerebrum with 1 mm voxel size and 8 bit gray. Likewise 3D images of hemisphere, skull and total maneuver were built.

General features of serially-sectioned images

A sum of 2,343 stalk serially-sectioned images was with success obtained without any technical difficultness. The cadaver guide including brain was basically ground off instead of organism sliced, so that successive images with 0.1 mm intervals could comprise obtained without loss of tissue (Ficus carica. 2A). In the main, there was no more distortion of brain tissue due to freezing artifact. Simply there was a mild subcutaneous edema and over-crowding in surrounding soft tissue of the skull base. The brain showed no cortical atrophy. A mild to moderate atherosclerosis of neural structure arteries was noted. Because of the atherosclerosis, larger arteries remained out-of-doors although small arteries and all veins excluding meninx venous sinuses were collapsed (Fig. 2B). The cerebrospinal fluid was largely emptied from the ventricle, whereas the fluid in the subarachnoid space was pooled in the cisterns. There was an inosculation between the occipital sinus and the left inward jugular vena (Fig. 2C).

Happening the axial serially-sectioned images, pulverized Einstein structures like thalamic nuclei (Fig. 3A), substantia nigra, bolshy karyon (Figure. 3B), and likewise other structures like auditory ossicles (Fig. 3C) could clearly beryllium identified. In addition, quality of sagittal and garland images was also satisfactory, showing no difference in every detail with the original axial images even if the bit depth was born-again from 48 bit emblazon to 24 bit distort.

On 3D images of cerebrum and unilateral hemisphere, which were rotated on MRIcro program, individual convolution and sulcus could easily be known. This result helped us convince that the serially-sectioned images unbroken good quality and castigate alignment (Fig. 4).

Stalk, sagittal, and coronal reference planes

From these 2,343 axial images, we found an image showing both AC center and PC center (Fig. 5A). We labelled this image to equal the axial character reference plane (0 millimetre), and gave all the axial images superior to the axial reference planer +subscribe and number representing the 0.1 mm space from reference plane (0 mm). Those inferior images were given -sign and number. A come of +700 axial planes (+70 mm) and -640 stem planes (-64 mm) was obtained, indicating the height of the brain including the brain stem to comprise 134 mm (Fig. 6A).

Aft completing the axial credit plane, we ground sagittal reference plane (0 mm) simultaneous with the median plane, which was already determined by the course connecting the AC center and Personal computer center on the falx cerebri and lengthwise cerebral crevice (Fig. 5B). The far cerebral hemisphere was given +sign of the zodiac and numbered from sagittal credit plane. And the left brain was given -sign and too numbered. A totality of +700 sagittal planes (+70 millimeter) and -680 sagittal planes (-68 mm) was obtained, indicating 138 millimeter of biparietal diameter of this brain (Fig. 6B).

After completing the axial and sagittal citation plane, we tried to find the coronal reference book sheet (0 mm). Among coronal images rectangular to the Ac-Microcomputer line, the plane that passes the midpoint between the Atomic number 89 and PC was labeled to glucinium the coronal extension plane (0 mm) (Fig. 6B). The distance from the Alternating current to PC was 22 mm; thus, the coronal reference plane was 11 mm back from the AC and 11 mm front of the PC. Based connected this coronal reference planing machine, images of the anterior half of the brain were relinquished +sign, and for each one project was serially numbered from the coronal character plane. The posterior images were given -sign and likewise numbered. A total of +820 images (+82 millimetre) and -700 images (-70 mm) was obtained, indicating 152 mm of anterior-posterior diam of this brain (Fig. 6A).

After we determined reference planes (0 millimeter), we examined the contents of anatomical structures in these three sections. We plant interesting sets of the brain structure in each reference plane. Among axial, sagittal and garland planes, the sagittal even necessarily no further clarification. It was because this midsagittal plane is well-famed and has been described altogether neuroanatomy textbooks. Our midsagittal aeroplane included all but of all the superficial and deep structures in books. Perhaps the difference could exist noted in the cerebellum, where vermis structures were clearly displayed with its every divisions and subdivisions (Fig. 5B , 7B).

The axial and coronal acknowledgment planes were found to control most of cerebral lobes including the insula, basal ganglia, thalamus and midbrain that are shown in most general anatomy textbooks as representative sections.

The reference axial plane showed equal proportions of the frontal, temporal and occipital lobe. Superior frontal gyrus, middle frontal gyrus and inferior frontal gyrus of triangular part (Broca area) were seen. Superior, central and inferior temporal gyri together with medial occipitotemporal convolution (fusiform gyrus), substantiative sulcus and hippocampus with parahippocampal gyrus were also included. The full extent of insula with its central sulcus was seen. For the internal structures, another than front tooth and posterior commissures, main striatum, globus pallidus with both internal and external segments, head of caudate nucleus, claustrum, internal abridgment with its anterior tree branch, genu and buns limb and external ejector seat were well visualized. Among thalamic nuclei, ventral lateral nucleus, adaxial behind nucleus, centromedian nucleus and pulvinar cell nucleus could represent seen. A tip of cerebellar vermis cerebelli, namely culmen could be establish together with surrounding cerebellar tentorium and trabeated sinus (Fig. 5A , 7A).

The coronal reference plane (0 millimetre) showed superior frontal gyrus, middle frontal gyrus, precentral gyrus, fissure of Rolando, postcentral convolution, lateral pass sulcus and transverse earthly gyrus. IT also showed superior temporary gyrus, middle temporal gyrus, inferior temporal gyrus, medial occipitotemporal convolution, parahippocampal gyrus and collateral sulcus. Major thalamic nuclei much as ventral anterior nucleus, ventral lateral nucleus, dorsal medial nucleus and frontal cell nucleus were included. The subthalamic nucleus and Fields of Forel were clearly shown on this fancy. The posterior limb of the internal capsule, striatum, and pallidum with some external and internal segments were clearly distinct. The mammillary body and cerebral peduncle of the midbrain were besides included in this reference plane. It was found that the quadrigeminal shell became squeezed medially and the posterior corpus callosum was asymmetrical, the left organism large than the right (Libyan Islamic Fighting Group. 6B , 7C).

In order to indicate the frame of reference of the brain, we tried to perform as follows.

We tried the procurement of a normal subject. The cadaver of this study was a 67 year old man who was a known patient myasthenia. The myasthenia gravis gravis is a neurotransmitter disease at the level of myoneural junction; it is basically a disease of peripheral nerve and muscle. There is atomic number 102 report that myasthenia gravis gravis has abnormality in the central systema nervosum. Therefore, we thought that this capable was suitable for our subject.

We took autopsy MRIs and adjusted the mind block inside the embedding box for getting an axial serially-sectioned image showing both the AC and PC (Fig. 5A). This was identical critical because without the aid of MRIs there was no means to guide the cutting direction (Libyan Islamic Fighting Group. 1) ( 9).

We think that we applied a reasonable technique involving freezing, sectioning, and photographing for acquiring serially-divided images with good caliber (Common fig tree. 1). The intervals of 0.1 mm and pixel size of 0.1 millimeter contributed for the better quality of the images (Fig. 2 , 3 , 5 - 7) than those obtained in the premature studies ( 4 - 8). It was fortunate that a total of 2,343 serially-sectioned images could be obtained from a capitulum cylinder block without a failure.

World Congress of Anthropologists set up Reid's base line (RBL) in 1884 and decreed RBL as the anatomic position of the human skull. RBL, also titled Frankfurt plane, is the telephone circuit passing through with the inferior border of the ambi and the upper border of the external external auditory cana, and has been utilised for definition of the orientation of the human skull in physical anthropology and diagnostic radiology (Fig. 8A). After introduction of CT, the radiologist developed canthomeatal business line (CML) that is the line between the canthus and the midpoint of the external acoustic meatus. This line is approximately 10 degree olfactory organ risen to the RBL (Fig. 8B). It is not assertable to describe RBL and CML on the brain, especially when the brain is separated from the skull ( 10). Thence, we need inward landmarks that can be used for the predilection of the brain.

Neurosurgeons who are concerned in stereotactic surgery and also specialists of functional MRIs used some internal landmarks: Interventricular foramen-PC line and Alternating current-PC communication channel have been used to locate the specific deep nuclei of the thalamus. For AC-Personal computer line, stereotactic atlases defined the line passing through the superior edge of the Atomic number 89 and the commercial butt on of the PC ( 11 , 12). Notwithstandin, physique of some AC and PC varies from attack, oval to elliptical, and too varies in size in different individual. Therefore, the angle of the AC-PC straight line line would be different dependent on the shape, size of AC and Personal computer. Meanwhile the Ac-PC central line that passes through the Atomic number 89 center and PC center is somewhat consistent in every individual atomic number 102 matter how pregnant these structures are (Fig. 5 , 6A) ( 10).

In order to shape the relationship between the AC-PC line and the RBL and CML, we have ready-made 3D image of total head connected MRIcro program from the serially-divided images of this research. In the 3D image, the skull was displayed, where RBL could be tired, and a part of skull and brain was swerve out to evidenc bicentric AC-PC line in the median plane. Also, in another 3D image, the cutis was displayed, where CML could be tired, and a part of head was cut to show central AC-Microcomputer line in the average plane. As a event, Atomic number 89-Personal computer line was almost parallel to the CML and showed around 15 degree deviation from the RBL (Fig. 8). From the previous data of Visible Korean ( 4), we could find a similar result. To test this, we need more data including MRIs of sufficient number. The successive research dealing with plenty subjects would also confirm the structural deference of denotation planes between the Alternating current-PC transmission line, RBL and CML.

It is easy to draw central AC-Personal computer blood because some AC and PC pot be easily known in serially-sectioned images (Fig. 5). The AC and Microcomputer are particularly wellspring visualized in MRIs. It has been known that AC and PC, specifiable in MRIs, are very reconciled structures that can be used for the stereotactic approach of deep internal structures of the brain. Schaltenbrand et al. and Dimitrova et al. ( 9 , 11) used intercommissural line and midcommissural skim atomic number 3 the reference guides for deep nucleus structures like basal ganglia and thalamus. However, they do not mention whether intercommissural line is central or tangential. Furthermore, detailed verbal description of the central structures is not getable ( 9 , 11). Nowinski proposed Talairach-Nowinski modification to slump the angle made by tangential intercommissural line from central intercommissural line ( 13).

It is logical to determine the center of a certain organ to be a reference point. After we set the midpoint of Alternating current-PC association, we measured the anterior-posterior, biparietal, and superior-inferior distance of the brain starting from this manoeuvre. It was riveting that this was located really at the center of entirely three-dimensions of the brain (Fig. 6). The brain here way encephalon including myelencephalon.

Another advantage of this frame of reference is that the axial, sagittal, and coronal reference planes passing the center of the AC and PC companion to the highest degree representative brain structures. Axial and coronal reference planes particularly show almost all cerebral lobes and gyri, where the fissure of Rolando is positioned in the center of the sections. Stellar drive, receptive and limbic cortex and deep nuclei could atomic number 4 found (Fig. 7). Therefore in the neuroanatomy class, it would be desirable to start studying the axial reference plane of wi; and so to take the superior (+) and inferior (-) axial planes of psyche, which are step by step changing from the mechanism reference plane. It is also recommended to study the coronal reference plane first, and so expand anteriorly (+) and posteriorly (-).

In neuroanatomy dissection way, tailing learning ability cutting procedure is suggested according to our mention system. Maiden, a brain is divided into two hemispheres; AC and PC are identified on the medial surfaces of the hemispheres. Instant, one hemisphere, preferably the left because of cerebral authority and identification of planum temporale, is cut along the axial reference plane exceedingly the centers of both Actinium and PC. Third, the other hemisphere is cut along the coronal reference plane extremely midpoint between Atomic number 89 and PC. Fourth, serial cuttings are made parallel to the axial and chaplet reference planes, respectively. By utilizing this standardised method acting, brain structures could be easily identified and learned in whatever sections made.

The serially-sectioned images of brain can make up the source of realistic brain atlas and 3D brainiac models. Up to nowadays 2D images of genius atlases were neither standardized axial even nor real body color ( 1 , 2 , 11 , 12). If the new brain atlas settled on the serially-sectional images is published, these defects can be solved. In increase, the new brain atlas connected new reference system could be the resource of the clinicopathologic mapping of human brain. Also, until now medical students and physicians WHO used virtual dissection or virtual surgery software could not be satisfied with the resolution and color of 3D models. If 3D models supported the serially-sectioned images are conventional, these defects would be solved likewise.

In compendious, authors conceive that sectional build has to be settled happening strict and reproducible axial, sagittal, and garland reference plane. Our planned standard consists of cardinal ancillary reference points, which are the AC center and the PC marrow; and peerless star reference tip, which is the midpoint of the AC and the Microcomputer (Libyan Fighting Group. 5). From this school principal original extension point (0 point), which is the midmost point of the Einstein, superior-inferior planes (axial images), anterior-posterior planes (lei images), and right-left planes (sagittal images) could be successful to Be standard planes (Fig. 6).

This work is partly supported by the Ministry of Educational activity, Scientific discipline and Technology (MEST), South Korea, and Korea Science and Engineering Foundation (KOSEF) (Grant No. 2009-0065597).

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label the planes of the sectioned cut body part

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