E2443. Anatomical Highways and Disease Traffic: How Structure Predicts Source and Spread
  1. Sindhura Tadisetty; University of Kentucky
  2. Adrian Dawkins; University of Kentucky
  3. Halemane Ganesh; University of Kentucky
  4. Aman Khurana; University of Kentucky
  5. James Lee; University of Kentucky
  6. Andres Ayoob; University of Kentucky
  7. Rashmi Nair; University of Kentucky
Understanding the anatomy of the various spaces, recesses, and ligaments in the abdomen and pelvis helps radiologists uncover the primary site of disease and predict the sites of extension. This is an infrequently discussed topic and the relevant information is scattered across topics when radiology is taught by organ systems. However, this knowledge is vitally important in day-to-day practice and is frequently used intuitively by experienced radiologists. This presentation is an attempt to introduce the topic with clinically relevant case examples to trainees and early career radiologists.

Educational Goals / Teaching Points
Understand the embryology and anatomy of the spaces in the abdomen and pelvis and how they influence the spread of disease. Describe classic patterns of disease spread based on a known source. Unexpected spread may change management or may represent a new diagnosis. Algorithmic approach when the source is unknown.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The exhibit will include a concise explanation of the embryology and anatomy of the subperitoneal, intraperitoneal spaces, major ligaments of the abdomen, and their relation to the organs of the abdomen and pelvis. Interconnections between various spaces can play a role in disease spread and can result in unexpected imaging patterns. Both classical and unexpected patterns of disease spread will be demonstrated using a case-based approach.

The extraperitoneal and intraperitoneal spaces are a challenging concept for trainees. Knowledge of these spaces, however, allows for a thoughtful pathophysiologic approach to disease spread and diagnosis. This information helps in choosing appropriate management by identifying the extent of disease spread when the diagnosis is known. The presence of pathology in unusual locations could signify the need for a change in management of a known diagnosis or the presence of a new diagnosis.