radiology.CVS 1st lecture.(dr.abeer)
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Transcript of radiology.CVS 1st lecture.(dr.abeer)
RADIOLOGY
Cardiovascular System
Imaging Techniques:
1 -Plain Radiography:
*The standard plain films for evaluation of cardiac diseases are the PA view & Lateral chest film, the PA view must be sufficiently penetrated to see the shadow within the heart, eg. The double contour of the Lt. atrium & valve & pericardial calcification.
*It provides limited informations about the Heart.
*It provides limited informations about the effect of the cardiac diseases on the lungs & pleural cavities.
*We should assess the following points:
a- Heart (shape & size). b- Great vessels (size, shape), Aortic arch (normally
located to the Lt. of the Trachea, we should exclude the signs of coarctation of aorta).
c- If there is any calcification. d- The main point is the examination of the Lung field
for altered blood flow & if there is any evidence of heart failure.
** Note :Look for any thoracic abnormality (such as Pectus Excavatum).
Normal CXR in PA view
Normal CXR in Lateral view
2- Echocardiography(Cardiac US) :
*It is the major or basic imaging technique used in cardiology.
*It gives important informations about the Morphology& Function of the heart.
*It is an excellent technique to look for:
a- Heart valves. b- Chamber morphology & volume.
c- Determining the ventricular wall thickness. d- Any intra-luminal mass.
3 basic techniques are used inEchocardiography, & they are :
a) M-mode :
*It is a continuous scan over a period of time (5-10 seconds), with pencil – beam of sound directed to the site of interest.
*It can demonstrate chamber dimensions, wall thickness, & valve movement (mainly for Lt. ventricular dimension in systole & diastole).
M-mode
b) Two-dimensional sector scanning(Real time echo.) :
*Demonstrates fun-shaped slices of the heart in motion.
*Standard examination consists of combination of short & long axis views + 4 chamber view.
*Long & short – axis views : cross-section of the of the Lt. ventricle + mitral valve + aortic valve, & it is done by placing the transducer in the intercostal space, just to the Lt. of the sternum.
*4 chamber view : both ventricles, both atria, mitral & tricuspid valves, & it is done by placing the transducer at the cardiac apex & aiming upward & medially.
4 chamber view in 2 dimensional scan
Para-sternal long axis
Para-sternal short axis
Apical 4 chamber view
Para-sternal short axis(at Mitral valve level)
*Changing in the frequency of the sound waves are reflected from moving objects, this change depends on the velocity of the reflecting surface.
*RBCs are used as reflecting surface & the velocity of the blood flow can be measured.
c) Doppler echocardiography(Color, Pulse wave):
Doppler flow measurements are used to :
1 -Measure cardiac output or Lt. to Rt. shunt.
2 -Detect & quantify valvular regurgitation.
3 -Quantify pressure gradients across stenotic valves.
4 -Quantify flow.
3- Trans-Esophageal Echocardiography :
*By placing the U.S. probe in the esophagus immediately behind the Lt. atrium, so it will view the heart from behind.
Trans-Esophageal Echocardiography
(A = normal descending thoracic aorta)
Thank You