Radiology: The Heart And Great Vessels: Imaging For Second Year Medical Students

Front 1

Mitral stenosis (MS) rtg

Back 1

-Powiększony lewy przedsionek,
-Nadciśnienie płucne
-Objawy obrzęku śródmiąższowego,
-Powiększone tętnice płucne (wtórne do nadciśnienia płucnego żylnego),
-Normalna wlk lewej komory.


[Zwapnienia zastawki mitralnej są rzadko spotykane na rtg kl.p. Zwężenie zastawki dwudzielnej oraz niewydolność (mitralnej) często występują razem, więc dominującym fizjologia musi być prawidłowo zdiagnozowana]

Front 2

Signs of interstitial edema on plain film

Back 2

(vascular blurring, bronchial cuffing, septal lines and pleural fluid)

Front 3

dilative cardiomyopathy (due to a mechanical dilatation and resultant insufficiency of the mitral apparatus) signs on plain film

Back 3

Powiększony lewy przedsionek, Nadciśnienie płucne żylnej Objawy obrzęku śródmiąższowego, Powiększone tętnic płucnych (wtórne do nadciśnienia płucnego żylnego), powiększenie lewej komory

Front 4

main etiologies of aortic stenosis

Back 4

Congenital bicuspid aortic valve ((Visible calcification begins about age 30), Rheumatic valvular disease(Visible calcification begins about age 30, 7 yrs after stenosis begins), Degenerative stenosis over age 65

Front 5

imaging of Aortic stenosis, modalities and manifestations

Back 5

1 heart is usually normal in size,
2. Echocardiography, MRI, and CT scanning all will show the calcified valve and post-stenotic dilatation,
2 Echo and MRI can show the stenotic jet as well.

Front 6

Aortic Insufficiency imaging, modalities and manifestations

Back 6

1 dilation of left ventricle,
2 LV enlargement (frontal and lateral projections),
3 enlargement of aortic root,
4 echo and MRI show the LVE, aortic dilatation, as well as the regurgitant jet

Front 7

Cardiomyopathy (or myocardiopathy) fundamental types

Back 7

Dilative(90% ischemia, alcohol, infection, etc), hypertrophic (familian or pressure overload), Restrictive (ventricle cannot dilate normally in diastole due to muscular thickening)

Front 8

Cardiomyopathy imaging

Back 8

1) evidence of pulmonary venous hypertension
2) enlarged cardiac shadow
3) relatively normal vascular pedicle is suspicious for dilative myocardiopathy.
4) Cross-sectional imaging (CT, Echo, or MRI all will show the thickened cardiac muscle
5) dynamic modalities (Echo and MRI) will show the depressed myocardial contraction.

Front 9

Coronary Artery Disease imaging modalities

Back 9

1 NM perfusion imaging with thallium-201 or technetium-99m-sestamibi (mibi scan),
2 Multi-planar sectional imaging reconstruction techniques with single photon emission computed tomography (SPECT),
3 Coronary angiography, Echocardiography

Front 10

NM perfusion imaging with thallium-201 or technetium-99m-sestamibi (mibi scan)

Back 10

is widely used for evaluating coronary artery insufficiency. These exams are commonly performed as rest-stress studies, which allow evaluation for areas of reversible coronary ischemia.

Front 11

Multi-planar sectional imaging reconstruction techniques with single photon emission computed tomography (SPECT) in coronary artery disease injury

Back 11

display the heart in multiple sections, allowing more accurate localization and diagnosis of ischemic areas

Front 12

Coronary angiography

Back 12

is a more invasive procedure that requires placement of a catheter, usually via the common femoral artery, directly into the coronary arteries. Injection of contrast and rapid filming of the flow (cine cardiography) gives very high resolution images of the coronary arteries (Figures 14a,b). Dilatation or stenting of lesions may be undertaken at this point in the cath lab, or the patient may require surgical grafting.

Front 13

Echocardiography for coronary artery disease

Back 13

may be used to evaluate cardiac wall motion for areas of dysfunction or aneurysm from ischemia. Doppler techniques allow detection and quantification of cardiac output, valvular function, and pulmonary artery pressure

Front 14

imaging modalities for congestive heart failure

Back 14

The PA and Lateral CXR as well as even the supine portable CXR

Front 15

Diagnostic imaging signs of hydrostatic pulmonary edema

Back 15

1 An enlarged cardiac silhouette (the maximum transverse cardiac diameter is normally <= half the chest diameter, measured from the inner margin of the rib cage at its widest point above the diaphragm on the erect frontal view) //
2 Increased vascular pedicle width (normally 4-6 cm in the erect PA film) //
3 Venous cephalization on the erect film //
4 Signs of interstitial pulmonary edema: Vascular blurring centrally in the lung, Bronchial cuffing, Septal (Kerley) lines //
5 Pleural fluid //
6 Alveolar flooding in severe cases

Front 16

The role of the CXR in pulmonary embolism

Back 16

The role of this modality in pulmonary embolism is basically confined to:1.Evaluating for other processes (pneumonia, pneumothorax, rib fractures, etc.) that may be accounting for the patient’s symptoms // 2. Correlation with NM ventilation perfusion scanning (V/Q) scanning.

Front 17

Perfusion scanning (the Q in V/Q)

Back 17

involves injection of on the order of 500K technetium-99m (Tc-99m) labeled macroaggregated albumin (MAA) particles into a peripheral vein and imaging the lungs to detect the perfusion pattern. Because many things (emphysema, pneumonia, etc.) can alter the perfusion pattern, another isotope (either xenon-133 gas or Tc labeled DTPA) is inhaled by the patient to provide a map of the lung ventilation. Comparison of the two studies can reveal areas that are not perfused but ventilated and therefore suspicious for embolism

Front 18

aortic laceration imaging

Back 18

rtg nie jest specyficzne dla rozpoznania uszkodzenia aorty
-Poszerzenie łuku aorty,
- wysięk płynu (krwi),
-złamania żeber,
-przemieszczenie zgłębnika nosowo-żołądkowego lub tchawicy z dala od łuku7