radiology - students

8/13/2019 Radiology - Students

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RADIOLOGY OF CARDIACAND VASCULAR

STRUCTURES

Cindy Chan, MD


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Cardiac Imaging Modalities

Chest radiography

Echocardiography

Angiocardiography

Nuclear Cardiology

Magnetic Resonance Imaging Also, computed tomography & cardiac

fluoroscopy


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Chest Radiograph


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Echocardiogram


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Angiogram


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Magnetic Resonance Imaging


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CXR

1 Position of the patient (True PA film or off center)

2 Determine right and left markers.

3 Examine the bony skeleton

4 Examine the depth of inspiration and the height of thediaphragm

5 Locate the image of the trachea

6 Examine both lungs for abnormalities

7 Examine the vascular shadows8 Then examine the cardiac silhouette

9 Look at the neck and the sub-diaphragmatic areas


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How to Read a Normal Frontal Chest Radiograph

Subclavian a.

Aortic knob

Main pulm a.

L atrial appendage

SVC

R pulm a.

R atrium

LV


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The Older Patient

Dilated aortawith HTN


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Abnormal observations, AP view

Aortic Contour

Dilated aorta

in syphilis


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Pulmonary Artery

Pulm HTN


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Left Atrium

LAE, with

prosthetic MV


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How to read a normal lateral chest radiograph

Pulmonary

trunk

RV

LA

LV

IVC


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Abnormal observations, LAT view

Right Ventricle


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Left Ventricle


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Left Atrium


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The Vessels, Aorta


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The Vessels, Aorta


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Pulmonary Vasculature


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Normal Pulmonary Vasculature


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Abnormal Pulmonary Vasculature

Centralizationpulmonary artery

hypertension

Overcirculationincreased pulmonaryarterial volume

Lateralizationunilateral increased

resistance


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Centralization

Pulmonary hypertensionchronic PE


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Overcirculation

Ventricular se tal defect


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Lateralization

Westermarks sign


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Pulmonary Veins

Pulmonary Venous Hypertension

(postcapillary)

Cephalization

Interstitial edema

Airspace (alveolar edema)

Often see in CCF


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Cephalization

Upper vessels larger

than lower vessels


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Interstitial Edema

Kurley B lines (thickened

septal lines of secondary

pulmonary lobules, from fluid)


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Airspace (alveolar) edema


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Cardiac Calcifications


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Myocardial Calcification


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Myocardial Calcification


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Pericardial Calcification


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Coronary Artery Calcification


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Computed Tomography


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Cross-Sectional Imaging


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Magnetic Resonance Imaging


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Radiography of Specific

Disorders


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Aortic Diseases

Aortic dissection

Aortic aneurysm Aortic stenosis

Aortic insufficiency

Congenital aortic abnormalities


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Aortic Dissection - CT

Intimal flap


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Aortic dissection - MRI


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Aortic dissection -transesophageal

echocardiography


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Aortic Aneurysm


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Congenital Aortic Abnormalities

R-sided

aortic arch


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Double Aortic Arch


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Aortic Stenosis

Enlarged ascending aorta

Prominent but not enlarged left ventricle

Valvular calcification visible on the lateral

view


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Aortic Insufficiency

Enlarged ascending and descending aorta

Left ventricular enlargement

No valvular calcification


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Aortic Insufficiency


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Mitral Valve Disease

Left Atrial Enlargement

Uplifted left main bronchus

Double density

Enlarged left atrial appendage

Posterior convexity of left atrium (lateral

view)


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Pulmonary Artery Hypertension

Chronic pulmonary emboli

Primary pulmonary hypertension

Pulmonary veno-occlusive disease


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Primary pulmonary hypertension


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Pericardial Effusion


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Congenital Heart Disease in the

Adult Atrial septal defect (ASD)

Ventricular septal defect (VSD)

Pulmonary stenosis

Patent ductus arteriosus


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Adult Congenital Heart Disease

Atrial septal defect

Large pulmarteries


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Coronary artery angiography


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Heart flipped, s/p pneumonectomy

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