2 d echocardiography views

2 d echo views

1. 2dEchocardiography Dr.Sruthi Meenaxshi MBBS,MD,PDF

2. Ultrasound waves Sound waves are mechanical vibrations that can be described in terms of frequency or Hertz (Hz), ie , the number of repetitions or cycles per second. Other characteristics include wavelength, the distance between excitations, measured in mm; and the amplitude of excitation, measured in decibels (dB).

3. Medical ultrasound imaging typically uses sound waves at frequencies of 1,000,000 to 20,000,000 Hz ( 1.0 to 20 MHz). In contrast, the human auditory spectrum comprises frequencies between 20 and 20,000 Hz.

4. INTERACTION OF ULTRASOUND WAVES WITH TISSUES When ultrasound beam hits the target it can undergo Reflection Refraction Scattering Attenuation – Reduce signal strength

5. ULTRASOUND TRANSDUCERS Ultrasound transducers use piezoelectric crystals to both generate and receive ultrasound waves These crystals (quartz or titanate ceramic) alternately compress and expand the alternating electric current that is applied, thereby generating the ultrasound wave. Following a brief period of transmission, typically 1 to 6 microseconds, the same crystal also acts as a receiver. When a reflected ultrasound wave impacts the piezoelectric crystal, an electric current is generated.

6. Ultrasound transducer

7. 2D image is generated from data obtained electronically using a phased-array transducer. Since each scan line of data requires a finite period of time for transmission and reception, the time required to complete each 2D image is directly related to the number of scan lines.

8. Tomographic View Each tomographic view is defined by the transducer position parasternal apical subcostal suprasternal

9. Views Views obtained by manipulation of transducer by combined angulation and rotation long axis short axis four-chamber five-chamber. 

10. Parasternal long axis view   Third or fourth left intercostal space, immediately adjacent to the sternum

11. Right ventricular inflow and outflow- PLAX   Infero medial angulation of Parasternal long axis view Visualize IVC, RA ,RV, TV

12. Parasternal short axis   From the parasternal long axis orientation, a 70º to 110º clockwise rotation of the transducer superior and inferior transducer manipulations permits delineation of the parasternal short axis views base (aortic valve) basal left ventricular (mitral valve) mid-left ventricular (papillary muscle) and apical left ventricular levels

13. PSAX- Apical level

14. MERCEDES BENZ SIGN All three leaflets of the aortic valve may be identified, forming a "Y" configuration during ventricular diastole, with the interatrial septum adjacent to the noncoronary cusp. 

15. Mitral valve PSAX FISH MOUTH APPEARANCE

16. VISUALISATION LEFT ATRIAL APPENDAGE

17. ANALYSIS OF WALL MOTION PSAX Slight inferior angulation of PSAX view helps in assessing wall motion abnormalities in Myocardial infarction patients

18. Apical 4 chamber view Transducer at apex Visualize all 4 chambers

19. Apical five-chamber   Anterior angulation and slight clockwise rotation of the transducer . permits imaging of the left ventricular outflow tract, right and left leaflets of the aortic valve, and proximal ascending aorta 

20. Apical two-chamber Counter clockwise direction from apical 4 chamber view reveals 2 chamber view

21. Apical Long Axis view Further counter clockwise direction and anterior angulation

22. Subcostal view obtained with the patient supine in full inspiration to bring the heart closer to the imaging probe and with the knees bent to relax the abdominal musculature The transducer is positioned immediately below or to the right of the xiphoid process.

23. Subcostal view Medial angulation shows IVS , hepatic veins

24. Visualisation of aorta subcostal view Sliding transducer to left visualizes aorta

25. Suprasternal notch   with the patient supine and the neck extended, the transducer is placed in the suprasternal notch to obtain an image of the distal ascending, transverse, and proximal descending aorta

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