cardiac radiology

BASIC CARDIAC RADIOLOGY BASIC CARDIAC RADIOLOGY

ObjectivesObjectives

Understand available Understand available imaging modalitiesimaging modalities

CXR Diagnostic approachCXR Diagnostic approach UnknownsUnknowns

Imaging modalitiesImaging modalities Radiography Echocardiography Nuclear Medicine Computed tomography Magnetic resonance imaging Angiography

Source Undetermined Source Undetermined

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Sources Undetermined (All)

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•Need to evaluate Need to evaluate

1. morphology1. morphology

2. physiology2. physiology

Diagnostic ApproachDiagnostic Approach

Normal Normal Cardiac Cardiac

ContoursContours

normal frontal viewnormal frontal view

L

MV

AV

Source UndeterminedGray’s Anatomy, wordpress

AV

MV

normal lateral viewnormal lateral view

Source Undetermined

Patrick Lynch, wikimedia commons

Abnormal Abnormal Cardiac Cardiac

ContoursContours

Enlarged Enlarged Right AtriumRight Atrium

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Enlarged Enlarged Right VentricleRight Ventricle

Source Undetermined

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Enlarged Enlarged Right VentricleRight Ventricle(lateral CXR)(lateral CXR)

Source Undetermined

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Enlarged Enlarged Left AtriumLeft Atrium

Source Undetermined

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Enlarged Enlarged Left AtriumLeft Atrium

calcified calcified mitral mitral

annulusannulus

Source Undetermined

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Enlarged Enlarged Left VentricleLeft Ventricle

Source Undetermined

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Enlarged Enlarged Left VentricleLeft Ventricle

IVCIVC

Source Undetermined Source Undetermined

• Pulmonary Blood FlowPulmonary Blood Flow

• Pulmonary Artery PressurePulmonary Artery Pressure

•Capillary Wedge PressureCapillary Wedge Pressure

Chest RadiographChest RadiographCardiovascular PhysiologyCardiovascular Physiology

Pulmonary Pulmonary Blood FlowBlood Flow

Normal Flow PatternSource Undetermined

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Normal Flow -Increased FlowSource Undetermined Source Undetermined

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Normal Flow Decreased FlowSource Undetermined Source Undetermined

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Normal Flow Pulmonary Hypertension

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Lung WaterLung Waterpulmonary edemapulmonary edemaWedge pressureWedge pressure

Normal Flow RedistributionSource Undetermined Source Undetermined

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Secondary Pulmonary Secondary Pulmonary LobuleLobule polyhedral shapepolyhedral shape center: center:

artery, bronchus, artery, bronchus, lymphaticslymphatics periphery: periphery:

» veins, lymphaticsveins, lymphatics borders:borders:» interlobular septainterlobular septa » 0.1 mm thick, 1-2 cm 0.1 mm thick, 1-2 cm longlong

1 - 2.5 cm in size 1 - 2.5 cm in size 3 - 12 acini3 - 12 acini

interlobular septa – Kerley B lines on CXRinterlobular septa – Kerley B lines on CXR

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UNKNOWNS

54 year old with dyspnea on exertion54 year old with dyspnea on exertion

a) mitral valve diseaseb) atrial septal defectc) primary PHTNd) pulmonary edema

Source Undetermined Source Undetermined

54 year old with dyspnea on exertion54 year old with dyspnea on exertion

a) mitral valve diseaseb) atrial septal defectc) primary PHTNd) pulmonary edema

Source Undetermined Source Undetermined

24 year-old with heart murmur

a) pulmonic stenosis

b) ASD

c) fluid overload

d) primary PHTN

Source Undetermined

24 year-old with heart murmur

a) pulmonic stenosis

b) ASD

c) fluid overload

d) primary PHTN

Source Undetermined

ObjectivesObjectives

Understand available Understand available imaging modalitiesimaging modalities

CXR Diagnostic approachCXR Diagnostic approach UnknownsUnknowns

Special thanks to Philip N. Cascade, M.D. Cardiothoracic Radiology, University of

Michigan

Additional Source Informationfor more information see: http://open.umich.edu/wiki/CitationPolicy

Slide 6: Sources UndeterminedSlide 7: Source UndeterminedSlide 8: Sources UndeterminedSlide 9: Sources UndeterminedSlide 10: Sources UndeterminedSlide 11: Sources UndeterminedSlide 14: Source Undetermined; Gray’s Anatomy, racquel68 wordpress, http://racquel68.wordpress.com/2007/03/13/next-term/Slide 15: Source Undetermined; Patrick Lynch, Wikimedia Commons, http://commons.wikimedia.org/wiki/File:Heart_right_anterior_oblique_diagrams.svg, CC:BY 2.5, http://creativecommons.org/licenses/by/2.5/deed.enSlide 17: Sources UndeterminedSlide 18: Sources UndeterminedSlide 19: Sources UndeterminedSlide 20: Sources UndeterminedSlide 21: Sources UndeterminedSlide 22: Sources UndeterminedSlide 23: Source UndeterminedSlide 26: Source UndeterminedSlide 27: Source UndeterminedSlide 28: Source UndeterminedSlide 29: Sources UndeterminedSlide 30: Source UndeterminedSlide 31: Sources UndeterminedSlide 32: Source UndeterminedSlide 33: Sources UndeterminedSlide 34: Source UndeterminedSlide 36: Sources UndeterminedSlide 37: Source UndeterminedSlide 38: Source UndeterminedSlide 39: Sources UndeterminedSlide 40: Sources UndeterminedSlide 41: Source UndeterminedSlide 42: Sources UndeterminedSlide 44: Sources UndeterminedSlide 45: Sources UndeterminedSlide 46: Source UndeterminedSlide 47: Source Undetermined