超聲檢查英文版課件

Chapter2：

ECHOCARDIOGREAPHY

Chapter2：1.NormalEchocardiography

1.NormalEchocardiography

TechnologyofEchocardiographyBasicTechnology：

Transthoracic：M-Mode，2-D,Doppler

Transesophygeal:Everyday,OR

TechnologyofEchocardiograpTechnologyofEchocardiographyOthers:Realtime3-DECHOSTRESSECHODopplerTissueImage,DTIAcousticQuantification,AQColorKinesis,CKIntravascular/intracardiacMyocardialcontractechocardiography,MCEStranrate:TechnologyofEchocardiograph心臟的位置Theheartisintheleftsideofthemiddlemediastinum心臟的位置Theheart超聲檢查英文版課件ValvesChambersandSeptumValvesChambersandSeptumParasternalApicalSubcostalSupersternalEchocardiographicviewsParasternalEchocardiographicv

ParasternalLong-AxisView:

Orientingtheplaneofsoundalongthemajoraxisoftheheart,formthepatient’slefthiptotherightshoulder.

ParasternalLong-AxisView:

Anatomy

FourChambers:Walls：Atriawall:2~3mmRightVentricularwall:3~5mm

LeftVentricularwall:8~11mmHeartValve:MitralValve,TricuspidValve

Aorticvalve,PulmonaryValveAnatomyFourChambers:

ParasternalLong-axisview

超聲檢查英文版課件

Rotatingthetransducer900clockwisefromtheparasternallong-axisview

(2)Parasternalshort-axisview:

Rotatingthetransdu超聲檢查英文版課件超聲檢查英文版課件

Short–axisview

attheMVlevel

Leftventricle:Circle

Rightventricle:Crescentshape

MV:Fishmonthatdiastolic

LineatsystolicShort–axisview

attheMVl超聲檢查英文版課件超聲檢查英文版課件Apical4chamberview

4chamberMV,TVAtrialSeptumVentricularSeptumApical4chamberview4chambe(3)心尖四腔心切面(3)心尖四腔心切面超聲檢查英文版課件超聲檢查英文版課件

Apical5chamberview

ThesoundplanetiltedanteriorlyApical5chamberview

SupraternalView

超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件

SubcostalView

SubcostalView超聲檢查英文版課件M-mode

⒈Levelofaorticvalve

⒉LevelofMV

⒊LevelofVentricleM-mode

⒈Levelofaorticv超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件ColorDoppler

ColorcodedRed、Blue、

Green

Red:Bloodflowtowardthetransducer

Blue:Bloodflowawayfromthetransducer

Green:Turbulence,Thevelocityisproportionaltothebrightnessofthecolor

ColorDoppler超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件SpectralDoppler(PW&CW)

Vertical=Velocity,Horizontal:TimeAboveBaseline=TowardtotransducerBelowBaseline=AwayfromtransducerSpectralDoppler(PW&CW)Ver超聲檢查英文版課件超聲檢查英文版課件EAEAMitralValve&TricuspidValvePWWaveformEAEAMitralValve&TricuspidV肺動脈瓣血流PulmonaryValveFlow肺動脈瓣血流PulmonaryValveFlowAoticValvecolorDoppler&PWwaveformAoticValvecolorDoppler&PWLeftventricularsystolicfunction

LeftVentricularVolume（EDV，ESV）

StrokeVolume（SV）EjectionFraction（EF）ShorteningFraction：（SF）Cardiacoutput（CO）

Cardiacindex（CI）

Leftventricularsystolicfunc超聲檢查英文版課件超聲檢查英文版課件RheumaticHeartdiseaseMitralValveStenosis(MS)MitralValveEfficiency(Regurgitation)(MR)AorticValveStenosis(AS)AorticValveRegurgitation(AR)

RheumaticHeartdiseaseMitralMitralStenosis

1.Theleafletsarethickenedanddomedandrestrictedinopening.

Theedgesoftheleafletsarerolledandgnarled.

Thechordaetendinaecanalsobethickened,tethered,andshortened.

Smallmitralvalvearea.

MitralStenosis

1.TheleMS

2.“GreatWall--battlements”3.Enlargedleftatriaandrightventricle4.Narrowed,Highvelocityflowwithbrightyellowandblue5.Thrombusinleftatriaorleftatriaappendage.(TEE)MS2.“GreatWall--batt二、風(fēng)濕性心臟病

MS二、風(fēng)濕性心臟病

MSMSMSMSMSMSBattlementsMSBattlementsMSMSMSAtriaFibrillationMSAtriaSmallanatomicareaMVarea=220/PHT

SmallanatomicareaMVarea=2SpontaneouscontractThrombiSpontaneouscontractThrombi超聲檢查英文版課件MitralRegurtgitation

1.MV/Chordaethickened,redundant,calcification,leafletleak,prolapse,poorcoaptationduringsystole

2.High-velocitymosaic(mainlyblueregurgitaionjetSeeninsystole.3.Leftatriaandventricleoverloaded.DilatedLAandLVMitralRegurtgitation超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件①Valveleafletsthickenedanddomed,immobilewithsmallopening

②Poststenoticdilationoftheascendingaorta.③ThickenedLVwall

④High-velocity,mosaic(mainlyblue)acrossAV.TheflowVelocity＞2m/s

AorticStenosis①ValveleafletsthickenedandASASASAS超聲檢查英文版課件超聲檢查英文版課件①AVleafletsThickened,Redundant,andleak,prolapse,poorcoaptationindiastole②DilatedLV③CDFI:Diastolichigh-velocitymosaicflowinLVOT④CW:DiastolicFlowcanbeusedforquantificationAorticRegurgitation①AVleafletsThickened,RedunLeakindiastoleLeakindiastoleARAR超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件3、CoronaryArteryDisease

(Atherosclerosis)1.RegionalLVwallmotionabnormality

Dyskinesis、Akinesis,Paradoxicalmotion2.LVaneurysms：Mostlyapex,Anteriorwallwithaparadoxicalmotion

3.Coronaryarteriesnarrowing.

3、CoronaryArteryDisease

(AthSeptumThinSeptumSeptumThinAneurysminapexAneurysminapexCK：RegionaldyskinesisCK：RegionaldyskinesisNormalLMandbifurcationNormalLMandbifurcationStressEchoStressEchoLVContractLVContract4、PericardialEffusion

(PCE)

Echofreespace(Clearspace,black)inpericardium4、PericardialEffusion

(PCE)PCEPCEPCEPCE超聲檢查英文版課件5、

CongenitalHeartDiseaseVentricularseptaldefect(VSD)Atrialseptaldefect(ASD)

Patentductusateriosus(PDA)

TetralogtofFallow(TOF)5、

CongenitalHeartDiseaseV

VSD

①DilatedLV,LA②Ventricularseptaldefectseen③Lefttorightshuntingacrosstheventricularseptum.

④CW：High-velocitysystolicflowabovethebaseline

VSD①DilatedLV,LA超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件

PDA

①DilatedLV,LA②PDAcanbeseenconnectingthemainPA(bifurcation,LPA)andtheDAO③Mosaic(Mainlyred)flowinPAfromDAO④High-velocityContinuousflowseenabovebaseline

PDA

①DilatedLV,LA超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件

ASD

①DilatedRA,RVandPA②Defect③L-RshuntingFlowthroughtheASDinbothsystoleanddastole④ContrastEcho:noncontrast-containingbloodpassesacrossASD

ASD①DilatedRA,RVand超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件超聲檢查英文版課件

TetralogyofFallot）

IncludePulmonarystenosis(RVOTO),VSD,OverridingAortaandRVhypertrophy.

TetralogyofFallot）

Echo：①DilatedandoverridingAorta②MalalignmentVSD

③

RVOTO④RVhypertrophy⑤R-Lshuntinginsystole⑥L-Rshuntingindiastole⑦High-velocityflowacrossRVOTEcho：AOLVLARVR→LshuntingOverridingaortaTOFAOLVLARVR→LshuntingOverridingRVOTORVOTO①Canbefindinanyofthecardiacchamber,butmostlyinLA②Generallyattachedtotheloweratrialseptumbyastalkthatpermitsthetumortomovewithintheatrialcavity.③Thetumorprolapsesthroughandocclu