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1 Author(s): Prachi Agarwal M.D., 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Non-commercial Share Alike 3.0 License: We have reviewed this material in accordance with U.S. Copyright Law and have tried to maximize your ability to use, share, and adapt it. The citation key on the following slide provides information about how you may share and adapt this material. Copyright holders of content included in this material should contact with any questions, corrections, or clarification regarding the use of content. For more information about how to cite these materials visit Any medical information in this material is intended to inform and educate and is not a tool for self-diagnosis or a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional. Please speak to your physician if you have questions about your medical condition. Viewer discretion is advised: Some medical content is graphic and may not be suitable for all viewers.
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3 Prachi Agarwal, MD Assistant Professor Cardiothoracic Radiology Fall 2008
4 Objectives Understand available imaging modalities CXR Diagnostic approach Unknowns
5 Imaging modalities Radiography Echocardiography Nuclear Medicine Computed tomography Magnetic resonance imaging Angiography
6
7
8
9 Sources Undetermined (All)
10
11
12 Diagnostic Approach Need to evaluate 1. morphology 2. physiology
13 Normal Cardiac Contours
14 L normal frontal view AV MV Gray s Anatomy, wordpress
15 normal lateral view AV MV Patrick Lynch, wikimedia commons
16 Abnormal Cardiac Contours
17 Enlarged Right Atrium
18 Enlarged Right Ventricle
19 Enlarged Right Ventricle (lateral CXR)
20 Enlarged Left Atrium
21 Enlarged Left Atrium calcified mitral annulus
22 Enlarged Left Ventricle
23 Enlarged Left Ventricle IVC
24 Chest Radiograph Cardiovascular Physiology Pulmonary Blood Flow Pulmonary Artery Pressure Capillary Wedge Pressure
25 Pulmonary Blood Flow
26 Normal Flow Pattern
27
28 Source: Undetermined
29 Normal Flow -Increased Flow
30
31 Normal Flow Decreased Flow
32
33 Normal Flow Pulmonary Hypertension
34
35 Lung Water pulmonary edema Wedge pressure
36 Normal Flow Redistribution
37
38 Secondary Pulmonary Lobule! polyhedral shape! center: " artery, bronchus, lymphatics! periphery:» veins, lymphatics! borders:» interlobular septa» 0.1 mm thick, 1-2 cm long! cm in size! 3-12 acini interlobular septa Kerley B lines on CXR
39
40
41
42
43 UNKNOWNS
44 54 year old with dyspnea on exertion a) mitral valve disease b) atrial septal defect c) primary PHTN d) pulmonary edema
45 54 year old with dyspnea on exertion a) mitral valve disease b) atrial septal defect c) primary PHTN d) pulmonary edema
46 24 year-old with heart murmur a) pulmonic stenosis b) ASD c) fluid overload d) primary PHTN
47 24 year-old with heart murmur a) pulmonic stenosis b) ASD c) fluid overload d) primary PHTN
48 Objectives Understand available imaging modalities CXR Diagnostic approach Unknowns
49 Special thanks to Philip N. Cascade, M.D. Cardiothoracic Radiology, University of Michigan
50 Additional Source Information for more information see: Slide 6: Sources Undetermined Slide 7: Slide 8: Sources Undetermined Slide 9: Sources Undetermined Slide 10: Sources Undetermined Slide 11: Sources Undetermined Slide 14: ; Gray s Anatomy, racquel68 wordpress, Slide 15: ; Patrick Lynch, Wikimedia Commons, CC:BY 2.5, Slide 17: Sources Undetermined Slide 18: Sources Undetermined Slide 19: Sources Undetermined Slide 20: Sources Undetermined Slide 21: Sources Undetermined Slide 22: Sources Undetermined Slide 23: Slide 26: Slide 27: Slide 28: Slide 29: Sources Undetermined Slide 30: Slide 31: Sources Undetermined Slide 32: Slide 33: Sources Undetermined Slide 34: Slide 36: Sources Undetermined Slide 37: Slide 38: Slide 39: Sources Undetermined Slide 40: Sources Undetermined Slide 41: Slide 42: Sources Undetermined Slide 44: Sources Undetermined Slide 45: Sources Undetermined Slide 46: Slide 47:
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Attribution: Department of Neurology, 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Non-commercial Share Alike 3.0 License: http://creativecommons.org/licenses/by-nc-sa/3.0/
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Author: A. Kent Christensen, Ph.D., 2009 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike 3.0 License: http://creativecommons.org/licenses/by-sa/3.0/