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X-Ray Diagnosis of Cardiovascular System

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Questions and Answers

What is the primary method of radial examination of the heart and thoracic aorta?

Radiography

What is the purpose of using X-rays in non-standard optimal projections?

To study a particular department of the cardiovascular shadow

What is the advantage of native X-ray examination of the thoracic aorta?

It can be supplemented with linear tomography when CT is inaccessible

What is the diagnostic value of previously used radiographic techniques?

<p>They have little diagnostic value and are no longer used</p> Signup and view all the answers

What is the role of fluoroscopy in the X-ray method of radial examination?

<p>It is a native technique used in conjunction with radiography</p> Signup and view all the answers

What is the primary advantage of the X-ray method in the study of the heart and thoracic aorta?

<p>It is still widely used despite the development of new methods</p> Signup and view all the answers

What is the indication for implementing a study to clarify the details of the morphological state of the aorta?

<p>Difficulty in differential diagnosis with pathological processes of other organs of the thoracic cavity</p> Signup and view all the answers

What is the distinctive feature of the cardiac shadow in a true radiographic study?

<p>Total combined uniform shadow</p> Signup and view all the answers

Where does the left contour of the heart typically lie in relation to the median line?

<p>2 cm to the left of the median-clavicular line</p> Signup and view all the answers

What is the ratio of the heights of the cardiac and vascular segments in a normal radiograph?

<p>1:1</p> Signup and view all the answers

How does the angle of inclination of the heart vary in different constitutional types?

<p>Normostenics have an angle of 45°, hypersthenics have more than 50°, and asthenics have less than 40°</p> Signup and view all the answers

What is the effect of the breathing phase on the position of the heart?

<p>In inspiration, the heart assumes a more vertical position</p> Signup and view all the answers

What is the point of intersection of the arcs forming the right contour of the heart?

<p>Right cardiovascular angle</p> Signup and view all the answers

Which of the following can cause changes in the position of the heart?

<p>Various pathological processes in adjacent organs and anatomical structures</p> Signup and view all the answers

What is the 'waist' of the heart formed by?

<p>The second and third arcs of the left contour</p> Signup and view all the answers

Which of the following is not a factor affecting the position of the heart?

<p>Age of the patient</p> Signup and view all the answers

What is the primary reason for the aorta's bending in the right pulmonary field?

<p>The considerable elongation of the aorta</p> Signup and view all the answers

What is the effect of the unfolding of the aortic loop on the contour of the descending aorta?

<p>It shifts to the left</p> Signup and view all the answers

What is the main reason for the increase in the intensity of the shadow on the radiograph?

<p>The increase in the mass of blood in the enlarged aorta</p> Signup and view all the answers

What is the normal cardio-thoracic coefficient (C/D x 100) for adults?

<p>Less than 50%</p> Signup and view all the answers

What is the manifestation of the right atrial enlargement on the radiograph?

<p>Elongation and protrusion of the lower arc of the right contour</p> Signup and view all the answers

What is the point of intersection of the arcs of the heart called?

<p>The left cardiovascular angle</p> Signup and view all the answers

What is the normal Goodwin coefficient for the right atrium?

<p>Less than 30%</p> Signup and view all the answers

What is the effect of the right ventricular enlargement on the left ventricular arch?

<p>It moves to the left</p> Signup and view all the answers

Which part of the heart forms the posterior contour of the cardiovascular shadow in the left lateral projection?

<p>The left atrium and ventricle</p> Signup and view all the answers

How many variants of the pathological form of the cardiovascular shadow are described in the text?

<p>5</p> Signup and view all the answers

What is the normal contact of the right ventricle with the anterior thoracic wall in the left lateral projection?

<p>1/4 of the sternum length</p> Signup and view all the answers

What is characteristic of the mitral configuration of the heart?

<p>Elongation and swelling of the second and third arcs of the left contour</p> Signup and view all the answers

What is the cause of the right atrium's upward movement on the radiograph?

<p>The enlargement of the right ventricle</p> Signup and view all the answers

What is the characteristic feature of the aortic configuration of the heart?

<p>Widening of the waist of the heart</p> Signup and view all the answers

Which condition is characterized by a globular shape of the heart?

<p>Exudative pericarditis</p> Signup and view all the answers

What is the characteristic feature of the trapezoidal (triangular) form of the heart?

<p>Diffuse lesions of the myocardium</p> Signup and view all the answers

What is the radiographic sign of aneurysms of the heart and aorta?

<p>Local expansion of the cardiovascular shadow</p> Signup and view all the answers

How is the lengthening of the aorta indicated in a radiograph?

<p>By a decrease in the distance from the upper contour of the aortic arch to the left sternoclavicular junction</p> Signup and view all the answers

What is the importance of understanding the radiographic features of the heart?

<p>It is important for diagnosing cardiac diseases</p> Signup and view all the answers

What is the primary indication for angiocardiography?

<p>Diagnosis of complex, combined heart defects</p> Signup and view all the answers

In a direct projection, what is the effect of an increase in the left atrium on the heart contour?

<p>Elongation of the left arc</p> Signup and view all the answers

What is the normal position of the esophagus in relation to the spine in a left lateral projection?

<p>Parallel to the anterior surface of the spine and not touching it</p> Signup and view all the answers

What is the significance of the posterior cardio-diaphragmatic angle in the left lateral projection?

<p>It indicates the size of the left ventricle</p> Signup and view all the answers

According to Moore's ratio, what is the normal size of the pulmonary artery relative to the transverse basal size of the chest?

<p>Less than 30%</p> Signup and view all the answers

What is the purpose of venous umbilical catheterization in angiocardiography?

<p>To insert a catheter into the inferior vena cava</p> Signup and view all the answers

What is the effect of an increase in the left ventricle on the retrocardial space in the left lateral projection?

<p>Narrowing of the retrocardial space</p> Signup and view all the answers

What is the primary purpose of coronary angiography?

<p>To accurately determine the nature, extent, localization of vascular lesions</p> Signup and view all the answers

What is the significance of the pulmonary ligament in the left lateral projection?

<p>It indicates the normality of the left ventricle</p> Signup and view all the answers

What is the main limitation of aortography?

<p>It does not allow to judge the state of the vessel wall</p> Signup and view all the answers

What is the method of contrasting the heart cavities in angiocardiography?

<p>Artificial injection of X-ray contrast preparations</p> Signup and view all the answers

What is the primary advantage of ultrasound in diagnosing heart disease?

<p>It provides a comprehensive and multifaceted evaluation of the heart</p> Signup and view all the answers

What is the primary intention of M-mode technique in echocardiography?

<p>To measure the biometric parameters of the heart</p> Signup and view all the answers

What is the main advantage of Color Doppler Mapping (CDM) in echocardiography?

<p>It accurately determines the spatial orientation and boundaries of blood flows</p> Signup and view all the answers

What is the purpose of puncturing the interatrial septum in angiocardiography?

<p>To insert a catheter into the left atrium</p> Signup and view all the answers

What type of echocardiography is used to obtain images of all anatomical structures of the heart?

<p>B-mode</p> Signup and view all the answers

What is the main indication for ultrasound in diagnosing heart disease?

<p>Coarctation of the aorta</p> Signup and view all the answers

What is the primary function of tissue dopplerography in cardiology?

<p>To assess the physiological function of the myocardium</p> Signup and view all the answers

What is the purpose of intracardiac pressure measurement?

<p>To determine the minute and shock volumes of the heart</p> Signup and view all the answers

What is the greatest clinical significance of Doppler echocardiography?

<p>To identify and assess the degree of valvular regurgitation and stenoses</p> Signup and view all the answers

What is the advantage of selective coronary angiography compared to general thoracic aortography?

<p>It allows for sequential probing of each coronary artery</p> Signup and view all the answers

What is the main goal of stress echocardiography?

<p>To determine the response of the left ventricle to the load</p> Signup and view all the answers

What is the significance of transesophageal ultrasound in cardiology?

<p>It is particularly important in atrial neoplasms and valve prosthesis pathology</p> Signup and view all the answers

What is the purpose of a complex ultrasound evaluation in diagnosing heart disease?

<p>To obtain a comprehensive and multifaceted evaluation of the heart</p> Signup and view all the answers

What is the main limitation of invasive techniques such as coronarography and aortography?

<p>They are burdensome and even unsafe for the patient</p> Signup and view all the answers

What is the advantage of using intravascular catheterization with microsensors in echocardiography?

<p>It provides information on the lumen of the coronary arteries</p> Signup and view all the answers

What is the purpose of suprasternal access in ultrasound evaluation of the heart?

<p>To study the thoracic aorta</p> Signup and view all the answers

What is the significance of spectral Doppler echocardiography in cardiology?

<p>It is used to calculate important parameters of central hemodynamics</p> Signup and view all the answers

What is the primary use of Doppler spectrography in echocardiography?

<p>To calculate important parameters of central hemodynamics</p> Signup and view all the answers

What is the advantage of combining echocardiography with stress tests?

<p>It allows for the assessment of the response of the left ventricle to the load</p> Signup and view all the answers

In native CT examination of the heart, what is the limitation in visualizing the heart chambers?

<p>The density of the blood is almost equal to the density of the myocardium</p> Signup and view all the answers

What is the primary indication for performing native CT examination of the heart?

<p>Diagnosis of exudative and adhesive pericarditis</p> Signup and view all the answers

What can be determined using the software of modern computer tomographs in native CT examination of the heart?

<p>The area, volume, number of calcinates, and mass of calcium phosphate</p> Signup and view all the answers

What is the purpose of using native CT examination in the diagnosis of ischemic heart disease?

<p>All of the above</p> Signup and view all the answers

In which section is the aortic arch visible in native CT examination of the heart?

<p>Longitudinal section</p> Signup and view all the answers

What is the limitation of native CT examination of the heart in terms of informativeness?

<p>It has little informativeness</p> Signup and view all the answers

What is the primary purpose of injecting 100-150 ml of X-ray contrast preparations in CT angiocardiography?

<p>To assess the condition of the heart, coronary arteries, and aorta</p> Signup and view all the answers

What is the advantage of dynamic scanning over static scanning in CT angiocardiography?

<p>It enables the evaluation of central hemodynamics, including the speed of passage of X-ray contrast preparations</p> Signup and view all the answers

What is the limitation of MSCT and EBT coronarography?

<p>All of the above</p> Signup and view all the answers

What is the purpose of multiplanar reformation and three-dimensional transformation in CT angiocardiography?

<p>To provide additional, important information about the heart and vessels</p> Signup and view all the answers

What is the advantage of CT angiocardiography over other imaging techniques?

<p>It provides a high spatial and temporal resolution</p> Signup and view all the answers

What is the purpose of volumetric rendering (VRT) in CT angiocardiography?

<p>To provide a clear image of the proximal and middle third of the coronary arteries and their large branches</p> Signup and view all the answers

What is the role of ECG synchronization in CT angiocardiography?

<p>It enables the scanning of the heart and vessels during specific phases of the cardiac cycle</p> Signup and view all the answers

What is the advantage of combining CT angiocardiography with functional examination of the heart?

<p>It enables the assessment of the heart's functional parameters, such as volume and contractility</p> Signup and view all the answers

What is the purpose of virtual aortoscopy in CT angiocardiography?

<p>To examine the mouth of the shunts from the inside of the aorta</p> Signup and view all the answers

What is the limitation of CT angiocardiography in assessing the coronary arteries?

<p>It has poor visualization of the distal parts of the coronary arteries and their small branches</p> Signup and view all the answers

What is the primary advantage of MRI in the diagnosis of heart and aortic diseases?

<p>Highly informative method of radiation examination</p> Signup and view all the answers

What is the main purpose of perfusion scintigraphy of the myocardium?

<p>To study the blood supply to the heart on the microcirculation level</p> Signup and view all the answers

What is the significance of radionuclide equilibrium ventriculography (REVG) in the diagnosis of heart disease?

<p>It is used to study the morphological and functional changes of the heart</p> Signup and view all the answers

What is the characteristic of diffuse violations of myocardial perfusion in perfusion scintigraphy?

<p>Uneven inclusion of RPPs throughout the image area</p> Signup and view all the answers

What is the advantage of PET over SPECT in studying the perfusion of the heart muscle?

<p>PET provides more accurate information on myocardial metabolism</p> Signup and view all the answers

What is the significance of 99mTc-pyrophosphate in scintigraphy of the focus of myocardial infarction?

<p>It is selectively taken up by injured myocardial tissue</p> Signup and view all the answers

What is the primary advantage of radionuclide methods in diagnosing heart disease?

<p>They provide functional information on the heart</p> Signup and view all the answers

What is the significance of physical or pharmacological stress in perfusion scintigraphy?

<p>It allows for the assessment of the functional reserves of myocardial blood supply</p> Signup and view all the answers

What is the primary indication for perfusion scintigraphy in the diagnosis of myocardial infarction?

<p>In the first hours of its development</p> Signup and view all the answers

What is the primary role of tin pyrophosphate in radionuclide equilibrium ventriculography (REVG)?

<p>It is used to label red blood cells in vivo</p> Signup and view all the answers

What is the primary purpose of table 1?

<p>To compare the diagnostic significance of various radial methods in cardiology</p> Signup and view all the answers

What is the purpose of synchronizing magnetic resonance imaging with cardiac contractions and respiratory phases?

<p>To obtain a high-quality image of the heart and coronary arteries</p> Signup and view all the answers

What is the advantage of using fast and ultrafast pulse sequences in magnetic resonance imaging?

<p>They significantly expand the diagnostic capabilities of the method</p> Signup and view all the answers

What is the benefit of performing multiphase cinoMRT simultaneously on several anatomical levels?

<p>It enables the observation of the passage of the contrast medium through the heart chambers</p> Signup and view all the answers

What is the characteristic of the signal obtained from the myocardium on magnetic resonance tomograms?

<p>It is an iso-intensive signal</p> Signup and view all the answers

What is the significance of the intensity of the magnetic resonance signal from the myocardium?

<p>It serves as a basis for assessing the state of the myocardium</p> Signup and view all the answers

What is the limitation of coronary arteries imaging with native magnetic resonance imaging?

<p>It differs fragmentarily, making it difficult to assess with clinical goals</p> Signup and view all the answers

What is the purpose of plotting intensity-time curves in cardiology?

<p>To establish a quantitative characteristic of the dynamics of accumulation and excretion of contrast medium</p> Signup and view all the answers

What is the significance of defects in perfusion in magnetic resonance imaging?

<p>They are manifested by the weakening of signals and the slowing of the supply of contrast medium to the affected parts of the myocardium</p> Signup and view all the answers

What is the advantage of performing a three-dimensional reconstruction in contrast magnetic resonance coronarography?

<p>It enhances the quality of the image</p> Signup and view all the answers

What is the primary function of 99mTc-per-technetate in radionuclideal equilibrium ventriculography?

<p>To bind firmly to pyrophosphate and label red blood cells</p> Signup and view all the answers

What is the diagnostic significance of perfusion scintigraphy of the myocardium in cardiac ischemia?

<p>It detects areas of the myocardium with a reduced accumulation of RPP</p> Signup and view all the answers

What is the primary indication for radionuclideal equilibrium ventriculography?

<p>All of the above</p> Signup and view all the answers

What is the gold standard for evaluating the state of coronary arteries?

<p>Traditional radiocontrast study</p> Signup and view all the answers

What is the primary advantage of radionuclideal equilibrium ventriculography over echocardiography?

<p>It allows for the evaluation of perfusion and metabolism of the myocardium</p> Signup and view all the answers

What is the diagnostic significance of visualization of images of the heart in different phases?

<p>It visualizes the motion of the ventricular walls</p> Signup and view all the answers

What is the primary benefit of using magnetic resonance imaging in the diagnosis of aneurysms of the thoracic aorta?

<p>Providing exhaustive information necessary for performing operative intervention</p> Signup and view all the answers

What is the diagnostic significance of radionuclideal equilibrium ventriculography in acute myocardial infarction?

<p>It shows a site of akinesia of the left ventricular wall</p> Signup and view all the answers

What is the primary limitation of radionuclideal equilibrium ventriculography?

<p>It requires a significant amount of radiation</p> Signup and view all the answers

What is the diagnostic significance of echocardiography in mitral stenosis?

<p>It visualizes the upward displacement of the right cardiovascular angle</p> Signup and view all the answers

What is the characteristic echocardiographic feature of mitral stenosis in B-mode?

<p>Dome-shaped diastolic deflection of the mitral valve flaps</p> Signup and view all the answers

What is the radiographic sign of aortic stenosis in the direct projection?

<p>Elongation and displacement to the left of the left ventricular arch</p> Signup and view all the answers

What is the Doppler echocardiographic feature of mitral valve insufficiency?

<p>Regurgitating blood flow through the mitral valve from the left ventricle to the left atrium</p> Signup and view all the answers

What is the radiographic feature of exudative pericarditis in the direct projection?

<p>A general increase in the cardiac shadow</p> Signup and view all the answers

What is the characteristic M-mode echocardiographic feature of mitral stenosis?

<p>Unidirectional diastolic movement of the mitral valve flaps</p> Signup and view all the answers

What is the echocardiographic feature of aortic valve insufficiency in B-mode?

<p>Incomplete diastolic closure of the valves of the aortic valve</p> Signup and view all the answers

What is the Doppler echocardiographic feature of aortic stenosis?

<p>An increase in the maximum rate of aortic blood flow</p> Signup and view all the answers

What is the radiographic feature of aortic valve insufficiency in the left lateral projection?

<p>Displacement of the left ventricle to the spine of the arc</p> Signup and view all the answers

What is the characteristic feature of exudative pericarditis in echocardiography?

<p>Direct visualization of fluid in the pericardial cavity</p> Signup and view all the answers

What is the Doppler echocardiographic feature of aortic valve insufficiency?

<p>Regurgitating blood flow through the aortic valve from the aorta to the left ventricle</p> Signup and view all the answers

What is the characteristic radiographic feature of adhesive constrictive pericarditis?

<p>Calcification of the pericardium with change in shape and decrease in the size of the heart shadow</p> Signup and view all the answers

What is the diagnostic value of MR-aortography in the diagnosis of aneurysms of the thoracic aorta?

<p>Accurate establishment of the aneurysm with comprehensive and detailed characterization</p> Signup and view all the answers

What is the characteristic echocardiographic feature of heart contusion?

<p>Regional deterioration of contractility and reduction of ventricular ejection fraction</p> Signup and view all the answers

What is the diagnostic value of CT-aortography in the diagnosis of aneurysms of the thoracic aorta?

<p>Accurate establishment of the aneurysm with comprehensive and detailed characterization</p> Signup and view all the answers

What is the characteristic radiographic feature of rupture of the outer walls of the heart?

<p>General increase in the cardiac shadow with a spherical shape</p> Signup and view all the answers

What is the diagnostic value of perfusion scintigraphy of the myocardium in the diagnosis of heart contusion?

<p>Assessment of areas of the myocardium with a decrease in accumulation of RPP</p> Signup and view all the answers

Study Notes

Invasive Diagnostic Methods

  • Invasive techniques are used to measure intracardiac pressure and determine the gas composition of the blood in various heart chambers
  • These techniques allow for detailed qualitative and quantitative characteristics of morphological changes in the heart and violations of central hemodynamics
  • Examples of invasive techniques include:
    • Angiocardiography: contrast radiographic examination of the thoracic aorta
    • Coronarography: contrast study of the coronary arteries of the heart
  • These techniques are invasive and may be burdensome and unsafe for patients, so indications for their use are narrowing

Ultrasound Method

  • Ultrasound is a non-invasive and highly informative method for diagnosing heart disease
  • It allows for the evaluation of:
    • Morphological and functional state of all cardiac structures
    • Anatomical features of the heart
    • Myocardial contractility
    • State of central hemodynamics
  • Types of echocardiography:
    • B-mode: used to obtain images of all anatomical structures of the heart
    • M-mode: used to measure biometric parameters of the heart
    • Doppler echocardiography: used to study blood flow in the heart cavities
  • Ultrasound is particularly useful for assessing the state of the thoracic aorta

X-Ray Diagnosis of the Cardiovascular System

  • X-ray methods are still widely used in the study of the heart and thoracic aorta
  • Native X-ray examination of the thoracic aorta is used to evaluate the morphology of the aorta
  • Linear tomography can be used to supplement native X-ray examination
  • X-ray methods are used to judge the position, shape, and size of the heart and aorta

Normal X-Ray Anatomy of the Heart and Thoracic Aorta

  • The cardiac shadow is median-asymmetrical, with 1/3 to the right of the median line and 2/3 to the left

  • The left contour of the heart does not reach the left median-clavicular line by 1.5-2 cm

  • The vascular bundle shadow is formed by the thoracic aorta, superior hollow vein, and pulmonary artery

  • The angle of inclination of the heart depends on the constitutional type of the patient### Cardiovascular Shadow in Radiography

  • The cardiovascular shadow in a direct projection has a corsal-positioned oval shape adjacent to the diaphragm and sternum.

  • The front contour of the cardiovascular shadow is formed by the ascending part of the aorta (top) and the right ventricle (bottom).

  • The posterior contour is formed by the left atrium (top) and the left ventricle (bottom).

Pathological Forms of the Cardiovascular Shadow

  • There are 5 variants of the pathological form of the cardiovascular shadow: mitral, aortic, globular, trapezoidal (triangular), and a form with local expansion.
  • Mitral configuration: elongation and swelling of the second and third arcs of the left contour of the cardiac shadow; upward displacement of the right cardiovascular angle.
  • Aortic configuration: westing of the waist of the heart; elongation of the lower arc along the left contour; enlargement and swelling of the upper arc on the right and displacement of the right cardiovascular angle downwards.
  • Globular shape: characteristic of exudative pericarditis, multivalve acquired heart defects.
  • Trapezoidal (triangular) form: characteristic of diffuse lesions of the myocardium.

Local Expansion of the Cardiovascular Shadow

  • Manifests aneurysms of the heart and aorta, tumors and cysts of the heart, neoplasms of the mediastinum.
  • Indicated by lengthening, bending, unfolding, expanding, and increasing the intensity of the shadow of the aorta.

Radiographic Signs of Aortic Pathology

  • Lengthening of the aorta: indicated by a decrease in the distance from the upper contour of the aortic arch to the left sternoclavicular junction (less than 1 cm).
  • Bending, unfolding, expanding, and increasing the intensity of the shadow of the aorta.

Left Atrium and Ventricles

  • Left atrium: in a direct projection, an increase in the left atrium leads to an elongation of its arc on the left contour; an additional arc appears on the right side of the heart in the zone of the right cardiovascular angle.
  • Left ventricle: in a direct projection, an increase in the left ventricle causes lengthening and swelling of its arch along the left contour of the cardiac shadow; in the left lateral projection, the magnitude of the left ventricle can be judged by the degree of abutment of the heart to the diaphragm.

Pulmonary Artery

  • Estimated in a direct projection from the middle line to the most distant point of its contour.
  • Normally, the size of the pulmonary artery does not exceed 30% of the transverse basal size of the chest (Moore's ratio).

Special X-ray-contrast Methods

  • Angiocardiography: method of artificial contrasting of the heart cavities; used to diagnose complex, combined heart defects.
  • X-ray computer tomography (CT): provides a general idea of the organs of the chest, including the heart and large vessels; used to diagnose exudative and adhesive pericarditis, and identify calcification in the coronary arteries.
  • Magnetic resonance imaging (MRI): provides a differentiated image of the walls of the heart and blood in its cavity; used to diagnose aneurysms of the heart and aorta, coarctation of the aorta, paracardial structures, hypertrophic cardiomyopathy.
  • Radionuclide method: used to study the blood supply to the heart on the microcirculation level; perfusion scintigraphy of the myocardium, scintigraphy of the heart of myocardial infarction, and radionuclide equilibrium ventriculography are used to diagnose heart diseases.### Radionuclide Ventriculography (REVG)
  • REVG is performed by injecting 99mTc-per-technetate intravenously, which binds to pyrophosphate, providing a stable label of at least 90% of red blood cells for up to 4 hours.
  • Several hundred images are recorded using a gamma camera, which are then analyzed by computer to form a single average image of the cardiac cycle.
  • Activity-time curves are constructed to reflect the contractile function of the heart during several cardiac cycles.
  • Ejection fraction is calculated by measuring the difference in blood levels of radioactivity in the ventricles between end-diastolic and end-systolic phases.

Indications for REVG

  • Ischemic heart disease
  • Myocardial infarction
  • Heart aneurysms
  • Hypertension
  • Diffuse lesions of the heart muscle
  • Evaluation of reserve capabilities of the myocardium by ejection fraction using dosed physical exercise

Diagnostic Significance of Radial Methods in Cardiology

  • Echocardiography is the preferred method for radial examination of the heart
  • Radionuclide study is necessary for assessing perfusion and metabolism of the myocardium
  • Traditional radiocontrast study is the gold standard for evaluating the state of coronary arteries
  • MRI and CT are priority methods for diagnosing diseases of the thoracic aorta

X-ray Semiotics of Heart and Thoracic Aortic Diseases

  • Cardiac ischemia:
    • Echocardiography: violation of contractility of individual sections of the left ventricular wall, reduction of left ventricular ejection fraction
    • Perfusion scintigraphy of the myocardium: areas of the myocardium with reduced accumulation of RPP
    • Contrastive X-ray and CT coronarography: narrowing, occlusion of various branches of the coronary arteries
  • Acute myocardial infarction:
    • Perfusion scintigraphy of the myocardium: complete absence of accumulation of RFP in the necrotic area of the myocardium
    • Scintigraphy of the focus of myocardial infarction: RPP hyperfixation site
    • Radionuclideal equilibrium ventriculography, echocardiography: site of akinesia of the left ventricular wall, reduction of left ventricular ejection fraction
  • Mitral stenosis:
    • Radiography: swelling along the left contour of the cardiac shadow, upward displacement of the right cardiovascular angle, changes in the lungs
    • Echocardiography: dome-shaped diastolic deflection of mitral valve flaps, reduction of the area of the mitral orifice, thickening, compaction, calcification of mitral valve flaps

CT Angiocardiography

  • Advantages: high spatial and temporal resolution, ability to visualize all structures of the heart, evaluation of morphological changes and state of central hemodynamics
  • Techniques: static or dynamic scanning, multiplanar reformation, and three-dimensional transformation
  • Applications: diagnosis of aneurysms, blood clots, and intracavitary neoplasms of the heart, cicatricial myocardial damage, hypertrophic cardiomyopathy, and other pathological conditions

Additional Radiological Findings

  • Mitral valve insufficiency:
    • Radiography: elongation and displacement to the left of the left ventricular arch, bulging along the left contour of the left atrial appendage
    • Echocardiography: incomplete systolic closure of the valves of the mitral valve, dilatation of the cavities of the left chambers of the heart
  • Aortic stenosis:
    • Radiography: elongation and displacement to the left of the left ventricular arch, expansion of the arch of the ascending aorta, displacement down the right cardiovascular angle
    • Echocardiography: decrease in the systolic divergence of the valves of the aortic valve, thickening, compaction, calcification of the aortic valve, decrease in the area of the aortic estuary
  • Aortic valve insufficiency:
    • Radiography: elongation and displacement to the left of the left ventricular arch, expansion of the arch of the ascending aorta, displacement down the right cardiovascular angle
    • Echocardiography: incomplete diastolic closure of the valves of the aortic valve, dilatation of the cavity of the left ventricle

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