X-Ray Diagnosis of Cardiovascular System
127 Questions
4 Views

Choose a study mode

Play Quiz
Study Flashcards
Spaced Repetition
Chat to lesson

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

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

  • Aortography
  • Coronary angiography
  • Radiography (correct)
  • Angiocardiography
  • What is the purpose of using X-rays in non-standard optimal projections?

  • To perform linear tomography
  • To detect calcifications of heart valves
  • To study a particular department of the cardiovascular shadow (correct)
  • To evaluate the contractile function of the heart
  • What is the advantage of native X-ray examination of the thoracic aorta?

  • It is a complex, invasive contrast study
  • It provides a detailed evaluation of the contractile function of the heart
  • It can be supplemented with linear tomography when CT is inaccessible (correct)
  • It is a highly informative method of obtaining medical imaging
  • 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

    Studying That Suits You

    Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

    Quiz Team

    Description

    Test your knowledge of x-ray methods used in the diagnosis of cardiovascular diseases, including the heart and thoracic aorta. This quiz covers the advantages and limitations of different radiological methods in various clinical situations.

    More Like This

    Cardiac Scintigraphy in Nuclear Cardiology
    5 questions
    Cardiovascular Imaging Techniques
    0 questions
    Cardiovascular System III
    37 questions

    Cardiovascular System III

    AppreciableDouglasFir avatar
    AppreciableDouglasFir
    Use Quizgecko on...
    Browser
    Browser