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Diagnostic Radiology of Cardiovascular System Chen, Shaoqiong Acknowledgement : most of the slices are refer to the ppt provided by Dr. Biling Liang is gratefully acknowledged
Basic X-ray features ,[object Object],[object Object],[object Object],[object Object],[object Object],/231 methods normal abnormities diseases
Basic X-ray features Changes of pericardium ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],/231 methods normal abnormities diseases
Basic X-ray features Changes of pericardium ,[object Object],/231 methods normal abnormities diseases
Normal pericardium ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Basic X-ray features Changes of pericardium ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],/231 methods normal abnormities diseases
Pericardial effusion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],/231 Tuberculosis rheumatism uraemia  virus neoplasm Fluid: Transudation exudation  blood methods normal abnormities diseases
Pericardial effusion Pericardial effusion on both lateral chest radiograph and axial CT.  Red arrow  points to fat outside of pericardium.  Green arrow   points to pericardial space which is 8 mm in this patient (<4 mm is normal.)  The   yellow arrow    points to fat outside of heart and the  blue arrow  to the myocardium.
Pericardial effusion
Pericardial effusion “ water-bottle” “flask” shape Globular shape methods normal abnormities diseases
Pericardial effusion general enlarge bilaterally Widened SVC methods normal abnormities diseases
Pericardial effusion /231 erect position  supine position methods normal abnormities diseases
Pericardial thickening 、 calcification ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],/231 methods normal abnormities diseases
Constrictive pericarditis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],/231 胸膜肥厚 methods normal abnormities diseases
Constrictive pericarditis /231 methods normal abnormities diseases
Pericardial calcification
Constrictive pericarditis   -  RA enlargement
Constrictive pericarditis   - RA enlargement
Constrictive pericarditis   -  RA enlargement
Diagnostic Radiology of Cardiovascular System /231 Imaging methods normal appearances abnormities diseases methods normal abnormities diseases
Common disease    of heart and great vessels ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],/231 method normal abnormities diseases
Rheumatic heart disease ,[object Object],[object Object],[object Object],[object Object],[object Object],/231 methods normal abnormities diseases
Mitral Stenosis Rheumatic Valvular Heart Disease ,[object Object]
Right Ventricular Hypertrophy Stenotic mitral valve © Frank Netter, MD Novartis®
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Time course of MS in adult © Frank Netter, MD Novartis®
[object Object],Effect of Mitral Stenosis  On Lungs
Mitral stenosis    hemodynamics /231 Mitral valve stenosis Left atrial output obstructed LV  engorge insufficiently LA   pressure increase  & dilate Pulmonary venous hypertension,  interstitial pulmonary edema RV  burden increase & enlarge aortic knob shrink LV  and aortic knob  shrink methods normal abnormities diseases
Mitral stenosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],/231 ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],methods normal abnormities diseases
Mitral stenosis /231 Four arus, diplopia,  Pulmonary venous hypertension ,[object Object],[object Object],[object Object],[object Object],methods normal abnormities diseases
Mitral stenosis LA LV RV LA LV LV LA Valve calcification Lat Cor
Mitral stenosis LA LV LA LV LA RV LV RA RV
Mitral stenosis LA LV LV LA RV RA
Mitral stenosis LA,RV enlarge, Hemosiderin pigmentation ,[object Object],[object Object],[object Object],methods normal abnormities diseases
Mitral stenosis /231 methods normal abnormities diseases
Mitral stenosis LA enlarge : esophagus compression, diplopia RV enlarge: heart touch the anterior chest wall  > 1/3 LA enlargement PA – right border : double density PA – left border : left atrial appendage enlargement Lat & RAO : esophagus compressed methods normal abnormities diseases
Mitral stenosis ,[object Object],[object Object],[object Object],methods normal abnormities diseases
Mitral stenosis ---    Hemosiderin deposited /231 methods normal abnormities diseases
Mitral stenosis—pulmonary interstitial   edema-- Kerley’s B-line /231 Perpendicular  to the chest wall methods normal abnormities diseases
Common disease    of heart and great vessels ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],/231 method normal abnormities diseases
 
Coronary artery disease ,[object Object],[object Object],[object Object],[object Object]
Coronary artery CTA MIP With Contrast Medium
VRT Recon. Normal Coronary artery CTA
前降支和旋支 前降支和对角支 前降支和旋支 心底部冠脉供血 正常冠脉 MIP 重建
正常冠状动脉 CT : 119148
Ischemic heart disease ,[object Object],[object Object],[object Object],[object Object],Aorta enlarged methods normal abnormities diseases
Ischemic heart disease cardiomegaly methods normal abnormities diseases
Multi-slice spiral CT /231 Plain scan Calcification in the coronary A. wall methods normal abnormities diseases
Coronary artery   CTA Negative prediction  100 % positive prediction  80 ~ 88 %
Coronary artery calcification & soft plaque
Coronary artery soft plaque
Coronary artery stenosis DSA
Myocardial infarction /231 Real time : infarcted myocardium non-enhanced Delay enhancement in the infarcted myocardium methods normal abnormities diseases
 
Common disease    of heart and great vessels ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],/231 method normal abnormities diseases
Congenital heart disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],/231 method normal abnormities diseases
ASD Right atrium open looking into left atrium through ASD Normal © Frank Netter, MD Novartis® fossa ovalis
ASD----hemodynamics /231 Left -> right shunt But  depend on the P. Vscular resistance  RA LA RA flow  ↑ RV flow  ↑ PBF↑ RA hypertrophy dilatation RV hypertrophy dilatation pulmonary  hypertension Right heart failure methods normal abnormities diseases
[object Object],[object Object],SCMR Auckland MRI
ASD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],/231 4 type: Ostium primum , ostium secundum Sinus venosus , coronary sinus Fossa Ovalis defect 80~90% Atrial septal defect methods normal abnormities diseases
ASD RA RA
ASD aorta shrink RA & RV↑ ,  RA↑ ↑   obviously RA RV PA Aorta svc
ASD RA & RV↑ ,  RA↑ ↑   obviously
ASD /231 Enlargement of RA methods normal abnormities diseases RA RV PA Aorta svc
ASD /231 methods normal abnormities diseases
ASD /231 Preoperative Postoperative methods normal abnormities diseases
ASD /231 Pulmonary hypertension methods normal abnormities diseases RA RV PA Aorta svc
ASD Prominent pulmonary vessels Prominent MPA Normal left atrium
Tetralogy of Fallot ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],/231 methods normal abnormities diseases
Fallot’s tetralogy /231 methods normal abnormities diseases
Tetralogy of Fallot
Tetralogy of Fallot
Tetralogy of Fallot /231 methods normal abnormities diseases
F4 ,[object Object],[object Object],[object Object],[object Object],LA RV MR:41655
F4 MR:41655
 

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Pericardial abnormal findings

Notas do Editor

  1. Greater spatial resolution for improved differential diagnosis: Visualization of smallest branches of coronary, cerebral, and mesenteric vessels Faster volume coverage when needed: Examination of pure arterial phase CTA
  2. 病例 6 :包括 X 线(胸部正位+左右斜位) 答题要求:诊断是什么,有那些诊断依据, 血流动力学改变?