Mostafa Eladawy MD,AFSA Basics of Echocardiography

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Transcript of Mostafa Eladawy MD,AFSA Basics of Echocardiography

  • Slide 1
  • Mostafa Eladawy MD,AFSA Basics of Echocardiography
  • Slide 2
  • Slide 3
  • Slide 4
  • Ultrasound principles
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  • Penetration depth and resolution Factors affecting ultrasound transmission: cycle length: (wavelength [mm]) frequency: (frequency f [Hz]) Speed: (propagation velocity c [m/s]) in the respective medium The relationship of these parameters is described by the wave equation: c = f = c / f longer wavelengths penetrate further than shorter wavelengths Image resolution cannot be greater than one wavelength the higher the ultrasound frequency, the better the image resolution
  • Slide 6
  • Types of resolution Axial resolution Lateral resolution Elevational resolution
  • Slide 7
  • Modes 1-A mode 2-B mode 3-M mode 4-2D Echogenicity
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  • Doppler principles Christian Doppler
  • Slide 9
  • The difference between the emitted frequency and the received frequency is called: Doppler shift (fd ) Blood flow V = fd c/2 f0 cos For practical application in Doppler echocardiography: the emitted frequency (f0) is known and the velocity of sound (c/2) is constant at 1540 m/s. Therefore, the velocity causing the Doppler shift can be calculated by: V = fd cos
  • Slide 10
  • PRF (or scale)
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  • Nyquist limit Nyquist Limit = Pulse Repetition Frequency / 2
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  • 1-PW 2-CW 3-CFM Angle of beam
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  • Pressure or pressure gradient?
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  • P = P 2 -P 1 = 4(V 2 2 V 1 2 )
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  • Transducers
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  • Manipulation of TEE probe
  • Slide 19
  • . The ASE/SCA 20 Views for a Comprehensive TEE Exam
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  • Left Ventricle function FS = EDD-ESD EDD FAC = EDA-ESA EDA EF = EDV-ESV EDV
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  • Left ventricle function Simpson mode M-mode 2D Eye balling TEI index
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  • Regional wall motion
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  • ME 4 chamber view
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  • Trans gastric view
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  • Right ventricle Size Contractility
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  • Rt Atrium
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  • LT atrium
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  • LV filling pressure
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  • Mitral valve leaflets
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  • Mitral valve Stenosis 1-gradient 2-planimetry 3-pressure half time
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  • Regurgitation 1-PISA 2-vena contracta 3-jet area 4-Regurgitant fraction 5-Indirect indices
  • Slide 32
  • Aortic valve Stenosis 1-gradient 2-planimetry
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  • Regurgitation 1-PISA 2-jet area 3- vena contracta 4-Indirect indices
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  • Tricuspid valve Stenosis Regurgitation
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  • Pulmonary valve Stenosis Regurgitation
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  • Pulmonary pressure
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  • Pulmonary veins
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  • Shunts
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  • Ascending aorta and LVOT
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  • Descending aorta
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  • IVC and hepatic veins
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  • Recent adavances 3D echo (live and offline)
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  • TDI Speckle Tracking: non-Doppler, angle- independent quantification of myocardial deformation, by tracking the displacement of the speckles during the cardiac cycle, strain and the strain rate can be measured offline.
  • Slide 44
  • Recommended books 1-Practical approach to transesophageal echocardiography(Perrino) 2-Core topics in echocardiography (Rob Fenneck) 3-Atlas of multiplane transesophageal echocardiography (Martin Dunitz) 4-transesophageal echocardiography in anesthesia and intensive care (BMJ) 5-Pocket atlas of echocardiography (Thieme) 5-Essential echocardiography (Humana press)
  • Slide 45
  • Questions??