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Atlas of Human Body Ultrasound Scanning_ Methods and Diagnostic Applications ( PDFDrive ).pdf
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78

S. He

 

 

2.3\ Parasternal Aorta Short-Axis

View (Main Pulmonary Artery

Long-Axis View)

a1

a2

RVOT

 

TV

PV

RA

mPA

Ao

LPA

RPA

 

 

DAo

b1

b2

RVOT

 

TV

PV

RA

mPA

AO

 

RPA

LPA

 

 

DAo

Fig. 6.7  Parasternal aorta short-axis view (main pulmonary artery long-axis view). (a) Systole. (b) Diastole

2.3.1\ Scanning Method

The patient lies flat or on the left lateral position. The probe is put near the left sternal edge (second to third intercostal space). The ultrasound beam is perpendicular to the left ventricular long-axis view by tilting the probe above the aortic valve level slightly.

2.3.2\ Section Structure

These structures, including right ventricular outflow, aortic root, right atrium, septal tricuspid leaflet, main pulmonary artery, left pulmonary artery, right pulmonary artery, and descending aorta, are shown in this view.

2.3.3\ Measuring Method and Normal Value

This is a cross-sectional cut at the base of the heart, too. Anterior–posterior diameter of right ventricular outflow tract, 25 ± 10 mm, is obtained about 10 mm below the right pulmonary valve.

Transverse diameter of main pulmonary artery, 20 ± 3.9 mm, is taken between the two inner edges about 10–20 mm above the pulmonary leaflets. Diameters of left and right pulmonary arteries, 12 ± 2.3 mm both, are measured at the bifurcation of the right and left pulmonary arteries. Transverse diameter ratio of aortic root to main pulmonary artery is about 1.2:1.

2.3.4\ The Clinical Application

Sizes of right ventricular outflow tract, main pulmonary artery, and its bifurcations can be measured. Appearances and activity of pulmonary leaflets and position of the septal tricuspid leaflet can be marked. We can also visualize whether there are abnormal structures and echoness in the right ventricular outflow tract and above pulmonary valve as well as an abnormal communication between the bifurcation of the pulmonary artery and descending aorta or not.

6  Echocardiography

79

 

 

2.4\ Parasternal Left Ventricular

Short-Axis View (At the Mitral

Valve Annulus Level)

a1

a2

RV

LVOT

LA

b1

b2

RV

IVS

LVOT

MV-AN

Fig. 6.8  Parasternal left ventricular short-axis view (at the mitral valve annulus level). (a) Systole. (b) Diastole

2.4.1\ Scanning Method

The patient lies supine or on the left lateral position. The probe is put near the left sternal edge (third to fourth intercostal space). The ultrasound beam is perpendicular to the left ventricular long-­ axis view by tilting the probe posteriorly.

2.4.2\ Section Structure

Right ventricle, interventricular septum, left ventricular outflow tract, and mitral valve annulus as

well as left atrial-ventricular groove are the main items to be shown.

2.4.3\ The Clinical Application

Emphasis should be put on the echogenicity and activity of mitral valve annulus. Abnormal echoness in the left ventricular outflow tract can be found while thickness and continuation of the interventricular septum can also be estimated in this view.

80

S. He

 

 

2.5\ Parasternal Left Ventricular

Short-Axis View (The Mitral

Valve Level)

a1

 

a2

 

 

 

 

RV

 

 

IVS

 

AMV

 

 

PMV

MV

 

 

b1

b2

RV

 

TV

 

RA

MV

 

Fig. 6.9  Parasternal left ventricular short-axis view (the mitral valve level). (a) Diastole. (b) Systole

2.5.1\ Scanning Method

The patient lies supine or on the left lateral position. The probe is put at the left sternal edge (third to fourth intercostal space). The ultrasound beam is perpendicular to the left ventricular long-­ axis view and the probe is moved towards the apex slightly.

2.5.2\ Section Structure

Right ventricle, interventricular septum, left ventricle, mitral valve, and septal tricuspid leaflet are the main items to be shown.

2.5.3\ Measuring Method and Normal Value

Planimetry of the mitral valve area can be made from a frozen diastolic frame to measure the mitral valve orifice. The normal value of mitral valve area is 3.5 ± 0.5 cm2.

2.5.4\ The Clinical Application

Echoness, opening–closing activity, and orifice size of mitral valves can be seen and measured in this view. The anterior mitral valve cleft and abnormal thickness of interventricular septum as well as discordance of left ventricular walls could be diagnosed in this view.

6  Echocardiography

81

 

 

2.6\ Parasternal Left Ventricular

Short-Axis View (The Mitral

Valve Chordae Tendineae

Level)

a1 a2

MB

RV

 

LV

PPM

APM

 

b1

b2

RV

LV

APM

PPM

Fig. 6.10  Parasternal left ventricular short-axis view (the mitral valve chordae tendineae level). (a) Diastole. (b) Systole

2.6.1\ Scanning Method

The patient lies supine or on the left lateral position. The probe is put at the left sternal edge (third to fourth intercostal space). The ultrasound beam is perpendicular to the left ventricular long-­axis view and the probe is manipulated, on the base of mitral valve level, towards the apex slightly.

2.6.2\ Section Structure

Right ventricle, interventricular septum, left ventricle, mitral valve chordae tendineae, and left ventricular posterior wall are shown in this section.

2.6.3\ Measuring Method and Normal Value

This is one of the standard sections to measure the anterior–posterior diameters. The diastolic internal diameters of right ventricle and left ventricle are 16 ± 9 mm and 36 ± 15 mm, respectively.

2.6.4\ The Clinical Application

Sizes of right and left ventricles, thicknesses of interventricular septum and left ventricular posterior wall, and coordination of the left ventricular walls can be understood in the section.