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Atlas of Human Body Ultrasound Scanning_ Methods and Diagnostic Applications ( PDFDrive ).pdf
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82

S. He

 

 

2.7\ Parasternal Left Ventricular

Short-Axis View (The Mitral

Valve Papillary Muscle Level)

a1 a2

MB

RV

 

LV

PPM

APM

 

b1

b2

RV

LV

APM

PPM

Fig. 6.11  Parasternal left ventricular short-axis view (the mitral valve papillary muscle level). (a) Diastole. (b) Systole

2.7.1\ 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 chordae tendineae level, towards the apex slightly.

2.7.2\ Section Structure

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

2.7.3\ The Clinical Application

This view is mainly used to understand the coordination of the left ventricular walls, position and number of the papillary muscle.

6  Echocardiography

83

 

 

2.8\ Left Ventricular Apical Level

Short-Axis View

a1

a2

RV

IVS

 

LV

b1

b2

RV

LV

Fig. 6.12  Left ventricular apical level short-axis view. (a) Diastole. (b) Systole

2.8.1\ 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 papillary muscle level, towards the apex slightly.

2.8.2\ Section Structure

Structures on this section include the apex segments of the right ventricle, interventricular septum, and left ventricle.

2.8.3\ The Clinical Application

This view should be used to assess the thickness and motion of the interventricular septum and left ventricle, and to find whether there is thrombus in left ventricular apex or not.

84

S. He

 

 

2.9\ Parasternal Four-Chamber

View

a1

 

 

a2

 

MB

 

IVC

 

 

 

 

RV

 

LV

 

 

 

 

RA

 

LA

 

 

 

 

 

RSPV

DAo

 

 

 

b1

b2

RV

 

 

LV

RA

 

 

LA

_________

DAo

RSPV

 

Fig. 6.13  Parasternal four-chamber view. (a) Diastole. (b) Systole

2.9.1\ Scanning Method

The patient lies supine or on the left lateral position. The probe is put in the left parasternal area, 2–3 cm away from the sternal edge (third to fourth intercostal space). The ultrasound beam is perpendicular to the left ventricular long-axis view with its reference point towards the right acromioclavicular joint.

2.9.2\ Section Structure

The structures seen and examined in this view are right ventricular free wall, interventricular septum, left ventricle, left ventricular lateral wall, right atrium, left atrium, mitral valve, and tricuspid valve.

2.9.3\ Measuring Method and Normal Value

Location of the septal tricuspid valve is nearer to the apex than anterior mitral valve. The normal distance between the two valves is 5–10 mm.

2.9.4\ The Clinical Application

Cavity size of the atriums and ventricles, morphology and closing–opening motion of mitral and tricuspid valves, and continuity of interventricular septum and interatrial septum are routinely obtained, while whether there are an abnormal echoness in the cavities and pericardial effusion can also be diagnosed in this view.