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6. SPECTRAL DOPPLER
This chapter covers spectral Doppler. Videos examples demomstrate how to optimize the signal, placement of the sample volume and shows examples of all vessels (common- internal-, external carotid and vertebral artery). Learn which measurements should be performed. 7. IMAGING THE VERTEBRAL ARTERIES Univ. Prof. Dr. Thomas Binder. Tue, 16/02/2021. Imaging of the vertebral arteries is part of a standard extra-cranial cerebrovascular ultrasound duplex scan. The vertebral arteries are smaller, located more distal from the transducer and partially “hidden” behind the bony structures of the vertebrae. Therefore they are more difficult toimage.
1.6.5 HARMONIC IMAGING 1.6.5 Harmonic Imaging. Our fast and efficient learning techniques help you practice the nuts and bolts of ultrasound. Start now - it's free! Harmonic imaging is a technique that employs the resonance characteristics of tissue. As images produced with harmonic imaging have a higher resolution and are associated with fewer artifacts than8. ECA VS ICA
The internal carotid artery (ICA) is more commonly larger than the external carotid artery. Shape. The internal carotid artery (ICA) has the bulb (the vessel is wider at its origin) Branches. The external carotid artery (ECA) has side branches. Carotid Bifurcation. 9. ASSESSMENT OF INTIMA MEDIA THICKNESS (IMT) An upper limit of 0.9 mm has been proposed as a cut off value that denotes an increased cardiovascular risk. However, the intima media thickness increases with age and also varies between males and females. It has therefore been proposed to use a higher cut off value for elderly patients. 4.4 HOW TO ASSESS DIASTOLIC FUNCTION 4.4.4 Color Doppler M-mode - flow propagation. The color-Doppler M-mode is another technique to study early diastolic inflow into the left ventricle and thus diastolic function. This method is basically a means of determining how rapidly blood travels from 16.2.2.1 PULMONARY ACCELERATION TIME TO ESTIMATE PULMONARY Its maximum velocity is in the range of 0.8 -1.2 m/sec. When pulmonary pressure and pulmonary vascular resistance are high the peak will occur earlier. This can be quantified using the pulmonary velocity acceleration time (PVAT). It is the interval between the onset of 12.7 QUANTIFICATION OF MITRAL REGURGITATION 12.7.5 Retrograde flow in the pulmonary veins. The flow pattern in the pulmonary veins is altered in mitral regurgitation. Two factors are responsible for this change: a) left atrial pressure is elevated, and b) reverse flow into the left atrium occurs during systole. ONLINE ECHOCARDIOGRAPHY COURSE & SONOGRAPHY TRAINING ECHO. The Echo MasterClass is a premium online training program that will bring your echo skills to the next level: “A complete mastery of Echocardiography”. With over 30 hours of high-quality video content, you will significantly deepen your knowledge of cardiac anatomy, function, clinical cardiology, imaging, hemodynamics andpatient
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6. SPECTRAL DOPPLER
This chapter covers spectral Doppler. Videos examples demomstrate how to optimize the signal, placement of the sample volume and shows examples of all vessels (common- internal-, external carotid and vertebral artery). Learn which measurements should be performed. 7. IMAGING THE VERTEBRAL ARTERIES Univ. Prof. Dr. Thomas Binder. Tue, 16/02/2021. Imaging of the vertebral arteries is part of a standard extra-cranial cerebrovascular ultrasound duplex scan. The vertebral arteries are smaller, located more distal from the transducer and partially “hidden” behind the bony structures of the vertebrae. Therefore they are more difficult toimage.
1.6.5 HARMONIC IMAGING 1.6.5 Harmonic Imaging. Our fast and efficient learning techniques help you practice the nuts and bolts of ultrasound. Start now - it's free! Harmonic imaging is a technique that employs the resonance characteristics of tissue. As images produced with harmonic imaging have a higher resolution and are associated with fewer artifacts than8. ECA VS ICA
The internal carotid artery (ICA) is more commonly larger than the external carotid artery. Shape. The internal carotid artery (ICA) has the bulb (the vessel is wider at its origin) Branches. The external carotid artery (ECA) has side branches. Carotid Bifurcation. 9. ASSESSMENT OF INTIMA MEDIA THICKNESS (IMT) An upper limit of 0.9 mm has been proposed as a cut off value that denotes an increased cardiovascular risk. However, the intima media thickness increases with age and also varies between males and females. It has therefore been proposed to use a higher cut off value for elderly patients. 4.4 HOW TO ASSESS DIASTOLIC FUNCTION 4.4.4 Color Doppler M-mode - flow propagation. The color-Doppler M-mode is another technique to study early diastolic inflow into the left ventricle and thus diastolic function. This method is basically a means of determining how rapidly blood travels from 16.2.2.1 PULMONARY ACCELERATION TIME TO ESTIMATE PULMONARY Its maximum velocity is in the range of 0.8 -1.2 m/sec. When pulmonary pressure and pulmonary vascular resistance are high the peak will occur earlier. This can be quantified using the pulmonary velocity acceleration time (PVAT). It is the interval between the onset of 12.7 QUANTIFICATION OF MITRAL REGURGITATION 12.7.5 Retrograde flow in the pulmonary veins. The flow pattern in the pulmonary veins is altered in mitral regurgitation. Two factors are responsible for this change: a) left atrial pressure is elevated, and b) reverse flow into the left atrium occurs during systole. HOW TO LEARN EFFICIENTLY Isn’t it strange? Even though learning is an essential part of becoming competent as a health care professional nobody really taught us how to learn? Are the strategies we use effectively? And how does our ability to learn change over the years? 1.4 BIOEFFECTS OF ULTRASOUND 1.4 Bioeffects of Ultrasound. Medical ultrasound as we use it for diagnostic purposes is safe. No adverse effects have been reported thus far. However, the ultrasound wave exerts certain physical effects on tissue. These effects are proportional to the intensity (mW/cm²) of the ultrasound wave. The intensity is the power of the ultrasoundbeam
4.4 HOW TO ASSESS DIASTOLIC FUNCTION 4.4.4 Color Doppler M-mode - flow propagation. The color-Doppler M-mode is another technique to study early diastolic inflow into the left ventricle and thus diastolic function. This method is basically a means of determining how rapidly blood travels from M-MODE ULTRASOUND IMAGING The M-mode was the preferred imaging modality in the early days of ultrasound. M-mode is defined as time motion display of the ultrasound wave along a chosen ultrasound line. It provides a monodimensional view of the heart. All of the reflectors along this line are displayed along the time axis. The advantage of the M-mode is its very highECHO MASTERCLASS
Three-dimensional echocardiography is a hot topic. In this chapter we will explain how it works and in which ways you can use it. We will discuss topics such as full volume- and multibeat acquisition, multiplane imaging and live 3D. Both transthoracic and transesophagealapplications of 3D
INFERIOR VENA CAVA ULTRASOUND Inferior Vena Cava Ultrasound. Ultrasound evaluation of the IVC can deliver important information on a patient's volume status. As a non-invasive, fast technique POCUS of the IVC has gained means in the assessment of fluid status in critically ill patients. Even in thediagnosis of
11.5.3 PRESSURE HALF TIME 11.5.3 Pressure Half Time. Quantification using the pressure half-time method is based on the assumption that the rate at which the gradient drops during diastole corresponds to the severity of mitral stenosis. The larger the mitral valve orifice area is, the quicker the left ventricle will fill and the more rapidly the gradients will drop. DIASTOLIC FUNCTION & DIASTOLIC DYSFUNCTION Diastolic function is defined as/describes the filling of the heart during diastole. The left ventricle is filled with blood initially by a pressure gradient between the left atrium (LA) and the left ventricle (LV). Especially ventricles of young healthy individuals also create suction in the very early phase of filling due to a rapidexpansion
16.2.2.1 PULMONARY ACCELERATION TIME TO ESTIMATE PULMONARY Its maximum velocity is in the range of 0.8 -1.2 m/sec. When pulmonary pressure and pulmonary vascular resistance are high the peak will occur earlier. This can be quantified using the pulmonary velocity acceleration time (PVAT). It is the interval between the onset of 16.2.2 HOW TO ASSESS PULMONARY HYPERTENSION 16.2.2.1 Tricuspid regurgitation signal to measure pulmonary pressure. To quantify pulmonary hypertension with echocardiography it is necessary to measure the maximal tricuspid regurgitation velocity with CW Doppler. Thus, pulmonary pressures can be obtained only in the presence of a measurable TR signal. ONLINE ECHOCARDIOGRAPHY COURSE & SONOGRAPHY TRAINING ECHO. The Echo MasterClass is a premium online training program that will bring your echo skills to the next level: “A complete mastery of Echocardiography”. With over 30 hours of high-quality video content, you will significantly deepen your knowledge of cardiac anatomy, function, clinical cardiology, imaging, hemodynamics andpatient
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2.1 INTRODUCTION
2.1 Introduction. written by. Prof. Thomas Binder, MD, FESC. The procedure for obtaining ultrasound images differs from that used to perform CT, MRI or scintigrams. While a semi-automated approach does all the work in the latter modalities, in ultrasound it is basically YOU who creates the individual images. A CT or MRI scans through theentire
6. SPECTRAL DOPPLER
This chapter covers spectral Doppler. Videos examples demomstrate how to optimize the signal, placement of the sample volume and shows examples of all vessels (common- internal-, external carotid and vertebral artery). Learn which measurements should be performed. 1.4 BIOEFFECTS OF ULTRASOUND 1.4 Bioeffects of Ultrasound. Medical ultrasound as we use it for diagnostic purposes is safe. No adverse effects have been reported thus far. However, the ultrasound wave exerts certain physical effects on tissue. These effects are proportional to the intensity (mW/cm²) of the ultrasound wave. The intensity is the power of the ultrasoundbeam
1.6.5 HARMONIC IMAGING 1.6.5 Harmonic Imaging. Our fast and efficient learning techniques help you practice the nuts and bolts of ultrasound. Start now - it's free! Harmonic imaging is a technique that employs the resonance characteristics of tissue. As images produced with harmonic imaging have a higher resolution and are associated with fewer artifacts than M-MODE ULTRASOUND IMAGING The M-mode was the preferred imaging modality in the early days of ultrasound. M-mode is defined as time motion display of the ultrasound wave along a chosen ultrasound line. It provides a monodimensional view of the heart. All of the reflectors along this line are displayed along the time axis. The advantage of the M-mode is its very high 11.5.3 PRESSURE HALF TIME 11.5.3 Pressure Half Time. Quantification using the pressure half-time method is based on the assumption that the rate at which the gradient drops during diastole corresponds to the severity of mitral stenosis. The larger the mitral valve orifice area is, the quicker the left ventricle will fill and the more rapidly the gradients will drop.COMMON MISTAKES
While left ventricular hypertrophy is a common finding, its assessment can be quite difficult. I certainly had my learning’s here. Lets start with the 5 most important things you should NOT do when you are looking at the thickness of the myocardium 3.5.2 SIZE OF THE RIGHT ATRIUM AND ASSOCIATED STRUCTURES 3.5.2 Size of the right atrium and associated structures. The right atrium is usually slightly smaller than the left one, and is largest in the superior inferior extension. To a certain degree the size and shape of the right atrium is also influenced by the dimensions of the ONLINE ECHOCARDIOGRAPHY COURSE & SONOGRAPHY TRAINING ECHO. The Echo MasterClass is a premium online training program that will bring your echo skills to the next level: “A complete mastery of Echocardiography”. With over 30 hours of high-quality video content, you will significantly deepen your knowledge of cardiac anatomy, function, clinical cardiology, imaging, hemodynamics andpatient
| 123 SONOGRAPHY
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2.1 INTRODUCTION
2.1 Introduction. written by. Prof. Thomas Binder, MD, FESC. The procedure for obtaining ultrasound images differs from that used to perform CT, MRI or scintigrams. While a semi-automated approach does all the work in the latter modalities, in ultrasound it is basically YOU who creates the individual images. A CT or MRI scans through theentire
6. SPECTRAL DOPPLER
This chapter covers spectral Doppler. Videos examples demomstrate how to optimize the signal, placement of the sample volume and shows examples of all vessels (common- internal-, external carotid and vertebral artery). Learn which measurements should be performed. 1.4 BIOEFFECTS OF ULTRASOUND 1.4 Bioeffects of Ultrasound. Medical ultrasound as we use it for diagnostic purposes is safe. No adverse effects have been reported thus far. However, the ultrasound wave exerts certain physical effects on tissue. These effects are proportional to the intensity (mW/cm²) of the ultrasound wave. The intensity is the power of the ultrasoundbeam
1.6.5 HARMONIC IMAGING 1.6.5 Harmonic Imaging. Our fast and efficient learning techniques help you practice the nuts and bolts of ultrasound. Start now - it's free! Harmonic imaging is a technique that employs the resonance characteristics of tissue. As images produced with harmonic imaging have a higher resolution and are associated with fewer artifacts than M-MODE ULTRASOUND IMAGING The M-mode was the preferred imaging modality in the early days of ultrasound. M-mode is defined as time motion display of the ultrasound wave along a chosen ultrasound line. It provides a monodimensional view of the heart. All of the reflectors along this line are displayed along the time axis. The advantage of the M-mode is its very high 11.5.3 PRESSURE HALF TIME 11.5.3 Pressure Half Time. Quantification using the pressure half-time method is based on the assumption that the rate at which the gradient drops during diastole corresponds to the severity of mitral stenosis. The larger the mitral valve orifice area is, the quicker the left ventricle will fill and the more rapidly the gradients will drop.COMMON MISTAKES
While left ventricular hypertrophy is a common finding, its assessment can be quite difficult. I certainly had my learning’s here. Lets start with the 5 most important things you should NOT do when you are looking at the thickness of the myocardium 3.5.2 SIZE OF THE RIGHT ATRIUM AND ASSOCIATED STRUCTURES 3.5.2 Size of the right atrium and associated structures. The right atrium is usually slightly smaller than the left one, and is largest in the superior inferior extension. To a certain degree the size and shape of the right atrium is also influenced by the dimensions of the HOW TO LEARN EFFICIENTLY Isn’t it strange? Even though learning is an essential part of becoming competent as a health care professional nobody really taught us how to learn? Are the strategies we use effectively? And how does our ability to learn change over the years?2.1 INTRODUCTION
2.1 Introduction. written by. Prof. Thomas Binder, MD, FESC. The procedure for obtaining ultrasound images differs from that used to perform CT, MRI or scintigrams. While a semi-automated approach does all the work in the latter modalities, in ultrasound it is basically YOU who creates the individual images. A CT or MRI scans through theentire
1.4 BIOEFFECTS OF ULTRASOUND 1.4 Bioeffects of Ultrasound. Medical ultrasound as we use it for diagnostic purposes is safe. No adverse effects have been reported thus far. However, the ultrasound wave exerts certain physical effects on tissue. These effects are proportional to the intensity (mW/cm²) of the ultrasound wave. The intensity is the power of the ultrasoundbeam
7. IMAGING THE VERTEBRAL ARTERIES Univ. Prof. Dr. Thomas Binder. Tue, 16/02/2021. Imaging of the vertebral arteries is part of a standard extra-cranial cerebrovascular ultrasound duplex scan. The vertebral arteries are smaller, located more distal from the transducer and partially “hidden” behind the bony structures of the vertebrae. Therefore they are more difficult toimage.
CAROTID ULTRASOUND MASTERCLASS Carotid Ultrasound MasterClass. The Carotid Ultrasound Masterclass is a video-based online teaching course (10 hours) that covers the entire spectrum of carotid and vertebral artery ultrasound. The target groups are; vascular sonographers, internists, cardiologists, radiologists, angiologists, neurologists, vascular surgeons, and all health 5. COLOR DOPPLER IMAGING OF THE CAROTID ARTERIES Doppler ultrasound is a modality, which allows us to study blood flow in the vessels during carotid ultrasound. It is performed as part of a standard carotid ultrasound exam. Both spectral and color Doppler provide information on blood flow velocity and the direction of flow. Doppler information must always be combined and interpreted together 9. ASSESSMENT OF INTIMA MEDIA THICKNESS (IMT) An upper limit of 0.9 mm has been proposed as a cut off value that denotes an increased cardiovascular risk. However, the intima media thickness increases with age and also varies between males and females. It has therefore been proposed to use a higher cut off value for elderly patients. IMAGING THE LEFT ATRIAL APPENDAGE USING TTE Second, the size of the left atrial appendage is a predictor of stroke. The larger (and deeper) the LAA is, the more likely it is that a thrombus will form. And finally, we can also detect thrombi in the LAA from a transthoracic approach. Here is such an example: Thrombus im LAA 2 Ch View from 123sonography on Vimeo. Play.2.3.2 APICAL WINDOW
2.3.2 Apical Window. The apical window is the second window from which you should image. The patient is again positioned on his/her left side, but not as far as is the case when using the parasternal window. The apical window is usually found in the fifth intercostal space but again, the patient's constitution largely determines the position of 11.5.3 PRESSURE HALF TIME 11.5.3 Pressure Half Time. Quantification using the pressure half-time method is based on the assumption that the rate at which the gradient drops during diastole corresponds to the severity of mitral stenosis. The larger the mitral valve orifice area is, the quicker the left ventricle will fill and the more rapidly the gradients will drop. ONLINE ECHOCARDIOGRAPHY COURSE & SONOGRAPHY TRAINING ECHO. The Echo MasterClass is a premium online training program that will bring your echo skills to the next level: “A complete mastery of Echocardiography”. With over 30 hours of high-quality video content, you will significantly deepen your knowledge of cardiac anatomy, function, clinical cardiology, imaging, hemodynamics andpatient
| 123 SONOGRAPHY
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2.1 INTRODUCTION
2.1 Introduction. written by. Prof. Thomas Binder, MD, FESC. The procedure for obtaining ultrasound images differs from that used to perform CT, MRI or scintigrams. While a semi-automated approach does all the work in the latter modalities, in ultrasound it is basically YOU who creates the individual images. A CT or MRI scans through theentire
6. SPECTRAL DOPPLER
This chapter covers spectral Doppler. Videos examples demomstrate how to optimize the signal, placement of the sample volume and shows examples of all vessels (common- internal-, external carotid and vertebral artery). Learn which measurements should be performed. 1.4 BIOEFFECTS OF ULTRASOUND 1.4 Bioeffects of Ultrasound. Medical ultrasound as we use it for diagnostic purposes is safe. No adverse effects have been reported thus far. However, the ultrasound wave exerts certain physical effects on tissue. These effects are proportional to the intensity (mW/cm²) of the ultrasound wave. The intensity is the power of the ultrasoundbeam
1.6.5 HARMONIC IMAGING 1.6.5 Harmonic Imaging. Our fast and efficient learning techniques help you practice the nuts and bolts of ultrasound. Start now - it's free! Harmonic imaging is a technique that employs the resonance characteristics of tissue. As images produced with harmonic imaging have a higher resolution and are associated with fewer artifacts than M-MODE ULTRASOUND IMAGING The M-mode was the preferred imaging modality in the early days of ultrasound. M-mode is defined as time motion display of the ultrasound wave along a chosen ultrasound line. It provides a monodimensional view of the heart. All of the reflectors along this line are displayed along the time axis. The advantage of the M-mode is its very high 11.5.3 PRESSURE HALF TIME 11.5.3 Pressure Half Time. Quantification using the pressure half-time method is based on the assumption that the rate at which the gradient drops during diastole corresponds to the severity of mitral stenosis. The larger the mitral valve orifice area is, the quicker the left ventricle will fill and the more rapidly the gradients will drop.COMMON MISTAKES
While left ventricular hypertrophy is a common finding, its assessment can be quite difficult. I certainly had my learning’s here. Lets start with the 5 most important things you should NOT do when you are looking at the thickness of the myocardium 3.5.2 SIZE OF THE RIGHT ATRIUM AND ASSOCIATED STRUCTURES 3.5.2 Size of the right atrium and associated structures. The right atrium is usually slightly smaller than the left one, and is largest in the superior inferior extension. To a certain degree the size and shape of the right atrium is also influenced by the dimensions of the ONLINE ECHOCARDIOGRAPHY COURSE & SONOGRAPHY TRAINING ECHO. The Echo MasterClass is a premium online training program that will bring your echo skills to the next level: “A complete mastery of Echocardiography”. With over 30 hours of high-quality video content, you will significantly deepen your knowledge of cardiac anatomy, function, clinical cardiology, imaging, hemodynamics andpatient
| 123 SONOGRAPHY
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2.1 INTRODUCTION
2.1 Introduction. written by. Prof. Thomas Binder, MD, FESC. The procedure for obtaining ultrasound images differs from that used to perform CT, MRI or scintigrams. While a semi-automated approach does all the work in the latter modalities, in ultrasound it is basically YOU who creates the individual images. A CT or MRI scans through theentire
6. SPECTRAL DOPPLER
This chapter covers spectral Doppler. Videos examples demomstrate how to optimize the signal, placement of the sample volume and shows examples of all vessels (common- internal-, external carotid and vertebral artery). Learn which measurements should be performed. 1.4 BIOEFFECTS OF ULTRASOUND 1.4 Bioeffects of Ultrasound. Medical ultrasound as we use it for diagnostic purposes is safe. No adverse effects have been reported thus far. However, the ultrasound wave exerts certain physical effects on tissue. These effects are proportional to the intensity (mW/cm²) of the ultrasound wave. The intensity is the power of the ultrasoundbeam
1.6.5 HARMONIC IMAGING 1.6.5 Harmonic Imaging. Our fast and efficient learning techniques help you practice the nuts and bolts of ultrasound. Start now - it's free! Harmonic imaging is a technique that employs the resonance characteristics of tissue. As images produced with harmonic imaging have a higher resolution and are associated with fewer artifacts than M-MODE ULTRASOUND IMAGING The M-mode was the preferred imaging modality in the early days of ultrasound. M-mode is defined as time motion display of the ultrasound wave along a chosen ultrasound line. It provides a monodimensional view of the heart. All of the reflectors along this line are displayed along the time axis. The advantage of the M-mode is its very high 11.5.3 PRESSURE HALF TIME 11.5.3 Pressure Half Time. Quantification using the pressure half-time method is based on the assumption that the rate at which the gradient drops during diastole corresponds to the severity of mitral stenosis. The larger the mitral valve orifice area is, the quicker the left ventricle will fill and the more rapidly the gradients will drop.COMMON MISTAKES
While left ventricular hypertrophy is a common finding, its assessment can be quite difficult. I certainly had my learning’s here. Lets start with the 5 most important things you should NOT do when you are looking at the thickness of the myocardium 3.5.2 SIZE OF THE RIGHT ATRIUM AND ASSOCIATED STRUCTURES 3.5.2 Size of the right atrium and associated structures. The right atrium is usually slightly smaller than the left one, and is largest in the superior inferior extension. To a certain degree the size and shape of the right atrium is also influenced by the dimensions of the HOW TO LEARN EFFICIENTLY Isn’t it strange? Even though learning is an essential part of becoming competent as a health care professional nobody really taught us how to learn? Are the strategies we use effectively? And how does our ability to learn change over the years?2.1 INTRODUCTION
2.1 Introduction. written by. Prof. Thomas Binder, MD, FESC. The procedure for obtaining ultrasound images differs from that used to perform CT, MRI or scintigrams. While a semi-automated approach does all the work in the latter modalities, in ultrasound it is basically YOU who creates the individual images. A CT or MRI scans through theentire
1.4 BIOEFFECTS OF ULTRASOUND 1.4 Bioeffects of Ultrasound. Medical ultrasound as we use it for diagnostic purposes is safe. No adverse effects have been reported thus far. However, the ultrasound wave exerts certain physical effects on tissue. These effects are proportional to the intensity (mW/cm²) of the ultrasound wave. The intensity is the power of the ultrasoundbeam
7. IMAGING THE VERTEBRAL ARTERIES Univ. Prof. Dr. Thomas Binder. Tue, 16/02/2021. Imaging of the vertebral arteries is part of a standard extra-cranial cerebrovascular ultrasound duplex scan. The vertebral arteries are smaller, located more distal from the transducer and partially “hidden” behind the bony structures of the vertebrae. Therefore they are more difficult toimage.
CAROTID ULTRASOUND MASTERCLASS Carotid Ultrasound MasterClass. The Carotid Ultrasound Masterclass is a video-based online teaching course (10 hours) that covers the entire spectrum of carotid and vertebral artery ultrasound. The target groups are; vascular sonographers, internists, cardiologists, radiologists, angiologists, neurologists, vascular surgeons, and all health 5. COLOR DOPPLER IMAGING OF THE CAROTID ARTERIES Doppler ultrasound is a modality, which allows us to study blood flow in the vessels during carotid ultrasound. It is performed as part of a standard carotid ultrasound exam. Both spectral and color Doppler provide information on blood flow velocity and the direction of flow. Doppler information must always be combined and interpreted together 9. ASSESSMENT OF INTIMA MEDIA THICKNESS (IMT) An upper limit of 0.9 mm has been proposed as a cut off value that denotes an increased cardiovascular risk. However, the intima media thickness increases with age and also varies between males and females. It has therefore been proposed to use a higher cut off value for elderly patients. IMAGING THE LEFT ATRIAL APPENDAGE USING TTE Second, the size of the left atrial appendage is a predictor of stroke. The larger (and deeper) the LAA is, the more likely it is that a thrombus will form. And finally, we can also detect thrombi in the LAA from a transthoracic approach. Here is such an example: Thrombus im LAA 2 Ch View from 123sonography on Vimeo. Play.2.3.2 APICAL WINDOW
2.3.2 Apical Window. The apical window is the second window from which you should image. The patient is again positioned on his/her left side, but not as far as is the case when using the parasternal window. The apical window is usually found in the fifth intercostal space but again, the patient's constitution largely determines the position of 11.5.3 PRESSURE HALF TIME 11.5.3 Pressure Half Time. Quantification using the pressure half-time method is based on the assumption that the rate at which the gradient drops during diastole corresponds to the severity of mitral stenosis. The larger the mitral valve orifice area is, the quicker the left ventricle will fill and the more rapidly the gradients will drop. ONLINE ECHOCARDIOGRAPHY COURSE & SONOGRAPHY TRAINING ECHO. The Echo MasterClass is a premium online training program that will bring your echo skills to the next level: “A complete mastery of Echocardiography”. With over 30 hours of high-quality video content, you will significantly deepen your knowledge of cardiac anatomy, function, clinical cardiology, imaging, hemodynamics andpatient
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7. IMAGING THE VERTEBRAL ARTERIES Univ. Prof. Dr. Thomas Binder. Tue, 16/02/2021. Imaging of the vertebral arteries is part of a standard extra-cranial cerebrovascular ultrasound duplex scan. The vertebral arteries are smaller, located more distal from the transducer and partially “hidden” behind the bony structures of the vertebrae. Therefore they are more difficult toimage.
IMPROVING YOUR SCANNING SKILLS The most important determinant of image quality is the technical skill of the investigator; still, much can be improved if you choose the right settings. Modern scanners provide many features and ways to optimize the image. Some are really important while others are of minor relevance. Actually, we only use a handful of the buttonsourselves.
1.6.5 HARMONIC IMAGING 1.6.5 Harmonic Imaging. Our fast and efficient learning techniques help you practice the nuts and bolts of ultrasound. Start now - it's free! Harmonic imaging is a technique that employs the resonance characteristics of tissue. As images produced with harmonic imaging have a higher resolution and are associated with fewer artifacts than DIASTOLIC FUNCTION & DIASTOLIC DYSFUNCTION2.3.2 APICAL WINDOW
2.3.2 Apical Window. The apical window is the second window from which you should image. The patient is again positioned on his/her left side, but not as far as is the case when using the parasternal window. The apical window is usually found in the fifth intercostal space but again, the patient's constitution largely determines the position of 4.4 HOW TO ASSESS DIASTOLIC FUNCTION 4.4.4 Color Doppler M-mode - flow propagation. The color-Doppler M-mode is another technique to study early diastolic inflow into the left ventricle and thus diastolic function. This method is basically a means of determining how rapidly blood travels from 16.2.2.1 PULMONARY ACCELERATION TIME TO ESTIMATE PULMONARY Its maximum velocity is in the range of 0.8 -1.2 m/sec. When pulmonary pressure and pulmonary vascular resistance are high the peak will occur earlier. This can be quantified using the pulmonary velocity acceleration time (PVAT). It is the interval between the onset of 16.2.2 HOW TO ASSESS PULMONARY HYPERTENSION 16.2.2.1 Tricuspid regurgitation signal to measure pulmonary pressure. To quantify pulmonary hypertension with echocardiography it is necessary to measure the maximal tricuspid regurgitation velocity with CW Doppler. Thus, pulmonary pressures can be obtained only in the presence of a measurable TR signal. ONLINE ECHOCARDIOGRAPHY COURSE & SONOGRAPHY TRAINING ECHO. The Echo MasterClass is a premium online training program that will bring your echo skills to the next level: “A complete mastery of Echocardiography”. With over 30 hours of high-quality video content, you will significantly deepen your knowledge of cardiac anatomy, function, clinical cardiology, imaging, hemodynamics andpatient
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7. IMAGING THE VERTEBRAL ARTERIES Univ. Prof. Dr. Thomas Binder. Tue, 16/02/2021. Imaging of the vertebral arteries is part of a standard extra-cranial cerebrovascular ultrasound duplex scan. The vertebral arteries are smaller, located more distal from the transducer and partially “hidden” behind the bony structures of the vertebrae. Therefore they are more difficult toimage.
IMPROVING YOUR SCANNING SKILLS The most important determinant of image quality is the technical skill of the investigator; still, much can be improved if you choose the right settings. Modern scanners provide many features and ways to optimize the image. Some are really important while others are of minor relevance. Actually, we only use a handful of the buttonsourselves.
1.6.5 HARMONIC IMAGING 1.6.5 Harmonic Imaging. Our fast and efficient learning techniques help you practice the nuts and bolts of ultrasound. Start now - it's free! Harmonic imaging is a technique that employs the resonance characteristics of tissue. As images produced with harmonic imaging have a higher resolution and are associated with fewer artifacts than DIASTOLIC FUNCTION & DIASTOLIC DYSFUNCTION2.3.2 APICAL WINDOW
2.3.2 Apical Window. The apical window is the second window from which you should image. The patient is again positioned on his/her left side, but not as far as is the case when using the parasternal window. The apical window is usually found in the fifth intercostal space but again, the patient's constitution largely determines the position of 4.4 HOW TO ASSESS DIASTOLIC FUNCTION 4.4.4 Color Doppler M-mode - flow propagation. The color-Doppler M-mode is another technique to study early diastolic inflow into the left ventricle and thus diastolic function. This method is basically a means of determining how rapidly blood travels from 16.2.2.1 PULMONARY ACCELERATION TIME TO ESTIMATE PULMONARY Its maximum velocity is in the range of 0.8 -1.2 m/sec. When pulmonary pressure and pulmonary vascular resistance are high the peak will occur earlier. This can be quantified using the pulmonary velocity acceleration time (PVAT). It is the interval between the onset of 16.2.2 HOW TO ASSESS PULMONARY HYPERTENSION 16.2.2.1 Tricuspid regurgitation signal to measure pulmonary pressure. To quantify pulmonary hypertension with echocardiography it is necessary to measure the maximal tricuspid regurgitation velocity with CW Doppler. Thus, pulmonary pressures can be obtained only in the presence of a measurable TR signal.2.3.2 APICAL WINDOW
2.3.2 Apical Window. The apical window is the second window from which you should image. The patient is again positioned on his/her left side, but not as far as is the case when using the parasternal window. The apical window is usually found in the fifth intercostal space but again, the patient's constitution largely determines the position of 4.4 HOW TO ASSESS DIASTOLIC FUNCTION 4.4.4 Color Doppler M-mode - flow propagation. The color-Doppler M-mode is another technique to study early diastolic inflow into the left ventricle and thus diastolic function. This method is basically a means of determining how rapidly blood travels fromECHO MASTERCLASS
Three-dimensional echocardiography is a hot topic. In this chapter we will explain how it works and in which ways you can use it. We will discuss topics such as full volume- and multibeat acquisition, multiplane imaging and live 3D. Both transthoracic and transesophagealapplications of 3D
IMAGING THE LEFT ATRIAL APPENDAGE USING TTE Second, the size of the left atrial appendage is a predictor of stroke. The larger (and deeper) the LAA is, the more likely it is that a thrombus will form. And finally, we can also detect thrombi in the LAA from a transthoracic approach. Here is such an example: Thrombus im LAA 2 Ch View from 123sonography on Vimeo. Play. M-MODE ULTRASOUND IMAGING The M-mode was the preferred imaging modality in the early days of ultrasound. M-mode is defined as time motion display of the ultrasound wave along a chosen ultrasound line. It provides a monodimensional view of the heart. All of the reflectors along this line are displayed along the time axis. The advantage of the M-mode is its very high 12.6 JET DIRECTION AND MECHANISM OF MR 12.6 Jet direction and mechanism of MR. The direction of the jet is an important indicator of the mechanism of mitral regurgitation. You will encounter situations in which the pathology itself is not visible. Your interpretation will be based on the direction of the jet alone. This section tells you how the mechanism influences the direction of 3.3.2 RIGHT VENTRICULAR SIZE The length of the right ventricle is less frequently used. Normal values are given in the following table: W Lai Int. J. Cardivasc. Imaging, 2008. Roughly, a mid-right-ventricular diameter of 35 to 40 mm or 42 to 45 mm at the base indicates right ventricular dilatation. Respiration influences the size of the right ventricle. 16.2.2 HOW TO ASSESS PULMONARY HYPERTENSION 16.2.2.1 Tricuspid regurgitation signal to measure pulmonary pressure. To quantify pulmonary hypertension with echocardiography it is necessary to measure the maximal tricuspid regurgitation velocity with CW Doppler. Thus, pulmonary pressures can be obtained only in the presence of a measurable TR signal. 3.4.3 LEFT ATRIAL SIZE 3.4.3 Left atrial size. Left atrial enlargement is either the result of elevated atrial pressure or an increase in flow. However, the degree of left atrial enlargement depends on the compliance of the left atrial wall. This is why you might see patients with fairly high atrial pressures but only modest enlargement of the left atrium, orvice versa.
16.4 RIGHT VENTRICULAR VOLUME OVERLOAD 16.4 Right ventricular volume overload. Several conditions may lead to right ventricular volume overload. The most common cause is tricuspid regurgitation, followed by atrial septal defects and pulmonary regurgitation. Coronary fistulas (into the right heart) are another rare cause of this condition. Its pathology and echocardiographic Skip to main content* Courses
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