Cardiovascular

Imaging

Cardiovascular Imaging
Methods of investigation. Radiology.
Conventional radiography (Chest X-ray)
PA
LL
OBLIC
RAOP
LAOP

Fluoroscopy
Computed Tomography (CT)

Cardiovascular Imaging
Methods of investigation. Radiology.
Contrast investigation
Ventriculography
Angiography

Aortography
Angiocoronarography
Arteriography
Flebography

Cardiovascular Imaging
Methods of investigation
Nuclear Medicine
Nuclear angiocardiography
Myocardial perfusion scintigraphy

Cardiovascular Imaging

Methods of investigation
Ultrasonography
M-mode
B-mode
Doppler

Cardiovascular Imaging

Methods of investigation
MRI

Cardiovascular Imaging
Radiological anatomy
PA projection
Left side:
Convexities

I. Aortic Knob
II. Main Pulmonary Artery
III. Left Atrial Auricula
IV. Left Ventricle

Right side:
Convexities
I. Ascending Aorta, Vena Cava Superior
II. Right Atrium

Cardiovascular Imaging

Aortic Knob
Ascending Aorta,
Vena Cava Superior

Main Pulmonary Artery

Left Atrial Auricula

Right Atrium
Left Ventricle

Topometry = Cardiothoracic ratio

CTR= A+B / C

The cardiothoracic ratio (CTR) shown in figure is the transverse cardiac diameter
(the horizontal distance between the most rightward and leftward borders of the
heart seen on a PA chest radiograph = maximum extension of the heart to the left
and right of the midline respectively) divided by the transverse chest diameter
(measured from the inner rib margin at the widest point above the costophrenic
angles on a PA chest film).

1. different degree of enlargement of the heart to the

left,
2. cardiac bay ,, golf disappears
3. poorly pronounced or absent aortic knob

Cardiovascular Imaging
Abnormal Radiological Findings
Mitral configuration

1.
2.
3.
4.
5.
6.
7.

mitral stenosis,
mitral regurgitation,
mitral valve defect,
ventricular septal defect,
patent ductus arteriosus,
stenosis of the pulmonary artery
pulmonary heart

1. cardiac enlargement to the left,

2. pronounced cardiac golf,
3. different variants of change of the
thoracic aorta,
4. cardiovascular angle moved caudal

Cardiovascular Imaging
Abnormal Radiological Findings
Aortal configuration

1.
2.
3.
4.
5.

aortic stenosis,
aortic insufficiency,
aortal defect,
tetralogy of Fallot,
hypertension

Trapezoidal configuration

1. enlarged heart shadow - transverse diameter

2. the hearts base is laying on diaphragm

Cardiovascular Imaging
Abnormal Radiological Findings
Trapezoid configuration

1. tricuspid stenosis,
2. tricuspid insufficiency,
3. tricuspid defect,
4. interatrial septal defect,
5. pericarditis

Pulmonary circulation

Hipovolemy
1. A pour pulmonary pattern
2. Major pulmonary transparency
3. Lung hilums are structured and slim
4. The second border on left pulmonary artery
is normal or decreased or dilated

Hipervolemy
1. An enhaced pulmonary
pattern
2. Lung hilums are structured, but dilated
3. Cardiac golf leveled

Arterial pulmonary hypertension

1.
2.
3.
4.

The pulmonary pattern is decreased at the borders of

the lungs
Major or normal pulmonary transparency
Lung hilums are structured, but dilated
The second border on left pulmonary artery is dilated

Cardiovascular Imaging
Abnormal Radiological Findings
Congenital Heart Disease (CHD)
Dextrocardia (situs inversus)
Acyanotic (left to right shunt)
Atrial septal defect
Ventricular septal defect

Cyanotic (right to left shunt)

Ebsteins anomaly
Tetralogy of Fallot
Trilogy of Fallot

Coarctation of the aorta

malformation complex with the

presence of three signs :
1. narrowing the opening of the
pulmonary artery
2. cleft of atrial sept
3.right ventricular hypertrophy