Post on 20-Jan-2016
CARDIAC RADIOLOGY
Timothy P. Morris, D.O., F.A.C.C.
www.sjhg.org
CARDIAC RADIOLOGY
• HISTORY– Williams 1899– Sones 1959– CT scanner 1980’s– Cine CT scanner 1984– MRI– ECHO– Multi-slice CT Scanner (64 slice)
CARDIAC RADIOLOGY
• PLAIN CHEST X-RAY– PA– AP– LATERAL– RAO– LAO
CARDIAC RADIOLOGY
• CHEST PA LANDMARKS– SUBCLAVIAN– AORTIC NOTCH– PULMONARY ARTERY– LEFT ATRIUM, LEFT VENTRICLE– AZYGOS– ASCENDING AORTA– RIGHT ATRIUM
CARDIAC RADIOLOGYNORMAL CHEST X-RAY
Dextrocardia with Situs Inversus
CARDIAC RADIOLOGY
• LANDMARKS LATERAL VIEW– RIGHT VENTRICLE– POSTERIOR WALL LEFT VENTRICLE– LEFT ATRIUM– PERICARDIUM– VALVE RINGS
CXR Lateral
CARDIAC RADIOLOGY
• MEASURING CARDIAC SIZE
• ATRIAL SIZE
• VENTRICULAR SIZE
CARDIAC RADIOLOGYLEFT HEART ENLARGEMENT
CARDIAC RADIOLOGYRIGHT HEART ENLARGEMENT
CARDIAC RADIOLOGY
• PULMONARY VASCULATURE– PULMONARY ARTERY HYPERTENSION– PULMONARY VENOUS HYPERTENSION– PULMONARY EDEMA
• DECREASED PULMONARY FLOW– PULMONARY STENOSIS– PNEUMOTHORAX
CARDIAC RADIOLOGYSEVERE PULONARY HYPERTENSION
CARDIAC RADIOLOGYCHRONIC CONGESTIVE HEART
FAILURE
CARDIAC RADIOLOGYCHRONIC CONGESTIVE HEART
FAILURE LATERAL
CARDIAC RADIOLOGYACUTE PULMONARY EDEMA
CARDIAC RADIOLOGYKERLEY B LINES
CARDIAC RADIOLOGYCONGESTIVE HEART FAILURE
CARDIAC RADIOLOGYPULMONARY FIBROSIS SECONDARY
TO AMIODARONE
CARDIAC RADIOLOGYPULMONARY STENOSIS
CARDIAC RADIOLOGYTENSION PNEUMOTHORAX
CARDIAC RADIOLOGY
• CALCIFICATION– MYOCARDIAL
• LV ANEURYSM
– PERICARDIAL• RV, RA, AV GROOVE
– VALVULAR– VESSELS– ANNULAR
Chronic Restrictive Pericarditis
Chronic Restrictive Pericarditis
Pericardial Calcification CT Scan
CARDIAC RADIOLOGY
• PERICARDIAL EFFUSION
• PERICARDIAL CONSTRICTION
• PERICARDIAL NEOPLASM
• PERICARDIAL CYST
• CONGENITAL ANOMALIES
CARDIAC RADIOLOGYPOST-PERICARDOTOMY SYNDROME
Pericardial Cyst
Pneumoperitoneum
CARDIAC RADIOLOGY
• VALVULAR ABNORMALITIES– AORTIC STENOSIS– MITRAL STENOSIS– AORTIC REGURGITATION– MITRAL REGURGITATION
Aortic Stenosis PA View
Aortic Stenosis Lateral View
CARDIAC RADIOLOGYAORTIC STENOSIS-POST STENOTIC
AORTIC DILATATION
CARDIAC RADIOLOGYMITRAL STENOSIS
Mitral Stenosis Lateral View
CARDIAC RADIOLOGYPRE AND POST AVR FOR AR
CARDIAC RADIOLOGYMITRAL REGURGITATION
Prosthetic Valves
CARDIAC RADIOLOGY
• CONGENITAL ABNORMALITIES– ACYANOTIC
• ASD (SECUNDUM)
• COARCTATION OF THE AORTA
• VSD
– CYANOTIC• TETRALOGY OF FALLOT
• EBSTEIN’S ANOMALY
• PDA
CARDIAC RADIOLOGYCOARCTATION OF THE AORTA/RIB
NOTCHING
Aortic Coarctation CT Scan
CARDIAC RADIOLOGYFOUR CHAMBER ENLARGEMENT / VSD
CARDIAC RADIOLOGYCONGESTIVE HEART FAILURE / VSD
CARDIAC RADIOLOGYRIGHT HEART FAILURE / ASD
CARDIAC RADIOLOGYRIGHT SIDED ARCH/TETROLOGY OF
FALOT
CARDIAC RADIOLOGYPULMONARY HYPERTENSION / PDA
Aortic Dissection
Thoracic Aortic Stent Graft
Biventricular AICD
MSCT Scan
Coronary Artery DiseaseMSCT Angiography
Coronary Artery DiseaseCardiac Catheterization
CARDIAC RADIOLOGY
• SUMMARY
– CLINICAL HISTORY IS IMPORTANT– LOOK AT THE ENTIRE CHEST– LOOK AT ALL BONEY STRUCTURES– ALLOW FOR ABNORMALITIES
SECONDARY TO BODY HABITUS