Advanced Modalities in echo Async. Flashcards
What is a GE Vscan?
Small bedside unit which can fit into a lab coat pocket
What are GE scans used for?
Used by cardiologists for quick look at the heart (full study recommended afterwards)
What is GE Vscans capable of?
2D + colour (no spectral) echo + vasc
What is the GE Vscan probe like?
Double ended probe
What does 3D probes use to plot points?
Cartesian coordinate system
What is biplane imaging?
Uses two 90 degree slices for simultaneous imaging
What does this image represent?
Biplane imaging
What is triplane imaging? What do we see?
When all views are seen simultaneously
1. Valves
2. Wall motion
3. Masses and veggies
What produces the most accurate estimation of EF?
Triplane imaging
All views must be taken within the same beat
What does this image represent?
Triplane imaging
What is 9/12 slice from 4D?
9 slices simultaneously
What might 9/12 slice from 4D be imaged with?
- Color doppler
- Contrast might be used for better visibility
What does this image represent?
9/12 slice from 4D
What is 12 slice 3D/4D
9 slices + 3 apical planes
with 12 slice 3D/4D ROI is displayed as what?
Lines on apicals
Information on 3D/4D images comes in what?
Voxels
3D/4D imaging uses what?
Volume rendered 3D
Surface rendered 3D echo only provides what?
Outer 3D rendering
Why do we use 3D to assess for? 3
- Valves
- LV volumes
- Massess
What do we need to have for a good 3D
Good 2D
How do we get real time 3D?
Image is formed by stitching pie shaped slices together to form a full volume data set
What does cropping in 3D do?
Crop to focus on specific information (Limited ROI)
What is strain imaging?
Describes the deformation of an object. Like how much a myocardial segment is moving
What is the formula for strain?
Why should strain values be negative?
Because L<Lo in the normal heart
In terms of strain in the heart, what happens?
Myocardial fibers shorten and lengthen in many directions during the cardiac cycle
What is the best window to see strain in the heart?
Apical window or the longitudinal plane
Label
In terms of 2D strain imaging, the machine does what?
Tracks the speckles in the 2D image throughout systole
What is AKA GLS or STE?
- AKA GLS: Global longitudinal strain
- STE: Speckle tracking echocardiography
When do we use GLS/ STE? 2
- LV functional assessment
- Prognostic factors
What are some LV functional assessments we can see with GLS/STE? 5
- Chemotherapy
- Heart transplant rejection
- Valvular disease
- Cardiomyopathies
- Hypertensive heart diseases
What does using GLS/STE for heart transplant rejections do? 2
- Reduces the need for myocardial biopsies
- STE very prognostic for ACR (Acute cellular rejection) while 2D echo methods have failed
What are some prognostic factors that GLS/STE is used for?2
- Heart failure outcomes from any cause
- Embolic risk for paroxysmal A-fib
How is strain done?
- With the technologist help, the machine identifies the region of interest or ROI
- Displays colour coded strain information over the 2D image
What does this image represent?
Strain imaging
What is a strain graph?
Software which plots a graph with the peak systolic strain values for each segment in the view
When are strain graphs done?
Done offline in the all 3 apical views
What are needed for strain graphs?
Good images
What does this image represent?
Strain graph
In terms of 2D strain imaging, software applies what?
Strain values to each LV segment
How is strain usually displayed?
On the echo bulls eye
What does the blue and red mean?
Red = good, Blue = bad
What does this image represent?
Display of GLSL (Bull’s eye plot)
Label
**Values are vendor dependent*
What is another good reason for strain?
Strain is not affected by tethering
What is tethering?
When diseased segment is getting pulled along by a healthy segment
Strain allows us to do what?
Differentiate normal from tethered segments
