Module 2: M mode Flashcards

1
Q

What is M mode or motion mode?

A

It displays the motion of a single line of imaging stretched over time

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2
Q

What structures is M mode good at assessing?2

A
  1. LV wall
  2. MV
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3
Q

What is the typical framerate of M-mode?

A

1800 FPS

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4
Q

Between M mode and 2D which has the higher Temporal (time) Resolution?

A

M-mode has a much higher temporal resolution

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5
Q

How does M- mode work?

A

Uses a single scan line to sample at extremely high rates

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6
Q

With FR in the thousands M-mode has the ability to make fast structures appear how?

A

Continuous

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7
Q

What is M-mode excellent for?3

A
  1. Imaging all four valves
  2. Correlating electrical and mechanical events such as ventricular motion
  3. Precise measurements of cardiac dimensions
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8
Q

It is standard practice to record M-mode at how many levels? 3

A

Three levels
1. Aortic valve
2. Mitral valve
3. LV base

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9
Q

What is the general principle of M-mode?

A

M-mode shows one scan line displayed over time, and that line must be perpendicular to the structure of interest

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10
Q

Should we measure with M-mode if not aligned?

A

No, if a measurement is made when oblique there will be a overestimation of dimension

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11
Q

What is the purpose of AV/LA M-mode?4

A

Assess the following
1. Variations in LA size (Related to rhythm)
2. LA size during systole (enlarged?)
3. AV cusp morphology (thickened?)
4. AV cusp excursion (opening?)

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12
Q

What is the process of getting the AV/LA level M mode window? 3

A
  1. Set the cursor line
  2. Transect through the AV leaflet tips
  3. Parallel to AV valve plane
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13
Q

Label the picture

A
  1. LA Filing
  2. LA Emptying
  3. Conduit phase
  4. Rapid phase
  5. Atrial systolic phase
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14
Q

Label the structures of AV/LA M-mode

A
  1. Anterior Ao Root
  2. RCC AV cusp
  3. NCC AV cusp
  4. Posterior Ao root
  5. LA
  6. AV Closure line
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15
Q

What are the two measurements we take for AO/LA M mode?

A
  1. Aortic root end diastole
  2. LA end systole
    use leading to leading measurement
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16
Q

Label the measurements from left to right

A
  1. Aortic root end diastole (it’s at QRS)
  2. LA (its at end systole @ its largest)
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17
Q

What is the purpose of M-mode of the MV? 4

A

To assess the following
1. MV morphology (thickening)
2. MV motion (stenosis/ prolapse)
3. Severity of an aortic valve leak which would affect movement of the MV
4. Indirect assessment of LV systolic function

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18
Q

Is there any measures needed for the M- mode of the MV?

A

Nope!

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19
Q

Label the wave

A
  1. Atrial Diastole
  2. Atrial Systole
  3. Atrial Diastole
  4. Ventricular Diastole
  5. Ventricular Systole
  6. Ventricular diastole
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20
Q

What is the appearance of the MV in m mode?

A

Batman symbol

21
Q

When taking a M- mode MV, it is important to do what?

A

Have the cursor at the point of coaptation of the MV leaflets

22
Q

What does the E/A MV values mean? 2

A
  1. E wave = early filling (LV sucking in blood)
  2. A wave = Atrial Kick (Atria Contracting)
23
Q

Label the structures for a MV waves from left to right

A
  1. E wave (Early filling) first peak of the M
  2. A wave (Atria Contracting) second peak
24
Q

What is normal EPSS measurement?

A

7-10mm

25
Q

How does MV M-mode in dilated cardiomyopathy look like?

A

Gap between the MV and the IVS when the MV is fulling opening

26
Q

What is Mitral Stenosis? 2

A
  1. Reduced MV leaflet excursion
  2. Thickened leaflets
27
Q

What is SAM (systolic anterior motion?)

A

When the AMVL is dragged anteriorly during mid systole

28
Q

What is MVP- Mitral valve prolapse?

A

One or both mitral valve leaflets are dragged backwards into the LA during systole

29
Q

Where is the M-mode of the LV taken?2

A

It is taken at:
1. LV base just past the MV leaflet tips
2. Level of Chordae tendonae

30
Q

What must we remember in terms of getting a M-mode image of the LV?

A

Must attempt to make the IVS as flat as possible before recording

31
Q

Why is it useful to have a M-mode of the LV? 3

A

Very useful to assess
1. Wall motion
2. Ejection fraction/ fractional shortening
3. Subtle wall motion abnormalities of the IVS

32
Q

Label the M-mode image of the LV

A
  1. RV
  2. LV
  3. ED
  4. ES
33
Q

Label the M-mode image of the LV from top to bottom

A
  1. RV Ant. Wall
  2. Septum
  3. Post LV wall
  4. Pericardium
34
Q

What are the M-mode measurements for LV Diastole? 3

A
  1. IVSd
  2. LVIDd
  3. LVPWd
35
Q

What part of the ECG do we take the diastolic measures for LV M-mode?

A

QRS

36
Q

What Systole M-mode measurements for LV do we take?

A

LVIDs

37
Q

What are some tips to get the measurements for LVIDs?

A

Measure when the LV is at its smallest

38
Q

How should we measure the IVSd for LV M-mode?

A

RV side of the LV septum to LV cavity

39
Q

How should we measure the LVIDd for LV M-mode?

A

Posterior IVS to the posterior wall

40
Q

How should we measure the LVPWd for LV M-mode?

A

LV cavity to the epicardium

41
Q

What is the formula for fractional shortening?

A
42
Q

What is the formula for ejection fraction?

A
43
Q

How do we calculate relative wall thickness?

A
44
Q

how often do we get a M-mode of the PV?

A

Performed infrequently

45
Q

What may the M-mode of the PV be used to diagnose?

A

Pulmonary hypertension

46
Q

What is the Pulmonary PV hypertension M-mode known as?

A

The flying W

47
Q

What can Anatomical M-mode correct for? And how?

A

Poor alignment to any structure by crossing over multiple scan lines.
green line in the image is the AMM, white dotted line is the original M-mode cursor

48
Q

What is the RV systolic function measurement?

A

In the Normal RV, the TV annulus moves >17mm toward and away from the apex over the cycle