CARDIOVASCULAR

IMAGING

Bachtiar Murtala
Department of Radiology
Medical Faculty Hasanuddin University
Makassar
 Scope/Objectives
Types of examination/modalities
Basics of interpretation
 Introduction
Radiology imaging has a very
important role in establishing
diagnosis of cardiovascular diseases
A variety techniques have already
developed
Conventional and advanced imaging
We must undestand classification and
hemodynamic of every abnormality
 Modalities
Chest x-ray ( PA/Lat)
Angiography
Ultrasound ( Echocardiography and
vascular US)
CT-scan ( Cardiac CT and CT angio)
MRI ( MR angio )
Scintigraphy
 Chest x-ray
Initial and routine examination
To evaluate heart, great vessels,
pulmonary vascularity, etc
Upright PA and lateral position
 Chest x-ray evaluation
Heart : position, size, shape, outer
contour
Great vessels : aorta, main
pulmonary arteries
Pulmonary circulation : normal,
increase, or decrease
Cardiac Anatomy
 Heart enlargement
Which chamber are enlarged?
Size of the aorta- small/narrow, wide?
Pulmonary vascularity : main trunk
widening or narrowing, oligemia or
hyperemia
Pulmonary knob in the left side
contour : enlarge/prominent?
 Enlargement of individual
chambers of the heart
I. Left ventricle
- cardiac apex bulges down and left
- Retrocardiac clear space narrowing ( lateral
view)
- esophagus 1/3 distal displaced posteriorly

II. Left atrial

- esophagus 1/3 middle displaced posteriorly
- prominent left auricle
- double contour on the right side
- elevated left main bronchus
III. Right ventricle
- cardiac enlargement toward left with
elevated apex
- filling/narrowing of retrosternal space
- may displace right atrium toward
right
- may displace left ventricle backward
IV. Right atrium
right heart border beyond 1/3 of the
right hemithorax
may fill retrosternal space
ASD
PDA
Hypertensive Heart Disease (HHD)
Cor Pulmonale and Pulmonary Hypertension
The main pulmonary artery segment [arrowhead] is dilated, and the peripheral vessels [arrows] are
narrowed in a patient with longstanding emphysema. Enlargement of the right heart is seen most
clearly on lateral view.
Early Congestive Heart Failure
Acute intraalveolar pulmonary edema in patient with left heart failure.
Note the central distribution of edema fluid batwing appearance
in the upper and lower zone of the lung.
CT-Thorax
 Vascular Imaging
1. Angiography :
Arteriography ( artery )
Venography/phlebography ( vein )
2. CT-angiography
3. MR-angiography
4. US / Doppler
Angiography
Equipments
Puncture needles: Seldinger, Abbocath
Introducer sheath & guide wire
Catheter : pigtail, head hunter,
Simmons, Yashiro, cobra head.
Size : 3,5 Fr (French), etc. 1mm = 3Fr
Contrast materials
Angiographic machine or DSA
 Introducer Sheath

Guide Wires & Catheters

CT Angiography
CT-
angiography
MR-Angiography
 Ultrasound
Grey Scale
Color Doppler
Thank You