Trends in pediatric imaging: ultrasound

2013 ◽  
Vol 54 (9) ◽  
pp. 1096-1105 ◽  
Author(s):  
Ansgar Berg ◽  
Gottfried Greve
Keyword(s):  
Heart Diseases ◽  
Three Dimensional ◽  
Cost Effective ◽  
Clinical Work ◽  
Ventricular Volume ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Strain And Strain Rate ◽  
2D Echocardiography ◽  
Systolic And Diastolic Function

For the last three decades, two-dimensional (2D) echocardiography and Doppler echocardiography have been the primary imaging modalities for the diagnosis and management of heart disease in infants, children, and adolescents. These methods are non-invasive, highly sensitive, and cost-effective, and widely available, making them very useful in clinical work. During this period, the anatomic and hemodynamic abnormalities associated with different congenital and acquired pediatric heart diseases have been well outlined by echocardiography. Recent advances in computer technology, signal processing, and transducer design have allowed the capabilities of pediatric echocardiography to be expanded beyond qualitative 2D imaging and blood flow Doppler analysis. New modalities such as three-dimensional echocardiography, tissue Doppler imaging and speckle tracking echocardiography have been used to evaluate parameters such as ventricular volume, myocardial velocity, regional strain, and strain rate, providing new insight into cardiovascular morphology and ventricular systolic and diastolic function. Accordingly, a comprehensive and sophisticated quantification of ventricular function is now part of most echocardiography protocols. Use of measurements adjusted for body size and age is common practice today. These developments have further strengthened the position of echocardiography in pediatric cardiology.

scholarly journals THE DIAGNOSTIC AND PROGNOSTIC VALUE OF RIGHT VENTRICLE SYSTOLIC AND DIASTOLIC FUNCTION IN INFERIOR MYOCARDIAL INFARCTION

Biomedika ◽  
2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Niniek Purwaningtyas
Keyword(s):  
Myocardial Infarction ◽  
Diastolic Function ◽  
Sensitivity And Specificity ◽  
Systolic Function ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Inferior Myocardial Infarction ◽  
St Segment Elevation ◽  
St Segment ◽  
Systolic And Diastolic Function

Right ventricular (RV) involvement increases mortality and morbidity in inferior myocardial infarction (MI). There are sparse data on the usefulness of pulsed tissue Doppler imaging (TDI) in the diagnosis of RV dysfunction in ST segment elevation MI (STEMI). This study evaluate the diagnostic and prognostic significance of RV systolic and diastolic function compared to classical electrocardiographic RVMI diagnostic criteria in this group of patients. Consecutive patients with first, acute, inferior STEMI were prospectively assessed. The RVMI was defined as an ST-segment elevation ≥ 0.1 mV in lead V4R. Echocardiography with TDI was performed within24 h of the onset of symptoms. Out of 31 patients (mean age 56.39 ± 9.02 years), RVMI was found in 18 (37%). Multivariate analysis showed that two variables—RV systolic and diastolic function, were independent predictors of in-hospital prognosis. Sensitivity and specificity the RV systolic function were 94,4% and 69,2%, respectively. While RV diastolic function were 44% and 76,9%, respectively. RV systolic function predict ECG diagnosis of RVMI with relatively high sensitivity and specificity. RV diastolic function predict ECG diagnosis of RVMI with relatively low sensitivity but with high specificity.Keywords: tissue Doppler imaging, RV myocardial infarction, inferior myocardial infarction

Right ventricle and pulmonary arterial pressure

2016 ◽  
Author(s):  
Annemien E. van den Bosch ◽  
Luigi P. Badano ◽  
Julia Grapsa
Keyword(s):  
Clinical Decision Making ◽  
Complex Geometry ◽  
Three Dimensional ◽  
Clinical Decision ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Prognostic Information ◽  
Recent Developments ◽  
And Function

Right ventricular (RV) performance plays an important role in the morbidity and mortality of patients with left ventricular dysfunction, congenital heart disease, and pulmonary hypertension. Assessment of RV size, function, and haemodynamics has been challenging because of its complex geometry. Conventional two-dimensional echocardiography is the modality of choice for assessment of RV function in clinical practice. Recent developments in echocardiography have provided several new techniques for assessment of RV dimensions and function, include tissue Doppler imaging, speckle-tracking imaging, and volumetric three-dimensional imaging. However, specific training, expensive dedicated equipment, and extensive clinical validation are still required. Doppler methods interrogating tricuspid inflow and pulmonary artery flow velocities, which are influenced by changes in pre- and afterload conditions, may not provide robust prognostic information for clinical decision-making. This chapter addresses the role of the various echocardiographic modalities used to assess the RV and pulmonary circulation. Special emphasis has been placed on technical considerations, limitations, and pitfalls of image acquisition and analysis.

Stress echocardiography: image acquisition and modalities

2016 ◽  
Author(s):  
Rosa Sicari ◽  
Edyta Płońska-Gościniak ◽  
Jorge Lowenstein
Keyword(s):  
Stress Echocardiography ◽  
Quantitative Methods ◽  
Wall Motion ◽  
Contrast Echocardiography ◽  
Image Interpretation ◽  
Three Dimensional ◽  
Visual Assessment ◽  
Tissue Doppler ◽  
Doppler Imaging ◽  
Endocardial Border

Stress echocardiography has evolved over the last 30 years but image interpretation remains subjective and burdened by the operator’s experience. The objective operator-independent assessment of myocardial ischaemia during stress echocardiography remains a technological challenge. Still, adequate quality of two-dimensional images remains a prerequisite to successful quantitative analysis, even using Doppler and non-Doppler based techniques. No new technology has proved to have a higher diagnostic accuracy than conventional visual wall motion analysis. Tissue Doppler imaging and derivatives may reduce inter-observer variability, but still require a dedicated learning curve and special expertise. The development of contrast media in echocardiography has been slow. In the past decade, transpulmonary contrast agents have become commercially available for clinical use. The approved indication for the use of contrast echocardiography currently lies in improving endocardial border delineation in patients in whom adequate imaging is difficult or suboptimal. Real-time three-dimensional echocardiography is potentially useful but limited by low spatial and temporal resolution. It is possible that these technologies may serve as an adjunct to expert visual assessment of wall motion. At present, these quantitative methods require further validation and simplification of analysis techniques.

scholarly journals Echocardiographic Evaluation of Left Atrial Mechanics: Function, History, Novel Techniques, Advantages, and Pitfalls

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Roman Leischik ◽  
Henning Littwitz ◽  
Birgit Dworrak ◽  
Pankaj Garg ◽  
Meihua Zhu ◽  
...  
Keyword(s):  
Diastolic Function ◽  
Left Atrial ◽  
Left Ventricular Diastolic Function ◽  
Tissue Doppler ◽  
Left Ventricular ◽  
Doppler Imaging ◽  
Current Standard ◽  
Ventricular Diastolic Function ◽  
Strain Rate Imaging ◽  
Strain And Strain Rate

Left atrial (LA) functional analysis has an established role in assessing left ventricular diastolic function. The current standard echocardiographic parameters used to study left ventricular diastolic function include pulsed-wave Doppler mitral inflow analysis, tissue Doppler imaging measurements, and LA dimension estimation. However, the above-mentioned parameters do not directly quantify LA performance. Deformation studies using strain and strain-rate imaging to assess LA function were validated in previous research, but this technique is not currently used in routine clinical practice. This review discusses the history, importance, and pitfalls of strain technology for the analysis of LA mechanics.

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