two-dimensional echocardiography

Two-dimensional echocardiography, also known as cross-sectional echocardiography, is referred to as two-dimensional ultrasound. The echo signals reflected from the human body form a slice image in the form of spots, also known as Brightness Mode. It is the basic inspection method that can clearly, intuitively and display the shape, spatial position and continuous relationship of the various structures of the heart in real time. Echocardiography has been widely used as a non-invasive examination of heart disease, and M-mode echocardiography can only record one-dimensional images of the heart structure and is therefore limited. Real-time tangential imaging of the heart—Two-dimensional echocardiography overcomes the limitations of M-type and is more suitable for evaluating myocardial contraction abnormalities and estimating ventricular function. When two-dimensional echocardiography is used to examine the heart, basically three planes perpendicular to each other are used, which are named as long-axis, short-axis and four-chamber. The basic section of the two-dimensional echocardiogram: 1, the left ventricular long axis section of the bone. 2. The short axis of the cusp horizontal. 3, pointed four cavity cut surface. 4, under the four-chamber cut surface. Two-dimensional echocardiography is the basis for the development of various types of echocardiography. Ultrasound contrast and transesophageal ultrasound should be based on two-dimensional echocardiography. It can display the fault structure, adjacent relationship and dynamic changes of different locations of the great vessels of the heart from two-dimensional space. It is the core examination method of cardiac ultrasound and is suitable for the examination of various types of cardiovascular diseases. Basic Information Specialist classification: cardiovascular examination classification: ultrasound Applicable gender: whether men and women apply fasting: not fasting Tips: When you check, relax and cooperate with your doctor. Normal value Cut surface (two-dimensional) echocardiography to measure the normal value of the inner diameter of the heart chamber and the large blood vessels are at the edge of both sides of the liquid dark area as the starting and ending point (excluding the width of the reflected light band between the heart wall and the blood interface), using electronic tour The ruler is measured directly on the screen, or the image is enlarged and then calculated using a common ruler. Unit mm. When measuring the long diameter of the ventricle (or atrium), one end is at the apex (or the top of the atrium) and the other end is at the midpoint of the attachment at both sides of the atrioventricular valve. When measuring the transverse diameter and the anteroposterior diameter, the longest connection line equal to the angle between the two sides of the heart wall (or the vessel wall) should be taken. In terms of phase selection, the T-wave peak of the ECG is taken at the end of the contraction. At the end of diastole, the peak of the R wave is taken. 1 left ventricular left ventricular long axis cut front and rear diameter (D) 56.98 ± 3.88, anteroposterior diameter (S) 34.31 ± 3.48, mitral horizontal anteroposterior diameter (D), male 52.1 ± 2.0, female 49.6 ± 1.6, short axis cut before and after Path (S), male 34.7±3.9, female 32.7±4.1, apical four-chamber transverse diameter (D), male 47.0±3.6, female 41.0±6.3, transverse diameter (S) male 36.5±3.7, female 32.4±5.0, The apical two-chamber long diameter (D) was 81.21±7.48, and the long diameter (S) was 56.21±9.28. 2 right ventricular left ventricular long axis cut front and rear diameter (D), male 21.2 ± 3.8, female 18.8 ± 2.2, anteroposterior diameter (S), male 21.0 ± 3.9, female 19.1 ± 4.0, apical four-cavity long diameter (D), Male 66.2±10.4, female 62.9±8.3, long diameter (S), male 50.2±9.1, female 46.1±7.5, transverse diameter (D), male 27.9±5.4, female 21.6±6.1 transverse diameter (S), male 22.0± 5.6, female 16.9 ± 5.1. 3 left atrial left heart long axis dense front and rear diameter (S), male 28.9 ± 4.3, female 28.1 ± 3.9, apical four-cavity long diameter (D), male 33.4 ± 8.8, female 32.6 ± 8.6, long diameter (S ), male 44.0 ± 9.1, female 3.0 ± 6.3, transverse diameter (D), male 5.8 ± 6.4, female 3.1 ± 5.0, transverse diameter (S), male 31.7 ± 3.6, female 30.5 ± 5.1. 4 right apex apical four-cavity long diameter (D), male 34.7 ± 5.9, female 30.6 ± 4.4, long diameter (S), male 46.4 ± 4.9, female 43.5 ± 4.7, transverse diameter (D), male 33.9 ± 5.8 Female 22.9±4.6, transverse diameter (S), male 35.8±5.7, female 31.9±6.9. 5 The aortic root anteroposterior diameter was 24.00±2.45, the aortic arch transverse diameter was 24.00±2.85, the abdominal aorta posterior diameter was 17.79±2.81, and the anterior and posterior diameter of the abdominal aorta was 17.68±1.22. 6 The pulmonary artery had a short-axis incision at the annulus, with a transverse diameter of 20.23±2.9, the widest point and a transverse diameter of 22.5±2.5. 7 The inferior anterior diameter of the inferior vena cava in the inferior vena cava was 11.34±3.94, and the anteroposterior diameter (call) was 18.75±3.92. The anteroposterior diameter of the neck of the 8 common carotid artery was 7.68±0.68 for males and 7.00±0.71 for females. 9 left coronary artery trunk left heart short axis cut front and rear diameter 4.70 ± 1.37. Clinical significance 1. The examination is used to diagnose the mitral valve, the aortic valve with or without stenosis, and insufficiency. 2, the valve has no thickening, sputum, prolapse, chordae rupture. 3, atrial septal defect, ventricular septal defect, endocardial riding, single ventricle, tricuspid valve down, complete large blood vessel translocation. 4. Location of myocardial infarction and ventricular aneurysm. 5, intracardiac tumor, valve atresia, pericardial effusion. 6, combined with ultrasound imaging, diagnosis of congenital heart disease. Low results may be diseases: myocardial infarction complicated by mitral regurgitation, high cardiac damage may be diseases: elderly pulmonary heart disease, aortic regurgitation, senile valvular heart disease, hypertensive cardiomyopathy, cardiomyopathy, children Dilated cardiomyopathy, aortic dissection, senile cardiomyopathy, stable angina pectoris in the elderly No contraindications, no side effects on the human body. Pay attention to your relaxation and check with your doctor. Inspection process Left sternal area (1) Left ventricular long-axis sectional view: The probe is placed at the left edge of the sternum or 2-3 cm from the left edge, and the direction of the ultrasound beam is parallel to the patient's right shoulder-left waist line. Display aorta and aortic valve (on the right side of the screen), left ventricle (on the left side of the screen), ventricular septum (continuous with the anterior wall of the aorta), anterior mitral valve (continuous with the posterior wall of the aorta), apex Posterior flap, chordae, left atrium, left ventricular free wall (endocardium, myocardium, epicardium, and pericardial wall), partial right ventricle, right ventricular outflow tract, coronary sinus (posterior mitral regurgitation, The left atrial sulcus), the transverse section of the descending aorta (behind the left atrioventricular groove), and the ultrasound beam plane is inclined downward inward, showing the apex, chordae, and posterior papillary muscles; the ultrasound beam plane is inclined downward and downward, showing Apical, chordae, anterior papillary muscles. The plane of the ultrasound beam is tilted toward the ascending aorta, showing the aortic root and the ascending aorta. (2) Long-axis cross-section of the right ventricular inflow tract: the probe position is the same as the front, but rotates clockwise and tilts to the lower right, showing the right ventricle (on the upper part of the screen), the tricuspid anterior flap (left side of the screen), and the tricuspid valve Posterior flap (right side of the screen), right atrium, and coronary sinus, inferior vena cava entrance. (3) Long-axis cross-sectional view of the right ventricular outflow tract: the probe position is the same as the front, but further clockwise rotation and slight upward tilt, the ultrasound beam is approximately parallel to the sagittal section of the patient's torso, showing the right ventricular outflow tract (upper screen ), pulmonary valve, main pulmonary artery (upper right of the screen), ventricular septum, left ventricular outflow tract, anterior and posterior tricuspid valve, left atrium. (4) Cross-sectional view of the four-heart cavity of the left sternal border: The probe is placed in the fourth intercostal space, 2-4 cm away from the left edge of the sternum. The direction of the ultrasound beam is approximately parallel to the surface of the heart, and the probe is gently tilted inward. Show left and left ventricle (on the right side of the screen), mitral anterior and posterior lobes, right and right ventricle (on the left side of the screen), tricuspid anterior and septum, septum, interatrial septum. (5) The long axis section of the descending aorta (thoracic segment); the position of the probe is the same as that of the first section, rotated 90° clockwise, showing an image similar to the long-axis section of the right ventricular outflow tract, reducing the sensitivity of the far zone, on the left The descending aorta is shown after the room. If not shown, the probe is displaced from the midline of the clavicle or as far as the anterior line of the iliac crest. The direction of the ultrasound beam is parallel to the left shoulder-right shoulder line of the patient, and the descending aorta is displayed behind the left or left atrium. (6) Left apex apex short-axis sectional view: The probe position is the same as the fourth sectional view, which is rotated 90° clockwise, and is inclined outward or downward or the probe is placed at the most obvious position of the iliac crest and apex, and the left ventricular apex can be displayed. (7) Short-axis cross-sectional view of left ventricular papillary muscle: the probe position is the same as above, but it is inclined upwards, showing the cross section of the left ventricle and the right ventricle (partial), showing the posterior medial papillary muscle at about 8 o'clock in the left ventricle, 4 o'clock The anterior lateral papillary muscle is shown. (8) Left ventricular mitral valve short-axis sectional view: the probe position is the same as before, and continues to tilt upward, showing the cross section of the left ventricle and part of the right ventricle. The anterior and posterior mitral valvules form a complete valve in the left chamber. Diastolic opening, systolic closure. (9) left ventricular outflow tract and left atrial appendage short axis sectional view; probe position is the same as before, continue to tilt upwards, showing right ventricular outflow tract, left ventricular outflow tract, mitral anterior valve, left atrium, left atrial appendage, atrial septum Wait. (10) Aorta short-axis sectional view: the position of the probe can be unchanged, but it is inclined upwards and outwards, showing the short-axis section of the aortic root. The right coronary valve, the posterior valve, the left coronary valve, and the systolic phase can be displayed in the aorta. The opening of the aortic valve constitutes a complete valve orifice. Appropriate adjustment of the probe direction and a slight decrease in sensitivity can show the left and right coronary artery proximal end and the opening in the aorta. The right ventricular outflow tract is above the aorta, and the left upper part is the pulmonary valve and the main pulmonary artery. The right upper part of the artery is the right ventricle (partial), the right side is the tricuspid anterior flap and the septum, and the lower right is the right atrium and the interatrial septum. Below the aorta is the left atrium, and the lower left is the left atrial appendage. (11) Long-axis cross-section of the pulmonary artery bifurcation: the probe is moved up one rib and tilted outward to show the short-axis section of the aorta (on the left side of the screen), the main pulmonary artery (on the right side of the screen), and the pulmonary artery Fork, left and right pulmonary arteries, showing a diagonal section of the descending aorta at the lower right of the left pulmonary artery. 2. Appointment area (1) apical four-heart cavity cross-section: the probe is placed slightly below the sacral and apical beat, the ultrasound beam plane is approximately parallel to the surface of the heart, and the probe is oriented toward the patient's right shoulder. Four heart chambers and atrial septum, interventricular septum are shown, with the left heart shown on the right and the right heart on the left. The right ventricle is generally triangular in shape and the left ventricle is oblong. The anterior mitral valve is large, the posterior valve is small, the anterior tricuspid valve is large, and the septum is small. The position of the anterior mitral valve is 0.5 to 1.0 cm higher than the septum. There is a band echo (temperate zone) near the right apex of the right room. The posterior wall of the left atrium can show the entrance of 1 to 4 pulmonary veins. (2) Four-chamber sectional view of the apical coronary sinus: the probe is tilted backward from the above position, so that the echo of the interatrial septum disappears, and the intact coronary sinus and the Ou's flap (inferior vena cava flap) are displayed in the right atrium. . Left ventricular, right ventricular and interventricular septum are still shown. (3) apical five-cardiogram sectional view: the probe is tilted forward from the apical four-chamber view, and the aortic root cross-section is displayed in the center of the screen. The anterior wall of the aorta is continuous with the interventricular septum, and the posterior wall and mitral anterior flap Continuously, the right coronary valve and the posterior valve are displayed in the aortic root. The interventricular septum and the four heart chambers still show that the interatrial septum is shown in the lower part of the aorta or not. (4) Long-axis cross-section of the left ventricle of the apex: The probe is rotated 90° clockwise from the apical position and tilted upward. The aorta and aortic valve (in the lower part of the screen), the ventricular septum continuous with the anterior wall of the aorta, the left ventricular and left ventricular apex, the anterior and posterior mitral lobes, and the left atrium (on the upper part of the screen) are shown. (5) Left ventricle two-chamber sectional view of the apex: the probe position is the same as before, but the clockwise rotation is greater, showing the mitral valve, the left ventricular anterior wall between the left atrium, the left ventricle, the left atrium and the left ventricle. Back wall. 3. Under the xiphoid (1) Short-axis view of the upper abdomen large vessel: The probe is placed under the xiphoid process, and the plane of the ultrasound beam is transversely scanned. The scanning plane is perpendicular to the long axis of the patient's torso. The left lobe of the liver is displayed on the top of the screen. The vertebral body and neural tube of the spine are shown in the middle and lower part of the screen. The right side is the short axis section of the abdominal aorta, and the left side is the short axis section of the inferior vena cava. (2) Long-axis cross-sectional view of the abdominal aorta: The probe is placed under the xiphoid, located slightly to the left of the midline, longitudinally scanned, and the plane of the ultrasound beam is parallel to the long axis of the patient's torso. The probe moves down from the xiphoid to the right side of the umbilicus, showing the part of the abdominal aorta from the xiphoid to the left and right common iliac artery. (3) Long-axis view of the inferior vena cava: the probe is placed on the right side of the xiphoid, the ultrasound beam plane is parallel to the long axis of the patient's torso, and the probe is tilted upward to the left, showing the left hepatic lobe and the inferior vena cava long-axis section, left The hepatic vein, the inferior vena cava at the entrance to the right atrium, the right atrium, the atrial septum, the left atrium, and the tricuspid valve. (4) Section of the four-cardiac cavity under the xiphoid process: The probe is placed under the xiphoid, the plane of the ultrasound beam is approximately parallel to the surface of the heart, and the probe is oriented toward the left shoulder of the patient. Show left lobe of the liver (at the top of the screen), right atrium, right ventricle, atrial septum, ventricular septum, left atrium, left ventricle, mitral valve, tricuspid valve. The apex is toward the right side of the screen and the bottom of the heart is on the left side. (5) Cross-sectional view of the atrial two-chamber under the xiphoid process: the probe position is the same as above, gently rotating clockwise and tilting upwards to the left clavicle, showing the left lobe of the liver, the right atrium, the interatrial septum, and the left atrium. (6) Section of the five-cardiac cavity under the xiphoid process: the position of the probe is the same as that of the lower ventricle, but it is more inclined forward and slightly clockwise, showing the left lobe, right atrium, right ventricle, and aorta. Root and aortic valve, ventricular septum (continuous with the anterior wall of the aorta), anterior mitral valve (continuous with the posterior wall of the aorta) and posterior, left ventricle, left atrium. (7) Short-axis view of the lower aorta of the xiphoid process: the probe is placed under the xiphoid process, the plane of the ultrasound beam is parallel to the long axis of the patient's torso, and the probe is tilted and tilted upwards, showing the left lobe of the liver and the vena cava on the right. Entrance, atrial septum, right atrium, tricuspid valve, right ventricle (partial), right ventricular outflow tract, pulmonary valve, main pulmonary artery, aortic root, and aortic valve. (8) Long-axis cross-section of the left ventricle under the xiphoid process: the probe position is the same as above, but continues to rotate clockwise and upward. Show left hepatic lobe, tricuspid valve (front flap, septum, sometimes posterior flap also shown), right ventricular part, right ventricular outflow tract, pulmonary valve, main pulmonary artery (above on the right side of the screen), ventricular septum, aortic root And aortic valve, mitral anterior flap, left ventricle, left atrium. (9) Short-axis cross-section of the left ventricle mitral valve under the xiphoid process: the probe position is the same as above, but further clockwise and upward tilting, showing the cross-sectional view of the left ventricle, the left mitral anterior and posterior lobes Form the mitral valve orifice. On the right side of the screen, the tricuspid valve, the right ventricle, the right ventricular outflow, the pulmonary valve, and the main pulmonary artery are shown. 4. Upper sternal area (1) Long-axis view of the superior sternum aorta: The probe is placed on the upper sternal notch or the right supraclavicular fossa, and the plane of the ultrasound beam is parallel to the direction of the aorta. The ascending aorta (sometimes showing the aortic valve), the aortic arch, the aortic branch on the aortic arch (innominate artery, left common carotid artery, left subclavian artery), descending aorta, left pulmonary artery (below the aortic arch), left atrium. (2) Short-axis view of the superior sternum aorta: the probe position is the same as above, but the ultrasound beam plane is parallel to the coronal plane of the patient's thorax and is inclined backwards and downwards. The left and right innominate veins, the long axis section of the superior vena cava, the cross section of the aorta, the long axis section of the right pulmonary artery, the left atrium, and the entrance of the pulmonary vein in the left atrium were displayed. 5. Right sternal area Atrial two-chamber sectional view: The probe is placed between the 4th and 5th ribs on the right edge of the sternum. The direction of the ultrasound beam plane is similar to the atrial view of the lower atrium of the xiphoid, and the probe direction is toward the upper left. Show right room, room interval, left room. Not suitable for the crowd Generally there is no suitable for the crowd. Adverse reactions and risks This test generally has no side effects on the human body.