Klein Chapter 11 - Contrast Enhancing Ultrasound Imaging

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16 Terms

1
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The current FDA indication for ultrasound contrast is truly for…

improvement in LV opacification

2
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Change in the gas molecular weight from room air gas to high molecular weight gases of UEA lead to improved…

transpulmonary passage and LV opacification because of persistence of microbubbles due to reduced diffusivity and solubility

3
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Low mechanical index with UEA helps with… (3)

  • Myocardial perfusion imaging

  • Endocardial border resolution

  • Detection and evaluation of intracardiac masses

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power modulation versus power pulse inversion

<p></p><p></p>
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Contraindication to using Optison

allergy to blood products

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Contraindication to all agents except Optison

Right to left intracardiac shunting

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Can in hospital cardiac sonographers start an IV line?

Yes!

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Why is UEA not used for PDA or intracardiac shunts?

Because you use agitated saline for those, not necessarily trans pulmonary contrast agents

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The very low MI imaging techniques (<0.2 MI) are designed to detect only _____ activity

non-linear (ie distortion in the sound wave as it passes through a given medium) from micro bubbles

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<p>Patient has h/o CAD and MI. Given bolus injection of IV contrast with very low MI imaging. What is shown at the blue arrows?</p>

Patient has h/o CAD and MI. Given bolus injection of IV contrast with very low MI imaging. What is shown at the blue arrows?

Apical pseudoaneurysm


FYI not apical aneurysm or apical thrombus

11
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<p>Diffuse T-wave inversions on ECG and the following end systolic images. What does this show?</p>

Diffuse T-wave inversions on ECG and the following end systolic images. What does this show?

Apical hypertrophic cardiomyopathy

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What does this LAA show

Spontaneous echo contrast but no thrombus

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<p>high MI impulse images with contrast — what coronary artery explains the perfusion defect?</p>

high MI impulse images with contrast — what coronary artery explains the perfusion defect?

left main

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The variables that determine what the MI is includes… (2)

peak negative pressure and transmit frequency

FYI MI = peak negative pressure divided by the square root of the transmit frequency (in MHz)

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<p>A patient with exertion SOB had a saline contrast injection performed to assess for intracardiac shunting. A right arm saline injection detected no evidence of intracardiac shunting. However, an apical 4 chamber image before and after a left arm saline contrast injection.</p>

A patient with exertion SOB had a saline contrast injection performed to assess for intracardiac shunting. A right arm saline injection detected no evidence of intracardiac shunting. However, an apical 4 chamber image before and after a left arm saline contrast injection.

An unroofed coronary sinus with a left sided superior vena cava

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