정상 심초음파도

Suprasternal notch

Echo Windows

Parasternal

Window

ApicalSubcostal

Parasternal window

2 D Echo 검사 순서

PLX

PSX

Parasternal long axis view

(PLAx)

Parasternal short axis view

Aortic Valve Pulmonic Valve

Parasternal short axis : Mitral Valve

Parasternal short axis : Papillary muscle

Apical view : 4 chamber View (Ap4C)

Apical view : Relation with LV Sx

Apical long axis view, Apical 5 chamber View

(ApLAx, Ap5C)

Apical 2 chamber View (Ap2C)

Subcostal View

4 chamber View

Long axis

4 chamber ViewShort axis

우심실유출로

Subcostal window

하대정맥및간정맥

Suprasternal window (흉골상부창)

Suprasternal window

대동맥장축단면폐동맥단축단면

Segmental analysis of LV walls

Coronary territories, myocardial Segments

M mode Echo 및 측정

Parasternal short axisAorta

Left atrial diameter

Left ventricular end-diastolic diameter (EDD) and end-systolic diameter (ESD) M-mode, guided by parasternal short-axis image

IVST(mm) 8.8±1.73PWT 8.4±1.54LVESD 31.1±3.85LVEDD 48.9±4.07Left ventricular mass 151 ± 40.9

우리나라 정상 성인심장 내부의 측정치 : M형 심초음파도

Left ventricular mass 151 ± 40.9LVMI(g/M2) 91± 22.6

Aorta 29.0±3.70Left atrial diameter 35.5±4.68

2 D Echo : Diameter 측정

Annulus Diameter

Sinus of Valsalva D.

Sinotubular junction D.

Anteroposrerior D. of

left atrium

Pulmonary a.

Journal of the American Society of Echo.

Volume 18:1440, 2005

Aortic annulus diameter(mm) 20.7±2.26Sinus of Valsalva diameter(mm) 30.1±3.23Sinotubular junction diameter(mm) 25.4±3.32

Aortic root diameter at sinuses of Valsalva

Calculation of LV volume, EF

Simpson’s Method : Ap4c, Ap2c view

Ejection fraction (EDV ESV) ⁄ EDV

IVC Change with respiration Estimated RA pr

Small(2.5cm) Decreased by >50% 15-20mmHg

Dilated with dilated hepatic vein

No change >20mmHg

Pulse wave vs Continious Doppler

Time X

Sample volume axis of entire ultrasound beamMaximal velocity

Color Doppler Echocardiography

Pulmonary vein flow

S D

A

S: systolic vel(cm/s)

D: diastolic Vmax(cm/s)

S/D

A: atrial reversal (cm/s)

5045>123

LV outflow tract (Aortic) Vmax(cm/s) 99±21.7VTI(cm) 20± 4.4

RV outflow tract (Pulmomic) Vmax(cm/s) 73±17.1

우리나라 정상 성인의 심장 혈류 속도

Mitral valve Tricuspid valve

E velocity(cm/s) 75±16.0 52±13.1A velocity(cm/s) 55±18.1 34±10.4A velocity(cm/s) 55 18.1 34 10.4E/A ratio 1.5±0.52 1.6±0.49IVRT(ms) 92±21.8DT(ms) 183±38.1 203±51.8

Pulmonary vein

Systolic Vmax(cm/s) 53±13.0Diastolic Vmax(cm/s) 46±11.6Atrial reversal Vmax(cm/s) 23± 5.1

Mitral flow and Annular velocities

Am

E

A

Em > 10cm/s

Em

Am