8/9/2019 Cine Angio

1/3

Method of recording sequential X-ray images of the heart and great arteries after

the selective injection of iodinated contrast medium. It is used to evaluate

morphology, dimensions and function of the heart and morphology of the great

arteries. Cineangiography has for decades served as the denitive technique for

demonstrating the morphology of congenital heart disease. Cineangiography after

selective injection of contrast media in the coronary arteries (coronaryarteriography is the imaging modality employed for dening coronary arterial

anatomy and pathology.

Cineangiography employs a cine camera to record the images from the image

intensier onto cine lm. Cardiac cineangiography is typically performed at !"

frames per second. Coronary angiography is typically performed at around #"

frames per second. Cardiac cineangiography is performed in either the single plane

or $iplane modes. %he $iplane mode is used for cardiac cineangiography in children

and sometimes also in adults. %he single plane mode is used for coronarycineangiography. In addition to recording of images on cine lm as the primary

archival medium, images may also $e simultaneously recorded on analogue

videotape or analogue optical dis& for immediate vie'ing. nalogue videotaping of

cardiac images is largely $eing replaced $y digital recording media.

In recent years cardiac angiography and coronary angiography have $een moving

to the utili)ation of digital acquisition and display of sequential images. *ith digital

recording of images, there is immediate conversion of image data into num$ers,

storage of the num$ers and the option of computer manipulation, processing andanalysis of the numerical data. %he num$ers are converted into a processed or

unprocessed image for vie'ing. +igital cardiac and coronary angiographic systems

employ a video camera to acquire an electronic video image from the X-ray image

intensier. %his signal is converted into digital (numerical form.

%ypes of cineangiograms

Cineangiograms are usually performed after selective injection of contrast media inthe right ventricle (right ventriculogram, left ventricle (left ventriculogram, andor

pulmonary artery (pulmonary aortogram. elective injection into the right and left

coronary arteries constitutes a coronary cineangiogram (see coronary

arteriography. Injection of any of these sites may $e necessary in congenital heart

disease in order to dene the complete morphology of anomalies. In acquired heart

disease left ventriculography is performed most frequently for the evaluation of

8/9/2019 Cine Angio

2/3

valvular heart disease, ischemic heart disease and cardiomyopathies. %horacic

aortography is performed for the evaluation of aortic valve disease, thoracic aortic

aneurysms and aortic dissection. /ight ventriculography is performed to assess

right ventricular function and tricuspid valve function.

0entriculograms are usually performed in the anteroposterior and lateral or !" right

anterior o$lique and #" left anterior o$lique projections. 1or the evaluation of

congenital heart disease and sometimes for acquired heart disease as 'ell, a

compound angulated vie' is used 'ith craniocaudal angulation com$ined 'ith right

or left anterior o$lique angulation of the image intensier.

nalysis of cine ventriculograms

%he left ventriculogram can $e evaluated using su$jective visuali)ation or

quantitative analysis usually employing computer-$ased programs. uch computer-

$ased quantitative analysis is facilitated $y digital recording of image data. %he left

ventriculogram is su$jectively evaluated $y visual assessment of ventricular si)e

and shape, 'all thic&ness, 'all motion during systole, motion of mitral and aortic

valves, and identication of intracavitary lling defects and valvular regurgitation.

*hile the volume of the ventricle can $e su$jectively estimated $y e2perienced

e2aminers, measurement of the outline of left ventricle at end-diastole and end-

systole is usually necessary to provide more precise estimation of left ventricular

volume at end-diastole and end-systole using various geometric models. %he area3

length method is the one usually applied for quantifying ventricular volumes.

0entricular contraction can $e readily evaluated $y cineangiography. $normalities

of 'all motion are generally glo$al in nonischaemic cardiac diseases such as

valvular heart disease and cardiomyopathy. *all motion a$normalities are usually

segmental in ischaemic heart disease and sometimes also in other diseases (1ig. 4.

%he a$normalities in 'all motion are termed hypo&inesis (decrease systolic in'ard

motion5 a&inesis (no systolic in'ard motion5 dys&inesis (out'ard systolic motion

(1ig. 6. %hese segmental 'all motion a$normalities are displayed $est on

cineangiograms acquired in the !"7 right anterior o$lique or caudal !"7 right

anterior o$lique projections (1ig. 4.

In congenital heart disease cineangiograms are analysed to assess dimension of the

t'o ventricles, arterioventricular connections, atrioventricular connections, valve

atresia, stenosis and regurgitation, shunts at atrial, ventricular and aortic levels, and

8/9/2019 Cine Angio

3/3

ventricular function. Cineangiograms are also employed $efore and after surgery to

assess the si)e of pulmonary arteries.