Exam acquisition protocol 检查方案

Clinical Echocardiographic Examination Protocol
Brief Operator Guide

General Rules

Please follow a the suggested standard viewing sequence, always the same, in every patient you scan: this method increases your accuracy and reproducibility and readability of the exams by your colleagues.
To acquire and maintain a necessary high measurement accuracy, you need to perform all the main measurements in all patients.

It is necessary to save for each view 3” (or 3 heart beats) video clips, and still images when required (with the performed measurements). The rationale is that it must always be possible to view your measurements on saved examinations, and eventually revise them.

Each exam must have the full patient name

Input patient height and weight. This allows the machine to normalise atrial and ventricular volumes measurements to the BSA

Alway connect the ECG cable to obtain a readable ECG trace on the machine.

2D Gain: the blood pool must be black, the pericardium white, the myocardium gray

临床超声检查方针
简要操作指南

总则

请遵循建议的标准图像序列,对每一位患者每次操作都保持一致:这样能提高准确性和高效性,并提高他人可读性。

为了获得并保持必要的测量高准确度,要在每位患者做检查时获取全部的测量

保存每个三秒长的动态图像是很有必要的(或3个节律),需要时还要获取静态图像(包含测量)。这是为了保证随时能在已存的超声检查中看到你获取的测量,及最终对其修正。

每个检查必须写有患者姓名

输入患者身高体重。这样能使机器根据体表面积规范出正常的心房心室容积

每次都要连心电,使在机器上能获取准确的心电轨迹

2D增益值:血池颜色必须是黑色,心包白色,心肌灰色

Acquisition sequence for each view

·  2D imaging video clip (3 heart beats)


·  2D still frame with measurements (if required)


·  Color Doppler video clip


·  M-mode still frame with measurements, if required


·  Pulsed Doppler still frame with measurements, if required


·  Continuous wave Doppler still frame with measurements, if required


·  Dopper Tissue Imaging still frame with measurements, if required

每个视图的图像获取序列

·  2D动态图像(3个节律)


·  2D图像含测量(如果需要)


·  颜色多普勒动图图像


·  M模图像含测量,如果需要


·  脉冲波多普勒图像含测量,如果需要


·  连续波多普勒图像含测量,如果需要


·  组织多普勒图像含测量,如果需要

Imaging Protocol

A. Parasternal Long Axis, Left Heart – 胸骨旁长轴,左心

1.
2D video clip
Left ventricular long axis (AV, LA, MV, LV, IVS, PL, DA); evaluation of wall motion

2D 动态图像
左室长轴(主动脉瓣、左房、二尖瓣、左室、室间隔、后侧壁、降主动脉);评估室壁运动

2.
2d still frame 2D
LV measurements: end-diastole: IVS thickness, LV diameter, PL thickness.
mid-systole: LVOT diameter

图像
左室的测量: 舒张末期:室间隔厚度,左室直径,后侧壁厚度
收缩中期:左室流出道直径

3.
CD video clip
AVF; locate and maximise regurgitant jet location / direction; base IVS integrity

彩色多普勒动态图像
主动脉瓣血流;放大图像,找到返流的射流位置/方向;室间隔基底段完整性

4.
CD video clip
MVF; locate and maximise regurgitant jet location / direction

彩色多普勒动态图像
二尖瓣血流;放大图像,找到返流的射流位置/方向

5.
2d still frame
Ascending aorta; measurement: diameter

2D图像
升主动脉; 测量:直径

6.
M-mode still frame
AoR, AV, LA

M模图像
主动脉根、主动脉瓣、左房

7.
M-mode still frame
MV, measure: EPSS

M模图像
二尖瓣, 测量:EPSS

B. Parasternal Long Axis, Right Heart – 胸骨旁长轴,右心

8.
2D video clip
Right ventricular long axis (RV, RA, TV, CS)

2D动态图像
右室长轴(右室、右房、三尖瓣、冠脉窦

9.
CD video clip
TVF; locate and maximise regurgitant jet location / direction

彩色多普勒动态图像
三尖瓣血流;放大图像,找到返流的射流位置/方向

10.
Continuous Wave Doppler still frame
TV regurgitation, measurement: peak velocity

连续波多普勒图像
三尖瓣返流, 测量:最大流速

C. Parasternal Short Axis, Base of the Heart – 胸骨旁短轴,心脏底部

11.
2D video clip
Short axis of the base, centered of the AV

2D 动态图像
底部短轴,主动脉瓣放中间

12.
CD video clip
AVF; locate EROA of regurgitation; basal IVS integrity

彩色多普勒动态图像
主动脉瓣血流;找到有效返流口面积

13.
2D video clip
Short axis of the base, centered of the TV

2D动态图像
底部短轴,三尖瓣放中间

14.
CD video clip
TVF; locate and maximise regurgitant jet location / direction; IAS integrity

彩色多普勒动态图像
三尖瓣血流;放大图像,找到返流的射流位置/方向;房间隔完整性

15.
Continuous Wave Doppler still frame
TV regurgitation, measurement: peak velocity

连续波多普勒图像
三尖瓣返流,测量:最大流速

16.
2D video clip
Short axis of the base, centered of the PV and PA

2D动态图像
底部短轴,肺动脉瓣和肺动脉放中间

17.
CD video clip
PV flow (regurgitation); search for Botallo defect

彩色多普勒动态图像
肺动脉瓣血流(返流);看是否有动脉导管未闭

18.
Continuous Wave Doppler still frame
PV regurgitation, measurement: peak end-diastolic velocity

连续波多普勒图像
肺动脉瓣返流,测量:舒张末期最大流速

19.
Pulsed Doppler
RVOT flow, measurement: time to peak flow

脉冲多普勒
右室流出道血流,测量:达到最大血流的时间

20.
Pulsed Doppler
RVOT flow, measurement: time-velocity integral

脉冲多普勒
右室流出道,测量:速度时间积分

D. Parasternal Short Axis, Left Ventricle – 胸骨旁短轴

21.
2D video clip
Short axis of the LV base, centered on the MV; evaluation of wall motion

2D动态图像
左室底部短轴,二尖瓣放中间;评估室壁运动

22.
CD video clip
MVF; locate EROA of regurgitation

彩色多普勒动态图像
二尖瓣血流;找到有效返流口

23.
2D video clip 2D
Short axis of the LV, papillary level; evaluation of wall motion

动态图像
左室短轴,乳头肌水平;评估室壁运动

24.
2D video clip
Short axis of the LV, apical level; evaluation of wall motion

2D动态图像
左室短轴,心尖水平;评估室壁运动

E. Apical views – 心尖图

25.
2D video clip
Short axis of the LV base, centered on the MV; evaluation of wall motion

2D动态图像
左室底部短轴,二尖瓣放中间;评估室壁运动

26.
2D still frame
4-chamber view, centered on the LA, measurement: LA planimetry for biplane volume

2D图像
4腔图,左房放中间,测量:双平面侧面法测左房容积

27.
2D video clip
2-chamber view, centered on the LA

2D动态图像
2腔图,左房放中间

28.
2D still frame
2-chamber view, optimized for the LA, measurement: LA planimetry for biplane volume

2D图像
2腔图,优化左房图像,测量:双平面侧面法测左房容积

29.
2D video clip
3-chamber view, optimized for the LA

2D动态图像
3腔图,优化左房图像

30.
CD video clip
3-chamber view, AVF and MVF; locate and maximise regurgitant jet location / direction

彩色多普勒动态图像
3腔图,主动脉瓣血流和二尖瓣血流;放大图像,找到返流的射流位置/方向

31.
CD video clip
4-chamber view, MVF; locate and maximise regurgitant jet location / direction

彩色多普勒动态图像
4腔图,二尖瓣血流;放大图像,找到返流的射流位置/方向

32.
Pulsed Doppler still frame
MVF trace, measurement: Ep, Ap, Edec.

脉冲多普勒图像
描绘二尖瓣血流,测量:E峰,A峰,E波减速时间

33.
TDI still frame
MV lateral annulus tracing, measurement: peak e’

组织多普勒图像
追踪二尖瓣侧面瓣环,测量:e’峰

34.
TDI still frame
MV septal annulus tracing, measurement: peak e’

组织多普勒图像
追踪二尖瓣底部瓣环,测量:e’峰

35.
2D video clip
5-chamber view, AV

2D动态图像
腔图,主动脉瓣

36.
CD video clip
5-chamber view, AVF; locate and maximise regurgitant jet location / direction

彩色多普勒动态图像
5腔图,主动脉瓣血流;放大图像,找到返流的射流位置/方向

37.
Pulsed Doppler still frame
LVOT flow; measurement: LVOT flow time-velocity integral

脉冲多普勒图像
左室流出道血流;测量:左室流出道速度时间积分

38.
Continuous wave Doppler
AVF; measurement: time-velocity integral

连续波多普勒
主动脉瓣血流;测量:速度时间积分

39.
2D video clip
4-chamber view optimized for the LV (maximum long axis); evaluation of wall motion

2D动态图像
左室优化的4腔图(长轴最大化);评估室壁运动

40.
2D still frame
4-chamber view optimized for the LV (maximum long axis); measurements: LV area planimetry to calculate LV biplane volumes; evaluation of wall motion

2D图像
左室优化的4腔图(长轴最大化);测量:量左室面积来计算左室双平面容积;评估室壁运动

41.
2D video clip
2-chamber view optimized for the LV (maximum long axis); evaluation of wall motion

2D动态图像
左室优化的2腔图(长轴最大化);评估室壁运动

42.
2D still frame
2-chamber view optimized for the LV (maximum long axis); measurements: LV area planimetry to calculate LV biplane volumes; evaluation of wall motion

2D图像
左室优化的2腔图(长轴最大化)测量:量左室面积来计算左室双平面容积;评估室壁运动

43.
2D video clip
3-chamber view optimized for the LV; (maximum long axis) evaluation of wall motion

2D动态图像
左室优化的3腔图(长轴最大化);评估室壁运动

44.
2D video clip
4-chamber view optimized for the RV (maximum long axis); evaluation of wall motion

2D动态图像
右室优化的4腔图(长轴最大化);评估室壁运动

45.
CD video clip
4-chamber view optimized for the TVF (regurgitation); locate and maximise regurgitant jet location / direction

彩色多普勒动态图像4-
三尖瓣血流(返流)优化的4腔图;放大图像,找到返流的射流位置/方向

46.
Continuous wave Doppler still frame
TVF regurgitation; measurement: peak velocity

连续波多普勒图像
三尖瓣返流; 测量:最大流速

47.
M-mode still frame
TAPSE

M模图像
三尖瓣环收缩期位移

F. Subcostal views – 腱突下

48.
2D video clip
4-chamber view; evaluate RV (optimize chamber area) and LV dimensions and wall motion

2D动态图像
4腔图,评估右室(优化右室区域),评估左室尺寸和室壁运动

49.
CD video clip
4-chamber view centerd on the IA septum; evaluate septal integrity

彩色多普勒动态图像
4腔图,房间隔放中间;评估间隔完整性

50.
2D video clip
Optimise view for the IVC; evaluate inspiratory collape

2D动态图像
下腔静脉优化图像; 评估呼吸塌陷

G. Suprasternal views – 胸骨上窝

51.
2D video clip
Optimise view for aortic arch

2D动态图像
主动脉弓优化图

52.
CD video clip
Aortic arch flow

彩色多普勒动态图像
主动脉弓血流

53.
2D still frame
Aortic arch; measure: diameter

2D图像
主动脉弓;测量:直径