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Principles and Practice of Echocardiography
Arthur G. Weyman
Principles and Practice of Echocardiography Retail Price: $255.00
Cardiotext Price: $249.90

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Product Information:
ISBN-13: 9780812112078
ISBN-10: 0812112075
Publisher: Lippincott Williams & Wilkins
Format: Hardcover, 1335 pages
Pub Date: 01/1994
Edition Number: 2



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Synopsis

Harvard University, Cambridge, Massachusetts. New edition of a comprehensive text for cardiologists and residents on the principles and clinical applications of imaging and Doppler echocardiography. Previous edition entitled Cross-Sectional Echocardiography, 1982. 29 contributors, 23 U.S.

Formerly titled Cross-Sectional Echocardiography, the Second Edition of Dr. Weyman's pioneering text is almost twice the size of the original. This edition includes both pulsed and continuous wave Doppler, color flow mapping, and M-mode echocardiography, in addition to superb, updated coverage of cross-sectional echocardiography.



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Additional Description

TABLE OF CONTENTS
Part 1 PHYSICAL PRINCIPLES, INSTRUMENTATION, AND ROUTINE
EXAMINATION
1. Physical Principles of Ultrasound 3
Properties of Sound 4
Properties of Ultrasound 6
The Transducer 13
The Echograph 17
Biologic Effects ot Ultrasound 23
References 27
2. Cross-Sectional Scanning: Technical Principles and Instrumentation 29
History ot Cross-Sectional Imaging 29
Dynamic Cross-Sectional Imaging Systems 34
Array Transducers 41
Annular Phased Arrays 42
Two-Dimensional Arrays 44
Principles of Dynamic Cardiac Imaging Common to All Systems 45
Factors Affecting the Cross-Sectional Display Characteristics of a Point
Target 53
References 54
3. Digital Image Processing 56
Digital Signal Processing 56
Introduction to Computer Technology 58
Current Echocardiographic Digital Processing 59
Image Processing 61
References 73
4. Cross-Sectional Echocardiographic Examination 75
Preliminary Steps 76
Examination Sequence 80
References 96
5. Standard Plane Positions-Standard Imaging Planes 98
Parasternal Long Axis Planes 99
Parasternal Short Axis Planes 106
Apical Views 111
Subcostal Examination 117
Suprasternal Views 120
Summary 122
References 123
6. Three-Dimensional Reconstruction of Echocardiographic Images 124
Basic Concepts 124
Methods for Acquiring Two-Dimensional Image Data 126
Methods for Locating Image t)ata in Three-Dimensional Space 126
Methods for Temporal Alignment of Images to the Cardiac Cycle 131
Alignment of Imaging Data, Positional Data, and ECG Data 131
Processing, integration, and Storage of Imaging Data 132
Methods for Displaying the Reconstructed Data 135
Methods for Quantifying Three-Dimensional Relationships 138
Fundamental Limitations of Three-Dimensional Reconstruction 139
Applications of Three-Dimensional Echocardiographic Reconstruction 139
Future Directions in Technology 141
Summary 42
References 142
7. Principles of Doppler Flow Measurement 143
History-Christian Johann Doppler 143
Frequency Description and Analysis 145
Representation of Waveforms of Varying Frequency and Amplitude 147
Combinations of Waveforms 151
Methods for Determining the Frequency of Unknown and Complex Sinusoidal
Waveforms 152
Application of Sampling Theory to Doppler Signal Analysis 154
Filters 154
The Doppler Effect 155
Limitations in the Direct Application of the Doppler Equation to Clinical Velocity
Measurement 159
References 162
8. Doppler Instrumentation 163
Doppler Pulse Transmission Attenuation, and Scattering: General Concepts and
Comparison with Imaging Echocardiography 163
Summary of Factors Affecting Doppler Sensitivity: Signal/Noise Ratio and
Dynamic Range 166
General Approaches to Signal Detection and Extraction 168
Specific Types of Doppler Instruments 175
Summary 183
References 183
9. Principles of Flow 184
Structure of Blood and Its Relation to Ultrasonic Scattering 184
Blood Flow 186
Hydraulic Energies 192
Pulsatile Flow 197
Vessel Diameter 197
Velocity Profile 198
Nonuniform Suspension of Cells 199
References 199
10. Doppler Signal Processing 201
Signal Processing 201
Relationship of the Zero-Crossing Definition of Frequency to the Fourier
Definition of Frequency 207
Methods of Extracting Specific Components of the Doppler Frequency
Spectrum 212
Combination of Doppler Flow Meters with Pulsed Echo Imaging Systems 215
References 216
11. Principles of Color Flow Mapping 218
General Overview and System Design 218
The Color Flow Mapper 219
Interrelationship of Velocity Resolution Depth of Field, Line Density, and Frame
Rate 230
Color Doppler Spatial Temporal and Velocity Resolution 231
Summary 232
References 233
12. Fluid Dynamics of Regurgitant Jets and Their Imaging by Color Doppler 234
Definitions 234
Mathematic Description of Jets and Their Color Flow Appearance 236
Current and Future Approaches to Color Jet Quantification 245
Summary 248
References 255
13. The Routine Doppler Examination 256
Instrument Controls 257
Choice of Echocardiographic Windows for Doppler Studies 259
Use of the Flow Signals as the Primary Method for Directing the Doppler
Beam 260
The Routine Examination 260
Doppler Examination-Apical Window 261
Doppler Examination-Parasternal Window 269
Doppler Examination-Suprasternal Window 270
Using Color Flow Mapping for Routine Data Acquisition 272
Commonly Encountered Artifacts in Pulsed and Continuous Wave Doppler 272
Display Phenomena and Artifacts Unique to Color Flow Mapping 278
References 281
14. M-Mode Echocardiography: Principles and Examination Techniques 282
History 282
Technical Aspects 286
Motion Patterns and Measurements of Major Structures by M-Mode 288
Norma M-Mode Echocardiographic Measurements 293
Examples of Current Applications of M-Mode Echocardiography 295
Limitations of the M-Mode Technique 298
Summary 299
References 300
15. Miscellaneous Echocardiographic Techniques I: Contrast Echocardiography 302
History 302
source of Echo-Contrast 303
Microbubbles as Echo-Contrast Agents 303
Microbubble Clearance, Coalescence, and Dissolution 304
Spontaneous Bubble Formation and Growth in Supersaturated Solutions 305
Source of Microbubbles in Injected Solutions 305
Factors Affecting Microbubble Survival 305
Relationship of Bubble Size to Resonant Frequency 306
Contrast Solutions 306
Injection Technique 308
Left-Sided Contrast Following Right-Sided Injection 308
Examination Technique 308
Effects of Injected Contrast on image Resolution 309
Analysis of Contrast Echograms 310
Clinical and Research Applications 314
Unique Applications of Contrast Echocardiography 319
Limitations 322
Potential Complications 322
Current Role Relative to Doppler 323
Spontaneous Contrast 324
Incidental Contrast 324
References 325
16. Miscellaneous Echocardiographic Techniques II: Transesophageal
Echocardiography, Epicardial Echocardiography, Intraoperative
Echocardiography, Catheter-Based (Intravascular and Intracardiac)
Echocardiography, and Sonomicrometry 327
Transesophageal Echocardiography 327
Epicardial Echocardiography 359
Intraoperative Echocardiography 361
Catheter-Based Imaging and Flow Recording: Intravascular and Intracardiac
Imaging and Flow Velocity Recordings 366
Sonomicrometry 384
References 385
Part 2 CLINICAL APPLICATIONS
17. Left Ventricular Inflow Tract I: The Mitral Valve 391
The Normal Valve 391
The Abnormal Mitral Valve Echogram 402
Structural Abnormalities of Leaflets or Supporting Structures 461
References 465
18. Left Ventricular Inflow Tract II: The Left Atrium, Pulmonary Veins, and
Coronary Sinus 471
Left Atrium 471
Pulmonary Veins 486
Coronary Sinus 491
References 496
19. Left Ventricular Outflow Tract: The Aortic Valve, Aorta, and Subvalvular
Outflow Tract 498
The Aortic Valve 499
The Abnormal Aortic Valve Echogram 505
The Aorta 543
The Subvalvular Left Ventricular Outflow Tract 564
References 569
20. Left Ventricle I: General Considerations, Assessment of Chamber Size and
Function 575
General Principles of Echocardiographic Imaging Pertinent to the Left Ventricular
Examination 576
Left Ventricular Volume 584
Left Ventricular Mass 584
Dynamic or Ejection Phase Indices of Left Ventricular Performance 605
Left Ventricular Response to Exercise 611
Valvular Diseases and the Left Ventricle 612
The Left Ventricle in Hypertension 617
References 620
21. Left Ventricle II: Quantification of Segmental Dysfunction 625
Technique and Image Characteristics 626
Assessment of the Extent and Severity of Abnormal Wall Motion Within a Single
Plane: Methods and Critique 628
Methods of Aligning Regional Wall Motion Data With Other Functional and
Morphologic Parameters 644
Method of Assessing Ventricular Size and Geometry in a Single Plane 645
Assessment of Global Function: Methods and Critique 645
References 654
22. Left Ventricle III: Coronary Artery Disease-Clinical Manifestations and
Complications 656
Acute Myocardial Infarction 656
Chronic Ischemic Heart Disease 670
Stress Echocardiography 677
References 681
23. Left Ventricle IV: Assessment of Myocardial Perfusion with Contrast Two-
Dimensional Echocardiography 687
Principles of Myocardial Contrast Echocardiography 687
Contrast Agents 688
Assessment of the Perfusion Territory of a Coronary Artery 690
Quantification of Regional Myocardial Blood Flow 702
Summary 718
References 718
24. Left Ventricle V: Diastolic Function-Its Principles and Evaluation 721
Definition of Diastole 722
Hemodynamic Phases During Diastole 722
Properties of the Left Ventricle During Diastole 723
The Noninvasive Evaluation of Diastolic Function 730
Echocardiographic Measurements of the Filling Characteristics of the Left
Ventricle 736
The Doppler Transmitral Flow Velocity Profile 745
Measurements of Left Ventricular Filling in Pathologic States by Doppler
Echocardiography 765
Summary 775
References 776
25. Echocardiographic Assessment of the Cardiomyopathies 781
Hypertrophic Cardiomyopathy 781
Dilated or Congestive Cardiomyopathies 804
Restrictive and Infiltrative Cardiomyopathies 808
References 817
26. Right Ventricular Inflow Tract 824
The Tricuspid Valve 824
The Abnormal Tricuspid Valve Echogram 829
The Right Atrium 846
The Vena Cavae 852
References 859
27. Right Ventricular Outflow Tract 863
The Pulmonary Valve 865
The Subvalvular Right Ventricular Outflow Tract: The Conus Arteriosus or
Infundibulum 885
The Pulmonary Artery 887
Patent Ductus Arteriosus 894
References 898
28. Right Ventricle 901
Right Ventricular Examining Planes and Linear Dimensions 902
Right Ventricular Volume Measurements 903
Right Ventricular Volume Overload 913
Right Ventricular Hypertrophy 914
Chronic Right Ventricular Pressure Overload 915
Acute Right Ventricular Pressure Overload 915
Right Ventricular Infarction 915
Right Ventricular Dysplasia 918
Right Ventricular Masses 919
Right Ventricular Biopsy 919
References 919
29. Interatrial and Interventricular Septa 922
The Interatrial Septum 922
The Interventricular Septum 934
References 952
30. Doppler Estimation of Volumetric Flow 955
Theoretic Considerations 956
Doppler-Echocardiographic Calculation of Volumetric Flow 956
Clinical and Experimental Validation 961
Approaches to Measuring Volumetric Flow at Individual Intracardiac Sites 962
Validation During Hemodynamic Interventions 967
Clinical Applications 968
Conclusions 975
References 976
31. Complex Congenital Heart Disease I: A Diagnostic Approach 979
Variations in Cardiac Position and Situs 979
The Initial Approach to the Heart 981
Atrial Situs and Visceroatrial Relations 982
Ventricular Number. Size. Orientation, and Identity 983
Atrioventricular Connections 988
Great Vessel Orientation and Identity 988
Ventricular-Great Vessel Relationships 991
Presence and Location of Intracardiac Shunts 993
Location and Presence of Outflow Obstruction 996
Estimation of Absolute Intracardiac Pressures 998
Unusual Atrioventricular and Ventriculoarterial Relationships 999
References 1000
32. Complex Congenital Heart Disease II: A Pathologic Approach 1002
Ventricular Abnormalities 1002
Abnormalities of Atrioventricular Valves 1018
Disorders of the Great Vessels 1025
Abnormalities of Venous Return: Total Anomalous Pulmonary Venous
Drainage 1048
References 1051
33. Fetal Echocardiography 1057
Background 1057
Echocardiographic Examination of the Human Fetus 1061
Echocardiographic Measurement of Chamber Size in the Normal Developing
Fetus 1065
Methods of Assessing Fetal Cardiac Performance 1066
Cardiac Morphologic and Functional Abnormalities Detectable in the
Fetus 1068
Fetal Arrhythmias 1073
Risks Associated with Fetal Echocardiography 1074
Relationships between in Utero Detection of Cardiac Defects and
Prognosis 1074
References 1075
34. Coronary Arteries 1076
Coronary Anatomy 1076
Examining Planes 1077
Normal Echocardiographic Anatomy 1080
Blood Flow Measurement by Pulsed Doppler Echocardiography 1082
Coronary Artery Stenosis 1083
Coronary Artery Aneurysms 1086
Anomalous Origin from the Pulmonary Artery 1089
Anomalous Origin from the Aorta 1092
Coronary Artery Fistulas 1095
Differential Diagnosis of Dilated Coronary Arteries 1097
High Frequency Epicardial Echocardiography (HFEE) 1098
Transesophageal Imaging 1099
Intra-arterial Echocardiographic Assessment of Coronary Artery Lumen 1100
References 1100
35. Pericardial Disease 1102
Anatomic Considerations 1102
Normal Pericardial Physiology 1102
Echocardiographic Examination of the Pericardium 1103
Morphologic Features of Pericardial Disease 1104
Cardiac Tamponade 1116
Constrictive Pericarditis 1128
Effusive-Constrictive Pericarditis 1131
Miscellaneous Disorders of the Pericardium 1131
Echocardiographic Guidance of Pericardiocentesis 1132
References 1133
36. Cardiac Tumors and Masses 1135
Primary Cardiac Tumors 1135
Secondary Tumors of the Heart and Pericardium 1156
Extracardiac Tumors 1161
Intracardiac Thrombi 1162
Vegetations 1168
Normal Variants Simulating Intracardiac Masses 1169
Man-made Objects in the Heart 1172
References 1173
37. Echocardiographic Findings in Infective Endocarditis 1178
Clinical Characteristics of Valvular Vegetations 1178
Echocardiographic Characteristics of Valvular Vegetations 1179
Prosthetic Valve Vegetations 1183
Sensitivity and Specificity of Echocardiographic Findings in the Diagnosis of
Vegetative Endocarditis 1184
Differentiation of Active from Healed Vegetations 1186
Valvular and Extravalvular Complications of Endocarditis 1186
Infected Prosthetic Materials 1192
Clinical Implications of Vegetations Detected by Echocardiography 1193
Role of Echocardiography in Culture-Negative Endocarditis 1195
References 1195
38. Echo-Doppler Assessment of Prosthetic Heart Valves 1198
Summary of Valve Types 1198
Echocardiographic Examination of Prosthetic Valves-general Principles 1207
Prosthetic Valve Examination-Assessment by Location 1214
Specific Prosthetic Valve Abnormalities 1222
References 1229
39. Echocardiography in Cardiac Transplantation 1231
Evaluation of Potential Donors 1231
Evaluation of the Potential Recipient 1232
Assessment of the Cardiac Transplant Recipient 1232
Noninvasive Indicators of Transplant Rejection 1236
References 1238
40. The Echocardiogram in Disorders ot Cardiac Rhythm and Conduction 1240
Effect of Disorders of Rate, Rhythm, and Conduction on the
Echocardiogram 1240
Clinical Applications of Echocardiography in Patients with Disturbances of
Rhythm and Conduction 1259
References 1262
41. Tissue Characterization 1264
General Methods of Waveform Analysis 1264
Tissue Characterization by Parameter Estimation 1266
Tissue Classification 1277
References 1285
Appendix A: Normal Cross-sectional Echocardiographic Measurements 1289
Appendix B: Application of Fourier Analysis in Echocardiography 1299
Index 1307

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