Ultrasound Basics
What does the term “anechoic” mean in ultrasound?
Black / no echoes (ex., fluid, blood)
What does 2D imaging primarily show?
Real-time anatomy (chambers, valves, walls, effusions)
True or False: M-mode can measure ejection fraction.
F
Normal LVIDd range for men?
4.2–5.9 cm
Which disease causes thickened IVS and LVPW?
Left ventricular hypertrophy
Which mode displays brightness levels of returning echoes as dots?
B-mode (2D grayscale imaging).
If you widen the sector, what happens to the frame rate?
Frame rate decreases.
You measure this RV parameter at TV annulus
TAPSE
What structure do we measure at end-expiration?
IVC diameter
Large anechoic space around the heart suggests…?
Pericardial effusion
What two 2D measurements are used to calculate LV mass?
IVSd + LVPWd + LVIDd
Name one view where we measure LVIDd and LVIDs.
Parasternal long axis (PLAX).
Which M-mode measurement increases when the LV is weak?
EPSS (E-Point Septal Separation)
When measuring LVIDs for EF calculation using Simpson’s biplane method, what two structures must be excluded from your tracing to avoid overestimating LV volume?
Papillary muscles and trabeculations
Dilated LV + reduced EF suggests…?
Dilated cardiomyopathy
Name two common 2D artifacts sonographers must recognize.
Reverberation, acoustic shadowing, mirror artifact, side-lobes, beam-width artifact. (Any 2)
What does the E-F slope on M-mode assess?
Mitral valve early diastolic motion / diastolic function.
In M-mode, a severely reduced aortic valve opening suggests what pathology?
Aortic stenosis or severely reduced stroke volume
If a patient’s IVSd and LVPWd are both increased, what additional calculated measurement helps determine whether the patient has concentric remodeling versus concentric hypertrophy?
Relative Wall Thickness (RWT)
Narrow, restricted valve opening suggests…?
Aortic stenosis
Which chamber measurement is most commonly indexed to body surface area?
LA Volume Index (LAVi)
What happens to EPSS in dilated cardiomyopathy?
It increases (large separation).
TAPSE is measured at ≤ 12 mm on M-mode.
What does this indicate?
Severely reduced right ventricular systolic function
Why must the LVOT diameter be measured specifically in mid-systole, and how would measuring it at another phase affect stroke volume and AV calculations?
Because the LVOT is largest in mid-systole.
Measuring it earlier or later gives a smaller diameter, leading to:
Underestimated stroke volume
Underestimated aortic valve area
False impression of severe stenosis
Right ventricular dilation + low TAPSE suggests…?
RV systolic dysfunction.