This document summarizes diagnostic radiology techniques for imaging the cardiovascular system. It describes normal appearances and abnormalities seen on x-rays, CT, MRI, echocardiography and nuclear medicine imaging. Key sections outline normal cardiac anatomy and sizes seen on x-ray, as well as abnormalities such as heart enlargement, pulmonary blood flow changes, aortic abnormalities like aneurysms and dissections. Imaging methods for evaluating these conditions are also mentioned.

1. Diagnostic Radiology of Cardiovascular System Chen, Shaoqiong Acknowledgement : most of the slices are refer to the ppt provided by Dr. Biling Liang is gratefully acknowledged.

2. Diagnostic Radiology of Cardiovascular System /231 Imaging methods normal appearances abnormities diseases methods normal abnormities diseases

3. Cadiovascular Anatomy

4. heart

6. 多层螺旋心脏大血管 CTA （三维重建图）

8. X-ray---- PA view ----high KV, 2M /231 X-ray methods normal abnormities diseases

14. PA view /231 Left atrium PV PA methods normal abnormities diseases

19. Size of the heart and great vessels /231 a b C/T ratio = a+b / T = ≤ 0.5 T methods normal abnormities diseases

22. normal heart shadow /231 ＝ 45 ° oblique heart horizontal heart dropping heart ＝ 38° ＝ 52° methods normal abnormities diseases

27. Basic X-ray features Heart dislocation /231 dextrocardia methods normal abnormities diseases

28. /231 mirror image dextrocardias Basic X-ray features Heart dislocation methods normal abnormities diseases

32. Left ventricular enlargement /231 methods normal abnormities diseases

33. If we draw a tangent line from the apex of the left ventricle to the aortic knob (red line) and measure along a perpendicular to that tangent line (yellow line) The distance between the tangent and the main pulmonary artery (between two small green arrows) falls in a range between 0 mm (touching the tangent line) to as much as 15 mm away from the tangent line

34. 0 mm Main Pulmonary Artery Ao 15 mm Main Pulmonary Artery Ao LV LV Main pulmonary artery ranges from 0 mm–15mm from tangent line

36. Right ventricular enlargement /231 methods normal abnormities diseases

38. Left atrium enlargement /231 methods normal abnormities diseases

40. Right atrium enlargement /231 methods normal abnormities diseases

42. general cardiac enlargement -- Pericardial effusion /231 methods normal abnormities diseases

47. Venous Hypertension RDPA usually > 17 mm Upper lobe vessels equal to or larger than size of lower lobe vessels = Cephalization

48. Rapid cutoff in size of peripheral vessels relative to size of central vessels Central vessels appear too large for size of peripheral vessels which come from them = Pruning Pulmonary Arterial Hypertension 31

49. Increased Flow RDPA usually > 17 mm All of blood vessels everywhere in lung are bigger than normal

50. Increased Flow Normal

51. Increased Flow Distribution of flow is maintained as in normal Lower lobe vessels bigger than upper lobe Gradual tapering from central to peripheral

52. PAH Increased Flow

53. Unrecognizable most of the time Small hila Fewer than normal blood vessels Decreased Flow

56. Aorta distortion and elongation /231 methods normal abnormities diseases

57. Aorta calcification /231 methods normal abnormities diseases

58. Aorta calcification /231 methods normal abnormities diseases

59. Coronary artery calcification /231 methods normal abnormities diseases

63. Dissection of aorta Usually medically Hypertension Atherosclerosis Descending aorta only Stanford Type B DeBakey Type III (most common) Usually surgically* Cystic medial necrosis e.g.Marfan’s Ehlers-Danlos Ascending aorta only Stanford Type A (ascending aorta involved) DeBakey Type II (least common) Usually surgically* Hypertension Atherosclerosis Involves entire aorta Stanford Type A (ascending aorta involved) DeBakey Type I RX Common causes Portion of Aorta Involved Stanford Classification DeBakey Classification

64. Dissection of aorta True lumen methods normal abnormities diseases

65. Dissection of aorta True versus false channel methods normal abnormities diseases

66. Dissection of aorta methods normal abnormities diseases

68. Abdominal aortic aneurysm /231 perianeurysmal fibrosis (10%) methods normal abnormities diseases

69. Aneurysm /231 methods normal abnormities diseases

70. Abdominal aortic aneurysm /231 methods normal abnormities diseases

71. CTA /231 angiocardiography CT MRI echocardiography X-ray methods normal abnormities diseases

72. Aneurysm of aorta （ syphilitic ） /231 methods normal abnormities diseases