CVT Echocardiography Techniques 2 — Questions and Answers
Question 1: Which Doppler modality is best suited for measuring high-velocity jets such as severe aortic stenosis?
- Pulsed-wave Doppler
- Continuous-wave Doppler (Correct answer)
- Color flow Doppler
- Tissue Doppler imaging
Correct answer: Continuous-wave Doppler
Continuous-wave Doppler has no aliasing limit and can accurately measure high-velocity jets exceeding 4 m/s.
Question 2: In M-mode echocardiography, which measurement is used to calculate fractional shortening?
- Left atrial diameter and aortic root diameter
- Left ventricular end-diastolic and end-systolic diameters (Correct answer)
- Right ventricular wall thickness and diameter
- Mitral valve E-point septal separation
Correct answer: Left ventricular end-diastolic and end-systolic diameters
Fractional shortening = (LVEDD − LVESD) / LVEDD × 100%, derived from M-mode LV diameter measurements.
Question 3: The apical four-chamber view is obtained with the transducer placed at the cardiac apex oriented to display which structures simultaneously?
- Both ventricles and both atria (Correct answer)
- Aortic valve and left ventricular outflow tract
- Right ventricle and pulmonary artery
- Inferior vena cava and right atrium
Correct answer: Both ventricles and both atria
The apical four-chamber view displays all four cardiac chambers and both atrioventricular valves in a single plane.
Question 4: Which artifact appears as a bright linear echo parallel to a strong reflector and is caused by reverberation between the transducer and a highly reflective surface?
- Side lobe artifact
- Mirror image artifact
- Comet tail artifact (Correct answer)
- Range ambiguity artifact
Correct answer: Comet tail artifact
Comet tail (ring-down) artifacts are reverberation echoes from metallic or calcified structures appearing as bright linear trails.
Question 5: When performing a subcostal echocardiographic view, which structure is best visualized to assess for pericardial effusion?
- Left ventricular apex
- Posterior pericardium adjacent to the right ventricle (Correct answer)
- Mitral valve leaflets
- Descending thoracic aorta
Correct answer: Posterior pericardium adjacent to the right ventricle
The subcostal view provides an excellent window to assess effusion posterior to the right ventricle and around the cardiac apex.
Question 6: Tissue Doppler imaging (TDI) of the mitral annulus is used primarily to assess which parameter?
- Pulmonary artery systolic pressure
- Myocardial velocities and diastolic function (Correct answer)
- Valvular regurgitation severity
- Left ventricular ejection fraction
Correct answer: Myocardial velocities and diastolic function
TDI measures annular velocities (e', a', s') to evaluate myocardial motion and estimate left ventricular filling pressures.
Question 7: Which formula is used to calculate cardiac output using Doppler echocardiography?
- CO = Heart rate × Left ventricular end-diastolic volume
- CO = LVOT area × LVOT VTI × Heart rate (Correct answer)
- CO = (Mean gradient / 4) × Heart rate
- CO = Stroke volume / Ejection fraction
Correct answer: CO = LVOT area × LVOT VTI × Heart rate
Cardiac output = LVOT cross-sectional area × left ventricular outflow tract velocity-time integral × heart rate.
CVT Echocardiography Techniques 2
Which Doppler modality is best suited for measuring high-velocity jets such as severe aortic stenosis?