Echocardiogram Echocardiograms Echocardiographic Techniques 3 — Questions and Answers
Question 1: Tissue Doppler imaging (TDI) measures:
- Blood flow velocity within cardiac chambers
- Myocardial wall motion velocities (Correct answer)
- Aortic root dimensions in real time
- Intracardiac pressure gradients directly
Correct answer: Myocardial wall motion velocities
TDI uses low-velocity, high-amplitude Doppler signals from myocardial tissue rather than blood to assess wall motion.
Question 2: Which parameter is calculated using the continuity equation in echocardiography?
- Left atrial volume
- Aortic valve area (Correct answer)
- Left ventricular mass
- E/A ratio
Correct answer: Aortic valve area
The continuity equation (AVA = LVOT area × LVOT VTI / AV VTI) is the standard method for calculating aortic valve area.
Question 3: To optimize a parasternal long-axis view, the sonographer should rotate the transducer marker toward the:
- Patient's right hip
- Patient's right shoulder (Correct answer)
- Patient's left shoulder
- Patient's left hip
Correct answer: Patient's right shoulder
In the parasternal long-axis view, the transducer marker is oriented toward the right shoulder (approximately 10 o'clock position).
Question 4: Speckle tracking echocardiography (STE) is used primarily to assess:
- Valve leaflet calcification density
- Myocardial deformation (strain and strain rate) (Correct answer)
- Pulmonary artery systolic pressure
- Intracardiac shunt location
Correct answer: Myocardial deformation (strain and strain rate)
STE tracks natural acoustic markers (speckles) frame-to-frame to quantify myocardial strain, providing angle-independent deformation analysis.
Question 5: Increasing the depth setting on an echocardiographic system will:
- Improve lateral resolution near the transducer
- Decrease the frame rate (Correct answer)
- Increase the pulse repetition frequency
- Improve temporal resolution
Correct answer: Decrease the frame rate
Greater depth requires longer time for ultrasound pulses to travel and return, reducing the number of frames per second.
Question 6: The proximal isovelocity surface area (PISA) method is used to quantify:
- Left ventricular end-diastolic volume
- Regurgitant orifice area and flow rate of valvular regurgitation (Correct answer)
- Myocardial perfusion defects
- Pulmonary venous flow reversal
Correct answer: Regurgitant orifice area and flow rate of valvular regurgitation
PISA calculates the effective regurgitant orifice area by measuring the radius of the flow convergence hemisphere on the upstream side of the regurgitant orifice.
Question 7: Which imaging plane is best for evaluating right ventricular size and function?
- Parasternal long-axis view
- Apical four-chamber view (Correct answer)
- Subcostal short-axis view
- Suprasternal notch view
Correct answer: Apical four-chamber view
The apical four-chamber view displays both ventricles side-by-side, allowing direct comparison of RV to LV size and assessment of RV free wall motion.
Echocardiogram Echocardiograms Echocardiographic Techniques 3
Tissue Doppler imaging (TDI) measures: