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81 terms

Anatomy & Blood Pool Imaging

Focuses on the anatomy and physiology of heart as well as Blood Pool Imaging
STUDY
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myocardial perfusion imaging
used to diagnose and evaluate ischemic heart disease, myocardial infarction, as well as radionuclide to diagnose CAD, valvular or congenital heart disease, and cardiomyopathy.
thallium-201 scan
thallium is injected into blood via IV to identify myocardial blood flow
thallium stress test
thallium injections are given intravenously in conjuction with the stress test to determine if there are changes in coronary blood flow during exercise. Changes may be indicative of ischemia, severe coronary narrowing, or infarction
positron emission tomography (PET)
an invasive imaging technique that provides color-coded images of brain activity by tracking the brain's use of a radioactively tagged compound, such as glucose, oxygen, or a drug
angioplasty
a procedure in which a small balloon is used to open a partially blocked coronary artery by flattening the plaque deposit and stretching the lumen
embolism
occlusion of a blood vessel by an embolus (a loose clot or air bubble or other particle)
nuclear cardiology
diagnostic specialty that uses radiologic procedures to aid in the diagnosis of cardiologic conditions
pericardiocentesis
procedure in which a surgeon withdraws fluid from the pericardial space by means of a needle inserted percutaneously into the space
stent
a stainless steel tube placed within a blood vessel or a duct to widen the lumen
ischemia
Temporary deficiency in blood supply due to either the narrowing or blockage of a blood vessel
reversible ischemia
when a heart artery is clogged and heart muscle performs at low level as result of lack of blood
irreversible ischemia
when heart artery is clogged and heart muscle dies
embolus
a clot that breaks loose and travels through the bloodstream. When it causes sudden closure of a blood vessel, this dangerous event is an embolism.
Epicardium
outermost layer of the heart
Myocardium
middle, thick, muscular layer
Endocardium
Inner layer of the heart
Sinoatrial Node (SA)
pacemaker of heart.. generates impulses, which are passed to the atrioventricular node
Atrioventricular Node (AV)
inferior portion of the interarterial septum and passes the wave of depolarization in to the atrioventricular branches
Purkinje Fibers
extend from branches of A-V bundle, stimulate muscle fibers in the ventricular walls
Systole
ventricular contraction from the heart to drive blood into the aorta and pulmonary artery
Diastole
ventricular relaxation - period in the cardiac cycle when blood enters the relaxed ventricles from the atria
Cardiac Output (CO)
measurement of the amount of blood ejected from either ventricle of the heart per minute
Stroke Volume (SV)
volume of blood pumped out by a ventricle with each beat
SV = EDV - ESV
Left Chamber
systemic circulation-oxygenated blood
Right Chamber
pulmonary circulation-deficient in oxygen
Blood Circulation In Heart
right atrium - right ventricle - out the lungs - left atrium - left ventrible - out the aorta
Pulmonary Arteries
carry deoxygenated blood out of the right ventricle and into the lungs
Left Anterior Descending (LAD)
Septum, anterior wall of Left Ventricle
Left Circumflex (LCx)
Left atrium, posterior, lateral wall of Left Ventricle
Right Coronary Artery (RCA)
Right heart, inferior wall of Left Ventricle
Infarction
localized necrosis resulting from obstruction of the blood supply
AV Bundle
enters interventricular septum, divides into 2 branches, then pass into R & L ventricles
Electrocardiogram (ECG)
a record of the electrical activity of the heart that, if abnormal, may indicate heart disease.
Depolarization
CONTRACTION OF THE HEART
P Wave
Depolarization of atria
QRS Complex
depolarization of ventricles
T Wave
Repolarization of the ventricles
Repolarization
RELAXATION OF THE HEART
Q Wave
first negative deflection; sign of infarction/ischemia
ST Elevation
(also known as ST Inversion)transmural ischemia, pericarditis, ventricular aneurysm - heart attack
ST Depression
subendocardial infarct or myocardial ischemia
Premature Ventricular Contraction (PVC)
a ventricular contraction preceding the normal impulse initiated by the SA node
Bigeminy
Pattern in which every other complex is a premature beat (2 beats = 1 normal / 1 abnormal)
Trigeminy
pattern in which every 3rd complex is a premature beat (3 beats = 2 normal / 1 abnormal)
Ventricular Tachycardia (V-Tech)
occurs when three or more successive PVCs occur. usually 140-240 bpm; , Abnormal rapid rhythm in ventricles
Atrial Fibrillation
cardiac arrhythmia characterized by chaotic, rapid electrical impulses in the atria; also can cause problems when gating
Bundle Branch Blocks
a condition that interferes with the heart's normal electrical activity.
LBBB
left bundle branch block; can alter stress perfusion images creating a false positive
RBBB
right bundle branch block; a defect in the heart's electrical conduction system.
Left ventricle contracts then right ventricle
Coronary Artery Disease
atherosclerosis of the coronary arteries that reduces the blood supply to the heart muscle due to plaque buildup on the walls
Angina
Chest pain
Coronary Artery Bypass Graph (CABG)
surgery that creates a bypass around a blocked segment of a coronary artery
PTCA
(percutaneous transluminal coronary angioplasty) , dilation of an occluded vessel using a balloon catheter
MUGA Scan
measures a decrease in the ejection fraction. Is the most accurate noninvasive test that measures the left ventricle's ejection fraction during rest and activity
Blood Pool Imaging
also known as MUGA, GBP, RNA; mainly for patients who undergo chemotherapy; views their EF and wall motion; 16-64 frames per R-R Interval; Ranges of images of heartbeart are 16,20,24,32
Cardiotoxicity
toxicity to the heart
Sestamibi (Cardiolite)
A radioactive tracer compound used to define areas of poor blood flow in heart muscle.
Thallium
a pharmaceutical that helps visualize the condition of the myocardium during a stress test
Ultra Tagged RBC Kit
In Vitro method; 10usp of Heparin within a 5ml syringe; take 3-4ml of patients blood within the same syringe as the heparin; inject blood mixture into vial and sit for 5 minutes; inject syringe 1 and syringe 2, inverting up to 5 times each insertion; insert Tc-99m sodium pertechnetate (around 40mCi) and invert up to 5 times - let sit for 20 minutes; inject after 20 minute timeframe and wait 30 minutes before scanning
In Vitro
"outside the body" - Procedures involving analysis of blood and urine specimens using radioactive chemicals.
In Vivo
"in the body" - traces amounts of radioactive substances within the body. Given directly to the patient to evaluate the function of an organ or to image it
Albumin
Protein in blood; maintains the proper amount of water in the blood
PYP
Tc99m Pyrophosphate; inhibitor of calcification that occrus in parotid saliva of humans in variable amounts
ACD (Acid Citrate Dextrose)
an anti-coagulant for Heparin Allergy
R Wave
The first positive deflection of the QRS Complex after the P wave, denotes continued ventricular depolarization.
Gate
triggers R Wave of ECG/EKG
R-R Interval
duration of ventricular cardiac cycle (an indicator of ventricular rate) / (60 /HR)
Cine Mode
Movie frame containing 16 frames
Beat Rejection of Blood Pool Imaging
Percent window: 20% for beat rejection and arrythmias
Short Beat
a type of beat rejection; occurs outside the normal heart beat frames (24) and causes R-Wave to restart - no images for the last set depending on when short wave occur
Long Beat
a type of beat rejection; occurs outside a predetermined range and data is lost due to elongated time of heart beat / past recommended amount of frames
LAO for EF Calculation
best septal separation; 45 and 135
Views for Blood Pool Imaging
Besides LAO, Anterior (LT Vent), Left Lateral, LPO, RAO
Caudal Tilt
5-10 degree tilt to help separate the Left Artery from the Left Ventricle
End-Diastolic Counts
The number of counts received from the left ventricle at the end of diastole, just before systole (contraction)
End-Systolic Counts
The number of counts received from the left ventricles just after ventricular systole (heart contraction).
Ejection Fraction (EF)
measurement of the volume percentage of left ventricular contents ejected with each contraction; Normal LVEF is 50% or above / Formula: EF=(EDC-ESC)/EDC x 100%
Region Of Interest (ROI) Creation
automatic or manual; can cause RV/LV overlap which is not good for septal separation; poor labeling; background which will have to be subtracted to receive accurate counts
Regional Ejection Fraction
right side of the heart containing lateral wall of the free wall which has a higher EF because of the exterior wall
First Pass Imaging
a flow study of the heart to watch the radioactive tracer go through the heart in one flow at one time which is like a MUGA but cannot use Tc-MAA since it will just stay in the lungs / preferable for RVEF instead of MUGA Scan
Ablation
removal of a part, pathway, or function by surgery, chemical destruction, electrocautery, freezing, or radiofrequency (RF)