Clase de Radiología

1. Cardiopatías Congénitas

7. The Pulmonary Vasculature

10. What to Evaluate 1 3 2 2

11. Right Descending Pulmonary Artery Serves right middle and lower lobes 1. Right Descending Pulmonary Artery

12. Diameter can be measured (before bifurcation) RDPA < 17 mm 1. Right Descending Pulmonary Artery

13. 2. Normal Distribution of Flow Upper Versus Lower Lobes In erect position, blood flow to bases > than flow to apices Size of vessels at bases is normally > than size of vessels at apex

14. Normal tapering of vessels from central to peripheral Central vessels give rise to progressively smaller peripheral branches 3. Normal Distribution of Flow Central versus peripheral

15. Normal Vasculature RDPA < 17 mm in diameter Lower lobe vessels larger than upper lobe vessels Gradual tapering of vessels from central to peripheral 1 3 2 2

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

17. Pulmonary Arterial Hypertension RDPA usually > 17 mm Main Pulmonary Artery projects beyond tangent line 23 Start Here

18. Increased pressure Increased flow Main pulmonary artery projects beyond tangent

19. 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

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

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

22. Increased Flow Normal

23. PAH Increased Flow

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

25. CRECIMIENTO DE CAMARAS

26. Ascending Aorta “ Double density” of LA enlargement Right atrium Left ventricle Indentation for LA Main pulmonary artery Aortic knob The Cardiac Contours

28. Right atrium–not important contour in adults

29. Left atrium sits in middle of heart posteriorly Left atrium forms no border of normal heart in PA view LA RA LV

30. “ Double Density” of left atrial enlargement

31. RA LA

32. Main Pulmonary Artery Left Atrial Appendage

33. Straight or convex at site of normal concavity “ Double density” at site of normal indentation

34. Left Ventricle

35. Si el corazon esta agrandado y la arteria pulmonar principal esta prominente >50% Que ventriculo esta crecido? El ventriculo derecho esta crecido

36. Si el corazon esta agrandado y la aorta es prominente >50% Que ventriculo esta crecido? El ventriculo izquierdo esta crecido

38. 27 Small pulmonary artery Truncus arteriosus Tetralogy of Fallot Main pulmonary artery is more than 15 mm from tangent

39. Disminucion del Flujo