Scribd
Upload
4 views

Segment Analysis

Uploaded by

Rajan Raj
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
4 views

Segment Analysis

Uploaded by

Rajan Raj
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
You are on page 1/ 14

SEGMENT ANALYSIS

LEFT VENTRICULAR SEGMENTATION

• The muscle and cavity of the left ventricle can be divided into a
variable number of segments.

• Based on autopsy data the AHA recommends a division into 17


segments for the regional analysis of left ventricular function or
myocardial perfusion
VIEWS
• PARASTERNAL
LONG AXIS
SHORT AXIS
• APICAL VIEWS
• SUBCOSTAL VIEW
• SUPRASTERNAL VIEW
PARASTERNAL SHORT AXIS VIEW
FOR REGIONAL ANALYSIS OF LEFT VENTRICULAR FUNCTION AND
MYOCARDIAL PERFUSION, THE LEFT VENTRICLE SHOULD BE DIVIDED
INTO EQUAL THIRDS PERPENDICULAR TO LONG AXIS OF THE HEART.
This will generate 3 circular
basal cavity
Mid cavity
Apical region
BASAL LEVEL
• In echo, the basal should be acquired and displayed from the area extending
the mitral annulus to tip of the papillary muscle at the end diastole.
• Basal part is divided into 6 segments 60* each.
• The segment nomenclature along the circumference is,
basal anterior
basal anteroseptal
basal inferoseptal
basal inferior
basal inferolateral
basal anterolateral
MID LEVEL
• The mid-cavity view should be selected from the region that includes
the entire length of papillary muscle.
• Mid-cavity is divided into six 60* segments each,
Mid anterior
Mid anteroseptal
Mid inferoseptal
Mid inferior
Mid inferolateral
Mid anterolateral
APICAL LEVEL
• In apical level, only 4 segments of 90* are used because of myocardial
tapering.
• The apical cap represents the true muscle at the extreme tip of the
ventricle where there is no longer cavity present.
• The segments are
apical anterior
apical septal
apical inferior
apical lateral
apex
OTHER VIEWS
CORONARY ARTERY TERRITORIES
• There is a tremendous variability in the coronary artery blood supply
to myocardial segments. The great variability occurs at apical cap ,
which can be supplied by any of the three arteries.
Coronary Artery: Segments

Left Anterior Descending 1, 2, 7, 8, 13, 14, 17


(LAD)

Right Coronary Artery 3, 4, 9, 10, 15


(RCA)

Left Circumflex (LCX) 5, 6, 11, 12, 16


Wall motion score index
• Wall thickening and movement is assessed in all myocardial segments.
• Each of the 17 myocardial segments are graded by a five point scale,
• NORMAL (1 point)-normal wall thickening and endocardial excursion.
• HYPOKINETIC (2 points)-less than 30% wall thickening ,reduced wall
thickening, reduced endocardial excursion.
• AKINETIC (3 points)- Less than 10% wall thickening, absence of either
wall thickening or endocardial excursion
DYSKINETIC (4 POINTS)- systolic outward stretching or thinning.
ANEURYSMAL (5 POINTS)-wall motion, which bulges eccentrically
during both systole and diastole
• A Wall motion score index can be calculated to quantify the extent of
regional wall motion abnormalities.
• WMSI = SUM OF WALL MOTION SCORE/ NUMBER OF SEGMENTS
VISUALIZED.
• Abnormal segments should be confirmed in multiple views to improve
specificity.
THANK YOU

You might also like