Circulation Studio · Imaging & interpretation
Echo.
Acquire. Recognize. Measure. Integrate.
Probe & patient
TTEDrag the probe across the chest. Its marker sets image orientation.
Surface landmark key
- Clavicles
- Suprasternal notch
- Sternum
- Ribs & intercostal spaces
- Xiphoid
- Physical probe marker
Probe movements & physiology
Drag the heart to rotate. The probe and imaging plane stay fixed.
Image formation controls
Detail stays fixed while scanning; load never silently reduces resolution. Ultra detail adds native samples and takes longer. Freeze for finer sampling before measuring; quality does not change calibration.
Gain changes brightness; TGC compensates by depth. Frequency trades penetration for detail. Focus changes lateral definition; depth and sector width change sampled coverage and rendering work. These are representative acoustic effects.
View guide & acquisition feedback
Coordinates, marker and near field
The sector vertex is the transducer and the top of the image is near field. The physical TTE marker identifies display-right under the standard cardiology convention. In apical four chamber, LV/LA appear on display-right and RV/RA on display-left. Patient left/right is different from screen left/right. Rotate the anatomy camera without changing the acquired section.
Practice: Identify LV and LA in the labelled and grayscale PLAX sections, then rotate only the anatomy camera and confirm that the echo image and probe pose stay fixed.
Parasternal long axis
Left parasternal interspace, often 3rd–4th; left lateral position
Marker: Patient’s right shoulder
Beam: Across the LV long axis toward its apex
Movements to explore
- Slide between interspaces to find a window
- Rock/tilt until LV and aortic root share their long axis
- Rotate toward the left shoulder for PSAX
Find these landmarks
- RVOT
- IVS
- LV
- MV
- LVOT
- AV
- LA
- descending aorta
Adequacy
- Elongated LV with parallel septum/posterior wall
- MV and aortic root in continuity
- Interpret anterior RV as an RVOT section, not global RV size
Common errors & corrective movements
- An oblique LV slice overstates thickness and distorts RVOT
- A papillary muscle in this plane suggests off-axis imaging
Measurements & Doppler
- LV dimensions and wall thickness
- MV/AV mechanism
- LA AP dimension
- Aortic root
- Effusion distribution
Required model landmarks are intersected. Verify resolved borders and phase before measuring; equivalent anatomical acquisitions are accepted.
Intersected model structures: lv, la, aorta, rv, pulmonary, aortic, mitral · target plane distance 0.0 mm
Presets move the virtual probe. Every intermediate pose samples the same patient. Use the probe controls to explore off-axis planes and loss of the acoustic window.
Integrated report
A defensible report integrates the evidence and its limitations. A single number does not need to “win.” Reports save with acquisitions.