Scanning methods from long axis to short axis and to all short axis images
Rotate the probe from the left ventricular longitudinal view exactly 90 degrees clockwise to visualize the mitral orifice level. From here, tilt the probe superiorly so that the ultrasound beam is directed upward to visualize the Aortic valve level. By tilting the probe inferiorly toward the LV apex, the chordae level, papillary muscle level, and the apex level will be visualized.If visualization is difficult, move the probe in the direction of the apex and confirm the view until the left ventricular cavity becomes invisible on the scanned image. This view provides the basis for observation of the aortic valve and the mitral valve as well as evaluation of the wall thickness and wall motion abnormalities. It is important to take care not to cause oblique cutting of the image.
Aortic valve level
At the aortic valve level of the short axis view of the left ventricle, the 3-cusp structure consisting of right coronary cusp of the aortic valve, the left coronary cusp, and the non-coronary cusp can be confirmed. The pulmonary valve can be seen on the right side of the screen and the tricuspid valve is on the left side. This view is used to visualize the cusps of the aortic valve, to measure the aortic valve area. Furthermore, this view visualizes pulmonary valve, tricuspid valve, the origin of the coronary arteries and utilize it for the classification of ventricular septal defects. |
Mitral orifice level
The mitral orifice level of the short axis view of the left ventricle depicts the mitral valve with a large anterior cusp in the front and a small and wide posterior cusp at the backside of the image. The anterior commissure is located on the right side of the screen and the posterior commissure on the left side. This view is used to determine the site of mitral valve prolapse and measure the mitral valve area in case of mitral valve stenosis. |
Chordae level
At the chordae level of the short axis view of the left ventricle, the chordae extending from the cusps of the mitral valve can be visualized. At this time, the left ventricle should be visualized so that it looks like a perfect circle. This view is used for evaluation of wall motion abnormality and measurement of the left ventricle by the M-mode method. |
Papillary muscle level
At the papillary muscle level of the short axis view of the left ventricle, the anterior papillary muscle is shown on the right side of the screen and the posterior papillary muscle on the left side. The image of the left ventricle should form a perfect circle. This view is primarily used for the evaluation of wall motion abnormalities. |
Apex level
At the apex level of the short axis view of the left ventricle, the image of the left ventricle should form a perfect circle. This view is used for evaluation of wall motion abnormalities. Since lesions confined to the apex can easily be missed, confirm the screen until the left ventricular cavity becomes invisible on the scanned image. |