The ICAEL example pediatric echocardiography imaging protocol (used at TCH).
PLAX
- Parasternal long axis of the left atrium, mitral valve, aortic valve, left ventricle and interventricular septum
- Parasternal 2-D sweep starting at the aorta to the tricuspid valve to the pulmonary valve
- Zoom on the aortic valve
- Obtain measurements of the aortic annulus, aortic root and sinotubular junction at end diastole
- Color and interrogation of the aortic valve Color interrogation of the mitral valve
- Color and spectral Doppler of the tricuspid valve
- Color interrogation of the interventricular septum
- Color and spectral Doppler of the pulmonary valve
PSAX
- Parasternal short axis view of the aortic valve, main pulmonary artery, left atrium, right atrium, tricuspid valve and right ventricle
- Zoom on the aortic valve; visualize all three leaflets
- Color interrogation of the aortic valve
- Visualize the coronary arteries by 2-D and color Doppler to confirm flow
- 2-D sweep from the base of the heart to the apex
- Zoom on the main pulmonary artery and branch pulmonaries
- Take measurements of the pulmonary valve and main pulmonary artery
- Take measurements of the right and left pulmonary arteries
- Color interrogation of the main and branch pulmonary arteries
- Pulse Doppler of the main and branch pulmonary arteries
- Color and spectral Doppler of the tricuspid valve
- If TR is present, obtain peak velocity
- 2-D sweep from the base of the heart to the apex
- 2-D of left ventricle at the mitral valve and papillary muscle level
- M-mode of the left ventricle
- Show M-mode measurements
- Color sweep of the interventricular septum
- Zoom on the pulmonary valve and main pulmonary artery
Apical
- 2-D sweep of the apical four chamber starting posteriorly at the coronary sinus level and sweeping anteriorly to the left ventricular outflow tract and then to the right ventricular outflow tract
- 2-D of the 3 chamber view
- 2-D of the 2 chamber view
- 2-D of the 5 chamber view
- Zoom on the mitral valve; take measurement
- Color interrogation of the mitral valve
- Pulse Doppler of the mitral valve
- Time measurement for MPI
- 2-D of the left ventricular outflow tract
- Color interrogation of the aortic valve and left ventricular outflow tract
- Pulse Doppler of the left ventricular outflow tract
- Time measurement for MPI
- Zoom on the tricuspid valve; take measurement
- Color interrogation of the tricuspid valve
- Pulse Doppler of the tricuspid valve
- Zoom on the left atrium, focusing on the pulmonary veins
- Color interrogation of the right upper pulmonary vein
- Pulse Doppler of the vein
- Color interrogation of the left lower pulmonary vein
- Pulse Doppler of the vein
- Color interrogation of the interventricular septum
- Strain imaging as needed in this view
Subcostal
- 2-D clip of abdominal sites
- Color interrogation of the abdominal aorta in long axis
- Pulse Doppler of the aorta
- Color interrogation of the inferior vena cava
- Pulse Doppler of the vena cava
- Invert images, 2-D sweep of the subcostal long axis
- 2-D sweep of the subcostal short axis
- Color interrogation of the superior vena cava
- Pulse Doppler of the vena cava
- Zoom on the atrial septum
- Color interrogation of the atrial septum
- Pulse Doppler of the septum
- Color and Pulse Doppler of the pulmonary veins if attainable
- Color interrogation of the left ventricular outflow tract
- Pulse Doppler of the left ventricular outflow tract
- Color interrogation of the right ventricular outflow tract
- Pulse Doppler of the right ventricular outflow tract
- Color interrogation of the interventricular septum
Suprasternal
- 2-D short axis views
- 2-D clip of arch sidedness
- Color interrogation of arch sidedness
- Measurement of right pulmonary artery
- Zoom on left atrium
- Color interrogation of the pulmonary veins
- Pulsed Doppler of the pulmonary veins
- 2-D long axis view of the aortic arch; take measurements
- Color interrogation of the arch
- Pulse Doppler of the arch
- Color interrogation for a patent ductus arteriosus
- Examining The Pediatric Transthoracic Echo Protocol
- IAC | IAC Newsletter. Retrieved February 13, 2009,
- from the Intersocietal Accreditation Commission Web site: http://www.intersocietal.org/iac/news/div_icael/ICAELwin09_1.htm