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Accoustic Windows & Planes
Education>Expert TTE>Image Orientation>Accoustic Windows & Planes>1
The anatomic view of the heart depends upon the acoustic window, the cardiac plane, and the cardiac structure of the ultrasound beam. Acoustic windows can be either transthoracic, transesophageal, epiaortic or epicardial. The ASE-SCA has developed standard nomenclature and views for transesophageal and transthoracic acoustic windows.
From the acoustic windows, a cardiac plane is imaged that contains cardiac structures. The combination of the three descriptors will determine the view of the heart imaged by the ultrasound beam.
The acoustic windows are named for the location of the TTE probe on the chest wall. The windows are:
Left parasternal (P) transducer position or window
Left apical (A) transducer position or window
Subcostal (SC) transducer position or window
Suprasternal (SSN) transducer position or window
Figures 3. Anatomical views depicting the standard transducer windows. Image source: Echocardiography Pocket Guide: The Transthoracic Examination. Bulwer BE, Jones and Bartlett Publishers, 2011.
The variety of TTE windows allows for scanning of the heart from multiple anatomic positions and is useful in patients with surgical dressings and wounds. Each window will be described in detail along with the corresponding TTE views. As with TEE, there are many off-axis and nonstandard views in TTE. For purposes here, standard views will be discussed.
Cardiac Imaging Planes
The left parasternal window has a long and short axis plane followed by the anatomical structures imaged, whereas the other imaging planes are named by the anatomical structure imaged. Below is a list of the acoustic windows, axis (for parasternal views), and the anatomical structure imaged to name each view.
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of University of Nebraska Medical Center, Center for Continuing Education and JLS Interactive, LLC.
The University of Nebraska Medical Center, Center for Continuing Education is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
This activity is approved by the American Society of Radiologic Technologists (ASRT) as sonography-related continuing education (CE). Credit(s) issued for successful completion of ASRT-approved CE activities are accepted by the American Registry of Diagnostic Medical Sonography, American Registry of Radiological Technologists, Cardiovascular Credentialing International and Canadian Association of Registered Diagnostic Ultrasound Professionals. Contact the applicable registry for additional information / restrictions on their acceptance of ASRT CE credit.