First Bristol Radiology Course, November 1989

arterial constriction combined with upper lobe blood diversion in the assessment of left ventricular failure, and went on to discuss the 'tubology' which should be recognised, and checked, on post-operative films. Paediatric Chest X-ray Interpretation, Dr. Raphael (National Heart Hospital) The neonatal chest radiograph should allow the Radiologist to answer two questions: Can pulmonary disease be excluded in a sick neonate? Can congenital heart disease be confirmed? On occasions, a specific cardiac diagnosis can be suggested, but these are limited by the slow rate at which characteristic cardiac adaption occurs, by the presence of the thymus and by the potential complexity of the cardiac lesions. Nuclear Cardiac Imaging, Dr. Wilde (Bristol) Reversible defects in myocardial perfusion can be a specific, if insensitive test for coronary artery disease; infarct imaging can be confir-matory when routine tests are inconclusive and ventriculogra-phy allows the quantitation of myocardial damage and the assessment of treatment. Uses of nuclear cardiology may be extended by the introduction of radiolabeled monoclonal antibodies and Technetium?99 m radiopharmaceuticals, cals. Echocardiography?Technical Developments, Professor Wells (Bristol) The opening session was concluded with a lucid summary of the major technical advances which have revolutionised echocardiography in the last decade. These from noise reduction and image storage to duplex scanning, colour flow doppler and transoesophageal probes. Echocardiography?Imaging and Doppler in Adults, Dr. Wilde (Bristol) Examples were show of how the improved resolution now available allows easier diagnosis, and has enabled echocardiography to become the major part of cardia diagnosis. The various advantages and disadvantages of pulsed and continuous wave Doppler as well as colour flow were illustrated. In the assessment of valve disease, cardiac catheterisation has been reduced to a pre-surgical technique and in some cases may not be needed at all. The clarity of the images was impressive, so much so that many extra small abnormalities were seen whose significance was not always certain. Transoesophageal echocardiography was advocated in intraoperative patients, patients on intensive care wards and in an outpatient setting where there were no clear praecordial ultrasound windows. Sedation is not always necessary. In those that do not require sedation the examination is often quicker than the conventional praecor-dial technique as a good view is always obtained. Further work is being done on transoesophageal colour flow. Children's Hospital) Children have numerous good echocar-diography windows, allowing a systematic sequential analysis of the heart. This comes under seven headings: What is the atrial situs, …