AROENTGENOLOGIC visualization of the heart, in such a manner as to give a radiologic equivalent to its anatomical cross-section, has been an old problem in cardiac roentgenology. This problem has been approached repeatedly in the past. The several available solutions are, however, complicated, time-consuming, not very exact, and require additional expensive equipment. The underlying principle for all these methods is based on the 360° rotation of the patient around his vertical axis with the recording of the heart borders in different diameters. In this manner, the cross-section can be reconstructed. Some authors go beyond this and produce three-dimensional models of the heart. Palmieri (4), in a very elaborate manner, cuts cardboard silhouettes of many different heart diameters and in setting them together completes the heart model. Lysholm (3) designed an ingenious arrangement permitting direct cutting of a three-dimensional heart model from clay. A rotating chair for the patient is connected with a rotating stand for the clay and an exact correlation with their degree of rotation is maintained. A narrow beam around the central ray is moved under fluoroscopic control along the heart borders. A steel string, mechanically connected with the tube, automatically cuts through the clay so that an approximate model of the heart is fashioned after cutting several diameters. This method was later revived by Schatzki (5). Klason (2) devised an attachment by which an electric rod mechanically follows the movements of the central ray controlled by the fluoroscopist and produces strip-like exposures on photographic paper as desired. He thus obtains a number of lines which produce an approximate outline of a cross-section through the heart. A similar principle for drawing under fluoroscopy or indirectly, after exposing several film strips at different angles, was recently published in this country by Szabados (6). (See Fig. 1.) All these methods, unfortunately, take considerable time, and any motion of the patient during the long examination greatly endangers the accuracy of the measurements. It is, furthermore, not possible to record fine details of the heart contour. Were a direct, instantaneous exposure of the cross-section of the heart possible, its superiority over the indirect methods described above would be apparent. The purpose of this study is to present such a roentgenologic possibility for a direct cross-section radiography of the heart using a fundamentally different projection from those commonly accepted. This study is limited only to its theoretic principles and roentgen-technical factors. The roentgen-clinical aspects of this method will be summarized in a later study. The principle underlying this technic is easily understood (Figs. 2 and 3). On examining a lateral view of the chest, we note that the long axis of the heart—its diagonal diameter—forms an angle averaging from 45 to 50 degrees with the longitudinal diameter of the thorax.
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