Ballard

Instructions for Measuring VHS

The VHS and VLAS measurement tool requires VHS and VLAS to be measured in sequence: VHS followed by VLAS

To begin VHS and VLAS measurement, click the “Measure” button in the toolbar. To go backwards and forwards by one step in the measurement process use the arrows on the toolbar

Measure VHS

1. Move your mouse to the base of the heart (at the center of the ventral aspect of the carina) click and hold the button down while dragging the green line to the apex of the heart. Release to complete the line.
2. Move your mouse to the cranial aspect of the cardiac silhouette, at the mid-point. Click and hold while dragging the purple line to the caudal border at the level of the ventral border of the vena cava (if it can be identified) or the widest part of the cardiac silhouette and release to complete the line. Green and purple lines should be drawn at approximately 90 degrees to each other.
3. Move your mouse to the cranial aspect of the 4th thoracic vertebra. Click and hold while dragging to show the green (long-axis) line and drag the line to the right with your mouse, rotating as needed to align the line parallel to the spine. Release to complete the line. The new green line will automatically be the same length as the green line that you drew representing the long-axis of the heart.
4. Click again at the cranial aspect of the 4th thoracic vertebra and hold while dragging to show the purple (short-axis) line and drag the line to the right with your mouse, rotating as needed to align the line parallel to the spine. Release to complete the line. The new purple line will automatically be the same length as the purple line that you drew representing the short-axis of the heart.
5. Count the number of vertebral bodies covered by both of the lines to the nearest 0.1 vertebral bodies. Type the numbers into the appropriate boxes in the bottom toolbar. VHS is the sum of the vertebral bodies covered by the green and purple lines. Once entered into the appropriate boxes click the submit button on bottom tool bar next to the VHS. This will bring up a text box that shows the VHS measurement obtained by the CEG. A general goal for repeatability among different examiners is +/- 0.25 vertebral bodies. However, studies have shown much greater differences occur between observers (about 0.5 VB is the typical difference). To view the CEG VHS measurements click on the Annotated Image button on the top toolbar.

Instructions for Measuring VLAS

Measure VLAS

Note: VHS measurement must be completed prior to measurement of VLAS in this viewer.

1. Move your mouse to the base of the heart (at the center of the ventral aspect of the carina, which is the same landmark you used for VHS measurement) click and hold the button down while dragging the turquoise line toward the caudal edge of the heart, where the caudal vena cava intersects the caudal portion of the cardiac silhouette . Release to complete the line.
2. Move your mouse to the cranial aspect of the 4th thoracic vertebra. Click and hold while dragging to show the turquoise (VLAS) line and drag the line to the right with your mouse, rotating as needed to align the line parallel to the spine. Release to complete the line. The new turquoise line will automatically be the same length as the turquoise line that you drew representing the VLAS.
3. Count the number of vertebral bodies covered by the turquoise line to the nearest 0.1 vertebral bodies. Type the number into the appropriate box in the bottom toolbar. Once VHS and VLAS values are entered into the appropriate boxes, click the submit button on bottom toolbar. This will bring up a text box that shows the VLAS measurement obtained by the CEG. A general goal for repeatability among different examiners is +/- 0.25 vertebral bodies. However, studies have shown much greater differences occur between observers (about 0.5 VB is the typical difference). To view the CEG VLAS measurement click on the Annotated Image button on the top toolbar.