ACUSON SC2000 2D Optimization

Welcome to the 2D Optimization course for the ACUSON SC2000™ volume imaging system, version 3.0 and lower. To determine your version, follow the steps below: Choose F4 Choose System Settings Choose Service Your version will be listed under System Information/ Product Version. If you do not have version 3.0 or lower, please close this web based training and launch the other web based training for version 3.5 and higher. Select Next to continue. Upon successful completion of this course, you will be able to: Identify the SC2000 screen layout Describe the functions of the image controls Explain how to create customized presets Describe the functions of the LCD control panel Manipulate the field of view Demonstrate how to obtain digital dynamic clips Identify when and how to utilize the IN Focus feature Identify when and how to utilize the contrast feature Select Next to continue.   You should now be able to: Identify the SC2000 screen layout Describe the functions of the image controls Explain how to create customized presets Describe the functions of the LCD control panel Manipulate the field of view Demonstrate how to obtain digital dynamic clips Identify when and how to utilize the IN Focus feature Identify when and how to utilize the Contrast feature  Proceed to the assessment to complete the course.   1.  Control area 2.  End exam with or without saving data 3.  2D image and data fields 4.  Task pane (eSieScan Workflow Protocols, Thumbnail and  Measurement area) 5.  Home-base display area (Home-base Keys, Soft Keys and  Scroll Wheel options) 1.  Transducer: Select which transducer is active. 2.  Exam Preset: Select the desired Preset for the exam typed.  Exam Presets can be customized       and saved or use pre-defined presets 3.  2D: Displays selections for 2D-mode imaging 4.  Persistence: Image smoothing over multiple frames 5.  2D Image Enhancement: Adjusts smoothing and contrast to enhance visualization of structures Transmit Power/ Mechenical Index Workflow Protocol/ Exam Preset/ Transducer Frame Rate/Depth Image Preset Frequency Gain Dynamic Range Image Enhancement/ Space/ Time Edge/Delta Map/Persistence/ Tint Color Doppler Setting/ Color Frequency Color Gain Space/Time/Edge 2D-Mode Control While live scanning, adjust 2D overall image gain by rotating the 2D Knob or FRINE wheel Quickly exit any mode by depressing the 2D Knob       2. 4D-Control Depress the 4D Knob to activate full volume imaging Adjust 4D gain by rotating the 4D Control clockwise While live scanning, adjust 2D overall image gain by rotating the 2D Knob or FRINE wheel Quickly exit any mode by depressing the 2D Knob     Depress the 4D Knob to activate full volume imaging Adjust 4D gain by rotating the 4D Control clockwise   RES enhanced resolution imaging Reformats image concentrating scanning elements into a smaller area of interest Increases image size of area of interest Increases detail resolution Zoom Control Activate Zoom by rotating Zoom knob clockwise PAN Zoom using the trackball while Zoom is active Re- activate Zoom by depressing the rotary knob a second time Exit Zoom by depressing the Zoom knob twice       Image Depth Image depth may be adjusted by rotating the depth knob on the control panel/Image Depth is displayed on the image screen and will be captured in stored/printed images (Note: Range of depth settings will vary based on transducer.)       Focus is positioned by rotating the focus knob On certain transducers, IN Focus coherent technology alleviates the need for manual positioning of the focal area   Image Size Selection Three selections Set and forget Available on linear and sector transducers Default     Size 1    Size 2 Size 3 Increase dynamic range to include more grays into the image, resulting in a softer look Decrease dynamic range for a more contrasting look Be cautious not to decrease too much as real information may be lost Increasing dynamic range will add:  More subtle information  Minimal noise   More real data Use highest setting as appropriate to patient Increase range until noise  is seen MultiHertz Imaging Use the MultiHertz toggle to cycle through available frequencies Press up to increase frequency, press down to decrease frequency Multiple imaging frequencies are available in 2D imaging including fundamental and Native tissue harmonics (NTH) Use higher frequencies for superior resolution and lower frequencies for penetration Note: Active Native tissue harmonics imaging Imaging frequency will be preceded by the letter H. frequencies and LVO settings: The frequency range will be dependent upon the active transducer. Controls how rapidly an image appears to change over time. Use lower levels for rapidly changing anatomy: A type of frame averaging Use higher levels to provide a smoother image for slow moving structures Adjusts smoothing and contrast to enhance visualization of structures         Zoom and Pan Zoom available Auto-measurements are not enabled in Dual 2D Labeled and Generic measurements available – active and inactive port, cine and Review Active side has the golden ACUSON       Quickly adjusts imaging parameters of the active mode The system is customized to your needs: Choices of imaging “looks” might include: Soft, Penetration, Detail in 2D  Imaging or Low, General and High in color Doppler Imaging sub-states are available while in 2D-mode, Color, PW and 3D/4D and are user defined The menu control allows you to navigate through on-screen functions: Activate features, use drop-down menus, and adjust the settings by depressing the menu control Rotate clockwise or counter clockwise Depth Gain Compensation (DGC) By using the DGC slide pots, gain in specific areas in the image can be adjusted   TEQ technology is the automatic optimization of the B-Mode gain at the push of a single button What does it do? EQ™ control optimizes the master gain, DGC and lateral gain (LGC)   Optimization results in:   Uniformity of the soft tissue brightness over the entire image and suppression of thermal noise in areas where there is no signal present is independent of current user gain settings Why do we want TEQ control? Improves ease of use by reducing / eliminating the need to adjust gain Lateral gain corrections in areas where the user cannot make adjustments Helps in standardizing image quality across users Improves workflow and reduces exam time   Technology Manual Functionality Manual mode:TEQ control gain is only updated when user presses the TEQ button. The tissue brightness offset can be set when the user presses “TEQ Offset” (Soft Key 1) at the desired master gain value. Technology Functionality Once activated, TEQ technology control gain will stay in effect (for all 3 levels) until: The user presses the TEQ technology control button again. The gain is re-optimized following this event The user adjusts the gain knob or DGC, which will incrementally override the optimized setting The user double-clicks the TEQ control button to turn it off  In this case the master gain and DGC values revert to the user-selected values prior to entering TEQ control Lateral gain reverts to the system lateral gain The screen icon disappears The user recalls a preset with TEQ control Off or switches transducers To activate TEQ control   1.  Single click the TEQ button on the console 5.  Set/change Gain 2.   Deactivate TEQ control: Double click of the TEQ button                                           6.   The tissue brightness offset can be set when the user presses “TEQ Offset” (Soft Key 1) at the desired mastergain value 3.   Update TEQ control: Single re-click the TEQ button 7.   Set TEQ control Level (in the imaging control area): Manual,semi-dynamic, dynamic (depending on license) 4.   Override TEQ control: Move the DGC pots and or Gain knob         Color Doppler TEQ control is available in the background B-mode image and follows the same functionality as B-mode For DTV/DTE sub-modes, the B-mode TEQ DGC will be applied to the Color Doppler image as well Spectral Doppler TEQ control is available to the user in the background B-mode image only while it is being updated M-mode TEQ control is not available to the user in M-mode in 3.0 Tip: Update prior to going into M-mode Color M-mode Functionality in this mode is similar to that in Spectral Doppler TEQ control is available to the user in the background B-mode image only while it is being updated                                                                  There are two types of acquisition-related presets Exam Image Exam Presets Transducer-specific and specify settings such as Display Format, Measurements, Reports, and Image Presets Image Presets Exam/mode-specific and specify parameters such as: Transmit Power, Maps, Frequency, Focus, and SpaceTime settings You can specify the default exam preset for each transducer and the default image preset for each mode of an exam Transducer-specific and specify settings such as Display Format, Text, Measurements, Reports, and Image Presets   Exam Presets You can capture an optimized configuration of imaging parameter settings for a specific transducer by saving a user-defined 1.  On the patient registration page choose exam presetunder exam information 2.  Choose desired exam presetfrom pull down list   Click on Exam/Dropdown   Control Area       To modify an existing preset: Make desired changes to image Choose Save New Preset Click OK Note: User-defined Exam and Image Presets are defined with a suffix of *     1. Optimize Image 2. Save New Preset 3. Click Okay Save New Exam Preset To save new preset: Make desired changes to Image using an existing preset:     1.Double-click on Preset name     2.Type new name     3.Click OK Note: User-defined Exam and Image Presets are defined with a suffix of *       1. Optimize the image 2. Double-click on  preset name 3. Type the new name 4. Click Okay Image Preset Quickly adjusts imaging parameters of the active mode The system is customized to your needs Choices of imaging “looks” might include: Soft, Penetration, Detail in 2D imaging or Low, General and High in color Doppler   You can capture an optimized configuration of imaging parameter settings for a specific transducer by saving a user-defined Exam Preset: 1.  On the patient registration page choose exam presetunder exam information 2.  Choose desired exam presetfrom pull down list     1. Image Knob   2. Select Preset To modify an existing preset: Make desired changes to image:                1.  Choose Save New Preset                2.  Click OK      1. Optimize image 2. Save new preset 3. Click OK To save new preset: Make desired changes to Image using an existing preset:     1.Double-click on Preset name     2.Type new name     3.Click OK Note: User-defined Exam and Image Presets are defined with a suffix of *       1. Optimize the image 2. Double-click on  preset name 3. Type the new name 4. Click Okay 1.  Space Time    2.  Edge 3.  Delta 4.  Capture 1 Beat 4.  Capture 1 Second 5.  Map 6.  Tint   4a.  Capture 1 Beat: Rotate knob to easily change from capturing 1 beat to a maximum of 30 beats 4b.  Capture 1 Second:  Rotate knob to easily change from capturing 1 second to a maximum of 30 seconds beats   When Contrast Could be Helpful  Rescue of non-diagnostic exams When EBD is poorly visualized Suspicious case history Discordant echo results Technically sub-optimal images Stress Echo Definition: When the left ventricle is full of contrast, it is said to be ‘opacified’ (appears white): Good LVO is a cavity that is completely full of contrast LVO is associated with Endocardial Border Delineation (EBD): The endocardial border defines the functional area of muscle from the cavity Good EBD is a white cavity and a darker muscle CPS is a proprietary pulse sequence technology Designed for contrast agents Agent-to-tissue specificity of contrast imaging is significantly increased Providing improved performance even at low-MI power levels Two ways to access CPS and LVO:        1.  Via MultiHz toggle      2.  Via Preset 1 and Preset 2 soft keys (Image Presets)   If LVO/CPS MultiHz settings is accessed through MultiHz key, this requires user to manually change transmit power.           Adjust overall 2D gain Adjust DGCs Add tint if desired Adjust clip capture length if needed Adjust transmit power as needed Adjust focal zone as needed 1. Manual- No automatic update on any image changes (i.e. Static TEQ) 2. Semi-Dynamic- Updates only on system setting changes 3. Dynamic- Updates on major image changes along with system setting changes.     System settings include (make tab1) MHz: Space-time/ASC Level Focus mode Focus position Display depth    TEQ Levels   Semi-Dynamic mode -TEQ control gain is automatically updated when the user changes a system setting (listed below). System setting includes:  MHz  Space-time/ASC Level  Focus Mode  Focus position  Display depth  RES, Image Width  TxPower  Unfreeze  B-mode update in strip modes  Exit strip modes Changing the overall gain will automatically change the Target Gain Offset – Streamlining patient specific workflow   Dynamic mode - TEQ control gain is automatically updated when: The change in imaging plane or view is significant enough to warrant a gain update. Change threshold has been optimized during internal clinical scans The user changes a system setting (listed in previous slide) Has built-in motion detector. Does not update during fast movements Time TEQ waits after motion ceases to update gain = 750 msec Clip Capture Behavior – Native TEQ updates are automatically suspended during clip capture Changing the overall gain will automatically change the Target Gain Offset – Streamlining patient specific workflow                Controls balances line density (resolution) and frame rate. Increasing the resolution, or line density,results in a slight decrease in frame rate. Increasing the frame rate results in a slight loss of line density.   Distinguishes the contours of an image by increasing the level of edge detection     Adjust to increase or decrease the level of differentiation in echo levels, which increases or decreases the contrast within the image   Select a post-processing curve to assign echo amplitudes to gray levels   Change the color of the image by adding colors to the gray in an image   Dynamic Range Toggle  Data Field Low Dynamic Range Mid Dynamic Range High Dynamic Range IN Focus is a real-time Coherent Image Formation technology that provides dynamic transmit focus at all depths. Never again out of focus: Focal zone image quality at all depths Eliminates the requirement to shift the focal zone during conventional imaging Less repetitive stress Enabled by the ACUSON SC2000 ultrasound system massive parallel beam formation capability and a Coherent Image former.   Transmit beam is tightly focused: Results in an image focused at one specific depth Requires shifting the focal point to optimize at different depths Listens down the middle of the transmit beam with one or two beams Leaves a lot of information behind   Achieved by Coherent Image Formation utilizing the power of up to 64 parallel beams Coherent Imageformerreceives and saves information from each beam Then combines multiple lines from multiple pulses to build up a focus for every point in the image Multi-pulse technique builds up transmit focus at every at every depth Massive parallel receive does not waste echo information Improves detail resolution of valves and with in the myocardium   Each point is imaged with a variety of different transmit angles - angle diversity. Phase and amplitude data is preserved from each beam: Combined to retrospectively synthesize a focus at every point in the image Frame rate advantage: Massive receive beam acquisition per each firing requires fewer transmits events   1. Conventional Focusing Image 2. IN Focus Technology Image         Best detail resolution only at focal point Suboptimal near field – poor transmit side focusing Adjustments needed to interrogate at different depths 3. Conventional Focus of the Left Ventricle 4. IN Focus of the Left Ventricle   Multiple pulses image creation brings in the Doppler effect. Velocity dependent mapping of blood cells: Higher velocities darken blood signal Dependencies: Signal strength from blood Varies with SpaceTime control setting (S2 Strongest) Varies with frequency (highest freq. strongest) Varies with view (apical strongest) Varies with patient