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syngo MR Systems with Tim Turnover Workbook

syngo MR Systems with Tim Turnover Workbook

SIEMENS SIEMENS T-class MAGNETOM Espree A Tim System User Services www.usa.siemens.com/education syngo® MR Systems with Tim Turnover Workbook Answers for life. syngo® MR Systems with Tim | Turnover Workbook User Services. Driven by More. More: Our philosophy for a lifelong improvement through continuing education and consulting. Working closely with you, we develop your personalized education and consulting strategy and support you and your staff with our comprehensive User Services to help gain: • More: Routine Confidence • More: Clinical Expertise • More: Superior Performance More: Personalized training, education, and consulting services from Siemens Healthcare Customer Services. For your leading edge in medical care. User Services. Driven by More. More: Personalized More: More: Superior Clinical Performance More: Routine Expertise Confidence 2 syngo® MR Systems with Tim | Turnover Workbook I Contact Information Summary Welcome to Siemens Healthcare Discover. Try. Buy. on webShop Siemens Healthcare is dedicated to helping you Do you want to “Discover. Try. Buy.” options, get the most out of your investment throughout accessories, and clinical education to make the most the entire product life cycle and beyond. Our goal of yourimaging equipment? Discover images, case is to enable you to take technology further, studies,and video demonstrations with the latest profitability higher, and patient care to the next clinicalapplications. Try advanced applications level. Find the information, resources, and tools utilizingfree software trials. Buy applications, coils, you need to get the most out of your recent clinicaleducation, and accessories, conveniently at investment and stay up-to-date. Visit any time. Visit www.usa.siemens.com/webShop today! www.usa.siemens.com/Welcome2Healthcare. Clinical Training and Siemens Training Centers Continuing Education Siemens Clinical Education Training Center – TDC2 Siemens Customer Care Center: 110 MacAlyson Court Call 1-800-888-7436 Cary, NC 27511 • Troubleshooting assistance • Immediate assistance for software applications and workflow issues • For Tech Support press option 2 / for applications support, press option 3 • Press the * key or enter the last six digits of your Functional Location Number • Press 7 for ultrasound Functional Location Number ____________________ Clinical Education Offerings: Serial Number ________________________________ Call 1-888-221-8010 (follow the prompts) IP Address System _____________________________ • Classroom Training (Offerings, Registration& Scheduling) Educational Symposia IP Address PACS _______________________________ • • On-site Training • Printed Self-studies • Virtual Education (Offerings & Registration) • Workshops & Fellowships Visit www.usa.siemens.com/clinicaleducation for more information regarding the current Siemens Clinical Training and Continuing Education portfolio. 3 syngo® MR Systems with Tim | Turnover Workbook II Contents I Contact Information Summary ............................................................................................... 3 II Contents .............................................................................................................................. 4 III Course Agenda .................................................................................................................... 7 Session 1 ........................................................................................................................... 7 Session 2 ........................................................................................................................... 7 Session 3 ........................................................................................................................... 7 Session 4 ........................................................................................................................... 8 Session 5 ........................................................................................................................... 8 IV Course Objectives ................................................................................................................ 9 1 System Introduction............................................................................................................ 10 1.1 System Start (System On)............................................................................................ 10 1.2 System Shutdown (System Off)................................................................................... 10 2 Table Controls..................................................................................................................... 11 3 Mouse and Keyboard........................................................................................................... 12 3.1 Mouse........................................................................................................................ 12 3.2 Keyboard.................................................................................................................... 12 3.3 Shortcuts ................................................................................................................... 12 4 Patient Table....................................................................................................................... 13 4.1 Table Weight Limit ..................................................................................................... 13 4.2 Table ......................................................................................................................... 13 4.3 Coil Sockets ................................................................................................................ 13 4.4 Table Connections ...................................................................................................... 13 4.5 Patient Table Safety .................................................................................................... 13 5 Quench Safety .................................................................................................................... 15 5.1 Magnet Stop Switch.................................................................................................... 15 6 Patient Safety ..................................................................................................................... 16 6.1 Screening form........................................................................................................... 16 6.2 Electrically Conducting Objects ................................................................................... 16 6.3 Patient Monitoring...................................................................................................... 16 6.4 Localized Regions of High RF and bore wall contact...................................................... 16 6.5 Hearing Protection...................................................................................................... 16 7 Quality Control (QA) ........................................................................................................... 17 7.1 Performing Quality Assurance ..................................................................................... 17 8 Intercom ............................................................................................................................ 18 8.1 Intercom Control Panel ............................................................................................... 18 8.2 Start automatic voice output....................................................................................... 18 8.3 Recording Voice Commands ........................................................................................ 18 9 Patient Registration ............................................................................................................ 19 9.1 Scheduler > Registration from Patient Browser............................................................. 19 9.2 Manual Registration.................................................................................................... 19 10 Patient Browser ................................................................................................................ 20 10.1 Quick Search ............................................................................................................ 20 10.2 Patient Search .......................................................................................................... 20 4 syngo® MR Systems with Tim | Turnover Workbook 10.3 Work Status .............................................................................................................. 20 10.4 Edit Correct Patient Information ................................................................................ 21 10.5 Sorting Patient Data.................................................................................................. 21 10.6 Study Split - Offline................................................................................................... 22 10.7 Importing Patient Data.............................................................................................. 23 10.8 Deleting Patient Information ..................................................................................... 23 10.9 Protecting Patient Data ............................................................................................. 23 11 Exam Task Card................................................................................................................. 24 11.1 Exam Task Card Navigation........................................................................................ 24 11.2 Position Toolbar Icon................................................................................................. 25 11.3 Inline Display Icon .................................................................................................... 26 11.4 Table Positioning Icon ............................................................................................... 27 11.5 Physiological Display Icon.......................................................................................... 28 11.6 Exam Explorer Overview ........................................................................................... 29 11.7 Exam Explorer – Protect User Tree.............................................................................. 30 11.8 Exam Explorer – Find ............................................................................................... 30 11.9 SAR Information Icon ............................................................................................... 31 12 Viewing Task Card............................................................................................................. 32 12.1 Manually Load Images ............................................................................................. 32 12.2 Scrolling Through Images.......................................................................................... 32 12.3 Dog ears in image segment....................................................................................... 32 12.4 View – Screen layouts .............................................................................................. 33 12.5 View – Image subtask card ....................................................................................... 35 12.6 View – Tools Subtask Card......................................................................................... 36 12.7 Windowing images ................................................................................................... 37 12.8 View – Patient Subtask Card...................................................................................... 37 12.9 View – Evaluation Subtask Card................................................................................. 38 12.10 View – Exam Subtask Card ...................................................................................... 39 12.11 Rotating and flipping an Image................................................................................ 40 12.12 Save New series...................................................................................................... 40 12.13 Image Text Information........................................................................................... 40 13 Filming Task Card.............................................................................................................. 41 13.1 Steps for Filming....................................................................................................... 41 13.2 Filming Properties..................................................................................................... 42 13.3 Copies ..................................................................................................................... 42 13.4 Camera .................................................................................................................... 42 14 Archiving.......................................................................................................................... 43 14.1 Export or Archive Patient Data................................................................................... 43 14.2 Eject from & Eject finalized........................................................................................ 43 14.3 Sending to a Network Node....................................................................................... 44 15 3D Task Card..................................................................................................................... 45 15.1 Load images into 3D Task Card .................................................................................. 45 15.2 3D Task Icons............................................................................................................ 45 5 syngo® MR Systems with Tim | Turnover Workbook 15.3 Type Subtask Card..................................................................................................... 46 15.4 Orientation Subtask Card .......................................................................................... 46 15.5 Settings Subtask Card ............................................................................................... 47 15.6 Lower Icons.............................................................................................................. 47 15.7 3D Task Card – MIP .................................................................................................. 48 15.8 MPR – Workflow ....................................................................................................... 49 Appendix A: Image Text Information ................................................................................... 52 Appendix B: MRI Acronyms .................................................................................................. 66 Appendix C: Sequences and Abbreviations .......................................................................... 71 Appendix D: Bandwith Conversion Chart Siemens to GE...................................................... 73 6 syngo® MR Systems with Tim | Turnover Workbook III Course Agenda Session 1 Introduction to MR System • RF Coils • Patient Table • System and Table Controls • System Start-Up and Shutdown Software Navigation – syngo Introduction MR Overview of Task cards MR Safety Session 2 Scan Volunteer Studies Overview of Patient Browser Image and Data Transfer and Archiving Phoenix Imaging Principles: Parameter Cards Auto/Manual Shim Building and Saving Protocols Postprocessing Session 3 Scan Volunteer Studies Auto/Manual Shim Building and Saving Protocols 7 syngo® MR Systems with Tim | Turnover Workbook Session 4 Scan Volunteer Studies Care Bolus & Timing Bolus Overview Subtraction Postprocessing Session 5 Scan Volunteer Studies Review: Questions and Answers Technologists & Education Specialist Complete Training forms and Checklist 8 syngo® MR Systems with Tim | Turnover Workbook IV Course Objectives Upon completing this course, you will be able to: Notes • Correctly perform startup and shutdown procedures • Be familiar with the table controls • Identify and acknowledge MR safety procedures • Know how to perform system QA • Describe the key features of the syngo interface of the MR Scanner • Correctly perform a patient registration • Utilize the exam task card to perform a patient procedure • Identify task cards including their functions • Perform post processing in 3D Task card • List the steps in order to archive patient data 9 syngo® MR Systems with Tim | Turnover Workbook 1 System Introduction 1.1 System Start (System On) Notes • Turn the key switch to the right • Press the SYSTEM ON button • SYSTEM ON LED lights up and the MR System is switched on • Note: Do not perform preliminary examination steps at the MR System during start-up. (e.g., moving the patient table, connecting coils) SIEMENS System On System Off 1.2 System Shutdown (System Off) • Prior to shutting down the system, the patient table should be in the home position (e.g., Table should be up and out) • If the user is logged on, the system must be shut down using • System > End Session • Select > Shutdown System • Note: Otherwise, data may be lost • Note: The message “It is now safe to turn off the system” will display. Then you may hit the System Off 10 syngo® MR Systems with Tim | Turnover Workbook 2 Table Controls Notes (2) (3) (5) (4) (1) Table Stop (2) Laser Light Localizer (3) Table Move (4) Set tunnel/music volume (5) Start/Stop 11 syngo® MR Systems with Tim | Turnover Workbook 3 Mouse and Keyboard 3.1 Mouse Notes • Three button mouse • Left mouse – Select objects or starting applications • Right mouse – calls up context (pop-up) menus • Middle mouse – window and center images 3.2 Keyboard • Quick access to frequently performed operations and Applications • Cannot be used as a numeric keypad Window Center +/- Window Width +/- Auto Window Sudy +/- Send to foroling Node 1 Senes +1. - Conect - Mark Scrolling Image +/- Copy to Fim Sheet Patient Registration Browser 3.3 Shortcuts F1 – syngo MR Online Help F5 – Examination Task Card F6 – Viewing Task Card F7 – Filming Task Card F8 – 3D Task Card • Press Ctrl +right arrow key switches to next task card • Ctrl + up arrow key +right arrow key switches back Ctrl + C – Copy object(s) Ctrl + F – Remove a filter (Patient Browser) Ctrl + I – Import data Ctrl + L – Opens Local Job Status dialog box Ctrl + N – Opens Network Job Status dialog box Ctrl + P – Expose Film Task (=Print) Ctrl + S – Save images or objects (in 3D Task Card) Ctrl + V – Paste object(s) Ctrl + W – Save Window Values (in Viewing Task Card) Ctrl + X – Cut Object(s) (in Patient Browser and Viewing Task Card) Cut images (in Filming Task Card) Up arrow key +F10 – Pop up Context menu 12 syngo® MR Systems with Tim | Turnover Workbook 4 Patient Table 4.1 Table Notes • Table comprised of several sockets and connections • Tabletop can be moved horizontally into the magnet bore • When moved completely out of the magnet, the tabletop can also be moved vertically 4.2 Coil Sockets • Coil sockets are located at the head and foot end of the patient table 4.3 Table Connections • Connections are located at the foot end of the patient table ( 2 ) (3) (1) Vacuum cushion connection (optional) (2) Headphones connection (3) Squeeze bulb connection 4.4 Patient Table Safety • Stop Table Movement – Press Table Stop button to stop table movement. • Table Stop Button – located on control unit and intercom. 13 syngo® MR Systems with Tim | Turnover Workbook • Patient Table Emergency Release – In case of power failure or defective Notes motorized drive • MR measurement is terminated and the table loses the referenced position. • Press Table Stop button. • Pull tabletop out of the magnet using the handle at the foot end of table to release • Emergency unlocking mechanism (2) • (1) Unlocking handle • (2) Reset button • Pull the unlocking handle outward up to the end stop. • Table Stop function is released and Table Stop button glows. • Pull the tabletop out of the magnet using the handle at foot end. • Resetting Emergency Release • Press reset button into the unlocking handle • Shift tabletop manually by approximated 10 cm in any direction until it audibly locks into the motorized drive unit • Press Table Up/Inward button • Press Table Down/Outward button • Table Stop is cancelled • Press Home Position button on control unit 14 syngo® MR Systems with Tim | Turnover Workbook 5 Quench Safety 5.1 Magnet Stop Switch Notes • Triggers a controlled magnet quench • Shuts down magnetic field • Note: Magnet stop should only be used in cases of emergency where there is a life threatening accident involving attracted metal parts or fire • MR System electronics are not disconnected. • Two separate MR System Magnet Stop (Quench) Buttons • Individual Quench Button • Alarm box Quench Button • Magnet Stop (Quench Button) switch has been pressed; an alarm is triggered on the alarm box. • Note: WARNING LED lights up and alarm signal sounds • Note: Siemens Service must be called following a quench. The magnet must only be put back into operation by Siemens Service personnel. Magnet Stop Switch Magnet Stop Switch (Alarm (Individual Quench Button) Box Quench Button) 15 syngo® MR Systems with Tim | Turnover Workbook 6 Patient Safety 6.1 Screening form Notes • A screening form for patients, personnel and non-personnel for MRI examinations and entry into the MRI environment must be completed • A comprehensive screening form should be filled out and a verbal interview performed to verify information on the form. • Check MR Safety guidelines for implants and prostheses prior to scanning the patient or entering the magnet room 6.2 Electrically Conducting Objects • Patient should remove all electrically conducting objects, (e.g., jewelry, piercings) • Patient should remove all clothing that has electrically conducting material, for example: bras, metallic appliqués or woven metallic yarns. • Note: It is recommended that patient’s are changed into a gown or scrubs. • Eyeliners and tattoos may contain ingredients causing artifacts or skin irritations during MR exams. Remove makeup prior to the MR examination. • Patients should seek medical attention in case of discomfort during or following the MR Exam. 6.3 Patient Monitoring • Routine Monitoring – All patients should receive routine monitoring • Mandatory monitoring – Sedated and physically unstable patients is required. • Note: Medical supervision is mandatory when the MR system is scanning in the First level Controlled Operating Mode. 6.4 Localized Regions of High RF and bore wall contact • Prevent potential localized regions of high RF by ensuring the patient is positioned with proper distance to magnet tunnel and between parts of body • A minimum distance of 5 mm is maintained between patient and tunnel covering. • Note: Ensure distance by using positioning aids, (e.g., blankets made of linen, cotton, paper, or dry material that is permeable to air). Sufficient ventilation is also recommended. • Instruct the patient of possible stimulation during the MR examination, such as twitching muscles and tingling sensations. 6.5 Hearing Protection • Appropriate hearing protection that lowers noise to at least 99 dB • Headphones are not classified as hearing protection. Headphones should only be used in combination with ear plugs for communication purposes • Provide anesthetized or unconscious patients with hearing protection. All patients and personnel in MR examination room should receive hearing protection. Note: For detailed system safety instructions consult the Operator Manual. 16 syngo® MR Systems with Tim | Turnover Workbook 7 Quality Control (QA) The quality measurement is performed with the quality measurement program. Notes • The program checks the signal-to-noise ratio for all RF coils. In addition, it checks the artifact behavior for the Body coil. • Phantoms are used for quality measurements 7.1 Performing Quality Assurance • Select Options > Service > Customer QA ation Scroll System Add-On Options Help from menu File Browser. Adjustments SAR Information Stimulation Info. Auto Expose Maintenance Configuration Local Service. Service Remote Service. Event Log Customer QA Problem Steps Recorder. syngo Remote Assist. • Quality Assurance dialog Siemens Med Service Software - Microsoft Internet Explorer provided by Siemens Medical Solutions window opens Quality Assurance Help EXIT Customer Quality Assurance - Head Matrix Customer QA 10Ch Breast F Sen 10Ch Breast H Sen Coil Check Done 16Ch Al Breast feet Rap 16Ch Al Breast head Rap 16Ch Breast F Sen 16Ch Breast H Sen 2Ch Breast feet Sen 2Ch Breast head Sen 32Ch Head 4Ch Breast head Sen 4Ch Flex Large 4Ch Flex Small 7Ch BI Breast feet Inv 7Ch BI Breast head Inv 7Ch Breast feet Inv 7Ch Breast head Inv 8Ch Breast head Sen Body 6 Body Matrix + Head Matrix Neck Matrix Spine Matrix TxRx 15Ch Knee QED Update • Go to the selection list and select the head coil for the quality measurement. • Activate the control box Coil Check and click Go • Workflow dialog window opens Siemens Med Service Software - Microsoft Internet Explorer provided by Siemens ... .. [D][x] showing the positioning for the Workflow Popup phantom in head coil Position the Head Matrix, the phantom holder 14 and the plastic bottle 1900 ml in the center of measurement field, as shown in the picture below • Once the quality measurement is finished, a message appears • Done – QA is completed and parameters correspond to specifications • Not OK – parameters are out of it at least 10 minutes to avoid motion specification. Check position of Light marker position phantom and repeat QA More detailed information can be found in Operating Instructions Section Quality Assuranc 092_HeadMatrix_ Tra jpg measurement. Note: If the repeated QA measurement does not provide satisfactory results: Notify Siemens Service. 17 syngo® MR Systems with Tim | Turnover Workbook 8 Intercom The intercom allows personnel and patients to communicate during the Notes examination. 8.1 Intercom Control Panel (5). (6) SIELIENS (8) (4) -(9) (3) (10) (2) (11) (1) (12) (13) (1) Patient instructions volume control (2) Listen mode volume control (3) CV/CBT switch (4) Trigger signal volume control (5) Table Stop button (6) Microphone (7) Listen LED (8) Listen button (9) Music on LED (10) Play music button (11) Squeeze bulb/announcement active LED (12) Speak button (13) Speakers 8.2 Start automatic voice output • Set Upper Volume limit • Play music button – switch off • Music on – LED off • CV/CBT switch – to CV • Use software to initiate automatic voice output 8.3 Recording Voice Commands • Patient cannot be registered • Set CV/CBT switch to CBT • Exam task card > Select Queue > Voice Output > Play • Select language • Select “New” to create a new file • Press record button • Press and hold speak button until recording complete • Click Record button on the “record voice platform” • Speak into microphone, when finished click stop button. • Press Play to check the quality of voice recording 18 syngo® MR Systems with Tim | Turnover Workbook 9 Patient Registration 9.1 Scheduler > Registration from Patient Browser Notes • Open > Patient Browser • Select > Scheduler – Contains Pre-Registered Patients and Patients scheduled by a HIS/RIS System • Select > Patient’s name or study • Select > Registration icon or Double left mouse click on Patient Study • Note: If the patient’s name is seen in the Scheduler update manually by Main menu > View > Update Worklist Local Database ABDOMEN 1_ abdomen upp Scheduler BRAN 1 DVD-ROM Abdomen 2 CD-R BRAIN 3 BRAIN 2 9.2 Manual Registration • Main Menu > Patient > Register • Complete all Bold Fields (e.g., Mandatory input) • Select > Exam Button Patient Registration X PROCEDURE PATIENT Last name Accession No First name Request ID Title Requested ----- Patient ID procedure(s) Date of birth [M/d/yyyy] Sex . Male Female . Other Study list ---- Age Years Height [m] Weight [kg] Add Delete Additional info Study Study comment Details ... Patient position HOSPITAL Referring physician Requesting physician Institution name Admission ID 1. Performing physician 1. Operator r NOTInITISNI 2. Operator Preregister Exam Search Cancel Help 19 syngo® MR Systems with Tim | Turnover Workbook 10 Patient Browser 10.1 Quick Search Notes • Open > Patient Browser • Select > Local Database • Type first letter of patient’s last name on keyboard (Example: S for Smith) • Continue typing first letter until the patient’s name is displayed 10.2 Patient Search • Search remote DICOM nodes for existing patient studies, series, images or report documents (structured reports and results). Import the required data into the local database for evaluation via the network transfer. • Patient and examination data can only be retrieved from workstations that have corresponding remote nodes configured as query/retrieve providers. • Main Menu > Patient > Patient Search Selected 10.3 Work Status • Indicates process or editing stage the patient and examination have reached. • Capital Letter – indicates that all data has been processed • Lower Case Letter – indicates some of the data has been processed. • Abbreviation consists of seven parts – r/com/p/a/e/s/h • Received: 1st part shows if patient images have been imported into the local database via the network (received) • (…/R/…)All patient images imported • (…/r/…) Only partial patient images were imported • (…/ /…) No patient images were imported • Workflow: 2nd part shows how far the examination and edits have progressed (e.g., Verified and Read can only be checked by the physician) • (…/com/…) Study has been completed • (…/verf/…) Images and examination data have already been verified • (…/rea/…) Images have already been read • Printed: 3rd part shows if patient have been printed or exposed on film • (…/P/…) All patient image printed • (…/p/…) Only part of the patient images printed • (…/ /…) No patient images printed. • Archived: 4th part shows if data has been archived to local storage media • (.../A/...) Data has been archived completely • (.../AC/...) Data has been archived and committed • (.../AV/...) Data has been archived and checked • (.../A?/...) Archiving and checking data is pending • (.../Af/...) Archiving and checking data has failed • (.../a/...) Part of the data has been archived • (.../ /...) No data has been archived • Exported: 5th part shows if images have been exported • (.../E/...) All data exported • (.../e/...) Part of the data has been exported • (.../ /...) None of the data has been exported 20 syngo ® MR Systems with Tim | Turnover Workbook Notes • Sent: 6th part shows the status of patient images • (.../S/...) Data has been sent completely • (.../SC/...) Data has been sent and committed • (.../SV/...) Data has been sent and checked • (.../S?/...) Sending and checking data is pending • (.../Sf/...) Sending and checking data has failed • (.../s/...) Part of the data has been sent • (.../ /...) No data has been sent • History available: 7th part if patient data was modified • (.../H/...) history available • (.../ /...) no history available 10.4 Edit Correct Patient Information • Correct patient data in local database • Open > Patient Browser • Select > Patient, Study, Series or images (Instances) to modify • Note: Patient data in all task cards must be closed and un-protected • Select Edit > Correct from Main Menu or Correct icon from toolbar • Fields that can be modified; e.g., tabs located down middle of screen are Patient, Hospital, Study, Series, Instance (images) • Select > OK to accept changes to patient data • Once changes are accepted an H is displayed in patient work status. (e.g., H is for history). 10.5 Sorting Patient Data • Image data can be sorted on the Patient, study, series and instance (Image) levels. • Sort data – select item to the left of what needs to be sorted. • Open > Patient Browser > Main Menu > Sort > (pull down change depending on area selected) • Select > Local Database: sorts Patient folders • Patient Name – Alphabetical • DB Date and Time – Date and time acquired • Patient ID • Patient Latest Exam Date • Work Status – Printed, Archived, Sent • Reverse Order – Combine with selections above to reverse sorting order • Select > Patient folders: sorts Study folders • Study Description – Alphabetically • Study Date and Time – Date and Time study acquired • Work Status – Printed, Archived, Sent, Workflow • Reverse Order – Combine with selections above to reverse sorting order • Select > Study folder: sorts series folders • Series Number – Numerically • Series Description – Alphabetically • Series Date and Time – Date and Time study acquired • Modality – (e.g., MR and CT images loaded in Patient Browser) • Performing Physician • Work Status – Printed, Archived, Sent, Workflow • Reverse Order – Combine with selections above to reverse sorting 21 syngo® MR Systems with Tim | Turnover Workbook • Select > Series folder: sorts Instances (Images) Notes • Instance Number – Numerically • Instance Date and Time – Date and Time study acquired • Slice Position • Modality Specific Data • Anatomical • Triggered • Chronological • Instance Oriented • Echo Time (TE) • Repetition Time (TR) • Inversion Time (TI) • Trigger Time (TT) • Main Orientation (MO) • Acquisition Time TA) • MR Slice Position (SP) • Time After Start (TD) • B_Value (BV) • Work Status – Printed, Archived, Sent 10.6 Study Split - Offline • Split patient studies after patient exam is completed into separate patient folders with different accession numbers • Patient data in all task cards must be closed and un-protected. • Open > Patient Browser • Applications > Study Split or Study Split Icon • Series can be copied or moved • Hover mouse over stamps to enlarge for viewing • Multiple selections Study Split - Dale, Test STUDIES • Move series – Drag & Drop Accession No. N.A. N.A. • Copy series – Ctrl Drag & Drop Requested Procedure TRIO HEAD TRIO HEAD Requested procedures provided Study Description TRIO^HEAD TRIO^HEAD • localizer SERIES from scheduler or manual input (1)localizer (2)csi_se_30 b)csi_nd EN • Add Study – Select > (+) (3)svs_se_30 button • Accession numbers populated from scheduler OK Cancel Help 22 syngo® MR Systems with Tim | Turnover Workbook 10.7 Importing Patient Data Notes • Import selected or entire patient examinations, studies, series, images (instances) from a CD or DVD • Open > Patient Browser • Select > CD_R or DVD_R drive • Select > Patient, Study, Series or Instances to import back to Local Database • Select > Import icon on toolbar or Main Menu > Transfer > Import • Select > Local Job Status icon to check import status ? 10.8 Deleting Patient Information • When deleting patient information, patient data in all task cards must be closed and un-protected. Deletion may occur at any level: Patient, Study, Series or Instance (Image) • Select > information to be deleted • Right mouse click > Delete or Main Menu > Edit > Delete • Delete Confirmation window opens • Select Yes – continue and delete information • Select No – cancels operation 10.9 Protecting Patient Data • Patient information can be protected from unintentional deletion • Protect Patient, Study, Series or Instances – Right mouse > Protect or Main Menu > Edit > Protect • Remove patient protection – Right mouse > Remove Protection 23 syngo® MR Systems with Tim | Turnover Workbook 11 Exam Task Card 11.1 Exam Task Card Navigation Reference Images Displayed in Graphic Segments BOMDIA Filming Stamp Segments Cancel TR Tool Bar Program Control Area Program Area Parameter Cards) (1) Reference image segments – reference images used to position graphic measurement objects (slices or slabs) are displayed (2) Stamp segments (Maestro Layout only) located below large GSP image segments • Main Menu > View > Maestro UI (3) Patient data – patient information located above program control (4) Program control – List of protocols to be measured (wait list) (5) Parameter cards –parameters on the parameters cards can be modified (6) Protocol info line – Information regarding the open protocol (7) Toolbar – buttons used to open dialog windows for editing and controlling the measurement Notes 24 syngo® MR Systems with Tim | Turnover Workbook 11.2 Position Toolbar Icon Notes Position Toolbar × X • Modify Graphics • Depress left mouse button on a reference image • Provides values relative to isocenter and original landmark • Zoom/Pan + Modify Graphics • Zoom and/or pan a reference image • Create Slice (Slab) Group • Create a new slice or slab after left mouse clicking on a reference image • Create a slice group in a particular plane – Depress left mouse > Move mouse and draw slice group > Release left mouse button • Yellow icon – Icon selectable; enough TR to create new slice groups • Gray icon – Icon not selectable; not enough TR to create new slice groups. Increase TR to add additional slices • Create Regular Sat • Create a Saturation region • Create a sat band in a particular plane – Depress left mouse > Move mouse and draw sat band > Release left mouse button • Yellow icon – Icon selectable, enough TR to create new sat bands • Gray icon – icon not selectable, not enough TR to create new sat bands. Increase the TR to create new sat band. • Create Slice (Slab) Group (Three Points) • Create a slice or slab group by defining three points • May be created on same image, multiple images and orientation • Delete • Delete a selected object (yellow) – Right mouse > Select > Delete or press delete on keyboard • Line Mode • Displays slices in line mode, shows center of each slice • Box Mode • Displays slices in box mode, shows volume each slice encompasses • Package Mode • Displays first, middle and last slice position • Ability to see through slices so anatomy is visualized • Selectable with Line or Box Mode • Extent Thickness • Activates the mode for changing the thickness of the slices or slabs of a group • Extend Slices (Slabs) • Activates the mode for changing the number of slices or slab of a group. • Extend Distance • Activates the mode for changing the distance between slices or slabs of a group. • Extend Slice Oversampling • Graphically modify oversampling in slice direction for 3D sequences only. • Extend Phase Oversampling on/off • Graphically modify Phase Oversampling (PhaseOS) 25 syngo® MR Systems with Tim | Turnover Workbook Notes • Reference Lines On/Off • Shows or hides reference lines. • Coils On/Off • Activates or deactivates the display of coil elements on reference images. • Adjust Volume • Shows or hides the adjustment volume (e.g., shim volume). • Image Text On/Off • Turns image text on or off in reference images. 11.3 Inline Display Icon • Inline Display Frame on or Off • Switch Viewing Modes – Right mouse > Inline Display > Select Frame On • Toggles Frame on or off Frame On Frame Off • Inline Display is also used to view images during image reconstruction • Windowing is applied to remaining images • User cannot scroll through images in Inline Display • Load images into reference image segments for review once image reconstruction is completed • Stop & Continue (or) F12 – Stops sequence currently running and continues onto next sequence • Primarily for Care Bolus contrast-enhanced MRA exams • Stop & Continue button > single Left mouse > Starts Care Bolus scan • Scan button (or) F12 – Starts PACE breath-hold and multi-breath hold sequences • Scan button – single left mouse to start measurement (or) F12 function key 26 syngo® MR Systems with Tim | Turnover Workbook 11.4 Table Positioning Icon Notes • Current Position • Displays current table position in millimeters Current position 1073 [mm] • Move Table By Move table by • Enter distance in millimeters to move table to a new position 100 [mm] • Move to Center button • Moves table to isocenter based on original landmark • Table moved during examination workflow • First button click – Moves table to last scan position • Next click – Moves table to zero table position • Move in/Move Out arrow buttons - Moves table by selected value entered towards patient’s head or feet • Move to Home • Moves Table to the home position (e.g., Table out of bore and up) • Stop Movement • Stops table movement if in motion • Release Table Stop • Select > Release Table Stop button • Release table button – located on the side of the table at the MR Bore >Turn Red Stop button > Releases table • Tunnel Lighting and Ventilation • Modify Lighting and ventilation – Click respective button to switch on in the magnet bore to one of three levels • Increase/decrease lighting or ventilation – click button again until appropriate level is reached 27 syngo® MR Systems with Tim | Turnover Workbook 11.5 Physiological Display Icon Notes The Physiological Display dialog window enables the user to observe the physiological signal curve and to select the triggering procedure • Triggered monitoring selections: • ECG I • ECG II • ECG III • Pulse • Resp • External Signal Physiological Display Pulse PF: 70 / min ECG HF : 70 / min HP :70 ms 2nd Track Statistics Reset Stat 28 syngo® MR Systems with Tim | Turnover Workbook 11.6 Exam Explorer Overview Notes Notes Overview of all the examinations and measurement programs stored on the system. Modifications can be made to existing protocols, new protocols can be created, and sequences can be added to existing protocols in the USER tree. • Exam Explorer Icon 1 ... • Two Program Trees • Siemens Program Tree • Protocols stored are used for reference and cannot be modified • Siemens protocols can be copied to the User tree or into the Exam Task Card program control area and modified • Regions are arranged in order of the type of exam and by body parts • Under each region is an exam named “library.” Library contains optional imaging techniques and is a fast way to locate specific sequences (e.g., T1, T2, etc) • USER Program Tree (Customer) – Requires 3 levels to save a sequence • Region – All examinations for a certain region of the body are grouped into a region. • Exam – All measurement programs for a certain part of the body or for anatomy of a body region. • Program – Contains pulse sequences. (e.g., Only level where sequences can be saved) 0 11 SIEMENS SequenceRegion Region Level head B Ld clinicalibraries Exam Level 4ª general He lesions N- trauma - pituitary - orbits Program Level ‘- lac 4- ms %- epilepsy He uncooperative %e vascular 40 advanced applications libranes @programs - @ library 29 syngo® MR Systems with Tim | Turnover Workbook • Create New Region – Sublevel of User Tree Notes Notes • Right Mouse > User Level > select New • Add New Region dialog window > Type New Name > select OK • Create New Exam • Right mouse > Region Level > select New • Add New Exam dialog window > Type New Exam Name > select OK • Create New Program • Right mouse > Exam Level > select New • Add New Program dialog window > Type New Program Name > select OK • Can insert sequences at the program level. 11.7 Exam Explorer – Protect User Tree • Customer User Tree can be password protected. This must be enabled by a Siemens Customer Service Technician (CSE). • Write-protect USER tree – to avoid accidental changes to the customer measurement program. This can be switched on and off without a password. • Exam Explorer > Select Tools > Protect USER Tree Exam Explorer - \SIEMENS head\clinical librarie Object Edit Tools | Insert Help Append to Queue SIEMENS Refresh F5 head Show Unlicensed Items - clinic Protect USER tree Ve le Update Filming Study Layout ... 11.8 Exam Explorer – Find • Find – If the name of a specific region, examination, measurement program, protocol, or pause if known, the user can search for the exact name. • Exam Explorer > Select Edit > Find • Find object in database dialog window opens • Name input field > enter name of the object • Select > Find Ol Exam Explorer - \USER Object Edit Tools Insert Help Find. + SIE Cut Ctrl+X US Copy Ctrl+C + Paste Ctrl+V + Delete Del + Select All Ctrl+A ..... + M Move Up + Move Down - Edit Protocol View Protocol Properties. Alt+Enter 30 syngo® MR Systems with Tim | Turnover Workbook 11.9 SAR Information Icon Notes Notes The SAR button on the tool bar of the Exam task card includes a level display and percentage display. This indicator determines to what degree the estimated highest and therefore limiting SAR 0% value of the measurement approximates the critical SAR limit. • Note: The SAR display is not updated during the measurement, for this reason it doesn’t show the current SAR load for the patient. • Additional information – select SAR icon • Prediction Tab – ability to set SAR Information SAR operating mode Current operating mode: Normalmode (NM) • Normal mode – SAR and db/ Operating mode for the next measurement: Normal mode First level dt limits are set to low values. Displayed values belong to the current patient! • First level mode – SAR and Whole Body [9] dB/dt limits are set to higher Exposed Body 26 196] values. Increased SAR values Head 1961 Head Local may cause Patient to Torso Local 0 [6] experience notable heat Legs Local 0 increases. Increased dB/dt B1+ rms 1951 values may cause patient to Calculation time: 14:09:40 81+ ms [P] 18 experience slight peripheral nerve stimulation. Prediction • Shows relative SAR values Chose Help • SAR Limits Exceeded • If SAR limits are exceeded during an exam, a SAR limits exceeded dialog window is displayed. • Dialog window shows current protocol parameters and suggested proposals of parameter modification in order for the examination to continue. • SAR Reduction Techniques • Parameters that may affect SAR • Increase TR – Decrease SAR • Note: Small cushion of 50 to 100 ms can be added to the minimum TR, this may allow for SAR recovery. • Must be conscious of additional TR may affect the weighting of the pulse sequence (e.g.- T1, Proton density) • Decrease number of slices or increasing the TR, SAR can be reduced • Increase number of Resolution and Phase encoding steps – Increase SAR • Additional RF Pulses (Spectral FS, Inversion, MT) due to an increase in TR, can increase SAR • Turbo Factor is increased – Increase SAR • Concatentations is increased – Decrease SAR • Pulse sequence types- using a spin echo or gradient echo vs. a turbo spin echo can reduce SAR • Hyperecho on 3T- will decrease SAR • Saturation Bands- Increase SAR • Note increase sat band thickness- SAR is increased • RF Pulse type – Low SAR and VERSE will decrease SAR • VERSE available on 3T Note: For detailed SAR system instructions see the Operator’s Manual. 31 syngo® MR Systems with Tim | Turnover Workbook 12 Viewing Task Card Tool for viewing, optimizing, and evaluating the patient’s data for diagnosis. A Notes maximum of three patients can be loaded into individual folders within the Viewing Task card simultaneously. If set accordingly, images will automatically load into the Viewing Task Card. 12.1 Manually Load Images • Select > Load to Viewing Icon from toolbar in Patient Browser • Drag and drop data from Patient Browser to Viewing Task Card • Main menu > select Patient > Load to Viewing • Viewing Task Card in foreground > Open Patient Browser and double left mouse click on patient, study, or series folder 12.2 Scrolling Through Images • Symbol Keypad: Image (+ and -) and Series (+ and -) to page through images or series. • Note: This method only works within the active segment. 12.3 Dog ears in image segment • Dog ears only available in series stack mode • Left mouse click on the dog ears to page through images • Page up/Page Down buttons on keyboard A AUBURN DIAGNOSTIC IMAGING 4/13/2007 Espree Dog Ears 9:40:57 AM MR B13 3 IMA 11 /18 HFS LPE 5cm MF 1.00 TR 711.0 om TE 160 SP F1.7 TA 02:16 2 SL 4.0 BY 120.0 FoV 160*160 A2IFS 192*320 C:SH Tra toe201 3/150 RIGHT W 772 308 32 syngo® MR Systems with Tim | Turnover Workbook 12.4 View – Screen layouts Notes Tools Image View auto • Modify screen layout • Stripe – images from a series populate all segments sequentially • Stack – Images from each series an individual segment. Dog ears can be used to page through the images. • Single View Segments • 1:1 • 2:1 • 4:1 • 9:1 • 16:1 auto • Multi View – Load up to four patients into a single folder. • Multi View Segments • 1:4 • 1:2 • 2:2 • 3:3 • 4:4 auto 33 syngo® MR Systems with Tim | Turnover Workbook • Automatic Movie Mode – Plays images in a movie mode in the active segment. Notes • Operator can change the frame rate, pause, reverse or play the images in a cine loop • Click on icon to start and stop movie auto Movie Properties X From To 120 Yoyo Show graphics 8 F/s Frame Rate 8 F/S Popup this dialog each time automatic movie is started Close Help 34 syngo® MR Systems with Tim | Turnover Workbook 12.5 View – Image subtask card Notes Tools |Image View D- auto • Minify by 0.5 – Reduces image size by a factor of 0.5 when icon is selected • Magnify by 2.0 – Enlarges image by a factor of 2.0 when the icon is selected • Zoom Factor –Manually type in a zoom factor for magnification • Fit to segment – Returns image to the original size • Zoom/Pan – Manually magnify and minify image. Manually pan the image in the active segment • Home Zoom/Pan – Image returns to original size and position in active segment • Auto Windowing – Default image window setting -O- auto 35 syngo® MR Systems with Tim | Turnover Workbook 12.6 View – Tools Subtask Card Notes Tools Imago View • Circle – Mark and evaluate anomalies in the images or evaluate gray scales • Distance – Measure the length between two points • Angle – Calculate an angle after two lines are created that intersect • Freehand ROI – Draw any ROI shape • Pixel Lens – Displays average gray scale value across a small area of 5x5 pixels. Displays the coordinates of the marker relative to the isocenter. • Annotate – Annotate using text and/or an arrow for interesting .XYZ or abnormal areas in the images (insert image 112 annotate icon) 36 syngo® MR Systems with Tim | Turnover Workbook 12.7 Windowing images Notes • Change image contrast and brightness using the mouse. • Window and level values are displayed in the image. • W (Window width) = contrast • C (Window center) = brightness • Select image with middle mouse button • Drag mouse left/right – contrast changes • Drag mouse up/down – brightness changes Note: To restore original window values, select Image >Home Window in the main menu 12.8 View – Patient Subtask Card Patient | Eval Exam • Patient Registration – Register a new patient or a patient from Scheduler • Position Display: Series – creates position display using two to three reference images utilized when positioning slices in Exam Task Card • Position Display: Selection – creates a reference image so the user can display slices onto a different image other than the one utilized when positioning slices in the Exam Task Card. • Close Patient – closes patient images in an open folder in the Viewing Task Card 37 syngo® MR Systems with Tim | Turnover Workbook • Film Preview – shows series/image numbers currently on virtual Notes film sheet (no images are seen) • Copy to Film Sheet – Sends series or images selected to Film Task Card • Local Database – Opens Patient Browser > Defaults to Local Database • 3D MPR – Sends selected images to 3D Task Card and loads into MPR • Send To – Sends selected images to a preferred network node 12.9 View – Evaluation Subtask Card Patient Eval Exam 6 + X ADC T1 0 T20 • Addition – Adds grayscale values from different images/series (equivalent to superimposed images) +0 • Subtraction – subtracts grayscale values from two separate sets of images or series - • Arithmetic mean – combines grayscale values across several images or series XI 38 syngo® MR Systems with Tim | Turnover Workbook Notes • ADC – Creates an Apparent Diffusion Coefficient (ADC) image and averages different spatial directions and b-values ADC • T1 – Permits quantification of T1 tissue contrast • T2 – Calculates T2 images, uses images with same slice position and TR, but multiple echo times (TE) T20 • Image Filter – post-processing filter (inline or offline availability) • Standard filters – Smooth, Offline Image Filter Paramete X Medium, Sharp Medium (3/3) Edge Enhancement 3 • Edge Enhancement Smoothing: F 3 • Degree of edge and line enhancement Store • 1: Least amount of edge Result Series Description enhancement 11 f13d tra dynaVIEWS PRE FIL 1 • 5: Maximum amount of edge OK Cancel Help enhancing • Smoothing • Degree of smoothing • 1: Least amount of smoothing • 5: Maximum amount of smoothing 12.10 View – Exam Subtask Card Patient | Eval Exam • Histogram – Evaluates distribution of grayscale values for drawn ROI’s; (e.g., circle, rectangle, freehand ROI) • Selected Marked – Activates all the sequences or images that have been marked • Selected Unmarked – Activates all the sequences or images that are not marked 39 syngo® MR Systems with Tim | Turnover Workbook 12.11 Rotating and flipping an Image Notes • Orientation labels are rotated and flipped together with the image. • Select images in viewing > Select > Series – selects all images within the segment • Main menu > Image mage Tools Scroll Evaluation Windowing Windowing OnSelection Windowing OnSucceeding Windowing OnSeries Color Lookup Table ... Invert Home Window Save Window Values Ctrl+W Auto Windowing Auto Windowing On Magnify by 2.0 Minify by 0.5 Zoom Factor Fit to Segment Acquisition Size Zoom/Pan Home Zoom/Pan Zoom/Pan OnSelection Zoom/Pan OnSeries Rotate. Rotate 90 Flip Horizontally Flip Vertically Rotate – Type amount in degrees Rotate Image X • to rotate image • Rotate 90 –rotates image 90 degrees clockwise Rotate by degree • Flip Horizontally – flips images horizontally • Flip Vertically – flips images OK Cancel Help vertically • Save flipped images – Main menu > Patient Save As. Patient Applications Transfer • New series created Register. Num 0 Browser. Num Search Search Selected Schedule Close Patient Save As. 12.12 Save New series • Save an image or images in a new series in the Viewing Task Card • Main menu > Patient > Save As 12.13 Image Text Information • Please refer to Appendix A for Image Text Information 40 syngo® MR Systems with Tim | Turnover Workbook 13 Filming Task Card The Filming Task card is where patient images, series, or studies are transferred Notes prior to sending them to the camera for printing. The patient’s name is displayed next to the folder(s) in the upper right hand corner of the Filming Task card virtual film sheet. 13.1 Steps for Filming • Patient Browser, select patient, series(s) or image(s) > select > Copy to Film Sheet icon. (Patient Browser toolbar). • Images can also be sent to the Filming Task card from the Viewing task card. Viewing Task Card > select image segment > right mouse Filming select series > select Copy to Film Sheet icon. • Selected images are loaded to the virtual film sheet on Filming Task Card. Select Filming Task Card • Select One Film Sheet – Click on the border of the film sheet. All images of the displayed film sheet are selected (e.g., marked with a continuous line border). • Select All Film Sheets – Click on the patient folder icon to select all film sheets in the folder (e.g., folder turns LIVER blue) • Deselect all images (or) film sheets: left mouse click outside the film sheet to deselect all images • Change Filming Layout – Click on Patient Folder (e.g., folder turns blue) > select Layout subtask card > select Layout. Layout | Images Camera H Layouts 3x4 • Send Film Sheets to Camera – Select > Expose Film Task icon – All selected film sheets are transferred to the camera. 41 syngo® MR Systems with Tim | Turnover Workbook 13.2 Filming Properties Notes • Open Filming Properties window – Right mouse click on Filming Task card > select Properties – Filming properties menu window opens Film Properties X Layout : Layout General Default All text Layout 4x4 · Customized text No text Aspect ratio Fit to segment Scale Bar MOrientation Label · Original Image OPatient Name (100%) Patient ID Clip document OOther Patient IDs Overlay graphics OBirth Date, Patient's Sex and Age Show DAccession Number OStudy ID Hide MAcquisition Date MAcquisition Time Reference image SeriesImageNumberAndTotalNumberOfimages Top right OInstitution Name Bottom right Manufacturers Model Name OSoftware Version OK Help • Filming properties window contains • Layout – pre-defined layouts in drop down menu • Text options – All text, Customized text, No text • Reference image – places a reference image in the Top or Bottom right corner of the image segments(s) • Change Reference Image in Film Sheet segment – Filming Task card in foreground > Open Patient Browser > select one image from a series > Drag and drop image into the reference image box on the Film sheet. 13.3 Copies 1 Copies • Filming Task Card > change number of copies from default selection for a single film job. 13.4 Camera Layout | Images Camera • Change Default Camera Camera • Camera Subtask Card > select different camera MrService from drop down menu. (e.g., available for scanners when multiple cameras are configured). Status: • Note: Change the default camera prior to processing the images and sending to the Film Size camera Lega 42 syngo® MR Systems with Tim | Turnover Workbook 14 Archiving Archiving to a DVD, CD-R, or local network prevents data loss and is used for Notes • long term storage of patient data. Patient data should be archived on a regular basis. • Media types – DVD-R or CD-R discs • Write-once media is supported • Re-writable media is not supported • Siemens recommends medical grade discs for long-term archival purposes since medical grade discs are more resistant to scratching • Medical grade discs can be found with an online search • Siemens Medical Solutions Accessory Solutions Corporation 1-888-222-9944, option 1 14.1 Export or Archive Patient Data • Open > Patient Browser • Select patient, study, series or images to be archived. • Select Main Menu > Transfer > Export to or Transfer > Archive to or Archive Icon (e.g., Service configures either Export to or Archive to for data storage) • Enter Label Dialog window – opens only when archiving to a new disc never used • Label on medium – minimum of three characters • Viewing tool • DICOM Viewer allows images to be viewed on any PC • Not recommended for image diagnosis 14.2 Eject from & Eject finalized • CPU Tower: Eject discs from the write drive drawer using Eject from or Eject Finalized. e.g., these options close all background files prior to ejecting the media from the write drive drawer. • Eject from • Main Menu > Transfer > Eject from… • Select drive drawer to eject the media Reader (DVD-ROM) (or) Writer (DVD-Write) • Note: It is recommended to remove the DVD or CD from the write drive drawer prior to shutting down or rebooting the system. • Eject Finalize • Closes all sessions on a DVD and finalizes the disk before ejecting the media • If this option is chosen the DVD is write protected and no additional data can be archived to the disk 43 syngo® MR Systems with Tim | Turnover Workbook 14.3 Sending to a Network Node Notes Patient data can be sent over the network (e.g., PACS, syngo.via; workstations) when system is connected to a network via the Send to function • Open Patient Browser > Select patient, study, series or images to be sent via the network • Select Send to Icon on the toolbar (Or) • Main Menu > select Transfer > Send to (Or) • Send to node 1 on Symbol keypad • Select Network node > select Send 44 syngo® MR Systems with Tim | Turnover Workbook 15 3D Task Card 15.1 Load images into 3D Task Card Notes • Images can be loaded from the Patient Browser or from another Task card • Select Patient Browser > select 3D images for reconstruction • Main menu > Applications 3D > MIP or MPR • MIP – Maximum Intensity Projection, used for vascular reconstructions • MPR – Multi-Planar Reconstruction, used for anatomical reconstructions • Sagittal, Coronal, and Axial projections are visualized • Top left segment (red border) – Sagittal projections displayed • Top right segment (blue border) – Coronal projections displayed • Bottom left segment (Blue border) – Axial projections displayed • Bottom right segment is reserved for 3D image reconstruction 15.2 3D Task Icons Free Hide Reference Orientation Mode Lines Control Rotate Zoom/ Home Images Pan Zoom/Pan • Free Mode – freely change reference lines angulations in any segment • Hide Reference Lines – Removes reference lines from all three image segments • Orientation Control – Controls in-plane rotation of reference and calculated images • Recommended when reformatting MPR Images • Rotate Images – Rotate image freely • Zoom/Pan – Magnify or pan images • Home Zoom/Pan – Resets images to original display (e.g., only effects active segments 45 syngo® MR Systems with Tim | Turnover Workbook 15.3 Type Subtask Card Notes MPR MPR Thick SSD Type Orien ... Image MIP Thin MIP • MPR (Multi-Planar Reconstruction) – Calculates two dimensional images from a 3D volume in other orientations and various angulations • MPR Thick – Defines the thickness of the original slice from which the image will be reconstructed • MIP (Maximum Intensity Projection) – Calculates a volume with the most intensive gray scale values for the projected image reconstruction (e.g. blood vessels) • MIP Thin – Projected image is calculated through a slice of the volume (user defines thickness of the slice for reconstruction) • Right mouse click MPR Thin icon – 3D MIP Thin dialog window opens > modify thickness 15.4 Orientation Subtask Card Patient Views Type Image Default Orientation Ortho Sync • Patient Views – Change orientation of the image in the active segment • Default Orientation – Changes all three segments back to the default orientation (sagittal, coronal and axial). • Note: Select default orientation prior to performing a MIP to avoid double oblique reconstructions • Ortho Sync – Two segments are made perpendicular to the reference segment 46 syngo® MR Systems with Tim | Turnover Workbook 15.5 Settings Subtask Card Notes Parallel Ranges Radial Ranges Curved Ranges Setti Curved Mode VOI Clip box" VOI Punch Mode • Parallel Ranges – Creates slices with a defined slice thickness and distance perpendicular to the reference image • Radial Ranges – Creates a range of images from different angles • Curved Ranges- Creates a series of curved parallel images with a defined thickness and distance perpendicular to the reference image • VOI Clipbox – Purple box displayed lower right segment, reduce size to remove unwanted tissue (e.g., updates image display in all segments) • VOI Punch mode – draw a freehand region to remove or keep structures (drawing tool) 15.6 Lower Icons • Save – Saves images in the active segment to the Patient Browser • Note: Saved under a generic description; (e.g., MPR Range) • Save and Copy to Film Sheet – Saves and sends images in the active segment to the Filming Task Card • Save As – Modify the series name and place a comment on the images prior to saving reconstructed mages to the Patient Browser • Close Patient – unload patient data in the 3D Task Card 47 syngo® MR Systems with Tim | Turnover Workbook 15.7 3D Task Card – MIP Notes • Select Patient Browser • Select 3D series • Select Applications > 3D > MIP – load images from Patient Browser into the 3D Task Card • Select 3D Task Card > Left mouse click on one of the three segments to activate • Select VOI Punch Mode icon • Select Draw Contour tool (e.g., default selection On) • Depress left mouse and draw by moving cursor over area in the segment • Leave a small space between the start and end of the drawing > Double left mouse click – closes drawing • Select Keep Inside (or) Remove Inside • Note: Repeat Draw Contour tool steps to remove additional areas of unwanted tissue ............. • Select Axial image segment – left mouse click on segment to activate • Rotation: Left to Right (or) Right to Left • Select Radial Ranges icon • 3D: Radial ranges window opens – define the following • Rotation start and end points • Angle between images (or) Number of images • Presets – Select a preset 3D: Radial Ranges from dropdown menu. (e.g., X MIP presets are defined and Presets RT to LT COM saved by user) Select Start – calculates MIP images in lower 3D: Radial Ranges • X right quadrant. Presets right to left Angle between images 10.0 deg Number of images 19 Start Close Help • Select Save As Icon • 3D: Save As window • Comment – comment placed on all images 3D. Save As Patient TOF • Range series name – names series in Patient Modality MR Exam date 02/01/11 13:51:34 Images 13 Browser Image type Range of MIP Reading Physician Comment Left to Right Range series name| Left to Right OK Cancel Help 48 syngo® MR Systems with Tim | Turnover Workbook Notes • Select OK – Calculated images saved to patient 3D: Save As browser Patient TOF Modality MR Exam date 02/01/11 13:51:34 Images 20 Image type Range of MIP eading Physician Comment MRA left to right Range series name MRA left to righ OK Cancel Help • Select Sagittal image segment – left mouse click on segment to activate • Rotation: Head to Feet (or) Feet to Head • Select Radial Ranges icon • Define 3D Radial ranges window • Rotation start and end points • Angle between images (or) Number of images • Presets – Select a preset from dropdown menu. (e.g., MIP presets are defined and saved by user) • Select Start – calculates MIP images in lower right quadrant. • Select Save As Icon • 3D: Save As window • Comment – comment placed on all images • Range series name – names series in Patient Browser • Select OK – Calculated images saved to patient browser 15.8 MPR – Workflow • Select Patient Browser • Select 3D series • Select Applications > 3D > MPR loads images from Patient Browser into the 3D Task Card • Select 3D Task Card > Left mouse click on one of the three segments to make it active (e.g., sagittal, coronal, or axial) • Select Parallel Ranges icon – Create a range of slices on one of the images • 3D: Parallel Ranges window opens – define the following • Select Horizontal Ranges icon (or) Vertical Ranges icon • Define ranges start and end points • Swap Range Order – Reverses image numbering (insert image 125 Swap Range Order) • Constant Number of Images • Icon on – keeps number of slices constant and modifies distance between images in millimeters when defining start and end points. • Icon off – keeps distance between images constant and modifies number of slices in millimeters when defining start and end points. 49 syngo® MR Systems with Tim | Turnover Workbook • Image thickness Notes • Note: Images cannot be reconstructed thinner than acquired. • Distance between images • Note: If defining, type in distance between images > deselect constant number of images > select enter > define start and end points > select start) • Number of images • Note: If defining, type in number of images > define start and end points > select start) • Select Start - calculates MPR images in lower 3D: Parallel Ranges X right quadrant Presets Default Parallel SCORE mage thickness 1.0 mm Distance between images 2.6 mm Number of images 22 Star Close Help • Select Save As Icon • 3D: Save As window 3D: Save As • Comment – comment placed on all images X Patient Wrist, left • Range series name – names series in Patient Modality MR Exam date 09/17/10 16:21:32 Images 20 Browser Image type Range of MPR Reading Physician Comment| Left wrist MPR axial Range series namel Left wrist MPR axial OK Cancel Help • Select OK – Calculated images saved to patient browser 50 syngo® MR Systems with Tim | Turnover Workbook Notes 51 syngo® MR Systems with Tim | Turnover Workbook Appendix A: Image Text Information 52 APPENDIX Text Information in P.2 Medical Images Various information is shown as image text on medical images. This information is used to identify the patient and to document measurement and image parameters. The image text is sorted by topic and positioned in the four cor- ners of the image. 6 Patient Name> Orientation Patient ID> < Other Patient IDs> label (1) "Birthdate;Age> (3) < Accession Number> "Acquisition Time> a *Sequence Mask> < Slice Position> (4) #Acquisition Matrix Interpolated> (5) Contrast Bolus Agent- Flow Duration *Sequence Name/ Flip Angle> Image Comment Image Comment (2) (1) Patient and examination data (2) Comment lines (3) System-specific information (4) Examination and image parameters (5) Data regarding the MR image (6) Orientation mark (7) Scale bar P.2–1 Text Information in Medical Images Appendix Content of the image text components Here is a list of the individual items of information in the image text components. (1) Patient and examination The top left corner shows the patient and examination data. data ➭ Text lines Other Patient IDs and Accession Number are sup- pressed when empty. All subsequent lines are moved upward. Image text Example Description Patient name Peter Patient Patient ID 02081948 Additional patient number 0123456789 Date of birth, age *11/11/1970; 30Y Accession number # 12345 Examination Number STUDY 1 Date acquired 17.10.01 Time acquired 13:47:46 Series and image number and 2 IMA 5/7 Series 2, a total of 7 images in total number of images series 2, image 5 is displayed P.2–2 Operator Manual Appendix Text Information in Medical Images (2) Comment lines At the lower edge next to the measurement and image parame- ters, data regarding contrast agent administration as well as an image comment are provided. ➭ The second line of the image comment is optional. Image text Example Description Contrast medium/time after GADOLINIUM 1.1 1.1 s after administering GADO- injection in sec LINIUM Image comment Motion: 0.27, -0.07, 1.29, -0.47, Motion correction parameter 0.11, -0.01 (3) System-specific The top right corner shows the name of your hospital or prac- information tice, the system name, the software version as well as the patient position and direction of viewing. Image text Abbreviation Example Institution St. Mary´s, New York - System name MAGNETOM Verio - Software version MR B15V - Patient position (orienta- HFS - Head First Supine tion and position) and HFP - Head First Prone viewing orientation HFDR - Head First Decubitus Right HFDL - Head First Decubitus Left FFS - Feet First Supine FFP - Feet First Prone FFDR - Feet First Decubitus Right FFDL - Feet First Decubitus Left P.2–3 Text Information in Medical Images Appendix Image text Abbreviation Example Coordinate system LPH (patient coordinate system left-posterior- +LPH head) Referring physician Dr. Mustermann Phase-encoding direction P.2–4 Operator Manual Appendix Text Information in Medical Images (4) Examination and image In the bottom left corner you can see the parameters used to parameters generate the image. Image text Abbreviation Example Rate of compression CR (Compression Ratio) CR 100 Loss of quality through com- How much storage space is saved (bits) pression 100 means that: an image that is normally 512 KB, is now only 5.12 KB This applies to lossless compres- sion as well. CQ (Compression Quality) CQ 75 Measure for loss on resolution 100 = no loss, 0 =greatest loss on resolution CQ! CQ! Image is compressed, however, the numbers for CR or CQ are missing ➭ Either CR or CQ is shown. Current zoom factor MF MF 1.51 Trigger time TT in msec TT 50 Inversion time TI in msec TI 50 Repetition time TR in msec TR 600 Echo time TE in msec TE 30 Measurement duration * TA TA 02:36*4 concatenations HH:MM:SS (hours range); MM:SS (minutes range); SS:HS (seconds range) Pixel bandwidth BW in Hertz/pixels BW 1000.0 Image type → Page P.2–17, List of image types p(x) - Grappa with acceleration factor x P(x) - Sense with acceleration factor x p2 M/MIP Measurement options (1st line) RG - Respiratory Gating RG/CT CG - Cardiac Gating RT - Respiratory Trigger CT - Cardiac Trigger EXT - External Trigger P.2–5 Text Information in Medical Images Appendix Image text Abbreviation Example Averages/measurement A(y) - Number of averages A4/FS/SAT1/MT options (2nd line) FS - fat saturation WS - Water saturation WE - Water excitation SAT (y) - Number of saturation regions DB - Dark blood IR - Inversion recovery SR - Saturation recovery G(x) - Grid tag with x mm grid distance or L (x) - Line tag with x mm line distance MT - MTC pulse PPF - Phase Partial Fourier Coil information → Page P.2–8, List of coil abbreviations in the NE1;SP1 image text Sequence name/flip angle A * in front of the sequence name means that an *TS2_23 80 original Siemens sequence was used. P.2–6 Operator Manual Appendix Text Information in Medical Images (5) Data about the MR The bottom right corner shows data regarding the position, ori- image entation, and thickness of the acquired slice, about the extent (FoV), as well as the window values. ➭ The text line Flow Encoding Direction is suppressed when empty. All subsequent lines are moved upward. Image text Abbreviation Example Sequence mask D - Door open D\I I - Interpolation R - Raw data filter E - Elliptical filter Table position (H,F) TP TP H300 H/F in mm Slice position (+LPH) SP in mm SP L8.7 Slice thickness SL in mm SL 4.0 Interpolated slice thickness SL i in mm SL 4.0 i FoV (field of view) FoV in mm FoV 230 230 X Acquisition matrix interpolated I - Interpolation Acquisition matrix not interpo- p - partial Fourier 192p 256s X lated s - swap 192p 256s x Image orientation Sag, Tra, Cor Tra>Cor(-20)>Sag(-30) Flow-encoding direction v(XXX)_inplane_xy - in-plane flow encod- v150_inplane_fh ing v(XXX)_through - through-plane flow encoding XXX - flow velocity in cm/sec xy - direction, e.g., fh (feet to head) Window width (contrast) W W -100 Window center (brightness) C C -200 P.2–7 Appendix Text Information in Medical Images List of image types The image type is shown in the lower left image text. Orientation label <"Birthdate;Age> Software Version> * Accession Number> : Referring Physician> Acquisition Time> Magnification Factor> Trigger Time>

"Acquisition Duration"Concatenations> Pixel Bandwidth> Slice Thickness> PAT Image Type> =FlowEncodingDirection= Contrast Bolus Agent- Flow Duration #Sequence Name/ Flip Angle> Image Comment Image Comment *Window Center> An image may include more than one image type, e.g., after several post-processing steps. These are appended to one another and separated by a forward slash. If the maximum line length is exceeded, the last image types are omitted. Example Assuming the defined maximum length is 18 characters: From TYP1/TYP2/TYP3/TYP4 (19 characters) will be truncated to TYP1/TYP2/TYP3 (14 characters). P.2–17 Text Information in Medical Images Appendix Abbreviation Image type Topic 3D EDITOR Image resulting from 3D editor processing 3D reconstruction 3D FUSION Fusion image 3D reconstruction ADC Apparent Diffusion Coefficient Map Diffusion, Stroke and Breast Perfusion ADD Image resulting from an addition Dynamic Analysis AVERAGE VRT image 3D reconstruction BLACK IMAGE Graphic image 3D reconstruction BLACK IMAGE Graphics and table image Mean Curve COMB Combination image Diffusion, Stroke and Breast Perfusion COMPOSED Composed Images Image Composing COR Correlation image Functional imaging Dynamic Analysis CV(xx) Filtered Images Dynamic Analysis (xx stands for filter strength, integer value) DIFFER Differentiation image Dynamic Analysis DIFFUS Diffusion image Dynamic Analysis DIS2D 2D distortion corrected image Inline post-processing DIS2D* 2D distortion-corrected image. Cannot be used Inline post-processing as a reference image for positioning, because measurement is too far off-center. DIS3D 3D_distortion-corrected image Inline post-processing DIV Division image Dynamic Analysis E1 Diffusion image that shows the weighting of Diffusion the eigenvector E1 E1-E2 Diffusion image that shows the weighting of Diffusion the eigenvector ratio E1-E2 E1-E3 Diffusion image that shows the weighting of Diffusion the eigenvector ratio E1-E3 P.2–18 Operator Manual Appendix Text Information in Medical Images Abbreviation Image type Topic E2 Diffusion image that shows the weighting of Diffusion the eigenvector E2 E2-E3 Diffusion image that shows the weighting of Diffusion the eigenvector ratio E2-E3 E3 Diffusion image that shows the weighting of Diffusion the eigenvector E3 EXP Exponential Map Diffusion FA Fractional Anisotropy Map Diffusion FIL Inline Image Filter Inline post-processing FILTERED BOLD or perfusion image with spatial filtering Inline post-processing FS(x_Y), FSH(x_y), Offline Image Filter Dynamic Analysis FM(x_y), FS, FSH or FM GBP Global time-density curve (Global Average Diffusion, Stroke and Breast Bolus Curve Plotted; passage of bolus) Perfusion GSP Reference image with graphic objects Graphic slice position INT Integration image Dynamic Analysis LIN Barycentric Map, category "Linear" Diffusion LOG Logarithmic function image Dynamic Analysis LOW_B Image with low diffusion weighting Diffusion M Rephased image (magnitude image) Flow quantification MAG Magnitude image Phase contrast Angio MEAN Mean value image Functional imaging Dynamic Analysis MIP Maximum Intensity Projection image 3D reconstruction Inline post-processing MIP THIN MIP Thin image 3D reconstruction MIP_COR Coronal image from MIP reconstruction Inline post-processing MIP_SAG Sagittal image from MIP reconstruction Inline post-processing MIP_TRA Transverse image from MIP reconstruction Inline post-processing P.2–19 Text Information in Medical Images Appendix Abbreviation Image type Topic MITP Maximum Intensity Time Projection image Diffusion, Stroke and Breast Perfusion MOCO BOLD or perfusion image with motion correc- Inline post-processing tion MOSAIC Mosaic image Functional imaging MPR Multiplanar reconstruction image (MPR) 3D reconstruction MPR CURVED Curved MPR image 3D reconstruction MPR THICK MPR Thick image 3D reconstruction MPR THIN MPR Thin image 3D reconstruction MSUM Sum image from magnitude images of a slice Phase contrast Angio MULT Multiplication image Dynamic Analysis ND non-distortion corrected image Inline post-processing NORM Image after normalization algorithm Inline post-processing OTHER Converted N3/3.5 image or SC (secondary cap- Import/Export tured) image P Phase contrast image Flow quantification PBP Percentage signal image (Percent-of-Baseline Diffusion, Stroke and Breast at Peak; bolus peak relative to baseline). Perfusion PDT1 T1-weighted proton density image Dynamic Analysis PDT2 T2-weighted proton density image Dynamic Analysis PEI Positive Enhancement Integral image Diffusion, Stroke and Breast Perfusion PLAN Barycentric Map, category "Planar" Diffusion POSDISP Position display image Position display PROJECTION IMAGE Projection image Inline post-processing R Real image Flow quantification RA Relative Anisotropy Map (relative FA) Diffusion P.2–20 Operator Manual Appendix Text Information in Medical Images Abbreviation Image type Topic RELCBF Relative CBF image (relat. cerebr. blood flow) Diffusion, Stroke, and Breast Perfusion RELCBV Relative CBV image (relat. cerebr. blood vol- Diffusion, Stroke, and Breast ume) Perfusion RELMTT Relative MTT image (relat. average transit Diffusion, Stroke, and Breast time) Perfusion RESAMPLED Zooming/panning image 3D reconstruction RETRO Retro-Gating image Inline post-processing SCM Signal Change image Diffusion, Stroke and Breast Perfusion SDEV Standard deviation image Dynamic Analysis SLOPE SLOPE evaluation result Dynamic Analysis sMRI Structural MRI (Anatomy) Diffusion SPEC Spectrum Spectroscopy SPHER Barycentric Map, category "Spherical" Diffusion SSD SSD reconstruction (Shaded Surface Display) 3D reconstruction STDDEV_COR Coronal standard deviation image Inline post-processing STDDEV_SAG Sagittal standard deviation image Inline post-processing STDDEV_TRA Transverse standard deviation image Inline post-processing SUB Subtraction image Dynamic Analysis SUBTRACT Subtraction image 3D reconstruction T1 T1 image Dynamic Analysis T2 T2 image Dynamic Analysis TCS Time Course of Signal Diffusion, Stroke and Breast Perfusion TG Tensor graphic Diffusion TMIP Temporal MIP, MIP reconstruction of time Inline post-processing sequence of images P.2–21 Text Information in Medical Images Appendix Abbreviation Image type Topic TMIP_COR Coronal TMIP image Inline post-processing TMIP_SAG Sagittal TMIP image Inline post-processing TMIP_TRA Transverse TMIP image Inline post-processing TRACE Trace weighted image Diffusion TSTDDEV Temporary standard deviation image Inline post-processing TTEST Student's t-test image (for BOLD images) Functional imaging Dynamic Analysis TTP Time To Peak image Diffusion, Stroke and Breast Perfusion TU The protocol parameters were automatically General changed by a tool (e. g. AutoAlign Spine) TU M Protocol parameters were automatically General changed by a tool (e. g. AutoAlign Spine) and then one more time manually. VR Volume Ratio Map Diffusion VRT VRT (Volume Rendering Technique) image 3D reconstruction WI Wash In image Diffusion, Stroke and Breast Perfusion WO Wash Out image Diffusion, Stroke and Breast Perfusion P.2–22 Operator Manual syngo® MR Systems with Tim | Turnover Workbook Appendix B: MRI Acronyms 66 Vendor MRI Acronyms Siemens GE Philips Hitachi Toshiba Sequence Type Spin Echo SE SE SE SE SE Gradient Echo GRE GRE Fast Field Echo (FFE) GE Field Echo Spoiled Gradient Echo FLASH SPGR T1-FFE RF Spoiled SARGE, RSSG FastFE Coherent Gradient Echo FISP GRASS SSFP Rephased SARGE FFE Steady-State Free Precession PSIF SSFP T2-FFE Time-Reversed SARGE True FISP TrueFISP FIESTA True SSFP Balanced FFE Balanced SARGE, BASG True FISP/Dual Excitation CISS FIESTA-C Phase Balanced SARGE, PBSG – – Double Echo Steady State DESS – – – – Multi-Echo Data Image Combination MEDIC MERGE M-FFE – – Ultrafast Gradient Echo TurboFLASH Fast GRE, Fast SPGR TFE RGE Fast FE Ultrafast Gradient Echo 3D MPRAGE 3D FGRE, 3D Fast SPGR 3D TFE MPRAGE 3D Fast FE Volume Interpolated GRE VIBE LAVA-XV THRIVE TIGRE Body Diffusion REVEAL DWIBS Body Vision Susceptibility-Weighted Imaging SWI (SWAN) (Venous BOLD) – Dynamic MRA with k-space Manipulation TWIST TRICKS-XV Keyhole (4D-TRAK) – High-Resolution Bilateral Breast Imaging VIEWS VIBRANT-XV BLISS RADIANCE Non-contrast MR Angio, TSE-based NATIVE-SPACE TRANCE VASC FSE FBI, CIA – Non-contrast MR Angio, TrueFISP-based NATIVE-TrueFISP Inhance Inflow IR B-TRANCE VASC ASL Time-SLIP Parametric Mapping MapIT CartiGram – – Inversion Recovery IR,Turbo IR (TIR) IR, MPIR, FastIR IR-TSE IR IR Short Tau IR STIR STIR STIR FastSTIR STIR Long Tau IR Turbo Dark Fluid FLAIR FLAIR FLAIR FastFLAIR True IR True IR Real IR FastIR – – Turbo Spin Echo/Fast Spin Echo TSE (Turbo Spin Echo) FSE (Fast Spin Echo) TSE (Turbo Spin Echo) FSE (Fast Spin Echo) FSE (Fast Spin Echo) Single-Shot TSE/FSE HASTE Single-Shot FSE Single-Shot TSE Single-Shot FSE FASE FSE/TSE with 90° Flip-Back Pulse RESTORE Fast Recovery FSE (FRFSE) Driven Equillibrium FSE T2 Puls FSE DRIVE Hyper Echoes Hyperecho – – – – 3D TSE with Variable Flip Angle SPACE CUBE VISTA – – Number of Echoes Turbo Factor Echo Train Length (ETL) Turbo Factor Shot Factor Echo Train Length (ETL) Time Between Echoes Echo Spacing Echo Spacing Echo Spacing Echo Spacing Interecho Time (ITE) Echo Planar Imaging (EPI) EPI EPI EPI EPI EPI Number of Echoes EPI Factor ETL EPI Factor Shot Factor Echo Train Length (ETL) Diffusion-Weighted Imaging DWI DWI DWI DWI DWI Apparent Diffusion Coefficient Map ADC ADC ADC ADC Map ADC Diffusion Tensor Imaging DTI Diffusion Tensor Imaging Diffusion Tensor Imaging DTI – DTI Tractography (Fiber Tracking) DTI Tractography FiberTrak FiberTrak – – Turbo Gradient Spin Echo (GRASE) TurboGSE, TGSE GRASE Hybrid EPI – – Motion Correction 1D Navigators for Cardiac Imaging 1D PACE Navigators 2D Navigators for Abdominal Imaging 2D PACE Navigators – – – 3D Prospective Motion Correction for fMRI 3D PACE – – – – 3D Retrospective Motion Correction for fMRI 3D ART – – Motion Correction with Radial Blades BLADE PROPELLER MultiVane RADAR JET Soft Tissue Motion Correction BRACE 2 Vendor MRI Acronyms Siemens GE Philips Hitachi Toshiba Sequence Type Spin Echo SE SE SE SE SE GRE GRE Gradient Echo Fast Field Echo (FFE) GE Field Echo Spoiled Gradient Echo FLASH SPGR T1-FFE RF Spoiled SARGE, RSSG FastFE Coherent Gradient Echo FISP GRASS FFE Rephased SARGE SSFP Steady-State Free Precession PSIF SSFP T2-FFE Time-Reversed SARGE True FISP TrueFISP FIESTA Balanced FFE Balanced SARGE, BASG True SSFP True FISP/Dual Excitation CISS FIESTA-C Phase Balanced SARGE, PBSG – – Double Echo Steady State DESS – – – – Multi-Echo Data Image Combination MEDIC MERGE M-FFE – – Fast GRE, Fast SPGR TurboFLASH Ultrafast Gradient Echo TFE RGE Fast FE Ultrafast Gradient Echo 3D MPRAGE 3D FGRE, 3D Fast SPGR 3D TFE MPRAGE 3D Fast FE Volume Interpolated GRE VIBE LAVA-XV THRIVE TIGRE Body Diffusion REVEAL DWIBS Body Vision Susceptibility-Weighted Imaging SWI (SWAN) (Venous BOLD) – Dynamic MRA with k-space Manipulation TWIST TRICKS-XV Keyhole (4D-TRAK) – VIBRANT-XV VIEWS High-Resolution Bilateral Breast Imaging BLISS RADIANCE Non-contrast MR Angio, TSE-based NATIVE-SPACE TRANCE VASC FSE FBI, CIA – Non-contrast MR Angio, TrueFISP-based NATIVE-TrueFISP Inhance Inflow IR B-TRANCE VASC ASL Time-SLIP CartiGram Parametric Mapping MapIT – – Inversion Recovery IR,Turbo IR (TIR) IR, MPIR, FastIR IR-TSE IR IR Short Tau IR STIR STIR STIR STIR FastSTIR Long Tau IR Turbo Dark Fluid FLAIR FLAIR FLAIR FastFLAIR True IR True IR Real IR FastIR – – Turbo Spin Echo/Fast Spin Echo TSE (Turbo Spin Echo) FSE (Fast Spin Echo) TSE (Turbo Spin Echo) FSE (Fast Spin Echo) FSE (Fast Spin Echo) Single-Shot TSE/FSE HASTE Single-Shot FSE Single-Shot TSE Single-Shot FSE FASE FSE/TSE with 90° Flip-Back Pulse RESTORE Fast Recovery FSE (FRFSE) DRIVE Driven Equillibrium FSE T2 Puls FSE Hyperecho Hyper Echoes – – – – 3D TSE with Variable Flip Angle SPACE CUBE VISTA – – Number of Echoes Turbo Factor Echo Train Length (ETL) Turbo Factor Shot Factor Echo Train Length (ETL) Time Between Echoes Echo Spacing Echo Spacing Echo Spacing Interecho Time (ITE) Echo Spacing Echo Planar Imaging (EPI) EPI EPI EPI EPI EPI EPI Factor ETL Number of Echoes EPI Factor Shot Factor Echo Train Length (ETL) Diffusion-Weighted Imaging DWI DWI DWI DWI DWI Apparent Diffusion Coefficient Map ADC ADC ADC ADC Map ADC Diffusion Tensor Imaging DTI Diffusion Tensor Imaging Diffusion Tensor Imaging DTI – DTI Tractography (Fiber Tracking) DTI Tractography FiberTrak FiberTrak – – Turbo Gradient Spin Echo (GRASE) TurboGSE, TGSE GRASE Hybrid EPI – – Motion Correction 1D Navigators for Cardiac Imaging 1D PACE Navigators 2D Navigators for Abdominal Imaging 2D PACE Navigators – – – 3D PACE 3D Prospective Motion Correction for fMRI – – – – 3D Retrospective Motion Correction for fMRI 3D ART – – Motion Correction with Radial Blades BLADE PROPELLER MultiVane RADAR JET BRACE Soft Tissue Motion Correction 3 Vendor MRI Acronyms Siemens GE Philips Hitachi Toshiba Parallel Acquisition Techniques iPAT PAT: Image-based Algorithm mSENSE ASSET RAPID SENSE SPEEDER PAT: k-space-based Algorithm GRAPPA ARC – – – Integrated Calibration Auto-Calibration Self-Calibration (with ARC) – – – Separate Calibration Turbo-Calibration (Calibration for ASSET) (Calibration for SPEEDER) (Calibration for RAPID) (Calibration for SENSE) / CLEAR Multiple datasets calibrate each other Self-Calibration, T-PAT – – – – Spectroscopy Prostate Spectroscopy 3D CSI PROSE – – Breast Spectroscopy GRACE BREASE – – – Comprehensive Cardiac Tool BEAT (2D/3D) – – – – Patient Orientation Sequence Localizer, Scout Localizer Locator Plan Scan Scanogram Contrast Bolus Timing/Visualization CARE Bolus Smart Prep; FluoroTriggered MRA BolusTrak FLUTE Visual Prep Sequence Parameters Repetition Time, Echo Time (in msec) TR, TE TR, TE TR, TE TR, TE Inversion Time (in msec) TI TI TI TI TI Averages Average NEX NSA NSA NSA Simultaneous Excitation Simultaneous Excitation POMP (Phase Offset Multiplanar) QuadScan Dual Slice Multi-Slice RF Pulse in Gradient Echo Flip Angle Flip Angle Flip Angle Flip Angle Flip Angle Scan Measurement Time Acquisition Time, TA Acquisition Time Acquisition Time Acquisition Time Scan Time Distance Between Slices Distance Factor (% of slice thickness) Gap Gap Slice Interval Gap Shifting Slices Off Center Off-center Shift Off-center FoV Off-center FoV Off-center FoV Phase & Frequency Shift Field of View (FoV) FoV [mm] FoV [cm] FoV [mm] FoV FoV Rectangular FoV FoV Phase/Rectangular FoV Partial FoV (PFoV) Rectangular FoV Rectangular FoV Rectangular FoV Bandwidth Bandwidth [Hz/Px] Receive Bandwidth [kHz] Fat/Water Shift [pixel] Bandwidth Bandwidth Variable Bandwidth Optimized bandwidth Variable Bandwidth Optimized Bandwidth Variable Bandwidth Matched Bandwidth Frequency Oversampling Oversampling Anti-Aliasing Frequency Oversampling Frequency Oversampling Frequency Wrap Suppression Phase Oversampling Phase Oversampling No Phase Wrap Fold-over Suppression Anti-Wrap Phase Wrap Suppression Segmented k-Space Lines/Segments Views per segment Segments Views/Segment Time Delay/Block k-space Time Delay Intersegment Delay TD TD Half Fourier Imaging Half Fourier 1/2 NEX; fractional NEX Half Scan Half Scan AFI Partial Echo Asymmetric Echo Partial Echo Matched Bandwidth Half Echo Partial Echo Gradient Moment Nulling GMR/Flow Comp Flow Comp Flow Comp; Flag GR FC Ramped RF Pulse TONE Ramped Pulse TONE ISCE SSP Magnetization Transfer Contrast MTC; MTS MTC SORS-STC MTC MTC Prep Pulse – Chemically Fat Sat Fat Sat/Chem Sat SPIR Fat Sat MSOFT Water Excitation Water Excitation PASTA Proset Water Excitation – Fat-Water separation DIXON IDEAL FatSep – Prep Pulse - Spatially Presat SAT REST Pre Sat Pre Sat Moving Sat Pulse Travel Sat; Tracking Sat Walking Sat BFAST Sequential Pre Sat Travel REST Scan Synchronization with ECG ECG Triggered Cardiac Gated/Triggering ECG Triggered/VCG ECG Triggered Cardiac Gated Delay after R-Wave Trigger Delay; TD Trigger Delay; TD Delay Time Trigger Delay; TD Trigger Delay; TD Respiratory Gating Respiratory Gated Respiratory Comp Trigger; PEAR MAR Respiratory Gated Multi-Channel RF Coil Sensitivity Normalization Prescan Normalize PURE NATURAL CLEAR – Central k-space Filling Arterial Visualization Elliptical Scanning Elliptic Centric PEAKS DRKS CENTRA Competition product descriptions, comparison, and specifications contained in this document are based on interpretation of available data at the time this material was being prepared and may require independent verification. Specifications have been obtained from competition brochures, websites, and other independent published sources. 4 Vendor MRI Acronyms Siemens GE Philips Hitachi Toshiba Parallel Acquisition Techniques iPAT PAT: Image-based Algorithm mSENSE ASSET SENSE RAPID SPEEDER ARC GRAPPA PAT: k-space-based Algorithm – – – Integrated Calibration Auto-Calibration Self-Calibration (with ARC) – – – Separate Calibration Turbo-Calibration (Calibration for ASSET) (Calibration for SENSE) / CLEAR (Calibration for RAPID) (Calibration for SPEEDER) Multiple datasets calibrate each other Self-Calibration, T-PAT – – – – Spectroscopy Prostate Spectroscopy 3D CSI PROSE – – Breast Spectroscopy GRACE BREASE – – – Comprehensive Cardiac Tool BEAT (2D/3D) – – – – Patient Orientation Sequence Localizer, Scout Localizer Plan Scan Scanogram Locator Smart Prep; FluoroTriggered MRA Contrast Bolus Timing/Visualization CARE Bolus BolusTrak FLUTE Visual Prep Sequence Parameters Repetition Time, Echo Time (in msec) TR, TE TR, TE TR, TE TR, TE Inversion Time (in msec) TI TI TI TI TI Averages Average NEX NSA NSA NSA Simultaneous Excitation Simultaneous Excitation POMP (Phase Offset Multiplanar) Multi-Slice Dual Slice QuadScan Flip Angle RF Pulse in Gradient Echo Flip Angle Flip Angle Flip Angle Flip Angle Scan Measurement Time Acquisition Time, TA Acquisition Time Acquisition Time Scan Time Acquisition Time Gap Distance Between Slices Distance Factor (% of slice thickness) Gap Slice Interval Gap Shifting Slices Off Center Off-center Shift Off-center FoV Off-center FoV Off-center FoV Phase & Frequency Shift Field of View (FoV) FoV [mm] FoV [cm] FoV [mm] FoV FoV FoV Phase/Rectangular FoV Rectangular FoV Partial FoV (PFoV) Rectangular FoV Rectangular FoV Rectangular FoV Bandwidth Bandwidth [Hz/Px] Receive Bandwidth [kHz] Fat/Water Shift [pixel] Bandwidth Bandwidth Variable Bandwidth Optimized bandwidth Variable Bandwidth Optimized Bandwidth Variable Bandwidth Matched Bandwidth Anti-Aliasing Frequency Oversampling Oversampling Frequency Oversampling Frequency Oversampling Frequency Wrap Suppression Phase Oversampling Phase Oversampling No Phase Wrap Fold-over Suppression Anti-Wrap Phase Wrap Suppression Views per segment Segmented k-Space Lines/Segments Views/Segment Segments Time Delay/Block k-space Time Delay Intersegment Delay TD TD Half Fourier Imaging Half Fourier 1/2 NEX; fractional NEX Half Scan Half Scan AFI Partial Echo Asymmetric Echo Partial Echo Partial Echo Half Echo Matched Bandwidth Gradient Moment Nulling GMR/Flow Comp Flow Comp Flow Comp; Flag GR FC Ramped RF Pulse TONE Ramped Pulse TONE SSP ISCE MTC; MTS MTC Magnetization Transfer Contrast MTC MTC SORS-STC Prep Pulse – Chemically Fat Sat Fat Sat/Chem Sat SPIR Fat Sat MSOFT Water Excitation Water Excitation Proset Water Excitation PASTA – Fat-Water separation DIXON IDEAL FatSep – Prep Pulse - Spatially Presat SAT REST Pre Sat Pre Sat Walking Sat Moving Sat Pulse Travel Sat; Tracking Sat Travel REST Sequential Pre Sat BFAST Scan Synchronization with ECG ECG Triggered Cardiac Gated/Triggering ECG Triggered/VCG ECG Triggered Cardiac Gated Delay after R-Wave Trigger Delay; TD Trigger Delay; TD Trigger Delay; TD Delay Time Trigger Delay; TD Respiratory Comp Respiratory Gated Respiratory Gating Trigger; PEAR MAR Respiratory Gated Multi-Channel RF Coil Sensitivity Normalization Prescan Normalize PURE CLEAR NATURAL – Central k-space Filling Arterial Visualization Elliptical Scanning Elliptic Centric CENTRA PEAKS DRKS 5 syngo® MR Systems with Tim | Turnover Workbook Appendix C: Sequences and Abbreviations 71 ci CISS (Constructive Interference in spcR NATIVE SPACE Steady State) csi Chemical shift imaging svs Single voxel spectroscopy de DESS (Dual Echo Steady State) swi Susceptibility-weighted imaging epfid EPI-FID tfi TrueFISP (trufi) epir EPI spin echo with inversion recovery tfi NATIVE TrueFISP epse EPI spin echo tfl TurboFLASH fi FISP (Fast Imaging with Steady State), tgir Turbo gradient spin echo with gradient echo sequence without RF inversion recovery spoiling fid Free induction decay tgse Turbo gradient spin echo fl FLASH (Fast Low Angle Shot), gradient tir Turbo spin echo with inversion echo sequence with active RF spoiling recovery h HASTE (Half Fourier Single Shot tirB Turbo spin echo with inversion TurboSE) recovery and BLADE trajectory hir HASTE with inversion recovery tirBR Turbo spin echo with inversion recovery, BLADE trajectory and “restore pulse” ir Spin Echo with inversion recovery tirR Turbo spin echo with inversion recovery and “restore pulse” me MEDIC (Multi Echo Data Image tse Turbo Spin Echo Combination) ps PSIF (time-reversed FISP) tseB Turbo spin echo with BLADE trajectory resolve RESOLVE (Readout Segmentation Of tseBR Turbo spin echo with BLADE Long Variable Echo trains), multi-shot, trajectory and “restore pulse” diffusion-weighted EPI se Spin Echo tseR Turbo spin echo with “restore pulse” spc SPACE (Sampling Perfection with Application-optimized Contrast using different flip angle Evolutions) syngo® MR Systems with Tim | Turnover Workbook Appendix D: Bandwith Conversion Chart Siemens to GE 73 syngo® MR Systems with Tim | Turnover Workbook Bandwidth Conversion Chart: Siemens to GE Siemens Bandwidth [Hz/pixel] 50 55 60 65 70 75 80 85 90 95 GE Bandwidth (256 Acquisition Matrix) [+/- kHz] 6.4 7.04 7.68 8.32 8.96 9.6 10.24 10.88 11.52 12.16 GE Bandwidth (512 Acquisition Matrix) [+/- kHz] 12.8 14.08 15.36 16.64 17.92 19.2 20.48 21.76 23.04 24.32 Siemens Bandwidth [Hz/pixel] 100 110 120 130 140 150 160 170 180 190 GE Bandwidth (256 Acquisition Matrix) [+/- kHz] 12.8 14.08 15.36 16.64 17.92 19.2 20.48 21.76 23.04 24.32 GE Bandwidth (512 Acquisition Matrix) [+/- kHz] 25.6 28.16 30.72 33.28 35.84 38.4 40.96 43.52 46.08 48.64 Siemens Bandwidth [Hz/pixel] 200 250 300 350 400 450 500 600 750 1000 GE Bandwidth (256 Acquisition Matrix) [+ / - kHz] 25.6 32 38.4 44.8 51.2 57.6 64 76.8 96 128 GE Bandwidth (512 Acquisition Matrix) [+ / - kHz] 51.2 64 76.8 89.6 102.4 115.2 128 153.6 192 256 Competitive information provided is based on interpretation of available data and may require independent verification. SIEMENS medical 74 On account of certain regional limitations of sales rights and service availability, we cannot guarantee that all products included in this brochure are available through the Siemens sales organization worldwide. Availability and packaging may vary by country and is subject to change without prior notice. Some/All of the features and products described herein may not be available in the United States. The information in this document contains general technical descriptions of specifications Local Contact Information and options as well as standard and optional Siemens Medical Solutions USA, Inc. features which do not always have to be 51 Valley Stream Parkway present in individual cases. Malvern, PA 19355-1406 Siemens reserves the right to modify the USA design, packaging, specifications and options Telephone: +1-888-826-9702 described herein without prior notice. Please www.usa.siemens.com/healthcare contact your local Siemens sales representative for the most current information. Global Business Unit Note: Any technical data contained in this Siemens AG document may vary within defined tolerances. Medical Solutions Original images always lose a certain amount Imaging & Therapy Systems of detail when reproduced. Magnetic Resonance Henkestr. 127 DE-91052 Erlangen Order No. A914CX-CS-14389-P1-4A00 Germany Printed in USA 01-2014 | All rights reserved Telephone: +49 9191 18-0 © 2014 Siemens Medical Solutions USA, Inc. www.siemens.com/healthcare Global Siemens Headquarters Global Siemens Healthcare Siemens AG Headquarters Wittelsbacherplatz 2 Siemens AG 80333 Muenchen Healthcare Sector Germany Henkestrasse 127 91052 Erlangen Germany Telephone: +49 9131 84-0 www.siemens.com/healthcare www.siemens.com/healthcare