syngo NATIVE SPACE Scanning Workflow (E-line)

syngo NATIVE SPACE Scanning Workflow (E-line) syngo MR Systems with E-line Software 1. NATIVE SPACE Exam Set-up: a. Patient Supine on table b. Orientation – Feet First c. Position laser marker on center of lower leg d. ECG Triggering is used for this workflow e. Note: Siemens protocol in the Dot Cockpit is set up with the peripheral angiography coil and spine elements 2. Run Localizers a. Multi-Step Localizer or optional FastView localizer 3. Select Cine_TD Scout Sequence a. Position Axial Slice for Cine_TD scout sequence with Middle of scan range b. Physio Tab i. Select Signal 1 ii. Click on not set for Captured Cycle button Signal1 Cardiac PACE 1st Signal/Mode ECG/Trigger Average cycle | 1000 + 3 ms Captured cycle -not set- Acquisition window 800 ms c. Apply Sequence i. Note: If acquiring a multi-step protocol, it is beneficial to perform a Cine_TD Scout at each imaging step EL_SPace_native EL_SPace_native 1.5.200828 O M/DIS2D trurisp_feet Fov 406-500 cor 1_trufisp_feet Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Job Aid | syngo NATIVE SPACE Scanning Workflow (E-line) Effective Date 05/18/2020 |HOOD 05162003088097 4. Mean Curve ROI Setup a. From the Patient Browser > Select the completed Cine_TD Scout Sequence b. Select Applications > Mean Curve c. Mean Curve Applications i. Select Tools > Circle icon ii. Draw a circle over an artery in each leg STUDY 1 Siemens Healthcare Sector MR 11/6/2008 4:10:50 PM 2 IMA 13 / 25 2 2 Min/Max: 5 /291 2 Area: 0.51 sql.cm 2 Mean/SD: 84.5 77. 10 cm MF 1.30 TT 357.1 TR 27.2 TE 3.2 TP H148 SP H147.7 p2 M/RETRO DIS2D SL 6.0 CT FoV 200*400 A1 128*256 T:PL2,3;PR2,3;SP8 Tra *f12d1r4 / 70 RR 744 +/- 38; 20 heartbeats 336 138 5. Mean Curve Evaluation a. Select Start Evaluation b. Select Mean Curve Graph segment with prescribed ROI’s c. Right mouse click > Scaling/Sorting > Axis Label > Select > Trigger Time Select Series Scaling Select OnSucceeding x-Axis y-Axis Clear Document(s) Minimum 0 Scaling/Sorting ... Smoothing Maximum Save Evaluation As ... Save As ASCII ... Axis Label o Ser / Ima No. O Trigger Time O Echo Time Slice Pos. O Normal Time Save As ... automatic Scaling Film Evaluation OK Cancel Help Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 2 of 5 Job Aid | syngo NATIVE SPACE Scanning Workflow (E-line) Effective Date 05/18/2020 |HOOD 05162003088097 d. Determine TD Maximum Flow from Mean Curve Graph i. Move vertical bar to highest peak of the intensity curve and note Trigger Time ii. Subtract 30 ms from Trigger Time EL_SPace_native Result Image 1 Mean Curve within (2 ima 1 - 2 ima 25) Scaling: Factor = 1.0 Offset = 0.0 SP H147.7 Average of mean values: 1: 78.00 58.52 Average of areas: 0.44 0.51 Average of max. values: 1: 199.04 155.04 NNN Trigger Time 268 Mean 312.2 233.1 312.2 - Select Series Select OnSucceeding Clear Document(s) 167.8. Scaling/Sorting Smoothing Save Evaluation As. Save As ASCII ... Save As ... ----------- Film Evaluation 23.4 O 143 286 429 572 Trigger Time> 6. NATIVE SPACE Sequence a. Position slices over area of interest b. Physio Tab i. Select Signal 1 Tab ii. Select not set for Captured Cycle button c. Physio Tab i. TD Peak flow – Type in number from Mean Curve Evaluation (Trigger ii. Time-30 ms) Signal1 Cardiac PACE 1st Signal/Mode ECG/Trigger Average cycle | 1000 + 3 Ins Captured cycle -not set- Acquisition window 800 Trigger pulse Max. Trigger Delay 300 TIS ................ 0.8 1.6 4.0 [s] NATIVE 3D Mode TR 450 Ins TD peak flow 300 ms Concatenations TD min flow 0 ms Flow sensitivity Default Measurements Default Weak Routine Medium Contras Strong ometry System Physio Inline Sequence Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 3 of 5 Job Aid | syngo NATIVE SPACE Scanning Workflow (E-line) Effective Date 05/18/2020 |HOOD 05162003088097 7. Apply Sequence 8. Imaging Tips: a. If there are different blood transit times on each leg due to stenosis in one extrem- ity, consider running two NATIVE measurements, each with the optimal TD for each extremity. b. Select Physio > Signal 1 > Increase Trigger pulses to 2 for groups closer to pelvis c. Reduced contrast behind stenosis due to lack of pulsatility of flow and high grade change of direction: To enhance flow sensitivity, work the extra flow sensitizing spoiler gradients i. Physio > Signal 1 > Flow Sensitivity ii. 4 Choices: 1. Off/Default > Normal way of using flow-spoiling Gradients as im- plemented with syngo SPACE Sequence 2. Weak > No flow spoiling gradient used 3. Medium > Higher flow sensitivity than off, due to sophisticated spoiler gradients 4. Strong > highest flow sensitivity TA: 2:46 PM: ISO PAT: 4 Voxel size: 1.0x1.0x1.0 mm Rel. SNR: 1.00 spcF Signal1 Cardiac PACE 1st Signal/Mode ECG/Trigger Average cycle | 1000 + 3 ms Captured cycle -not set- Acquisition window 800 ms Trigger pulse Max. Trigger Delay |30 ms 0.8 .6 4.0 [s] NATIVE 3D Mode TR 450 ms TD peak flow 300 ms Concatenations TD min flow :ms O Flow sensitivity Default Measurements 2 Default Weak Routine Contras Strong metry System Physio Inline Sequence Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 4 of 5 Job Aid | syngo NATIVE SPACE Scanning Workflow (E-line) Effective Date 05/18/2020 |HOOD 05162003088097 Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH 2020 Siemens Healthineers Headquarters Siemens Healthcare GmbH Henkestr. 127 91052 Erlangen, Germany Phone: +49 9131 84-0 siemens-healthineers.com Unrestricted | Published by Siemens Healthcare GmbH © Siemens Healthcare GmbH, 2020 SIEMENS Master Template Effective Date: 3/5/2020 | HOOD05162003074494 Job Aid Effective Date: XX/XX/XXXX | HOOD/HILS Healthineers Page 5 of 5