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syngo.via Cardiac Analysis Workflow (VA30)

syngo.via Cardiac Analysis Workflow (VA30)

syngo.via MR Cardiac Analysis Workflow (VA30) 1. Functions of MR Cardiac Analysis Workflow:  Reading the MR Cardiac morphology and flow images (Included with MR General Engines license)  Viewing the MR Cardiac function, perfusion and delay enhancement with structured report (Included with MR General Engines license)  Calculate the function parameter like EF, LV mass est. with the license MR cardiac function (Included with MR Cardiac Function license)  Flow evaluation in aorta and CSF to calculate the velocity, flow, peak velocity and net flow of the contour (Included with MR Cardiac Flow license) 2. MR Cardiac Analysis workflow  Open the patient using “assign workflow” or “view as read-only with” to the MR Cardiac Analysis workflow o When using the Assign workflow feature, do not open the patient until the status is “Ready to read.”  Note: Do not assign a workflow until the scan is complete and all required images have been sent to syngo.via. Do not interact with the system while the progress bar is visible. MM Unco + C1 Bone Last Name *cardiac* Date of Birth MM Onco + CT Vascular + - 2 Study Date and Ti ... Study Description Accessic MM Oncology Date of Birth Modality MM Reading Workflow State Workflow Description Patient Name mMR General dy Description Referi AZ < All> MR Abdomen Cardiac Via Case1_1 1/1/1940 MR, OT, SR MR Angio MultiStation ho^Cardiac Dot Engine Cardiac Via Case1_2 1/1/194 MR MR Angio SingleStation ho^Cardiac Dot Engine Cardiac Via Case2_1 12/15/1946 MR MR Angio TimCT rt_ohne_Dot^localizer Cardiac Via Case2_2 12/15/1946 MR, SEG, SR MR Angio TWIST rt_ohne_Dot^localizer Scheduled MR Cardiac Analysis Cardiac Via Caso2 1 MR Basic @Cardiac Dot Engine Cardiac Via Ca Open MR Breast rt^Cardiac Dot Engine Cardiac Via Flc MR BreVis View as Read-Only t^Cardiac Dot Engine Cardiac Via Flc MR Cardiac Analysis View as Read-Only with ... "Cardiac Dot Engine MR C-Spine Cardiac Via Case3_1 (Re-)Assign Workflow Template MR Head Group and Assign Workflow Template ... MR Hip Data Cancel Workflow for Manual Reassignment MR Knee Instance Number - Image Type Instance Creatic MR L-Spine Argus - 2D manual, 252, MR Cancel Procedure MR Neuro 3D DE_segmented_SAX_PSIR, 10, MR Prevent Archiving MR Neuro Perfusion DE_segmented_SAX_MAG, 10, MR MR Neuro Tumor DE_segmented_LAX_3Ch_4Ch_2Ch_PSIR, 3, MR Delete MR Onco Brain DE_segmented_LAX_3Ch_4Ch_2Ch_MAG, 3, MR Protect from deletion MR Onco Liver DE_overview_2Ch_SAX_4Ch_3Ch_PSIR, 13, MR Remove deletion protection MR Onco Multi-Region DE_overview_2Ch_SAX_4Ch_3Ch_MAG, 13, MR MR Onco TimCT CINE_segmented_SAX_InlineVF, 300, MR CINE_segmented_SAX_b10, 25, MR MR Prostate CINE_segmented_SAX_b9, 25, MR MR Shoulder CINE_segmented_SAX_b8, 25, MR MR Spectro CINE_segmented_SAX_b7, 25, MR MR Tissue4D CINE_segmented_SAX_b6, 25, MR MR TMJ CINE_segmented_SAX_b5, 25, MR MR T-Spine CINE_segmented_SAX_b4, 25, MR MR Whole Spine DICOM Neuro_Tumor Sari F SIEMENS www.usa.siemens.com/healthcare Page 1 of 13 3. Overview of the MR Cardiac Analysis Workflow MR Cardiac Analysis There have three advanced analysis tasks integrated in the cardiac analysis workflow. MR Cardiac Reading 20 MR Cardiac Reading is general reading task, include overview, functional, dynamic, tissue characterization, Overview combined and flow reading step. Functional MR Cardiac Function is a software to diagnosis the left ventricular and right ventricular function. Tissue Characterization MR Flow Quantification is a software to analysis the Combined phase contrast images to calculate the velocity parameter etc. Flow MR Cardiac Function O MR Flow Quantification 4. MR Cardiac routine reading A. Overview: The overview step provides a comprehensive view of the images sorted by their time stamp. It is not possible to load a prior study into MR Cardiac Analysis for comparison studies, a new patient folder must be opened instead. MR Cardiac Analysis AFR - MR Cardiac Reading CURRENT Functional Dynamic Tissue Characterization DUOCONCAN OLTAL Combined Cardiac Ma Canoy 1 Remaining Images TE & A DMOCONORWUETEL. ICALLED MOCONON Cadac Villasej i Cardiac Via Casa , HP 11.00 0 Findings Navigator TE 1:1 E Ca dar Ma Case1 1 Canliac Vi Case3 7 HLA PAH 4:40 PM SIEMENS www.usa.siemens.com/healthcare 778 Effective Date: 09/06/2016 Page 2 of 13 B. MR Cardiac Reading – Functional MR Cardiac Analysis Real-time Segmented HLP HLP Cardiac "11/20/ The user can easily switch from Real-time or MR Cardiac Reading CURREN Cine Segmented images. Overview 6/23/20 Functional 29IMA Dynamic ARM ARH Tissue Characterization SPA0.2 T195.8 TT 181.4 SL 8.0/2 32 Combined TR 40.3 FOV 438-438 192-192 Flow Cor>Sag(38)> Trac TE 1.0 TA 04. 59-10 Cor Sag(38)>Tra(16) 579 MR Cardiac Function p2 MRETRO/NORM DIS2D p2 M/RETRONORM/DIS2D p2 M/RETRO/NORM/DIS2D C 258 MR Flow Quantification Press the "Space bar" on the keyboard to view the segment in movie mode MR Cardiac Perfusion O O Cardiac Via Case- Cardiac Via Case3 Cardiac Via Case3 Remaining Images "11/20/1972, F. 38Y "11/20/1972, F. 38Y Aera "11/20/1972, F. 38Y CURRENT CURRENT hera CURRENT Cine_Segmented_SA_01 Cine_Segmented_SA_01 Cine_Segmented_SA_01 6/23/2011 6/23/2011 6/23/2011 32 IMA 7 33 IMA 7 34 IMA 7 ARMO ARCH ARH Findings details T980 S SL 8.0/2:32 TT 103.4 TR 40.3 FoV 438-438 192:192 TR 403 TE 1.9 Cor Sac(38)> Tra(-16) TE 10 TA 04:54-10 5 79 70*10 Cor Findings Navigator p2 MRETRO/NORMOIS2D 258 Short axis cine images ETRO/NORM/DIS20 Name Value Source & j with contrast with contrast Real-time Segmented RHA HLA Cardiac Via Case3 1 Cardiac Via Case3_1 Cardiac Via Case3_1 *11/20/1972, F. 38Y Aera *11/20/1972.F. 38Y vera *11/20/0972. F. 38Y CURRENT CURRENT CURRENT Cine_Segmented_LA Cine_Segmented_LA Cine_Segmented_LA 6/23/2011 6 IMA 7 27 IMA 7 6/25/ 2011 28 IMA 7 RFP ALH PRH SP H63 4 TT 190.1 SL 6.0 TT 181 7 TR 35.5 FoV 309:341 174-192 TR 35.4 TE 1:2 TA 05 59 Tra>Cor(24)>Sag(5) 70-2 Sag>Con(-38)>Tra(5) 622 W 622 4:45 PM DRMRETRO/NORMDIS2D 286 Long axis cine images ETRO/NORM DIS20 286 with contrast Findings details Cardiac Via Case3_1 Age: 38 Years Height: 62.99213 Inches Create Findings Weight: 226.8723 Lbs Functional Dynamic DE 2 13 12 6 17 18 AK 15 11 Akinetic HO 10 NO 4 Hypokinetic HE Normal DY 1. basal anterior 7. mid-anterior 13. apical anterior NA 2. basal anteroseptal 8. mid-anteroseptal 14. apical septal Motion Hyperkinetic 3. basel inferoseptal 9. mid-inferoseptal 15. apical inferior 4. basel inferior 10. mid-inferior 16. lateral Dyskinetic 5. basel inferolateral 11. mid-inferolateral 17. apex 6. basel anterolateral 12. mid-anterolateral Not Applicable Set Remaining to Normal AHA Segment SIEMENS www.usa.siemens.com/healthcare Page 3 of 13  Radiologist can input the function viewing result > right mouse click to each American Heart Association (AHA) segment o Akinetic: No motion during the cine o Normal: Normal motion o Dyskinetic: Motion with different direction o Hypokinetic: Reduce motion strength o Hyperkinetic: Increase motion strength o Not Applicable: NA o MR Cardiac Reading - Flow C. MR Cardiac Reading – Tissue Characterization MR Cardiac Analysis MAG-Over. PSIR-Over ... Easily toggle between Magnitude and Phase Cardiac Via Case3_1 "11/20/1 972-F-38Y 1.2.6 Sensitive Inversion Recovery (PSIR) images by MR Cardiac Reading CURRENT 43 IMA/9 one click Overview O Functional Dynamic O Tissue Characterization SAX Combined MAG-Over ... PSIR-Over. Flow AFR RHA Cardiac Via Cases11 Cardiac Via Case3_1 Cardiac Via Case3_1 MR Cardiac Function *11/20/1 972. F.38Y *11/20/1972 E 3BY 11/20/1 972. F. 38Y MR Flow Quantification CURRENT CURRENT CURRENT 43 IMA 1 43 IMA 12 43 IMA 13 MR Cardiac Perfusion O O PRH RFP ALH Current MR.DE DE_Overview_PSRLA." Jatest Remaining Images cm Ti 220.0 0cm TR 758.0 TÉ 110 3.5 p2 RIDIS2D LAX S2D SP H62.4 with contrast with contrast MAG-High PSIR-High HLP HLP Cardiac Via Case3_1 Cardiac Via Case3_1 Cardiac Via Case3 1 *11/20/1 972. F.38Y *11/20/1972. F. 3BY Findings details *11/20/1972 5. 38y CURRENT CURRENT CURRENT 46 46 IMA & 46 IMA Findings Navigator ARH ARH arert MR.DE DE_Jigh-res_PSR.SA_01.+.lates Name Value Source TI 220. 32 MD SAX SP AT2.4 with contrast ontrast contrast MAG-High ... PSIR-High .. AFR Cardiac Via Case3 1 CURRENT ATH RFP Current MR.DE DE_high-zes_PSRLA. Jstest LAX 4:46 PM with corsa? SIEMENS www.usa.siemens.com/healthcare Page 4 of 13 Findings details Cardiac Via Case3_1 Age: 38 Years Height: 62.99213 Inches Create Findings Weight: 226.8723 Lbs 2 13 12 6 Functional Dynamic DE 16 3 9 15 NO 25% 10 Normal 50% 75% 1-25% 100% 1. basal anterior 7. mid-anterior 13. apical anterior 26-50% sue Characterization NA 2. basal anteroseptal 8. mid-anteroseptal 14. apical septal 3. basel inferoseptal 9. mid-inferoseptal 15. apical inferior 51-75% 4. basel inferior 10. mid-inferior 16. lateral 5. basel inferolateral 11. mid-inferolateral 17. apex 76-1009 6. basel anterolateral 12. mid-anterolateral Not Applicable Set Remaining to Normal AHA Segment  Radiologist can create findings by right mouse clicking each AHA segment o Normal finding o 26-50%: 26-50% myocardium has high signal o 76-100%: 76-100% myocardium has high signal o 1-25%: 1-252% myocardium has high signal o 51-75%: 51%-75% myocardium has high signal SIEMENS www.usa.siemens.com/healthcare Page 5 of 13 D. MR Cardiac Reading – Combined MR Cardiac Analysis Real-time Segmented MAG-Over. PSIR-Over. MAG-High .. PSIR-High Cardiac Via Case3_1 Cardiac Via Case3_1 MR Cardiac Reading 313131 Aera 313131 *11/20/1972. F. 38Y Aera MR D11 *11/20/1972. F. 38Y Overview O HAS CURRENT HIS Cine_Segmented "A .LPH DE_Overview PSIR LA .LPH Functional CINE_segmenteg_LAX_4CMlatest DE_overview 2Ch SAX_4Ch JUMPSIRlatest -- > Current MR Functional Cine_Segmented LAINDXIXDNICINE_segmented -- > CurrentMR DE DE_Overview_PSIRLAINDXIXDNIDE ovemew_20h_SAX 6/23/2011 6/23/2011 Tissue Characterization 10:50:15 AM 11:15:25 AM 6 IMA 1 43 MA 12 Combined RFP RFP Flow MR Cardiac Function TI 220.0 TR 35.5 TR 758.0 MR Flow Quantification O TE 1.2 TP H61 TE 1.0 TA 05.59 SP H63.4 TA 00 20*13 BWV 930.0 SL 6.0 BWV 1080.0 Remaining Images P2 MRETRONORM/DIS20 FoV 309 341 TROIS2D FOV 438*438 174-192 142"160 TUAT Tra>Cor(24)>Sag(5) Tra>Cor(24)>Sag(5) BO1-3;SP1-3 BO1-3,SP1-5 Zoom 2.81 "31201_13/54 "31201_88 / 40 $36 Functional Delay 2444 Original MOCO Original Moco Cardiac Via Original and MoCo 313131 Aera "11/20/1972 MR D11 CURRENT HIS Dynamic_ReGLLA .LPH The Combined step provides automatic spatial synchronization for different contrasts. [email protected] Dynamic_RestLAINDXIXDN OmnemitReet 5h latel 6/23/2000 11-00:51 AM 19 MAO Current MR Dynamic Dynamic_Stress." Istest RFP TI 105.0 TR 183 7 TE 1.1 TA 00 16 BWV6500 D2 MOIS2D CT Tra Cor(24)>Sag(5) AT/SR BO1-3,8P1-5 Zoom 2.77 434 31201_65/12 211 4:48 PM with contrast SIEMENS www.usa.siemens.com/healthcare Page 6 of 13 E. MR Cardiac Reading – Flow Carda Vallow Casel_1 MR Cardiac Reading Overview CURAINI -LPH Functional Tissue Characterization Combined Flow MR Cardiac Function MR Flow Quantification Hema ning images TE 34 CT Phase image Mag/PCA image Findings Navigator Phase image overview Mag/PCA image overview 4 57 PM SIEMENS www.usa.siemens.com/healthcare Page 7 of 13 5. MR Cardiac Function  The ventricles are covered by short and long axis cine slices which are used to provide automatic contours of the epi and endocardial borders, allowing calculation of the left ventricle blood volume and muscle mass for each slice.  The software will segment the contour automatically, however the user can define the contour themselves using the following steps: o Define Apical Extent: defines the extent of the apex on the Short Axis (SAX), End Diastole (ED), and End Systole (ES) phases o Define LV Blood Pool: defines the LV base plane when only SAX images are used for calculation (similar to Argus calculation) o Define RV Insertion Point: needed for defining segments for the AHA model o Define Base Plane: defines the base plane of the mitral valve on long axis cine images for ED and ES phases o Refine the segmentation: allows user to modify, delete, draw, or automatically adjust contours o RV analysis: Allows the user to manually create contours for the right ventricle MR Cardiac Analysis Time Volume Cardiac Via Case3-1 Cardiac Via Case3-1 313131 313131 > MR Cardiac Reading *11/20/1972. F. 38Y Syngo MR D11 *11/20/1972. F. 38Y Syngo MR D11 135 HFS HFS 120 MR Cardiac Function 105 232011 90 75 Revert to auto 60 0.00 192*192 45 segmentation 0.00 TT 326.40 30 SPP20.5 LV Analysis SL 8.0 HO.00 FOV 438.438 0 10 20 30 40 50 60 70 80 90 100 % Define Apical Extent 3g(38)>Tra(-16) 0 77 153 230 307 383 450 537 613 690 717 ms Define LV Blood Pool ES ED LV EF 62.00 % LV ED Volume 149.01 ml Define RV Insertion Point Movie segment Working segment LV Mass 110.71 g LVES Volume 56.62el Define Base Plane Refine Segmentation Cardiac Via Case3 1 313:31 Cardiac Via Case3 1 4D segment -11/20/1 972. F. 38Y Syngo MR DT 9/20/1 972. F. 38Y Syngo MR DTS STUDY 6/23/2011 STUDY 6/23/201-1 6/23/2011 6/23/2011 10:50:23 AM 10 50:23 AM 6 IMA 25 -192 6 IMA 11 Refine segmentation tools FOV 309-341 Tra>Cor(24)>Sag(5) Exclude from Findings details RR 792 ++ 11;8 heartbeats calculation View slice plane in EV E V 2,4 4D segment Findings Navigator Name Value Source SAX Gallery segment EM EV rent MR. CardocFunction LA." Jedrent MR.CarlosFunction LA." Jalert MR. CardiacFunction.LA." 3 4 0.00 LAX X 4:49 PM SIEMENS www.usa.siemens.com/healthcare Page 8 of 13 Note: syngo.via MR Cardiac Analysis provides reliable automatic contours of the left ventricle, however the user should always verify the contours and make manual changes as needed. Current phase + 25 > Total phases in the series 150 1135| ៛12.00 0.00 0.00 105 Volume-time curve Y-axis: summed 90 0.00| 0.00| volume of ventricular 75 0.00| 60 0.00| 45 30 0.00 Derivative rate 15 0.00| 0.00 0.00 10 10 20 30 41 50 60 70 80 90 100 % X-axis: trigger time and 0 77 153 230 383 460 537 613 690 70x ms percentage of whole duration ES ED LV EF 62.00 % LV ED Volume 149.0 ml LV Mass 110.71 g LVES Volume 56.62 ml >>Simple result, more details in findings details ED/ES point Right mouse click on the TVG to display the LV Epi curve, LV Endo 1st  derivatative Curve, LV Mass Curve SIEMENS www.usa.siemens.com/healthcare Page 9 of 13 Findings details Cardiac Via Case3_1 Age: 38 Years Create LV Findings Create LV findings in finding navigator Height: 62.99213 Inches Create RV Findings for printing and sending to PACS Weight: 226.8723 Lbs Heart Rate: 75 b/min ( max 80; min:69; avg: 75; med:76 ) Thickening Analysis * >100% 75-100% 50-75% Display segmentation After segmentation, the result of 25-50% thickening relative analysis will 0-25% display automatically. <0% LV Thickening NA Results . Long- axis and short- axis Short-axis only Long and short axis uses both data LV LV NORM RV RV NORM LV Thickening for calculation, where Short axis only Normal Range (F) excludes long axis images (same as Unit Ejection Fraction: 62 56.00 - 78.00 % Argus). ED Volume: 149.01 52.00 - 141.00 ml ES Volume: 56.62 13.00 - 51.00 ml Stroke Volume: 92.38 33.00 - 97.00 ml Cardiac Output: 6.93 2.65 - 5.98 Vmin Myocardial Mass (at ED): 111.73 75.00 - 175.00 g Myocardial Mass (Avg): 110.71 75.00 - 175.00 Details result of the left ventricular. Myocardial Mass (SD): 1.24 n.a. g Peak Ejection Rate: -430.3 n.a my's Peak Ejection Time: 115.03 n.a. ms Peak Filling Rate: 473.06 n.a my/s Peak Filling Time: 492.06 n.a ms Finding details display the total result of LV, LV normal, LV thickening 6. MR Flow Quantification MR Cardiac Analysis MR Cardiac Analysis >MR Cardiac Reading Adjust threshold + MR Flow Quantification MR Cardiac Function O Vessel Segmentation MR Flow Quantification Evaluation Options Vessel Segmentation Velocity anti-aliasing < O O O O Up to four contours Background Phase Adjustment Stationary tissus threshold O >Define and adjust the contour nin Auto +0 O+ Copy backward/forward Evaluation Options. Delete contour Apply Reset All] Remaining Images O Exclude aliasing < SIEMENS www.usa.siemens.com/healthcare Page 10 of 13 MR Cardiac Analysis AF Cardiac Via Flow Casc 1-1 + MR Cardiac Reading *4(20(1 988. M. 72Y CURRENT MR D11 MR Cardiac Function 12:0998971ETAD MES STUDYDI LP MR Flow Quantification 3/24/2011 2 08-29PM 60.57 omc 63 MA5 Flow : 305 47 mil/s Vessel Define and adjust the contour Alca : 0.00 02 C RFP SP F89.6 SLED TIT 232 2 EL GO FOV202-380 TR 460 FOV 202-380 TE94 Phase image TA 17:40 ra Cor(6) 850(2) p2 W/RETRO/DIS2D Rephase image 255 Evaluation Options MR Cardiac Perfusion Few Peat:Va Vel Mit Flow Ares Remaining Images O Cardiac Via Flow Casc1 1 Switch to display Apra CURRENT MB DI1 510 459 different result Howy 150 t tetro un MES CLP 408 3/24/2011 2.08 29 PM 354 64 MA5 Flow: 105 47 ml/'s Arco 6 08 cmin 251 RFP Findings Navigator Value Source TT 232 2 TR 46 10 20 0C AD 70 00 TE 34 031 44 GG1 002 172 002 TA 17:40 Magnitude image Stort CEG p2 VAG/RETRO/DIE End Feal.Vel Forw.Vclume Rev.Voume Avg.FlowAfin 120 101 102 957 5.364 + Result segment Gallery segment X :58 PM SP F85.5 Flow: product of mean velocity* surface area Peak-Velocity: peak velocity in the ROI Velocity: Mean velocity in the ROI Net flow: difference between forward and reverse flow Area: surface area of the segmented vessel SIEMENS www.usa.siemens.com/healthcare Page 11 of 13 MR Cardiac Analysis Cardiac Via Flow Case1_1 "4/20/1 988. M. 22Y MR Flow Quantification CURRENT KR 011 flow_150-tp_retro_bh Ves Correction the phase aliasing due to too STUDYID 1 3/24/2011 Eval small velocity is set in the scanning 2 08:29 PM :305:47 63 IMA 5 : 6 00 cm2 RFP Background Phase Adjustment Stationary tissue threshold SP F85 6 SP F85.6 TT 232.2 SL 6.0 FOV 262-380 TT 2322 SL 6.0 FOV 262.380 min Auto TR 46.1 132-192 TR 46.1 TE 34 132-192 max Tra Cor(6)> Sagt? TE 34 TA 17:40 Tra>Cor(6)>Sag(2) S2D 255 To define a stationary pixel mask, then 100 RR 1161 ++ 325; 17 heartbeats subtract the phase contrast image to Apply Reset All reduce the background phase w Case1_1 Aer MR Cardiac Perfusion MR 011 ro_bh HFS STUDY ID 1 OLPH 3/24/2011 2 08 29 PM 64 IMA 5 RFP Findings Navigator Norte Findings detail SP F85 6 TT 232.2 SL 6.0 30 TR 460 FOV 262.380 10 50 90 132*192 110 221 331 551 712 882 662 772 993 Red area is the background phase Start Peak-Vel Forw-Volume Rev.Volutie Avg-FlowMin 120.101 102 977 5.355 C ROG 5:01 PM SP F85. SP F85.6 SP F85.6 Findings details Patient Information Evaluation Options Patient Name: Cardiac Via Flow Case1_1 Background Phase Adjustment Age 22 Years Start Height 72.05 Inches End 1102 9 ms In findings details, the user venc Weight 167.4 Los 150 can toggle between the ROI Heart Rate: beats/min tabs and create findings for ROI 1 RO1 2 RO13 ROI 4 each ROI.| Region ROI 1_F86.6 Create Finding Flow Velocity and Pressure Avg Flow Over Range 93.365 ml/'s Average Velocity 15.756 cm/s Avg Flow Per Minute 5.355 Mmin Peak Velocity 128.101 cm/S Peak Flow 498.172 m/s Time to Peak Velocity 116.1 ms Time to Peak Flow 116.1 ms Peak Average Velocity 80.595 cm/s Forward Volume 102.977 ml Time to Peak Average Velocity 116.1 ms Reverse Volume Om Pressure Gradient (4Vmax2) 6.564 mmHg 4X(Peak velocity) ^2 Net Forward Volume 102.977 ml Area Regurgitant Fraction 0 % Average Area 5.247 cm Body Surface Area 1.977 m2 Minimal Area 4.538 cm2 Avg Flow per Minute/BSA 2.709 Vmin/m2 Maximal Area 6.181 cm2 Net Forward Volume/BSA 52.09 m/m2 Save Results as Text SIEMENS www.usa.siemens.com/healthcare Page 12 of 13 Processing steps:  Use the definition and adjustment tools to define a new contour on the vessel in any segment and then adjust contour  The software displays the result in real-time  View the results in the Findings details and create the finding for each ROI to send results to PACs 241 Eind End Forw.volume A-p-Flown 1.28.101 102 957 5.354 123.101 102 967 Peak velocity curve Mean velocity curve R R 10 Forw Volare Asv./Volarte Prak -Vel Forw: Volume 120 101 5.354 182 957 Net flow curve Vessel area curve SIEMENS www.usa.siemens.com/healthcare Page 13 of 13

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