syngo.via Neuro Perfusion
syngo.via Neuro Perfusion
syngo.via Neuro Perfusion Workflow (VA30) 1. Functions of neuro perfusion workflow: Including three different calculation methods Calculating the DSC parameter maps for the Brain Mismatch evaluation for diffusion and perfusion images 2. There are four steps to evaluate the perfusion images: Overview: Review morphology images and mark if an acute hemorrhage is seen or not. Motion Correction: This step allows you to verify the automatic alignment of 4D perfusion data. You can apply motion correction if image quality is insufficient. Perfusion Evaluation: Select different algorithm to calculate the parameter maps (i.e. PBP, TTP< CBV, rel. CBF,etc) Mismatch Evaluation: Can calculate comparative values between the diffusion and perfusion ROIs drawn 3. Neuro Perfusion Steps: a. Open the patient using “assign workflow” or “view as read-only with” to the Neuro Perfusion workflow Note: Select the corresponding series (i.e. ep2d_perf, T2_dark fluid tirm, TOF, Diffusion weighted, etc.) and open the data by “View as read-only with”; this will increase the processing speed. MM Basic Last Name *perfusion* Date of Birth MM Basic Compare +- Study Date and Ti ... Study Description v AC MM Onco + CT Bone MM Onco + CT Vascular Workflow State Workflow Description Patient Name Date of Birth MM Oncology and Time Study Description AZ MM Reading MR Neuro Perfusion A AVM mMR General 12:44:45 PM head^APPLICATION MR Neur Open MR Abdomen 55:50 PM BRAIN&T-M Ready to read MR Neuro Perfusion MR_Neur View as Read-Only MR Angio MultiStation 1:38:04 AM Head Perfusion MR_Neur View as Read-Only with ... MR Angio SingleStation 10:24:25 AM Head_Perfusion MR Angio TimCT (Re-)Assign Workflow Template. MR Angio TWIST Group and Assign Workflow Template ... MR Basic Cancel Workflow for Manual Reassignment MR Breast MR BreVis Cancel Procedure MR Cardiac Analysis Prevent Archiving MR C-Spine MR Head Delete MR Hip Protect from deletion MR Knee Remove deletion protection MR L-Spine MR_Neuro_Perfusion_A_AVM MR Neuro 3D MR Neuro Perfusion Data MR Neuro Tumor Instance Number - Image Type Instance Creation Date ... Archiving Stat ... MR Onco Brain TTP_ep2d_perf_p2_MOCO, 1, MR MR Onco Liver RELCBF_LOCAL_ep2d_perf_p2_MOCO, 1, MR MR Onco Multi-Region RELMTT_LOCAL_ep2d_perf_p2_MOCO, 1, MR MR Onco TimCT RELCCBV_LOCAL_ep2d_perf_p2_MOCO, 1, MR MR Prostate TTP_ep2d_perf_p2_MOCO, 1, MR MR Shoulder RELCBV_LOCAL_ep2d_perf_p2_MOCO, 1, MR MR Spectro RELCBF_LOCAL_ep2d_perf_p2_MOCO, 1, MR MR Tissue4D RELMTT_LOCAL_ep2d_perf_p2_MOCO, 1, MR MR TMJ SIEMENS www.usa.siemens.com/healthcare 783 Effective Date: 09/06/2016 Page 1 of 12 b. Overview Step: The goal of the Overview step is to get a summary of the morphology. If necessary, you can document potential signs of a hemorrhage with the corresponding check box. The Overview step has a dedicated default Layout Gallery MR Neuro Perfusion AH MR_Neuro_Perfsision_A_AVM NOR EL-ISLAM MR_Neuro_Perfusion_A_AVM NOR EL-ISLAM MR Neuro Perfusion 15Yo 15yo *1/1/1995, M. 14Y Avando MR BIS *1/1/1993. M. 14Y Avanto MR B15 Overview CURRENT HFS CURRENT HFS SWIImages .LPH 12_tren_tra_danke-flujo nofat sat FIL Acute Hemorrhage Istest latest .> Current MR_12_STAR -> Current.MR_FLAIR Yes STUDY ID 2 STUDY ID 2 10/22/2009 No 10/22/2009 23 IMA 34 3 IMA 12 O Undetermined RHP F F Motion Correction Perfusion Evaluation TI 2215.4 DIE TR 49.0 TE 40.0 TP O TR TODO O TP O Mismatch Evaluation TE 87,0 TA 02:55 SP H278 SP H26.6 5L 2:01 TA 56 41-2 SL 5 5/1,1 Remaining Images BWV 80.0 BW 190.0 FOV 191-231 P2 M/SWUND NORM FoV 166-231 145*258s MONDINORMFAUF 170-2565 Tra-Con(-4)-Sap(-1) ALAR Tra>Cor(-4).Sag(-1) d HE1 Zoom 0.92 832 C.HE1-4 920 "1e201_20/150 T2 Star T2 FLAIR AH MR_Neuro_Pe usion_A AVM NOR EL-ISLAM MR Necto Perfusion_A_AVM NOR EL-ISLAM 15Yo 15yo 1/1/1 995, M. 14Y Avanto MR BIS "1/1/1995, M. 14Y Avanto MR 815 CURRENT HFS Findings Navigator CURRENT HFS TOF_3D_mult- stab ep2d_diff_mddw_20_p2 TRACEW Value So latest latest Hemontage Lindetermined MA ... Current MR_TOF > Current.MR_TRACE W STUDVID 2 STUDYID 2 10/22/2000 10/22/2009 09:40 PM 9 IMA ROHP 14 TR 2800.0 TR A TE 94.0 TP O SP H20.8 TE 7.0 BW 13450 SL 5011.5 FOV 231-231 MIP p2 MUND SPA1 p2 DIFFITRACEWIND 120p-128 A1/3AT1 ALIPFPIFS Tra-Cor(-4)>Sag(-1) THE1-4 108 Adtr :70/25 ep_b10001/90 6:35 PM TOF DWI Note: After the box is selected yes for acute hemorrhage, the result will create a finding which will contain all visual images in the findings navigator. c. Motion Correction Step: Image quality may be insufficient due to slight movements of the patient’s head during acquisition. If image quality is insufficient, you can apply motion correction. You can use the spatial filter function to apply a smoothing filter to loaded data. MR Neuro Perfusion MR Neuro Perfusion Overview Motion Correction Motion Correction Rigid motion correction for multiple phase perfusion images Spatial Filter Reduce background noise by spatial filter Width 3 mm >The width of the filter. The smaller value, the smoother image Trigger to do motion correction Perfusion Evaluation Mismatch Evaluation Remaining Images O SIEMENS www.usa.siemens.com/healthcare Page 2 of 12 MR Neuro Perfusion AH AH MR_Neuro_Perfusion_A_AVM NOR EL-ISLAM MR Neuro Perfusion A AVM NOR EL-ISLAM MR Neuro Perfusion 15yo *1/151 995, M, 14Y Avanto 15yo *1/1/1995, M, 14Y SMRVA30A Overview CURRENT Different series name CURRENT HFS Motion Correction ep2d_perf_p2 ep20_pert_p2_MOCO +LPH latestPhase_21 atestPhase_21 -> Current.MR_PERF_ORIG.021 -> Current.MR_PERF.021 v Motion Correction STUDY ID 2 STUDY ID 2 10/22/2009 10/22/2009 Spatial Filter 1:25:25 PM 1:25:25 PM Width 3 mm 32 IMA 390 2 IMA 1 FRM 10 Different SNR Perfusion Evaluation Mismatch Evaluation Remaining Images O RHP RHP Findings Navigator 10cm 10cm Value So ¥ Hemorrhage Undetermined MR F DUR DUR TR 1480.0 TP O TR 1480.0 TP O TE 30.0 SP H20.1 TE 30.0 SP H20.1 TA 00.05 SL 5.01.5 TA 00.04 SL 5.01.5 53 BW 1345.0 FOW 231-231 HOW 1346 n FOV 231-231 p2 MIND Different image comment 128p-128 AT/PFPIFS Tra Cor(-4)>Sag(-1) THE1-4 Zoom 3.69 1454 epfid201_128/90 727 prid201 6:36 PM -O Motion: 0.00, 0.00 ,- 0.41, 0.00.0.75, 0.00 with contrast with contrast Note: The system corrects the motion in translation and rotation, and filters the image with a low pass filter. d. Perfusion Evaluation: In this step you can calculate maps. These perfusion maps show different perfusion characteristics of the underlying tissue. MR Neuro Perfusion MR Neuro Perfusion Overview Motion Correction Local AIF calculate method Perfusion Evaluation Global AIF calculate method + Local AIF with T1 correction calculate method v PBP 4095 Parameter maps need to TTP be calculated in Global rel. CBV Color bar in parameter maps AIF method rel. CBF 0 rel. MIT Perfusion Mismatch Evaluation Remaining Images SIEMENS www.usa.siemens.com/healthcare Page 3 of 12 MTT CBV Time TTP (sec) CBF Schematics of different parameter maps 1. Global AIF To navigate through perfusion series > Right mouse click and hold : o Moving mouse up and down > scrolls through slices o Moving mouse left and right > navigates through measurements of viewed slice MR Neuro Perfusion AH Arterial Input F ction (AIF MR Neuro Perfusion_A_AVM NOR EL-ISLAM MR Neuro Perfusion 15yo *1/51995. M. 14Y SMRVA30A Overview CURRENT HFS Motion Correction ep2d_per(_p2_MOCO +LPH latestPhase_22 Perfusion Evaluation -. > Current.MR_PERF.022 STUDY ID 2 10/22/2009 2 IMA 1 FRM 9 RHP 4095 O TR 1480.0 TP O Y rel CBV TE 30.0 SP H1 3.6 TA 00.04 2 SL 5.01.5 ¥ rel CBF BWV 1345.0 FOW 231-231 0 D2 NAVAILMOCO 128p-128 rel MTT Perfusion (-4).Sag(-1) |THE1-4 Position the voxel Zoom 3.69 Mismatch Evaluation 1-eend201_128/9 Select the curve with good 1450 Remaining Images in healthy side first pass. O No. of Timepoints: 50 MR_Neuro_Perfusion_A_AVM NOR EL-ISLAM 15Yo +1/51 995. M. 14Y Avanto MR B15 Findings | HFS 1. Click the Global AIF icon Name Hemorrhage 2. Position the red voxel on the vessel, usually On the contra-lateral side 3. Select the AIF curve. Note: Amount of Curves chosen should be consistent on all patients. This ensures consistent results for follow-up exams. Al 4. Shift the BLs, BLe and FPe 4 5. Start processing A1.2 5 6:41 PM Select All Clear All Start Processing SIEMENS www.usa.siemens.com/healthcare Page 4 of 12 The processing steps of Global AIF method: o Determines the incoming flow of contrast agent with one reference to all of the voxels o Manually select the AIF and the BLs, BLe, and FLe lines o Processing speed is much faster than other two methods 2. Local AIF Determines the incoming flow of contrast agent with a reference volume around every voxel Calculate an AIF for each voxel (3 cm x 3 cm x 3cm) Minimizes bolus delay between artery and the tissue of interest MR Neuro Perfusion AH MR Neuro Perfusion A AVM NOR EL-ISLAM - MR Neuro Perfusion *1/1/1995, M, 14Y Avanta Overview SMRVA3CA CURRENT HFS Motion Correction p2d_pert_p2_MOCO -LPH LatestPhase_22 Perfusion Evaluation Current MR PERF. 022 STUDYID 2 10/22/2009 2 IMA 1 FRMG PBP Just only one click, F TTP processing automatically. TP.O rel CE SP H13.6 SL 5.0/1 5 rel CBF 0 BW 1345.0 FoV 231.231 p2 NAVAIL MOCO 1 28p*128 rel. MIT Perfusion AT/PEPIFS Tra>Con(-4).Sag(-1) THE1-4 Zoom 3.69 1450 Mismatch Evaluation Pep50201 128/ 90 C Remaining Images Motion:-0.11. 0.11, - 0.41 ,- 0.06,0.91, 0.00 with contrast OUI PERF AF_DLO H MR_Netto_Perfusion A_AVM NOR EL-ISLAM 15Yo "1/1/1995. M. 14Y Avando MR B15 Findings Navigator CURRENT HES TOF 3D mub-stab None Value Latest Hemorrhage Undetermined MEL -> Current MR_TOF STUDYID 2 MR 10/22/2008 09:40 PM M TR 25.0 A TE 7.0 MIP : 52 MIND SP 41 2 AT/SATI 43dir_170/25 6:42 PM The results of relCBV, relCBF, relMMT are different with Global AIF SIEMENS www.usa.siemens.com/healthcare Page 5 of 12 3. Local AIF with T1 correction In case of the blood brain barrier breakdown, the extra-vasation of contrast agents yields T1 effect. Therefore, T1 correction is needed to make more accuracy relCBV result. 0,45- 0,36- 0,27 - 0,18 0,09 23 46 69 -115 138 161 Normaltime (sec) -0,09- -0,18 MR Neuro Perfusion MR Neuro Perfusion A AVM NOR EL-ISLAM - MR Neuro Perfusion 15YO *1/1/1995, M. 14Y Overview SMRVA3DA CURRENT HFS Motion Correction ep2d_perf_p2_MOCO latest Phase_22 Perfusion Evaluation -> CurrentMR PERF.022 STUDY ID 2 10/22/2009 V- 2 IMA 1 FRM 9 rial input function(AIF) with T1 correction F & PBP TIP Just one click, TP O - ret processing automatically SP H13.6 SL 5.001.5 FoV 231-231 rel. MIT Perfusion D2 NAVALIMODO 1280*128 AT/PFPIFS Tra Cor(-4)>Sap(-1) THE1.4 Zoom 3.69 1450 Mismatch Evaluation epfid201 128190 Remaining Images Moson:-0.11. 0.11 .- 0:41, - 0.06.0.91, 0.00 with contrast GU_PERF :AF_DLO- MR_Neuro_Perfusion_A_AVM NOR EL-ISLAM *1/111 995, M. 14Y Avanto MR B15 Findings Navigator CURRENT HFS TOF 3D multi-slab Nste Value late Hemorrhage Undetermined MR. CurrentMR TOF STUDYID 2 MR 10/22/2008 :09: 40 PM R A TR 250 TE T.O MP : p2 MIND SP A1 2 AL/SATI 6:43 PM Only the relCBV is different with the Local AIF SIEMENS www.usa.siemens.com/healthcare Page 6 of 12 Data Groups Current ! MR, 10/22/2009 head APPLICATION !TTP_ep2d_perf_p2_MOCO All the methods have the same TTP result ! RELCBF_LOCAL_ep2d_pe. ! RELMTT_LOCAL_ep2d_pe. Result of Local AIF ! RELCCBV_LOCAL_ep2d_p. Result of Local AIF with T1 correction ! RELCBV_LOCAL_ep2d_pe. Result of Local AIF ! RELCBV_GLOBAL_ep2d_p. ! RELCBF_GLOBAL_ep2d_p. ! RELMTT_GLOBAL_ep2d_p Result of Global AIF ! PBP_ep2d_perf_p2_MOCO Series Navigator 4. Viewing with different layout and improved the visual image quality MR Neuro Perfusion MR Neuro Perfusion Overview Motion Correction Perfusion Evaluation Layout Gallery MTDF20_Lisa PWI_Maps Private Layouts MTT_ Stripes Public Layouts Processing Layout + TTP_ Stripes Processin MTT_Strip TTP_Strip g Layout Mack es CBF_Stripes + CBV_Stripes CBF_Strip CBV_Strip es es >> Advanced Close SIEMENS www.usa.siemens.com/healthcare Page 7 of 12 Select the different layouts to display different parameter maps CUPEN PWI_Maps including all parameter maps MTT_Stripes layout May use parallel ranges to improve the parameter maps image quality MR Neuro Perfusion AH MR_Neuro_Perfusion_A_AVM NOR EL-ISLAM MR_Neuro_Perfusion_A_AVM NOR EL-ISLAM MR_Neuro_Perfusion_A_AVM NOR EL-ISLAM 15yo MR Neuro Perfusion 1/51 995. M. 14Y Avanto "1/1/1995, M. 14Y Poratie 1/1/1995, M. 14Y Avanto Overview CURRENT CURRENT CURRENT TTP_ep2d_pert_p2_MOCO RELCBF_LOCAL_ep2d_perf_p2_MOCO POP_ep20_per_p2_MOCO Motion Correction LatestPhase_08 latest latestPhase_08 -- > Current.MR_TTP .>> Current NR_RCBF Current.MR_PBP Perfusion Evaluation STUDY ID 2 STUDYID 2 STUDY ID 2 10/22/2009 10/22/2009 10/22/2009 MTDF20_Lisa 1:25:06 PM 1:24:55 PM 1:25:06 PM 2 IMA 1 FRMJ 2 MA 1 FRM 17 1 MA 1 FRM Private Layouts RHP PHP Public Layouts F OR DIR DIR TP O TR 1480.0 TP O Improve image quality: SP H65.6 TE 30.0 SP H65.6 SL 5.011.5 T.A. 00.05 SL 5.00.5 Processin 9 Layout MIT_Stri TTP_Stip FoV 231 231 BW 1345.0 FOV 231-231 CBF 128p 128 P2 PERF/SCM 128p-128 1. Transfer 2D mode to Tra>Cor(-4)>SapF-1) Zoom 2.45 A1JPFPIFS Tra>Coe[-4).Sag(-1) Zoom 2.45 MPR mode THE1.4 28/90 Reference vo 625 1686 312 "epid201_128/ 90 Motion: 0.00 868 CUV_SUR 2. Parallel Ranges and save with contrast with contrast the result. AH Perfusion_A_AVM NOR EL-ISLAM >> Advanced Auranto PELECIN Close L 14Y CURRENT CURRENT STACY 02 Findings Navigator RELMTT_LOCAL_ep2d_perf_p2_MOCO RELCCBV_LOCAL_ep2d_pert_p2_MOCO latest latest Name Value So ... => Current.MR_MTT .- > Current.MR_RCBV Hemorrhage Undetermined MR. STUDY ID 2 STUDY ID 2 Mapa_Pert .... MR 10/22/2009 10/22/2009 1:24:55 PM 1:24:55 PM Mips_Pert. MR 3 IMA 1 FRM 4 IMA 1 FRM 17 ¥ Maps_Pert. MR 17.39 cm2 MR RHP RHP VRT Thin DIR TR 1480.0 MinIP Thin TP O TE 30.0 SP H65.6 SP H65.6 TA 00.05 SL 5.0/1.5 SL 5.0/1.5 BW 1345.0 FoV 231.231 FoV 231*231 Result of ranges P2 PERFIMTT 128p*128 MPRIMPR 128p*128 AT/PFPIFS Tra>Con(-4)>Sap(-1) Tra>Con(-4)>Sap(-1) THE1-4 Zoom 2.45 L. MPR Thick Zo4m 2.45 3.94 6:56 PM *epfid201_128/ 90 Reference v .. 6 with contrast 0 20 erence vo with contrast SIEMENS www.usa.siemens.com/healthcare Page 8 of 12 e. Mismatch evaluation for diffusion and perfusion parameter maps MR Neuro Perfusion Perfusion Evaluation Mismatch Evaluation Layout Gallery The ROI transparency ROI Transparency : on DWI and PWI images 0% ** * * * * * * * 5 100% 392 Result Handling Result from only one slice or many slices 20 Comb 2D Color bar of the parameter maps Plot Display : 2 Signal curve of the ROI+ Perfusion Signal Log Normalized Different ROI curve have the same scale Fixed Scale Mirror the ROI Remaining Images O Overview of mismatch evaluation MR Neuro Perfusion AH Ellipse ROI Perfusion Evaluation MR_Neuro Perfusion_A_AVM3 FreeHand ROI 15yo Diffusion Area = 21.49 cm2 Mismatch Evaluation MR B15. CURRENT HFSI ROI Transparency ep2d_in_mddw_20_p? TRACEW Perfusion Area = 13.18 cm2 Latest 0% ** * ** **** 50 100% -- > Current MR_Di_For_Mismatch STUDY ID 2 Mismatch Area = 8.31 cm2 10/22/2009 Result Handling 392 9 IMA -1 FRM +1 Mismatch Ratio = - 63 % . 20 Comb 2D Plot Display 1. Draw the abnormal ROI in DWI Perfusion Signal TR 2800.0 images. Log Normalized TE 94.0 Fixed Scale MPR THICK ; .. STRACEWIND 2. Draw the abnormal ROI in PWI AT/PFPIFS TrapC "ep_b1000t/ 90 parameter maps. Remaining Images O 3. The result is displayed on the upper left segment. MR Neuro Perfusion_A_AVM 15yo 15Yo "10/1995. M. 14Y Avanto Avanto SMRVA30A +1/1/1995, M, 14Y SMRVA30A Findings Navigator CURRENT HE'S CURRENT HFS RELMIT_LOCAL_ep2cipert_p2 TTP_ep2d_pert_p2_M None Value So ... Latest latestPhase_08 Hemorrhage Undetermined MR .. O .>> Current MR_Per_ For_Misma -> Current.MR_Per STUDY ID 2 STUDY ID 2 Mapa_Pert ... MR ... 10/22/2009 10/22/2009 ¥ Maps_Port .. MR .. 3 IMA -1 FRM ~10 2 IMA -1 FRM Maps_Perf. MR. RHP RHP F F DUR TR 1480.0 TP O TR 1480.0 TP O TE 30.0 SP H20.1 TE 30.0 SP H20.1 BW 1345.0 SL 5.0/1.5 BWV 1345.0 SL 5.0/1.5 MPR THICK : p2 PERFIMTT SPC 6.5 MPR THICK : p2 PERFITTP SPC 6.5 A1/PFPIFS 128p*128 128p*128 Tra Cor(-4)>Sag(-1) AI/PFPIFS THE1-4 Tra>Cor(-4)>Sag(-1) 390 THE1-4 epfid201_128/ 90 "epfid201_1285 90 25 197 Mobon 6:48 PM Reference volume for motion correction. L. 0:00, 0:06/0:41. 0.22.0.22, 0.00 with contrast with contrast SIEMENS www.usa.siemens.com/healthcare Page 9 of 12 Processing steps of mismatch MR Neuro Perfusion Slices taken into account : 2 Perfusion Evaluation Mismatch Evaluation Diffusion Area = 43.24 cm2 ROI Transparency : Perfusion Area = 25.85 cm2 0% ** * * * * * * * * 100% 3744 Draw the ROI in Mismatch Area = 17.39 cm2 Result Handling different slices, Mismatch Ratio = - 67 % 20 . Comb 2D Calculating result include multiple Plot Display : 0 slices ROI Perfusion Signal Log Normalized Fixed Scale Remaining Images O Result Handling: Comb 2D mode MR Neuro Perfusion AH Sices taken into account : 2 MR_Neuro_Perfusion_A_AVM NOR EL-ISLAM Diffusion Area 43.24 cm2 Perfusion Evaluation 15yo Avanto Perfusion Area 25.85 cm2 Mismatch Evaluation MR B15 Mismatch Area 17.39 cm2 Click the layout gallery to HFS Mismatch Ratio = -67 % MTDF20_Lisa change the layout 1176 Mean Private Layouts 10/22/2009 Public Layouts 9 IMA n.a. RHP 1 cm F Default Mismatch Detaled Evaluation Momsich E valuation TR 2800.0 TE 94.0 Fixed Scale Detailed mismatch MPR THICK: .. STRACEWIND SPC 6.5 evaluation layout ALIPFPIFS Tra>Cor(4)>53D "ep_510001/ 90 >> Advanced Close AH V Signal-time curve 00 matme (sec) MR_Neuro Perfusion_A_AVM NOR EL ISLAM 1176 115Yo *1/151 995, M, 14Y Pranto SMAVA3DA 1150 Findings Navigator CURRENT HFS RELMIT_LOCAL_ep20 Ren p2 1125 Name Value So ... latest Hemorrhage Undetermined MR. -> Current.MR_Per-For Misma STUDY ID 2 1100 Maps_Perf ... MR 10/22/2009 Mops_Perf ... 3 IMA n.a 1076 MR Mapa_Pert. MR RHP 1060 F 1025 DUR TR 1480.0 1000 TP Q TE 30.0 SP H13.6 53 BWV 1345.0 SL 5.0/1.5 MPR THICK : p2 PERFATT SPC 6.5 AL/PFPIFS 1280 128 950 THE1-4 Tra>Cor(-4)>Sag(-1) 3 90 10 20 40 70 ephid2d1_128/90 Normatime (sec) 197 6:49 PM Reference volurne for motion correction. L. with contrast O Display the enhancement curve of the ROI with detailed mismatch evaluation layout SIEMENS www.usa.siemens.com/healthcare Page 10 of 12 Slices taken into account : 2 Diffusion Area 43.24 cm2 MR Neuro Perfusion Perfusion Area = 25.85 cm2 Mismatch Area = 17.39 cm2 Perfusion Evaluation Mismatch Ratio -67 % Mismatch Evaluation 0.15 Ratio (%) ROI Transparency : 0% ** * ****** 100% 0.13 3744 Result Handling 0.1 20 Comb 20 Plot Display : O 0.00 Perfusion Sianal Log Normalized O Log Normalized 0.05 Fixed Scale 0.03 Remaining Images O o 10 30 60 70 Log Normalized of the signal-time curve MR Neuro Perfusion Slices taken into account MR_Neuro Perfusion A AVM NOR EL-ISLAM Difusion Area 43.24 cm2 Perfusion Evaluation 15yo Avanto Perfusion Area 25.85 cm2 "1/1/1995, M. 14Y MR B15 Mismatch Area 17.39 cm2 Mismatch Evaluation CURRENT HFS Mismatch Ratio # 67 % ROI Transparency ep2d_diff_mddw_20_p2.TRACEW 0% ******* 5: 100% Current.MR_DindFor Mismatch!! Ratio (%) STUDY ID 2 3744 10/22/2009 0.33 Result Handling : 9 IMA -1 FRM - @ 20 RHP CO . Comb 20 1cm Plot Display : F Perfusion Signal TR 2800.0 . Log Normalized TE en 0 GP H13.6 SL 6.5 Fixed Scale MPR THICK; TRACEWIND SPC 6.5 0.1 AUIPFPIFS Tra.Con(-4)>Sag(-1) "ep_b10001/ 90 Shift and rotate Create Mismatch Finding Remaining Images Mirror the ROI the center line to 0.06 to normal side mirror the ROI Right mouse click to create sion_A_AVM 04 the mismatch finding. -1/1/1995. M. 14Y Avanto SMIRVA3DA 0.35 Findings Navigator CURRENT HES RELMIT_LOCAL_ep?o D 58. latest Hemorrhage Undetermined MR -- > Current MR_Petro STUDY ID 2 0.25 Maps Pert MR 10/22/2009 Maps_Perf MR 3 MA -1 FRM -9/ 02 Mips_Perf MR RUHP 0.15 F 0.1 DAR TR 1480.0 TP O 0.06 TE 30.0 SP H13.6 BW 1345,0 SL 5.0/1.5 MPR THICK : p2 PERFIMTT SPC 6.5 AUJPFPIFS 120p*128 -0.06 THE1-4 Tra Cor(-4]>Sap(-1) 20 epfid201_128/90 97 Normatime (see) 5:52 PM Refererice volume for modon correction. L. wm contrast Mirror the ROI and create the mismatch finding SIEMENS www.usa.siemens.com/healthcare Page 11 of 12 f. Complete the processing MR Neuro Perfusion Perfusion Evaluation Mismatch Evaluation ROI Transparency : 3744 Result Handling 2D O Comb 2D Plot Display : 0 Perfusion Signal . Log Normalized Fixed Scale Complete the workflow, the processing Remaining Images result like parameter maps and mismatch findings will send to PACS automatically SIEMENS www.usa.siemens.com/healthcare Page 12 of 12
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