4D Ventricular Analysis

4D Ventricular Analysis 1. Select > Short axis stack (SA) and long axis stack (VLA, 4-ch) in the Patient Browser 2. Select > Load to Argus Icon on the toolbar or Applications >Argus Patient Browser Lood to Argus Patient Applications Transfer WRA Nonve B17 Argus MRA Brain_B17 [11] 4 Chartbox IWR Bran [12] Short Axis Stock Report Open Mop__B17 [13] Short Axis Stack Map : B17 Short Axis Stock Report Tools Mop B17 [15] Short Axis Stack Mapt_B17 [16] Short Axis Stock Mosaic head coil [17] Shon Axis Stack Flow Quant_Lumber_B17 [18] Short Axis S Dil Tractography 817 19; Short Axis Stad C [20] Short Ans Stack CSI. POMs [21] Short Axis Stack Composing [22] Short Axis St Local Datshape Cardiac Vino B17 [22] 2 Chartder VLA 3. The Argus Task Card is displayed in the Argus Viewer mode  Select > Argus 4DVF icon in the control area 4C 4DVF 4. The Argus Task Card is updated. The following images will load in the segments: (1) Long Axis Movie (2) Long Axis Working (3) Short Axis Movie (4) Short Axis Working Pubert Applications Argus Analysis Argus Tools 4D VEOptions System Options Help Cardiac_Verio_B17 Exam Apleal Central Axis Basal Central Axis Viewing Select and eda basal cent Base Plane Points RV Insertion Points RETRONOR Filming 32538' 5885883888 99 160 249 320 400 480 S60 640 720 800 10 4m LV MASS ED VOLUME Argus ES VOLUME View SLOW Fast 11 60 PPE 02/0 1/2014 12:17.0 www.usa.siemens.com/healthcare SIEMENS 492 Effective Date: 09/06/2016 Page 1 of 5 5. Setting Landmarks  Initialize the 4D heart model by identifying a few anatomical land marks o Start by determining the central axis of the left ventricle o Subsequently, you identify the base plane and then the transition from left to the right ventricle 6. Setting the Apical Point of the Central Axis  Select > the Apical Central Axis in the Control Area o As soon as you have selected the Apical Central Axis, the short-axis work segment shows the ED phase of the apical slice  Place a point into the center of the left ventricle in the short-axis work segment o Note: If the displayed slice is too far below the apex, select a higher slice within the apex form the postage stamp images at the bottom of the screen andine Vens_617 Vere Chety sous Vanle Cardiac_Veno_B17 15250 4D Apical Central Axis ARH Select and edit apical central axis Basal Central Axis OF 147 Base Plane Points RV Insertion Points MRETRONDROITML PHY 070.0 2 M.RETRONORMDIEGOR MI_3 Guide Points RESULTS 1241 12151 207-420 T 118.1 7. Setting the Basal Point of the Central Axis  Select > the Basal Central Axis in the control Area o Place a point into the center of the left ventricle in the short-axis work segment o Note: If the displayed slice is too far above the base, select a lower slice within the base from the postage stamp images at the bottom of the screen Cardiac_Verio_B17 Anonymous Cardiac_Verio_B17 Verio Anonymous 7H Verio Cardiac_Verio_B17 HFS HFS 13:50:53 09/01/2013 13:50:53 4D Apical Central Axis Basal Central Axis ARH ARH Select and edit basal central axis MF 1.00 MF 1.00 Base Plane Points TR 33.5 TR 33.5 RV Insertion Points TE 1.2 TE 12 BW 970.0 BWV 970.0 Guide Points p2 M/RETRO/NORM/DIS2D/FM1_3 02 M/RETRO/NORM/DIS2D/FM1_3 CT RESULTS 41 Base FoV 293 420 Base #62d1 12 /51 tf12d1_12 /51 FoV 293 420 TT 0.0 ED TT 583.2 SP L41.3 SP L41.3 21 Short Axis Stack Short Axis Stack www.usa.siemens.com/healthcare SIEMENS Page 2 of 5 8. Base Plane Points mode, the long-axis work segment shows the ED phase of the selected slice  Use the time-volume diagram to check the correct assignment of the images to the ED or ES phase, drag the ED or ES markers to the correct phase if necessary  Select > ED phase in the long-axis work segment, place 2 pink seed points at the level of the base plane (mitral valve)  Select > ES phase in the long-axis work segment, move the 2 pink seed points to again coincide with the base plane (mitral valve)  Check the position of the points in the remaining phases Verio Cardiac_Verio_B17 HFS R8/91/2013 Dynamic SI Apical Central Axis Basal Central Axis ARM Base Plane Points MIF 1.50 Select and edit base plane points TE 12 RV Insertion Points Guide Points P2 AURETRO/NORM/DIS2D/FM1_3 FoV 293 420 RESULTS Base tried1 12/51 TT6415 SPL41.3 23 Short Axis Stack Cardiac Verio 817 AFR Anonymous HFS 100 12/28.3913 90 80 70 60 50 40 30 20 RH 10 0 80 160 240 320 400 480 560 640 720 800 Tine - (msec) MF 1.56 ED TE 12 EF: ES TR 33.5 ED VOLUME: LV MASS: BWV 970.0 ES VOLUME: 52 M/RETRO/NORM/DIS2D/FM1_3 View CT 21 tfi2d1_12 /51 299 420 Slow Fast TT 662.6 SP H00.3 Chamber 11 T 0.0 RIV Stack SEIRI stack 9. Determining the transition from left to right ventricle  Click the RV Insertion Points in the control area  Two purple points are automatically displayed as an automatic suggestion for the transition from the left to right ventricle  At the same time the model is initialized specific to the patient  Check to ensure that the automatically determined transition from the left to the right ventricle in the short-axis cuts is correct o Note: Move the points if necessary www.usa.siemens.com/healthcare SIEMENS Page 3 of 5 Cardiac_Verio_B17 anonymous Verio Cardiac_Verio_B17 09/01/20 13 13:51-20 Apical Central Axis Basal Central Axis ARK Base Plane Points RV Insertion Points 6IF 1.44 TR 30.5 TE 12 10cm Select and edit RV Insertion Points DUV 97/0.0 Guide Points P2 MLRETRO/NORM/DIS2D/FM1_3 CT RESULTS @12/51 ED FoV 293-420 1 Short Axis Stack ¥ 1984 Cardiac Verio B17 AFR anonymous Verio 300 270 13:48:52 240 210 180 150 120 90 60 30 RH 0 80 160 240 320 400 480 560 640 720 800 Time - ( msec ) MF 1.39 TR 33.5 TE 12 EF: 62.1 % ED VOLUME: 225.6 ml LV MASS: 200.1 g Bwv 970.0 ES VOLUME: 85.6 ml p2 M/RETRO/NORM/DIS2D/FM1_3 O View CT A1 FoV 293-420 Slow Fast tfi2d1 12 / 51 TT OO ED ISP H60.3 Chamber 10. Setting Guide Points  Select > Guide Points in the control Area  The model can be further adapted to the patient’s anatomy by setting additional guide points  In either the long-axis or the short-axis work segment, select on the contour to set points and then drag them to adjust the contours to the patient’s anatomy  For a detailed display of the results of the analysis, use the brief summary in the time- volume diagram Aardige_Verno_B17 Anonymous Cardiac__Verio_B17 13.81.2813 Apical Central Axis Basal Central Axis ARH Base Plane Points RV Insertion Points : 33.5 10 cm Guide Points DUv 970.0 P2 GURETRO/NORM/DIS2D/FM1_3 Select and edit guide points RESULTS #1241_12/51 ED V 203-42 IT OO SP 151.3 Short Axis Stack FOOT Cardiac Verio_B17 AER Anonymous Verio 300 270 240 210 180 150 120 90 60 RH 30 0 80 160 240 320 400 480 560 640 720 800 Time - (msec) MF 1.30 EF: 62.0 % ED VOLUME: 193.7 ml LV MASS: 214.3 g BUV 970.0 ES VOLUME: 73.6 ml CT p2 M/RETRO/NORM/DIS2D/FM1_3 View FOV 203-42 Slow Fast Ftfi2d1 12 /51 TT O.O ED SP H60.3 4 Chamber ₩ 1283 SIEMENS www.usa.siemens.com/healthcare Page 4 of 5 11. Results  Click the results mode with the left mouse button  Identical to the classic ventricular function analysis, the results are shown in the form of plots and tables  You may optionally select > 4D Mode icon to view whole heart o Select > Movie Play to view in 4D Mode  This 4D display may be rotated to view from various perspectives by holding the left mouse button while moving the mouse  The epicardial and endocardial surfaces may be displayed as either opaque or wireframe, and the base plane may be either enabled or disabled NORM/DIS2D/FM1_3 RETRO/NORM/DIS2D/FM1_3 RESULTS olume Graph X Patient Name: Cardiac_Verio_B17 Patient Name: Cardiac_Verio_B17 Patient ID: Anonym ... Examination Date: 09/01/2013 Patient ID: Anonym ... Examination Date: 09/0 1/2013 Patient Height: .... in. Patient Weight: .... Ibs. Heart Rate: 88 Beats/min Patient Height: - in. Patient Weight: . lbs. Heart Rate: 88 Beats/min 300 LV Volume Vol(ml) Legend: Left Ventricle - Absolute 270 203 Cardiac Function Normal Range (O) Units 240 -- Spline (MRD) 190 Ejection Fraction 57.00 ... 78.00 % 210 EF 177 End Diastolic Volume EDO 193.7 55.00 ... 187.00 ml 180 End Systolic Volume 73.6 13.00 ... 67.00 ml 150 164 Stroke Volume 120.2 36.00 ... 127.00 mi 120 90 151 Cardiac Output I/min Myocardial Mass (at ED) 194.5 82.00 ... 234.00 60 138 Myocardial Mass (Avg) 14.3 + 20.2 82.00 ... 234.00 30 125 Filling and Ejection Data 0 80 160 240 320 400 480 560 640 720 800 112 Peak Ejection Rate 741.4 m/sec Time - (msec) Peak Ejection Time 96.5 msec Peak Filling Rate 582.3 mi/sec EF: 62.0 % ED VOLUME: 193.7 ml 86 Time LV MASS: 214.3 g (ms) Peak Filling Time from ES 126.0 msec ES VOLUME: 73.6 ml 73 View 70 140 210 280 350 420 490 560 630 700 Slow - Fast Check end systole/end diastole phases. They may not correspond to optimal values. Check contours. Computer generated contours may not correspond to anatomy. O ¥ Include Include Close Close Save As RESULTS 2 300 270 240 210 180 150 120 90 60 30 80 160 240 320 400 480 560 640 720 800 O Timne - (msec) ED EF: 62.0 % ES ED VOLUME: 193.7 ml LV MASS: 214.3 g ES VOLUME: 73.6 ml View Slow Fast 4D Mode 12. Results  Select > Save As icon to name and Save Argus Session o This will save all Argus images in the Patient Browser www.usa.siemens.com/healthcare SIEMENS Page 5 of 5