ACUSON Origin Major Modes (Color/PW/CW Doppler) Presentation

SIEMENS Healthineers SIEMENS Healthineers .. ACUSON Origin ultrasound system Cardiology Major Modes Spectral and Color Doppler 2.0 software version 1 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. Notes No. 1 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Review Doppler controls • Describe Doppler optimization features CO 2 Unrestricted © Siemens Healthineers 2024 Speaker Notes: In this presentation we will: • Review Doppler controls • Describe Doppler optimization features Notes No. 2 SIEMENS Healthineers Doppler modes SIEMENS. Healthineers' ... CW2 Cardiac Candiac 1.20 TIS:1.05 MI:0.08 1.00 95% D -0.80 AuxCW Per -0.60 -12dB/DR80 MapE/T2 -0.40 GS 0.0 PRF 8333 50 20 F 250 - 0.20 General E-0.40 PI/LD2 PRF 3788 S2/P12 MapC/F2 20 + Color D PW Color Doppler Aux CW 2.0 (non-imaging) Spectral (PW) Doppler 3 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The ACUSON Origin system supports 2D, Color, Spectral (PW), imaging and non-imaging CW Doppler for cardiology. The left image is an example of the 5V1 transducer with color demonstrating the flow through the Aorta and Left Ventricular Outflow Tract (LVOT). The middle image demonstrates flow through the Aorta using the Aux CW 2.0 transducer. The right image shows a PW Doppler through the Left Ventricular Outflow Tract (LVOT). Notes No. 3 SIEMENS Healthineers Doppler controls SIEMENS .. : Healthineers ... Touch Screen Workflow O Patient Colo Report End Exam Invert Auto TEQ werp Speed Gate Size Control Panel Soft keys 4 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Doppler image may be optimized by the: 1. Control Panel 2. Soft keys 3. Touch Screen Notes No. 4 SIEMENS Healthineers Doppler controls on the control panel SIEMENS .. : Healthineers ... CW / PW Color Doppler Zoom Measurements Update Key Depth Home Base 5 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The primary Doppler controls on the Control Panel are: • C enters / exits color Doppler. Rotate C to change overall color Doppler gain. • PW activates the Doppler cursor. • Press PW again to enter PW (pulsed wave) Doppler • Rotate PW to adjust overall spectral Doppler gain • Press PW or 2D to exit • Press Update (located above the trackball) to cycle between the image and Doppler spectrum • CW (continuous wave) activates SCW (steerable continuous wave Doppler) for phased array transducers or for the auxiliary CW pencil transducers Note: Dual, Zoom and HD Zoom are available in color Doppler. Zoom is available for the B- mode reference image in spectral Doppler. Roll the trackball and press the right or left Set key (located adjacent to the trackball) to perform functions in Doppler such as: • Position the color Doppler ROI • Size the color Doppler ROI • Position the spectral Doppler cursor • Cine the Doppler image or spectral Doppler waveform in freeze • Position the Pointer Notes No. 5 SIEMENS Healthineers Touch screen layout SIEMENS . Healthineers ... 5V SZ1 Cardiac Workflow Patient 2D Color PW Physio Major Modes Imaging 10 Review Report ANAmist End Exam Invert TV AVILVOT AI Assist User-defined LOW Auto TEQ MV.AV Putm V controls OTI Sweep Spee Scale Baseline Gate Size Filter 75 mm/s 3 mm 250 Soft key rotatory controls 6 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Touch Screen layout for Doppler is consistent with the 2D Touch Screen. In Doppler, multiple modes are used, so it may be necessary to access each mode individually. The Tab controls across the top allows the user to move easily between modes. For example, while in split mode, the user can freeze the image, select the Color tab, then cine back to a frame of choice, zoom and pan the image. The active tab is highlighted in orange. If AI Assist is activated on the system, the Touch Screen will display the view options. The user can customize the user-defined controls for the Touch Screen. There are two. In this example, Full Screen mode was selected and service image. Go to System Configuration > System Settings > Display to make a selection. If using the software DVR, the Start/Stop/Pause/Resume can be added here for ease of access. Additional frequently used controls are accessed directly from the Touch Screen. In this example, accessing UltraArt for PW Doppler, Doppler TEQ, Display size, accessing Spectral DTI (Doppler Tissue Imaging) or changing the audio volume are available. The soft key controls at the bottom of the Touch Screen are different based on the mode. There are two pages but the most used ones are on Page 1. Press the Page arrow key or swipe across the Touch Screen to access page two. Notes No. 6 SIEMENS Healthineers Color controls on the touch screen > live SIEMENS. Healthineers ... SZ CW2 Workflow 5V1 Cardiac X CW2 Workflow Patient 2D Color Physio Patient 2D Color Physio Imaging Imaging L/R Flip UID Flip Timer Review Review Report Invert Report End Exam End Exam 20 + Color 20 Only Color Only Coronary Low General DTI Frequency Smooth ine Density Priority Persist Maps Mid Scale Baseline Page One Page Two 7 Unrestricted © Siemens Healthineers 2024 Speaker Notes: These are the Touch Screen controls for Color Doppler. There are two pages. To access the second page, select the Page arrow key or swipe across the Touch Screen. The Touch Screen is designed with controls commonly used, closer to the bottom for easy reach. We will discuss the optimization later in the presentation. Notes No. 7 SIEMENS Healthineers Color controls on the touch screen > frozen SIEMENS. Healthineers ... 5V1 Workflow 1014 712 Workflow Patient 2D Color Physio Patient 2D Color Physio Imaging Imaging L/R Flip UID Flip Review Review Report Invert Report End Exam End Exam D + Color Color Only Go To ED Go To ES ED-ES Split DTI Left Margin Right Margin Baseline Playback Cine Clip Capture Playback Speed MBPS Current Current Frs Beats Beats Sec 100% Page One Page Two 8 Unrestricted © Siemens Healthineers 2024 Speaker Notes: These are the Touch Screen controls for Color Doppler when frozen. The Cine functions as well as available post-processing controls are displayed in white. Notes No. 8 SIEMENS Healthineers Color Doppler controls on the soft keys SIEMENS .: Healthineers ... Frequency Scale Baseline Filter Mid Smooth Line Density Priority Persist 2 Maps 9 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Doppler soft key rotary controls are located on the Control Panel and lie beneath and correspond to the controls listed on the bottom row of the Touch Screen. The active control is highlighted in white. To activate, push the corresponding rotary control or touch the desired control on the Touch Screen. Once activated, rotate the control to adjust. If the system is frozen, only those controls available in freeze will be available and they will be backlit in white. Controls that are not available will appear dithered. Soft key controls do not change when navigating pages. The selected parameters are displayed in the data field. When a change is made, they quickly highlight to orange as shown here. These are not programmable. The left image is demonstrating mitral regurgitation in a Live Dual image. The image on the right is demonstrating aortic insufficiency. Note how the user decided to turn off the imaging parameters displayed on the imaging screen. Notes No. 9 SIEMENS Healthineers PW controls on the touch screen > live SIEMENS. Healthineers ... 521 Workflow 1014 SV1 712 Workflow Patient 2D Color PW Physio Patient 2D Color PW Physio Imaging Imaging 10 Review Review Report Report End Exam End Exam Invert AVILVOT MV Auto TEQ MVHAY Puim V = Low DTI Sweep Spee Scale Baseline Gate Size Filte Maps 75 mmls 3 mm 250 Page One Page Two 10 Unrestricted © Siemens Healthineers 2024 Speaker Notes: These are the Touch Screen controls for Spectral (PW) Doppler in a live image. There are two pages. Notes No. 10 SIEMENS Healthineers PW controls on the touch screen > frozen SIEMENS. Healthineers ... 0 7 0 9 57 SV1 ₼ 1014 TA SC1 Workflow 521 Caldine 10L SCI Workflow Patient 2D Physio Patient 20 Physio Imaging Imaging Review Review Report AM Assing None Report End Exam End Exam Invert AVILVOT MV Auto TEQ PVJRVOT MV+AV LV Low DTI Sweep Speed Scale Baseline Filter Edge Maps Tint 75 mmla 200 Page One Page Two 11 Unrestricted © Siemens Healthineers 2024 Speaker Notes: These are the Touch Screen controls for Spectral (PW) Doppler when frozen. Notes No. 11 SIEMENS Healthineers PW Doppler controls on the soft keys SIEMENS .. ; Healthineers ... Cardine MIO.52 5V1 Cardiac TIB:3.81 TIC:2.30 TIS:0.92 2D H High MI:0.63 BdB/DR60 36fps LD 1 95% UA 1 2D MapD/T4 H High P1 0dB/DR58 General @LOW P1/LD2 GS 3.0 PRF 3788 17 cm 100mm PRF 3968 S2/Pr2 MapC/F2 D PW Low 3dB/DR60 MapE/T5 GS 3.0 HPRF 5952 F 200 Sweep Speed Scale PROF HPHE Baseline Gate Size Filter 3 mm 200 Angle Correct DR Edge Maps Tint 50 dB 12 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Doppler soft key rotary controls for PW Doppler is two pages. We will review the optimization in the next section. The left image shows a PW Doppler in the left ventricular outflow tract ( LVOT) . Note the spatial resolution of the color Doppler and sensitivity of the PW Doppler. The image on the right is a PW Doppler of mitral inflow used for diastolic function assessment. To display additional image parameters on the image screen, select the System Configuration icon on the Touch Screen (System Configuration > Image Settings > Image Display Parameters) and check the desired display settings. Notes No. 12 SIEMENS Healthineers CW controls on the touch screen SIEMENS. Healthineers ... A 10L4 Workflow 52 x CW2 Workflow Patient Physio Patient 2D CW Physio Imaging 12 Imaging Timer Review Review Report Report End Exam End Exam Invert Auto TEQ Sweep Spee 75 mm/s Scale Baseline Angle Correct 60 0 60 Page One Page Two 13 Unrestricted © Siemens Healthineers 2024 Speaker Notes: These are the Touch Screen controls for imaging Continuous Wave (CW) Doppler. There are two pages as in other modes. To access Auxiliary CW Doppler, select the Aux CW transducer. Notes No. 13 SIEMENS Healthineers CW Doppler controls on the soft keys SIEMENS .. ; Healthineers ... CW2 ZGT: <37'C Cardiac TIS:1.05 1 MR VTI=168.33 cm TIS 0.65 MI:0.08 MR Vmax=4.58 m/s MI.0.04 95% MR Mean Grad=57.2 mmHg 13tps 95% D 2 MR VTI-169.30 cm AuxCW MR Vmax=4,58 m/s 20 MR Mean Grad=56.9 mmHg Res Pen 3 MR VTI-169.83 cm -1GB/DR50 12dB/DR60 MR Vmax=4.65 m/s LD 3 MapE/T2 MR Mean Grad=57.6 mmHg UA 3 GS 0.0 MR Peak Grad-86.5 mmHg MapDITS PRF 8333 MR EROA=0.30 cm2 P F 250 =5.00 c Low -4.00 OdB General P1/LD2 -3.00 PRF 5102 S2/P/2 MapD/F3 D CW Low 0dB/DR65 MapE/T5 PRF 29762 F 340 DR Edge Maps Tint 60 dB 3 E 2 Angle Correct 60 0 60 14 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Doppler soft key rotary controls for CW Doppler are listed above. The image on the left is a Z6T Transesophageal image demonstrating CW Doppler of a mitral valve regurgitant jet with measurements. The image on the right is a CW2 Doppler of aortic valve flow. We will review the optimization in the next section. Notes No. 14 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Review Doppler controls • Describe Doppler optimization features CO 15 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Next, we will describe the Doppler optimization features. Notes No. 15 SIEMENS Healthineers Color Doppler SIEMENS .. ; Healthineers' ... Cardiac 521 CW2 Workflow Patient 2D Color Physio Imaging L/R Flip UID Flip Review Report Invert End Exam 20 + Color 20 Only Color Onk Coronary Low General High DTI Frequency Scale Baseline Filter Mid 16 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Color Doppler velocity applies colors to vascular structures based on velocity and direction of flow (as displayed here in the left ventricular outflow tract). Color Doppler controls include: • Color Display - activates / deactivates the color display (ROI remains on the image) without unfreezing the image. Choices are 2D + Color, 2D Only and Color Only • Flow States - optimize multiple parameters for specific flow states . Choices are Low, General, High and Coronary. Choices may be different depending on the preset and transducer. • Invert - reverses the colors depicting flow towards or away from the transducer in the color ROI and the color bar (located on the left side of the image) • Color - activates color Doppler velocity • DTI - not a specific Color feature but will automatically enter spectral DTI when selected. Notes No. 16 SIEMENS Healthineers Dual / live dual / full screen SIEMENS. Healthineers ... Dual 5V1 Cardiac TIS:0.73 Enable Seamless Dual MI:0.99 45fps Display all Imaging Parameters 95% Enter Full Screen When Activating Dual H High -8dB/DR60 LD 2 UA 2 MapD/T5 Full Scree Service Image U1 52bpm Lead 17 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Pressing the Dual key on the Control panel activates Live Dual when in a cardiac preset. Live Dual displays the same image side-by-side with and without color when in Color mode. To activate in Full Screen mode each time you press Dual, check “Enter Full Screen when Activating Dual” in System Configuration > Image Setting >General as shown in this slide. Users can also enter Full Screen mode when needed by programming it on the Touch Screen user-defined control or the UD key on the Control Panel by selecting System Configuration > System Settings > Display. Live Dual is often used to compare the B-mode image next to the color Doppler image to evaluate both the hemodynamics and the underlying B-mode image. As a note: Text and Measurements should be stored prior to entering Full Screen as they will not be displayed on the Full Screen image and will not be there once exiting Full Screen mode. Text and Measurements can be added on a Full Screen image but should be stored when in that mode. Notes No. 17 SIEMENS Healthineers Reduce FOV when in color Doppler SIEMENS. Healthineers' ... 5Z1 Cardiac 501 10V4 TIS:0.38 Workflow MI:0.90 52fps 95% 20 Color Physio 2D H High SdB/DR57 Review Reduce FOV UR Flip UND Flip LD 2 DITS Invert Al Assist End Exam 2D + Color 2D Only Color Only Bi-Planet TV AV /LVOT MV Coronary Reset Angle PV IRVOT MV+AV LV Low General High DTI 4D Zoom X Scale Baseline Angle 19cm 45bpm Lead Il › Sire Position 18 Unrestricted © Siemens Healthineers 2024 Speaker Notes: During live imaging, when a color Doppler region of interest is activated and placed, the Reduce FOV option becomes available on the Touch Screen. Selecting Reduce FOV will narrow the lateral 2D image just to the outside of the color Doppler region of interest. This increases frame rate for 2D imaging, and volume rate for 4D imaging. This function does not impact the imaging depth. This function is available during Bi-plane+, Dual imaging, 2D imaging and 4D imaging. Notes No. 18 SIEMENS Healthineers Zoom SIEMENS. Healthineers ... Cardiac 5V Cardiac MI. 1.24 TIS:0,48 19fps ME:0.63 27fps 95% 2D H High 2D 3dB/DR60 H High LD 2 6dB/DR53 UA 3 LD 2 MapD/T5 UA 3 P1 MapD/T5 P1 C OdB Mid Gongral OdB General PRF 4545 52/Pr1 D PW Low GS 3.0 PRF 3968 F 200 19 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The user can also Zoom in Doppler Mode. When in Color Doppler, rotate the Zoom control to increase / decrease magnification of the image. Roll the trackball to pan the image. A “Z” will appear next to the depth display, When in Split mode, while the image is active, the user can increase/decrease the size of the image and pan to place in the area of interest. This can also be done when in Freeze. This does not change the spectral display. Once the image is frozen, the user can press the color Touch Screen tab to Cine back to the desired color frame or select the Update key on the Home base to Cine back. Notes No. 19 SIEMENS Healthineers HD Zoom in color Doppler SIEMENS. Healthineers' ... TIS 0.94 Cardiac M1.1.20 TIS:0.94 MI:1.20 22fps 95% 2D H High 20B/DRS5 -2dB/DR55 LD 2 MapO/TS UA 3 MapD/T6 COISAS General ........ Stre Posible 20 Unrestricted © Siemens Healthineers 2024 Speaker Notes: During live imaging when in Color Doppler, users can Press Zoom on the control panel which automatically enters HD Zoom and adjusts to the color Doppler region of interest. Note that the HD Zoom 2D region of interest is slightly larger than the color Doppler region of interest. Notes No. 20 SIEMENS Healthineers Display modes SIEMENS .. : Healthineers ... Z6T:38.5ºC NIC CARDIAC TIS:0.73 2D + Color 2D Only Color Only MEO.53 21fps 95% 2D Mid 2dB/DR60 c=1540 LD 3 UA 2 MapD/T5 Coronary P1 Low OdB General P1/LD2 PRF 7353 S2/Pr2 Low General High MapD/F3 2D + Color 12cm 21 Unrestricted © Siemens Healthineers 2024 Speaker Notes: There are multiple display modes for color Doppler that can be changed while live and when frozen. This is a Z6T transesophageal (TEE) image demonstrating an atrial septal defect using the standard 2D+Color mode. Display modes: • 2D + Color - Displays both the grayscale image and the color Doppler information • 2D Only - Removes the color Doppler information • Color Only - Removes the grayscale image within the ROI Select on the Touch Screen in live scanning or in Freeze. Notes No. 21 SIEMENS Healthineers Flow states SIEMENS .. ; Healthineers ... 2D + Color 2D Only Color Only Coronary Low General High 22 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Flow states optimize multiple parameters for specific flow states. They are displayed on the Color Touch Screen. Select the choice based on clinical need. In this example in a pediatric patient using the 8V3 transducer, the coronary flow state was selected to visualize flow in the coronary artery. General as shown in this image on the left of an interatrial septal defect using the Z6T transesophageal transducer. • Low - provides maximum sensitivity to low velocity flows by incorporating the lowest possible filter settings and lower pulse repetition frequency. You may experience increased flash (motion artifacts). • General - produces an optimal balance between flash suppression and maximum sensitivity by using an adaptive wall filter. • High - optimizes the system for the high arterial flow common to pulsatile vessels and stenotic conditions. Additional settings are available based on anatomy and transducer, for example, Coronary as shown in this image. Notes No. 22 SIEMENS Healthineers Auto flash artifact suppression SIEMENS .. : Healthineers ... • Reduces motion artifacts 5V1 Cardiac(2) TIS:1.09 MI:1.05 21fps • Enhances color 100% TISO 2D ME.O.91 H High 20fps sensitivity OdB/DR61 c=1540 LD 2 UA 2 MapG/T5 P1 • Allows high quality scanning at a fast pace PRF 6410 General P1/LD2 PRF 3333 S3/P:2 MapF/F2 2D + Color Lead 11 23 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Auto flash artifact suppression is a patented technology in color Doppler. In color Doppler, auto flash artifact suppression: • Reduces motion artifacts • Enhances color sensitivity • Allows high quality scanning at a fast pace Note how the color Doppler displays excellent color sensitivity without motion artifacts. The image on the left is demonstrating flow through the left ventricular outflow tract. The image on the right is a pediatric patient with fast heart rate where this technology can be very useful. 23 SIEMENS Healthineers Color Doppler > soft keys SIEMENS .. : Healthineers ... Frequency Scale Baseline Filter 21fps Mid 95% 2D H High BdB/DR80 LD 1 UA 1 MapD/T4 Page One odB General P1/LD2 PRF 3788 S2/Pr2 MapC/F2 2D + Color Smooth Line Density Priority Persist Maps 2 C Page Two 122pm 24 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Color Doppler applies colors to vascular structures based on velocity and direction of flow (as displayed here in this view of the five-chamber heart). Color Doppler controls include: • Frequency - adjusts the range of frequencies for the Color Doppler and are independent of the 2D. Decrease to increase Color Penetration and increase for greater sensitivity. • Choices are Pen, Med and High and Res. • Scale - adjusts the pulse repetition frequency (PRF) - the color velocity range • Baseline - adjusts the range of flow velocities displayed above and below the baseline • Filter - adjusts the color wall filter • Settings are 1-4 (low to high) • Smooth - adjusts the level of spatial (both axial and lateral) averaging used to smooth the flow pattern display • Settings are 1-4 (low to high) • Line Density - adjusts the balance between the image line density (resolution) and the frame rate (speed) • Settings are 1 (low resolution / high frame rate) to 3 (high resolution / low frame rate) • Priority - adjusts the threshold for overlaying color pixel information on the B-mode image • Settings are 1-4 • Persist - (persistence) adjusts the time that the color flow data remains in the ROI before being replaced by another color • Settings are 1-4 • Maps - selects a processing curve that assigns the velocity / variance range for (Color) or flow amplitudes (Power) to a range of colors • Choices are A-G Many settings are available as post-processing. Notes No. 24 SIEMENS Healthineers Color post-processing SIEMENS .. ; Healthineers ... 5V1 Cardiac • 2D and Color Gain TIB:0.98 TIC:3.56 TIS:0.98 MI:0.95 Baseline 22fps • 95% 2D H High • Map 10dB/DR58 c=1540 C Priority 2ans Mid OdB • General PRF 3788 • Invert 18 cm 70bpm Lead 11 25 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The following optimizations controls can be changed on a frozen image: • 2D / Color Gain • Baseline • Map • Priority • Invert This is an example of a color Doppler image of the left ventricular outflow tract. Notes No. 25 SIEMENS Healthineers Pulsed wave (PW) Doppler SIEMENS .. ; Healthineers ... 521 Work how PW Patient 20 Physio imaging 10 Review Export Exam Presets A.F AVICVOT Cardiac Auto TEO DTi Imaging Cursor Workflow weep Speed 75 ments Baseline Gate Size ]Enable Cursor Mode 26 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Pulsed wave (PW) Doppler measures flow velocity within a gated sample volume (as displayed in this image of Mitral valve inflow). To activate PW Doppler: • Press the PW key on the Control Panel • This will go directly into PW Doppler if Enable Cursor Mode is not checked in System Configuration (System Configuration > Imaging Setting > Imaging Mode) • If not, press the Update key on the Control Panel to enter split mode • Press the Update key to toggle back and forth from the 2D / Color image and the trace. • Upon freeze, press the Color tab and roll the trackball to cine the 2D / Color image if needed. Notes No. 26 SIEMENS Healthineers Pulsed wave (PW) Doppler > touch screen SIEMENS. Healthineers ... 000 / cardiac SZ x CWz Workflow Cardias 52 x CW2 Workflow Patient 20 PW Physio Patient 2D PW Physio Imaging Imaging 10 Review Timer Review Report Wane Report End Exam End Exam Invert AVILVOT MV Auto TEQ Live/Live PVJRVOT MV+AV LV Low DTI Sweep Spee Scale Gate Size Filte 75 mmls Baseline Angle Correct Maps 3 mm 200 60 dB Page One Page Two 27 Unrestricted © Siemens Healthineers 2024 Speaker Notes: PW Touch Screen Doppler controls include: • UltraArt - instantly optimizes the spectral trace (contrast and edge) for different patient types • Auto TEQ - Auto optimization of the baseline, scale and gain • Physio settings - adjusts the ECG controls when in cardiac imaging • Invert - reverses the Doppler spectrum (values display above / below the baseline) • Audio setting - adjusts the spectral Doppler audio volume • Live / Live - triplex mode • Display modes - 1/2 B-mode - 1/2 trace ; 1/3 B-Mode - 2/3 trace ; Side by Side ; 2/3 B-Mode 1/3 trace ; Full Screen - • DTI (Doppler Tissue Imaging) - enters Spectral DTI • AI Assist - provides real-time view recognition when using Doppler • Timer - provides access to a timer Notes No. 27 SIEMENS Healthineers UltraArt universal image processing SIEMENS . Healthineers ... Off LOW Mid High Mid Liveltive Off Mid Low High 28 Unrestricted © Siemens Healthineers 2024 Speaker Notes: UltraArt for PW Doppler is accessed on the Touch Screen and provides enhancement of edge and contrast. • Selections are displayed as Off, Low, Medium and High, not an image as in 2D imaging, but as the spectral tracing • Off is the natural image trace • The edge and contrast enhancement is increased from Low to High Notes No. 28 SIEMENS Healthineers Doppler tissue imaging (DTI) SIEMENS .. ; Healthineers ... G 5V1 1 MV s' Vmax (L)=11.113 cm/s 5Z1 Cardiac 2 MV e' Vmax (L)=15.366 cm/s Cardiac TIS:1.13 3 MVa Vmax (L)=9.329 cm/s TIS:0.65 MI:0.42 4 MVs Vmax (L)=10.015 cm/s MI:0.37 36fps 55 5 MV e' Vmax (L)=13.582 cm/s 24fps 95% MV E/e' (L)=4.71 100% 2D 6 MVa' Vmax (L)=9.604 cm/s H High MV e'/a' (L)=1.51 H High -9dB/DR57 LD 2 UA 2 17cm 91mm MapD/T5 18cm 126mm P2 1dB -30 General -20 D PRF 3571 D 15 -20 DTI Mid 10 GS 5.0 PRF 2000 -10 F 35 5 -cm/s cm/s 5 -- 10 -10 -- 15 -- 20 F-20 486pm Lead Il 29 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Spectral DTI (Doppler Tissue Imaging) capability measures myocardial velocities. The left image demonstrates flow at the medial mitral valve annulus. The right image demonstrates flow at the lateral mitral valve annulus with measurements. To activate Spectral DTI: • Select DTI on the Touch Screen • This will go directly into PW Doppler if Enable Cursor Mode is not checked in System Configuration (System Configuration > Imaging Setting > Imaging Mode) • If not, press Update key on the Control Panel to enter split mode • Press the Update key to toggle back and forth from the 2D / DTI and the trace The system supports Spectral DTI only. Notes No. 29 SIEMENS Healthineers Pw Doppler display modes SIEMENS . Healthineers ... Auto Trace VIA AN 30 Unrestricted © Siemens Healthineers 2024 Speaker Notes: There are multiple display modes for Doppler that can be changed live or when frozen. Display modes (1/2 B-mode - 1/2 trace ; 1/3 B-Mode - 2/3 trace ; Side by Side ; 2/3 B-Mode - 1/3 trace ; Full Screen) Select on the Touch Screen in live scanning or in Freeze. The default display can be set in the System Configuration > Image Settings > Image Mode. The image on the left displays 2/3 image / 1/3 Doppler trace of a tricuspid regurgitation. The middle image displays 1.3 image / 2/3 Doppler trace of mitral valve inflow. The image on the right displays Side by Side image and trace of a tricuspid regurgitation. Notes No. 30 SIEMENS Healthineers Pulsed wave (PW) Doppler > soft keys SIEMENS .. ; Healthineers ... Sweep Speed Scale Gate Size Cardiac TIS:0.82 75 mm/s PRE HPRE Baseline Filter 3 mm 200 MI:0.65 21fps 95% General P1/LD2 PRF 3571 S2/Pr2 MapC/F2 Com PW Low 3dB/DR60 Page One MapE/T5 GS 3.0 PRF 3678 F 200 ................. 31 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To access the PW optimization controls on the soft keys, press the rotary key on the Control Panel and rotate left and right to change. This is an image demonstrating a spectral tracing of mitral valve inflow. PW Doppler soft key controls include: • Sweep Speed - adjusts the scrolling speed of the Doppler spectrum. Decrease to display more heart cycles and increase to display fewer cycles • Settings range from 8-200 mm/sec (8,12,16,25,33,50,60,67,100,150, 200) • Scale - adjusts the pulse repetition frequency (PRF) the spectral Doppler frequency range- there are two options: • The PRF is dependent on the transmit frequency and depth of the Doppler gate. Turn the rotary dial to increase or decrease the scale. • It also provides access to HPRF - High Pulse Repetition Frequency – setting to overcome the limitations of PW Doppler when the velocity is too high, and aliasing occurs. HPRF is defaulted off. • Baseline - adjusts the range of velocities displayed on either side of the baseline • Gate - adjusts the sample volume size. It is transducer and exam dependent • Setting choices are 1-20 mm • Filter - rejects signals below the selected frequency setting (e.g., signals generally caused by tissue clutter). Increase the filter to reduce clutter Notes No. 31 SIEMENS Healthineers Pulsed wave (PW) Doppler > soft keys SIEMENS .. ; Healthineers ... Cardiac IS.0.65 22fps 95% Angle Correct DR Edge Maps Tint 2D H High 60 0 60 60 dB 2 5 2dB/DR55 LD 2 UA 2 MapC/T4 Mid Fcmis OdB General P1/LD2 PRF 3906 5-20 S2/P12 MapC/F2 2D + Color D Page Two -- 60 PW Mid 0dB/DR60 MapE/T5 GS 3.0 PRF 4717 F 250 ............................................................................. 32 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To access the PW optimization controls, select on the Touch Screen or press the rotary key on the Control Panel. This is an image demonstrating a Doppler sample through the left ventricular outflow tract. PW Doppler soft key controls include: • Angle Correct - depicts the degree of angle correction for the Doppler spectrum • Press Angle to adjust the flow angle from 60/0/-60 degrees or rotate to adjust the flow angle by 1-degree increments. When the angle is 61 degrees or greater, the system highlights the value of the angle in white. • Dynamic Range - adjusts the overall contrast resolution of the spectral display in 5 dB increments • Lower levels are more black / white, and higher levels show a greater range of gray shades • Settings range from 10 dB to 80 dB. • Edge – increases or decrease the sharpness of the spectral trace • Settings range from 1-3 • Maps - selects a processing curve that assigns echo amplitudes to gray shades in the Doppler spectrum • Settings range from A-H • Tint - colorizes the Doppler Spectrum • Settings are 1-10 Notes No. 32 SIEMENS Healthineers Edge in PW Doppler SIEMENS . Healthineers ... 3 Edge Edge 1 Edge 4 33 Unrestricted © Siemens Healthineers 2024 Speaker Notes: UltraArt includes edge enhancement, but the ACUSON Origin system provides additional edge control for Doppler. To increase the sharpness of the spectral trace, increase the edge. For a softer spectral trace, decrease the edge. Notes No. 33 SIEMENS Healthineers HPRF - high pulse repetition frequency SIEMENS .. ; Healthineers ... SV1 5Z1 CW2 Workflow 5V1 Cardiac TIB:4.52 TIC:2.93 Patient 2D PW Physio TIS:1.18 MI:0.43 25fps Imaging 95% 10 - 1.00 2D Review H Mid -15dB/DR60 Report Al Assist C None -0.50 Mid OdB/ General End Exam PRF 2976 Invert TV VILVOT MV PW Low GS 3.5 HPRF 6250 uto TEQ Livellive IV/RVOT MY.AV LV F 250 Low DTI .1.00 ............................................. Scale 75 mm/s COF HPFF Baseline Gate Size 0.5 mm Filter 19cm HD Z 160mm 200 34 Unrestricted © Siemens Healthineers 2024 Speaker Notes: HPRF is high pulse repetition frequency and is used when the velocity scale is too low for the depth required. A ghost sample gate is added to allow for greater sampling and increase of scale. It is important to not have the ghost gate in the color ROI. HPRF is defaulted off. HPRF was used in this example when sampling from a deeper depth to measure the pulmonary veins. To activate, press the soft key on the Control Panel under Scale. This typically occurs in areas where Doppler is sampled deep or in areas of a high degree of stenosis (e.g. aortic stenosis). To avoid going into HPRF, reduce frequency when in PW Doppler or utilize CW Doppler. Notes No. 34 SIEMENS Healthineers Tint SIEMENS .. : Healthineers ... 1.00 OdB General P1/LD2 PRF 3731 92/ P/2 MapC/F2 2D + Color D PAF 126:26 35 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Select Tint to colorize the Doppler spectrum. (Selections include 1 – 10). Adding a Tint may assist in measurements and spectral evaluation. The left image highlights the tricuspid regurgitant jet. The middle image highlights the flow through the Right Ventricular Outflow tract (RVOT). The right image is a CW image of a tricuspid regurgitant jet in Full Screen Doppler mode. Notes No. 35 SIEMENS Healthineers Continuous wave (CW) Doppler imaging > touch screen SIEMENS .. ; Healthineers' ... SV1 10L CW2 Workflow 5V1 Cardiac TIS:0.90 Patient Physio MI:0.08 64fps 95% imaging 2D 12 -4.00 H High Review 5dB/DR56 3.00 LD 2 Report UA 2 MapE/T5 -2.00 End Exam c Mid Invert - 1.00 -0.5dB General mis PRE 3068 D Mid Auto TEQ -- 1.00 CW PRF Low -2.00 F 340 -- 3.00 Sweep Speed Scale Baseline -4.00 16.7cm 105mm 53bpm Lead 1 36 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To access the imaging CW optimization controls, select on the Touch Screen or press the rotary key on the Control Panel. This is an image demonstrating tricuspid regurgitation using imaging CW Doppler in a Side-by-Side display. CW Doppler controls on the Touch Screen include: • UltraArt • Auto TEQ • Invert • Audio control These have the same functionality function as in PW Doppler. Notes No. 36 SIEMENS Healthineers Continuous wave (CW) Doppler > soft keys SIEMENS .. : Healthineers ... 1 AR Slope=2.22 m/s" Vmax+3.35 m/s Vmin=2,33 m/s AR DT-1508 ms 23fps AR PHT=442 ms Frequency Filter DR Maps Tint 2 AR Slope=2.22 m/s2 Vmax=3.48 m/s Vmin=2.33 m/s 20B/DR55 Low 88 65 dB D 5 AR DT=1571 ms MARCA AR PHT 460 ms 3 AR Slope=1,94 m/s2 19cm Vmax=3.38 m/s Vmin=2.41 m/s AR DT=1742 ms 6.00 odB Genera AR PHT=510 ms PRF 3521 D CW Low RF 31250 F 340 Page One -. 2.00 37 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To access the CW optimization controls, select on the Touch Screen or press the rotary key on the Control Panel. This is an image measuring pressure half-time on an aortic valve insufficiency using CW Doppler. CW Doppler soft key controls on include: • Frequency • Filter • Dynamic Range • Maps • Tint These controls have the same functionality as the PW Controls. Notes No. 37 SIEMENS Healthineers Auxiliary continuous wave (CW) Doppler SIEMENS .. : Healthineers ... SV1 10LA CW2 Workflow CW2 Cardiac 1.80 TIS:1.05 MI:0.08 Patient Physio 1.60 95% -1.40 Imaging AuxCW -1.20 Pen 12 12dB/DR60 Review -1,00 MapE/T2 GS 0.0 Report F 250 DB'D- -0.60 End Exam -0.40 Invert 0.20 mis Mid Auto TEQ -0.20 -0.40 -0.60 -0.80 Sweep Speed Scale Baseline Filter -1.00 -- 1.20 Lead Off 38 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To access the Auxiliary CW optimization controls, select on the Touch Screen or press the rotary key on the Control Panel. Aux Doppler controls include: • Sweep Speed • Scale • Baseline • Filter We will now review some of the most frequently used controls for PW and CW Doppler. Notes No. 38 SIEMENS Healthineers Doppler post-processing SIEMENS .. ; Healthineers ... • 2D / PW Gain • Ultra Art 5V1 Cardiac TIS:0.82 MI:0.61 Scale 81fps • • Sweep Speed 20 H Mid 1dB/DR60 UA 2 Baseline Dynamic Range MapD/T5 • • D PW Low GS 3.0 PRF 4310 • Invert • Maps F 200 • Angle Correct • Tint • Edge • Format (1/3-2/3, side-by-side, • Auto Trace 2/3-1/3, 1/2-1/2) 39 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The following Doppler controls can be changed when the image is frozen. • 2D and PW Gain • Scale • Baseline • Invert • Edge • UltraArt • Angle Correct • Sweep Speed • Dynamic Range • Maps • Tint • Format (1/3-2/3, side-by-side, 2/3-1/3, 1/2-1/2) • This is an example of a spectral Doppler of the LVOT (Left Ventricular Outflow Tract) Notes No. 39 SIEMENS Healthineers Summary SIEMENS . Healthineers ... • Review Doppler controls • Describe Doppler optimization features CO 40 Unrestricted © Siemens Healthineers 2024 Speaker Notes: We have reviewed the Major Modes for Cardiology Imaging. Notes No. 40 SIEMENS Healthineers The products/features mentioned in this document may not be commercially available in all countries. Due to regulatory reasons their future availability cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details. ACUSON O r i g in, DT I, T E Q a nd U l t r aA rt a r e trademarks of Siemens Medical Solutions USA, Inc. At Siemens Healthineers, our purpose is to enable healthcare providers to increase value by empowering them on their journey towards expanding precision medicine, transforming care delivery, and improving patient experience, all enabled by digitalizing healthcare. An estimated five million patients worldwide everyday benefit from our innovative technologies and services in the areas of diagnostic and therapeutic imaging, laboratory diagnostics and molecular medicine as well as digital health and enterprise services. We’re a leading medical technology company with over 120 years of experience and 18,500 patents globally. With over 50,000 employees in more than 70 countries, we’ll continue to innovate and shape the future of healthcare. Siemens Healthineers Headquarters Manufacturer Siemens Healthineers AG Siemens Medical Solutions USA, Inc. Siemensstr. 3 Ultrasound 91301 Forchheim, 22010 S.E. 51st Street Germany Issaquah, WA 98029, USA Phone: +49 9191 18-0 Phone: 1-888-826-9702 siemens-healthineers.com siemens-heathineers.com/ultrasound 41 Unrestricted © Siemens Healthineers 2024 Notes No. 41 SIEMENS Healthineers Thank you for your enthusiasm! SIEMENS . Healthineers ... Questions? 42 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. 42