ACUSON P500 Ultrasound System 3.0 Major Modes Presentation

SIEMENS Healthineers SIEMENS Healthineers ... ACUSON P500 Ultrasound System Major Modes 3.0 Software Release 1 Unrestricted © Siemens Healthineers 2022 Speaker Notes: This presentation provides an overview of the Major Modes that are available on the ACUSON P500 Ultrasound system. Notes No. 1 SIEMENS Healthineers Objectives SIEMENS. Healthineers ... • Review 2D and M-mode Controls MEMENS • Describe 2D and M-mode Optimization Features • Explain Display Modes • Review Doppler Controls • Describe Doppler Optimization SIEMENS Features 2 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Here are the objectives for this presentation and we will start with reviewing the 2D and M- mode controls. Notes No. 2 SIEMENS Healthineers 2D Controls SIEMENS . Healthineers ... 2D O Physio ....... Stress Settings Echo SieScape eSieScan Edge Persist Dyn R Map Tint 70 dB 12 Biopsy Needle Visual. << Steer Steer >> UR Flip J/D Flip Full Size Trapezoid Dual Split 3 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The 2D image is optimized using three different methods: 1. Control panel 2. Soft Keys 3. Left Control Panel Keys Notes No. 3 SIEMENS Healthineers Control Panel SIEMENS. Healthineers ... 4 4 4 4 2D Depth / Zoom 4 4 11 2 4 Unrestricted © Siemens Healthineers 2022 Speaker Notes: 2D is a dual-function control • Press 2D control to activate or return to gray scale imaging • Rotate 2D control to change the overall 2D gain Depth • Depth is adjustable using the dual purpose and dual function Depth/Zoom control and rotating adjusts the Depth • Imaging Depth occurs in 1.0cm increments • The range is 2cm – 30cm and is transducer dependent Zoom • To magnify an image, press the Depth / Zoom control • The system activates the Zoom function and displays a Z below the image • Rotate Depth / Zoom to adjust the magnification • To deactivate the Zoom function, press Depth / Zoom again Tissue Equalization (TEQ) TM Ultrasound Technology • TEQ technology is a proprietary auto-gain optimization feature • In 2D, TEQ technology optimizes the master gain, Time Gain Compensation (TGC) and Lateral Gain Compensation (LGC) to automatically balance the image grayscale and suppress noise Notes No. 4 SIEMENS Healthineers TEQ TM Ultrasound Technology SIEMENS . Healthineers ... 13-5. Small Parts Tx Power 100% MI 0.90 TIS 0.1 TIB 0.1 ASC 2 DTCE High Dyn R 75 dB THI 10.7 MHZ -1 dB 61 fps Fr 394 IR 3 3.5 cm 1 Fr394 5 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Once TEQ TM ultrasound technology is activated, a gold icon is visualized. It’s recommended to set the Depth Gain Compensation (DGC) controls in the middle prior to activating TEQ technology. The TEQ technology control gain will remain active until: 1. The user presses the TEQ technology control button again. The gain will be re-optimized following this event. It is recommended the user does this for each new scan window. 2. The user adjusts the gain or DGC, which will incrementally override the optimized setting. TEQ technology gain is selectable on the soft keys after the gain is adjusted. This allows the user to set the gain for the lighting in the room. Please note: TEQ technology is not supported in Doppler. Notes No. 5 SIEMENS Healthineers 2D Soft Keys SIEMENS . Healthineers .. 3 < V 00 Image Pre ... MultiHertz Tx Power Focus 2 Adv. SieCl ... THI Number Focus Posi ... 100% DTCE Edge Persist Dyn R Map Tint 1 2 70 dB E 12 1 A 4 A D D D 6 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The 2D image soft keys that contain the 2D Optimization controls are customizable in the System Config > Soft Keys setting. 1. The functionality is displayed on the Touch Screen, which corresponds to the gray Control Panel hard keys. They can be activated either by pressing the gray hard key or by selecting the control on the Touch Screen. 2. The soft key menus operate on a sideways (horizontal) “slide”. Once the black boxes on the periphery are selected, secondary menus will populate in the primary window. 3. For some functionalities, an additional vertical slide will also populate, in this example, Tint. These controls may not be visible as there are more options than placeholders. If the setting required is not visible, go to System > Config > Soft Keys and assign the choice to a key. Notes No. 6 SIEMENS Healthineers Left Panel Keys SIEMENS . Healthineers .. 20 System Serial Number : PP3018 ACUSON SIEMENS 05/03/2015 13:00:35 VF 13-5 Small Parts Physio Tx Power 1 Settings MI 0.90 TIS 0.2 TIB 0.2 SieScape Siesan DTCE High Dyn R 76 dB THI 10.7 MHZ -1 dB Biopsy Needle Visual . 6 fps Fr 26 << Steer Steer >> WD Flip L U Full Sipe Trapezoid 3.5 cm Dual Split F126 Clear Set End M. Previous Frame Next Frame DTCE Dyn R Map Tint High Play/Pause Play/Pause 75 dB 12 7 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The left side of the Touch Screen displays the Left Panel Control keys. 1. Physio Settings have four options, ECG, AUX ECG, RESP & AUX SIGNAL. These are addressed in the Getting Started presentation. 2. SieScape TM panoramic imaging activates the SieScape imaging feature. 3. Biopsy activates the biopsy guide. 4. Needle Visual is Enhanced Needle Visualization for linear transducers. This functionality is explained in the Enhanced Needle Visualization presentation. 5. Steer controls unidirectional 2D beam steering. Please Note: when activated, this will automatically deactivate SieClear TM multi-view spatial compounding. 6. L/R Flip U/D Flip L/R flip and U/D flip re-orient the image. The “a” icon will indicate the activated orientation. 7. The Trapezoid function action key will angle the periphery of the 2D image on the linear transducers. This is useful clinically to demonstrate entire anatomies, for example, testicle, thyroid or a soft tissue mass. This function adds 15 degrees to either side of the image area. 8. Dual functionality acquires two images side-by-side. There are a number of different dual modes which will be explored later in the presentation. 9. Split allows for simultaneous viewing of two identical images in real-time or while frozen. Notes No. 7 SIEMENS Healthineers M-Mode SIEMENS. Healthineers ... M SIEMENS P4-2 EM Tx Power 100% MI 0.81 TIS 0.6 TIB 1.0 THI F 3.6 MHZ 3 dB 38 fps O ..... : Map Dyn R MultiHorta 55 GB 3.0 MHZ Full M ............................. 8 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Motion Mode (M-Mode) is the functionality of the system that represents temporal changes in echoes, where the depth of the structure is displayed along the vertical axis and time is displayed along the horizontal axis. The M-mode on the control panel is a dual-function control: • Press the M-mode control to activate it • Rotate the M-mode control to change the overall M-mode gain When M-mode is activated, the Left Panel Control keys will convert to the M-mode relevant options. Select Full M to remove the 2D image and display the M-mode trace only. M-mode is available on all imaging transducers. Notes No. 8 SIEMENS Healthineers Objectives SIEMENS. Healthineers ... • Review 2D and M-mode Controls MEMENS • Describe 2D and M-mode Optimization Features • Explain Display Modes • Review Doppler Controls • Describe Doppler Optimization SIEMENS Features 9 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Next, we will discuss the 2D and M-mode optimization features. Notes No. 9 SIEMENS Healthineers 2D Optimization SIEMENS . Healthineers ... Image Pre ... MultiHertz Tx Power Focus Adv. SieCl ... THI Number DICE Focus Posi ... 100% Edge Persist Dyn R Map Tint 2 70 dB E 12 4 4 4 A D V V 4 A 10 Unrestricted © Siemens Healthineers 2022 Speaker Notes: 2D optimization occurs largely using the soft keys. Depth and gain controls are located on the Control Panel and should be optimized first, prior to adjustments of other controls. 1. Edge increases the contrast resolution of subtle borders. Increasing edge will enhance/sharpen borders. Decreasing edge will smooth borders and the settings range from 1-4. 2. Persistence controls the number of images the system will average per frame. • Persistence increases the number of images averaged; Persistence of 0 updates the image with every sweep of the transducer and is excellent for fetal hearts, bowel and venous imaging • Decreasing the persistence decreases the number of images averaged which reduces noise and makes the image appear smoother 3. Dynamic Range affects the range of returning signal amplitudes that are displayed. Higher Decibel (dB) settings produce a “softer” 2D image and lower dB settings produce a higher contrast image. Dynamic range is available in live scanning and in a frozen image. 4. Maps enhance the Gray maps aesthetics by adjusting greyscale assignments to modify image contrast. 5. Tint adds color to the entire 2D image. It can be adjusted live, or on a frozen image. Tints are numbered 1-15 and appear on a vertical slide when selected. 6. R/S is the RES / Speed which balances line density (spatial resolution) and frame rate. Increase to improve image detail and decrease to improve frame rate. 7. Transducer (TX) Power is the manual adjustment of the transmit power setting. All of these controls may not be visible as there are more options than placeholders. If the setting required is not visible, go to Config> Soft Keys and assign the parameter to a soft key. Notes No. 10 SIEMENS Healthineers 2D Optimization SIEMENS . Healthineers ... Image Presets ACUSON SIEMENS 11:17:35 VF 10-6 Small Parts Tx Power 100% MI 1.01 TIS 0.3 TIB 0.3 ASC 2 DTCE Med Dyn R 80 dB Pen Gen Detail THI 9.4 MHZ -1 dB 39 fps Image Presets Edge Persist Gen Edge Persist Image Presets Detal 11 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Image Presets controls the line density, or the number of acoustic scan lines per frame. • Detail increases the line density and improves detail resolution although also reduces the frame rate • Gen is the primary scanning mode and balances the line density • Pen reduces the frequency for overall better penetration When the image preset changes, settings that are affected will briefly change in yellow on the image data settings. There is no reference in the data field as to which image preset is used. It is displayed on the soft key menu in real-time scanning. This is accessed on the soft key menu. If the choice is not displayed on the soft keys, go to System Config>Soft Keys and add it to one of the selections. Notes No. 11 SIEMENS Healthineers 2D Optimization SIEMENS . Healthineers ... SieClear Compounding Image Adv. Presets SieClear DICE MultiHertz THI Focus Position Detail 3 High 9.4 MHZ On VF134 THYROID Tx Power 100% MI 0 90 THIO TI5 0 9 DICE High TIB O Dyn R 10:40 ASC3 THE 10.7 MHZ DTCE High 2 48 Dyn R. 80 48 24 fps Pr221 Fr 800 2.5 cm Without SieClear compounding With SieClear compounding 12 Unrestricted © Siemens Healthineers 2022 Speaker Notes: SieClear compounding is proprietary technology that increases contrast resolution and enhances border definition. Settings range from Off to 3 and are transducer and mode dependent. The higher the number the higher the number of interrogating angles. These multiple scanning angles combine to reduce artifacts and increase tissue differentiation. As seen in the above image, a higher SieClear compounding setting provides a smoother image. To enhance clinical markers such as a through transmission or shadowing, reduce the compounding. Notes No. 12 SIEMENS Healthineers 2D Optimization SIEMENS . Healthineers .. Dynamic TCE TM Tissue Contrast Enhancement Technology Image Adv. DTCE MultiHertz THI Focus Presets SieClear Position Detail 3 High 9.4 MHZ On CH6-2 Renal CH6-2 Tx Power 100% Renal MI 0.90 Tx Power 100% TIS 0.4 MI 0.90 TIB 0.4 TIS 0.4 ASC 1 TIB 0.4 Dyn R 75 dB ASC THI 3.6 MHZ DTCE High -4 dB Dyn R 75 dB 23 fps THI 3.6 MHZ Fr 92 4 dB 23 fps Fr 166 13 cm Without Dynamic TCE technology With Dynamic TCE technology 13 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Dynamic TCE TM tissue contrast enhancement technology (DTCE) is proprietary, advanced post- processing method for speckle reduction. Dynamic TCE technology has the following benefits: • Enhances anatomic border definition and subtle tissue contrast • Compatible with other advanced imaging modes including Advanced SieClear compounding, Tissue Harmonic Imaging (THI) and TEQ technology • Compatible with all exam-specific applications, in both 2D and in Color • Available in three levels: low, medium and high • In applications where color Doppler will be used, it is recommended to use lower levels of Dynamic TCE technology In this image of the kidney, the borders are more clearly defined and the image is overall less noisy using a higher Dynamic TCE technology level Notes No. 13 SIEMENS Healthineers 2D Optimization SIEMENS . Healthineers .. MultiHertz Multiple Frequency Imaging Image Adv. Focus Presets SieClear DTCE MultiHertz THI Position Detail 3 High 9.4 MHZ On 4 4 A D D V V V V 4 14 Unrestricted © Siemens Healthineers 2022 Speaker Notes: MultiHertz enables the user to adjust the transducer center frequency, which will adjust the resolution and penetration. Multiple fundamental and harmonic frequencies are available on each transducer. It is suggested for MSK imaging, to use both fundamental and harmonic frequencies. Depending on the specific clinical image, fundamental frequencies provide a better overall aesthetic image. THI works independently in 2D and Color Doppler. Notes No. 14 SIEMENS Healthineers 2D Optimization SIEMENS . Healthineers .. Tissue Harmonic Imaging Image Adv. Presets SieClear DTCE MultiHertz THI Focus Position Detail 3 High 9.4 MHZ On CH5-2 Renal CH5-2 Tx Power 100% Renal 1125 MI 0.63 Tx Power 100% TIS 0.6 MI 0.90 TIB 0.6 TIS 0.4 ASC 1 TIB 0.4 DTCE Med ASC 1 Dyn R 75 dB DTCE Med 3.6 MHZ Dyn R 76 dB 1 4B THI 3.6 MHZ 60 fps .7 dB Fr 958 23 fps Fr 109 Without THI With THI 15 Unrestricted © Siemens Healthineers 2022 Speaker Notes: THI is an advanced signal processing technique, when activated, the system will only process the harmonic pulse component for image formation. THI benefits include: • improved contrast resolution and border delineation • improved visualization of clinical markers • improved lateral resolution • reduced clutter Harmonic imaging is used frequently in most applications. This is an example in the urinary bladder where the near field noise is reduced by applying THI. Notes No. 15 SIEMENS Healthineers 2D Optimization SIEMENS . Healthineers .. Clarify Vascular Enhancement (VE) Technology TM L10-5v Configuration Soft Keys CV 2D Lv 20 Frz CLv CFrz PLv PFrz MLv M Frz DLv D FIz General 1 Tx Power 100% General 2 MI 0.91 Custom Keys Display TIS 0.6 Physio Setting Stress Echo Exam TIB 0.6 Soft Keys M&R Rotate -30- eSiescan Clarify VE 7 Report ASC 1 Text Annotation Body Marker Rotate 490" Noodle Visual. Focus Position DTCE Low Wireless Dyn R 55 dB Network Focus Number Service cc Steer Steer>> DTCE Adv. SieClear THI 8.0 MHZ Clip Store Image Presets 0 dB Archive Security Clarify VE Printer UR Flip Clarify VE Levels 24 fps Barcode Fr 157 Rotate 90" (TEE) Utility Full Size CENTER Stress Echo eSieScan Dual Split Ade. SieClear DICE Dyn R MultiHertz Focus Position Default Clear Page Default Clear Page Clear All Pages THI Dyn R Adv. Sie Clarify VE MultiHertz v Levels Map TEQ Gain Position DICE Save Cancel Focus Posi ... On Position Mint 14 16 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Clarify Vascular Enhancement (VE) technology is a unique imaging technology from Siemens TM Healthineers that reduces image noise and artifacts in vascular studies, producing exceptional definition that promotes the detection of vascular disease. Clarify VE technology uniquely utilizes power Doppler flow information to enhance 2D-mode imaging in real-time, adaptive, pixel-by-pixel analysis which provides exceptional contrast resolution for clear delineation of vessels. This application is great for any vascular studies. User Tip: Select Split to view conventional 2D and Clarify VE technology side by side as shown in this carotid image. Clarify VE technology is available on all linear and curved transducers in live imaging only. Adjusts levels of sensitivity when using Clarify VE technology. A higher level will increase the sensitivity and a lower level will decrease the sensitivity and is useful for anatomy that has increased motion. Clarify VE technology does not change the B-mode image in nonvascular structures, e.g., within the gallbladder or urinary bladder. Please Note: Clarify VE technology VE is not set as one of the soft keys as a factory default. It is important to go into the Configuration menu > Soft Keys and assign the keys. One option is to change Power and Map to Clarify / Clarify VE levels, and then change the focus number key to Maps. Notes No. 16 SIEMENS Healthineers 2D Optimization SIEMENS . Healthineers .. Focus SIEMENS 04/02/2015 16:49:01 CH6-2 OB Tx Power 100% MI 0.88 TIS 0.5 TIB 0.5 ASC 1 DTCE Med Dyn R 75 dB THI 4.4 MHZ 5 dB 31 fps Fr 559 12 cm Image Adv. Presets SieClear DICE MultiHertz THI Focus Position Detail 3 High 9.4 MHZ On 17 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Both the focal position and the number of focal zones are selected using the soft keys. It is recommended to place the focal zone at or below the area of interest for best results. Notes No. 17 SIEMENS Healthineers Post-Processing Features SIEMENS . Healthineers ... AM System Serial Number : PP3018 System Serial Number : PP3000 SIEMENS 16:02.25 ACUSON 20 LC9 4 P42 EM GYN Tx Power 100% Tx Power 100% MI 1 34 MI 0.83 TIS 0 9 TIS 04 TIB 3.4 TIB 0 4 ASCIT DTOL Med Dyn R 05 da THI 9 4 MHZ 2 dE 29 Fps Fr 262 One Rate UR FSP Dyn A Map Set Start ... Setzod M. Next Frame DICE Med Dyn R Frozen M Mode Frozen 2D Mode 18 Unrestricted © Siemens Healthineers 2022 Speaker Notes: In 2D and M-mode, once the image is frozen, the post-processing features will be seen in the soft key menu. The following parameters can be changed: 2D M-Mode • Dynamic Range (DR) • DR • Gray Map • Gray Map • Tint Map • Tint Map • Measurements • Measurements • Reports • Reports • Annotations • Annotations • Body Marker • Body Marker • Zoom/Pan • Sweep Speed • Dynamic TCE technology • L/R flip • U/D flip Notes No. 18 SIEMENS Healthineers Objectives SIEMENS. Healthineers ... • Review 2D and M-mode Controls MEMENS • Describe 2D and M-mode Optimization Features • Explain Display Modes • Review Doppler Controls • Describe Doppler Optimization SIEMENS Features 19 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Next, we will discuss the display modes. Notes No. 19 SIEMENS Healthineers Trapezoid SIEMENS . Healthineers ... 2D o SIEMENS ACUSON VF13-5 Small Parts Physio Stress Tx Power 100% Echo MI 0.68 TIS 0.1 TIB 0.1 SieScape eSieScan DTCE Med Dyn R 75 dB THI 8.9 MHZ Biopsy Needle Visual. 0 dB 15 fps Fr 88 < Steer Steer >> R Flip UID Flip U Full Size Trapezoid Dual Split 20 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Trapezoid imaging expands the field of view when using a linear transducer. Trapezoid imaging is great for displaying large thyroid glands, large masses, MSK imaging or referencing anatomy in breast imaging and vascular anatomy. Advanced SieClear compounding and Dynamic TCE technology stays on when Trapezoid imaging is activated. If trapezoid is on and the user enters Dual Mode, the trapezoid image will automatically switch to a linear format. When exiting Dual mode, the image will return to trapezoid imaging. Notes No. 20 SIEMENS Healthineers Dual Mode SIEMENS . Healthineers ... SIEMENS 2D 06/08/2015 17:26:28 CH5-2 Trim2routi Echo Tx Power 100% MI 0.86 Sinscape eSieScan TIS 0.5 TIB 0.5 ASC 1 Biopsy DTCE Med Dyn R 80 dB << Steen Steer>> THI 5.0 MHZ 3 dB 23 fps Fr 626 UR Flip UID Flip Full Size Trupemolit Dual Split on RUS Edge Focus Nu .. Persist Focus Posi ... TWIN A 13 cm TWIN B 13 Cill 21 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Dual is the functionality on the system which allows two separate images to be viewed and / or acquired adjacent to each other and is activated by touching the left panel control keys. In dual mode, the user will have the option to annotate, measure and place body markers on each adjacent image. Color Dual is also available. Seamless dual can be activated in the Config>Exam menu. This will remove the Depth markers from the left image so that the dual images “seamlessly blend” together. This is useful for imaging a single structure over the two screens for example, a testicle, thyroid or tendon. Please note: There are two system behaviors: 1. The on-screen “a” icon will indicate image orientation as well as identify the active image 2. The system will unfreeze a full screen image when launching the dual mode Notes No. 21 SIEMENS Healthineers Split Mode SIEMENS . Healthineers .. 2D VF10-5 11.3 PV-Venous Tx Power 100% Echo MI 0.99 TIS 0.1 Sinscape eSieScan TIB 0.1 5.3 MHZ 1563 Hz Biopsy Flow Med -1 dB 20 fps << Steen Steer>> Fr 219 UR Flip UID Flip Full Size Trapocolit Dual Split 3 cm Edge Focus Nu .. Persist Focus Posi ... 21 Fr219 22 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Split mode provides two identical simultaneous images in real time. Modes include: 2D, 2D with Clarify VE technology, 2D and 2D with Color / Power Doppler. This feature is great to demonstrate a reference gray scale image next to an image with Color or when using Clarify VE technology. Notes No. 22 SIEMENS Healthineers SieScape TM Panoramic Imaging SIEMENS . Healthineers .. 2D SIEMENS L10-5v Breast Settings Stress Echo Tx Power 100% MI 0.47- TIS 0.1 SieScape eSieScan TIB 0.1 ASC 1 DTCE Med Bigy Dyn R 70 dB Visual. THI 8.0 MHZ 0 dB < Steer Steer >> 45 fps Fr 510 R Flip J/D Flip U Full Size Trapezoid Dual Split 23 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The SieScape TM panoramic imaging feature allows acquisition and display of grayscale images up to 60 cm in length to a maximum curvature of 360 degrees It is available on all curved and linear transducers. This slide demonstrates an image across the entire breast. Potential applications are: • Thyroid (nodules, goiters) • Breast (masses, areas of inflammation, reference anatomy) • Musculoskeletal (Baker’s cysts) • Vascular (anastomoses, varicose veins) To launch this application, select the SieScape imaging soft key which is located on Left Panel Controls then select SieScape imaging, and a white ROI will appear. Then press Start, which is located next to the Touch Pad and move slowly along the long axis of the transducer. When complete, select End or press Freeze. Notes No. 23 SIEMENS Healthineers Zoom SIEMENS. Healthineers ... VF 13-5 Configuration Custom Keys Small Parts Tx Power 100% General 1 General 2 Depth and Zoom Knob Direction MI 0.84 Custom Keys TIS 0.2 Display Increase Depth . Clockwise Counter-Clockwise TIB 0.2 Exam Increase Zoom Clockwise . Counter-Clockwise ASC 2 Soft Keys DTCE High Dyn R 75 dB Report Key Functio THI 10:7 MHZ Text Annotation 0 dB Body Marker Print/Store 1 Image Store Wireless $1 fps Network Print/Store 2 Image Store Fr 878 Service Clip Store Clip Store Clip Store Archive Left Pedal Freeze Security Right Pedal Freeze Printer Image Store Depth / Zoom Barcode User Defined 1 Clip Store Utility User Defined 2 Calliper Stress Echo Update eSieScan TEQ Update Configure New Key WD Flip UR Flip Not Used Rotate -90' (TEE) Rotate +90º (TEE) 3.5 cm Save Cancel 24 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Zoom (or magnification) is controlled by the Depth/Zoom control and is located on the right- hand side of the control panel. It is available in both real-time or when the image is frozen. Press the Zoom key to activate. The Zoom window is indicated on screen by the green crop cursors on the corner of the image. Pressing the key again exits Zoom. Pressing and turning the key magnifies the pixels (up to 10x). The direction to turn the key to increase / decrease Zoom is customizable in the Config > Custom Keys menu. When Zoom is active, sliding on the touch pad will Pan the image around the screen, such that the user can center the Region of Interest (ROI). Zoom also works when in Color Doppler and Split Mode, the 2D / Color image can also be zoomed. System behavior note: The ZOOM function is a read-zoom functionality. This means that the image size is increased by magnifying the pixels, therefore the chosen area of the image will appear magnified. A decrease in spatial resolution is typically seen. Notes No. 24 SIEMENS Healthineers Objectives SIEMENS. Healthineers ... • Review 2D and M-mode Controls MEMENS • Describe 2D and M-mode Optimization Features • Explain Display Modes • Review Doppler Controls • Describe Doppler Optimization SIEMENS Features 25 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Next, we will review the Doppler controls. Notes No. 25 SIEMENS Healthineers Doppler Controls SIEMENS . Healthineers ... O 2D C PW 2D C Settings Auto Stat Sensi- -SleScan tivity 1 Off O eSieScan Volume O 11 << Steer Steer >> 3 ‹‹ Steer Steer >> Color Display Full D CW 4 4 D 2 4 4 Simult CW Dual Split 26 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The Doppler controls are manipulated using three different methods: 1. Control panel • The Color (C) key enters and exits color Doppler and controls color gain • The Pulsed Wave (PW) key enters and exits PW Doppler and controls PW gain; the Update key on the home base cycles between the image and Doppler tracing • Scale in color Doppler changes the range of displayed color velocities by adjusting the scale factor of pulse repetition frequency (PRF) and when in PW or Continuous Wave (CW) Doppler, adjust the scale factor of PRF to improve flow sensitivity or to control aliasing • Baseline in color Doppler extends the range of displayed velocities in one direction by repositioning the color baseline and when in PW or CW Doppler, extend the range of the displayed velocities by repositioning the Doppler baseline • Angle corrects the flow angle and when pressing the control this will adjust the flow angle in 60 ◦ increments (60 ◦ 0 ◦ and -60 ◦ ) and rotating the control adjusts the flow 60◦ angle in 1 ◦ increments , , • Invert in Color Doppler, inverts the colors depicting forward and reverse flow in the color ROI; the color bar in PW or CW reverses the Doppler spectrum relative to the baseline and inverts the Doppler audio 2. Soft Keys • Soft Keys are the Doppler optimization keys including RES / Speed, Smoothing, Filter, Persistence, Flow States, Priority and Entering Color Doppler Energy (CDE) 3. Left Panel Control Keys (these change depending on the Mode) Notes No. 26 SIEMENS Healthineers Objectives SIEMENS. Healthineers ... • Review 2D and M-mode Controls MEMENS • Describe 2D and M-mode Optimization Features • Explain Display Modes • Review Doppler Controls • Describe Doppler Optimization SIEMENS Features 27 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Lastly, we will discuss the Doppler optimization features. Notes No. 27 SIEMENS Healthineers Color Doppler Optimization SIEMENS . Healthineers .. ACUSON SIER SIEMENS 20/10/2015 10:58:37 VF 16-5 22.6 CV Tx Power 100% MI 0:85 TIS 0:1 TIB 0.1 5.3 MH: 3125 H5 Flow Med 25 cm Map Filter Smooth Priority MultiHertz CDE Flow Tx Power R/S Position Position 5.3 MHZ Med Persist 28 Unrestricted © Siemens Healthineers 2022 Speaker Notes: When in Color, the soft key menus provide the optimization controls. The soft keys are customizable in the configuration menu. To change the parameters on the soft keys, select (using the pointer) or touch the desired parameter. In addition, the hard keys below the soft keys on the control panel also make the changes. • Filter reduces clutter by adjusting the level of motion discrimination during real-time imaging and the settings are between 0-3 • Smooth adjusts the level of spatial, both axial and lateral, averaging used to smooth the flow pattern display and the settings are between 0-3 • Priority adjusts the threshold for overlaying color pixel information on the 2D image and the settings are between 0-4 • MultiHertz has three frequencies depending on transducer and is independent of 2D • CDE or CDV activates Color Doppler Velocity or Color Doppler Energy • DTI /DTE activates Doppler Tissue Imaging or Doppler Tissue Energy • Flow has three settings and optimizes hemodynamic flow conditions: • Low - small parts, low volume flow • Med - general abdomen, vascular, OB • High - aorta, fetal heart, cardiac Notes No. 28 SIEMENS Healthineers Color Doppler Optimization (Con’t) SIEMENS . Healthineers .. ACUSON SIER SIEMENS 20/10/2015 10:58:37 VF 16-5 22.6 CV Tx Power 100% MI 0:85 TIS 0:1 TIB 0.1 5.3 MH: 3125 H5 Flow Med 25 cm Map Filter Smooth Priority MultiHertz CDE Flow Tx Power R/S Position Position 5.3 MHZ Med Persist 29 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Additional Color Flow parameters are: • R/S adjusts the balance between the image line density (resolution) and the frame rate (speed): the settings are between 0-5 and low produces better resolution where as, the high setting produces better frame rates • Map assigns color to the velocity or energy information and the choices are between A-I; Velocity and Velocity Variance maps are available • TX Power adjusts Transmit Power between 0-100% • Persist adjusts the time that the colors corresponding to blood flow velocity remain in the region of interest before decaying or being replaced by another color and the settings are between 0-4 Notes No. 29 SIEMENS Healthineers Dynamic Persistence & Auto Flash Suppression SIEMENS . Healthineers .. SIEMENS 11/06/2017 13:40:21 VF 16-5 14.1 PV Dynamic Persistence adjusts Tx Power 100% • MI 0.80 persistence relative to user TIS 0.2 TIB 0:2 5.3 MHZ motion 1950 Hz Flow Low 5 dB 17 fps • Auto Flash Artifact Control applies flash suppression relative to user motion 2.5 cm 30 Unrestricted © Siemens Healthineers 2022 Speaker Notes: There are two unique technologies for Color Doppler, Dynamic Persistence and Auto Flash Suppression Control. Dynamic Persistence technology applies in both 2D and Color Doppler and the benefits include: • Preventing ghosting motion • Enhanced static color sensitivity • Reduces static B-mode noise Auto Flash Artifact Suppression applies in Color Doppler. When scanning with Color Doppler, there are less flash artifacts when quickly moving the transducer. The benefits include: • Preventing motion artifacts • Enhances color sensitivity • Allowing high quality scanning at a fast pace Notes No. 30 SIEMENS Healthineers DTI TM Doppler Tissue Imaging Capability SIEMENS . Healthineers ... P4-2 20 C Cardiac Tx Power 100% Cardizo MI 0.64 Tx Power 10 TIS 12 MI 0.78 TIB 1.7 TIS 0.8 TIB 0.8 3.3 MHZ 2.2 MHz 1953 Hz 610 Hz Gate 3.0 mm Flow Med 0 dB 25 fps 27 fps Fr 321 72 bpm 73 mm 16 cm Cone Rate CW Display Dual 46.5 mm's 31 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The system has Doppler Tissue Imaging capability (DTI ) for Cardiac imaging with the P4-2 and TM P8-4 transducers. System Spectral Doppler DTI capability utilizes real time Doppler shift information from moving tissue to better visualize and quantify myocardial diastolic function. The spectral Doppler DTI capability calculation package provides guided velocity and acceleration measurements and includes a measurement report package. Color DTI capability can be used for qualitative evaluation of wall motion and displays the relative change of velocities. There are five maps available to select: A, B, C, D and E. To activate DTI capability, select C for color Doppler, and DTI will appear as a soft key option. To measure, press Freeze, then select Measure. Clinical Note: DTI capability is part of many standard exams. This is increasingly important with individuals who are undergoing chemotherapy because a side effect is heart failure. Chemo patients will have serial exams to check the function of their heart. These evaluations give the patient’s physicians an insight as to whether their chemo type or dosage should be modified. Notes No. 31 SIEMENS Healthineers Color Doppler Energy (CDE) SIEMENS . Healthineers ... 20 P ACUSON 10112016 10:56-34 CH5-2 Abdomen Tx Power 100% Settings MI 1.08 TIS 0.6 TIB 0.6 2.7 MHZ 1220 Hz Flow Med 6 dB 5 fps Fr 45 Reset Markers Cine Rate Display Dual Map Filter Smooth Priority MultiHertz CDE Flow Tx Power R/S Persist 4 Position Position 5.3 MHZ Med 32 Unrestricted © Siemens Healthineers 2022 Speaker Notes: To select Color Doppler Energy (CDE) or Power Doppler, select CDV on the Touch Screen. It will change the active mode to CDE. The Mode menu will change to P for Power and the optimization or soft keys will change for Power Doppler parameters. This will remain the active color mode unless CDE is pressed again to return to CDV. CDE is best used for low volume, low velocity flow states to demonstrate the presence or absence of flow. Notes No. 32 SIEMENS Healthineers Color Doppler Functionality SIEMENS . Healthineers ... Adjusting Color Region of Interest (ROI) Size Size 33 Unrestricted © Siemens Healthineers 2022 Speaker Notes: When in the color mode, the color box will appear with a solid green line. When adjusting the color box size, it will appear with dotted lines. There are three ways to adjust the Color Box: 1. Press Select and use the touch pad to adjust size, then press Select again to set 2. Press the touch pad once and use touch pad to adjust size, then press once to set 3. Pinch the touch pad to adjust size 4. Once it is set, use the touch pad to adjust the location in the pan mode Notes No. 33 SIEMENS Healthineers Color Doppler Functionality SIEMENS . Healthineers ... Steering the Color ROI << Steer Steer >> 34 Unrestricted © Siemens Healthineers 2022 Speaker Notes: To steer the color box, use the steer right and left key located on the left panel control keys. Note that Steer will cycle through the angle’s and it is not necessary to select left or right Steer. Select Steer to the right continuously and it will cycle through all the right angles. User Tip: Customize a user-defined key to Steer, thus providing all Doppler keys on the Control Panel for easier workflow. The steering angles are 0/7.5 and 15 degrees on both sides. Notes No. 34 SIEMENS Healthineers Pulsed Wave Doppler Functionality SIEMENS. Healthineers ... Display -Monitor DGC Screen Saver Delay 20 minutes DGC Invert with Image Invert • Available option to bypass System Power Off 2 hours DGC Curve Display Time Out Current Image Depth bringing up cursor Brightness DGC Control Patient Banner Patient Data Age Date of Birth Doppler / M-Mode Doppler / M-Mode Bypass Cursor Mode Doppler Frequency/Velocity Frequency O Velocity Bypass Cursor Mode Doppler Frequency/Velocity Save Cancel 35 Unrestricted © Siemens Healthineers 2022 Speaker Notes: For PW Functionality the user has the option to bypass the cursor. This is selected in the Configuration Menu>Display. When this feature is turned on and PW is selected, it will bypass the cursor and go straight into PW Doppler. Notes No. 35 SIEMENS Healthineers PW / CW Doppler Optimization SIEMENS . Healthineers ... 20 CV System Serial Number : 391035 ACUSION CH5-2 Abdomen Tx Power 100% MI 0.72 TIS 0.9 TIB 2.6 Auto Stat 2.7 MHZ Off 2790 Hz Gate 4.0 mit Volume -4 4B 10 fps 1 46.5 mmk Tint Map Pym R Snoep Update Rate Filter Map Dyn R Update MultiHertz Gate Sweep Tx Power Tint 188 Hz 60 dB Position Position 5.3 MHZ 2.0 mm 3 36 Unrestricted © Siemens Healthineers 2022 Speaker Notes: When in PW mode, the soft key menus provide the optimization controls. The soft keys are customizable in the configuration menu. To change the parameters on the soft keys, select (using the pointer) or select the desired parameter. In addition, the hard keys below the soft keys on the control panel also make the changes. • Filter rejects signals below the selected frequency setting, for example, signals generally caused by tissue clutter, increase the filter to reduce clutter • Map selects a processing curve that assigns echo amplitudes to gray levels • Tint changes the color of the Doppler spectrum by adding blue, red, yellow, or green to the gray in a gray map • Dynamic Range adjusts the overall contrast resolution of the spectral display in 5 dB increments and lower levels are more black/white and higher levels show a greater range of velocities • Gate changes the size of the Doppler cursor gate, increase to acquire greater sample size • Sweep adjusts the scrolling speed of the Doppler spectrum, decrease to display more heart cycles and increase to display less Notes No. 36 SIEMENS Healthineers PW / CW Doppler Optimization Con’t SIEMENS . Healthineers ... 20 CV System Serial Number : 391035 ACUSION CH5-2 Abdomen Tx Power 100% MI 0.72 TIS 0.9 TIB 2.6 Auto Stat 2.7 MHZ Off 2790 Hz Gate 4.0 mit Volume -4 4B 10 fps 1 46.5 mmk Tint Map Pym R Snoep Update Rate Filter Map Dyn R Update MultiHertz Gate Sweep Tx Power Tint 188 Hz 60 dB Position Position 5.3 MHZ 2.0 mm 3 37 Unrestricted © Siemens Healthineers 2022 Speaker Notes: When in PW mode, the soft key menus provide the optimization controls. The soft keys are customizable in the configuration menu. To change the parameters on the soft keys, select (using the pointer) or select the desired parameter. In addition, the hard keys below the soft keys on the control panel also make the changes. • When in Split Mode, the user can also Zoom the image; This can be done in a live or frozen mode • The Left Panel control keys are customizable in the System Config menu • Full Screen Doppler displays only the Doppler spectrum and hides the 2D image • Auto Stats: Statistics, including pulsatility index (PI), resistive index (RI), systolic/diastolic ratio (S/D), and heart rate. Select Auto Stat in the left control panel: • Off disables the display of Doppler statistics • Above displays statistics for Doppler data above the baseline • Below displays statistics for Doppler data below the baseline • Both displays statistics for Doppler data above and below the baseline • Select Sensitivity in the left control panel and then select the required sensitivity level of the detection • Volume adjusts the Doppler Audio volume • Simult enables or disables the simultaneous display of the 2D and color image and Doppler spectrum in real time • Physio Settings adjusts the ECG controls when in Cardiac imaging Notes No. 37 SIEMENS Healthineers PW / CW Doppler Optimization SIEMENS. Healthineers .. 2D C PW 20 C MY System Serial Number : 391635 SIEMENS CH5-2 Abdomen Tx Power 100% Physio MI 0.72 Settings TIS 0.9 TIB 2.6 Auto Stat 2.7 MHZ Auto Stat 2790 Hz Gate 4.0 mm Volume -4 4B 10 fps Volume 56 mm 15 cm 23 Full D Tint Map Dyn R Snoop Update Rate Tx Power Tint 38 Unrestricted © Siemens Healthineers 2022 Speaker Notes: • Update Rate adjusts the interval for refreshing the 2D image • When in Split mode, the user can also Zoom the image • The left panel control keys are customizable in the Configuration menu • Full Screen Doppler displays only the Doppler spectrum and hides the 2D image • Auto Stats are statistics, including pulsatility index, resistive index, systolic/diastolic ratio, and heart rate. Select Auto Stat in the left panel to display the following options: • Off disables the display of Doppler statistics • Above displays statistics for Doppler data above the baseline • Below displays statistics for Doppler data below the baseline • Both displays statistics for Doppler data above and below the baseline • Press Sensitivity in the left panel and then select the required sensitivity level of the detection • Volume adjusts the Doppler audio volume • Simult enables or disables the simultaneous display of the 2D and color image and Doppler spectrum in real time • Physio Settings adjusts the ECG controls when in cardiac imaging Notes No. 38 SIEMENS Healthineers PW / CW Doppler Optimization SIEMENS . Healthineers .. 20 CW SIEMENS Systems Serial sperber : 391635 CHE-2 Aadoren Tx Power 100% MI 0.32 TIS 0.9 TIB 2.5 2.7 MHZ 2790 Hz Gite 4.0 mm Volume 5 6 19 V o WI Tint Map Dyn R Sweep 3 70 dB Play Play 39 Unrestricted © Siemens Healthineers 2022 Speaker Notes: To change the tint of the Spectral Display in PW or CW Doppler, select Tint and a pop-up menu is displayed to allow selection of the tint. Notes No. 39 SIEMENS Healthineers Pulsed Wave Doppler Functionality SIEMENS. Healthineers ... Angle Correction SIEMENS ACUSON 16/04/2015 12:59:43 VF 10-5 31.2 CV Tx Power 100% MI 0.53 TIS <0.1 TIB <0.1 5.3 MHZ 6250 Hz Gate 2.0 mm 0 dB cmis Angle 15 fps 4 mm 3.5 cm -100 -50 61 14 mm 50 40 Unrestricted © Siemens Healthineers 2022 Speaker Notes: To adjust the Doppler angle, rotate the Angle control to change the angle. When the angle is changed, the angle display will be highlighted and once over 60 degrees, the angle will be highlighted in green. Press the Angle control to rotate through 0/60/0 degrees. Notes No. 40 SIEMENS Healthineers Pulsed Wave Doppler Functionality SIEMENS . Healthineers .. Auto Stats 20 C PW 20 C PW System Serial Number : 391537 ACUSON 02/05/2017 13:50:18 28.2 CV Physio myxig Tx Power 100% Settings MI 0.62 TIS 0.4 TIB 0.7 Auto Stat Off 5.3 MHZ tivity Auto Stat Both Both Above Gate 1.5 mm Volume Below 10 Both 91 bpm 4 Cm Z ....... Sensi- Settings tivity Auto Stat Off Volume PIE 1.72 S/D = 4.14 PS = 74.7 cm/s Both Above 10 ED = 18.1 cm/s TAmax = 33.0 cm/s 3 TAmean = 19.3 cm/s Below Both 5 Tint Map Dyn R Sweep 60 da Play 41 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The Auto Stat option is available when in PW Doppler. Choose from above the baseline, below the baseline or both. Please Note: the heart rate is also displayed. The measurements that are calculated with Auto Stat are: • PI • S/D • ED • Time Average mean (Tamean) • RI • PS • Time Average Max (Tamax ) To adjust the sensitivity, select Sensitivity which is also located on the Left Panel Control keys. The user sets the sensitivity settings to match the yellow PSV line and adjust to include more or less of the spectrum via Sensitivity. Increase for higher sensitivity. Auto Stats is available on live and frozen images. Notes No. 41 SIEMENS Healthineers Pulsed Wave Doppler Functionality SIEMENS . Healthineers ... Simultaneous (Triplex) 2D C PW SIEMENS 11/06/2017 13:50:11 VF16-5 40.3 Physio PV Tx Power 100% MI 0.80 Auto Stat TIS 0.2 tivity TIB 0.8 Off 5.3 MHZ SieScan Volume 5580 Hz Gate 1.0 mm 11 Emis 10 fps << Steer Steer >> 2 cm Z -100 Full D Simult CW 50 42 Unrestricted © Siemens Healthineers 2022 Speaker Notes: Simultaneous is the triplex mode. With this mode, the color and Doppler will be live at the same time. Select Simult on the Left Panel Control keys to activate. Note, when in Simult, the frame rate will be lower. Select Update Rate on the Soft keys, to update from 1-8 seconds. Notes No. 42 SIEMENS Healthineers Continuous Wave (CW) Doppler Functionality SIEMENS . Healthineers .. Pad Echa Ta Fewer 100% PA- 1IS-12 61.3 6.0 MHZ EM Tx Power 100% MI 0.70 TIS 0.9 TIB 0.9 DTCE Low Dyn R 60 dB THI 3.6 MHZ 0 dB 18 fps Fr 165 100 mm 18 cm -100 -100 43 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The system also has imaging Continuous Wave (CW) Doppler and Aux CW 2.0 option for adult cardiac and 5.0 for pediatrics and vascular. CW Doppler is accessed via the Left Panel Control keys, although can be assigned to a user- defined key Config > Custom Keys menu for easier access. Selecting the AUX CW transducer enables the non-imaging CW Doppler. Notes No. 43 SIEMENS Healthineers Full Screen Doppler SIEMENS . Healthineers ... VF10-5 CV 60 º Physio Tx Power 100% 120 Settings MI 0.53 TIS <0.1 Auto Stat Volume TIB <0.1 100 5.3 MHZ Off Off 6250 Hz Gate 2.0 mm -7 dB << Steer Steer >> -60 40 20 Full D Simult CW 44 Unrestricted © Siemens Healthineers 2022 Speaker Notes: The Full D mode allows the user to have a full imaging screen of just Doppler in PW and CW Doppler. CW Doppler only works with the Cardiac and Pediatric exam preset using the P8-4 and P4-2 transducer. Notes No. 44 SIEMENS Healthineers Trademarks and Disclaimers SIEMENS. Healthineers ... • Advanced SieClear compounding, Clarify VE technology, DTI, Dynamic TCE, SieScape imaging and TEQ technology are registered trademarks of Siemens Medical Solutions USA, Inc. 45 Unrestricted © Siemens Healthineers 2022 Speaker Notes: No speaker notes. Notes No. 45 SIEMENS Healthineers Thank you! SIEMENS. Healthineers ... Questions? 46 Unrestricted © Siemens Healthineers 2022 Speaker Notes: No speaker notes. Notes No. 46