ACUSON Maple 1.0 Major Modes Presentation

SIEMENS Healthineers SIEMENS Healthineers ... ACUSON Maple Ultrasound System Major Modes 1.0 Software Release 1 Unrestricted © Siemens Healthineers 2023 Speaker Notes: In this presentation we will discuss the Major Modes for the ACUSON Maple™ ultrasound system. Notes No. 1 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Review B-mode and M-mode controls • Describe B-mode and M-mode optimization features • Explain display modes • Review Doppler controls • Describe Doppler optimization features 2 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Here are the objectives for this presentation. We will begin with reviewing the B-mode and M- mode controls. Notes No. 2 SIEMENS Healthineers B-mode controls SIEMENS . Healthineers ... Control Panel 2 702 Touch Add Exam Workflow 20 Contrast Elasticity Screen ? SieScape esiescan Clarify VE Persist Full Screen Extensive View 20 PW = M Touch Clarity VE Levels Edge UR Flip UND Flip CW 3D14D Screen Screen THI Biopsy Line Biopsy $ Depth Physio Settings> Split Image Clip Settings Full FOV High Density DTCE Med RIS Tint TEQ Gain MultiHertz 5.0 MHZ Adv. SieClear Dyn R 68 dB Map Image Size Tx Power Calis Fixer Soft Keys 3 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The B-mode image may be optimized using three different methods: 1. Control Panel 2. Soft Keys 3. Touch Screen Notes No. 3 SIEMENS Healthineers B-mode controls on the Control Panel SIEMENS. Healthineers .. 2D E 30/40 Steer $ Depth / Focus C O) 0000 UD1 O (B) UD 2 Print Store 1 Clip Store $ Depth / Focus C O Select UD 3 Print Store 2 Dual Zoom 4 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The primary B-mode imaging controls on the Control Panel: • 2D activates or returns to B-mode imaging; rotate 2D to change the overall B-mode gain/brightness • eSieImage™ multiparametric optimization automatically optimizes gain, DGC (depth gain compensation) and suppresses noise in B-mode imaging • Depth changes the depth of the field of view (FOV) and is adjustable using the multi- function Depth/Focus toggle control (customizable functionality under System Configuration > Custom Keys > Depth/Focus) • Focus repositions the focal zone(s) and changes the number of focal zones displayed; it is adjustable using the multi-function Depth/Focus toggle control and its functionality is customizable under System Configuration > Custom Keys > Depth/Focus • Dual displays two different images side-by-side • Zoom activates either Zoom (read) or HD Zoom (write) Notes No. 4 SIEMENS Healthineers B-mode controls on the Soft Keys SIEMENS . Healthineers ... ₱ 7C2 Add Exam Workflow System Configuration Soft Keys ? 20 Contrast Elasticity SieScape eSieScan General 1 20 Lv 20 Frz CLV C Frz PLV Clarify VE Persist Full Screen Extensive View Adv. SieClear Display Clarify VE Persist Full Screen Clarify VE Levels Custom Keys Clarify VE Levels LUR Flip UND Flip Soft Keys Clarity VE Edge UR Flip DTCE Exam Dyn R Sorten THI Biopsy Line Biopsy Measurement THI Trapezoid Edge Text Annotation Focus Width Patient Physio Settings > 48 Split Body Marker Physio Settings 48 FOV Size Stress Echo Clip Settings eSieScan Olip Settings Full FOV Full FOV High Density Contrast Clip Store High Density Image Size DICE High Density DICE Med RIS 3 Tint TEQ Gain Printer MultiHertz Adv. SieClear Adv. SieClear L/R Flip MultiHertz 5.0 MHz Adv. SieClear Dyn R 68 dB| Map nage Size Tx Power 100% Barcode Clarify VE Levels Map DTCE Wireless Clear Page Clear All Pages Dyn R MultiHertz Network Edge Focus Width Utility FOV Size Archive Full FOV High Density Security Service UR Flip fultiHertz 5 Unrestricted © Siemens Healthineers 2023 Speaker Notes:Notes s • The B-mode Soft Key rotary controls are located on the Control Panel and lie beneath and correspond to the controls listed on the bottom two rows of the Touch Screen • These controls are customizable for live imaging and when frozen in, System Configuration > Soft Keys. The available control options are displayed above on the slide; Alternatively, all B- mode Soft Key optimization controls, except for MultiHertz and Focus Width, can be configured to the Touch Screen • The active control is highlighted in white. To alternate activation between the first and second row controls, push the corresponding rotary control OR touch the desired control; Once activated, turn the rotary control clockwise/counterclockwise to adjust • If the system is frozen, only those controls available in freeze will be available; Controls that are not available will appear dithered out • Soft Key controls do not change when navigating pages Notes No. 5 SIEMENS Healthineers B-mode controls on the Touch Screen SIEMENS . Healthineers ... A 7C2 Abd 16L4 4 Add Exam Workflow Dyn R Full FOV Clv CHE Edge Split ? 20 Contrast Elastic Siescape eSieScan 20 H Motane Ima Map 4B Clarify VE Persist Full Screen Extensive View Tint U/D Flip Edge Persist L/R Flip Clarify VE Levels Edge UR Flip UND Flip Wide FOV Fut FOV Tx Power Trapezoid Physio Settings R/S Biopsy Screen Biopsy Line Biopsy Off Ole Settings Trapezoid TEQ Gain Biopsy Settings THI Clip Settings Hide Patient Physio Settings > 4B Split DTCE Physio Settings > Adv. SieClear Needle Visual. Clip Settings Full FO Clarify VE Timer End Exa Clarify VE Levels .. Blank FOV Size DICE Med R/S Tint TEQ Gain Image Size MultiHertz 5.0 MHz Adv. SieClear Dyn R 68 dB Map mage Size x Power 100% DTI CTI High Density 6 Unrestricted © Siemens Healthineers 2023 Speaker Notes: • The B-mode imaging Touch Screen controls are customizable for live imaging and when frozen in System Configuration > Soft Keys and the available control options are displayed above on the slide; Alternatively, all B-mode Touch Screen optimization controls, except for THI, Clarify VE, CTI, Split and 4B can be configured to the Soft Keys • SieScape™ panoramic imaging controls are available under the tab labeled SieScape with linear and curved array transducers • A control is highlighted in blue when it is active, and gray when it is unactive or dithered out • Touch the control to activate/deactivate or open a menu selection; if the system is frozen, only those controls available in freeze will be available • Select the arrowhead in the lower right corner to view the second page Notes No. 6 SIEMENS Healthineers M-mode controls SIEMENS. Healthineers ... M A P4-2 Adult Ech Add Exam Workflow 2D Contrast esiel! Stress Echo eSieScan ? Full Screen Extensive View 3 cm Screen Physio Settings> Full M M Mode Clip Settings Angle AMM Marker AMM Tint MultiHertz 3.6 MHZ Edge 2 Dyn R 65 dBM Sweep 4 Tx Power 100% 7 Unrestricted © Siemens Healthineers 2023 Speaker Notes: M-mode (or motion mode) displays a B-mode reference image and an M-mode sweep. M- mode allows a graphic display of motion, such as tracing a fetal heart rate or, in the example shown, a lung ultrasound to check for pneumothorax. The cursor or M-line indicates the path used to obtain the M-mode tracing. Anatomy that remains stationary displays as a straight line while curved or peaked lines mirror the moving anatomy. To activate M-mode: • Press M on the Control Panel to access the B-mode image/M-mode sweep on the imaging screen and the M-mode menu on the Touch Screen • Roll the trackball to position the M cursor • If desired, select Full M on the Touch Screen to enter/exit full screen sweep • Rotate M to change the overall M-mode gain • To exit, press the M or 2D control on the Control Panel The M-mode Soft Key and Touch Screen controls are customizable for live imaging and when the image is frozen in System Configuration > Soft Keys. The 2D-/M-mode imaging formats are (1/2 2D, 1/2 trace; 1/3 2D, 2/3 trace; 2/3 2D, 1/3 trace; Side-by-Side) configurable under System Configuration Exam > 2D/M & 2D Doppler Display Format. For M-mode functionality, the user has the option to bypass the cursor. This is selected in System Configuration > Display > Doppler/M-mode > Bypass Cursor Mode. Uncheck to display full screen B-mode display with the M cursor after pressing M. Check to bypass initial full screen B-mode display with the M cursor and immediately activate in B-mode/M-mode sweep format. Notes No. 7 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Review B-mode and M-mode controls • Describe B-mode and M-mode optimization features • Explain display modes • Review Doppler controls • Describe Doppler optimization features 8 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, we will discuss the B-mode and M-mode optimization features. Notes No. 8 SIEMENS Healthineers eSieImage multiparametric optimization SIEMENS . Healthineers ... 9VC2 OB Tx Power 98% MI 1.11 TIS 0.3 TI8 0.3 ASC 2 System Configuration Exam DTCE High Dyn R 70 dB THI F 5.7 MHZ General 1 -7 dB 59 fps General 2 Exam Carotid Display Freeze Behavior Cine Custom Keys Seamless Dual On Off Soft Keys Dual Behavior on Freeze O Left Dual Image Live Exam ED-ES Split Measurement Text Annotation eSielmage On off 9 Unrestricted © Siemens Healthineers 2023 Speaker Notes: eSieImage™ multiparametric optimization automatically and intelligently optimizes key imaging parameters in real-time B-mode imaging, reducing scan time and operator effort. This allows the user to smoothly navigate from one scan window to another with little to no adjustment while maintaining image quality, uniformity and contrast resolution throughout the entire field of view (as displayed in this image of a large liver hemangioma). eSieImage optimization continuously adjusts overall gain and depth gain compensation (DGC) and performs continuous noise analysis and correction. It automatically tracks tissue on a frame-by-frame basis, identifying tissue versus noise, ensuring that B-mode image quality, uniformity and contrast resolution are optimally maintained across different tissue types. • When active, the eSieImage optimization control on the Control Panel is backlit in blue and a gold icon appears on the image screen. Press eSieImage once on the Control Panel to activate or press twice to deactivate • Automatic activation with exam selection is customizable under System Configuration > Exam > eSieImage > On/Off Notes No. 9 SIEMENS Healthineers Tissue harmonic imaging (THI) SIEMENS. Healthineers ... THI 3.5 cm 3.5 cm Without THI With THI 10 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Tissue harmonic imaging (THI) improves contrast and spatial resolution by reducing noise and clutter within cysts and vessels and is especially helpful in reducing noise in large, difficult-to- image patients. THI is generated within the tissue beyond the window that causes beam distortion and scattering; therefore, the undesirable effects of the acoustic window are generally reduced. The harmonic frequency received is twice the fundamental frequency (e.g., if a 2 MHz fundamental signal is sent into the body, the ultrasound system uses the 4 MHz harmonics signal that returns from the body to form the image. THI can be used to decrease artifacts such as haze, noise and clutter in vessels (as displayed here in the carotid bulb) or from large, difficult-to-image patients. THI can help reduce grating lobes and side lobe artifacts (low-intensity weak echoes outside of the main ultrasound beam) typically seen near the diaphragm or near large cystic structures. It can also reduce reverberation artifacts (linear equally spaced echoes) on the anterior portion of cystic structures such as the urinary bladder or gallbladder. • To activate/deactivate select THI on the Touch Screen Notes No. 10 SIEMENS Healthineers MultiHertz multiple frequency imaging SIEMENS. Healthineers ... High Density 2 DTCE Med R/S 3 Tint Image Size Tx Power 100% N MultiHertz 3.6 MHZ Adv. SieClear Dyn R 63 dB Map C Focus Width TEQ Gain O Abd Tx Power 98% MI 0.79 TIS 0.9 TIB 0.9 ASC 1 DTCE Med Dyn R 68 dB THI 5.0 MHZ 5 dB 20 fps 13 cm 11 Unrestricted © Siemens Healthineers 2023 Speaker Notes: MultiHertz™ imaging enables the user to adjust the center frequency of the transducer to improve resolution (higher frequency setting) or increase depth of penetration (lower frequency setting). It provides a clear visualization the entire FOV from near field to far field in B-mode imaging (as displayed in this image of the liver). MultiHertz imaging allows the user to independently select B-mode fundamental and harmonic frequencies. In color Doppler and spectral Doppler, the user can independently select the center frequencies (e.g., the Doppler frequency can be adjusted without changing the B-mode frequency). Each imaging mode has its own frequency settings to achieve the highest resolution, penetration and sensitivity for the structure being imaged. Multiple fundamental and harmonic frequencies are available on each transducer via the corresponding Soft Key rotary control. • Rotate the MultiHertz Soft Key rotary control to change the frequency Notes No. 11 SIEMENS Healthineers SIEMENS Healthineers Advanced SieClear spatial compounding SIEMENS . Healthineers ... High Density 12 DTCE Med R/S 3 Tint 2 Image Size 12 Tx Power 100% MultiHertz 3.6 MHZ Adv. SieClear 1 Dyn 63 dB Map C Focus Width TEQ Gain O Without Compounding With Compounding 12 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Advanced SieClear™ spatial compounding combines multiple images acquired at different steering angles (multiple lines of site) to produce a compounded image with less noise, increased contrast resolution and improved border delineation. Setting selections include: Off, SC2, 1, 2, 3 and are transducer and mode dependent. Increase Advanced SieClear compounding to add to the number of steering angles for a smoother/softer appearing image (as displayed in this sagittal image of the liver/IVC). Advanced SieClear provides greater vascular delineation, musculoskeletal tissue definition or enhancement to structures with curved or irregular borders (a stronger reflection occurs with a perpendicular angle of incidence). Decrease Advanced SieClear compounding for a more granular appearance or to enhance clinical markers such as cysts or calcifications. • Rotate the Adv. SieClear Soft Key rotary control to change the Advanced SieClear compounding. Notes No. 12 SIEMENS Healthineers Dynamic TCE tissue contrast enhancement technology (DTCE) SIEMENS . Healthineers ... High Density DTCE Med R/S 3 Tint 12 Image Size 12 Tx Power 100% MultiHertz 3.6 MHZ Adv. SieClear Dyn R 63 dB Map C Focus Width TEQ Gain 0 Without DTCE With DTCE 13 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Dynamic TCE™ tissue contrast enhancement (DTCE) technology reduces image speckle (as displayed in this sagittal image of the liver/IVC) while maintaining detail resolution for improved tissue contrast. Dynamic TCE technology is a Siemens Healthineers proprietary advanced method for speckle reduction. Speckle is displayed as a granular pattern formed from interferences of backscattered ultrasound waves which substantially lowers contrast and obscures image details. Its suppression must be balanced, as it can also contain diagnostic information. Select one of four levels of Dynamic TCE technology (Off, Low, Med and High) to apply to the image. Dynamic TCE technology can be used with Advanced SieClear compounding to enhance visualization of tissue texture, subtle tissue contrast differences, border definition and pathology. Notes No. 13 SIEMENS Healthineers Clarify vascular enhancement (VE) technology SIEMENS . Healthineers ... 16L4 Thyroid Clarify VE Tx Power 100% MI 1.11 TIS 0.5 TIB 0.5 Clarify VE 4 ASC 1 DTCE Med Clarify VE Levels Dyn R 65 dB THI 10.7 MHZ 6 dB 4 17 fps 3 cm Without Clarify VE With Clarify VE 14 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Clarify™ vascular enhancement technology is a real-time, adaptive, pixel-by-pixel analysis which provides exceptional contrast resolution for clear delineation of vessels. It reduces noise and artifacts (as displayed here in the mid superficial femoral artery). It improves visualization of micro- and macro-vasculature, and increases contrast resolution within tissue and between tissues. It is a patented technology that uniquely utilizes power Doppler flow information to enhance B-mode imaging. Use Clarify VE technology to reduce noise and artifacts within macro-vascular structures (larger vessels) such as the carotid artery, aorta and femoral vein. Also in micro-vascular structures, such as the small vessels found in the thyroid, testicle and kidney. Use it on vessels to help delineate surrounding structures (e.g., on the splenic vein and portal confluence to help delineate the pancreas). Clarify VE technology does not change the B-mode image in nonvascular structures (e.g., within the gallbladder or urinary bladder). To activate/deactivate, select Clarify VE on the Touch Screen. Select Clarify VE Levels (1-7) to adjust Clarify VE technology sensitivity levels: • Select a higher level to increase sensitivity • Select a lower level to decrease sensitivity Please note: To display Clarify VE on the Touch Screen, go to System Configuration > Soft Keys, select an area on the Touch Screen and select Clarify VE from the drop-down menu. Repeat to add Clarify VE technology Levels to the Touch Screen or add it to the Soft Key rotary controls. Notes No. 14 SIEMENS Healthineers Focus SIEMENS . Healthineers ... High Density O DTCE Med R/S 4 Tint 10 Image Size 12 Tx Power 100% MultiHertz 8.4 MHz Adv. SieClear Dyn R 58 dB Map D Focus Width TEQ Gain O L10-5v Tx Power 98% MI 0.89 TIS 0.2 TIB 0.2 ASC 3 DTCE High Dyn R 70 dB 1 Depth / Focus C THI 9.4 MHZ -4 dB 57 fps 15 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Focus control repositions the focal zone(s) and changes the number of focal zones displayed. The sagittal view of the diffusely inflamed Achilles tendon on the left displays one focal zone, while the image of the small complex thyroid nodule on the right displays two focal zones spaced closely together. The lateral resolution of the image is best within the focal zone area. It is recommended to place the focal zone at or below the area of interest. Focus is adjustable using the multi-function Depth/Focus toggle control located on the Control Panel. • Rotate the toggle control clockwise or counterclockwise to reposition the focal zone(s) • Press the toggle control to increase/decrease the number of focal zones (available with Adv. SieClear <2) • Focus is customizable under System Configuration > Custom Keys > Depth/Focus Focus Width is a Soft Key control that can be rotated to increase/decrease the distance between multiple focal zones. Notes No. 15 SIEMENS Healthineers High Density SIEMENS. Healthineers ... High Density 2 DTCE Med R/S 4 Tint 10 Image Size 2 Tx Power 100% MultiHertz 8.4 MHZ Adv. SieClear 2 Dyn R 68 dE Map D Focus Width TEQ Gain O High Density 0 High Density 1 High Density 2 16 Unrestricted © Siemens Healthineers 2023 Speaker Notes: • High Density increases/decreases line density (higher levels = higher resolution) when HD Zoom is activated • The septation and echogenic focus within the small complex thyroid nodule displayed here is most visible at a High Density level of 2 Notes No. 16 SIEMENS Healthineers Additional optimization features SIEMENS . Healthineers' ... 7C2 Add Exam Workflow C5-2 Add Exam Workflow 20 Elasticity Siescape eSiescan 2D Contrast Elasticity SieScape eSieScan ? Clarify VE Persist Full Screen Extensive View Clarify VE Levels Edge UR Flip UID Flip Screen THI Biopsy Line Biopsy Physio Settings > 48 Split Patient Image Clip Settings Timer End Exam DICE Med RIS Tint Focus Width TEQ Gain High Density DICE Med RVS Tint 2 Focus Width TEQ Gain MultiHertz 5.0 MHZ Adv. SieClear Dyn R 58 dB Map mage Size 2 Tx Power 100% MultiHertz 4.0 MHz Adv. SieClear Dyn R 65 dB Map G Image Size 3 Tx Power 98% Page 1 Page 2 17 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Additional B-mode and M-mode optimization features include: • CTI (Custom Tissue Imaging) optimizes the B-mode image by adjusting the speed of sound resulting in improved lateral resolution and boundary definition. User-selectable levels provide a higher quality image, based on the speed of sound appropriate for a specific tissue type. CTI corrects for phase aberrations caused by the speed of sound mismatch and optimizes the image in real-time. CTI can be used in breast exams to improve the image quality in fatty or dense tissues • R/S (Res/Speed) adjusts the balance between the image line density (resolution) and the frame rate (speed) and settings are 0 (low resolution/high frame rate) to 5 (high resolution/low frame rate) • DynR (Dynamic Range) affects the number of gray shades that are displayed; increase the Dynamic Range to produce a “softer” B-mode image; decrease the settings to produce an image with more contrast; dynamic range is available on a live or frozen image (settings range from 10-90) • Tint individually colorizes the grayscale image to aid in visualization of subtle tissue differences; clinical uses may include nerve imaging and fetal echocardiography; tint can be adjusted on a live or frozen image and are numbered 0-15 • Map enhances aesthetics by adjusting greyscale assignments to modify image contrast (only aesthetics change, as maps do not affect data content); Map may be adjusted on a live or frozen image and determines how dark or light you prefer to show each level of white/gray/black based upon the strength of the ultrasound signal; Settings range from A-G. Notes No. 17 SIEMENS Healthineers Additional optimization features (cont'd) SIEMENS . Healthineers' ... 7C2 Add Exam Workflow C5-2 Add Exam Workflow 20 Elasticity Siescape Contrast Elasticity SieScape eSieScan ? eSiescan 2D Clarify VE Persist Full Screen Extensive View Clarify VE Levels Edge UR Flip UID Flip Screen THI Biopsy Line Biopsy Physio Settings > 48 Split Patient Image Clip Settings Timer End Exam DICE Med RIS Tint Focus Width TEQ Gain High Density DICE Med RVS Tint 2 Focus Width TEQ Gain MultiHertz 5.0 MHZ Adv. SieClear Dyn R 58 dB Map mage Size 2 Tx Power 100% MultiHertz 4.0 MHz Adv. SieClear Dyn R 65 dB Map G Image Size 3 Tx Power 98% Page 1 Page 2 18 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Additional B-mode and M-mode optimization features include (cont'd): • Tx Power (transmit power) allows manual adjustment of the acoustic energy delivered to the patient (settings range from .20-100%) • TEQ Gain is a user-definable threshold that accommodates different user preferences for gain settings and various room lighting conditions (settings range from -5 to 5) • Persist (Persistence) controls the number of images the system will average per frame; increasing the persistence increases the number of images averaged reducing noise and making the image appear smoother; an average persistence setting is 2 or 3 (settings range from 0-4) • Edge (Edge Enhancement) enhances or smooths edges or borders; increasing edge will enhance/sharpen borders whereas decreasing edge will smooth borders; Settings range from 0-3 Notes No. 18 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Review B-mode and M-mode controls • Describe B-mode and M-mode optimization features • Explain display modes • Review Doppler controls • Describe Doppler optimization features 19 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, we will discuss the display modes. Notes No. 19 SIEMENS Healthineers SieScape panoramic imaging SIEMENS . Healthineers ... Pause SieScape Acquire Acquire End End Pan Rotate Pan Rotate A 05-2v 9VE4 Add Exam Workflow 2D SieScape Contrast Elasticity SieScape eSiescan Ruler Restart Redisplay Reset Exit Cine Best Fit Full Fit End Exam 20 Unrestricted © Siemens Healthineers 2023 Speaker Notes: SieScape panoramic imaging offers a larger field of view (FOV) to visualize and measure structures in their entirety or to better visualize and understand spatial relationships between anatomy (or between anatomy and pathology). SieScape imaging is a technique where the user moves the transducer along the patient's anatomy and the system blends the multiple images together to form one long image with an extremely wide field of view (as displayed here in the longitudinal image of the femoral artery). It compares consecutive images, rotating and stitching them together to form the final image. SieScape imaging Cine can be used to recall single frames for review. SieScape imaging allows acquisition and display of grayscale images up to 240 cm in length to a maximum curvature of 180 degrees. It is available on curved and linear transducers. Clinical applications for use may include: Thyroid (nodules, goiters), Breast (masses, areas of inflammation, reference anatomy), Musculoskeletal (Baker’s cysts), Vascular (anastomoses, varicose veins). To activate, select the SieScape tab (appears on the Touch Screen when a linear or curved array transducer is active, and the system is unfrozen). • Press one of the Set keys to acquire the image and press Freeze or one of the Set keys to end acquisition • Unfreeze to reactivate acquisition if desired • Use the Panoramic Review controls after completing the acquisition to size, rotate, pan, zoom or measure the SieScape imaging • Press the Panoramic Cine function on the Touch Screen to recall single frames for review and use the trackball to change the Cine image displayed • Press Redisplay to return to the full SieScape imaging • Select Exit to exit SieScape imaging review Notes No. 20 SIEMENS Healthineers Trapezoid SIEMENS . Healthineers ... L10-5v Venous Trapezoid Tx Power 98% MI 0.75 TIS 0.2 TIB 0.2 4.0 MHZ 1220 Hz Flow Med 0 dB 18 fps 4 cm 21 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Trapezoid angles the outer edges of the image on linear transducers to extend the far-field display. Some common areas where trapezoid imaging is clinically used include: • Thyroid imaging to show a large nodule • Testicular imaging for pathology (e.g., hydrocele) • Pediatric imaging when higher frequency is needed • Early OB imaging • Vascular imaging (as displayed here in the longitudinal image of the femoral artery) • Appendix To activate/deactivate Trapezoid imaging, select Trapezoid on the Touch Screen. Please note: The 13L4 has a different behavior than the other linear transducers which will be discussed in the following slides. Notes No. 21 SIEMENS Healthineers Dual SIEMENS . Healthineers ... Dual G8 Wall Thickness 1.9 mm 3 cm Conventional Dual Seamless Dual 22 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Dual displays two separately acquired images side-by-side. In Dual, the user is able to annotate and measure. The image on the left is of a conventional dual display of the sagittal gallbladder next to a transverse image and measurement of the gallbladder wall thickness. Body markers are also available in dual for each image. Press Dual to activate and toggle between images. Press 2D to exit Dual. The gold “a” denotes the active side. The system can be configured for conventional dual or seamless dual (e.g., image on right seamlessly connects the upper and lower poles of the sagittal thyroid). Go to System Configuration > Soft Keys > Exam > Seamless Dual > On/Off. Conventional Dual allows measurements on either the right or left image. Seamless Dual allows for measurement across the center where both of the images meet. Notes No. 22 SIEMENS Healthineers Live Dual (Split) SIEMENS . Healthineers ... Split Note: This presentation uses the term “Live Dual” to refer to Split imaging displayed as Split on the ultrasound system 23 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Live Dual (Split) displays the same image side-by-side. Comparisons may include: B-mode, B-mode with Clarify VE (as displayed here in the image on the left of the splenic vein delineating the pancreas). Also, B-mode and B-mode with color/power Doppler or an image with and without measurements (as displayed here in the image on the right of a liver hemangioma). Live Dual is often used to compare the B-mode image next to the color Doppler image in order to evaluate both the hemodynamics and the underlying B-mode image. On a live image, select Split to activate/deactivate. Please note: This presentation uses the term “Live Dual” to refer to Split imaging displayed as Split on the ultrasound system. Notes No. 23 SIEMENS Healthineers Zoom and HD Zoom SIEMENS . Healthineers ... Zoom 12 cZ HD Z Zoom HD Zoom 24 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Zoom activates either Zoom (read) or HD Zoom (write). Zoom magnifies the image on a live or frozen image. A “Z” is displayed on the image screen (as displayed here in the image of the common bile duct on the left). • Rotate Zoom to increase/decrease magnification of the image and roll the trackball to pan the image • Rotation is customizable under System Configuration > Custom Keys > Increase Zoom > Clockwise/Counter Clockwise • Zoom is also available in color Doppler in Split. The B-mode/color Doppler image can also be zoomed HD Zoom (write) increases image size, detail resolution and frame rate in a region of interest (ROI). Available on live image only. When selected, “HD Z” displays on the image screen (as displayed here in the image of the CBD on the right). • Press Zoom once to display the ROI • Rotate Zoom to resize the ROI • Roll trackball to position the ROI • Press Zoom a second time to activate • Press Zoom a third time to deactivate Notes No. 24 SIEMENS Healthineers Image Size SIEMENS . Healthineers ... High Density DTCE Med R/S 13 Tint Image Size Tx Power 100% N MultiHertz 3.6 MHZ Adv. SieClear Dyn R 63 dB Map C Focus Width TEQ Gain O - Abd Ab Tx Power 100% Tx Power 100 MI 0.09 MI 0.89 TIS 0.7 TIS 0.7 TIB 0 7 TIB 0.7 ASC 1 ASC 1 DTCE Med DICE Med Dyn R 63 dB Dyn R 63 dh THI 3,6 MH: THI 3.8 MHZ 17 fps 17 fpa 10 cm Image Size 0 Image Size 4 25 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Image Size changes the size of the image. The default Image Size is 2. Increase or decrease Image Size for personal display preference. Pixels may appear tighter when using a smaller Image Size (as displayed in the image on the left of the hepatic veins). The field of view (FOV) width is not affected when the image size is changed (settings range from 0 – 4). Notes No. 25 SIEMENS Healthineers Extensive View SIEMENS. Healthineers ... Clarify VE Persist Full Screen Clarify VE Levels Edge L/R Flip U/D Flip U Extensive View Clear THI Full FOV Screen Biopsy Line Biopsy Off Hide Patient Physio Settings > 4B Split CTI 1540 m/s Image Param Clip Settings End Exam V High Density DTCE Med R/S 3 Tint 12 Focus Width TEQ Gain MultiHertz 3.4 MHZ Adv. SieClear Dyn R 0 dB Map Image Size Tx Power 100% N W 26 Unrestricted © Siemens Healthineers 2023 Speaker Notes: There are 3 different display options. The default image size will be Normal. This is indicated by the Extensive View and the Full Screen view Soft Keys not backlit in blue. The image sizes are not available in 3D/4D or review modes. Notes No. 26 SIEMENS Healthineers Extensive View SIEMENS . Healthineers ... Extensive View Full Screen Thyroid Normal View Extensive View Full Screen Captures patient information, • Captures patient information • Does not capture patient • patient banner, thumbnails and banner information and banner and trackball legend • Hides thumbnails • Hides thumbnails • Hides trackball legend • Hides trackball legend 27 Unrestricted © Siemens Healthineers 2023 Restricted © Siemens Healthineers 2023 Speaker Notes: The three image displays can be changed throughout an exam and will stay in the size the user decides. When the system is rebooted, the view size will return to the default, Normal View. • The Normal View will capture the patient information, patient banner, thumbnails and the trackball legend • The Extensive View will capture the patient information and the patient banner, although it hides the thumbnails and the trackball legend • The Full Screen view will display the largest diagnostic image on the monitor and will not capture the patient information or the patient banner. It will also hide the thumbnails and the trackball legend. The image sizes are also available when in the Text, Body Marker and Arrow functionality. Once all the additions to text, Body Markers or arrows are complete, press the Esc Key on the Control Panel to return to the 2D imaging Soft Key menu on the Touch Screen and select the size to be displayed. Notes No. 27 SIEMENS Healthineers Rotate Image SIEMENS . Healthineers ... • Rotate Image button on 2D live C5-2v 9VE4 14L4a Add Exam Workflow Thyroid Touch Screen 20 Contrast Elasticity SieScape eSieScan • Available on linear transducers ? Clarify VE Persist Full Screen Extensive View • Rotates image -90°, 0°, 90° Does not work with trapezoid, Clarify VE Levels Edge LUR Flip UID Flip • U dual or zoom Clear THI Trapezoid Rotate Image Biopsy Line Biopsy Off Hide Patient Physio Settings > 4B Split Needle Visual. Image Clip Settings Full FOV High Density DTCE Med RIS Tint 10 Focus Width TEQ Gain MultiHertz 11.4 MHZ Adv. SieClear Dyn R 68 dB Map C Image Size Tx Power 98% 28 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Image rotation is available on linear transducers when in live 2D and is located on the Touch Screen. This is beneficial when scanning pediatric hips. The user can rotate the image -90°, 0°, 90°, although it will not be available in trapezoid, dual mode or zoom. Notes No. 28 SIEMENS Healthineers Image rotation 0°, 90°, -90° SIEMENS . Healthineers ... 14L4 -90 90 . a Ped Hip Tx Power 100 Rotate Image MI 0.89 Depth indicators and TGC line on top 14L4 90 º 90º a Ped Hip Tx Power 100% Rotate Image MI 0.89 90 14L4 a Ped Hip -90 . 90 . Tx Power 100% Rotate Image -90 29 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Here are examples of each rotation. Notice when the image is in the 90° or -90°, the depth indicators and TGC line are on the top of the image. Notes No. 29 SIEMENS Healthineers 4B SIEMENS. Healthineers ... 9VC2 4B OB Default -5 dB Surface Op 65 Dyn R 60 Br 46 S 70 LowTh 61 Map D Tint 2 Fetus A 1 01 66.3 mm 2 02 33.1 mm 3 Q3 50.5 mm Q4 84.4 mm AFI 234.3 mm 12 cm 30 Unrestricted © Siemens Healthineers 2023 Speaker Notes: 4B displays four separately acquired images in a quadrant. For example, when performing an AFI, you can display and measure all four quadrants on one image. There are many additional uses for the 4B display. • To activate, select 4B on the Touch Screen and then select 4B for the first three quadrants • Press Freeze for the last quadrant Notes No. 30 SIEMENS Healthineers Additional display modes SIEMENS . Healthineers' ... 7C2 Add Exam Workflow C5-2 Add Exam Workflow 20 Elasticity Siescape Contrast Elasticity SieScape eSieScan ? eSiescan 2D Clarify VE Persist Full Screen Extensive View Clarify VE Levels Edge UR Flip UID Flip Screen THI Biopsy Line Biopsy Physio Settings > 48 Split Patient Image Clip Settings Timer End Exam DICE Med RIS Tint Focus Width TEQ Gain High Density DICE Med RVS Tint 2 Focus Width TEQ Gain MultiHertz 5.0 MHZ Adv. SieClear Dyn R 58 dB Map mage Size 2 Tx Power 100% MultiHertz 4.0 MHz Adv. SieClear Dyn R 65 dB Map G Image Size 3 Tx Power 98% Page 1 Page 2 31 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Additional B-mode display modes include: • L/R Flip and U/D Flip re-orient the image and the gold “a” icon will indicate the active orientation; xamples for use include: U/D Flip may be used during prostate imaging and L/R Flip may be used if the transducer position is reversed (e.g., during a biopsy procedure) • Full FOV maximizes the field of view when the sector size has been decreased • FOV Size increases/decreases the sector size for transducers displaying a curved array, trapezoid or sector format • The trackball can be used to increase or decrease the FOV • The Select Key can be used to toggle between FOV Size and position • The Touch Screen can be used to change the FOV Size as well If the setting required is not displayed, go to System Configuration > Soft Keys and assign the control to the Touch Screen or Soft Key. Notes No. 31 SIEMENS Healthineers Biopsy indicator SIEMENS. Healthineers ... Biopsy Indicator 7C2 Abd Tx Power 100% MI 0.85 TIS 0.9 TIB 0.9 ASC 1 DTCE Med Dyn R 68 dB Off 5 THI 5.0 MHZ O dD 17 fps Biopsy Off Biopsy 1 32 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The biopsy feature can be found on the Touch Screen and displays which angle is selected on the monitor. The angle selected is displayed on the lower left side of the image. Notes No. 32 SIEMENS Healthineers Post-processing features SIEMENS . Healthineers ... Zoom P4-2 A ₱ 702 Add Exam Workflow A Add Exam Workflow Adult Echo ? 20 Contrast Elasticity SieScape eSieScan ? 2D Contrast eSieLH Stress Echo eSiescan Clarify VE Persist Full Screen Extensive View Full Screen Extensive View Clarify VE Level UID Flip Screen Biopsy Line Biopsy Physio Settings > Split Physio Settings > Full M AM Mode Clip Settings Clip Settings Angle AMM Marker AMM High Density DICE Mod RIS Tint 2 Focus Width TEQ Gain MultiHertz 5.0 MHz Adv. SieClear Dyn R 68 dB Map Image Size 2 Tx Power 100% B-mode M-mode 33 Unrestricted © Siemens Healthineers 2023 Speaker Notes: When the image is frozen, the available post-processing features will be displayed on the Touch Screen or Soft Keys. The available post-processing features on the Control Panel will be backlit. The following optimization controls may be adjusted after the image is frozen: • Zoom • B-mode: DTCE, DynR, Tint, Map, L/R Flip, U/D Flip • M-mode: DynR, Tint, Map, Sweep Notes No. 33 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Review B-mode and M-mode controls • Describe B-mode and M-mode optimization features • Explain display modes • Review Doppler controls • Describe Doppler optimization features 34 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Next, we will review the Doppler controls. Notes No. 34 SIEMENS Healthineers Doppler controls SIEMENS . Healthineers ... A Add Exam Workflow 12 20 Contrast Elasticity eSieScan Full Screen Extensive View Touch Screen Physio Settings > Full D 0000 Clip Settings Irrvert 20 dn Tint 4.0 mm Soft Keys Control Panel 35 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Doppler image may be optimized using three different methods: 1. Control Panel 2. Soft Keys 3. Touch Screen Notes No. 35 SIEMENS Healthineers Doppler controls on the Control Panel SIEMENS. Healthineers ... PW 30 /40 Angle : Depth / Focus C O 0000 Esc Dual UD 2 Body Marker Caliper Print Ston Cup Store O Pointer Print Store 2 E an 36 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The primary Doppler controls on the Control Panel are: • C (color) enters/exits color Doppler; rotate C to change overall color Doppler gain • Press PW (pulsed wave) to activate the Doppler cursor and press PW again to enter pulsed wave Doppler and rotate PW to adjust overall spectral Doppler gain; press PW or 2D to exit or 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 • Steer will steer the color Doppler ROI and the spectral Doppler cursor right/left and steering angles for all linear transducers are: -30, -22.5, -15, -7.5, 0, 7.5, 15, 22.5, 30 degrees • Angle changes the degrees of angle correction for the Doppler spectrum • eSieImage optimization activates automatic spectral Doppler optimization • Roll the trackball and press the right or left Set key (located adjacent to the trackball) to perform functions in Doppler such as: • Position of the color Doppler ROI • Size of the color Doppler ROI • Position of the spectral Doppler cursor • Cine the Doppler image or spectral Doppler waveform when frozen • Position of the Pointer Please note: Dual, Zoom and HD Zoom are available in color Doppler; Zoom is available for the B-mode reference image while in spectral Doppler Notes No. 36 SIEMENS Healthineers Doppler controls on the Soft Keys SIEMENS . Healthineers ... Filter RIS Priority 4 smooth Tx Power 100% MultiHertz 2.7 MHZ Scale 1220 Hz Baseline Map G Flow Med Persist 2 Color Doppler MultiHertz 2.7 Mhz Filter 98 Hz. Dyn R 80 dB Tint Tx Power 100% Gate 4.0 mm Scale 2170 Hz Baseline Map c Sweep 3 Volume 10 Spectral Doppler 37 Unrestricted © Siemens Healthineers 2023 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 two rows of the Touch Screen. These controls are customizable for live imaging and when frozen in System Configuration > Soft Keys. All color Doppler Soft Key optimization controls, except for Frequency, Scale, and Baseline can be configured to the Touch Screen. All spectral Doppler Soft Key optimization controls, except for Frequency, Filter, Scale, and Baseline can be configured to the Touch Screen. The active control is highlighted in white. To alternate activation between the first and second row controls, push the corresponding rotary control OR touch the desired control. Once activated, turn the rotary control clockwise/counterclockwise to adjust. If the system is frozen, only those controls available in freeze will be active. Controls that are not available will appear dithered. Soft Key controls do not change when navigating pages. Notes No. 37 SIEMENS Healthineers Doppler controls on the Touch Screen SIEMENS . Healthineers ... 7CZ Add Exam Workflow ₱ 702 Add Exam Workflow ? 2D C Contrast Elasticity Siescape esiescan ? 2D PW Contrast Elasticity esiescan Full Screen Extensive View Full Screen Extensive View MelTag Auto Stat Trace Direction Hide Physio Settings> 48 Split Physio Settings> Full D Update Rate Sensitivity Clip Settings 2D Adv. SieClear Invert Color Display CDE Clip Settings Invert a-Blend Off Filter RVS Priority Smooth 2 Tx Power 100% 5.3 MHZ| Filter 98 H2 Dyn R MultiHertz 3.3 MHZ Scale 1220 Hz Baseline Map C| Flow Med Persist Gate 4.0 mm Color Doppler Spectral Doppler 38 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Doppler Touch Screen controls are customizable for live imaging and when frozen in System Configuration > Soft Keys. Alternatively, all color Doppler Touch Screen optimization controls, except for CDE, Color Display, Invert, 4B and Live Dual (Split) can be configured to the Soft Keys. All spectral Doppler Touch Screen optimization controls, except for DTI, Invert, Full D, Auto Stat, Live-Live (triplex), Mute and Mean Trace can be configured to the Soft Keys. A control is highlighted in blue when it is active, gray when it is available and will be dithered out if unavailable. Touch the control to activate/deactivate or open a menu selection. If the system is frozen, only those controls available in freeze will be available. Notes No. 38 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Review B-mode and M-mode controls • Describe B-mode and M-mode optimization features • Explain display modes • Review Doppler controls • Describe Doppler optimization features 39 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Lastly, we will describe the Doppler optimization features. Notes No. 39 SIEMENS Healthineers Dynamic persistence SIEMENS . Healthineers ... Auto flash artifact suppression • Dynamic persistence adjusts persistence P4-2 Adult Echo relative to user motion Tx Power 98% MI 1.28 Auto flash artifact suppression applies TIS 0.7 • TIB 0.7 • flash suppression relative to user motion 2.5 MHZ 3541 Hz Flow Med 0 dB 13 fps 18 cm 40 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Dynamic persistence and auto flash suppression are two unique technologies for color Doppler. Dynamic persistence technology: • Prevents the “ghosting” motion in B-mode and color Doppler imaging • Enhances static color sensitivity • Reduces static B-mode noise Color Doppler auto flash artifact suppression: • Prevents motion artifacts • Enhances color sensitivity • Allows high quality scanning at a fast pace • Notice how the color Doppler – in the video of the heart shown here – displays excellent color sensitivity without motion artifacts Notes No. 40 SIEMENS Healthineers Color Doppler velocity (CDV) SIEMENS . Healthineers ... C C5-2v Abd A 2 702 Add Exam Workflow Tx Power 98% MI 1.49 TIS 0.7 C Contrast Elasticity SieScape eSieScan TIB 0.7 ? 2D 3.1 MHZ 2437 Hz Full Screen Extensive View Flow High O de 19 fps VelTag Physio Settings > 4B Split Clip Settings 20 Adv. SieClear Invert Color Display CDE a-Blend 11 an Off Filter R/S Priority Smooth Tx Power 100% MultiHertz 3.3 MHZ Scale 1220 Hz Baseline Map C Flow Med Persist 41 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Color Doppler velocity (CDV) applies colors to vascular structures based on velocity and direction of flow (as displayed here in the carotid bulb). Color Doppler controls include: • VelTag (velocity tag) designates (or tags) a single (Sngl) blood flow velocity or a range (Rng) of blood flow velocities in a color Doppler image • Color Display activates/deactivates the color display without unfreezing the image (ROI remains on the image) • Invert reverses the colors depicting flow towards or away from the transducer in the color ROI and on the color bar (located on the right side of the image) • CDE or CDV activates color Doppler velocity or color Doppler energy (power Doppler) • MultiHertz imaging adjusts the color Doppler frequency independent of the B-mode frequency maintaining color flow sensitivity in vessels located in the near, mid and far field • Filter adjusts the color wall filter; settings are 0-3 (low to high) • Scale adjusts the pulse repetition frequency (PRF) – the color velocity range or the power frequency range • R/S (Res/Speed) adjusts the balance between the image line density (resolution) and the frame rate (speed); settings are 0 (low resolution/high frame rate) to 5 (high resolution/low frame rate) Notes No. 41 SIEMENS Healthineers Color Doppler energy (CDE) SIEMENS . Healthineers ... 1414V 7C Add Exam Workflow Tx Power 99% 20 P Contrast Elasticity MI 0.68 SieScape eSieScan TIS 0.4 ? TIB 0.4 4.4 MHZ 1220 Hz Full Screen Extensive View Flow Med 6 de 28 fps Screen Hide Patient Physio Settings > 48 Split Image Param Clip Settings 2D Adv. SieClear Invert Color Display Dir Power CDV a-Blend Off Filter Priority Smooth Tx Power 100% MultiHertz 3.3 MHZ Scale 122 112 1.5 cm HD Z RIS Map H Flow Med Persist 42 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Color Doppler energy (CDE) or power Doppler applies colors to vascular structures based on flow amplitude (versus velocity information). CDE demonstrates less angle dependence than CDV and is useful for low volume, low velocity flow states to demonstrate presence or absence of flow (as displayed here on a thyroid nodule). • To activate CDE imaging, select CDE on the Touch Screen, and the Touch Screen menu will change to P for power Doppler; the optimization controls will change for power Doppler parameters; to deactivate, select CDV Directional power Doppler applies colors based on amplitude and direction of flow (towards or away from the transducer). • To activate/deactivate directional power Doppler, select Dir Power Notes No. 42 SIEMENS Healthineers Flow SIEMENS . Healthineers ... Filter 1 R/S 4 Priority Smooth Tx Power 100% MultiHertz 6.7 MHZ Scale 781 Hz Baseline Map C Flow Low Persist 3 Flow Low Flow Med Flow High 43 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Flow opens the flow state optimization preset selections. In this sagittal view of a multinodular thyroid, the Low Flow setting reveals the greatest color Doppler flow information. Select Flow to quickly optimize the color Doppler flow state without changing multiple controls: • Flow Low (e.g., renal perfusion, pancreas, small parts, testicular, thyroid, breast, ovarian, calf veins, fetal head, placenta) • Flow Medium (e.g., liver, splenic vein, portal vein, hepatic veins, peripheral vascular in extremities, OB cord) • Flow High (e.g., fetal heart, aorta, cardiac) Notes No. 43 SIEMENS Healthineers Color and Color a-Blend (Alpha Blending) SIEMENS . Healthineers ... Color Doppler Color a-Blend (Alpha Blending) 44 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Alpha Blending, is a function to adjust the transparency level of Color. As the a-Blend index increases, the color transparency increases, so the resulting image is a blended B-mode and color. Notes No. 44 SIEMENS Healthineers Live Dual (Split) SIEMENS . Healthineers ... 14L4V Split Thyroid Tx Power 98% MI 0.89 TIS 0.5 TIB 0.5 6.2 MHZ 976 Hz Flow Med 3 dB 17 fps 3 cm 45 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Split displays the same image side-by-side. Split is often used to compare the B-mode image next to the color Doppler image in order to evaluate both the hemodynamics and the underlying B-mode image (as displayed here on the common carotid artery). On a live image: • Select Split to activate/deactivate • Select Split in B-mode first and then press C on the Control Panel to activate Live Dual with color Doppler Notes No. 45 SIEMENS Healthineers Pulsed wave (PW) Doppler SIEMENS . Healthineers ... PW 2 7C Add Exam Workflow 14L4 v Carotid Tx Power 100% MI 1.04 2 2D PW Contrast Elasticity eSieScan TI5 0.3 718 1.3 4.0 MHZ ull Screen Extensive View 3063 Hz Gate 1.5 mm 0 ds 22 fps 84 bom PI = 1.98 Ri = 0.74 Screen Simult Auto Stat Trace Direction 5/0 - 3.79 PS - 54.3 cmv/s ED = 15,4 cm/s TAmax a 21.6 cm/s Hide Patient Physio Settings > Full D Update Rate Sensitivity Image Clip Settings Invert Mean Trace MultiHertz 5.3 MHZ Filter 98 Hz Dyn R 80 GB Tint Tx Power 100% Gate 4.0 mm Scale 2170 Hz Baseline Map Sweep 46 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Pulsed wave (PW) Doppler measures flow velocity within a gated sample volume (as displayed here in the carotid artery). PW Doppler controls include: • Physio Settings adjusts the ECG controls when in cardiac imaging • Invert reverses the Doppler spectrum (values display above/below the baseline) • Mute deactivates the spectral Doppler audio volume • Update Rate adjusts the interval for refreshing the B-mode image; selections include Off, 1-4 and 8 seconds • MultiHertz imaging adjusts spectral Doppler frequency independent of the B-mode or color frequency, maintaining spectral Doppler flow sensitivity in vessels located in the near, mid or far field • Gate adjusts the sample volume size. Setting choices are 0.5-15.0 mm • Filter rejects signals below the selected frequency setting (e.g., signals generally caused by tissue clutter); increase the filter to reduce clutter • Scale adjusts the PRF for the spectral Doppler frequency range and is dependent on the transmit frequency and depth of the Doppler gate Notes No. 46 SIEMENS Healthineers Doppler auto optimization SIEMENS . Healthineers ... Automatic spectral Doppler optimization of: • Gain • Scale/Baseline • Dynamic Range 112 • Auto Invert Doppler Auto Optimization Gain Dynamic Range Scale/Baseline Auto Invert 47 Unrestricted © Siemens Healthineers 2023 Speaker Notes: • Press eSieImage on a live spectral Doppler trace to automatically optimize selected parameter(s) • Select the System Configuration icon to select optimized parameter(s) under System Configuration > Display > Doppler/M-Mode > Doppler Auto Optimization • Parameters that can be automatically optimized include: Gain, Dynamic Range, Scale/Baseline and Auto Invert Notes No. 47 SIEMENS Healthineers Tint SIEMENS . Healthineers ... MultiHertz 6.7 MHZ Filter 188 Hz Dyn R 60 dB Tint 6 Tx Power 100% Gate 1.5 mm Scale 6250 Hz Baseline Map Sweep Volume 10 W P4-2 P4-2 TCD TCD Tx Power 98% Tx Power 98% MI 0.46 MI 0.46 TIS 0.9 TIS 0.9 TIB 3.2 TIB 3.2 2.2 MHz 2.2 MHZ 6510 Hz 6510 Hz Gate 5.0 mm Gate 5.0 mm o de O.dB 9 1ps 9 fps F100 59.3 mmis 48 Unrestricted © Siemens Healthineers 2023 Speaker Notes: • Tint: To change the Doppler spectrum color, select 0-11 • Adding a Tint may assist in measurements and spectral evaluation Notes No. 48 SIEMENS Healthineers Auto Stat SIEMENS . Healthineers ... 14L4v Off Above Below Both Arterial Tx Power 98% MI 1.07 TIS 0.2 TIB 1.2 Auto Stat 4.0 MHZ 2790 Hz Off Gate 0.5 mm 13 dB 21 fps 65 bpm 0.9 cm 56. PS = 41.21 cm/s ED . 0.00 cm/s PS = 41.21 cm/s MD = 13,96 cm/s RI = 1.00 ED = 0.00 cm/s PI(ED) = 16.88 PI(MD) = 21.26 S/D = XX MD = 13.95 cm/s TAmax = 2.60 cm/s RI = 1.00 PI(ED) = 15.88 PI(MD) = 21.25 S/D = XX TAmax = 2.60 cm/s 49 Unrestricted © Siemens Healthineers 2023 Speaker Notes: The Auto Stat (statistics) function automatically traces the spectral Doppler waveform and records several measurements in PW Doppler. In this clip of Auto Stat calculating during live PW, notice the numbers updating to reflect the live waveform. Auto Stat enables the display of Doppler statistics including beats per minute (bpm), pulsatility index (PI), resistive index (RI), systolic/diastolic ratio (S/D), peak systole (PS), end diastole (ED) and time average max (TAmax). Select settings for data above, below or on both sides of the baseline. When Auto Stat is enabled, Sensitivity is made available on the Touch Screen to select the required sensitivity level of the trace (settings are 0-7). Auto Stat is available on live and frozen images. It is also available in Caliper mode when PI Auto is selected. Measurements populate to the report once entered into the measurement package. Notes No. 49 SIEMENS Healthineers Angle correction SIEMENS . Healthineers ... L10-5v 30.1 Tx Power 98% MI 0.88 TIS 0.2 TIB 1.0 4.0 MHZ Angle 5580 Hz Gate 1.0 mm -3 dB 32 fps 1.5 cm 60º 3.5 cm_ -150 100 Invert .50 cm/s -50 nvert 44.5 mm/s 50 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Angle depicts the degree of angle correction for the Doppler spectrum. The default angle for the carotid exam, as displayed here, is 60 degrees. • Press Angle to adjust the flow angle from -60/0/60 or rotate to adjust the flow angle by one- degree increments The initial display of the flow angle indicator to the Doppler cursor is exam-dependent. When the Angle is 61 degrees or greater, the system highlights the value of the angle in green. Notes No. 50 SIEMENS Healthineers Simultaneous Tiplex (Simult) SIEMENS . Healthineers ... 14L4a Simult Tx Power 98% MI 0.76 TIS 0.2 TIB 0.9 4.0 MHZ 4340 Hz Gate 1.5 mm 0 dB 4 fps 3.5 cm - 1.7 cm 60 g =120 100 -20 5-40 29.6 mm/s 51 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Simult enables or disables the simultaneous live display (i.e., duplex or triplex mode ) of the B- mode, color image and/or Doppler spectrum in real time. • Select Simult on the left panel control keys to activate/deactivate Notes No. 51 SIEMENS Healthineers Full D – Doppler spectrum display SIEMENS . Healthineers ... P4-2 Full D TCD 140 Tx Power 98% MI 0.45 120 TIS 1.0 TIB 3.2 100 2.2 MHZ 6510 Hz E80 Gate 5.0 mm -3 dB E60 F40 20 cm/s -20 -40 -60 59.3 mm/s 52 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Full D displays only the Doppler spectrum and hides the B-mode image. Notes No. 52 SIEMENS Healthineers Bypass cursor mode SIEMENS. Healthineers ... System Configuration Display General 1 General 2 Monitor Doppler / M-Mode V Enable Screen Saver Bypass Cursor Mode Display Custom Keys Screen Saver Delay Frequency Velocity 20 minutes Doppler Frequency/Velocity Gain Soft Keys Doppler Auto Optimization Dynamic Range Screen Saver Type SIEMENS Scale/Baseline Auto Invert Exam Measurement Text Annotation Body Marker DGC VDGC Invert with Image Invert Stress Echo eSieScan DGC Curve Display Time Ou Contrast DGC Control Current Image Depth Clip Store Printer Thermal Index Display (Neo Head Exam Only) Barcode Wireless TISITIB Network Utility 53 Unrestricted © Siemens Healthineers 2023 Speaker Notes: For PW functionality, the user has the option to bypass the cursor. This is selected in System Configuration > Display > Doppler/M-mode > Bypass Cursor Mode. • Uncheck the box to display the full-screen B-mode image with the Doppler cursor after pressing PW • Check the box to bypass the initial full screen B-mode image with the Doppler cursor and immediately activate the B-mode/Doppler split format Notes No. 53 SIEMENS Healthineers Continuous wave (CW) Doppler SIEMENS . Healthineers ... CW P4-2 A Adult Echo Add Exam Workflow P4-2 Adult Echo Contrast ? 2D CW eSieLH Stress Echo eSieScan Tx Power 98% MI 0.09 TIS 0.6 TIB 3.4 Full Screen Extensive View Mute 1.8 MHZ 9191 Hz 17 fps 7.9 cm 15 cm Screen Simult Auto Sta Trace Direction Hide Patient Physio Settings > Full D Update Rate Sensitivit Param Clip Settings Invert DTI Mean Trace MultiHertz 5.3 MHZ Filter 276 Hz Dyn R 65 dB Tint 11 Tx Power 98% Gate 5.0 mm Scale 9191 Hz Baseline Map D Sweep 54 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Continuous wave (CW) Doppler is available on the phased array transducers (displayed on the upper image of the adult heart), on the Aux CW2 pencil probe for adult cardiac (displayed in the lower image) and Aux CW5 and CW8 pencil probes for pediatrics and vascular. CW Doppler is accessed via the left panel controls but can be assigned to a User Defined key under System Configuration > Custom Keys for easier access. Selecting the AUX CW transducer automatically enables non-imaging CW Doppler. Notes No. 54 SIEMENS Healthineers Continuous wave (CW) Doppler SIEMENS . Healthineers ... CW 5 Arterial CW Tx Power 100% MI 0.04 TIS 0.6 TIB 1.2 8.0 MHZ 11.2 kHz -4 dB -10 55 Unrestricted © Siemens Healthineers 2023 Speaker Notes: Here is a short clip using the CW5 showing a triphasic waveform of the posterior tibial artery. Notes No. 55 SIEMENS Healthineers Post-processing features SIEMENS . Healthineers ... Zoom Add Exam Workflow Add Exam Workflow D ? 20 Contrast Elasticity Siescape eSiescan ? 20 PW Contrast Elasticity esteScan Full Screen tensive View * Full Screen Extensive View VelTag Auto Sta race Direction Physio Settings > 48 Split Physio Settings > Full D Sensitivity Clip Settings 2D Adv. SieClear Invert Color Display CDE Clip Settings Invert Mean Trace a-Blend Off Filter R/S Priority Smooth Tx Power 100% MultiHertz 5.3 MHZ Filter 98 Hz Dyn R 80 de Tx Power 100% MultiHertz 3.3 MHZ Scale 1220 Hz Baseline Map Flow Med Persist Gate 4.0 mm Scale 2170 Hz Baseline Sweet Color Doppler Spectral Doppler 56 Unrestricted © Siemens Healthineers 2023 Speaker Notes: When the image is frozen, the available post-processing features will be displayed on the Touch Screen or Soft Keys. Available post-processing features on the Control Panel will be backlit. The following optimization controls may be adjusted after the image is frozen: • Color Doppler: Invert, VelTag, Color Display, Baseline, Priority, Map, Zoom • Spectral Doppler: Invert, Auto Stat, DynR, Baseline, Tint, Map, Sweep Notes No. 56 SIEMENS Healthineers Trademarks and Disclaimers SIEMENS . Healthineers ... ACUSON Maple, Advanced SieClear, Clarify, Dynamic TCE, eSieImage, MultiHertz and SieScape are trademarks of Siemens Medical Solutions USA, Inc. 57 Unrestricted © Siemens Healthineers 2023 Speaker Notes: No Speaker Notes. Notes No. 57 SIEMENS Healthineers Thank you for your enthusiasm! SIEMENS . Healthineers ... Questions? 58 Unrestricted © Siemens Healthineers 2023 Speaker Notes: No Speaker Notes. Notes No. 58