ACUSON Sequoia™ Ultrasound System Auto Intima Media Thickness | VA30 Software Release

Continue Button Continue Auto IMT Course Master Template HOOD05162003052540 | Effective Date: 26-Nov-2019 ? Auto Intima Media Thickness (IMT) Online Training This course contains information on the automatic IMT feature on the ACUSON Sequoia™ ultrasound system with the VA30 software. Discuss IMT use and measurement values Describe Auto IMT acquisition Explain Measurement & Report (M&R) customization 1 3 2 There is no audio on this slide. Welcome Preview site: https://360.articulate.com/review/content/eeb5c0d7-cf96-45b7-8388-e3d7d465f710/review Password: imt Additional resources: Auto Intima Media Thickness (Auto IMT) with electrocardiogram (ECG) HOOD05162003254350 ? Auto IMT with Preview Function Purpose Measures two inner layers Tunica intima Tunica media Establishes risk profiles Helps classify patients with intermediate vascular disease Known calcifications exclude use Note: the vascular age will not be seen on the report page. Auto IMT with Preview Function Purpose Audio file: sequoia-imt-va30-001.mp3; sequoia-imt-va30-001.vtt Audio script: The Auto IMT with preview function is new on the ACUSON Sequoia ultrasound system and can be performed in just a few steps. After placing a region of interest or ROI over the wall of the vessel, it automatically locates and measures the thickness of the two inner layers of the carotid artery, the tunica intima and the tunica media. This technology will help to establish a risk profiles and to classify patients with intermediate vascular disease. Patients that already have calcified plaque present in the carotid artery are usually excluded from having this examination. When completed, a vascular age will not be seen. Image: sequoia-imt-va30-001.png, HOOD05162002936877; HOOD05162002979115 ? Normal IMT Values Age 101, 2 ~ 0.4 - 0.5 mm ≥ 502 ~0.7 - 0.8 mm or more Normal IMT Values Audio file: sequoia-imt-va30-002.mp3; sequoia-imt-va30-002.vtt Audio script: The normal IMT value at age 10 is approximately 0.4 to 0.5 millimeters. For those who are 50 and older, the range is approximately 0.7 to 0.8 millimeters or more. Image: sequoia-imt-va30-001.png, HOOD05162002936877; HOOD05162002979115 Reference 1: Baroncini, L. A., Sylvestre, L., & Pecoits Filho, R. (2016). Assessment of Intima-Media Thickness in Healthy Children Aged 1 to 15 Years. Arquivos brasileiros de cardiologia, 106(4), 327–332. https://doi.org/10.5935/abc.20160030 Reference 2: Buljan, K., Soldo, S. B., Janculjak, D., Kadojić, D., Candrlić, M., Bensić, M., & Buljan, V. (2015). Relationship between Age and Thickness of Carotid Arteries in a Population without Risk Factors for Atherosclerosis. Collegium antropologicum, 39(3), 779–784. Reference 3: van den Munckhof, I., Jones, H., Hopman, M., de Graaf, J., Nyakayiru, J., van Dijk, B., Eijsvogels, T., & Thijssen, D. (2018). Relation between age and carotid artery intima-medial thickness: a systematic review. Clinical cardiology, 41(5), 698–704. https://doi.org/10.1002/clc.22934 ? Auto IMT Overview All linear transducers B-mode images Available with Frozen Zoomed frozen Review images Guidance function – dotted vertical line ROI (Region of Interest) placement *Simulated graphics Auto IMT Overview Audio file: sequoia-imt-va30-003.mp3; sequoia-imt-va30-003.vtt Audio script: Auto IMT is available on all linear transducer B-mode images, and can be performed on frozen images, zoomed frozen images, and images in review. There is a dotted guidance line to the left of the ROI to help support more consistent alignment. Once the ROI is placed, a preview of the intima outline can be seen. The outline can be easily edited if it needs to be adjusted. Graphic: sequoia-imt-va30-004.png ? Report Results Configurable results Per Label Configuration ^ ^ Hover on the image to enlarge. Click NEXT> to continue. 10 mm Report Results Audio file: sequoia-imt-va30-004.mp3; sequoia-imt-va30-004.vtt Audio script: The Auto IMT results displayed in the report are configurable using the Per Label Configuration page in the System Configuration under Measurements and Reports. The maximum and mean values are always displayed in the Measurement Display Area or MDA. Displaying the minimum and C10 values are optional. The C10 value is a measurement used in Japan and is automatically calculated when placing the dotted reference line at the origin of the bulb. The measurement is located 10 millimeters from the bulb origin as shown in this enlarged view indicated by the two carats at the left edge of the intima tracings. Graphic: sequoia-imt-va30-005.jpg ? Measurement and Report Customizable Report MDA System Configuration Edit Report Custom Measurements Select the tab arrows to learn more about customizing the Measurement and Report section in System Configuration. Measurement and Report Base layer audio file: sequoia-imt-va30-005.mp3; sequoia-imt-va30-005.vtt Base layer audio script: The Auto IMT technology allows the user to customize the values to display in the report and on the monitor in the Measurement Display Area. System configuration audio file script: First select the wheel cog icon in the upper left corner of the touch screen to enter the System Configuration page. Select Measurement and Report on the monitor and then select Measurement. Next, select the Per Label Configuration tab at the top right and select the Carotid exam from the exam drop-down menu. Next, select the measurement you wish to customize. Here, for example, the distal CCA IMT measurement is selected. Now select the 2D default tool drop-down menu for the distal CCA IMT carotid exam measurement. There is only one option in this menu which is IMT and it will already be selected. The default method drop-down menu allows you to choose the IMT value to display in the report summary. The minimum, maximum, last, or average value. If average is selected, only the average of all measurements that were obtained will be displayed in the report summary. The individual measurements that were saved can be found under the edit report option on the monitor or touch screen. During an examination, regardless of the method chosen for display in the report, the values in the measurement display area will be from the current image measurements just performed. Next, under output, customize the output values you can display in the onscreen Measurement Display Area. The maximum and mean values will always appear in the Measurement Display Area, although the C10 and minimum values are displayed optionally and will only be shown in the Measurement Display Area by checking the corresponding box in the Show column. A unit drop down menu allows the choice between a millimeter or centimeter value display in the Measurement Display Area. The precision drop-down menu enables the user to select up to three decimal places to show in the Measurement Display Area. Graphic file: sequoia-imt-va30-006.mp3; sequoia-imt-va30-006d.vtt; PEPconnect ID 19070; Articulate embed code: https://pep.siemens-info.com/stream/5185a8bb-f5c2-4d7a-820c-c49a282f1ca0 Edit report audio file script: The edit report function allows the user to see the individual measurements that were obtained during the study. It also allows the user to delete measurements or change the method value displayed in the report summary. To enter the Edit Report page, select Edit Report from the monitor or touch screen. All measurements saved during the exam will be seen here. Select the X next to a measurement to delete it. The method or value to display in the report can also be changed here, which includes last average, minimum, maximum or any individual measurement saved during the exam. Note that the minimum or C10 values can only be edited before beginning an exam. A Carotid Assessment package is also available to fill out, if desired. Select Summary to go back to the summary report page. Graphic file: sequoia-imt-va30-007a.mp3; sequoia-imt-va30-007b.vtt; PEPconnect ID 19101; Articulate embed code: https://pep.siemens-info.com/stream/3e19e910-c1da-4948-a295-9c588ebf6d36 Custom measurements audio file script: Users do have the ability to enter in custom IMT measurements. Select the wheel cog icon again to enter System Configuration. Select the Measurement and Report option and then the Custom Measurement Label. Select Carotid under the exam package drop-down. Select the CCA bulb or ICA IMT measurement corresponding to the measurement being entered. Now enter the name of the measurement in the label Root Field, which here is Distal CCA 2. Select Carotid from the second exam package drop-down. Select the Right / Left modifier so the measurement is available on both sides. Select the segment from the choices listed - Prox, Mid, Distal, or Origin - that correspond to the added measurement. Under the Tools tab, the imaging mode selected will already be the 2D-mode, and be sure IMT is also selected in the right column. Select Save and Close to finish. Graphic file: sequoia-imt-va30-008a.mp3; sequoia-imt-va30-008b.vtt; PEPconnect ID 19074; Articulate embed code: https://pep.siemens-info.com/stream/0ce1e3cf-71e6-416a-b128-bbad7d1b9972 Custom Measurements Edit Report System Configuration ? Performing an Auto IMT measurement takes only fours steps. Select the numbered steps below to learn more about acquiring an Auto IMT measurement. Acquiring an Auto IMT Measurement 1 1 1 2 2 2 3 3 3 4 4 4 There is no audio in this slide. Acquiring an IMT Measurement No audio on base layer. Graphic: sequoia-imt-va30-005.jpg Step 1 audio file script: Performing an IMT measurement can be achieved in a few steps. First select a linear probe and the Carotid preset as auto IMT is not available on other transducers. Acquire an image of the distal carotid artery and bulb. Ensure the vessel is imaged as perpendicular to the ultrasound beam and clearly shows the intimal lining. You can use the jugular vein as a window and have the patient Valsalva if they are able. Press Freeze. Graphic file: sequoia-imt-va30-009.mp3; sequoia-imt-va30-009.vtt; PEPconnect ID 19097; Articulate embed code: https://pep.siemens-info.com/stream/ecf1e764-da12-4891-ad22-1170d6062338 Step 2 audio file script: Next, press Caliper on the control panel. Select an IMT measurement from the touch screen and a dotted vertical reference line and the ROI will appear on the image. Here are the reference line and ROI zoomed up so they can be easily seen. The reference line is one centimeter from the ROI and the ROI is one centimeter in length. Graphic file: sequoia-imt-va30-010.mp3; sequoia-imt-va30-0010.vtt; PEPconnect ID 19098; Articulate embed code: https://pep.siemens-info.com/stream/47f1add3-b695-4606-bd18-3fc7d7125927 Step 3 audio file script: Next, roll the trackball and place the dotted reference line at the desired position with the ROI over the desired area of the common carotid artery posterior wall. Protocols will vary from institution to institution, so placement of the ROI may vary. Once the ROI is placed, press the Update key to enter the Preview mode. The user will now see the two blue lines tracing the intima. The user can roll the trackball again and the preview will disappear. Then reposition the reference line and ROI again and press Update to re-enter the preview mode. Once satisfied with the placement, either press the Set key to enter the Edit mode to able to adjust the tracings, or, if no adjustments are needed, press Update or Image to store the image and enter the measurement into the report. Graphic file: sequoia-imt-va30-012.mp3; sequoia-imt-va30-012a.vtt; PEPconnect ID 19099; Articulate embed code: https://pep.siemens-info.com/stream/bd6cdf23-9527-4bf1-a214-8c6bc31038d4 Step 4 audio file script: If editing the tracings once in Edit mode, the more anterior trace will now be blue, indicating the line that can be edited. Use a trackball and the tiny cursor to re-adjust the tracing if needed. Place the cursor where you want the new trace to be and press either Set key to adjust the line. When finished editing the top tracing, roll the trackball posteriorly towards the other tracing if desired. Now, the more posterior tracing will be blue and can be edited. Use the cursor and Set key to adjust the tracing, if desired. Press Update or press Image to end editing and store the image and enter and enter the measurement into the report. Graphic file: sequoia-imt-va30-011.mp3; sequoia-imt-va30-0011a.vtt; PEPconnect ID 19100; Articulate embed code: https://pep.siemens-info.com/stream/ae8c77bb-5d7f-4479-8fee-9fc172d31c58 4 Step 4 3 Step 3 2 Step 2 1 Step 1 ? References / Suggested Reading 1. Baroncini, L. A., Sylvestre, L., & Pecoits Filho, R. (2016). Assessment of intima-media thickness in healthy children aged 1 to 15 years. Arquivos Brasileiros de Cardiologia, 106(4), 327–332. https://doi.org/10.5935/abc.20160030 2. Buljan, K., Soldo, S. B., Janculjak, D., Kadojić, D., Candrlić, M., Bensić, M., & Buljan, V. (2015). Relationship between age and thickness of carotid arteries in a population without risk factors for atherosclerosis. Collegium Antropologicum, 39(3), 779–784. 3. van den Munckhof, I., Jones, H., Hopman, M., de Graaf, J., Nyakayiru, J., van Dijk, B., Eijsvogels, T., & Thijssen, D.(2018). Relation between age and carotid artery intima- medial thickness: a systematic review. Clinical Cardiology, 41(5), 698–704. https:// doi.org/10.1002/clc.22934 References/Suggested Reading ? Course Review Congratulations. You have completed the Auto Intima Media Thickness (IMT) Online Training. Select the numbered buttons below to review the material. There is no audio on the review slides. 1 1 1 3 3 3 2 2 2 Discuss IMT use and measurement values Describe Auto IMT acquisition Explain Measurement & Report (M&R) customization Course Review No audio. Describe Auto IMT acquisition Step 1 Select a linear transducer and Carotid preset Acquire an image of the distal CCA and bulb using a perpendicular angle of incidence (90 degrees) Press Freeze Step 2 Press Caliper to open the measurement options Choose situs (right or left) Select the Dist CCA IMT from the touch screen Roll the trackball to position the dotted reference line and the ROI Ensure the ROI is over a section of the posterior wall of the CCA Step 4 Edit the anterior and posterior wall tracing if needed Select Edit Report on the touch screen or monitor to view or delete individual measurements A blue line indicates the editable trace Roll the trackball to adjust the tracing Press Set to activate the posterior tracing When finished, press Set to enter the new measurement into the report Step 3 Roll the trackball to place the dotted reference line and ROI on the posterior CCA Press Update to preview the measurement Select Set to enter Edit mode Explain Measurement & Report Customization Customize the Measurement and Report page in System Configuration On this page you can: Choose the 2D measurements displayed Minimum Maximum Last Average Select millimeter or centimeter values Edit measurements displayed in the report Input a Custom Measurement Label Discuss IMT use and measurement values Use Measures the tunica media and tunica media of the carotid artery Establishes risk profiles Aids in intermediate vascular disease classification Measurement values Age 10 ~ 0.4 to 0.5 millimeters age 50 and older ~ 0.7 to 0.8 millimeters or more Disclaimer ? Please note that the learning material is for training purposes only! For the proper use of the software or hardware, please always use the Operator Manual or Instructions for Use (hereinafter collectively “Operator Manual”) issued by Siemens Healthineers. This material is to be used as training material only and shall by no means substitute the Operator Manual. Any material used in this training will not be updated on a regular basis and does not necessarily reflect the latest version of the software and hardware available at the time of the training. The Operator's Manual shall be used as your main reference, in particular for relevant safety information like warnings and cautions. Note: Some functions shown in this material are optional and might not be part of your system. Certain products, product related claims or functionalities (hereinafter collectively “Functionality”) may not (yet) be commercially available in your country. Due to regulatory requirements, the future availability of said Functionalities in any specific country is not guaranteed. Please contact your local Siemens Healthineers sales representative for the most current information. The reproduction, transmission or distribution of this training or its contents is not permitted without express written authority. Offenders will be liable for damages. All names and data of patients, parameters and configuration dependent designations are fictional and examples only. ACUSON Sequoia is a trademark of Siemens Medical Solutions USA, Inc. All rights, including rights created by patent grant or registration of a utility model or design, are reserved. Copyright © Siemens Healthcare GmbH 2022 Siemens Healthineers Headquarters\Siemens Healthcare GmbH\Henkestr. 127\ 91052 Erlangen, Germany\Telephone: +49 9131 84-0\siemens-healthineers.com Disclaimer Exit To access your Certificate of Completion, select the Launch button drop down on the course overview page. You can also access the certificate from your PEPconnect transcript. ? You have completed the Auto Intima Media Thickness (IMT) Online Training. Completion Navigation Help Select the icon above to open the table of contents. Click Next to continue. Next Welcome Slide The timeline displays the slide progression. Slide the orange bar backwards to rewind the timeline. Click Next to continue. Next Tmeline Select the CC icon to display closed captioning (subtitles). Click Next to continue. Next Caption Icon Select the buttons to learn more about a topic. Be sure to review all topics before navigating to the next slide. Click Next to continue. 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Next Layer Slide Question Bank 1 HOOD05162003254387 | Effective Date: 23-Feb-2022 Auto Intima IMT with preview function Quick Reference Card Auto Intima IMT with ECG Job Aid Average The value representing the central number of a group of numbers Bulb The confluence of the common carotid artery, internal carotid artery, and external carotid artery C10 A single point 10 millimeters from the distal common carotid artery termination used in Japan Calcified plaque Buildup of calcium in the walls of a vessel Common carotid artery (CCA) Main artery located on the lateral sides of the neck Distal CCA Section of the CCA adjoining the bulb closest to the patient head Internal carotid artery (ICA) Branch of the CCA supplying the brain Intima Media Thickness (IMT) Combined measurement of the tunica intima and tunica media Maximum The highest value Mean The middle value in a series of numbers Measurement Display Area (MDA) The site on the monitor and ultrasound image where measurements appear Preset Ultrasound system settings for an exam type i.e., Dynamic range, Tint Region of interest (ROI) User-defined area to obtain the IMT measurement Risk profiles Determination of a person's chance of developing arterial disease Tunica intima Internal vessel layer closest to blood flow Tunica media Central layer of a vessel Valsalva Forced expiration used to increase pressure within the chest Vascular age Age measurement based on arterial stiffness 1.1 Welcome 1.2 Auto IMT with Preview Function Purpose 1.3 Normal IMT Values 1.4 Auto IMT Overview 1.5 Report Results 1.6 Measurement and Report 1.7 Acquiring an IMT Measurement 1.8 References/Suggested Reading 1.9 Course Review 1.10 Disclaimer 1.11 Completion