ACUSON Sequoia 3.5 (VB30) Cardiac Major Modes Part 1 Presentation

SIEMENS Healthineers SIEMENS Healthineers .. ACUSON Sequoia ultrasound system Cardiology Major Modes – Part 1 2D and M-mode 3.5 (VB30) 1 Unrestricted © Siemens Healthineers 2024 Speaker Notes: This presentation will provide an overview of the imaging controls for 2D and M-mode for echocardiography imaging. We will also review the specifications of the available cardiology transducers. The Doppler controls and display modes will be discussed in Part 2. 4D imaging and the Vascular capabilities will be discussed in separate presentations. Notes No. 1 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Discuss transducers and modes • Review 2D and M-mode controls • Describe 2D and M-mode optimization features ....- 2 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The objectives of this presentation are to: • Discuss Transducers and Modes • Review 2D and M-mode controls • Describe 2D and M-mode optimization features Notes No. 2 SIEMENS Healthineers Major modes SIEMENS . Healthineers ... 3 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The system supports 2D, M-mode, Color, PW and CW Doppler and 4D Volume Imaging for Echocardiography. The systems supports a 2D/4D Transesophageal (TEE) transducer as well as a 2D / Volume ICE catheter. In this presentation, we will focus on the 2D and M-mode. Color, PW and CW Doppler is covered in the ACUSON Sequoia Ultrasound System Release | Major Modes - Part 2 presentation. For Volume Imaging please refer to the ACUSON Sequoia Ultrasound System Release | Cardiac Volume Fundamentals presentation. For Vascular Imaging please refer to the ACUSON Sequoia Ultrasound System Release | Vascular Option presentation. Notes No. 3 SIEMENS Healthineers Cardiology transducers SIEMENS. Healthineers ... av3 ACUSDE Transducer 5Z1 5V1 8V3 10V4 2.0 Aux CW Primary Application Volume Cardiac Adult Cardiac Pediatric Pediatric, Neonatal Non-imaging CW Imaging Cardiology Cardiology Doppler Depth 1 - 30 cm 1 - 8 cm 1 - 24 cm 1 - 8 cm Bandwidth .8 - 3.8 MHz 1.1 - 4.9 MHz 2.1 - 8.3 MHz 2.7 - 10.7 MHz Transducer Design Single Crystal, 1D, Single 1D, Hanafy, 1D, Single Crystal Matrix Crystal Piezoceramic Trophon Compatible Yes* Yes* Yes* Yes* No Gesture Detection Yes Yes No No N/A *See disinfectant chart for specific cleaners : https://www.siemens-healthineers.com/ultrasound/ultrasound-transducer-catalog#Cleaners_and_Disinfectants 4 Unrestricted © Siemens Healthineers 2024 Speaker Notes: These are the cardiac transducers available on the ACUSON Sequoia system. The 5Z1 4D volume transducer is a single solution adult cardiac transducer. It has four 2D frequencies (HLow (1.29MHz), HMid (I.48MHz), HHigh (1.74 MHz), Mid (fundamental 3.2 MHz). The default is HMid. There are two 4D frequencies (4D fundamental - Mid (2.5 MHz) and HMid (1.38MHz). The default is HMid. The 5V1 is the primary adult transthoracic echo transducer. It has four frequencies. HLow (1.4MHz), HMid (I.8MHz), HHigh 1.4 MHz blended frequency of 2nd and 3rd harmonic), Pen (fundamental 2.5 MHz). The default is HMid. The 8V3 transducer is the pediatric transducer and has a bandwidth of 2.1-8.3 MHz. It has four fundamental frequencies Low, Mid, High, RES and two harmonic frequencies (Mid, High). The default is Mid. The 10V4 is the pediatric/neonatal cardiac transducer. It has a bandwidth of 2.7-10.7 MHz. It has three fundamental frequencies (Low, Mid, High) and two harmonic frequencies (Low and Mid). The default is Mid. The Auxiliary CW transducer is a 2MHz non-imaging pencil probe. Notes No. 4 SIEMENS Healthineers Transducers > Z6T transesophageal transducer SIEMENS. Healthineers ... 2D Fundamental 2D Harmonics 4D Display Setting PEN MID RES HMID MID TX Frequency 5.0 5.5 5.8 2.6 5.0 5 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Z6T transducer is the Volume Transesophageal (TEE) transducer. It supports a true volume 90 x 90 field of view, Bi-Plane, 2D, PW, CW, Color Doppler and 3D/4D imaging. It has four 2D frequencies - one harmonic (HMID - 2.6 MHZ) and three fundamental (RES - 5.8MHz, MID - 5.5MHz, PEN-5.0 MHz.) There are two 4D frequencies - one harmonic (HMID – 2.6 MHz) and one fundamental (MID - 5.0 MHz).The default is HMID. Notes No. 5 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Discuss transducers and modes • Review 2D and M-mode controls • Describe 2D and M-mode optimization features ....- 6 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Next, we will review 2D (B-mode) and M-mode controls. Notes No. 6 SIEMENS Healthineers Image screen SIEMENS . Healthineers ... Live 1. Active Mode 1 2 .O 2. Transducer Orientation Marker OdB/DRS 3 3. Data Field 4. Imaging Depth 5. Home Base Controls 4 5 7 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Imaging Screen display layout is: 1. Active Mode (Live or Frozen) 2. Transducer Orientation Marker- corresponds with the notch on the transducer 3. Data Field (for each active mode, customizable in the System Configuration Menu). This is explained on the next slide. 4. Imaging Depth (ranges from 3cm-55cm) depending on the transducer. The primary cardiac transducers have an imaging depth of 30cm. The DAX transducer has an imaging depth of 55cm on the Abdominal Difficult preset. 5. Home base controls (highlights the active selection of the trackball, set keys and Update key) Notes No. 7 SIEMENS Healthineers Mode imaging parameters SIEMENS . Healthineers ... System Configuration System Settings . Workflow Enhancement Image Paramatar Dhplay Preview Imaging Settings Seat Wave Forampt OInstitution Name General Last Name, First Name Capture Settings D Last Name D Date of Birth Thermal Index - Bone (Ta1) Thermal Index - Cranium (TIC) imaging Mode Date . Time (short) hermal Inder - Soft Tissue (TIS) marge Parameter Dirplay' Mechanical Index (MI) D Operator Frame Rate Transmi Fowet 2D Transducer Frequency Gain Dynamic Range Connectivity & Network Thermal intiles Cranium (TIC) Speed of Sound Line Density › Preiphone Dovirens UltraArt Mapilint System Management 1 Frame Rate Fersalenice Selection System Management Transmit Power Oatty Level 3DMD Image Screen Frequency Ventime- Sihiep Quality Screen 5 GaintDynamic Range Volume Swoop Angle Speed of Sound Thrinhalt Display Line Density Opacity Smsothing 1 Map/Tint Contrast 1 Persistence MPR Map/Tint 1 Clarity Level VA MapTint C 1 Gain Dynamic Range Frequency Gan 13 Volume Sweep Quality How State Volume Sweep Angle Persstoncen ine Dumity Threshold Opacity MagFilter (20) Smoothing Smoothing Priority (20) Restore Details 8 Unrestricted © Siemens Healthineers 2024 Speaker Notes: For each mode, the user can select which imaging parameters are displayed on the Image screen. This will apply for all transducers and presets. To configure, select the System Configuration icon on the Touch Screen (System Configuration > Imaging Settings > Image Parameter Display) and check the parameters you wish to display. The image on the right will provide a snapshot of what will be visualized on the Image screen. Notes No. 8 SIEMENS Healthineers 2D controls SIEMENS . Healthineers' ... Cateine 521 Touch Screen Workflow Patient Physio maging UR FIP UID Fip Report End Gum Auto TEQ Harmonies on Capture Type Pinspective Frequency OR Cip Capture Control Panel Soft Keys Touch Screen 9 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The 2D image may be optimized using the: 1. Control Panel 2. Soft keys (via rotatory controls) 3. Touch Screen Notes No. 9 SIEMENS Healthineers Control panel SIEMENS . Healthineers ... Soft key rotary controls Power O Contrast Imaging Major modes User-defined Controls Clip Capture Pointer / Delete Forward/Backward Key Image Capture Text / Body Marker / Arrow Measurements Home base Freeze 10 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Power control - powers on or powers off the ultrasound system. • Orange lighting indicates the ultrasound system is powered on • Blinking orange lighting indicates the ultrasound system is plugged in, but not powered on • No lighting indicates the ultrasound system is powered off and not plugged in CEUS – provides access to Contrast Enhanced Ultrasound (LVO) User-defined key, U1 – provides access to a customizable key. Go to (System Configuration > System settings > Display) to select the option Pointer – a control is used to highlight or select an area of interest Delete: • During the measurement function, the Delete control deletes the measurement in progress in reverse sequence • During the annotation function, the Delete control deletes the annotation in progress in reverse chronological sequence • Deletes the selected image in review AI: provides access to software packages – AI Measure and AI Assist Measure: Provides access to calculations packages and generic measurement tools. The measurements can be customized in the System Configuration Menu > Measurements and Reports > Measurements Home base: • The Trackball and Set keys size and position an object on the image screen, for example, the region of interest, Doppler cursor, and measurement markers. • The Update key has multiple functions depending on the mode you are in. The icons on the imaging screen provides the specific operation. For example, allows the user to cycle back and forth from the image to the spectral Doppler tracing when in PW mode. Major modes: Operating mode controls activate the operating mode and adjust the gain. Press the operating mode control on the Control Panel to activate the operating mode. Rotate the operating mode control to adjust the gain for the operating mode. Freeze control: • Freezes or unfreezes the acquisition of an image, sweep, or spectrum • Enables or disables CINE playback • During clip capture, ends the capture Capture: • Pressing Clip during a live scan will capture a clip • Pressing Image on a frozen image will capture a still image of a still or a moving clip Notes No. 10 SIEMENS Healthineers Touch screen layout SIEMENS . Healthineers ... System Configuration Transducer Selection Operating Mode Login / Logoff Cardiac 521 Workflow System User Manual Patient 20 Physio Workflow Selection Imaging WD Flip Review LAR Flip Exam Workflow Report End Exam Gray - Available Selection User-defined selections Auto TEQ Orange - Active Selection Harmonics DTI Capture Type Pointer Prospective Frequency Mid Jip Capture Additional Soft Key Rotary Page Control Selections Controls 11 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Touch Screen primary controls are: Log-in / Logoff - options for logging in to the ultrasound system to restrict access to the ultrasound system System User manual – provides access to the Instruction for Use manual System Configuration - selections for configuring the ultrasound system Exam Workflow includes: Patient Registration - activates patient registration and displays selections for retrieving patient studies and registering a patient Imaging - activates real-time imaging and displays workflow-specific selections for the operating mode and exam Review - activates review and displays workflow-specific selections Report - activates the patient report and displays report navigation and selections End Exam - displays selections for ending the current exam and patient study User-defined Selections - user-defined selections, as specified in the configuration settings Pointer – provides Touch Screen access to the pointer (also available on the Control Panel) Additional Selections – Provides access to different system functions (see next slide) Soft Key Rotary Controls - Press and rotate controls (soft keys) on the control panel are labeled on the Touch Screen Page Control - Additional pages of selections Transducer Selection - Additional selections based on the workflow selection and operating mode • During patient registration, includes access to the patient registration form and other patient studies • During imaging, includes selections for activating a transducer and selecting an exam • During the annotation function, includes selections for Body Markers, Text, and Arrows • During measurements, includes access to measurement categories • During system configuration, includes selections to change the brightness of the control panel, Touch Screen, or keyboard Operating Mode - During combined mode imaging, indicates the active operating mode Workflow Selection - Provides access to Stress Echo, Physio, Protocols, Panoramic imaging, and Modality Compare Gray – Available Selection - displays when available for the active mode Orange – Active Selection - active features- Press to activate / deactivate Notes No. 11 SIEMENS Healthineers Additional selections SIEMENS . Healthineers ... Patient Imaging Review Review Report End Exam End Exam Service Image Hide Banner DVR Record/Pause DVR Menu Enable Screen Lock Screen Unlock USB Eject USB Reconnect Wi-Fi Job Status Send to Store Print Film Sheet Server Clip Capture 12 Unrestricted © Siemens Healthineers 2024 Speaker Notes: These are the options for the Additional Selection menu: Service Image - saves a screenshot of the current Imaging Screen and Touch Screen to the service image folder on the ultrasound system. The system also hides any patient information in the imaging parameters. Hide Banner - temporarily hides the patient banner on the image screen. The system also hides any patient information in the imaging parameters. DVR Menu - displays selections for the digital video recording device. The DVR records and stores video clips. The file format is mp4. It will remain dithered if there is not a USB / CD/DVD inserted or not enabled in the System Configuration menu. DVR Record/Pause - temporarily stops recording to a digital video recorder. Using this control will continue to add to the DVR recording. Enable Screen Saver - enables the Screen Saver. This is a great tool to utilize you need to step way from the patient during the exam or at the end of an exam. Rolling the trackball will take you back to imaging. Lock Screen - locks the Touch Screen and trackball. Pressing the Freeze key unlocks the Touch Screen and trackball Eject USB - disconnects all USB-compatible storage devices from the ultrasound system. Unlock USB - accesses the security configuration settings for an encrypted USB storage device connected to the ultrasound system. You must enter the password for the encrypted USB storage device to grant the ultrasound system read-write access to the storage device, for example, to import or export data Job Status - displays the status of sending to PACS and importing and exporting to USB / CD/DVD Send to Storage Server - sends images and clips to all DICOM storage servers configured for transfer at the end of the exam. Print - sends a screenshot of the image screen to the printer. Reconnect Wi-Fi - reconnects the ultrasound system to the wireless network. Film Sheet - displays selections to copy images to the film sheet Notes No. 12 SIEMENS Healthineers 2D controls on the control panel SIEMENS . Healthineers ... DGC 2D (B-mode) Zoom ABC Dual Depth Freeze 13 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The primary 2D imaging controls on the Control Panel are: • The DGC slide pods manually adjust brightness and gain at depth. Move to right to increase and to the left to decrease. The recommended placement is in the center. This is adjustable on a live or frozen image. • 2D activates or returns to B-mode imaging. Rotate 2D to change the overall B-mode gain / brightness. • Depth changes the depth of the field of view (FOV) and is adjustable by rotating to decrease and increase depth. The field of view (FOV) is adjustable from 3-55 cm depending on the selected transducer. • Dual displays two different images side-by-side. In cardiology imaging, it activates Live Dual or Full Screen Live Dual when enabled in the System Configuration Menu> Imaging Settings > • General Zoom activates either Zoom or HD Zoom. • Freeze freezes and unfreezes the image. Notes No. 13 SIEMENS Healthineers 2D controls on the touch screen > live SIEMENS . Healthineers ... 5V1 transducer Cardiac Workflow Cardiac 521 › CW2 Workflow Patient Physio Patient 2D Physio Imaging Imaging UR Flip WD Flip Timer Review Review Report Report End Exam End Exam Auto TEQ = Harmonics Capture Type Prospective Image Size Frequency lip Capture Transmit Power Line Density Cropping Mode Maps Tint H Mid Beats S 95 % Page One Page Two 14 Unrestricted © Siemens Healthineers 2024 Speaker Notes: These are the Touch Screen controls for 2D when in live mode on the 5V1 transducer. There are two pages. To access the second page, select the page key or swipe across the Touch Screen. Active selections are highlighted in orange. Available selections are gray and dithered out is not available for the mode, transducer or preset. We will discuss the optimization later in the presentation. Notes No. 14 SIEMENS Healthineers 2D controls on the touch screen > live SIEMENS . Healthineers ... 5Z1 transducer Workflow 521 SVI Workflow Patient Physio Patient Physio Imaging Review WO Flip Imaging Timer Review Report Report End Exam End Exam Bi-Planet Auto TEQ Reset Angle Harmonks DTI AD Zoom Setup Capture Typ mage Size X Prospective H Mid OR Ange rangmit Power ine Density Cropping Mod Mapa 95 % Page One Page two 15 Unrestricted © Siemens Healthineers 2024 Speaker Notes: These are the Touch Screen controls for 2D when in live mode on the 5Z1 transducer. There are two pages. The soft keys are the same with both the 5V1 and 5Z1 transducers. The 5Z1 transducer has the Bi-Plane+ option. Notes No. 15 SIEMENS Healthineers 2D controls on the touch screen > frozen SIEMENS . Healthineers ... 1014 Workflow 1014 SV1 712 Workflow Patient Physio Patient 2D Physio Imaging Imaging LAR Flip UID Flip Revien Review Report Report End Exam End Exam Go To ED Go To ES ED-ES Split DTI 20 Heart Al X 6 Left Margin Right Margin DR Playback Cine Clip Capture Cropping Mode Playback Speed Maps Tint 60 dia Fis Icaes Beats Sec) 100% Page One Page Two 16 Unrestricted © Siemens Healthineers 2024 Speaker Notes: These are the Touch Screen controls for 2D when in Frozen mode. There are two pages. If the image is frozen, the controls available in freeze will be white on the Touch Screen. Controls that are not available will appear dithered. The Cine controls will be displayed on the soft keys. Notes No. 16 SIEMENS Healthineers 2D controls on the soft keys SIEMENS . Healthineers ... Cards 521 Workflow Cardio 521 CWZ Workflow Patient Physio Patient Physio Imaging LAR Flip UND Flip Imaging Review Timer Report Report End Exam End Exam Auto TEQ × Harmonica Capture Type Prospective hage Size Frequency H Mid DR Clip Capture Beats So ransmit Power Line Density Cropping Mod Persist Map 95 % 17 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The 2D soft key rotary controls are located on the Control Panel and lie beneath and correspond to the controls listed on the bottom of the Touch Screen. The active control is highlighted in white. Press to activate the control, then turn the rotary control clockwise / counterclockwise to adjust. Soft key controls are not customizable but change as you move from live to frozen. Only the items available as post-processing will be displayed in white when frozen. Notes No. 17 SIEMENS Healthineers Physio control > ECG SIEMENS. Healthineers .. 5V1 Cardiac Workflow Cardiac TIS:0.72 Patient MI:0,91 2D Physio 47fps 95% Imaging 2D ECG AUX Resp H High 0dB/DR60 Review LD 2 UA 3 Report MapD/T5 ECG Trace Set QRS End Exam Lead Lead it Lead ill Invert -wave Marker First R-wave Offset Last R-wave Offset 0 Frames 0 Frames Sweep Speed Size Position 16cm 59bpm Lead Il 18 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Physio displays a physio trace on the active image. When the user changes the active window from one side to another, the system redraws the physio trace. The recommended placement of the electrodes on the chest are RA, LA, L but is not required. The vertical position of the Physio waveform is set-and-forget for each mode (2D, M-mode, Doppler) and can be set-up in a preset. There are three leads choices available on the Touch Screen. Lead II is the default. The Heart Rate and Lead choice is displayed on the same level as Depth display on the bottom right side of the imaging area. Physio Inverted Physio signal (ECG and AUX) are triggered and can be triggered on inverted R waves. Notes No. 18 SIEMENS Healthineers Physio control > ECG SIEMENS . Healthineers ... 5V1 Cardiac Workflow Patient 2D Physio Imaging ECG AUX Resp Review + Report ECG Trace Set ORS End Exam Lead Lead il Lead ill Invert First R-wave Offset Last R-wave Offset -wave Marker 0 Frames 0 Frames First R-wave Offset Last R-wave Offset 0 Frames O Frames sweep Speed Size Position 19 Unrestricted © Siemens Healthineers 2024 Speaker Notes: First R-Wave Offset indicates the user-defined number of frames to capture before the first R- wave. Last R-Wave Offset indicates the user-defined number of frames to capture after the last R- wave. Notes No. 19 SIEMENS Healthineers Physio control > auxiliary SIEMENS . Healthineers ... Workflow Patient 2D Physio Imaging ECG AUX Resp Review Report Aux Trace Set QRS End Exam Aux In "ECG" Invert R-wave Marker Sweep Speed Size Position 20 Unrestricted © Siemens Healthineers 2024 Speaker Notes: There are two Auxiliary connections: • Aux-in – allows connection from an external source like a monitoring system in the Intensive Care Unit (ICU). • Aux-out – connects to an external device like a treadmill for Stress Echo. Notes No. 20 SIEMENS Healthineers 2D controls > respirometer SIEMENS . Healthineers ... 5V1 Cardiac Workflow Patient 2D Physio Cardiac Imaging ECG AUX Resp Review Report esp Trace End Exam Lead I Lead II Lead ill Invert weep Spee Size Position 21 Unrestricted © Siemens Healthineers 2024 Speaker Notes: There is a Transthoracic Impendence Respirometer (TIR). The respirometer shows the patient’s breathing pattern (inspiration and expiration) for timing purposes. A respirometer trace is important for evaluation of constrictive vs. restrictive heart disease, patients with pericardial effusions, and for more accurate measurements. The respirometer has the same capabilities as the Physio-ECG. The user can adjust the size, position and sweep speed using the soft key controls. Notes No. 21 SIEMENS Healthineers Workflow control SIEMENS . Healthineers' ... . 521 Workflow Patient 2D Physio Imaging Workflow UR Flip UD Flip Review Report Protocols End Exam Modality Compare Physio Auto TEQ capture type Stress Echo Harmonies Prospective Frequency H Mid DR Clip Capture 8 dB Beats Sec 22 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Workflow Control is available on the Touch Screen. It provides access to some of the advanced applications and options. As a reminder, the AI Cardiac applications (2D HeartAI and 4D HeartAI), 4D, AI Assist and Contrast options are accessed from the Control Panel or directly from the Touch Screen. AI measure is activated from the Touch Screen.. Options will be displayed as white if available and dithered out if not available for a specific transducer or mode or if the option does not have an active license on the system. To access, select Workflow, then the specific application required. There are separate presentations for Protocols and the Stress Echo option. Physio is covered in this presentation. Notes No. 22 SIEMENS Healthineers Workflow > protocols SIEMENS . Healthineers' ... Cantine 521 Workflow Workflow Patient Physio Imagina LIR FIp UND FID Protocols End Exam Modality Compare Physio Auto TEQ Stress Echo Harmonics DTI Capture Type Prospective Frequency Clip Capture Cardio 521 CV/2 Workflow 2D Protocols Physio Exit Breast Cardiac ECHO COMPLETE Cardiac Advanced 08 Carotid 23 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Workflow Control provides access to protocols. To access these, select Workflow, then Protocols. The factory default Protocols in echocardiography imaging include Cardiac and Cardiac Advanced. In this example, the protocol option includes ECHO COMPLETE - a customized protocol that was added. When protocols are exported to a USB, a protocol editor file is available and protocols can be customized offline and reimported. It is imported to keep all extensions in the folder to reimport the file. Please review the ACUSON Sequoia Protocol Presentation for more information. Notes No. 23 SIEMENS Healthineers Free cursor SIEMENS . Healthineers' ... Exam Presets Cardiac Imaging Cursor Workflow Enable Cursor Mode 24 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Free Cursor is a continuous active on-screen cursor that provide users with the option to quickly access the cursor for Doppler and M-mode applications. It is activated or deactivated by selecting (System Configuration > Imaging Setting > Imaging Mode > Imaging Cursor Workflow). • Uncheck to activate (as shown in this image) • Check to deactivate Note: AI Assist technology is not available when the Free Cursor feature is activated. Notes No. 24 SIEMENS Healthineers M-mode controls SIEMENS . Healthineers ... M 521 x cu ordine Workflow Patient M Mode Physio Imaging H High Review Exam Presets Report MapA/T4 Cardiac End Exant Imaging Cursor Workflow Enable Cursor Mode Harmonics DTI 25 Unrestricted © Siemens Healthineers 2024 Speaker Notes: M-mode (or motion mode) displays a B-mode reference image and an M-mode sweep. M- mode is used to assess valve motion, chamber sizes, aortic root size, wall thickness, and ventricular function. 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, change the display format by selecting the icon on the Touch Screen. • Rotate M to change the overall M-mode gain. • To exit, press the M or 2D control on the Control Panel. To enable M-mode to directly enter split mode, uncheck the Enable Cursor mode in the System Configuration Menu - (System Configuration > Imaging Setting > Imaging Mode > Imaging Cursor Workflow). Notes No. 25 SIEMENS Healthineers Anatomic and color M-mode SIEMENS . Healthineers ... 5V1 ECHOLC 5Z1 TIS:0.77 Cardiac MI:0.86 TIS:0.68 MI:1.10 100% 23fps 2D 95% H High 2D 4dB/DR65 H Mid c=1540 2dB/DR61 LD 1 UA 2 C MapE/T3 16cm Mid OdB General M PRF 4167 9dB/DR56 M MapB/T6 E2 0dB/DR60 PLAX LVM Stopm . Lead Il 8,9 sec 26 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Anatomic M-mode allows the user to modify the angle of the cursor based on patient anatomy and is independent of the transducer orientation. It is available only in the Cardiac exam preset and accessed through the Angle control on the soft keys when in M-mode. To perform Anatomic M-mode: • Rotate Angle on the soft keys and the system activates Anatomic M-mode. The Anatomic M- mode cursor displays as a dashed line with an arrow pointing in the direction of the deeper part of the image. • To reposition the Anatomic M-mode cursor, roll the trackball. • To reset Anatomic M-mode, press Reset on the soft keys. • To exit Anatomic M-mode, press 2D. • In this example, it was used to better position the angle to demonstrate M-mode in the mitral valve. Color M-mode provides color to the M-mode trace when using a cardiac transducer. • When in M-mode, press C on the Control Panel to activate. • Color M-mode works on cardiac transducers and presets. This is an example of a Color M-mode showing aortic insufficiency. Notes No. 26 SIEMENS Healthineers Notes No. 26 SIEMENS Healthineers M-mode touch screen and soft key controls SIEMENS . Healthineers' ... 7 521 SC1 Workflow 1014 SC1 Workflow Patient M Mode Physio Patient U Mode Physio imaging imaging Timer Review Review Report Report Eind Exam End From: Harmonics Sweep Speed Arge Frequency Edge Maps Tint 27 Unrestricted © Siemens Healthineers 2024 Speaker Notes: When scanning in M-mode the Touch Screen provides a choice to change the Display modes. • Choices are: (1/2 B-mode - 1/2 trace; 1/3 B-Mode - 2/3 trace Side by Side; 2/3 B-Mode - 1/3 trace; and Full Screen). The soft keys controls for M-mode are: • Sweep Speed - adjusts the scrolling speed of the M-mode trace. Decrease to display more heart cycles and increase to display fewer cycles (settings range from 8-200 mm/sec (8,12,16,25,33,50,60,67,100,150,200). • DR (Dynamic Range) - increases the number of gray shades displayed in the M-mode Sweep. Choices are 10-80 dB. • Angle - allows the user to modify the angle of the cursor based on patient anatomy and is independent of the transducer orientation • Frequency - adjusts B-mode frequency the enhances the M-mode trace. Choices are transducer and exam dependent. • Edge - sharpens the contours of a structure in the M-mode sweep. Select on the Touch Screen to modify. Increase for more sharpness and decrease for less sharpness. Choices are 1-4. • Maps - Applies different shades of gray to the M-mode trace. Settings range from A-G. Maps A-F display low to high contrast and Map G is a linear map. They are also gain- balanced, exception for Map G. • Tints - Individually colorizes the M-mode trace to aid in visualization of tissue motion differences. There are ten tints with six different gray shades, blue, inverted rainbow, sepia, and gold. They are also gain-balanced. Notes No. 27 SIEMENS Healthineers Objectives SIEMENS . Healthineers ... • Discuss transducers and modes • Review 2D and M-mode controls • Describe 2D and M-mode optimization features ....- 28 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Discuss Transducers and Modes Review 2D and M-mode controls Describe 2D and M-mode optimization features Notes No. 28 SIEMENS Healthineers InFocus coherent image formation SIEMENS . Healthineers .. 5V1 5V1 Cardiac Cardiac TIS:0.73 TIS:0.73 MI:0.89 MI:0.88 74fps 83fps 95% 95% 2D 2D H High High 1dB/DR54 -1dB/DR54 LD 1 LD 1 UA 2 UA 3 MapE/T3 MapE/T3 P1 16cm 16cm 56bpm Lead Il 59bpm Lead Il 29 Unrestricted © Siemens Healthineers 2024 Speaker Notes: InFocus is a patented technology, known in academia as retrospective dynamic transmit. With the power of the image beamformer, the system can transmit broader beams than a conventional system, using massive parallel image-formation to collect many different angles simultaneously. The beams are then corrected, creating a more tightly focused image from near field to far field. There is no longer a need to transmit at multiple depths to maintain image uniformity or have a transmit focus control. InFocus technology is always in use and is noted on the image screen by the icon. There will be no focal zones on the image screen. Traditional focus is not available on the cardiac transducers unless in Contrast imaging. These are a few example images that were done using InFocus technology. Notes No. 29 SIEMENS Healthineers InFocus coherent image formation – selectable focus SIEMENS . Healthineers .. 5Z1 Cardiac TIS:0.01 MI:0.20 38fps 2D 0dB/DR60 UA Off MapG/T5 P3 InFocus Contrast Mid 0dB/DR70 P2 16cm 78bpm Lead Il 30 Unrestricted © Siemens Healthineers 2024 Speaker Notes: In Contrast imaging, InFocus is always active. Selectable focus is available. To move the selectable focus, select InFocus from the Touch Screen or press the soft key and select the selectable focus Icon. The image screen displays an icon on the depth scale to indicate the location of the focal zone. Rotate the InFocus soft key to position the focal zone at or below the area of interest. This is an example with selectable focus in Contrast Imaging. Notes No. 30 SIEMENS Healthineers Harmonic imaging SIEMENS . Healthineers .. Harmonics Cardiac TIS 0.68 Cardine MEO.67 H High GB/ORSS . 10cm In Lead 11 Fundamental Harmonics 31 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Harmonic imaging improves contrast and spatial resolution by reducing noise and clutter and is especially helpful in reducing noise in large, difficult to image patients. Harmonics can be used to decrease artifacts such as haze, noise and clutter. Harmonics can help reduce grating lobes and side lobe artifacts (low-intensity weak echoes outside of the main ultrasound beam) typically seen in the region of the lateral and anterior walls of the heart. It can also reduce reverberation artifacts (linear equally spaced echoes) generally caused by rib and lung artifact. To activate / deactivate harmonics, select Harmonics on the touch screen. The available harmonic and fundamental frequencies on the 5V1 adult cardiac transducer are adjusted using the Frequency control on the soft keys. Choices are: • Harmonics - H Low, H Mid, H High • Fundamental - Pen The available harmonic and fundamental frequencies on the 5Z1 volume cardiac transducer are adjusted using the Frequency control on the soft keys. 2D choices are: • Harmonics - H Low, H Mid, H High • Fundamental - Mid 4D choices are: • Harmonics - H Mid • Fundamental - Mid Notes No. 31 SIEMENS Healthineers Frequency imaging > harmonics SIEMENS . Healthineers ... H Low H Mid H High 32 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Frequency imaging enables the user to adjust the range of frequencies of the transducer in order to improve resolution (higher frequency setting) or increase depth of penetration (lower frequency setting) and clearly visualize the entire FOV from near field to far field in B-mode imaging. Frequency imaging allows the user to independently select B-mode fundamental or harmonics, color Doppler, M-mode and spectral Doppler frequencies (e.g., the Doppler frequency can be adjusted without changing the B-mode frequency). Each imaging mode has its own range of frequency settings to achieve the highest resolution, penetration and sensitivity for the structure being imaged in each mode. There are several frequency choices for each transducer and are available via the corresponding soft key. These images are parasternal long axis views with each frequency. Notes No. 32 SIEMENS Healthineers Auto TEQ image optimization SIEMENS . Healthineers ... Auto TEQ 5V1 Cardiac TIS:0.73 MI:0.93 61fps 95% 2D H High 521 8dB/DR60 Workflow LD 1 UA 1 MapD/T4 Patient 20 Physio Imaging UR Flip UID Flip Review Report End Exam Auto TEQ Harmonics DI 42bpm Lead In Prospective Frequency Clip Capture H High Beats Sec 33 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Auto TEQ (Tissue Equalization technology) optimizes the overall field of view (FOV) image brightness uniformity by changing the depth gain compensation and overall gain. Auto TEQ continuously applies the TEQ technology to a B-mode image (as displayed in this image). To activate Auto TEQ, select Auto TEQ from the Touch Screen. The default is off. When active, the Auto TEQ control on the Control Panel is backlit in orange and a white icon display appears on the image screen. Press to activate or deactivate. Notes No. 33 SIEMENS Healthineers UltraArt TM universal image processing SIEMENS . Healthineers ... Off 3 Cardiac TIS:0.39 MI:1.00 59fps 95% Off 2D H High -2dB/DR58 LD 2 UA 5 MapD/T5 Speckle Reduction Contrast Enhancement Edge Enhancement Motion Compensation 11cm Lead 11 Dynamic Range Fr2950 Control IIIII 34 Unrestricted © Siemens Healthineers 2024 Speaker Notes: A unique capability available on the system is UltraArt universal image processing. Image post processing parameters can be selected with a single touch to instantly optimize images for different patient types. This allows quick and easy matching of the systems acoustic DNA parameters to individual patients in the specific scanning window. The intensity of enhancement applied to the image increases as the number increases. The 5V1, 5Z1, TEE and 8V3 transducers UltraArt selection offers six options from 0ff-5. There are new UltraArt options for settings 3 and 5 from the 1.0 release. The UA3 setting was applied to setting 4 in this release. Images are no longer displayed on the Touch Screen. The 10V4 transducer offers 4 options (0ff-4) with no changes from the 1.0 software release. By unifying multiple parameters into optimal settings for each individual patient, the effect of UltraArt patient specific image processing improves contrast resolution of different organs and visualization of small or isoechoic lesions. In the end, UltraArt improves exam quality and consistency across different users by avoiding combinations of individual post processing parameters that do not provide the result the user needs. Reading physicians can look forward to better exam quality standardization. Some of the settings that are optimized include Speckle, Edge Enhancement, Contrast, Motion Compensation and Dynamic Range. This is acquired during real-time, so the changes can also be applied on a frozen image. We will review these in more detail on the next slide. Notes No. 34 SIEMENS Healthineers Deep dive into UltraArt SIEMENS Healthineers ** UltraArt: parameter enhancement by level Speckle Reduction Edge Enhancement Dynamic Range Control Higher levels = More granular noise Higher levels = Edge enhancement Higher levels = Amplified luminance suppression, resulting in a becomes more significant. Sharper edges differences, emphasizing key details and smoother, clearer image. Improves with clearer borders, aiding in structural improving contrast. Enhances visualization visibility of low-contrast structures. definition. Improves detection of of tissue interfaces and fine structures. abnormalities and tissue differentiation. Contrast Enhancement Motion Compensation Higher levels = more pronounced global Higher levels = Improved & Better contrast. Enhanced differentiation adaptation to motion, reducing artifacts between tissues, improving visibility of for stable image quality. Ensures critical structures. Highlights vessel walls consistency during dynamic scanning and organ boundaries more effectively. scenarios. “Shimmer Reduction” 35 35 Unrestricted © Siemens Healthineers 2024 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To further explain UltraArt and the changes that are applied to the image, lets take a deeper dive into the technology. 1. Speckle Reduction: • Increasing Levels: Higher levels of UltraArt increase the intensity of speckle reduction. This means that more granular noise (speckle) is suppressed, resulting in a smoother and clearer image. The suppression aims to improve the visibility of low-contrast structures while minimizing the random granular pattern in the image. 2. Contrast Enhancement: • Increasing Levels: As the levels increase, there is a more pronounced adjustment of both local and global contrast. This helps in improving the differentiation of adjacent tissues, making it easier to distinguish between different anatomical structures. Increased levels lead to enhanced contrast between structures, thereby making features like vessel walls, organ boundaries, and other critical anatomical markers more visible. 3. Edge Enhancement: • Increasing Levels: With higher UltraArt levels, edge enhancement becomes more significant. The algorithm sharpens the edges of structures, making them better defined. This results in clearer borders for features like organ margins, making it easier to detect structural abnormalities. The sharpening effect becomes more prominent, emphasizing the differences between tissues. 4. Motion Compensation: • Increasing Levels: Motion compensation also becomes more effective as levels increase. The algorithm adapts to bulk motion more accurately, which is particularly useful during dynamic scanning scenarios or when scanning moving organs. This reduces motion artifacts and contributes to a stable image quality. Typically appreciated more in abdominal vasculature. 5. Dynamic Range Control: • Increasing Levels: Higher levels of UltraArt lead to increased adjustments in dynamic range control. This parameter ensures better differentiation of luminance between the structures in the image, making the finer details more prominent. It emphasizes the differences between high-contrast areas, such as tissue interfaces, enhancing the overall quality and diagnostic value of the image. Summary of Parameter Changes as Levels Increase: • Speckle Reduction: Greater suppression of granular noise for a smoother image. • Contrast Enhancement: Increased contrast adjustment for better tissue differentiation. • Edge Enhancement: More pronounced sharpening of structure edges for better definition. • Motion Compensation: Enhanced correction of motion artifacts for consistent image quality. • Dynamic Range Control: Amplified luminance differences for emphasizing key structures. 35 SIEMENS Healthineers UltraArt universal image processing SIEMENS. Healthineers ... off 2 Off 1 2 3 4 5 36 Unrestricted © Siemens Healthineers 2024 Speaker Notes: To change the setting: • Select the UltraArt icon on the Touch Screen and press the desired selection. • The image will be displayed on the imaging monitor. • Note the setting on the image parameter display • Selections are Off-5 or Off-3 depending on the transducer. These images represent stored images with each setting. Notes No. 36 SIEMENS Healthineers ED-ES split SIEMENS . Healthineers .. • Side-by-side display of end diastolic and end systolic frames • Press the Update key to toggle the active image • Measurements can be performed on the active image • ECG must be connected 100% Fr 36 62b 62bp 37 Unrestricted © Siemens Healthineers 2024 Speaker Notes: ED-ES Split enables side-by-side display of end diastolic and end systolic frames. The primary functionality of this feature is to obtain end diastolic and end systolic measurements more efficiently (e.g. left ventricular dimensions in the parasternal long axis or Simpson’s Biplane measurements). To use ED-ES Split: Obtain the desired view > press Freeze > select ED-ES Split on the Touch Screen. To perform a measurement, press Measure. Press Update to alternate between the ED and ES sides. Note: An ECG must be connected to use ED-ES Split. Notes No. 37 SIEMENS Healthineers Left/Right and Up/Down flip SIEMENS . Healthineers ... Cardias 20 IdBORSA L/R Flip MOPErTS U/D Flip Sebom Lead 38 Unrestricted © Siemens Healthineers 2024 Speaker Notes: On the Touch Screen the image can be L/R flipped or U/D flipped. This may be useful in pediatric echocardiography. Select on the Touch Screen to change the orientation. In this image, we are demonstrating the Up/Down flip. Notes No. 38 SIEMENS Healthineers Line density SIEMENS . Healthineers ... BV1 Cardiac TIS:0.73 MI:0.89 78fps 95% 20 H High 1dB/DR64 .30High LD 1 LDZ UA 3 MapE/T3 P1 Stepm Lost Line Density Line Density Line Density 1 2 3 39 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Line Density adjusts the balance between the image line density (resolution) and the frame rate (speed). Settings are from 1 (low resolution / high frame rate) to 3 (high resolution / low frame rate). Line density is accessed on the second page of the soft keys. Rotate the control to change the level. •The image on the left is imaged with a Line Density of 1 which provides less detail but better temporal resolution (frame rate of 78fps). •The image in the middle is imaged with a Line Density of 2 which provides better spatial resolution with a reduced temporal resolution (frame rate 40fps). •The image on the right is imaged with a Line Density of 3 which provides the overall better detail resolution but the lowest resolution (frame rate 34fps). The user can also decrease the sector width to increase frame rate using the trackball and set keys. Notes No. 39 SIEMENS Healthineers Transmit power SIEMENS . Healthineers .. 4321 ECHOLC TIS:0.30 95% 2D H High 0dB/DR60 c=1540 LD 1 UA 2 MapD/T3 P1 16cm 54bpm Lead 11 40 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Transmit power can be adjusted by the user and is displayed as Mechanical(MI) and Thermal indices (TI). The settings display the percentage of power where 100% is the FDA (USA- Food and Drug Administration) and IEC (International Electrotechnical Commission) agencies regulated maximum in each imaging condition / mode / sub-mode. Setting choices are .2% to 100% . The default is 95% for the Cardiac preset on the 5V1 and 5Z1 transducer. Rotate the Transmit soft key to adjust. Settings apply across all modes. Turning the power down will show the changes in the TI and MI display and other regulated factors. The MI and TI display values should be interpreted as relative information and only used to assist the operators to implement the ALARA (As Low As Reasonably Achievable) principle for patient examinations; the acoustic output should be the lowest level required to satisfactorily perform the examination. Indices displayed in the abbreviated form shown below: MI: Mechanical Index MIF: Maximum of the Mechanical Indices measured at the active focal zones (displayed during CCAI (contrast exams only) TIB: Bone Thermal Index (fetal application) TIS: Soft Tissue Thermal Index TIC: Cranial Thermal Index Notes No. 40 SIEMENS Healthineers Dynamic range SIEMENS . Healthineers ... Frequency DR Clip Capture H High 58 dB Beats Sec 41 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Dynamic Range affects the number of gray shades that are displayed (settings range from 10 - 80 dB) . Increase the Dynamic Range to produce a “softer” B-mode image; decrease the Dynamic Range to produce an image with more contrast. Dynamic Range is available on a live or frozen image. Dynamic Range is adjusted by rotating the soft keys and is available on Page one of the 2D Touch Screen. The average Dynamic range on the presets is 53 - 65 dB. Note the excellent contrast resolution displayed in the images. The blacks are maintained while displaying the subtle gray scale changes. The image on the right with the higher Dynamic Range displays greater definition of the intratrial septum. Notes No. 41 SIEMENS Healthineers Maps SIEMENS. Healthineers ... Cardiac 6V1 TIS 0.25 ECHOLO MI.0.95 TIS 0.77 54fps ME0.86 95% 95fps 100% 2D 20 HHigh H Mid 20 14B/DR55 OdB/DR55 H High 44B/DR65 UA 2 UA 2 MapC/T4 MapDIT5 PI P1 HOPE/TS Transmit Power Line Density Cropping Mode Persist Maps Tint 5 % 2 R-R D 5 42 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Map may be adjusted on a live or frozen image. A gray map determines how dark or light you prefer to show each level of gray based upon the strength of the ultrasound signal. Settings range from A-G. Maps A-F display low to high contrast and Map G is a linear map (primarily used in research) but can be useful in technically difficult patients . They are also gain balanced with the exception of Map G. • Maps are available on Page two of the 2D Touch Screen and are also adjustable by rotating the soft key. Notes No. 42 SIEMENS Healthineers Tint SIEMENS . Healthineers .. 5V1 Cardiac TIS:0.73 MI:0.93 Z6T : 38.5ºC 61fps Cardiac 95% TIS:1.00 MI:0.87 2D 34fps H High 95% 3dB/DR60 2D LD 1 Pen UA 1 MapA/T7 DRS5 MapDT 12cm 19cm do6pm Lead 11 43bpm Lead 11 Sepia Gold 43 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Tint individually colorizes the grayscale image to aid in visualization of subtle tissue differences. There are 10 tints. Six with different shades of gray, as well as blue, inverted rainbow, sepia, and gold. Tint 1 is a true gray and Tints 2-6 are additional gray shades. Tints 7-10 are the color options. They are also gain balanced. The use of Tints may enhance low level echoes in blood and contrast resolution in the adult, pediatric and fetal heart. It can be especially useful in M-mode and Spectral Doppler tracings. Tint can be adjusted on a live or frozen image. The image on the left is using the Sepia tint. It enhances the blood pools and endocardial border. The image on the right is using the Gold tint. It is a Biplane image using the Z6T TEE transducer. t Notes No. 43 SIEMENS Healthineers Image size SIEMENS . Healthineers ... HO Image Size Image Size Image Size 1 3 5 44 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Image Size changes the size of the image. The default Image Size is 4. 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). The field of view (FOV) width is not affected when the image size is changed (settings range from 1 – 5). Notes No. 44 SIEMENS Healthineers Additional display mode > vector size and position SIEMENS . Healthineers .. 5V1 Cardiac Cardine TIS:0.73 TIS:0.73 MI:0.99 MI:0.99 36fps FUI FOV 59fps 95% 20 H High H High 3dB/DR56 3dB/DR56 LD 2 LD 2 UA 2 UA 2 MapE/T5 MapE/T5 Set Size Position 19cm 18cm 45 Unrestricted © Siemens Healthineers 2024 Speaker Notes: An additional B-mode display mode is the ability to increase and decrease the vector size or field of view. This is useful to remove rib artifacts from the image or to increase the frame rate. To adjust the vector size, press the Update key to activate Size and use the trackball to increase or decrease the size. To adjust the position of the vector, press the Update key to activate Position and move the vector to the right or left. Once you make a change in the sector size, Full FOV (Field of View) will pop-up on the Touch Screen. Pressing Full FOV will return to a full field of view eliminating the need for pressing the trackball and set keys. Notice how in this example, the frame rate increased from 36 to 59 fps when narrowing the vector size. Notes No. 45 SIEMENS Healthineers Bi-Plane+ imaging SIEMENS . Healthineers' ... 8V3 521 SV1 5Z1 Workflow Cardiac 1.0,95 30fps Patient Physio 95% 2D Imaging H High dB/DR53 UR Flip UID Flip LD 2 Review UA 3 MapD/T5 Report End Exam Bi-Plane+ Right Invert Auto TEQ Reset Angle Perpendicular Harmonics Left Both Right D Zoom Capture Type Prospective 15cm 40 Z Frequency Angle Tilt Angle H High 150- lip Capture Bests Sec 58bpm Go to Right Tilt Size Position 46 Unrestricted © Siemens Healthineers 2024 Speaker Notes: The Bi-Plane+ imaging function is available on the Z6T Volume Transesophageal (TEE) and 5Z1 transducers. In Bi-Plane+ imaging, the system scans two imaging planes with different rotation and tilt angles and views the planes in a side-by-side display format. This enables individual manipulation of the planes. • A biplane angle indicator displays between the two planes. • The left plane is the reference plane; in this example the right plane is the orthogonal (90˚) angle to the reference plane • The left and right planes can be manipulated separately or simultaneously • The Tilt Angle is indicated by the green arrow at the bottom of the left image and can be adjusted from the trackball or by rotating the Tilt Angle soft key. A green line will appear for a few seconds when the Tilt Angle is adjusted and then disappear. Notes No. 46 SIEMENS Healthineers Bi-Plane+ scan plane and angle indicators SIEMENS . Healthineers ... • The left plane is labeled as the red (lateral) plane • The right plane is labeled as the green (elevation) plane 90º • To adjust both planes together, select Both and rotate the Angle soft key to change the angle in 1˚ or 30 ˚ increments (press the soft key to change) • To adjust the red plane only select Left; to adjust the green Reset Angle Perpendicular plane only select Right • The currently active plane(s) indicator will appear bold • Rest Angle resets both angles to the default orthogonal Left Both Right position (0 and 90 degrees or 0 and 270 degrees, determined by configuration of the transducer) Angle Perpendicular aligns right plane perpendicular (orthogonal) to 180º 1º 300 • the current angle of the left plane 47 Unrestricted © Siemens Healthineers 2024 Speaker Notes: A scan plane and angle indicator is located on the monitor. Use the following controls to adjust angles in Bi-plane+: • The left plane is labeled as the red (lateral) plane • The right plane is labeled as the green (elevation) plane • To adjust both planes together, select Both and rotate the Angle soft key to change the angle in 1˚ or 30 ˚ increments (press the soft key to change) • To adjust the red plane only select Left; to adjust the green plane only select Right • The currently active plane(s) indicator will appear bold • Rest Angle resets both angles to the default orthogonal position (0 and 90 degrees or 0 and 270 degrees, determined by configuration of the transducer) • Perpendicular aligns right plane perpendicular to the current angle of the left plane Notes No. 47 SIEMENS Healthineers Bi-Plane+ imaging SIEMENS . Healthineers .. Tilt Angle adjusted from mitral valve to aortic valve DReo Go to Right Perpendicular (Orthogonal) scan planes of Perpendicular (Orthogonal) scan planes of the mitral valve in the parasternal long axis Tilt Size Position ........ the aortic valve in the parasternal long axis 48 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Adjusting the Tilt Angle moves the green line which is the location the plane on the right images. In this example, the image on the left demonstrates two perpendicular (orthogonal) planes – a parasternal long axis view and a parasternal short axis view of the mitral valve. In the image on the right, the Tilt Angle was moved over the aortic valve in the parasternal long axis to display a short axis view of the aortic valve in the orthogonal imaging plane. The Tilt Angle can be adjusted from the Tilt Angle soft key or the trackball. Notes No. 48 SIEMENS Healthineers Bi-Plane+ imaging SIEMENS . Healthineers .. 5Z1 ZGT : 38.5ºC Cardiac Cardiac 146 TIS:0.51 TIS:1.00 MI:0.90 MI:0.87 19fps 34fps 95% 95% 2D 2D H High Pen 1dB/2dB 2dB DR59 DR55 LD 3 UA 2 Mid OdB MapD/T8 General P1 PRF 4310 . 12 cm 696pm Lead il Lead Il Two views of tricuspid valve with color Doppler Transesophageal Bi-Plane+ image of the tricuspid valve 49 Unrestricted © Siemens Healthineers 2024 Speaker Notes: In this example, the image on the left demonstrates Bi-Plane+ imaging of the tricuspid valve. By adjusting the angle of the right plane to 146˚, an alternative view of the tricuspid valve is obtained, allowing a more thorough assessment of tricuspid regurgitation. • Note that when the user enters spectral Doppler the image will exit out of Bi-Plane+ mode for sample gate placement. The image on the right demonstrates a Transesophageal Bi-Plane+ image of the tricuspid valve. Notes No. 49 SIEMENS Healthineers Bi-Plane+ SIEMENS. Healthineers .. 5Z1 • Image parameter adjustments will Cardiac 306º TIS:0.38 apply to the currently active plane(s) MI:0.95 35fps 2D Right plane (green) angle indicator is H High • 0dB/16dB bold, and Gain was increased DR55 LD 2 UA 3 MapE/T5 P2 16cm 57bpm Lead II 50 Unrestricted © Siemens Healthineers 2024 Speaker Notes: • Image parameter adjustments will apply to the currently active plane(s) • Right plane (green) angle indicator is bold, and Gain was increased • Image parameter adjustments will apply to the currently active plane(s) • In this example, the right plane (green) angle indicator is bold, and Gain was increased only for that plane Notes No. 50 SIEMENS Healthineers Single plane angle adjustment SIEMENS . Healthineers ... • Angle adjustments can be made while in single plane imaging mode • Rotate the Angle soft key to adjust the angle Apical 4 chamber 0˚ Apical 2 chamber ~310˚ Apical 3 chamber ~250˚ 51 Unrestricted © Siemens Healthineers 2024 Speaker Notes: Angle adjustments can also be made while in single plane imaging mode by rotating the Angle soft key. In these clinical images, apical 4 chamber, apical 2 chamber, and apical 3 chamber views are obtained by rotating to the approximate angles displayed on the slide. This reduces the need for the user to manually rotate the transducer on the patient's body. Notes No. 51 SIEMENS Healthineers 2D post-processing features SIEMENS . Healthineers ... 5V1 Cardiac • DR TIS:0.73 • Gain MI:0.80 179fps 95% 2D H High • Map • M-mode Gain -3dB/DR49 LD 1 UA 3 MapE/T8 P1 • Tint • UltraArt • Image Size • L/R Flip • DGC • U/D Flip 11.8cm HD Z 52 Unrestricted © Siemens Healthineers 2024 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 in white. The following optimization controls may be adjusted after the image is frozen: • DR • Gain • M-mode gain • L/R Flip • U/D Flip • Image Size • UltraArt • Map • Tint • DGC Notes No. 52 SIEMENS Healthineers Summary SIEMENS . Healthineers ... • Discuss transducers and modes • Review 2D and M-mode controls • Describe 2D and M-mode optimization features ....- 53 Unrestricted © Siemens Healthineers 2024 Speaker Notes: We have reviewed the 2D and M-Mode for echocardiology imaging . Notes No. 53 SIEMENS Healthineers The products/features mentioned in this document may not be commercially available in all countries. Due to regulatory reasons their future availability cannot be guaranteed. Please contact your local Siemens Healthineers organization for further details. ACUSON S equoi a, T E Q a nd U l t r aArt a r e trademarks of Siemens Medical Solutions USA, Inc. At Siemens Healthineers, our purpose is to enable healthcare providers to increase value by empowering them on their journey towards expanding precision medicine, transforming care delivery, and improving patient experience, all enabled by digitalizing healthcare. An estimated five million patients worldwide everyday benefit from our innovative technologies and services in the areas of diagnostic and therapeutic imaging, laboratory diagnostics and molecular medicine as well as digital health and enterprise services. We’re a leading medical technology company with over 120 years of experience and 18,500 patents globally. With over 50,000 employees in more than 70 countries, we’ll continue to innovate and shape the future of healthcare. Siemens Healthineers Headquarters Manufacturer Siemens Healthineers AG Siemens Medical Solutions USA, Inc. Siemensstr. 3 Ultrasound 91301 Forchheim, 22010 S.E. 51st Street Germany Issaquah, WA 98029, USA Phone: +49 9191 18-0 Phone: 1-888-826-9702 siemens-healthineers.com siemens-heathineers.com/ultrasound 54 Unrestricted © Siemens Healthineers 2024 Notes No. 54 SIEMENS Healthineers Thank you for your enthusiasm! SIEMENS. Healthineers ... Questions? 55 Unrestricted © Siemens Healthineers 2024 Speaker Notes: No speaker notes. 55