QMass MR v7.6 Quick Start Manual
Contents
1. 1 Click z or press F9 to open the report window This creates a report in the layout last selected From the Report Layout drop down list select Time SI Click Save at the bottom of the Report window 2 To save the analysis select File gt Save gt All Series QMass MR 7 6 Quick Start Manual 16 T1 Analysis If you have the T1 analysis module you can use QMass to analyze the T1 magnetization recovery of a region of interest This chapter explains how to e Performa T1 analysis e Create aT1 analysis report A T1 analysis determines the rate of magnetization recovery of a region of interest To perform a T1 analysis e Select File gt Open Study and select the series you want to analyze In the Study Matrix right click the series tab and check if the series is labeled correctly as a T1 series If needed you can change the series label in the submenu e Select the T1 Analysis tab e Inthe Thumbnail View select an image that shows sufficient contrast e Select your preferred drawing tool and draw the endocardial contour E Make sure to exclude the LV blood pool to avoid its high intensity signal affecting the results e Click and draw the epicardial contour E Make sure to exclude the RV blood pool to avoid its high intensity signal affecting the results e Mark one or more regions of interest in the septum Select the region of interest icon for example and draw a region of interest in the2. November 20 2013 QMass MR 7 6 Quick Start Manual 9 10 250 76 2 v1c0 Medis medical imaging systems bv Medis medical imaging systems Inc Schuttersveld 9 9360 Falls of Neuse Road Suite 103 2316 XG Leiden Raleigh NC 27615 2484 P O Box 384 USA 2300 AJ Leiden the Netherlands Telephone 31 71 522 32 44 Telephone 1 919 278 7888 Fax 31 71 521 56 17 Fax 1 919 847 8817 E mail supportemedis nl E mail supportemedis nl Web www medis nl Web www medis nl QMass MR 7 6 Quick Start Manual II Legal Notices Copyright Notice O 2010 2013 Medis medical imaging systems bv All rights reserved This manual is copyrighted and is protected by worldwide copyright laws and treaty provisions No part of this manual may be copied reproduced modified published or distributed in any form or by any means for any purpose without prior written permission of Medis medical imaging systems bv Permission is granted to freely print unmodified copies of this document as a whole provided that copies are not made or distributed for profit or commercial advantage Trademark Acknowledgments QMass and QFlow are registered trademarks of Medis Associated BV in the United States and in other countries All other brand product and company names mentioned in this document are trademarks or registered trademarks of their respective owners Regulatory Information Intended Use QMass has been developed for the objective and reproducible
3. FUNCION ANALYSIS ecexviexsccicanccsacerieeseccaneuaaciee eee teccaneuaaceueee bec easeeascawegeeeceneeeade 4 Performing extended LV Function Analysis cc ccc ccc ceeccceeeecceeeeceeeeceeesceeeeeeeeeeceeneceeaeees 6 Creatine REDONS eseseccndsose necios 7 DSUANAE YSIS oerien E E E ETa 10 RAR ANALYSIS ooreo eaNL EE ENEE EEEE EEEE EEEE TEE 13 TSLANA Sii 14 TI ANALYSIS oi ii iii 17 COSME OMIS od 23 MORE INFORMA TION asnos ina oa os 24 QMass MR 7 6 Quick Start Manual Vil Introduction About QMass QMass is Medis software solution for the analysis of cardiac MRI studies Its automatic contour detection enables you to perform quantitative analyses quickly and accurately QMass features ventricular function analysis scar tissue analysis referred to as Delayed Signal Intensity or DSI analysis Edema analysis Area at Risk referred to as AAR first pass perfusion analysis referred to as time signal intensity or TSI analysis stress level function analysis referred to as comparison analysis T1 analysis T2 analysis and T2 analysis QMass can also read CT reformatted data and perform functional analysis on that data E QMass must be used by qualified medical personnel or trained technicians If the analysis results are used to reach a diagnosis the results must be interpreted by a qualified medical professional QMass should not be used for purposes other than those indicated in the section Intended Use E QMass cannot perform
4. PgUp or PgDn key on your keyboard To zoom in or out i or in the toolbar e Use the slider under the View or click To pan e Press the middle mouse button or mouse wheel hold it down and drag This pans the image To return to editing mode release the middle mouse button or mouse wheel To adjust window width and level e Press 2 on the keyboard to optimize window width and level Or e Inthe Active View right click and drag Move the mouse to the left or right to adjust window width move it up or down to adjust window level QMass MR 7 6 Quick Start Manual Performing LV Function Analysis Now that we have reviewed the series we are going to perform an LV function analysis using the Ventricular Analysis wizard There are a number of wizards in QMass which provide a guided workflow to help you perform an analysis quickly and easily The Ventricular Analysis wizard consists of four steps selecting the long axis series and the short axis series and placing valve and apex markers in the ED phase of the long axis series placing markers in the ES phase of the long axis series and selecting the type of contours to be detected reviewing the detected contours reviewing the results Y The Ventricular Analysis wizard is only available when the study contains both long axis and short axis cine images If you have no long axis images you can still perform an analysis using the standard automatic detection feature Refe
5. analysis of LV and RV function based on cardiac MR and CT reformatted data sets The software enables the display of images for use by trained medical personnel The intended purposes are e Supporting clinical diagnoses on the status of the global and regional function and anatomy of the cardiac chambers e Supporting the subsequent clinical decision making processes WARNINGS E QMass must be used by cardiologists radiologists or trained technicians who are qualified to perform cardiac analyses If the analysis results are used to reach a diagnosis the results must be interpreted by a qualified medical professional In clinical practice QMass should not be used for purposes other than those indicated in the section Intended Use E Users must make sure to read this manual to become familiar with the software and be able to obtain reliable analysis results QMass MR 7 6 Quick Start Manual HI European Regulations QMass is qualified as a class lla medical device It complies with the requirements of the Dutch Medical Devices Decree Besluit Medische Hulpmiddelen Stb 243 1995 and the European Medical Device Directive 93 42 EEC North American Regulations QMass has been cleared for market in the United States by the FDA Food and Drug Administration under the provisions of Section 510 k of the Food Drug and Cosmetic Act with the exception of the first pass perfusion analysis late enhancement analysis and T1 mapping
6. from the Registration submenu Click the arrow next to Contours and the other menu items that apply 2 Click Al This copies the selected contours to the other images in the slice and performs breathing motion correction and then select Register ROI1 O Contour registration is performed based on the contour registration settings To access and modify these settings select Settings gt Registration 3 Check the contours in the Thumbnail View or in the Movie Tool to see if the automatic positioning of the contours needs correcting To move a set of contours to another position press SHIFT CTRL and drag them to their new position E Do not edit the contours using the drawing tools If you want to add new ROIs after performing registration make sure to create the ROI contours in the same image in which you created the initial contours To view TSI analysis results 1 Click to display the analysis results in a graph 2 From the Show drop down list select the Myo Intensity Time or ROI Intensity Time graph Or 1 Click to display the analysis results in a bull s eye diagram 2 From the Show drop down list select SI Analysis This adds a drop down list to the dialog window 3 Select the type of diagram that you want to view E For a detailed description of the bull s eye diagrams refer to the User Manual QMass MR 7 6 Quick Start Manual 15 TSI Analysis To create a report and save the analysis
7. scar tissue analysis perfusion analysis T1 analysis T2 analysis and T2 analysis on CT reformatted data The QMass Workspace The QMass main workspace consists of a menu bar a set of toolbars a study matrix and three views Which icons are active in the toolbars depends on the type of study that is being analyzed and on its orientation The scanline views present the slice position of the selected series In the first two views you can switch to another series by right clicking and selecting the new series You can also pan and you can zoom in or zoom out by using the sliders MENU BAR a TOOLBARS Pre lee irita ACTIVE VIEW SCAN LINE VIEWS y Z ee eeey pe 9 2 llela oOo oio 438 E Ee eee ee le eee le eles jejeje ln s gt i i i ajoje e e 8 e819 4 a t tes THUMBNAIL VIEW o QMass MR 7 6 Quick Start Manual 1 Quick Tour In this quick tour you will get to know QMass s key features and basic workflow You will open a study review it perform an LV function analysis view analysis results create a report and export the report You can find instructions on performing late enhancement and first pass perfusion analysis in the last two sections of this Quick Start Manual Starting QMass and Reviewing Studies QMass is usually installed by Medis support personnel or by your system administrator If you need installation instruc
8. Matrix tab and check if the series is labeled correctly You can do this by right clicking the series tab In the Thumbnail View select an image that shows sufficient contrast in both the left and the right ventricle By default the drawing mode is set to tracing To draw in point mode click a In the Active View draw the endocardial contour then click E and draw the epicardial contour E Make sure to exclude the LV and RV blood pool to avoid that its high intensity signal affects the results If you want to analyze signal intensity over time in a region of interest click al In the Active View draw a contour around the region of interest ROI If you want to compare one or more ROIs with each other click one of the other ROI icons View Or and draw the corresponding contour or contours in the Active To place reference points REF Click In the Active View place a reference point at the inferior or anterior junction of the right ventricle and the left ventricle If you place the reference point at the anterior septum make sure to first change the bull s eye settings so that the cardiac segments are labeled correctly Select Settings gt QMass MR 7 6 Quick Start Manual 14 TSI Analysis Bull s Eye On the Display tab under Reference Point Location select Anterior and click OK To register contours 1 If you have drawn one or more ROIs select the corresponding menu item or items
9. V Functional Analysis O To obtain regional analysis results you need an additional license 7 Click or to view analysis results Click Mil to view regional analysis results To save the contours you created select File gt Save from the menu bar 8 Click Done to close the wizard Performing extended LV Function Analysis The Blood muscle segmentation checkbox in the Functional Analysis offers an alternative method to determine blood and muscle volumes for functional analysis in addition to papillary muscle volume Using a threshold slider one can determine a threshold that distinguishes blood from muscle in both the Right Ventricular aswell as the Left Ventricular chambers The threshold can be copied to other slices or phases To perform a functional analysis using blood and muscle segmentation 1 Select the tab Functional Analysis and select the checkbox Blood muscle segmentation 2 Draw the Epicardial contours in all slices and phases 3 Draw the Endocardial contours if one needs to distinguish between Papillary volume and Myocardial volume 4 Drag the LV or RV thresholds slider to modify the blood muscle classification 5 Click the toolbar button Edit LV Papillary tissue to manually add or remove muscle tissue 6 Click to view analysis results or view the results in the Volume graph in the Functional Analysis Tab QMass MR 7 6 Quick Start Manual 6 LV Functional Analysis Creating Reports Report
10. alyze 3 Start the Edema Analysis Wizard by pressing next to Fe and select Edema Analysis Wizard 4 In the wizard click and draw LV endocardial contours in each slice of the series in the Active View Similarly click to draw LV epicardial contours in each slice of the series V See also Transferring contours from short axis cine series 5 Click Detect and check if the ROI1 contour is detected in healthy myocardium and if ROI2 is detected in Edema myocardium If necessary you can edit the contours or re detect them using the Detect button 6 Check the Edema core threshold by reviewing the edematose tissue segmentation in all slices You can override the calculated threshold by dragging the slider under Intensity Threshold Y You can copy a manually set threshold value to other slices using Copy to All Copy Down or Copy Up 9 You can calculate another threshold value based on the healthy contour area by specifying the Standard Deviation calculation method and to supply a standard deviation QMass MR 7 6 Quick Start Manual 8 Edema Analysis Click ES to draw areas with Edema tissue To start erasing pixels click Ed You can hide the masks by deselecting Display masks Q You can click to create an Edema report Transferring contours from short axis cine series If contours are already available in the short axis cine series you can load the series and transfer the contours from this series to the Ede
11. d setting a reference point in the Active view at the inferior or anterior end of the interventricular septum Make sure a reference point is placed in every slice you are analyzing E If you place the reference point at the anterior septum make sure to change the bull s eye settings so that the cardiac segments are labeled correctly Select Settings gt Bull s Eye On the Display tab under Reference Point Location select Anterior If you want to change the default transmurality threshold of 50 you can modify the threshold under Transmurality Threshold You can click your choice from the Show drop down list Right click in the window to access options for to open a bull s eye window You can also select the diagram of QMass MR 7 6 Quick Start Manual 11 DSI Analysis saving the diagram and for adding it to reports Y You can click to create a DSI report Transferring contours from short axis cine series If contours are already available in the short axis cine series you can load the series and transfer the contours from this series to the DSI series by clicking a Contour transfer works best if you manually create contours in the phase of the short axis cine series in which the DSI series was scanned QMass MR 7 6 Quick Start Manual 12 AAR Analysis Area At Risk AAR analysis helps one determine the amount of edematose tissue in the myocardium that is defined as salvageable tissue This chapter e
12. indicates T2 for T2 analysis or T2 for T2 analysis You can also view the decay rate per pixel using mouse cursor tracking Click Eo and then hover the mouse over the region of interest This displays the currently tracked pixel s decay rate in the status bar at the bottom of the QMass window To create a T2 or T2 report 1 Click z 2 On the Graphic tab from the Report Layout drop down list select T2 T2Star This creates a T2 or T2 report To set a default for the cut off value and for the overlay colors 1 Select Settings gt T2 T2 Settings This opens the T2 T2 Settings dialog window Under Overlay Colors choose your preferred color scheme After Cut off value specify the default to be used during the current session V You can specify a persistent default cut off value in the Configuration File Editor E For instructions on modifying settings refer to the Configuration File Editor documentation To export the decay times per slice to DICOM 1 Click the Export button V The exported maps can be saved to disk to pacs or to an OEM database E For instructions on modifying export settings refer to the Configuration File Editor documentation QMass MR 7 6 Quick Start Manual 22 Closing QMass When you have finished analyzing you close QMass Enterprise Solution as follows To close QMass Enterprise Solution 1 In QMass select File gt Quit 2 Close the currently selected study in QMas
13. lay tab select the Hide all drawings option View gt Movie Contours can be saved ina CON file QMass MR 7 6 Quick Start Manual Names of buttons fields menus menu options and tab names are capitalized and in bold A sequence of menu options that you select to perform a specific task is indicated by angular brackets Text that you type or that appears on the screen such as file names and file locations is displayed in Courier New Symbols Used Py e e Pp QMass MR 7 6 Quick Reference Points to related documentation or to related sections in the document that may be relevant in your situation Tip Provides helpful information or an alternative working method Note Brings additional information to your attention Caution Tells you to be careful when performing a task Warning Warns you for a potentially dangerous situation in the image representation or analysis which may lead to incorrect results You are advised to follow the instructions to avoid this Start Manual VI Table of Contents Table Contents Dd VII INTRODUCTION wsicas ciocotancseneses Gienetanscunceasccuw eden ncand saa ceun scan eueneses eueninancacwerancucmiuaneaenesens 1 ADO OMIS AA aos 1 Tine OMAaSS WOlKS PACE sais iaa 1 QUICK FOUR suis entered snveasai eee seat soveseuven lesen tesesnewse a 2 Starting QMass and REVIEWING Studies ccccseccccnccceeeccceecccenscceeessesesceeescceeescesescesesceeees 2 Performing LV
14. ma series by clicking Al Contour transfer works best if you manually create contours in the phase of the short axis cine series in which the Edema series was scanned QMass MR 7 6 Quick Start Manual 9 DSI Analysis In QMass you can perform a scar tissue analysis using the Delayed Signal Intensity DSI wizard if your organization has obtained the DSI module The wizard consists of four steps creating LV endocardial and epicardial contours verifying the areas of healthy and hyper intense myocardium verifying the DSI threshold and segmentation placing a reference point setting the transmurality threshold viewing the results and creating a report To perform a DSI analysis 1 Load a DSI dataset into QMass Y See also Transferring contours from short axis cine series Select the DSI series you want to analyze Start the DSI Analysis Wizard by pressing next to Fy and select DSI Analysis Wizard _ In the wizard click Active View Similarly click to draw LV epicardial contours in each slice of the series Y See also Transferring contours from short axis cine series Click Apply and check if the ROI1 contour is detected in healthy myocardium and if ROI2 is detected in hyper intense myocardium If necessary you can edit the contours or re detect them using the Apply button The DSI core threshold is also calculated when the Apply button is pressed V The calculated threshold value is copied auto
15. matically to all other slices if the option Auto copy is selected If you use the Apply button without Auto copy selected then the ROI contours and threshold value are determined for the current slice only You can repeat this for each slice separately Check the DSI core threshold by reviewing the scar tissue segmentation in all slices You can override the calculated threshold by dragging the slider under Intensity Threshold QMass MR 7 6 Quick Start Manual 10 DSI Analysis Click ZA and ES to draw areas with micro vascular obstructions To start erasing pixels click Ed Y You can copy a manually set threshold value to other slices using Copy to All Copy Down or Copy Up You can calculate another threshold value based on the healthy contour area by specifying the Standard Deviation calculation method and to supply a standard deviation Q You can specify areas at risk by selecting Dual Threshold in the DSI analysis box Two threshold sliders will appear You can define a gray zone threshold by moving the bottom slider or start drawing a gray zone mask by clicking VA You can increase the tip size of the brush or the eraser by increasing the Draw size 4 Select Smart brush or click 2 in the toolbar if you want to edit the current mask without overwriting or erasing other masks Y You can hide the masks by deselecting Display masks REF 7 Seta reference point You can place a reference point by clicking amp an
16. modules as the use of contrast agents for cardiac MR procedures is not FDA approved The first pass perfusion analysis late enhancement and T1 mapping analysis modules are available in the United States for scientific research purposes only QMass complies with the requirements of the Canadian Medical Devices Regulations and has been licensed as a Class Il medical device QMass MR 7 6 Quick Start Manual IV Conventions Used The following conventions are used throughout this manual to indicate mouse and keyboard actions and to refer to elements in the user interface Mouse Click Right click Middle click Double click Keyboard SHIFT click CTRL O Press and release the primary mouse button If you are left handed you may have set the right mouse button as your primary mouse button Press and release the secondary mouse button If you are left handed you may have set the left mouse button as your secondary mouse button Press and release the wheel button or the middle mouse button If you have a two button mouse press and release the left and the right mouse button simultaneously Press and release the primary mouse button twice Press and hold down the SHIFT key on your keyboard while you click a button or object Press and hold down the CTRL key on your keyboard while you press O then release both keys This example opens the dialog window for opening a study Typographical Conventions On the Disp
17. myocardium This chapter explains how to e perform a T2 or T2 decay time analysis e create a T2 or T2 decay time report A T2 or T2 decay time analysis consists of two steps first you must draw a contour around the region of interest in the myocardium and then you must exclude the measurements from the curve that are biased by MR noise To perform a T2 or T2 analysis 1 Select File gt Open Study and select the series you want to analyze 2 In the Study Matrix right click the series tab and check if the series is labeled correctly as a T2 T2 series If needed you can change the series label in the submenu 3 Select the T2 T2 Analysis tab 4 Inthe Thumbnail View select an image that shows sufficient contrast 5 Select your preferred drawing tool and draw the endocardial contour E Make sure to exclude the LV blood pool to avoid its high intensity signal affecting the results 6 Click and draw the epicardial contour E Make sure to exclude the RV blood pool to avoid its high intensity signal affecting the results 7 Mark one or more regions of interest in the septum Select the region of interest icon for example a and select y Click the epicardial contour to mark the beginning of the septal segment and then double click the endocardial contour to mark the end This creates the region of interest The following illustrations show an example QMass MR 7 6 Quick Start Manual 20 T2 T2 Analysis M
18. myocardium V You can deselect Auto copy under Contours to prevent copying the contours of the regions of interest to the other images e The T1 Analysis tab now shows two curves per region of interest the curve of the measured values in the color of the region of interest and the fitted curve as a dotted line e The Time ms box now shows the T1 recovery time Y You can click on the icons in the Time ms box to show or hide the various regions of interest QMass MR 7 6 Quick Start Manual 17 T1 Analysis Module Y You can select and display the T1 T1 or the Residual overlay by selecting an Overlay from the drop down selection box Y You can select the Acquisition type Look Locker LL which displays the T1 T1 or the tO results or Progressive Saturation PS which displays the T1 and the t0 results T1 T1 for progressive saturation studies corresponds to the Progressive following equation saturation A EXP t T1 B T1 Look T1 for Look Locker studies corresponds to the following Locker equation A EXP t T1 B T1 value for Look Locker studies corresponds to the following T1 Look equation Locker T1 T1 A B 1 tO is the Nulling time i e the time at which the signal intensity crosses the zero on the horizontal axis One can also roughly estimate the t0 value from the graph You can also view the recovery rate per pixel using mouse cursor tracking Click a
19. nd then hover the mouse over the pixel in the image This displays the currently tracked pixel s recovery rate V Please refer to the following article for information about T1 mapping in Look Locker studies Daniel R Messroghli et al Modified Look Locker Inversion Recovery MOLLI for High Resolution T mapping of the Heart Magnetic Resonance in Medicine 52 141 146 2004 To create a T1 report 1 Click z QMass MR 7 6 Quick Start Manual 18 T1 Analysis Module 2 On the Graphic tab from the Report Layout drop down list select T1 This creates a T1 report To set a color range and color map setting 1 Select Settings gt T1 Settings This opens the T1 Settings dialog window Under Color range choose your preferred color range of colors Under Color Map choose your preferred overlay color map V You can specify a default color map in the Configuration File Editor E For instructions on modifying settings refer to the Configuration File Editor documentation To export the relaxation times per slice to DICOM 1 Click the Export button V The exported maps can be saved to disk to pacs or to an OEM database E For instructions on modifying export settings refer to the Configuration File Editor documentation QMass MR 7 6 Quick Start Manual 19 T2 T2 Analysis Module If you have the T2 T2 analysis module you can use QMass to analyze the T2 or T2 decay time of a region of interest in the
20. odule Y You can deselect Auto copy under Contours to prevent copying the contours of the regions of interest to the other images 8 The T2 T2 Analysis tab now shows two curves the curve of the measured values in the color of the region of interest and the fitted curve in black To remove the measurement points that are biased by MR noise and calculate the correct T2 T2 value of the region of interest you must drag the cut off slider to the point where the curve starts to level off O If the curve slopes upward instead of downward at the end make sure to first exclude the corresponding images You do this by clicking the green squares in the bottom right corner of the images in the Thumbnail View Pick up the white triangle at the bottom of the diagram and drag it up This marks the points under the slider as excluded and makes the black curve fit the non excluded part of the measured curve Make sure that the black curve runs through the first measured points The following illustration provides an example 9 The Decay Time box now shows the T2 or T2 decay time Use the icons in the Decay Time box to show or hide the various regions of interest You can display a color overlay of the decay time by selecting Show overlay under Display QMass MR 7 6 Quick Start Manual 21 T2 T2 Analysis Module The result corresponds to the following equation A EXP TE T2 where TE is the Echo Time in ms and whereT2
21. r to the QMass User Manual for instructions To perform an LV function analysis using the Ventricular Analysis wizard 1 QMass MR 7 6 Quick Start Manual In the Study Matrix select the tabs of the various series and check for each series if the correct icons are displayed in the toolbar If needed you can correct the labeling of a series by right clicking its tab and selecting the correct label from the menu Select Analysis gt Ventricular Analysis Wizard Under Series Selection from the LAX series drop down list select the long axis series you want to use as a reference to specify the locations of the mitral valve and the apex If you have loaded a long axis radial scan you can select the long axis slice you want to use in the LAX Slice field From the SAX series drop down list select the short axis cine series you want to analyze Under ED Phase check if the phase presented as the LV ED phase is correct In the Active View pick up the long axis markers and drag them to the correct positions Place the A marker over the apex and place the B markers over the mitral valves LV Functional Analysis Click Next 4 Under ES Phase check the phase In the Active View place the A and B markers as described in the previous step Under Contour Selection select the type of contours that you want to be detected in the short axis images Click Next 5 When the automatic contour detection has finished review the de
22. s Enterprise Solution by clicking Select Defer or Complete in the Close Study dialog window 3 Click the close icon in the top right corner In the log in window click Quit QMass MR 7 6 Quick Start Manual 23 More Information This Quick Start Manual outlines the basics of working with QMass You can find more details and more instructions for example on stress level function analysis in the QMass User Manual On the QMass installation CD ROM you can also find the QMass Installation Manual Release Notes Reference Manual DICOM Conformance Statement and Declaration of Conformity To access the QMass User Manual e In QMass press F1 To access all QMass documentation 1 Look up the QMass installation directory in your file system 2 You can find the QMass documentation set in the Documents directory Or 1 Insert the QMass CD ROM 2 In Windows Explorer browse the directory structure of the CD ROM The documentation is located in the Documents directory QMass MR 7 6 Quick Start Manual 24
23. s contain a summary of patient and study information and a number of analysis results You can create graphic reports save as HTML PDF or as DICOM SC text reports save as TXT or as DICOM SC or XML reports Graphic reports may contain images movie frames movies and result diagrams To create a report 1 Click or press F9 2 From the Report Layout drop down list select a new report type if needed This immediately creates the new report 3 To create a text or XML report select the TXT or XML tab If you are creating a text report you can select the results you are interested in by selecting the corresponding check boxes under Contents You can select the level of detail from the Detail drop down list Click Generate 4 Click Save at the bottom of the Report window QMass MR 7 6 Quick Start Manual 7 Edema Analysis An Edema analysis helps you determine the amount of Edematose tissue in the myocardium This chapter explains how to perform an analysis using the Edema wizard Performing an Edema Analysis QMass features an Edema analysis It is a simple one page analysis tool One should e Create LV endocardial and epicardial contours e Detect and verify the areas of healthy and edema myocardium e Verify the Edema threshold and segmentation To perform an Edema analysis 1 Load an Edema dataset into QMass Y See also Transferring contours from short axis cine series 2 Select the Edema series you want to an
24. tected contours Review both the ED phase and the ES phase by selecting the corresponding View icon E To ensure that analysis results are accurate all automatically detected contours must be reviewed and edited where necessary Y For an overview of all detected contours you can switch to the Study Matrix tab To edit a contour click Al e or a e For detailed instructions on editing refer to the QMass User Manual and then start editing To exclude or include individual images click the green or red square in the bottom right corner in the Thumbnail View This automatically removes or detects contours Click Next 6 To switch between viewing the ED and the ES phase in the Thumbnail View click the corresponding View button in the wizard To change the ED or ES phase and automatically redetect contours select the new phase number under Redetect Contours in the wizard and click Apply REF To obtain regional analysis results make sure that is selected and then click in the Active View to mark the posterior or anterior septum in the current slice Repeat this for the other slices you are analyzing E If you place the reference point at the anterior septum make sure to first change the bull s eye settings so that the cardiac segments are labeled correctly Select Settings gt Bull s Eye On the Display tab under Reference Point Location select Anterior and click OK QMass MR 7 6 Quick Start Manual 5 L
25. tions refer to the QMass Installation Manual on the installation CD ROM To start QMass e Double click the QMass icon on the desktop Or e Select Start gt All Programs gt Medis QMass gt QMass 7 6 To open a study 1 Click or select File gt Open Study In the dialog window browse the directory structure and select the directory in which the series are located 2 In the upper pane of the dialog window double click the series or select the series and click OK O Make sure to leave the Comparison mode check box unselected when you are opening a study that is not a comparison study To select a series e If you have opened more than one series you can switch between the series by clicking their tabs under the Study Matrix Move the mouse over a tab to view a tooltip that shows the series name A O O O E S401 S501 5601 51501 51801 QMass MR 7 6 Quick Start Manual 2 Quick Tour To browse a series e Use the arrow keys on your keyboard to scroll the images in the Thumbnail View and in the Active View To select an image e Click an image in the Thumbnail View to select it This displays the image in the Active View In the Thumbnail View the selected image is marked with a red frame To view a series in the Movie window F in the toolbar or press F5 To scroll the series in the Movie window e Use the arrow keys on your keyboard To switch between series in the Movie window e Press the
26. xplains how to perform an AAR analysis Performing an AAR Analysis QMass features an AAR analysis It is a simple analysis tool One should e Load and create LV endocardial and epicardial contours in both Edema and DSI series e Do an Edema and DSI analysis on the respective datasets To perform a AAR analysis 1 Load a DSI and Edema dataset into QMass Start the AAR Analysis Wizard by pressing next to pa and select AAR Complete a DSI analysis on the DSI dataset Complete an Edema analysis on the Edema dataset Review the AAR Results in the AAR tab of the AAR analysis oo lee E In the AAR analysis the edema volume is always assumed to be larger or equal to the volume of the scar DSI core tissue If the scar tissue is greater in volume than the edema volume then the volume and calculations will be rounded to zero as opposed to showing the negative values QMass MR 7 6 Quick Start Manual 13 TSI Analysis In QMass you can perform a first pass perfusion analysis which is called a Time Signal Intensity TSI analysis if your organization has obtained the TSI module To do this you must take the following steps draw endocardial and epicardial contours place reference points register the contours To draw endocardial and epicardial contours 1 Select File gt Open Study select the series you want to analyze and click OK If the Time Signal Intensity toolbar with the A icon does not appear select the Study
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