QFlow 5.6 User Manual
Contents
1. ccccccsccccccccscccceesccessccesssccesssceseccs 13 D7 Hiding and Showing Patient and Study Data kk eee ee eee 13 5 8 Hiding and Showing Contours Center Points and Flow Profiles eeeeeees 14 5 9 UNWiraDDING PITA SOS ca ky k 4400008451220258 0p4151 20 4005y R ONE N WE sno le e KA e a UA sae kbk 14 5 10 Performing Distance MeasurementS EE keke eee ke ee eee eee eee eee ee eee eee 14 DT ADDYS COO COOMO lt aye s lava EAR k n NAyek EE G TEE EWAYA W k DAN DE EWANA E 2 KN 15 5 12 Applying Background SUDtractiON cece eee ke eee ke ee eee ee ee eee ee ee eee eee 15 6 Performing Flow Analyses of Vessels seesesesecececsecesecececsecececececcececececeeseseceo 17 6 1 Performing Flow Analyses Using Automatic Contour Detection j j jJ eEe lJl 17 6 2 VIEWING Analysis ResUl Si kk cots a w S la kake Sete ka W eda ke WA Sete ka W W na ke W Sete ku w ede seeds 18 QFlow 5 6 User Manual VII 6 3 Applying a Background Correction Method h ke ee ee ee eee eee eee e 20 6 4 Performing a Customized Contour Detection kk eee ee eee ee 22 6 4 1 Contour Detection SettingsS sessescessesoesossescesoesoesoesessesoesoeseeee 23 7 Performing Flow Analyses of Valves sessesesesecececsecececececsecececececsececececeeseceoeo 26 8 Creating and Editing Contours 144454535135444 5ak1 50 eba l2 E ER 28 8 1 About Detec2. ee eee eee eee eee 14 valve analysis results viewing 26 valve analysis performins 26 velocity profile creating j jjjjj j 33 velocity profile viewing j j jjj 33 Viewing a flow profile ccc cee eee eeeees 33 QFlow 5 6 User Manual viewing a velocity profile 33 viewing an intensity profite 33 VIEWING FLOW results ccc cee eee eeeeeeeees 18 viewing valve analysis results 26 window and level adjusting 12 window and level optimizing 12 window width and level resetting 13 WOIKSD ACC sia yen kah r E GA enue Weh naa 5 AME TEDOS xoxa ye Sayan a v n eka x D gan y se kek 34 XML reports Creating l 36 zoom factor applying default 11 zoom factor specifying default 11 ZOOMIE Dy n r r cae ewece 11 47
3. kk k 14 Phase View printing J z e 37 Phase View SAVING kk k 37 PIXELMOGE Sava nekeyn HERA D RAN du i RENAN h 30 PONE TOO uraren kela e xie n k Wae a XAR Nen AE k n 29 DIMMU r vr 37 regurgitant fraction calculating 19 removing color coding _ 15 removing curves from flow diagrams 19 report typeS keke ee eee eee 34 reports adding comments j j j 36 reports PMNUING 2s S va l y k Y nO kan ve ku e L k 37 freportsy Savio 2 n ly ceert kulak ke b k kek 37 resetting window width and level 13 ROI labels Adding j l 20 rubberband editing j EEz 30 Rubberband Tool sceeceeececeeeeeees 30 Saving contours in contour files 32 Saving to DICOM server 38 Saving to file or network 38 selecting IMAGES e k k 10 SNOPLCUL KEYS yalan kes l w eel W ne 2yan k ya 42 specifying default zoom factor 11 46 Index Stal nO OE OW icoicssuce oera E A 3 studies OPENING e kk ke 3 subtracting background flow 21 subtracting surrounding contour flow 21 surrounding contour correction applying 21 text reports creating j j j kn 35 LOOLDU LOL a kenl e k H ya k y y k We 6 Trace ale PR ND k 29 unwrap phases
4. October 15 2013 9 10 400 56 1 QFlow 5 6 User Manual 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 support medis nl E mail support medis nl Web www medis nl Web www medis nl QFlow 5 6 User Manual lI Legal Notices Copyright Notice 2003 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 Acknowledements QFlow is a registered trademark of Medis Associated BV in the United States and in other countries Microsoft Windows Windows XP Windows Vista and Windows 7 are either registered trademarks or trademarks of Microsoft Corporation in the United States and or other countries All other brand product and company names mentioned in this document are trademarks or registe
5. e Select all the expiring licenses e Click Delete e Click Close e Click Close e Click Install an additional license e Browse to the license file with the non expiring license e Make sure all licenses are selected e Click Install e Click Close You are now able to see the licenses with their correct expiration date in View available licenses Multiple slices in one series If there are multiple flow locations combined in one series and you are not able to separate them the arrows up and down keys will then allow you to switch slices Reference 12 Function Keys When you are working with QFlow you can use the function keys on your keyboard to quickly perform the following tasks show the graph window view the flow profile open the report window Reference 13 Shortcut Keys Shortcut keys are combinations of keys that you can press on your keyboard to give a command Shortcut Use to General CTRL Q close QF low Studies and Contour Files CTRL O open a study CTRL L load a contour file CTRL S save changes in the current contour file CTRL SHIFT S save the contours as a new contour file CTRL drag move the active contour relative to the image in the Phase or Modulus View drag using the middle mouse pan the image button or mouse wheel right click and adjust the window and level of the images A horizontal movement adjusts drag the window width and a vertical movement adjusts t
6. 5 6 User Manual 13 Working With QFlow 5 8 Hiding and Showing Contours Center Points and Flow Profiles You can hide the contours center points and velocity or intensity profiles that are shown in the Phase View the Modulus View and the Thumbnail View You can choose to hide them all or to hide specific elements To hide or show contours center points and flow profiles 1 Select Settings gt Main in the menu bar 2 To hide all contours center points and velocity or intensity profiles select the Display tab and under Hide select the All drawings check box Clear this check box to display these elements again To hide specific types of contours or data under Display clear the check boxes of the contours or data you want to hide Under Display clear the Show ROI statistics check box to hide the analysis results shown in the Image View Select the check box to show them 5 9 Unwrapping Phases In velocity encoded images values in the phase images may get wrapped if they do not fit the scale used QFlow allows you to adjust the scale for a specific study To unwrap phases 1 Select Settings gt Main 2 On the Phase unwrap tab drag the slider to modify the scale 3 Click Apply This instantly applies the new scale to the image shown in the Phase View You can adjust the scale or click Reset to return to the initial scale 4 Click OK 5 10 Performing Distance Measurements QFlow enables you to perform d
7. gt Open Study from the menu bar In the dialog window browse the directory structure and select the directory in which the series you want to analyze are located 2 Inthe top right pane of the dialog window select the series and click OK P If the series are located in different subdirectories select the top directory in the browser select the Recursive option in the top right corner and then click Rescan This displays all series from all subdirectories in the top right pane Some scanners store phase and modulus series separately by default To combine QFlow 5 6 User Manual separate phase and modulus series in the Open Study dialog window press CTRL and select them and then click OK 3 3 Loading Contour Files Contours are the basis for calculations in QFlow They are created automatically or manually when you perform an analysis Contours are saved in contour files The contour file is loaded automatically with the associated series if the contour file was saved in the default contour directory with the file name proposed by QFlow Otherwise you must load the contour file manually ep You can enable or disable automatic loading of contour files by editing the configuration settings For instructions refer to the QFlow Reference Manual y To change the default contour directory select Tools gt Options and then select a new directory on the General tab under Folders behind Contour Folder To load a co
8. OE e 35 adding labels to regions of interestcurves in als sl yl i SAM NM YN N N ND N a 20 adjusting brightness k J_ j_J_ i 13 adj stin6 CcOD AS y w l 453005512522224 2 21an 13 adjusting window and level 12 applying background correction 21 applying Color coding 15 applying default zoom factor 11 applying surrounding contour correction 21 reas imal K S yi i k l n sect Kak kak ad ka 30 automatic contour detection 17 background correction applyins 21 brightness adjusting j j j en 13 browsing images keke kek ee k 10 calculating regurgitant fraction 19 color coding applying j j lll 15 color coding removing j j _ i 15 contour detection settinss j j 24 CONTOUR NiE Saanen 32 contour files loadins j j je j 4 contours Copying ssssessseseesescescesoeee 30 contours deleting _ ekn 31 contours drawing ssssessesescecesesceeeo 28 QFlow 5 6 User Manual contours SAVING cisions cei kk kk kk k k 32 contrast adjusting hL k na 13 CopyinS COtO U l 3 5 5455 41 42uesaaes una n e 30 creating a flow profile j j j 33 creating a velocity profite 33 creating an intensity profile 33
9. Performing Flow Analyses of Vessels This chapter explains how to e perform a flow analysis of a vessel using the automatic contour detection e view analysis results and calculate the regurgitant fraction e apply background correction to the analysis results e perform an analysis using customized contour detection 6 1 Performing Flow Analyses Using Automatic Contour Detection When you are performing a flow analysis of a vessel you must first detect a sample contour in one of the images which is then used to guide the automatic detection of contours in the other images of the series amp Automatic contour detection is performed based on the settings specified in the Contour Detection Settings window You can access these settings by selecting Settings gt Contour Detection For a description of the contour detection settings refer to section 6 4 1 amp Make sure to measure flow parameters only in sequences that are validated for flow measurements Reliable measurement results can only be obtained with validated acquisitions amp When you are using the analysis to obtain results on the average flow velocity make sure that contours are present in every phase E If you want to perform a flow analysis of a valve you must manually draw contours For instructions on creating and editing contours refer to Chapter 7 To perform a flow analysis of a vessel 1 Select the image that shows most contrast between the vessel and the
10. background 2 Click in the toolbar 3 Click 4 Inthe Phase or Modulus View click to select the center point of the vessel you want to analyze Working With QFlow 5 Verify that the contour is correct The maximum velocity pixel within the contour in this phase is marked by an orange square the minimum velocity pixel is marked by a blue square To create a new contour you can place the center point again To draw or edit the contour click n or and trace the contour in the Modulus or Phase View or click and drag the contour To reshape the contour right click in the view select Contour Shape and select one of the reshaping options from the submenu 6 If you want to analyze a second third or fourth vessel in the same series click QI l or in the toolbar and create a contour for each of the vessels you want to analyze as described in steps 3 through 5 7 Click BSA or press CTRL D to automatically detect contours in the other images of the series Q Some series require customized contour detection For a detailed description of when best to use which type of contour detection refer to section 6 4 You can detect contours for all vessels you marked in one go Click the arrow next to this icon SA49 and from the submenu select Detect Contours of All ROIs This detects contours for all vessels regions of interest you marked in the entire series 8 Check if all contours have been detected co
11. edge of ROI 4 e ROI 4 area which subtracts the average velocity values of the pixels inside ROI 4 e Stationary Flow Fit which subtracts slowly varying velocities inside ROI4 The Stationary Flow Fit is based on the principle that there are 3 types of flow regions in Velocity Encoded or Phase Contrast images 1 Air with random phase e g lungs 2 Vessels with flow 3 Static tissue QFlow 5 6 User Manual 20 Working With QFlow In theory the flow in static tissue will be zero In practice errors occur causing small flow offsets that vary slowly over time The Stationary Flow Fit estimates and corrects this offset by measuring the flow velocities in static tissue and subtracts it from flow in non static tissue To apply the surrounding contour correction method 1 Select Settings gt Main or click 2 On the Background subtraction tab from the Subtract background flow drop down list select Surrounding contour 3 In the Distance of subtraction contour field specify the distance in pixels of the surrounding contour s from the detected or traced contour s 4 Inthe Phase View and the Modulus View the surrounding contour is shown as a dotted line 5 Click Close The area between the surrounding contour s and the detected or traced contour s is now used for subtraction 6 Press F7 This displays the diagram window 7 Review the corrected graph If adjustments are needed repeat this instruction
12. ee eee eee eee eee eee eee eee eee ee ee eeeee 36 11 Printing Saving and E MainG lt ccs2csscxccessscassaeasennsaaseduciaussaneiessscrostessenesaasseseianss 37 TET SPRING cessere terrena E NEEE EEEE TENTENE 37 HZ SVN ra a y nO a n SA T ee ws Saws A Ge P Bal 37 er zol la yy Bnr gde 38 TROUBLE SHOOTING 414 4x456 K tete an e dae Kl E E Ran l neren KE Ece AN b ane V D CE BAD b vara v eceba Sea nan R 40 REK KENC a4a y k 820 XU Va SA KERO SE S200 0100 EA 1 EREN GO WEN SAS NE WO AW Va A WBA En S Ye te Tekane Ken 41 12 PURMCHOM KOYS yi siy kan kabe Kay Kan N Q N N WA k K Ne Kad W Q W d Q NE Bak 41 13 SHOFLCUE KOY Ss s niy ea a stead Kaya Ko a ke dale ce wate KO Sa os ON Ka Kekan a bre a 4 42 INDEX se herete iene EEEE ENE ENEE Seca EEEE EE EEEE EEEE EE EE 45 QFlow 5 6 User Manual VIII Introduction 1 About QFlow QFlow is the Medis software solution for the quantitative analysis of velocity encoded MR studies It enables cardiologists radiologists and technicians to quantify arterial and transvalvular blood flow QFlow features e automatic contour detection e easy to use functionality for editing contours e graphical display of results e reporting e saving of images movies and results 2 Support Medis is committed to offering high quality products and services If you have questions about the s
13. gradient from the maximum velocity curve The diagram sliders are the white triangles under the diagram This will display the mean pressure gradient under the diagram By clicking in the graph the graph will show the mean min and max for a particular trigger time To calculate the regurgitant fraction 1 In the diagram window select the Volume diagram from the Show drop down list QFlow 5 6 User Manual 19 Working With QFlow 2 Inthe top right corner of the Graphs dialog window select the Regurgitation mode option for the appropriate curve This displays the regurgitant fraction under the diagram 3 If necessary you can drag the diagram sliders to edit the calculation To add or modify labels for the ROIs 1 Select Settings gt Main 2 Click or On the ROIs tab under ROI names and options you can type labels for the various regions of interest 3 Click Apply and then click Close The label is now shown in the diagram window and in reports 6 3 Applying a Background Correction Method You can subtract background flow from the analysis results to correct the results for the positive or negative offset of the background flow There are three methods for subtracting background flow e Surrounding contour which subtracts the average velocity values of a small area surrounding the contour for example the vessel wall e ROI 4 contour which subtracts the average velocity value of the pixels on the
14. gt Options and then selecting a new directory on the General tab under Folders behind Contour Folder 2 You can save any changes you make by pressing CTRL S or by clicking again To save a contour file in another directory on your system or network 1 Select File gt Save As or press CTRL SHIFT S This opens the Save Contours and Settings As dialog window 2 Select the directory in which you want to save the contours then select CON or DCM as the file type from the Save as type drop down list The directory initially specified is the default contour directory If you save the contour file in this directory it is automatically loaded with the associated series the next time it is opened in QFlow If you save it in another directory you must load the contour file manually as described in section 3 3 3 Click Save You can save changes by pressing CTRL S or by selecting File gt Save Working With QFlow 9 1 Working With Flow Profiles This chapter explains how to e create flow profiles e view flow profiles 9 2 Creating Flow Profiles A flow profile shows the individual pixel values along a line To create a flow profile 1 Click in the toolbar 2 Inthe Phase or Modulus View click the start point and end point of the line that you want to look at The following illustration shows an example 9 3 Viewing Flow Profiles You can view flow profiles in a diagram and also view additional profiles parallel
15. the currently selected image or from all images contours marked areas and profile lines To delete the currently selected contour marked area or profile line 1 In the toolbar select the icon of the element that you want to delete 2 Press DEL or right click in the Phase or Modulus View and select Delete current contour To delete a contour marked area or profile line from the currently selected image or from all images e Right click in the Phase or Modulus View select Delete in Current Image or Delete in All Images and then select the name of the element you want to delete Working With QFlow 9 Saving Contours and Image Settings Contours can be saved in a contour file that is associated with the series The contour file also stores any comments that you added to the report and the following image properties window width and window level specified Zooming and panning applied and the phase unwrap value You can save a contour file as a CON file or a DICOM file in the default contour directory or ina directory on your system or network A contour file does not store the DICOM metadata or the MRI images only the contours created in QFlow the settings specified and the comments added to the report To save a contour file in the default contour directory 1 Click Lal or select File gt Save This saves the current contours to the default contour directory You can change the default contour directory by selecting Tools
16. to the profile you created To view the flow profile 1 Click press F8 or select View gt Profile This creates a diagram 2 To view a graph that shows the intensity values select Modulus under Show To look at a range of parallel profiles in the region of interest select Square under Dimension This draws a box around the initial profile in the image and adds the profiles that run parallel to the initial profile in the diagram a gt You can add the flow profile diagram to a graphic report For instructions refer to section 10 2 QFlow 5 6 User Manual 33 Working With QFlow 10 Creating Reports This chapter explains how to create graphic reports add graphs images movie frames and flow profiles to a graphic report create text reports create XML reports add comments to reports 10 1 About Reports Reports enable you to export information from QFlow You can generate three types of reports graphic reports which you can save in HTML or PDF format or as a DICOM SC plain text reports which you can save in TXT format or as a DICOM SC TXT reports can be viewed in any text editor and imported into spreadsheet or database applications XML reports which contain data structured in XML format This type of report can be shared between XML based applications 10 2 Creating Graphic Reports Graphic reports contain both text and graphics You can add your comments to a graphic report as well as dia
17. 5 Reviewing This chapter explains how to e review series e zoom e pan e adjust window width and level e adjust contrast and brightness e hide and show patient and study data e hide and show contours center points and flow profiles e unwrap phases e perform distance measurements e apply color coding to visualize various velocities 5 1 About the Image Settings The image settings described in this chapter can be stored for the next time you work with the Same study You do this by saving the settings in a contour file For instructions refer to Chapter 9 The following image settings are stored e zoom factor e panning e window width and window level e phase unwrap value 5 2 Reviewing Series You can review series in the main window or in the Movie window To browse the series e Use the arrow keys on your keyboard to browse the images in the Modulus View and Phase View QFlow 5 6 User Manual 10 Working With QFlow To select an image e Click an image in the Thumbnail View to select it This displays the image in the Phase and Modulus Views To switch between phase and modulus images in the Thumbnail View e Select View gt Modulus Images or View gt Phase Images To view the series in the Movie window e Click HI in the toolbar or press F5 5 3 Zooming To zoom in e In the toolbar click Or e Press To zoom out e In the toolbar click Or e Press To specify a default zo
18. Profiles You can copy the following elements to one or more images contours marked areas and profile lines QFlow 5 6 User Manual 30 Working With QFlow The Undo command only works if you copy and paste an element to a single image If you want to copy an element to multiple images make sure to save your contours before you start copying In this way you can always reload the contours with which you started Press CTRL S or select File gt Save To copy a contour marked area or profile line to another image 1 In the toolbar select the icon of the element that you want to copy 2 Press CTRL C or right click in the Phase View or Modulus View and select Copy 3 Inthe Thumbnail View select the image you want to copy to 4 Press CTRL V or right click in the Phase View or Modulus View and select Paste gt Single To copy a contour marked area or profile line to a range of images 1 In the toolbar select the icon of the element that you want to copy 2 Press CTRL C or right click in the Phase View or Modulus View and select Copy 3 Press CTRL F to copy to the images from the currently selected image onward Press CTRL B to copy to the images from the currently selected image backward Press CTRL SHIFT V to copy the element to all images in the slice You can also use the menu options in the context menu or the Edit menu 8 5 Deleting Contours Marked Areas and Profiles You can delete the following elements from
19. To apply the ROI 4 background correction method This method assumes that you have not used ROI 4 yet If you have delete the ROI 4 contours first or use the surrounding contour correction method instead You can create a ROI4 contour or a ROI4 area 1 Inthe toolbar select 4 2 Click or to create a subtraction contour 3 gt For detailed instructions on drawing contours refer to section 8 1 For detailed instructions on marking areas refer to section 8 3 In the Phase or Modulus View draw an ROI as close to the vessel or valve as possible 3 Copy the ROI 4 contour or area to the other images by pressing CTRL C and then CTRL SHIFT V 1 Lankhaar JW et al Correction of Phase Offset Errors in Main Pulmonary Artery Flow Quantification Journal of Magnetic Resonance Imaging 22 73 79 2005 QFlow 5 6 User Manual 21 Working With QFlow 10 11 Check the contours or areas in all images to verify that they do not cover parts of the analyzed vessel Edit the contours if necessary P You can move a contour as follows Select its ROI icon in the toolbar then press CTRL and use the left mouse button to move the contour Press F7 This displays the diagram window In the diagram window click 4 From the Show drop down list select one of the velocity graphs Check if background flow is measured in this region of interest or Select Settings gt Main and select the Background subtraction tab From the Su
20. aphs images and MOVEN AME Sier rer E EEEE 35 graphic reports creating j j ___ 34 gr phs PANNE LL sl y 44 see be h a n 37 graphs SAVING y si sukan uk uz k ebAva AWAN AN 37 images browsing k kk kk k 10 images panning k kk k 12 images selecting k na 10 images ZOOMING ccccccccccccsscesccescces 11 intensity profile creating j j 33 intensity profile VIEWING j E jj j 33 interpolation method j jl 24 EMC MOGE s 4 xalan x SO ken wa ben N X N n ONA WAW E 28 loading contour files j _ j 4 manual contour detection 66 22 MARKING areas ys 13452344522 e e 30 measurements performins 14 measuring distances ek 14 mirroring flow curve in diagram 19 Modulus View printing j jJj 37 Modulus View SAVING ceeecceeccceeeees 37 moto m l00 4 5454545544555532525555544425555 3444 24 movie frames SAVING j meene 3 7 QFlow 5 6 User Manual MOVIES SAVING k ya k k l k denser QR KER AW 0A0 37 OPENING studies e keke 3 optimizing window and level 12 Dall DD r 12 performing a flow analysis 17 performing a valve analysis 26 performing distance measurements 14 phase unwrapping
21. bexin y K ku E Qi 0N 1b N 2 l k KANA 3 6 4 1 24y KA Ay lb 4 0 tes 2 3 Starting QFlow and Opening Studies sessesececececsecececececsececececeesececececeecececseceoo 3 3 1 SAR GINS OE OW ZI N N N DD N DD DD ETE OIO DD 3 3 2 Opening Studies from System Or NEtWOrk csccceecccceecccceccceeeccceececeeeceeeees 3 3 3 LOading CONTOUN F L 5 ya i sus ul y Abad kn y a kek k A be Ka e ka b A e SA SA ANA DAS k Y WA 4 4 Whe OFOW WORKSD ACE econ decors di cee se da cies site aces secsceeebichedeseetacnceescncceeeneaaeenaeiaaees 5 4 1 TDOODAL Sy y n nes e n Se Ce KRA AS Even n es Ce K ve KENARE Y SN A be SE yad HE De KEYS y E Ke 6 WORKING WITH QEL O W siya say 82002503 0 E 3 Qa EWANA QU NE EW N QU WE RE N3 G W 0290300 a0 000 0 y k QAW Ey na GEN 10 5 E ala ME WD VI DN DO DR N Scns canes ek cae DD VE e A KDN YN 10 5 1 ADOUL TNE Mage SEINI S 2 siyay ci E M QUR OEE EEE TEE h 10 5 2 REVISW INS SENES ioe sist siete ane l We kax Sota kaw Wien nn W e db wale iw baye fo turn We ban dials 10 3 3 LOOMING 3 eee Y E N eas AEE ees e DD DN A 11 5 4 PAL T Aks y k AE OAE EEE akli te ewk SK e ake K Weye Re ek d0n Ke ek d earn tbe 12 5 5 Adjusting Window Width and Level cceeccceecccceccceeeecceececeececeenseeeeeees 12 5 6 Adjusting Contrast and Brightness
22. btract background flow drop down list select ROI 4 contour or ROI 4 area depending on the correction method you want to use Click Close In the diagram window review the corrected graph If adjustments are needed repeat this instruction Any results that you now view are corrected for background flow To apply the Stationary Flow Fit When selecting this method a large ROI 4 contour will be placed on each image If spatial aliasing infolding artefacts occur they should be outside the ROI4 This can be done manually by modifying the contour Modifications made to ROI4 in one phase will automatically be copied to all other phases 6 4 Performing a Customized Contour Detection If necessary you can perform a customized contour detection which uses a different model or method or which applies to a different range of images than automatic contour detection Q A customized contour detection only uses a single contour detection method whereas automatic contour detection always combines the motion and deformation methods Automatic contour detection always applies to all images that do not have contours yet and uses the nearest contour instead of the currently selected contour as a model You use customized contour detection in the following cases if the vessel gradually changes shape during the cardiac cycle interpolation method if the vessel significantly changes shape during the cardiac cycle deformation method if the
23. creating graphic reports ceecceeeees 34 creating text reportS k 35 creating XML reports c cece ee ceeeceeees 36 curves in flow diagrams adding 19 curves in flow diagrams removing 19 customized contour detection performing 22 customizing contour detection 22 default zoom factor applying 11 default zoom factor specifying 11 deformation method 24 deleting Contours eeee eee ee 31 deleting distance measurements 15 distance measurements deleting 15 distance measurements performing 14 distances measuring E k n 14 drawing COntOUIS MH eke ke eee 28 editing contours using rubberband editing 30 flow analysis using automatic contour Q le C lO use yy41 5422255154552418 260 29214444444 17 flow analysis using customized contour CELECUION sya a yA ken h W a 22 flow analysis performing 17 45 Index flow curve mirroring j j 19 flow profile creating j j e_e e 33 flow profile viewing j 33 flow results viewing nn 18 UNCON KEYS su ay vek K k na V Kak Kal E KE KA VADERA 41 graphic T epOlSy cay s e ky n yaya k h k k k u kaw k n 34 graphic reports adding flow profiles 35 graphic reports adding gr
24. cree Besluit Medische Hulpmiddelen Stb 243 1995 and the European Medical Device Directive 93 42 EEC North American Regulations QFlow 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 QFlow complies with the requirements of the Canadian Medical Devices Regulations and has been licensed as a Class II medical device QFlow 5 6 User 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 Press and release the left mouse button If you are left handed you may have set the right mouse button as your primary mouse button Double click Press and release the left mouse button rapidly twice If you are left handed you may have set the right mouse button as your primary mouse button Right click Press and release the right mouse button If you are left handed you may have set the left mouse button as your secondary mouse button Middle click 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 Keyboard SHIFT click Press and hold down the SHIFT key on your keyboard while you click a button or object CTRL O Press and hold down the CTRL key on your keyboard while you p
25. e 1 If you want to save a graph or movie right click in the window and select the save option If you want to save the Phase or Modulus View image right click and select Snapshot gt Save Image If you want to save a report click Save in the Report window If you want to change the report s or graphical object s file name click in the Filename text field and type the new name Select DCM from the drop down list Click OK 11 3 E Mailing QFlow has a custom e mail tool that enables you to e mail movie frames movies graphs profiles and reports directly from QFlow To e mail a report or graphical object 1 If you want to e mail a graph or movie frame right click and select the send option If you want to e mail a Phase or Modulus View image right click in the Phase or Modulus View and select Snapshot gt Send Image By Email QFlow 5 6 User Manual 38 Working With QFlow If you want to e mail a report click Send in the Report window 2 Inthe dialog window that opens type the e mail address of the person to whom you want to send the item in the To text field You can change the standard subject of the e mail in the Subject text field and write an accompanying message in the Comments text field 3 Click Send 4 The bar at the bottom of the dialog window indicates progress A message appears if the mail has been sent successfully 5 If you want to send the e mail to another recipient type
26. es the strength of the smoothing effect applied Note that the higher the value the less smoothing is applied The default value is 5 Q These three settings also influence the automatic contour detection that you start by clicking Performs the customized contour detection in all images Working With QFlow Missing Performs the customized contour detection in the images that do not contain contours yet Active Performs the customized contour detection only in the image that is currently selected in the Phase View and Modulus View Active Takes the contour from the image that is currently shown in the Phase View and Modulus View as a model for the contours to be detected Closest Takes the contour that is nearest to the target image as a model for contour detection QFlow 5 6 User Manual 25 Working With QFlow 7 Performing Flow Analyses of Valves This chapter explains how to e draw a contour around the valve e copy the contour to the other phases e view analysis results To draw a contour around the valve 1 In the toolbar click oO to indicate that you are drawing your first region of interest ROI or click one of the other ROI icons 2 To trace the contour click NI To mark the contour by placing points click P If these tool icons are not active you are in Pixel Mode To switch to Contour Mode select Contours gt Contour Mode ep For detailed instructions on tracing or on placing points refe
27. grams snapshots and movie frames To create a graphic report Click This creates a report in the format last selected If this is not a graphic report perform the following steps press F9 or select View gt Report Under Format click Graphic You can further customize the report if custom layout templates have been created for your organization From the Report Layout drop down list select the custom layout template you want to apply Click Generate to create the new report Click Save to save the report Working With QFlow To add a graph image movie frame or flow profile to a report 1 Right click in the graph image or movie window and select the menu option for adding the graph image or movie to a report In the Image Name text field you can type a new name for the graph image or movie frame In the Comments field of the dialog window you can enter additional comments Click OK Click This creates a report in the format last selected If this is not a graphic report click Graphic under Format in the toolbar press F9 or select View gt Report 4 Click Save to save the report 10 3 Creating Text Reports Text reports contain text only You can select the type of information and the level of detail that you want to see in the report To create a text report Click This creates a report in the format last selected If this is not a text report perform the followi
28. he window level Zoom in on the images zoom out scroll forward through the Thumbnail View drm inontnemases st tomers ous be Thumb view Reference scroll backward through the Thumbnail View reset window width and level optimize window width and level Elements CTRL Z undo the last action CTRL Y redo the action that was undone CTRL X cut the currently active element and place it onto the clipboard CTRL C copy all elements from the active image to the clipboard CTRL V paste the element to the selected image CTRL F paste the element or elements to all images from the selected image onward paste the element or elements to all images from the selected image CTRL B backward CTRL SHIFT V paste the element to all images DEL delete the currently active element from the active image SHIFT DEL delete all elements in the active image CTRL SHIFT DEL delete all elements in the entire slice CTRL D automatically detect contours based on the active contour CTRL gt move the profile line to the right CTRL move the profile line to the left ALT SHIFT S smoothen the active contour QFlow 5 6 User Manual IN CJ Reference QFlow 5 6 User Manual 44 Index adding comments to reports 000 36 adding curves in flow diagrams 19 adding flow profiles to reports 35 adding graphs images and movie frames to FEDOM Siva N VR
29. ile Click the arrow next to this icon to select an item to delete indicate that you are detecting drawing or editing the contours of a region of interest draw a line across a vessel to view its velocity or intensity profile draw or edit a contour by tracing This icon is only active when you are in Contour Mode Select Contours gt Contour Mode draw or edit a contour by placing points This icon is only active when you are in Contour Mode Select Contours gt Contour Mode apply rubberband editing to a contour This icon is only active when you are in Contour Mode Select Contours gt Contour Mode place a center point in an image This automatically creates a contour that can serve to guide the automatic detection of contours in the other images This icon is only active when you are in Contour Mode Select Contours gt Contour Mode perform a distance measurement mark the vessel area at pixel level This icon is only active when you are in Pixel Mode Select Contours gt Pixel Mode erase pixels from the marked area This icon is only active when you are in Pixel Mode Select Contours gt Pixel Mode perform automatic contour detection Click the arrow next to this icon to specify if current contours must be redetected or not By default existing contours are redetected Medis General Toolbar launch Medis website launch Medis help manuals Working With QFlow
30. istance measurements to determine the diameter of a vessel To perform a distance measurement 1 Click in the toolbar Working With QFlow 2 Inthe Phase View or Modulus View click to place the starting point in the image This inserts a yellow cross 3 Click to place the end point This opens the Set Distance Measurement dialog window 4 Select a label for the distance The default labels are Label 1 Label 2 or Label 3 ep For instructions on changing the default labels refer to the QFlow reference manual 5 Click OK The distance in millimeters is now shown in the image and added to the report To delete distance measurements e Select Edit gt Delete Distance Labels and then select a distance label or select Delete All 5 11 Applying Color Coding You can apply color coding to visualize the velocities in the modulus images Red is used to indicate positive flow and blue to mark negative flow To apply color coding Click To remove color coding e Click El 5 12 Applying Background Subtraction To apply a background correction method e Select Settings gt Main or click e On the Background subtraction tab from the Subtract background flow drop down list select Surrounding contour QFlow 5 6 User Manual 15 Working With QFlow ep See 6 3 Applying a Background Correction Method how to select a background correction method QFlow 5 6 User Manual 16 Working With QFlow 6
31. n the text field and click OK 3 Click Generate This adds your comments to the report QFlow 5 6 User Manual 36 Working With QFlow 11 Printing Saving and E Mailing This chapter explains how to e print graphs and reports e Save graphical elements such as movie frames movies graphs snapshots of the Phase or Modulus View and save reports to a location on your system or network e Save graphs snapshots of the Phase or Modulus View and reports as DICOM secondary captures e e mail movie frames movies graphs snapshots of the Phase or Modulus View and reports 11 1 Printing You can print graphs and profiles with a short overview of basic patient and study details You can also print reports that may include a number of graphs and images Refer to Chapter 10 for information on how to create and customize reports To print a graph or a report 1 In the diagram or profile window click Print for a preview You cannot modify the contents of this preview Click Print 2 Inthe Print window specify your printing preferences and click Print 3 Click Close 11 2Saving You can save movie frames movies graphs profiles snapshots of the Phase or Modulus View and reports in various file formats to a location on your system or network You can also save graphs profiles snapshots of the Phase or Modulus View and reports as DICOM secondary captures to a location on your system or network gt For instruc
32. ng steps press F9 or select View gt Report Under Format click Plain Text This creates a plain text report according to the content items last specified To modify which sections the report shows perform the following steps Under Contents and under Show select the type of information that you want to include in your text report The Summary option adds a section that provides general results and information on the type of background correction applied y The Full Table option adds a table with detailed results per image If you want to export the data to a spreadsheet or database application make sure to select the correct marker for the end of each column from the Column Separator drop down list Click Generate to create the new report Click Save to save the report QFlow 5 6 User Manual 35 Working With QFlow 10 4Creating XML Reports XML reports contain data structured in XML format This type of report can be imported into applications that support XML To create an XML report 1 Click zs press F9 or select View gt Report This creates a report in the format last selected If this is not an XML report perform the following step 2 Under Format click XML 3 Click Save to save the report 10 5 Adding Comments To Reports You can add your own comments to a report To add comments to a report 1 At the bottom of the Report Window click Add Comment 2 Type your comments i
33. ntour file 1 If the study is not opened yet follow the instructions in section 3 2 or select File gt Load 3 In the Load Contours and Settings dialog window select the directory in which the contour file is saved from the drop down list 4 Double click the contour file or select the contour file and click Open QFlow 5 6 User Manual 4 The QFlow Workspace The QFlow main workspace consists of a menu bar a set of toolbars and three views MENU BAR TOOLBARS em eee Pret UnBen 9 7 PHASE view W MODULUS VIEW SA N THUMBNAIL VIEW Jma a 4 1 Toolbars File Toolbar open a series load a set of contours Save a set of contours show findings dialog open the reporting window show the flow series as a movie show analysis results in a graph view the velocity or intensity profile take a snapshot which you can save or add to a report Click the arrow next to the icon and select the Phase or Modulus View Zooming Toolbar switch between editing mode and window level mode You can see which mode is active by checking the type of cursor Zoom in zoom out apply the zoom percentage that you specified in the zoom drop down list You can access the zoom factor list by clicking the arrow next to this icon apply velocity color coding Undo Redo Toolbar undo your editing actions a redo your editing actions delete the selected contour or prof
34. oftware or if you would like to make suggestions for improvements in the software or in the documentation please contact the Medis helpdesk If you contact the Medis helpdesk by e mail mention the name of the software and the version number in the subject field To look up the version number of your software select Help gt About in the menu bar North and South America Medis medical imaging systems Inc E mail support medis nl Telephone 1 919 278 7888 working days 9 00 17 00 EST Europe Africa Asia and Australia Medis medical imaging systems bv E mail support medis nl Telephone 31 71 522 32 44 working days 9 00 17 00 CET 3 Starting QFlow and Opening Studies This chapter explains how to e start QFlow e open studies from a location on your system or network e load contour files 3 1 Starting QFlow QFlow must be installed and the licensing mechanism must be enabled before you can start E For instructions on installing QFlow and on enabling the license mechanism refer to the QFlow Installation Manual To start QFlow e Double click the QFlow icon on your desktop Or e Select Start gt All Programs gt Medis QFlow gt QFlow 5 6 3 2 Opening Studies from System or Network After you have started QFlow you select the series that you want to analyze To perform a flow analysis QFlow requires both a phase and a modulus series To open a study from your system or network 1 Click Bw or select File
35. om factor e Select View gt Zoom or click the arrow next to the drop down menu and select a zoom percentage from To apply the default zoom factor e Click This applies the zoom factor specified in the zoom list QFlow 5 6 User Manual 11 Working With QFlow 5 4 Panning 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 5 5 Adjusting Window Width and Level You can have QFlow determine the optimal window width and level settings for the current series and you can also adjust window width and level settings manually To optimize window width and level automatically e Inthe Phase or Modulus View right click and select Optimize W L Or e Press 2 on the keyboard To adjust window width and level manually e Inthe Phase or Modulus View right click and drag the mouse Moving the mouse to the left or right adjusts window width Moving the mouse up or down adjusts window level 1 Click in the toolbar QFlow is now in window width and level mode Or 2 Inthe Phase or Modulus View drag the mouse anywhere in the image using the left mouse button Moving the mouse to the left or right adjusts window width Moving the mouse up or down adjusts window level Or 1 Select Settings gt Main 2 On the Image tab drag the Window and Level sliders You can also enter a value in
36. r to section 8 2 To copy the contour to the other phases 1 Select Edit gt Copy or press CTRL C 2 Select Edit gt Paste gt All or press CTRL SHIFT V 3 Use the Thumbnail View to browse the phases Check that the contour is correct and that it covers no other structures in any of the phases If needed you can edit the contour using the trace tool the point tool or the rubberband tool P To reposition a contour press CTRL and then drag the contour ep For instructions on editing contours using the rubberband tool refer to section 8 2 To view analysis results 1 Click ac press F7 or select View gt Graph This displays the Mean Velocity diagram 2 Select the diagram of your choice from the Show drop down list In the top right corner click the ROI icon that corresponds with the valve contour QFlow 5 6 User Manual 26 Working With QFlow Click a point in the curve to display the corresponding image in the Phase View and Modulus View gt For instructions on creating reports refer to Chapter 10 QFlow 5 6 User Manual 27 Working With QFlow 8 Creating and Editing Contours This chapter explains how to e draw or edit contours in Contour Mode e edit contours using rubberband editing e mark areas in Pixel Mode e copy contours marked areas and profiles e delete contours marked areas and profiles 8 1 About Detecting Versus Drawing Regions of Interest Automatic detection of vessel contou
37. red trademarks of their respective owners Regulatory Information Intended Use QFlow has been developed for the objective and reproducible analysis of velocity encoded cine MR imaging studies of arterial vessels and heart valves The intended purposes are e Supporting clinical diagnoses with data on the function of the cardiac ventricles e Supporting clinical diagnoses with data on the flow velocity and flow volume through cardiac and peripheral vessels both under basal and increased flow conditions e Supporting subsequent clinical decision making processes QFlow 5 6 User Manual HI GENERAL WARNINGS Q You are explicitly recommended to measure flow parameters only in sequences that are validated for flow measurements Reliable measurement results can only be obtained with validated acquisitions Q QFlow 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 QFlow should not be used for purposes other than those indicated in the section Intended Use Users must make sure to read this manual to familiarize themselves with the software and be able to obtain reliable analysis results European Regulations QFlow is qualified as a class Ila medical device It complies with the requirements of the Dutch Medical Devices De
38. ress O then release both keys This example opens the dialog window for opening a study You can find an overview of keyboard shortcuts in Chapter 13 Typographical Conventions On the Display tab clear the Show patient Names of buttons fields menus menu options data check box and tab names are capitalized and in bold View gt Movie A sequence of menu options that you select to perform a specific task is indicated by angular brackets Contours can be saved in a CON file File names and text that you type or that appears on the screen such as file names and file locations is displayed in Courier New Symbols Used ep e QFlow 5 6 User Manual 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 VI Table of Contents EBU RN Sale Sy re_ee_e_ rl dl ll dd r r lll lr l_o Wr II INTRODUC FION osicortesneanernia N y y k a a a a 1 1 PDOUE OMIOW s lt 4 545040543515434 50 151230405454081042 E E E EE G QO 000K E 2 RAN 1 2 SUD DOME Si s sayey nen
39. rrectly Make sure to edit incorrect contours Click or press CTRL D again to automatically redetect the contours The maximum velocity pixel within the contour in this phase is marked by an orange square the minimum velocity pixel is marked by a blue square 6 2 Viewing Analysis Results You can view the results of the analysis in a number of diagrams To view analysis results 1 Click Ez press F7 or select View gt Graph This displays the Mean Velocity diagram QFlow 5 6 User Manual 18 Working With QFlow Click a point in the curve to display the corresponding image in the Phase View and Modulus View 2 Select the diagram of your choice from the Show drop down list To add or hide curves in flow diagrams e Inthe diagram window click Q or to show or hide the corresponding curves in the diagram To mirror a curve vertically e Inthe diagram window select the Invert check box under the icon of the contour or contours that you want to mirror Make sure to display the curve first by clicking OT f To calculate mean pressure gradients 1 In the Mean velocity diagram window select Pressure Gradient mode for the desired ROI 1 Invert J Pressure Gradient mode V 2 If necessary you can invert the graph to make the contribution of the flow to the mean pressure positive 3 Drag the diagram sliders to select the interval of positive net flow to calculate the mean pressure
40. rs using QFlow is fast and accurate You can use automatic contour detection when you are performing a flow analysis of a vessel When you are performing a flow analysis of a valve or when you are editing contours you must draw contours manually There are two modes for marking regions of interest manually e Contour Mode e Pixel Mode Q Automatic contour detection based on one or more manually marked vessels only works for contours not for regions of interest marked in Pixel Mode For instructions on performing automatic contour detection refer to section 6 1 amp Make sure to switch to Pixel Mode if the vessel that you want to mark is smaller than ten pixels in diameter This ensures that the analysis results are accurate For instructions on marking areas using Pixel Mode refer to section 8 3 8 2 Drawing Contours in Contour Mode When you are marking regions of interest in Contour Mode you can choose to use the trace tool or the point tool When you are editing existing contours you can use the trace tool the point tool or the rubberband editing tool You must mark areas in Pixel Mode if any of the vessels that you want to mark is smaller than ten pixels QFlow 5 6 User Manual 28 Working With QFlow To draw or edit a contour using the trace tool 1 In the toolbar click to indicate that you are tracing your first region of interest ROI or click one of the other ROI icons 2 Click A P If this tool icon is no
41. t active you are in Pixel Mode To switch to Contour Mode select Contours gt Contour Mode 3 When you move the cursor over the Phase or Modulus View it becomes cross shaped 4 Click in the image hold down the left mouse button and trace the vessel contour 5 When you reach the end of the contour release the mouse button This automatically closes the contour 6 When you are performing a flow analysis of a vessel you can now use this contour to guide the automatic contour detection Press CTRL D to start the automatic contour detection ep For instructions on performing a flow analysis of a vessel refer to section 6 1 When you are performing a flow analysis of a valve you can now copy this contour to the other phases 3 gt For instructions on performing a flow analysis of a valve refer to Chapter 7 To draw or edit a contour using the point tool 1 In the toolbar click to indicate that you are tracing your first region of interest ROI or click one of the other ROI icons 2 In the toolbar click P If this tool icon is not active you are in Pixel Mode To switch to Contour Mode select Contours gt Contour Mode 3 Place points along the contour that you want to draw Avoid changing direction while you do this You can place the points in either clockwise or counter clockwise direction 4 When you place the last point double click This automatically creates the contour along the points that you ha
42. the Window and Level text fields or select a value by clicking the selection arrows Working With QFlow To return to the original window width and level settings e Inthe Phase or Modulus View right click and select Reset W L Or e Press 1 on the keyboard Or 1 Select Settings gt Main 2 On the Image tab behind the Window and Level sliders click Reset 5 6 Adjusting Contrast and Brightness If needed you can adjust the contrast or brightness for the current series To adjust contrast and brightness 1 Select Settings gt Main 2 On the Image tab under Contrast and Brightness drag the Contrast and Brightness sliders for the Phase or Modulus Views You can also enter a percentage in the Contrast and Brightness text fields or select a percentage by clicking the selection arrows Click Reset to return to the default value 5 7 Hiding and Showing Patient and Study Data The Phase View Modulus View and the Thumbnail View display a number of patient and study data by default You can hide these data from view or redisplay them To hide or show patient and study data 1 Select Settings gt Main in the menu bar 2 On the Display tab under Hide select the All annotations check box to hide study and image details including analysis results Clear the check box to show them You can also choose to hide or show specific types of information Use the check boxes under Display to hide or show them QFlow
43. the new recipient s e mail address in the To field and click Send again To close the e mail window click Close QFlow 5 6 User Manual 39 Trouble Shooting Floating license error after a crash of the software In a floating license setup licenses will be returned to the license server when QFlow is closed In case of a crash the licenses will not be returned and remain locked on the license server Restarting QFlow will give a warning that the licenses are not available To solve this issue you have to wait at most 2 minutes before you can start the software again The license server checks every 2 minutes if the claimed licenses are still in use on the client machine If the licenses are not in use the license server will release the licenses Expiration date not updated after install non expiring license When you install a temporal license with CMS License Manager the license will be given an expiration date You can see this expiration date in View available licenses in CMS License Manager When you install a non expiring license after you installed the temporal license the expiration date is not updated To see the correct expiration date of your licenses you have to delete the expiring license before you install the non expiring license You can do this with the following steps e Start CMS License Manager click Start All Programs Medis System Tools CMS License Manager 2 5 e Click Advanced e Click Delete licenses
44. ting Versus Drawing Regions of Interest cece kk kk 28 8 2 Drawing Contours in Contour Mode cece eee eee eee eee eee eee eee eee eee eee eee ese 28 8 3 Marking Areas in Pixel MOdeC ccscccccccccecccceseccceesccessscessccesescceessceeeces 30 8 4 Copying Contours Marked Areas and Profiles cece kk kek k 30 8 5 Deleting Contours Marked Areas and Profiles kk k 31 9 Saving Contours and Image Settings ceeccccccccccccccccccccccescccccccssesccccccssessecs 32 9 1 Working With FlOW Profes ccecsvscsreccanccsaceviesbecicanseseceviesbecdandeseceviesbeaeanees 33 9 2 Creating Plow Profiles ccsa a aie aededian a eas 33 9 3 VIEWING FOW PIOTILGS cctcsctdstatiedsocncuetdetaacadsosucessdetagsadsesnceceeetaasedsesaceceate 33 10 Creating R DOL S c yay k ley k n Pewa y k Celk n Ke kay kar Caka k w e WE W E CEME K ce EWE DE WE CEBE N E EWE WENE 34 TOT eel l RE POMS N NA DD n 34 10 2 reatie Graphic REPOS ss 4i042 54440 5l kunda a kun da kal un dle W Pal e n k k d Ela ka 34 10 3 Creating Text Reports i x4 5a cak keca n Hanan ca bu ka kin a na kl a xalan mana S eux a ak Haw AN 35 10 4 Creating XML R DOL Sos 4 4 acss y On Dek K Ne S NN E O R Vu ben X V Wc Ve bu k V VO SENA ve kU WENAY 36 10 5 Adding Comments To ReportS E EE keke eee
45. tions on saving the contour files that store contours image settings and report comments refer to Chapter 9 You can change the default directories in which studies reports and contour files are stored Select Tools gt Options On the General tab under Folders specify or select the new directories Working With QFlow To save a frame movie graph profile snapshot or report to a location on your system or network 1 If you want to save a graph or movie right click in the window and select the save option If you want to save a Phase or Modulus View image right click in the Phase or Modulus View and select Snapshot gt Save Image If you want to save a report click Save in the Report window In the dialog window that opens you can change the directory in which the report or graphical object is saved by clicking Browse selecting another directory and clicking OK If you want to change the report s or graphical object s file name click in the Filename text field and type the new name Select the file format or location of your choice from the drop down list Selecting DCM stores the report as a DICOM file in the specified directory Click OK This saves the report or graphical object to the specified location If you are saving a movie a command box opens that shows conversion progress When the box closes the movie has been saved To save a graph profile snapshot or report as a DICOM secondary captur
46. tructions on accessing and using the contour detection settings refer to section 6 4 QFlow 5 6 User Manual 23 Working With QFlow Contour Detection Setting Interpolation Deformation Which Calculates the average contours between two model contours that you draw in the Study Interpolation is a calculation method rather than a detection method it does not use any information from the images Copies the model contour that you draw and positions it over the vessel in the target image or images If you select Motion you can set the maximum number of pixels that the contour is moved in the Max motion setting at the bottom of this window Q The Max motion setting also influences the automatic contour detection that you start by clicking Copies the model contour and reshapes it around the vessel that it detects in the target image s If you select Deformation you can specify values in the Max deformation Pressure and Curvature settings at the bottom of this window Max deformation determines the maximum number of pixels that the contour is reshaped The default value is 1 Pressure lets you include or exclude high intensity pixels which are likely to be unrelated to flow around the contour A negative pressure excludes high intensity pixels while a positive pressure includes high intensity pixels Select 0 if you want the contour to remain unchanged The default value is 1 Curvature determin
47. ve placed 5 When you are performing a flow analysis of a vessel you can now use this contour to guide the automatic contour detection Press CTRL D to start the automatic contour detection a gt For instructions on performing a flow analysis of a vessel refer to section 6 1 QFlow 5 6 User Manual 29 Working With QFlow When you are performing a flow analysis of a valve you can now copy this contour to the other phases gt For instructions on performing a flow analysis of a valve refer to Chapter 7 To edit a contour using the rubberband tool 1 In the toolbar click the icon of the contour that you want to edit 2 Click 3 Move the mouse over the contour and pick up the middle of the section that you want to reposition 4 Position the contour over the place in the image where it fits and release the mouse button 8 3 Marking Areas in Pixel Mode When you are marking regions of interest in Pixel Mode you mark or erase the individual pixels To mark an area in Pixel Mode 1 Switch from Contour Mode to Pixel Mode by selecting Contours gt Pixel Mode Pa a active 2 Inthe toolbar select O or to indicate which vessel you want to mark This makes 3 Zoom in on the image by clicking i or by pressing on the keyboard 4 Inthe Phase or Modulus View click or drag to include pixels in the marked vessel area You can erase pixels using 8 4 Copying Contours Marked Areas and
48. vessel moves during the cardiac cycle but does not significantly change shape motion method QFlow 5 6 User Manual 22 Working With QFlow amp Make sure to measure flow parameters only in sequences that are validated for flow measurements Reliable measurement results can only be obtained with validated acquisitions To perform a customized contour detection 1 Create an initial contour by performing steps 1 through 4 of section 6 1 2 Select Settings gt Contour detection or click This opens the following dialog window Contour Detection Settings Method Interpolation Motion Deformation Mizsing Model Achye Man deformation pis Pressure Curvature Mas motion pis ak ak ak ak Detect The Detection Method settings at the bottom of the window apply to both the customized and automatic contour detection If you make changes to the default Detection Method settings the new settings also apply to the automatic contour detection that is performed when you click press CTRL D or select Contours gt Detect Contours 3 Select the detection method range and model of your choice Then select motion or deformation values in the Detection Method Settings at the bottom of the pane The table in section 6 4 1 describes the options 4 Click Detect 6 4 1Contour Detection Settings This section describes the settings that you use to customize the automatic contour detection For ins
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