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EchoPAC PC User`s Manual

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1. 145 Optimizing NE Y axIS esnaera ove roit evi mte quen voted 145 Trace SMOOTNING ccceccc cece eeeseeceeeceeeseeeseeeeeeseeeseeeeseeaess 146 Switching modes or traces anrnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnennnnnnnun 147 TOUS WITCH MOOG sanne d unpu RM PES DXURPSI EKPEREM 147 TOSWILCH TEGE Lue 147 Curve fitting analysis ennrnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnennnnnnnunnnne 148 Wash in curve fitting analysis eeeseeessse 150 Wash out curve fitting analysis 155 Anatomical M Mod iinscvisx Pin e AR Vaparvsbrs ai 157 MOAN 157 Using Anatomical M Mode rrrannnnnnnnennnnnnnennnnnnrnnnnnanennnnn 157 Optimizing Anatomical M Mode 159 VI EchoPAC PC User s Manual EP092537 02 Table of Contents Chapter 7 Worksheet MOAN cistern de pases C OE TES 162 NENNE nn 163 USING WOIKSTIGOT Lassen udatert 164 To scroll through pages se 164 To select the type of value rrrrnrrnanrnanernnrnnnnnnnrrnnnennnnr 164 Excluding or including measurements 164 Manually changing a value eeeeeeeeeesese 164 Deleting measurement parameter 165 Chapter 8 Report NTOAUCNON anna eee 168 Creating a repors 22 169 Working with the report function 1
2. sessssssssesseseee nennen nennen 114 TISSUE TRACKING RR 117 Quantitative analysis sa sineira a a aA 118 Editing creating a template eese s 119 e Template editor screen overview rrrrarrnnnrnnrnnnnnnnnnnernernunneeneene 119 e Selecting a base template to edit sssuss 123 EchoPAC PC User s Manual 103 EP092537 02 Stress echo analysis Introduction 104 EchoPAC PC provides an integrated stress echo package with the ability to review perform wall segment scoring and report for a complete efficient stress echo analysis Users can define various quad screen review groups in any order and combination that will suit their normal review protocol The stress package provides protocol templates for exercise as well as pharmacological stress examinations In addition to preset factory protocol templates templates can be created or modified to suit users needs Users can define various quad screen review groups in any order and combination that will suit their normal review protocol When reviewing stress examination images the images are viewed at their original image quality and different post processing and zoom factors may be applied to the images under review for effective image optimization In addition to standard wall motion scoring analysis the user can perform quantitative stress analysis based on tissue
3. P M 9 EE 16 Export PAN 26 F Formatting REMOVE MENN Se 215 Image MZ ION 2 eee 52 68 SJEL 1 KOMEN EN 52 Images Delete an image J UP Lave mddiddile 51 Grouping IMAGES cece cccccccecescsscscscsecseecsecaesaesessesacsessessessesecsessesacsecsesecsecsecaecaesecseseeeea 49 REVNE 45 EchoPAC PC User s Manual 247 EP092537 02 Index es M 0 Ws ad C MNT 75 Import PETN 32 J PE 75 L Language METAN 225 SE EE EE EO PEER Rd 225 M Magneto Optical Disk FANN 215 Measurements Cardiac retener 83 101 AD cca M M 90 ROEA SUA AN 94 Assign and Measure sse tette tnnt inniti nn tenes 85 88 Biejos I ee 96 ES UN s 94 Measure and ASS eee 89 100 NENNE 93 Moving the Result table 5 tetra aeta tutu SAGE sad 101 MENS er 98 EVE S UV A 95 MPE re 77 O MMR 8 P Patient record ANNET NN 14 Creating a heWTFeGOFQ uvaner etsende 18 Editing GE MO AP AEE 18 SAN 12 248 EchoPAC PC User s Manual EP092537 02 Index Q Quantitative Analysis Manual TENG Jaaa EN 139 STEN 138 TNT 138 Quantitative analysis 127 159 AnatemicalVi MOGOe ENE 157 BE 106 1 Ol AACS EEE EE eaten telecine 141 FAIS disabling E ELT T TTE 141 Labelling a sample AEA uie aspectu rtm bles eb cut boton od EID bda o bono dpa biduo 143 Optimizing Anatomical M Mode sse 159 Opumizild sample ales xiu ctt et tec ee
4. rrrannnnnnnannannvnnnnnrnnrnnnnnnrnnnnnnnennnnn 164 e Deleting measurement parameter eeeeeeeeeeese 165 EchoPAC PC User s Manual 161 EP092537 02 Worksheet Introduction The worksheet function enables the user to review edit delete or print measurement data independently of a report All measurements and calculations taken during the examination can be viewed at any time using the worksheet 1 62 EchoPAC PC User s Manual EP092537 02 Worksheet Overview 1 Measurement type 4 Measured calculated values 2 Measurement parameter 5 Value type 3 Value Averaging Max Min or Last 6 Measurement type selection Figure 7 1 The Worksheet screen EchoPAC PC User s Manual 1 63 EP092537 02 Worksheet Using Worksheet 1 Press Worksheet and select the measurement type To scroll through pages 1 Press Page up or Page down To select the type of value 1 Select the relevant cell in the Method column see Figure 7 2 A pop up menu is displayed showing the different options available Figure 7 2 2 Select the required option The value is updated accordingly 1 Average of the measurements taken 2 Maximum measurement as Minimum measurement 4 Last measurement that was taken Figure 7 2 The Calculation method options list Excluding or including measurements One or more measurement values from a set of measurements for a parameter can be excluded w
5. 101 EchoPAC PC User s Manual 83 EP092537 02 Measurements and Analysis Introduction A study is a set of related measure ments or measure ments that are logically grouped together The mea surements in a study are some times used in a for mula to calculate new parameters e g biplane volume with EF SV and CO A CAUTION 84 EchoPAC PC provides functionality for two measurement conventions e Assign and Measure Measure Protocols the user selects a study consisting in a set of pre labeled measurements related to the active scanning mode and clinical application The user is prompted through the measurements in the order of the measurements labels This convention is started from the Measure button A set of tools is implemented to make the measurement process as fast and easy as possible for the user The user is guided through the study an auto sequence functionality automatically selects the next measurement in a study he selected measurement is highlighted in the Measurement menu The performed measurement is indicated in the Measurement menu The studies and their parameters are user configurable The user can create its own studies containing the relevant measurements only e Measure and Assign Free style the user performs a measurement and assigns a label This convention is started either from the buttons Measure or Caliper Only assigned measurements will be saved Meas
6. 99 Controlling the Measurement result table display 101 Minimizing the Measurement result table 101 Moving the Measurement result table 101 Chapter 5 Stress echo analysis LVEF OGUGTION i 104 Review of protocol studies 105 Selecting images for analysis esssssss 105 Loop synchronlzallorn aa a ex eo vea necs 107 Stress echo analysis rranrnnnennnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnennnnnnnnr 108 otabtrigaridlySlsS caucho scitudd A 108 SCONO e E 109 Image OVUMIZALION i iioii eue tdi va Dados uerus 111 To optimize IITId ges tritt emot tee exe 111 ZOOM TUNCUO nuc vvs eee 111 Quantitative TVI Stress echo analysis 112 Accessing QTVI Stress analysis tools 114 Vpeak measurement sruron 114 TiSsue TTACKING saa 117 Quantitative analysis rrrrrrerrrnrerrnrrerrarrernarenrannenrnnnennnn 118 BELE Le ae NE EE EE Mt pEd ded Ure dtes 118 Editing creating a template 119 Template editor screen overview 119 Selecting a base template to edit 123 Chapter 6 Quantitative Analysis MER OGUCTON o ues c 129 Fo PN 129 For Tissue Tracking uurneeneee Gene 129 EchoPAC P
7. 12 EchoPAC PC User s Manual EP092537 02 Image Management Enter new text E x Text Full text Figure 3 18 The Enter new text window 3 4 Enter a title for the item in the Text field Enter the pre defined text in the Full text field Press OK New Pathology text 1 2 3 4 o Select the item in the first column Select the second column Press New The Enter new text window is displayed Figure 3 18 Enter a title for the Pathology in the Text field Enter the pre defined text in the Full text field Press OK New Descriptor text 1 Select the item in the first column 2 Select the Pathology term in the second column 3 Select the third column 4 Press New The Enter new text window is displayed Figure 3 18 5 Enteratitle for the Descriptor in the Text field Enter the pre defined text in the Full text field 6 Press OK EchoPAC PC User s Manual 13 EP092537 02 Image Management Editing a pre defined text input 1 2 3 Select the term to edit in one of the columns Press Edit The Edit text window is displayed Full text All chambers are within normal size and function All valves are functioning normally with normal structure Mo other abnormalities are noted Ejection fraction is normal Figure 3 19 The Edit text window 4 5 Edit the text in both the Text and Full text fields Press OK Deleting a pre defined text input 1 2 3 4
8. 3 Press Properties The Properties window is displayed 4 Adjust the device specific parameters as desired Some of the settings can be changed directly in the Image to Produce field in the sublevel Additional outputs Configuration parameter Select between e Raw DICOM e DICOM e AVI e JPEG Image frames Select between e Single stores single frame only e Multiple stores cineloop e Secondary Capture screen shot Image compression Select compression mode from the pop up menu Quality Set picture quality from 1 to 100 A low picture quality level allows high data compression while a high picture quality restrains the compression Capture Area Select between e Video Area 1 e Whole Screen 2 EchoPAC PC User s Manual 213 EP092537 02 Program configuration To remove a device select the device in the Selected devices field and press the Left arrow button 2 1 4 EchoPAC PC User s Manual EP092537 02 Tools Program configuration The Tools sublevel sheet deals with e formatting of removable media MO disk CD R or ZIP disk e verification of DICOM directory on removable media COWNHECTIVITT Dataflow Additional Output Tools Removable Media Media Label 9 Capacity 1056 0 ME Free space 971 0 MB Formatted Yes Database present Yes DICOMDIR present Yes Finalized CD onby Ho Write protected Export Paths Export To Excel Export To HL Remote Path 1 Select removable media t
9. EchoPAC PC takes special advantage of TruAccess to the ultrasound raw data provided from the Vivid 7 and Vivid 3 enabling full image post processing EchoPAC PC has also access to ultrasound data through DICOM Media Interchange offering the possibility to read and display DICOM images from removable media and DICOM storage to removable media single or multiframe EchoPAC PC captures scan data from basic ultrasound applications to multiple reporting packages for various applications such as adult and pediatric echocardiography exercise and pharmacological stress echo transesophageal and intra operative imaging TruData acquisition Digital raw data single frames and cineloop of 2D M Mode spectral and color Doppler modalities at original resolution and frame rate from the Vivid 7 and Vivid 3 ultrasound units DICOM Media Read Magneto Optical Disk and CD R ECG phono and three auxiliary traces recorded with raw data capture Patient record and Image management Shared patient archive with Vivid 7 or Vivid 3 Ultimate workflow with instant access data management Utilize SQL open relational database for patient Fast search amp recall of patient studies Patient browser screen for registration of demographic data and quick review of image clipboard contents Storage of single frame multiframe and raw data images in raw data DICOM format DICOM media store US and US MF and secondary EchoPAC PC User s Manual EP092537
10. The GE Vingmed Ultrasound product families are tested to meet all applicable requirements in relevant EU Directives and European International standards See Standards used below Any changes to accessories peripheral units or any other part of the system must be approved by the manufacturer GE Vingmed Ultrasound Ignoring this advice may compromise the regulatory approvals obtained for the product Please consult your local GE Vingmed Ultrasound representative for further details Standards used The EchoPAC PC software is a Class I with measuring function device according to the Medical Devices Directive 93 42EEC To fulfill the requirements of relevant EC directives and European Harmonized International standards the following documents standards have been used 93 42 EEC Medical Devices Directive MDD The EchoPAC PC software is installed and runs in a commercially available PC According to applicable legislation compliance to the following EC directives and European Harmonized International standards are required for the PC in USE C C 0470 93 68 EEC CE Marking Directive 89 336 EEC Electromagnetic compatibility EMC Directive 73 23 EEC Low Voltage Directive 93 68 EEC Amendment of 73 23 EEC 234 EchoPAC PC User s Manual EP092537 02 Appendix UL1950 1996 1996 US and Canadianstandard ior niormalon Technology and Canadian standard for information Technology Equipment EchoPAC PC User s
11. The container is displayed in the template 5 Insert the information containers of interest within each cell as described in the previous section Insert Table E x Box Alignment Left v Ho of Columns 2 Ho of Rows Width 640 Pixels Height 150 Pixels Border cea Figure 8 4 The Table properties window Editing the information container Resizing the information container 1 Move the Mouse cursor over the border of the container to resize The mouse cursor is changed to a cross gt 2 Press Left mouse button once The container is displayed with anchor squares on the sides and at the corners 3 Resize the container by dragging from the anchor points EchoPAC PC User s Manual 179 EP092537 02 Report 180 Editing the information container properties Modifying the container s specific properties 1 Move the Mouse cursor over the border of the container to edit The mouse cursor is changed to a cross 2 Double click on the Left mouse button The Container properties window is displayed 3 Adjust the parameters specific to the selected container Modifying the layout properties 1 Press Box properties in the Container properties window The Box properties window is displayed see Figure 8 5 2 Set the options as desired 3 Press OK EchoPAC PC User s Manual EP092537 02 Table Properties x Alignment Text Lent Heading Lett Box Left Marg fo Tn Appearance Width
12. Using removable media A CAUTION A CAUTION A CAUTION Do not eject the CD using the button on the CD drive 24 The following removable media can be used for data storage e 51 4 Magneto Optical disk 1 3 5 4 and 8 6 Gb e 3 1 2 Magneto Optical disk 1 3 Gb option e Zip disk 250 Mb option e CD R CD RW is not supported The 9 1 Gb MOD is not supported on the EchoPAC PC Use only 24x or higher CD R Recommendation concerning CD R handling To avoid data loss never touch the recordable surface of a CD R Handle the disk only by the outer edge Do not place it face down on a hard surface Fingerprints or scratches will make the disk unusable Before usage verify that CD R surface has no visible scratches If there are any scratches do NOT use the CD R Avoid using CD R to store patient data The CD R can be used for storage of images for presentation purposes Formatting removable media Removable media have to be formatted prior to use as described in Tools on page 215 Ejecting removable media 1 Press ALT E to eject the disk The Eject device menu is displayed EchoPAC PC User s Manual EP092537 02 Patient record management CD Rewritable 5 1 3 MO Disk 3 1 2 MO Disk ZIP Disk Figure 2 8 The Eject device menu 2 Select the relevant media The selected media is ejected EchoPAC PC User s Manual 25 EP092537 02 Patient record management Export Import patie
13. 16 The user can edit the actual text in the Examination List window see Figure 2 2 using the alphanumeric keyboard and by inserting pre defined text input Text edition 1 Inthe Examination list window Figure 2 2 click in the required field to activate the text marker 2 Using the alphanumeric keyboard edit the information Inserting pre defined text input 1 Inthe Examination list window press Insert Text for the actual field The Pre defined texts list is displayed showing the abbreviation for the pre defined text inputs see Figure 2 3 The list has two levels expand the list by selecting in front of a top level text input 2 Select the pre defined text input to insert The entire text is displayed as a preview see Figure 2 3 3 Double click on the selection The text is inserted in the main text at the cursor position Creating text input 1 Inthe Examination list window press Insert Text for the actual field The Pre defined texts list is displayed see Figure 2 3 2 Press New text in the Pre defined texts list to create a new top level text input or select a top level text input and select New subtext to create a sublevel text input The Text input window is displayed 3 Type an abbreviation in the Code field Type the text input in the Full text window 5 Press OK to confirm and exit The Pre defined texts list is updated accordingly EchoPAC PC User s Manual EP092537 02 Pat
14. GE Medical Systems Technical Publications EchoPAC PC version 3 0 x C 0470 User s Manual GEVU EP092537 GEVU Rev 02 Operating Documentation Copyright O 2003 By General Electric Co GE Medical Systems MANUAL STATUS GE Medical Systems All rights reserved No part of this EP092537 02 manual may be reproduced stored in a retrieval system or 20 05 03 transmitted in any form or by any means electronic mechanical photocopying recording or otherwise without the prior written permission of GE Medical Systems COMPANY DATA GE VINGMED ULTRASOUND A S Strandpromenaden 45 N 3191 Horten Norway Tel 47 3302 1100 Fax 47 3302 1350 Table of Contents Table of Contents Table of Contents Introduction Main TUMGUONANILY Lassen 1 Indications TOF USG 1 EchoPAC PC product range eese eee nee 1 MP arve 2 LUE Ie 8 rz fefoje r ip Cen 3 PINGING INTORMAU OM Eo nauk 3 Conventions used in this manual 3 Contact INIOFIMANON ceiescceeras rede eoe ioco eo etn eet sg o dne ao curas aus 5 Chapter 1 Getting started Launchihng EChoPAQG PG teen iE cet ied die be Ebou Ge 8 TO Start ECNOPAG P uncia eee eee E 8 EChoPAC PG VEVEN Aude 9 Chapter 2 Patient record management Searching a Patient record eese 12 sje Uele Eee ER 12 Todind pallerit K CO Id aor etr Yo OE Mv ee Ves tort ud eve 12
15. Patient record management Restore procedure Insert the Backup Restore MO disk in the MO drive The Restore procedure will OVERWRITE the existing database on the local harddrive Make sure to insert the right MO disk Press Config on the alphanumeric keyboard The Log In window is displayed asking for operator ID and password Select the user with administration rights and enter the password Select Log on The Setup dialogue window is displayed Select the Admin setup category Select the Restore sheet in the Admin setup category Figure 2 18 Select e Patient archive to restore patient records and reports e System setting to restore copy system settings and user presets Make sure that the Backup Restore MO disk is inserted in the MO drive and selected as the source Press Restore Now The process status for each item is displayed in the Result column EchoPAC PC User s Manual 41 EP092537 02 Patient record management MEM AME Backup Restore Users Logon System Admin Archiue to restore 9 estore Factory nerau C SE s 1 4MO Disk Hi Restore Now E Imaging Measure Report connectivity System About Admin Service 1 Select the item to restore 3 Start restoring data 2 Select the Backup Restore disk 4 Reset the system setting to factory default Figure 2 18 The Restore setup sheet 42 EchoPAC PC User s Manual EP092537 02 Image Management Chapter 3 Image Man
16. Stress echo analysis To display a Vpeak measurement 1 Perform segment scoring as described on page 109 When performing scoring i a view from a peak level the Vpeak measurement button V is displayed in the corresponding diagram In the Scoring diagram press V The trackball cursor is changed to sampling area and the scored peak views are updated showing e Adiagram with the current segment highlighted scoring bullet with a ring and the segment s velocity cutoff see Figure 5 6 Color coded velocity in tissue The color coding convention is as follow Green Velocities above threshold value 5 Yellow Velocities near threshold 5 interval White Velocities below threshold value 5 A result window to display tissue velocity profile shown when moving the sampling area in the view In the 2D sector move the sampling point over the wall area corresponding to the current segment shown as the highlighted segment in the diagram A tissue velocity profile for the actual segment is generated in the Result window see Figure 5 6 Press Next or Previous to analyze other segments in the peak view OR Select another scoring bullet in the diagram in one of the peak views Turn off the Vpeak measurement tool 1 Select the V button in one of the peak view scoring EchoPAC PC User s Manual 115 EP092537 02 Stress echo analysis pe Sampling point Current segment diagrams OQ V X XX CM
17. 2 Press Config The Log In window is displayed asking for operator ID and password 3 Select the user with administration rights and enter the password 4 Select Log on The Setup dialogue window is displayed 5 Select the Admin setup category The Backup sheet is displayed Figure 2 16 6 Select Patient archive to backup patient records System setting to copy system settings and user presets The system configuration backup can be used to configure several EchoPAC PC units with identical presets providing the units have the same software version Move oldest images to move images and reports from the local harddrive onto MO disks Adjust the time span next to Older than to move images and reports older than that setting T Select the MO disk as destination 8 Press Backup Now EchoPAC PC User s Manual 37 EP092537 02 Patient record management 38 e The system is checking that the MO disk is inserted If not a dialogue window is displayed prompting the user to insert a MO disk Press OK to resume backup The system is checking that the MO disk is formatted If not a dialogue window is displayed prompting the user to format the disk e The system is checking the available space on MO disk for the patient archive If there is not sufficient free space a dialogue window is displayed Press OK the media is ejected and insert a new formatted MO disk A progress dialogue is displayed showing the c
18. Advanced search 2 14 SONING Cale EE TC 15 Editing Referral Reasons Comments and Diagnosis 16 MOXCO OON trm 16 Editing demographic data esses 18 Creating a new Patient record 20 Deleting archived information 21 Deleting a patient record sseeeeseeeeeeeeeeeee 21 Deleting an examination rarnnnrnnnrnannnnnnnnrnnnnnannnannnnennsnnnne 21 EchoPAC PC User s Manual III EP092537 02 Table of Contents Moving examinationsS ranxrnnrnnnnnnnnnnnnnnennnnnnnnnnennnennunnnnnnnennnnnnnenn 22 Using removable MENA ssir peerage 24 Recommendation concerning CD R handling 24 Formatting removable media rrarrnnrrarrnnnrnrvnnrrnnnnnnnnennne 24 Ejecting removable media eesseeeeees 24 Export Import patient records examinations 26 Exporting patient records examinations 26 Importing patient records examinations 32 Data Backup and restore esee eren 36 Data backup for EchoPAC PC Software Only 36 BACKUP DIOCCG UNG ae 3 Restore Procedur e nescio DV Reda cH Fl Ear a Ea roe ERO 41 Chapter 3 Image Management Introd clon ss NIE ERBEN EU IERI I
19. ExaminfoBox 1 Select a container Preferences Box Title Data Font Type Font Size Font Color Times Hew Roman 14 5 Hox Value Data 9 Font Type Font Size Font Color Times Hew Roman 14 gt Factory Defaults cone 3 Adjust the container s core text font parameters 2 Adjust the container s title font parameters 178 Figure 8 3 The Preferences dialogue window Inserting an information container in the report template body Procedure for a single insertion 1 Press the Left mouse button at the desired insertion point in the Report template design area Press Customize or Insert and select the actual information container The Container properties window is displayed Adjust the parameters as required If the default layout parameters have to been changed press Box Properties Adjust as desired see page 180 and press OK EchoPAC PC User s Manual EP092537 02 Report 5 Press OK in the Container properties window The container is added to the template Procedure for multiple side by side insertion To insert two or more information containers side by side a table with multiple cells must be created first 1 Press the Left mouse button at the desired insertion point in the Report template design area 2 Press Insert and select Table The Container properties window is displayed see Figure 8 4 3 Adjust the parameters as desired 4 Press OK
20. Scored segment 25 11 01 15 53 53 Figure 5 4 Segment scoring 1 10 EchoPAC PC User s Manual EP092537 02 Stress echo analysis Image optimization During analysis the user can adjust the images by exiting the Stress Echo analysis screen To optimize images 1 4 5 Press Exit in the Stress Echo analysis screen The 2D control panel is displayed Select a loop If necessary deselect Run Cineloop to freeze the image and scroll through the cineloop using the Frame slider to display the desired image Check Apply to all if global adjustment is desired Adjust the image controls to optimize the display Zoom function The image can be magnified as described in Zoom function on page 66 EchoPAC PC User s Manual 1 1 1 EP092537 02 Stress echo analysis Quantitative TVI Stress echo analysis A QTVI Stress analysis is meant as a guide to wall motion scoring WARNING Diagnosis must not be based on results achieved by QTVI Stress analysis only EchoPAC PC provides a Quantitative TVI QTVI Stress analysis package based on Tissue velocity information TVI The TVI data is stored in a combined format with grey scale imaging during stress examination When selecting a template supporting TVI data acquisition the ultrasound unit will automatically store TVI information generally for the apical views of the stress examination The QTVI Stress analysis option currently applies only to Dobutam
21. The Insert menu Meu Desorption Insert Preferences Page Break insert a new page in the report template Table configure and insert a table in the report template Logo select and insert a logo to the report template Archive info select and insert data from the following categories Patient information Exam information Site information Page Break Table Logo Archive Info 1 76 EchoPAC PC User s Manual EP092537 02 Report Designing a report template The different type of information to be included in a report are grouped in information containers Designing a report template consists in inserting and configuring the different information containers in the template page in an ordered manner Starting template designing 1 Start the Report designer see page 173 2 Press File and select New to display a default page or use the current report template as basis template Setting the layout preferences Adjusting the default fonts and container background colors 1 Press Preferences The Preferences dialogue window is displayed see Figure 8 3 2 Select a container and adjust the parameters as desired 3 Repeat step 2 for each information container Adjusting the report page color background 1 Press Customize and select Page Color The Color selection window is displayed 2 Select the desired color 3 Press OK EchoPAC PC User s Manual 1 Tf EP092537 02 Report
22. press Image list or the Image browser menu button The Image browser screen is displayed see Figure 3 3 showing thumbnails of stored images for the current patient sorted by examination sessions If the images are stored on a removable media that is not mounted the image thumbnail is replaced by a symbol 2 Move the Mouse cursor over a thumbnail to display a preview of the image 3 Select the images to review or press Analyze to review all images e If all images are available the images are displayed for review e f some of the images are not available locally the Restore images window is displayed EchoPAC PC User s Manual 45 EP092537 02 Image Management Restore Image Dialog E X some of the Selected Images are not located on the local Storage select one of the following options Static Restore only the Selected Images C Restore All Images of the selected exam Restore Current patient canc Figure 3 1 The Restore images window 4 Select between Restore only the selected images only selected images that are not available locally are restored Restore all images of the selected exam all images that are not available locally in the exams where an image was selected are restored Restore current patient restores all images in all examinations 5 Press OK The Insert media window is displayed 46 EchoPAC PC User s Manual EP092537 02 Image Management Insert the St
23. the left column contains additional notes and warning texts Bold type describes button name on the screen Italic type describes program windows screens and dialogue boxes 4 EchoPAC PC User s Manual EP092537 02 Introduction Contact information If additional information or assistance is needed please contact the local distributor or the appropriate support resource listed bellow Europe GE Ultraschall KG Tel 0130 81 6370 Deutschland GmbH amp Co Tel 49 0 212 28 02 208 Beethovenstrake 239 Postfach 11 05 60 D 42655 Solingen USA GE Medical Systems Tel 1 800 437 1171 Ultrasound Service Engineering Fax 1 414 647 4090 4855 W Electric Avenue Milwaukee WI 53219 On line Applications Support Tel 1 800 682 5327 or 262 524 5698 Canada GE Medical Systems Tel 1 800 664 0732 Ultrasound Service Engineering 4855 W Electric Avenue Milwaukee WI 53219 On line Applications Support Tel 1 800 682 5327 or 262 524 5698 Latin and South America GE Medical Systems Tel 1 305 735 2304 Ultrasound Service Engineering 4855 W Electric Avenue Milwaukee WI 53219 On line Applications Support Tel 1 800 682 5327 or 262 524 5698 EchoPAC PC User s Manual 5 EP092537 02 Introduction Brazil GE Ultrasound Tel 55 11 887 8099 Rua Tomas Carvalhal 711 Fax 55 11 887 9948 Paraiso Cep 04006 002 S o Paulo SP 6 EchoPAC PC User s Manual EP092537 02 Getting started C
24. 250 Pts Height 60 Piz Border 1 E Background Color x Columns 1 Heading Font Type Font Style Size Color Times Hew Roman Bold 16 Change Font Sorting Order Change Text Hame o Original Text Hame Restore Original Data Hame Font Type Font Style Size Color Change Font Times New Roman Bota 14 5 Set all fields Data Value Font Type Font Style Size Color Change Font Times New Roman Bota 14 Set all fields caa Figure 8 5 The Box properties window example Inserting a new page 1 Inthe template position the Mouse cursor at the insertion point 2 Press the Left mouse button 3 Press Insert and select Page Break EchoPAC PC User s Manual 1 81 EP092537 02 Report Saving the report template Replace an existing template Factory templates cannot be overwritten 1 Press File and select Save A dialogue window is displayed asking for confirmation 2 Select Yes to save the report template No to discard the report template e Cancel to go back to the Report designer without saving the report template Selecting Yes or No will quit the Report designer and display the Report function Save existing template with a new name 1 Press File and select Save as The Save as template window is displayed Save Template As X Template Hame or cmn f Figure 8 6 The Save as template window 2 Entera name for the template 3 Pr
25. 74 Select the term to delete in one of the columns Press Delete A Confirmation window is displayed Press Yes The selected text input is deleted including the belonging text inputs EchoPAC PC User s Manual EP092537 02 Image Management Saving stored images and cineloops to a standard format Stored images and cineloops can be saved to a formatted see page 215 MOD or a CD R in the following standard formats e Still images JPEG DICOM and RawDICOM Raw data DICOM e Cineloops AVI DICOM and RawDICOM Raw data DICOM Images can also be stored as MPEG format on a CD R using the Export function as described on page 77 Procedure 1 Inthe Image analysis screen select the required image or loop 2 Press the Right mouse button The System menu is displayed Image Properties Figure 3 20 The System menu 3 Select Save as The Save as menu is displayed EchoPAC PC User s Manual 15 EP092537 02 Image Management SAVE AS Save in archive 5 V4MO Disk H File name Imagen Store Image only Secondary capture Compression Jpeg Quality 10 Save as type Avi avi Cancel Figure 3 21 The Save as menu 4 Select the desired removable media from the Save in archive pull down menu 5 Enter a file name in the File name field If the image or cineloop is saved as DICOM or RawDICOM the file name is automatically generated to follow the DICOM standard 6 Selec
26. 8 Curve fitting examples A wash in B wash out A AU B 300 AU for all curves 149 s Manual EchoPAC PC User EP092537 02 Quantitative Analysis Up to eight different sample areas may be generated in the myocardium Refer to page 139 for further details 150 Wash in curve fitting analysis Overview The purpose of wash in curve fitting analysis is to find and estimate local perfusion rate using contrast agent There are two methods to obtain this information Use the Real time Myocardial Contrast application with low transmit power MI 0 1 Applying Flash will destroy most or all contrast within the imaging plane The period of low power imaging immediately following the flash will contain the information on how fast contrast agent washes into different segments of the myocardium By storing data 5 to 10 seconds after Flash and performing curve fitting to this data set the user can explore myocardial perfusion Use the myocardial Contrast application in triggered mode This imaging mode is destructive for the contrast agent and the interval between each frame determines the image intensity Vary the triggering interval to obtain information regarding how fast the contrast agent washes into the myocardium after destruction Performing wash in curve fit From a contrast examination in Quantitative analysis 1 2 Disable frames that are significantly different i e because of respiration or probe movemen
27. Analysis Angio dB I I 1 Parameter window Figure 6 12 Wash in curve fitting after varying triggering interval 1 54 EchoPAC PC User s Manual EP092537 02 Up to eight different sample areas may be generated in the myocardium Refer to Manual tracking of the sam ple area dynamic anchored sample ar ea on page 139 for further details Quantitative Analysis Wash out curve fitting analysis Overview The purpose of wash out curve fitting analysis is to find and estimate a local wash out rate The analysis may be used for wash out of contrast from LV or myocardium Performing wash out curve fitting From a contrast examination in Quantitative analysis 1 Disable frames that are significantly different i e because of respiration or probe movements see page 141 2 In one of the Cineloop windows Anchor a sample area in the myocardium 3 If desired reshape the sample area as described on page 143 4 Because of heart motion the sample area in each frame has to be adjusted manually to be located inside the myocardium Manual tracking of the sample area The signals originating from the heart cavities are typically 10 to 20 times stronger than the signals from the myocardium and will have a major effect on the averaging of signals in the sample area 5 Using the Frame slider or F3 and F4 keys browse through the cineloop to ensure that the sample area is in the same anatomical position in all
28. CATEGORIES Enables selection of the measurement 7 Abdominal categories to display in the 7 Cardiac Measurement menu Only checked 7 Vascular 7 Pediatric create copy items will be displayed a suse netete Create Copy Enables copy of a Obstetrics selected measurement category Gynecology Study rn selection is done by selecting the Urology Study Plrinscolnskeletal El category name Delete enables deletion of user defined measurement categories Factory Default restores factory display 2D MM and Dop radio buttons Enables the display of mode related Measurement menu in the configuration window EchoPAC PC User s Manual 1 91 EP092537 02 Program configuration Folder LA Area RA Area MYA Planimetry AVA Planimetry LYA d LYA LAA d E M A 3 L O H Measurement Hame Tool 20 caliper LwiDd Index EDV Teich Envi cube W Auto sequence 192 LviDd Configuration tools Deletes selected entry folder or measurement in the Measurement menu The factory entries cannot be deleted Folder Displayed when a folder is selected in the Measurement Menu Moves selected measurement or folder up or down inside the Measurement menu Shows the entire contents of a selected folder e v the items is displayed in the Measurement menu e The item is hidden from the Measurement menu Measurement Displayed when a measurem
29. EM D MEI IE 44 image EVIE Museene 45 Review from the Image browser screen 45 Review from the Review Screen arrrrnnnrrnanrnannnnrnnnennnenene 49 Working with grouped images eeseeeeereeeeeee 49 Image optimization anxrnnnnnnnnnnnnnnnnnnnnnennnnnnnnnnennnennnnnnnnnnennnnnnnenn 52 Image analysis screen overview eese 02 Control panel OVErVICW cccceccceeeceeceeeteeeeeeeeeeeeeeeeeeteeess 54 Image controls adjustment eeeeseeeseeeseeee 64 Mage OPIMZANON see 66 Generated Anatomical M Mode rrrrnnnnnnnnranannnennnnnnnnennnen 69 Direct DOM ua 70 Saving stored images and cineloops to a standard format 75 DICOM SDOOIEN NE 80 Starting the DICOM spooler eeeeeeeeeee 80 Chapter 4 Measurements and Analysis NMToauelonsavvr ee 84 Assign and Measure modality 85 Starting the Assign and Measure modaality 85 IV EchoPAC PC User s Manual EP092537 02 Table of Contents Entering a study and performing measurements 87 Measure and Assign modality 89 Starting the Measure and Assign modality 89 Performing measurements rrranananananennnnnnnnnrannnanennennnnnn 90 Post measurement assignment labels
30. Eb obe heic d e e Rea ehe ete io 143 Optimizing the trace display rrrvrrvvrrrrvorvrrverrervenrerrevvrnrrverververververververnerververvevnennenen 145 TO GENENE a TATE mI T UU c LT 138 ugctex ieqnere ger 146 Wash T cU Ve MING eee 150 VWasrheolubcur ve UN uer 155 R Reus E o 234 Standards VEE SE 234 Removable media ENN 24 FT 215 RODO EE E EE EN 167 182 FANE Ne 171 HS AUN PEER EEE NE OI SE ET NENNE ENKE io 169 Bl 415 0 0 SE EN NE NET 70 Fl 2 171 RE 04 ao ER EE EE EE RE SN EN ER EEE 172 SEVERN EEG EON lane 171 RENSE eee 175 Designing a template sores TRES 177 S Searching PAET 12 S 0 Ge EN E REE LEE 236 SJ ped 60 EN SNE EE ER NE NE nee LEE 138 Stress Echo PANNIS NECI ES EE NN DN 108 EchoPAC PC User s Manual 249 EP092537 02 Index EEE 119 Image JONS NN 105 Image selection for analysis sess 105 KOOP SVNENONZANON Lavest 107 STELLE INE INGLY EE EN 118 Quantitative stress analysis sss 112 Review OF DEIOIOCOL SIUOIOS iie rei eo OE eem t hue ide Ebr et bebo 105 vaio D ti 109 Tissue TEN ee 117 System setup Examinator S WING OW Poe E 217 E Tate 16 Se EEE caeno sens ease case 217 Magno SENNA 188 Eigelb EEE EE ET Ede DEE 223 MO og EN EN EE 232 Pauen SER ENE T EE E 217 Patient information sss eene nnnm nn tnter nnn 189 Big PLE 223 RISER COMM QU AU ON RE m 229 W VNR 161 165 Changing a v
31. Gee image and report archives as well as EchoPAC PC page 229 configuration settings see page 36 e Restore enables data retrieving of patient and report archives as well as EchoPAC PC configuration settings see page 36 e Users deals with operators registration operator s rights setting and registration of staff related to an examination e g referral doctors sonographers etc e Logon deals with logon procedure e System Administration keeps track of all the options implemented in the unit 228 EchoPAC PC User s Manual EP092537 02 Program configuration Users The Users sheet deals with operators registration operator s rights setting and registration of staff related to an examination e g referring and interpreting physicians PETTEE SSS ERE Logon System Admin Backup Restore Users User List Identity f All USF C Oper C RefDoc C DiagPhy Id ADM Password Full Hame System Administrator Member of Group s Cardiologist HospAdmin Sonographer DiagPhys h Operator SysAdmin Fellow Physican la GEAdmin RefDoc IE Operator Rights Admin Service Create StoreRep PrintRep rs Autologon Disable T Autologoff min 0 Imaging Measure Report connectivity System About Admin Service Figure 9 18 The Users setup sheet Users are divided in groups with different rights There are two types of groups e Us
32. KHz scale when selected displays the KHz scale on the left side of the Doppler spectrum Patient Info Patient Info Patient Info Title bar Line1 amp 2 selects from the Titlebar Line 1 Last FirstName pop up menu the patient information to display on the Title bar Titlebar Line 2 i T I ebar Line Birth ote E e Anonymous patient when checked no patient information is displayed on Anonymous patient the Title bar Scan Info Scan Info ae Ba v displays scan information on the cale req El cFreq Oeisv video record csv svp Carrs Cccp vRej tProc trinepth JiDjsecale EchoPAC PC User s Manual 1 89 EP092537 02 Program configuration Measure The Measure setup category enables the organization of the Factory default Measurement menu or the creation of user defined Measurement menus to best suit the user s requirements 1 Configuration window see next pages for 2 The measurement menu displays updated details configuration Figure 9 4 The Measurement menu setup sheet 190 EchoPAC PC User s Manual EP092537 02 Program configuration Add measure SOG BESS SEN Create or select from the pop up list a measurement to be added to a folder Cancel Blank C Use copy of Add folder Add fold Enables the user to create its own folder with the desired measurements The folder is displayed the Measurement menu M amp A Categories M amp A
33. Manual EP092537 02 Program configuration The system settings SYSTEM location setup date time formats Settings Test Date and Time 20 03 2003 10 19 39 Time Forrnat 24 Date Format Location Hospital GE Vingmed Ultrasound Default Century Language Department ENG Manual Language ENG Units Metric Development Imaging Measure Report connectivity System About Admin Service Figure 9 17 The System settings setup sheet EchoPAC PC User s Manual 223 EP092537 02 Program configuration Location Location Location Hospital Enter the hospital name up to 64 characters This information is displayed GE Vingmed Uitrasaund on the Title bar up to 24 characters and on the image properties of all saved images Hospital e Department Enter the department name up to 64 characters This information is displayed on the image properties of all saved images Department Development 224 EchoPAC PC User s Manual EP092537 02 Program configuration Date and Time Date and Time Date sets the date Select the correct 2003 2003 10 19 41 date from the pop up window Time sets the time Press the arrow head DI En ha o ske set the time hour minute and Date and Time Date Format Time Format select the desired format 24 or 12AM PM from the pop up menu Default Century Date Format select the desired format EU
34. Manual EP092537 02 Enables to perform an examination without storing the data to the archive Local archive internal harddrive The local database is used for patient archiving Images are stored to internal harddrive Local archive Magneto Optical Disk MOD The local database is used for patient archiving Images are stored to a MOD Remote archive remote harddrive A remote database either on EchoPAC workstation or on EchoServer is used for patient archiving Images are stored to a network image volume either internal HD on EchoPAC workstation or EchoServer volume Remote archive Magneto Optical Disk A remote database either on EchoPAC workstation or on EchoServer is used for patient archiving Images are stored to a MOD DICOM 3 5 Magneto Optical Disk Read DICOM Media from the 3 5 MO drive DICOM 5 25 Magneto Optical Disk Read DICOM Media from the 5 25 MO drive 207 Program configuration picomcDread CD read DICOM CD read CD read Read DICOM Media from the CD drive EP MAC MOD EchoPAC Mac MOD read EchoPAC Macintosh Magneto the MOD must be Optical Disk read PC formatted Read MOD from EchoPAC Only images can Macintosh be read DICOM Print DICOM Print Send images to a DICOM printer Query Retrieve Query Retrieve Retrieve images from a DICOM server 208 EchoPAC PC User s Manual EP092537 02 Program configuration To select the default dataflow 1 Select the
35. Manual 235 EP092537 02 Appendix Short cuts Keyboard short cuts Shortcut Description ooo In Freeze displays previous and next frame Disabled when Direct report is activated Displays previous state window Starts Annotation application Ejects removable media Store screen image to clipboard Run stop cineloops Space bar does not start stop cineloop when Direct report is activated DICOM spooler 236 EchoPAC PC User s Manual EP092537 02 Appendix SHIFT F1 In the Analysis screen select previous image SHIFT F2 In the Analysis screen select the next image Help starts On line user manual Starts EchoPAC PC configuration package Adjusts Cine speed when the selected cineloop is running F3 decrease F4 increase Enables Frame scrolling when the selected cineloop is frozen F3 backward F4 forward Adjusts the Baseline when a Doppler window is selected F3 up F4 down Adjust the Horizontal sweep speed when a Doppler window is selected F5 decrease F6 increase F8 or ARROW UP zoom in F7 or ARROW DOWN zoom out The Arrow keys do not control the Zoom function when Direct report is activated Je h N M EEE Ls Co TT O A EEE u 7 e EE u 7 Panning tool when in Zoom mode Disabled when Direct report is activated a F EchoPAC PC User s Manual 237
36. a cross Press and hold down the Left mouse button while drawing a sample area Release the Left mouse button The sample area is automatically closed The trace is updated accordingly in the Analysis window Manual tracking of the sample area dynamic anchored sample area A sample area can be moved within the loop to ensure that data in the trace are generated from the same anatomical location during the cyclic motion of the heart 1 Place a sample area over a region of interest Note the anatomical location of the sample area Using the Frame slider or F3 and F4 keys scroll to a new frame Select the sample area The sample area is unanchored Drag the sample area to the corresponding anatomical location in the new frame Press the Left mouse button to anchor the sample area to the location When the sample area is anchored in more than one frame linear interpolation is performed so that the sample area is smoothly moved between the anchored positions in the selected frames when running the cineloop Scroll through the cineloop and control that the sample area follows the moving anatomical structure Add anchored sample areas in several frames to obtain a more accurate displacement of the sample area To move a dynamic anchored sample area 1 Using the Frame slider or F3 and F4 keys browse through the cineloop to display one of the frames where the EchoPAC PC User s Manual 1 39 EP092537 02 Qu
37. a defined zone The measurements tool generates results by two methods Qr ses RD DEL 10 11 Method of Disk displayed as Vmod in the Measurement result table known as Simpson s method Area Length method displayed as Va l in the Measurement result table To perform a volume measurement If necessary deselect Run cineloop to freeze the image and scroll through the cineloop using the Frame slider to select the desired frame Press Measure Select Volume in the Measurement Menu see Figure 4 3 Move the cursor to the start point of the measurement Press the Left mouse button to anchor the start point of the measurement Draw the length by dragging the mouse Press the Left mouse button to anchor the second point Drag the mouse to outline the area of interest The current area circumference and Area Length Volume Va l values are displayed in the Measurement result table and are instantaneously updated when moving the cursor Press the Left mouse button to complete the measurement The measurement results including Vmod Simpson are displayed in the Measurement result table To assign a label to the measurement see page 99 Repeat steps 4 through 9 to make additional volume measurements 2D Depth measurements The measurements described in this section enable depth measurement from the probe to a selected point 1 To perform a depth measurement If necessary deselect Run cineloop to freeze the i
38. action when ending an examination 7 Go directly to scanning from search Go directly to scanning from search Not applicable in EchoPAC PC 220 EchoPAC PC User s Manual EP092537 02 Program configuration TCP IP This configuration category enables the user with administration rights to set the Transmission Protocol Internet Protocol for the system and connected remote archive COWNHECTIVITT Dataflow Additional Outputs Tools Formats Tepip Computer Hame TEST IP setti SE Save settings o IP Address 3 222 22 8 9 Subnet Mask 255 255 252 0 Default Gateway 3 222 23 250 Remote Archive Setup Remote Archive IP Addr 3 222 23 74 Remote Archive Hame ECHOSRV7 000777 Imaging Measure Report Connectiity System About Admin Service 1 obtain an IP address automatically 3 Save TCPIIP settings 2 Manually specify IP address and subnet mask Figure 9 16 The sublevel TCP IP EchoPAC PC User s Manual 221 EP092537 02 Program configuration System This configuration category is divided in two sheets e System Settings enables the user to set the date and time choose the measurement unit and language for the system and enter basic information about the organization such as the institution name and department e Test enables testing of the different parts of the unit This sheet is accessible to users with administration rights only 222 EchoPAC PC User s
39. button large the Measure The Measurement result table is minimized to the heading ment result table bar Moving the Measurement result table 1 Move the Mouse cursor to the symbol on the heading of the Measurement result table see Figure 4 5 2 Press the Left mouse button to grab the table Move the Measurement result table to a new position 4 Press the Left mouse button to anchor the table 1 Minimize maximize table 2 Move table Figure 4 5 Measurement result table display tools EchoPAC PC User s Manual 101 EP092537 02 Measurements and Analysis 1 02 EchoPAC PC User s Manual EP092537 02 Stress echo analysis Chapter 5 Stress echo analysis Contents MON Suis UNDO t RE Sd QM EI iauSA PM IA MEME LEAL UE ait 104 e Review of protocol studies 1eeeeeeeeee nennen aa 105 e Selecting images for analysis rrrrrnreranrrarnrarnanennnennrrnernnnennnne 105 e Selection of images from a group eeeeeeeeeeeeeee 105 LOOP SYNENFONIZatlon BEEN RR P DUE 107 Stress echo analysis Aa 108 SENSE aa a adut ovt tuens suede ws yaa aieeee 108 PS COMING essea a a eae 109 IMAGE ODUMIZALON oan otros uis eta iaaa ene 111 TOODIImize IIiages 1 111 Aere dise E m T 111 e Quantitative TVI Stress echo analysis 112 e Accessing QTVI Stress analysis tools 114 e Vpeak measurement
40. button and drag the image in the Image container in the report 3 Depress the Left mouse button To print a report 1 Press Print The report is printed on the default printer A status window is displayed showing the printing process To save a report Only members of the user group Cardiologist are allowed to store a report see page 229 1 Press Store The report is stored in the Report archive A confirmation window is displayed when completed 2 Press OK Alternative storage Reports can also be saved in a user defined locations in the following formats e Compiled HTML CHM files readable from any web browser e Portable Document Format PDF files readable with Adobe Acrobat reader 1 Press Save as The Save as dialogue window is displayed 2 Select the destination folder from the Save in pull down menu The Report archive folder is selected by default EchoPAC PC User s Manual 1 71 EP092537 02 Report 3 Enter a file name 4 Select PDF or CHM format from the Save as type pull down menu 5 Press Save Retrieving an archived report 1 Press Retrieve A list of the available reports for the actual examination is displayed 2 Select the report to retrieve 1 72 EchoPAC PC User s Manual EP092537 02 Report Report designer The Report designer software package enables the user to create report templates that best suit its needs Designing a report template consists of
41. choosing the information to display in the report e g header footer logo patient information images measurements etc and arrange it in the report viewer The Report designer function is based on the information container concept each type of information is included within a container with parameters that can be configured size color font properties information to display etc Accessing the Report designer 1 Press Report 2 Press Designer in the Report screen The Report designer screen is displayed with the selected template in the Report template design area see Figure 8 2 EchoPAC PC User s Manual 173 EP092537 02 Report Report designer overview The Report designer screen 1 Menu bar File Edit Customize Insert Preferences 2 Report template design area Figure 8 2 The Report designer screen 1 74 EchoPAC PC User s Manual EP092537 02 Report The menu bar The File menu Meu Desorption gt Fie Edit Customiz New display an empty template e Save save the template using the same name and exits the Report designer Factory report templates cannot be overwritten Save as save the template using a new name and exits the Report designer Page setup display the printing version of the template where the user can adjust parameters specific to the Exit paper version i e margins Print Preview display a print preview of the report template Exit exit th
42. dataflow in the Name drop down menu see Figure 9 10 2 Check the Default box The dataflow will be selected by default when restarting the unit To create a new dataflow 1 Press Add The Add dataflow window is displayed Question Add Dataflow 2 Enter new name Workflow 1 cancel Figure 9 11 The Add dataflow window 2 Enter a name for the new dataflow 3 Press OK 4 Select an Input device in the Available inputs outputs field and press the Right arrow button to assign the service to the dataflow 5 Repeat step 4 to assign input output devices as desired Most dataflows consist of one input device and one or several output devices However in two cases it is possible to have two input devices when defining a dataflow with DICOM Worklist or DICOM Query Retrieve in combination with a database 6 Adjust the device s parameters as described below T To remove a device from the dataflow select the device in the Selected devices field and press the Left arrow button EchoPAC PC User s Manual 209 EP092537 02 Program configuration Adjusting the assigned devices 1 Select the device in the Selected devices field 2 Press Properties The Properties window is displayed 3 Adjust the device specific parameters as desired see table below Not all the settings listed below apply to all devices Alowrawdata raw data v save data in both raw and i save data in both raw and DICOM format f
43. following source archive from the Source drop down menu e Removable MOD Archive imports raw and DICOM data if present from a MOD Pure DICOM MOD525 350 RW imports DICOM data only from a MOD Removable CD Archive imports raw and DICOM data if present from a CD R Pure DICOM CD R imports DICOM data only from a CD R Remote Import Export Archive imports raw and DICOM if present data from an Echo server network EchoPAC PC User s Manual EP092537 02 Patient record management or EchoPAC PC direct connect or network Query Retrieve imports data from a DICOM server 6 Press OK The Import patient window is displayed see Figure 2 14 Copy Select All Done IMPORT PATIENT Removeable MOD 525 Last Name Patient ID First Name Birthdate dd mm yyyy Age Sex female male Echolab Born between i Diagn code zl Exam between _ Today Patient List 1 records fetched of total 1 Show All Delete selected patient s after copy lw Copy Images Copy only exams with on line images Import to Local Archive Int HD v Operator ADM M Figure 2 14 The Import patient window 7 Search and Select the patient records to import in the Patient list The following selection methods can be used Press and hold down SHIFT while selecting patient records examinations to select several consecutive items at a time e Press and hold down CTRL while selecting pat
44. frames 6 Use the Horizontal sweep slider and scroll through the cineloop to visualize a specific part of the data 7 Adjust the left and right markers to apply curve fitting to a specific region 8 Press the Right mouse button in the Analysis window The System menu is displayed 9 Select Curve fitting The Curve fitting menu is displayed EchoPAC PC User s Manual 1 55 EP092537 02 Quantitative Analysis Wash in A 1 exp kt 6 Wash out Aexpi kt B Figure 6 13 The Curve fitting menu 10 Select Wash out The Wash out curve is displayed in the Analysis window see Figure 6 14 Angio dB Figure 6 14 Wash out curve fit of two sample regions in an in vitro experiment 1 56 EchoPAC PC User s Manual EP092537 02 Quantitative Analysis Anatomical M Mode Introduction M Mode applied to TVI Tissue tracking Strain rate Strain or intensity data Contrast calculates and color codes data accordingly along a path drawn by the operator Using Anatomical M Mode 1 Select CAMM on the control panel 2 In one of the Cineloop windows anchor the first point of the path 3 Move the Mouse cursor to the location for the next anchoring point of the path Toeditapathunder 4 Press the Left mouse button to anchor the second point construction fol A path with two anchor points will give a straight low the line back anatomical M Mode profile By creating more than two ward and retrace anchor point
45. images on the template preview see page 124 Update group edits a selected group after new loop selection on the template preview see page 125 Delete group deletes selected group seepage 125 Hew group Update group Delete group Selecting a base template to edit Determine the re 1 Select the template to edit in the Template popup menu quired number of The selected template is displayed in the Protocol projections and lev template preview field showing the levels and projections els you need and se lect the most appropriate founda tion template and their labels see Figure 5 8 Adding deleting levels and projections 1 Enter the number of levels and projections in the Grid size field see Figure 5 8 The new grid size is displayed in the Protocol template preview field 2 Press New Template to create a new template OR Press Save Template to update the base template EchoPAC PC User s Manual 123 EP092537 02 Stress echo analysis The timers can also be started or stopped at any time during stress exam ination using the assignables T1 and T2 on the control panel After configura tion press either New Template or Update Template 124 Display timer s 1 Check the box es to display timer s as specified see Figure 5 8 Start analysis automatically 1 Check Auto start analysis to display the Stress Echo Analysis screen when the last acquisition is performed Assig
46. or US from the pop up menu Default Century select the desired Changes done on the date or time format format 1900 2000 or None from the will be effective only after rebooting the pop up menu system 1900 the number 19 is automatically displayed when entering the year in the patient date of birth to edit century press Backspace twice 2000 the number 20 is automatically displayed when entering the year in the patient date of birth to edit century press Backspace twice None the four digits have to be typed when entering the year in the patient date of birth Languages Language Language ENG select the desired language for the system from the pop up menu Manual Language Manual language ENG guag Select the desired language for the Online manual If not available the English manual will be displayed as default Units EchoPAC PC User s Manual 225 EP092537 02 Program configuration Units Select the desired units Metric or US from the pop up menu 226 EchoPAC PC User s Manual EP092537 02 Program configuration About The About sheet gives informations about the ultrasound unit concerning e software e hardware EchoPAC PC User s Manual 221 EP092537 02 Program configuration Administration Only users withad The Admin category is divided in six sheets ministration rights Backup enables the backup procedures for local patient have access to this RUE UI
47. r Database EA Worklist Outputs Properties x V r Database E dueryRetrieve ea Echopac MAC mgl Eemote Mstahase Check fe 1 Check Imaging Measure Report Connectivity System About Admin Service 1 Select a dataflow to edit 6 Add Remove a user defined dataflow Factory defined dataflows cannot be edited 7 Available input output devices that can be 2 Use selected dataflow as default assigned to the current dataflow 3 Store data directly to archive 8 Input output devices assigned to the current 4 Hide selected dataflow from the list of available dataflow dataflow 9 Add remove selected device to from the current 5 Option for the search function In the Search dataflow user defined dataflows only Create patient window select between None All 10 Adjust the settings for the selected assigned patients and Today s patient device Figure 9 10 The sublevel Dataflow example Dataflows available A set of pre defined dataflows is available on the unit as listed in the table below Input output devices cannot be added 206 EchoPAC PC User s Manual EP092537 02 Program configuration removed to from the pre defined dataflows However the settings for the devices can be adjusted see page 210 Pam LocalArchive Int HD LocalArchive MOD RemoteArch RemoteHD This dataflow RemoteArchive MOD cannot be used with an ImageVault 3 0 server mM s DICOM MOD 5 25 EchoPAC PC User s
48. see Figure 9 8 2 Press Delete 202 EchoPAC PC User s Manual EP092537 02 Program configuration The Comment texts sheet This sheet enables the creation and deletion of text inputs that can be used when entering comments in the Examination list window see Figure 2 2 page 14 REPORT LOOKUP VALUES Templates Diag Codes Comment Texts lten Pathology Descriptor Full text IMAGE QUALITY Consistent with cavity size STUDY TYPE dilatation Mormal STUDY CONDITION elongation Abnormal ELG RHYTHM catheter in left atrial ca Borderline LEFT VENTRICLE catheter in left atrial ap Small LEFT ATRILIM thombus Trivial RIGHT ATRIUM mass tumior Mild RIGHT VENTRICLE AORTIC VALVE MITRAL VALVE TRICUSPID VALVE PULMONIC VALVE PERICARDIUM AORTA PULMONARY ARTERY PULMONARY VEINS HEPATIC WEIN INFERIOR VENA Cava NORMAL STUDY Test Mildly Mild to moderate Moderate Moderately Moderate to severe Large Severe Severely Increased Decreased Absence of Presence of Anterior Posterior Hew Edit Delete Figure 9 9 The Comment texts sheet Refer to Direct report on page 70 for more information on creating editing and deleting comment text inputs EchoPAC PC User s Manual EP092537 02 Imaging Measure Report Connectivity System About Admin Service 203 Program configuration Connectivity This configuration set
49. velocity information TVI EchoPAC PC User s Manual EP092537 02 Stress echo analysis Review of protocol studies Image acquisitions based on a protocol study e g stress echo examinations can be reviewed from the Protocol screen See Figure 5 1 Exit Templ Editor Delete Images Move Image Analyze Sync Select 3 Level selection 4 Group of views 1 Projection selection 2 Selected loops Figure 5 1 The Protocol screen Selecting images for analysis Images can be selected manually or from a pre defined group in the Protocol screen Figure 5 1 Selection of images from a group If groups of images have been defined in the protocol template see page 124 the user can select a group of images for 105 EchoPAC PC User s Manual EP092537 02 Stress echo analysis analysis and sequentially analyze all images from all groups from within the Image analysis screen see page 108 1 Move the Mouse cursor over the group in the Group list to select the images Both the group name and the belonging images are highlighted 2 Select the group to start analysis of the selected group of images 1 Select a Projection 2 Select an image hal 1 1 1 1 HR 58 3 Select and open an Tis 0 8 26 1101 15 34 58 Image group J Apical A PSAX ER S DDE Parasternal Figure 5 2 Image selection from the Protocol screen Manual selection of images in the Analysis Screen 1 When currently in protocol analysis in
50. written to the CD After creating the CD the MPEGvue folder should be deleted otherwise its content will be added to the next MPEGvue export Reading MPEGvue CD MPEGvue CD can be read form any computer with Windows 98 2000 XP provided that DirectX 8 1 or later and Windows Media Player 7 1 or later are installed 1 Insert the MPEGvue CD in the computer CD drive The MPEGvue Patient list is displayed EchoPAC PC User s Manual Tf EP092537 02 Image Management Patient List mm Esan pate dl per Tees 1 Select the examination date Figure 3 22 The MPEGvue Patient list 2 Select the desired examination date to display the belonging images The MPEGvue screen is displayed Figure 3 23 78 EchoPAC PC User s Manual EP092537 02 Image Management GE Ultrasound 1 Clipboard select the image to display 6 Scrolling tool when in Freeze 2 Selected image 7 Display previous image 3 Single frame image 8 Display next image 4 Cineloop Display the MPEGvue patient list 5 Freeze run cineloop Figure 3 23 The MPEGvue screen EchoPAC PC User s Manual 19 EP092537 02 Image Management DICOM spooler DICOM spooler displays the current DICOM output jobs The jobs may be Storage Print Modality Performed Procedure Step or Storage Commitment The DICOM spooler is used for checking the current job s status when a job is saved or when the total spooler status on the right of the Archive windows displays an
51. 02 Appendix capture e DICOM network storage to DICOM server e Storage of reports and worksheets e Export of reports as PDF CHM Excel and ASCII formats e Export of cineloop as AVI e Export of single frame images as JPEG TruAccess Image review e TruAccess allows for instant access recall to digital raw data for uncompromised analysis and reporting e Fast and efficient image recall e Thumbnail image display for quick overview e Flexible image layout with multiple images allows for serial comparison of image data from different exam dates up to 12 images single frames and cineloops Image post processing e GE raw data enables full scanner post processing functionality e Anatomical M Mode Compress Reject e Gain Cine speed adjustment e Freeze unfreeze e Frame by frame review of cineloop Up Down and Invert e Zoom and pan facility Color map selection e DDP control e Color display on off e Horizontal sweep adjustment e Baseline shift e Physiological traces control gain and position e Tissue priority e Variance EchoPAC PC User s Manual 241 EP092537 02 Appendix 242 Image analysis Cardiac calculation package including extensive measurement and display of multiple repeated measurements Vascular measurement package Parameter annotation follows ASE standard User configurable measurement protocol Measure and assign capability The measurements can be automatically exported to the report Doppl
52. 2 Stress echo analysis Other options Grid size Grid size Humber levels 2 Humber projection views 4 Enter the number of levels and projections for the selected template Timers Start T1 at start of exam Start T2 at second level f starts T1 and T2 timers automatically Auto start analysis vi anaw yatoe n analele Auto start analysis e m displays the Stress Echo Analysis screen when the last acquisition is performed Smart Stress Smart stress MA stores a subset of the image acquisition settings geometry incl zoom gain compress reject power etc for each view in the protocol Smart Stress enables to set image acquisition settings for each view at baseline level and automatically get the same image settings in the corresponding views in the next levels In Continuous capture acquisition at peak stress the active cell must be moved manually through the views using the arrow buttons or foot pedal Reference image Reference image Baseline level When Show Reference is selected see Previous level page 121 selects either corresponding baseline loop or corresponding loop from the previous level to be displayed as reference image during acquisition 122 EchoPAC PC User s Manual EP092537 02 Stress echo analysis Pre defined groups Pen Pre defined groups e Shows the image groups created 1256 New group creates a new image group FLAA Select the desired
53. 69 TO PMES EP 171 TO SAVE STEP REDE T 171 Retrieving an archived report rrrarnarrvarenarrnervarrrnnnnnnnnn 172 FRE DON ESN REESE Ea 173 Accessing the Report designer 173 Report designer overview esses 174 Designing a report template eeeeesssss 177 Saving the report template rrrarrnnrrarerarrrerrnrrrnrrnernnnrnnne 182 Chapter 9 Program configuration NTOAUTTNN 184 Starting the Configuration package 186 To open the Configuration package 186 NEMNE 187 Ima dO o teen reet toes RE DRUMS ORE 188 The Global setup Sheeting aE 188 MOaSUTO ae 190 Configuration of the Measurement menu 193 EchoPAC PC User s Manual Vil EP092537 02 Table of Contents REP 198 The Report templates sheet 199 The diagnostic codes sheet seeeeeeeessss 201 The Comment texts sheet eeeeeeseeeeesee 203 CONNGCUVINY centri theese tee eas 204 DENN GR 205 Aagditioral Outpls iei vive eise posti den evi et piv PEE e Om DIOS TERMS 212 TROON ER 215 FOA TT 217 TR acer 221 SUNN 222 The system settings c or ioter an neste 223 jYorej eme a 227 AGOmIAISIFalIOD cis dex o rix XP XENON EE E ER RO ere 228 USE are 229 LOOP 232 Appendix Regulatory information ax
54. C User s Manual V EP092537 02 Table of Contents FOT SANNE NG 129 FOT STAN Se 129 FG AS RE T omnes 129 Accessing the Quantitative analysis package 130 OVeNEN see 131 The color cineloop WINKOW ccccccecceeceeeeeceeeseeeeeeaeenees 132 The Tissue cineloop window cccc eee eeeeeeeeeeseeeeeeeeenees 133 The analysis window rrrarrnrrrnrrrnnrvanrnnnrnnenanevannrrnnnennsennne 134 TRE COOL PA El 137 Generation OF TATE see 138 About the sample area rrannanrnannanrnnrnnrnannnnrnannannnnrnannnene 138 TO g nerate a trace nece pita Ree ie ped eei edes oio us 138 Manual tracking of the sample area dynamic anchored sample EA Ne 139 Zooming in the Analysis window eese 140 Deletion OF d trade gun 141 To delete all faGes ibat rese pi riii een ste 141 To delete one specific trace eeeseeeeeeseesee 141 Frame disSabDIllig iusen iod OcviietreEDSUEI e So Du CE 141 Disabling frames from the frame marker 141 Disabling frames in the cineloop windows 142 Re enabling all frames eeeeeeeeeeeereeeeeee 142 Optimizing sample area eese eene nenne 143 Reshaping a sample area eeeseeeeeereeee 143 Labelling a sample area eeeseeeeeeeeee 143 Optimizing the trace display
55. EP092537 02 Appendix Shortcut Description S Zoom select any point in a image and drag upward to zoom in downward to zoom out Panning tool in Zoom mode press and hold down SHIFT select any point in the image and drag around to display the different parts of the image Color modes select any point in the color bar and drag vertically to change the Baseline position Select the Start or End cineloop marker and drag horizontally to adjust the position In freeze select the frame marker on the ECG and drag horizontally or select any point on the ECG to display another frame Doppler select the Baseline and drag vertically to change its position 238 EchoPAC PC User s Manual EP092537 02 Appendix Doppler select any point in the Doppler spectrum except for the baseline and drag horizontally to adjust the Horizontal sweep AN Anatomical M Mode select the AMM cursor and drag vertically to change the position Y Anatomical M Mode select the AMM angle cursor arrow head and drag horizontally to change the angle Tissue Tracking Tissue Synchronization Imaging select the Start or End marker and drag horizontally to change its position EchoPAC PC User s Manual 239 EP092537 02 Appendix Product description 240 TruAccess EchoPAC PC workstation utilizes the TruScan architecture to provide patient archival and raw data image storage and is compatible with the Vivid 7 and Vivid 3 ultrasound units
56. G VED Annotation oe Sadr ET PR Ao zu 6 Control panel Physio Apply to all 7 Sample area tools Compare Reset en ge eg ee TE Img Size M2 35452557 UP DOWN SAMPLE SHAPE Q4 p mom mmm m m 4 Bampress b 4 Reject b re Figure 6 1 The Quantitative analysis window here with TVI data EchoPAC PC User s Manual 1 31 EP092537 02 Quantitative Analysis The color cineloop window Displays TVI Tissue Tracking Strain Strain rate or Angio color coded data Sample area 1 Indicates sampling position of the velocity TVI displacement Tissue Tracking percent deformation Strain deformation rate Strain rate or intensity Contrast trace The sample area is color coded the first sample area is yellow the second green etc The cineloop windows system menu This menu is entered by pressing the right Save As ack mouse button when the cursor is within one of Image Properties the Cineloop windows Direct Report Delete all Sample areas removes all traces at once Delete all sample areas Disable frame the current frame is excluded from the cineloop display Set Sample area Shape enables resizing of a selected sample area by setting height Label sample area width and tilt angle The trackball marker Delete anchor must be pointed at an anchored sample area Set sample area shape Label Sample area set a descript
57. MOD or CD R Figure 9 7 The Report templates sheet EchoPAC PC User s Manual 1 99 EP092537 02 Program configuration 200 Configuration of the Template selection menu The configuration of the Template selection menu is done by Selecting the application specific Template list left field and the application specific Template selection menu right field Inserting or removing report templates to from the Template selection menu Sorting the report templates in the Template selection menu Procedure Selecting the application specific template list and Template selection menu Select the desired application from the Application selection pop up menu over the list of report templates left field see Figure 9 7 The list of factory and user defined report templates left field see Figure 9 7 is updated showing the available templates for the selected application Likewise select the application for the Template selection menu right field see Figure 9 7 Inserting a template to the Template selection menu Select the template to insert in the Template list left field Press the Right arrow button The selected template is inserted in the Template selection menu right field Removing a template from the Template selection menu Select the template to remove in the Template selection menu right field Press the Left arrow button The selected template is removed from the Template selection men
58. MONARY ART w PL bdh A sA ACIR Consistent with Mormal Abnormal Borderline Small Mild Mildly Mild to moderate Moderate Moderately Moderate to severe Large cavity size dilated global dilatation wall thickness shape ejection fraction concentric hypertro asymmetric hypertro eccentric hypertrop paradoxical septal flattened septum in flattened septum in septal bounce can Severe excessive respirator Severely diffuse hypokinesis gt Increased gt hdl mcm mn Mew E dit Delete Close More gt gt Figure 3 17 The Insert text window The pre defined text list is organized in a three level hierarchy Selecting one item in column one Item displays a specific pre defined text list in column two Pathology related to the item selected Likewise selecting a pathology term in column two displays a specific pre defined text list in column three Descriptor related to the pathology selected 3 Navigate through the pre defined text list by selecting items in the columns and double click on the desired pre defined text to be inserted If a descriptor is selected both the descriptor and the pathology texts are inserted Press More gt gt to display the full text for the selected term Creating pre defined text input Creating a new Item first level 1 Select the first level 2 Press New The Enter new text window is displayed
59. Manual EP092537 02 of Image Management Advanced CM Run BREE T AME E Caliper Store Measure Alt Store 1 Q Analysis Alt Store 2 Direct Report lt lt Basic Active Mode 20 MM GM pw cw Tvi FT AMM Annotation Physio Apply to all Compare Reset Img 5ize gt gt 40689040 Color Maps Invert Baseline gt ffissue Pri gt Her Sw gt 4 Zoom gt Basic CM Run a BRR gt Rs GE Caliper Store Measure Alt Store 1 Alt Store 2 Direct Report Advanced gt Minimized Measure Store Figure 3 11 The M Mode Color control panel 58 EchoPAC PC User s Manual EP092537 02 Advanced Run peed Fram iban Gen Caliper Store Measure Alt Store 1 Alt Store 2 Direct Report lt lt Basic Active Mode DE s BERE n IE v AMM Annotation Physio Apply to all Compare Reset Img 5ize M2 3 4 6 8 9 22 DColor Maps Invert 1 Compress gt 4 Reject gt HerSwp gt 4 Zoom gt Angle Cor gt Baseline gt Image Management Basic cw 2 Run peed Fram Rs GEN Caliper Store Measure Alt Store 1 Alt Store 2 Direct Report Advanced gt gt Minimized Run eed Fram Measure Store Figure 3 12 The Doppler Spectrum control panel EchoPAC PC User s Manual EP092537 02 59 Image Management Run Stop Cineloop All modes Starts and stops the cineloop shortcut ALT R or SPACE BAR When running use Speed Frame to adjust th
60. S t X XX s Threshold for current segment green 5 Color coded tissue velocity 6 Result window with tissue velocity profile Vpeak threshold for current segment Color coding velocity thresholds and tissue e Green velocities above threshold value Yellow velocities near threshold 0 to 10 interval White velocities below threshold value 10 116 Figure 5 6 Vpeak Q stress display V peak measurement interpretation The systolic Vpeak in the tissue velocity profile is automatically detected and highlighted by a vertical bar see Figure 5 6 The automatically detected Vpeak should be visually verified by the user In addition Vpeak thresholds are displayed as color coded horizontal lines These thresholds represent statistical guideline values for peak velocity at peak stress level Dobutamine stress procedure for the three apical views Only threshold values for basal and mid segments for each apical view are defined see reference 1 on page 118 The result is highlighted by a color coding of the thresholds lines the color coding in the 2D image and the scoring bullet see Figure 5 6 EchoPAC PC User s Manual EP092537 02 Stress echo analysis Tissue Tracking Tissue Tracking calculates and color codes the displacement in tissue over a given time interval The displacement is found as the time integral sum of the tissue velocities during the given time interval The color coded displacements calculated
61. To perform a measurement from another study 1 Select to the required study The study folder is opened displaying the measurements related to this study Other related studies may also be available from within this study Select the measurement to perform Perform the measurement Completed measurements are marked with a check mark Figure 4 2 When the measurement operation is completed the next measurement on the list is automatically selected EchoPAC PC User s Manual a7 EP092537 02 Measurements and Analysis To skip a measurement in a study 1 Select the desired measurement 1 Performed measurement Cardiac 2 Next measurement is automatically selected Dimension AVAPIanimetry Q _ WallMotion Figure 4 2 Display of a performed measurement example 88 EchoPAC PC User s Manual EP092537 02 Measurements and Analysis Measure and Assign modality In this measurement modality the user performs a measurement and assign a label i Only assigned measurements will be saved CAUTION Starting the Measure and Assign modality Alternative Select 1 Inthe Image analysis screen click on Measure Caliper on the con The Measurement Menu is displayed over the control trol panel and select panel the measurement tool from the as 2 If not already selected select the actual measurement tool signables see Figure 4 3 1 Measurement tools Cardiac I Generic Area trace Volume Volume
62. agement Contents MONNA 44 IMAGE FEVIEN sr 45 e Review from the Image browser screen sesesse 45 e Review from the Review screen sseseeeeene 49 e Working with grouped IMAGES rrrnnnnnnnnnnnnnrnnnnvnnnnnnnnnnnanennenneennn 49 Image OPUMIZAUON o o dos ero Gentine dende 52 e Image analysis screen overview rrrurrnnnnnnrnannnernnnrnnnevannnnnnneennn 52 Control panel overview saccra ioi a a a a 54 e mage controls adjustment rranrnannrnnnnnnvnnrnnnnvannnnnnnnnnnnnnnnnnnnnnn 64 image OPUMIZAUON users 66 e Generated Anatomical M Mode c ccccceeceeeeeeeeeeeeeaeeeeeeeaes 69 Peep MUERE 70 e Saving stored images and cineloops to a standard format 15 e DICOM spooler uvaner ches 80 e Starting the DICOM spooler rrrrnnennnrnnnnnnnrnnanenanrnanennnnnnanennnen 80 EchoPAC PC User s Manual 43 EP092537 02 Image Management Introduction EchoPAC PC allows post processing of DICOM ultrasound images and raw data images from GE ultrasound scanners The user selects the images to analyze from the Image browser screen displays a thumbnail overview of all stored images sorted by examination for the current patient or from the Review screen displays all images for the current examination or from the Protocol screen for examinations based on protocol studies The main features of the EchoPAC PC image analysis package are e Image optimization adj
63. al apr Gen 164 Deleting a measurement masnnnnnnrn vennen ven ren renren teen enne nnne tnnt tna 165 Excluding mieasureimielllsemeeiadodp del seh eccm en tains lutte EN 164 Including measurements vennen vennen vennen vennen tenter tna 164 VEN een 164 XYZ ZN 66 250 EchoPAC PC User s Manual EP092537 02 GE Medical Systems GE Medical Systems Telex 3797371 P O Box 414 Milwaukee Wisconsin 53201 U S A Asia Pacific Latin America North America GE Ultraschall TEL 49 212 28 02 208 Deutschland GmbH amp Co KG FAX 49 212 28 02 431 Beethovenstralse 239 Postfach 11 05 60 D 42655 Solingen GERMANY
64. all frames eeeeeeeeeeeneeeennne 142 e Optimizing sample area oie Eie eren ace Fa Frank ku Esu EP Ue ERR YNSER Nu ERES ERR 143 e Reshaping a sample area rrurranrnnnranvnnnnnrnnnnannnnrnannannnnnnasnnene 143 e Labelling a sample area eeeeeeeeeeeeeee 143 e Optimizing the trace display eene e 145 sOpt rmiziHd NE Y axis ee 145 ECE SNOOP 146 e Switching modes or traces rennrnnnennnennnnnnnnnnnnnnnnnnnnnnnnnnnnnennnnnnnuen na 147 TO switch mode ups 147 TO SMN ACC TT TERT TE 147 GUrve fitting analysis assvslsdssssressrsaoensseev 148 Anatomical M Mod siccicckscsisciineveenecintadeantantntiesivesbistiancetnesaeenionine dE 157 MOAUUN 4 157 EchoPAC PC User s Manual 127 EP092537 02 Quantitative Analysis e Using Anatomical M Mode rrrrnrannnnrnarnannnnnnnnnnnnnnnnernnnnnennasnnnnn 157 e Optimizing Anatomical M Mode cccceccseecseeeeeeseeeteeeeeeeeees 159 128 EchoPAC PC User s Manual EP092537 02 Quantitative Analysis Introduction The quantitative analysis software package is designed for analysis of TVI Tissue Tracking Strain Strain rate and Contrast related raw data The main features of these options are For TVI e Multiple Time motion trace display from selected points in the myocardium e Arbitrary Curved anatomical M Mode For Tissue Tracking e Multiple tissue displacem
65. antitative Analysis sample area was anchored 2 Select the sample area to move in one of the Cineloop windows The sample area Is unanchored 3 Drag the sample area to a new location 4 Press the Left mouse button to anchor the sample area to the new location Zooming in the Analysis window 1 In the Analysis window press and hold down the Left mouse button while dragging the Mouse cursor to define the zooming area 2 Release the Left mouse button The selected area is displayed in the Analysis window To unzoom 1 Press the Right mouse button The System menu is displayed 2 Select Unzoom 140 EchoPAC PC User s Manual EP092537 02 Quantitative Analysis Deletion of a trace Alternatively press Delete or Back space The user can delete all traces at once or one at a time To delete all traces 1 Press the Right mouse button The System menu is displayed 2 Select Delete all traces To delete one specific trace 1 Place the Mouse cursor on the sample area to delete 2 Press the Right mouse button The System menu is displayed 3 Select Delete trace Frame disabling To re enable a frame select the corresponding frame marker To re enable succes sive frames press the left mouse button and drag over the frame markers Frame disabling excludes the actual frame from the cineloop display Frame disabling is available only with contrast data There are two ways to disable a f
66. ayed in the selected column 1 Insert new column to the left of the selected column 2 Delete selected column 3 Select column heading Dataflow Additional Columns in e sert A DELETE O Date ped fijee text ad Study StressEcho b rtkaate Tape Counter efrtended Lab WiMScores eftended DiagCode Disk arch for Report Image fined text M Imaging Figure 9 15 Configuration of the Examination list window Other configuration settings 21 8 EchoPAC PC User s Manual EP092537 02 Program configuration 7 Use free text addresses Use free text addresses Inthe Patient information window see Figure 2 4 page 19 The address information e g street city etc is entered in type specific fields v The address information is entered in a single field free text Use Date of birth In the Patient information window see Figure 2 4 page 19 enter either the patient age or the birth date L Enter age birth date field not available M Enter birth date the age is calculated 7 Use extended patient dialog Use extended patient dialog Inthe Patient information window see Figure 2 4 page 19 A The entire patient information data is displayed Patient information data displayed is restricted to a minimum e g name and Patient ID When unchecked press More to display the entire patient information data FEES Use extended search dialog In the Search Create Patie
67. blevels of the EchoPAC PC configuration package oets the cineloop controls and display Sets the patient information display Configures Measurement menu All page 190 by selecting and defining the sequence of the measurements and calculation to perform The selected measurements and calculation are displayed in the worksheet Templates Configures the Report templates All menu by selecting and ordering the templates to show in the menu Diagnostic codes 184 Create or delete pre defined text All input for the referral reasons and diagnosis EchoPAC PC User s Manual EP092537 02 Program configuration Comment texts Create or delete pre defined text All input for the comments e Dataflow Create new dataflows or Admin configure existing dataflows Additional outputs Configure the Alt Store 1 and Admin Alt Store 2 keys Tools Formats and verifies removable All media Formats Configures the Examination list All window display and other options related to the patient management e TCPIP Sets the Transmission Protocol Admin Internet Protocol e Settings Sets the date and time format Admin language and units Test Enables testing of the different Admin parts of the unit Displays information about the All page 227 software hardware and probes Administration e Backup Local archive and system Admin configuration backup Restore Restore local archive and Admin system
68. city traces The quantitative analysis is described in Chapter 6 Quantitative Analysis on page 127 113 Stress echo analysis Accessing QTVI Stress analysis tools The three QTVI Stress analysis tools are entered by pressing a dedicated button on the scoring diagram see Figure 5 5 of the selected view Only views with TVI data acquired will display QTVI Stress tools buttons on the respective diagrams 1 Vpeak measurement V peak measurement is 2 Tissue Tracking displayed in views from peak levels and only 35 Quantitative analysis after scoring A CAUTION 114 Figure 5 5 Q stress tools buttons Vpeak measurement This tool enables the user to generate a tissue velocity profile for a given wall segment through the entire heart cycle and display color coded Vpeak in tissue From the velocity trace the user can determine whether the systolic Vpeak is over or under a clinically determined velocity threshold see reference 1 on page 118 to confirm the wall motion scoring QTVI Stress can be used only in conjunction with wall motion scoring analysis as a guiding tool When activating QTVI Stress the measurement applies only to the latest completed scoring i e for a particular segment at a given level and projection view The scoring bullet in the segment is highlighted accordingly EchoPAC PC User s Manual EP092537 02 See page 116 for further information on Vpeak measure ment interpreta tion
69. color coded Tissue Tracking Displays tissue displacement trace Y axis displacement scale mm A X axis time s 1 L 1 1 1 L EO 0 TOT OF OS 06 0 TLL espen nr 3 um ECG With Tracking start and Tracking end markers Time at cursor position Displacement at cursor position Displacement at frame marker position color coded Strain rate Displays Strain rate trace rate of deformation s 1 Y axis s 2 Xaxis time s 3 ECG 4 Time at cursor position 5 Strain rate at cursor position 6 otrain rate at frame marker position 1 34 EchoPAC PC User s Manual EP092537 02 Quantitative Analysis Strain Displays Strain trace extent of tissue deformation Y axis percent displacement X axis time S ECG with Strain start and Strain end markers Time at cursor position deformation at cursor position deformation at frame marker position color coded i Contrast STE IEEE Displays time intensity curve Satis disci ficu Y axis Intensity scale logarithmic dB or linear acoustic units AU X axis Time s or dT s elapsed time from previous frame ECG displays ECG trace the current frame marker and the start and stop markers for the cineloop Time at cursor position Intensity dB or AU at cursor position Intensity dB or AU at frame marker position color coded EchoPAC PC User s Manual 1 35 EP092537 02 Quantitative Analysis Save As Image Propert
70. configuration from a backup page 228 Users Operator and referring staff Admin registration operator s rights settings Service This sheet is for service staff Admin only Deals with printer definition and keyboard configuration GT EchoPAC PC User s Manual 1 8 EP092537 02 Program configuration Starting the Configuration package To access the Configuration package the user has to log on as a specific user see page 229 This ensures user specific and user defined settings and presets to be used The access to the entire configuration package is user configuration dependent see page 229 To open the Configuration package 1 Select config The Log In window is displayed asking for operator ID and password see Figure 9 1 2 Select Log on when completed The Setup dialogue window is displayed see Figure 9 2 1 Select the operator 2 Type password OPERATOR LOGIN Operator Password Emergency Figure 9 1 The Operator login window 1 86 EchoPAC PC User s Manual EP092537 02 Program configuration Overview The configuration management package consists of a Setup dialogue window divided in different setup categories with sublevels sheets labelled with tab The functionality of each configuration category and associated sublevels are described on the following pages 1 Sublevel tabs for the selected Setup category 2 Setup categories Global Application A
71. cord management Press Today to display today s examinations and select the actual examinations Fill in the Exam between field to display the patient records done during a specific time period and select the actual records e Fill in the Born between field to display the patient records of patients born during a specific time period and select the actual records 8 Adjust the following settings as desired Delete selected patient s after copy Copy images Copy only exams with on line images when checked only selected examinations with accessible images will be copied 9 Press Copy lf one or more patient examination is already present in the destination archive the Export Import conflict window is displayed see Figure 2 11 For each conflicting item select Keep to keep the existing examination in the destination archive Replace to replace the existing examination with the corresponding item in the source archive EchoPAC PC User s Manual 29 EP092537 02 Patient record management IMPORT EXPORT COHFLICTS EEE 020202 20 02 0002 020202 20 02 0002 Do not eject the CD using the button on the CD drive 30 Figure 2 11 The Export Import conflict window 10 11 12 Press OK to resume export A progress indicator is displayed When done a status window is displayed showing the number of patient records that have been successfully exported Press OK A check mark is displayed in
72. d Volume s Dist Ratio Area ratio R R I Dimengie M Figure 4 3 the 2D Mode Measurement tools Cardiac application EchoPAC PC User s Manual 89 EP092537 02 Measurements and Analysis Alternative Press Caliper and select Caliper from the pull down menu See the Status bar to get the next step to perform The measurements displayed on the 2D image and the cor responding results are numbered Alternative Press Caliper and select Dist Ratio from the pull down menu See the Status bar to get the next step to perform 90 Performing measurements 2D Measurements 2D Length measurements 1 ROEN If necessary deselect Run cineloop to freeze the image and scroll through the cineloop using the Frame slider to select the desired frame Press Measure Select Caliper in the Measurement Menu see Figure 4 3 Move the cursor to the start point of the measurement Press the Left mouse button to anchor the start point of the measurement Move the cursor to the measurement end point The current distance value is displayed in the Measurement result table and is instantaneously updated when moving the cursor Press the Left mouse button to anchor the end point of the measurement The measurement result is displayed in the Measurement result table To assign a label to the measurement see page 99 Repeat steps 5 through 8 to make additional length measurements 2D length mea
73. d lt Q Cancel Figure 6 4 The sample area labelling window 4 Type a name for the sample area 5 Press OK to return to the Quantitative analysis screen 144 EchoPAC PC User s Manual EP092537 02 Quantitative Analysis Optimizing the trace display Applicable with contrast data only Optimizing the Y axis Auto scaling The system can be configured to display the full unit range or a range according to the maximum and minimum values of the displayed trace s auto scaling function In addition the auto scaling function can be set to be live update updates while the sample area is moved or delayed updated when the sample area Is anchored Setting the auto scaling function 1 Press the Right mouse button in the Analysis window The System menu is displayed 2 Select Vertical auto scaling The Vertical autoscaling menu Is displayed Figure 6 5 The Vertical Auto scaling menu 3 Select one of the following options Delayed autoscaling takes place after anchoring the sample area e On autoscaling while moving the sample area e Off displays full scale Vertical units When analyzing contrast data the Y axis can be set to display either logarithmic scale dB or linear acoustical units AU for both tissue intensity 2D or Angio intensity data EchoPAC PC User s Manual 145 EP092537 02 Quantitative Analysis Selecting the Y axis unit 1 Press the Right mouse button in the Analysis
74. d points position To assign a label to the measurement see page 99 Repeat steps 3 through 6 to make additional measurements Manual Doppler trace measurements 1 2 Press Measure Select Manual trace in the Measurement Menu A vertical green cursor is displayed on the spectrum Move the cursor to the start point on the left side of the trace Press the Left mouse button to anchor the start point of the measurement Trace the Doppler envelope The trace can be adjusted while tracing by moving the cursor backward to erase portion of the trace or the entire trace and then create the trace again Press the Left mouse button to complete the trace The following measurement results are displayed in the Measurement result table e Maximum and mean Velocities e Maximum and mean pressures e Env Ti e Velocity time integral VTI Move the cursor to the start point of the next heart beat Press the Left mouse button to anchor the next heart beat starting point The heart rate BPM is displayed in the Measurement result table Automatic Doppler trace measurements 1 Press Measure 2 Select Auto trace in the Measurement Menu Auto trace from Aar ea ean d th t lie radon vertical green cursor is displayed on the spectrum menu 3 Move the cursor to the starting point 4 Press the Left mouse button to anchor the start point of the measurement EchoPAC PC User s Manual 97 EP092537 02 Measurements and Ana
75. dialogue window is displayed Figure 9 5 ADD MEASUREMENT Cancel Blank C Use copy of Figure 9 5 The Add Measurement dialogue window EchoPAC PC User s Manual EP092537 02 Program configuration To add an existing measurement with pre defined parameters 1 select Use Copy of 2 Select the measurement in the pop up menu 3 Press OK To create a measurement with user defined parameters 1 In the Add measurement dialogue window select Blank 2 Press OK 3 Inthe Measurement field enter the measurement name 4 Select the desired measurement type in the Tool pop up menu The actual measurement parameters are displayed 5 Select the first parameter in the Parameter column 6 Enter a name for the parameter Adding a user defined function to a measure ment 1 Select the actual measurement in the Measurement menu The parameters related to the measurement are listed in Parameter list 2 Presstwice on an empty line at the bottom of the Parameter list The free text cursor is activated 3 Enter a name for the parameter 4 Select the Parameter line once again The Edit Formula dialogue window is displayed EDIT FORMULA Operators Parameters Functions Cancel Formula Unit Herre FS Figure 9 6 The Edit formula dialogue window EchoPAC PC User s Manual 1 95 EP092537 02 Program configuration 5 Create a formula by selecting parameters op
76. djust column width 13 Figure 2 2 The Examination list window Advanced search The list of searching To restrain the search to a specific patient group one or more filters may vary de filters may be applied to the search The table below shows the pending on the filters applicable to a patient search dataflow selected Searching filter Echolab Diag code 14 EchoPAC PC User s Manual EP092537 02 Patient record management Searching filter Date of birth time span Examination date time span Current date Stress examinations Sorting data The search result can be sorted according to the fields displayed in the patient list in ascending or descending order To sort data 1 Inthe Patient list field click on the header by which the sort is to be performed Figure 2 1 page 13 The patient list is sorted in ascending order according to the field selected 2 Click once more on the header The patient list is sorted in descending order according to the field selected EchoPAC PC User s Manual 15 EP092537 02 Patient record management Editing Referral Reasons Comments and Diagnosis Use the Arrow keys to move text mark er The Insert Text key can be configured to display an extended writing field see page 217 In this configuration the pre defined text in put function is started from within this new window The Code is the ab breviation shown in the Pre defined texts list
77. e Caliper Store cine speed When stopped use Speed Frame to scroll through the cineloop 2D Gain All modes Tissue gain Gain All modes but 2D Gain for the active mode Measure Alt Store 1 Q Analysis Alt Store 2 Direct Report lt lt Basic Caliper All modes Activates measurement tool unassigned measurement Measure All modes Activates the Measurement amp Analysis M amp A calculation program protocol based pre assigned measurements Quantitative Analysis 2D 2D Color otarts the Quantitative analysis program for TVI and contrast applications see page 127 Direct report All modes Displays the Direct report where the user can enter comments diagnosis and Ref reason information while doing image analysis The Direct report displays also an overview of the measurements performed Store All modes otores the currently active image to disk Alt Store 1 and 2 All modes otores the image to an alternative media This function is configurable Basic Advanced Displays the basic or advanced control panel 60 EchoPAC PC User s Manual EP092537 02 Image Management Active Mode 200 mm EFM pw cw Tvi AMM Annotation Cine Loop Physio Apply to all Compare Reset Img Size EchoPAC PC User s Manual EP092537 02 Active mode Color M Mode Doppler In combined mode switches between modes to activate the mode specific controls Mode selection A
78. e Report designer and returns to the report function The user can choose whether to save the updates or restore the original template Mew Save Save s Page Setup Print Preview The Edit menu p Meu scription gt Edit Customize Delete remove the selected object from the report template so Del Undo restore the previous state of the report template Undo EchoPAC PC User s Manual 175 EP092537 02 Report The Customize menu Meu BPesoritlon Customize Insert Prefere Page Color sets the default background color for the template page Anatomical graphics select and insert an anatomical Anatomical Graphics graphic cardiac vascular or TEE Image Image create a container for the display of ultrasound Page Color images Wall motion analysis insert a container for the display Measurements of Stress Echo analysis results cut planes Bull s eye Text Field and scoring table Fixed Text Measurements insert a container for the display of measurements and calculations When creating a measurement container the user is prompted through a configuration procedure enabling the selection of mode specific measurements and or calculations Text field insert a container where the user can write in the report Fixed text insert a container with static text The text typed during the creation of the container will be displayed in the report Wall Motion Analysis F
79. e in analysis Previous level Delete group OK Cancel Hew template Save as template Save template Delete template Figure 5 8 The Template editor screen Template be Template Exercise2x4 o e select a pre defined template from the pop up menu The Protocol template preview see below is updated accordingly 120 EchoPAC PC User s Manual EP092537 02 Stress echo analysis Protocol template preview Protocol template preview P rotocol te m p ate p revi ew ten ach max vi esax vi displays an updated preview of the template accordingly to the settings applied To edit Projection and Stress level labels select a pre defined label from the pop up menu or click on the label to edit and type a new name QStress acq Template settings Template settings Cycles Cont capt Preview of Show store reference Cycles selects the number of cineloop heart cycles to store for each level from the drop down menu 1 sr Continuous capture m enables continuous image acquisition throughout the level The images acquired are temporarily stored in the unit s storage buffer Preview of store hM enables review and adjustment of cineloops before storage Show reference m displays a dual screen with the reference level first or previous level on the left and the live image on the right EchoPAC PC User s Manual 121 EP092537 0
80. e intensi Ganee Figure 6 7 The Analysis signal menu 3 Select the desired trace The Analysis window is updated with the selected trace EchoPAC PC User s Manual 147 EP092537 02 Quantitative Analysis Curve fitting analysis Curve fitting analysis is used to estimate local myocardial perfusion rate using ultrasound contrast agents The analysis is based on two algorithms Note that A B contrast tissue plateau level Note that A B is the initial intensity level 148 Wash in curve fitting find and estimate local perfusion rate using contrast agent Exponential wash in is described by the function y t A 1 e kt B where e A dB or AU is the intensity from the contrast agent e B dB or AU is the intensity at time t 0 defined as the time of left marker This corresponds to the tissue baseline signal if no contrast is present at the selected starting point e k 1 s is a time constant Wash out curve fitting find and estimate the wash out rate of contrast agent locally e g LV or myocardium Exponential wash out is described by the function y t Ae kt B where A dB or AU is the intensity from the contrast agent e B dB or AU is the intensity from the tissue baseline signal e k 1 s is a time constant EchoPAC PC User s Manual EP092537 02 Quantitative Analysis eG occoceodeeedeecdecoobooo Intensity AU 1 2 Time s 900 Figure 6
81. e path to the shared volume on Vivid HL7 Gateway must be pre configured in the Sublevel Tools in the Configuration package see page 215 DICOM Print prints images to a DICOM printer via DICOM spooler EchoPAC PC User s Manual 27 EP092537 02 Patient record management e MPEGvue converts ultrasound images to MPEG format readable from a regular computer and export them to a CD 6 Press OK The Export patient window is displayed see Figure 2 10 Copy Select All Done EXPORT PATIENT Removeable MOD 525 More Last Name Patient ID First Name Birthdate dd mm yyyy Age Sex female male Patient List 2 records fetched of total 2 J Show All Patient ID Birthdate Status Msg Images Demo 020202 02 01 1902 Test Try 2323 Delete selected patient s after copy lv Copy Images Copy only exams with on line images Export from Local Archive Int HD v Operator janm nd 28 Figure 2 10 The Export patient window 7 Search and Select the patient records to export in the Patient list The following selection methods can be used Press and hold down SHIFT while selecting patient records examinations to select several consecutive items at a time Press and hold down CTRL while selecting patient records examinations to select several discrete items Press Select all in the Export patient window to export all patient records EchoPAC PC User s Manual EP092537 02 Patient re
82. e time after ECG R peak when the mode specific calculation starts TT End Tissue Tracking Strain End Strain The time after Track or Strain End when the mode specific calculation should end TT scale Tissue Tracking Controls the color cut off value of max displacement displayed SI length Strain rate Strain Determines the Strain Strain rate sample volume size SRI reject Strain rate SI reject Adjusts the cut off level of the low tissue velocity to be discarded Rejected values are uncolored Strain or green Strain rate Cine compound All TVI modes Calculates and displays cineloops generated from a temporal averaging of multiple consecutive heart cycles 63 Image Management SI scale Strain SRI scale Define the scale for the color coding for strain or strain rate TSI start Tissue Synchronization Imaging The time from the onset of QRS when TSI starts indicated by a red marker on the ECG The default value is set to approximate the time for start ejection and by the value on the left side of the color bar TSI end The time after TSI start when TSI ends indicated by a red marker on the ECG The default value is set to approximate the aortic valve closure and by the value on the right side of the color bar TSI algorithms Tissue Synchronization Imaging Enables the display of the following TSI features 4 TSIAlg gt Time to peak positive velocity color cod
83. egments due to low velocities and segment orientation see side note Tissue Doppler does not have perfect site specificity because of tethering by adjacent segments Thus although an ischemic segment has little thickening and therefore could be expected to show low velocity measured velocity may be influenced by local tethering reflecting contraction in surrounding segments Conversely a normal segment may have its velocity reduced by an adjacent segment with reduced velocity This tethering effect may decrease the sensitivity for single vessel disease but nonetheless the sensitivity and specificity of the cut offs are approximately 80 see reference 1 on page 118 Three different analysis tools based on TVI data are available e Vpeak measurement on page 114 enables the display of a tissue velocity trace for a selected region of a previously scored segment through the entire heart cycle In addition Vpeak is color coded on the 2D image From the velocity trace the user can estimate the peak systolic velocity see reference 1 on page 118 This tool is available in views from peak levels only and only when a segment has been scored in one of these views e Tissue Tracking on page 117 enables visualization of the systolic contraction of the heart by color coding the myocardial displacement through the systole e Quantitative analysis on page 118 enables further quantitative analysis based on multiple tissue velo
84. elect the source archive in the Dataflow field LocalArchive Int HD exports data from the local archive RemoteArch RemoteHD exports data from an Echo server 4 Press Export in the Search Create Patient window The Export dialogue window is displayed EchoPAC PC User s Manual EP092537 02 Patient record management EXPORT From To Local Archive Int HD am Removeable MOD Archive Me To change source press cancel and change current dataflow ca Figure 2 9 The Export Dialogue window 5 Select one of the following destinations from the Destination drop down menu e Removable MOD Archive exports raw and DICOM if present data to a removable MOD Pure DICOM MOD525 350 RW export DICOM data only to a removable MOD e Removable CD Archive exports raw and DICOM if present data to a CD R Pure DICOM CD R export DICOM data only to a CD R Remote Import Export Archive exports raw and DICOM if present data to an Echo server network or Vivid 7 direct connect Pure DICOM Storage exports DICOM data only to a DICOM server e Excel file exports data to a spreadsheet The excel file is stored in the location defined in the Sublevel Tools in the Configuration package see page 215 e HL7 exports examination results to the Vivid HL7 Gateway which feeds the results to HIS through HL7 protocol M amp A and diagnosis codes are stored as an Excel file reports are stored as CHM files The fil
85. ent is selected in the Measurement Menu Shows all the parameters related to the selected measurement e M the items is displayed in the Measurement menu e The item is hidden from the Measurement menu Only checked parameters will be displayed in the Measurement result window the worksheet and the report Auto sequence h Prompts the next measurement in the folder EchoPAC PC User s Manual EP092537 02 Factory Measure ment categories cannot be renamed Only user created items can be delet ed Program configuration Configuration of the Measurement menu Display of the Measurement categories 1 Press M amp A categories in the Configuration window The M amp A categories are displayed in a pop up window see page 191 2 Check the categories to be displayed Uncheck the categories to hide To copy a Measurement category 1 Press M amp A categories in the Configuration window The M amp A categories are displayed in a pop up window see page 191 2 Select the M amp A category name 3 Press Create copy A copy of the selected measurement category is displayed in the Measurement menu To rename the Measurement category 1 Select the Measurement category in the Measurement menu 2 Enter anew name in the Measurement field Selection of a Measurement category 1 Select to the Measurement menu heading The measurement categories are displayed in a sub menu 2 Select to t
86. ent trace display from selected segments in the myocardium e Arbitrary Curved anatomical M Mode For Strain rate Multiple Strain rate Rate of deformation s 1 trace display from selected segments in the myocardium e Arbitrary Curved anatomical M Mode For Strain e Multiple Strain extend of tissue deformation trace display from selected segments in the myocardium e Arbitrary Curved anatomical M Mode For Contrast e T ime Intensity analysis from multiple region of interest e Curve fitting e Arbitrary Curved anatomical M Mode If not otherwise specified the topics described in this chapter are applicable for both TVI and contrast data EchoPAC PC User s Manual 129 EP092537 02 Quantitative Analysis Accessing the Quantitative analysis package The Quantitative Analysis application is entered from the Image analysis screen see page 52 1 In the Image analysis screen select a TVI or Contrast acquisition 2 Press Quantitative Analysis The Quantitative analysis screen is displayed 1 30 EchoPAC PC User s Manual EP092537 02 Quantitative Analysis Overview 1 Color cineloop window 2 Tissue cineloop window Run Stop 4 peedFrame gt ban gt gt Caliper Store 3 Analysis window Measure Alt Store 1 4 Sample Area Alt Store 2 5 Time at cursor EE poe position and velocity at cursor position Active Mode EJ MM Color P CW m ME TR SRI IE Lo A
87. er auto trace function with automatic calculation Average calculation User defined mathematical functions Metric and US units Report ASE recommended report structured text statements help create reports in minutes on your Vivid 7 or off line on the EchoPAC PC Report function includes e Patient information Measurements Calculations e Ultrasound images e Wall motion scoring Contains a set of pre defined clinical report templates Printable on ink jet printer Report can be exported as PDF CHM Excel and ASCII formats EchoStress option Review of stress echo studies acquired with the Vivid 7 or Vivid 3 ultrasound units User configurable exam templates and labels including settings for pharmacological and exercise stress single loop and continuous loop capture Continuous loop capture EchoPAC PC User s Manual EP092537 02 Appendix e upto 14 levels e up to 10 projection views e User definable groups e Heart rate and ECG stored with each loop e Parallel raw data acquisition of greyscale 2D and tissue velocity information for quantitative stress analysis e Qualitative Wall motion scoring e Quantitative TVI Stress analysis provides three different analysis tools based on TVI data stored during stress acquisition e Vpeak measurement enables the display of a tissue velocity trace for a selected region of a previously scored segment through the entire heart cycle Tissue Tracking enables visua
88. er groups members of these groups see table below are allowed to login on the system when selected together with the group Operator They have group specific rights e Referring groups members of these groups Diagnosing physician and Referring doctor are not allowed to login on the system They are registered as references that can be EchoPAC PC User s Manual 229 EP092537 02 Program configuration associated to a patient record with a somme Paw p p J memes Wee p Sm 1 The rights associated to the user groups are a Create and delete e Create update and delete a patient record e Create update and delete an examination e Create update and delete an user or a referring member e Import Export patient records examinations e Move examinations Creating a user or a referring member 1 Press New 2 Enter e the person ID usually initials e a password e The full name 3 Select the type of user referring member in Member of Group s 230 EchoPAC PC User s Manual EP092537 02 Program configuration To be able to login on the system the group Operator MUST be A selected CAUTION Editing an user configuration 1 Select the actual user in the User list 2 Make the desired changes 3 Press Archive to exit the Configuration management package Deleting a user 1 Select the actual user in the User list 2 Press Delete The user is removed from
89. erators and functions Unit All results are calculated in SI units If the unit is not specified or not one in the table below the displayed value will be in SI units All conversions to other units must include a conversion factor in the formula If the unit is one in the table below the conversion factor will be included in the formula Make sure that the formula gives a SI unit that is compatible with A the conversion unit CAUTION 6 Press Check to control the formula 7 Press OK to store the parameter GE Ultrasound do not take any responsibility for the correctness A of the user defined functions CAUTION Gwen 8 Mem rm a a rad Angle deg grad Distance cm dm cm mm inch feet pixels Velocity dm s cm s mm s inch s Acceleration dm s2 cm s2 mm s2 inch s2 Area dm2 cm2 cm 2 mm2 inch2 Volume dm3 cm3 dl cl ml gallon quart Volume flow dm3 s cm3 s I s dl s cl s ml s m3 min dm3 min cm3 min l min L min dl min cl min ml min ml m2 Pressure mmHg Pa kPa bar torr atm psi Pressure time mmHg s mmHa s 1 96 EchoPAC PC User s Manual EP092537 02 Program configuration Other Co NR Date WeekDay Day NoUnit l minm2 g m2 cm m2 EchoPAC PC User s Manual 1 97 EP092537 02 Program configuration Report 198 The Report configuration category is divided in three sheets Templates enables the configuration of the Temp
90. error From the DICOM spooler the user can also e Delete non active jobs e Resend a job that has failed or is in hold e end a job that has failed or is in hold to a new destination The job s status displayed in the D COM spooler window can be e Pending the job is complete waiting to be active e n hold the job is incomplete waiting for more images e n progress the job is connected to the destination device but is waiting for more images Direct store function e Active the job is complete but one or more images failed to transmit to the destination device e Failed the job is complete but failed to connect to the destination device e Done the job is saved to the destination device The jobs that are done are removed from the spooler after a while Starting the DICOM spooler 1 Press and hold down the ALT key and press S The DICOM spooler window is displayed see Figure 3 24 The DICOM spooler window is automatically updated every minute Press Refresh to update the information displayed at any time 80 EchoPAC PC User s Manual EP092537 02 Image Management DICOM JOB SPOOLER 4 iastname Patientib Destime Type Contents Status Error informa Retresh Delete Resend Send To Hide Only non active jobs can be deleted Only jobs that failed or are in hold can resent Only jobs that N Figure 3 24 The DICOM job spooler window Deleting a job 1 Select the job t
91. es at what time the tissue velocity reaches its peak positive value Time to onset of positive velocity color codes at what time the velocity increases above a given TSI Threshold default 0 cm S Time to peak negative Strain rate color codes at what time the tissue strain rate reaches its peak negative value TSI Threshold Tissue Synchronization Imaging Controls the minimum value to detect Image controls adjustment Controls with multiple settings can be adjusted in two ways as shown in Figure 3 13 64 EchoPAC PC User s Manual EP092537 02 Image Management Decrease stepwise Increase stepwise 9 Select setting on the Q r o scale S I I I I y I I N I I Figure 3 13 Image control adjustment EchoPAC PC User s Manual 65 EP092537 02 Image Management 66 Image optimization 1 6 Select the image of interest The control panel displays the mode specific controls If necessary display the advanced control panel see page 54 If applicable deselect Run Cineloop to freeze the image and scroll through the cineloop using the Speed Frame control or by dragging the frame marker on the ECG to display the desired image In dual modes press Image size until the desired display is shown see page 61 Press Active mode to toggle between modes The control panel is updated accordingly Adjust the mode specific image controls to optimize the display Press Store to save the changes Zo
92. ess OK The template is saved and the Report screen is displayed 1 82 EchoPAC PC User s Manual EP092537 02 Program configuration Chapter 9 Program configuration Contents PEP OG UG OID ee 184 TOVE EN ar 187 Mag ete 188 The Global setup sheet rrrrrrarenannnnrranerannnnrnnernanenurnnennnnennnnn 188 SCAN INTO sagaen 189 PIMC AS UNG Luna 190 e Configuration of the Measurement menu 193 REN NN 198 COnnecUIy vasre 204 D UM ve 205 AMONA OUMU ve 212 MOOI EEUU 215 FONN NN 217 TOPP vu 221 Maki 222 e he system settings d 223 SADOUE onna EEE eI DER IN 227 e lnc 228 USES qa UE 229 eon 232 EchoPAC PC User s Manual 183 EP092537 02 Program configuration Introduction Global This chapter describes the configuration management package of EchoPAC PC workstation The EchoPAC PC configuration package enables the user to customize the global configuration for the workstation In addition users with administration rights have access to the local archive backup function local archive restore function and creation of users The configuration management package consists of a Setup dialogue window divided in different setup categories with sublevels The table below summarizes the contents and access rights of the different categories and su
93. examinations Examinations can be moved from one patient record to another 1 In the Search Create Patient window press in front of the patient record containing the examination s to move see Figure 2 1 page 13 2 Select the examination to move To select several examinations press and hold down CTRL or SHIFT while selecting 3 Press Move Exam The Move exam window is displayed Move Exam Cancel Move Exam To New Patient More se Patient ID First Hame Birthdate dd mm yyyy Age Category Sex female male Echolab Born between j Diagn code Exam between M ead Images Stress Report Diagn Phys v Patient List 2 records fetched of total 2 Images Demo 020202 02 01 1902 F Test Try 030203 02 02 4952 Dataflow Local Archive Int HD X Operator ADM Figure 2 6 The Move exam window 4 Search and select the target patient record o Press Move Exam 22 EchoPAC PC User s Manual EP092537 02 Patient record management A warning message is displayed asking the user to confirm the action to perform see Figure 2 7 You re about to move exam N exam 6 on patient 020202 to Patient 030203 Are you sure you want to move the exam cot Figure 2 7 Moving examination prompt 6 Press OK An information window is displayed to confirm the operation T Press OK EchoPAC PC User s Manual 23 EP092537 02 Patient record management
94. hapter 1 Getting started Contents e Launching EChoPAG P uu cdosxetua emus douce a eo esa ducis eese ad 8 To start ECNOPAG PC 12 ose t eaae doe suo De Ve ek Y YErSrsoz2ReYcri a D 8 e EchoPAC PG overview 2 oen o ic pevsce ds bat eoo seu o een di ds Foo queue con soe toes 9 EchoPAC PC User s Manual r EP092537 02 Getting started Launching EchoPAC PC To start EchoPAC PC 1 Start the EchoPAC PC workstation The unit undergoes an initialization sequence and the Operator login dialogue box is displayed see Figure 1 1 2 Enter the required information and press Log on The Search Create patient window is displayed with the default dataflow selected see Figure 2 1 page 13 1 Select the operator 2 Enter password OPERATOR LOGIN Operator Password Emergency Figure 1 1 The Operator login windows For user of EchoPAC PC Software Only It is possible in Windows to start several instances of EchoPAC PC I e the same application is launched more than once It is strongly recommended not to do this as this will cause several functions and features in EchoPAC PC not to work properly Only ONE instance of EchoPAC PC should be running CAUTION 8 EchoPAC PC User s Manual EP092537 02 EchoPAC PC overview Archive Patient Img Browser Getting started EchoPAC PC is build on eight different main screens that can be entered by selecting the buttons in the top of the window see Figure 1 2 Rev
95. he control panel see Figure 3 14 4 Using the Cycle select control move from heart beat to heart beat to select the heart cycle of interest To jump directly to 5 Using the Num cycles adjust the number of heart cycle to the first or to the incorporate to the cineloop last heart beat i A S He 6 Using the Left marker and Right right controls trim or Last cycle button expand the cineloop boundaries 7 Check Sync to synchronize all the cineloop EchoPAC PC User s Manual 6 Image Management 8 Press Done to return to the Image Analysis screen 68 EchoPAC PC User s Manual EP092537 02 Image Management Generated Anatomical M Mode Anatomical M Mode AMM displays can be generated from raw data 2D 2D Color and TVI images To generate Anatomical M Mode images 1 Inthe Image analysis screen select a 2D 2D Color or TVI image 2 Select MM or AMM The Display window is updated with an M Mode image The 2D sector displays a time motion cursor for the AMM 3 Adjust the AMM cursor position and angle as shown in Figure 3 15 All other controls are similar to conventional M Mode see page 54 and followings 1 AMM cursor angle adjustment 2 AMM cursor position adjustment Figure 3 15 Adjustment of the AMM cursor EchoPAC PC User s Manual 69 EP092537 02 Image Management Direct report Direct report enables the user to write comments during image analysis that will be part of the final report Direct repor
96. he group to edit The selected cell are highlighted in the Protocol template preview field Either select a new cell s to add to the group or deselect an existing cell s to remove from the group Press Update group in the Pre defined group field The display in the Protocol template preview field is updated accordingly Deleting a group A selected group is 1 Inthe Pre defined group field select the group to delete Fe 2 Press Delete group d The group is removed from the list in the Pre defined group field EchoPAC PC User s Manual 125 EP092537 02 Stress echo analysis 126 EchoPAC PC User s Manual EP092537 02 Quantitative Analysis Chapter 6 Quantitative Analysis Contents MOUM IN onte uda Risa OUR RU A id 129 e Accessing the Quantitative analysis package 130 EO ET Me me 131 e Generation OF d trace eio bee boa Elche GRS 138 ADOUL ING sample ar a sce trovi PO Dese et D v Pe Ped 138 TO GENENE a Tace eee 138 e Manual tracking of the sample area dynamic anchored sample ar e EE ERE eae ES 139 s DEIEUON F ACE se 141 e To delete all traces va ecd Ara bt eeriinis d rd 141 e To delete one specific trace mrmnrmrrnrernnrvnvernrvaveneerurnusenurnueenenn 141 Frame disabDIIFiQ saadan ean U d QER ae 141 e Disabling frames from the frame marker 141 e Disabling frames in the cineloop windows 142 e Re enabling
97. he measurement category of interest The measurement category is displayed Moving an item in the Measurement menu 1 Select the entry to move into the Measurement menu 2 Press or to move the selection up or down inside the Measurement menu Deleting an item in the Measurement menu 1 Select the entry to delete in the Measurement menu 2 Press to delete the item EchoPAC PC User s Manual 1 93 EP092537 02 Program configuration 194 Display hide a folder or a measurement in the Measurement menu The Measurement menu Folders and Measurements can be configured to display only the entries folders and measurements of interest To hide a folder or a measurement 1 Uncheck the actual folder or measurement in the Folder or Measurement field in the Configuration window To display a hidden folder or measurement 1 Check the actual folder or measurement in the Folder or Measurement field in the Configuration window Creating a user defined folder 1 If the folder is to be inside another folder select the actual folder in the Measurement menu 2 Press Add folder The Measurement menu is updated 3 Select the new folder and Enter the folder name in the Name text field Adding a measurement to a folder The user can either add a pre defined measurement or create a new measurement with user defined parameters to a folder 1 Select the folder in the Measurement menu 2 Press Add Measure The Add measurement
98. hen doing average calculation To exclude include a measurement 1 Move the cursor over the measurement value to exclude include 2 Press the Right mouse button and select Exclude value Include value in the displayed menu Manually changing a value Individual measured values can be manually changed using the alphanumeric keyboard 1 64 EchoPAC PC User s Manual EP092537 02 Worksheet To manually change a value 1 Move the cursor over the value that is to be changed An asterisk indi 2 Press the Left mouse button cates that the value 3 Use the alphanumeric keyboard to enter the required value has been manually altered The calcula To restore automatic calculation tion type is changed to Edit 1 Move the cursor to the relevant cell in the Method column 2 Press the Left mouse button A pop up menu is displayed showing the different calculation options available Figure 7 2 3 Select the required option The value is updated accordingly Deleting measurement parameter 1 Move the cursor over the value that is to be deleted 2 Press the Right mouse button and select Delete value in the displayed menu EchoPAC PC User s Manual 1 65 EP092537 02 Worksheet 1 66 EchoPAC PC User s Manual EP092537 02 Report Chapter 8 Report This chapter includes the following information ANTONIO see 168 Creanga FO DONG avs n 169 e Working with the report function esseeeee
99. ient records examinations to select several discrete items Press Select all in the mport patient window to export all patient records Press Today to display today s examinations and select EchoPAC PC User s Manual 33 EP092537 02 Patient record management the actual examinations e Fill out the Exam between field to display the patient records done during a specific time period and select the actual records Fill out the Born between field to display the patient records of patients born during a specific time period and select the actual records Adjust the following settings as desired Copy images Copy only exams with on line images when checked only selected examinations with accessible images will be copied Press Copy If one or more patient examination is already present in the destination archive the Export Import conflict window is displayed see Figure 2 11 For each conflicting item select Keep to keep the existing examination in the destination archive Replace to replace the existing examination with the corresponding item in the source archive 34 EchoPAC PC User s Manual EP092537 02 Patient record management IMPORT EXPORT COHFLICTS ER ee 020202 20 02 0002 020202 20 02 0002 Figure 2 15 The Export Import conflict window Press OK to resume import A progress indicator is displayed When done a status window is displayed showing the number of patient records tha
100. ient record management Begin Exam EndExam Patient Info Search Image list AddExam DelExam Export To Excel Export To HI EXAMINATION LIST Local Archive Int HD Spend pate 0 LR 21 02 2002 23 09 2002 1710 2002 0811 2002 Referral Reasons Diagnosis Code Local HD xu x J AORTA y 40 aSArans dilatatec AO asArans desc dia AO asc dialatated Insert Text AO asc dilatated Insert Text AO desc dilatated AO desc dilatated Ao Horm AO root asc desc dili o AO root asc trans dil AO root dilatated AO root Horm Insert Text AO root sinuses asc AO root sinuses asc AO root trans desc a AO sinuses dilatated 4 Hew Text Hew Sub Text 1 Pre defined text input list 4 Highlighted text input 2 Create top level text input 5 Expanded text input 3 Create sublevel text input Figure 2 3 The pre defined text input tool EchoPAC PC User s Manual 17 EP092537 02 Patient record management Editing demographic data A WARNING A CAUTION 18 If you modify the Patient ID Last name First name or Date of birth on a patient in the archive be aware that the contents of the archived images for that patient is not updated If the images are still in the buffer and not yet archived the image files are updated if you modify any patient information but not if the images are archived So if any of these images are later on exported to DICOM media or DICOM server they will still contain the original patie
101. ies Direct Report Delete all sample areas Analysis signal Drift compensation Horizontal scale Vertical auto scaling Line style smoothing Export traces Curve fittin Camel Vertical unit b Cuvettting a With contrast data only b Shown only in zoom mode The analysis window system menu This menu is entered by pressing the right mouse button when the mouse cursor is within one of the analysis window Delete all Sample areas removes all traces at once e Analysis signal toggles trace display between velocity displacement strain rate stain or greyscale intensity curves Drift compensation compensates drifting of strain or Tissue Tracking curves by either resetting the curve to zero at the tracking start point cycle resetting or by linear compensation throughout the cycle linear compensation Horizontal scale set horizontal unit as time s or time interval dt between frames Vertical auto scaling selects between full unit range or a range according to the maximum and minimum values of the displayed trace s e Vertical unit toggles between logarithmic dB and linear acoustical units AU Line style selects between solid line only or solid line with square markers at each data point e Smoothing smooths the trace displayed by applying a filter over a defined time window Both the filter type and time window are user selectable The type of filter available is de
102. iew Protocol Img Analysis Worksheet Report Contig Hi 0900 09 9 0 00 ig Help Exit gt DO 1 2 Selected screen Archive e Search patient Create patient Patient Patient info Examination list Medical info Image Browser Displays a thumbnail overview of all images stored for the current patient record Review Image Analysis Image optimization Measurements Quantitative analysis Worksheet Measurements listing Report e Summarizes data from examination Config EchoPAC PC configuration Help Displays on line user documentation e Displays all images of the selected examination 42 Exit Protocol Review protocol based examinations Figure 1 2 The EchoPAC PC navigation buttons EchoPAC PC User s Manual EP092537 02 Getting started 1 0 EchoPAC PC User s Manual EP092537 02 Patient record management Chapter 2 Patient record management Contents e Searching a Patient record rnnennnnnnnnnnnnnnnnnnnnnnnnnnnnnennnnnnnunnnuvnn venn 12 s odd PEUENEIECOTO pva 12 e Advanced search rranrnnnnnannnnrnnnnnnnnnnnnnnennnnnnnenannnnrnnnennnnnnnnnnnnnn 14 Editing Referral Reasons Comments and Diagnosis 16 TOT EAON ansees gen aaariee aes 16 e Inserting pre defined text input r rrrarnnnnnnnrrannrannnnernneranevaennennn 16 Editing demographic data rnnnnnnnnnennnnnnnvnnnnnnennnnnnnnnnennnnnnnennnnnnunnn ees 18 e Creat
103. in the myocardium are displayed as color overlay in the respective acquisition window By studying the color patterns generated in the different segments the user can confirm the standard segmental wall motion scoring see page 109 at peak levels To display Tissue Tracking 1 Select a loop with TVI data usually an apical view at peak level 2 Inthe corresponding Wall segment diagram press T see Figure 5 5 page 114 The Tissue Tracking color overlay is displayed in the acquisition window Figure 5 7 Tissue Tracking display EchoPAC PC User s Manual 1 1 r EP092537 02 Stress echo analysis Quantitative analysis Quantitative analysis enables further analysis based on multiple tissue velocity traces Quantitative analysis is performed using the Quantitative analysis package described in Chapter 6 Quantitative Analysis on page 127 To start quantitative analysis 1 Select a loop with TVI data usually an apical view at peak level 2 Inthe corresponding Wall segment diagram press Q see Figure 5 5 page 114 to launch the Quantitative analysis package see page 130 References 1 Application of Tissue Doppler to Interpretation of Dubotamine Echocardiography and Comparison With Quantitative Coronary Angiography Cain P Baglin T Case C Spicer D Short L and Marwick T H Am J Cardiol 2001 87 525 531 1 18 EchoPAC PC User s Manual EP092537 02 Stress echo analysis Editing creating a te
104. indow Up to eight different sample areas may be generated in the myocardium 152 Figure 6 10 Wash in curve fit of Real Time MC data Wash in curve fitting using varying triggering intervals If the data set contains frames with uneven time intervals e g triggered images with increasing triggering intervals it is possible to plot the data using the time interval dt on the X axis 1 Disable unwanted frames see page 141 Curve fitting will be performed using all enabled frames 2 In one of the Cineloop windows Anchor one or more sample areas in the myocardium 3 dfdesired reshape the sample areas as described on page 143 EchoPAC PC User s Manual EP092537 02 Quantitative Analysis 4 Perform manual tracking see page 139 of the sample areas on all frames to ensure that the sample area is inside the myocardium 5 Press the Right mouse button in the Analysis window The System menu is displayed 6 Select Horizontal scale The Horizontal scale menu is displayed 7 Select dT scaling The X axis in the Analysis window is updated accordingly 8 Press again the Right mouse button in the Analysis window 9 Select Curve fitting The Curve fitting menu is displayed Washin A 1 expi kt B Wash out Aexspf kt B Figure 6 11 The Curve fitting menu 10 Select Wash in The Wash in curve is displayed in the Analysis window EchoPAC PC User s Manual 1 53 EP092537 02 Quantitative
105. ine stress echo Wall Motion Scoring remains the basis for the diagnosis of CAD in stress echocardiography QTVI Stress may be used as a guidance tool to check this interpretation The current version of QTVI Stress is based on the assessment of peak velocity at peak dobutamine stress see reference 1 on page 118 The normal ranges have been validated in the average patient presenting for stress testing The velocity cutoff values for the Vpeak measurement will not work in the following cases e Submaximal stress lt 85 predicted max HR e Patients at extremes of age 40 or gt 70 e Previous myocardial infarction revascularization e Previous heart failure cardiomyopathy hypertrophy arrhythmia aortic regurgitation 1 12 EchoPAC PC User s Manual EP092537 02 Velocity measure ments in mid and basal segments of the myocard will contain contribu tions from the api cal region of the myocard E g if measured value in a mid segment is be low the cutoff value for this segment then this might re late to a reduced function in the mid or apical region EchoPAC PC User s Manual EP092537 02 Stress echo analysis The velocity cutoff values are based on placing the sample volume at center of each cardiac segment at start of systole the left ventricle myocardial segments are defined by the American Society of Echocardiography 16 segments model However the velocity cutoff model does not cover the apical s
106. ing below In these particular frames the sample area is displayed with an anchor The sample area moves smoothly between the anchored positions when playing scrolling the cineloop To generate a trace Trace from a pre defined sample area 1 If necessary select the sample area Shape button I2 2 Move the Mouse cursor to one of the Cineloop windows The mouse cursor is changed to a sample area white circle A preview of the trace in white is displayed in the Analysis window 3 Press the Left mouse button to anchor the sample area In this frame the sample are is marked with an anchor If the cineloop has more than one heart cycle a sample area will also be anchored in the corresponding frame in the next heart cycles The trace is updated accordingly in the Analysis window The Strain cursor In Strain and Strain rate modes the sample area displays a Strain cursor showing the segment along the beam direction that is used for Strain and Strain rate calculations Make sure that the Strain cursor is within the myocardium when anchoring the sample area EchoPAC PC User s Manual EP092537 02 In the original frame and this par ticular frame the sample area is marked with an an chor In these frames the sample area is marked with an an chor Quantitative Analysis Trace from a freehand sample area Select the Pencil button 7 Move the Mouse cursor to one of the Cineloop windows The mouse cursor is changed to
107. ing a new Patient record cessere vann 20 e Deleting archived information eeeeseee sees 21 e Deleting a patient record rnrrnnnrnnnnnrrnnrnannvnnvnannnnrnnnrnnnnnnnnnnnnnn 21 e Deleting an examination rrnnrrnnnnnnrnnnnnnnnnnrnnnnnannnnrnnnnnnnnnnnnnnnnnn 21 e Moving examinations rrennennnnnnnnnnennnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnennnunnn unne 22 e Using removable media annnnnnnnnnnnnnnnnnnnnnnennnnnnnnnnnnnnnnnnnnnnnnnennnennn e 24 e Recommendation concerning CD R handling 24 e Formatting removable media rrrarernrrnnnnnnevannnernnnnnanenannnnnnnnnnnn 24 e Ejecting removable media cccccccececeeceseceeceeeceeeaeesaeeseeeaes 24 Export Import patient records examinations 26 e Exporting patient records examinations 26 e Importing patient records examinations 32 Data Backup ANA T S E ja ie 36 BACKUP POLENE Mee TE Em 37 eIestore DrOCOBUE S Lua uvm T PvE Dieu oo Nrin 41 EchoPAC PC User s Manual 11 EP092537 02 Patient record management Searching a Patient record Refer to page 204 for further informa tion on connectivity setup EchoPAC PC can be configured to generate patient ID The automatic searching tool dis playing matching patient information in the Patient lis
108. ing and data archiving capability compatible with the Vivid 7 ultrasound unit EchoPAC PC takes special advantage of the easy access to ultrasound raw data provided from the Vivid 7 enabling full image post processing EchoPAC PC has also access to ultrasound data through DICOM Media Interchange allowing import from removable media and storage to removable media of DICOM images single or multiframe EchoPAC PC captures scan data from basic ultrasound application such as adult and pediatric cardiac stress echo cardiography transesophageal and intra operative imaging EchoPAC PC product range The EchoPAC PC product range consists of EchoPAC PC User s Manual 1 EP092537 02 Introduction e EchoPAC PC Workstation a turnkey solution consisting of hardware and software in a complete package e EchoPAC PC Software Only only the software to be installed on any PC that fulfills minimum requirements The EchoPAC PC Workstation and The EchoPAC PC Software Only have the same clinical functionality except for the following features that are not available in EchoPAC PC Software Only e No writing directly to CD RW Must be done by other software packages e The TCPIP settings cannot be configured within the application it must be done in Windows e InSite iLink is not available e Removable media cannot be formatted within the application e Removable media cannot be ejected from within the application e The
109. is displayed in the Measurement result table 7 To assign a label to the measurement see page 99 8 Repeat steps 3 through 6 to make additional length measurements Editing M Mode Length measurements 1 Double click on the anchor point to move The selected marker turns green and is unanchored EchoPAC PC User s Manual 93 EP092537 02 Measurements and Analysis Alternative Press Caliper and select Ao LA from the pull down menu See the Status bar to get the next step to perform Alternative Press Caliper and select LV study from the pull down menu 94 2 Drag the anchor point to a new position 3 Press the Left mouse button to anchor the point at the new location Ao LA study 1 Press Measure 2 Select Ao LA in the Measurement Menu 3 Move the cursor along the time axis to the required point to start measurement of Aorta root diameter 4 Press the Left mouse button to anchor the starting point for the measurement 5 Move to the measurement end point 6 Press the Left mouse button to anchor the measurement end point The Aorta root diameter measurement value is displayed in the Measurement result table A new free moving cursor is displayed on the image ready for the next measurement 7 Repeat steps 3 through 6 to measure Left Atrium The LA value is displayed in the Measurement result table The Ao LA ratio is displayed in the Measurement result table LV study The LV study consis
110. ith administration rights See page 229 have access to the backup function Data backup for EchoPAC PC Software Only Moving images EchoPAC PC Software Only Moving images from the local harddrive to a removable media can only be done using the procedure described in Backup procedure on page 37 DO NOT attempt to move copy images in Windows Explorer as the image pointers in the patient database will not be updated for the images in the new location If you copy images in Windows Explorer and delete EchoPAC PC User s Manual EP092537 02 A CAUTION When formatting the MO disk give it a logical name and make sure to physi cally label the disk with the mention Backup A label ling convention should be followed so that each MO disk gets a unique label Patient record management the original images you will not be able to retrieve the images again Backup of patient archive EchoPAC PC Software Only Backup of the patient archive should be done using the procedure described in Backup procedure on page 37 Backup procedure Use a blank dedicated MO disk when doing a backup This MO disk should only be used for backup restore purpose Do not use this MO disk when doing Export or Save as The backup procedure will OVERWRITE the existing data on the MO disk If moving images make sure to have enough formatted MO disks before disponible 1 Inserta formatted see page 215 MO disk in the MO drive
111. ive name to the sample area The label is useful for identification of the sample area when exporting data Delete sample area a Shown only when a sample area is C selected pointed at Delete anchor remove anchoring from a dynamic sample area see also page 138 b With Contrast data only and page 139 Shown only when pointing at an Delete Sample area removes selected anchored sample area sample area from the Cineloop window and belonging trace in the Analysis window The trackball marker must be pointed at an anchored sample area e Cancel exits the System menu 1 32 EchoPAC PC User s Manual EP092537 02 Quantitative Analysis The Tissue cineloop window Displays 2D data Sample area 1 Indicates sampling position of the velocity TVI displacement Tissue Tracking percent deformation Strain deformation rate Strain rate or intensity Contrast trace The sample area is color coded the first sample area is yellow the second green etc Sample area tools e Fd creates a sample area based on freehand drawing e 2 creates a sample area with a pre defined circular elliptic shape configurable see page 143 EchoPAC PC User s Manual 1 33 EP092537 02 Quantitative Analysis The analysis window TVI Displays velocity trace Y axis velocity scale cm s X axis Time s ECG Time at cursor position Velocity at cursor position Velocity at frame marker position
112. ker axis 3 Enabled frame green marker 4 Disabled frame red marker 5 ECG 6 Current frame Figure 6 2 Frame disabling 142 EchoPAC PC User s Manual EP092537 02 Quantitative Analysis Optimizing sample area The sample area can be reshaped and labelled Reshaping a sample area 1 Place the Mouse cursor over the actual Sample area 2 Press the Right mouse button The System menu is displayed 3 Select Set Sample area shape A Dialogue window is displayed where the user can adjust the height the width and the angle of the sample area see Figure 6 3 Height zr E mm width 1 6 0 mm Tilt angle EE 0 deg Set as default Figure 6 3 The sample area reshaping window 4 Drag the sliders to adjust the shape of the sample area as desired 5 Press OK to return to the Quantitative analysis screen and use the settings for the current analysis only OR Press Set as default to return to the Quantitative analysis screen and keep the settings as default Labelling a sample area The sample area label is used to identify data associated to the sample area when exporting to a spreadsheet program 1 Place the Mouse cursor over the actual sample area 2 Press the Right mouse button The System menu is displayed 3 Select Label Sample area EchoPAC PC User s Manual 143 EP092537 02 Quantitative Analysis A Dialogue window with a free text field is displayed 1 Free text Area I
113. late selection menu Diagnostic codes enables the creation of pre defined text inputs to be used in the Diagnosis information field in the Examination list window see Figure 2 2 page 14 Comment texts enables the creation of pre defines text inputs to be used in the Comment information field in the Examination list window see Figure 2 2 page 14 EchoPAC PC User s Manual EP092537 02 Program configuration The Report templates sheet REPORT LOOKUP VALUES Templates Diag Codes Comment OD 9 l Cardiac Cardiac EF Users Factory Cardiac Complete ZEE adiac Report Test p Factory Stress Bullseye 16 l Factory Factor Stress Lut Planes Cardiac Complete Dardiac Medium H Cardiac Valves Cardiac Short 4 Images T Images Stress Bullzepe T6 Stress Cut PI re 2 Cardiac Medium Cardiac Valves Edt Template Cardiac Shart Delete Imaging Measure Report Connectivity System About Admin Service 1 Application selection pop up menu 5 Move selected template up down in the Template 2 List of factory and user defined report templates selection menu for the selected application 6 Open selected template in the template 3 List of report templates shown in the Template designer selection menu for the selected application 7 Delete selected template user defined 4 Add remove selected template to from the templates only Template selection menu 8 Export template to
114. lization of the heart contraction at peak level by color coding the displacement in the myocardium e Quantitative analysis enables further quantitative analysis based on multiple tissue velocity traces e M amp A capability e Report capability EchoResearch option Quantitative TVI Analysis Multiple time motion trace display from selected points in the myocardium e Arbitrary straight Anatomical M Mode e Arbitrary curved Anatomical M Mode Quantitative profiles for TVI and Tissue Tracking can be derived e Strain and Strain rate option e Multiple time motion trace display from selected points in the myocardium e Arbitrary straight Anatomical M Mode e Arbitrary curved Anatomical M Mode e Quantitative profiles for Strain and Strain rate e Dual focus increases sensitivity of signals e Cine compound for image loops and strain traces EchoPAC PC User s Manual 243 EP092537 02 Appendix 244 e Drift compensation e Quantitative Contrast analysis post processing on Contrast Harmonic images 2D and Angio data e Time Intensity analysis allows instant time intensity calculation from up to eight regions of interest e Curve fitting analysis for research studies of myocardial perfusion rates using contrast agents e Arbitrary straight Anatomical M Mode e Arbitrary curved Anatomical M Mode Caliper Area e ECG triggering DICOM Ethernet network connection e DICOM support e Storage read wri
115. ll modes In combined mode select the mode to display Annotation Enables the insertion deletion of body marks arrows and text in the selected image Physio Enables to display hide and adjust the physiological traces Compare All modes Displays a copy of the selected cineloop Enables frame by frame comparison of the selected cineloop independent scrolling Image size Doppler M Mode Toggles the display priority of 2D Mode or Doppler M Mode and top bottom 1 or side by side display with 2D priority 2 or time motion priority 3 when working in combined mode MIE Cineloop Displays the cineloop controls see page 66 Apply to All All modes Applies changes on all opened images Works for the following controls Up Down Left Right Invert Variance Persistence Tissue priority Gain Compress Reject Baseline Mode selection and Color Map Reset All modes Restore all controls to original setting 61 Image Management 1 to 12 1 PEPE quas ENE Select the number of images to display Up Down env Right Up down 2D 2D Color M Mode Color Maps Invert Flips the image 180 degrees Variance Simultan Map All modes Selects mode specific color map from the pop up menu Variance 2D Color Controls the amount of variance data added to a color display Variance enables computer aided detection of turbulent flow e g jets o
116. lysis See the Status bar to get the next step to perform Alternative Press Caliper and select MV F A ratio from the pull down menu See the Status bar to get the next step to perform 98 pO SJ eS WS oS Move to the end trace position Press the Left mouse button to anchor the end point of the trace The trace is automatically generated and the following measurements are displayed in the Measurement result table e Maximum and mean Velocities e Maximum and mean pressures e Env Ti e Velocity time integral VTI Move the cursor to the next heart beat Press the Left mouse button to anchor the next heart beat starting point The heart rate BPM is displayed in the Measurement result table V E A ratio Press Measure Select MV E A ratio in the Measurement Menu Move the cursor to the peak of the E wave Press the Left mouse button to anchor the point Drag cursor to baseline to mark dT Press the Left mouse button to anchor the second point Move the cursor to the peak of A wave Press the Left mouse button to anchor the point the velocity at peak for E and A waves and the calculated E A ratio are displayed in the Measurement result table EchoPAC PC User s Manual EP092537 02 The selection of a measurement with out pre defined la bels will not display the Parameter la bel menu A CAUTION Measurements and Analysis Post measurement assignment labels Each type of mea
117. mage EchoPAC PC User s Manual EP092537 02 Measurements and Analysis Alternative Press Caliper and select Point from the pull down menu Alternative Press Caliper and select Caliper from the pull down menu The measurements displayed on the M Mode image and the corresponding re sults are numbered and scroll through the cineloop using the Frame slider to select the desired frame 2 Press Measure Select Point in the Measurement Menu see Figure 4 3 4 Move the cursor to the position to measure The current distance from the probe is displayed in the Measurement result table and is instantaneously updated when moving the cursor 5 Press the Left mouse button to anchor the point The depth value cm is displayed in the Measurement result table x M Mode Measurements In M Mode the user can perform distance and time measurements This measurement package has also the following pre defined measurement studies LA Ao e LV RV Mode Length measurements Press Measure M 1 2 Select caliper in the Measurement Menu 3 Move the cursor to the start point of the measurement 4 Press the Left mouse button to anchor the point 5 Move the cursor to the measurement end point The current distance value is displayed in the Measurement result table and is instantaneously updated when moving the cursor 6 Press the Left mouse button to anchor the end point of the measurement The measurement result
118. mplate The stress package provides protocol templates for exercise as well as pharmacological stress examinations The user can create new templates or modify existing templates to suit the individual needs Up to ten projections and fourteen stress levels can be created in a template The templates created can be used for acquisition on the scanner The editing that may be performed includes e Adding deleting levels and projections see page 123 e Assigning new labels to levels and or projections see page 124 e Defining level options see page 124 e Defining new image groups see page 124 Templates are edited created from the Template editor screen Template editor screen overview 1 Inthe Protocol screen select Template Editor The Template Editor screen is displayed see Figure 5 8 EchoPAC PC User s Manual 119 EP092537 02 Stress echo analysis Ok Cancel Template Predefined groups Exercise 2x4 v Apical Protocol template preview en 1256 Cont capt Preview of Show ical Il M denas se B store reference Parasternal 3478 QStress acq Other options Grid size IV Start T1 at start of exam v Smart stress Hew group Humber levels v Start T2 at second level Reference image Update grou Humber projection views 4 Auto start analysis Baseline level __ Mpdegrup v Show systol
119. ning new labels to levels and projections 1 Inthe Protocol template preview field select a pre defined label from the pop up menu OR double click on the Label to highlight the text that is to be changed and type a new name Configuring levels The following options can be set up for each level Number of cycles to be stored in the cineloop 1 Enter the desired number in the Cycles field Up to four cycles cineloop can be stored Continuous capture 1 Check Continuous capture if continuous image acquisition throughout the level is desired When Continuous capture is selected preview of cineloop and reference display see below during acquisition are not possible Preview of store 1 Check Preview of store if review and adjustment of cineloops before storage is desired Show reference 1 Check Show reference if the display of the corresponding reference loop is desired during acquisition dual screen mode Adding a group 1 Inthe Protocol template preview field select the cells to be part of the group 2 Inthe Pre defined group field press New group EchoPAC PC User s Manual EP092537 02 A selected group is highlighted by a yellow frame Stress echo analysis A dialogue box is displayed asking the user to enter a name for the new group Enter the group name Press OK The new group is displayed in the Pre defined group field Updating an existing group iP In the Pre defined group field select t
120. nt information as it was before you did the modification in the archive The system does not alter the contents of the image files at all when doing DICOM export The demographic data for a selected patient record can be edited from the Patient Information window Do NOT use Vor in patient information fields as these characters might cause problems with some DICOM devices 1 Select a patient record see page 12 and press Patient Info in the Examination List window see Figure 2 2 The Patient information window is displayed see Figure 2 4 2 Edit the information using the keyboard or by choosing a new selection from the drop down menus Select the patient information category to enter application specific patient information Displayed when the button More is depressed see Figure 2 4 EchoPAC PC User s Manual EP092537 02 Begin Exam End Exam Exam List Search Image List Patient record management Last Hame First Hame Operator PATIENT INFORMATION Local Archive Int HD GE Patient ID 020202 D 02011902 ddimmiyyyy Age 100 Birthdate p female Address Phone Ref Doc Diagn Phys Ward Dept Echolab 1 The date format is configurable see page 222 3 2 The window can be configured to display the 4 Development 9 BP Contrast Study Id Accession Tape Counter The Address field is configurable see page 217 Select patie
121. nt information category expanded patient info as default see page 217 Figure 2 4 The Patient information window EchoPAC PC User s Manual EP092537 02 19 Patient record management Creating a new Patient record EchoPAC PC can 1 Inthe Search Create Patient window see Figure 2 1 be configured to enter patient Last Name and or ID le a 2 press Create Patient The Patient Information window is displayed see Figure 2 4 3 Enter the necessary patient information Do NOT use Vor in patient information fields as these A characters might cause problems with some DICOM devices CAUTION 20 EchoPAC PC User s Manual EP092537 02 Patient record management Deleting archived information Deleting a patient record 1 Select the patient record to delete see page 12 2 Inthe Search create Patient window Figure 2 1 page 13 press Delete A dialogue window is displayed asking for confirmation 3 Press OK to delete the patient record Deleting an examination 1 Select the examination to delete see page 12 2 Inthe Examination list window see Figure 2 2 select Del Exam A dialogue window is displayed asking for confirmation 2 Question You are about to delete the selected examination Image in exam is stored on Local HD W Delete image s to exam cane Figure 2 5 Delete Examination prompt EchoPAC PC User s Manual 21 EP092537 02 Patient record management Moving
122. nt records examinations 26 Patient records examinations from the local archive on one system EchoPAC PC or EchoPAC PC can be exported to the local archive on another system via a formatted Magneto Optical MO disk or CD R Patient records examinations from the local archive can also be exported directly to a remote archive Echo server DICOM server or EchoPAC PC depending on the environment In addition patient records examinations from a remote archive Echo server or EchoPAC PC depending on the environment can be exported to a removable media or to a DICOM server Database information patient and report archives can be exported with or without images No data is deleted from the source archive when exporting data unless the command Delete selected patient s after copy is checked in the Export patient window see Figure 2 10 page 28 Similarly patient records examinations from the local archive on one system can be imported to the local archive on another system via a formatted MO disk or CD R Database information can be imported with or without images No data is deleted from the source archive when importing data In addition patient records from a removable archive can be imported to a remote archive Echo server Exporting patient records examinations 1 Insert a blank formatted see page 215 removable media in the drive 2 Press Archive The Search Create Patient window is displayed see Figure 2 1 page 13 3 S
123. nt window see Figure 2 1 page 13 v All the searching filters are displayed as default The searching criteria are restricted to a minimum When unchecked press More to display all the searching filters EchoPAC PC User s Manual 219 EP092537 02 Program configuration 7 Auto search for patient Auto search for patient In the Search Create Patient window see Figure 2 1 page 13 MM The system searches automatically through the patient archive selected while entering patient information The system searches through the patient archive after pressing enter 7 Predefined text directly Pre defined text directly In the Examination list window see Figure 2 2 page 14 J the Insert text button launches pre defined text input _ the Insert text button open the extended text field Examination List on Archive button Examination list on Patient button When a patient is selected pressing Patient will v open the Examination list window for the selected patient _ open the Patient Information window for the selected patient Automatic generation of patient ID Automatic generation of patient ID In the Search Create Patient window see Figure 2 1 page 13 w Patient ID is not required when entering a new patient in the archive EchoPAC PC generates automatically an ID number Patient ID is required when entering a new patient in the archive M The user is asked to confirm
124. o delete in the DICOM job spooler window 2 Press Delete Resending a job 1 Select the job to resend in the DICOM job spooler window 2 Press Resend 3 Press SELECT Sending a job to a new destination 1 Select the job to send in the DICOM job spooler window failed or are in hold 2 Press Send to can be sent to a new A dial p S PN dialogue window is displayed 3 Select the new destination from the Destination popup menu 4 Press Send EchoPAC PC User s Manual 81 EP092537 02 Image Management 82 EchoPAC PC User s Manual EP092537 02 Measurements and Analysis Chapter 4 Measurements and Analysis Contents MOUNT 84 e Assign and Measure modality sees sane 85 e Starting the Assign and Measure modality 85 e Entering a study and performing measurements 87 e Measure and Assign modality ees eus 89 e Starting the Measure and Assign modality 89 e Performing measurements rrnrrnanenannnnnnnrnanerannnnennnenunenuvnneennn 90 e Post measurement assignment labels 99 e Controlling the Measurement result table display 101 e Minimizing the Measurement result table 101 e Moving the Measurement result table
125. o verify format 2 Label a new removable MO disk free text 3 Verify DICOM directory on removable DICOM disk 4 Start formatting 5 Install a DICOM viewer Screens Tcpip f P s 1 4 MO Disk M Y LABEL Dicom Viewer 9 Binary Select the device for patient information exported as Excel Set the path for the repository for HL7 export format server name share name Set a user defined remote path for Save as function and export to Excel Figure 9 13 The sublevel Tools EchoPAC PC User s Manual EP092537 02 215 Program configuration A CAUTION Do not eject the CD using the button on the CD drive 216 CD RW is not supported only CD R recordable Formatting a removable media 1 2 3 4 5 6 Select the removable media from the Media pop up menu Enter a name for the removable media in the Label field Check DICOM viewer is desired DICOM viewer enables the display of DICOM images from the removable media without the need of any other software Press Format Wait for the display of the Information window indicating that the formatting process is completed Press ALT E to eject the disk Verifying a removable media 1 2 Insert the removable media to verify Select the pre configured removable media from the Media pop up menu Press Verify The unit is verifying the DICOM directory on the selected media EchoPAC PC User s Manual EP092537 02 P
126. om function 1 Select inside the Zoom scale or press the Zoom increase button OR Press ARROW UP A portion of the selected image is magnified and a situation picture is displayed showing the outlined zoom region Press and hold down the Left mouse button while moving the mouse upward to increase magnification or downward to decrease magnification OR Press ARROW UP to magnify or ARROW DOWN to decrease magnification Press and hold down SHIFT and the Left mouse button while moving the mouse to move the zoomed area OR Press SHIFT and RIGHT ARROW or LEFT ARROW Optimizing cineloop The cineloop boundaries can be adjusted by dragging the left and right markers on the ECG or by using the cineloop controls as described below EchoPAC PC User s Manual EP092537 02 1 ECG 2 Loop display EP092537 02 Left marker drag to Image Management Cineloop overview ms o 9 o o 9 4 Current frame in V4 N N freeze drag to select 11 frame or select frame on ECG 5 Right marker drag to move 6 Cine speed replay Cine Loop 4 Left Marker 4 Right Marker 4 d Cycle Select 1 kiHum Cycles First Cycle Last Cycle Sync Select All Done Figure 3 14 The cineloop display and controls Torun stopacineloop 1 Press Run Stop or ALT R or SPACE BAR Cineloop adjustment 1 Select a cineloop 2 If necessary press Run Stop to freeze the cineloop 3 Press Cineloop The cineloop controls are displayed on t
127. orage Media Labelled TEST Press OK to Continue Cancel to abort If the require media is not available press Skip Media Skip Media Cancel Figure 3 2 The Insert media window 6 Insert the required media 7 Select between e OK the images on the mounted media are restored on the local hard drive If not all the required images are on the inserted media the user is prompted to insert another media until all required images are restored on the hard drive Skip media the images stored on the media required are not restored If not all the required images are on the inserted media the user is prompted to insert another media until all required images are restored on the hard drive Cancel no images are restored The selected images are displayed for review EchoPAC PC User s Manual 4T EP092537 02 Image Management Examination Examination date and archive location RAN E Selected image Aass LO Preview of selected L ET cele TERT c1 A O N EIS aS VA VAR VAN VAN VAN VAN FY PE ET odia Ex 2H Figure 3 3 The Image browser screen 48 EchoPAC PC User s Manual EP092537 02 Image Management Review from the Review screen 1 Inthe Examination list window select an examination and press the Review menu button The Revie
128. ore 1 Q ANALYS Alt Store 2 Mini Report Basic Annotation CINE LOOP Physio Apply to all Compare Reset BCOLOR MAPS ATO res gt Bees gt ME a zon gt 1 Display window 4 Selected image Highlighted frame 2 Control panel 3 Status bar Figure 3 7 The Analysis screen EchoPAC PC User s Manual 53 EP092537 02 Image Management Control panel overview The control panel can be displayed in three states Minimized displays only a few controls This setting enables maximum image display area e Basic displays a selection of mode specific controls e Advanced displays all the mode specific controls Control panel display Switch between minimized and basic advanced display 1 Press the button on the upper left corner of the control panel Switch between basic and advanced display 1 When the advanced control panel is displayed press Basic When the basic control panel is displayed press Advanced gt gt 54 EchoPAC PC User s Manual EP092537 02 Advanced 20 stop REMI gt BE gt Caliper Store Measure Alt Store 1 Q Analysis Alt Store 2 Direct Report lt lt Basic Active Mode 20 MM CFM pw cw TYI AMM Annotation Cine Loop Physio Apply to all Compare Reset Img Size E e l 4 6 8 9 12 Up Down BColor Maps ATO 1 Compress 4 fReiect hoe a Image Management Basic 20 stop BEER Dn gt Caliper Sto
129. ormat save data in DICOM format only Max Framerate Select 25 30 or Full from the pop up menu Full original acquisition is default Compression Select compression type or no compression Quality Set picture quality from 1 to 100 A low picture quality level allows high data compression while a high picture quality restrains the compression Allow Multiframe v allow cineloop storage Retry oet maximum number of connection tentatives time interval between tentatives and time out AE Title The Application Entity Title is set during DICOM configuration Refer to the network specifications 21 0 EchoPAC PC User s Manual EP092537 02 Program configuration DICOM settings Definition Port The Port no is allocated during DICOM configuration Refer to your network specifications Verify the connection to another DICOM application Storage commitment Send a request to a PACS asking it to permanently archive image s MPPS Modality Perform Procedure Step send information typically to a HIS that a scheduled exam has been started performed or interrupted EchoPAC PC User s Manual 21 1 EP092537 02 Program configuration Additional outputs The Button sheet deals with configuration of the Alt store 1 and Alt store 2 buttons Several outputs e g Video Print Laser print DICOM storage etc can be associated to these buttons i e pressing Alt store 1 or 2 can result in printing a Color video print and s
130. ort Import Dicom Properties Move Exam Last Hame First Hame Category Echolab Diagn code Images Patient List Last Hame SEARCH CREATE PATIENT Patient ID Birthdate Sex female male Born between Exam between Stress Report Diagn Phys 020202 02 01 1902 2002 02 15 2002 02 21 2002 09 23 2002 10 17 2002 11 08 030203 02 02 1952 Local Archive Int HD Operator 1 Press one of the headings to sort the list 4 Select the column heading border and drag to accordingly adjust column width 2 Select new archive and other pre defined 5 Expended Patient record displaying belonging services examinations 3 The system can be configured to display the Advanced search tool as default see page 217 The Search Create patient window may be slightly different depending on the Dataflow selected Figure 2 1 The Search Create Patient window EchoPAC PC User s Manual 1 3 EP092537 02 Patient record management Begin Exam End Exam Patient Info Search Image List AddExam DelExam Export To Excel Export To HI7 4 2 EXAMINATION LIST Local Archive Int HD 21 02 2002 23 09 2002 1710 2002 0811 2002 Referral Reasons EE Comments Insert Text Diagnosis Code 1 The information displayed in the Patient listis 3 Insert pre defined text in the Comment field configurable see page 217 4 Select the column heading border and drag to 2 Goto Search Create Patient window see page a
131. pending on the analysis signal displayed Export traces saves trace data in ASCII format readable in spreadsheet programs If present trace data for physiological traces are also exported Curve fitting toggles between Wash in Wash out and off Unzoom restores full analysis window display when in zoom mode Cancel exits the System menu 136 EchoPAC PC User s Manual EP092537 02 Quantitative Analysis The control panel The control panel is mode dependent Refer to TVI QAnalysis page 54 for control description Caliper Measure Alt Store 1 Direct Report lt lt Basic Active Mode 20 mm CFM PW cw MEM IT SRI SI TSI TR CAMM Annotation Physio Apply to all Compare Reset Img Size We Up Down EchoPAC PC User s Manual 1 37 EP092537 02 Quantitative Analysis Generation of a trace The free sample area disappears when the QA cursor is moved over a static an chored frame The trace and sam ple area are color coded First gener ated trace is yellow second green etc 138 Up to eight traces can be generated About the sample area The sample area can be in three different states e Free sample area freely moving sample area QA cursor before anchoring e Static sample area the free sample area is anchored by pressing the left mouse button e Dynamic anchored sample area the sample area is anchored in two or more frames see Manual track
132. pplication Menu 3 Selected Setup category x Cine loop store 10 Time before heart cycle ms 15 Time after heart cycle ms 1000 Time span no ECG ms Preview loop before store Doppler h Show kHz scale Imaging Measure Report Figure 9 2 The Setup dialogue window structure EchoPAC PC User s Manual 187 EP092537 02 Program configuration The Imaging configuration category enables the user to configure display related settings The Global setup sheet IMAGING AND ANALYSIS GLOBAL LEVEL Global Patient Info Titlebar Line 1 Last FirstName Titlebar Line 2 Birth date A Crop Images Scan Info when showing more than two images oO T Octave o C Freq Oo D Proc O 1 Freq Osy Croc Cccp vRej O a Power Scale Cares Coy vRej r Doppler 4 C T Depth C D Freq O C Gain O Psy Show kHz scale c Scale L svp imaging Measure Report Connectivity System About Admin Service Figure 9 3 The Global setup sheet Crop images Crop Images Crop images Bl hen chert arme dier kan mans M In the Analysis screen removes top and bottom of the image when more than two images have been selected 1 88 EchoPAC PC User s Manual EP092537 02 Program configuration Doppler Doppler Doppler ned ce e Show
133. printer setup cannot be done from within the application e The Computer name cannot be set from within the application Important To ensure optimal performance do NOT attempt to install any A software on the EchoPAC PC workstation CAUTION The EchoPAC PC workstation must NOT be placed inside the A patient environment refer to local regulations and EN 60601 1 1 CAUTION 2000 2 EchoPAC PC User s Manual EP092537 02 Introduction 1 Patient environment 25m m mo mo mo ee N 1 Y 1 5m l l Q i I I j S pte Figure 1 1 The patient environment Manual contents The EchoPAC PC User manual is organized to quickly provide the information needed for patient management and ultrasound image post processing using the EchoPAC PC software Finding information Data has been arranged in a format that will assist the user in finding information easily and quickly Table of Contents list the main topics and their location Headers and footers displays the chapter name and page number References cross references are noted in the text Index Extensive tool that provides easy reference to ideas topics terms titles headings and cross references Conventions used in this manual The following typographic conventions are used in the indication of different types of information EchoPAC PC User s Manual 3 EP092537 02 Introduction 2 columns layout the right column contains the main text
134. r regurgitation Left Right 2D 2D Color Creates a mirror image of the original image The left right reference marker V moves to the other side of the image Invert 2D Color Doppler Enables the color scheme assigned to positive and negative velocities to be inverted Simultaneous 2D Color TVI modes Enables simultaneous display of 2D image and color image 4 Compress gt Compress All modes Controls the amount of contrast DDP 2D 2D Color Performs temporal processing which reduces random noise without affecting the motion of significant tissue structures Reject All modes Discards low levels echoes when increased Zoom All modes Magnifies the image display in both frozen and live see page 66 Horizontal sweep M Mode Doppler Controls the time scale in the time motion display 62 EchoPAC PC User s Manual EP092537 02 Image Management Cine Comp Ld EchoPAC PC User s Manual EP092537 02 Tissue priority 2D Color Emphasize either the color of the color mode or the greyscale tissue detail of the 2D image Angle Correct Doppler Enables stepwise angle correction by 2 degrees of the Doppler velocity scale Transparency All TVI modes Controls the degree of transparency of the color display Threshold All TVI modes Controls the level of greyscale intensity that is used as a threshold for color TT Start Tissue Tracking Strain Start Strain Th
135. rame Disabling frames from the frame marker 1 Select the Frame marker beneath the Analysis window see Figure 6 2 The frame marker turns red disabled frame disabling successive frames at a time 1 Press the Left mouse button and drag the Mouse cursor over the frame markers of the frames to disable The frame markers turn red disabled frames ECG triggered frame disabling In a multi cycle acquisition the user may deselect all frames in all heart cycles but a selected one This function can be used for example to select a particular systolic frame for each heart cycle 1 Scroll through the cineloop to identify the cardiac phase to analyze or identify the cardiac phase on the ECG trace 2 Press the Right mouse button on the frame marker of the frame of interest in one of the heart cycles see Figure 6 2 EchoPAC PC User s Manual 141 EP092537 02 Quantitative Analysis The System menu is displayed 3 Select ECG triggering All frames in all heart cycles are disabled except for the selected and corresponding frames in the other heart cycles Disabling frames in the cineloop windows 1 Press the Right mouse button The System menu is displayed 2 Select Disable frame The current frame is disabled and the corresponding frame marker is displayed in red Re enabling all frames 1 Press the Right mouse button over the Frame marker axis 2 Select Enable all frames 1 Analysis window 2 Frame mar
136. ranvnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnnr 234 Standards used eene nnne nennen 234 NES NG 236 ISevDoara SNOr CUlS sanse det Herten uem d detur add 236 MOUSE SNOT CUIS su Re 238 Product description use 240 VA Sn 240 Tr pata acquisltlOFt eenn a ts 240 Patient record and Image management 240 TruAccess Image review eeeeeeeeeeeeeenne 241 Image post processing cccceccseeceeeceeceeeceeeceeecueeeeeseeess 241 Image analysis me 242 REDO eM PO NETTE NOMEN 242 EcChoStress OPIL 242 Echolsesearch PIN se 243 BOO 244 LE 0 VE EE EE ET eee ee 244 SN 244 orga seers e weseseoleceeee 245 Index Vill EchoPAC PC User s Manual EP092537 02 Introduction Introduction EchoPAC PC is a post processing program designed for ultrasound image review analysis and reporting EchoPAC PC allows post processing of DICOM ultrasound images and raw data images from GE ultrasound scanners Main functionality EchoPAC PC offers the following functionality e Read display DICOM ultrasound and GE raw data images e Ultrasound image optimization as on a scanner e Measurement and analysis e Advanced quantitative analysis based on raw data such as quantitative TVI contrast and stress analysis research options e Image storage e Patient record database e Report generator Indications for use EchoPAC PC is a workstation with post process
137. re Measure Alt Store 1 Alt Store 2 Direct Report Advanced gt Minimized sop lt SBE gt Measure Store Figure 3 8 The 2D control panel EchoPAC PC User s Manual EP092537 02 99 Image Management Advanced MM Run BE dean Gen P Caliper Store Measure Alt Store 1 Q Analysis Alt Store 2 Direct Report lt lt Basic Active Mode ENS ere pw cw ovi AMM Annotation Physio Apply to all Compare Reset Img 5ize Mi 2 3 4 6 8 9 122 BColor Maps irene Re gt Her Swp gt 4 Zoom gt Basic MM E Run BERE Rs DB o Caliper Store Measure Alt Store 1 Alt Store 2 Direct Report Advanced gt Minimized Run GE gt Measure Store Figure 3 9 The M Mode control panel 56 EchoPAC PC User s Manual EP092537 02 Advanced CF stop EE T ME BE Caliper Store Measure Alt Store 1 Q Analysis Alt Store 2 Direct Report lt lt Basic Active Mode 200 MM GEM pw cw Tv ON AMM Annotation Cine Loop Physio Apply to all Compare Reset Img 5ize gt a4l6 8 9142 Up Down Color Maps Invert Variance Simultan Baseline gt 4 Pri gt 4 o0r b 4 foom b Image Management Basic CF E stop BERE El DB o Caliper Store Measure Alt Store 1 Alt Store 2 Direct Report Advanced gt gt Minimized sop EBEEERO Measure Store Figure 3 10 The 2D Color control panel EchoPAC PC User s
138. rement result table 3 Repeat steps 3 through 2 to measure IVS LVID and LVPW in systole RV study The RV study consists of measurement in fixed time mode of Right ventricular internal dimension RVID in both diastole and systole To perform RV study 1 Press Measure Select LV study in the Measurement Menu Move the cursor along the time axis to the required point to start measurement of RVIDd 4 Press the Left mouse button to anchor the measurement starting point 5 Move to the end point of the measurement 6 Press the Left mouse button to anchor the measurement end point The RVIDs measurement value is displayed in the Measurement result table A new free moving cursor is displayed on the image ready for the next measurement EchoPAC PC User s Manual 95 EP092537 02 Measurements and Analysis Alternative Press Caliper and select Point Caliper from the pull down menu Alternative Press Caliper and select Caliper from the pull down menu See the Status bar to get the next step to perform 96 7 Repeat steps 3 through 6 to measure RVIDS The RVIDs value is displayed in the Measurement result table Doppler Measurements The following measurements may be calculated on Doppler mode spectra e Maximum peak and mean velocity e Maximum and mean pressure gradient e Pressure half time PHT e Velocity time integral VTI e Mitral valve area MVA derived from PHT Velocity and Pres
139. rogram configuration Formats The Formats sublevel enables configuration of the Examination list window see Figure 2 2 page 14 and other tools related to patient management as described below COWNHECTIVITT Dataflow Additional Outputs Tools Formats Tcpip Columns in examination listing opea bas megco Tepe Counter Report Image mex Use free text addresses Examination List on Archive button Use birthdate Automatic generation of patient ID Use extended patient dialog Request acknowledge of End Exam action Use extended search dialog W Go directly to scanning from search Auto search for patient Predefined text directly Imaging Measure Report Connectiity System About Admin Service Figure 9 14 The sublevel Formats example Configuration of the Examination list window The user can configure the examination list displayed in the Examination list window see Figure 2 2 page 14 by deleting adding columns and change the information type displayed in each column EchoPAC PC User s Manual 21 F EP092537 02 Program configuration Column configuration To adjust column 1 Select to the column to edit width select and A sub menu is displayed see Figure 9 15 drag column head ing border 2 Select the action to perform Insert creates a new column Delete removes selected column select the desired information to be displ
140. s the user can bend the path and obtain a e path curved anatomical M Mode profile 5 Double click the Left mouse button to end the trace Adjust the Hori The color coded display of the corresponding data zontal sweep and calculated along the path is shown in the Analysis window scroll through the see Figure 6 15 cineloop to optimize the display to the portion of interest EchoPAC PC User s Manual 157 EP092537 02 Quantitative Analysis 0 3 0 4 1 Cineloop window 3 Path anchor point 2 Analysis window 4 Time scale 0 5 ao Figure 6 15 The anatomical M Mode display here TVI data 1 58 EchoPAC PC User s Manual EP092537 02 Quantitative Analysis Optimizing Anatomical M Mode Edition of the curve The drawn Anatomical M Mode path can be edited by moving the anchor points To move an anchor point 1 Select the anchor point to move 2 Move the anchor point to a new position 3 Press the Left mouse button to anchor the point to its new location EchoPAC PC User s Manual 1 59 EP092537 02 Quantitative Analysis 1 60 EchoPAC PC User s Manual EP092537 02 Worksheet Chapter 7 Worksheet Contents NTOAUGNON see 162 TOVE I OW TER 163 USING WOrkshedf saved a2 164 TO SCrOMTAROU GAO AGES sr 164 e To select the type of value rr rrrnnnrnanenanrvnnrnnnnnnannnannnannnnnnnnnne 164 e Excluding or including measurements 164 e Manually changing a value
141. seeseeesse 169 TOP SEN NS 171 O Save a FE DOM siren a N eds GANGEN 171 e Retrieving an archived report rrirnnnrranrnannrnrnnnrnnnrnarnneennnnnnnn 172 e Report designer ett em 173 e Accessing the Report designer rrrnrrrananannrarnnnennnrnnrnnernnnennen 173 e Report designer overview rrnnrrnnnrnnnnnnnnnnnnnnnnnnnannnnnnnnnnnnennne 174 e Designing a report template eeeeeeeeeeeeeeeeeee 177 e Saving the report template rrrrrarnnnrranerarnnnrnnernanrnnrnnennnnennnen 182 EchoPAC PC User s Manual 167 EP092537 02 Report Introduction The EchoPAC review station enables the generation of patient reports based on the examination performed and the analysis that were made during the examination The reports are generated using the data that is stored in the system using pre selected templates Saved reports are read only Therefore it is recommended that the data be carefully reviewed before the report is created Use the worksheet see page 161 to facilitate the review and adjustment of data before generating a report The final report can be printed on a regular laser printer 1 68 EchoPAC PC User s Manual EP092537 02 Report Creating a report Reports summarize data obtained in the examination They can contain data and images Once generated the report can be viewed images can be added and the patient s personal data can be modified The examination data itself canno
142. ser screen To update an image group 1 3 Select the group to update from the Group list Both the group name and the belonging image thumbnails are highlighted e To add images to the group select the image thumbnails To remove images from the group deselect the image thumbnails Press Update Group To delete an image group 1 Select the group to delete from the Group list 2 Press Delete Group The Group list is updated accordingly EchoPAC PC User s Manual 51 EP092537 02 Image Management Image optimization Image optimization is performed in the Image analysis screen after selection of the image of interest in the Image browser screen the Review screen or the Protocol screen From the Image browser screen the user can analyze images from different examination sessions for the selected patient From the Review screen the user analyzes images from the currently selected examination From the Protocol screen the user can analyze images from a stress echo examination Image analysis screen overview The Image analysis screen consists of e a Display window showing up to 12 ultrasound images single frame and cineloop see Figure 3 7 e a Control panel for image optimization and analysis The control panel is mode dependent see Figure 3 8 through Figure 3 12 52 EchoPAC PC User s Manual EP092537 02 Image Management Run Stop 4 peedFrame gt 4 2D Gain Caliper Store Measure Alt St
143. sure point measurements 1 Press Measure 2 Select Point Caliper in the Measurement Menu 3 Move the cursor to the position to measure The current velocity is displayed in the Measurement result table and is instantaneously updated when moving the cursor 4 Press the Left mouse button to anchor the point The velocity m s and pressure mmHg values are displayed in the Measurement result table Velocity and Pressure caliper measurements 1 Press Measure 2 Select Point Caliper in the Measurement Menu 3 Move the cursor to the start point of the measurement 4 Press the Left mouse button to anchor the start point of the measurement 5 Move the cursor to the measurement end point The current velocity and pressure values are displayed in the Measurement result table and are instantaneously updated when moving the cursor 6 Press the Left mouse button to anchor the end point of the measurement The following measurement results are displayed in the Measurement result table EchoPAC PC User s Manual EP092537 02 The measurement display on the spec trum and the corre sponding result are numbered Alternative Press Caliper and select Manual trace from the pull down menu Alternative Press Caliper and select Measurements and Analysis Velocity and pressure at anchor point positions e Velocity V3 and pressure p3 differences between anchor point position Time difference dT between anchore
144. surement within each mode can be associated with a set of pre defined parameter labels Parameter labels can be assigned to the highlighted measurement by the user To assign a parameter label to a measure ment 1 Select to the actual measurement in the Measurement result table see Figure 4 4 A Parameter label menu is displayed 2 Select the required label in the Parameter label menu The assigned measurements may be reviewed in the Worksheet see Chapter 7 Worksheet on page 161 Up to five assigned measurements with the same label can be stored in the patient archive Only assigned measurements will be saved Measurements without assignment will be lost when scanning Is resumed EchoPAC PC User s Manual 99 EP092537 02 Measurements and Analysis 100 1 Parameter Label menu fae IMAGES DEMO 2 Selected label VES 03 03 1903 Q ty INSd Assignment erre paret 3 Assigned al IMAGES DEMO measurement EE 93 03 1903 Figure 4 4 Measurement assignment EchoPAC PC User s Manual EP092537 02 Measurements and Analysis Controlling the Measurement result table display The display of the Measurement result table can be minimized and moved to prevent the table obscuring parts of the ultrasound image Minimizing the Measurement result table 1 Move the Mouse cursor to the symbol je on the heading of the Measurement result table see Figure 4 5 Repeat step 1 toen 2 Press the Left mouse
145. surement ratio 1 If necessary deselect Run cineloop to freeze the image and scroll through the cineloop using the Frame slider to select the desired frame Press Measure Select Dist ratio in the Measurement Menu see Figure 4 3 Perform two length measurements as described in the above section The measurement results including the ratio 96 of the two measured lengths are displayed in the Measurement result table Editing 2D Length measurements 1 2 Double click on the anchor point to move Drag the anchor point to a new position EchoPAC PC User s Manual EP092537 02 Alternative Press Caliper and select Area from the pull down menu See the Status bar to get the next step to perform The measurements displayed on the 2D image and the cor responding results are numbered 3 Measurements and Analysis Press the Left mouse button to anchor the point at the new location 2D Area measurements 1 GN If necessary deselect Run cineloop to freeze the image and scroll through the cineloop using the Frame slider to select the desired frame Press Measure Select Area in the Measurement Menu see Figure 4 3 Move the cursor to the start point of the measurement Press the Left mouse button to anchor the start point of the measurement Trace the area planetary by dragging the mouse The current area and circumference values are displayed in the Measurement result table and are ins
146. t can be turned off 12 When the login procedure is completed the Search Create patient window is displayed see Figure 2 1 About dataflow The connectivity on EchoPAC PC is based on the dataflow concept Each dataflow defines the transfer of patient information from an input source to the unit and from the unit to an output source Patient information can include demographic data and images as well as reports and Measurement and Analysis data A dataflow is a set of pre configured services When beginning a search the user selects a pre configured dataflow see page 204 about connectivity that will automatically customize EchoPAC PC to work according to the services associated to the dataflow and search in the archive associated To find a patient record 1 Type the patient Last Name and or ID When default configured EchoPAC PC automatically searches to see if the patient is already in the database The result of this search is displayed in the Patient list field 2 If necessary select another dataflow to search in other databases 3 Inthe Patient list field Double click the desired patient record or click once on the patient record and press Select Patient Or Press in front of the actual patient record and select the desired examination The Examination List window is displayed see Figure 2 2 EchoPAC PC User s Manual EP092537 02 Patient record management Create Patient Select Patient Delete Exp
147. t be changed Working with the report function 1 Select Report The default template is displayed The information entered during the creation on the patient record is automatically filled in e g demographic Diagnosis Comments etc The report entries such as Name Date of Birth Diagnosis and so on are hot linked to the original screen from which the data was taken This data can be modified in the report by selecting the heading EchoPAC PC User s Manual 1 69 EP092537 02 Report Print Store Retrieve Template Designer Save As Delete 1 Report for the current examination 2 Clipboard with images from the current examination Figure 8 1 The Report screen To change patient information 1 Move the Mouse cursor over the heading of the information to change The mouse cursor marker is changed to a hand with pointing finger sm 2 Press the Left mouse button The original location of the data is displayed 3 Change the information entered if required 4 Press Report when completed 1 70 EchoPAC PC User s Manual EP092537 02 Report To choose another report template 1 Press Template A list of available templates is displayed 2 Select the desired template To add an image to the report Images are inserted in the report by dragging a selected image from the clipboard into an Image container in the report 1 Move the mouse marker over the image of interest 2 Press and hold down the Left mouse
148. t between e Store image only saves the image or cineloop only e Store secondary capture creates a still image of the entire screen The secondary capture is not available when saving images as DICOM or RawDICOM 7 Select the image compression type JPEG or Rle or no compression 8 Enter in the desired Image quality between 10 and 100 A high quality setting will give a lower compression 9 Inthe Save as type field select one of the following formats 76 EchoPAC PC User s Manual EP092537 02 Image Management e RawDICOM saves the still image or cineloop in both GE raw format and DICOM format e DICOM saves the still image or cineloop in pure DICOM format e JPEG saves a still image in JPEG format AVI saves the cineloop in AVI format 10 Press Save A file is saved in the selected archive MPEGvue MPEGvue enables the user to convert ultrasound images to MPEG format and create a CD that is readable from a regular computer Creating a MPEGvue CD EchoPAC PC Workstation 1 Insert a formatted CD R in the drive 2 Export the actual patient records as described on page 26 Make sure to select MPEGvue as the export destination EchoPAC PC Software Only When export patient records to MPEGvue on EchoPAC PC Software Only the data is stored to a folder called MPEGvue on the local harddisk This folder is located in Archive Export To make a MPEGvue CD the entire contents of the MPEGvue folder must be
149. t have been successfully imported 10 Press OK A check mark is displayed in the Copied field in the Import patient window for each item imported A status message is displayed for each item imported Make sure that the operation was successful for each item imported 11 Press Done in the mport patient window to complete the process EchoPAC PC User s Manual 35 EP092537 02 Patient record management Data Backup and restore A WARNING 36 The Backup Restore function enables the user to e Copy Restore the patient archive patient database e Move images and stored reports from the local harddrive to MO disks e Copy Restore the system configuration To minimize accidental loss of data perform backup of the patient archive patient data and reports stored on the local harddrive at least once a week GE Medical Systems is not responsible for lost data if the suggested backup procedures are not followed and will not aid in the recovery of lost data There is no backup function for the images no creation of a safety copy For long term storage images should be moved to MO disks when performing backup as described below The backup of the patient archive on the harddrive and the system configuration is done from the configuration management package as described on page 37 Data from Backup Restore disks may be restored to the local harddrive using the Restore procedure as described on page 41 Only users w
150. t provides also an overview over the measurements completed Creating comments 1 Press Direct report see Figure 3 16 2 Select the comment type 3 Type your comments in the Text field 70 EchoPAC PC User s Manual EP092537 02 Image Management 1 Open Direct report Direct ort 2 Select the type of T Exarniners comments information 3 Create insert pre 9 Diagnosis defined text Referral Reasons 9 Text field hi OF 5 List of measurements completed 6 Exits the Direct report Measurements overview L OT Diam 2 71 cm L Ld A4C 7 33 cm LVEDV A L A4C 398 345 ml LVEDV MOD 440 440 52 mi BUE A4C 6 34 em LVESV A L AMC 227 71 ml LVESV MOD 44 284 11 ml EF 4 L 440 42 84 SV A L A4C 170 65 mi LVEF MOD A4C 35 56 SU MOD 440 156 31 mi LETT 1 38 em LVIDd 5 50 cm LuPyWd 1 72 cm vss 1 72 cm LVIDs 3 55 cm LuPyWs 2 65 em EDVW Teich 147 42 ml ESV T amp eich 52 62 ml EF Teich 64 31 Figure 3 16 The Direct report Inserting pre defined text input 1 Select the insertion point in the Text field 2 Select Insert text EchoPAC PC User s Manual 71 EP092537 02 Image Management The Insert text window is displayed see Figure 3 17 Insert Text E x ltem Pathology Descriptor IMAGE QUALITY STUDY TYPE STUDY CONDITION ELG RHYTHM LEFT VENTRICLE LEFT ATRIUM RIGHT ATRIUM RIGHT VENTRICLE SORTIC VALVE MITRAL VALVE TRICUSPID VALVE PULMONIC VALVE PERICARDIUM ADATA PUL
151. t the first image group see page 105 REECE 2 press Start Analysis The Stress Echo analysis screen is displayed see Figure 5 3 showing the first four images and the corresponding scoring diagrams 1 08 EchoPAC PC User s Manual EP092537 02 2001 1 1 26 15 50 52 Stress echo analysis 2001 11 26 15 50 58 lar Peak FN MW p l3 1 Selected loop highlighted frame 4 Change page or enter next image group 2 Highlighted segment name 5 Exit Wall motion scoring 3 Wall segment diagrams 6 displayed loops highlighted frames Figure 5 3 The Stress Echo Analysis screen Scoring 1 Click on a segment in one of the scoring diagrams The Score popup list is displayed see Figure 5 4 If the segment 2 Select the score from the Score popup list The score is scored is displayed displayed in the relevant segment area in the diagram in more than one di 3 R tet 1th h3t t t v emu RU l epeat steps roug o score relevant segments displayed in theoth 4 Press Next page to access to the next images in the EPIO S group or to the next group EchoPAC PC User s Manual 109 EP092537 02 Stress echo analysis 1 Selected segment 2 Selected score 4 1 HR 56 26 11 04 15 51 37 x Unable te interpret 1 Normal 2 Hypokinetic 3 Akinetic 4 Dyskinetic 5 Aneurvsmal 6 Akinetic wscar 7 Dyskinetic w scar aj segments normal All segments not scored ZN Th 1
152. tantaneously updated when moving the cursor Press the Left mouse button to complete the measurement The measurement result is displayed in the Measurement result table To assign a label to the measurement see page 99 Repeat steps 4 through 7 to make additional area measurements 2D area measurement ratio 1 If necessary deselect Run cineloop to freeze the image and scroll through the cineloop using the Frame slider to select the desired frame Alternative Press 2 Press Measure Caliper and select 4 Select Area ratio in the Measurement Menu see Figure 4 Area Ratio from 3 the pull down menu 4 Perform two area measurements as described in the above section The measurement results including the ratio 96 of the two measured areas are displayed in the Measurement result table Editing 2D Area measurements 1 Double click on the anchor point to move The selected marker turns green and is unanchored 2 Drag the anchor point to a new position EchoPAC PC User s Manual 91 EP092537 02 Measurements and Analysis Alternative Press Caliper and select Volume from the pull down menu See the Status bar to get the next step to perform The measurements displayed on the 2D image and the cor responding results are numbered 92 3 Press the Left mouse button to anchor the point at the new location 2D Volume measurements The measurements described in this section enable volume measurement in
153. te images on DICOM format US US MF and secondary capture e Verify Hardware e Compaq DeskPro Workstation 300 Pentium 4 1 4 GHz e 512 MB RAM e 36 GB Harddrive e CD R e Modem 56 Kbit e 19 Monitor e 18 LCD Screen option e 9 1 GB 5 25 Magneto Optical Disk e 1 3 GB 3 5 Magneto Optical Disk option e 250 MB Zip drive option e HP Deskjet 990 CXI option Software Microsoft Windows based TruScan architecture EchoPAC PC User s Manual EP092537 02 Appendix Safety e Built to meet the requirements of e EchoPAC software is CE Marked in accordance with 93 42 EEC Medical Device Directive e Computer hardware is CE Marked in accordance with 89 336 EEC Electromagnetic compatibility EMC Directive e Computer hardware is CE Marked in accordance with 73 23 EEC Low Voltage Directive UL 1950 1996 AN Not all features or products described in this document may be available or cleared for sale in all markets Please contact your CAUTION local GE Medical Systems representative to get the latest information O 2001 2003 GE Medical Systems EchoPAC PC User s Manual 245 EP092537 02 Appendix 246 EchoPAC PC User s Manual EP092537 02 Index A MN 75 C Cineloop SAS Nan 75 eism EE EN RE 66 CEN Geer nen eiut Nee a I ML 204 221 BUNN 212 0 ERE ER EEE OE 205 D BE OE ERE EE 204 DICOM SPOOL avden 80 DICOM verification 215 PES SUS OUR ga 70 E EchoPAC GEN ssa E
154. the Copied field in the Export patient window for each patient exported see Figure 2 10 A status message is displayed for each item exported Make sure that the operation was successful for each item exported Press Done in the Export patient window to complete the process Press ALT E to eject the disk The Eject device menu is displayed EchoPAC PC User s Manual EP092537 02 Patient record management CO Rewritable 5 14 MO Disk 3 1 2 MO Disk ZIP Disk i Figure 2 12 The Eject device menu 13 Select the relevant media The selected media is ejected EchoPAC PC User s Manual 31 EP092537 02 Patient record management 32 Importing patient records examinations 1 Insert the removable media of the source archive in the corresponding drive MO drive Zip drive or CD ROM 2 Press Archive The Search Create Patient window is displayed see Figure 2 1 page 13 3 Select destination archive in the Dataflow field LocalArchive Int HD imports data to the local archive RemoteArch RemoteHD imports data to an Echo server network or a Vivid 7 direct connect 4 Press Import in the Search Create Patient window The mport dialogue window is displayed see Figure 2 13 IMPORT From To Removeable MOD Archive mul Local Archive Int HD To change destination press cancel and change current dataflow ca Figure 2 13 The Import Dialogue window 5 Select one of the
155. the Stress analysis quad screen Figure 5 3 page 109 hold down Shift while performing steps 2 and 3 2 Select the first image in the Template matrix The selected loop is displayed in the Stress analyze screen and the next window in the quad screen Is automatically selected 3 Repeat step 2 to select other images 106 EchoPAC PC User s Manual EP092537 02 To select a level or a projection click on the selection but ton close to the heading see Figure 5 1 To select a level or a projection click on the selection but ton close to the heading see Figure 5 2 Stress echo analysis 4 Depress SHIFT Manual selection of images in the Protocol screen 1 Inthe Protocol screen click once on the images of interest The selected images are displayed with a highlighted frame see Figure 5 1 2 Select Analyze to start analysis Loop synchronization 1 Inthe Protocol screen select the loop to synchronize 2 Click Sync Selected EchoPAC PC User s Manual 1 07 EP092537 02 Stress echo analysis Stress echo analysis Stress echo analysis consists of viewing previously saved loops and assigning a score to each cardiac segment in order to quantify the function of the muscle The usual procedure consists of sequentially opening all image groups and perform scoring from image to image Starting analysis Up to 12 cineloops 1 From The Protocol screen see Figure 5 1 page 105 can be displayed si selec
156. the User ist Auto logon and auto logoff Auto logon 1 Select the desired logon setup from the pull down menu Disabled no default user is selected when logging on Last user the last user is selected automatically when logging on e A specific user select one of the users to be the default user when logging on Auto logoff 1 Setthe time span from 10 min for the system to automatically log off when not in use EchoPAC PC User s Manual 231 EP092537 02 Program configuration Logon The Log on sheet deals with the on logging procedure ADMIH Backup Restore Users Logon System Admin Remote Database Logon cm T Database maintenance Imaging Measure Report Connectivity System About Admin Service Figure 9 19 The Log on sheet Remote Database Logon Give access to the network refer to your network specifications Unlock all Unlock all lock patient records in the local database Patient records are locked if an examination is not terminated properly or if it is opened View audit Displays a log file showing the operations performed on the unit 232 EchoPAC PC User s Manual EP092537 02 Appendix Appendix Contents e Regulatory information rnnnrnnnnnnnnnnnennnnnnnnnnnnnnnnennnnnnnnnnnnnnnnennnnen av 234 e ShOFPEcults ua 236 Product descriDUOD ss 240 EchoPAC PC User s Manual 233 EP092537 02 Appendix Regulatory information
157. torage to a DICOM media CONHECGTIVITY Dataflow Additional Outputs Tools Formats Tepip TT TT Print Single Assosiation Q d Video Printer d Printer B EA Store to clipboard Properties Check f6 9 Repeats Po Eheck k Image to produce Format Dicom dem Capture Area Image frames Image compression Video Area C Single None Multiple f Secondary Capture Quality fo C whole Screen Imaging Measure Report Connectivity System About Admin Service 1 Select between Alt store 1 and Alt store 2 5 Adjust the device settings for the selected buttons assigned device 2 Available output devices that can be assigned to 6 Select the type of images to produce and adjust the current button image settings These settings will overrule the 3 Output devices assigned to the current button adjustment made in the Properties window 4 Add or remove selected device to from the current button Figure 9 12 The sublevel Additional outputs example 21 2 EchoPAC PC User s Manual EP092537 02 Program configuration The image configuration parameters The table below gives a list of the configuration parameters To configure the Alt store 1 and Alt store 2 buttons 1 In Button field select Alt store 1 or Alt store 2 2 Select an output device in the available outputs field and press the Right arrow button to assign the service to the dataflow
158. ts see page 141 In one of the Cineloop windows Anchor a sample area in the myocardium If desired reshape the sample area as described on page 143 Because of heart motion the sample area in each frame has to be adjusted manually to be located inside the myocardium Manual tracking of the sample area The signals originating from the heart cavities are typically 10 to 20 times stronger than the signals from the myocardium and will have a major effect on the averaging of signals in the sample area Using the Frame slider or F3 and F4 keys browse through the cineloop to ensure that the sample area is in the same anatomical position in all frames EchoPAC PC User s Manual EP092537 02 Quantitative Analysis 6 Use the Horizontal sweep slider and scroll through the cineloop to visualize a specific part of the data typically the region immediately after Flash 7 Adjust the left and right markers to apply curve fitting to a specific region 8 Press the Right mouse button in the Analysis window The System menu is displayed 9 Select Curve fitting The Curve fitting menu is displayed or 4 Wash in A 1 exp kty B Wash out Aexp kt B Caneet 0 Figure 6 9 The Curve fitting menu 10 Select Wash in The Wash in curve is displayed in the Analysis window see Figure 6 10 EchoPAC PC User s Manual 1 51 EP092537 02 Quantitative Analysis ZA e STITT pit ie tT tT Tt l 1 Parameter w
159. ts of measurements in fixed time mode in both systole and diastole of e Interventricular septum thickness IVS e Left ventricular internal dimension LVID e Left ventricular posterior wall thickness LVPW The following parameters are also calculated e EDV End diastole volume e ESV End systole volume e SV Stroke volume e EF Ejection Fraction To perform LV study 1 Press Measure 2 Select LV study in the Measurement Menu 3 Move the cursor along the time axis to the required point to start measurement of IVSd EchoPAC PC User s Manual EP092537 02 See the Status bar to get the next step to perform Alternative Press Caliper and select RV study from the pull down menu Measurements and Analysis 4 Press the Left mouse button to anchor the point 5 Move to the end point of the measurement 6 Press the Left mouse button to anchor the measurement end point The IVSd measurement value is displayed in the Measurement result table The end point of the IVSd is also the start point for the LVIDd 1 Move to the end point of the LVIDd measurement 2 Press the Left mouse button to anchor the point The LVIDd measurement value is displayed in the Measurement result table The end point of the LVIDd is also the start point for the LVPWd 1 Move to the end point of the LVPWd measurement 2 Press the Left mouse button to anchor the point The LVPWd measurement value is displayed in the Measu
160. u right field Sorting the templates in the Template selection menu Select the template to move in the Template selection menu right field Press the Up or Down arrow buttons 4 v The selected template is moved accordingly in the Template selection menu EchoPAC PC User s Manual EP092537 02 Program configuration The diagnostic codes sheet This sheet enables the creation and deletion of text inputs that can be used when entering diagnostic codes in the Examination list window see Figure 2 2 page 14 REPORT LOOKUP VALUES Templates Diag Codes Comment Texts Code List Code Atrium 03 Full Text Q Wwewren verte Imaging Measure Report Connectivity System About Admin Service 1 List of text inputs 4 Create a text input 2 Text input name 3 Text input display area free test area Figure 9 8 The Diagnostic codes sheet Creating a text input 1 Press New Text see Figure 9 8 2 In the Code field enter a name for the text input EchoPAC PC User s Manual 201 EP092537 02 Program configuration 3 Move the Mouse cursor in the Text input display area 4 Press the Left mouse button o Enter the text The new text input is created and can be selected when entering diagnostic information in the Examination list window see page 16 for more information about diagnostic information entry Deleting a text input 1 Inthe Code list field select the text input to delete
161. up category deals with e Dataflow connection and communication setup of the EchoPAC PC with other devices e Additional outputs configuration of the Alt Store 1 and Alt Store 2 buttons e Tools formatting of removable media e Formats configuration of the Examination list window and other tools related to patient management e TCPIP internet protocol configuration 204 EchoPAC PC User s Manual EP092537 02 Program configuration Dataflow Communication between the EchoPAC PC and other information providers on the network takes the form of dataflows Each dataflow defines the transfer of patient information and images from an input source to the workstation and from the workstation to an output source A dataflow is a set of pre configured settings Selecting a dataflow will automatically customize the unit to work according to the settings associated with this dataflow Dataflows are configured in the Dataflow sublevel sheet in the Connectivity setup category as described below The Dataflow sublevel sheet is only available to users with administration rights EchoPAC PC User s Manual 205 EP092537 02 Program configuration COHHECTIVITT Dataflow Additional Outputs Tools Formats Tcpip Dataflove Local Archive Int HD fyr Defautt T Direct Store Direct search All Al patients vi M Hidden gt tl o Available Input Ouputs A Selected devices Available Inputs 7 Inputs Datah ase
162. urements without assignment will be lost when scanning is resumed EchoPAC PC User s Manual EP092537 02 Measurements and Analysis Assign and Measure modality In this measurement modality the user selects a study consisting in a set of related pre labelled measurements Starting the Assign and Measure modality 1 Inthe Image analysis screen click on Measure The Measurement Menu is displayed over the control panel see example Figure 4 1 The cursor is in the display window ready for starting measurement EchoPAC PC User s Manual 85 EP092537 02 Measurements and Analysis Active application Study Cardiac Selected study Opened study Generic Measurements related to the area Caliper study for the cardiac application ET ow pe I rm The studies are configurable see page 190 JwallMotion LA Area _ WwallMotion Figure 4 1 Example of a measurement study 86 EchoPAC PC User s Manual EP092537 02 Measurements and Analysis Entering a study and performing measurements 1 Press Measure on the front panel to enter the Assign and Measure modality The Measurement menu with a list of studies is displayed in the Parameters window see example Figure 4 1 When entering the Measurement mode for the first time the Caliper tool is selected by default When re entering the Measurement mode the first measurement in the actual study that has not been performed is selected by default
163. urrent operation being performed If the amount of data exceeds the capacity of the MO disk the user is prompted to insert a new formatted MO disk At the end of the process a status for each item is displayed in the Result column lf errors occur during backup a list of the patient records examinations that could not be backed up Is displayed EchoPAC PC User s Manual EP092537 02 Patient record management AM Backup Restore Users Logon System Admin Archive to back up Last sucessful backup W Patient Archive 02 0ct 2002 01 Jan 2000 p Backup Interval 1 Week 9 9 k Destination s 14 MO Disk HAGEMS BACKUP Backup Now Cancel Imaging Measure Report connectivity System About Admin Service 1 Select the item to backup 4 Start backup 2 Select and adjust the Move images function 5 Adjust the backup reminder 3 Select the MO disk as backup destination Figure 2 16 The Backup sheet Set up backup reminder 1 Inthe Backup sheet select the time interval or none for the backup reminder next to Backup interval When the backup reminder time expires a reminder is displayed when starting the system to prompt the user to take a backup EchoPAC PC User s Manual 39 EP092537 02 Patient record management Backup reminder time has expired Press Yes to goto backup x enes Figure 2 17 The Backup reminder prompt 40 EchoPAC PC User s Manual EP092537 02 A CAUTION
164. usts image settings such as Compress Reject Tissue priority Zooming image rotation cineloop replay adjustment etc e Measurement and Analysis performs either single measurement with post assignment or protocol based pre assigned measurements see Chapter 4 Measurements and Analysis on page 83 e Review and analyze protocol studies such as Stress echo examinations including quantitative stress echo analysis see Chapter 5 Stress echo analysis on page 103 e Quantitative analysis of Tissue Velocity Tissue Tracking and contrast imaging data see Chapter 6 Quantitative Analysis on page 127 44 EchoPAC PC User s Manual EP092537 02 Image Management Image review Images can be reviewed from the Image browser screen or from the Images review screen The Image browser screen displays a thumbnail overview of all stored images sorted by examination session for the current patient The user can preview and group images from one or more examinations for the current selected patient to enable comparison analysis The Image review screen displays all images for the current examination Review from the Image browser screen The procedure described below enables the analysis of images belonging to different examinations for a selected patient record If images are stored on multiple removable media they have to be restored to the local hard drive prior to review as described below 1 In the Examination list window
165. w screen is displayed showing all images for the current examination see Figure 3 4 Select All Select Page Analyze Save Delete Freeze 4 Speeds Frame Review Screen EA n 81 cg i J Wh AM A AM A Adele A JA Au A G Uy A da ir eS in PENE rere TET PR 1 Page number 3 Selection tools 2 Selected image bold frame Figure 3 4 The Review screen Working with grouped images Grouping images 1 From the Image browser screen click once on each image thumbnail of the images to group The selected image thumbnails are displayed with a highlighted frame 2 Press New Group EchoPAC PC User s Manual 49 EP092537 02 Image Management A dialogue box is displayed prompting the user to name the group see Figure 3 5 1 Images belonging to the selected group 2 Enter a name for the group Figure 3 5 Creating a group of images in the Image browser screen 3 Type a name for the group 4 Press OK The group list on the right side of the screen is updated 5 To select the group press on the group in the Group list Both the group name and the belonging image thumbnails are highlighted see Figure 3 6 6 Select Analyze to start analysis see Chapter 4 Measurements and Analysis on page 83 50 EchoPAC PC User s Manual EP092537 02 1 Images belonging to the selected group 2 Selected group Image Management Groups Figure 3 6 Selecting a group of images in the Image brow
166. window The System menu is displayed 2 Select Vertical unit The Vertical unit menu is displayed Decibel Acoustic units Caneet 0 Figure 6 6 The Vertical unit menu 3 Select the desired option Trace smoothing The system can smooth the traces displayed by applying a filter over a defined time window The type of filter available is depending on the analysis signal displayed Smoothing trace s 1 Press the Right mouse button in the Analysis window The System menu is displayed 2 Select Smoothing The Smoothing menu is displayed 3 Select a smoothing filter The trace display is updated 146 EchoPAC PC User s Manual EP092537 02 Quantitative Analysis Switching modes or traces The user can toggle between TVI Tissue Tracking Strain rate or Strain modes to access to the mode specific controls Soft menu and assignable or display alternative traces from within a selected mode To switch mode 1 Select the desired mode TVI Tissue Tracking Strain rate or Strain from the control panel The Color cineloop window and the Analysis window are updated accordingly The settings specific for the selected mode can be adjusted by pressing Settings in the TVI modes field To switch trace 1 Press the Right mouse button in the Analysis window The System menu is displayed 2 Select Analysis signal The Analysis signal menu is displayed Displacement strainrate stim Grayscal

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