SONOS 7500/5500
Contents
1. Edition Date Software Revision Edition 1 April 1999 B 0 Edition 2 June 2000 B 1 Edition 3 June 2002 C 0 Edition 4 November 2002 D 0 Preface This guide describes the basic operation of Acoustic Densitometry or AD on the SONOS 7500 and SONOS 5500 systems Use this guide in conjunction with the following books Use this guide in conjunction with the following books System Basics Describes the basic operation of the Philips SONOS 7500 and SONOS 5500 systems Controls Reference Provides a detailed description of all system controls Safety and Standards Guide Provides information on safety issues Measurements and Calculations Reference Provides information on measurements and calculations that you can perform on your ultrasound system Transducer Reference Provides information on the operation care and cleaning of transducers Additionally several specialty guides and multimedia products describe SONOS imaging applications and optional packages Using Integrated Digital Interface IDI Using Stress Echocardiography Using 3 Dimensional and BiPlane Imaging Using Acoustic Quantification Using Contrast Imaging LVO and Contrast CK A Practical Approach a video guide to SONOS contrast echocardiography detection techniques Stress Audio CD a spoken guide to performing SONOS stress echocardiography studies Conventions Used in This Guide The following conventio2. SONOS 7500 5500 Using Acoustic Densitometry User s Guide Using Acoustic Densitometry Philips SONOS 7500 Philips SONOS 5500 2002 Philips Electronics North America Corporation All rights are reserved Reproduction in whole or in part is prohibited without the prior written consent of the copyright holder Publication number M2424 30000 ad 02 Edition 4 Published November 2002 Printed in U S A Warranty The information contained in this document is subject to change without notice Philips Medical Systems makes no warranty of any kind with regard to this material including but not limited to the implied warranties of merchantability and fitness for a particular purpose Philips shall not be liable for errors contained herein or for incidental or consequential damages in connection with the furnishing performance or use of this material This product may contain re manufactured parts equivalent to new in performance or have had incidental use WARNING Electrical Shock Hazard Do not remove system covers To avoid electrical shock use only supplied power cords and connect only to properly grounded wall wall mains outlets Explosion Hazard Do not operate the system in the presence of flammable anesthetics Safety Information Before you use the Philips ul trasound system be sure to read the Safety and Standards guide Pay special attention to the Wa
3. 1 3 Mean transit time 3 6 Measurement choices color study 3 4 integrated backscatter 3 4 time intensity study 3 3 tissue doppler 3 4 Measurement parameters 3 6 Measurements and calculations contrast studies 3 5 Measuring myocardial velocity gradient 2 18 velocity 2 17 MTT 3 6 MVG see myocardial velocity gradient Myocardial velocity gradient 2 18 measuring 2 18 multiple measurements 2 19 N Noise reducing 2 10 O Optical disk exporting to 2 12 Overview AD 1 2 P PA 3 6 Parameters measured and computed 3 6 Peak intensity 3 6 Peak negative velocity 3 8 Peak positive velocity 3 8 Peak to peak amplitude of the image intensity 3 7 PI 3 6 Planimetered area 3 6 PNV 3 8 Post processing settings 1 2 PPI 3 7 PPN 3 8 Pre contrast baseline 3 6 Preface 1 i Preset multiple studies 2 2 R Reduce noise 2 10 Region of Interest marker see ROI Rescale 2 10 ROI creating 2 3 measurement with 1 2 planimetered area 3 6 positioning 2 6 sampling with 2 5 2 6 types 2 3 user defined 2 3 user specified 1 2 using 2 5 S Safety information 1 11 Sampling data 2 3 live image 2 5 loop 2 4 time interval 3 6 Saving a data set 2 12 SDI 3 7 Select Calcs touch control 3 2 Selecting data sets 2 13 SI 3 6 Slope descending 3 6 Smoothing 2 12 data 2 10 examples 2 11 setting 2 12 Software revision compatibility 1 3 Standard deviation of image intensity 3 7 Symbols used on sy
4. It Appears With the Velocity Caliper Active Revision D 0 2 17 Procedures Caliper Measurements of Velocity in AD Measuring the Myocardial Velocity Gradient The Myocardial Velocity Gradient MVG is the difference in velocity between two points divided by the distance between the two points Vi distance To display the MVG at two points in a color doppler loop do the following 1 Make sure the frame you want to measure is in Loop Display The image must be frozen 2 Press Caliper A crosshair appears on the screen 3 Use the trackball to position the crosshair where you want to measure the first instance of velocity 4 Press Caliper A second crosshair appears on the screen 5 Use the trackball to position the second crosshair where you want to measure the next instance of velocity Press Enter A dashed line appears between the two crosshair points The myocardial velocity gradient MVG between the two crosshair points is shown in a box at the upper left corner of the SONOS screen 2 18 Revision D 0 NOTE Procedures Caliper Measurements of Velocity in AD To get a more accurate value MVG measurements should be made along the same acoustic line a radial line starting at the apex of the image A MVG Figure 2 11 SONOS Screen As It Appears With Two Velocity Calipers Active You can measure additional MVGs on the same image leaving the prior measurements activ
5. Revision D 0 2 15 Procedures Using Acoustic Densitometry Data Sets Deleting a Data Set Touch Delete Dataset The dialog box shown in Figure 2 9 appears This Dataset contains data O Delete this dataset O Delete all datasets Okay Cancel Figure 2 9 Dialog Box For Dataset Deletion You can chose to delete all data sets or only the data set you selected Highlight the corresponding item on the dialog box move the cursor to it and press Enter Highlight Okay and press Enter 2 16 Revision D 0 Procedures Caliper Measurements of Velocity in AD Caliper Measurements of Velocity in AD AD also allows calculations with the caliper in Color Flow Color Tissue Doppler images You can use the caliper feature to derive velocity for a small square ROI around a single point in the image or the myocardial velocity gradient between two points Measuring Velocity To display the flow or tissue velocity at a certain point in a Color Doppler or Color Tissue Doppler loop do the following 1 Make sure the loop you want to measure is in Loop Display 2 Press Caliper A crosshair appears on the screen 3 Use the trackball to position the crosshair where you want to measure velocity The velocity at the crosshair point is shown in a box at the upper left corner of the SONOS screen The velocity is displayed in centimeters per second At VEL 1 234 cm s Figure 2 10 SONOS Screen As
6. SET 1 64 PPI 8 7 AII SDI I GAIN 50 N COMP 74 T 48 E N 32 I 4CM T 30HZ o 16 Lx ot xX Kk d B 0 P 0 20 40 60 1 6 3 2 SAMPLE Figure 3 6 Typical Time Intensity Curve for a Cyclic IBS Study In an integrated backscatter study the AD package measures and computes the following parameters Symbol Unit Description AII dB Average image intensity SDI dB Standard deviation of image intensity PPI dB Peak to peak amplitude of the image intensity Revision D 0 3 7 Color Flow Studies Measurements and Calculations Reference Figure 3 7 shows a time velocity curve for color flow study MI 1 2 S3 22 FEB 01 11 22 58 2 0 78 5 E Philips Medical Systems Adult GAIN 50 COMP 74 178 BPM 16CM 62HZ 16 3 2 G HOO RN lt G S O PPV 1 6 PNV 2 4 Xx xX xe RO S 20 40 60 SAMPLE Figure 3 7 Time Velocity Curve for a Color Flow Study Ina velocity time study the AD package measures and computes the following parameters Symbol Unit Description PPV cm sec Peak Positive Velocity of V t curve PNV cm sec Peak Negative Velocity of V t curve 3 8 Revision D 0 Numerics 2D image visualizing changes 2 9 A About this manual 1 1 Acquiring image 2 2 AD study overview 2 1 AII 3 7 Analyzing
7. optical disk 1 Insert an optical disk 2 Ontheleft touch panel ensure Loop and Display are highlighted 3 Touch Disk Store Data set values are saved with the loops Only the datatsets that belong to the image loop are saved with the image 2 12 Revision D 0 NOTE Procedures Analyzing the Data Comparing Data Sets Simultaneously The AD package lets you acquire as many as twelve data sets and twelve associated time intensity or time velocity curves You can select up to three data sets for simultaneous display and comparison 1 Touch Select Datasets on the right touch panel The Select Dataset window appears Data sets containing data are displayed others are grayed out Select up to 3 Datasets for Comparison Deselect some datasets first if necessary Dataset 1 Dataset 2 Dataset 3 Dataset 4 Dataset 5 Dataset 6 Dataset 7 Dataset 8 Dataset 9 XIDataset 10 Dataset 11 Dataset 12 Cancel Figure 2 6 The Select Datasets Dialog Box If none of the data sets in a study are analyzed then the Select Datasets key is not displayed You cannot compare data sets that are not yet analyzed 2 Highlight the data sets you want to compare Press Enter An X appears in the check box To deselect a check box select it again and press Enter 3 When you have selected the data sets you want to compare highlight Okay and press Enter 4 You can compare data sets on a table or on a
8. Procedures Analyzing the Data 56 ie 48 E 40 E 24 2 16 on 10 20 30 40 50 60 SAMPLE NUMBER TIME Figure 2 4 Time Intensity Graph with no data smoothing 64 56 FIPEI ve B c 48 i S e S B ES X E49 1 f s lt 2 32 E i s 4 t E Pa e e 24 e s B z l 9 i 16 N Y Dr hee a S E Ww d M O 10 20 30 40 50 600 10 20 30 40 50 600 10 20 30 40 50 60 SAMPLE NUMBER TIME SAMPLE NUMBER TIME SAMPLE NUMBER TIME LOW MEDIUM HIGH Figure 2 5 Time Intensity graphs after low medium high smoothing NOTE A high degree of smoothing reduces random noise significantly but also tends to mask genuine changes in the data Revision D 0 2 11 NOTE Procedures Analyzing the Data To perform data smoothing do the following On the right touch screen turn the Smoothing rotary to the desired smoothing setting Off Low Medium Or High The system calculates a new set of measurements applying a smoothing filter Exporting a Data Set When you have a data set that you are satisfied with you can save the values to the floppy disk or optical disk To save the values to the floppy disk 1 Insert a floppy disk 2 Onthe right touch panel touch Export to Floppy The data exported includes intensity velocity and time To save the values to an
9. ated graph and a numeric chart Lets you change the baseline of the graph changing the zero point on the Y axis of a curve of data points Lets you apply smoothing to graphed data Lets you apply non linear curve fitting gamma variate of time intensity data Extracts parameters from time intensity curves including peak intensity area under the curve half time of washout mean transit time descending slope time to peak intensity and goodness of fit Compares data sets from different studies for example pre and post intervention studies Stores raw time intensity and time velocity data for all datasets with an image file for offline use and later analysis of data on SONOS along with analysis results Exports raw time intensity and time velocity data for all datasets to disk for offline analysis Provides quick AD caliper measurements for velocity and velocity gradient Provides system settings of acquired images Backward Compatibility AD for SONOS 7500 and SONOS 5500 Release D 0 can read and analyze results from previously analyzed images dating back to Rev B 1 and later Revision D 0 1 3 Introduction Acoustic Densitometry Features 1 4 Revision D 0 Chapter 2 Procedures Introduction There are three parts to an AD study Acquiring an image The image from which you collect data can be an acquired loop or a live image Sampling data from the images Using the Region of I
10. data 2 7 Area under the time intensity curve 3 6 AUC 3 6 Average image intensity 3 7 B Backward compatibility 1 3 Baseline pre contrast 3 6 selecting 2 9 BL 3 6 C Calcs rotary control 3 2 Calculations configuring 3 1 parameters 3 6 Caliper velocity 2 17 Color Flow studies curve 3 8 Color Study measurement choices 3 4 Colormap 2 9 Comparing data sets simultaneously 2 13 Compatibility with software 1 3 Compression settings 1 2 Configuring calculations 3 1 Contrast studies measurements and calculations 3 5 Conventions 1 ii Creating ROI 2 3 Custom ROI 2 3 D Data analyzing 2 7 sampling 2 3 smoothing 2 10 2 12 Data sets comparing 2 13 deleting 2 16 labeling 2 15 saving 2 12 selecting 2 13 using 2 15 Deleting datasets 2 16 Descending slope time intensity curve 3 6 Disk Store 2 12 DS 3 6 E Electrical warning 1 11 Explosion warning 1 ii Exporting data set 2 12 Exporting to disk 2 12 Index F Features 1 3 Floppy disk exporting to 2 12 G Geometric length 3 6 GF 3 6 GL 3 6 Goodness of fit 3 6 H Half time of descent 3 6 HT 3 6 Images acquiring 2 2 Integrated Backscatter study curve 3 7 measurement choices 3 4 Introduction 1 2 L Labeling data sets 2 15 Live image sampling 2 5 sampling overview 2 3 Index i Index Loop adjusting speed 2 5 intensity 2 9 measuring velocity 2 17 sampling 2 4 software compatibility
11. data set See Figure 2 3 The SONOS system plots the data points on a graph a time intensity or time velocity graph and logs them on a chart numerical datalog When you finish sampling data the system automatically goes to AD analysis mode The Region of Interest Marker The region of interest ROT can be A fixed shape square circle ellipse crescent rectangle A variable size Oriented in one of twelve positions in increments of 30 degrees A user defined shape When AD is selected in the left touch panel ROI controls appear in the right touch panel The ROI color control appears in Secondary Controls Touch the ROI control and move the rotaries to create an ROI tool that is the right shape and size For a full description of ROI controls see the Controls Reference Creating an ROI You can create a customized region of interest ROI The dimensions of the ROI must not exceed 200 X 300 pixels Any region of the ROI that exceeds this limit is clipped to fit a 200 X 300 pixel area A user defined ROI exists until it is cleared or you exit AD To create a user defined ROI 1 Touch ROI and turn the ROI Shape rotary to UserDef 2 Ifa user defined ROI already exists touch Clear ROI A crosshair appears Revision D 0 2 3 NOTE Procedures Sampling 3 Press Trace move the trackball to outline the ROI shape and then press Enter 4 Move the ROI to the location you want You can use the key to ed
12. e on the screen To enable a second MVG do the following 1 Press to finish deriving the first MVG 2 Repeat steps 2 through 5 in the procedure above The mean velocity gradient MVG between the two crosshair points is shown in a second box at the upper left corner of the SONOS screen Revision D 0 2 19 Procedures Caliper Measurements of Velocity in AD 2 20 Revision D 0 Chapter 3 Measurements and Calculations Configuration When you obtain and save a data set a window appears showing calculations applied to the data The calculations performed are configurable See Figure 3 1 0 0 0 s 6 MI 1 2 0 0 0 5 S3 0 0 0 5 22 DEC 01 0 0 11 22 58 0 0 2 0 E T2 8 1 Philips Medical 12 0 Systems 13 7 Adult 64 UVTCOGNNME 15 5 15 4 i 46 5 GAIN 50 N 48 14 8 COMP 74 T 2 3 E 7 8 7 8 1 32 6 7 T 5 5 4CM Y 4 9 4 0 161 x 1 i x x Xx x 2 1 Xx 1 2 x Xx Xxxx 1 0 oxx xxx XKXX X Xx 0 8 0 5 1 1 2 2 3 0 5 0 5 01 0 8 CO SAMPLE 13 3 6 Figure 3 1 AD Screen Showing Measurement and Calculations Window For a Contrast Study Revision D 0 3 1 Measurements and Calculations Configuration An AD analysis can be conducted in three types of studies For each study type the AD package provides a default set of measurements and calculations You can change the type of measurements and calculations du
13. ect the calculations Revision D 0 2 9 NOTE NOTE Procedures Analyzing the Data 1 Select the desired data smoothing and curvefit options with Select Baseline off 2 Touch Select Baseline and set the baseline This is the amount that will be sub tracted from every data point 3 When you finish selecting the baseline press Enter The results are displayed 4 Use the Rescale rotary to display the graphed data with the desired magnification You may make a different baseline selection and repeat this step The measurements and calculations are automatically performed from the time intensity data after baseline subtraction The new data points appear on the time intensity graph Changing the baseline in Color Flow Tissue Doppler does not effect the calculations Data Smoothing The AD package lets you further reduce noise data by smoothing data across image frames prior to curve fitting and data analysis Collecting data with larger ROIs minimizes noise Statistical errors in the individual time intensity curve samples resulting from patient motion breathing artifact and other causes can obscure the underlying shape of the time intensity curve In these cases you can smooth the data before further analysis Figure 2 4 shows a time intensity plot for a data set with no data smoothing Figure 2 5 shows the result of smoothing the data with low medium and high smoothing filters 2 10 Revision D 0
14. elps you visualize changes in a 2D image showing the intensity in a loop image before you sample data When you turn Colormap on the gray scale AD image changes to an image with colorization and gray scale AD Colormap works only on a 2D image AD Colormap is only available before a data set is sampled To enable Colormap do the following 1 Make sure the loop you want to measure is in Loop Display 2 On the right touch panel touch Secondary Controls 3 Touch AD Colormap The loop image is displayed in color with the areas of greatest intensity accented 4 Turn the Baseline rotary on the right touch panel to modify the intensity range of the colormap This control adjusts the threshold that determines what part of the image is colored and what part remains black and white The effect appears on the scale in the upper right of the screen Selecting a Baseline In a contrast study the AD package lets you subtract the pre contrast background intensity from the data acquired using contrast to get an estimate of the intensity solely due to the contrast agent The Select Baseline key automatically turns on when the SONOS system enters AD Analysis mode after data sampling ends You can also touch the Select Baseline button When you select Select Baseline the original data set is plotted on the time intensity graph with the baseline displayed in the same color as the graph Changing the baseline in Color Flow Tissue Doppler does not eff
15. es 1 Make sure AD is selected on the SONOS system On the left touch panel touch Tools Then touch the AD button Tools Loop Contrast AD OOOOO Revision D 0 2 5 Procedures Sampling 2 Touch Physio Make sure the Trigger rotary is set to either ECG or Timer not Off Physio Trigger Timer O O O O Q 3 On the right touch panel select the Shape Size and Orientation for the Region of Interest ROT cursor 4 Position the ROI marker on the region of the image you want to sample On the right touch panel touch Sample Data to start the acquisition of data points into the current data set The SONOS system records the average intensity or average velocity within the ROI 5 Use the trackball to move the ROI marker keeping it over the region you want to sample 6 When you are finished sampling press Sample Data again to unselect it 7 Move the trackball up or down to set the baseline and then press to set the baseline See Selecting a Baseline on page 2 9 The system records the average intensity or velocity for each frame as it advances After selecting a baseline the system performs the calculations you chose for the type of image to be analyzed 2 6 Revision D 0 Procedures Analyzing the Data L Analyzing the Data When you finish sampling data from a loop the SONOS s
16. graph On the right touch screen touch Compare Table or Compare Curve A table or a graph appears display ing the multiple data sets you selected Figure 2 7 shows a graph comparing two datasets Revision D 0 2 13 Procedures Analyzing the Data NOTE On a graph comparing data sets the data points from different data sets are designated by different markers as shown by the rectangles and Xs in Figure 2 7 DATASETS 3 894 4 X I 64 N T E 48 S I T 32 Y a 16 7 i 2 5 1 1 2 2 3 0 5 0 5 0 SAMPLE Figure 2 7 Graph Comparing Two Data Sets 2 14 Revision D 0 Procedures Using Acoustic Densitometry Data Sets Using Acoustic Densitometry Data Sets AD lets you acquire up to twelve data sets To select a data set on the right touch panel turn the Dataset rotary to the number of the data set The data set number appears in the upper right corner of the graph If the selected data set contains data it is plotted on the graph Labeling Data Sets You can attach labels to the graphed curve for the selected data set Touch Dataset Label on the right touch panel A dialog box appears on the screen See Figure 2 8 Enter the text of the label The label text appears at the top of the Analysis time intensity or time velocity graph display Enter Dataset Label Okay Cancel l Figure 2 8 Dialog Box for Dataset Annotation
17. it the ROI Sampling a Loop 1 Make sure AD is selected on the SONOS system On the left touch panel touch Tools Then touch the AD button Tools Loop Contrast AD O O O O 2 Touch Graph on the right touch panel to remove the graph from the screen 3 Select the desired loop and make sure it appears in Loop Display Edit the loop if necessary Press Freeze 4 Use the Speed rotary on the right touch panel to set the frame advance speed 5 On the right touch panel under Secondary Controls select the scale default is V Square 6 On the right touch panel select the Shape Size and Orientation for the Region of Interest ROI cursor 2 4 Revision D 0 Procedures Sampling 7 Position the ROI marker on the region of the image you want to sample Touch Sample Data to start the acquisition of data points into the current data set The SONOS system records the average intensity velocity within the ROI 8 Move the ROI between frames by moving the trackball You can adjust the speed of the loop using the Speed rotary on the right touch panel 9 Usethe trackball to move the ROI marker keeping it over the region you want to sample 10 When sampling finishes move the trackball up or down to position the baseline and then press to set the baseline See Selecting a Baseline on page 2 9 Sampling a Live Image AD can sample images live but they must be triggered imag
18. locity in ultrasound images It measures and displays either the average acoustic intensity or average velocity depending on the imaging mode Measurement occurs in a user specified region of interest ROI at user specified time trigger intervals Unlike conventional video densitometry AD measurement data is minimally affected by the compression and post processing settings of the ultrasound system The AD package lets you perform measurements on a selected region of an ultrasound image AD lets you analyze loops collected using 2D AQ angio integrated backscatter IBS 2D color doppler and 2D color tissue doppler imaging modes AD lets you measure image data in SONOS Study Manager that is after you have captured image loops The AD tool can be used in research applications such as contrast tissue doppler and tissue characterization studies 1 2 Revision D 0 Introduction Acoustic Densitometry Features Acoustic Densitometry Features SONOS AD package provides the following capabilities Lets you collect and analyze images acquired in 2D angio AQ 2D color doppler 2D color tissue doppler and integrated backscatter imaging modes Lets you perform analysis on live triggered images or loops acquired into SONOS Study Manager Provides programmable colorization capability Works with a contrast study Lets you store twelve datasets with as many as 300 data points each Displays the data on both an annot
19. ns are used in this guide Touch panel and rotary control names appear in bold text For example Acquire Loop Function keys appear in a box For example Enter Revision D 0 iii Contents PV CTACC ERE LEE UCET EM TEM 1 i Conventions Used in This Guide 0 00 1 ii Chapter 1 Introduction About This M nu al cL ee beet eee etes 1 1 Acoustic Densitometry Overview 0 cette 1 2 Acoustic Densitometry Features 00 0 0 ect teens 1 3 Backward Compatibility 1 3 Chapter 2 Procedures Introduction 284 54 sola L H aai L os b nr Eben ie tao ARTN ER ok 2 1 Acquiring an Images er she een dT TINY MPVES C AREE pase E SS 2 2 Sampling 4 02 LV ee el a ora ties ede ak Sa AED 2 3 The Region of Interest Marker esee 2 3 Creating an ROLL e qu Eie ie a Ro e ges 2 3 Sampling a bo0pz o eic eR Mu xU eee e Ds 2 4 Sampling a Live Image 1 2 0 eect eees 2 5 Analyzing the B cec ete eek ee VER Woe wey X eT es ut 2 7 Colormap Display cscs oas iiare iina a cette eee E 2 9 Selecting a Baseline ess D eee T ARE KRA EE 2 9 Data Smoothing scssi iie i ee ORG Pelee A EE ERE ERE 2 10 Expor ng a Data Sets os csecbepnecs TI RPUDUPSUISR eee ly oped hele ges 2 12 Comparing Data Sets Simultaneous 0 eee eee eee eee 2 13 Using Acoustic Densitometry Data Ses 2 15 Labeling Data Sets occiso rito opto aA Soe els O PEO EO ER Na 2 15 Deleting Data Set sourn sce oe seek RR e deine eve ak Rs 2 16 Caliper Measu
20. nterest tool you select data from the image and store the collected data set You can sample data from live images as well as saved loops Analyzing the data Using the data set you can create graphs and tables manipulate the data and perform calculations For a complete description of all AD controls see the Controls Reference Revision D 0 2 1 NOTE Tip The loop must be frozen for all the buttons on this touch panel to appear Procedures Acquiring an Image Acquiring an Image Unless you plan to sample data from live ultrasound images acquiring loops is the first stage in an AD study For multiple studies of the same type consider creating a preset See the System Basics Guide You can perform AD analysis on images acquired using 2D AQ Angio Integrated Backscatter IBS color doppler and color tissue doppler imaging modes If you acquire a loop using color doppler or color tissue doppler the data you derive from the loop will pertain to velocity Otherwise AD analysis pertains to image intensity 2D Loop Display Secondary Numeric Controls Data Delete Dataset System Dataset Graph ROI Sample Settings Label Data ROI Shape ROI Size Ellipse 21x21 Speed Dataset ROI Pos 7 1 00000 Figure 2 1 The Right Touch Panel as it Appears in Sample Mode 2 2 Revision D 0 Procedures Sampling Sampling Data sampled over consecutive frames constitutes the
21. rements of Velocity in AD 2 17 Measuring Velocity s owesetzbpsorETSUDERYGISUIQUESRUOISUR Rea OS 2 17 Measuring the Myocardial Velocity Gradient 000000 2 18 Contents 1 Contents Chapter 3 Measurements and Calculations Configuration SRM Naess H Mee ort coh Nhe Medes RC nt 3 1 Reference terse ec Seated tae eit teh net ne Be hel E Pu eins ce es 3 5 Contrast Studies ore fee RAR ON ee ek EIER PR ue 3 5 Integrated Backscatter Studies 0 0 0 cee cece tenes 3 7 Color Flow Studies iue ica hin he teed poe tie tee DA Reo RR eee 0 R 3 8 Contents 2 Chapter 1 Introduction About This Manual This user s manual provides you with all the information you need to start using Acoustic Densitometry AD This manual is divided into three chapters Chapter 1 Introduction provides an overview of AD and its features Chapter 2 Procedures explains how to perform an AD study important information for new users It describes how to use AD features Chapter 3 Measurements and Calculations describes the calculations the SONOS AD package performs on data sets The AD manual assumes a working knowledge of the SONOS 7500 or SONOS 5500 system see the System Basics Guide Revision D 0 1 1 NOTE Introduction Acoustic Densitometry Overview Acoustic Densitometry Overview Acoustic Densitometry AD is a tool for quantification of brightness intensity and ve
22. ring a study 1 Touch Secondary Controls on the right touch panel 2 The Calcs rotary defaults to the current type of study You may rotate it to select IBS TD Tissue Doppler or Contrast NOTE The Cales rotary control appears only after measurements are taken from a sampled data set 3 Touch Select Calcs Depending on which type of study you select one of three selection boxes appears These selection boxes let you chose which calculations you want for each type of study Contrast see Figure 3 2 Integrated Backscatter see Figure 3 3 Color Doppler Color Tissue Doppler see Figure 3 4 3 2 Revision D 0 Measurements and Calculations Configuration Time intensity study measurement choices Measurements X Peak Intensity PI X Area Under the Curve AUC C Time to Peak TP X Half time of Descent HT L Descending Slope DS X Mean Transit Time MTT X Sampling Interval ST Cl Planimetered Area PA U Geometric Length GL IX Goodness of Fit GF Okay Cancel Figure 3 2 Calculations For a Contrast Study Revision D 0 3 3 Measurements and Calculations Configuration Integrated Backscatter Study Measurement Choices Measurements Peak to Peak Intensity PPI XI Average Image Intensity AII Standard Deviation of Image Intensity SDI Okay Cancel Figure 3 3 Calculations For an Integrated Backscatter Study TD Color Flow Study Measurement Choice
23. rnings and Cautions The warnings explain the dan gers of electrical shock and ex plosion hazard the safety of ultrasound applications guidelines for fetal use and guidelines for setting controls that affect acoustic output and accuracy of clinical measure ments The cautions explain potential dangers to equipment Warning Symbol Used in the Text WARNING Caution Symbol Used in the Text CAUTION Warning Symbols Used on the System AN Instruction manual symbol the product will be marked with this symbol when it is neces sary for the user to refer to the instruction manual in order to protect the product against damage 74 Indicates potential for electri cal shock Monitor Radiation The monitor used in this system complies with the FDA regulations that were applicable at the date of manufacture 21 CFR Subcategory J Prescription Device The United States Food and Drug Administration requires the following labeling statement Caution Federal Law restricts this device to use by or on the order of a physician Important C c 0123 marking is for Council Directive 93 42 EEC This system complies with the Medical Device Directive Authorized EU Representative Philips Medizinsysteme Boeblingen GmbH Hewlett Packard Str 71034 Boeblingen Germany Philips Medical Systems 3000 Minuteman Road Andover Massachusetts 01810 1099 978 687 1501 Printing History
24. s Measurements Peak Positive Velocity PPV Peak Negative Velocity PNV Okay Cancel Figure 3 4 Calculations For a Tissue Doppler or Color Study 4 Inthe selection box highlight the calculations you want to perform Press Enter An X appears in the check box To deselect a check box select it again and press Enter 5 When you have made your selections highlight Okay and press Enter 3 4 Revision D 0 Measurements and Calculations Reference Reference Below is a detailed description of the measurements and calculations performed for contrast and integrated backscatter studies Contrast Studies Figure 3 5 shows a time intensity curve for a contrast study APPEARANCE WASHOUT PHASE PHASE INTENSITY DS SLOPE OF LINE BASELINE INTENSITY Figure 3 5 Time Intensity Curve For A Contrast Study Revision D 0 3 5 Measurements and Calculations Reference For a contrast study the following parameters are measured and computed Symbol Unit Description BL au au 2 dB Pre contrast baseline or background intensity SI sec Sampling time interval For ECG triggers it is the R R interval and for Internal triggers it is the interval delay For non gated and frame locked modes it is the frame interval which is 33 msec for NTSC US and 40msec for PAL Europe PI au au 2 dB Peak of the time intensity curve after background sub
25. stem 1 ii System warning symbols 1 ii Index ii T Time to peak 3 6 Time intensity curve contrast study 3 5 Time intensity study measurement choices 3 3 Tissue Doppler Study measurement choices 3 4 TP 3 6 Trigger 1 2 U Using data sets 2 15 V Velocity gradient measuring 2 17 Velocity measuring 2 17 W Warning symbols 1 11 Warranty 1 1 Index iii Index Index iv
26. traction AUC au sec au 2 sec Areaunder the time intensity curve after background subtraction dB sec TP sec Time elapsed from the first appearance of contrast to the time at peak intensity HT sec Half time of descent of the time intensity curve that is from peak intensity to half peak intensity MTT sec Mean Transit Time which represents the average time of flow of contrast within the region of interest DS au sec au 2 sec Descending slope of the time intensity curve For gamma variate curvefit the dB sec descending slope represents the maximum descending slope For no curvefit the descending slope is computed from the 0 85P to 0 35P points on the descending limb of the time intensity curve GF none Goodness of fit measure of the gamma curvefit to the raw time intensity data A goodness of fit of 1 0 represents a very good fit whereas a GF of 0 0 represents a very poor fit to the data If GF is not selected raw and fitted data are graphed GL cm The geometric length of a line segment on the image using the measurement calipers PA cm2 The planimetered area of a region of interest in the image using the trace measurement calipers 3 6 Revision D 0 Measurements and Calculations Reference Integrated Backscatter Studies Figure 3 6 shows a typical time intensity curve for an integrated backscatter study MI 1 2 s3 O 22 FEB 01 11 22 58 2 0 E H5 Philips Medical Systems Adult DATA
27. ystem goes to Analysis mode 2D Loop Display Secondary Numeric Select Controls Data Datasets Exportto Delete Compare Select Floppy Dataset Tables Baseline System Dataset Compare Go to Settings Label Curves Sample Smoothing Dataset Rescale Off 1 QOOOQOOQ Figure 2 2 Right Touch Panel As It Appears in AD Analysis Mode After you finish sampling a dataset and selecting the baseline the right touch panel displays the primary Analysis mode keys as shown in Figure 2 2 The Analysis graph for the currently selected data set appears on the screen with a plot of the sampled data points as shown in Figure 2 3 Revision D 0 2 7 MI 1 2 S3 22 FEB 01 11 22 58 2 0 E T2 Philips Medical Systems Adult GAIN 50 COMP 74 4CM O G HD SN AH N gt G 0 Procedures Analyzing the Data 14 64 e 14 AUC 41 3 22 HT 0 7 34 MTT 0 9 34 48 x BL 7 7 46 SI 0 2 14 GF 0 3 32 16 XX X x XX ox X x x x AXXXXXXXX 0 1 2 2 3 5 0 5 o SAMPLE Figure 2 3 The Analysis Graph GO GO GO CO v O O O O O O O O NM O0 O0 LM O0 UI to HP J1 C CO CO O O O O ooo OOO OO M 4 4 ooo ooo On the right touch screen touching Numeric Data or Graph turns these features on or off on the screen 2 8 Revision D 0 NOTE NOTE Procedures Analyzing the Data Colormap Display The SONOS AD Colormap feature h
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