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GE Vivid 7 User Manual

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    							Scanning Modes
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     Figure 3-17: The Strain Mode controls on the front panel
    Strain calculates and color-codes the extent of tissue 
    deformation (lengthening or shortening) relative to the original 
    size over a given time interval, typically the systole.
    1. Assignable keys:
    • Strain start R
    • Strain end R
    • Strain scale R
    • Invert R
    • Simultaneous R
    • Color maps R
    • Q-Analysis (Freeze 
    only)
    • Cineloop (Freeze 
    only)
    MORE
    • 2D width
    ALT
    • Curved AMM R
    • AMM R
    • Tissue Tracking R
    • Strain rate R
    • Strain R
    2. Zoom
    • Display zoom
    • HR zoom
    3. Soft menu:
    • Frame rate
    • Strain Length R
    • Strain Reject R
    • Compress R
    • Transparency R
    • Threshold R
    • Frequency
    • Lateral avg.
    • Radial avg.
    • Power
    • Cine compound R 
    (Freeze only)
    4. Freeze
    5. TVI
    6. 2D
    Controls marked with R are 
    also available in freeze and 
    cine replay
    4
    6
    7
    1
    2
    3
    5 
    						
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    Strain controls
    Strain assignable controls
    Strain start
    The time after ECG R-peak when the strain calculation should 
    start. The strain start time is displayed on the screen and is 
    represented on the ECG by a red marker.
    Strain end
    The time after strain start when the strain calculation should 
    end. The strain end time is displayed on the screen and is 
    represented on the ECG by a red marker.
    Strain scale
    Defines the scale for the color coding of the tissue deformation.
    Invert
    Enables the color scheme assigned to shortening and 
    elongation tissue deformation to be inverted. Invert is available 
    in live and cine replay.
    Simultaneous
    Enables simultaneous display of 2D image and 2D image with 
    St ra i n  c o lo r.
    Color maps
    Displays a menu of color map options. Use the trackball to 
    point a color map and press 
    SELECT to activate a desired color 
    map.
    Q-analysis (in Freeze only)
    Starts the Quantitative analysis application (see Chapter 7, 
    ’Quantitative Analysis’ on page 233).
    Cineloop (in Freeze only)
    Starts cineloop acquisition.
    2D width (More menu)
    Controls the angular width of the 2D image sector.
    Alter native assignable controls
    Press ALT to access to the following modes: 
    						
    							Scanning Modes
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    •  Curved Anatomical M-Mode (see page 98)
    •  Tissue Synchronization Imaging (see page 142)
    •  Tissue Tracking (see page 125)
    •  Strain rate (see page 130)
    •  Strain (see page 136)
    Strain Soft menu controls
    Frame rate
    Controls the line density. When adjusting frame rate, there is a 
    trade off between spatial and temporal resolution.
    Strain length
    Determines the strain sample volume size.
    Strain Reject
    Adjust the cut-off level of the low tissue velocity to be discarded 
    when generating the color image. Rejected values are 
    uncolored.
    Compress
    Controls the amount of color compression. The color bar is 
    adjusted accordingly.
    Transparency
    Control the degree of transparency of the strain color.
    Threshold
    Controls the level of greyscale intensity that is used as 
    threshold for color.
    Frequency
    Enables the adjustment of the transmission frequency to 
    control the sensitivity or the level of penetration.
    Lateral Averaging
    Smooths the image by averaging collected data along the 
    same horizontal line. An increase of the lateral averaging will 
    reduce noise, but this will also reduce the lateral resolution. 
    						
    							Scanning Modes
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    Use Averaging con-
    trols with caution 
    so as not to obscure 
    significant diagnos-
    tic information.Radial Averaging
    Smooths the image by averaging collected data along the 
    same radial line. An increase of the radial averaging will reduce 
    noise, but this will also reduce the radial resolution.
    Power
    Controls the amount of acoustic power applied. When power is 
    reduced the signal to noise ratio is reduced, so that the image 
    may become noisier.
    Cine Compound (Freeze only)
    Calculates and displays cineloops generated from a temporal 
    averaging of multiple consecutive heart cycles. The number of 
    cycles averaged is controlled from the Soft menu rocker. The 
    number of averaged cycles i displayed on the top left corner. 
    						
    							Scanning Modes
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    Using Strain
    1. From TVI Mode, press  ALT on the control panel and press 
    STRAIN.
    2. Adjust 
    STRAIN START close to the R-peak.
    3. Adjust 
    STRAIN END near the T-wave.
    Optimizing Strain
    •  From an optimized Strain rate display adjust strain tracking 
    to pick out the systolic phase.
    •  The main use of Strain is to map negative systolic 
    deformation. This means that 
    STRAIN START and STRAIN 
    END should be adjusted to pick out the systolic phase of the 
    cardiac cycle: Adjust 
    STRAIN START close to the R-Peak. 
    Adjust 
    STRAIN END near the T-wave.
    •  Positive deformation can be mapped by pressing 
    INVERT. 
    STRAIN START and STRAIN END must then be adjusted to pick 
    out the diastolic phase of the cardiac cycle.
    •  The maximum deformation that is color-coded can be 
    adjusted using the 
    STRAIN SCALE assignable. If set too low, 
    most of the wall will show the color indicating maximum 
    deformation. If set too high, the maximum deformation color 
    is never reached.
    •  Strain provides velocity information only in the beam 
    direction. The apical view typically provides the best 
    window since the beams are then approximately aligned to 
    the longitudinal direction of the myocardium (except near 
    the apex). 
    						
    							Scanning Modes
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    Tissue Synchronization Imaging (TSI)
    TSI over view
     Figure 3-18: The TSI mode screen
    1. TSI start/end
    2. TSI start and end 
    markers
    3. TSI color bar
    4. Status window
    5. Soft menu
    Controls marked with R 
    are also available in 
    freeze and cine replay. 
    						
    							Scanning Modes
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     Figure 3-19: The TSI mode controls on the front panel
    TSI calculates and color-codes the time from onset of QRS to a 
    detected event, typically the time to peak systolic velocity.
    1. Assignable keys:
    • Frame rate
    • TSI R
    • Simultaneous R
    • Color maps R
    • Cineloop (Freeze 
    only)
    • Q-Analysis (Freeze 
    only)
    MORE
    • 2D width
    • TSI start R
    • TSI end R
    ALT
    • Curved AMM R
    • AMM R
    • Tissue Tracking R
    • Strain rate R
    • Strain R
    2. Zoom
    3. Soft menu:
    • TSI Cut-off R
    • Threshold R
    • Transparency R
    • Frequency
    • Power
    • Cine compound 
    (Freeze only)
    4. Freeze
    5. TVI
    6. 2D
    Controls marked with R are 
    also available in freeze and 
    cine replay
    4
    6
    1
    2
    3
    5 
    						
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    TSI controls
    TSI assignable controls
    Frame rate
    Controls the line density. When adjusting frame rate, there is a 
    trade off between spatial and temporal resolution.
    TSI
    Starts/stops TSI.
    Q-analysis (in Freeze only)
    Starts the Quantitative analysis application (see Chapter 7, 
    ’Quantitative Analysis’ on page 233).
    Simultaneous
    Enables simultaneous display of 2D image and 2D image with 
    TSI color.
    Cineloop (in Freeze only)
    Starts cineloop acquisition.
    Color maps
    Displays a menu of color map options. Use the trackball to 
    point a color map and press 
    SELECT to activate a desired color 
    map.
    TSI start
    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.
    Press 
    MORE to access this control.
    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.
    Press 
    MORE to access this control. 
    						
    							Scanning Modes
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    Alter native assignable controls
    Press ALT to access to the following modes:
    •  Curved Anatomical M-Mode (see page 98)
    •  Tissue Synchronization Imaging (see page 142)
    •  Tissue Tracking (see page 125)
    •  Strain rate (see page 130)
    •  Strain (see page 136)
    TSI Soft menu controls
    TSI Cut-off
    Controls the cut-off time: using this control it is possible to color 
    all parts of the TSI image that has a time to peak less than a 
    certain cutoff time.
    Threshold
    Controls the level of greyscale intensity that is used as 
    threshold for color.
    Transparency
    Control the degree of transparency of the strain color.
    Frequency
    Enables the adjustment of the transmission frequency to 
    control the sensitivity or the level of penetration.
    Power
    Controls the amount of acoustic power applied. When power is 
    reduced the signal to noise ratio is reduced, so that the image 
    may become noisier.
    Cine Compound (Freeze only)
    Calculates and displays cineloops generated from a temporal 
    averaging of multiple consecutive heart cycles. The number of 
    cycles averaged is controlled from the Soft menu rocker. The 
    number of averaged cycles i displayed on the top left corner. 
    						
    							Scanning Modes
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    Using TSI
    1. From TVI, Tissue Tracking, Strain or Strain rate mode, 
    select 
    TSI.
    2. Press 
    MORE and adjust TSI START and TSI END.
    3. Optionally adjust 
    THRESHOLD.
    Optimizing TSI
    •  Use apical view when imaging.
    •  Activate TSI from an optimized TVI or Strain rate display.
    •  To detect regions with post-systolic contraction, adjust 
    TSI 
    START to start ejection to avoid detecting IVC peaks and TSI 
    END to mitral valve opening or later. Regions with post-
    systolic contraction will show up in red.
    •  To detect asynchronous regions, adjust 
    TSI START to start 
    ejection to avoid detecting IVC peaks and 
    TSI END to aortic 
    valve closure. Regions colored in red have delayed peak 
    velocity compared to regions colored in green. 
    						
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