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GE Vivid 7 User Manual

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    							Stress Echo
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    Editing/creating a template
    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.
    Templates created may be temporary, used only during the 
    current examination, or saved as new templates, for future use 
    and reference. The editions that may be performed include:
    •  Adding/deleting levels and projections, page 181
    •  Assigning new labels to levels and projections, page 182
    •  Defining level options, page 182
    •  Defining new groups, page 183
    Templates are edited/created from the Template editor screen.
    Entering the Template editor screen
    1. Press PROTOCOL to enter the stress echo mode.
    2. Press the assignable 
    TEMPLATE.
    The Template pop-up menu is displayed.
    3. Trackball to Template Editor.
    4. Press 
    SELECT.
    The Template editor screen is displayed (see Figure 4-14). 
    						
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    Template editor screen over view
     Figure 4-14: The Template editor screen
    Te m p l at e
    Parameter Description
    Te m p l a t e :
    •  select a pre-defined template from the pop-
    up menu. The Protocol template preview 
    (see below) is updated accordingly. 
    						
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    Protocol template preview
    Template settings
    Parameter Description
    Protocol template preview:
    •  displays an updated preview of the 
    template accordingly to the settings 
    applied.
    • To change Projection and Stress level 
    labels, select a pre-defined label from the 
    pop-up menu or press 
    SELECT in the actual 
    label field and type a new name.
    Q Stress acquisition: enables TVI data 
    acquisition for QTVI Stress analysis.
    Parameter Description
    Template settings:
    • Cycles: select the number of cineloop 
    heart cycles to store for each level from the 
    drop-down menu.
    • Continuous capture:
    : enables continuous image acquisition 
    throughout the level. The images acquired 
    are temporarily stored in the units storage 
    buffer.
    • Preview of store:
    : enables review and adjustment of 
    cineloops before storage (see page 273 for 
    further information).
    • Show reference:
    : displays a dual screen with the 
    reference level (first or previous level) on 
    the left and the live image on the right. 
    						
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    Other options
    Parameter Description
    Grid size:
    •  Enter the number of levels and projections 
    for the selected template.
    Timers:
    •  : starts T1 and T2 timers automatically
    Auto-start analysis:
    •  : displays the Stress Echo Analysis 
    screen when the last acquisition is 
    performed.
    Smart Stress:
    •  : 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:
    • When Show Reference is selected (see 
    page 179), selects either corresponding 
    baseline loop or corresponding loop from 
    the previous level to be displayed as 
    reference image during acquisition. 
    						
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    Pre-defined groups
    Editing/Creating a template
    Selecting a base template to edit
    1. Trackball to the Template pop-up menu on the upper left 
    corner of the Template editor screen.
    2. Press 
    SELECT on the arrow.
    The Template pop-up menu is displayed.
    Determine the re-
    quired number of 
    projections and lev-
    els you need and se-
    lect the most 
    appropriate founda-
    tion template.3. Trackball to the base template to edit.
    4. Press 
    SELECT.
    The selected template is displayed in the Protocol 
    template preview field, showing the levels and projections 
    and their labels.
    Adding/deleting levels and projections
    1. Enter the number of levels and projections in the Grid size 
    field (see Figure 4-14).
    The new grid size is displayed in the Protocol template 
    preview field.
    2. Press New Template to create a new template.
    Parameter Description
    Pre-defined groups:
    •  Shows the image groups created.
    • New group: creates a new image group. 
    Select the desired images on the template 
    preview (see page 183).
    • Update group: edits a selected group after 
    new loop selection on the template preview 
    (see page 183).
    • Delete group: deletes selected group (see 
    page 183). 
    						
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    Or
    Press Save Template to update the base template.
    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.Display timer(s)
    1. Check the box(es) to display timer(s) as specified (see 
    Figure 4-14).
    Star t analysis automatically
    1. Check Auto start analysis to display the Stress Echo 
    Analysis screen when the last acquisition is performed.
    Assigning new labels to levels and projections
    1. In the Protocol template preview field, Trackball to the Label 
    field that is to be changed.
    2. Select the Label pop-up menu and press 
    SELECT on the 
    desired pre-defined label.
    Or
    • If the Label field is empty:
    Press 
    SELECT and enter the label or projection name.
    • If the Label field has a name to be changed:
    Press 
    SELECT twice (double-click) to highlight the text to be 
    replaced and enter the new label or projection 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  
    						
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    mode).
    Adding a group
    1. In the Protocol template preview field select the cells to be 
    part of the group.
    2. In the Pre-defined group field, press New group.
    A dialogue box is displayed asking the user to enter a 
    name for the new group.
    3. Enter the group name.
    4. Press OK.
    The new group is displayed in the Pre-defined group field.
    Updating an existing group
    A selected group is 
    highlighted by a 
    yellow frame.1. In the Pre-defined group field, select the group to edit.
    The selected cell are highlighted in the Protocol template 
    preview field.
    2. Either select (a) new cell(s) to add to the group or deselect 
    (an) existing cell(s) to remove from the group.
    3. 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 
    highlighted by a 
    yellow frame.1. In the Pre-defined group field, select the group to delete.
    2. Press Delete group.
    The group is removed from the list in the Pre-defined 
    group field. 
    						
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    							Contrast Imaging
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    Chapter 5 
    Contrast Imaging
    This chapter includes the following information:
    • Introduction  ................................................................................... ..  186
    • Data acquisition  ............................................................................ ..  188
    • Left Ventricular Contrast Imaging ............................................. 188
    • Myocardial Contrast Imaging  ................................................... 194
    • Real-Time Myocardial Contrast Imaging  .................................. 202 
    						
    							Contrast Imaging
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    Introduction
    The two basic steps of contrast imaging are data acquisition 
    and quantification. Data acquisition is described in this chapter. 
    Quantification is described in Chapter 7, ’Quantitative Analysis’ 
    on page 233.
    Data acquisition
    Three main acquisition applications are available:
    • Left Ventricular Contrast imaging: optimized for 
    endocardial border detection and assessment of wall 
    motion and wall thickening.
    • Myocardial Contrast imaging: optimized for assessment 
    of myocardial perfusion. The MC Contrast application is 
    pre-configured to give access to high power settings of the 
    Coded Harmonic Angio technique, which combines the 
    strength of harmonic imaging and power Doppler. MC 
    Contrast application shall be used in intermittent mode. The 
    application is intended for clinical research.
    • Real-time Myocardial Contrast imaging (RTMC): is 
    intended for visualization of myocardial perfusion by the 
    use of ultrasound contrast agents. As opposed to MC 
    Contrast, RTMC will perform myocardial contrast imaging 
    in a non-triggered mode. The application is intended for 
    clinical research.
    Quantification
    Refer to Chapter 7, 
    ’Quantitative 
    Analysis’ on 
    page 233.Quantification enables the user to perform the following 
    analysis:
    • Time-Intensity analysis: allows instant time-intensity 
    calculation from up to eight regions of interest (Angio power 
    or tissue intensity display).
    • Curve fitting analysis: for research studies of myocardial 
    perfusion rates using contrast agents.
    • Arbitrary Anatomical M-Mode (Curved and Straight): M-
    WARNINGMC Contrast and Real Time MC applications are for research 
    purposes only. Diagnosis must not be based on results achieved 
    by contrast analysis alone. 
    						
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