GE Vivid 7 User Manual
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Contrast Imaging Vivid7/Vivid7 PRO Users Manual187 FC092326-03 Mode applied to intensity data calculates and color-codes tissue and Angio intensity along a path drawn by the operator vs. time. WARNINGMisdiagnosis based on image artifacts Misdiagnosis in ultrasound contrast images may be caused by several artifacts, most importantly: Motion artifacts: gives rise to signals independently of contrast presence. This may be caused by patient movement; including respiration, or by probe movement influenced by the operator. Regional drop outs: caused by unintentional destruction of the contrast agent, too low concentration of contrast agent, poor acoustic penetration due to rib/lung shadows or system failing to detect the contrast agent due to erroneous settings induced by the operator. Tissue harmonics: gives contrast-like signals independently of the presence of contrast agent. The field of myocardial perfusion using contrast agents is still a research field. The myocardial applications Real Time MC and MC Contrast are research tools for the development of this field. Default machine settings are set to minimize the amount these artifacts, but the operator has to take these artifacts into account while analyzing the data and confirm the results using other techniques.
Contrast Imaging 188Vivid7/Vivid7 PRO Users Manual FC092326-03 Data acquisition Left Ventricular Contrast Imaging The Left Ventricular (LV) Contrast application has an optimized system preset for optimal resolution of endocardial borders and for optimal assessment of wall motion and wall thickening. The LV Contrast application may help to identify LV thrombus and evaluate wall motion.
Contrast Imaging Vivid7/Vivid7 PRO Users Manual189 FC092326-03 LV Contrast over view Figure 5-1: The LV Contrast acquisition screen 1. Status window: 2. Soft menu Controls marked with R are also available in freeze and cine replay.
Contrast Imaging 190Vivid7/Vivid7 PRO Users Manual FC092326-03 Figure 5-2: The LV Contrast controls on the front panel 1. Application 2. Probe 3. Gain R 4. Assignable keys: • Width • Frequency • Focus • Frame rate • Up/Down R • Left/Right R • Angio • Cineloop (in Freeze, only) • Review page (in Freeze, only) • B color maps 5. Soft menu • Power • Compress R • Reject R • Dynamic Range • Tilt • Contour • Diff On/Off • DDP R Controls marked with R are also available in freeze and cine replay 4 5 3 1 2
Contrast Imaging Vivid7/Vivid7 PRO Users Manual191 FC092326-03 LV Contrast controls LV Contrast assignables controls Width Controls the size and angular width of the image sector. A smaller angle generally produces a scan with a higher frame rate. Frequency Enables the adjustment of the probes operating frequency. A higher frequency gives better resolution. Focus Changes the location of the focal point. A triangular marker on the depth scale along the image sector indicates the position of the focal point. Frame rate Lower frame rate gives better resolu- tion.Controls the line density. Up/Down Enables the 2D image to be flipped 180 degrees. Left/Right Enables the display of a mirrored image. When applied, the reference marker V moves to the other side of the image. Angio Turns Coded harmonic angio (color) on/off. B Color maps Displays a 2D maps menu to optimized the grey scale presentation. The menu enables an option from a list of non- linear grey-curves or different 2D-colorized curves to be selected. LV Contrast Soft menu controls Power Controls the amount of acoustic power applied to the transmitted pulse.
Contrast Imaging 192Vivid7/Vivid7 PRO Users Manual FC092326-03 Too high Power lev- el will destroy the contrast agent.Compress Controls the degree of image contrast. Reject Controls the Echo rejection level. When increased, low level echoes are rejected and appear darker in the 2D image. Dynamic Range Controls the image contrast. A high dynamic range setting gives a softer image. Tilt Enables the axis of the 2D image to be tilted to the left or to the right. By default the axis of the 2D image is vertical. Contour Controls the image processing related to the extent of edge enhancement applied. The Diff control de- creases the frame rate and the number of focal zones when turned on.Diff on/off Affects the level of reverberation in the image. The reverberation in the image is reduced when Diff control is turned on. DDP (Data Dependant Processing) Performs temporal processing, which reduces random noise without affecting the motion of significant tissue structures.
Contrast Imaging Vivid7/Vivid7 PRO Users Manual193 FC092326-03 Running LV Contrast The LV Contrast application works only with the M3S, 3S, 5S and 6T probes. To select LV Con- trast application without changing the current probe, press APPL. on the control panel. 1. Press PROBE on the control panel. A list of the connected probes is displayed. 2. Trackball to the desired probe supporting the LV Contrast application. The Application menu for the selected probe is listed. 3. Trackball to LV Contrast application. 4. Press SELECT to launch the application. 5. Perform the acquisition. Optimizing LV Contrast The default setting for the LV contrast application is optimal setting for the application (MI=0.5; Freq.=1.7/3.4; Focus=9 cm). However, depending on the acoustic window of the patient or the specific contrast agent being used, there may be need for further adjustment. If image quality is not acceptable before contrast injection, the power level should be increased. When contrast is observed in the left ventricle, the power should be reduced to a level giving homogenous opacification with no destruction (shown as a swirling pattern) of the contrast agent in the LV cavity. If a swirling pattern is observed and persists after the LV cavity has been filled with contrast, the power should be reduced until homogenous opacification is obtained. WARNINGAlways read and follow carefully the manufacturer instructions on the contrast agent label. CAUTIONToo high Power setting will destroy the contrast agent in the LV cavity.
Contrast Imaging 194Vivid7/Vivid7 PRO Users Manual FC092326-03 Myocardial Contrast Imaging The main goal of the Myocardial (MC) Contrast application is in the 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. WARNINGThis application is intended for clinical research only. Diagnosis must not be based on results achieved by contrast analysis alone.
Contrast Imaging Vivid7/Vivid7 PRO Users Manual195 FC092326-03 MC imaging over view Figure 5-3: The MC Contrast acquisition screen 1. Sample volume 2. Status window 3. Soft menu Controls marked with R are also available in freeze and cine replay.
Contrast Imaging 196Vivid7/Vivid7 PRO Users Manual FC092326-03 Figure 5-4: The MC Contrast controls on the front panel 1. Application 2. Probe 3. Gain R 4. Assignable keys: • Horizontal sweep • ECG Trig 1 • ECG Trig 2 • ECG Trig interval • Simultaneous R • ECG Trig • Angio • Color maps R • Cineloop (in Freeze) • Frequency • Focus 5. Soft menu: • AF Live: • Power • Sample volume • Frame rate • Color threshold • PRF • Low velocity reject • Radial average • Lateral average • DDP R • Traces: • ECG Trig 1 • ECG Trig 2 • ECG Trig Interval • Timer Delay 6. Trackball • ROI position • ROI size Controls marked with R are also available in freeze and cine replay 4 5 3 1 2