Magnetic Resonance syngo MR. Version syngo MR 2004A Quick Guide. medical

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1 Magnetic Resonance syngo MR Version syngo MR 2004A Quick Guide medical

2 Manufacturer s note: This product bears a CE marking in accordance with the provisions of Directive 93/42/ EEC of June 14th, 1993 concerning medical devices. The CE marking applies only to medico-technical products/medical products introduced in connection with the above-mentioned comprehensive EC directives. 2

3 System Information System type: Serial number: Gradient configuration: Connected cameras: Software options: Customer service phone numbers: 3

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5 Overview Introduction Switching the system on/off Preparing Examinations Examination Patient Browser Viewing Saving and Sending Filming 3D Troubleshooting Sequence Nomenclature 5

6 Contents Introduction... 9 Switching the system on/off Starting up the system Switching on standby mode Switching the system off...13 Preparing the Examination Registering a patient for an examination Preregistering patients for examination at a later point in time Preparing the patient table Positioning the patient Determining the center of the measurement field Examination Examination of the head Examination of the lumbar spine Printing protocols Abdominal examinations Generating a protocol from acquired images (Phoenix) Patient Browser Open patient browser Selecting data Transferring data to other applications Correcting data Moving data Deleting data Viewer task card Loading and displaying images Selecting images Scrolling Windowing images

7 Contents Zooming and panning images Rotating and flipping images Image evaluation Determining grayscale values of pixels (pixel lens) Hiding an area of the image Position display Filtering Images Distortion correction Saving images Saving and Sending Storing data on CD Sending and receiving data via network Automatic data transfer Filming Transferring images to the virtual film sheet Selecting images and film sheets Editing film jobs Exposing on film D Evaluation with MPR Evaluation with MIP Saving and viewing 3D images Filming 3D images Troubleshooting Status bar System Manager Automatic adjustment failed In case of emergency Sequence Nomenclature

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9 Introduction Welcome to the high-performance software syngo MR used to operate MAGNETOM MR systems manufactured by Siemens. This syngo MR Quick Guide is intended to help you with your examination routine providing you quickly with information about the most important functions of syngo MR. This Quick Guide is only valid in conjunction with the system manual and the safety information contained therein. The right pages contain step-by-step instructions on how to use the basic functions of syngo MR. The left pages contain supplemental figures and notes. This guide describes quick and easy operations using buttons and pop-up menus. Of course, most actions can also be selected from the main menu. The Quick Guide provides information about the following: Switching the system on and off Registering patients and preparing MR examinations Performing routine examinations Managing patient data Processing images Filming images Storing and sending patient data 3D evaluation The chapter titles of the Quick Guide refer to the terms used in the user interface. Please note that syngo MR includes a comprehensive Online Help. Press the F1 key on your keyboard or click the help button in the active dialog box to call up the online help. 9

10 Switching the system on/off Function checks prior to switch-on: Is the display of the alarm box functioning? Are all warning signs posted? Are there fluids on the floor? Magnetizable materials? (1) Keyswitch (2) Switching off the system (3) Switch on Host Standby (4) System On LED (5) Line LED (6) Plexiglas cover (7) Magnet Stop (8) Magnet Stop LED (9) Helium level LED (10)Confirm alarm (11) Switching on the system Function checks after switch-on: Is the patient table functioning? Is the squeeze bulb functioning? Is the monitoring equipment functioning? Is the intercom system functioning? Is the door of the examination room closed? 10

11 Switching the system on/off Starting up the system Before starting up the system, please perform the daily function checks. Turn the key in the alarm box 90 clockwise. Press the System On button. The System On LED at the alarm box lights up. The system is switched on. At the control computer, Windows NT and syngo MR are booted automatically. CAUTION Do not operate the patient table while syngo MR is starting up. Perform function checks after the system has been started. 11

12 Switching the system on/off HIPAA supports high-performance user management and access control in syngo MR. This ensures the safety, integrity and consistence of patient data. 12

13 Switching the system on/off Switching on standby mode In standby mode, the measurement unit and patient table are switched off. The control computer (HOST) is operational. While you are able to evaluate and report, you are not able to perform measurements. Press the Host Standby button at the alarm box. If the system is switched on, all the components except for the HOST computer are switched off. If the system is switched off, only the HOST computer is switched on. If you press the System On button in standby mode the system is ready again for scanning. Switching the system off First end the session syngo MR, then shut down the system. Select System > End. Click the Shutdown System button. The Confirm Action dialog window opens. Click the Yes button. Press the System Off button on the alarm box. Turn the keyswitch to the left. The system is now blocked. 13

14 Preparing the Examination InvokeRegistration allows you to call up the registration form and complete it. If you do not enter a patient ID, the system automatically assigns a unique identification code derived from the date, time, abbreviation for daylight-saving or standard time, and the identification number of your system (unique worldwide). 14

15 Preparing the Examination Registering a patient for an examination Before each MR examination you have to register the patient. You may proceed in one of two ways: Enter a new patient plus all data Select a known patient from the database Registering a new patient Press this key on the symbol keypad. The Patient Registration dialog box opens. Fill out at least the compulsory fields displayed in boldface font in the Patient Registration dialog box: Last name Patient ID Date of birth Sex Weight Studies Patient position Click Exam. 15

16 Preparing the Examination You can select the required patient in the Patient Browser first and then call up registration. Page 79, Selecting data You can use wildcards (*) to shorten data entry, e.g.: 16

17 Preparing the Examination Registering a known patient Press this key on the symbol keypad. Enter the name and/or the ID of the known patient in the Patient Registration window. Click Search to start searching for the patient in the databases. Select the required patient from the Patient Search list. Click OK to place the information stored into the Patient Registration window. Add missing data in the Patient Registration window. Page 15, Registering a patient for an examination Click Exam. If your system is connected to a HIS/RIS system, you can search for a known patient in the network, import the data into the local database, and register the patient afterward. Page 85, Searching patients 17

18 Preparing the Examination 18

19 Preparing the Examination Preregistering patients for examination at a later point in time If you preregister a new patient, you subsequently just call up the examination data in the Scheduler of the Patient Browser. Press this key on the symbol keypad. Fill out the following fields in the Patient Registration dialog box: Last name Patient ID Date of birth Sex Studies Patient position Click Preregister. The patient information is now preregistered for a later examination. 19

20 Preparing the Examination The System Manuals provide detailed information regarding operating the patient table, using the coils, and patient positioning. (1) This function is not available (2) Starting/stopping the measurement (3) Playback volume of the wall speaker (4) Ventilation in measurement tunnel (5) Lighting in measurement tunnel (6) Joystick (7) Table Stop (8) Home Position (9) Playback volume of the headphones (10) Center Position (11) Laser light localizer 20

21 Preparing the Examination Preparing the patient table Place the necessary positioning aids on the patient table. Place the coil on the table. Lower the patient table. Positioning the patient Position and secure the patient on the table. How the patient is positioned on the table depends on the planned examination. Position the coil at the patient and connect it. The area to be examined has to be located in the center of the coil. Determining the center of the measurement field Raise the table using the joystick. Move the table partly into the magnet using the joystick. Instruct the patient to close his eyes. Switch on the laser light localizer. Move the table into the magnet until the laser crosshairs are fully aligned with the marked coil center. Switch off the laser light localizer. Move the table into the center of the magnet isocenter using the Center position button. 21

22 Examination You can display reference images in the threesegment, two-segment, or Maestro layout. The Maestro layout displays the acquired series as stamp segments below the three image segments. 22

23 Examination This chapter describes basic operating steps as well as some important functions of the Examination task card using a head examination, a spinal as well as an abdominal examination as examples. Examination of the head Loading a head routine examination Select the following examination data during patient registration: Examination: head general Patient position:head First Supine Click Exam. Select scan program standard 1 on the Program parameter card. Click <<. The 5 program steps of the scan program are transferred to the program control. Acquiring reference images The Localizer (overview scan) starts automatically. The reconstructed reference images are displayed in the image area in the three main orientations sagittal, transverse, and coronal. 23

24 Examination You can change the size of the FoV using the grab handles on the border line of the FoV: Enlarging/reducing in the phaseencoding direction. Enlarging/reducing in the read-out direction. During graphic slice positioning, the mouse pointer changes shape according to the various drawing modes. Examples: Adding a slice/slab group in 3 point mode Adding a saturation region Adding a slice and 3D slab group Rotating graphic objects Selecting and moving graphic objects Changing the number of slices/slabs 24

25 Examination Positioning sagittal slices After a localizer, the following protocol t1_se_sag opens automatically. The sagittal slices of this protocol are displayed in the reference images for positioning. In the sagittal reference image, the projection corresponds to the field of view (FoV). You can adjust the position of the FoV in the sagittal reference image: Click the grab handle in the center of the FoV and hold the mouse button down. Move the FoV until the head is positioned in its center. Move and tilt the slices in the coronal or transverse reference image, if necessary. Starting the protocol measurement Click Apply to apply the parameter settings and start protocol t1_se_sag. Positioning transverse slices When protocol t1_se_sag is running, the following protocol pd+t2_tse_tra opens automatically. The transverse slices of this protocol are displayed in the reference images. 25

26 Examination If you want to document further details of the use of contrast agent (type and quantity) for subsequent invoicing, click the syringe icon to select a substance from the contrast agent catalog. 26

27 Examination Adjust the position of FoV in the transverse reference image: Move the FoV until the head is positioned in its center. Adjust the tilt of the transverse slices in the sagittal reference image: Left-click the list entry and keep the mouse button pressed. Tilt the slices to adjust them to the anatomy of the head. Starting the Starting the protocol measurement protocol Click Apply to apply the parameter settings and start protocol pd+t2_tse_tra. Documenting contrast agent After protocol pd+t2_tse_tra, a contrast agent pause follows. Examination is stopped and the Examination Pause window opens. Activate the Contrast agent administration check box. Close the Examination Pause window. 27

28 Examination You can also use the Copy parameter group function to transfer other important parameter settings to another protocol. Call up online help with the F1 key in the Copy parameter group window or by using the Help button for information about the different parameter groups. Page 44 28

29 Examination Copying parameter settings Protocol t1_se_sag opens automatically. To avoid positioning the FoV again, transfer its position from the previously run protocol t1_se_sag. Click protocol t1_se_sag in the job list and select Copy Parameter. Select the entry Center of slice/ 3D slab groups & sat. region in the Copy Parameter window and confirm with OK. Administering contrast agent Before starting a contrast agent scan with Apply, administer the contrast agent to the patient. Open the Table Positioning window, if the patient has to be moved out of the magnet for contrast agent administration. Click this button on the Table Positioning window to move the patient table almost completely out of the magnet. NOTE Do not move the patient table completely out of the magnet (do not move it into the HOME-Position!). Otherwise, the examination is considered ended. 29

30 Examination Icons in the job list: A protocol without an icon is complete and will be started automatically. A protocol with a construction worker icon cannot be automatically started. The protocol parameters are still incomplete. A protocol with a flagman has to be started manually. A protocol identified by a flagman with several flags can be started and measured several times in a row. This icon marks a protocol that includes automatic image postprocessing after completion of a scan. A syringe icon marks a protocol as a contrast agent scan. A series icon indicates a successfully run protocol with completely reconstructed images. A lightning icon indicates canceled or skipped protocols. A reference icon marks a protocol that uses the copied parameter settings of another scan protocol. 30

31 Examination Administer the contrast agent to the patient in the examination room. Press the Center position button on the control panel of the magnet. Or Click this button in the Table Positioning window at the console to move the patient table back into the magnet isocenter. NOTICE Do not use the light localizer to determine the center of the measurement field again. Otherwise, you are not able to return the patient table to the exact same position in the center of the measurement field. Starting a contrast agent scan Click Apply to apply the copied parameter settings and start protocol t1_se_sag. In the job list a syringe icon marks the protocol as a contrast agent scan. Adding, editing, and running protocols You will append protocol t1_mpr_ns_sag (3DMPRAGE) to the routine scan program. You can calculate new slices from the scanned slab via Multiplanar Reconstruction (MPR) on the 3D task card. Page 147, Evaluation with MPR 31

32 Examination The head coil selected is displayed in the sagittal and coronal reference image. 32

33 Examination Click this button to open the Exam Explorer. Open the SIEMENS\head\seizure directory in the navigation area and select the standard scan program. Click protocol t1_mpr_ns_sag in the content area and drag and drop it to the end of the job list. Double-click the appended protocol to open it. The 3D slab of this protocol is displayed in the reference images. Click the Routine parameter card into foreground. You have to adjust the slice parameters so that the 3D slab covers the entire anatomy: For example, by increasing the number of Slices in the 3D slab from 72 to 128. Or by reducing Slice-Oversampling, for example, from 100 to 25. Position the 3D slab. Page 25, Positioning sagittal slices 33

34 Examination You can activate the MIP-Tra option on the Angio-Inline parameter card. If you are working with a Maestro Class System, MIP images of transverse (sagittal or coronal) orientation are computed from the measured 3D slabs of the current protocol. 34

35 Examination Click Apply to apply the parameter settings and start protocol t1_mpr_ns_sag. While protocol t1_mpr_ns_sag is running, append protocol tof_fi3d_tra to it. With the volume data set acquired, you can perform a Maximum Intensity Projection (MIP) on the 3D task card for optimum display of the vessels. Page 155, Evaluation with MIP Open the SIEMENS\angiography\Basic- Programs directory in the navigation area and select the carotids scan program. Click protocol t1_mpr_ns_sag in the content area and drag and drop it to the end of the job list. Double-click the appended protocol to open it. The transverse slices and saturation regions of this protocol are displayed in the reference images. 35

36 Examination 36

37 Examination Move the FoV until the head is positioned in its center. Position the center of the 3D slab group in the sagittal reference image. Page 25, Positioning sagittal slices In protocol tof_fi3d_tra, a parallel saturation region is defined to suppress the sinus sagitalis signal. The position and orientation of this saturation region are defined by the 3D slab group and may be changed only together with the 3D slab group. Click Apply to apply the parameter settings and start protocol tof_fi3d_tra. Saving a changed scan program The routine scan program that you changed by appending additional protocols may be saved, for example, under a new name in the customer area. Place the mouse pointer on the black background of the job list and select Save As Program. Assign the changed scan program to the corresponding region and examination in the Save Program As window and enter a name. Click Save. 37

38 Examination 38

39 Examination Examination of the lumbar spine Loading a routine examination of the lumbar spine Select the following examination data during patient registration: Examination: l-spine general Patient position: Head First Supine Click Exam. Select the scan program Standard on the Program parameter card. Click <<. The 4 protocols of the scan program are transferred to the program control. Acquiring reference images The Localizer (overview scan) starts automatically. The reconstructed reference images are displayed in the image area in the two main orientations sagittal and coronal. Positioning sagittal slices After the localizer, the next protocol t1_se_sag opens automatically. The sagittal slices of this protocol are displayed for positioning in the reference images. 39

40 Examination Tools for graphic positioning: Changes the graphic object Zooming/panning the reference image Adds a new slice/3d slab group Adds a new saturation region Adding a slice/3d slab group in the 3 point algorithm mode Deletes a graphic object Displays slices in line mode Displays slices/slabs in box mode Displays slices/3d slabs in package mode Changes the thickness of a slice/3d slab group Changes the number of slices/3d slabs in a group Changes the distance between slices/3d slabs of a group Changes the extent of slice oversampling Changes the extent of phase oversampling Shows/hides position lines Shows/hides coil elements of array coils Shows/hides the adjustment volume Shows/hides image text 40

41 Examination For easier positioning of slices, change to the package mode display: Activate the tool bar for graphic slice positioning. Click this button to activate the package mode. Position the slices in the lumbar region of the spinal column: Click the pivot handle in the coronal reference image and hold the mouse button down. Drag the slice group over the lumbar region of the spinal column. Click a line and hold the mouse button down. Tilt the slices to adapt them to the anatomy of the lumbar region of the spinal column. Positioning a saturation region In protocol t1_se_sag a saturation region is defined. You position this region in front of the lumbar region of the spinal column. Click the pivot handle in the center of the saturation region and hold the mouse button down. Drag the saturation region in front of the lumbar region of the spinal column. 41

42 Examination Only coil elements with a fixed table position (array coils) can be displayed. They are displayed on reference images with sagittal or coronal main orientation. The image comment is valid for all protocols that still need to be scanned during the current examination. If necessary, you can change or delete it in the Image Comment window. 42

43 Examination Click the saturation region to define its pivotal center (use the pivot handle). Click the edge of the saturation region and hold the mouse button down. Tilt the saturation region to adapt it to the anatomy of the lumbar region of the spinal column. Selecting coil elements Click this button to display the coil elements of the connected array coils in the reference images. Click the coil elements that you want to activate to scan the lumbar region of the spinal column (e.g. SP5 and SP6). Select Queue > Automatic Coil select for automatic transfer of the coil selection into the protocols that you are going to open next. Entering an image comment Before scanning a protocol, you can enter a comment that will appear as image comment on the reconstructed images. Place the mouse pointer on the outside edge of the program control and select Image Comment. Enter a comment in the Image Comment window and confirm with OK. 43

44 Examination The Copy Parameter function can also be assigned to a protocol as a protocol property. You can do this either in the job list or in the Exam Explorer. Open the Protocol step property window under Properties. Define the source protocol and the parameter group on the Copy References subtask card and activate copy references. 44

45 Examination Starting the protocol measurement Click Apply to apply the parameter settings and start protocol t1_se_sag. Copying parameter settings When scanning protocol t1_se_sag, the following protocol t2_tse_sag opens automatically. You transfer the position and orientation of the slice group and saturation region of protocol t1_se_sag to protocol t2_tse_sag. Page 29, Copying parameter settings Click protocol t1_se_sag in the job list and select Copy Parameter. Select the entry Center of slice/ 3D slab groups & sat. region in the Copy Parameter window and confirm with OK. Starting the protocol measurement Click Apply to apply the copied parameter settings and start protocol t2_tse_sag. 45

46 Examination You can use the Reference lines On/ Off button to display the position lines of the reference images. You can then observe the changes of position in the scanned slices as you scroll. Double-click with the left mouse button to restore the reference image to its original size and position. To improve display of intersection lines in bright image areas, you can additionally display shadow. Select View > Graphics > Shadow On. 46

47 Examination Positioning transverse slices While protocol t2_tse_sag is running, protocol t1_se_tra_msma opens automatically. The transverse slice groups of this protocol are displayed in the reference images. To position the transverse slices, load one of the two scanned sagittal series into the image area and select a suitable reference image. Double-click the series icon to load the series into the active image segment (input focus!). Scroll through the images of a series to select a reference image with the keys of the symbol keypad, or use the dog ears. Page 101, Scrolling You can optimize display of the selected reference image: Activate the Zoom&Pan + Modify Graphics mouse mode. Change the size and position of the reference image in the image segment. Page 107, Zooming with the mouse Page 109, Panning images Change the brightness and contrast of the reference image. Page 105, Windowing using the mouse Subsequently, activate the Select mouse mode again. 47

48 Examination Use the Geometry parameter card, if you want to set the orientation and position of graphic objects precisely by entering values. 48

49 Examination Adapt the position and inclination of the transverse slice group in the sagittal reference image to the anatomy of the lumbar spine. Page 39, Positioning sagittal slices Position the saturation region in front of the lumbar spine and adapt the inclination to the anatomy. Page 41, Positioning a saturation region Starting the protocol measurement Click Apply to apply the parameter settings and start protocol t1_se_tra_msma. 49

50 Examination To print out material, connect the printer to your system either locally or via a network. 50

51 Examination Printing protocols Since these functions are time-consuming, they are generally not used during clinical examinations. Printing data Printing a parameter overview of protocols and contents of scan programs, examinations, and regions Go to the parameter card Program and select the following: region I-spine, examination general, measurement program standard as well as the protocols t1_se_sag, t2_tse_sag and t1_se_tra_msma. Select Print from the pop-up menu. The Print dialog box opens. Select the desired printer from the Name selection list. Select the print option Protocol and Contents. Click the OK button in the print dialog box. Or Click the Preview button in the Print dialog box. Click the OK button in the print dialog box. The displayed data are printed via the default printer of the system. 51

52 Examination The first time you export data, the Path input box is empty. The storage dialog box allows you to create subdirectories on drives A:\, T:\, and U:\. 52

53 Examination Exporting data into a file If no printer is installed or you would like to evaluate the print-out or print at another location, you can print the protocols and table of contents directly into a pdf file. Open the print dialog box. Select the Print to file item from the Name selection list. The Path input box is active. Click the Find button. The storage dialog box opens. Set the required storage location on your system here. Enter a name for the export file in the Filename field. Click the Save button. The save dialog closes. The settings for the archive directory and the name of the export file are entered as a path in the Path field. Subsequently, set the print range. Click the OK button in the print dialog box. The selected data are exported to the desired pdf file. The print dialog box is closed automatically. 53

54 Examination 54

55 Examination Abdominal examinations Connecting the CP Body Array Place the CP Body Array on the patient's abdomen. Secure the CP Body Array using the two straps provided. Insert the coil plug of the CP Body Array into the respective connector. Loading the abdominal examination Select the following examination data during patient registration: Examination: Abdomen Patient position: Head First Supine Click Exam. Select the scan program Standard on the Program parameter card. Click <<. The 7 program steps of the scan program are transferred to the program control. 55

56 Examination When using surface coils, you also select a coil element adjacent to the navigator. 56

57 Examination Acquiring reference images The Localizer (overview scan) starts automatically. The program reconstructs reference images in the main orientation (sagittal, transverse and coronal) and displayed in the image area. Selecting coil elements Go to Tools Positioning and click this button to display the coil elements of the connected array coils in the reference images. Click the coil elements (i.e. SP3, SP4 and SP5) you would like to activate for the abdominal scan on the parameter card System or the GSP segment. Select Queue > Automatic Coil select for automatic transfer of the coil selection into the protocols that you are going to open next. 57

58 Examination (1) Saturation region (2) Navigator 58

59 Examination Preparing a protocol The following protocols of the Standard program run with breathhold control. You would like to monitor the patient's breathing prior and during breathhold commands without changing the slice position. Click the Physio parameter card into foreground. Click the PACE subtask card. Select the option Breathhold & Monitor in the Breathhold control field. Positioning the navigator A navigator is defined in protocol t1_fl2d_tra_mbh. The navigator signals show the respiratory movement of the diaphragm. Go to the main menu and select View > Display > Projection On. The navigator is shown. You position the navigator on the edge of the diaphragm in a coronal reference image. Select the navigator. The navigator selected is shown in yellow. Click the pivot handle in the center of the navigator and hold the mouse button down. Shift the navigator. One half of the navigator volume should be located in the lungs and the other half in the liver. 59

60 Examination (1) Navigator signal (2) Detected diaphragm position (3) Edge of diaphragm Buttons to operate the Inline display: Image storage Save Pause the display Stop & Continue Copy image position Display filter Measure breathhold 60

61 Examination Checking to see if navigator position is correct Go to the Inline Display and monitor the respiratory movement of the diaphragm. Start the multiple breathhold control protocol. After each breathhold command, the image rows of the slices belonging to one concatenation are scanned. Click this button to display the Inline Display window. Starting the protocol measurement Click Apply to apply the parameter settings and start the measurement via protocol t1_fl2d_tra_mbh. Monitor the respiratory curve in the Inline Display. When the navigator positioning is correct, the full range of free breathing motion of the transition between the dark signal of the lungs and the bright signal of the liver should be visible. The detected diaphragm position follows the edge of the diaphragm, however, it does not cover it. 61

62 Examination 62

63 Examination Enter the breathhold command as soon as the message "press scanning in Inline Display when the Pat. is ready appears in the Inline Display. Press the Talk button on the intercom system and hold it pressed. Give the command "breathe in, breathe out, hold your breath." Click the Scan Breathhold button. Scanning starts. The navigator signal is not recorded during scanning. After the slices of the first concatenation have been scanned, the navigator signal is scanned and displayed again. As the message "continue breathing" is displayed in the status line, enter the appropriate command. Press the Talk button on the intercom system and hold it pressed. Apply the command to breathe again. The patient should draw several normal breaths. Apply the breathhold command to scan the image lines of the next concatenation and click the Scan Breathhold button again. 63

64 Examination Patient information and instructions are given during an examination via manual or automatic voice outputs, e.g. breathing control instructions (however not for BOLD, multibreathhold scans). The characteristics of the protocol determine voice output. 64

65 Examination Copying parameter settings Protocol t1_fl2d_fs_tra_mbh is opened automatically. To avoid positioning the navigator again, transfer its position from the previously run protocol t1_fl2d_tra_mbh. Page 29, Copying parameter settings Click protocol t1_fl2d_tra_mbh in the job list and select Copy Parameter. Select the entry Center of slice/3d slab groups & sat. region in the Copy Parameter window and confirm with OK. Starting the protocol measurement Click Apply to apply the parameter settings and start the measurement via protocol t1_fl2d_fs_tra_mbh. The measurement run is identical to protocol t1_fl2d_tra_mbh. Press the Talk button on the intercom system and hold it pressed. Give the command "breathe in, breathe out, hold your breath." Click the Scan Breathhold button. Apply the command to breathe again. The patient should draw several normal breaths. Apply the breathhold command to scan the image lines of the next concatenation and click the Scan Breathhold button again. 65

66 Examination 66

67 Examination Copying parameter settings Protocol t2_tse_tra_mbh opens automatically. To avoid positioning the navigator again, transfer its position from the previously run protocol t1_fl2d_tra_mbh. Page 29, Copying parameter settings Click protocol t2_tse_tra_mbh in the job list and select Copy Parameter. Select the entry Center of slice/3d slab groups & sat. region in the Copy Parameter window and confirm with OK. Adjusting the measurement parameters Click the Physio parameter card into foreground. Click the PACE subtask card. Select the option Breathhold & Follow in the Breathhold control field. In addition, the offset between slices acquired at different breathhold intervals is minimized using the navigator signal. The position of the slices acquired in the second and following breathhold intervals is adjusted, if necessary. 67

68 Examination (1) Accept window 68

69 Examination Starting the protocol measurement Click Apply to apply the parameter settings and start protocol t2_tse_tra_mbh. Monitor the respiratory curve in the Inline Display. The measurement run is identical to protocol t1_fl2d_fs_tra_mbh. Press the Talk button on the intercom system and hold it pressed. Give the command "breathe in, breathe out, hold your breath." Click the Scan Breathhold button. Apply the command to breathe again. The patient should draw several normal breaths. Give the breathhold command for scanning the image rows of the next concatenation. Click the Scan Breathhold button. 69

70 Examination 70

71 Examination Documenting contrast agent After protocol t2_tse_tra_mbh, a contrast agent pause follows. The examination is stopped and the Examination Pause window opens. Activate the Contrast agent administration check box. Close the Examination Pause window. Page 27, Documenting contrast agent Administering contrast agent Before starting a contrast agent scan with Apply, administer the contrast agent to the patient. Page 29, Administering contrast agent Starting a contrast agent scan Click Apply to apply the copied parameter settings and start protocol t1_fl2d_tra_mbh. Press the Talk button on the intercom system and hold it pressed. Give the command "breathe in, breathe out, hold your breath." Click the Scan Breathhold button. Apply the command to breathe again. 71

72 Examination With single shot sequences (e.g. HASTE), the patient continues to breathe freely during the measurement. During a preparation phase, the system determines the most likely position of the diaphragm (tolerance center). After the preparation phase, scanning begins whenever the deviation of the current position of the diaphragm from the tolerance center is less than the tolerance window. 72

73 Examination The patient should draw several normal breaths. Give the breathhold command for scanning the image rows of the next concatenation. Click the Scan Breathhold button. A syringe icon in the job list marks the protocol as a contrast agent scan. Adjusting the measurement parameters After measuring protocol t1_fl2d_tra_mbh, the t1_haste_tra_8mm free br. protocol is opened automatically. Click the Physio parameter card into foreground. Click the PACE subtask card. Select the option Gate in the Breathhold control field. Starting the measurement of the protocol Click Apply to apply the parameter settings and start protocol t1_haste_tra_8mm free br.. Monitor the respiratory curve in the Inline Display. The results of the slices that have been measured are saved. The Inline Display closes as soon as the current image calculation is completed. 73

74 Examination If the patient data are no longer available in the Patient Browser, import the patient data to the Patient Browser. 74

75 Examination Generating a protocol from acquired images (Phoenix) You may create a new protocol from previously acquired series and individual images and add them to the scan program. For this purpose, select images from different sources: Stamp segments Large segments Patient Browser Repeating the measurement You can view and evaluate the measured images in the image segments. You can repeat the complete scan of a protocol if, for example, the result images for a breathhold scan are of poor quality. Select the faulty image in the stamp or large segment. Select Append To Queue from the context menu. Or Drag and drop the image into the program control. A copy of the protocol is generated and converted into an executable program instruction. 75

76 Examination 76

77 Examination Reconstructed protocol through conversion If the system type or software version used to generate the series or image does not match your system, you can attempt conversion. Select a series or image from the stamp segments of the Maestro layout, from the large image segments, or from the Patient Browser. Press and hold the Shift key, press and hold the left mouse button and drag the series or image into the job list (drag & drop). 77

78 Patient Browser (1) Data carrier (2) Patient (3) Study (examination) (4) Series (selected) (5) Images (of selected series) (6) Navigation area (7) Content area You can hide the navigation area as follows: Deselect the View > Tree. 78

79 Patient Browser The Patient Browser is used for administration, editing, and archiving of patient and examination data. Open patient browser Press this key on the symbol keypad. Or Select the Patient > Browser. The Patient Browser is displayed. The Patient Browser window uses a hierarchical study to show all patient and examination data in the databases and on the external data media. Selecting data Scroll through the list of patients in the navigation area until you find the required patient. Then click the patient entry. All studies of this patient are displayed in the content area. 79

80 Patient Browser In the content area, you can display series and images not only as image stamps but also as a list. Deselect View > Image Stamps. With Options > Filter setting, you can open the Filter Specification dialog box to create your own filter criteria. These user-defined filters are listed as additional menu items in the Filter menu. If specific patient data is not located during a search, ensure that no filter is activated. A filter remains active until you replace it by another filter. 80

81 Patient Browser Click a study in the navigation area to select it and to view all associated series in the content area. Click a series in the navigation area to select it and to obtain an overview of all images in the content area. To select an image, click on it in the content area. Filtering data Select a filter using the Filter menu or the tool bar. Not archived Only data that have not yet been archived are displayed. Not filmed Only data that have not yet been filmed are displayed. Not sent Only data that have not yet been sent in the network are displayed. Not marked Only data that have not yet been marked are displayed. Marked Only marked data are displayed. Deactivating filters Click this button to have all the data displayed again (unfiltered). 81

82 Patient Browser Different sorting criteria are offered to you depending on the data level selected. Depending on the criterion selected, the data in the content area are sorted in alphanumeric or chronological order. They can also be selected according to whether the sorting criterion has been met completely, partially, or not at all. Only data stored in the local database can be processed. Depending on the configuration of your system, the scheduler is automatically and regularly updated with information from registration. 82

83 Patient Browser Sorting data Select a data level (patient, study, series) in the navigation area to display its elements in the content area. Select the Sort menu and click one of the sorting criteria stated. Select Sort > Reverse Order to arrange the data in reverse order. Retrieving data from the archive media Click the icon of a data medium to display all the data stored there. Search for and select data by clicking through the data levels in the navigation area. Select Transfer > Import to import the selected data into your local database. Updating the display Click the Update Information button to update the display of the navigation and content areas. Double-click the icon Scheduler to update it first and then open it. 83

84 Patient Browser Patient Search is used to retrieve data not displayed in the navigation area from other user terminals working with other or older programs. If you are searching for another series or study or patient, go and switch first to the appropriate data tree and open the lower data levels again. Before you start the data search on another network node, click Reset to terminate the current data search. 84

85 Patient Browser Searching patients Select Patient > Search to display the Patient Search window. Select the network node containing the data you are searching for. Enter the last name and ID of the patient searched for (wildcards * and? are supported). Click the Start Search button to start the search. Select a patient from the search output list. Click the Start Search button to display all studies of that patient. WARNING If the ID of the patient is not unique, studies may be listed that do not belong to the patient selected and displayed in the information area. Open the lower data levels in the same way until the required images as well as the output list are displayed. Select the data that you want to import to your database from the search list. Click the Import button. 85

86 Patient Browser You can also drag and drop the selected data into the open Patient Registration window or onto the Viewer task card. You can use multiple selection to transfer the images of more than one patient onto the Viewer task card. If you select Options > Closed after Loading, the Patient Browser will close automatically after image transfer. You can also start special postprocessing functions from the Patient Browser, such as Argus, Mean Curve, Spectroscopy. 86

87 Patient Browser Transferring data to other applications Registering and examining a patient again Select the patient or the study in the Patient Browser. Click this button on the tool bar. Check and complete the data in the Patient Registration window, then start the examination. Loading images onto the Viewer. Select the patient or study or series. Click this button on the tool bar. Or Click the Viewer task card into foreground and double-click the selected data in the Patient Browser. Loading images for 3D evaluation Suitable two-dimensional slices can be processed on the 3D task card using various techniques to create three-dimensional representations. Select the images (at least 4) or the series. Click the 3D MPR button on the tool bar. Page 147, Evaluation with MPR Or Select, for example, Patient > 3D MIP. Page 155, Evaluation with MIP 87

88 Patient Browser These data must not be loaded on a task card. Otherwise, it will no longer be possible to edit the image comment. Depending on the data level, some fields of the dialog box may be dimmed. You cannot correct any data that are deleteprotected due to Edit > Protect or their work status. 88

89 Patient Browser Correcting data Never correct data of a patient who is currently registered for scanning. Otherwise, scanning will be stopped and a new patient registration is necessary. Select the patient, study, series or images that you want to correct. Click the icon button on the tool bar to open the Correct dialog box. Correct or complete the selected data. Enter your name under Modifier s name or select it from the selection list. Click OK to save the new data. Or Click Cancel to cancel correction mode. All data remain unchanged. Displaying the change history Select the patient, study, series, or images stored in the local database whose history you want to view. Click this icon button on the tool bar. All corrections to the data (corrections and rearrangements) are listed in chronological order in the Correction List. 89

90 Patient Browser You can only group examination data together that were acquired by the same method and with the same patient position. You cannot move data that are delete-protected. You cannot move data that are being used in another application syngo MR. You cannot move data from a higher hierarchical level to a lower level. 90

91 Patient Browser Moving data The images of a patient are grouped together in hierarchically arranged groups, that is, in patient, study, and series. You can rearrange studies, series, and images by moving data. Select the data and drag and drop it to a new position. Or Select Edit > Cut or click this icon button. Click the target position. Select Edit > Paste or click this button. Enter your name in the Rearrange dialog box under Modifier s name and confirm the move with OK. 91

92 Patient Browser Delete protection always includes both all lower data levels as well as related higher data levels. Delete-protected data are marked with the status prot. 92

93 Patient Browser Deleting data WARNING Ensure that all data are archived before you delete them from the database. Select the data that you want to delete. Click this button. Or Select Delete. Protecting data from deletion Select the data that you want to protect against deletion. Click this button. Or Select Protect. Removing delete protection Select the data from which you want to remove delete protection. Click this button. Or Select Remove Protection. 93

94 Viewer task card The Viewer task card is used to view the results of the MR examination and evaluate them. You can use multiple selection to transfer images of two or more patients onto the Viewer task card. You can load measured series automatically from the Exam onto the Viewer task card. Just select the Load images to viewer option under protocol properties. 94

95 Viewer task card Loading and displaying images Transferring images from the Patient Browser to the Viewer task card Select the patient, study, series, or images in the Patient Browser. Click this button to transfer the selected data to the Viewer task card. Or Double-click your selection. Or Drag and drop your selection to the desired segment on the Viewer task card. Gallery or image stack display Click the View subtask card to move it into foreground. The Gallery display shows the images of a loaded series next to each other. Activate the Gallery display. The Stack display shows all images of a series in a stack one on top of the other. You can see the first image of a series. This allows you to compare the images of two or more series. Activate the image stack display. You can scroll through a stack using the dog ears in the corner of each stack. 95

96 Viewer task card Image stack display is only possible for a layout up to 3x3. (1) (2) (3) (2) (7 (4) (6) (5) (1) Patient data (2) Orientation labels (3) Hospital / system information (4) Acquisition-specific settings (5) Image comment (6) Window values, data for image geometry, orientation cube (for images from 3D) (7) Scale bar 96

97 Viewer task card Division of the image area You can define your own division of the image area into segments. Select a layout from the View menu or use the buttons on the View subtask card. Select a small format display to obtain an overview or a large format display for evaluation. Showing and hiding image text and grid Select View > All Text to show the image text. Select View > Selected Text to show important image information. Select View > No Text to hide the image text. Select View > Grid to show the grid. Selecting images Selecting a single image implicitly Click the image. The active segment is marked by a blue border shown as dashed lines (input focus). The image is selected implicitly. Use the arrow keys of the keyboard to put the input focus on another image and to select it implicitly. 97

98 Viewer task card If none of the segments is marked by a continuous blue border, one or more images are selected in background. 98

99 Viewer task card Selecting individual images explicitly Press the Ctrl key and click on an image. The segment is marked by a blue border shown as a continuous line. The image is selected explicitly. Hold the Ctrl key down and click additional images to extend the explicit selection. Selecting images up to the end of the series Click an image of the desired series. Select Select the following. Selecting a complete series Click an image of the desired series. Select Select Series. Deselecting images Hold the Ctrl key down and click individually selected images to deselect them again. Or Select Deselect All. 99

100 Viewer task card Im- Im- If you want to compare the images of different series, you can scroll image-by-image through two or more stacks and compare them. For this purpose, select the desired stacks explicitly before scrolling Page 77, Reconstructed protocol through conversion 100

101 Viewer task card Scrolling The Viewer task card allows you to scroll as follows: By using the Scroll menu By using the scroll bar on the right of the image area By using the dog ears at the upper right corner of the images (only in stack display) By using the keys on the symbol keypad. Scrolling using the symbol keypad Press the Study+ or Study- key to scroll to the next or previous study. Press the Series+ or Series- key to scroll to the next or previous series. Press the Image+ or Image- key to scroll forward or back by one image. Scrolling to the next patient Switch to the patient you require by clicking his patient folder. 101

102 Viewer task card Use a layout (1x1 or 2x2) large enough to be able to recognize all details. You can also use Scroll > Auto- Movie On or this button to have movie display run automatically. If some images are selected explicitly, only these images will be windowed, even if Windowing On Succeeding On is activated. 102

103 Viewer task card Playing movie display back interactively Select Scroll > Interactive Movie On. Hold the left mouse button down in the image and move the mouse up or down to view the images in quick succession like a movie. Select Scroll > Interactive Movie On again. Movie mode is stopped. The left mouse button is in selection mode again. Windowing images During windowing images you change image brightness and contrast. Setting the scope Select a complete series if you want to window all images of a series. Select Image > Windowing On Succeeding On, if you want to window all images up to the end of the series. Deactivate Windowing On Succeeding On, if you want to window only a single image. Select individual images explicitly to window a special selection of images. 103

104 Viewer task card The changed window values are displayed immediately in the image that your are currently windowing. As soon as you release the mouse button, the new window values are applied to all images of the same selection. You can use the keys of the symbol keypad for fine adjustment: Changing the contrast Changing the brightness 104

105 Viewer task card Automatic windowing Click Auto Windowing on the Image subtask card. Or Double-click with the center mouse button. The selected images are assigned automatic window values. Windowing using the mouse Click an image and drag the mouse up/down holding the center mouse button pressed to change the brightness. Move the mouse right/left to change the contrast. Restoring window values Select Home Window to undo your changes. Saving window values Select Save Window Values to save the images with the changed window values. 105

106 Viewer task card It is not possible to zoom continuously in the Zoom Image window. The factor entered is always applied to the original image. When you zoom with the mouse, the new zoom factor will be applied to all selected images. 106

107 Viewer task card Zooming and panning images Zooming with buttons Click this button on the Image subtask card to reduce the zoom factor by 0.5. Click this button to enlarge the selected images by a factor of 2.0. Click this button and enter a zoom factor in the Zoom Image dialog box to enlarge or reduce the selected images by an individually set zoom factor. Zooming with the mouse Activate the Zoom & Pan mouse mode. Position the mouse pointer in the outer area of the image. Drag the mouse pointer up holding the left mouse button pressed to enlarge the image. Drag the mouse pointer down holding the left mouse button pressed to reduce the image. Deactivate the Zoom & Pan mouse mode. 107

108 Viewer task card Home Zoom/Pan restores the zoom factor and image position to the values last stored in the database. Panning with the mouse is applied to all selected images. 108

109 Viewer task card Restoring the zoom factor and image position Click this button. Or Select Home Zoom/Pan. Fitting the image size to a segment Click this button. Or Select Fit to segment. Panning images Activate the Zoom & Pan mouse mode. Position the mouse pointer in the inner part of the image. Drag the mouse up, down, right, or left holding the left mouse button down to pan the image as required. Deactivate the Zoom & Pan mouse mode. 109

110 Viewer task card As soon as you rotate or mirror an image, the comments and graphic elements entered by you are deleted. The orientation labels are adjusted according to the rotation or mirroring. Enter a negative value to rotate the selected images counterclockwise. 110

111 Viewer task card Rotating and flipping images Rotating images Select Image > Rotate 90 to rotate the selected images 90 clockwise. Or Select Image > Rotate and enter an individual angle of rotation in the Rotate Image dialog box. Flipping images Select Image > Flip Horizontally to flip the selected images horizontally. Select Image > Flip Vertically to flip the selected images vertically. Inverting images Select Image > Invert Gray Scale to invert the grayscale assignment in the selected images. Select Image > Invert Gray Scale again to restore the original grayscale assignment. 111

112 Viewer task card You can process a Random Line like a freehand ROI. Page 115, Drawing ROIs Pull both lines either toward the intersection (1) or away from the intersection (2). If you do not follow this procedure, the supplementary angle (B) (180 ) instead of the intended angle (A) will be calculated (3). A (1) (2) (3) A A B 112

113 Viewer task card Image evaluation WARNING For optimum results, use quantative analysis on distortion-corrected images only. This is especially important for evaluations at the edge of the image and for large FoVs. Measuring distances Click this button on the Tools subtask card. If you want to determine the distance between two points, drag a line between the two points, holding the left mouse button down. Measuring angles Click this button on the Tools subtask card to activate the Angle mode. Drag a line holding the left mouse button down. This line represents the first leg of the angle. Draw another line for the second leg. The size of the angle is displayed in the image. 113

114 Viewer task card ROIs (Regions Of Interest) are used to mark abnormalities in the images and to provide statistical evaluations of the grayscale values within these regions. ROIs can be drawn as circular, rectangular, or freehand regions. You can also draw the freehand ROI point-bypoint by clicking the mouse at each change of direction (polygon definition). 114

115 Viewer task card Drawing ROIs Click this button to draw a circular ROI. Or Select Tools > Rectangle to draw a rectangular ROI. Click the image and draw a circle or a rectangle holding the left mouse button pressed. Release the mouse button as soon as the ROI has the desired size. Or Click this button to draw a freehand ROI. Click the image, hold the left mouse button pressed, and drag the mouse around the region of interest. Double-click the end point. The results of ROI evaluation are displayed in the image. (1) Evaluated grayscale range (2) Highest and lowest grayscale value (3) Mean value and standard deviation (4) Number of pixels in the ROI (5) Area of the ROI in cm 2 115

116 Viewer task card You can write up to 30 characters per line. After that, line breaks are inserted automatically. You can also force a line break by pressing Shift + Return. 116

117 Viewer task card Annotating images Click this button on the Tools subtask card. Click the position in the image where you want to insert the text. Enter the desired text in the text field displayed, then press the Enter key. Deleting graphic and text elements Select the graphic or text element. Or Select Edit > Select all Graphics. Select Edit > Delete Graphics or press the Del key. 117

118 Viewer task card You can use the pixel lens to display the average value of grayscales of a small area of 5 x 5 pixels as well as the patient coordinates. When images are saved, the pixel lens markers in the images are saved as superimposed graphics. 118

119 Viewer task card Determining grayscale values of pixels (pixel lens) Inserting the pixel lens marker at a fixed position Click this button of the Tools subtask card Place the mouse pointer on a pixel in the image whose grayscale value you want to find out. The gray scale value is displayed in the first line. The second line shows patient coordinates. Press the left mouse button if you want to have the pixel and gray scale value permanently displayed in the image. Selecting or moving the pixel lens marker Position the cursor at the marker until the crossing arrows are enlarged. Move the marker in the second image until the patient coordinates are the same as shown in the first image. Deleting the pixel lens marker Click on the marking and press the Del key if you want to delete the marking. 119

120 Viewer task card The program is based on reference images that you used for graphic slice positioning before acquiring the series. You can also use any image or series of the patient for a position overview. 120

121 Viewer task card Hiding an area of the image Select Tools > Shutter. Hold the left mouse button pressed and draw a rectangle. The area outside the rectangle is blanked out. Position display The position display allows you to have the measured images calculated and displayed as cut lines in the reference images. Displaying the Position of a Whole Series Click an image of a series that you want to have displayed in the position display. Click the Position Display Series button on the Patient subtask card. Reference images with cut lines are displayed as an independent series in the image area. 121

122 Viewer task card The data images and the reference images have to meet the following conditions for calculating the position lines: Same series block Same table position The images are part of the current examination of the current patient 122

123 Viewer task card Displaying the position of selected images Explicitly select the images that you want to display in the position display. Click the Position Display Selection button on the Patient subtask card. Displaying the position of two or more series Transfer the series that you want to display as well as the reference series to the Viewer task card. First select the image of the series that you want displayed in the position display. Then click on the image or images that you want to use as a reference. Click the Position Display Series button on the Patient subtask card. Changing the display of the current position display series Select Evaluation > Position Display > Settings. The Position Display dialog box allows you to set the number and annotation of the cut lines displayed. Put the input focus on an image of the Pos- Disp series again. Calculate the position display again. 123

124 Viewer task card Use filter strengths of group 1-10 for images of matrix size 256, filter strenghts of group for matrix size 512. High filter settings amplify the signal and enhance structures. Low filter settings suppress noise and smoothen structures. 124

125 Viewer task card Filtering Images You can postprocess fuzzy images or images showing much noise using the ContextVision filter. Select theimages/series in the Patient Browser or Viewer task card. Select Evaluation > Dynamic Analysis > ContextVision Filter. Or Click the button on the Evaluation subtask card. Select an option (Smooth, Medium, Sharp) and start postprocessing with OK. Or Select an option (Smooth, Medium, Sharp) and assign a new filter strength to it. Click the Adopt button and start postprocessing with OK. You can follow the progress of filtering in the Calculation Status dialog box. For this purpose, click this icon on the status bar. After calculation, the filtered images are displayed on the Viewer task card. 125

126 Viewer task card (1) Image with distortion artifacts (2) Image after distortion correction The images have to meet the following prerequisites for distortion correction: The images have been acquired with syngo MR The images have not been distortion-corrected before 126

127 Viewer task card Distortion correction Geometric distortions (barrel-shapes/pin cushion) may occur at the edge of images with a large FoV. These image errors can be eliminated using the distortion correction postprocessing function. Correcting distortion artifacts prior to the measurement Before scanning switch on the FoV compensation filter. Click the Resolution parameter card into foreground. Click the ipat subtask card. Click the field to the right of the Large FoV entry. A selection list is displayed. Select On in the list. The images resulting from this measurement are distortion-corrected. Correcting distortion artifacts after the measurement Select Patient > Browser. Select the images or series in the Patient Browser. Select Evaluation > Distortion Correction from the Patient List. A subsequent distortion correction generates a new series. The uncorrected original images are retained and can be used for slice positioning additional scans. 127

128 Viewer task card You can save your processed images in one of two ways: You can save the images in a new series. You can append the images to an existing series. 128

129 Viewer task card Saving images Saving all changes Select the images or series that you want to save. Select Patient > Save As. Click the Save images in new series option in the Save As dialog box. Enter the new series description in the text input field and confirm with OK. Or Click the Append images to series option. Select the series in the selection list using the serial number and serial description and confirm with OK. Saving window values only Select Saving window values of the subtask card Report The selected images are saved with the new window values. 129

130 Saving and Sending MODs may be used for data import only. Single or multi-session mode: CDs can be written in one operation (single session) or in two or more operations (multisession). The name may consist only of letters, numbers or underscores. It cannot be shorter than three characters or longer than eleven characters. You can reimport the data into your local database at any time using the CD-ROM drive. The Local Job Status window shows you the save jobs in the queue. You can stop, restart, or delete them there. 130

131 Saving and Sending Storing data on CD Your system is equipped with a CD recorder. Preselecting data for saving To make the best possible use of the storage capacity of a CD, first accumulate a sufficiently large volume of data and then save it in to the CD. Select the data either in the Patient Browser or on the Viewer or 3D task card. Select Transfer > Export to CD-R or click this button in the Patient Browser. The first time you preselect data for a new CD, the Enter label dialog box will open. Assign a unique name to the CD. Writing data to CD You can save all the data preselected so far on CD at any time. Or you can wait until the system informs you that you have accumulated enough data to fill a CD. Insert a CD into the CD recorder. Select Transfer > Record to CD-R. Managing archiving jobs Select Transfer > Local Job Status or click the icon on the status bar. 131

132 Saving and Sending During installation, Siemens Service sets up various network connections (e.g. Node 1 and Node 2) as standard addresses in the network. Multiple selection enables you to send data to more than one user simultaneously. You can reimport the data from the network address into your local database at any time. The Network Job Status window informs you about the network jobs. You can stop, restart, or delete them there. 132

133 Saving and Sending Sending and receiving data via network Select the data either in the Patient Browser or on the Viewer or 3D task card. Press the Send To Node1 key on the symbol keypad or one of the two buttons in the Patient Browser to send the data to the preconfigured standard address Node 1 or Node 2. Or Select Transfer > Send To or click this button. Select the network address in the Send To window. Managing network jobs Select Transfer > Network Job Status or click the icon on the status bar. 133

134 Saving and Sending 134

135 Saving and Sending Automatic data transfer Select Options > Configuration on the Viewer or 3D card. Double-click this icon on the configuration panel. Select the Transfer Configuration window and go to the Auto Transfer card and click it into foreground. You can define the rules at series level and activate automatic archiving here. Postprocessed images must be assigned the "completed" status manually. Only then are the existing rules for automatic data transfer activated. 135

136 Filming The segment of a selected image is marked by a blue dashed-line border (single selection) or by a blue continuous-line border (multiple selection with the Ctrl key). Page 97, Selecting images Prior to exposing the film, you can view the images/film sheets, edit them to some extent, change the selection, or define the film sheet layout. 136

137 Filming Filming or printing is handled in two steps: Page 136, Filming Transfer the selected images to the virtual film sheet. Start exposing or printing. Transferring images to the virtual film sheet Select the images in the Patient Browser or on a task card (Viewer, 3D...). Select Patient > Copy to Film Sheet or press this key on the symbol keypad. Go to the Filming task card. The selected images are arranged on the virtual film sheets. Selecting images and film sheets Selecting images Click the image. Hold the Ctrl key down and click all images you want to select. Select Select On Succeeding to extend the selection up to the end of the series. Select Select Series to select the entire series. Hold the Shift key pressed, click the first and last image of a sequence of images to select all images located in between the first and last image. 137

138 Filming The folder icon of a selected film job is highlighted in color. All images of this job will be displayed with a blue continuous-line border. The layout of the film sheet also allows you to define the number and size of the segments on a film sheet. 138

139 Filming Selecting film sheets Click the border of the film sheet to select all images on the sheet. Or Hold the Ctrl key down and click the border of the first film sheet of your choice. Page to another film sheet using the dog ears. Extend your selection by a single film sheet (with the Ctrl key pressed), or by all film sheets located between the two film sheets (with the Shift key pressed). Selecting an entire film job Click the opened film job to select all film sheets with all images of this job. Editing film jobs Changing the layout of film sheets Explicitly select images, a film sheet or an entire film job. Go to the Layout subtask card and click it into foreground. Click the button that sets the appropriate division for the film sheet. Or Select Properties Go to the dialog box and select a film division from Range in the selection list for Film Properties. 139

140 Filming You can also change the size of the selected images using the buttons on the Image subtask card: Click the Fit to Segment button to display the images as large as possible in the segment. Click the Original Image button to display the images in their original size in the segment. Click the Clip document button to fully display the shorter side of the images in the segment. You can also drag and drop images within a film sheet. In this case Zoom/Pan cannot be activated. Use drag and drop to add images to a film job from the Patient Browser. The images are inserted into the film job in front of the selected segment. The film job is called a multiple job if it contains images of two or more patients. 140

141 Filming Windowing images Select the images. Click this icon button to assign predefined window values to the images. Use the mouse or the symbol keypad for fine adjustment. Page 103, Windowing images Zooming and panning images Select the images. Click the Zoom/Pan button. Change the image size of the selected images (zoom) and the image position in the segment (pan). Page 107, Zooming and panning images Copying and moving images or film sheets Select the images or film sheets. Select Copy. Or Select Cut. Now select the image in front of which you want to insert your selection. Select Paste. 141

142 Filming You can set the text information for the Customized text option in the Film Properties dialog box. Select Properties. You can delete images by selecting Clear Document(s). In that case, the segments of the deleted images will remain empty. Use Film > Repack afterward to reorganize the film sheet or the entire film job (gaps will be filled again). 142

143 Filming Showing and hiding graphic elements and text Go to the Image subtask card. Click the All Text button to have the entire image text filmed together with the images. Click the Customized Text button to have a part of the image text filmed together with the images. Click the No Text button to hide all text information. Click the Show Graphics button to display graphics. Click the Hide Graphics button to hide graphics. Displaying reference images Open the Film Properties dialog box (Filming > Properties). Activate the Reference Image option. Select the position (Top right or Bottom right) of the reference image. Deleting images or film sheets Select the images or film sheets. Select Delete. Or Click this button. Empty segments on the film sheet are automatically filled. 143

144 Filming The newly selected camera is used as the default camera. It is used until you select another one. The Film Job Status dialog box informs you about the status of film jobs that are waiting to run in the camera and printer queue. Click this button if you want to open the Film Job Status dialog box. 144

145 Filming Selecting another camera Go to the Camera subtask card. Select a camera from the list. This selection list contains all the cameras connected to your system. Exposing on film Exposing a film sheet Select the film sheets. Select Film > Expose Film Sheet. Exposing a film job Click the Expose Film Job button. The currently opened film job is exposed. Or Select Patient > Expose Film Job if you want to expose one of the film jobs in the queue. Select a job in the Select Film Job dialog box and click Expose. 145

146 3D You are also able to first move the 3D card into foreground and subsequently load the series from the patient browser into the 3D card. A list will be displayed, if you load two or more series or unsuitable images into the 3D task card. This list also allows you to select the series that you want to evaluate first. You can "move" through the volume as follows: Moving and rotating reference lines (crosshair) Scrolling with dog ears Rotating the cut plane with the mouse Set standard views on the subtask card Align 146

147 3D Evaluation with MPR Multiplanar reconstruction generates images/series with any orientation from a 3D data set (or a series of suitable 2D images). This section describes a typical MPR evaluation using the data of the t1_mpr_ns_sag series. Page 23, Examination of the head Loading images for MPR evaluation Select the t1_mpr_ns_sag series in the Patient Browser or Viewer task card. Click the 3D MPR button. The task card 3D is moved into foreground. You can now see a sagittal, a coronal, as well as a transverse cut line in the 3 image segments through the 3D data set loaded. Setting the reconstruction plane You will now "move" through the volume data set to find an appropriate plane for MPR reconstruction. The colored lines of the crosshair (reference lines) indicate the position of the respective cut planes that are shown in the reference segments. The arrows indicate the viewing direction. 147

148 3D Orientation aids in the image: Description of orientation (transverse cut tilted through 43 in the coronal plane) Orientation cube indicates the position of the slice displayed with reference to the patient coordinate system. Orientation labels displayed on the top and left edges of the image Dashed reference lines symbolize cut planes that are not perpendicular to the displayed view. You can return to the standard view with this button or by selecting Orientation > Reset. You can align the cut planes perpendicularly in the reference segments with Orientation > Ortho Sync or this button. 148

149 3D You can set a reconstruction plane using the crosshair as follows: Activate the Orientation control. Click a reference line and drag it to its new position while holding the left mouse button down. Or Click the center of the crosshair and move both reference lines at the same time. The new slice plane or the new position of the crosshair is displayed in the other two segments. You can set an oblique tra-cor plane by rotating the crosshair: Select Free Mode. Click the transverse reference line (blue) in the sagittal image (red) and, while holding the left mouse button down, tilt it toward the Head. The new tra-cor plane is displayed in the blue segment. In the green segment it is indicated by a blue dashed line. Deselect Free Mode again. 149

150 3D You can recognize the reference segment by its thick colored border. You can recognize the selected reference line by the "grab handles". Move the Parallel Ranges window so that it is not above the reference or output segment. Use this button to create series whose cut planes run horizontal/vertical in the center of the reference image. Use this button to reverse the image numbering of the series. This button allows you to change the distance of the slices to one another. The angle between the slices remains the same. You can edit a new MPR Series and, if necessary, expand it with Ranges Expand. The MPR method also allows you to generate radial and curved slices. 150

151 3D Generating a series of parallel images Select an image segment as the reference segment. Select a line in the reference segment to define the position of the slices. Click Parallel Series on the Settings subtask card. The Parallel Series dialog box opens. The intended slices are displayed in yellow in the reference segment. The center slice (thick yellow border) is dispiayed in the output segment. You set the range of parallel series in the reference segment. Move the yellow start and end line to the required position. Enter the number of parallel images in the Parallel Series dialog box and change the image thickness, if necessary. Click the Start button. Calculation of the new series starts. Each image is displayed in the output segment as soon as it has been calculated. 151

152 3D The program is in the drawing mode, the cursor changes shape. (1) Start line (identified as number 1) (2) Reference line (3) End line (4) Arrows in the direction of view (5) Distance and thickness 152

153 3D Generating curved cuts Select the segment that contains your reference image Click Curved cuts on the Modi subtask card. Draw the cut line by clicking the individual points with the left mouse button. End the line with a double-click. Select the curved series Click the Curved Series on the Prepare subtask card. Draw a reference line by doubleclicking the left mouse button and keeping it pressed. The positioning of the parallel slices to be computed is graphically displayed in the reference segment. The output segment shows the slice of the selected reference line. 153

154 3D (1) Voxel in the MIP image (2) Most intensive voxel in the volume data set 154

155 3D Evaluation with MIP When you use the Maximum Intensity Projection, the voxels are projected onto an area with maximum intensity in a selected viewing direction. In the following you will find a description of a typical MIP evaluation using the data of the tof_fi3d_tra series. Page 35 Loading images for MIP evaluation Select the tof_fi3d_tra series in the Patient Browser or on the Viewer task card. Select Patient > 3D MIP. The task card 3D is moved into foreground. You can now see a sagittal, a coronal, as well as a transverse cut line in the 3 image segments through the 3D data set loaded. Positioning and defining a VOI You can limit a 3D data set to a partial volume by drawing a Volume Of Interest. Activate the Orientation control. Select VOI Control Volume on the Settings subtask card. 155

156 3D You will find all the buttons you require for VOI processing in the VOI Punch Mode dialog box. 156

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