chapter 10 cardiac imaging

Chapter 10 Cardiac Imaging

How to perform a basic cardiac exam:Place the RAPID Body coil directly on the patient table in the area between the red arrows and the end of the patient table nearest the magnet

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How to perform a basic cardiac exam:

nearest the magnet.

2 Position the patient supine on the coil, with their arms up. Center the heart at the transaxialCenter the heart at the transaxial positioning mark on the coil. If patient size permits, offset the patient to the right side within the coil, so that the heart is positioned in the center of the

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positioned in the center of the coil.

If the patient is unable to be positioned with their arms up,

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their arms may be placed down at their sides.

Note: if the patient does not fit using the RAPID Body coil, the

For detailed safety information, refer to Chapter 1, “Safety” in the

10-1Copyright 2012 by Hitachi Medical Systems America, Inc. All rights reserved. DM# 86716v1

Flex Body coils can be used. Oasis MR system Reference Manual.


4 ECG gating will be used for the cardiac exam, which requires that ECG electrodes be placed on the patient. Before placing the ECG electrodes on the patient, wipe the skin on the chest where the electrodes will be placed with skin preparation gel. Follow the application instructions on the bottle.

5 Wipe off excess skin preparation gel with clean gauze

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gel with clean gauze.

Peel the backing from the electrodes.



7LARA

7 Place the electrodes on the patient’s chest as demonstrated here, left of midline and centered approximately halfway between the sternal notch and the xiphoid

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the sternal notch and the xiphoid process. Make sure that the center points of the electrodes are not placed directly over the patient’s ribs.

8 Attach the ECG leads from the induction cord to the appropriate electrodes. Each lead is labeled and color-coded for correct

Note: If you do not receive a usable ECG waveform, the ECG leads can be rearranged until the waveform is acceptable.

and color coded for correct placement around the heart: towards the top of the diamond (RA, White), towards the right side of the diamond (RL, Green), towards the bottom of the

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W i D t ECG t h th t h d d th i towards the bottom of the diamond (LL, Red), and towards the left side of the diamond (LA, Black). Do not press on the electrodes, as the electrode gel may escape and adversely affect

Warning: Do not use ECG patches that have exceeded their expiration date or appear to be damaged. Failure to comply could result in patient injury.

For additional safety information, please refer to Chap 1,

10-3Copyright 2012 by Hitachi Medical Systems America, Inc. All rights reserved.

may escape and adversely affect the MR signal.Safety in the Oasis Reference Manual.

DM# 86716v1


Arrange the induction cord to be as straight as possible alongside the patient’s body. Do Not allow the induction cord to form a loop or contact the patient’s skin

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or contact the patient s skin directly.

10 Connect the induction cord to the ECG connector on the PMM

d l l t d th l ft idmodule, located on the left side of the gantry.

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10Warning: Do not allow gating cables to come in contact with a surface coil or surface coil cable.

Prevent the EGC lead wires and cable from coming in contact with the patients skin. Use padding or other materials to separate the ECG lead wires and the ECG cable from the patient. Contact with wires/cables can lead to thermal injury.


For additional safety information, please refer to Chap 1, Safety , page 1-28 in the Oasis Reference Manual.

DM# 86716v1


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At the Oasis console, click the Waveform button on the Launcher toolbar. The WaveForm window will open.

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Click on the ECG tab to activate the ECG gating. The tab highlights yellow

1213 Monitor the waveform for

approximately one minute to ensure a strong, steady signal.

highlights yellow.

The system calculates the patient’s heart rate and displays it in the WaveForm window. If the waveform is erratic or otherwise unstable, reposition the electrodes on the patient, then check the waveform again.



C t th il bl t th

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Place the upper portion of the RAPID Body coil on its base.

Connect the coil cable to the patient table connector.

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yPush firmly on both sides of the coil to securely close the coil.

On the gantry control panel, turn on the LASER localizer and press

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pand hold the IN button to advance the patient table until the transaxial midline on the RAPID Body coil is aligned with the transaxial laser localizer beam.

16localizer beam.

On the gantry control panel, press and hold the SET button to move the patient table into the magnet i t Th l it di l

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isocenter. The longitudinal move counter on the gantry control panel displays zero and the patient table stops moving when the imaging region is in the center of the

ti fi ld

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magnetic field.

DM# 86716v1


18 Load your site’s Cardiac protocol. If your site does not have one, select a Cardiac protocol from the System library.

Refer to Chapter 3-4, Gating, for information on selecting gating parameters.19

19 In the Protocol Properties window, select the Scanogram task.

20 Click .

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21 In the Protocol Properties window, select the Shim task. Adjust the slice number and slice position so that the entire heart is coveredcovered.

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22 Click .



2323 To perform axial cardiac imaging,

select an axial scan task. Adjust the position and number of slices to cover the entire heart.

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24 View the patient’s heart rate in the WaveForm window.

25 Under the Gating area, enter the patient’s heart rate in the Beat Rate box. Be sure to enter a value that is a little higher than the

Click .

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that is a little higher than the patient’s actual heart rate.

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27 To perform left ventricle long axis (VLA) cardiac imaging, select a VLA scan task. Adjust the slice position so that the slice is angled parallel to the

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is angled parallel to the interventricular septum.


29 Under the Gating area, enter the patient’s heart rate in the Beat R t b B t tRate box. Be sure to enter a value that is a little higher than the patient’s actual heart rate.

Click . 3029



31 To perform left ventricle short axis (SA) cardiac imaging, select an SA scan task. On the axial image, adjust the position and number of slices to cover the

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number of slices to cover the entire left ventricle.

32 On the VLA image, adjust the position and number of slices to


cover the entire left ventricle.

34 Under the Gating area, enter the patient’s heart rate in the Beat Rate box. Be sure to enter a

l th t i littl hi h th33

Click .35

value that is a little higher than the patient’s actual heart rate.



To perform four chamber cardiac imaging, select a 4-Chamber scan task. On the VLA image, position the slice through the center of the left ventricle. The slice should be

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parallel to the length of the left ventricle.

37 On the SA image, position the slice so that it passes through the

38 View the patient’s heart rate in th W F i d

gcenter of the left ventricle, and the apex of the right ventricle.

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the WaveForm window.

Under the Gating area, enter the patient’s heart rate in the Beat Rate box. Be sure to enter a

Click . 40

value that is a little higher than the patient’s actual heart rate.39



T f th h b di41 To perform three chamber cardiac imaging, select a 3-Chamber scan task. On the SA image, position the slice so that it passes diagonally through the center of

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the left ventricle.


43 Under the Gating area, enter the patient’s heart rate in the Beat Rate box. Be sure to enter a value

Click .

that is a little higher than the patient’s actual heart rate.

444443



T f d i f45 To perform candy cane views of the aortic arch, select an oblique aorta scan task. On the axial image, position the slice so that it passes diagonally through b th th di d

A45

both the ascending and descending aorta.

46 View the patient’s heart rate in the WaveForm window

R L

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the WaveForm window.

Under the Gating area, enter the patient’s heart rate in the Beat Rate box Be sure to enter a

P

Cli k

Rate box. Be sure to enter a value that is a little higher than the patient’s actual heart rate.

48 Click .4847


Chapter 10 Interactive Scan Control (I-Scan)

How to use Interactive Scan Control function: Register the patient and choose protocol. Refer to chapter 2 of this manual for complete patient and study registration details.

1How to use Interactive Scan Control function:

2 If not already in the protocol, add a Scanogram I-Scan task.

Note: A Shim task must be run prior to running I-Scan

3 In the Protocol Properties window, click the Scanogram I-Scan task to select it.

prior to running I-Scan.

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On the ALL parameter tab, select the desired slice plane. Turn on Auto Voice if needed.

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5 Click START to begin the Scanogram I-Scan task. When started, the system performs a prescan and automatically pauses when the prescan completes.



How to perform a basic cardiac exam:How to perform a basic cardiac exam:If you are instructing the patient for breath holds, give breathing instructions and click CONTINUE. If you are using Auto Voice, breathing instructions will be givenbreathing instructions will be given to the patient after CONTINUE is clicked. In either case, after CONTINUE is clicked, the Scanogram I-Scan task continues to run and images are displayed into run and images are displayed in the fluoro viewports on the bottom row of the Exam window.

66 Changes to slice position can be

made by manipulating the slice group in one of the viewports. The changes are immediately reflected

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changes are immediately reflected in the Fluoro viewport.



How to perform a basic cardiac exam:How to perform a basic cardiac exam:While acquiring images with the I-Scan task, the overview icon can be opened. Parameters that are white can be changed during acquisition

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To save a fluoro image, click SAVE in the lower right corner of

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acquisition.

7 gthe Exam window. The saved image is listed in the Output Series window. If multiple images are saved without stopping the I-Scan, they will be pp g , yplaced in the same series in the Output Series window.

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How to perform a basic cardiac exam:How to perform a basic cardiac exam:Click STOP in the lower right corner of the Exam window to stop the Scanogram I-Scan task. The last displayed fluoro image is saved as a series and is listed

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is saved as a series and is listed in the Output Series window.

The Scanogram I-Scan task can be stopped and started multiple times Each time the task istimes. Each time the task is stared and stopped, images are saved, and another series is created in the Output Series window. These series are listed as Scanogram I Scan S 1

10 I-Scan images can be used as reference images or used to copy slice position in the Copy

as Scanogram I-Scan-S-1, Scanogram I-Scan-S-2 etc.

copy slice position in the Copy Option window.

Note: The I-Scan and the selected scan task must be the same plane in order to use Copy

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same plane in order to use Copy Option.

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chapter 10 cardiac imaging

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