Siemens SOMATOM Sensation Cardiac Version A60 Provozní pokyny

SOMATOM Sensation CardiacApplication GuideSoftware Version A60

10GeneralThe following tables show you the possibilities of imagereconstruction in spiral and sequential scanning.Slice Collimation and Slice Width fo

100NeckAngioCarotidIndications:Noninvasive CT angiography of carotid stenosis or occlusions, plaques course abnormalities of the carotids and vertebra

101NeckAngioCarotid 2ndReconstr.kV 120Effective mAs 120Slice collimation 0.75 mmSlice width 5.0 mm 1.0 mmFeed/Rotation 12.0 mmRotation time 0.5 sec.Ke

102ThoraxOverview• LungLowDoseSpiral mode with very low dose for special lung studies, e. g. early visualization of pulmonary nodules• PulmonaryEmboli

103ThoraxHints in General1. Topogram: AP, 512 mm.2. Patient positioning:Patient lying in supine position, arms positionedcomfortably above the head in

104LungLowDoseIndications:Lung studies with low dose setting, e.g. early visuali-zation of pulmonary nodules.A typical thorax study in a range of 30 c

105LungLowDose 2ndReconstr.kV 120Effective mAs 20Slice collimation 0.75 mmSlice width 5.0 mm 1.0 mmFeed/Rotation 18.0 mmRotation time 0.5 sec.Kernel B

106PulmonaryEmboliIndications:For Pulmonary Emboli studies.There are two recon jobs predefined. The first one,with 5 mm slice thickness, the second re

107PulmonaryEmboli 2ndReconstr.kV 120Effective mAs 100Slice collimation 0.75 mmSlice width 5.0 mm 1.0 mmFeed/Rotation 15.0 mmRotation time 0.5 sec.Ker

108ThoraxThoraxCombiIndications:Combining thin slice lung and routine thorax studieswith one spiral scan. E.g. thorax studies in general andinterstiti

109ThoraxThoraxCombi 2ndReconstr.kV 120Effective mAs 100Slice collimation 0.75 mmSlice width 5.0 mm 1.0 mmFeed/Rotation 15.0 mmRotation time 0.5 sec.K

11GeneralRecon JobIn the Recon card, you can define up to 3 reconstruc-tion jobs with different parameters either before orafter you acquire the data.

110ThoraxThoraxRoutineIndications:Routine studies for the region of thorax, e.g. screeningof tumors, metastases, lymphoma, lymphonodes,vascular anomal

111ThoraxThoraxRoutinekV 120Effective mAs 100Slice collimation 1.5 mmSlice width 6.0 mmFeed/Rotation 30.0 mmRotation time 0.5 sec.Kernel B41fIncrement

112AbdomenOverview• AbdRoutineFor routine abdominal studies• AngioFastFor long-range CTA studies• AngioRoutineFor CTA routine studies• AbdomenSeqSeque

113AbdomenHints in General1. Topogram: AP, 512 or 768 mm.2. Patient positioning:Patient lying in supine position, arms positionedcomfortably above the

114AbdomenNote: In general, for abdominal studies such as liver,gall bladder (query stones), pancreas, gastrointestinalstudies, focal lesion of the ki

115Abdomen

116AbdomenAbdRoutineIndications:All routines in the region of abdomen, e.g. screening,follow-up examinations etc.A complete abdomen/pelvis scan, in a

117AbdomenAbdRoutinekV 120Effective mAs 140Slice collimation 1.5 mmSlice width 5.0 mmFeed/Rotation 24.0 mmRotation time 0.5 sec.Kernel B31fIncrement 5

118AngioFastIndications:Long range CTA studies.E.g.: a typical study of the whole aorta including itsbranchiocephalic trunk and iliac arteries in a ra

119AngioFast 2ndReconstr.kV 120Effective mAs 130Slice collimation 1.5 mmSlice width 5.0 mm 2.0 mmFeed/Rotation 21.0 mmRotation time 0.5 sec.Kernel B30

12GeneralEffective mAsIn sequential scanning, the dose (Dseq) applied to thepatient is the product of the tube current-time (mAs)and the CTDIwper mAs:

120AngioRoutineIndications:For abdominal CTA studies.E. g.: a typical study of renal arteries in a range of 40 cm will be covered in 13.9 s.Abdomen

121AngioRoutine 2ndReconstr.kV 120Effective mAs 130Slice collimation 0.75 mmSlice width 5.0 mm 1.0 mmFeed/Rotation 15.0 mmRotation time 0.5 sec.Kernel

122AbdomenSeqIndications:Sequential mode for addomen studies.AbdomenSeqkV 120Effective mAs 140Slice collimation 5.0 mmSlice width 5.0 mmFeed/Scan 10.0

123Abdomen

124ExtremitiesOverview• AngioRunOffFor long range CTA studies

125ExtremitiesHints in General1. Topogram: AP, 1024mm for CTA.2. If Topo length 1024 mm is not long enough, youcan also choose the 1540 mm long Topog

126AngioRunOffIndications:For CTA studiesA range of 100 cm will be done in 21.4 s.AngioRunOff 2ndReconstr.kV 120Effective mAs 130Slice collimation 1.5

127* CARE Bolus may be used to optimize the bolus timing.Set the ROI for monitoring scan in the abdominal aorta at the beginning of the scan range wit

Siemens reserves the right to modify the design and specifications containedherein without prior notice. Please contact your local Siemens Sales Repre

13GeneralDose InformationThe dose as described by CTDIwis displayed on the user interface for the selected scan parameters. TheCTDIwis measured in the

14GeneralFig. 1: User interface of the PC program WinDose. All parameters necessary for the effective dose calcu-lation have to be specified.** The Ca

15GeneralFig. 2: A graphic interface of WinDose allows to specify the anatomical scan range.Fig.3: Results as output of WinDose with the organdose rea

16GeneralFig. 1: Example of scanning in the region of shoulder.CARE DoseCARE Dose is a clinical application package that pro-vides real-time tube curr

17GeneralFig. 2: Principle of CARE Dose tube current adaptation.• CARE Dose is pre-selected by default for all standardprotocols, except head and card

18GeneralWorkflowAuto Load in 3D and Postprocessing PresetsYou can activate the “Auto load in 3D” function on theExamination Card/Auto Tasking and lin

19GeneralSome of the Scan protocols, mainly for Angio exami-nations, are already delivered with Auto load in 3D. If you do not like, please deselect t

2The information presented in this application guide is for illustration only and is not intended to be reliedupon by the reader for instruction as to

20GeneralHow to Create your own Scan ProtocolsUser-specific scan protocols can be saved with the following basic procedure:– Register a test patient,

21GeneralTips:– It is recommended that you save your own scan protocol with a new name in order to avoid over-writing the default scan protocol.– You

22HeartView CTHeartView CTHeartView CT is a clinical application packagespecifically tailored to cardiovascular CT studies.The BasicsImportant Anatomi

23HeartView CTFig. 1: Blood fills both atriaFig. 2: Atria contract, bloodenters ventriclesA: AortaP: Pulmonary ArteryRV: Right VentricleLV: Left Ventr

24HeartView CTCoronary arteries:• Right coronary artery (RCA)Right coronary artery supplies blood to the rightatrium, right ventricle, a small part of

25HeartView CTCardiac Cycle and ECGThe heart contracts when pumping blood and restswhen receiving blood. This activity and lack of activityform a card

26HeartView CTTechnical PrinciplesBasically, there are two different technical approachesfor cardiac CT acquisition:• Prospectively ECG triggered sequ

27HeartView CTAbsolute – delay: a fixed time delay after the onset ofthe R-wave (Fig. 11).Absolute – reverse: a fixed time delay prior to the onsetof

28HeartView CTECG Trace EditorThe ECG trace editor is used for adaptation of imagereconstruction to irregular heart rates. This editingtool can be use

29HeartView CTFig. 14CardioCAREThis is a dedicated cardiac filter which can reduceimage noise thus provides the possibility of dose reduc-tion. It is

33OverviewGeneral 8HeartView CT 22Bolus Tracking 54WholeBodyAngio 62LungCARE 64CT Colonography 66Children 68Head 88Neck 98Thorax 102Abdomen 112Extremi

30HeartView CTHow to do itCalcium ScoringThis application is used for identification and quanti-fication of calcified lesions in the coronary arteries

31HeartView CTPlacement of ECG Electrodes:US Version (AHA standard)White Electrodeon the right mid-clavicular line, directly below the clavicleBlack E

32HeartView CTCaScoreSpiStdIndications:This is a standard spiral scanning protocol, using an ECG gating technique for coronary calcium scoringstudies,

33HeartView CT* Depends on heart rate.CaScoreSpiStd0.5sIndications:This is a spiral scanning protocol, using an ECG gatingtechnique for coronary calci

34HeartView CTCaScoreSeqStdIndications:This is a sequential scanning protocol using an ECGtriggering technique for coronary calcium scoring studies.To

35HeartView CTCoronary CTAThis is an application for imaging of the coronaryarteries with contrast medium. It can be performedwith both ECG triggering

36HeartView CTGeneral Hints:• Generally speaking, the ECG gated protocol is recom-mended for premium image quality of the coronaryarteries, and whenev

37HeartView CTCoronaryStdIndications:This is a standard spiral scanning protocol, using aRotation Time of 0.42 s, with an ECG gating techniquefor coro

38HeartView CTCoronaryStd0.5sIndications:This is a standard spiral scanning protocol, using aRotation Time of 0.5 s, with an ECG gating techniquefor c

39HeartView CTCorStd_LowHeartRateIndications:This is a special spiral scanning protocol for coronaryCTA studies. It uses ECG gating technique and a 0.

4ContentGeneral 8· Concept 8· Scan Set Up 8· Scan and Reconstruction 9– Slice Collimation and Slice Width 9– Pitch 10– Recon Job 11– Kernels 11– Image

40HeartView CTCoronaryCAREIndications:This is a spiral scanning protocol, using a rotation time of 0.42 s, ECG gating technique and a dedicatedcardiac

41HeartView CTCoronaryCARE0.5sIndications:This is a spiral scanning protocol, using a RotationTime of 0.5 s, ECG gating technique and a dedicatedcardi

42HeartView CTCoronarySharpIndications:This is a spiral scanning protocol, using a RotationTime of 0.42 s, ECG gating technique and a dedicatedcardiac

43HeartView CT

44HeartView CTCoronarySharp0.5sIndications:This is a spiral scanning protocol, using a RotationTime of 0.5 s, ECG gating technique and a dedicatedcard

45HeartView CTFig. 1: Image reconstructionwith (a) and without (b) Cardio Sharp kernel.ab

46HeartView CTECGTrigCTAIndications:This is a sequential scanning protocol with an ECG triggering technique for coronary CTA studies. It couldalso be

47HeartView CTECGTrigCTAkV 120Effective mAs 120Slice collimation 1.5 mmSlice width 1.5 mmFeed/Scan 18 mmRotation time 0.42 sec.Temporal resolution 210

48HeartView CTAortic and Pulmonary StudiesThe following scan protocol is predefined:• PulmonaryECG– Spiral scanning protocol with ECG gatingGeneral Hi

49HeartView CTPulmonaryECGIndications:This is a spiral scanning protocol with an ECG gatingtechnique for aortic and pulmonary studies, e. g. aorticdis

5ContentHeartView CT 22· The Basics 22– Important Anatomical Structures of the Heart 22– Cardiac Cycle and ECG 25– Temporal Resolution 25– Technical P

50HeartView CTAdditional Important InformationBy default, the “Synthetic Trigger” (ECG triggered scanning) or “Synthetic Sync” (ECG gated scanning) is

51HeartView CTACV (Adaptive Cardio Volume) (Fig. 3) is a dedicatedalgorithm for bi-phase image reconstruction. The imagetemporal resolution of 105 ms

52HeartView CTYou can activate the “Auto load in 3D” function on theExamination Card/Auto Tasking and link it to a reconjob. If the postprocessing typ

53HeartView CTCalcium Scoring evaluation is performed on a separatesyngo task card:1. The threshold of 130 HU is applied for score calculation by defa

54Bolus TrackingThe BasicsThe administration of intravenous (IV) contrast material during spiral scanning improves the detectionand characterization o

55Bolus TrackingAortic time-enhancement curves after i.v. contrastinjection (computer simulation*).All curves are based on the same patient parameters

56Bolus TrackingHow to do itTo achieve optimal results in contrast studies, use ofCARE Bolus is recommended. In case it is not available,use Test Bolu

57Bolus Tracking• After the Topogram is performed, the predefined spiral scanning range and the optimal monitoringposition will be shown.• If you need

58Bolus TrackingTestBolusIndications:This mode can be used to test the start delay of anoptimal enhancement after the contrast mediuminjection.TestBol

59Bolus TrackingApplication Procedures:1. Select the spiral mode that you want to perform,and then “Append” the TestBolus mode under Specialprotocols.

6ContentBolus Tracking 54· The Basics 54· How to do it 56· CARE Bolus 56– General Hints 56· Test Bolus 58– Application Procedures 59· Additional Impor

60Bolus TrackingAdditional Important Information1. The preset start delay time for monitoring scansdepends on whether the subsequent spiral scan willb

61Bolus Tracking5. If API is used in conjunction with CARE Bolus, theactual start delay time for the spiral will be as longas the length of API includ

62WholeBodyAngioThis scan protocol can be used for a whole Body Angio.A range of 100 cm can be covered in 21.4 s.WholeBodyAngio 2ndReconstr.kV 120Effe

63WholeBodyAngio

64LungCareLungCarekV 120Effective mAs 20Slice collimation 0.75 mmSlice width 1.0 mmFeed/Rotation 18.0 mmRotation time 0.5 sec.Kernel B50fIncrement 0.5

65LungCare

66CT ColonographyFor Colonography studies.A typically range of 40 cm can be covered in 13.9 s.CT Colonography 2ndReconstr.kV 120Effective mAs 100Slice

67CT ColonographyWe recommend using a tube voltage of at least 120 kV.A comprehensive study consists of four sections:Preparation, examination in supi

68Children OverviewThis folder contains 8 organ specific pediatric proto-cols with 2 to 5 age or weight dependant subgroups.For your convenience, the

69Children Hints in General1. Topograms: 256 mm lateral topograms are definedfor the head modes, and 512 mm AP topograms aredefined for the body modes

7ContentThorax 102· Overview 102· Hints in General 103· LungLowDose 104· PulmonaryEmboli 106· ThoraxCombi 108· ThoraxRoutine 110Abdomen 112· Overview

70The proper personnel and equipment must also be readily available at your disposal in the event of a problem.6. Oral and rectal contrast administrat

71Note: these are injector guidelines based on an antecubital injection site. These guidelines may needto be adjusted if the site is more peripheral.N

72HeadSpi0.5sIndications:Spiral mode for routine head studies, e.g. tumors,hydrocephalus, hemorrhaging, abnormalities, etc.HeadSpi0.5skV 120Effective

73Tips• Children, who are more than 6 years old, should be scanned with an adult protocol as the skull by thistime is fully grown.• When bone structur

74HeadSeq0.5sIndications:Sequential mode for routine head studies for children, e.g. tumors, hydrocephalus, hemorrhaging,abnormalities, etc.HeadSeq0.5

75Tips• Children, who are more than 6 years old, should be scanned with an adult protocol as the skull by thistime is fully grown.• When bone structur

76HeadAngioIndications:Spiral mode for head CT angiography, e.g. cerebralvascular abnormalities, tumors etc.HeadAngio 2ndReconstr.kV 80Effective mAs *

77Tips• Children, who are more than 12 years old should bescanned with an adult protocol.• The first recon job is defined for soft tissue visuali-zati

78Children CarotidCTAIndications:CT angiography of the carotid arteries, e.g. carotid stenosis or occlusion, vascular abnormalities of thecarotids or

79Children Tips• Children, who are more than 12 years old should bescanned with an adult protocol.• The first recon job is defined for soft tissue vis

8GeneralConceptThe scan protocols for adult are defined according to body regions – Head, Neck,Thorax, Abdomen,Extremities.The pediatric scan protocol

80Children NeonateBodyIndications:Spiral mode for routine neonate body studies, e. g.tumors, abnormalities, malformations, abscesses, etc.NeonateBodyk

81Children Tips• You can modify the slice width for image reconstruc-tion according to the clinical indications.Contrast medium IV injectionStart dela

82Children ChestRoutineIndications:Spiral mode for routine thorax studies, e.g. pneumonia, tumors, metastases, lymphoma, vascularabnormalities etc.Che

83Children Tips• Children with a body weight of more than 54 kgshould be examined with an adult protocol.• The first and second recon jobs are defined

84AbdPelRoutineIndications:Spiral mode for routine studies in the region of abdomen and pelvis, e.g. tumors, lymphoma,abscesses, post-traumatic change

85Contrast medium IV injectionStart delay exam dependentFlow rate dependent upon needle size/Access siteTotal amount 1– 2 ml per kg of body weightTips

86Children AbdCTAIndications:For abdominal CT Angio studies, e. g. vascular abnormalities, aneurysms, etc.AbdCTA 2ndReconstr.kV 80Effective mAs *Slice

87Children Contrast medium IV injectionStart delay exam dependentFlow rate dependent upon needle size/Access siteTotal amount 1– 2 ml per kg of body w

88HeadOverview• AngioHeadFor CT Angio studies using 0.75 mm slice collimationand a 1.0 mm slice thickness• AngioThinSliceFor CT Angio studies using 0.

89HeadHints in General1. Topogram: Lateral, 256 mm.2. Patient positioning:Patient lying in supine position, arms resting againstbody, secure head well

9GeneralScan and ReconstructionSlice Collimation and Slice WidthSlice collimation is the slice thickness collimated bythe tube collimator, which deter

90HeadAngioHeadIndications:Spiral mode for cerebral CT Angios, e. g. cerebralvascular abnormalities, tumors and follow up studiesetc.A range of 80 mm

91HeadAngioHead 2ndReconstr.kV 120Effective mAs 100Slice collimation 0.75 mmSlice width 4.0 mm 1.0 mmFeed/Rotation 15.0 mmRotation time 0.5 sec.Kernel

92HeadAngioThinSliceIndications:For cerebral CT Angio studies, with one reconstructionjob for a 0.75mm slice thickness.E.g. cerebral vascular abnormal

93HeadAngioThinSlice 2ndReconstr.kV 120Effective mAs 130Slice collimation 0.75 mmSlice width 4.0 mm 0.75 mmFeed/Rotation 6.8 mmRotation time 0.5 sec.K

94HeadHeadSeq0.5sIndications:Sequence mode for routine head studies, e. g. stroke, brain tumors, cranial trauma, cerebral atrophy,hydrocephalus, and i

95HeadThinSliceSeq RoutineSeqkV 120 120Effective mAs 250 250Slice collimation 0.75 mm 1.5 mmSlice width 4.5 mm 9.0 mmFeed/Scan 9.0 mm 18.0 mmRotation

96HeadHeadSpi0.5sIndications:Spiral mode for routine head studies, e. g. stroke, brain tumors, cranial trauma, cerebral atrophy, hydro-cephalus, and i

97HeadThinSliceSpi RoutineSpikV 120 120Effective mAs 320 320Slice collimation 0.75 mm 1.5 mmSlice width 4.0 mm 8.0 mmFeed/Rotation 6.8 mm 13.7 mmRotat

98NeckOverview• AngioCarotidFor CTA studies

99NeckHints in General1. Topogram: Lateral, 256 mm.2. Patient positioning:Patient lying in supine position, hyperextend neckslightly, secure head well