ge680ct用户学习-快速操作手册ssf心脏冠脉冻结技术

SnapShot

Freeze心脏冠脉冻结技术70

bpm,

extrememotion

exampleSSF技术背景55-58BPM

example3

/GE

Healthcare

/08/27/200784bpm

exampleSSF技术背景A

current

challenge

in

Cardiac

CT

…coronary

artery

motion>2mm

motion

blur

even

on

~75msDSCTHardware

solutions

alone

can

be

inadequatein

freezing

coronary

artery

motion4GE

Title

or

job

number3/30/20155

/GE

Healthcare

/08/27/200770

bpm,

extreme

motion

exampleHalfscan

FBP

ReconSnapShot

FreezeSnapShot

Freeze6

/GE

Healthcare

/08/27/200784bpm

example

with

correction

of

RCA

and

LCx.Halfscan

FBP

Recon7GE

Title

or

job

number3/30/2015Snap

Shot

Freeze

is:智能化的冠脉运动伪影校正技术›利用目标相位及其 期相分析冠脉运动的路径及其速率，从而找到冠脉运动的特征性›确定目标相位实际位置，形态GEProprietary

InformationFor

Internal

Use

Only8GE

Title

or

job

number3/30/2015SSF

工作流程9GE

Title

or

job

number3/30/2015SnapShot

Freeze工作流程扫描重建后处理GEProprietary

InformationFor

Internal

Use

Only10GE

Title

or

job

number3/30/2015SnapShot

Freeze

扫描(Temporal

Enhanced)前门控扫描SnapShot

Pulse*80

ms

padding

required后门控扫描(仅单扇区SnapShot

Segment)11/GE

Healthcare

/08/27/2007Cardiac

gated

helical

and

SnapShot

Pulse

acquisitionsHelical

acquisitionTablemoveSS-Cine

acquisition:

1

cycle

ISDTablemoveTablemovex-ray

duration12GE

Title

or

job

number3/30/2015SnapShot

Freeze

重建前门控›只能在回顾性重建中进行›相位补偿时间不小于80毫秒后门控›前瞻性或回顾性重建均可›图像可以设定自动传输到工作站2.重建GEProprietary

InformationFor

Internal

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OnlySS

Freeze

前门控扫描设定低心率65BPM以下平稳，对于65-70BPM且心率稳定可以酌情使用回顾性重建3个期相的图像用于SSF处理13/GE

Healthcare

/08/27/2007SSFreeze

后门控扫描设定选择单扇区扫描（SnapShot

segment)心率65-70，相对稳定；70-75BPM酌情使用›可以使用前瞻性重建重建3期相图像›也可以应用回顾性重建›对于心率较快的病例，同时进行舒张中期和收缩末期重建14/GE

Healthcare

/08/27/2007TE（％）序列生成3个期相的图像序列（以目标相位为中心，前后各自动重建一个相位的图像）16GE

Title

or

job

number3/30/2015TE

序列重建的限定在下列情况下无法重建TE序列图像选择多扇区重建时；使用SnapShot

Segment-Plus重建时；使用ASiR重建但是ASIR设置大于50%时；使用心脏滤过C3功能（Cardiac

filter）显示野DFOV<15

cm6、旋转时间非0.35秒GEProprietary

InformationFor

Internal

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OnlySnapShot

Freeze

后处理(CardIQ

Xpress

Process)›TE序列传输到工作站（自动或手动）›工作站识别TE序列， 自动启动CardIQ

Xpress

process程序产生SSF即冠脉冻结的单一期相序列›使用用SSF序列图像

进入CardIQ

Xpress

2.0

Reveal

进行图像后处理分析3/30/2015主机TE

序列AWSSF

序列CardIQ

Xpress2.0

Reveal

AW曲面、拉直、VR图像18GE

Title

or

job

number3/30/2015总结：SnapShot

Freeze

流程（自动）SSF手动流程1:如果工作站无法自动产生SSF序列图像或者对自动产生的SSF

序列效果不满意时启用手动流程2对自动产生的SSF序列效果不满意时启用手动流程SSF

Auto

OutputOriginal

ImageSSF

w/

Manual

Tracking19GE

Title

or

job

numberGEProprietary

Information

For

Internal

Use

Only.

510k

Pending.

Not

commercially

available

in

the

USA.

3/30/2015Claims

not

cleared

by

FDA.

For

application

training

purposes

only.Example.

Small

Z-gap

in

mid-RCA.Original

Image SSF

Auto

OutputSSF

w/

Manual

Tracking20GE

Title

or

job

number3/30/2015GEProprietary

InformationFor

Internal

Use

OnlyExample.

Larger

Z-gap

in

mid-RCA.Original

Image SSF

Auto

Output SSF

w/

Manual

Tracking21GE

Title

or

job

number3/30/2015GEProprietary

InformationFor

Internal

Use

Only手动流程步骤1:选择TE序列或SSF序列图像进入CardIQ

Xpress22GE

Title

or

job

numberGEProprietary

Information

For

Internal

Use

Only.

510k

Pending.

Not

commercially

available

in

the

USA.Claims

not

cleared

by

FDA.

For

application

training

purposes

only.3/30/2015手动流程步骤2:如果选择3期相的TE序列，可见下面窗口，仅选择中心期想的图像23GE

Title

or

job

numberGEProprietary

Information

For

Internal

Use

Only.

510k

Pending.

Not

commercially

available

in

the

USA.Claims

not

cleared

by

FDA.

For

application

training

purposes

only.3/30/2015手动流程步骤3:选择进入常用的心脏血管分析或利用快速血管分析工具，编辑所有需要冻结的血管注意:如果你是使用工作站自动产生

的SSF序列进一步进行手工冠脉冻结，你仍需追踪编辑所有血管分支24GE

Title

or

job

numberGEProprietary

Information

For

Internal

Use

Only.

510k

Pending.

Not

commercially

available

in

the

USA.Claims

not

cleared

by

FDA.

For

application

training

purposes

only.3/30/2015手动流程步骤4:使用编辑路径（edit

trace

）或其他一些功能进一步追踪血管注意:如果需要编辑tree

VR图像,确认选择Edit

Volume

功能而非Auto

Select功能效果更好。25GE

Title

or

job

numberGEProprietary

Information

For

Internal

Use

Only.

510k

Pending.

Not

commercially

available

in

the

USA.Claims

not

cleared

by

FDA.

For

application

training

purposes

only.3/30/2015手动流程步骤5:界面上点击右键，在下拉菜单中选择Processvessels

for

motion26GE

Title

or

job

numberGEProprietary

Information

For

Internal

Use

Only.

510k

Pending.

Not

commercially

available

in

the

USA.Claims

not

cleared

by

FDA.

For

application

training

purposes

only.3/30/2015手动流程步骤6:跳出窗口提示“all

vessels

blurred

in

the

original

3phase

images

must

be

tracked

to

ensure

that

the

motionreduction

is

applied

to

those

vessels”.选择Yes

继续.27GE

Title

or

job

numberGEProprietary

Information

For

Internal

Use

Only.

510k

Pending.

Not

commercially

available

in

the

USA.Claims

not

cleared

by

FDA.

For

application

training

purposes

only.3/30/2015手动流程步骤7:提示信息“Vessels

are

now

being

processed

for

motion

in

the

background.”可以选择继续停留在Volume

Viewer

界面或者退到患者列表界面28GE

Title

or

job

numberGEProprietary

Information

For

Internal

Use

Only.

510k

Pending.

Not

commercially

available

in

the

USA.Claims

not

cleared

by

FDA.

For

application

training

purposes

only.3/30/201529GE

Title

or

job

number3/30/2015影响SSF技术使用效果的因素30使用SSF技术需要注意的问题恰当的期相选择(舒张中期和/或收缩末期）是获得良好效果最基本的要求当使用心电图电流调制技术（

ECGmodulation）时要保证最大电流的期相选择范围是足够涵盖期望的TE序列的相位的范围的。使用前门控扫描时，为了重建TE序列，要求期相补偿要超过80ms。因心率的变化需要适当增加额外的期相补偿。避免过大的图像噪声,要选择适当的kV/mA(ASiR

or

Cardiac

filter

C1/C2)对于高分辨率扫描无法使用Volume

ASiR

，可以使用最大的50％Slice

ASiR血管内较差的造影剂充盈会使SSF运动修正效果下降。GE

Title

or

job

number3/30/2015GEProprietary

InformationFor

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Use

Only使用SSF技术需要注意的问题来自于外科术后

，起搏器导线等的条带伪影，影响冠脉运动校正效果重建图像的显示野（DFOV

）最少超过心脏心脏边缘2厘米，不要为了放大图像过度缩小显示野SSF技术仅针对冠脉运动，如果扫描范围明显超出心脏范围，图像重建时要选择限于心脏的恰当的范围利用毫秒进行心脏期相的定义选择及使用现有的心电图编辑功能同样适用于SSF技术，可以根据需要使用31GE

Title

or

job

number3/30/2015特殊

病例SSF技术的应用技巧›使用多点法、桥接技术帮助追踪血管›选择不同期相去重建三期相的TE序列（收缩及舒张期）›利用心电图编辑功能改进阶梯伪影，产生最小运动的TE序列›不同的心动周期采用不同期相重建图像，即混合期相进行图像重建32GE

Title

or

job

number3/30/201545%SSF，右冠中段冻结效果不佳，仍存在明显波动伪影病例：该患者扫描前心率在72-73BPM左右，波动4-5次，采用后门控单扇区扫描，扫描过程中心率变化在81-77BPM之间33GE

Title

or

job

number3/30/2015中国医学附属第一医院45%+42%phaseSSF考虑在冠脉中段所在心动周期采用不同相位数据重建，通过筛选最后选定

42%期相进行，进行了42%+45%相位融合的TE重建，经过SSF重建得到满意效果35/GE

Healthcare

/08/27/2007FAQ:SSF对于冠脉成像的配位不良是否是万能的良方？冠脉配位不良的一些潜在因素：＃1时间分辨率不足＃2心率随着心脏每次跳动的变化＃3心脏每次跳动时运动的非重复性＃4患者自身运动及呼吸控制＃5扫描床与机架角度配准不佳Cardiac

Banding

Example

(1)Original

Image

SnapShot

FreezeInitial

Banding

dueprimarily

to

insufficienttemporal

resolution.Reduction

of

stepartifact

is

not

anintended

result

of

SSF.36/GE

Healthcare

/08/27/2007GEProprietary

InformationFor

Internal

Use

OnlyCardiac

Banding

Example

(2)Non-repeatable

beat-to-beat

motion

was

obscured

by

in-plane

motion.Original

Image

SnapShot

Freeze37/GE

Healthcare

/08/27/2007GEProprietary

InformationFor

Internal

Use

OnlyCardiac

Banding

Example

(2)Extent

of

vessel

motion

profile.

True

po