Siemens SOMATOM Sensation Cardiac Version A60 - Manuals

9 General Scan and Reconstruction Slice Collimation and Slice Width Slice collimation is the slice thickness collimated bythe tube collimator, which determines the Z-coverageper rotation. In Multislice CT, this is divided by thenumber of active detector channels (e. g. 16 x 0.75 mm). Slice width is ...

10 General The following tables show you the possibilities of imagereconstruction in spiral and sequential scanning. Slice Collimation and Slice Width for Spiral Mode0.75 mm 0.75, 1, 1.5, 2, 3, 4, 5, 6, 7, 8, 10 mm 1.5 mm 2, 3, 4, 5, 6, 7, 8, 10 mm Cardio Spiral Modes0.75 mm 0.75, 1.0, 1.5, 2,3 mm 1...

11 General Recon Job In the Recon card, you can define up to 3 reconstruc-tion jobs with different parameters either before orafter you acquire the data. When you click on “Recon”,they will all be done automatically. In case you want to add another (4 th ) recon job, simply click the little icon on ...

14 General Effective mAs In sequential scanning, the dose (D seq ) applied to the patient is the product of the tube current-time (mAs)and the CTDI w per mAs: D seq = D CTDIw x mAs In spiral scanning, however, the applied dose (D spiral ) is influenced by the “classical“ mAs (mA x Rot Time) andin ad...

15 General Dose Information CTDI W and CTDI Vol The average dose in the scan plane is best described bythe CTDI w for the selected scan parameters. The CTDI w is measured in the dedicated plastic phantoms – 16 cmdiameter for head and 32 cm diameter for body (asdefined in IEC 60601-2-44). This dose n...

19 General Fig. 1: Example of scanning in the region of shoulder. CARE Dose CARE Dose is a clinical application package that pro-vides real-time tube current modulation for Spiral andSequential Scanning. CARE Dose reduces patient dose significantly, espe-cially in the regions of shoulder and pelvis....

20 General Workflow Fig. 2: Principle of CARE Dose tube current adaptation. lateral 1.00 0.75 0.50 0.25 rel. units a.p. time Object attenuation Modulated tube current • CARE Dose is pre-selected by default for most standard protocols, except head and cardiac protocols. It canbe switched on/off in th...

21 General Auto Load in 3D and Postprocessing Presets You can activate the “Auto load in 3D” function on theExamination Card/Auto Tasking and link it to a reconjob. For example, the 2 nd recon job with thinner slice width in some of the examination protocols. If the post-processing type is chosen fr...

22 General How to Create your own Scan Protocols User-specific scan protocols can be saved with the following basic procedure:– Register a test patient, patient position must be Head First-Supine. – Select a scan protocol.– Set the table position to 0 (either at the gantry panel, or on the topogram ...

24 HeartView CT HeartView CT HeartView CT is a clinical application packagespecifically tailored to cardiovascular CT studies. The Basics Important Anatomical Structures of the Heart Four chambers:• Right atrium – receives the deoxygenated blood from the body circulation through the superior and inf...

27 HeartView CT Cardiac Cycle and ECG The heart contracts when pumping blood and restswhen receiving blood. This activity and lack of activityfrom a cardiac cycle, which can be illustrated by anElectrocardiograph (ECG) (Fig. 8). To minimize motion artifacts in cardiac images, tworequirements are man...

28 HeartView CT Technical Principles Basically, there are two different technical approachesfor cardiac CT acquisition:• Prospectively ECG triggered sequential scanning.• Retrospectively ECG gated spiral scanning. In both cases, an ECG is recorded and used to eitherinitiate prospective image acquisi...

31 HeartView CT Placement of ECG-electrodes The correct placement of the ECG electrodes is essential inorder to receive a clear ECG signal with marked R-Waves.Incorrect placement of the electrodes will result in an un-stable ECG signal which is sensitive to movements of thepatient during the scan. U...

32 HeartView CT Preview Series Reconstruction The Preview Series should be used to define the optimaltime window for image reconstruction in ECG-gatedspiral scanning, before the full series is reconstructed.A default value of 60% relative gating (or -400 msabsolute reverse gating) can be used as an ...

38 HeartView CT How to do it Calcium Scoring This application is used for identification and quan-tification of calcified lesions in the coronary arteries. It can be performed with both Prospective ECG trigger-ing (sequen-tial scanning) and Retrospective gating(spiral scanning) techniques. The follo...

39 HeartView CT Hints in General • Kernel B35f is dedicated to calcium scoring studies, providing most accurate determination of the HU-value of small calcified lesions. To ensure the bestimage quality and correlation to known referencedata, other kernels are not recommended. • Use the ECG-triggered...

40 HeartView CT CaScoreRoutine Indications: This is a standard spiral scanning protocol, using an ECG gating technique for coronary calcium scoringstudies, with 12-slice acquisition, 1.5mm collimationand 0.42 s gantry rotation time. Topogram: AP, 512 mm.From the carina tothe apex of the heart.A typi...

41 HeartView CT * Depends on heart rate. ** Reduced by 30%-50% with ECG-pulsing. CaScoreFastVolume Indications: This is a standard spiral scan protocol using ECG-gatingfor coronary calcium scoring , with 16-slice acquisition,1.5 mm collimation and 0.42 s gantry rotation time.With the superior abilit...

42 HeartView CT CaScoreSeq Indications: This is a sequential scanning protocol with ECG-triggering and simultaneous acquisition of six 3 mmslices for coronary calcium scoring studies. Topogram: AP, 512 mm.From the carina untilthe apex of the heart. CaScSeq kV 120 mAs 30 Slice collimation 1.5 mm Slic...

43 HeartView CT Coronary CTA This is an application for imaging the coronary arterieswith contrast medium. With the software version VA70both, 12- and 16- slice scan protocols for ECG gatedspiral scanning are supported, we recommend usingonly ECG gated spiral scanning. The following scanprotocols ar...

44 HeartView CT • CoronaryCTAAdaptSpeed – This protocol is identical to CoronaryCTAFastVolume, except that it uses 0.5 s gantry rotation time insteadof 0.42 s. The protocol is intended to provide dosereserves for obese patients with sufficiently lowheart rates. It may be also worth trying for patien...

46 HeartView CT CoronaryCTARoutine Indications: This is a standard spiral protocol with ECG-gatingwhich has been clinically used so far, relying on 12-slice acquisition, 0.75 mm collimation and 0.42 sgantry rotation time. The table feed is 2.8 mm/rotation. Topogram: AP, 512 mm.Approximately, fromthe...

47 HeartView CT CoronaryCTAFastVolume Indications: ECG-gating using 16-slice acquisition, 0.75 mm collimation and 0.42 s gantry rotation time. With thesuperior ability 16-slice acquisition, the table feed isincreased to 3.4 mm/rotation. The time to cover a typi-cal scan range of 12 cm will therefore...

48 HeartView CT CorCTALowHeartRate Indications: This spiral scanning protocol is identical to CoronaryCTAFastVolume, except that it uses a reducedtable feed of 2.6 mm/rotation, corresponding to 6.2 mm/s. It is intended for patients with very lowheart rates below 50 bpm. Topogram:AP, 512 mm.Approxima...

50 HeartView CT CoronaryCTAAdaptSpeed Indications: This is a spiral scanning protocol, using a rotation timeof 0.5 s, with an ECG gating technique for coronaryCTA studies. This protocol is intended to provide dosereserves for obese patients with sufficiently low heartrates. It can be also used for p...

51 HeartView CT Aortic and Pulmonary Studies The purpose of these applications is to reduce motionartifacts in the lung, the aorta and the pulmonary arteries due to transmitted cardiac pulsation. It isintended for imaging the aorta and pulmonary arterieswith contrast medium and ECG-triggered sequent...

52 HeartView CT AngioECG Indications: This is a spiral scanning protocol using a rotation time of 0.42 s with an ECG gating technique for aorticand pulmonary studies. Topogram: AP, 512 mm.Approximately, fromthe carina to theapex of the heart.A typical range of 30 cm covering theentire heart can be d...

54 HeartView CT AngioECGSeq Indications: This is a sequential scanning protocol with an ECG triggering technique for coronary CTA studies. It couldalso be applied for aortic CTA studies. Topogram: AP, 512 mm.From the aortic archto the apex of theheart. If you apply API for a single breathhold acquis...

60 Bolus Tracking The Basics The administration of intravenous (IV) contrast mate-rial during spiral scanning improves the visualizationand characterization of lesions, as well as the opacityof vessels. The contrast scan will yield good resultsonly if the acquisition occurs during the optimal phaseo...

64 Bolus Tracking TestBolus Indications: This mode can be used to test the start delay of optimal enhancement after the contrast mediuminjection. TestBolus kV 120 mAs 30 Slice collimation 5.0 mm Slice width 10 mm Feed/Scan 0 mm Rotation time 0.5 sec. Kernel B40f Cycle time 2 s

65 Bolus Tracking Application Procedures: 1. Select the spiral mode that you want to perform, and then “Append” the TestBolus mode under Specialprotocols. 2. Insert the Test Bolus mode above the spiral mode for contrast scan by “cut/paste” (with right mousebutton). 3. Perform the Topogram, and defin...

68 Interventional CT To facilitate CT interventional procedures, we createddedicated multislice and single slice sequential modes. • Biopsy This is the multislice biopsy mode. E. g. 4 slices, 4.5 mm each, will be reconstructed and displayed foreach scan. • BiopsyCombine This is a single slice biopsy...

69 Interventional CT How to do it Biopsy Indications: This is the multislice biopsy mode. Four slices, 4.5 mm each, will be reconstructed and displayedfor each scan. It can be appended to any other scanprotocol, e. g. ThoraxRoutine for biopsy procedures inthe thorax. Change the mAs setting according...

70 Interventional CT 5. Click “Load” and then “Cancel move”. Press the “Start” button and 4 images will be displayed. 6. Press “Start” again, you’ll get another 4 images with the same slice position. BiopsyCombine Indications: This is the biopsy mode with one com-bined slices. It can be appended to ...

72 WholeBodyAngio This scan protocol can be used for a whole Body Angio. A range of 100 cm can be covered in 14.5 sec. WholeBody 2 nd Reconstr. kV 120 Effective mAs 130 Slice collimation 1.5 mm Slice width 6 mm 2 mm Feed/Rotation 27.0 mm Rotation time 0.5 sec. Kernel B30f B20f Increment 6 mm 1.5 mm ...

74 LungCARE LungCARE kV 120 Effective mAs 20 Slice collimation 0.75 mm Slice width 1.0 mm Feed/Rotation 13.5 mm Rotation time 0.5 sec. Kernel B50f Increment 0.5 mm Image order cr-ca CTDI Vol 1.6 mGy Effective dose Male: 0.6 mSvFemale: 0.7 mSv A dedicated low dose Spiral mode for the syngo LungCARE e...

76 CT Colonography This is a promising application, dedicated to visualizeand evaluate lesions in the colon. This study is not onlynon-invasive, but a much more comfortable methodfor the patient. A typically range of 40 cm can be covered in 11.7 sec. Colonography 2 nd Reconstr. kV 120 Effective mAs ...

78 Children Overview This folder contains 8 organ specific pediatric proto-cols with 2 to 5 age or weight dependant subgroups. For your convenience, the protocols are numberedaccording to the body regions, i. e. from head to abdomen. The scan protocols for Head and Neck regions are defined according...

82 Children Head kernels The VA70 provides three new kernels for head proto-cols: H21, H31, H41. The endings “s” or “f” depend on the rotation time. They are comparable to H20, H30 or H40 with respectto sharpness but they show a different granularity witha finer image noise pattern. In general, the ...

84 Head05s Indications: Spiral mode for routine head studies, e. g. tumors,hydrocephalus, hemorrhaging, abnormalities, etc. Head kV 120 Effective mAs * Slice collimation 1.5 mm Slice width 4.0 mm Feed/Rotation 12.2 mm Rotation time 0.5 sec. Kernel C30f Increment 4.0 mm Image order ca-cr Contrast med...

85 Tips • 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 structure are of interest, use kernel C60s for image reconstruction. • Posterior Fossa Optimization Filter PFO: To reduce beam-hardening artifacts in headi...

88 HeadAngio Indications: Spiral mode for head CT angiography, e. g. cerebralvascular abnormalities, tumors etc. HeadAngio 2 nd Reconstr. kV 80 Effective mAs * Slice collimation 0.75 mm Slice width 2.0 mm 1.0 mm Feed/Rotation 6.8 mm Rotation time 0.5 sec. Kernel H20f H10f Increment 2.0 mm 0.7 mm Ima...

89 Tips • Children, who are more than 12 years old should be scanned with an adult protocol. • The first recon job is defined for soft tissue visuali- zation. Contrast medium IV injectionStart delay 18 – 20 sec. Flow rate dependent upon needle size/Access site Total amount 1 – 2 ml per kg of body we...

90 Children CarotidCTA Indications: CT angiography of the carotid arteries, e. g. carotid stenosis or occlusion, vascular abnormalities of thecarotids or vertebral arteries, etc. CarotidCTA 2 nd Reconstr. kV 80 Effective mAs * Slice collimation 0.75 mm Slice width 5.0 mm 1.0 mm Feed/Rotation 12 mm R...

92 Children NeonateBody Indications: Spiral mode for routine neonate body studies, e. g.tumors, abnormalities, malformations, abscesses, etc. NeonateBody kV 80 Effective mAs 25 Slice collimation 1.5 mm Slice width 6.0 mm Feed/Rotation 24 mm Rotation time 0.5 sec. Kernel B30f Increment 6.0 mm Image o...

94 Children ThoraxRoutine Indications: Spiral mode for routine thorax studies, e. g. pneumonia, tumors, metastases, lymphoma, vascularabnormalities etc. Thorax 2 nd Reconstr. kV 120 Effective mAs * Slice collimation 1.5 mm Slice width 6.0 mm 6.0 mm Feed/Rotation 24.0 mm Rotation time 0.5 sec. Kernel...

96 AbdPelRoutine Indications: Spiral mode for routine studies in the region of abdomen and pelvis, e. g. tumors, lymphoma,abscesses, post-traumatic changes, etc. AbdPelvis 2 nd Reconstr. kV 120 Effective mAs * Slice collimation 1.5 mm Slice width 5.0 mm 5.0 mm Feed/Rotation 24.0 mm Rotation time 0.5...

98 Children AbdCTA Indications: For abdominal CT Angio studies, e. g. vascular abnormalities, aneurysms, etc. AbdCTA 2 nd Reconstr. kV 80 Effective mAs * Slice collimation 0.75 mm Slice width 3.0 mm 1.0 mm Feed/Rotation 12 mm Rotation time 0.5 sec. Kernel B30f B20f Increment 3.0 mm 0.7 mm Image orde...

99 Children Contrast medium IV injectionStart delay exam dependent Flow rate dependent upon needle size/Access site Total amount 1 – 2 ml per kg of body weight Tips • Children with a body weight of more than 54 kg should be examined with an adult protocol. • The first recon job is defined for image ...

100 Head Overview • AngioHead For CT Angio studies using 0.75 mm slice collimationand a 1.0 mm slice thickness • AngioHead100kV This protocol is identical to “AngioHead“, except thatit uses 100 kV tube voltage instead of 120 kV • HeadSeq05s Sequence mode for base of the skull and cerebrumroutine stu...

102 Head AngioHead Indications: Spiral mode for cerebral CT Angios, e. g. cerebralvascular abnormalities, tumors and follow up studiesetc. A range of 80 mm will be covered in 3.3 sec.

105 Head AngioHead 2 nd Reconstr. kV 100 Effective mAs 120 Slice collimation 0.75 mm Slice width 4.0 mm 1.0 mm Feed/Rotation 15.0 mm Rotation time 0.5 sec. Kernel H20f H10f Increment 4.0 mm 0.7 mm Image order ca-cr CTDI Vol 16.9 mGy Effective dose Male: 0.6 mSvFemale: 0.7 mSv Use of CARE Bolus with ...

107 Head ThinSliceSeq RoutineSeq kV 120 120 mAs 250 250 Slice collimation 0.75 mm 1.5 mm Slice width 4.5 mm 9.0 mm Feed/Scan 9.5 mm 19.0 mm Rotation time 0.5 sec. 0.5 sec. Kernel H31f H31f Image order ca-cr ca-cr CTDI Vol 53.0 mGy 45.5 mGy Effective dose Male: 1.9 mSv Male: 1.6 mSv Female: 2.0 mSv F...

109 Head ThinSlice Routine kV 120 120 Effective mAs 320 320 Slice collimation 0.75 mm 1.5 mm Slice width 4.0 mm 8.0 mm Feed/Rotation 6.8 mm 13.7 mm Rotation time 0.5 sec. 0.5 sec. Kernel H31f H31f Increment 4.0 mm 8.0 mm Image order ca-cr ca-cr CTDI Vol 67.5 mGy 60.8 mGy Effective dose Male: 2.4 mSv...

110 Neck Overview • AngioCarotid For CTA spiral studies

112 Neck AngioCarotid Indications: Noninvasive CT angiography of carotid stenosis or occlusions, plaques course abnormalities of the carotids and vertebral arteries, etc. A range of 20 cm including the aortic arch will be covered in 8.9 sec.

113 Neck AngioCarotid 2 nd Reconstr. kV 120 Effective mAs 120 Slice collimation 0.75 mm Slice width 5.0 mm 1.0 mm Feed/Rotation 12.0 mm Rotation time 0.5 sec. Kernel B30f B30f Increment 5.0 mm 0.7 mm Image order ca-cr CTDI Vol 9.4 mGy Effective dose Male: 1.6 mSvFemale: 1.7 mSv CARE Bolus may be use...

116 LungLowDose Indications: Lung spiral studies with low dose setting, e. g. earlyvisualization of pulmonary nodules. A typical thorax study in a range of 30 cm will be covered in 8.9 sec. Thorax

118 Embolism Indications: For Pulmonary Emboli studies. There are two recon jobs predefined. The first one,with 5 mm slice thickness, the second reconstruction,with 1 mm slice thickness and 0.7 mm increment isused for postprocessing. A range of 30 cm will be covered in 10.6 sec. Thorax

122 Thorax ThoraxCombi Indications: Combining thin slice lung and routine thorax studieswith one spiral scan. E. g. thorax studies in general andinterstitial changes in the lungs. There are two recon jobs predefined. The first one,with 5 mm slice thickness, for the mediastinum, the second reconstruc...

123 Thorax ThoraxCombi 2 nd Reconstr. kV 120 Effective mAs 100 Slice collimation 0.75 mm Slice width 5.0 mm 1.0 mm Feed/Rotation 15.0 mm Rotation time 0.5 sec. Kernel B31f B80f Increment 5.0 mm 0.7 mm Image order cr-ca CTDI Vol 7.8 mGy Effective dose Male: 3.0 mSvFemale: 3.9 mSv If you want to recon...

126 Abdomen Overview • AbdRoutine For routine abdominal spiral studies • AngioFast For long-range CTA spiral studies • AngioRoutine For CTA routine spiral studies • AbdomenSeq Sequence mode for routine studies

128 Abdomen Note: In general, for abdominal studies such as liver,gall bladder (query stones), pancreas, gastrointestinalstudies, focal lesion of the kidneys and CTA studies, itis sufficient to use just water. Water is more effectivethan positive oral contrast agent in depicting thelinings of the st...

130 Abdomen AbdRoutine Indications: All routines in the region of abdomen, e. g. screening,follow-up examinations etc. A complete abdomen/pelvis scan, in a range of 40 cmwill be covered in 8.9 sec.

132 AngioFast Indications: Long range CTA studies. E. g.: a typical study of the whole aorta including itsbranchiocephalic trunk and iliac arteries in a range of80 cm will be covered in 11.7 sec. Abdomen

134 AngioRoutine Indications: For abdominal CTA studies. E. g.: a typical study of renal arteries in a range of 40 cm will be covered in 13.9 sec. Abdomen

135 AngioRoutine 2 nd Reconstr. kV 120 Effective mAs 130 Slice collimation 0.75 mm Slice width 5.0 mm 1.0 mm Feed/Rotation 15.0 mm Rotation time 0.5 sec. Kernel B30f B20f Increment 5.0 mm 0.7 mm Image order cr-ca CTDI Vol 10.1 mGy Effective dose Male: 6.0 mSvFemale: 9.1 mSv Do not administer oral co...

136 AbdomenSeq Indications: This protocol is created for measurement with sequential mode in the region of the abdomen. AbdomenSeq kV 120 mAs 140 Slice collimation 5.0 mm Slice width 5.0 mm Feed/Scan 10.0 mm Rotation time 0.5 sec. Kernel B31f CTDI Vol 8.8 mGy Image order cr-ca Abdomen

138 Extremities Overview • AngioRunOff For long range CTA spiral studies

140 AngioRunOff Indications: For CTA studies A range of 100 cm will be done in 21.4 sec. AngioRunOff 2 nd Reconstr. kV 120 Effective mAs 130 Slice collimation 1.5 mm Slice width 6.0 mm 2.0 mm Feed/Rotation 24.0 mm Rotation time 0.5 sec. Kernel B30s B20s Increment 6.0 mm 1.5 mm Image order cr-ca cr-c...