Siemens SOMATOM SENSATION CARDIAC A60 - User Manual

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 ...

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 recon job, simply click the little icon onthe chron...

12 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 mAs (mA x Rot Time) and in addi-tion by ...

13 General Dose Information The dose as described by CTDI w is displayed on the user interface for the selected scan parameters. TheCTDI w is measured in the dedicated plastic phantoms – 16 cm diameter for head and 32 cm diameter for body (as defined in IEC 60601-2-44). This dose numbergives a good ...

16 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....

18 General Workflow 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 ...

19 General Some of the Scan protocols, mainly for Angio exami-nations, are already delivered with Auto load in 3D. If you do not like, please deselect the Auto load in 3Dand save your scan protocol. Some of the Scan protocols are delivered with links to a postprocessing protocol. If you do not like ...

22 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 back from the body circulation through the superiorand...

25 HeartView CT Cardiac Cycle and ECG The heart contracts when pumping blood and restswhen receiving blood. This activity and lack of activityform a cardiac cycle, which can be illustrated by anElectrocardiograph (ECG) (Fig. 8). To minimize motion artifacts in cardiac images, thefollowing two requir...

26 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...

27 HeartView CT Absolute – delay: a fixed time delay after the onset ofthe R-wave (Fig. 11). Absolute – reverse: a fixed time delay prior to the onsetof the next R-wave (Fig. 12). Preview Series Reconstruction Preview series can be used to define the optimal timewindow before the full series is reco...

28 HeartView CT ECG Trace Editor The ECG trace editor is used for adaptation of imagereconstruction to irregular heart rates. This editingtool can be used after the scan is acquired. By using the right mouse menu on the Trigger card you can useseveral modification tools for the ECG Sync, such asDele...

29 HeartView CT Fig. 14 CardioCARE This is a dedicated cardiac filter which can reduceimage noise thus provides the possibility of dose reduc-tion. It is applied in a pre-defined scan protocol called“CoronaryCARE.” CardioSharp This is a dedicated reconstruction kernel used for better edge definition...

30 HeartView CT How to do it Calcium Scoring This application is used for identification and quanti-fication of calcified lesions in the coronary arteries. Itcan be performed with both ECG triggering (sequen-tial scanning) and gating (spiral scanning) techniques.The following scan protocols are pred...

32 HeartView CT CaScoreSpiStd Indications: This is a standard spiral scanning protocol, using an ECG gating technique for coronary calcium scoringstudies, with a rotation time of 0.42 seconds. Topogram: AP, 512 mm.From the carina untilthe apex of the heart.A typical range of 15 cm covering theentire...

34 HeartView CT CaScoreSeqStd Indications: This is a sequential scanning protocol using an ECGtriggering technique for coronary calcium scoring studies. Topogram: AP, 512 mm.From the carina untilthe apex of the heart. CaScoreSeqStd kV 120 Effective mAs 30 Slice collimation 1.5 mm Slice width 3 mm Fe...

37 HeartView CT CoronaryStd Indications: This is a standard spiral scanning protocol, using aRotation Time of 0.42 s, with an ECG gating techniquefor coronary CTA studies. Topogram: AP, 512 mm.Approximately, fromthe carina until theapex of the heart. A typical range of 12 cm covering theentire heart...

39 HeartView CT CorStd_LowHeartRate Indications: This is a special spiral scanning protocol for coronaryCTA studies. It uses ECG gating technique and a 0.42 srotation time, and should be used for patients withheart rate below 50 bpm. Topogram:AP, 512 mm.Approximately, fromthe carina until theapex of...

40 HeartView CT CoronaryCARE Indications: This is a spiral scanning protocol, using a rotation time of 0.42 s, ECG gating technique and a dedicatedcardiac filter which can reduce images noise thusmakes the dose reduction possible for coronary CTAstudies. Topogram: AP, 512 mm.Approximately, fromthe c...

42 HeartView CT CoronarySharp Indications: This is a spiral scanning protocol, using a RotationTime of 0.42 s, ECG gating technique and a dedicatedcardiac reconstruction kernel for better edge defi-nition in coronary artery imaging. Topogram: AP, 512 mm.Approximately, fromthe carina until theapex of...

46 HeartView CT ECGTrigCTA Indications: This is a sequential scanning protocol with an ECG triggering technique for coronary CTA studies. It couldalso be applied for aortic CTA studies, e. g. aortic dissection. Topogram: AP, 512 mm.From the aortic archuntil the apex of theheart. If you apply API for...

48 HeartView CT Aortic and Pulmonary Studies The following scan protocol is predefined:• PulmonaryECG – Spiral scanning protocol with ECG gating General Hints: • The PulmonaryECG protocol is recommended for aortic or pulmonary studies, e. g. aorta dissection orpulmonary emboli.

49 HeartView CT PulmonaryECG Indications: This is a spiral scanning protocol with an ECG gatingtechnique for aortic and pulmonary studies, e. g. aorticdissection or pulmonary emboli. PulmonaryECG kV 120 Effective mAs 200 Slice collimation 1.5 mm Slice width 3.0 mm Feed/Rotation 5.6 mm Rotation time ...

54 Bolus Tracking The Basics The administration of intravenous (IV) contrast material during spiral scanning improves the detectionand characterization of lesions, as well as the opacityof vessels. The contrast scan will yield good resultsonly if the acquisition occurs during the optimal phaseof enh...

58 Bolus Tracking TestBolus Indications: This mode can be used to test the start delay of anoptimal enhancement after the contrast mediuminjection. TestBolus kV 120 Effective 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

59 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...

62 WholeBodyAngio This scan protocol can be used for a whole Body Angio. A range of 100 cm can be covered in 21.4 s. WholeBodyAngio 2 nd Reconstr. kV 120 Effective mAs 130 Slice collimation 1.5 mm Slice width 6 mm 2 mm Feed/Rotation 24.0 mm Rotation time 0.5 sec. Kernel B30f B20f Increment 6 mm 1.5 ...

64 LungCare LungCare kV 120 Effective mAs 20 Slice collimation 0.75 mm Slice width 1.0 mm Feed/Rotation 18.0 mm Rotation time 0.5 sec. Kernel B50f Increment 0.5 mm Image order cr-ca CTDI w 1.7 mGy Effective dose Male: 0.6 mSvFemale: 0.7 mSv A dedicated low dose Spiral mode for the syngo LungCARE eva...

66 CT Colonography For Colonography studies. A typically range of 40 cm can be covered in 13.9 s. CT Colonography 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 B30f B30f Increment 5.0 mm 0.7 mm Image or...

68 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...

69 Children Hints in General 1. Topograms: 256 mm lateral topograms are definedfor the head modes, and 512 mm AP topograms aredefined for the body modes. Please keep in mind thatthe children’s size can be dramatically different. Youshould press the “Hold Measurement“ button when-ever the range shown...

73 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 is of interest, use kernel C60s for image reconstruction. • Posterior Fossa Optimization Filter PFO: To reduce beam-hardening artifacts in headim...

76 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...

77 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...

78 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...

80 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...

82 Children ChestRoutine Indications: Spiral mode for routine thorax studies, e. g. pneumonia, tumors, metastases, lymphoma, vascularabnormalities etc. ChestRoutine 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. K...

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

86 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...

87 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 ...

88 Head Overview • AngioHead For CT Angio studies using 0.75 mm slice collimationand a 1.0 mm slice thickness • AngioThinSlice For CT Angio studies using 0.75 mm slice collimationand 0.75 mm slice thickness • HeadSeq0.5s Sequence mode for base of the skull and cerebrumroutine studies and a 0.5 s rot...

90 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 s.

92 Head AngioThinSlice Indications: For cerebral CT Angio studies, with one reconstructionjob for a 0.75mm slice thickness. E. g. cerebral vascular abnormalities, tumor, and followup studies etc. A range of 80 mm will be covered in 6.5 s.

93 Head AngioThinSlice 2 nd Reconstr. kV 120 Effective mAs 130 Slice collimation 0.75 mm Slice width 4.0 mm 0.75 mm Feed/Rotation 6.8 mm Rotation time 0.5 sec. Kernel H20f H10f Increment 4.0 mm 0.5 mm Image order ca-cr CTDI w 27.4 mGy Effective dose Male: 0.6 mSvFemale: 0.7 mSv Use of CARE Bolus wit...

95 Head ThinSliceSeq RoutineSeq kV 120 120 Effective mAs 250 250 Slice collimation 0.75 mm 1.5 mm Slice width 4.5 mm 9.0 mm Feed/Scan 9.0 mm 18.0 mm Rotation time 0.5 sec. 0.5 sec. Kernel H31f H31f Image order ca-cr ca-cr CTDI w 58.2 mGy 60.3 mGy Effective dose Male: 0.7 mSv Male: 1.6 mSv Female: 0....

97 Head ThinSliceSpi RoutineSpi 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 w 50.6 mGy 45.6 mGy Effective dose Male: 0.7 ...

100 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 s.

101 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 cr-ca CTDI w 9.4 mGy Effective dose Male: 1.6 mSvFemale: 1.7 mSv CARE Bolus may be used ...

102 Thorax Overview • LungLowDose Spiral mode with very low dose for special lung studies, e. g. early visualization of pulmonary nodules • PulmonaryEmboli Spiral mode for Pulmonary Emboli studies • ThoraxCombi For the combination of thin slice lung and routinethorax studies • ThoraxRoutine For rout...

104 LungLowDose Indications: Lung studies with low dose setting, e. g. early visuali-zation of pulmonary nodules. A typical thorax study in a range of 30 cm will be covered in 8.9 s. Thorax

106 PulmonaryEmboli 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. A range of 30 cm will be covered in 10.6 s. Thorax

107 PulmonaryEmboli 2 nd Reconstr. kV 120 Effective mAs 100 Slice collimation 0.75 mmSlice width 5.0 mm 1.0 mm Feed/Rotation 15.0 mm Rotation time 0.5 sec. Kernel B30f B80f Increment 5.0 mm 0.7 mm Image order cr-ca CTDI w 7.8 mGy Effective dose Male: 3.0 mSvFemale: 3.9 mSv * CARE Bolus may be used t...

108 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...

110 Thorax ThoraxRoutine Indications: Routine studies for the region of thorax, e. g. screeningof tumors, metastases, lymphoma, lymphonodes,vascular anomalies etc. A range of 30 cm will be covered in 5.6 s.

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

114 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...

116 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 s, and a typical liver scan in a rangeof 20 cm will be covered in 4.5 s.

118 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 19.6 s. Abdomen

120 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 s. Abdomen

121 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 w 10.1 mGy Effective dose Male: 5.8 mSvFemale: 7.5 mSv Do not administer oral cont...

122 AbdomenSeq Indications: Sequential mode for addomen studies. AbdomenSeq kV 120 Effective mAs 140 Slice collimation 5.0 mm Slice width 5.0 mm Feed/Scan 10.0 mm Rotation time 0.5 sec. Kernel B31f Image order cr-ca Abdomen

124 Extremities Overview • AngioRunOff For long range CTA studies

126 AngioRunOff Indications: For CTA studies A range of 100 cm will be done in 21.4 s. 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-ca ...