Operation Instructions

for Signa ® Ovation® with EXCITE Technology

Rev. 1 (April 2004)

Rev. 1 (04/2004)

Copyright 2004 General Electric Company. All rights reserved.

Medical Device Directive
These products conform with the requirements of council directive 93/42/EEC
concerning medical devices, when they bear the following CE Mark of Conformity:

European Representative:
GE Medical Systems S.C.S
Quality Assurance Manager
283 rue de la Minière
78530 BUC France
Telephone: +33 1 30 70 40 40
This equipment generates, uses, and can radiate radio frequency energy. The
equipment may cause radio frequency interference with other medical and non-medical
devices and radio communications. To provide reasonable protection against such
interference, the:
GE Signa® Ovation with EXCITE™ Technology
comply with emissions limits for (Group 2, Class A) Medical Devices as stated in EN
60601-1-2. However, there is no guarantee that interference will not occur in a
particular installation.

If this equipment is found to cause interference (which may be determined by turning

the equipment on and off), the user (or qualified service personnel) should attempt to
correct the problem by one or more of the following measures:
• reorient or relocate the affected devices;
• increase the separation between the equipment and the affected device;
• power the equipment from a source different from that of the affected device; and/or
• consult the point of purchase or service representative for further suggestions.
The manufacturer is not responsible for any interference caused by using interconnect
cables that are not recommended or by unauthorized changes or modifications to this
equipment. Unauthorized changes or modifications could void the user’s authority to
operate the equipment.

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© 2003 General Electric Company. All rights reserved.
Do not use devices that transmit RF Signals (cellular phones, transceivers, or radio
controlled products) in the vicinity of this equipment as they may cause performance
outside the published specifications. Keep the power to these types of devices turned
off when near this equipment.
The medical staff in charge of this equipment is required to instruct technicians,
patients, and other people who may be around this equipment to fully comply with the
above requirement.
Immunity/Emissions Exceptions: Note the exceptions from the EMC test results. Check
with the business EMC engineer for this information.
In accordance with the international safety standard IEC 601-1, this system is a Class I
device, acceptable for Continous Operation, having ordinary protection against ingress
of water with type B applied parts and is not for use in the presence of flammable
anesthetics.

CAUTION: CAUTION: User to call or contact the local authorities for disposal of
the MR System and its components at the end of its useful life.

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© 2003 General Electric Company. All rights reserved.
 About This Guide

Chapter 1
About This Guide

Introduction
This chapter explains the purpose and design of this Learning and Reference Guide. It
is an introduction to the guide, providing information on the purpose, prerequisite skills,
guide organization, chapter format, and graphic conventions that identify the visual
symbols used throughout the guide.

Purpose of This Guide

This guide is written for health care professionals (namely, the MR technologist) to
provide the necessary information relating to the proper operation of this system. The
guide is intended to teach you the system components and features necessary to use it
to its maximum potential. It is not intended to teach magnetic resonance imaging or to
make any type of clinical diagnosis.

Prerequisite Skills
This guide is not intended to teach magnetic resonance imaging. It is necessary for you
to have sufficient knowledge to competently perform the various diagnostic imaging
procedures within your modality. This knowledge is gained through a variety of
educational methods including clinical working experience, hospital based programs,
and as part of many college and university Radiologic Technology programs.

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© 2004 General Electric Company. All rights reserved.
 About This Guide

Chapter Format
Each chapter contains a consistent format. This consistency provides uniformity for
content delivery and a better learning environment for you. Listed below are the
components for each chapter.

Introduction
The Introduction provides a short introduction to the chapter and a list of tasks to be
presented.

What Do I Need to Know About...

The What Do I Need to Know About... section lists and explains concepts necessary
to perform the tasks within the chapter.

How Do I...
The How Do I... section provides the detailed steps necessary to complete a given task.
These detailed steps not only provide the steps to complete a task, but also provide
additional information, as needed, related to a step.
Each task also includes a Quick Steps table. This Quick Steps table is intended to be
used as a quick reference by the experienced technologist and provides only the steps
necessary to complete a task. Be sure to read the detailed steps before using this table.

Decision Matrix
The How Do I... section in the Clinical Pulse Sequence volume provides examples, in
the form of a decision matrix, of the pulse sequences for a particular application.
The decision matrix is used to provide examples of what values could be selected for
prescribing a particular sequence. The purpose of the decision matrix is to help you
understand the trade-offs that occur when you change the values for a particular
parameter and to provide a framework with which you may build your own unique
protocol.
NOTE: The example protocols provide information on what could be used for the pulse
sequences and are not to be considered recommendations by GE Medical
Systems. For specific protocols, refer to the protocols on your system.

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© 2004 General Electric Company. All rights reserved.
 About This Guide

Mouse Controls
The mouse (Figure 1-1) is a hand-operated device that you maneuver across the
surface of a pad. As you do, the on-screen cursor mimics the movement of the mouse,
allowing you to move among windows and menus. For instance, moving the mouse to
the right causes the on-screen cursor to move to the right. The mouse is used to make
selections by clicking the left, right, and middle buttons. Table 1-1 describes the
terminology used for the various mouse functions.
Figure 1-1 The Mouse

Table 1-1 Conventions for Mouse Actions

Mouse Action Description

Clicking the left mouse button to select a button or

Click icon. The button can be pressed in, not pressed in, or
popped in/out.

Right-click Clicking the right mouse button.

Middle-click Clicking the middle mouse button.

Clicking and holding the left mouse button down while

Click and drag
dragging the cursor to the desired location.

Clicking and holding the right mouse button down

Right-click and drag
while dragging the cursor to the desired location.

Clicking and holding the middle mouse button down

Middle-click and drag
while dragging the cursor to the desired location.

Clicking the left mouse button twice in rapid

Double-click
succession.

Clicking the left mouse button three times in rapid

Triple-click
succession.

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 About This Guide

Graphic Conventions and Legends

This guide uses special conventions for graphics and legends to make it easier for you
to work with the information. Table 1-2 describes the conventions used when working
with menus, buttons, text boxes and keyboard keys.
Table 1-2 Conventions for Menus, Buttons, Text Boxes, and Keyboard Keys

Example Describes

Selecting an option in a check box or radial button and

Select
selecting a tab.

Press Enter Pressing a hard key on the keyboard.

Press and hold Shift Pressing and holding down a hard key on the keyboard.

Pressing multiple hard keys on the keyboard

Press Ctrl + Enter
simultaneously.

Click [Viewer] A button label or Interface button name.

Click Selecting an icon-based button.

(Exam prior)

The name of text box in which you can select or type

In the Matrix text box,...
text.

Type supine in the

Patient Position text
Text you enter into a text box.
box (different font and
bold)

Select Sort > Sort by

The pathway of selecting option(s) in a pull-down menu.
date

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 About This Guide

Safety Notices
The following safety notices are used to emphasize certain safety instructions. This
guide uses the international symbol along with the danger, warning, or caution
message. This section also describes the purpose of an Important notice and a Note.

DANGER: Danger is used to identify conditions or actions for which a specific

hazard is known to exist which will cause severe personal injury, death,
or substantial property damage if the instructions are ignored.

WARNING:Warning is used to identify conditions or actions for which a specific

hazard is known to exist which may cause severe personal injury, death,
or substantial property damage if the instructions are ignored.

CAUTION: Caution is used to identify conditions or actions for which a potential

hazard may exist which will or can cause minor personal injury or
property damage if the instructions are ignored.

CAUTION: Coil Caution is used to identify conditions or actions for which a

potential hazard of crossing or looping coil cables may exist which will
or can cause minor personal injury or property damage if the
instructions are ignored.
IMPORTANT!:Important indicates information where adherence to procedures is crucial
or where your comprehension is necessary to apply a concept or
effectively use the product.
NOTE: A Note provides additional information that is helpful to you. It may emphasize
certain information regarding special tools or techniques, items to check before
proceeding, or factors to consider about a concept or task.

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 About This Guide

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© 2004 General Electric Company. All rights reserved.
 Getting Started

Chapter 2
Getting Started

Introduction
This chapter helps you to start using your system. It explains the system and
workstation components and describes some basic problem resolutions. It also contains
key concepts and the step-by-step instructions to help you learn how to:
• Power on the MR System
• Login and Logout of the System
• Configure Users for the System
• Load an MOD
• Navigate Through Screens and Menus
• Obtain Remote Assistance
• Reset the TPS
• Save Raw Data
• Restart the System
• Shut Down the MR System

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© 2004 General Electric Company. All rights reserved.
 Getting Started

What Do I Need to Know About...

This section presents the concepts necessary to successfully get started using your
Signa® system. Specifically, you need to understand:
• Magnetic Resonance Suite
• Magnet Room, Bore, and Enclosure
– Physiologic Acquisition Controller
– Patient Call Button
– Status Display Panel
– Control Panel Buttons
– Patient Table
• Console Room with Workstation
– Keyboard
– Mouse
– Intercom
– Computer
• System Cabinet Room
• Basic Desktop Functions
– Desktop Overview
– Desktop Control Panel
– Menu Types
• HIPAA
• Remote Training
– Features
– Security

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© 2004 General Electric Company. All rights reserved.
 Getting Started

Magnetic Resonance Suite

This section identifies and describes the primary areas of the magnetic resonance (MR)
suite (Figure 2-1). The MR suite typically consist of the following:
• Magnet room
• Console room
• System cabinet room (or computer room)
Figure 2-1 MR Suite
Computer Room

Magnet Room

Console Room

Magnet Room, Bore, and Enclosure

The MR magnet room houses the magnet, magnet enclosure, and the table. All of the
equipment in the room should be equipment that is not harmed by the intense magnetic
field. No other equipment or ferrous materials are allowed in the magnet room. For
example, you should not take a metal mop bucket into the magnet room.
The magnet and magnet enclosure consist of the unit used to create the magnetic field,
buttons and displays found on the magnet enclosure, and critical components such as
the gradient coils and radio frequency (RF) coils necessary for image production.
The magnet is the heart of the system. It is a permanet magnet that generates the static
magnetic field required for polarization of the body’s nuclei. During imaging, gradient
coils produce the gradient magnetic fields and RF coils produce the RF field.
The magnet bore is the area the patient is moved for scanning. Optional patient comfort
features include bore lighting and a fan to circulate air through the bore.
The magnet enclosure houses the controls used to position the patient, squeeze bulb or
patient end of the patient alert device, and the Physiologic Acquisition Controller (PAC).

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 Getting Started

Physiologic Acquisition Controller

The PAC (Figure 2-2) is a device that collects triggering information from a bellows,
electrocardiogram (ECG), or photopulse sensor and sends it into the system to trigger
the acquisition. The PAC has LEDs to display the ECG, peripheral, and respiratory
signals.
The PAC can be located on either side of the magnet. A cable routing device attached
to the PAC unit is designed to keep the cables separated.
Figure 2-2 PAC Unit

• Respiratory: The port for the respiratory compensation bellows.

• ECG: A six pin connection for a high impedance ECG leads.
• Peripheral Gating: A two port fiber optic connection for the peripheral gating lead.
• Patient Call: A patient activated system that allows a patient to signal for assistance
during a scan.

Patient Call Button

The patient end of the patient alert system (Figure 2-3) is located on the magnet. It
plugs into the PAC unit. The patient alert system consists of a hand switch with a call
button. When squeezed, an audible tone sounds in the control room. This sound pattern
can be changed to either pulsed or steady. A toggle switch on the control box selects
the sound pattern. The control box is typically located on the operator workstation desk,
or mounted on the wall close to the desk.
Figure 2-3 Patient Alert System

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 Getting Started

NOTE: Be careful not to pinch the cable that connects the squeeze ball to the PAC unit,
in the table. This could sound the patient alarm continuously and cause table
cradle obstruction. Have your service personnel check cable if you feel there
might be a tear in the cable. If a tear has occurred, the patient alarm may not
function properly.

Status Display Panel

The status display panel (Figure 2-4) is located centrally on the magnet cover. It
provides two Emergency Stop buttons and displays for the scan time and table position,
as well as for the respiratory, peripheral pulse, and cardiac light-emitting diode (LED)
displays.
Figure 2-4 Status Display Panel

Table 2-1 provides a description of the Status Display Panel indicators.

Table 2-1 Status Display Panel Indicators

Button or Display Description

Disables the power to the patient handling and scan related
Emergency Stop
equipment.
Bar graph LED that views and indicates signal return and
Respiratory
strength for the respiratory compensation bellows. At least half
Display
of the bar should be illuminated for indication of a good signal.
Time Display Displays the scan time countdown.
Patient Position Displays the distance of the table from isocenter after
Display landmarking.
Bar graph LED that indicates signal return and strength for the
ECG/Peripheral peripheral gating lead. At least half of the bar should be
Gating Display illuminated for indication of a good signal. The ECG symbol
blinks when the ECG leads are connected.

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 Getting Started

Control Panel Buttons

The button controls (Figure 2-5) used to position the patient are located symmetrically
on each side of the magnet enclosure. They control the magnet bore environment, table
movement, alignment lights, and scan processes.
Figure 2-5 Control Panel

Table 2-2 describes the Control Panel buttons.

Table 2-2 Control Panel Buttons

Button Description
Turns all of the alignment lights on or off. Alignment lights turn off
automatically when the Move to Scan button is pressed. When the
Align
alignment lights are on, this button is lit and the landmark on message
Light
is posted on the status panel. The alignment light cannot be used during
scans or emergency stops.
Provides quick cradle movement by advancing the transport at 4 inches
In Fast per second. This button can override any other cradle command, such
as Move to Scan, but it cannot be used during emergency stops.
Provides slow cradle movement by advancing the transport a 0.5
In Slow inches per second. This button cannot be used during emergency
stops.
Provides slow cradle movement by retracting the transport at 0.5 inches
Out Slow
per second. This button cannot be used during emergency stops.

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 Getting Started

Button Description (Continued)

Provides quick cradle movement by retracting the transport at 4 inches
Out Fast per second. This button can override any other cradle command, such
as Move to Scan, but cannot be used during emergency stops.
Enters the landmark being defined with the laser alignment lights. It
Landmark
does not function during active or paused scans or emergency stops.
Move to Advances the defined landmark to magnet isocenter. This functions
Scan before or after a scan, as long as the transport is at maximum height.
Halts the in-and-out cradle movement. Also located on the operator’s
Stop Move console, this button overrides any other cradle motion command, such
as Move to Scan.
Back to Returns the table back to last landmarked position. This button cannot
Landmark be used during scans or emergency stops.
Restarts a study if the Pause Scan button has been pressed, or the
Start
scan room door opens during a scan.
Temporarily halts scanning. Image quality can be affected during a scan
Pause
pause if the patient moves or breathes differently when the scan is
Scan
resumed.
Aborts a scan during either prescan, an active scan, or after the Pause
Abort Scan button is pressed. Once selected, the scan cannot be restarted
Scan using the Start Scan hard key. The [Scan] button has to be clicked
from the Scan Rx Desktop, which starts the scan from the beginning.
Returns the table to the home position, fully retracted on the patient
Home
transport.
Controls the circulation of air within the magnet bore to help reduce the
Fan claustrophobia some patients experience. It should remain on at all
times.
Controls the light within the magnet opening to help reduce the
claustrophobia some patients experience. It may remain on at all times.
A timer automatically turns off the light after one hour if the scan table is
Light
undocked or lowered, or if the cradle is in the home position. The light
automatically turns on again when the table is re-docked and the cradle
leaves the home position or when the cradle is raised.

Patient Table
The patient table is permanently fixed to the magnet system. It can be lowered or raised
and has lateral swing movement for easy off-center FOV patient positioning. The cradle
swing motion is 25° left or right, horizontally from the mid-line position. The patient table
supports 500 pounds (225kg).

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 Getting Started

CAUTION: Never exceed the rated load of patient handling devices.

The patient table (Figure 2-6) connects to the base of the MR unit. It has up and down
pedals, located on both sides of the magnet. This allows for easy table up and down
movement.
Figure 2-6 Patient Table

Lateral
Movement
Crank

Mouse House
for coil plug-in

Up/Down
Pedals

The Cradle Release Handle can be used when it is imperative to remove the cradle
and patient from the magnet as quickly as possible. Removal of a patient in this fashion
can be much quicker than Out Fast buttons on the magnet enclosure. Grasp the handle
and roll the cradle release handle forward and pull.
Š Use after pressing Emergency Stop.
Š Use in the event of power outage to the magnet room.
Š Using the cradle release handle for moving the cradle from the bore disconnects
the cradle from the drive.

CAUTION: The Cradle release does not disconnect the coil from the coil port.
Therefore be sure to disconnect any coils prior to using the cradle
release.

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 Getting Started

Figure 2-7 Cradle Release

Cradle Release
Handle
Unlock

Lock

There are brakes located at the end of the patient table. These hold the table in the
swing position. Use the Lock foot brake to secure the table from movement. Use the
Unlock brake to release the brake lock and allow table movement.
The Signa Ovation has an adjustable swing table. The table swings in 25 degree
increments. In order to operate the table swing movement, the table should be cranked
to 12 cm from center in the direction you would like it to swing. It is important the table is
not off center +/- 12 cm. This offset is required so that the table does not hit the magnet
post. The following table defines typical swing and lateral table position for several
anatomical areas.
Table 2-3 Swing and Lateral Table Positions

Anatomy Table Position Lateral Offset/Comments

Shoulder, Brachial Plexus, 9 cm away from isocenter. Toward
±25°
Humerus, Elbow, Wrist isocenter for feet first imaging.
±25° 9 cm away from isocenter. Toward
Large Patient Knee
isocenter for feet first imaging.
Abdomen for patient
±25° 9 cm away from isocenter.
access
Head, CTL Spine, Pelvis, 0 mm left or right of isocenter. Adjust
0°
Peripheral Vascular Runoff with Explicit or Graphic Rx.

Table Hazard Warnings

There are seven different types of table hazard warnings that you should be aware of.
• Collision: the system senses a possible table/post collision. If this warning (Figure
2-8) appears, readjust lateral table location until warning disappears.

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 Getting Started

Figure 2-8 Collision Warning

• Pinch: the pinch sensors, attached to the posts of the magnet, come in contact with
either the patient or table. If this warning (Figure 2-9) appears, adjust either the
table or patient away from the posts of the magnet.
Figure 2-9 Pinch Warning

• Collision and Pinch: the system senses both a collision and a pinch hazard. If this
warning (Figure 2-10) appears make sure that neither the patient or the table is in
contact with the post.
Figure 2-10 Collision and Pinch

• Table Not at Approved Pivot Angle: the table is in a swing position other than
-25°, 0°, or +25°. If this warning appears, reposition the table to an approved angle.
• Collision and Table Not at Approved Pivot Angle: the system senses a possible
table/post collision and the table is in a swing position other than -25°, 0°, or +25°. If
this warning (Figure 2-11) appears, reposition the table to an approved angle and
adjust the lateral movement until the warning clears.
Figure 2-11 Collision and Table Pivot Angle Warning

• Pinch and Table Not at Approved Pivot Angle: the system senses contact with
either post (by patient or table) and that the table is in a swing position other than
-25°, 0°, or +25° positions. If this warning (Figure 2-12) appears, reposition the table

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© 2004 General Electric Company. All rights reserved.
 Getting Started

to an approved angle and adjust either the patient or table away from the post until
the warning clears.
Figure 2-12 Pinch and Pivot Angle Warning

• Collision, Pinch and Table Not at Approved Angle: the system senses a possible
collision, contact with the posts and that the table is in a swing position other than
the -25°, 0°, or +25° positions. If this warning (Figure 2-13) appears, reposition the
table to an approved angle and move both the table and patient away from the posts
until the warning clears.
Figure 2-13 Collision, Pinch, and Pivot Angle Warning

CAUTION: When loading the table the table, should be at isocenter, at pivot
location, and locked.
NOTE: Someone must assist patient on and off the table. The table must be at the proper
height.

CAUTION: Do not let anything (surface coil cables, pads, extremities, etc.) press
against the collision sensors located on the front edge, and on inside
posts of the magnet. If the system detects something pressing against
the sensors, cradle movement will stop. If this happens, clear the
obstruction and then select one of the table movement buttons
(advance to scan, table in, etc.) to continue cradle movement.

Console Room with Workstation

The console room, also called the control room, is the room designed from which the
technologist scans from and monitors the patient. It holds all of the necessary system
components designed to accomplish scanning. Your Signa Ovation has several
components in this room.

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 Getting Started

Figure 2-14 displays the workstation and components and Table 2-4 lists the system
components in the Console room.
Figure 2-14 Console Room System Components

Table 2-4 Console Room System Components

No. Component Function

Workstation Monitor that displays images and scan display, archive & network
1 program information. All routine operations are carried out from
Monitor this workstation monitor.
Keyboard Allows for communication to the workstation monitor and PC
2
and Mouse monitor.
Displays the computer based training (CBT) programs, on-line
documentation, cardiac and/or respiratory waveforms.
3 PC Monitor Communicate with this monitor through the keyboard and/or
mouse. Switch between monitors by moving the mouse across
one monitor to the other monitor.
MOD
4 Archives and loads images from the Signa system.
(optional)
Patient Alert Allows you to turn off the patient alarm when the patient has
Reset Device pressed the Patient Call Button.
Houses the computer that controls your MR system operations
Operator
and PC. The computer includes an MOD drive, CD/DVD drive,
Console Cabinet
and floppy disk drive.

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 Getting Started

Keyboard
The keyboard has several special function keys and alphanumeric keys for entering text
in text boxes. This is useful for annotating scan images and entering basic information
such as filenames and network commands.
The keyboard (Figure 2-15) also contains hard keys to activate a move table function;
scan or stop table movement; start, pause, or stop a scan; an emergency stop; and
intercom with volume controls.
Figure 2-15 Keyboard Buttons

6 7 8
3
1
4 4
2
9 10
5

12

13

Standard keyboard functions include:

• Delete or Backspace erases characters.
• Enter confirms what is typed or selected.
• Tab moves across the areas on the current screen.
• Up or Down arrow keys move between text boxes or adjust window width and
window level values.

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 Getting Started

Table 2-5 describes the keyboard functions.

Table 2-5 Keyboard Button Functions

No. Button or Key Function

Press to disable all electrical power sources near the patient. It
Emergency shuts down the RF, gradient amplifier, table movement, shim
1
Stop power supply, and main MRI magnet power supply cabinets. It
will not quench the magnet nor turn off the computer.
Operator Microphone for you to talk to patient inside bore. Used in
2
Microphone conjunction with the Press to talk feature.
Patient
3 Speaker for you to hear patient talking inside the bore.
Speaker
These controls regulate the volume for the patient
Microphone communication system. Left control adjusts the MR
4
Volume Adjust microphone volume. The right control adjusts the patient
microphone volume.
Press to activate the intercom system so the MR operator can
5 Press to talk speak to the patient inside the bore. Release Talk button to
listen to the patient.
Press to resume scanning after you have paused a scan or
6 Start Scan
during scans for breath-held techniques.
7 Pause Scan Press to stop the scan temporarily.
Press to abort a scan during prescan, an active scan, or after
8 Stop Scan
pressing Pause scan. No data will be reconstructed.
Press to move the cradle to scan position. Release Move to
9 Move to Scan Scan to stop the cradle. The system often posts a message in
the system status display to prompt the user to press it.
10 Stop Move Press to stop the cradle if it is moving.
Press these keys for short cuts in certain filming and preset
11 Function Keys
window width and level procedures.
Use the keyboard for entering text in text boxes, for annotating
Alphanumeric
12 images, and entering basic information such as filenames and
Keyboard
network commands.

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 Getting Started

Mouse
The mouse (Figure 2-16) is the primary tool for interacting with the workstation. It allows
selections to be made from the desktop, window width and level adjustments, and
image scrolling and magnification. The mouse is a hand-held device that moves across
the surface of a mouse pad. The mouse should always be operated on its mouse pad.
Moving the mouse to the right causes the pointer on the screen to move to the right,
and so on. If you have never used a mouse before, it does requires practice —
especially double-clicking.
Figure 2-16 Mouse

The mouse has four main functions:

• Moving the pointer to position the cursor in a text box.
• Clicking an area of the screen by pointing to it and pressing the mouse button
(usually the left). This single-click function highlights an option, positions a cursor in
a text box, and toggles a toggle button on or off.
• Double-clicking an option or function by pointing to it on the screen and then clicking
the mouse button twice in rapid succession. In this example, a single click
highlights, and the second (double) click finalizes or selects the highlighted option.
• Clicking and dragging; which means to click and hold a button while moving the
mouse across the pad (and the cursor across the screen).
There are two ways to configure the mouse for left handed operation on the system.
One is permanent and the other lasts only until the system is rebooted and then reverts
back to the default configuration.
To make it permanent, contact your service engineer.
The mouse can be changed temporarily by opening a command window on the Scan
Rx Desktop and typing mouse. A window appears that allows you to change the mouse
mapping to left-handed. This setting lasts until you change it back or the system is
logged out of Signa scanning software.

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 Getting Started

Intercom
The intercom provides communication between you and your patient. The components
of the intercom are the Talk button, microphone, volume controls, and the speaker.

Computer
The computer (Figure 2-17) interfaces the functions selected at the workstation to all
the systems. The hard disk, also called the system disk, and a CD drive reside here.
Figure 2-17 Computer

The hard disk holds the operating software, which is a collection of computer programs
that initiates scans, presents messages, displays images, and archives data. This
software also self-tests to detect computer problems. The hard disk also holds the
reconstructed image data. This image data remains on the hard disk until it has been
removed via the remove function on either the Image Management or Display desktops.
Note that raw data, the information the system collects from the patient which is then
reconstructed into image data, is not automatically stored on the hard disk.

Software
The computer programs receive, send, and translate information for your system to
function.
Operating software is the collection of programs on the computer’s hard disk that
initiates scans, presents messages, aids in image display and archiving. These
programs give you and your service engineers an interface with the system through the
screen.
Applications software contains programs for pulse sequences, imaging options, etc.
When you make a selection on the screen, it is this software that activates the selection.
It is also used for system tests and diagnostics by your service engineer.

CAUTION: Do not load non-system software onto the system computer.

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 Getting Started

System Cabinet Room

The System Cabinet room houses the Power Distribution Unit (PDU), RF Power
Amplifier (PA), Gradient Amplifiers, and system control cabinets.
NOTE: The System Cabinet room is often referred to as the Computer room because it
used to house the computer; however, the computer is now in the console room.
This room is usually kept at very cool temperature, in order to keep the equipment from
overheating. If you have any questions about the temperature settings, or the
equipment kept in this room, please consult your service engineer.

System cabinets and computer room equipment include:

• Penetration Panel: the penetration panel (Figure 2-18) provides a means for
cables to penetrate the RF shield as the cables enter the magnet room. Without the
penetration panel, stray RF could enter the room at the point where the computer
and other system cables enter the room.
Figure 2-18 Penetration Panel

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 Getting Started

• Gradient Cabinet: the Gradient, RFcabinet contains the gradient and the power
supplies for the magnet room equipment. The gradient signal amplifiers amplify the
waveforms generated within the system cabinet and are sent to the gradient coils in
the magnet. The RF signal amplifiers amplify the RF waveforms generated within
the system cabinet and are sent to the RF coils in the magnet.
• System Cabinet: the system cabinet houses three components: Multi-generational
data Acquisition(MGD), the Combined Exciter Receiver Data acquisition.
Figure 2-19 Gradient Cabinet ,System Cabinet

Gradient Cabinet System Cabinet

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 Getting Started

Basic Desktop Functions

Your system interface is organized into desktops based on function. The desktop is a
series of intuitive, user-friendly graphic areas. Text labels and icon buttons provide
quick visual recognition of the MR functions.

Desktop Overview
Figure 2-20 displays the main Scan Rx Desktop and Table 2-6 describes the basic
features of the desktop.
Figure 2-20 Desktop Overview

1 3 4
5

2 14 7

8
9

10

11

12

13

14

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 Getting Started

Table 2-6 Basic Desktop Functions

No. Description Function

Display the primary desktops for scanning, display and
Desktop Control filming, networking, advanced applications, and other
1
Panel functions. Refer to the Desktop Control Panel for additional
information.
System Status Displays the system status messages and status errors.
2
Display Clicking here displays the Message Log.
Displays the name or title of a window or window section in
3 Area Title
large text.
Allows text to be typed in box after clicking in these areas.
4 Text Box Some text boxes provide alternative pull-down menu
selections.
Clicking and holding on the small arrow to the right side of
Pull-down Menu
5 these buttons produces a pull-down menu. Pull-down menus
Button
provide mouse selectable options.
Autoview
6 Displays scanned, reconstructed images.
Window
Provides a way to scroll through lists of information or groups
7 Image Slider
of images.
System Activity Display status messages for image reconstruction, filming,
8
Status archive, and network functions.
Window Toggle
9 Toggles you back and forth from one window to another.
Button
Provides access to specialized control functions through
Pop-up Window
10 temporary pop-up windows. Selecting one of these buttons
Button
produces a window full of separate control parameters.
List/Select Lists series of the current exam being prescribed. Scroll bars
11
Menu can bring additional text into view.
Provide ascending (up arrow) and descending (down arrow)
12 Scroll Arrows
numeric increments.
Clicking one of these buttons causes a function to occur, as
13 Control Panel indicated by the button. These buttons provide no options
and produce no pop-up windows or pull-down menus.
Scan Operation
14 Displays detailed information about the scan in progress.
Area

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 Getting Started

Desktop Control Panel

The Desktop Control Panel (Figure 2-21) allows access to the following information:
• Hard drive image capacity: displays the disk capacity for 256 and 512 images and
a bar graph indicating the percentage of the disk that is full.
• System status display: displays the system status messages and status errors.
Clicking inside the status box displays the Message Log with the error history.
• Desktop control: displays the six desktop icons listed in Table 2-7.
• System activity status: displays the reconstruction, archive, network, and film
status.
Figure 2-21 Desktop Control Panel

Hard drive
Hard drive image capacity
image capacity
System status
display

Desktop control

System activity
status

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 Getting Started

Each desktop icon opens as a separate desktop with a self-contained series of

commands grouped by function. You can access these desktops at any time during
workstation operation. Table 2-7 describes the function of each desktop icon.
Table 2-7 Desktop Icons and Functions

Icon Desktop Function

Displays a desktop that allows you to enter patient
Scan Rx information, select protocols, create protocols, define
specific scan parameters, and scan.
Displays a desktop that allows you to preregister
Protocol patients, link existing protocols to registered patients,
and build new protocols.

Displays a desktop that allows you to view and

Display manipulate images, post-process with specialized
applications, and access image management functions.

Image Displays a desktop that allows you to network, archive,

Management and remove images from the database.

Displays a desktop that allows you to access to service

utility functions, TPS reset, system shutdown, and
Service restore or save protocols. Also allows the GE Service
Engineer to check calibrations and system diagnostics,
or access the install program and coil configurations.
Displays a desktop that allows you to communicate with
a GE OnLine Center Engineer or a GE Applications
iLinq
Specialist about questions regarding your MR system.
This is a purchaseable option.

Menu Types
The Signa system uses three types of main menus:
• Display menu: contains selections that activate sub-menus for the Selection mode,
Sort mode, removing images, networking images, archiving images, queue
management, Service window, and the Message window. This menu is located at
the top of the Browser.
• Control menu: contains options for system setup, fault recovery, service functions,
and general utility functions. You can access this menu by right-clicking on a
window’s title bar.
• Root menu: contains the options for system setup, fault recovery, service functions,
and general utility functions. You can access this menu by right-clicking on the
background (not on a window or desktop).

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 Getting Started

HIPAA
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was signed by
President Clinton on July 21, 1996 and has the general objectives to:
• Guarantee health insurance coverage of employees.
• Reduce health care fraud and abuse.
• Introduce/implement administrative simplifications in order to augment effectiveness
and efficiency of the health care system in the United States.
• Protect the health information of individuals against access without consent or
authorization. Within HIPAA there are Administrative Simplification regulations that,
in early 2001, are in work.
GE Medical Systems has a long-standing reputation of providing custom, clinical
solutions to protect the privacy and security of your organization's unique clinical
workflow, as well as your patient's confidentiality. Our scanner, software and services
already incorporate many of the core HIPAA requirements. We are committed to
working with you, our customer, to provide additional value to help you meet the
continuing HIPAA challenge.
Please recognize the intended use of the product when determining how critical any
privacy risk is, relative to patient care and safety. GE is very concerned with providing
the best care to the patients; and in some cases we may have determined that patient
care is more important than the risk to privacy. In these cases we take every precaution
to minimize the privacy risk.
Security and Privacy are maintained across a Healthcare system. Any product that is
placed into an uncontrolled environment will not be secure and can not protect privacy.
As we design scanners we design them to be implemented in a "Secure Environment".
A secure environment is based on multiple layers of security, a concept known as
defense in depth. For example: a Best Practice that is gaining much attention places
firewalls between departments, as well as at a demilitarized zone (DMZ), between all
extranets, and the external Internet access point. In this example a radiology firewall
may allow DICOM and HL7 traffic through, but no other protocols. These DICOM and
HL7 protocols would be blocked at the DMZ and again at the internet firewall.
Due to HIPAA regulations, you are required to log on to the scanner and log off the
scanner when you are done scanning for a period of time. If you do not log off, the
system will log you off and you will have to log back on.
Each user has a level of access specifically set by the site administrator. User types
include:
• Empowered users who can modify protocols and perform service functions
• Administrative users who can set up and delete users
• Operator users who can perform all scanning functions
• Service users who can perform all functions

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NOTE: For information on using administrative responsibilities, contact your service

engineer.
HIPAA log in security is an option that can be turned on or off by your service
engineer.

Remote Training
Training in Partnership® (TiP™) Virtual Assist (TVA) combines the hands-on benefits of
on-site training with the convenience and cost savings of distance learning. TVA
provides one-on-one training through a high-speed broadband link that allows GE
personnel to connect directly to your imaging console. You and the trainer see the same
screen at the same time and share control of the console.

Features
TVA provides:
• Live, on-demand support to troubleshoot system performance.
• The ability to share control of the console to demonstrate and instruct complex
procedures.
• Real-time critique of image quality.

Security
Security features of TVA include:
• Secure firewall protection with site-to-site Virtual Private Network (VPN).
• Lockout that prevents GE personnel from performing a scan, moving the table, or
editing patient data.
• TVA initiation by the customer only. GE cannot access your console without your
permission.
• Compliance with HIPAA guidelines.
• Full control by your site at any time.
A default password is provided to each console for GE personnel to use when
accessing the console. As an added layer of security, you may choose to change the
password for your console. If the password is changed, you need to provide the new
password to any GE personnel using your console for remote training or
troubleshooting.
After the scans are completed, the changes in SNR can be monitored by placing a
region of interest (ROI) (the size does not matter but needs to be the same size and
placed in the same location each day) inside the phantom.

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The mean pixel value displayed for the ROI should be divided by the mean pixel value
for the same ROI placed out side the borders of the phantom. This number will give you
a value that will allow you to track SNR.
The Center Frequency can be tracked by recording the AX values the is displayed on
the Manual Prescan window after the completion of a successful Auto Prescan. AX is
the Center Frequency value the was found during Auto Prescan.
Record SNR, Center Frequency (AX), and TG in a spread sheet to document the
values.
During Preventative Maintenance (PM) visits the system is tested to ensure that it
meets all major system performance specifications. Testing is done as part of the
system calibration process during installation and is done typically six times per year
during regularly scheduled PMs. These tests are designed to identify any system
performance issues that would degrade the diagnostic capabilities of the Signa system.
The TLT and System Level Test (SLT) measure either directly or indirectly the systems
image uniformity, spatial linearity, high contrast spatial linearity, slice thickness, location,
and separation.
The systems QA testing is performed as part of a written procedures and guidelines by
qualified GE Service Engineers. The results of these tests are recorded and can be
reviewed with you upon request. The local GE service team will be happy to review the
results of the testing done as part of the PMs, System Service History, and the Daily
SNR and Center Frequency results that you have documented.

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 Getting Started

How Do I...
This section provides the step-by-step instructions for getting started using your Signa
system. Specifically, it describes how to:
• Power on the MR System
• Login and Logout of the System
– Login
– Logout
• Configure Users for the System
• Load an MOD
• Navigate Through Screens and Menus
• Obtain Remote Assistance
– Launch TVA
– Close TVA
– Change Password
• Reset the TPS
• Save Raw Data
• Restart the System
• Shut Down the MR System

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 Getting Started

Power on the MR System

Before you can begin using your MR system, you need to know how to power on and
log into the system.
Use this procedure to power on your MR system.
1. Press Power button on the computer.

Š When the power is on, the power indicator light is illuminated.

Š As the system powers on, a Login screen is displayed.
2. Type signa in the Login text box.

3. Type adw2.0 in the Password text box.

Š If you decide to shut down at this point, select System > Halt.

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4. Wait until all messages are removed from the screen and the Scan Rx Desktop is
complete before clicking on the desktop.
Š A message appears across the screen stating, Do not interact with the
system until this message disappears. You should not use the mouse
or the keyboarding keys at this time, as to not delay the startup process.
Š The startup process usually takes about 5 minutes. You will know your system is
ready when the message disappears and the Scan Rx Desktop, Rx Manager,
Patient Register, and Autoview window display.
NOTE: If the HIPAA login function is turned on, you will not see the Scan Rx Desktop.
Refer to the Login and Logout of the System procedure to complete login.

Quick Steps: Power on the MR System

1. Press Power button on the computer.
2. Type signa in the Login text box.
3. Type adw2.0 in the Password text box.
4. Wait until all messages are removed from the screen and the Scan Rx Desktop is
complete before clicking on the desktop.

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Login and Logout of the System

Login
Use this procedure when you are going to scan on the system and you have the HIPAA
security function turned on. You need to login to the scanner so the scanner knows
which user you are. This is for security purposes.
Use this procedure to login to the scanner.
1. At the Login window select Login from the Operation menu.
Š If you need to log in quickly for emergency purposes only, click [Emergency
Login].

2. Select your user name from the Select User list.

Š Names can be assigned by your system administrator.
3. Type your password in the Password text box.

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 Getting Started

4. Click [OK].
Š The system logs you into the scanner.
Š After a period of inactivity, you are automatically logged off the scanner. When
you or another user logs back in, the system returns to its last known state.

Quick Steps: Login and Logout of the System – Login

1. At the Login window select Login from the Operation menu.
2. Select your user name from the Select User list.
3. Type your password in the Password text box.
4. Click [OK].

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Login and Logout of the System

Logout
Use this procedure when you have the HIPAA security function turned on and you need
to logout of the system. When you leave the system, you should log off the system for
security purposes.
Use this procedure to log out of the scanner.
1. Right-click on a blank area of the screen and select Lock Screen.
Š The Login window displays, indicating you are logged out of the system.

Š You will need to reenter your password to log back in to the system. Otherwise,
another operator could change the user name and enter his or her password to
log onto the system.

Quick Steps: Login and Logout of the System – Logout

1. Right-click on a blank area of the screen and select Lock Screen.

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Configure Users for the System

To add users to the system for use, you must be a user with the administrative option
added to your name. Normal users do not have permission to access this area.
1. At the Login window, select Login & Administer users from the Operation menu.
Š For information on how to login to the system, refer to the Login and Logout of
the System procedure.

2. Select your user name from the Select user menu.

Š You have to be an assigned administer to add or remove users from the system.
3. Enter your password in the Password text box.

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4. Click [Ok].
Š The User, Groups, Permissions window is displayed.

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5. Select groups/permissions to user/groups from the drop-down menu.

6. Type a new user name in the New User text box or a new group in the New Group
text box.
7. Press Enter.
Š The new user or group is added.
NOTE: The initial password is the user name the first time the new user logs in. The new
user is then prompted to change his or her password.
8. Select the groups and permissions for an individual users or assign permissions to
groups.

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9. Select the Modify user tab.

Š Make any changes to the password, user id, password expiration, or
re-authentication.

10. Click [Apply].

11. Select the Password constraints tab.
Š Make any changes that apply (for example minimum length or character types).
NOTE: By entering 0 in the Max bad logins before account is locked text box, the user
will have unlimited bad password attempts. If you enter a number here and the
user logs the number that you enter, the system locks that users out and the
Admin user has to unlock that user. To unlock a user from bad password attempts,
select the User, Groups, Permission tab and click Lock User. Select the user
name from the list and click [Unlock User].

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 Getting Started

12. Click [Apply].

13. Click [Exit Admin].
Š The Admin screen closes.
14. Enter your password in the Password text box.
15. Click [Ok].
Š You are now at the scanning desktop.

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Quick Steps: Configure Users for the System

1. At the Login window, select Login & Administer users from the Operation menu.
2. Select your user name from the Select user menu.
3. Enter your password in the Password text box.
4. Click [Ok].
5. Select groups/permissions to user/groups from the drop-down menu.
6. Type a new user name in the New User text box or a new group in the New Group
text box.
7. Press Enter.
8. Select the groups and permissions for an individual users or assign permissions to
groups.
9. Select the Modify user tab.
10. Click [Apply].
11. Select the Password constraints tab.
12. Click [Apply].
13. Click [Exit Admin].
14. Enter your password in the Password text box.
15. Click [Ok].

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 Getting Started

Load an MOD
Maxoptic MODs are used with the Linux computer for archiving patient examinations.
Use this procedure to load an MOD.
1. Place the MOD, label side up, into the MOD drive.

2. Gently push the MOD into the drive.

NOTE: Refer to the Managing Images chapter for details on saving and restoring
examinations, series, and images.

Quick Steps: Load an MOD

1. Place the MOD, label side up, into the MOD drive.
2. Gently push the MOD into the drive.

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 Getting Started

Navigate Through Screens and Menus

This section does not include any quick steps. All steps for screen navigation are
discussed below.
• To open a desktop, use the mouse to position the cursor on the icon you wish to
open and then click with left mouse key.
• To change desktops, click the desktop icon that you want to change to. You do not
need to close the desktop that is currently displayed.
• When entering data into a text box:
– Use the mouse to position the cursor in the text box
– Click once using the left mouse button
– Enter your data
– If text is already in the text box, use the mouse to position the cursor in the text
box
– Click and drag the left mouse over the text
– Press the Backspace or Delete key on your keyboard
– Enter your new data
• When a message box appears, read the message click [OK] to close the box.
NOTE: Unless you click [OK], you will not be able to proceed.
• Right-click the title bar to access the control menu for a window.
• Right-click and hold the background to access the root menu. Drag to the desired
item.
• Use the quit selection to exit the film composer and display applications. Do not use
the iconify function.
NOTE: Do not click repetitively with any of the mouse buttons if the system does not
seem to be responding; wait a moment and perform a software reset if necessary.

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Obtain Remote Assistance

Launch TVA
The Remote Training application allows GE personnel to connect directly to your
imaging console through a high-speed broadband link. TVA must be running to allow a
GE trainer access to your console for training or troubleshooting.
Use the following procedure to launch TVA.
1. Click the iLinq icon on the desktop control panel.

2. Click [Virtual Assist] and select TiP Virtual Assist from the list.
Š The Prepare to Start Training window displays.

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 Getting Started

3. Click [Accept] to use TVA.

Š The Remote Training window displays and the console connects to TVA.

Š Once the console connects to TVA, the [Pause] button is active.

– Click [Pause] to pause the session.
– Click [Resume] to resume the session.

Quick Steps: Obtain Remote Assistance – Launch TVA

1. Click the iLinq icon on the desktop control panel.
2. Click [Virtual Assist] and select TiP Virtual Assist from the list.
3. Click [Accept] to use TVA.

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Obtain Remote Assistance

Close TVA
You can exit TVA at any time during the training or troubleshooting, or wait until the
session is complete.
Use the following procedure to close TVA.
1. Click [Exit Training] on the Remote Training window.

Š If you or the GE trainer do not use the console for 10 minutes, TVA automatically
disconnects.
Š Click [Restart Server] to resume training or troubleshooting.

Quick Steps: Obtain Remote Assistance – Close TVA

1. Click [Exit Training] on the Remote Training window.

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Obtain Remote Assistance

Change Password
A default password is assigned to each console. GE personnel use the default
password when logging on to your console to train and troubleshoot. For additional
security, you can assign a new password to your console.
Use the following procedure to change the session password.
1. Click [Change Session Password] on the Preparing to start Training Mode
window.

Š The Change Session Password window displays.

2. Type a new password in the New Password text box.

3. Retype the new password in the Confirm Password text box to confirm entry.
4. Click [OK].
Š Your password has been changed for this session.
5. Inform each person accessing your console of the new password.
Š Others will need to know the new password to access the console for training or
troubleshooting.

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Quick Steps: Obtain Remote Assistance – Change Password

1. Click [Change Session Password] on the Preparing to start Training Mode
window.
2. Type a new password in the New Password text box.
3. Retype the new password in the Confirm Password text box to confirm entry.
4. Click [OK].
5. Inform each person accessing your console of the new password.

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 Getting Started

Reset the TPS

The TPS is a subsystem of your Signa system that oversees all raw data processing.
The TPS is housed in your system cabinet, located in your computer room. Resetting
the TPS is one way to safely recover from many errors and conditions. You need to
perform this procedure when the system prompts you to or when told to by an InSite
Technician.

CAUTION: Performing a TPS reset in the middle of a scan or reconstruction stops

the reconstruction process, eliminates the landmark and deletes the
image data. It takes a few minutes for the system to go through the
complex process of resetting itself and the system cannot be used until
it is finished.
1. Click the Service Desktop icon on the control panel.

Š The Service Desktop Manager displays.

2. Click [TPS Reset].
3. Confirm your selection.
4. Wait for a TPS reset is completed message.
5. Re-landmark and resume scanning.

Quick Steps: Reset the TPS

1. Click the Service Desktop icon on the control panel.
2. Click [TPS Reset].
3. Confirm your selection.
4. Wait for a TPS reset is completed message.
5. Re-landmark and resume scanning.

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Save Raw Data

Raw data is the unreconstructed data that is used to create an image. You may be
asked by your service engineer to save raw data if you an image appears with an
artifact or distortion. The service engineer can then use this information to help
determine the cause of the artifact or problem.
Use this procedure to save the raw data, that was used to create a specific image, to
the system disk.
NOTE: Because raw data resides in the temporary memory of the system, it is imperative
to save the raw data before downloading the next series in the examination (save
raw data before selecting the [Save Series] or [Prepare to Scan] buttons).
1. Click the Service Desktop icon on the control panel.

Š The Service Desktop Manager

displays.
2. Click [Utilities].
3. Select Raw File Manager from the
list.

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4. Click [Start...].
Š The RawFileMngr (Raw File Manager) window displays.

5. Select a method to save the raw data from the Options menu.
Š Save By Pass: saves the entire series
Š Save By Slice: saves only the selected slices

6. Select the desired data from the TPS area.

7. Click [TPS to Disk].
Š The raw data is saved to the hard disk of the system, until it is removed.
NOTE: Raw data uses disk space, and as the disk becomes full system performance
can be degraded.
8. Select File > Exit to close the RawFileMngr window.

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Quick Steps: Save Raw Data

1. Click the Service Desktop icon on the control panel.
2. Click [Utilities].
3. Select Raw File Manager from the list.
4. Click [Start...].
5. Select a method to save the raw data from the Options menu.
6. Select the desired data from the TPS area.
7. Click [TPS to Disk].
8. Select File > Exit to close the RawFileMngr window.

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Restart the System

Use this procedure to restart your system.
1. To log out of the scanner, click the Service Desktop icon on the control panel.

Š The Service Desktop Manager displays.

2. Click [System Restart].

3. Click [OK].
Š The system displays a blue screen with the icon status area at the beginning of
logging out. When the Welcome to... Login window displays, log out is complete.
4. Type signa in the Login text box.

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5. Type adw2.0 in the Password text box.

NOTE: If the HIPAA login function is turned on, you will not see the Scan Rx Desktop.
Refer to the Login procedure to complete login.

Quick Steps: Restart the System

1. To log out of the scanner, click the Service Desktop icon on the control panel.
2. Click [System Restart].
3. Click [OK].
4. Type signa in the Login text box.
5. Type adw2.0 in the Password text box.

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 Getting Started

Shut Down the MR System

A system shutdown terminates power to the system electronics in an orderly fashion so
image files are saved. This procedure does not turn off power to the MRI magnet.
Safety rules should still be followed to prevent injury or damage to the magnet.
NOTE: System shutdown may occasionally take longer than expected. When performing
a shutdown, wait at least thirty seconds before initializing another shutdown. The
increased shutdown time may not always be observed.
Use this procedure to shut down your MR system.
1. Make sure all images have reconstructed.
Š Check the Browser to ensure images are available for display.
2. Click [End Exam] in the Rx Manager, if necessary.
3. Wait for archive and network operations to complete.
4. Select Archive > Detach on the Browser menu bar.
5. Press Detach on the MOD drive and remove the MOD.

Š Removing the MOD prior to shutdown helps to prevent MOD corruption.

6. To log out of the scanner, click the Service Desktop icon on the control panel.

Š The Service Desktop Manager displays.

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7. Click [System Restart].

8. Click [OK].
Š The system displays a blue screen with the icon status area at the beginning of
logging out. When the Welcome to... Login window displays, log out is complete.
9. Select System > Halt.

NOTE: As an alternative,you can move the cursor to a blank area on the screen, then
right-click and select Service Tools > System Shutdown.

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Quick Steps: Shut Down the MR System

1. Make sure all images have reconstructed.
2. Click [End Exam] in the Rx Manager, if necessary.
3. Wait for archive and network operations to complete.
4. Select Archive > Detach on the Browser menu bar.
5. Press Detach on the MOD drive and remove the MOD.
6. To log out of the scanner, click the Service Desktop icon on the control panel.
7. Click [System Restart].
8. Click [OK].
9. Select System > Halt.

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Chapter 3
Scan Rx Desktop

Introduction
This chapter is an introduction to the scanning operations performed on the Scan Rx
Desktop. It contains key concepts and guidelines on the user-friendly graphic areas
contained in the desktop. This section describes the basic features of the Scan Rx
Desktop and provides instructions to help you navigate through the required areas.
The Scan Rx Desktop is designed for one-screen scanning operation. The desktop
provides the means for:
• Patient Registration
• Protocol Selection
• Scan Prescription
• Rx Manager
• Scan Initiation
• Prescan
• Protocol Creation

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What Do I Need to Know About...

This section presents the concepts necessary to successfully understand and complete
the primary functions of the Scan Rx Desktop areas and windows. Specifically, you
need to understand the following areas and the text boxes contained prior to scanning:
• Scan Rx Desktop Basics
• Patient Information
• Patient Position
• Imaging Parameters
• AutoView Window
• Scan Timing
• Additional Parameters
• Scanning Range
• Acquisition Timing
• Rx Manager
• Series Control and Advisory Panel
• Scan Operations

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Scan Rx Desktop Basics

The Scan Rx Desktop provides all the clinical tools necessary for comfortable, efficient
set up of patient studies. These tools include patient scheduling and data entry,
examination protocol selection, protocol viewing and editing with graphic prescription,
scan data acquisition, image reconstruction, and dual AutoView image display layouts.
The Scan Rx Desktop opens progressively. As you complete the information required
for each area, another area becomes available to access and complete.
The Scan Rx Desktop (Figure 3-2) opens when you click on the Scan Rx icon (Figure
3-1) located in the control panel.
Figure 3-1 Scan Rx Icon

Figure 3-2 Scan Rx Desktop

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Patient Information
The Patient Information area (Figure 3-3) requires detailed information about the
patient. This area opens after you click the [New Pt] button located in the patient
registration area.
Figure 3-3 Patient Information Area

NOTE: You cannot leave the Patient Information area unless a Patient ID is entered. You
need to enter the patient’s weight to pass the Imaging Parameters area.
Table 3-1 describes acceptable values in the Patient Information area.
Table 3-1 Patient Information Area Text Boxes

Selection Description
This is generally related to a number assigned by the hospital, clinic, or
Accession site, and is tied to the patient’s records. You can enter the number
Number manually or by using the optional barcode reader (if applicable).
This text box is limited to 16 characters.
The patient’s identification (ID) can be any combination of numbers,
letters, and dashes. If the system finds the same ID in it’s memory, it
displays all the pertinent data so long as the entry is identical, including
Patient ID
the use of upper-case and lower-case letters. Enter MR and the system
displays the last (most recent) patient’s data. This text box is limited to
64 characters.
Patient The patient’s name should be entered without numbers preceding the
Name name. This text box is limited to 64 characters.

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Selection Description (Continued)

The birth date can be entered using numbers 1 to 12 for the month, 1
to 31 for the day, and 19xx or 20xx for the year as mm/dd/yyyy or
Birth Date mm-dd-yyyy. The year entry must contain four digits. This entry is
optional when pre-registering patients. The system can be configured
for dd/mm/yyyy by the service engineer.
The age is automatically calculated if the birth date is entered. Only
whole numbers (i.e., no decimals) can be entered. Age ranges from 1
Age
to 123 years. Days (1-90), weeks (1-52), or months (1-23) can also be
entered. For example, 28D, 4W or 1M.
Sex The sex of the patient can be entered as M for male or F for female.
The patient’s weight can be entered in pounds or kilograms. The
system automatically calculates and displays the other weight
measure. Limits are 2 to 500 lb. (1 to 227 kg). Accurate weight
Weight
information is essential for safe scanning.
Precision is important. If inaccurate, the system could abort the
scan or deliver the wrong amount of RF power to the patient.
Rad The name of the radiologist.
Refer The name of the referring physician.
Operator The initials of the operator. This text box is limited to 3 characters.
A status of the patient can be selected from the menu. The pre-defined
Status
selections include: None, In, Out, Emergency, and Referral.
Exam A description for the examination. If this area is not completed, no
Description information appears on the Exam Page.
Relevant background information regarding the patient’s symptoms or
History
other relevant information.
[Schedule] Provides access to the ConnectPro option.
[Position] Provides access to the Abbreviated Patient Information.

NOTE: Entries made in the Patient Information area should not contain a backslash (\)
character.

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Abbreviated Patient Information

An abbreviated version of the patient information area (Figure 3-4) appears in the
Patient Information area when the [Position] button is clicked in the Patient Information
area. You can display the full patient information again by clicking the [Full Info] button.
Figure 3-4 Abbreviated Patient Information Area

Table Entry
Table Entry represents the swing position of the table. You must set the table swing
position by choosing either LEFT, CENTER, or RIGHT.
• Left: the table is at +25 degrees from center.
• Center: the table is at 0 degrees, directly center.
• Right: the table is at -25 degrees from center.
NOTE: If the swing position is not entered at the beginning of a new examination, an
advisory message prompts you to complete the Table Entry selection before
continuing.

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Patient Position
The Patient Position area (Figure 3-5) opens after you select Patient Position from the
Patient Protocols window. This area indicates the patient’s position, patient entry, the
type of coil being used, and a description of the scan prescribed.
Figure 3-5 Patient Position Area

Patient Position
The Patient Position text box contains four selections pertaining to the orientation of
the patient.
If you have the Abbreviated Patient Information area displayed (by selecting the
[Position] button in the Full Patient Information area,) the patient icon changes its
orientation as you change the patient position information. Figure 3-6 displays the
available positions to select for your patient.
Figure 3-6 Patient Positions

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You can select patient position from the pre-defined list or by typing one of the following
shortcuts: (S) for supine, (P) for prone, (L) for left decub, (R) for right decubitus. These
entries are not case sensitive.

WARNING:Ensure that the Patient Position selection matches the actual patient
orientation. Making a selection that does not match the patient’s actual
position results in incorrectly annotated and/or rotated images,
possibly resulting in improper medical treatment.

Patient Entry
Patient Entry describes the orientation of the patient as head first or feet first into the
magnet bore. If you have the abbreviated Patient Information area displayed, the
patient icon changes its orientation as you change the patient entry information.
The patient entry position is determined by the anatomical area being scanned. For
example, a cervical spine is typically placed head first and a knee is typically placed feet
first.
In the Patient Entry text box select an entry from the pre-defined list or type in one of
the following shortcuts: (H) for head first or (F) for feet first. These entries are not case
sensitive.

WARNING:Ensure that the Patient Entry selection matches the actual orientation
of the patient. Making a selection that does not match the patient’s
actual position results in incorrectly annotated and/or rotated images,
possibly resulting in improper medical treatment.

Coil Type
The Coil text box allows you to select the coil from which the signal is transmitted and
received, or in the case of a surface coil, only the receiving the signal. Selecting Surface
or Phase Array displays a listing of all coils configured for the system.
When you select coil from the Patient Position area, the Coil Names window (Figure
3-7) opens.

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Figure 3-7 Coil Names Window

Your coil selection must match the coil connected and the anatomy to be scanned.
Select a coil from the Coil Names window or by typing in one of the following shortcuts
in the Coil text box: (H) for head coil, (B) for body coil or the full name of a surface or
phased array coil. These entries are not case sensitive.
When selecting a coil, consider the following:
• The penetration depth of a coil is approximately half the coil’s diameter.
• The smaller the coil, the better the signal-to-noise ratio (SNR) but less coverage
and/or depth penetration.
• If a prescan failure occurs, make sure the coil key selection matches the coil in use.

WARNING:Improper use of arrays and coils may cause patient burns and other
hazards. Read and understand all the surface coil warnings in the
Gradient and Imaging Coils chapter before using an array or coil.

CAUTION: The coil selected should match the coil that is connected.

Coil ID
Coil identification (ID) displays a picture of the coil selected for the examination. Each
coil has a self identification code that is recognized by the system. The coil selected in
the protocol must match the coil connected to the system.
An examination using the body coil would show the picture of the body coil of the
Ovation system in the Coil ID area.

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NOTE: If the coil connected does not match the coil selected in the current protocol, the
system will post a message advising of the discrepancy.
If the system does not display an image for the connected coil, it posts a message.

Series Description
The Series Description text box allows you to enter a brief description of the series
being prescribed. This information appears on the series description line that is part of
the series text page, which can be filmed and kept as part of the patient’s MRI
examination. It also appears in the Rx Manager during scan prescription and in the
Browser after a series has been scanned. The description may be helpful when you are
trying to locate a particular series.
If a predefined protocol has been selected, the series description appears
automatically. However, this description does not change if the scan parameters are
later adjusted.
If a description is not entered, the system creates one based on the current patient
entry, position, coil, mode, pulse sequence, and plane. For example, the default
description could be Body, Cor, 2D, SE.

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Imaging Parameters
The Imaging Parameters area (Figure 3-8) provides the selection of the imaging plane,
mode, gradient mode, pulse sequence, imaging options, PSD Name, and Protocol.
Figure 3-8 Imaging Parameters Area

Imaging Plane
The planes used in MR imaging that can be selected are axial, sagittal, coronal,
oblique, or 3-Plane.
• Orthogonal: planes are perpendicular to one another. Axial, sagittal, and coronal
planes are all perpendicular to each other and are therefore orthogonal. Orthogonal
images cannot be graphically prescribed from a localizer of the same plane.
• Oblique: planes are scan planes prescribed in any orientation other than the axial,
sagittal, and coronal planes.
– A simple oblique is a plane that has been tilted in just one direction from an
orthogonal plane.
– A complex oblique is a plane that has been tilted in two directions from an
orthogonal plane.
– Oblique prescriptions can increase TR, TE, FOV, and slice thickness, and
decrease the matrix selection and number of slices.
– The system annotates axial, sagittal, and coronal images as oblique if you select
the oblique plane in the Imaging Parameters area.
• 3-Plane: a localizer that allows the sequential acquisition of three orthogonal scan
planes acquired in a single series with one scan prescription. This feature uses a
Fast Gradient Echo (GRE) pulse sequence and can obtain the three planes in a
single breath-hold.
Figure 3-9 displays the orthogonal and oblique planes. The bold line in each figure
represents the line cursor in Graphic Rx or the cutting edge of the oblique.

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 Scan Rx Desktop

Figure 3-9 Orthogonal and Oblique Planes

The Plane text box contains a pre-defined list for plane selection. You can also type in
the following shortcuts: (A) for axial, (S) for sagittal, (C) for coronal, (O) for Oblique, or
(3) for 3-Plane. These entries are not case sensitive.

Imaging Mode
The imaging mode defines the image format and type of image information to be
gathered. The Mode text box has predefined values to select 2D, 3D, or Cine, or MR
Spectroscopy. The desired imaging mode may be selected from the predefined values
on the list or you can type in the following shortcuts: (2) for 2D, (3) for 3D, (C) for Cine,
or (M) MR Spectroscopy. These entries are not case sensitive.

2D Mode
The 2D Mode acquires and reconstructs raw image data into two-dimensional images,
whose brightness is proportional to the intensity of the MRI signal from the
corresponding protons. The radio frequency (RF) pulse and gradient pulse occur at the
same time to excite an individual slice of a specific thickness of tissue.

3D Mode
The 3D mode excites an entire scan volume or slab with a wide RF pulse. The entire
scan volume is excited with a wide RF pulse and spatial encoding is performed in the
phase, frequency, and slice axes.

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Pulse Sequence
The Pulse Sequence text box provides access to the Pulse Sequence window (Figure
3-10), which contains pre-defined available pulse sequences for detecting specific
types of proton emissions.
Figure 3-10 Pulse Sequences Window

NOTE: Refer to the Clinical Pulse Sequences section for specific information on PSDs
and pulse sequence selection.

Imaging Options
Imaging Options provide appropriate image processing or filters for enhancing
anatomical features or reducing noise.
The Imaging Options text box provides access to the Imaging Options window (Figure
3-11), which contains a list of predefined available options. You may also type in the
name of the imaging option in this text box. Multiple imaging options can be selected,
but availability may be limited by the pulse sequence, other imaging options selected, or
the optional software packages your site has purchased.

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Figure 3-11 Imaging Options Window

NOTE: Refer to the chapter Imaging Options chapter for additional information.

Pulse Sequence Database Name

The Pulse Sequence Database (PSD) Name text box can be used to select pulse
sequences that are not listed in the Pulse Sequences Window.

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Protocol
The Protocol text box allows you to type in the name of a protocol to download all the
predefined values. Alternatively, click the Humanoid icon (Figure 3-12) to access the
list of predefined protocols.
Figure 3-12 Humaniod Icon

Figure 3-13 Patient Protocols Area

NOTE: For additional information on protocols, refer to the Managing Protocols chapter.

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AutoView Window
The AutoView window (Figure 3-14) is located in the upper right-hand corner of the
screen and displays images as they are reconstructed.
Figure 3-14 AutoView Window

Slider

Autoview
ON

Use the AutoView Window to monitor the images reconstructing while performing other
tasks, such as setting up for the next acquisition or archiving.
Images displayed in the AutoView Window are annotated with the following information:
• Examination number, series number, image number, patient name
• PSD name, TR, TE, echo number, FOV
• Scan location, report cursor with RAS values
• Window and level values

AutoView
AutoView turns the AutoView feature on or off. When the button is selected, AutoView is
on and the system automatically displays each image as it is reconstructed for the
current examination. The images are displayed in the order of the reconstruction. When
using the slider, the images are viewed in order of series, image, and echo number. In
addition, the image viewed has its image number noted to the left of the slider.

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The AutoView Window buffer holds 256 images. When images from series one of the
current examination reconstruct, images from the previous examination are deleted
from the AutoView buffer. The viewport’s standard image display is 256x256.
When AutoView is not selected, you are in the Review mode. The Review mode allows
you to scroll through the images in AutoView display. When you turn AutoView back on,
Review mode is turned off and the most recently reconstructed images are displayed.
Use the slider to the right of the image for moving within the image set. Click on the
arrows to move through the images one at a time. You may scroll through the images
when AutoView is on. Moving the slider temporarily pauses the display of any newly
reconstructed images. Image display resumes once the slider activity is completed.
During a SAT or Graphic prescription, the AutoView Window is moved to the left and
overlays the area reserved for Patient Register or Patient Information. The AutoView
Window is returned to its original location once the prescription is complete for the SAT
or Graphic prescription.

Report Cursor
Report Cursor displays the cursor-location Right, Anterior, Superior (RAS) coordinates
with respect to the cursor’s position on the image.
• Selecting Report Cursor turns AutoView off.
• Selecting AutoView turns Report Cursor off.
Figure 3-15 Report Cursor

Update Images
The [Update] button becomes active if images have reconstructed while AutoView was
turned off.
• Click the [Update] button to add these images to the AutoView memory.
• Use the slider to review these images.

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Auto Window/Level
Auto W/L is the window and level feature that automatically calculates during
reconstruction. It toggles on and off.
• The Auto W/L feature is on when the Auto W/L box is depressed. Manual
window/level changes override the system settings.
• The Auto W/L feature is off when the Auto W/L box is not depressed. Manual
window and level changes do not override the system settings.
Changing the window level with the middle mouse button temporarily pauses the
display of images. Image display resumes once the middle mouse button is released.

Save Window/Level
Save W/L saves the window and level settings of the image. Then, each time you scroll
through the images for later recall, the system holds that window and level setting.
When the Save W/L feature is turned off, no new window and level settings are saved.
Save W/L overrides Auto W/L.

Maximize/Minimize
Maximize increases the size of the image display to a 512x512 resolution, while
minimize displays the images at a 256x256 resolution.
A magnifying glass is available in the AutoView window when the right mouse button is
pressed and held. The moveable square zone magnifies the image (in the zone) two
times.

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Scan Timing
The Scan Timing area (Figure 3-16) defines the time to echo (TE) and time to repeat
(TR) scan timing parameters as well as the number of echoes, echo train length (ETL),
number of shots, inversion time (TI), flip angle, and receive bandwidth (RBw). An
advisory area to the right of each text box displays the minimum and maximum values
allowed.
Figure 3-16 Scan Timing Area

You can enter values in this area in one of three ways:

• Select text from the pre-defined list.
• Click on the up or down arrows to increase or decrease values already in the text
boxes.
• Delete the text and type in a new text value.

Number of Echoes
Number of Echoes determines the number of images produced from each slice
location. Each echo yields an image. The number of echoes (Figure 3-17) allowed is
dependent on the pulse sequence. In late echo images, SNR decreases and T2
contrast increases.

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Figure 3-17 Number of Echoes

Acquisitions with different numbers of echoes can result in different contrast weighting,
as shown in Table 3-2.
Table 3-2 Number of Echoes with Resultant Contrast Weighting

Contrast
# of Echoes
T1 PD T2 T2*
1 SE or SPGR Usually FSE Usually FSE GRE
Seldom
2 NA SE or FSE SE or FSE
Acquired
SE #1 PD/SE #2 SE #3 middle
4 NA NA
early T2 T2/SE #4 late T2

Consider the following when choosing the number of echoes for your sequence:
• Choosing two echoes requires choosing two echo times, TE and TE2. When [1] or
[4] is selected, there is no TE2 selection because four echo studies use multiples of
the first echo.
• The Flow Compensation option allows a maximum of two echoes.
• For 2 or 4 echo acquisitions, two bandwidths must be defined. Bandwidth is for echo
1, while Bandwidth2 is for echoes 2 to 4.

Number of Shots
Number of Shots selection determines the number of TR periods to be repeated for an
echo planar acquisition. This also determines the speed and image quality of an EPI
sequence. The fewer the number of shots, the shorter the scan time. However,
geometric distortion increases as the number of shots decrease.
To calculate the scan time for an EPI sequence, use the formula in Equation 3-1.
Equation 3-1 EPI Scan Time

Scan Time = TR x Number of Shots x NEX

As the number of shots increase, the effective echo spacing decreases and blurring in
the image decreases. As the number of shots decrease, scan time decreases.

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A single shot EPI sequence is one in which all the required phase encoding steps are
collected within one TR period. Single shot [1] is the only selection for DW EPI. EPI
protocols that use more than one shot to complete the image acquisition are referred to
as multi-shot EPI. Multi-shot EPI fills k-space lines in an interleaved manner. The
interleaved k-space yields a reduced effective echo spacing.
NOTE: The number of shots selection is valid only if the EPI option is purchased and
installed on your system.
The number of shots selection replaces the Number of Echoes selection when
an Echo Planar pulse sequence is chosen.

Echo Time
Echo Time determines the time between the center of the first excitation pulse and the
peak of the echo in milliseconds, which usually occurs at the center of the readout
gradient.
TE2, available for two echo sequences, is the time between the center of the first
excitation pulse and the center of the second readout.
The following pulse sequence diagram (Figure 3-18) displays a 90° excitation pulse and
180° refocusing pulses that generate the echo.
Figure 3-18 Pulse Sequence Diagram

• The TE text box contains a list of predefined selections for the scan TE value, or you
may enter a value in the text box. The arrows can also be used to change the TE.
– Minimum obtains the minimum TE, whether it is a full or fractional echo. With
fractional echoes, SNR may decrease because only a portion of the echo is read.
The loss in SNR may be offset by the shortened TE which allows less T2 decay
and therefore greater SNR. The smaller the FOV, the longer the minimum TE.
– Min Full provides the shortest possible TE times without setting a fractional TE.
This selection may increase SNR over a shorter TE acquired with a fractional
echo technique.
• The TE2 text box is available only for two-echo sequences.

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Fractional Echo
Fractional Echo is a technique that shortens the time in which the readout gradient (Gx)
is applied so that shorter echo times can be achieved. Since the Gx is turned on for a
shorter time, not all of the rephase portion of the echo is read which, effects the SNR.
Figure 3-19 illustrates the pulsing differences between a fractional and full echo. Note
the timing differences where the Gx is applied.
Figure 3-19 Fraction vs. Full Echo

Table 3-3 demonstrates the effects TE has on contrast and Table 3-4 shows the effects
on imaging parameters and artifacts.
Table 3-3 TE and Contrast

T1 PD T2
As TE ⇓ ⇑ ⇑ ⇓

Table 3-4 TE and Imaging Parameters and Artifacts

# of Scan Flow Mag

SNR Res. RBw
Slices Time Artifact Susc
As TE ⇓ ⇑ NA ⇑ NA ⇓ ⇓ ⇑

Consider the following when using fractional echoes:

• When GRE is selected with a fractional echo, the system only reads about 60% of
the echo.
• When a Spin Echo (SE) is selected with a fractional echo, the system uses a sliding
scale from 60 to 100% for the amount of signal it reads. As the TE gets closer to a
full echo, the system has more time to read the signal and therefore it approaches
reading 100% of the echo.
• The longer the TE, the greater the magnetic susceptibility artifacts. This is
especially true in GRE and EPI imaging.
• Using a fractional echo with lower bandwidths may compensate for SNR loss. As
bandwidth decreases, SNR increases.
• Fractional Echo may affect the minimum values allowed for FOV, slice thickness,
and matrix size.

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Repetition Time
Repetition Time (TR) represents the interval between successive excitation pulses of a
slice in milliseconds.
Figure 3-20 TR in a Pulse Sequence Diagram

TR controls the amount of transverse magnetization that recovers to the longitudinal

plane. If full recovery for any given tissue does not take place, it eventually becomes
saturated.
• In a T1-weighted image, a short TR is programmed to achieve saturation effects.
The shorter the TR, the more saturation (T1) effects are seen in the contrast.
• In a PD or T2-weighted image, a long TR is programmed to minimize the saturation
effects. Other effects such as dephasing (T2) or the number of protons in tissue
(PD) can then predominate the image contrast.
Table 3-5 demonstrates the effects TR has on contrast and Table 3-6 shows the effects
on imaging parameters and artifacts.
Table 3-5 TR and Contrast Weighting

T1 PD T2
As TR ⇓ ⇑ ⇓ ⇓

Table 3-6 TR and Imaging Parameters and Artifacts

# of Scan Flow Mag

SNR Res.
Slices Time Artifact Susc
As TR ⇓ ⇓ ⇓ ⇓ NA ⇓ NA

Table 3-7 Contrast Weighting vs. TE and TR

TE TR
T1-weighted Short ≤ 30 Short ≤ 600
PD-weighted Short ≤ 30 Long TR ≥ 2000
T2-weighted Long TE ≥ 80 Long TR ≥ 2000

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Different anatomy exhibit different characteristics, depending on the TR and TE

selected, which in turn determines the weighting of the image (T1, PD, or T2). Table 3-8
illustrates some of these differences.
Table 3-8 Anatomy Characteristics with Contrast Weighting

Characteristic T1- Weighted PD-Weighted T2-Weighted

CSF Dark Intermediate Bright
Gray Matter Dark Gray Light Gray Intermediate
White Matter Light Gray Dark Gray Dark
Edema Dark Intermediate Bright
Fat Bright Bright Dark
Muscle Gray Intermediate Dark
Bone Marrow Gray Intermediate Intermediate
Cyst Dark Dark Bright

Inversion Time
Inversion Time (TI) primarily controls the contrast in an IR pulse sequence. It is the time
between the first (180°) inverting pulse and the middle of the second (90°) refocusing
pulse in an IR pulse sequence (Figure 3-21). TI affects the number of slices.
NOTE: This text box indicates the Prep Time when SPECIAL is selected or when IR
Prepared or DE Prepared Imaging Options are chosen.
Figure 3-21 TI Time in a Pulse Sequence Diagram

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Flip Angle
Flip Angle determines the rotational angle of the magnetization vector produced by an
RF pulse relative to the longitudinal axis of the static magnetic field.
SE uses enough RF to move the longitudinal magnetization into the transverse plane. A
standard 90° flip angle (Figure 3-22) is used for the excitation pulse.
Figure 3-22 Standard 90° Flip Angle

GRE and SE pulse sequences allow the flip angle to be varied. The amount of
longitudinal magnetization moved to the transverse plane changes, based on the flip
angle. Select the flip angle based on the contrast and SNR results desired. The flip
angle affects the total amount of signal that recovers over time.
Figure 3-23 Varied Flip Angle

• As flip angles increase, T1 contrast increases.

• As flip angles decrease, T2* contrast increases.
• Flip angle selection range is 1 to 180° for most pulse sequences. If the system
prompts you that there is a limitation, check the Advisory Panel.
When prescribing a flip angle, consider the following:
• GRE images may exhibit a lower SNR than conventional SE pulse sequences.
• The saturation effects of short TRs in Fast SPGR/GRE scans limits the usable
range of flip angles. Some sequences may prevent you from using large flip angles.
• When a GRE is acquiring data in the steady state, the TR is less than the T2 of the
tissue and the Ernst angle effects SNR. In general, keep the flip angle and TR within
ten points of one another to get maximum SNR.

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Echo Train Length

ETL is the number of echoes per TR that you prescribe. ETLs can contribute from 2 to
16 times more image data per TR, thereby decreasing acquisition time. ETL is available
for FSE and Fast Inversion Recovery (Fast IR) and FRFSE pulse sequences.
• In FSE, the initial 90° pulse is followed by the acquisition of 2 to 128 echoes within a
single TR (depending on the system configuration).
• Long TR acquisitions can be performed in reasonable scan times because the scan
time is divided by the ETL.
• The time between each echo in the echo train is called the echo space.
Figure 3-24 demonstrates that each echo is acquired with a different phase-encode
gradient and each echo fills a unique line of k-space.
Figure 3-24 Echo Train Length

For Example, If you prescribe a 32 ETL, the scan time is already reduced by a factor of
32. For example, a 256x256 image with a 32 ETL requires 8 repetitions to obtain the
required data. This is calculated by the following formula: TR x 256 ÷ 32 = 8.
Table 3-9 shows how various factors are effected as the ETL increases.
Table 3-9 ETL Effects

PD T2 #of Slices Scan Time Edge Blurring

ETL ⇑ ⇓ ⇑ ⇓ ⇓ ⇑

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Bandwidth
Bandwidth is a range within a band of frequencies that an MR system is tuned to
receive. The RBw of an image determines the number of frequencies sampled in an
image. As the RBw is narrowed, a smaller range of frequencies is sampled, thereby
reducing the amount of aberrant frequencies detected. The result is an improved SNR.
Figure 3-25 shows that varying the bandwidth can narrows the system’s receiver
bandwidth to increase SNR.
Figure 3-25 16kHz Bandwidth Sampling Range

The system default is ±15.63 kHz for a 256 frequency matrix or ±32 kHz for a 512
frequency matrix. This means that the system detects signal from protons resonating at
frequencies in the range of ±16 kHz, or ±32 kHz, from the Center Frequency.
In the Scan Timing area, you have the following choices:
• Bandwidth: the bandwidth selection for one echo sequences.
• Bandwidth2: the bandwidth selection for echoes 2 and 4 in multi-echo sequences.
The system annotates bandwidth in kHz in the lower left corner of the image. The
minimum and maximum bandwidths depend on the TE, matrix, and FOV selected. The
Scan Timing area lists the minimum achievable bandwidths for the first (RBw) and
subsequent (RBw2) echoes.
If a bandwidth is entered manually and the entry falls outside the minimum and
maximum bandwidth values, the system requests a different selection.
• Decrease the RBw to improve SNR.
• Increase the RBw to decrease the minimum TE.
There are many trade-offs associated with narrowing the receive bandwidth. Table 3-10
shows the effect decreasing RBw has on several parameters.
Table 3-10 Decreasing Bandwidth Effects

Sampling # of Chem Echo

SNR TE Motion
Time Slices Shift Spacing
RBw ⇓ ⇑ ⇑ ⇑ ⇓ ⇑ ⇑ ⇑

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Additional Parameters
The Additional Parameters area contains settings for presaturation pulses, graphic
prescription, vascular imaging, User Control Variables, gating,multi phase, enhancing
images, and DWI imaging. These icons become available when a pulse sequence or
imaging option that requires additional parameters to be defined.

SAT Prescription Screen

The SAT Additional Parameter screen provides functions for graphically and explicitly
prescribing presaturation pulses and/or suppression techniques for an exam. Saturation
pulses are used to saturate (and thereby eliminate signal from) tissues, a selected area,
or across the FOV when suppression SAT pulses are used.
Refer to the Prescribing Images chapter for additional information on SAT Prescription.

Graphic Prescription Screen

Graphic Rx Additional Parameter screen is used to graphically define the scan locations
on a localizer image using the same landmark.
Refer to the Prescribing Images chapter for additional information on Graphic
Prescription Basics.

Vascular Screen
The Vascular Screen is available in the Additional Parameters area when prescribing a
TOF, PCor 3D Fast GRE pulse sequence.
The available options for reconstructions for vascular imaging are accessed in the
Vascular Screen. There are four different types of image reconstructions: magnitude,
weighted-phase, collapsed, and projection images.
• Magnitude images for TOF sequences demonstrate the vessels clearly, while
suppressing the static tissues.
• Magnitude images for PC sequences demonstrate both vessels and static tissues.
These images provide an anatomical frame of reference with an appearance similar
to that of GRE.
• Weighted-phase images provide static tissue suppression to vividly reveal vascular
anatomy.
• Collapsed images provide quick visualization of the vascular data set in the plane of
acquisition, without interference from stationary tissue.
• Projection images create multiple views of a particular data set and permit
visualization of the anatomy at various angles.

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Table 3-11 shows the vascular pulse sequences that are compatible with various
vascular reconstruction techniques.
Table 3-11 Compatible Reconstruction Techniques with Vascular PSDs

Weighted 0, 19, 0r 37
Pulse Sequences Magnitude Collapsed
Phase Projections
2D TOF X2 X X

3D TOF X2 X X

3DFast GRE X2 X X

2D PC X X2 X

3D PC X X2 X X
Cine PC X X
1. Optional.
2. Used as input for the creation of collapsed and /or projection images because they
suppress static tissue.

NOTE: Refer to the applicable pulse sequences for additional information on the Vascular
Screen Additional Parameter selections.

User CVs Screen

User CVs Screen is used to define control variables which must be specified to initiate
an acquisition for certain pulse sequences. Certain timing parameter combinations
require access to User CVs for data entry. Depending on the pulse sequence chosen,
the User CVs screen may vary. If a pulse sequence requires a User CV, the User CVs
Screen icon in the Additional Parameters area will be available.
Refer to the User Control Variables chapter for specific User CVs.

Gating/Triggering Screen
The Gating/Triggering Screen is a combined Cardiac Gating/Triggering and Respiratory
Gating/Triggering screen. It is used to enter gating/triggering parameters and allows for
compatibility between features for selected pulse sequences.
The Gating/Triggering Screen is available in the Additional Parameters area when
Cardiac Gating/Triggering or Respiratory Gating/Triggering is selected from the
Imaging Options window.
Refer to the chapter Gating and Triggering chapter for additional information.

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Multi Phase Screen

The Multi Phase Screen allows you to define parameters for imaging of the same slice
at different times to provide temporal resolution. The Multi Phase Screen icon is
available in the Additional Parameters area when the Multi Phase imaging option is
selected with a compatible pulse sequence.

DWI Screen
Diffusion Weighted Imaging (DWI) Screen in the Additional Parameters area is
available with the optional DW-EPI package. Diffusion-Weighted Echo Planar Imaging
(DW-EPI) is a single shot EPI pulse sequence designed to create images that
differentiate tissues with restricted diffusion from tissues with normal diffusion.
The DWI Screen is available when a DW-EPI pulse sequence is selected from the pulse
sequence window. Refer to the Clinical Pulse Sequences section for additional
information on the DW-EPI optional software package.

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Scanning Range
The Scanning Range area (Figure 3-26) is used to select the Field of View (FOV)
covering the anatomy of interest, the slice thickness and spacing, location of the slices
and FOV center, and the number of slices in the acquisition. The entries can be made
explicit or graphically for the scan locations, FOV center, and slice number.
Figure 3-26 2D Scanning Range Area

Figure 3-27 3D Scanning Range Area

Field of View
FOV is the area of the anatomy selected for imaging. Prescribe FOVs as large as the
scanning range.
• For the body coil, choose FOVs from 1 cm to 40 cm, in 1 cm increments in all
planes. The minimum and maximum alternatives vary, depending upon scan
parameters and system configuration.
• For the head coil, choose FOVs from 1 cm to 28 cm, in 1 cm increments in all
planes. The minimum and maximum alternatives vary, depending upon scan
parameters and system configuration.
The FOV should be larger than the total number of slices times the slice thickness for
the best spatial resolution. To calculate the pixel size (spatial resolution) for an
acquisition, divide the FOV in millimeters by the phase or frequency of the acquisition
matrix. For example, Equation 3-2 demonstrates an 8 cm (or 80 mm) FOV and an
acquisition matrix of 256x384. The resulting pixel size is 0.31 x 0.21 mm.

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Equation 3-2 Pixel Size for an 8 cm FOV and 256x384 Matrix

80 ÷ 256 = 0.31 mm, 80 ÷ 384 = 0.21 mm

As pixel size decreases, the SNR is reduced because fewer signal-producing protons
are present per pixel. Other parameters assumed to be equal, SNR is proportional to
the square of the FOV. For example, halving the FOV from 24 to 12 results in an SNR
reduction of 75%. A 12 cm FOV image of the orbit is better resolved than a 24 cm FOV
image. However, there is a substantial reduction in SNR under this scenario.
To compensate for loss of SNR, increase the number of excitations (NEX), adjust the
TR, or slice thickness. Alternatively, decrease the matrix size or TE to generate more
signal and improve image quality.
Consider the following when prescribing the FOV:
• When using a 3D acquisition as a localizer, make sure the FOV of the prescription
intersects the localizer. To avoid FOV restrictions, use a center slice.
• To change FOV size for a graphic prescription, Graphic Rx must be open.
• The frequency gradient slope determines FOV. As the FOV decreases, gradient
heating and minimum TE increases. This can lead to a reduction of slices.

Slice Thickness
The Slice Thickness text box is for selecting the thickness of the slices being
prescribed. In general, the thinner the slice, the better the resolution, and the lower the
SNR.
Slice thickness range in millimeters:
• 2D – 1.2mm in 0.1 mm increments
• 3D – 0.2mm to 5.0 mm in 0.1 mm increments
• 2D PC slabs – 3 to 99 mm
Use thin slices of 3 to 4 mm for small structures such as the pituitary, inner ear, spine,
and vessels. Use thicker slices for studies of the abdomen, pelvis, and heart.
Consider the following when prescribing the slice thickness:
• The thicker the slice, the more partial voluming and certain structures may be
hidden by overlying tissue.
• SNR is improved with a larger slice thickness.
• To avoid excess low-signal graininess when using thin slices, increase the FOV,
NEX, or TE.
• To change slice thickness for a graphically prescribed series, Graphic Rx must be
open.

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Spacing
The Spacing text box allows selection of the space between the slices for all
prescriptions, except 2D and 3D vascular prescriptions.
The Locs per Slab text box allows for the number of scan locations and overlap
locations for 3D acquisitions.
• Slice Spacing in millimeters
– 2D: variable interslice spacing in increments as small as 0.1 mm. The interleave
option is available for multi-slice imaging.
• Number of Scan Locs
– 3D: 12 to 124 cm contiguous slice volume imaging in increments of 2.
• Overlap Location allows you to select up to 4 overlaps for 3D acquisitions (each
overlap = 1 mm).
– Prescribing an overlap allows you to acquire a continuous series of slices—with
no gaps. Remember, any 3D acquisition has aliased image data on both ends of
the slab, which is discarded. If this aliased (and discarded) image data is in the
overlap area, the scan prescription should result in a continuous, no gap, set of
slices.
Choosing spacing allows you to increase the scan range or image coverage with larger
interscan spacing to ensure complete coverage. Insert small gaps (spacing) between
slices, to reduce crosstalk, typically 20% of the actual slice thickness. Crosstalk or
overlap is caused by partial excitation of adjacent slices during RF excitation and
refocusing by a 180° pulse. This results in a reduction of image contrast and SNR, as
the expected TR and the effective TR may differ.
To change spacing for a graphically prescribed series, Graphic Rx must be open.
Figure 3-28 displays the effect slice spacing has on the excitation time. Note, for
example, that excitation of slice #5 at time t = 0.2 TR also results in partial excitation of
slices #4 and #6, which are excited at time t = 0.6 and t = 0.7 TR.
Figure 3-28 Slice Spacing Effects on Excitation Time

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This difference in TR alters the contrast-to-noise ratio (CNR) and SNR. The effects on
short TR/TE sequences may be lower SNR and possibly, greater T1 contrast, similar to
decreasing TR. The overall effect may be decreased CNR. Decreased SNR tends to
offset the increase in contrast. This usually means that the scan’s CNR has been
decreased, although the cross talk effect may not be the same for all slices.
If Interleave is selected or you have two or more acquisitions, the system acquires data
from every other slice during the first pass, then goes back and acquires data from the
rest. For example, slices 1, 3, 5, 7 first, then slices 2, 4, 6, and 8. Crosstalk is eliminated
with interleaved acquisitions.
To reduce the effects of interslice crosstalk use:
• Interleave (doubles the scan time)
• Larger interscan spacing
• 3D technique
• Sequential

Start and End Location

The Start and End location text boxes specify the scanning range in relation to the
landmark in the left to right (L-R), superior to inferior (S-I), or anterior to posterior (A-P)
directions. Together, start and end determine the area covered in the scan and can be
prescribed explicitly or graphically.
The system acquires the data in the order of the slices prescribed and automatically
calculates the actual end location and the number of locations. This is based on scan
thickness and the interscan spacing selected. The actual end location is displayed at
the bottom of the Scanning Range area.
Enter the scanning range from L-R, I-S, or P-A (LIP to SAR) so 2D and 3D acquisitions
have images collected in the same direction within the examination. To modify the end
location or to add or subtract slices, enter a different value for the number of locations.
The system automatically updates the actual end location. Multiple slice thicknesses
cannot be prescribed.
In 3-Plane Localizer acquisitions, start and end locations are not entered in the text box.
Entries reflect the FOV center for the axial images.

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FOV Center
The FOV Center defines the center of an image. Ideally, this is located at the magnet’s
isocenter. An off-center FOV is a FOV not centered at isocenter. This is accomplished
by typing in appropriate numbers at the FOV center prompt in the Explicit Scanning
Range area or using Graphic Rx.
The FOV Center defaults to zero unless otherwise specified. FOV center offsets can be
done in the phase and frequency directions. In axial, sagittal, and coronal image
prescriptions, two offsets are allowed. The system accommodates for any offset in the
S/I direction by means of a table movement.
Table 3-12 demonstrates the slice select axis and offset for a defined orthogonal plane.
Table 3-12 Slice Select Axis and Offsets

Plane Slice Select Axis Offset

Axial S/I R/L and/or A/P
Coronal A/P R/L and/or S/I
Sagittal R/L A/P and/or S/I

Consider the following when prescribing the FOV Center.

• Multiple groups and offsets in two directions can be prescribed in orthogonal
acquisitions. In oblique acquisitions, only multiple groups can be prescribed.
• Axial images with a two direction offset prescribed explicitly results in a tilted image
on the screen. Note that the annotation is correct.
• S/I offsets bring the anatomy to isocenter by moving the table. You are prompted to
move the table before prescanning.
• A/P and L/R offsets cannot be larger than 240 mm for body and surface coil
imaging, or 120 mm for head coil imaging.
• In 3-Plane Localizer acquisitions, the FOV Center determines the center of the FOV
for the middle slice of each plane. For example, if you prescribe three slices per
plane are selected, the second slice of each plane is located at the FOV Center.

Number of Slices/Slabs
The # of Slices or Slabs text box specifies how many slices (slabs) are prescribed per
acquisition. This text box only becomes available after the Graphic Rx icon is selected
in the Additional Parameters area. The start and end locations determine the number of
slices (slabs). A value is automatically entered in this text box if slice thickness, slice
spacing, and start/end locations are specified.
The number of slices define a 2D prescription, while the number of slabs define a 3D
prescription.

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A limited number of slices can be acquired in a given scan time. If too many slices are
prescribed, the system automatically increases the number of acquisitions. Scan time
increases accordingly. Your options are to:
• Accept the longer scan time.
• Increase the TR, shorten the TE, or reduce the SAT pulses. However, these choices
may prevent the desired tissue contrast.
• Switch from an oblique to an orthogonal plane.
• Enter a smaller scanning range to reduce the number of slices.
• Increase the FOV.
• Increase the slice thickness or spacing to get the same coverage with fewer slices.
In a 3-Plane Localizer acquisition, the number of slices entry determines how many
slices are acquired for each plane. This entry must be an odd number.

Acquisition Timing
The Acquisition Timing area (Figure 3-29) allows selection of timing parameters that
define scan time, resolution, prescan settings, and indication for contrast material.
Figure 3-29 Acquisition Timing Area

Acquisition Matrix
An Acquisition Matrix is the number of data points collected in the frequency and phase
encoding directions. More data points result in higher resolution. The matrix selections
are frequency and phase.
• Frequency controls resolution. Frequency encoding options are 256 or 512.
• Phase controls scan time and may control resolution. Phase encoding options from
128 to 512 in steps of 32.

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A matrix can be square or asymmetrical.

• A square matrix means that both phase and frequency values are equal.
• An asymmetrical matrix means that the phase axis is smaller than the frequency
axis.
Matrix values, FOV, the Square Pixel imaging option, and the Phase FOV entry
determine the size and shape of the pixel, which in turn determines image resolution.
This results in the following equation:
FOV
----------------------------------- = PixelValue
MatrixValue

For example, a 250 mm FOV and a 192 Phase x 256 Frequency Matrix results in a
1.28 pixel size.
250mm 250mm
-------------------------------- = 1.3 -------------------------------- = 0.98
192Pmatrix 256Fmatrix
therefore, 1.3 = 0.98 = 1.28 mm pixel.
• When the Square Pixel imaging option is selected, the pixel shape is always square
and its size is determined by the frequency axis only. An asymmetrical matrix
results in a rectangular FOV shape.

• When the Phase FOV is less than one and a symmetrical matrix is selected, the
pixel shape is square and the FOV shape is rectangular.

• When Phase FOV is less than one and asymmetrical matrix values are selected,
both the pixel shape and the FOV shape are rectangular.

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• When Phase FOV is one and an asymmetrical matrix is selected, the pixel is
rectangular and the FOV is square.

Match the size and shape of the matrix, FOV, and Square Pixel, or Phase FOV options
to resolve the anatomy being imaged.
• Select a frequency encoding matrix from the pre-defined list or enter a value in the
text box.
• Select a phase encoding matrix from the pre-defined list or enter a value between
128 and 512 in increments of 32, in the text box. The system automatically selects
the closest valid value for each entry.
NOTE: The frequency encoding matrix value cannot be smaller than the phase encoding
matrix, except for EPI sequences.
Consider the following when prescribing the matrix:
• A small matrix has a shorter acquisition time but less resolution. A 256 matrix
produces standard resolution.
• A large matrix has more resolution but takes longer to acquire. A 512 matrix
produces high resolution.
• Acquisition matrix selection does not affect the size of the displayed image.
Normally, all images are displayed in an “auto expand” mode on a 512x512 matrix.

NEX
The Number of Excitations (NEX) is the number of times the phase encoding steps are
repeated in a given acquisition. You can prescribe up to 150 NEX. The SNR increases
by the square root of the ratio of NEX. For example, increasing the NEX from 2 to 4
results in a 40% increase in SNR and a doubling of the scan time.
NEX is a factor in calculating scan time. Note the following equation: (TR) x (Phase
Steps) x (NEX) = basic 2D scan time
Adjust NEX to change SNR and/or scan time. Typically, as resolution increases, the
NEX value needs to be increased. An exception to this is 3D imaging.
Select the NEX value that produces adequate SNR to make the diagnosis. Too much
SNR wastes time, too little SNR produces undiagnostic images.

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Phase FOV
The Phase FOV shortens scan time by scaling down FOV size in the phase direction.
The pulse sequences you prescribe determines the range and increments you can
choose from. The pre-defined list displays the allowable values and the new FOV.
Phase FOV can be combined with a symmetrical or asymmetrical matrix.
• When Phase FOV is 0.5 or 0.75 and a symmetrical matrix is selected, the pixel
shape is square and the FOV shape is rectangular.

• When Phase FOV is 0.5 or 0.75 and asymmetrical matrix values are selected, the
pixel shape and the FOV shape are both rectangular.

The number of phase steps acquired is equal to: (Number of phase steps programmed)
x (Phase FOV), which reduces the scan time in comparison to a full phase FOV.
For example, a 256 Frequency matrix, a 192 Phase matrix and a selection of 0.75
Phase FOV, results in the reduced scan time of: (TR) x (192P) (0.75) x (NEX) = new
scan time.
Useful applications for a small Phase FOV:
• Scans with anatomy smaller than the FOV in the phase direction, such as
extremities, spines, axial, and coronal heads.
• High resolution images in a short scan time when combined with a symmetrical
matrix.
Consider the following when prescribing the Phase FOV:
• Phase FOV requires more precise placement of anatomy in the center of the FOV.
This is easily accomplished with FOV center offsets and swing table positions.
• Phase wraparound occurs if anatomy exists outside the new, reduced FOV. SAT
pulses placed in the phase direction can reduce the aliasing artifact.
• Phase FOV is not compatible with No Phase Wrap, POMP, Square Pixel, or NEX
greater than one with Respiratory Compensation.

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• SNR is reduced by approximately:

– 14% for 0.75 Phase FOV.
– 30% for 0.5 Phase FOV.
• Decrease the Phase FOV in EPI acquisitions to decrease geometric distortion and
increase spatial resolution.
• Typically a Phase FOV less than one is not selected on a sagittal or coronal if phase
and frequency are swapped.
Figure 3-30 shows how an image is effected when phase and frequency are swapped.
Figure 3-30 Swapping Phase and Frequency

A. Phase and Frequency swapped with a Phase FOV of 1.

B. Phase and Frequency swapped with a Phase FOV of 0.75.

Number of Acquisitions/Locations Before Pause

Scan pause techniques can be used to pause a scan at predetermined points for scans
with more than two prescribed slices. This text box name automatically changes
depending on the pulse sequence selected to:
• # of Locs Before Pause: indicates the number of locations to be acquired before
pausing the scan.
• # of Acqs Before Pause: indicates the number of acquisitions to be acquired
before pausing the scan.
• # of Reps Before Pause: indicates the number of TRs to be acquired before
pausing the scan in FSE sequences.
This feature is useful for pausing scanning at predetermined points for breath-hold, joint
motion, or contrast perfusion studies. The “scan time remaining” clock counts down
time before the pause. The [Scan] button must be selected to resume scanning after
each pause.
NOTE: The number of slices must be determined before the number of locations before
pause is available.

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Frequency Direction
Frequency Direction is the scanning direction associated with the frequency encoding
gradient. The phase and frequency axis determine the vertical and horizontal axis of the
displayed image. In general, frequency is the long axis of the imaging plane. Default
frequency (F) and phase (P) directions are displayed in Figure 3-31 and Figure 3-32.
Figure 3-31 Default Axial Directions

Figure 3-32 Default Sagittal and Coronal Directions

The default frequency direction is automatically entered in the Freq DIR text box. Swap
frequency and phase directions by changing the entry from the predefined list.

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Table 3-13 summarizes the default directions for phase, frequency, and slice-select
based on the coil selection.
Table 3-13 Default Directions Based on Coil Selection

Slice
Coil Plane Frequency Phase
Select
Axial R/L A/P S/I
Body, Extremity,
Neurovascular, and Receive Sagittal S/I A/P R/L
Only Surface Coils
Coronal S/I R/L A/P
A/P or R/L or
Axial S/I
EPI-R/L EPI-A/P
Head Coil Sagittal S/I A/P R/L
S/I or R/L or
Coronal A/P
EPI-R/L EPI-S/I

NOTE: Changes to the coil configuration files may change the default directions.
For oblique prescriptions, the frequency direction selections in the Freq DIR text box
are Unswap or Swap. Unswap is the frequency direction displayed prior to prescribing
oblique slices.
NOTE: When acquiring a 3-Plane Localizer acquisition, the Freq DIR text box is not a
selectable parameter and does not follow the default conventions for determining
the frequency direction.
Flow, motion, and other phase artifacts, such as aliasing or wraparound, are mapped
onto the image in the phase direction. A wise choice of frequency direction can reroute
these artifacts away from the region of interest. For example, sagittal spines have the
frequency direction in the S/I direction and phase A/P, which routes motion artifacts
through the vetebral bodies and spinal canal. One solution is to make phase run S/I so
that the flow artifact from the aorta and vena cava runs parallel to the cord, rather than
through it.

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Auto Center Frequency

Auto Center Frequency (CF) fine-tunes the system’s RF transmit/receive frequency to
the precessional frequency of the protons under study. Four CF options are available:
• Current
– Skips center frequency tuning in prescan and uses the last center CF values.
– Is used if a scan is stopped and the scan is re-initiated.
– Is not used if scan parameters have changed since last series.
• Water
– Is the default and centers on the water peak as long as a valid fat/water pair is
present.
– Uses maximum peak if it cannot determine a valid fat/water pair.
– Is the mandatory choice for fat suppression.

• Fat
– Centers on fat protons, assuming a valid fat/water pair is present.
– Uses maximum peak if it cannot determine a valid fat/water pair.
– Is the mandatory choice for water suppression.

• Peak
– Centers on the maximum peak.

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Flow Comp Direction

The flow compensation direction allows you to prescribe a direction to reduce flow
artifacts by putting the flowing protons into phase with the stationary protons. This
feature is only available with FSE acquisitions.
One direction must be chosen to apply the flow comp gradient: slice selection or
frequency encoding. The system suggests a direction based on the scan plane.
• With sagittal or coronal scan planes, frequency is the default.
• With an axial scan plane, slice is the default.
• With oblique scan planes, no default is highlighted.
The flow compensation direction should match the direction of the flowing protons. For
example, a sagittal spine should have the same frequency axis as the flow
compensation direction, which is head to foot, the direction of CSF and blood flow. Only
one direction can be selected.
NOTE: A pre-defined flow compensation direction selection from a protocol, previous
series, or scan takes precedence over these defaults.
The flow compensation gradient is applied in the frequency or slice direction only. If
phase and frequency have been swapped, the flow motion runs in the phase direction
of the image and flow comp is then ineffective.

Autoshim
Autoshim improves image quality by optimizing the X, Y, Z gradient shim settings,
particularly with Chem SAT, Fast, and chemical-shift imaging.
There are two Autoshim Modes:
• Automatic, which is selected in the Acquisition Timing area.
• Manual, which is selected from the Manual Prescan window as Grad Shimming.
NOTE: Not all systems have the Grad Shimming option.
Autoshim is the system’s default and is included in Prescan. Autoshim uses the scan
prescription parameters to calculate the optimal shim region. For the ROI, the system
scans the intersection of three orthogonal planes in the following order: axial, sagittal,
and coronal. ROI size depends on coil type and the FOV.
• The axial plane is always acquired at isocenter.
• The sagittal and coronal planes are acquired from the scan coordinates of the first
and last slices scanned.
• Autoshim generates up to 12 images, two magnitude and two phase, from each
scan plane.
• Nine images are displayed in Manual Mode, three magnitude, three phase, and
three phase-difference images.

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• Shim results can be saved in one of the ten Gradient Shim files.
• Autoshim sets up the PSD to acquire data from the sagittal and coronal plane. For
display, the analysis program calculates both the linear and quadratic coefficients
for shim correction.
• No Current CF option appears, unless Autoshim is deselected.
• If Autoshim fails, prescan continues. You can still proceed with the scan. An error
message is posted to the Advisory Panel.
Select Autoshim for the following applications:
• First series for each new exam or area of anatomy.
• Chem SAT acquisition.
• Fat/Water suppression prescriptions.
• When using the imaging option Classic.

Phase Correct
Phase Correct is an option for FSE and EPI pulse sequences. It obtains additional data
prior to image acquisition and is used to correct for phase shifts.
Phase Correct, and EPI compensates for undesired phase shifts due to eddy currents
and RF misalignment. This is more noticeable on FSE scans because FSE combines
data from many echoes acquired at different times to form a single image. Phase errors
between acquired echoes lead to ghosting and/or signal loss. Phase Correct
compensates for these phase errors by means of RF phase shifts and gradient
amplitude calibration.
• In EPI, Phase Correct performs a reference scan following a successful prescan.
• Phase Correct is annotated on the text page.
• Select Phase Correct for the following applications:
– Off-Center FOV with FSEs that exhibit blurring.
– Peripheral signal artifacts on sagittal FSE spines when using phased array coils.
– Echo Planar Imaging.
When using Phase Correct, scanning starts approximately four seconds after selecting
the [Scan] button due to the additional data acquisition and calculations of correction
values. Phase Correct cannot be used with the number of locations before pause in the
Acquisition Timing area.
NOTE: Phase Correct is an optional selection that is strongly recommended.

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Contrast
The Contrast selection provides a place to enter a contrast agent and amount for the
current and all subsequent series.
If Autoscan is On and Contrast is selected, the first series in the Rx Manager containing
contrast is not started until the contrast injection message box appears and you select
the [OK] button. Autoscan must be reselected to restart auto scanning mode.
The contrast injection message does not appear again on this exam for subsequent +C
series. An exception to this occurs when there is a series prescribed with contrast
followed by a series prescribed without contrast, then another series with contrast. The
contrast injection message appears again following the no contrast series.

Rx Manager
The Rx Manager (Figure 3-33) is used to create, view or edit, and prepare a series to be
scanned. A series list is created in the Rx Manager upon selection of a protocol.
Additionally, gating controls for the waveform display are accessed from Gating Control
window and Auto Archive and Auto Transfer features from Scan Modes.
Figure 3-33 Rx Manager

Refer to the Scanning with a Protocol chapter for information on the Rx Manager.

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 Scan Rx Desktop

Series Control and Advisory Panel

Series Control area allows prescribed acquisitions to be saved, parameters to be reset
to their original values, and the relative SNR% to be monitored. This area also contains
an Advisory Panel to provide information about scan time, the number of acquisitions,
the maximum number of slices per acquisition, estimated and peak SAR, real time
imaging frame rate notification, and posts messages during the prescription process.

Save Series
The Save Series selection accepts the parameters and places the series in the RXD
State in the Rx Manager.
A landmark must be established and all parameters must be completed for Save Series
to be valid. The first series is automatically downloaded to scan when the [Save Series]
button is clicked.
Once Save Series is initiated for the first series, patient information can no longer be
updated.

Reset Values
The Reset Values selection resets parameters to their original values before any
modifications were made.

Relative SNR%
The Relative SNR% meter reflects changes to parameters within a prescription that
impact SNR.
The parameters used to calculate changes in SNR are:
• Fractional or full TE
• Receiver bandwidth
• FOV
• Slice thickness
• Frequency matrix
• Phase matrix
• NEX
• Phase FOV
• Square pixel
• 3D number of locations per slab

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 Scan Rx Desktop

The relative SNR% is not an absolute value but a relative value based on the current
set of parameters being equal to 100%. Changes made to parameters that affect SNR
are calculated and relative SNR% is updated to indicate their impact on SNR. The
relative SNR% for a protocol can be reset to 100% using the Reset SNR selection.
Changes for SNR are not calculated for changes in TR or TE. Significant changes in TR
and TE can change the SNR for an acquisition. The calculation does not include
changes for TR, PSD, or coil selected.
For a variable SE sequence, a relative SNR% is given for TE and TE2.

SAR Level
Specific Absorbtion Rate (SAR) refers to the RF power absorbed per unit of mass of an
object (Watts/kg).
• The SAR limits are not exceeded when the patient’s correct weight is entered on the
Patient Information area.
• If the head coil is in use, the estimated average head SAR shall be displayed along
with the estimated average and peak SAR values.
• SAR levels for the patients are based on current scientific literature related to safety.
The level of exposure shall be a medical judgment as to the patient’s potential risk
versus benefit.

Frames per Second Notification

Frames per Second (FPS) notifications are displayed during Real Time Imaging
acquisitions. FPS is dependent on the system hardware configuration. The FPS rate for
the prescribed series appears prior to the beginning of the scan.
NOTE: For Real Time Interactive Imaging frame rates refer to the Imaging Real Time
chapter.

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 Scan Rx Desktop

Scan Operations
Scan Operations area displays the dB/dt level, provides prescan options to improve
image quality, and allows you to start the scan prescription.

STL% or dB/dt Level

The STL% or dB/dt level displays the value your site’s governing board (Investigational
Review Board) has approved for scanning limits.
• DB/dt refers to the rate of change in magnetic field to time which is expressed in
Tesla/seconds.
• STL is an abbreviation for Stimulated Threshold Limit and the dB/dt is expressed in
T/s. Your service representative sets the units in T/s or STL%.
• The Signa system is capable of operating under several modes: normal, first level
controlled operating mode (research mode), and second level controlled operating
mode (proprietary license agreement with GE).
• The screen appearance changes based on the operating mode (clinical vs
research), the governing regulator (IEC vs FDA), and the pulse sequence (non-EPI
or EPI).
NOTE: STL% values appear on systems outside the US.

Prescan
The Prescan procedure optimizes performance and improves image quality. Prescan
accomplishes this by:
• Providing shim consistency through the Autoshim Program.
• Fine-tuning the system for optimal sampling of the individual patient’s anatomy
through the Center Frequency Program.
• Adjusting the RF transmit gain to ensure precise flip angles.
• Adjusting the RF receive gain to optimize the use of the receiver’s dynamic range.
There are two Prescan Programs: Auto and Manual.
• Auto Prescan automatically adjusts and sets Center Frequency, Transmit and
Receive Gain.
• Manual Prescan requires that you set the Center Frequency, Transmit, and Receive
Gains.
For detailed information on prescanning, refer to the Prescanning chapter.

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 Scan Rx Desktop

Prep Scan
Prep Scan can be used to eliminate the lapse in time between the moment you select
the [Scan] button and the moment the system begins scanning. It is useful for
breath-hold examinations. Prep Scan can be selected after Auto or Manual Prescan
and before Scan.

Scan
Scan initiates the acquisition and begins to scan the prescribed series. When selected
first, scan automatically adjusts and sets Center Frequency, Transmit and Receive gain
then begins scan. Scan can also be selected after a successful Auto or Manual
prescan.

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 Gradient and Imaging Coils

Chapter 4
Gradient and Imaging Coils

Introduction
This chapter provides a brief overview of the function of the gradient and shim coils.
This chapter also explains the function and use of radio frequency (RF) and imaging
coils. The guidelines in this chapter will help you to select the appropriate coil for
common examinations.
This chapter contains the step-by-step instructions to help you learn how to:
• Position a Patient in the Body Coil
• Position a Patient in a Head Coil
• Position a Patient with a Surface or Phased Array Coil

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 Gradient and Imaging Coils

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete the coil
selection and patient positioning process. Specifically, you need to understand:
• Gradient Coils
• Imaging Coils
– Coil Classifications
– Coil Hazards
– Coil Selection
– Coil Connections
– Coil ID
• Quality Assurance

Gradient Coils
The gradient coils are three sets of wire coils wrapped around a fiberglass cylinder
located within the magnet housing. Electric current flows through the gradient coils and
is turned on and off very rapidly, thereby producing expansion and contraction of the
gradient coils. This expansion and contraction creates the tapping sound when
scanning.
The electric current flowing through these coils produces another magnetic field.
Because the current is turned on and off in a specified manner, this magnetic field
varies and is called a time-varying magnetic field. The Magnetic Resonance (MR)
image is the representation of a slice of anatomy that has been divided into cubes or
voxels. These time-varying magnetic fields create controlled and graded variations in
the static magnetic field, thus affecting nuclear precessional frequency in any given
voxel of anatomy and allowing for spatial detection of signal within a slice. Knowing how
much the magnetic field has been graded or altered at any given point in a slice, the
system can determine where each voxel is located by reading the precessional
frequency of the signal within that voxel.
Each of the three gradient coils affect a different plane (XY, YZ, or XZ plane) as it is
turned on and off at different points in a pulse sequence. The scan plane and pulse
sequence selected will determine which gradient functions as the slice selective, phase
encoding, and frequency encoding gradient. The system calculates this automatically.
Consider the Z-axis gradient, which is created by enclosing two coils, one on the top of
the bore, the other on the bottom of the bore. If current is passed through the coil at the
top of the bore, then magnetic field lines are created along the +Z-axis. Then, by
passing current in the opposite direction through the wire at the bottom of the bore, a
similar but opposite field is created along the -Z-axis. The net effect is offset at the

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 Gradient and Imaging Coils

middle of the two coils (isocenter), resulting in zero change to the static magnetic field
at isocenter. The X and Y gradients are also located on the top and the bottom of the
bore and use a similar method to localize signal in these planes.

Imaging Coils
Imaging coils are RF coils that consist of loops of copper wire that transmit and/or
receive the RF signal. Imaging coils are used to transmit matching radio frequencies to
resonate with nuclei in the anatomy of interest. The RF coil acts as a receiver of the
signal emitted by the nuclei upon cessation of the RF transmission. The received signal
is the raw data used to create an image.
Imaging coils are tuned to match the precessional frequency of nuclei under evaluation.
Table 4-1 provides the precessional frequency of hydrogen protons according to the
magnetic field strength.
Table 4-1 Precessional Frequency of Hydrogen Protons per Field Strength

Hydrogen Proton
Magnet Field Strength
Precessional Frequency
0.35T 14.8 MHz

Generally, the length of a coil is equal to the FOV it covers. The depth of penetration is
half the width of the coil. When selecting a coil, keep in mind the FOV, the depth you
need to image, and the size of the patient. It is best to choose the smallest coil possible
to get the optimum signal-to-noise ratio (SNR).

Coil Classifications
The broad category of imaging coils can be classified into four sub-categories:
• Body
• Head
• Surface
• Surface Coil
Generally, the Body and head coils give a uniform depth of signal. Surface coils are
specialized coils for imaging limited areas with limited depth penetration. Phased array
coils are two or more, closely coupled surface coils that receive signal over an area.

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 Gradient and Imaging Coils

Body
The Body coil is located within the magnet enclosure and is invisible to you and the
patient. The Body coil is a transmit and receive coil, which excites nuclei and collects
signals as the nuclei relax. It transmits the RF pulses that excite and rephase the
protons, receiving the signals created by the protons. The Body coil can also act as a
transmit-only coil when used with receive-only coils. The Body coil is a volume coil and
is used for large FOV imaging and for uniform depth penetration.

Head
The head coil transmits and receives RF signals. It provides a higher SNR than the
Body coil due to its smaller size. The head coil is primarily used to image the head,
although it can be used for imaging any body part that fits into the coil. Figure 4-1
displays an example head coil.
Figure 4-1 Head Coil
Mirror

WARNING:Do not let the patient’s skin touch the head coil. Place sponges or cloths
between the head coil and the patient.

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 Gradient and Imaging Coils

Surface
Surface coils are used to increase SNR when imaging a limited area. They need to be
placed close to the imaging area. Flat surface coils do not have uniform depth
penetration and are susceptible to artifacts due to signal from excited tissue outside the
volume of interest. An example of a surface coil is the Body Flex XL coil shown in
Figure (Figure 4-3).
Figure 4-2 Surface Coil

Phased Array
Phased array coils are a number of coils combined together to increase SNR and,
depending on the coil design, may increase available FOV without decreasing SNR.
Phased array coils provide better SNR over a localized area if they are placed in close
proximity to the imaging area. An example of a phased array coil is the small extremity
coil (Figure 4-3).
Figure 4-3 Small Extremity Phased Array Coil

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 Gradient and Imaging Coils

Coil Hazards
It is extremely important to keep the following warnings in mind when positioning
patients in imaging coils.

WARNING:The following general warnings should be followed when using cables

and accessory connection equipment:
Use only GE or GE-authorized accessory coils and cables.
Use only accessories, coils, and cables that are in good condition. If
you suspect that an accessory is not in good condition, discontinue
its use and contact your GE Service Engineer.
Remove unplugged surface coils or unused accessory devices from
the magnet bore; a patient burn can result.
RF can heat non-compatible surface coils, damaged surface coils, or
surface coils that are not properly plugged in. Improperly routed
cables can cause burns.
The use of cable-connected surface coils can result in localized
heating, leading to a burn or fire if proper scan preparation is not
followed. The cables often extend into the high intensity region of the
RF field and it is possible that induced electrical currents in the cables
may cause arcing.
Always bring the cable directly out of the center of the magnet bore
with no slack.
Keep the length of cable in the bore to a minimum. Avoid bending the
cable 180°.
Place cables under the cushion whenever possible. Routing near the
sides of the bore increases the likelihood of cable heating (from
induced currents).
Do not cross or loop cables. Arcing and patient burns could result.
ONLY USE HIGH IMPEDENCE electrocardiogram (ECG) LEADS when
doing surface coil or phased array coil ECG gated scans.
The practice of allowing a cable to touch a patient could result in
burns. Use a thermal resistant material or pad to keep the cable from
touching the patient.
The patient should not touch the magnet bore. Place pads between
patient and bore to avoid this. For large patients, use wide patient
safety straps across the arms (or any other area that touches the
bore).

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 Gradient and Imaging Coils

Coil Selection
Imaging coils must be selected during scan prescription to communicate the active coil
to the MR system. This can be accomplished by clicking the button to the right of the
Coil text box in the Patient Position area (Figure 4-4) of the Scan Rx desktop and
selecting a coil from the Coil Names window (Figure 4-5).
Figure 4-4 Patient Position Area

The Coil Names window (Figure 4-5) lists the coil type, coil name, and configuration.
When you select a coil type, the coil names and configurations update to reflect that
type of coil.
Figure 4-5 Coil Names Window

NOTE: The coils listed in the Coil Names window may differ depending on the coils your
site has purchased.
If the coil or patient position are changed in a protocol during the scan prescription, a
window (Figure 4-6) opens with two selections: apply or apply all.

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 Gradient and Imaging Coils

Figure 4-6 Coil Change Message Window

• Apply: changes the patient position or coil for the current series labeled as INRX in
the Rx Manager.
• Apply All: changes the patient position or coil for all remaining un-scanned series in
the examination.

Coil Connections
Coils are plugged into the outlet at the narrow end of the table.

Coil ID
The Coil identification (ID) feature displays a picture of the coil selected for the
examination. Each coil has a self identification code that is recognized by the system.
There are two purposes for this feature: matching the coil plugged in with the coil
selected in the scan prescription and checking if the coil is properly seated in the plug.
An examination using the Body coil would show the picture of the Body coil of the
Ovation system in the Patient Position area (Figure 4-7).
Figure 4-7 Patient Position Area with Coil ID

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 Gradient and Imaging Coils

Matching the Coil

The coil selected in the protocol must match the coil connected to the system.
NOTE: If the coil connected does not match the coil selected in the current protocol, the
system will post a message advising of the discrepancy.

CAUTION: The coil selected should match the coil that is connected.

Checking the Light Indicator

The coil light indicator is a light-emitting diode (LED) that signifies if the coil is properly
seated in the plug and if the coil selected at the operator’s console matches the coil that
is currently plugged in. The LED has two states:
• Yellow: indicates a coil is initially being plugged into the port or that a coil is
improperly seated.
• Green: indicates a properly seated plug and the coil matches the coil pictured in the
Patient Position area.
If the light is yellow, unplug and try to plug the coil in again. If the coils do not match, you
must then either change the coil selected or change the coil from the operator’s
console.
To change the Coil ID, click the button to the right of the Coil text box. The Coil Names
Window opens and allows you to select a different coil.
Table 4-2 summarizes the functions of the Coil ID LED.
Table 4-2 Coil ID LED

Action Coil ID LED Description

Coil is not plugged in No indication No coil present
Coil plugged in - immediate Yellow Coil present
Coil plugged in - after 5 seconds Green Coil ID verified

WARNING:Some coils are transmit and receive coils. Be sure that the proper coil
is selected at the system console before scanning the patient. DO NOT
SCAN TRANSMIT AND RECEIVE COILS WITH THE BODY COIL. Making
a coil selection that does not match the actual coil used may result in
severe damage to the coil and possible patient warming.

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 Gradient and Imaging Coils

Quality Assurance
You should perform a Quality Assurance (QA) test on your coils as recommended by
the manufacturer. When a coil is working normally, a QA scan produces a normal image
showing no holes, distortions, or other artifacts. If there are artifacts in the visual image,
contact your GE Service Engineer and do not use the coil for patient studies.
NOTE: When performing QA tests for other coils, refer to the operator manual of each
individual coil.

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 Gradient and Imaging Coils

How Do I...
This section provides the step-by-step instructions for selecting coils and positioning
patients. Specifically, it describes how to:
• Position a Patient in the Body Coil
• Position a Patient in a Head Coil
• Position a Patient with a Surface or Phased Array Coil

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 Gradient and Imaging Coils

Position a Patient in the Body Coil

Use the Body coil whenever you need to use a large FOV or need uniform depth
penetration. Abdomen imaging and cardiac/chest imaging may be examinations that
require the use of the Body coil.
Use this procedure to position your patient in the Body coil.
1. Remove any other coil or unused accessory device from the magnet.
Š The Body coil is built inside the magnet housing, so no coils need to be placed on
the cradle.
2. Place comfort pads on the table to make the patient comfortable.
Š The large pads should be placed on the table so the patient is positioned
comfortably.
3. Place a clean cotton sheet over the comfort pads.
Š Cover these items so the patient’s skin will not come in direct contact with the
comfort pads.
4. Move the table entry position to the center.
Š Most Body coil scans require the center table position, although you may use the
left or right positions also.
5. Have the patient lie supine on the table, either head first or feet first.
Š Feet first is preferred, due to fewer problems with claustrophobia.
6. If possible, try to position the patient’s arms away from the area of interest.
Š When imaging the abdomen or chest you may want to bring the patient’s arms
above his or her head (if the patient can tolerate it).
Š Do not allow the patient’s arms to touch the bore. Place sponges between the
patient’s arms and the bore if needed.
Š Do not allow the patient to cross his or her arms.

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 Gradient and Imaging Coils

7. Use additional pads to immobilize and make the patient comfortable.

Š Security straps across the arms, abdomen, or legs provides safety for the patient
and help control patient motion.
Š Usually, placing an angled pad under the patient’s knees helps to take pressure
off his or her back.
8. Provide the patient with the Patient Alert Bulb and give instructions on its use.
9. Provide ear plugs for the patient after all instructions have been given.
Š Instruct the patient that during the scan it gets quite noisy.
Š If available, headphones may be substituted for ear plugs.
Š Since the acoustic noise of the Ovation does not exceed 92.2 dBA, ear
protection is not required, but is recommended.
10. Instruct the patient to close his or her eyes.

WARNING:Instruct the patient to close his or her eyes before turning on the
alignment light and landmarking. The eyes must be protected from laser
radiation. Exposing eyes to the laser alignment lights may result in eye
injury.
11. Press the Align Light to turn on the red laser light.
12. Move the table in slowly until the crosshair of the alignment light is over the center of
the area of interest.
13. Press Landmark to communicate the region of interest center to the system.
Š Do not leave the laser light on after you position the patient.
14. Press Move to Scan to move the patient to isocenter (center of magnet).
15. Place thermal pads where the patient touches the bore to help prevent warming.
16. Proceed with the scan prescription, selecting Body for the coil type.
Š Make sure the coil pictured in the Coil ID displays the Body coil.

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 Gradient and Imaging Coils

Quick Steps: Position a Patient in the Body Coil

1. Remove any other coil or unused accessory device from the magnet.
2. Place comfort pads on the table to make the patient comfortable.
3. Place a clean cotton sheet over the comfort pads.
4. Move the table entry position to the center.
5. Have the patient lie supine on the table, either head first or feet first.
6. If possible, try to position the patient’s arms away from the area of interest.
7. Use additional pads to immobilize and make the patient comfortable.
8. Provide the patient with the Patient Alert Bulb and give instructions on its use.
9. Provide ear plugs for the patient after all instructions have been given.
10. Instruct the patient to close his or her eyes.
11. Press the Align Light to turn on the red laser light.
12. Move the table in slowly until the crosshair of the alignment light is over the center
of the area of interest.
13. Press Landmark to communicate the region of interest center to the system.
14. Press Move to Scan to move the patient to isocenter (center of magnet).
15. Place thermal pads where the patient touches the bore to help prevent warming.
16. Proceed with the scan prescription, selecting Body for the coil type.

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 Gradient and Imaging Coils

Position a Patient in a Head Coil

A Head coil is designed to create an evenly distributed magnetic field within its volume.
Use a head coil whenever imaging the head and for any body part that fits into the head
coil. Remember to place sponges so that the patient’s skin does not touch the coil.
Use this procedure to position your patient in a head coil.
1. Select the appropriate head coil type and name.
a) Select the button to the right of the Coil text box in the Patient Position Area.
b) Select the Head/Neck coil type from the Coil Names Window.
– The list of coils displays only those coils that have been configured for that
system.
c) Select the appropriate coil name.
d) Select the appropriate configuration.
e) Click [Accept].
2. Remove any other coil or unused accessory device from the magnet.

CAUTION: Patient burns may result from coil to coil coupling.

3. Move the table entry position to the center.
Š Most head coil scans require the center table position.
4. Place the head coil on the magnet end of the table.
Š The coil must be for this particular system. Coils from other MR systems
(including coils from other GE MR systems) must NOT be used.
a) Place the posterior half of the coil at the top of the patient cradle.
b) Plug in the connector, while making sure the cables extend into the magnet.
– The cables from the quick-disconnect box to the head coil should always be
straight, with no crossovers or loops evident from the outside.
c) Lock the baseplate into the table slots.
5. Place the comfort pads into the base of the head coil.
Š The large pads should be placed on the cradle so the patient is positioned
comfortably on the table with his or her head centered in the head coil.
6. Place a clean cotton sheet over the coil and comfort pad.
Š Cover these items so the patient’s skin will not come in direct contact with the coil
or the comfort pad.

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 Gradient and Imaging Coils

7. Position the patient head-first and supine, with his or her head as far into the coil
form as possible.
Š The patient’s head should be in the posterior half of the coil.
Š The patient’s shoulders should rest against the inferior edge of the coil.

8. Instruct the patient to place his or her arms at his or her sides during the
examination.
Š Do not allow the patient’s arms to touch the bore. Place sponges between the
patient’s arms and the bore if needed.
Š Do not allow the patient to cross his or her arms.

9. Use additional pads to immobilize the patient and make him or her comfortable.
Š Security straps across the arms, abdomen, or legs provides safety for the patient
and help control patient motion. Usually, placing an angled pad under the
patient’s knees helps to take pressure off the back.
10. Provide the patient with the Patient Alert Bulb and give instructions on its use.
11. Provide ear plugs for the patient after all instructions have been given.
Š Inform the patient that during the scan it gets quite noisy.
Š If available, headphones may be substituted for ear plugs.
Š Since the acoustic noise of the Ovation does not exceed 92.2 dBA, ear
protection is not required, but is recommended.

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 Gradient and Imaging Coils

12. Instruct the patient close his or her eyes.

WARNING:Instruct the patient to close his or her eyes before turning on the
alignment light and landmarking. The eyes must be protected from laser
radiation. Exposing eyes to the laser alignment lights may result in eye
injury.
13. Press the Align Light to turn on the red laser light.
14. Move the table to align the light at the center of the coil, approximately at the
patient’s nasion.
Š The localizing light should be aligned with the crosshairs on the coil for
positioning accuracy within the bore.
15. Press Landmark to communicate the region of interest center to the system.
Š Do not leave the laser light on after you position the patient.
16. Place the anterior half of the coil over the patient’s head, if applicable.
17. Check to make sure the LED at the coil plug-in is green.
Š A green light indicates the plug is properly seated.
Š If the LED is yellow, the coil plugged in is not the coil that was selected at the
console. Go back to the operator’s console and select the coil you wish to use
and the LED will turn green.

CAUTION: If there is any visible damage to the coil or cables DO NOT USE. Notify
your GE Service Engineer.
18. Press Move to scan to move the patient to isocenter.
19. Place thermal pads where the patient touches the bore to help prevent warming.
20. Make sure the coil pictured in the Coil ID displays the selected head coil.

WARNING:Be sure that the proper coil is selected on the system console before
scanning with a head coil. Do not scan using a head coil when the Body
coil is selected on your system console. This could result in damage to
the coil and possible patient warming.

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 Gradient and Imaging Coils

Quick Steps: Position a Patient in a Head Coil

1. Select the appropriate head coil type and name.
2. Remove any other coil or unused accessory device from the magnet.
3. Move the table entry position to the center.
4. Place the head coil on the magnet end of the table.
5. Place the comfort pads into the base of the head coil.
6. Place a clean cotton sheet over the coil and comfort pad.
7. Position the patient head-first and supine, with his or her head as far into the coil
form as possible.
8. Instruct the patient to place his or her arms at his or her sides during the
examination.
9. Use additional pads to immobilize the patient and make him or her comfortable.
10. Provide the patient with the Patient Alert Bulb and give instructions on its use.
11. Provide ear plugs for the patient after all instructions have been given.
12. Instruct the patient close his or her eyes.
13. Press the Align Light to turn on the red laser light.
14. Move the table to align the light at the center of the coil, approximately at the
patient’s nasion.
15. Press Landmark to communicate the region of interest center to the system.
16. Place the anterior half of the coil over the patient’s head, if applicable.
17. Check to make sure the LED at the coil plug-in is green.
18. Press Move to scan to move the patient to isocenter.
19. Place thermal pads where the patient touches the bore to help prevent warming.
20. Make sure the coil pictured in the Coil ID displays the selected head coil.

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 Gradient and Imaging Coils

Position a Patient with a Surface or Phased Array

Coil
When imaging a small region of interest, remember that the smaller the coil, the better
the SNR. Use Surface coils and Surface Coil coils when imaging an area where you are
able to place the coil close to the region of interest. Surface and phased array coils
have a limited depth of penetration, typically about half the width of the coil. They are
NOT volume coils.
Use this procedure to position your patient with a surface or phased array coil.
1. Select the appropriate coil type and name.
a) Select button to the right of the Coil text box in the Patient Position Area.
b) Select the correct coil type from the Coil Names Window.
– The list of coils displays only those coils that have been configured for that
system.
c) Select the appropriate coil name.
d) Select the appropriate configuration.
e) Click [Accept].
2. Remove any other coil or unused accessory device from the magnet.

CAUTION: Patient burns may result from coil-to-coil coupling.

Š Observe all warnings that are listed in the Coil Hazards section.
3. Place comfort pads on the table to make the patient comfortable.
Š The large pads should be placed on the table so the patient is positioned
comfortably.
4. Place a clean cotton sheet over the comfort pads.
Š Cover these items so the patient’s skin will not come in direct contact with the
comfort pads.
5. Position the patient on the table and the coil in the area of interest on the patient.

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 Gradient and Imaging Coils

6. Use additional pads to immobilize and make the patient comfortable.

Š Security straps across the arms, abdomen, or legs provide safety for the patient
and help control patient motion.
Š Usually, placing an angled pad under the patient’s knees helps to take pressure
off his or her back.
Š Do not allow the patient’s arms to touch the bore. Place sponges between the
patient’s arms and the bore if needed.
Š Do not allow the patient to cross his or her arms.

7. Provide the patient with the Patient Alert Bulb and give instructions on its use.
8. Provide ear plugs for the patient after all instructions have been given.
Š Instruct the patient that during the scan it gets quite noisy.
Š If available, headphones may be substituted for ear plugs.
Š Since the acoustic noise of the Ovation does not exceed 92.2 dBA, ear
protection is not required, but is recommended.
9. Instruct the patient to close his or her eyes.

WARNING:Instruct the patient to close his or her eyes before turning on the
alignment light and landmarking. The eyes must be protected from laser
radiation. Exposing eyes to the laser alignment lights may result in eye
injury.
10. Press the Align Light to turn on the red laser light.
11. Plug in the coil.
Š The coil must be for this particular system. Coils from other MR systems
(including coils from other GE MR systems) must NOT be used. Also, the cables
should not be twisted or looped.

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 Gradient and Imaging Coils

12. Check to make sure the LED at the coil plug-in is green.
Š A green light indicates the plug is properly seated.
Š If the LED is yellow, the coil plugged in is not the coil that was selected at the
console. Go back to the operator’s console and select the coil you wish to use
and the LED will turn green.

CAUTION: If there is any visible damage to the coil or cables, DO NOT USE THEM.
Notify your GE Service Engineer.
13. Move the table to the desired the table entry position.
Š Extremity imaging may require that the table entry be left or right to get the area
of interest as close to isocenter as possible.
Š When the table entry is at left or right, the tabletop can be moved laterally
+/- 12 cm.

CAUTION: If the table entry is at left or right, use caution when moving the patient
into the scanner to avoid collisions and pinches with the pillars.
14. Move the table in slowly until the crosshair of the alignment light is over the center of
the area of interest.
Š The localizing light should be aligned with the crosshairs on the coil for
positioning accuracy within the bore.
15. Press Landmark to communicate the region of interest center to the system.
Š Do not leave the laser light on after you position the patient.
16. Press Move to Scan to move the patient to isocenter (center of magnet).
17. Place thermal pads where the patient touches the bore to help prevent warming.
18. Make sure the coil pictured in the Coil ID displays the correct coil.

WARNING:Some coils are transmit and receive coils. Be sure that the proper coil
is selected at the system console before scanning the patient. DO NOT
SCAN TRANSMIT AND RECEIVE COILS WITH THE BODY COIL. Making
a coil selection that does not match the actual coil used may result in
severe damage to the coil and possible patient warming. Refer to the
individual coil operator documentation for specific cautions and
warnings.

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 Gradient and Imaging Coils

Quick Steps: Position a Patient with a Surface or Phased Array Coil

1. Select the appropriate coil type and name.
2. Remove any other coil or unused accessory device from the magnet.
3. Place comfort pads on the table to make the patient comfortable.
4. Place a clean cotton sheet over the comfort pads.
5. Position the patient on the table and the coil in the area of interest on the patient.
6. Use additional pads to immobilize and make the patient comfortable.
7. Provide the patient with the Patient Alert Bulb and give instructions on its use.
8. Provide ear plugs for the patient after all instructions have been given.
9. Instruct the patient to close his or her eyes.
10. Press the Align Light to turn on the red laser light.
11. Plug in the coil.
12. Check to make sure the LED at the coil plug-in is green.
13. Move the table to the desired the table entry position.
14. Move the table in slowly until the crosshair of the alignment light is over the center
of the area of interest.
15. Press Landmark to communicate the region of interest center to the system.
16. Press Move to Scan to move the patient to isocenter (center of magnet).
17. Place thermal pads where the patient touches the bore to help prevent warming.
18. Make sure the coil pictured in the Coil ID displays the correct coil.

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 Managing Protocols

Chapter 5
Managing Protocols

Introduction
A protocol is a series of pre-programmed scan parameters used for imaging a particular
part of the body. Using pre-programmed protocols optimizes the scanning process and
helps maintain consistent imaging. You are able to create, save, copy, edit, restore, and
print protocols to help your site manage a custom set of protocols.
This chapter explains the protocol building and saving process. It provides key concepts
and brief guidelines for building protocols and saving protocols for future use. This
chapter also contains the step-by-step instructions to help you learn how to:
• Select a Protocol
• Build a Protocol
• Copy a Protocol
• Copy a Series in a Protocol
• Edit a Protocol
• Save a Protocol While Scanning
• Delete a Site Protocol
• Reorganize Site Protocols
• Save Site Protocols to MOD
• Restore or Delete Site Protocols from MOD

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 Managing Protocols

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete the building and
saving protocol processes. Specifically, you need to understand:
• Protocol Manager
• Protocol Libraries
– GE Library
– Site Library
• Managing Site Protocols
– Saving Protocols
– Printing Protocols
– Restoring or Deleting Protocols
– Protocol Lockout

Protocol Manager
A protocol is a series of scan parameters that is used for imaging a particular part of the
body. You can build and save protocols using the Protocol Manager. The Protocol
Manager Desktop icon is located on the control panel (Figure 5-1).
Figure 5-1 Control Panel with Protocol Desktop Manager

Protocol Manager
Desktop

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 Managing Protocols

Protocol Libraries
Protocol libraries are sets of scan parameters that are pre-programmed into your
system. Using pre-programmed protocols optimizes the scanning process and helps
maintain consistent imaging.
Your Magnetic Resonance (MR) system has the following libraries of protocols:
• GE Library
• Site Library
Each library contains eight protocol categories:
• Head
• Neck/Cervical
• Chest/Thoracic
• Upper Extremities
• Abdomen/Lumbar
• Pelvis
• Lower Extremities
• Other
Protocol categories can contain up to 100 protocols, with up to 100 series each.
The Patient Protocol area (Figure 5-2) allows you to select the protocol library and
category. You can select the protocol category by clicking on the desired anatomy on
the Humanoid icon or by typing the protocol name in the Protocol text box.
Figure 5-2 Patient Protocol Area

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 Managing Protocols

GE Library
The GE library contains pre-programmed protocols. You can edit the protocols from the
GE library and save them to the Site library.

Site Library
You create and save your own protocols into the Site library; the protocols from the GE
library can be used (and edited) as a starting point. The Site library is empty until you
add your site’s protocols. The Site library can be updated by editing or adding new
series to the protocol. This library can also be stored on a Magnetic Optical Disk (MOD)
and printed. This is especially important when software is upgraded and new features
are added to your system.

Managing Site Protocols

Protocols from the GE and Site libraries can be edited, copied, pasted, and saved to
suit your particular needs. To streamline scanning, you may want to have the commonly
performed examination protocols stored in your Site library. You may also want to have
protocols saved with different parameters or coils to maintain efficiency, i.e., an
abdomen protocol saved with the patient positioned head first and one with the patient
positioned feet first.

Saving Protocols
You can choose a protocol from any of the protocol libraries and save it to the Site
Library. Protocols from the GE and Site library can be edited, although edited GE
protocols can only be saved to the Site library. It is your individual site’s responsibility to
save your own site protocols on an MOD as a backup. If you have the protocols saved
on an MOD, you can easily and quickly restore your protocols to the system. You can
save by anatomical area, by protocol, or by series.
You can create new protocols and save them or you can save protocols after you have
entered in the parameters for a scan prescription during scanning. The [Save Rx as
Protocol] button in the Protocol Manager or the Rx Manager allows you to save
protocols. After this button is clicked, the Save Protocol Rx window (Figure 5-3) opens.
This window allows you to choose a category and unique name to save your protocol.

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 Managing Protocols

Figure 5-3 Save Protocol Rx Window

When you select the [Save Rx as Protocol] button, you are prompted for the Table
Entry in addition to the Protocol Category and Name. You can select a table entry of
None, Left, Center or Right. If you select None, when you use the protocol, the table
entry is left blank. If you select any of the other choices, this choice is automatically
entered into the prescription along with the other parameters you prescribed in the
protocol.

Printing Protocols
The Print Protocol feature requires a postscript printer. Many printers are “PostScript
ready” and an upgrade may not guarantee the printer’s compatibility with the Print
Protocol feature. It is recommended not to use this feature at this time. DICOM print will
be made available at a time that is yet to be determined.

Restoring or Deleting Protocols

A restore option is available to easily restore your site’s protocols from an MOD in the
event of accidental deletion. You also have the option to delete protocols from an MOD.
This gives you the opportunity to delete old or outdated protocols.

Protocol Lockout
The Protocol Lockout feature restricts changes to the site protocols by password
protecting the site protocols. When defining a Protocol Lockout password, be sure to
notice the case of the sequence of characters in the password. The password text is
case-sensitive. Figure 5-4 displays the Save Protocol Rx window with the Protocol
Lockout feature activated.

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 Managing Protocols

Figure 5-4 Save Protocol Rx Window with Protocol Lockout

NOTE: Refer to your service engineer for setting up administrative privileges.

If an incorrect password is entered, an Invalid Password error message opens. Click
the [OK] button on the message window and re-enter the correct password. Refer to
your site administrator to gain protocol editing privileges.

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 Managing Protocols

How Do I...
This section provides the step-by-step instructions for building and saving protocols.
Specifically, it describes how to:
• Select a Protocol
• Build a Protocol
• Copy a Protocol
• Copy a Series in a Protocol
• Edit a Protocol
• Save a Protocol While Scanning
• Delete a Site Protocol
• Reorganize Site Protocols
• Save Site Protocols to MOD
• Restore or Delete Site Protocols from MOD

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 Managing Protocols

Select a Protocol
Using protocols while you are scanning helps to maintain consistent imaging while
optimizing your patient flow.
Use this procedure to select a pre-existing protocol for scanning.
1. Click the Scan Rx Desktop icon in the control panel.

2. Click [New Patient] in the Patient Protocol area.

3. Enter the necessary patient data.
4. Click the button to the right of Patient Protocols and select the library from which to
select the protocol.
Š Select GE to access pre-programmed protocols.
Š Select Site to access protocols that you have created and saved.

5. Click an anatomical region of the Humanoid icon to select the protocol category.
Š Alternatively, you may type in a protocol name in the Protocol text box.

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 Managing Protocols

6. Select the desired protocol category from the left side of the Protocol and Series
Description window and the desired series from the right side of the window.
Š To download all series, you only need to select the protocol.
Š To download series that are not in a sequential order, click the selected series.

7. Click [Accept].
Š The selected series loads into the Rx Manager.

Quick Steps: Select a Protocol

1. Click the Scan Rx Desktop icon in the control panel.
2. Click [New Patient] in the Patient Protocol area.
3. Enter the necessary patient data.
4. Click the button to the right of Patient Protocols and select the library from which to
select the protocol.
5. Click an anatomical region of the Humanoid icon to select the protocol category.
6. Select the desired protocol category from the left side of the Protocol and Series
Description window and the desired series from the right side of the window.
7. Click [Accept].

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 Managing Protocols

Build a Protocol
Protocol building is a valuable tool for you to use to maintain protocols that are
customized to your site’s needs. Having pre-programmed protocols saves you from
entering the scan parameters each time you scan a patient.
Use this procedure to build a protocol from the beginning.
1. Click the Protocol Manager Desktop icon in the control panel.

2. Click [Protocol Rx] from the Protocol Prescription area.

Š The [Schedule Rx] button only appears if you have purchased the ConnectPro
Plus option.

3. Click [New Protocol] in the Protocol Rx area.

Š The Patient Information and Patient Position areas become available.
4. Enter the necessary parameters for the protocol prescription.
Š When building protocols, not every text box needs to be filled in. This allows you
to create protocols even if you do not know the exact parameters for every text
box, window, or area. When you use the protocol, you can “fill in the blanks” to
meet the requirements for the current patient. If an entry is required, you are
prompted to enter data in text box before continuing.
Š Select the appropriate Table Entry position.

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 Managing Protocols

a) Enter the Imaging Parameters information.

– The mode and pulse sequence text boxes must be filled in to view the
remaining areas and windows.
b) Enter the Scan Timing parameters.
c) Click the Additional Parameters icons as needed and complete the applicable
information.
d) Enter the Acquisition Timing parameters.
e) Enter the Scanning Range parameters.
– If this is the first series of a protocol, enter a scan range (For example: scan
plane sagittal, type L40 in the Start text box and type R40 in the End text
box). If this is not the first series of the protocol, and you plan to use Graphic
Rx, no entries are needed for the Start/End locations.
5. Click [Save Series].
Š The series status in the Protocol Manager changes from INRX (in prescription) to
RXD (prescribed).
Š If no additional series are needed, go to step 7.
6. Click [New Series] from the Protocol Manager to add another series to the protocol
and repeat steps 3 to 5.
7. Once all the series are created, click [Save Rx as Protocol] on the Protocol
Manager.

8. Assign a category and name your protocol.

a) Click the button to the right of Protocol Category.
b) Select a category from the pre-defined list.
c) Enter a unique name in the Protocol Name text box. For example,
Claustrophobic Brain.

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 Managing Protocols

9. Enter your password in the Protocol Password text box.

Š Passwords are case-sensitive.
Š If Other is selected as the Protocol Category, a password is not required to save
the prescription as a protocol.
Š A password is only required if the Protocol Lockout feature is active.
10. Click [Accept] to save the protocol and return to the Protocol Prescription area.
Š The protocol is saved in the Site library.
Š To begin the protocol building process again, click the [Protocol Rx] button.

Quick Steps: Build a Protocol

1. Click the Protocol Manager Desktop icon in the control panel.
2. Click [Protocol Rx] from the Protocol Prescription area.
3. Click [New Protocol] in the Protocol Rx area.
4. Enter the necessary parameters for the protocol prescription.
5. Click [Save Series].
6. Click [New Series] from the Protocol Manager to add another series to the protocol
and repeat steps 3 to 5.
7. Once all the series are created, click [Save Rx as Protocol] on the Protocol
Manager.
8. Assign a category and name your protocol.
9. Enter your password in the Protocol Password text box.
10. Click [Accept] to save the protocol and return to the Protocol Prescription area.

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 Managing Protocols

Copy a Protocol
You may find that you want to copy an entire protocol into another protocol. Instead of
creating a new protocol, it is much faster and easier to copy an existing protocol.
Protocols can only be copied into the Site Library.
Use this procedure to copy a protocol to the Site library.
1. Click the Protocol Manager Desktop icon in the control panel.

2. Click [Protocol Rx] from the Protocol

Prescription area.
Š The Protocol Prescription window
opens.
Š The [Schedule Rx] button only
appears if you have purchased the
ConnectPro Plus option.

3. Click the button to the right of Patient Protocols and select the library that contains
the protocol.

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 Managing Protocols

4. Click an anatomical region of the Humanoid icon to select the protocol category.
Š Alternatively, you may type in a protocol name in the Protocol text box.
5. Select the desired protocol category from the left side of the Protocol and Series
Description window and the desired series from the right side of the window.
Š To download all series, you only need to select the protocol.

6. Click [Accept] to continue.

7. Click [Save Rx as Protocol] in the Protocol Manager.
Š The Save Protocol Rx window opens.

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 Managing Protocols

8. Assign a category and name your protocol.

a) Click the button to the right of Protocol Category.
b) Select a category from the pre-defined list.
c) Enter a unique name in the Protocol Name text box.
9. Enter your password in the Protocol Password text box.
Š Passwords are case-sensitive.
Š If Other is selected as the Protocol Category, a password is not required to save
the prescription as a protocol.
Š A password is only required if the Protocol Lockout feature is active.
10. Click [Accept] to save the protocol and return to the Protocol Prescription area.
Š The protocol is saved in the Site library.

Quick Steps: Copy a Protocol

1. Click the Protocol Manager Desktop icon in the control panel.
2. Click [Protocol Rx] from the Protocol Prescription area.
3. Click the button to the right of Patient Protocols and select the library that contains
the protocol.
4. Click an anatomical region of the Humanoid icon to select the protocol category.
5. Select the desired protocol category from the left side of the Protocol and Series
Description window and the desired series from the right side of the window.
6. Click [Accept] to continue.
7. Click [Save Rx as Protocol] in the Protocol Manager.
8. Assign a category and name your protocol.
9. Enter your password in the Protocol Password text box.
10. Click [Accept] to save the protocol and return to the Protocol Prescription area.

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 Managing Protocols

Copy a Series in a Protocol

You may want to repeat a series either while scanning or when saving a protocol. For
example, pre- and post-contrast injection. The same process is used for copying while
scanning and while saving protocols.
1. Follow steps 1 to 6 in the Copy a Protocol procedure and continue with these steps.
2. Select the desired series in the Rx Manager.
3. Right-click on the selected series and select Copy
Series.
Š To delete a series in the Rx Manager, right-click
on the series to be deleted and select Cut.
4. Select the series to place the copied series below.
5. Right-click on the selected series and select Paste
Series.
Š The copied series is placed just below the
selected series. For example, if you copy Series
2 and you want to paste it after Series 4, select
Series 4 after you select Copy Series and
before you select Paste Series.
6. Click [Save Rx as Protocol] to save the updated
protocol in the Site library.
Š The Save Protocol Rx Window opens.
7. Assign a category and name your protocol.
a) Click the button to the right of Protocol Category.
b) Select a category from the pre-defined list.
c) Enter a unique name in the Protocol Name text box.
8. Enter your password in the Protocol Password text box.
Š Passwords are case sensitive.
Š If Other is selected as the Protocol Category, a password is not required to save
the prescription as a protocol.
Š A password is only required if the Protocol Lockout feature is active.
9. Click [Accept] to save the protocol and return to the Protocol Prescription area.
Š The protocol is saved in the Site library.

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 Managing Protocols

Quick Steps: Copy a Series in a Protocol

1. Follow steps 1 to 6 in the Copy a Protocol procedure and continue with these
steps.
2. Select the desired series in the Rx Manager.
3. Right-click on the selected series and select Copy Series.
4. Select the series to place the copied series below.
5. Right-click on the selected series and select Paste Series.
6. Click [Save Rx as Protocol] to save the updated protocol in the Site library.
7. Assign a category and name your protocol.
8. Enter your password in the Protocol Password text box.
9. Click [Accept] to save the protocol and return to the Protocol Prescription area.

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 Managing Protocols

Edit a Protocol
Once a protocol is saved, you may wish to adjust the parameters or create a new
protocol using the existing parameters as a base. Editing a protocol allows you to do
this without re-building the entire protocol. Protocols from the GE Library and Site
Library can be edited. Edited protocols can only be saved to the Site library.
If you are creating a new protocol from an existing protocol, follow the Copy a Protocol
procedure before editing the protocol.
Use this procedure to edit an existing protocol.
1. Download the protocol you wish to edit.
a) Click the button to the right of Patient Protocols and select the library from which
you would like to edit a protocol.
b) Click an anatomical region of the Humanoid icon to select a protocol category.
c) Select the desired protocol from the menu.
d) Click [Accept] to continue.
2. Select the series you want to edit from the Rx
Manager.
3. Click [View Edit].
Š The series state changes to INRX.
4. Modify the series, as necessary.
5. Click [Save Series] in the Scan Operations area.
6. Repeat steps 2 to 5 to make changes to additional
series.
7. Click [Save Rx as Protocol] in the Rx Manager.
Š The Save Protocol Rx Window opens.
8. Save your prescription over the existing protocol or
as a new protocol.
Š To update the existing protocol, continue with step
9.
Š To save the prescription as a new protocol, follow
these steps:
a) Click the button to the right of Protocol
Category.
b) Select a category from the pre-defined list.
c) Enter a unique name in the Protocol Name text box.

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 Managing Protocols

9. Enter your password in the Protocol Password text box.

Š Passwords are case-sensitive.
Š If Other is selected as the Protocol Category, a password is not required to save
the prescription as a protocol.
Š A password is only required if the Protocol Lockout feature is active.
10. Click [Accept] to save the protocol and return to the Protocol Prescription area.
Š The protocol is saved in the Site library.

Quick Steps: Edit a Protocol

1. Download the protocol you wish to edit.
2. Select the series you want to edit from the Rx Manager.
3. Click [View Edit].
4. Modify the series, as necessary.
5. Click [Save Series] in the Scan Operations area.
6. Repeat steps 2 to 5 to make changes to additional series.
7. Click [Save Rx as Protocol] in the Rx Manager.
8. Save your prescription over the existing protocol or as a new protocol.
9. Enter your password in the Protocol Password text box.
10. Click [Accept] to save the protocol and return to the Protocol Prescription area.

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 Managing Protocols

Save a Protocol While Scanning

After you have entered the parameters for a scan you may want to save them as a
protocol. Saving a protocol is similar to building a protocol.
Use this procedure to save a protocol while you are scanning.
1. Once all the scan parameters have been entered on the Scan Rx Desktop, click
[Save Rx as Protocol] in the Rx Manager.
Š All series that are in the Rx Manager will be saved.
2. Assign a category and name to your protocol.
a) Click the button to the right of Protocol Category.
b) Select a category from the pre-defined list.
c) Enter a unique name in the Protocol Name text box.
– When you are in the Scan Rx Desktop you are creating a new protocol. You
must type a new name in the Protocol Name text box.
– You can only update an existing protocol when you are in the Protocol
Manager Desktop.

3. Enter your password in the Protocol Password text box.

Š Passwords are case-sensitive.
Š If Other is selected as the Protocol Category, a password is not required to save
the prescription as a protocol.
Š A password is only required if the Protocol Lockout feature is active.
4. Click [Accept] to save the protocol.
Š The protocol is now saved in the Site library.

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 Managing Protocols

Quick Steps: Save a Protocol While Scanning

1. Once all the scan parameters have been entered on the Scan Rx Desktop, click
[Save Rx as Protocol] in the Rx Manager.
2. Assign a category and name to your protocol.
3. Enter your password in the Protocol Password text box.
4. Click [Accept] to save the protocol.

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 Managing Protocols

Delete a Site Protocol

If a protocol is no longer needed, you may want to delete it from your Site Library.
Use this procedure to delete a protocol from your Site library.
1. Click the Protocol Manager Desktop icon in the control panel.

2. Click [Protocol Rx] from the Protocol Prescription area.

Š The [Schedule Rx] button only appears if you have purchased the ConnectPro
Plus option.
3. Select the Site library from the Patient Protocol menu.
Š Only protocols from the Site library can be deleted.

4. Click an anatomical region of the Humanoid icon to select the protocol category.
Š Alternatively, you may type a protocol name in the Protocol text box.
5. From the menu, select the protocol you want to delete.
6. Right-click on the selected protocol and select Protocol Cut from the menu.
Š If the Protocol Lockout feature is active,
the Enter Protocol Password window
opens.
7. Enter your password in the Protocol
Password text box and click [Accept].
Š Passwords are case-sensitive.

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 Managing Protocols

8. Click [Confirm] to remove the protocol from the Site library.

Š The protocol is deleted from the Site library.
9. Click [Backup].
10. Click [Cancel] to exit.

Quick Steps: Delete a Site Protocol

1. Click the Protocol Manager Desktop icon in the control panel.
2. Click [Protocol Rx] from the Protocol Prescription area.
3. Select the Site library from the Patient Protocol menu.
4. Click an anatomical region of the Humanoid icon to select the protocol category.
5. From the menu, select the protocol you want to delete.
6. Right-click on the selected protocol and select Protocol Cut from the menu.
7. Enter your password in the Protocol Password text box and click [Accept].
8. Click [Confirm] to remove the protocol from the Site library.
9. Click [Backup].
10. Click [Cancel] to exit.

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 Managing Protocols

Reorganize Site Protocols

Site protocols in the Protocol Desktop Manager can be reorganized within a protocol
category (i.e., Head, Neck/Cervical, Chest/Thoracic, Upper Extremity,
Abdomen/Lumbar, Pelvis, or Lower Extremity.)
Use this procedure to reorganize your site’s protocols within a category.
1. Click the Protocol Desktop Manager icon on the control panel.

2. Click [Protocol Rx] from the Protocol Prescription area.

3. Select the Site library from the Patient Protocol menu.
Š Only protocols from the Site library can be reorganized.

4. Click an anatomical region of the Humanoid icon to select the protocol category.
Š Alternatively, you may type a protocol name in the Protocol text box.
5. From the menu, select the protocol you want to reorder.
6. Right-click on the protocol and select
Protocol Cut.
Š If the Protocol Lockout feature is active,
the Enter Protocol Password window
opens.
7. Enter your password in the Protocol
Password text box and click [Accept].
Š Passwords are case-sensitive.

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 Managing Protocols

8. Click [Confirm] to cut the protocol from the category.

Š The protocol is deleted from the selected category.
9. Select the protocol that you want the cut protocol to appear below.
10. Right-click on the selected protocol and select Protocol Paste.
Š The Protocol Name Entry window opens.

11. Enter a new name for the protocol.

12. Click [Accept] to save the reordering of the protocol.
Š The protocol is saved in the newly assigned order.

Quick Steps: Reorganize Site Protocols

1. Click the Protocol Desktop Manager icon on the control panel.
2. Click [Protocol Rx] from the Protocol Prescription area.
3. Select the Site library from the Patient Protocol menu.
4. Click an anatomical region of the Humanoid icon to select the protocol category.
5. From the menu, select the protocol you want to reorder.
6. Right-click on the protocol and select Protocol Cut.
7. Enter your password in the Protocol Password text box and click [Accept].
8. Click [Confirm] to cut the protocol from the category.
9. Select the protocol that you want the cut protocol to appear below.
10. Right-click on the selected protocol and select Protocol Paste.
11. Enter a new name for the protocol.
12. Click [Accept] to save the reordering of the protocol.

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 Managing Protocols

Save Site Protocols to MOD

Saving your protocols onto an MOD eliminates the need to recreate them if they are
deleted from your hard disk. For example, if your hard disk is reformatted, your Site
library will be deleted.
Use this procedure to save site protocols to an MOD.
1. Insert a new MOD into the disk drive.
Š It is very important to choose a new MOD to avoid accidental removal of already
archived data.
Š If the MOD has patient images on it, this patient information will be lost when you
save the protocols on the same MOD.
2. Click the Service Desktop icon in the control panel.

Š The Service Desktop Manager opens.

3. Click [Utilities] in the Service Desktop
Manager.
4. Click and drag the slider to scroll down the
Utilities list and select Save/Restore/Print
Protocols.
5. Click [Start].
Š The protUtilShell window appears.
Š The Protocol Selection menu defaults to the
Site library in the protUtilShell window.
6. Select the desired protocol category.
Š Once the protocol category is selected, the
Site’s protocols for that category are shown
in the middle column.
Š To select sequential categories, click and
drag on the categories. The middle and left
column remain blank.
Š To select non-sequential categories, press
and hold Ctrl and select each category. The
middle and left column remain blank.

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 Managing Protocols

7. If desired, select the specific protocol from the middle column.

Š Once the protocol is selected, the protocol’s series are shown in the far right
column.
8. If desired, select the series to be saved from the right column.
9. Click [Save].
Š A message opens to confirm that you want to save the selected item(s).
Š A second message opens, stating that the MOD will be reformatted, and all
existing data on the MOD will be erased.
10. Click [Continue] to format the MOD and save the selected series to MOD. If done
saving, continue with step 11.
Š Repeat steps 6 through 9 if you would like to save more protocols or series to the
MOD.
Š To add an additional protocol to already saved protocols, it is best to re-save all
protocols. This ensures all protocols and changes are saved.
11. Click Media from the Protocol Selection menu to check that protocols are saved to
the MOD.
Š Select the protocol category to ensure the protocols appear in the middle
column.
Š Select the protocol to ensure the series appear in the right column.
12. Click [Exit] to exit the protUtilShel window.
Š A confirmation message opens.
13. Click [OK] to exit and eject the MOD.

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 Managing Protocols

Quick Steps: Save Site Protocols to MOD

1. Insert a new MOD into the disk drive.
2. Click the Service Desktop icon in the control panel.
3. Click [Utilities] in the Service Desktop Manager.
4. Click and drag the slider to scroll down the Utilities list and select
Save/Restore/Print Protocols.
5. Click [Start].
6. Select the desired protocol category.
7. If desired, select the specific protocol from the middle column.
8. If desired, select the series to be saved from the right column.
9. Click [Save].
10. Click [Continue] to format the MOD and save the selected series to MOD. If done
saving, continue with step 11.
11. Click Media from the Protocol Selection menu to check that protocols are saved to
the MOD.
12. Click [Exit] to exit the protUtilShel window.
13. Click [OK] to exit and eject the MOD.

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 Managing Protocols

Restore or Delete Site Protocols from MOD

You can easily restore your site’s protocols from an MOD in the event of accidental
deletion or delete old or outdated protocols from the MOD.
Use this procedure to restore or delete protocols from an MOD.
1. Insert the MOD that contains the Site protocols in the MOD drive.
2. Click the Service Desktop icon in the control panel.

Š The Service Desktop Manager opens.

3. Click [Utilities] in the Service Desktop Manager.
4. Click and drag the slider to scroll down toward the
bottom of the Utilities list, and select
Save/Restore/Print Protocol.
5. Click [Start].
Š The protUtilShell window opens.
6. Click Media from the Protocol Selection menu.
7. Select the protocol category in the left column that
you want to restore or delete.
Š If necessary, select the individual series.
8. In the protUtilShell window, click [Restore] or
[Delete].
Š Restore places the selected protocols back on
your system.
Š Delete removes the selected protocols from the
MOD.
9. Click [OK] to begin the process.
10. Check the progress of the process.
Š If you are restoring, select Site Protocols on the
Protocol Selection menu and select the protocol category. The protocols are
listed in the middle column and series are listed in the right column.
Š If you are deleting, select Media on the Protocol Selection menu and select the
protocol category. The protocol should no longer be listed.

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 Managing Protocols

11. Click [Exit] to close the protUtilShell window.

Š A confirmation message opens.
12. Click [OK] to exit and eject the MOD.

Quick Steps: Restore or Delete Site Protocols from MOD

1. Insert the MOD that contains the Site protocols in the MOD drive.
2. Click the Service Desktop icon in the control panel.
3. Click [Utilities] in the Service Desktop Manager.
4. Click and drag the slider to scroll down toward the bottom of the Utilities list, and
select Save/Restore/Print Protocol.
5. Click [Start].
6. Click Media from the Protocol Selection menu.
7. Select the protocol category in the left column that you want to restore or delete.
8. In the protUtilShell window, click [Restore] or [Delete].
9. Click [OK] to begin the process.
10. Check the progress of the process.
11. Click [Exit] to close the protUtilShell window.
12. Click [OK] to exit and eject the MOD.

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 Registering Patients

Chapter 6
Registering Patients

Introduction
This chapter explains how to pre-register a patient, enter patient demographic
information before their arrival in the magnetic resonance (MR) department, and use
the ConnectPro™ Plus feature. These features can increase throughput by reducing
patient setup time. This chapter contains the step-by-step instructions to help you learn
how to:
• Pre-Register a Patient
• Link a Protocol to a Patient at Pre-Registration
• Select a Registered Patient
• Sort the Patient Register
• Delete a Registered Patient
• Enter Patient Information Using PPS
• End Examinations Using PPS
• Check Configuration of Guided Install
• Map Protocols to Action Items

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 Registering Patients

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete the
pre-registration process and use the ConnectPro Plus features. Specifically you need to
understand:
• Patient Pre-Registration
• ConnectPro Plus (PPS)
– Patient Information
– Schedule Worklist Navigation
– End Examinations
– Delete a Registered Patient
• Guided Install

Patient Pre-Registration
You can pre-register patients before their arrival in the MR department, facilitating
increased throughput. Once a patient arrives, you can bring up his or her information
and move forward with scanning. To begin a scan, you must, at a minimum, enter the
patient’s ID and weight. The patient’s weight determines the Specific Absorbtion Rate
(SAR) limits.
NOTE: Refer to the Registering Patients chapter for more information about SAR.

WARNING:Entering a weight different than the actual patient weight could

potentially harm the patient by exposing him or her to high RF values
and warming the patient.

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 Registering Patients

The Patient Information area (Figure 6-1) requires detailed information about the
patient. Table 6-1 details what each selection is asking for.
Figure 6-1 Patient Information Area

Table 6-1 Patient Information Area Descriptions

Selection Description
This is generally a number assigned by the hospital, clinic, or site,
Accession
and tied to the patient’s records. You can enter the number manually
Number
or by using the optional bar code reader (if applicable).
The patient’s identification (ID) can be any combination of numbers,
letters, and dashes. If the system finds the same ID in its memory, it
Patient ID displays all the pertinent data so long as the entry is identical,
including the use of upper-case and lower-case letters. Enter MR to
display the last (most recent) patient’s data.
The patient’s name should be entered without numbers preceding
Patient Name
the name.
The birth date can be entered using numbers 1 to 12 for the month,
1 to 31 for the day, and 19xx or 20xx for the year (mm/dd/yyyy or
Birth Date mm-dd-yyyy). The year entry must contain four digits. This entry is
optional when pre-registering patients. The system can be
configured for dd/mm/yyyy by the service engineer.
The age is automatically calculated if the birth date is entered. Only
whole numbers (i.e., no decimals) can be entered. Age ranges from
Age
1 to 123 years. Days (1-90), weeks (1-52), or months (1-23) can also
be entered. For example, 28D, 4W or 1M.

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 Registering Patients

Selection Description (Continued)

Sex The sex of the patient can be entered as M for male or F for female.
The patient’s weight can be entered in pounds or kilograms. The
system automatically calculates and displays the other weight
Weight
measure. Limits are 2 to 500 lb. (1 to 227 kg). Accurate weight
information is essential for safe scanning.
Rad The name of the radiologist.
Refer The name of the referring physician.
Operator The initials of the operator.
A status of the patient can be selected
from the menu. Selections include None,
In, Out, and Emergency.
Status

Exam A description for the examination. If this area is not completed, no

Description information appears on the Exam Page.
History The patient’s symptoms or other relevant information.
[Schedule] Provides access to the ConnectPro Plus option.
[Position] Provides access to the Abbreviated Patient Information area.

NOTE: Entries made in the Patient Information area should not contain a backslash (\)
character.

ConnectPro Plus (PPS)

ConnectPro Plus, also known as Performed Procedure Step (PPS) on your system, is a
purchasable option. It is a patient information manager that is designed to enhance your
productivity and reduce manual transcription errors. This feature allows direct scanner
integration with information systems such as the Image Management Systems (IMS),
Picture Archival Computerized System (PACS), Hospital Information System (HIS), or
the Radiology Information System (RIS). To connect the information system and the
MR system to activate PPS, you need the assistance of your facility’s Information
Technology department and service engineer to help set up the server and port
configurations. A bar code reader can also be purchased with this option to further
facilitate efficient entry data.
Using the demographic data from an information system eliminates errors in the entry of
unique patient identifiers such as patient name, requisition number, accession number,
and ID number. This helps operations that rely exclusively on accurate patient data
entry to locate and retrieve digital patient records.

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 Registering Patients

Some background information may be needed to understand the purpose of the

ConnectPro Plus feature. HIS/RIS use procedure codes when ordering and charging for
an examination or procedure. These codes vary by institution. An example is the use of
Current Procedural Terminology (CPT) codes (codes for various procedures
established by the American Medical Association (AMA) and used by federal
Medicare/Medicaid programs). The codes used by the HIS/RIS may be unique to a
hospital or clinic, but these codes can be configured on the system and linked to
protocols in the system protocol library. When patient information from the HIS/RIS is
called to the MR system through PPS, the procedure code is part of the information. If
the code is linked to a system protocol, that protocol is displayed on the Scan Rx
Desktop along with the patient information. Series one of the protocol loads into the
series prescription. The remaining series in the protocol are seen in the Rx Manager.
ConnectPro Plus uses the DICOM Modality Worklist protocol to retrieve the schedule
and patient demographic information from the information system. The DICOM Modality
Worklist standard facilitates the direct exchange of patient demographic data and
associated examination schedules between diagnostic imaging equipment and
information systems.
PPS is a closed loop of information transfer. The loop starts when you select the patient
from the Schedule Worklist with the information system and the patient information is
transferred to the MR system. The PPS is completed when the images are archived and
transferred to a PACS. The information system is notified that the examination is
complete and indicates the location of images (e.g., at the PACS).
Figure 6-2 shows the complete circle of events that ensue when ConnectPro Plus with
PPS is used. The dashed lines represent the PPS connectivity additions: from pushing
images to end destinations, to a fully integrated image and text workflow. PPS provides
a feedback loop to the HIS/RIS system that the patient “session” is completed (or not)
and subsequently, the MR Worklist (schedule) is updated to reflect the patient’s session
status.
Figure 6-2 PPS Process

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 Registering Patients

PPS maintains connectivity between the information system, the MR system, and
networked stations through the following procedures:
• Detailed retrieval and display of patient information and procedures.
• Capability of prescribing protocols in advance on the Protocol Desktop with Worklist
entries.
• Auto-load of protocols for Scan Rx and Protocol Rx from Worklist entry selection.
• Reports real-time scan status to the information system, including actual protocols
and Worklist entries being performed.
• Enables auto verify with PACS system with the list of completed images acquired
and stored for the study.
• W/L transferred to PACS when ss is typed in the Accelerator Line at the operator’s
console. The ss entry must occur prior to network activity.
• Auto Archive on/off selection is retained after a reboot.
There are three basic methods of using PPS:
• Via a bar code reader: you can scan a bar code on the requisition form (containing
the requisition number or patient ID). ConnectPro Plus then retrieves the patient’s
demographics from the worklist and automatically enters the information into the
Patient Information Area (if the patient exists). If there are multiple entries in the
schedule that match the bar code, you can select an entry from the worklist.
• By patient ID: In the Patient Information Area you can type in the requisition number
or the patient ID to retrieve that patient’s demographics from the worklist and
automatically have the patient’s information entered. If there are multiple entries in
the schedule that match the bar code, you can select an entry from the worklist.
• Query the information system: On the Schedule Worklist you can request an update
to the schedule from the information system. From the updated schedule, you can
select the desired patient or examination entry from the schedule and that patient’s
information is automatically entered into the Patient Information area.

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 Registering Patients

Patient Information
In the Patient Information area (Figure 6-3) of the Scan Rx Desktop, you can enter as
few as two characters in the Accession Number or Patient ID text box to search
through the ConnectPro Plus Worklist for a match. The search looks for the sequence
of digits within the accession number or the patient ID, depending on which text box
was used to enter the data. If the sequence is found, the patient information for that
patient is entered into the Patient Information area.
Figure 6-3 Patient Information Area

If two or more matches are found, the Schedule Worklist opens, displaying a list of all
the matches. The Schedule Worklist can also be accessed by clicking either the
[Schedule] button in the Patient Information area in the Scan Rx Desktop, or by
clicking the [Schedule Rx] button in the Patient Information window in the Protocol
Manager Desktop.
When patient information is passed from the ConnectPro Plus Schedule Worklist, the
patient weight is not passed along with the other patient information. This means that,
the patient weight needs to be manually entered into the Patient Information area. This
is to ensure patient safety (in regards to RF deposition) the patient weight must be
verified and entered by the MR operator.
The information provided for the History text box is pulled from the Additional History
window accessed using the [More Info] button on the ConnectPro Schedule Worklist.
The ConnectPro Accession Number is automatically placed into the Protocol text box
located in the Imaging Parameters area. This does not interfere with the normal use of
the Protocol text box.

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 Registering Patients

Schedule Worklist Navigation

The Schedule Worklist (Figure 6-4) displays a list of all patients that have been entered
into the HIS/RIS system. Selecting the desired patient and clicking the [OK] button at
the bottom of the window enters the information in the Patient Information Area.
The buttons across the bottom of the Schedule Worklist allow you to access additional
patient information and change the procedure code associated with the patient. Table
6-2 describes the available selections.
Figure 6-4 Schedule Worklist

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 Registering Patients

Table 6-2 Schedule Worklist Buttons

Button Description
Accepts the selected patient and enters the patient information
[OK]
into the Patient Information area of the Scan Rx Desktop.
[Update] Updates the list of scheduled patients.
Lists more information about the patient, such as allergies, alerts,
weight, etc. This information is for viewing purposes only and
cannot be edited. The information in this window can be viewed by
clicking and dragging on the slider on the right side of the window.
[More Info] The most important information is accessed by clicking the
[Scheduled Procedure A.I.] button. This button is found at the
bottom of the More Information window. The meaning column
shows the procedure for which this patient is scheduled. This
information comes across from HIS/RIS.
Sorts the list of patients by ID
(identification), Name, or Time (time the
patient was scheduled).
[Sort]

Lets you customize the Schedule Worklist. This window allows

you to decide when the Worklist is updated, the modalities to be
included in the list, and the range of examination dates in the list.
[Preferences]
You can also include a specific Accession Number, Patient Name,
or Patient ID by entering the data on the Query Preferences
Window.
Displays the A.I. (Action Items) Mappings Browser, which lists the
[A.I.]
items that are attached to the patient at the RIS system.
[Close] Exits the Worklist window and the ConnectPro Plus feature.

You can customize the Schedule Worklist by defining your preferences in the Query
Preferences window (Figure 6-5). Following that, Table 6-3 details the selections.

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 Registering Patients

Figure 6-5 Query Preferences Window

Table 6-3 Query Preferences

Selection Description
Determines when the Schedule (Worklist) window updates. You can
choose to have the system automatically update the Schedule
Update
window when it opens or choose only to update the Schedule
window when the [Update] button is clicked.
Get Patient Allows you to list patients in the Schedule window for the scanner
List for you are currently operating, the modality, or all scanners.
Allows you to list patients in the Schedule window by date or a range
With a Date
of dates. The selections with a text box to the right require a number
Range
entered into the text box.
The remaining text boxes allow you to perform a search for a specific
Search Text patient. The search can be performed by typing the patient’s name,
Boxes ID number, Accession number, or by typing the Requested
Procedure ID that lists all the patients scheduled for that procedure.
[Accept] Accepts your parameters and closes the Query Preferences window.
[Cancel] Cancels your changes and closes the Query Preferences window.

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 Registering Patients

End Examinations
If you have used the ConnectPro Plus feature, an additional window opens when you
click the [End Exam] button. The End PPS window (Figure 6-6), allows you the choice
of completing, deferring, discontinuing, or canceling the examination. Table 6-4
provides a description of each of these choices.
Figure 6-6 End PPS Window

Table 6-4 End PPS Window Buttons

Button Description
Ends the examination and PPS. You can add a series, such as a
screen save, or annotate the images. However, you should not edit
the patient information, such as the patient name, ID number, etc. If
[Complete] you edit the examination (through Edit Patient Data), the examination
is no longer recognized by the HIS/RIS system as the examination it
requested. On the Browser, the PPS column displays the patient
status as COMP (completed).
Does not end PPS. You can still post-process and edit the patient
information, such as the patient name, ID number, etc. On the
[Defer] Browser, the PPS column displays the patient status as INPR (in
progress). Selecting PPS from the Browser menu bar allows you to
complete or discontinue the PPS on the patient.
Notifies the HIS/RIS you are aborting the PPS. This should be used
only if the images you acquired were unacceptable or were not for the
[Discontinue] correct patient. You would then need to rescan the patient. On the
Browser, the PPS column displays the patient status as DISC
(discontinued).
Closes this window without ending or changing anything. On the
[Cancel] Browser, the PPS column displays the patient status as INPR (in
progress).

Editing patient information gathered from the HIS/RIS is NOT recommended, but the
ConnectPro feature does NOT “lock” an examination from being edited.

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 Registering Patients

CAUTION: If patient information that has originated from the HIS/RIS Worklist is
edited, this information at the operator’s console WILL NOT match the
patient information in HIS/RIS.

Delete a Registered Patient

To automatically remove a patient’s name from the Patient Register, click the [End
Exam] button on the Rx Manager.
If a patient cancels his/her examination or does not show up for an appointment, you
can delete him/her from the Patient Register. It is also possible to copy, paste, and cut
patient information within the Register.

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 Registering Patients

Guided Install
Guided Install is used to confirm that the HIS/RIS system has been linked to the MR
system. It is also used to map protocols to action items. The actual configuration must
be done by a service engineer with assistance of your facility’s Information Technology
department. You do not need a password to access HIS/RIS DICOM.
The Guided Install Window (Figure 6-7) allows you to save, change, or delete protocols
that are mapped (connected) to an Action Item Code in HIS/RIS and the host computer.
Figure 6-7 Guided Install Window

On the HIS/RIS tab you can configure the server and port setup. On the SCP tab, you
can display the action item code and protocol name (Figure 6-8).

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 Registering Patients

Figure 6-8 SCP Tab

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 Registering Patients

There are three areas you should be familiar with on the SCP tab. These areas are
described in Table 6-5.
Table 6-5 SCP Tab Areas

Area Description
Displays the HIS/RIS Action Item Codes and the protocols
Display
linked to the codes.
Action Item Code Lists the Action Item Codes for the system.
Protocols Lists the system protocol libraries (GE and Site).

The Verification tab is available to verify that changes made to HIS/RIS are legal. The
Log File can also be viewed from this mode.

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 Registering Patients

How Do I...
This section provides the step-by-step instructions for pre-registering and entering
patient information into the system. Specifically, it describes how to:
• Pre-Register a Patient
• Link a Protocol to a Patient at Pre-Registration
• Select a Registered Patient
• Sort the Patient Register
• Delete a Registered Patient
• Enter Patient Information Using PPS
• End Examinations Using PPS
• Check Configuration of Guided Install
• Map Protocols to Action Items

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 Registering Patients

Pre-Register a Patient
You can pre-register your patients prior to their arrival in the MR Department, promoting
increased throughput. The following steps help you to pre-register a patient.
1. Click the Protocol Manager Desktop icon.

2. Click [Patient Rx] in the Protocol

Prescription area.
Š The Patient Register opens.

3. Click [New Pt] in the Patient Register.

Š The Patient Information window
opens.

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 Registering Patients

4. Enter at least the Patient ID and Patient Name.

Š The time and date are not required text boxes.

5. Click [Accept].
Š The full Patient Information window opens.
6. Enter additional information in the Patient Information area, if known.
Š Type information in each text box and press Enter.
7. Once all the information is entered for the patient, click [Save Rx as Protocol] in
the Protocol Manager.
Š You can enter additional information at scan time.
Š This completes the registration process.

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 Registering Patients

Quick Steps: Pre-Register a Patient

1. Click the Protocol Manager Desktop icon.
2. Click [Patient Rx] in the Protocol Prescription area.
3. Click [New Pt] in the Patient Register.
4. Enter at least the Patient ID and Patient Name.
5. Click [Accept].
6. Enter additional information in the Patient Information area, if known.
7. Once all the information is entered for the patient, click [Save Rx as Protocol] in
the Protocol Manager.

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 Registering Patients

Link a Protocol to a Patient at Pre-Registration

Pre-registering a patient can also include assigning a protocol. All patients for the day
can be pre-registered with a protocol. The following steps show you how to link a
protocol to a pre-registered patient.
1. Complete steps 1 to 5 of the Pre-Register a Patient procedure.
2. Click [Position].
Š Position provides options for the
alignment light position.
Š Only position locations from the
pull-down menu can be used.

3. Click the button to the right of Patient Protocols and select the library from which to
select the protocol.
Š Select GE to access pre-programmed and other protocols.
Š Select Site to access protocols that you have created and saved.

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 Registering Patients

4. Click an anatomical region of the Humanoid icon to select the protocol category.
Š Alternatively, you may type in a protocol category name in the Protocol text box.

5. Select the desired protocol category from the left side of the Protocol and Series
Description window and the desired series from the right side of the window.
Š To download all series, you only need to select the protocol.
Š To download series that are not in a sequential order, click on each individual
series you want to download.

6. Click [Accept].
Š The selected protocol and series are loaded into the Protocol Manager.

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 Registering Patients

7. Click [Save Rx as Protocol] in the Protocol Manager.

Quick Steps: Link a Protocol to a Patient at Pre-Registration

1. Complete steps 1 to 5 of the Pre-Register a Patient procedure.
2. Click [Position].
3. Click the button to the right of Patient Protocols and select the library from which to
select the protocol.
4. Click an anatomical region of the Humanoid icon to select the protocol category.
5. Select the desired protocol category from the left side of the Protocol and Series
Description window and the desired series from the right side of the window.
6. Click [Accept].
7. Click [Save Rx as Protocol] in the Protocol Manager.

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 Registering Patients

Select a Registered Patient

Once a patient is ready to be scanned, this function gives you the ability to select him or
her from the Patient Register.
Use this procedure to select a pre-registered patient.
1. Click the Protocol Manager Desktop icon on the control panel.

2. Click [Patient Rx] in the Protocol Prescription area.

Š The Patient Register opens.
3. Select a patient’s name in the Patient Register.
Š Click and drag the slider to view all data in the Patient Register. The patient
name and ID text boxes are 64 characters in length to accommodate long patient
names and other useful data such as session numbers, left or right extremity,
etc.

4. Click [Select] to choose a patient.

Š The selected patient is loaded into the Patient Information area.
5. Click [Accept] in the Patient Information area.
Š This allows you to view the information already entered for the patient.
6. Enter additional information for the patient, as required.

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 Registering Patients

Quick Steps: Select a Registered Patient

1. Click the Protocol Manager Desktop icon on the control panel.
2. Click [Patient Rx] in the Protocol Prescription area.
3. Select a patient’s name in the Patient Register.
4. Click [Select] to choose a patient.
5. Click [Accept] in the Patient Information area.
6. Enter additional information for the patient, as required.

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 Registering Patients

Sort the Patient Register

You can sort patients in the register by ID number, name, or date/time.
1. Click the Protocol Manager Desktop icon.

2. Click [Patient Rx] in the Protocol Prescription area.

Š The Patient Register opens.
3. Click [Sort] in the Patient Register and select ID, Name, or Time.

Š If you sort by ID, the patient’s ID will display first, followed by the patient’s name
and the appointment time.
Š If you sort by Name, the patient’s name will display first, followed by the patient’s
ID and the appointment time.
Š If you sort by Time, the appointment time will display first, followed by the
patient’s name and ID.

Quick Steps: Sort the Patient Register

1. Click the Protocol Manager Desktop icon.
2. Click [Patient Rx] in the Protocol Prescription area.
3. Click [Sort] in the Patient Register and select ID, Name, or Time.

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 Registering Patients

Delete a Registered Patient

When patients cancel an examination or do not show up for an appointment, they can
be deleted from the Patient Register.
Use this procedure to delete a patient from the register.
1. Click the Protocol Manager Desktop icon.

2. Click [Patient Rx] in the Protocol Prescription area.

Š The Patient Register opens.
3. Select the entry to be deleted in the Patient Register.
4. Right-click, then select cut to remove that patient from the Register.
Š A confirmation message is displayed.

5. Click [Confirm].
Š The patient is removed from the Patient Register.

Quick Steps: Delete a Registered Patient

1. Click the Protocol Manager Desktop icon.
2. Click [Patient Rx] in the Protocol Prescription area.
3. Select the entry to be deleted in the Patient Register.
4. Right-click, then select cut to remove that patient from the Register.
5. Click [Confirm].

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 Registering Patients

Enter Patient Information Using PPS

If your facility has purchased the ConnectPro Plus (PPS) option, you can enter the
patient in HIS/RIS more quickly and with more accuracy than entering this information
manually.
Use this procedure to enter patient information with PPS.
1. Click [New Pt] in the Scan Rx Desktop.
Š Alternatively, PPS can be accessed from the Protocol Manager Desktop by
clicking the [Schedule Rx] button in the Protocol Prescription area. This
pre-registers the patient and attaches a protocol. (You CANNOT scan from the
Protocol Manager Desktop; you can only pre-register the patient and attach a
protocol.)
Š The Patient Information area opens.
2. Enter the patient’s name in the Patient Name text box or type as few as two digits in
the Accession Number or Patient ID text boxes to display matching records.
3. Click [Schedule] at the bottom of the Patient Information area.
Š The Schedule Worklist opens, displaying a list of all the patients that have been
entered through the HIS/RIS system.
4. Select the desired patient from the Schedule Worklist.
Š The buttons across the bottom of the Schedule Worklist allow you to add
information on the patient (refer to Table 6-2).
5. Click [OK] to enter the patient information and the attached protocol into the
system.
Š The patient’s information is automatically updated in the Patient Information
area.
Š Patient weight is not passed with the other patient information and must be
entered manually in the Patient information area.
NOTE: Patient data text boxes in the Patient Information area can be edited after the
data is imported from the worklist. However, editing patient information from the
Scan Rx Desktop results in the HIS/RIS data differing from the local patient data.

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 Registering Patients

Quick Steps: Enter Patient Information Using PPS

1. Click [New Pt] in the Scan Rx Desktop.
2. Enter the patient’s name in the Patient Name text box or type as few as two digits
in the Accession Number or Patient ID text boxes to display matching records.
3. Click [Schedule] at the bottom of the Patient Information area.
4. Select the desired patient from the Schedule Worklist.
5. Click [OK] to enter the patient information and the attached protocol into the
system.

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 Registering Patients

End Examinations Using PPS

If your facility has purchased the ConnectPro Plus (PPS) option, you will need to take
additional steps to end the patient examinations.
Use this procedure to end a patient examination with PPS.
1. When scanning is complete, click [End Exam] in the Rx Manager.

Š The End PPS window opens.

2. Select the appropriate choice from the End PPS window to end the examination.
Š Click [Complete] to end the examination and PPS.
– A message is sent to the radiologist’s console, the PACS, and the HIS/RIS
confirming that the examination is complete and that the images may be
retrieved and archived.
Š Click [Defer] to keep the examination in progress to allow post-processing and
editing of the patient information.
Š Click [Discontinue] to notify the HIS/RIS you are aborting the PPS.

Quick Steps: End Examinations Using PPS

1. When scanning is complete, click [End Exam] in the Rx Manager.
2. Select the appropriate choice from the End PPS window to end the examination.

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 Registering Patients

Check Configuration of Guided Install

The following steps are used to ensure that the HIS/RIS system is configured to
communicates with the MR System.
1. Click the Service Desktop icon on the control panel.

2. Click [Guided Install].

3. Select GI: HIS/RIS DICOM.

4. Click [Start...].
Š The Guided Install Window opens.

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 Registering Patients

5. Select the HIS/RIS tab from the top of the Guided Install window.
Š If the systems have not been configured, notify your GE Service Engineer and
facility’s Information Technology department to complete this task.
6. Check the HIS/RIS tab to verify the MR system is communicating with the HIS/RIS.
7. To exit the Guided Install window, select File > Quit from the menu.

NOTE: Do not click the button in the right-upper corner of the window. Clicking
this button moves the window behind the Desktop Control Panel icons
where it cannot be accessed until the system is rebooted.
8. Click [Yes] to confirm that you want to exit.

Quick Steps: Check Configuration of Guided Install

1. Click the Service Desktop icon on the control panel.
2. Click [Guided Install].
3. Select GI: HIS/RIS DICOM.
4. Click [Start...].
5. Select the HIS/RIS tab from the top of the Guided Install window.
6. Check the HIS/RIS tab to verify the MR system is communicating with the
HIS/RIS.
7. To exit the Guided Install window, select File > Quit from the menu.
8. Click [Yes] to confirm that you want to exit.

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 Registering Patients

Map Protocols to Action Items

This function allows you to create the maps of protocols to Action Items. You can also
attach billing codes to procedures on the SCP tab.
Use this procedure to map protocols with the Action Items in Guided Install.
1. Click the Service Desktop icon from the control panel.

2. Click [Guided Install].

3. Select GI: HIS/RIS DICOM.
4. Click [Start...].
Š If HIS/RIS configuration has been done, continue with step 5.
Š If the HIS/RIS configuration has NOT been done, you need the assistance of
your facility’s Information Technology department and service engineer to help
set up the server and the port configurations. Continue with step 5 when the
configurations have been completed.
Š The Guided Install Window opens.
5. Select the SCP tab from the top of the Guided Install window.

Š The SCP Tab opens.

6. To map protocols, select the procedure number from HIS/RIS Action Item Code in
the Display area, and enter the desired code.
Š A code such as CPT code can be entered.
7. Select the procedure number from the Action Item Code in Action Item Code area
and enter the same number (code) used in the HIS/RIS Action Item Code.
8. Select the desired Protocol Library.
9. Select the protocol to map from the system Protocols area.
10. Select the desired Protocol Category and protocol.

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 Registering Patients

11. Click [Save] to save the mapping of the Action Item Code with the selected
protocol.
Š Click [Delete] to remove the mapping of this protocol to the Action Item Code.
Š Click [Cancel] to cancel the mapping process.
12. Select Help > Display help for current page to display step-by-step instructions
for the mapping procedure.
Š Refer to Help when you have questions about the Guided Install.

13. Select File > Quit to close the Guided Install window.

NOTE: Do not click the button in the right-upper corner of the window. Clicking this button
moves the window behind the Desktop Control Panel icons where it cannot be
accessed until the system is rebooted.

14. Click [Yes] to confirm that you want to quit.

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 Registering Patients

Quick Steps: Map Protocols to Action Items

1. Click the Service Desktop icon from the control panel.
2. Click [Guided Install].
3. Select GI: HIS/RIS DICOM.
4. Click [Start...].
5. Select the SCP tab from the top of the Guided Install window.
6. To map protocols, select the procedure number from HIS/RIS Action Item Code in
the Display area, and enter the desired code.
7. Select the procedure number from the Action Item Code in Action Item Code area
and enter the same number (code) used in the HIS/RIS Action Item Code.
8. Select the desired Protocol Library.
9. Select the protocol to map from the system Protocols area.
10. Select the desired Protocol Category and protocol.
11. Click [Save] to save the mapping of the Action Item Code with the selected
protocol.
12. Select Help > Display help for current page to display step-by-step instructions for
the mapping procedure.
13. Select File > Quit to close the Guided Install window.
14. Click [Yes] to confirm that you want to quit.

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 Prescribing Images

Chapter 7
Prescribing Images

Introduction
Prescribing images can be done explicitly or graphically. 3-Plane graphic prescription
(GRx) allows you to define slice locations and saturation (SAT) bands while visualizing
their exact locations on three different image planes simultaneously. This feature helps
you achieve reductions in prescription time, as well as increase your prescription
accuracy.
This chapter explains the process of prescribing images. It provides the concepts
necessary to graphically prescribe image locations, the tracker location, and SAT
bands, as well as the basic steps to apply these techniques. It contains the step-by-step
instructions to help you learn how to:
• Prescribe 2D Graphic Locations
• Prescribe 3D Graphic Locations
• Prescribe SAT Locations
• Copy Graphic Locations

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 Prescribing Images

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete the process of
prescribing images. Specifically, you need to understand:
• Explicit Prescription Basics
• Graphic Prescription Basics
– Acquiring Valid Localizers
– Defining the Scanning Range
– Localizer Viewports
– Selecting Images
– Using Protocols
• Two-Dimensional Prescription
– Graphic Prescription
– Multi-Group Prescription
– Radial Prescription
• Three-Dimensional Prescription
– Graphic Prescription
– Multi-Slab Prescription
– Tracker Prescription
• Saturation Basics
– Spatial Saturation
– Chemical Saturation (Option)
• SAT Prescription
• 3-Plane Graphic Functions
– Report Cursor
– Zoom
– Display Normal
– Window Width and Level
– Pan
– Reference Lines
– Copy Rx
– Fallback to R0
– Reset Center

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 Prescribing Images

Explicit Prescription Basics

Explicit prescription allows start, end, and the number of scan locations to be
specifically entered into the Scanning Range area without entering Graphic Rx. This
allows you to define exact locations for your scan.
Explicit prescription can be used to prescribe a:
• 3-Plane Localizer
• 2D orthogonal slice locations
• 2D oblique slice locations
• 3D orthogonal volumes
• 3D oblique volumes
You can explicitly prescribe a series of scan locations by typing coordinate values in the
Scanning Range area that represent the desired coverage of the anatomical location.
The actual end and total number of slices or slabs are calculated by the system, then
displayed in the Scanning Range area.

Graphic Prescription Basics

3-Plane GRx allows you to define slices and SAT bands while visualizing their exact
locations on three different image planes simultaneously. This feature is facilitated by
using one image (acquired from a 3-Plane localizer) from each plane in conjunction with
another during graphic prescription. It allows you to graphically prescribe on any of the
images from the localizing series. It also gives you the flexibility of manipulating slice
location and placement on any one of the three images interactively, while observing
the resultant changes in the prescription in the other two planes. 3-Plane GRx helps you
achieve reductions in prescription time, as well as increase your prescription accuracy.
During 3-Plane GRx, you can:
• Use the List Select window to load a series of images into the viewports
• Create different slice groups (parallel, oblique, radial, 2D, 3D, Tracker, and SAT)
• Move, size, and rotate the prescription not only on the viewport in which you
deposited the prescription, but also the other two viewports
• Increase or decrease the number of slices or slabs
• Operate on the different slice groups (edit, delete, rotate, or resize)
• View graphic slice locations and SAT bands together in all viewports
• View and edit some application parameters based on the prescription and pulse
sequence you select
• Save a 3-Plane GRx prescription as protocol

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 Prescribing Images

3-Plane GRx is available with all scan planes, although the behavior it exhibits may
differ depending on the scan plane prescribed. Table 7-1 lists the action taken by
3-Plane GRx with each scan plane.
Table 7-1 Scan Plane and 3-Plane GRx Behavior

Scan Plane Action in 3-Plane GRx

Axial Only axial slices shall be prescribed. No rotation is allowed.
Sagittal Only sagittal slices shall be prescribed. No rotation is allowed.
Coronal Only coronal slices shall be prescribed. No rotation is allowed.
No restrictions on prescribed slices. Rotation is allowed in all
Oblique
intersections shown.

3-Plane GRx allows you to prescribe the following types of prescriptions:

• Two-dimensional (2D)
– Radial
– Multi-group
– SAT
• Three-dimensional (3D)
– Tracker
– Multi-slab
– SAT
The 3-Plane GRx can be manipulated in either the 2D or 3D GRx mode and also in the
SAT mode. 3-Plane GRx is viewable and editable in the SAT mode, and the SAT bands
are viewable and editable in the GRx mode. However, new SAT bands cannot be
created on the GRx screen and new GRx groups cannot be deposited on the SAT
screen.
The 3-Plane GRx and the Tracker prescription display together in the Tracker mode
and you are able to manipulate the tracker as well as the GRx volume. The tracker is
only displayed on the image to which it is prescribed.
Upon completion of a 2D, 3D, or SAT prescription, the 3-Plane GRx data is translated
into right, anterior, and superior (RAS) coordinates, these values are passed on to
scan, and the geometry calculations are completed and updated.

Acquiring Valid Localizers

The Graphic Rx icon (Figure 7-1) is available in the Additional Parameters area when
you are defining a series prescription.

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 Prescribing Images

Figure 7-1 Graphic Rx Icon

3-Plane GRx can be used after an axial, sagittal, coronal, oblique, or 3-Plane scan has
been completed. A valid localizer has the same patient entry, patient position, and
landmark as the current prescription. The valid localizers for 2D and 3D mode for each
plane are given in Table 7-2.
Table 7-2 Valid Localizers for 2D and 3D Modes

Current Prescription Plane Valid Localizer

Axial Sagittal, Coronal
Sagittal Axial, Coronal
Coronal Axial, Sagittal
Oblique Axial, Sagittal, Coronal, Oblique

Valid localizers for SAT prescriptions for each plane are given in Table 7-3.
Table 7-3 Valid Localizers for SAT Prescriptions

Current SAT Band Valid Localizer

Axial Axial, Coronal, Sagittal
Sagittal Axial, Coronal, Sagittal
Coronal Axial, Coronal, Sagittal
Oblique Axial, Sagittal, Coronal, Oblique

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 Prescribing Images

Defining the Scanning Range

When defining the scanning range in 3-Plane GRx, there are some prescription
limitations you need to consider. Table 7-4 provides you with the limitations of 3-Plane
GRx prescriptions.
Table 7-4 Prescription Limitations

Prescription Limitations
3-Plane GRx A maximum of 255 slices or 85 locations can be prescribed.
3-Plane SAT A maximum of 6 SAT bands can be prescribed.
3-Plane Tracker A maximum of 1 Tracker prescription can be deposited.

3-Plane GRx allows you to change the following Scanning Range parameters as per
the mode selected in Table 7-5. The corresponding changes display in all three
viewports.
Table 7-5 Editable Scanning Range Parameters

Mode Scanning Range Parameters

2D FOV, Spacing, Slice Thickness, Frequency Direction, and Phase Direction
FOV, Slice Thickness, Overlap Locations, Number of Locations per Slab,
3D
and Number of Slabs

The Scanning Range area updates after you accept the prescription. You cannot edit
the parameters once a prescription is present and you close 3-Plane GRx. You are only
able to see and modify the graphic prescription previously made by re-entering the
Graphic Rx icon in the Additional Parameters area.
If you prescribe a new 3-Plane GRx series, the default scan parameters are entered
automatically. You can change any of the default parameters and you must enter the
scan locations.
The slice tilt angle is displayed in the lower-right portion of each localizer image in the
3-Plane GRx screen.

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 Prescribing Images

Localizer Viewports
When you open 3-Plane GRx, there may be a time lapse until initialization is complete
and the appropriate three localizer images display. 3-Plane GRx has three 410x410
localizer viewports (Figure 7-2).
Figure 7-2 3-Plane GRx Viewports

The localizer images can be images from a 3-Plane Localizer or, if another series is
used, three images of the same plane display. You can also display an image from a
unique series in each viewport. The intersections of the slices prescribed are shown on
the other viewports. For example, if a graphic prescription is made on the Viewport1
localizer image, the slice intersections are shown on Viewport2 and Viewport3 localizer
images. The intersections signify the area on the localizer image that will be scanned.
There are various scenarios 3-Plane GRx uses for determining which localizer images
are displayed as default images in the three viewports. The default load is the last valid
3-Plane Localizer.
• If you are opening 3-Plane GRx for the first time, the middle image of the coronal set
of the most recent series of the 3-Plane Localizer loads in the first viewport. The
middle image of the sagittal set loads in Viewport2 and the middle image of the axial
set loads in Viewport3.
– If the localizer series is not a 3-Plane Localizer, the last compatible series
scanned is divided into thirds and loads in the viewports, displaying the center
slices of each third.
• If you are entering 3-Plane GRx for the second time and have acquired a 3-Plane
Localizer, the system displays this series.
– If this localizer series is not a 3-Plane Localizer, the valid localized series for the
set prescription displays.
• If you had previously prescribed SAT bands, then the default images are the
localizers that were used in the SAT prescription.

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 Prescribing Images

At any instant of time one of the three viewports is always highlighted. The active
viewport is highlighted with a green or bright border. There are various graphic tools
that can be applied either to a selected viewport or to all the viewports. The following
tools operate on the images loaded into the viewports:
• Window and Level (W/L) – using the center mouse button
• Pan – using the right mouse button
• Zoom – using the slider
• Report cursor – using the toggle button
When communication with the Graphic server is lost and the system does not respond
to any of your actions on the 3-Plane GRx screen for an amount of time, an error
message posts (Figure 7-3) and the 3-Plane GRx window closes. You are able to
re-enter 3-Plane GRx by clicking the Graphic Rx icon again, retaining all of your
deposited prescriptions.
Figure 7-3 Communication Error Message Box

If there are problems with the 3-Plane GRx interface, such as slice prescription lines are
colored improperly and are difficult to see or the viewports turn blue, you can reset
3-Plane GRx by pressing the Shift key and clicking the [Accept] button. You can then
re-enter 3-Plane GRx and continue with slice prescription.

Selecting Images
The List Select window allows you to select a series other than the default localized
series for the scan. When you click the [Select Series] or [Select Image] buttons
(Figure 7-4), the List Select Series (Figure 7-5) or the List Select Image window opens
in the bottom corner of the 3-Plane GRx screen.
Figure 7-4 Select Series and Image Buttons

The List Select window provides a filtered list of series that fit to the current patient, with
same study and same location.

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 Prescribing Images

Figure 7-5 List Select Series Window

You are able to select any series from the list. For any series other than a 3-Plane
Localizer, the middle image of the selected series loads in the second viewport and
images on either end of the same series load in viewports one and three. For example,
if there are nine images in the currently selected series, then image 2, 5, and 8 are
loaded in the viewports.
Each of the three Graphic Rx viewports can display an image from a unique series, i.e.,
all the images displayed need not be from the same series. Then you are able to select
an individual viewport and put a specific image in that viewport from the selected series.
Loading a specific image on any of the three viewports can be accomplished by clicking
the [Select Series] button to choose the desired series and the [Select Image] button
to load the selected image. The advantage of displaying an image from an unique
series in Graphic Rx, is that the image quality of the localizer can be superior to that of
a 3-Plane Localizer and thus potentially make slice positioning easier.
The [Select Series] button is disabled when there is a prescription on any of the
viewports. When you click the [Erase All] button or when there are no prescriptions on
the viewport, the [Select Series] button is enabled again.
The [Select Image] button displays all the images of the current series. The image
shown in the currently highlighted viewport is highlighted in the list of images. You are
able to select any image from the list and that image loads in the currently highlighted
viewport.
You are also able to switch between images in a valid localizer image set using the [+]
(Next) or [-] (Prior) buttons. The Next button moves to the next image of the currently
selected series for the active viewport. The Prior button moves to the previous image of
the currently selected series for the active viewport.

WARNING:Do not deposit slice locations on a projection image in 3-Plane GRx.

Instead, deposit the slices or volume on a source image and use the
projection image as a reference.

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 Prescribing Images

Using Protocols
When a series is prescribed in 3-Plane GRx, the graphic prescription lines are dropped
from left to right. The series can be saved as part of a protocol in the Site Library. When
the series is recalled from the library, the start and end locations reflect the saved state
of the series, with the slices shown as being acquired left to right in the Scanning Range
area. When you open 3-Plane GRx, the start and end locations continue to reflect the
saved state of the locations, left-to-right. When you click to deposit the prescription lines
in 3-Plane GRx, the slice locations are applied to the image, however, the slices are
applied right to left. The start and end locations change to reflect this new state.
To obtain the left to right slice prescription originally saved in the protocol, the slices
need to be rotated or erased and prescribed again.

Two-Dimensional Prescription
The 2D Mode acquires and reconstructs raw image data into two-dimensional images.
Brightness is proportional to the intensity of the Magnetic Resonance Imaging (MRI)
signal from the corresponding protons. The radio frequency (RF) pulse and gradient
pulse occur at the same time to excite an individual slice of a specific thickness of
tissue.
An individual slice is the area where the RF pulse frequency is the same as the
resonant frequency created by the main magnetic field plus the slice-select gradient.
Additional locations are excited by varying the excitation frequency of the RF pulse,
thereby causing resonance in a slightly different location.
Spatial encoding (Figure 7-6) takes place in two dimensions, frequency and phase
axes, to produce an image.
Figure 7-6 2D Spatial Encoding

2D images can be acquired as multi-planar or sequential acquisitions.

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 Prescribing Images

Multi-planar acquisitions acquire multiple images within a single repetition time (TR).
The order of slice excitation is odd-numbered images first, then even-numbered
images. Once all the slices are excited, the number of phase steps multiplied by the
number of excitations (NEX) selected determines how many times this process is
repeated. Figure 7-7 illustrates a multi-planar single acquisition with five slices.
Figure 7-7 Multi-Planar Single Acquisition

Sequential acquisitions acquire all the data necessary for one slice location before
moving on to the next location. An example of this is a 2D Gradient Echo (GRE)
sequence with the sequential option selected from the Imaging Options window. Figure
7-8 illustrates a sequential acquisition with three separate slice locations for a total of
three acquisitions.
Figure 7-8 Sequential Acquisition

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 Prescribing Images

Graphic Prescription
Upon clicking the Graphic Rx icon in a 2D prescription, the 3-Plane GRx screen opens
and displays with the default images in the viewports (Figure 7-9).
Figure 7-9 3-Plane GRx Screen for a 2D Prescription

Table 7-6 provides a description and acceptable values for each selection on the
3-Plane GRx screen for 2D prescriptions.
Table 7-6 3-Plane GRx Selections

Selection Description
Erases a particular group of slices or slabs and its corresponding
[Erase Group]
intersections.
Erases all the prescriptions and its intersections. Only enabled
[Erase All]
when there are prescriptions present.
Allows you to page through a data set and reselect a new center
[Reset Center] image for prescription. The new center is based on the image in the
active viewport.

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 Prescribing Images

Selection Description (Continued)

Instructions
Adds a group of slices in a different location.
for Add Group
Moves the slice centers from off center prescribed position to
Fallback to R0
isocenter in the slice select direction of the localizer image.
Provides a report of the cursor location on each of the three
Report Cursor
viewports.
Keeps the selected W/L for the active viewport. The W/L remains at
the Keep W/L values as the [+] and [-] buttons are used to view
Keep W/L other images within the selected viewport. If Keep W/L is not on,
then as the [+] and [-] buttons are used to view other images within
the selected viewport, the W/L reverts to the auto W/L values.
Allows you to view the reference lines on all viewports. The lines
represent the location of the other two graphic planes. For example,
Loc Ref Lines
the lines on the sagittal localizer image represent the locations of
the axial and coronal localizer images.
Displays the AutoView window in the lower right corner of the GRx
screen for viewing images as they are reconstructing. This
AutoView eliminates the need to close 3-Plane GRx to see the AutoView
window. The window cannot be maximized when displayed in
3-Plane GRx, however, all other AutoView functions are available.
Opens the SAT screen. The currently prescribed slices are
SAT icon
automatically accepted.
Copies a previous prescription with the same field of view (FOV),
slice thickness, and spacing. The slices are copied onto the image
[Copy Rx] used to originally prescribe them. You may single-click on the
desired series and click [Accept] or double-click to display the
locations.
[Accept] Registers slice prescription and exits Graphic Rx.
Displays the middle slice of the first third of the most recent series
Viewport1 which could be used as a localizer. Displays the middle coronal
image if a 3-Plane Localizer was acquired.
Displays the middle slice of the most recent series which could be
Viewport2 used as a localizer. Displays the middle sagittal image if a 3-Plane
Localizer was acquired.
Displays the middle slice of the last third of the most recent series
Viewport3 which could be used as a localizer. Displays the middle axial image
if a 3-Plane Localizer was acquired.
Auto Update:
Enables the W/L function to apply on all viewports.
W/L
Auto Update:
Enables the pan function to apply on all viewports.
Pan

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 Prescribing Images

Selection Description (Continued)

Auto Update:
Enables the Zoom function to apply on all viewports.
Zoom
Zoom Slider Adjusts magnification factor for displayed images using the slider.
[Select Series] Lists valid series from which a localizer image can be selected.
[Select Image] Lists the images for the selected series.
[Display Returns the displayed image to its default size and location. In
Normal] other words, it removes the pan and zoom factors.
[-] [+] Displays the previous or next image in the series from the currently
(Prior/Next) displayed image.
Allows you to shorten the scan time by scaling down the FOV size
Phase FOV in the phase direction. The pulse sequence determines the range
and increment values.
Defines the scanning direction associated with the frequency
encoding gradient. In general, frequency is the long axis of the
Freq DIR imaging plane. The default frequency direction is automatically
entered, but you can swap frequency and phase directions by
changing the entry from the predefined list.
Defines the number of acquisitions or locations to acquire before
# of
pausing the scan. Only available for appropriate sequences.
Acqs/Locs
Dividing the prescription into groups is advantageous when
Before Pause
acquiring breath-hold scans.
Allows you to enter the image number for the image you wish to
Accel. Bar
display.
Defines the area of the anatomy selected for imaging. The size is
FOV
indicated in centimeters.
Slice
Assigns thickness of each slice location in millimeters.
Thickness
Spacing Assigns space between the slices.
Displays the slice location coordinates when a slice or volume is
deposited. The text boxes update when changes are made to the
Start/End slice or volume locations. These text boxes are not editable. If a
Locations single group or volume is deposited and erased, the locations
remain in the text boxes until new locations have been prescribed
or the 3-Plane GRx screen is exited.
Reports the number of slices prescribed from the Start and End
locations. A value is automatically entered in this text box if slice
# Slices
thickness, slice spacing, and the start and end locations are
specified. You cannot manually enter a value.

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 Prescribing Images

The length of the Slice lines in a 2D graphic prescription represent the FOV coverage.
The graphic objects on the Slice lines in 3-Plane GRx enable you to define where and
how to acquire the slices.
The graphic objects have handles for rotating, adding, or removing slices based on the
prescription restrictions. You can move and rotate the prescription in progress not only
in the viewport in which you deposited the locations, but also in the other two viewports.
The graphic objects provide the following functionality:
• The Add handle gives you the ability to increase or decrease the number of slices.
• The Rotate handles appear at the center of the slice group for oblique prescriptions
to give you the ability to turn the slice prescriptions.
• The Slice lines allow movement of the prescription by clicking and dragging on any
area of the slice line other than the handles, to adjust the position of the entire
graphic prescription.
The selected graphic objects in the active viewport appear blue and the unselected
graphic objects appear yellow. The graphic objects of a 2D prescription are shown in
Figure 7-10.
Figure 7-10 2D Graphic Objects

As you add or delete slices, the slice numbers appear or disappear accordingly.
NOTE: If your system has a black and white monitor, the graphic objects appear white
and the active group displays the graphic handles.

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 Prescribing Images

Multi-Group Prescription
It is possible to prescribe multiple groups of slice locations, each with a unique tilt angle
within the same acquisition, on all GE Signa® MRI systems. This capability is referred to
as Multi-slice, Multi-angle (MSMA). MSMA is available for all PSDs except
spectroscopy. This is useful when an entire range of slice locations is not desired or
needed for a given anatomical body part (e.g., axial spine and sagittal TMJ
examinations).
Note that dark banding artifacts, commonly known as crosstalk, and low signal-to-noise
ratio (SNR) tissue contrast changes are likely to occur when MSMA slices intersect.
The data for multiple groups are generally acquired in an interleaved slice acquisition
order. For example, two groups of five slice locations are prescribed and the slices
intersect one another. The first group contains image numbers 1 to 5; the second group,
6 to 10. Interleaved slice acquisition order results in the image data being gathered as
slices 1/3/5/7 and 9 gathered first, then the system goes back and collects data for
2/4/6/8/ and 10. Collecting the data in this manner results in crosstalk where the groups
intersect (Figure 7-11). Care should be taken to avoid overlapping groups on top of the
anatomy of interest.
NOTE: Sequential GRE and sequential Fast GRE/SPGR sequences do not exhibit this
crosstalk because the slices are acquired one at a time.
Figure 7-11 MSMA and Crosstalk

Multi-slice Multi-group (MSMG) means only the slices within an angled group are
acquired within a single acquisition. Three angled groups of slices therefore results in
three separate acquisitions. Crosstalk artifacts are not seen with MSMG.
The following PSDs have a User Control Variable (CV) with the prescription, allowing
you to choose between MSMA and MSMG: Fast Spin Echo (FSE), Fast Spin Echo -
Excel (FSE-XL), or Fast Recovery Fast Spin Echo - Excel (FRFSE-XL).

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 Prescribing Images

You must define the acquisition order by selecting an Interleaved Acquisition or a

Sequential Group. Selecting Sequential Group (1) results in a MSMG acquisition and
selecting Interleaved (0) results in a MSMA acquisition. Interleaved is the default
selection.
MSMA means all prescribed slices are acquired within a single acquisition and MSMG
means all data is collected for the slices in one group before the system goes on to the
next group to start a new acquisition. During an MSMG acquisition, there is a time
interval of one TR period from the end of one group acquisition to the start of the next
group. This allows spins to return to a state of equilibrium, thus reducing the possibility
of crosstalk.
With MSMA and MSMG prescriptions, the color for the selected group and its
corresponding intersections is blue and a yellow color represents the unselected group
and its corresponding intersections. The intersections display on all the three viewports
for all the groups present.
When prescribing MSMA or MSMG acquisitions, the group with the largest number of
slices controls the frequency and phase direction. For example, if you are prescribing
axial slices through the disc spaces on a Lumbar (L) spine examination, you may
prescribe three slices through L3-4 and L4-5 that have a small angle. Then you may
prescribe five, very steep angled slices through the L5-S1 disc space. The steep angle,
passing 45°, makes the slices an obliqued-coronal and the frequency direction changes
to S/I.
You may only perform the move, rotate, or add slices operations on one group at a time.
Any changes within a group reflect in the corresponding displayed intersections. One
group is always in the selected state. You are able to erase a single group after
selecting the group and clicking the [Erase Group] button.
As you add or delete the slices in a multi-group prescription, the slice numbers appear
or disappear accordingly with the slices shown. The numbers are contiguous across
multiple groups.
NOTE: When using MSMA acquisitions, if two slices or groups of slices are 90° to each
other, one of the groups of the resulting images will be rotated. The R/L, A/P, and
S/I annotations on the images are correct.

Radial Prescription
Radial prescriptions can be prescribed graphically with 3-Plane GRx. This allows
multiple slices to be acquired around a central axis in the same series. Radial and
partial radial graphic prescription is available with FSE-XL, FRFSE-XL, 2D Gradient
Echo (GRE), Single Shot Fast Spin Echo (SSFSE) and SSFSE-Inversion Recovery (IR)
pulse sequences. This type of prescription can be useful for imaging, but not limited to,
knees, Magnetic Resonance Cholangiopancreatographies (MRCPs), myelograms, and
hearts.

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 Prescribing Images

When you are prescribing a radial sequence with 3-Plane GRx the GRx screen appears
with several additional selections, as seen in Figure 7-12 and defined in Table 7-7.
Figure 7-12 3-Plane GRx Screen for Radial Prescription

Table 7-7 3-Plane GRx Selections for Radial Prescription

Selection Description
The number of slices prescribed for a radial graphic prescription. The
# of Slices maximum allowable is 36. Keep the number of slices at the default of
one if you do not desire to perform a radial prescription.
Clockwise and counter clockwise directions for radial prescription.
Radial Dir.
System defaults to clockwise.
Controls the angle between slice locations by defining the degree of
space between each slice. Entering a value results in a “Cat
Spacing
Whiskers” type of prescription and leaving the text box empty results
in a “Wagon Wheel” prescription type.

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 Prescribing Images

For radial prescriptions, you must define the number of slices and the radial direction
while prescribing the acquisition. You have to explicitly type the number of slices in the
# of Slices text box. The intersections accordingly display the number of slices in the
three viewports. You can enter a different number of slices to dynamically change an
active prescription. Set the number of slices before prescribing the slice locations. If a
slice is prescribed then the number of slices is changed, the system sees any additional
slices as a second group. The slice locations will be numbered and scanned as two
separate groups.
The radial prescription has Rotate handles to turn the prescription and the slice
numbers are displayed as in Figure 7-13. You are also able to move and rotate the
intersections of the radial prescriptions. The intersections of the radial prescriptions
display as blue bounding boxes (Figure 7-12). You are not able to graphically change
the number of slices in a radial prescription.
Figure 7-13 Radial Graphic Objects

The radial direction can be clockwise or counterclockwise as shown in Figure 7-14. The
system defaults to one slice and clockwise rotation. These settings can be changed.
Figure 7-14 Radial Directions

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 Prescribing Images

The maximum number of slices in a single group is determined by the selected pulse
sequence. The largest number of slices that can be prescribed per group is 36
locations. If this limit is exceeded, the system does not accept the value. To continue,
you must enter a new value with a lower number of slices.
The # of Slices and Spacing text boxes control the angle between the slices of the
radial prescription. For example, if you select 5 slices in the Radial Parameters area
and leave the Partial Radial Spacing text box empty, your graphic prescription looks
like a wagon wheel with a 36° angle between each slice (Figure 7-15).
Figure 7-15 Wagon Wheel Radial Prescription

If you select 5 slices in the Radial Parameters area and 5° of spacing in the Partial
Radial area, your graphic prescription looks more like cat whiskers (Figure 7-16) and
there are 5° between each slice location.
Figure 7-16 Cat Whiskers Radial Prescription

You may also prescribe multiple radial groups. Once you have deposited the first
graphic prescription group, pressing the Shift key and clicking on the image allows you
to deposit the second group. The new, active radial graphic displays blue and the
inactive, first group turns yellow. Changing the number of slices parameter changes the
number of slices in the active (blue) group.

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 Prescribing Images

If you are prescribing a FSE-XL radial sequence and the slice ordering is interleaved
(acquires the maximum number of slices per acquisition,) your images may exhibit
crosstalk and you do not have the option of choosing the number of locations before
pause. Selecting Sequential slice ordering on the User CVs screen changes the
number of slices to equal the number of acquisitions with no slice crosstalk.
After accepting a graphic prescription, you need to enter the number of locations before
pause in the Acquisition Timing area. The number of locations before pause can be of a
confusing nature. If you select 0, you do not have to push the scan button for every slice
(angle), but you may have crosstalk problems. If you select 1, you control the scan, so
you could let the tissue relax by waiting a few seconds before clicking the [Scan]
button.
Since each slice is an angle and each angle is a group, the maximum number of
locations before pause is always one, unless you prescribe an oblique group on the
same series. For example, if you prescribe a radial scan with 4 slices and an oblique
group with 8 slices, you could enter 8 in the # of Locs Before Pause text box. You
would start the scan, the system would acquire those 8 slices, then you would press
scan four more times (once for each slice) to acquire the radial. The oblique slices in the
group (single angle) would let you select 4 (or whatever number of locations before
pause). See the example in Figure 7-17.
Figure 7-17 Multi-Group Oblique and Radial Prescription

In addition, there are several factors you should consider when setting the locations
before pause in radial prescriptions:
• Set the number of locations before pause to 0 if all slices are the same angle. This
allows you to scan all slices in one breath hold. For multiple shorter breath holds,
type in any number to break up the group.
• Set the number of locations before pause to 0 or 1 for a radial prescription. If you
select one, the system pauses after each slice and you need to click the [Scan]
button for each slice. Although 0 is compatible, it causes crosstalk where the slices
intersect.
• Set the locations before pause to the number of slices of the largest group when
using MSMA. This enables you to scan one group or one angle at a time.

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Three-Dimensional Prescription
The 3D mode excites an entire scan volume or slab with a wide RF pulse. Explicit or
graphic orthogonal and oblique 3D mode is available. The oblique 3D feature allows
multiple groups of 3D volumes to be prescribed with different rotation angles and
different offsets. The oblique 3D volumes can be prescribed explicitly and graphically
for 3D Fast GRE/SPGR, 3D TOF, 3D Fast TOF GRE/SPGR, and SmartPrep IA.
Figure 7-18 illustrates the entire scan volume being excited with a wide RF pulse and
spatial encoding for 3D being performed in the phase, frequency, and slice axes.
Figure 7-18 3D Spatial Encoding

When acquiring images in the 3D mode:

• The slice-select gradient is applied to create areas with slightly different phase
relative to a point at gradient isocenter.
• The number of slice encodings effect scan time (Equation 7-1).
Equation 7-1 3D Scan Time

TR x Phase Encodings x Slice Encodings x NEX = 3D scan time

• The number of slice encodings performed determines the number of slices obtained
from the volume.
• The amplitude of the slice encoding gradients determines the thickness of the slices
to be reconstructed.
• Images acquired in 3D mode produce no crosstalk since there is no slice gap.
• As the slice thickness decreases, the slice aliasing increases. To reduce the
aliasing artifact in the anatomy of interest, either increase the slice thickness or scan
a larger slab.

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 Prescribing Images

Figure 7-19 illustrates a 3D volume prescription in the head.

Figure 7-19 3D Volume Prescription

The 3D volume can be divided into a minimum of 12 slices for vascular imaging and 28
for non-vascular up to a maximum of 128 in increments of two. The system acquires
four additional slices, two on each end of the volume. These end slices, which are
aliased data, are then thrown out. The number of locations available depend on the
pulse sequence, as shown in Table 7-8.
Table 7-8 3D Number of Locations

Pulse Sequence Min Max

3D Fast GRE/SPGR 8 128
3D GRE/SPGR 28 124
3D Vascular 16 128
3D Fast Vascular 8 128

NOTE: Whatever value of locations is prescribed, you obtain four less images, but the
graphic volume deposited on the localizer image shows you exactly your end
result. For example, if 32 locations are prescribed, 24 images reconstruct,
although the images are acquired at the number of locations seen in Graphic Rx
and the number of locations posted in the Scanning Range area.
3D images result in more RF pulses delivered to each slice in comparison to 2D
images. The increased SNR due to the increased number of RF pulses can be used to
increase the spatial resolution. This can be accomplished because the SNR is higher,
so that you can afford to increase the matrix, decrease FOV, or prescribe thinner slices
to improve spatial resolution.
3D volumes are acquired as prescribed by Explicit and Graphic Rx, but not all pulse
sequences allow volume prescription in both right, superior, anterior (RSA) and left,
inferior, posterior (LIP) directions. Table 7-9 can be used to determine the availability of
RSA versus LIP volume prescriptions for 3D pulse sequences.

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 Prescribing Images

Table 7-9 Volume Prescription Capabilities

Pulse Multi-Slab
Volume Rx Capabilities
Sequence Allowed
Explicit Rx can be done in either LIP or RSA directions.
Graphic Rx can only be done in LIP direction for
3D GRE/SPGR no
orthogonal planes (note that oblique scan planes are not
allowed with 3D GRE/SPGR).
3D Fast Explicit and Graphic Rx can be done in either LIP or RSA
yes
GRE/SPGR direction.
3D TOF Explicit and Graphic Rx can be done in either LIP or RSA
yes
GRE/SPGR direction.
3D Fast TOF Explicit and Graphic Rx can be done in either LIP or RSA
yes
GRE/SPGR direction.
Explicit and Graphic Rx with no obliques can be done in
3D FSE yes
either LIP or RSA direction.
Explicit and Graphic Rx can be done in either LIP or RSA
3D FIESTA yes
direction.

NOTE: Images are annotated “3D” next to the PSD.

Graphic Prescription
3-Plane GRx is also available in a 3D mode, as shown in Figure 7-20. The 3D mode
excites an entire scan volume or slab with a wide RF pulse. Images acquired in 3D
mode are spatially encoded in the phase, frequency, and slice axes.
The Localized Reference Lines (yellow or bright) are turned on in the 3D prescription in
Figure 7-20. This is not automatic, you must click the [Loc Ref Lines] button to enable
the feature.

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 Prescribing Images

Figure 7-20 3-Plane GRx Screen for 3D Prescriptions

In addition to most of the selections described in Table 7-6, the following selections in
Figure 7-10 are available on the 3-Plane GRx screen for 3D prescriptions.
Table 7-10 3-Plane GRx Selections for 3D Prescriptions

Selection Description
Defines the tracker slice location and thickness in a SmartPrep™
[Tracker] acquisition. (Only available with 3D Gradient Echo (GRE), Spoiled
Gradient Echo (SPGR) or Time of Flight (TOF) pulse sequences.)
# of Scan Defines the number of scan locations to be acquired in a single slab or
Locs multi-slab prescription.
Assigns the number of overlap locations (slices) per slab in a multi-slab
Overlap
prescription. (Only available with 3D GRE, SPGR, and TOF pulse
Locs
sequences.)
# Slabs Reports the number of slabs prescribed for a multi-slab acquisition.

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 Prescribing Images

In 3D prescription, the box displayed (Figure 7-21) represents the size of the imaging
volume based on FOV, slice thickness, and number of scan locations selected in the
scanning range. A selected 3D graphic object in the active viewport appears blue, while
the unselected graphic objects appear yellow.
Figure 7-21 3D Graphic Objects

Oblique 3D has the same operation on the graphic slabs as in the 2D oblique mode.
The Rotate handle and Add handle for slice prescription are available along with a tic
mark indicating the center of the volume. If the number of slices is defined prior to
opening 3-Plane GRx, that number of slices automatically appears when you click on
the image.
When the slice range extends to the center of the reference line, the FOV size is
displayed on the localizer scan plane that is the same as the prescribed plane. The
graphic box can be picked up by the edges and moved. This is a useful tool to verify the
anatomy is not outside the phase FOV. If it is, you can move the FOV accordingly.
Figure 7-22 is an example of a 3D axial prescription. Note the FOV box displayed on the
axial image. The box does not appear for 2D oblique prescriptions.
Figure 7-22 3D Axial Prescription

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 Prescribing Images

The 3D slice direction is displayed by the “1” and “+” which are displayed in the volume
(Figure 7-23). The side the “1” is closest to, is the side of the volume that begins with
slice 1.
Figure 7-23 Slice Ordering

Prescription A displays the “1” to the left of the “+” indicating the images will be acquired
left to right. Prescription B displays the “1” to the right of the “+” indicating the images
will be acquired right to left.

Multi-Slab Prescription
3D multi-slab acquires multiple, overlapping image volumes, and combines overlapping
locations from two adjacent slabs. The active slab and its intersections appear blue and
an unselected slab appears yellow, along with its corresponding intersections.
Multi-slab minimizes the saturation effects of slowly moving blood by allowing multiple
volumes with decreased slab thickness. Multi-slab provides coverage of larger volumes
with decreased saturation of slow-moving or in-plane blood flow.
The multi-slab editable text boxes in 3D 3-Plane GRx are shown in Figure 7-24.
Figure 7-24 3D Multi-Slab Text Boxes

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 Prescribing Images

The purpose of the overlap is to have a prescription of slabs with overlaps that result in
a continuous series of slices — with no gaps. Remember, any 3D acquisition has
aliased image data on both ends of the slab, which is discarded. If this aliased (and
discarded) image data is in the overlap area, the scan prescription should result in a
continuous — no gap, set of slices.
With 3D multi-slab TOF acquisitions, if no overlap is prescribed between adjacent slabs,
a substantial inter-slab boundary artifact (venetian blind) is created due to the decrease
in blood-background signal to noise. An overlap of 25% is recommended, with uniform
flip angle excitations, to minimize the artifact.
When the overlap locations are positioned over the center reference line, the slices
perpendicular to the prescribed plane display the graphic volume with a grid-like
appearance (Figure 7-25).
Figure 7-25 3D Multi-Slab Overlap

The shading in Figure 7-25 is to help you visualize anatomy that is overlapped on a
multi-slab prescription. Note the grid-like appearance of the slab on the sagittal image.
This is due to the overlap area being placed over the sagittal reference line on the
coronal localizer image. If you move the overlap area away from the sagittal reference
line and the slab on the sagittal loses the grid like appearance.

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 Prescribing Images

Tracker Prescription
In 3-Plane GRx, you are able to deposit a Tracker prescription for 3D Fast TOF or 3D
Fast GRE pulse sequences. The Tracker Rx screen (Figure 7-26) is accessed by
clicking the [Tracker] button on the 3D 3-Plane GRx screen.
Figure 7-26 3-Plane GRx Screen for a Tracker Prescription

In addition to several of the selections available on the 3-Plane GRx Screen for 3D
Prescriptions, Table 7-11 lists the other selections and their descriptions that become
available when prescribing your tracker volume.
Table 7-11 3-Plane GRx Selections for Tracker Prescription

Selection Description
Tracker Length (mm) Defines the length of the tracker in millimeters.
Tracker Thickness (mm) Defines the thickness of the tracker in millimeters.
Accepts the Tracker prescription and brings you back to
[Accept]
the 3-Plane GRx screen.

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 Prescribing Images

The Tracker prescription, as shown in Figure 7-27, has two Rotate handles. One handle
is above the prescription and one is below the prescription. The middle cross hair
represents the thickness of the tracker and the length is represented by the size of the
line.
Figure 7-27 Tracker Graphic Objects

You can use the Rotate handles to turn the Tracker prescription to angle with your
vessel of interest. You can move the location of the Tracker prescription by clicking the
prescription and dragging it.
The length of the Tracker prescription can be adjusted by entering a value in the
Tracker Length (mm) text box in millimeters or by selecting the value from the drop
down list provided. You can also change the thickness of the Tracker prescription by
entering a value or selecting the value from the drop down list in the Tracker
Thickness (mm) text box.

Saturation Basics
You can explicitly or graphically prescribe SAT pulses on a localizer image from a valid
series within the current examination. A valid series is any prospective orthogonal or
oblique series with the same landmark.
A combination of RF and gradient pulses decrease SNR in specific locations where
spatial SAT has been supplied. SAT pulses can be applied spatially to saturate an
entire area of tissue or chemically to saturate (suppress) specific chemical components.

Spatial Saturation
Spatial saturation pulses are 90° RF pulses applied before the slice-selective excitation
pulse. They deliver the RF pulses to anatomy outside or inside the imaging volume to
saturate nuclei, so that the signal from this area does not contribute to the image.

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 Prescribing Images

The basic diagram in Figure 7-28 shows the location of the SAT pulse in a pulse
sequence.
Figure 7-28 SAT Diagram

Shortly after the 90° SAT pulse, the 90° slice excitation pulse is applied. The tissues
affected by the SAT pulses do not have time to adequately recover, thus, there is little
or no longitudinal magnetization to excite from these tissues and little or no signal is
produced. Immediately following the SAT pulse, a dephasing gradient is applied to
dephase the spins in the region of the SAT pulse. A combination of RF and gradient
pulses decrease SNR in the locations spatial SAT has been applied.
There are three types of Spatial SAT:
• Conventional SAT (SAT outside of the FOV)
• Concatenated SAT
• SAT in the FOV

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 Prescribing Images

Conventional SAT (SAT outside the FOV)

A conventional SAT pulse applies extra RF pulses outside the FOV to minimize the
signal from protons flowing into the FOV. If blood is flowing along the slice-select axis,
blood from outside the imaging volume flows into the entry and exit slices (Figure 7-29).
This blood has not experienced RF excitation.
Figure 7-29 Blood Flow and SAT

Spatial presaturation can reduce the signal from moving spins by saturating them
before the spins move into the area being imaged. SAT pulses are generally applied in
the slice-select direction to saturate blood that may flow into the slice and cause either
flow-related enhancement (bright blood) or phase-blurred artifact.
Conventional Spatial SATs outside the FOV are useful to suppress the signal from
protons that move within the imaging FOV, such as:
• Cardiac imaging
• Cervical, thoracic, and lumbar spines
• Body
• Joints
• Axial heads
Figure 7-30 displays axial images of the abdomen acquired without and with a
conventional SAT pulse outside the FOV.
Figure 7-30 Without and With SAT

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 Prescribing Images

Use SAT bands inside the FOV (Figure 7-31) to eliminate the signal from moving
structures.
Figure 7-31 Spatial SAT Band

Concatenated SAT
Concatenated SAT makes spatial SAT move along with slice-select acquisitions for
even more effective suppression of motion in the slice-select direction of concatenated
acquisitions.
If the prescription is compatible with concatenated SAT, the [Concat SAT] button can
be selected and the SAT pulses are automatically concatenated if:
• A SAT band is prescribed in the slice-select direction, without explicit instructions.
• More slices than a single TR can accommodate are prescribed resulting in a
concatenated scan.
• The thicknesses of each slice of a pair, in the slice-select direction, are equal.
With a concatenated SAT activated, SAT overall performance is improved, especially
when the scanning range is large enough to give presaturated protons time to recover
before they reach the middle slices, when there is blood flow in the slice-select
directions, and when the SAT pulses are outside the scanning range.
When a Concatenated SAT is selected, the scanning range is divided into groups
composed of contiguously ordered slices. For each acquisition, it moves the slice-select
SAT pulses to presaturate regions outside of the acquisition range. For example, in a
10-slice, 2 acquisition prescription, the SAT pulses would be applied first around slices
1 to 5, and then around slices 6 to 10. Slice spacing plays an important role with this
subgrouping, since the acquisitions are grouped in contiguous order.
After the system divides the scanning range into as many acquisitions as necessary,
slices are distributed within each acquisition. For instance, in the 10 slice example
(Figure 7-32), the first-acquisition 1 to 5 would be acquired: 1, 3, 5, 2, 4. Then, after a
3-second delay, slices 6 to 10 would be acquired in this order: 6, 8, 10, 7, 9.

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 Prescribing Images

Figure 7-32 10 Slice Concatenated SAT Acquisition

Spatial Concatenated SATs improve SAT performance during scans, by:

• Maintaining the effectiveness of slice-select SAT pulses over large scanning
ranges.
• Minimizing flow related artifacts, which can mimic pathology.
• Moving SAT pulses in the slice-select direction along with the acquisitions,
saturating tissue before acquiring each slice.
There are several things to consider when using Spatial Concatenated SATs:
• The possibility of getting fewer slices per TR exists because of the time required to
apply SAT pulses, increased SAR, and increased application of gradients.
• At least one default band in the slice select direction must exist.
• A concatenated acquisition does not concatenate the SAT pulses unless the
[Concat SAT] button is selected and there are SAT pulses selected in the slice
direction. Concatenated acquisition and concatenated SAT are entirely independent
functions.

SAT in the FOV

SAT pulses are applied in the FOV to effectively saturate specific tissues, which may
otherwise give rise to flow or motion artifacts.
The inside edge of each SAT pulse is placed explicitly or graphically. Figure 7-33 shows
the locations of spacial SATs in reference to a sagittal spine image.
Figure 7-33 SAT Locations

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 Prescribing Images

You can select the thickness of the slice, so only the appropriate amount of tissue is
saturated. Note the leading edge of the SAT pulse is moved close to the anatomy
imaged in Figure 7-34.
Figure 7-34 Leading Edge of SAT Band

The thickness of the pulse may greatly affect the effectiveness of the saturation.
Generally, the thinner the pulse, the better the saturation, because the RF power is
focused over a small area. If there is only 40 mm of tissue to saturate, make the SAT
pulse 40 mm wide. However, if the tissue area is larger, the area of suppression is
smaller and all unwanted tissue may not be suppressed.
Spatial SATs moved inside the FOV are useful to suppress tissue motion that moves
within the imaging FOV, such as:
• Anterior abdominal wall
• Descending aorta when imaging the lumbar and thoracic spine
• Swallowing motion for the cervical spine
• Signal from tissue at the edge of the FOV, reducing wraparound
When imaging with spatial SATs, consider the following:
• When using SAT in the FOV over or near air-tissue interface, a loss of saturation
due to susceptibility may be noticed.
• When using these SAT pulses in very large FOV (48 cm) scans, the SAT bands
may appear to bend outward at the bottom and the top of the image. This is due to
the magnetic field remapping process (GradWARP – Conformal Remapping) that
occurs. This technique is used to correct for non-linearity inherent in any gradient
magnetic field. This bend of the SAT pulse can be used as an advantage by moving
the pulse closer to the anatomy in the middle.
• Directional pairs of SAT pulses (S, I or R, L or A, P) with the same thickness and tilt
can be applied in 8 ms. If the pair have different thicknesses or tilts, they are applied
individually causing a further reduction in the number of slices, which can be
acquired per TR.
• Overlapping SAT bands can result in artifacts.
• SAT pulses take time to apply and increase the Specific Absorption Rate (SAR).
Therefore, SAT pulses can reduce the number of slices available.

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Chemical Saturation (Option)

Chemical saturation suppresses the signal from either fat or water. Chemical saturation
delivers RF pulses within the FOV at a specific frequency to saturate and eliminate
unwanted signal from selected nuclei. Chemical saturation takes advantage of the fact
that fat and water precess at different frequencies, as shown in Figure 7-35. Transverse
axis indicates RF frequency, which has lower frequency in right. Vertical axis indicates
signal intensity.
Figure 7-35 Water and Fat Precession Frequencies

Chemical saturation affects only the nuclei precessing at the same frequency as the RF
pulse. During auto prescan, the system selects the appropriate center frequency based
on your choice. If Fat SAT is chosen, for example, water is the required center
frequency for auto prescan. The system then determines two peaks, fat and water, and
centers on water. It then centers the narrow SAT pulse at the appropriate frequency on
the spectrum.
The success of these spectral saturation techniques depend on the uniformity of the
anatomical area being imaged, in addition to the pulse sequence and coil being used.
While the system is shimmed to a system specification to provide you with optimal
homogeneity, once a patient is placed in the magnet bore, the homogeneity can be
affected. For example, an abdomen may be more uniform than a shoulder. It works best
with anatomy of interest at isocenter ( at least within +/- 40 mm distance from the center
)and a small FOV (<20 cm).
Fat or water suppression reduces chemical shift artifacts because these artifacts are
caused by relative shifts of fat from water. When one component is suppressed, there is
nothing for the other component to shift away from.
NOTE: When using chemical saturation, confirm the projection by [Manual Prescan]
following [Auto Prescan]. If the projection has some problems,adjust the
Gradient Shimming manually. Refer to the Prescanning chapter for information
on chemical saturation prescan techniques.

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Figure 7-36 illustrates the saturation of the fat and water peaks.
Figure 7-36 Fat and Water Saturation

Use chemical saturation to reduce the signal from competing tissue and to increase the
conspicuity of pathology. Chemical Saturation techniques are useful to suppress fat or
water in your images, such as:
• Suppressing fat in abdominal studies to reduce anterior abdominal wall breathing
artifacts
• Identifying fatty infiltrate in the liver
• Demonstrating musculoskeletal or optic nerve tumors when used with contrast
agents
• Dramatically reducing chemical shift artifacts
• Identifying fat by its dark appearance in fat-suppressed images
• Using chemical saturation to reduce chemical shift artifacts
• Using chemical saturation to identify fat or fatty structures by its low signal intensity
Figure 7-37 displays images of the orbits and knee acquired with chemical saturation.
Figure 7-37 Images with Chemical Saturation

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 Prescribing Images

There are several things to consider when using chemical saturation:

• Chemical suppression decreases slice locations per TR because of extra time
required to apply the pulse and contributes to SAR.
• Site or patient specific inhomogeneities may be unavoidable even at isocenter. The
result can be uneven suppression.
• Fat and water cannot be selected at the same time.
• Fat/water suppression selections turn off when the pulse sequence (PSD) is
changed.

Classic Fat Saturation

In the classic version of Fat SAT, the saturation flip angle is set at a fixed value. This
fixed flip angle is not always optimal when considering multiple fat components, number
of slices acquired, and other parameters such as the pulse sequence, TE, and TR.
Improved Fat SAT is the default for Spin Echo (SE) and Fast Spin Echo pulse
sequences. This includes the following selections as they are made from the pulse
sequence: SE, FSE and SSFSE.
The multiple component nature of fat tissue and the use of multiple slice acquisition
techniques have been determined to have a major impact on the effectiveness of Fat
SAT. The Improved Fat SAT alters the flip angle based on all of the prescription
parameters to improve and give a more uniform tissue saturation.
Overall uniformity of the fat suppression may or may not improve with the Improved Fat
SAT algorithm. However, non-uniformity may appear greater on Improved Fat SAT
images. This is because there is better fat suppression with this technique. The
improved suppression contrasts greatly with areas of uneven suppression, giving the
appearance that there is a problem with the Fat SAT itself.
Factors affecting overall Fat SAT effectiveness remain the same:
• Anatomy offset from isocenter is likely to experience more non-uniformity than
anatomy at isocenter.
• The shape and composition of the anatomy affects Fat SAT uniformity.
• Overall magnet homogeneity affects Fat SAT uniformity.
There are no changes to the user interface with the Improved Fat SAT for SE and FSE
sequences. However, it may not be necessary to use Manual Prescan to adjust the
CSA and CSF, although this procedure can be used if desired.
NOTE: Refer to the Prescanning chapter for information on chemical saturation prescan
techniques.
The Improved Fat SAT has been optimized to make fat appear very dark. If you prefer
less saturation, input following psd name at "Psd Name" blank and select Fat on
3-Plane SAT Screen. Then Classical Sat is invoked.
SE : mempc, fcmempc, t1mempc, t1fcmempc

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FSE/FRFSE : fse-xlc, fsec-rpc

T1FLAIR : t1flairc
SSFSE : ssfsec
.
Several things to consider when using Fat SAT:
• For FSE T2 fat suppressed accusations with Improved Fat SAT, non-fatty tissue
(muscle in particular) may appear darker than desired.
– Use the TE values of 70 to 80 ms to obtain better tissue contrast. The T2 of
muscle is such that it loses signal at longer TEs.
– Use echo train lengths (ETLs) of 8 to 12. Long ETLs average in signal from very
late echoes, resulting in decreased signal from non-fatty tissue.
• The overall SNR of improved Fat SAT images may slightly decrease. Consider
adjusting parameters which affect SNR, e.g., increase NEX, increase the FOV,
decrease matrix size, decrease the Receive Bandwidth (RBw).
• The Fat SAT improvements decrease the possibility of poor or uneven saturation,
however, tissue saturation may be reduced when the FOV is greater than 20 cm.
• Uneven saturation can still occur as a result of local inhomogeneities, e.g., at
air/tissue interfaces or when the anatomy of interest is non-uniform.

Spectral Spatial Chemical SAT (Option)

Spectral Spatial Chemical SAT (SpSp ChemSAT) uses slice selective RF/Gradient
pulses for chemical saturation. This method saturates Fat signal only.
As saturation pulse is slice selective, there is no fat saturation interference between
slices and so it is robust to B0 inhomogeneity. As a result, effective chemical saturation
range becomes wider.
This method is compatible with Real Time blurring Cancellation (RTBC) option. RTBC
makes this method robust to B0 drift and fat saturation becomes more accurate.

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To select SpSp ChemSAT, select [Fat] button on the 3-Plane SAT screen.

Then input USER CV20=1 in User CV screen. Default value of CV20 is 1. If it is 0,

normal Chem SAT is available.
NOTE: Available PSDs are as follows;
2D GRE/SPGR, 2D FSE/FRFSE, SS-DW-EPI, SE-EPI, GRE-EPI.
NOTE: Available Coils are as follows;
Head, Knee(L), Knee(S), NeuroVasc(Head), Shoulder.

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SAT Prescription
The SAT icon in the Additional Parameters area (Figure 7-38) becomes available after
you acquire a valid series and if the series you are prescribing supports SAT bands.
Figure 7-38 SAT Additional Parameter

Upon clicking the SAT icon, the 3-Plane SAT screen (Figure 7-39) opens and displays
with the default images in the viewports. Alternatively, you can access the SAT mode by
clicking the SAT icon on the 3-Plane GRx screen.
Figure 7-39 3-Plane SAT Screen

In addition to the 3-Plane GRx Selections, Table 7-12 provides you with the selections
that become available on the 3-Plane SAT screen.

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Table 7-12 Selections Unique to the 3-Plane SAT Screen

Selection Description
Defines Spatial Saturation pulses in the direction of the selected
S, I, A, P, L, R
plane.
Defines the location of the leading edge of the SAT pulse. Leave this
text box blank for default positioning of SAT outside FOV or adjacent
Location
to the first or last slice. A positive or negative numerical value is
entered here to explicitly prescribe the SAT location.
Defines the thickness/width of the SAT band. The default thickness
Thickness is defined by the PSD and in most cases is 40 mm. Enter a value
from 10 to 200 in steps of 1.
Graphic Rx Opens the 3-Plane GRx screen. The currently prescribed saturation
icon bands are automatically accepted.
Copies SAT prescriptions for a previously prescribed series to
current series. All SAT selections must be deselected to use copy
[Copy Rx] Rx. Select the desired series and click the [Accept] button or
double-click the series. The SAT bands copy to and appear on the
currently displayed images.
Enables "walking SAT" for slice-select direction SAT pulses in
[Concat SAT] concatenated acquisitions. Only valid with orthogonal images,
parallel slices, and multi-acquisitions.
Suppresses fat using Chemical Saturation (Option) pulses. Center
Fat
Frequency must be set to Water.
To suppress water using spectral or chemical saturation pulses.
Water
Center Frequency must be set to FAT.
Fat Classic Employs the Classic Fat Saturation technique.
SPECIAL Employs the SPECIAL saturation technique.
[Accept] Registers SAT prescription and exits 3-Plane SAT.

Clicking the directional buttons (S, I, A, P, R, L) allow you to prescribe SAT bands on
any of the three localizer images. You are able to drop up to six SAT bands at one time.
The intersections of the SAT bands display on the other two viewports.
The SAT bands display as rectangular dotted areas representing thickness and
location. The SAT localizer images can be changed to prescribe SAT bands on various
planes. You are able to move, size, and rotate the SAT bands on all the three viewports.
A selected SAT band appears red and an unselected SAT band is yellow.
NOTE: If your system has a black and white monitor, the SAT bands appear white and
the active band displays the handles.

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There are two Rotate handles on the leading edge of the SAT band, one on each side
of the center of the SAT band. A Thickness handle for changing the width of the band is
also provided. You can change the bands location by clicking anywhere on it, except for
the handles, and dragging it. These objects are shown in Figure 7-40.
Figure 7-40 SAT Objects

Not all six SAT bands are visible on one viewport. Table 7-13 provides the SAT bands
you can see on the different planes of localized images.
Table 7-13 Visible SAT Bands for Localizers

SAT Bands Localizer Plane

A, P, R, L Axial
S, I, A, P Sagittal
S, I, R, L Coronal
S, I, A, P, R, L Oblique

You are able to drop all six bands on different localizers based on the validity of the SAT
bands for that localizer. For example, you may drop S and I bands on the sagittal
localizer, A and P bands on the axial localizer, and R and L bands on the coronal
localizer. The intersections for all of the bands display on the other viewports.
Once you deposit the band, you cannot drop the same type of band again in any of the
other viewports. For example, if you drop an S band on the sagittal localizer, you cannot
drop an S band again in any of the other localizers.
You can change the thickness of any band you deposit by dragging the Thickness
handle provided on the SAT band or by explicitly typing the thickness value in the
Thickness text box provided in the SAT screen. The change in the thickness of one
SAT band changes the thickness in its corresponding intersections also.
The SAT pulse default location and thickness value change based on the pulse
sequence selected. Generally, the thickness for Spatial SAT pulses default to 40 mm in
all directions if a complimentary band does not currently exist. A complimentary band is

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a band opposite the selected band. For example, and inferior SAT band is
complimentary to a superior SAT band. If a complimentary band exists, then the
thickness of the band equals the thickness of the complimentary pair band. Default
location for most Spatial SAT pulses are 30 mm away from the last slice, abutting the
FOV in phase and frequency directions.
SAT bands may be prescribed inside or outside the scanning volume. SAT locations
entered state the leading edge of the SAT pulse as shown in Figure 7-41.
Figure 7-41 SAT Band Leading Edges

The SAT icon, located in the Additional Parameters area, updates after you accept the
prescription. It indicates the SAT pulses applied within the current series. For example,
Figure 7-42 indicates the series prescription includes fat SAT, as well as an S and I SAT
band.
Figure 7-42 SAT Icon with Applied Pulses

The icon only indicates if SAT has been turned on at its default value or if the SAT pulse
location/thickness has been altered. It does not indicate the actual thickness or location.
To view the thickness and location of SAT pulses, enter the SAT screen. Several
examples of the SAT icon labels are listed below.
• Spatial SAT pulses applied at the default location and thickness are shown in
uppercase letters beneath the SAT icon, e.g., S, I.
• Spatial SAT pulses applied with a change to their thickness or location are shown in
lowercase letters, e.g., s. i.
• If Fat or Water suppression has been selected, the selection is indicated as FAT or
WATER.
• If no SAT selections are made, the icon label reads, "SAT."

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Disabling the direction button (S, I, A, P, R, L) deletes the corresponding band and its
intersections from all the viewports. For example, if you click the [S] direction button
and then click the sagittal localizer, an S band copies to the sagittal and coronal
localizers. If you again click the [S] direction button (disabling), the S band that was
copied to the sagittal and coronal localizers erases.
When copying or pasting a series or using a prebuilt protocol from a library, SAT
selections are retained when changes are made to any of the following parameters:
Patient Position, Patient Entry, Coil, and Plane. This allows you to select a protocol and
make changes to the above parameters without losing the SAT selections.

3-Plane Graphic Functions

There are various graphic functions that can be performed on a selected viewport or all
three of the viewports. You can individually selected a viewport by clicking in that
viewport. When a viewport is individually selected, it has a green colored or bright
border.

Report Cursor
A report of the location of the cursor can be defined by selecting the [Report Cursor]
button. The button toggles the location report on and off. When on, a yellow crosshair
cursor is reported on all localizer images and the RAS coordinates are displayed in red
at the bottom-right corner of each viewport. You are able to modify the prescriptions
even in the presence of the Report Cursor.

Zoom
You are able to zoom all the three localizer images with the Zoom slider (Figure 7-43).
The range of zoom factor is from 0.5 to 8.0. The images default at a zoom factor of 1.0,
i.e., no zoom.
Figure 7-43 Zoom Slider

Zoom applies for all the three localizer images with the Auto Update [Zoom] button
(Figure 7-44) enabled. If the Auto Update [Zoom] button is disabled, the zoom applies
only to the currently selected image.
Figure 7-44 Auto Update Area

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The zoom option functions with or without prescriptions in the viewport. You are able to
page through the image sets either by clicking the [+] and [-] buttons or by selecting an
image and the previous Zoom value will be retained. Clicking the [Display Normal]
button removes the zoom factor.

Display Normal
The [Display Normal] button brings the zoomed image to a default zoom factor of 1.0,
removes the pan factor, and displays the default W/L settings. This action applies to all
the three viewports if Auto Update [Zoom] button is enabled.

Window Width and Level

Turning on the Keep W/L feature, keeps the selected W/L for the active viewport. The
W/L remains at the Keep W/L values as you click the [+] and [-] buttons to view other
images within the selected viewport. If Keep W/L is not on, then as you click the [+] and
[-] buttons to view other images within the selected viewport, the W/L reverts to the auto
W/L values.
You are also able to change the window width and window level on Viewports 1, 2, and
3 by middle-clicking and dragging on the image. The change in window width and level
applies on all the 3 localizer images if the Auto Update [W/L] button is enabled. During
window leveling, the cursor appears as a windowing cursor.
If the Auto Update [W/L] button is disabled, then the window leveling applies only on
the image on which the action is being done.

Pan
You are able to move (pan the image) using the right mouse button. The panning action
applies on all the three viewports if the Auto Update [Pan] button is enabled. If the Auto
Update [Pan] button is disabled, then the movement applies only on the image on
which the action is being done. You are able to page through the image sets either by
clicking the [+] and [-] buttons or by selecting an image and the previous Pan value will
be retained. Clicking the [Display Normal] button removes the pan factor.

Reference Lines
Reference Lines are displayed on all of the viewports based on the intersections made
by that localizer image with the other two localizer images by enabling the [Loc Ref
Lines] button. The localized reference lines appear as a yellow color line, exactly at the
localizers' intersection. You are not be able to make any operations, such as moving or
rotating the localized reference lines.

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Copy Rx
Copy Rx is used to copy the graphic prescription from a previous series to the current
series, provided the current prescription has the same patient position, patient entry,
landmark, mode, FOV, slice thickness, spacing, and appropriate scan plane.
Copy Rx opens a series list and displays all of the prescriptions which match the
localizer image on the selected viewport. The behavior of Copy Rx changes based on
how the copied series is selected.
Double-clicking on a series you wish to copy automatically changes the displayed
image to the image used to prescribe the original series and displays the slice locations.
If there are no series meeting the copy requirements, the list of series does not appear
and a message posts in the Advisory panel after clicking the [Copy Rx] button to inform
you of no matching prescriptions.
Single-clicking on the series you wish to copy and clicking the [Accept] button posts the
slices on an active viewport based on the location of the image in the active viewport,
which can be a different location than the original prescription.

Fallback to R0
Fallback moves the slice centers from their graphically prescribed position to isocenter,
along the localizer slice-select direction. This can be in either the phase or the
frequency direction on any non-slice direction images in 3-Plane GRx.
Changes to the graphic prescription are not readily noticed, but the resulting images fall
back to isocenter in the slice-select direction for sagittal and coronal slices. The fallback
occurs only in the slice-select direction of the localizer and the imaging plane
determines the phase and frequency direction.
When axial slices have been prescribed and the sagittal viewport is active, the button
reads [Fallback to R0]. The button changes to [Fallback to A0] when the coronal
image viewport is active. With axial slices prescribed, fallback is not available for use in
the axial viewport. If the slice plane is obliqued and locations have been deposited, the
system determines the closest orthogonal plane based on the slice angle and fallback
will not be allowed in that plane.
Make sure the FOV is large enough to include the anatomy of interest when the FOV
falls back. Of course, as FOV increases, resolution decreases. The system does not
prevent you from scanning any FOV with an offset.
If you use the fallback feature on a collapsed or projection image, the fallback occurs in
the acquisition plane. For example, if you click the [Fallback to R0] button on a sagittal
projection image from an axial 2D TOF, the FOV falls back to S/I. To adjust the L/R
offset of the image, use one of the axial source images.
The [Fallback to R0] button automatically turns off when a new image is displayed.
However, the fallback location remains unless the button is clicked again.

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Reset Center
The Reset Center option allows you to graphically prescribe your locations on one slice
location and redefine a new center image at another slice location.
Redefining the center image can be useful when prescribing axial orbits or shoulder
images. For example, use a sagittal image where you see the optic nerves to prescribe
the slice locations, then move to the center of the image and select the [Reset Center]
button.

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How Do I...
This section provides the step-by-step instructions for prescribing images. Specifically,
it describes how to:
• Prescribe Explicit Scan Locations
• Prescribe 2D Graphic Locations
– Single and Multi-Group Locations
– Radial Locations
• Prescribe 3D Graphic Locations
– Single and Multi-Slab Locations
– Tracker Location
• Prescribe SAT Locations
• Copy Graphic Locations
– Prescribe Locations on Active Viewport Localizer
– Prescribe Locations on Original Localizer

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Prescribe Explicit Scan Locations

Explicit prescription allows single groups of slices or volumes to be prescribed by typing
in the exact coordinate values representing the anatomical locations.
Use this procedure to guide you through the process of explicitly defining the scanning
range.

1. Enter the FOV, in centimeters, to cover the area of anatomy selected for imaging.
Š Choose one of the system pre-defined values or enter your own value into the
FOV text box. Use the scroll arrows to increase or decrease the value in steps of
2 cm.
Š Anatomy outside the FOV in the phase direction results in aliasing.
Š Small FOVs increase resolution and the minimum TE value, while decreasing
SNR.
2. Enter the slice thickness in millimeters.
Š Choose one of the system pre-defined values or enter your own value into the
Slice Thickness text box. Use the scroll arrows to increase or decrease the
value in steps of 1 mm.
Š Thin slices increase resolution and decrease SNR.
3. Enter the slice spacing or number of scan locations in millimeters.
Š This value assigns a space between the prescribed slices.
Š Select a spacing that reduces crosstalk. Typically, this value is 20% of the slice
thickness. To reduce the effects of crosstalk, you can also interleave the slices
(doubles scan time), use the Sequential Imaging Option, use a larger scan
interspacing, or use a 3D technique.
Š Choose one of the system pre-defined values or enter your own value into the
Slice Thickness text box. Use the scroll arrows to increase or decrease the
value in steps of 1 mm.
Š For 3D acquisitions, also define the overlap locations if prescribing multiple
groups. Enter the number of slices you want to overlap between slabs within the
same group.

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4. Enter the start and end locations to determine the area covered in the scan.
Š Axial scan plane – enter the S/I values for the most inferior and superior
locations.
Š Coronal scan plane – enter the A/P values for the most anterior and posterior
locations.
Š Sagittal scan plane – enter the R/L values for the most right and left locations.
Š Oblique scan plane – place the crosshair at the desired start location and enter
the coordinates displayed on the image. Place the crosshair at the end location
and enter the coordinate values.
NOTE: The system automatically calculates the end location and the number of locations
(2D) or the number of slabs (3D) based on the scan thickness and interspacing
values. The actual end location is shown in brackets to the right of the end location
explicitly entered.
5. Enter the FOV Center to define the center of the image.
Š Axial scan plane – enter the desired values for A/P and R/L center locations.
Enter zero for no offset.
Š Coronal scan plane – enter the desired values for S/I and R/L center locations.
Enter zero for no offset.
Š Sagittal scan plane – enter the desired values for S/I and A/P center locations.
Enter zero for no offset.
Š Oblique scan plane – place the crosshair at the desired FOV center on the image
and enter the coordinate

Quick Steps: Prescribe Explicit Scan Locations

1. Enter the FOV, in centimeters, to cover the area of anatomy selected for imaging.
2. Enter the slice thickness in millimeters.
3. Enter the slice spacing or number of scan locations in millimeters.
4. Enter the start and end locations to determine the area covered in the scan.
5. Enter the FOV Center to define the center of the image.

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Prescribe 2D Graphic Locations

Single and Multi-Group Locations
3-Plane GRx allows you to define a Two-Dimensional Prescription on a localizer image
using the same landmark while viewing the exact locations on three different image
planes simultaneously. Either orthogonal or oblique imaging can be used.
Use this procedure to guide you through the process of graphically prescribing the
scanning range for 2D prescriptions.
1. Enter the Scanning Range parameters.
Š Choose one of the system pre-defined values or enter your own value in the text
box. Use the scroll arrows to increase or decrease the selected value.
a) Enter the FOV in centimeters.
– Cover the area of anatomy selected for imaging. Anatomy outside the FOV in
the phase direction results in aliasing.
b) Enter the slice thickness in millimeters.
c) Enter the slice spacing in millimeters.
– Select a spacing that reduces crosstalk. This is typically 20% of the slice
thickness. Crosstalk or overlap is caused by partial excitation of adjacent
slices during RF excitation and refocusing by a 180° pulse. This causes a
reduction in image contrast and SNR.
– To reduce the effects of crosstalk choose Interleave (doubles scan time), a
larger interscan spacing, or change to a 3D technique.
2. Click the Graphic Rx icon in the Additional Parameters area.

Š The 3-Plane GRx Screen for a 2D Prescription displays with the system selected
default images loaded in the three viewports.
3. Right-click in the desired viewport to activate the viewport.
Š You can also middle-click, press Shift + click, or press Ctrl + click to activate the
viewport.

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4. Select the image desired for the localizer.

a) If necessary, click [Select Series] to choose a different series to be used as a
localizer.
b) Select a series from the list.
c) Click [OK].
– Alternatively, click [-] and [+] to review the previous or next image in the
series and select the desired image or type the desired image number in the
text box.
5. Magnify the image using the Zoom Slider, if necessary.
Š Enabling Auto Update: Zoom applies the magnification to all three viewports.
6. Click in desired viewport to deposit the start location.
Š Click the graphic line anywhere except on either the Rotate or Add handles and
drag it to the desired start location.
Š The start graphic line appears on the image and displays on the corresponding
intersections in the other viewports.
7. Click the Add handle and drag the cursor to the desired end location and release.
Š The corresponding intersections in the other viewports are updated.
8. Rotate and center the slices, as needed.
Š Click the Rotate handles, at the center of the slice group, to turn oblique slice
prescriptions.
Š Click and drag on any area of the slice line, other than the handles, to adjust the
position of the entire graphic prescription.

9. Press the Shift key and click image to add another group to the prescription.
Repeat steps 6 to 8 as necessary.
10. Enter new values in the corresponding text boxes to adjust the FOV, spacing, slice
thickness, and phase FOV, if necessary.
Š This changes the FOV, spacing, and thickness for all slice groups.

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11. Adjust the number of slices, rotation, and start and end locations in any of the three
viewports.
a) Click the Add handle to add or remove slices on the prescription.
b) Click the Rotate handle at the center of the slice group for oblique prescriptions
to adjust the tilt angle.
c) Click and drag on any area of the Slice lines other than the handles to adjust the
entire prescription.
12. If necessary, move to desired center location and click [Reset Center].
Š The center is reset to the active viewport’s location.
13. Note the start, end, and center locations and number of slices.
Š Ensure that you have not exceeded the number of slices so that the number of
acquisitions has increased, which increases the scan time.

14. Click [Accept].

Š The 3-Plane GRx screen closes and you may continue with series prescription
and acquisition.
Š Once you have accepted the prescription, you cannot make additional changes
to the scanning range.
Š When you have prescribed multiple slices with multiple angles and you want all
of the slices within each group to be acquired within a breath hold, enter the
number of slices that comprises the largest group of slices as the locations
before pause value. Entering a number less than this can result in more
breath-hold acquisitions.

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Quick Steps: Prescribe 2D Graphic Locations – Single and Multi-Group

Locations
1. Enter the Scanning Range parameters.
2. Click the Graphic Rx icon in the Additional Parameters area.
3. Right-click in the desired viewport to activate the viewport.
4. Select the image desired for the localizer.
5. Magnify the image using the Zoom Slider, if necessary.
6. Click in desired viewport to deposit the start location.
7. Click the Add handle and drag the cursor to the desired end location and release.
8. Rotate and center the slices, as needed.
9. Press the Shift key and click image to add another group to the prescription.
Repeat steps 6 to 8 as necessary.
10. Enter new values in the corresponding text boxes to adjust the FOV, spacing, slice
thickness, and phase FOV, if necessary.
11. Adjust the number of slices, rotation, and start and end locations in any of the
three viewports.
12. If necessary, move to desired center location and click [Reset Center].
13. Note the start, end, and center locations and number of slices.
14. Click [Accept].

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Prescribe 2D Graphic Locations

Radial Locations
A Radial Prescription enables you to acquire multiple slices around a central axis in the
same series. You can graphically prescribe radial locations and view their exact
locations on three different image planes simultaneously. A radial or partial radial
prescription can be useful for imaging, but not limited to, knees, MRCPs, myelograms,
and hearts.
Use this procedure to guide you through the process of graphically prescribing a radial
sequence.
1. Click [New Series] in the Rx Manager.
2. Enter the Imaging Parameters.
Š Oblique Image Plane
Š 2D Image Mode
Š FSE-XL, FRFSE-XL, SSFSE, SSFSE-IR Pulse Sequence
3. Enter the Scan Timing, Acquisition Timing, and Scanning Range.
4. Click the Graphic Rx icon.
Š The 3-Plane GRx Screen for Radial Prescription displays with the system
selected default images loaded in the three viewports.
5. Right-click in the desired viewport to activate the viewport.
Š You can also middle-click, press Shift + click, or press Ctrl + click to activate the
viewport.
6. Select the image desired for the localizer.
a) If necessary, click [Select Series] to choose a different series to be used as a
localizer.
b) Select a series from the list.
c) Click [OK].
d) Alternatively, click [-] and [+] to review the previous or next image in the series
and select the desired image or type the desired image number in the text box.
7. Select the radial direction.
Š The radial direction can be clockwise or counterclockwise.
Š The system defaults to clockwise rotation.

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 Prescribing Images

8. Enter a value in the # of Slices text box and press the Enter key.
Š Controls the number of slices in the radial prescription.
Š The maximum number of slices in a single group is determined by the pulse
sequence. If this limit is exceeded, the system does not accept the value. Enter a
new value with a lower number of slices.
9. Enter a value in the Partial Radial Spacing text box and press the Enter key, if
necessary.
Š For a radial graphic prescription that looks like a wagon wheel, enter a value in
the # of Slices text box and leave the Spacing text box empty.

Š For a partial radial prescription that looks like cat whiskers, enter a value in the #
of Slices text box and the degree of the angle between the slices in the Spacing
text box.

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 Prescribing Images

10. Click one of the images in 3-Plane GRx.

Š Radial graphics appear on the image and display the corresponding intersections
in other viewports.
Š If you "draw" the slices using the cursor, you are not able to get the angles.
11. Adjust the radial prescription.
a) Place the cursor in the center of the prescription and drag entire prescription to
the desired location on image.
b) Click the Rotate handle and turn the prescription to the desired starting slice
number.
12. Press the Shift key and click image to add another group to the prescription.
Repeat as necessary.
Š The new, active radial graphic displays blue and the first, inactive group appears
yellow.
Š Changing the number of slices parameter changes the number of slices in the
active (blue) group.
13. Click [Accept].
Š Accepts the radial prescription, closes the 3-Plane GRx screen, and allows you
to continue with series prescription and acquisition.
Š When you have prescribed multiple slices with multiple angles and you want all
of the slices within each group to be acquired within a breath hold, enter the
number of slices that comprises the largest group of slices as the locations
before pause value. Entering a number less than this can result in more
breath-hold acquisitions.
NOTE: Refer to the Radial Prescription section for detailed information on setting the
number of locations before pause during scanning.

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 Prescribing Images

Quick Steps: Prescribe 2D Graphic Locations – Radial Locations

1. Click [New Series] in the Rx Manager.
2. Enter the Imaging Parameters.
3. Enter the Scan Timing, Acquisition Timing, and Scanning Range.
4. Click the Graphic Rx icon.
5. Right-click in the desired viewport to activate the viewport.
6. Select the image desired for the localizer.
7. Select the radial direction.
8. Enter a value in the # of Slices text box and press the Enter key.
9. Enter a value in the Partial Radial Spacing text box and press the Enter key, if
necessary.
10. Click one of the images in 3-Plane GRx.
11. Adjust the radial prescription.
12. Press the Shift key and click image to add another group to the prescription.
Repeat as necessary.
13. Click [Accept].

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 Prescribing Images

Prescribe 3D Graphic Locations

Single and Multi-Slab Locations
Use 3-Plane GRx to graphically define a Three-Dimensional Prescription on a localizer
image using the same landmark while viewing their exact locations on three different
image planes simultaneously. Either orthogonal or oblique imaging can be used.
Use this procedure to guide you through the process of graphically prescribing the
scanning range for 3D prescriptions.
1. Enter the Scanning Range parameters.
Š Choose one of the system pre-defined values or enter your own value in the text
box. Use the scroll arrows to increase or decrease the selected value.
a) Enter the FOV in centimeters.
– Cover the area of anatomy selected for imaging. Anatomy outside the FOV in
the phase direction results in aliasing.
b) Enter the slice thickness in millimeters.
c) Enter the number slices millimeters.
– Each 3D group is able to overlap on another group for a multi group
prescription. Enter the number of slices that you want to overlap between
slabs within the same group to acquire a continuous series of slices—with no
gaps.
– An overlap of 25% is recommended, with uniform flip angle excitations, to
minimize the venetian blind artifact on multi-slab 3D TOF acquisitions.
d) Enter the number of scan locations per slab.
– This defines how many slices are in each volume.
2. Click the Graphic Rx icon.
Š The 3-Plane GRx Screen for 3D Prescriptions displays with the system selected
default images loaded in the three viewports.
3. Right-click in the desired viewport to activate the viewport.
Š You can also middle-click, press Shift + click, or press Ctrl + click to activate the
viewport.

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 Prescribing Images

4. Select the image desired for the localizer.

a) If necessary, click [Select Series] to choose a different series to be used as a
localizer.
b) Select a series from the list.
c) Click [OK].
d) Alternatively, click [-] or [+] to review the previous or next image in the series and
select the desired image or type the desired image number in the text box.
5. Magnify the image using the Zoom Slider, if necessary.
Š Enabling Auto Update: Zoom applies the magnification to all three viewports.
6. Click image in the desired viewport to deposit slab.
Š Deposits a box representing the size of the imaging volume based on FOV, slice
thickness, and number of scan locations selected.
Š Displays the corresponding intersections in the other viewports.
7. Click and drag the Add handle to display the “1” and “+” orientation for the desired
slice direction order.
Š Displays the relationship of the 3D slice direction in the center of the volume. The
side to which the “1” is closest is the side of the volume that begins with slice
one.
Š For ASC, drag the Add handle across to the opposite side of the volume.

8. Enter new values in the corresponding text boxes to adjust the number of slabs,
FOV, slice thickness, overlap locations, number of locations per slab, and phase
FOV, if necessary.

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 Prescribing Images

9. Create multiple groups, if needed, and position the 3D volume.

a) Click the Add handle to add or remove slabs on the volume prescription.
b) Click the Rotate handle on the volume for oblique prescriptions to adjust the tilt
angle.
c) Click and drag on any area of the box other than the handles to move the entire
prescription.
10. If necessary, move to desired center location and click [Reset Center].
Š A new center image is redefined at another center location than where you
graphically prescribed your locations.
11. Note the start, end, and center locations and the number of slabs.
Š Ensure that you have not exceeded the number of slabs so that the number of
acquisitions has increased, which increases the scan time.

12. Click [Accept].

Š The 3-Plane GRx screen closes and you may continue with series prescription
and acquisition.

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 Prescribing Images

Quick Steps: Prescribe 3D Graphic Locations– Single and Multi-Slab

Locations
1. Enter the Scanning Range parameters.
2. Click the Graphic Rx icon.
3. Right-click in the desired viewport to activate the viewport.
4. Select the image desired for the localizer.
5. Magnify the image using the Zoom Slider, if necessary.
6. Click image in the desired viewport to deposit slab.
7. Click and drag the Add handle to display the “1” and “+” orientation for the desired
slice direction order.
8. Enter new values in the corresponding text boxes to adjust the number of slabs,
FOV, slice thickness, overlap locations, number of locations per slab, and phase
FOV, if necessary.
9. Create multiple groups, if needed, and position the 3D volume.
10. If necessary, move to desired center location and click [Reset Center].
11. Note the start, end, and center locations and the number of slabs.
12. Click [Accept].

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 Prescribing Images

Prescribe 3D Graphic Locations

Tracker Location
3-Plane GRx allows you to access the Tracker Rx screen to deposit a Tracker
Prescription and view its exact locations on the image viewport. Either orthogonal or
oblique imaging can be used. The 3-Plane GRx and the tracker prescription display
together in the Tracker mode and both prescriptions can be manipulated.
Use this procedure to guide you through the process of graphically prescribing a tracker
for 3D Fast GRE or Fast TOF GRE/SPGR pulse sequences with SmartPrep
prescriptions after prescribing your 3D volume in the 3-Plane GRx screen.
The tracker is only enabled if the SmartPrep option key is present and you have
selected the SmartPrep Imaging Option.
1. Click [Tracker].
Š Located on the 3-Plane GRx screen for 3D prescriptions.
Š A tracker monitors a selected region of interest for the arrival of a contrast bolus.
2. Click an image in any of the three viewports.
Š The tracker volume is deposited.
3. Angle and move the tracker to the desired position over the main vessel.
Š Tracker placement should be no farther than ¼ above or below the center of the
FOV to be scanned and should be completely contained within the vessel of
interest.
a) Turn the Rotate handles to angle the tracker prescription with your vessel of
interest.
b) Click and drag the tracker prescription to move its location.
– The intersections are displayed in the corresponding viewports.

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 Prescribing Images

4. Resize the tracker volume.

Š Recommended typical tracker size is a 20x20x20 mm volume to help minimize
tracker movement.
a) Enter a value in the Tracker Length text box in millimeters.
– Tracker length is represented by the size of the line.
b) Enter a value in the Tracker Thickness text box in millimeters.
– Tracker thickness is represented by the middle crosshair.
5. Reposition the 3D volume prescription, if necessary.
6. Click [Accept].
Š The Tracker Rx screen closes and brings you back to the 3-Plane GRx screen.
7. Click [Accept].
Š The 3-Plane GRx screen closes and you may continue with series prescription
and acquisition.

Quick Steps: Prescribe 3D Graphic Locations – Tracker Location

1. Click [Tracker].
2. Click an image in any of the three viewports.
3. Angle and move the tracker to the desired position over the main vessel.
4. Resize the tracker volume.
5. Reposition the 3D volume prescription, if necessary.
6. Click [Accept].
7. Click [Accept].

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 Prescribing Images

Prescribe SAT Locations

Use the following procedure to define a SAT Prescription. 3-Plane SAT allows you to
graphically prescribe SAT bands on an image from a series within the current exam
while viewing your GRx in three different image planes. This option is also used for
prescribing a concatenated SAT or prescribing a chemical saturation technique.
Use this procedure to guide you through the process of prescribing SAT locations
during scanning.
1. Click the SAT icon in the Additional Parameters area or on the 3-Plane GRx screen.

Š The SAT screen displays with any 3-Plane GRx locations that may have been
deposited.
2. Right-click in the desired viewport to activate the viewport.
Š You can also middle-click, press Shift + click, or press Ctrl + click to activate the
viewport.
3. Select the image desired for the localizer.
a) If necessary, click [Select Series] to choose a different series to be used as a
localizer.
b) Select a series from the list.
c) Click [OK].
d) Alternatively, click [-] and [+] to review the previous or next image in the series
and select the desired image.
4. Click [Copy] if you desire to copy a SAT prescription from a previous series and all
SATs are deselected from the current prescription.
a) Select the series from the list.
b) Click [Accept] in the Copy window.
c) Skip to step 9.
5. Magnify the image using the Zoom Slider, if necessary.
Š Enabling Auto Update: Zoom applies the magnification to all three viewports.

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 Prescribing Images

6. Prescribe the desired spatial saturation bands.

Š You are able to deposit up to six SAT bands at one time on any of the three
viewports if the pulse sequence supports it.
Š The intersections of the SAT bands display on the other viewports.
Š The default SAT thickness is 80 mm for most sequences.
Š If you do not enter any value in the location text box, the SAT band is placed at
the edge of the FOV.
a) Click [S], [I], [A], [P], [R], or [L] to prescribe directional spatial SAT bands.
b) Accept the default thickness and location or enter a value for thickness and
location.
– Alternatively, position the cursor on the image at the desired location for the
inside edge of the saturation band, press the Shift key and click.
7. Resize and move the SAT band to its desired location.
a) Click and drag the Thickness handle to change the width of the band or type in a
value in the Thickness text box.
b) Click and drag the Rotate handles on the leading edge of the SAT band to turn it.
c) Click and drag either edge of the SAT band to change its location. Do not click on
the Rotate or Thickness handles to move it.
8. Prescribe the desired concatenated spatial saturation, if necessary.
Š Two concatenated saturation pulses can be placed parallel to the acquisition
slice when used with a sequential series, or with an orthogonal series with two
acquisitions.
a) Click saturation bands in the slice direction.
b) Click [Concat SAT].
– Do not change the thickness or location of the band.
9. Prescribe the desired chemical saturation, if necessary.
Š Fat
Š Water
Š Fat Classic
Š SPECIAL
10. Click [Accept].
Š The 3-Plane SAT screen closes and you may continue with series prescription
and acquisition.

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 Prescribing Images

Quick Steps: Prescribe SAT Locations

1. Click the SAT icon in the Additional Parameters area or on the 3-Plane GRx
screen.
2. Right-click in the desired viewport to activate the viewport.
3. Select the image desired for the localizer.
4. Click [Copy] if you desire to copy a SAT prescription from a previous series and all
SATs are deselected from the current prescription.
5. Magnify the image using the Zoom Slider, if necessary.
6. Prescribe the desired spatial saturation bands.
7. Resize and move the SAT band to its desired location.
8. Prescribe the desired concatenated spatial saturation, if necessary.
9. Prescribe the desired chemical saturation, if necessary.
10. Click [Accept].

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 Prescribing Images

Copy Graphic Locations

Prescribe Locations on Active Viewport Localizer
You are able to copy a graphic prescription from a previous series with the Copy Rx
feature, provided the current prescription has the same patient position, patient entry,
landmark, mode, FOV, slice thickness, spacing, and scan plane.
Use this procedure to copy exact graphic locations from a localizer in the active
viewport to the current prescription.
1. Click the Graphic Rx icon.
Š The 3-Plane Graphic screen displays with the system selected default images
loaded in the three viewports.
2. Select a localizer image that is different than the image used to prescribe the
original series.
3. Click [Copy Rx].
Š The current prescription must have the same patient position, patient entry,
landmark, mode, FOV, slice thickness, spacing, and scan plane as the selected
series.
Š The 3Plane GRx Series List window opens.

4. Select the series from the 3Plane GRx Series List window that has the locations you
wish to copy.
5. Click [Present Loc].
Š The graphic lines are pasted to the image on the active viewport.

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 Prescribing Images

Quick Steps: Copy Graphic Locations – Prescribe Locations on Active

Viewport Localizer
1. Click the Graphic Rx icon.
2. Select a localizer image that is different than the image used to prescribe the
original series.
3. Click [Copy Rx].
4. Select the series from the 3Plane GRx Series List window that has the locations
you wish to copy.
5. Click [Present Loc].

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Copy Graphic Locations

Prescribe Locations on Original Localizer
You are able to copy a graphic prescription from a previous series with the Copy Rx
feature, provided the current prescription has the same patient position, patient entry,
landmark, mode, FOV, slice thickness, spacing, and scan plane.
Use this procedure to copy graphic locations from a previous series to the current
prescription with the same locations as the original localizer.
1. Click the Graphic Rx icon.
Š The 3-Plane Graphic screen displays with the system selected default images
loaded in the three viewports.
2. Click [Copy Rx].
Š The current prescription must have the same patient position, patient entry,
landmark, mode, FOV, slice thickness, spacing, and scan plane as the selected
series.
Š The 3Plane GRx Series List window opens.

3. Select the series from the 3Plane GRx Series List window that has the locations you
wish to copy.
4. Click [Original Loc].
Š The graphic lines are posted on the selected image.
Š The prescription is exactly the same as the selected series.
NOTE: Alternatively, you can obtain an exact copy of the original locations by selecting
the exact viewport and localizer image used for the series from which you will be
copying the slice locations, clicking [Copy Rx], and double-clicking the series
containing the desired locations.

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 Prescribing Images

Quick Steps: Copy Graphic Locations – Prescribe Locations on Original

Localizer
1. Click the Graphic Rx icon.
2. Click [Copy Rx].
3. Select the series from the 3Plane GRx Series List window that has the locations
you wish to copy.
4. Click [Original Loc].

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 Scanning with a Protocol

Chapter 8
Scanning with a Protocol

Introduction
This chapter focuses on prescribing and performing scans using a protocol. It highlights
key concepts and provides brief guidelines for registering a patient, selecting a protocol,
editing a series, prescribing scan locations and saturation bands, and scanning a
series.
This chapter contains instructions to help you learn how to:
• Start a Scan Prescription
• Transfer the Patient to the System Table
• Position the Patient
• Align and Landmark
• Review the Protocol Parameters
• Scan
• Help the Patient off the Table

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 Scanning with a Protocol

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete a scan
prescription process and begin scanning. Specifically, you need to understand:
• Scan Prescription
• Rx Manager
– Series Control
– Auto Scan
– Rx Manager List

Scan Prescription
Scan prescription begins on the Scan Rx desktop. The Scan Rx Desktop provides all
the clinical tools necessary for comfortable, efficient set up of patient studies. These
tools include patient scheduling and data entry, examination protocol selection, protocol
viewing and editing with graphic prescription, scan data acquisition, image
reconstruction, and dual AutoView image display layouts. The Scan Rx Desktop opens
progressively. As you complete the information required for each area, another area
becomes available to access and complete.
When you click on the Scan Rx icon (Figure 8-1) located in the control panel, the Scan
Rx Desktop (Figure 8-2) opens.
Figure 8-1 Scan Rx Icon

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 Scanning with a Protocol

Figure 8-2 Scan Rx Desktop

The desktop is divided into the following areas: Rx Manager, Patient Information,
Patient Position, Imaging Parameters, AutoView, Scan Timing, Additional Parameters,
Acquisition Timing, Scanning Range, Advisory Panel, and Scan Operations.
This chapter describes the Rx Manager and setting up a scan prescription using a
predefined protocol. Refer to the Scan Rx Desktop chapter for additional information on
the other areas of the desktop.

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 Scanning with a Protocol

Rx Manager
The Rx Manager is used to create, view, edit, and prepare series for scanning. A series
list is created in the Rx Manager upon selection of a protocol. The Rx Manager reduces
scan prescription time by using predefined patient protocols and has time-saving
benefits of multiple prescribe ahead series concurrent with scanning. It also provides
access to the scan mode selection and gating control. The Rx Manager (Figure 8-3) is
located on the left side of the Scan Rx Desktop. It appears after the selection of a
protocol.
Figure 8-3 Rx Manager

The Rx Manager has several controls for starting and ending an examination or a
pre-programmed protocol. The status of a series is listed in the window with the series
description.

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 Scanning with a Protocol

Table 8-1 describes the selections in the Rx Manager.

Table 8-1 Rx Manager Functions

Selection Description
Sets Auto Archive, Auto Transfer, and system operation mode.
[Scan Modes] Refer to Auto Archiving and Networking Functions for additional
information.
[Gating Controls the waveform display. Refer to the Gating Control Window
Control] in the Gating and Triggering chapter for additional information.
Adds a blank series to the patient’s examination in the Rx Manager
[New Series]
list.
Completes the current examination and returns the desktop to the
Patient Register. It separates patient examinations or anatomical
regions for one patient. Completing an examination with this key:
• Changes the status of the exam from current to completed
• Closes the Rx Manager and displays the Patient Register
• Enables the New Patient selection for the next patient or anatomy
to be scanned
[End Exam]
• Makes the examination number available for archiving
No additional images can be added to the examination number after
this button is clicked. You must select the this button before Auto
Store can save the examination’s images to the MOD.
If your system has the ConnectPro Plus (PPS) option, clicking the
[End Exam] button provides you with the choices to complete,
defer, discontinue, or cancel the examination.
Allows you to review or edit a series in the Rx Manager. It can also
[View Edit] be used to adjust a scan range after viewing the most recent
acquisition. A series can be modified and saved again.
[Prepare to Activates the Scan Operations area with parameters of the selected
Scan] series.
Saves the current prescription to the Site protocol library. This
[Save Rx as allows you to build predefined site protocols to reduce prescription
Protocol] set-up time and increase productivity. The entire series list in the Rx
Manager is saved as a protocol in the Site library.
Automatically downloads, prescans, and scans all RXD series in the
Rx Manager. This feature extends the multi-tasking capabilities by
[AutoScan] allowing you to prescribe multiple scans in advance. The next RXD
series in the list begins automatically when AutoScan is selected. All
RXD series in the Rx Manager list are scanned sequentially.
Provides automatic table movement and scan initialization for data
acquisitions containing more than one station, until all stations are
[AutoStep] acquired. It is available with the Multi Station Imaging Option. All
prescribed stations in the meta-series must be saved and
prescanned before selecting AutoStep to initiate an acquisition.

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 Scanning with a Protocol

Series Control
A series cannot be scanned unless a series is saved. Saving the series changes its
status from INRX (in prescription) and places it in the prescribed or RXD state in the Rx
Manager. The system automatically moves the first series in the Rx Manager list to
active status.
The system automatically downloads the first series and, therefore, selecting the
[Prepare to Scan] button is not required. Prepare to Scan changes the status of a series
from prescribed (RXD) to active (ACT) or ready to be scanned.
There are several factors you should consider about the [Prepare to Scan] button.
• Prepare to Scan is not needed if AutoScan is selected.
• Prepare to Scan is not needed for the first series of an examination.
• Prepare to Scan is required to download series on an individual basis.
• The series highlighted in the Rx Manager is the series prepared. Note that the
series represented on the Scan Rx Desktop is not necessarily the series highlighted
in the Rx Manager.

Auto Scan
There are several factors you should consider before using the [AutoScan] button.
• Auto Scan turns OFF if:
– A table move is required (Move to Scan).
– Move to scan is not activated after two audio alarms and scan times out.
– A contrast series is in the queue following a non-contrast series.
– A new landmark is selected.
– New Patient or a patient from Patient Register list is selected.
• The following describes the behavior of contrast-enhanced series when Auto Scan
is active:
– AutoScan is on and there are no series in the Rx Manager in the RXD state.
– When the first series containing contrast On is ready to scan, the contrast
injection message box appears. You must select the [OK] button to proceed.
– The contrast message does not appear again in this exam for subsequent
contrast-enhanced series. An exception to this occurs when there is a series
prescribed with contrast followed by a series prescribed without contrast, then
another series with contrast selected on. The contrast injection message
appears again following the no contrast series.
• If Auto Scan is turned on and there is no series in the Rx Manager in the RXD state
but a series in a SCND or ACT state has been copied, the system
AUTOMATICALLY changes its status to RXD. The system scans this series before
there is a chance to edit the copied series.

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 Scanning with a Protocol

Rx Manager List
The Rx Manager List (Figure 8-4) shows the prescribed series state and series
description. All scan information can be recalled by selecting and copying a series. This
allows you to repeat a series exactly, without entering any information. Series are
loaded from the protocol library into the Rx Manager.
Figure 8-4 Rx Manager List

Each series in the Rx Manager list contains three pieces of information:

• The current state.
– NEW: series is not yet prescribed or saved and cannot be scanned.
– INRX: (in prescription) series is opened, not yet saved, and cannot be scanned.
– RXD: (prescribed) series is saved and can be scanned.
– ACT: (active) series is ready for scan and can no longer be edited.
– SCND: (scanned) series has been scanned and can no longer be edited but can
be re-scanned.
– PSCD: (prescanned) series is pre-scanned and ready for scan (can no longer be
edited).
– ACRX: (active but prescribed) Propeller series has been both saved and
downloaded it can still be edited.
• The series number. A series number is not assigned until the scan is initiated.
• The series description.
A new series in the Rx Manager list changes to INRX if a View Edit is performed. If you
view or edit another series before a Save Series is initiated for the current series
(INRX), changes for the current series (INRX) are saved and the INRX series is relisted
in the Rx Manager as NEW. You can view but not edit a series that has a status of ACT
or SCND, even though the status of the series changes to INRX.

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 Scanning with a Protocol

For example, a typical series of entries in the Rx Manager List might include:
SCND 1. Sagittal T1 Loc
This indicates the series has been scanned, was the first series, can be used as a
localizer, and remains in the list for easy access to the scan values.
ACT 2. Axial T2
This indicates that this scan was the second series and is currently being scanned
or it is ready to scan.
RXD 3. Axial T1 Pre
This indicates that this scan is the third series and is ready for downloading.
INRX 4. Coronal T1 Pre
This indicates that the scan is the fourth series and has not been saved, it is being
view/edited.
NEW 5. Sagittal T1 Pre
This indicates that the scan is the fifth series and has not been saved, nor is it being
view/edited.
There are several factors you should consider when using the Rx Manager.
• Select the entries in the Rx Manager list in any order.
• The series highlighted in the Rx Manager is not necessarily the series being viewed
on the desktop. The series in the INRX state is the series on the desktop.
• If a series on the desktop in the INRX state is saved and the [Scan] button is
clicked, the system does not scan this series (the one on the desktop) but repeats
the scan on the series previously scanned or in the ACT state.
• Series from different protocols can be added to the list. For example, if the current
patient examination is a thoracic and lumbar spine study, the list can be arranged to
have both examinations ready to scan. Keep the landmark and orientation the same
for each scan.
• The Rx Manager list is created as soon as a protocol is selected. Select any series
in the list and prescribe slice and SAT locations, change the stored protocol values,
and save the protocol to the Rx Manager. The process can be repeated for as many
series as needed.

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 Scanning with a Protocol

How Do I...
This section provides the step-by-step instructions for scanning with a protocol.
Specifically, it describes how to:
• Start a Scan Prescription
• Transfer the Patient to the System Table
• Position the Patient
• Align and Landmark
• Review the Protocol Parameters
• Scan
• Help the Patient off the Table

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 Scanning with a Protocol

Start a Scan Prescription

Use this procedure to start a scan prescription. This procedure guides you through
beginning a scan with a predefined protocol.
1. Click the Scan Rx Desktop icon in the control panel.

Š This allows you to start a new patient prescription.

Š Once the system is ready, the Patient Register, Rx Manager, and AutoView
areas appear on the desktop.
2. Click [New Pt] in the Patient Register.
Š The Patient Information area opens.
3. Complete the Patient Information text
boxes.
Š Type the appropriate information in the
text boxes and press Enter.
Š At a minimum, you must enter the
patient’s identification (ID) number and
correct weight.
Š The exam description and history
appear on the Exam text page and can
be filmed as part of the patient’s
record.
4. Confirm that all information is correct
before proceeding.
Š After you click the [Save Series] button
for the first series, you cannot modify
the patient information entries while an examination is open. If you make a typing
error and need to edit the patient information (name and ID) you must wait until
the examination has ended. At that time, you can click the [Edit Patient] button
from the Browser. Refer to the Editing Patient Information chapter for additional
information.
Š Entries made in the Patient Information area should not contain a backslash (\)
character.

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 Scanning with a Protocol

Quick Steps: Start a Scan Prescription

1. Click the Scan Rx Desktop icon in the control panel.
2. Click [New Pt] in the Patient Register.
3. Complete the Patient Information text boxes.
4. Confirm that all information is correct before proceeding.

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 Scanning with a Protocol

Transfer the Patient to the System Table

The table is stationary and can support up to 500 pounds. It is designed to
accommodate the transfer of ambulatory, wheelchair, and gurney patients. It is very
important to remember that conventional life-support equipment, cannot be brought into
the magnet room because it might contain metal parts and may malfunction or cause
serious injury. Although each procedure requires a few deviations, the general
procedure is very similar. Follow these steps when transferring a patient and refer to the
specific steps for each patient type (ambulatory, wheelchair, or gurney).
1. Ensure that the patient is "magnet ready."
Š The patient has completed the screening sheet and has removed all metal items.
2. Bring the patient to the table.
Š If using a wheelchair or a gurney, be sure it is non-ferrous.
Š If using a ferrous wheelchair or gurney, undock the table, and bring it out of the
room to transfer the patient.

WARNING:Do not bring conventional life-support equipment into the magnet room
because it may contain metal parts and may malfunction, or cause
patient injury or equipment damage.
3. If using a coil, place it on the table.
4. Swing the table into position if an offset FOV is required and lock in place.
5. Adjust the table height.
Š Use the up/down foot pedals at the side of the magnet or at the end of the table.

Š If the patient is in a wheelchair, lock the wheels.

Š If the patient is on a gurney, place it next to the table and lock the wheels. The
table and gurney height should be the same.
6. Transfer the patient onto the table.
7. Help the patient with any medical accessories they may have.

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 Scanning with a Protocol

8. Secure the patient with padding and straps.

Š Straps are to stabilize, not restrain the patient.
Š Use sponges and wedges to relieve pressure points and support the body in the
correct position.
9. Raise the table to scanning height.

Quick Steps: Transfer the Patient to the System Table

1. Ensure that the patient is "magnet ready."
2. Bring the patient to the table.
3. If using a coil, place it on the table.
4. Swing the table into position if an offset FOV is required and lock in place.
5. Adjust the table height.
6. Transfer the patient onto the table.
7. Help the patient with any medical accessories they may have.
8. Secure the patient with padding and straps.
9. Raise the table to scanning height.

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 Scanning with a Protocol

Position the Patient

Patient positioning depends on a range of factors including the type of study, the RF coil
being used, and the patient’s condition. Regardless of patient position and orientation,
patient comfort and safety are of primary importance.
Use this procedure as a guide to position the patient for an examination.
1. Position the swing and lateral positions of the table.
Š The table can only be swung with the patient off the table.
Š General rules for head first patient positioning:
– The table should be swung in the opposite direction of the anatomical area of
interest. For example, if you are imaging the left shoulder and the patient is
head first, swing the table to the right.
– The cradle should be laterally offset to the maximum distance away from
isocenter (120 mm).
Š General rules for feet first positioning:
– The patient should be swung in the same direction of the anatomical area of
interest.
– The cradle should be laterally offset to the maximum toward isocenter
(120 mm).

CAUTION: The system table should only be swung with the patient off the table. If
you are pivoting the table for the examination, move the table prior to
positioning your patient.
NOTE: Refer to the Getting Started chapter for defined swing and lateral table positions.

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 Scanning with a Protocol

2. Position the patient in the coil.

a) Decide whether to have the patient lie head first or feet first.
– For head and neck examinations, generally use the head first position.
– For body examinations, the decision might be made to position the patient
feet first, although head first remains more common.
– When using the coils or prescribing a gated study, position the patient to
minimize the distance that the cables extend into the bore of the magnet.
b) Decide whether to have the patient lie supine, prone, left decubitus, or right
decubitus. Coil requirements and patient comfort considerations can affect these
choices.

NOTE: Always compare the patient entry and patient position with the information
entered at the operator’s console. Incorrect entries can result in incorrect left/right,
anterior/posterior, or inferior/superior image annotation.
3. Provide cushions for comfort and to minimize any contact heating.
Š Use sponges and wedges to relieve pressure points and support the body in the
correct position.
Š Use accessories, such as knee bolster.

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 Scanning with a Protocol

WARNING:To help prevent a patient burn from closed loops formed by clasped
hands, by hands touching the body, or from thighs or knees contacting
over a small area, insert non-conducting pads at least 0.25 inches thick
between the touching parts.

4. Provide the patient with hearing protection.

Š Earplugs reduce the intensity of the sound, while allowing your patient to hear
normal conversations.
Š Headphone systems soften acoustic noise, but may impede verbal
communication with patients while the system is operating.
5. Ensure that the patient is comfortable and ready to begin the examination.
Š Use sponges and wedges to relieve pressure points and support the body in the
correct position.
Š Ask if a blanket is needed.

Quick Steps: Position the Patient

1. Position the swing and lateral positions of the table.
2. Position the patient in the coil.
3. Provide cushions for comfort and to minimize any contact heating.
4. Provide the patient with hearing protection.
5. Ensure that the patient is comfortable and ready to begin the examination.

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 Scanning with a Protocol

Align and Landmark

Alignment and landmarking are steps taken to ensure the Region of Interest (ROI)
center is as close as possible to isocenter. That is, the location in the bore where the
magnetic field is most homogenous. The purpose of selecting a landmark is to establish
an anatomical point from which all images in a series are referenced. This procedure
guides you through the alignment and landmarking processes.
Use this procedure to align and landmark a patient during the scanning procedure.
1. Position the patient on the scan table.
Š Refer to the Position the Patient procedure.
2. Press the Alignment Light on the magnet button control panel.

CAUTION: Exposing eyes to the laser alignment lights may result in eye injury.
Š Instruct patients to close their eyes during landmarking to avoid eye exposure to
the alignment light while the laser light is on.
Š Do not leave the laser beam on after you position the patient.
3. Press In Slow or In Fast to advance the cradle until the axial alignment light rests at
the desired landmark.
Š Confirm centering with the sagittal and axial alignment lights.
Š Note that there are three sets of alignment lights: one for no cradle lateral
movement, and one at +/- 9 cm offset location.

NOTE: Homogeneity decreases as distance from isocenter increases. Although it is not

always possible to place the anatomy being scanned at isocenter, bring the
anatomy as close to isocenter as possible, while keeping the patient comfortable.

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 Scanning with a Protocol

4. Press Landmark to inform the system the position of the landmark.

Š The cradle location display reads "0" when the landmark has been established.
Š A scan cannot be started until a landmark is defined in the magnet room.

5. Press Move to Scan.

Š The table moves the patient to isocenter.
Š The laser alignment lights turn off automatically.
Š The cradle location display now counts down to "0" again as the cradle moves
the landmark into isocenter.
6. If the cradle location display fails to count down to "0," press Move to Scan a
second time.
Š If that does not work, move the table in or out with the in/out buttons and press
Move to Scan one more time.

CAUTION: Make sure the patient connected intravenous (IV) lines, oxygen tubing,
urinary catheters, and any other tubing and cables are long enough to
allow full travel of the system and will not become entangled, pinched,
or pulled.
7. Stay in the scan room until the cradle stops and check to make sure that the patient
is comfortable.
8. Return to the scan console.
9. Select the desired table swing in the Table Entry text box.
Š Set the table swing position by choosing either LEFT, CENTER, or RIGHT.
– Left: the table swing position is at +25 degrees.
– Center: table swing position is at 0 degrees.
– Right: table swing position is at -25 degrees.
NOTE: If the swing position is not entered at the beginning of a new examination, an
advisory message prompts you to complete the Table Entry text box before
continuing.

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 Scanning with a Protocol

Quick Steps: Align and Landmark

1. Position the patient on the scan table.
2. Press the Alignment Light on the magnet button control panel.
3. Press In Slow or In Fast to advance the cradle until the axial alignment light rests
at the desired landmark.
4. Press Landmark to inform the system the position of the landmark.
5. Press Move to Scan.
6. If the cradle location display fails to count down to "0," press Move to Scan a
second time.
7. Stay in the scan room until the cradle stops and check to make sure that the
patient is comfortable.
8. Return to the scan console.
9. Select the desired table swing from the Table Entry text box.

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 Scanning with a Protocol

Review the Protocol Parameters

Use this procedure to review the selected protocol parameters prior to beginning your
scan. It is important to re-examine the protocol parameters to ensure your desired
choices are selected.
1. Select an imaging protocol.
Š Refer to the Select a Protocol procedure.
2. Select the desired series in the Rx Manager.
3. Click [View Edit] to open the series on the Scan Rx Desktop and display the
pre-defined parameters.
Š Allows the revision or editing of a series in the Rx Manager. The series can then
be modified and saved again.
Š A new series changes to INRX in the Rx Manager if a View Edit is performed.
4. Review the pre-defined scan parameters.
a) Confirm the Patient Position and Patient Entry parameters are correct for the
current patient’s orientation in the magnet.
– If the patient position and entry do not match the patient’s orientation, the R,
L, A, P, S, I image annotation will be incorrect.
– Make sure the patient orientation icon matches the actual patient orientation.
b) Confirm the coil selection is correct.
– The coil selected in the protocol must match the coil connected to the system.
– Incorrect coil selection can result in prescan failure, coil damage, or degraded
image quality.
– If the coil connected does not match the coil selected in the current protocol,
the system posts a message warning of the mismatch.
– If the coil has a Coil ID label, the system does not allow you to click [Prepare
to Scan] unless the coil plugged in matches the coil selected.
c) Confirm the Imaging Parameters are correct for this patient and sequence.
d) Confirm the Scan Timing parameters are selected to produce the desired
contrast.
e) Confirm the Scanning Range parameters allow proper coverage of the anatomy
being imaged.
f) Confirm the Acquisition Timing parameters are selected to produce the desired
spatial resolution, scan time, and SNR.
5. Explicitly or graphically prescribe your scan locations.
Š Refer to the Prescribing Images chapter for additional information.

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 Scanning with a Protocol

6. Make parameter changes, if needed.

7. Review the Advisory Panel for the scan time, number of acquisitions, and changes
to the Relative SNR% meter.
Š The Relative SNR% meter is not an absolute value but a relative value based on
the current set of parameters being equal to 100%. Changes made to
parameters that affect SNR are calculated and relative SNR% is updated to
indicate its impact on SNR. The relative SNR% for a protocol can be reset to
100% using the Reset SNR selection.
Š The Relative SNR% meter changes when any of the following parameters have
been changed: Minimum TE, Minimum Full TE, FOV, Slice Thickness, matrix,
NEX, PFOV, Square Pixels, 3D slabs. Make adjustments as needed based on
MR trade-offs.
8. Note the Specific Absorption Rate (SAR) level, which is based on the patient’s
weight.
Š SAR refers to the RF power absorbed per unit of mass of an object (Watts/kg).

Quick Steps: Review the Protocol Parameters

1. Select an imaging protocol.
2. Select the desired series in the Rx Manager.
3. Click [View Edit] to open the series on the Scan Rx Desktop and display the
pre-defined parameters.
4. Review the pre-defined scan parameters.
5. Explicitly or graphically prescribe your scan locations.
6. Make parameter changes, if needed.
7. Review the Advisory Panel for the scan time, number of acquisitions, and changes
to the Relative SNR% meter.
8. Note the Specific Absorption Rate (SAR) level, which is based on the patient’s
weight.

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 Scanning with a Protocol

Scan
Use the following scanning procedure after all scan prescription information is
complete.
1. When a series prescription is complete, click [Save Series].
Š A landmark must be established before you save the series. Once a series is
saved, you can no longer edit entries in the Patient Information area.
Š The completed series is saved in the Rx Manager and the series state changes
from INRX to RXD.
Š The system automatically downloads the first series and, therefore, clicking
[Prepare to Scan] is not required.
2. Select the desired saved (RXD) series in the Rx Manager.
3. Click [Prepare to Scan].
Š The parameters are automatically downloaded for scanning.
4. Click [Scan].
Š The system prescans and immediately proceeds to scan.
– Each time a new series is prescanned, the system will use the previous
prescan data (within the current examination) to make the prescan
calculations for center frequency, transmit gain, and receive gain. For this
reason, prescan time varies from one series to the next.
Š Alternatively, click [Auto Prescan] to start auto prescan, which automatically
adjusts Center Frequency, Transmit Gain, and Receive Gain. Allow it to
complete and if further adjustments are needed click [Manual Prescan] to
manually adjust the Center Frequency, Transmit Gain, and Receive Gain. When
manual prescan adjustments are complete, click [Scan].
– Refer to the Prescanning chapter for additional information.
Š If you are acquiring a breath-hold scan, click [Prep Scan] to eliminate the lapse
in time between the moment you click the [Scan] button and the moment the
system begins scanning.
– [Prep Scan] can be clicked after [Auto Prescan] or [Manual Prescan] and
before [Scan].
Š To automatically prescan and scan all saved series, click [Autoscan] in the Rx
Manager.
5. Click [New Series] to prescribe or add a new series to the Rx Manager.
6. Click [End Exam] when finished.

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 Scanning with a Protocol

Quick Steps: Scan

1. When a series prescription is complete, click [Save Series].
2. Select the desired saved (RXD) series in the Rx Manager.
3. Click [Prepare to Scan].
4. Click [Scan].
5. Click [New Series] to prescribe or add a new series to the Rx Manager.
6. Click [End Exam] when finished.

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 Scanning with a Protocol

Help the Patient off the Table

When an examination is complete, assist your patient in getting off the table and exiting
the scan room safely.
1. Press Out Slow or Out Fast to bring the patient out of the magnet, while paying
careful attention to all health lines and medical accessories.

2. Remove any coils, pads, or supportive straps that were used during the
examination.
3. Adjust the table height to safely transport the patient back to a gurney, wheel chair,
or to exit the table and walk out of the scan room.
Š If using a wheelchair or a gurney, be sure it is non-ferrous.
Š If using a ferrous wheelchair or gurney, undock the table, and bring it out of the
room to transfer the patient.

WARNING:Do not bring conventional life-support equipment into the magnet room
because it may contain metal parts and may malfunction, or cause
patient injury or equipment damage.
4. Assist the patient as he or she gets off the table, while paying careful attention to all
health lines and medical accessories.

CAUTION: Following the examination, your patient may need assistance when
getting off the table. After lying in a prone position for a length of time,
your patient may experience light-headedness upon sitting up.

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 Scanning with a Protocol

Quick Steps: Help the Patient off the Table

1. Press Out Slow or Out Fast to bring the patient out of the magnet, while paying
careful attention to all health lines and medical accessories.
2. Remove any coils, pads, or supportive straps that were used during the
examination.
3. Adjust the table height to safely transport the patient back to a gurney, wheel
chair, or to exit the table and walk out of the scan room.
4. Assist the patient as he or she gets off the table, while paying careful attention to
all health lines and medical accessories.

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 Prescanning

Chapter 9
Prescanning

Introduction
This chapter focuses on manual prescan and chemical saturation tuning. These are
important tools to help you improve your image quality. The chapter highlights key
concepts and provides guidelines for manual prescan and chemical saturation tuning. It
also contains the step-by-step instructions to help you learn how to:
• Automatically Prescan
• Manually Prescan
– Match Coarse Center Frequency to the Patient
– Adjust the Transmit Gain
– Match Fine Center Frequency to the Patient
– Adjust the Receiver Gain
• Optimize Chemical Saturation

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 Prescanning

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete the prescanning
process. Specifically, you need to understand:
• Purpose and Benefits
• Auto Prescan
– Auto Prescan Failures
• Manual Prescan
– Precessional and Transmit Frequency
– Transmit Gain
– Scan TR
• Prescan for Chemical Saturation

Purpose and Benefits

Prescan optimizes the system’s transmit and receive values for each patient and area
of interest. Every patient is a unique collection of protons and requires a unique
combination of radio frequency (RF) and power to image. There are many reasons to
prescan. The primary reasons are as follows:
• Prescan optimizes auto shim values (when selected) to improve the homogeneity of
the magnetic field with the patient in the bore.
• Prescan allows the manual optimization of chemical saturation.
• Prescan sets:
– Center Frequency Coarse
– Transmit Gain
– Center Frequency Fine
– Receive Gain
There are two prescan programs:
• Auto Prescan
• Manual Prescan

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 Prescanning

Auto Prescan
Auto Prescan (APS) automatically adjusts the center frequency and the transmit and
receive gains. These values appear in the message area upon completion of a
successful APS.
Use APS for the most efficient, accurate, and consistent prescan.
Each time a new series is prescanned, the system uses the previous prescan data
(within the examination) to make the prescan calculations for center frequency, transmit
gain, and receive gain. For this reason, the prescan time varies from one series to the
next.

Auto Prescan Failures

During an APS, the system may fail to automatically calibrate the RF power transmitted
and received in a slice. If an error is detected, the message Prescan Failed appears
in the scan operations area, followed by a reason.
• If APS fails and the system can determine the cause, the Prescan Failed
message contains additional information. Two common messages and problems
are:
– Auto Prescan Failed. Table not at scan plane. The solution to this
problem is to press the Move to Scan button to move the table to scan plane.
Then try to Auto Prescan again.
– Auto Prescan Failed. RF amplifier not ready. To correct this
problem, wait for the RF amplifier ready message to appear in the
message area.
• In certain Center Frequency prescriptions, fat and water peaks may not be readily
discernible. In such cases, the system displays Auto Prescan Incomplete and
Set AX manually. At this point, the MRI system requires an MPS to find the
desired peak.
• An improperly connected coil may result in a failed prescan with the message, TR
Driver Fault. Check coil connections before proceeding with prescan.

Manual Prescan
Manual Prescan (MPS) allows you to manually adjust the center frequency, transmit
gain, and scan TR. The accuracy of MPS is very much dependent on you, the
technologist.
Use MPS:
• If APS fails
• When a particularly strong or weak signal exceeds the system’s ability to self-adjust
• When values have been manually set for chemical saturation techniques

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 Prescanning

Four transceiver hardware settings are used in MPS:

• Center Frequency Coarse (CFL)
• Transmit Gain (TG)
• Center Frequency Fine (CFH)
• Scan TR (R1/R2)
The Manual Prescan window (Figure 9-1) opens when you click the [Manual Prescan]
button in the Scan Operations area of the Scan Rx Desktop.
Figure 9-1 Manual Prescan Window

NOTE: Remember that you are delivering RF to the patient during prescan.

Precessional and Transmit Frequency

The goal of a center frequency adjustment is to match the transmitting frequency of the
system to the precessional frequency of the nuclei in the patient and region of interest.
The closer these frequencies match, the more efficient the transfer of energy and the
shift to resonance.

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 Prescanning

Each patient magnetizes differently and this results in a unique precessional frequency.
The Larmor Equation calculates this frequency as shown in Figure 9-2.
Figure 9-2 Larmor Frequency

Various adjustments are made in order to move the location of the bandwidth and
center frequency.

Center Frequency Coarse

Center frequency adjustments tune the digital transceiver to match the resonant
frequency of the region of interest. Coarse center frequency adjustments can be made
on a usable bandwidth frequency range of ±2,000 Hz (Figure 9-3). The course
adjustment allows you to view the spectrum, regardless of its location, compared to the
current bandwidth location. Fat and water may appear as one peak when viewed in this
frequency range.
Figure 9-3 Spectrum Viewed with Course Adjustment

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 Prescanning

Center Frequency Fine

Center frequency fine adjustments are made on a usable bandwidth frequency range of
±500Hz (Figure 9-4). At this point the spectrum often has a fat and a water peak. You
can center the spectrum’s midpoint on the desired location.
Figure 9-4 Spectrum Viewed with Fine Adjustment

Transmit Gain
Transmit gains are applied to change the amount of transmit attenuation and allow the
appropriate RF energy to achieve the maximum signal. They adjust the transmitting
power (amount of RF) the system uses in order to obtain the correct flip angles.
A correct transmit gain means that a 90° RF pulse flips the net magnetization vector
exactly 90° (Figure 9-5).
Figure 9-5 RF Pulse Flip Angles

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 Prescanning

Scan TR
Receive gain adjusts the analog and digital receivers for the level of signal returning
from the patient. The receiver must be able to convert or translate the MR signal coming
from the patient into a useful electronic signal. Signal exceeding the translation range of
the receiver cannot be converted and becomes noise, like a radio playing too loudly.
Scan TR can be adjusted to maximize receive gains and achieve the best SNR. The
various adjustments are made in order to move the location of the bandwidth, and more
importantly, the center frequency line (AX), where AX represents actual frequency to
the center of the spectrum.
Scan TR (R1 and R2) are used to adjust the receive gains:
• R1: Analog Gain
• R2: Digital Gain
NOTE: Improper adjustment of R1 and R2 settings results in distortion and possible
image quality degradation. If R1 and R2 are set too high, contrast reversal effects
can occur. If R1 and R2 are set too low, a low SNR can occur.

Prescan for Chemical Saturation

ChemSAT Tune (CSTUN) is a prescan function for the chemical saturation pulse. You
must match the transmit frequency with the precessional frequency, and adjust the
amplitude of the imaging pulse for the suppression pulse. The overall success of
ChemSAT depends somewhat on the uniformity of the anatomy being imaged, in
addition to the pulse sequence and coil being used.
CSTUN:
• Allows the optimization of fat or water peak suppression.
• Adjusts the frequency of the SAT pulse using CSF.
• Adjusts the amplitude of the SAT pulse using CSA.

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 Prescanning

How Do I...
This section provides the step-by-step instructions for performing an APS or MPS.
Specifically, it describes how to:
• Automatically Prescan
• Manually Prescan
– Match Coarse Center Frequency to the Patient
– Adjust the Transmit Gain
– Match Fine Center Frequency to the Patient
– Adjust the Receiver Gain
• Optimize Chemical Saturation

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 Prescanning

Automatically Prescan
Use this procedure to automatically prescan with routine scan prescriptions. APS
automatically adjusts and sets the center frequency, transmit gain, and receive gain.
This procedure guides you through the APS process.
Proceed with a routine scanning prescription to begin this procedure.
1. Click [Auto Prescan] in the Scan Operations area.

2. Verify the completion of a successful APS.

Š The prescan values are displayed in the Scan Operations area.
3. Click [Scan] to begin the acquisition.

Quick Steps: Automatically Prescan

1. Click [Auto Prescan] in the Scan Operations area.
2. Verify the completion of a successful APS.
3. Click [Scan] to begin the acquisition.

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 Prescanning

Manually Prescan
Match Coarse Center Frequency to the Patient
Use this procedure during MPS to manually adjust and set the Center Frequency
Coarse to the patient. This allows you to tune the system for optimal sampling of the
individual patient and anatomy.
Use this procedure to match center frequency to your patient.
1. Click [Manual Prescan] in the Scan Operations area.
Š The Manual Prescan window opens.
2. Click [Center Freq Coarse (CFL)] in the Transceiver Hardware Settings area.
Š The center frequency coarse setting displays a window of ±2000Hz.
Š Fat and water usually appear as one peak.

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 Prescanning

3. Enter the actual frequency value or adjust the midpoint by moving the Delta
Freq (DX) slider.
Š Your goal is to get the water peak centered on the frequency line. Make changes
in small increments to avoid moving the peak out of the window. If you lose the
peak, exit MPS and restart.
Š Each time a frequency number is applied, the value is cumulative.
– A negative number moves the peak to the left. If the transmit frequency is too
high, subtract frequency.
The transmitting frequency
of the system is higher than

the precessional frequency

of the patient.

– A positive number moves the peak to the right. If transmit frequency is too
low, add frequency.

The transmitting frequency

of the system is lower than

the precessional frequency

of the patient.

4. Click [Apply] to activate your selection.

Š The peak is updated according to the applied value.
5. Repeat steps 3 and 4 until the peak aligns with the center line.
Š To return the Actual Frequency (AX) to its original value, click [Reset] in the
Gradient Shimming area of the window.
6. To continue the MPS process and achieve an optimum flip angle, proceed to the
Adjust the Transmit Gain procedure.
Š Otherwise, click [Done] to close the Manual Prescan window.

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 Prescanning

Quick Steps: Manually Prescan – Match Coarse Center Frequency to the

Patient
1. Click [Manual Prescan] in the Scan Operations area.
2. Click [Center Freq Coarse (CFL)] in the Transceiver Hardware Settings area.
3. Enter the actual frequency value or adjust the midpoint by moving the Delta
Freq (DX) slider.
4. Click [Apply] to activate your selection.
5. Repeat steps 3 and 4 until the peak aligns with the center line.
6. To continue the MPS process and achieve an optimum flip angle, proceed to the
Adjust the Transmit Gain procedure.

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 Prescanning

Manually Prescan
Adjust the Transmit Gain
Use this procedure during MPS to manually adjust and set the RF Transmit Gain to
ensure precise flip angles. This allows the appropriate RF energy to achieve maximum
signal.
Complete the Match Coarse Center Frequency to the Patient steps prior to setting the
TG.
1. Click [Transmit Gain TG] in the Transceiver Hardware Settings area.
Š The correct TG produces the highest peak. Too much or too little gain produces
a smaller peak.
2

2. Select Markers > Horizontal Hairline on the MPS menu bar.

Š A horizontal white line marker appears on the spectrum that you can use to mark
the height of the image profile each time you change the gain.

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 Prescanning

3. Select the horizontal marker and move the marker to the peak of the image profile.
Š The goal of TG is to get the image profile at the highest peak. The highest peak
indicates the protons have been flipped 90° or into the transverse plane.
4. Adjust the Transmit Gain slider.
Š Increase the TG until the peak no longer increases.
Š Change the gain in increments of 10 to 20 initially and then 5 to 10 as you get
closer to the peak value.
5. Continue to move the horizontal marker with the profile peak until an optimum
setting is reached.
Š Increase the TG as long as the peak increases.

If the peak increases,

the magnetization is
moving closer to the
transverse plane.

Š Decrease the gain until you find a setting that places the profile at the highest
peak. Once the peak of the profile falls below the marker, you have surpassed
the optimum TG setting.

If the peak decreases,

the magnetization is
moving away from the
transverse plane.

6. Select Markers > Horizontal Hairline.

Š The white line horizontal marker is turned off.
7. To continue the MPS process, proceed to the Match Fine Center Frequency to the
Patient procedure.
Š Otherwise, click [Done] to close the Manual Prescan window.

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 Prescanning

Quick Steps: Manually Prescan – Adjust the Transmit Gain

1. Click [Transmit Gain TG] in the Transceiver Hardware Settings area.
2. Select Markers > Horizontal Hairline on the MPS menu bar.
3. Select the horizontal marker and move the marker to the peak of the image profile.
4. Adjust the Transmit Gain slider.
5. Continue to move the horizontal marker with the profile peak until an optimum
setting is reached.
6. Select Markers > Horizontal Hairline.
7. To continue the MPS process, proceed to the Match Fine Center Frequency to the
Patient procedure.

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 Prescanning

Manually Prescan
Match Fine Center Frequency to the Patient
Use this procedure during MPS to manually adjust and set the Center Frequency Fine
to the patient. This allows you to fine-tune the system for optimal sampling of the
individual patient and anatomy.
Complete the Match Coarse Center Frequency to the Patient and Adjust the Transmit
Gain prior to matching the fine center frequency to your patient.
1. Click [Center Freq Fine (CFH)] in the Transceiver Hardware Settings area.
Š The center frequency fine setting displays a window of ±500 Hz spectrum. The
smaller range in frequency values allows you to see both the fat and the water
peak.

2
3

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 Prescanning

2. Enter the actual frequency value or adjust the midpoint by moving the Delta
Freq (DX) slider.
Š The goal is to fine-tune the desired peak on the center frequency line. Make
changes in small increments to avoid moving the peak out of the window.
– A negative number moves the peak to the left. If the transmit frequency is too
high, subtract frequency.
– A positive number moves the peak to the right. If transmit frequency is too
low, add frequency.

Transmit frequency Transmit frequency

optimized for water optimized for fat

3. Click [Apply] to activate your selection.

Š The peak is updated according to the applied value.
4. Repeat Steps 2 and 3 until the peak is aligned with the center line.
Š To return the Actual Frequency (AX) to its original value, click [Reset].
5. To continue the MPS process, proceed to the Adjust the Receiver Gain procedure.
Š Otherwise, click [Done] to close the Manual Prescan window.

Quick Steps: Manually Prescan – Match Fine Center Frequency to the Patient
1. Click [Center Freq Fine (CFH)] in the Transceiver Hardware Settings area.
2. Enter the actual frequency value or adjust the midpoint by moving the Delta
Freq (DX) slider.
3. Click [Apply] to activate your selection.
4. Repeat Steps 2 and 3 until the peak is aligned with the center line.
5. To continue the MPS process, proceed to the Adjust the Receiver Gain procedure.

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 Prescanning

Manually Prescan
Adjust the Receiver Gain
Use this procedure during MPS to manually adjust and set the Scan TR to optimize the
use of the receiver’s dynamic range. This procedure guides you through the process of
adjusting the receive gain to achieve the best SNR.
Complete the Match Coarse Center Frequency to the Patient, Adjust the Transmit Gain,
and Match Fine Center Frequency to the Patient steps prior to adjusting the receiver
gain.
1. Click [Scan TR (R1/R2)] in the Transceiver Hardware Settings area.
Š The goal of Scan TR is to assure both R1 and R2 values fall below 50%.

1
2
3

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 Prescanning

2. Set the Analog Gain R1 value.

Š Check the analog gain (R1) value in the upper right corner of the spectrum
display to verify the signal is less than 50%. If so, no change is necessary.
Š If the R1 value exceeds 50%, use the Analog Gain (R1) slider to decrease the
gain. Decrease the R1 value in increments of one until the R1 value is as high as
possible without exceeding 50%.
Š Analog receive gain range is 1 to 15. In most cases, the default setting of 11
provides the best SNR.
3. Set the Digital Gain R2 value.
Š Check the digital gain (R2) value in the upper right corner of the spectrum display
to verify that the signal is less than 50%. If so, no change is necessary.
Š If the R2 value exceeds 50%, use the Digital Gain slider to decrease the gain.
Decrease the R2 value in increments of one until the value is less than 50%.
Š Digital receive gain range is 1 to 15 (1 to 30 with Extended Dynamic Range).
4. Click [Done] in the lower left corner of the window.
Š The Manual Prescan window closes.
5. Click [Scan] to begin the acquisition.

Quick Steps: Manually Prescan – Adjust the Receiver Gain

1. Click [Scan TR (R1/R2)] in the Transceiver Hardware Settings area.
2. Set the Analog Gain R1 value.
3. Set the Digital Gain R2 value.
4. Click [Done] in the lower left corner of the window.
5. Click [Scan] to begin the acquisition.

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 Prescanning

Optimize Chemical Saturation

Use this procedure for the best manual prescanning results when using chemical
saturation techniques. This procedure guides you through the process of optimizing
Prescan for Chemical Saturation techniques.
NOTE: It may not be necessary to use MPS to adjust the CSA and CSF for Spin Echo
and Fast Spin Echo sequences using the default improved Fat SAT; however,
this procedure can be used if desired.
1. Click [Auto Prescan] in the Scan Operations area.
Š At completion, note the results, especially any accompanying messages
referring to CF peak selection.
– When performing Fat SAT, make sure CF is set to water.
– When performing Water SAT, make sure CF is set to fat.
2. Click [Manual Prescan] in the Scan Operations area.
Š The Manual Prescan window opens.
3. Click [Center Freq Fine (CFH)] in the Transceiver Hardware Settings area.

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 Prescanning

4. Check the offset between fat and water.

Š At 0.35T, the shift is about 51 Hz.
5. Evaluate for the correct positioning of CF on the appropriate peak.
Š Set CF to water when using fat saturation.
– At 0.35T, subtract 51 Hz.

CF should shift to
the fat peak after
51Hz is subtracted.

– The CF shifts to the fat peak.

– If not, adjust the frequency to determine the actual offset, and return center
frequency to water.
Š Set CF to fat when using water saturation.
– At 0.35T, add 51 Hz.
– The CF shifts to the water peak. If it does not, adjust the frequency to
determine the actual offset and return center frequency to fat.
6. Select Options > Modify RSP on the MPS menu bar.
Š The Display RSPs (Real-time Sequence Parameters) window appears.

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 Prescanning

7. Scroll through the list of names in the Display RSPs window and double-click csf.
Š Alternatively, you can enter csf in the RSP Name text box to adjust the offset
value.
Š CSF allows changes in the frequency shift value expected between fat and water
peaks.
8. Enter the actual offset value for the chemical saturation pulse found in step 5 in the
Current Value text box.
Š This should be a negative number for Fat SAT and a positive number for Water
SAT.
9. Scroll through the names in the Display RSPs window and double-click cstun.
Š Alternatively, you can enter cstun in the RSP Name text box to turn on the
saturation pulse.
Š CSTUN allows entrance into the program to tune the ChemSAT pulse.
10. Enter 1 in the Current Value text box.
Š Valid values are 0 and 1.
Š The presaturation pulse is turned on to suppress either fat or water.
11. Click [Accept].
Š The spectrum changes to display the result of the applied suppression pulse.
12. Check the peak suppression.

Fat Peak not sufficiently

suppressed.

Š Look at the spectrum to see if the peak you are trying to suppress is gone. If the
peak is not sufficiently suppressed, continue to step 14.
13. Select Options > Modify RSP on the MPS menu bar.

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 Prescanning

14. Scroll through the list of names in the Display RSPs window and double-click csa.
Š Alternatively, you can enter csa in the RSP Name text box.
Š CSA allows changes in the amplitude of the ChemSAT pulse and represents a
percentage of the original flip angle used to saturate the selected tissue.
Š CSA defaults to a particular value unique to the MRI magnet strength and pulse
sequence chosen.
Š Increasing CSA may provide a chemical SAT pulse which produces better
saturation.
15. Enter a new value in the Current Value text box.
Š Typical changes are in increments of 5.
Š Increase this value until the desired peak is optimally suppressed.
– Carefully evaluate both the fat and water peak.
– Your goal is to decrease the desired peak without affecting the peak centered
over the line.
Š For example, change the value from 80 to 85, then observe the spectrum. If the
fat peak is still not suppressed, enter 90.
16. Re-check the peak suppression.

Fat Peak sufficiently

suppressed.

Š You cannot always make the fat/water peak disappear.

17. Click [Accept] to accept the changes and close the Display RSPs window.
18. Click [Done] to close the Manual Prescan window.
19. Click [Scan] to begin the acquisition.

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 Prescanning

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 3-Plane Localizer

Chapter 10
3-Plane Localizer

Introduction
This chapter explains the pulsing components and timing factors directly related to
3-Plane Localizer. This chapter explains the concepts and the step-by-step instructions
to help you learn how to:
• Prescribe a 3-Plane Localizer

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 3-Plane Localizer

What Do I Need to Know About...

This section presents the concepts necessary to understand 3-Plane Localizer.
Specifically, you need to understand:
• 3-Plane Localizer Basics
• Supported Features
• Applications
• Decision Matrix

3-Plane Localizer Basics

3-Plane Localizer allows the sequential acquisition of three orthogonal scan planes
scanned in a single series with one scan prescription. The images from three planes
can be used in Graphic Rx to define slices and SAT bands while visualizing their exact
locations in all three planes. 3-Plane Localizer uses a Fast Gradient Echo (Fast GRE)
pulse sequence and can obtain the three planes in a single breath-hold.
3-Plane Localizer is launched when 3-Plane is selected from the Plane pull-down menu
in the Imaging Parameters area. Once 3-Plane is selected, Localizer must be selected
from the Pulse Sequence window. This sequence can only be acquired in the
two-dimensional (2D) mode.
The Scanning Range area for the 3-Plane Localizer is shown in Figure 10-1. Field of
View (FOV), Slice Thickness, and Spacing are available parameters. You must enter a
Center of FOV for each plane, plus the number of slices desired for each plane. The
number of slices must be an odd number between 1 and 85. As the number of slices
increases, the scan time increases. Each plane has the same number of slice locations.
If more than the allowed slices for the gradient platform are programmed, the system
automatically increases the number of acquisitions. If more than one slice is prescribed,
then the FOV center coordinates represent the center slice, not the starting slice.
Figure 10-1 3-Plane Localizer Scanning Range Area

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 3-Plane Localizer

The images are acquired in the following order:

1. Axial
2. Sagittal
3. Coronal
3-Plane Localizer images are valid images for Graphic Rx, SAT, and SmartPrep tracker
pulse prescriptions.
3-Plane Localizer images are annotated “LOC.” The image plane annotation reflects the
plane of acquisition for that image: Ax, Sag, or Cor.
The type-in option is L and is not case sensitive.
There are several factors you should consider when using a 3-Plane Localizer pulse
sequence:
• The following scan parameters are not programmable:
– TR (the minimum value is automatically selected)
– TE (the minimum value is automatically selected)
– Flip Angle (a 30° flip angle is used)
– Receive Bandwidth (10.42 Khz is used)
• Each plane is acquired in a different pass.
• If the Center of FOV, for any of the prescribed slices, falls outside of the scan range
of the selected coil, a message is posted. Change the Center of FOV location or
decrease the number of slices per plane.

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 3-Plane Localizer

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. The X in Table 10-1 indicates the imaging options available for use with the
3-Plane Localizer pulse sequence.
Table 10-1 3-Plane Localizer Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Real Time Blurring Cancellation

Cardiac Gating/Triggering Respiratory Compensation

CCOMP Respiratory Gating/Triggering

Classic Sequential

DE Prepared Single Quadrature Fat Imaging

Extended Dynamic Range Single Quadrature Water Imaging

Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

IR Prepared Variable Bandwidth

Magnetization Transfer ZIP x 2

Multi-Phase ZIP x 4

X Multi Station ZIP 512

Navigator ZIP 1024

NOTE: The Imaging Options shown in Table 10-1 may not always be compatible with
each other.
When No Phase Wrap is selected with a 3-Plane Localizer, 2 NEX is required. Only use
this option to avoid alias artifacts.

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 3-Plane Localizer

Applications
3-Plane Localizers can be used to acquire a localizer series with all three orthogonal
planes simultaneously. This eliminates the need to prescribe and scan three separate
series.
Use 3-Plane Localizer to acquire three planes in a single acquisition and then display all
three planes in Graphic Rx to prescribe the following:
• Orthogonal and oblique locations
• 3D volume locations
• Tracker pulse locations
• Radial locations
• SAT pulse locations (inside or outside the FOV)
Figure 10-2 3-Plane Localizer

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 3-Plane Localizer

How Do I...
This section provides the step-by-step instructions for prescribing a 3-Plane imaging
pulse sequence. Specifically, it describes how to:
• Prescribe a 3-Plane Localizer

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions.
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

WARNING:Hearing protection is required for all people in the scan room during a
scan to help prevent hearing impairment. Acoustic noise levels may
exceed 99 db(A).

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 3-Plane Localizer

Prescribe a 3-Plane Localizer

The 3-Plane Localizer sequence can be used to acquire a localizer series with all three
orthogonal planes. This eliminates the need to prescribe and scan three separate
series.
The decision matrix (Table ) is only for prescribing a 3-Plane Localizer sequence.
3-Plane Localizer Protocol Example

3-Plane Localizer
What You Select Selection Notes
Scan Rx Desktop
Scan Rx Allows you to begin a scan prescription.

Patient Protocol [New Patient] Allows you to begin prescribing your new series when the
Patient Protocol window becomes active.
Patient Position

Head

Patient Position Supine A 3-Plane Localizer pulse sequence is compatible with any
patient position and entry.
Patient Entry Head First
Coil Head Allows selection of the coil from which the signal is transmitted
and received. Use a coil that produces the optimum coverage
and SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system enters
text box. a default series description with the selected scan mode, PSD,
and selected imaging options.

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 3-Plane Localizer

3-Plane Localizer
What You Select Selection Notes
Imaging Parameters

Plane 3-Plane Acquires three planes in one sequence.

Mode 2D 2D is the only valid mode.
Pulse Seq Localizer Localizer is the only available Pulse Sequence when 3-Plane
is the selected plane. Click the [Accept] button to register the
selection.
Imaging Options None No Phase Wrap and Multi-Station are the only available
Imaging Options with 3-Plane Localizer. Use NPW to prevent
aliasing or wraparound artifact if anatomy falls outside the FOV
in any of the three planes.
PSD Name N/A
Protocol N/A

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 3-Plane Localizer

3-Plane Localizer
What You Select Selection Notes
Scan Timing

# of echoes N/S Only 1 echo is allowed.

TE N/S The minimum available TE is set by the system.
TR N/S The minimum available TR is set by the system.
TI N/A
Flip Angle N/S The flip angle is set to 30 degree and cannot be changed.
Echo Train Length N/A
Bandwidth N/S The Bandwidth is set to 10.42 Khz and cannot be changed.
Bandwidth2 N/A

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 3-Plane Localizer

3-Plane Localizer
What You Select Selection Notes
Scanning Range

FOV 24 Select a FOV that covers the anatomy of interest. Anatomy

outside the FOV in the phase direction results in aliasing.
Small FOVs increase resolution, decrease SNR, and can
increase the minimum TE value.
Slice Thickness 5.0 Thin slices increase resolution and decrease SNR.
Spacing 2.5 Interslice crosstalk is eliminated on sequential gradient
echoes. Typical spacing is 0 to 20% of the slice thickness.
Center of FOV R/L: 0.0 Enter the FOV center for each plane. If the value entered is
A/P: 0.0 outside the scannable range of the coil, a message is posted.
S/I: 0.0
# Slices per Plane 3 If more than one slice per plane is prescribed, the Center of
FOV coordinates entered designate the middle slice, not the
first or starting slice location. Only an odd number of slices can
be prescribed. Observe the Advisory panel to note the number
of acquisitions that have been prescribed. As the number of
slices per plane increases, scan time increases.
Acquisition Timing

Freq 256 Increasing the frequency matrix increases the minimum TE

and TR, increases resolution, and decreases SNR.
Phase 192 Phase controls scan time and resolution.

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 3-Plane Localizer

3-Plane Localizer
What You Select Selection Notes
NEX 1.0 Select a NEX value that produces sufficient SNR. A minimum
of 2 NEX is required if No Phase Wrap is selected.
Phase FOV 1.00 Select 0.75 or 0.5 if you wish to reduce phase steps and thus
decrease scan time, decrease FOV in the phase direction, and
decrease SNR slightly. The phase FOV dimension is displayed
next to the phase FOV factor. The Phase FOV value is applied
to all three planes. A Phase FOV less than one is not
compatible with No Phase Wrap.
Freq DIR N/S 3-Plane Localizer does not follow the normal convention for
determining frequency direction. Turn on No Phase Wrap any
time a 3-Plane Localizer acquisition contains anatomy outside
the selected FOV in any direction.
Auto Center Freq Water Water is generally the center frequency selected.
Flow Comp DIR N/A
Autoshim On Autoshim is recommended when using an off center FOV and
on the first series of each examination.
Phase Correct N/A
# of Acqs/Locs N/A
Before Pause
Additional Parameters- SAT window
None SAT pulses are not allowed in 3-Plane Localizer.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the prescription,
and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Downloads the series.
Scan]
Scan Operations
Scan [Scan] Initiates the acquisition.

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 3-Plane Localizer

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 Spin Echo

Chapter 11
Spin Echo

Introduction
This chapter explains the pulsing components and timing factors directly related to the
Spin Echo (SE) pulse sequences. This chapter explains the concepts of SE pulse
sequence and the step-by-step instructions to help you learn how to:
• Prescribe a SE Pulse Sequence

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© 2004 General Electric Company. All rights reserved.
 Spin Echo

What Do I Need to Know About...

This section presents the concepts necessary to understand SE pulse sequences.
Specifically, you need to understand:
• SE Basics
• Imaging Characteristics
• Scan Parameters
– Scan Timing Parameters
– Supported Features
• Supported Features
• Applications

SE Basics
SE is a two-dimensional (2D) pulse sequence, consisting of an initial 90° excitation
pulse followed by at least one 180° refocusing pulse in one repetition time (TR) period.
The 90° excitation pulse creates magnetization in the transverse plane. This is followed
by the 180° pulse, which rephases the magnetization to produce spin echo signals.
Figure 11-1 SE Pulse Sequence

Figure 11-2 displays how SE is played out for a single echo and Figure 11-3 displays a
variable echo sequence.

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 Spin Echo

Figure 11-2 SE Single Echo Sequence

180°

Figure 11-3 SE Variable Sequence

180° 180°

With SE, either one, two, or four echoes can be acquired within a single acquisition. SE
is used to acquire images with T1, Proton Density, or T2-weighted contrast.
Variable, or two-echo acquisition, allows the second echo time to be a non-multiple of
the first echo time, e.g., TE1 = 14 ms and TE2 = 95 ms. A four-echo acquisition results
in 4 images where each image represents a TE that is a multiple of the first echo, e.g.,
TE 20 results in 4 images acquired at the following TE times: 20, 40, 60, and 80 ms.
Each echo is used to create a different image, usually displaying different image
contrast. The images in Figure 11-4 were acquired using a SE variable echo sequence.
The first echo displays PD-weighting, while the second echo displays T2-weighting.

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 Spin Echo

Figure 11-4 Echo Contrast

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© 2004 General Electric Company. All rights reserved.
 Spin Echo

Imaging Characteristics
SE images are generally less sensitive to magnetic field inhomogeneties and
paramagnetics than most other pulse sequences. This is due to the RF rephasing of
protons.
Less geometric blurring is seen on SE images in comparison to Fast Spin Echo (FSE)
images, therefore producing sharper image edges. One drawback of SE sequences
compared with FSE is that longer scan times for sequences with the same TR values
are seen.
To control SE image characteristics, imaging parameters TE and TR play important
roles. TR regulates the level of saturation or T1 contribution. The repetition rate of the
excitation pulse and the T1 relaxation time of the tissue affect the amount of recovery
that occurs between each excitation pulse. When TR decreases, saturation and T1
effects increase. When TR increases, saturation and T1 effects decrease.
Figure 11-5 TR Regulation

Short T1 Tissue

Long T1 Tissue

TE regulates the level of dephasing or T2 contribution. The timing of the rephasing

pulse and the T2 relaxation time of the tissue affect the amount of dephasing that
occurs before the echo signal is read. When TE decreases, dephasing and T2 effects
decrease. When TE increases, the dephasing and T2 effects increase.
Figure 11-6 TE Regulation

Long T2 Tissue

Short T2 Tissue

SE contrast is determined by the varying combinations of TR and TE times (Table

11-1).

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 Spin Echo

Table 11-1 SE Contrast

Timing* PD Weighting T2 Weighting T1 Weighting

TR Long > 2000 ms Long > 2000 ms Short < 500 ms
TE Short < 30 ms Long > 90 ms Short < 25 ms
*As field strength decreases, TR & TE decrease.

Changes made to SE timing factors are likely to result in a decrease in the maximum
number of slice locations allowed per TR. As a result, you may see SE protocols that
are forced to a double acquisition when the number of slices exceeds the allowed
maximum per TR. Increase the TR or decrease the number of slice locations to avoid a
double acquisition. In most instances, decreasing the number of slices by one location
is sufficient.
T1 is the time constant for longitudinal relaxation and thermal or spin lattice relaxation.
Scan protocols that allow the T1 effects to predominate over the other relaxation effects
produce T1-weighted images. In T1-weighted images, tissues with short T1 are bright
and tissues with long T1 are dark. In the brain, white matter is brighter than gray matter,
and cerebrospinal fluid (CSF) is dark. For T1-weighting, selecting a short TR and short
TE allows T1 saturation effects to dominate contrast.
Figure 11-7 T1-Weighted SE Image

Longitudinal
Magnetization

T1-weighted images cannot be produced in conjunction with Proton Density

(PD)-weighted or T2-weighted images, because the TR requirements are not
compatible.
T2 is the time constant that measures the transverse magnetization decay and
spin-spin effects. Scan protocols that allow the T2 effects to predominate over the other
contrast effects produce T2-weighted images. In T2-weighted images, tissues with
short T2 are dark and tissues with long T2 are bright. In the brain, CSF produces the
brightest signal on moderate to late TE images; pathology that alters and delays T2 also
appear bright. For T2-weighting, selecting a long TR and long TE allows T2 dephasing
effects to dominate contrast. The TR should be at or above 2000 ms and the TE at or
above 90 ms.

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 Spin Echo

Figure 11-8 T2-Weighted Spin Echo Image

Transverse
Magnetization

PD-weighted images have contrast that is primarily due to the density of protons in the
structures. PD-weighted images result when you select scan timing parameters that
minimize the T1 (long TR) and the T2 (short TE) contrast effects. For PD-weighting,
selecting a long TR and short TE allows proton density to dominate contrast. The TR
should be at or above 2000 ms and at or below 30 ms for TE. With PD-weighted
images, tissues with a greater number of protons are bright and tissues with fewer
protons are dark. In the brain, gray matter is brighter than white matter, due to the
amount of protons it contains.
Figure 11-9 PD-Weighted Image

PD and T2-weighted images can be produced in the same acquisition using two echoes
because the TR requirements are compatible. Tissues with long T2 times, such as CSF,
are darker on SE PD-weighted images than on FSE PD-weighted images. This is due to
SE typically using a TR of 2000 ms, which produces saturation in CSF.

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 Spin Echo

Scan Parameters
There are several scanning parameters that are important when prescribing a SE pulse
sequence. These parameters are responsible for image contrast, scan time, and signal.
The following sections describe the adjustable parameters that have an effect on SE
pulse sequences.

Scan Timing Parameters

When prescribing your scan parameters, you should consider the affects of changing
TR and TE on your images. The affects on T2 images are shown in Table 11-2 and
Table 11-3 shows the affects of changing TR and TE on T1 images.
Table 11-2 TR and TE Changes on T2 Images

TR and TE Change CNR SNR Scan Time # of Slices

As TR ⇑ ⇑ ⇑ ⇑ ⇑
As TE ⇑ ⇑ ⇓ ---- ⇓

Table 11-3 TR and TE Changes on T1 Images

TR and TE Change CNR SNR Scan Time # of Slices

As TR ⇑ ⇓ ⇑ ⇑ ⇑
As TE ⇑ ⇓ ⇓ ---- ⇓

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 Spin Echo

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 11-4, an X indicates the imaging options available for use with the SE
pulse sequence.
Table 11-4 SE Imaging Options

Imaging Options
X None Navigator

ASSET X No Phase Wrap

ASSET Calibration Real Time

Blood Suppression X Respiratory Compensation

X Cardiac Gating/Triggering Respiratory Gating/Triggering

CCOMP Sequential

Classic (Not compatible) SmartPrep

X Classic Spectral Spatial RF

DE Prepared X Square Pixel

X Extended Dynamic Range Tailored RF

X Flow Compensation T2 Prep

Fluoro Trigger X Variable Bandwidth

fMRI ZIP x 2

Full Echo Train ZIP x 4

IR Prepared X ZIP 512

X Magnetization Transfer ZIP 1024

Multi-Phase X POMP

Multi Station Real Time Blurring Cancellation

FSE/FIR Blurring Cancellation X Single Quadrature Fat Imaging

X Single Quadrature Water imaging

NOTE: The Imaging Options shown in Table 11-4 may not always be compatible with
each other.
Spacial Sat is available.
POMP is not compatible with Single Quadrature Fat & Water, Square Pixel, No
Phase Wrap, and Magnetization Transfer.

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© 2004 General Electric Company. All rights reserved.
 Spin Echo

Applications
SE sequences are used to acquire images throughout the body. It is used for T1, T2,
and PD contrast weighting. When too much geometric and/or edge blurring is produced
in FSE images, the SE sequence is often used. Use SE instead of Gradient Echo (GRE)
to decrease magnetic susceptibility affects. For example, when scanning in the vicinity
of air-tissue or tissue-bone interfaces.

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© 2004 General Electric Company. All rights reserved.
 Spin Echo

How Do I...
This section provides the step-by-step instructions for prescribing SE imaging pulse
sequences. Specifically, it describes how to:
• Prescribe a SE Pulse Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions.
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

NOTE: Since the acoustic noise of the Ovation does not exceed 92.2 dBA, ear protection
is not required, but is recommended.

WARNING:Hearing protection is required for all people in the scan room during a
scan to help prevent hearing impairment. Acoustic noise levels may
exceed 99 db(A).

11-11
© 2004 General Electric Company. All rights reserved.
 Spin Echo

Prescribe a SE Pulse Sequence

The SE pulse sequence can be used to acquire T1, T2, and PD contrast weighting
images throughout the body.
This decision matrix (Table ) is only for prescribing a SE sequence. The following
example protocol is for prescribing a T1-weighted sequence in the brain.
SE Protocol Example (T1 Brain)

SE Protocol Example (T1 Brain)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series if the
Patient Protocol window becomes active.
Patient Position

Head

Patient Position Supine A SE pulse sequence is compatible with any patient

position and entry.
Patient Entry Head First
Coil Head Select thecoil that produces the optimum coverage and
SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the text prescribed. If you do not enter a description, the system
box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

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© 2004 General Electric Company. All rights reserved.
 Spin Echo

SE Protocol Example (T1 Brain)

What You Select Selection Notes
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. Compatible with
any scan plane. Select the plane that best meets your
clinical need.
Mode 2D Prescribes a two-dimensional sequence.
Pulse Seq Spin Echo Activates the SE pulse sequence. Click [Accept] to
register the selection.
Imaging Options Variable Bandwidth Select imaging options that optimize SNR, spatial
resolution, the number of slices, and reduce motion
artifacts. Click [Accept] to register the selections. For a
complete list of compatible options, refer to Table 11-4.
PSD Name
Protocol N/A

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© 2004 General Electric Company. All rights reserved.
 Spin Echo

SE Protocol Example (T1 Brain)

What You Select Selection Notes
Scan Timing

# of echoes 1 Select one echo for a T1-weighted acquisition. Select two

echoes for a PD/T2-weighted acquisition.
TE Min Full Short TEs increase T1 and PD contrast, SNR, and the
number of slices with multi-planar acquisitions. Minimum
TE changes as RBw changes. Minimum is a fractional
echo and may compromise SNR.
TE2 N/A Available only when “2” is selected as # of Echoes.
TR 400 Short TRs decrease SNR, the number of slices in
multi-planar acquisitions, and scan time. They increase T1
contrast. In a SE T1-weighted acquisition, do not exceed a
500 ms TR. Long TRs increase SNR, the number of slices,
PD/T2 contrast, and scan time. Changes made to SE
timing factors are likely to result in a decrease in the
maximum number of slice locations allowed per TR. As a
result, acquisitions may double if the number of slices
exceed the maximum per TR. To avoid a double
acquisition, decrease the number of slices.
Inv Time N/A
Flip Angle N/A
Echo Train Length N/A
Bandwidth 15.63 As RBw decreases, SNR, chemical shift artifact, and the
minimum TE increase. This can potentially decrease slices
and increase motion artifact.

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© 2004 General Electric Company. All rights reserved.
 Spin Echo

SE Protocol Example (T1 Brain)

What You Select Selection Notes
Bandwidth 2 N/A Only available with a double echo acquisition. The RBw2
value (for the second echo) is typically lower than RBw1.
Scanning Range

FOV 22 Select a FOV that covers the anatomy of interest. Anatomy

outside the FOV in the phase direction results in aliasing.
Small FOVs increase resolution, decrease SNR, and can
increase the minimum TE value.
Slice Thickness 5.0 Thin slices increase resolution and decrease SNR.
Spacing 1.0 Select a spacing that reduces cross-talk between slices
(typically 20% of the slice thickness) If your scan is a dual
acquisition with no concatenated SAT pulse, zero spacing
is allowed.
Start, End Typically the start and end locations are programmed from
Locations the Graphic Rx program.
# Slices The maximum number of slices available is determined by
the TR, TE, SAR, and gradient stress.
Acquisition Timing

Freq 256 Increasing the frequency matrix increases resolution, while

decreasing SNR and the number of slices.
Phase 192 Phase controls scan time and may control resolution.

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© 2004 General Electric Company. All rights reserved.
 Spin Echo

SE Protocol Example (T1 Brain)

What You Select Selection Notes
NEX 2.00 Select a NEX value that produces sufficient SNR.
Phase FOV 1.00 Select 0.75 or 0.5 to reduce phase steps and thus
decrease scan time, FOV in the phase direction, and SNR
slightly. The phase FOV dimension is displayed next to the
phase FOV factor.
Freq DIR A/P The direction displayed is the default frequency direction
which is typically the long axis of the image. To swap phase
and frequency, select the other direction.
Auto Center Freq Peak Sets this CF peak during prescan.
Flow Comp DIR Can be selected only when Flow Comp is active.
Autoshim On Select Autoshim when using fat SAT or an FOV off center,
and on the first series of each examination.
Phase Correct N/A
# of Acqs/Locs N/A
Before Pause
Additional Parameters - User CVs

Enhanced 1 The images with high signal intensity can be gotten

180[deg.] pulse: because the width of 180 RF pulse is expanded slightly.
0=off, 1=on Default value is 1.
Accept [Accept] Confirms the selected values and closes the User Control
Variables screen.

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© 2004 General Electric Company. All rights reserved.
 Spin Echo

SE Protocol Example (T1 Brain)

What You Select Selection Notes
Additional Parameters - Graphic Rx
[+] Next and [-] [+] and [-] Allows you to page through the localizer images to check
Prior the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and remove
cursor. slices. Position the slices to cover anatomy of interest and
view the Advisory Panel to note the maximum number of
slices per acquisition and the number of acquisitions you
are prescribing.
Copy Rx [Copy Rx] Copies the exact locations of a prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
SAT Rx I40 SAT pulses may decrease the number of slices per
S40 acquisition.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Scan [Scan] Initiates the acquisition.

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 Spin Echo

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 FSE

Chapter 12
FSE

Introduction
This chapter explains the pulsing components and timing factors directly related to the
Fast Spin Echo (FSE) pulse sequences. There are several pulse sequences that are
derived from the FSE pulse sequence. This chapter explains the concepts of each and
the step-by-step instructions to help you learn how to:
• Prescribe a FSE Sequence

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© 2004 General Electric Company. All rights reserved.
 FSE

What Do I Need to Know About...

This section presents the concepts necessary to understand the FSE pulse sequences.
Specifically, you need to understand:
• FSE Family Basics
– User Control Variables
• FSE and FSE-XL
• Imaging Characteristics
• Scan Parameters
– Considerations
– Supported Features
• Supported Features
• Applications

FSE Family Basics

The FSE family of pulse sequences uses a modification of existing Spin Echo (SE)
concepts to acquire multiple lines of data per repetition to produce the desired reduction
in scan time. Pulse sequences included in the FSE family are:
• Fast Spin Echo (FSE)
• Fast Recovery Fast Spin Echo Excel (FRFSE)
• Fast Spin Echo-Inversion Recovery (FSE-IR)
• Single Shot Fast Spin Echo (SSFSE)
• Single Shot Fast Spin Echo-Inversion Recovery (SSFSE-IR)
• T1 FLuid Attenuated Inversion Recovery (T1 FLAIR)
• T2 FLuid Attenuated Inversion Recovery (T2 FLAIR)
• 3D Fast Spin Echo (3DFSE and 3DFRFSE)

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© 2004 General Electric Company. All rights reserved.
 FSE

User Control Variables

Figure 12-1 displays the User CVs available for FSE PSDs. Table 12-1 describes each
User CV.
Figure 12-1 FSE User CV Screen

1.00

Table 12-1 FSE User CV Descriptions

User CV Mode Description

Acquisition 0 = Interleaved Allows you to choose the desired method for
Order 1 = Sequential acquiring slices.
Annefact Annefact artifact (Frequency direction wrap
Reduction around artifact) reduction
Determine Sat on/off in Phase Correction. This
Sat in Prescan
option is available only with SpSat pulse.
Add statistical analysis to Phase Correction
Phase Correct 0 = Off
data. This option is available only with Phase
Optimization 1 = On
Correction.
PhaseCorr 1 = Freq only
Control 7 = All
Helps to reduce ghosting, particularly at bright
fat/air interfaces. The number of reference data
1 = 1 Reference sets that are acquired for the new phase
Data Set (default) correction. Some long FSE scans (i.e., longer
RetroPC
2 = 2 Reference than approximately 5 minutes) may benefit from
Data Sets setting this CV to 2.0.This option is available
only with fse-rpc, fsec-rpc, t1flair-rpc and
t1flairc-rpc.

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© 2004 General Electric Company. All rights reserved.
 FSE

User CV Mode Description

Eliminates ghosting from final combined images.
For Auto, the system uses the selected FOV to
0 = Off identify which receivers to use during
Auto N-coil
1 = Auto reconstruction. For N, the system chooses the
Select
N = up to N coils prescribed number (2 to 4) of receivers with the
highest signal intensity to use during
reconstruction.

NOTE: Activation of the RetroPC User CV is performed by using the fse-rpc or fsec-rpc
(FSE/FRFSE/FSE-IR/T2FLAIR), t1flair-rpc or t1flairc-rpc (T1FLAIR) type-in
name in the Imaging Parameters area with a compatible FSE pulse sequence.
IMPORTANT!:The regular Phase Correction option in the Acquisition Timing area should
still be used in the prescription for all FSE scans.

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© 2004 General Electric Company. All rights reserved.
 FSE

FSE and FSE-XL

FSE is a pulse sequence that consists of an initial 90° excitation pulse followed by
multiple 180° refocusing pulses in one TR period. Figure 12-2 displays the FSE pulse
sequence diagram.
Figure 12-2 FSE Pulse Sequence Diagram

180

90

ESP

TR

In order to completely understand FSE, a brief review of SE is helpful. During a SE

pulse sequence, only one 180° refocusing pulse is played out in a single TR producing
one echo. Resulting in one line of k-space during one TR period.
Figure 12-3 SE Pulse Sequence Filling K-Space

180

A single TR period with multiple 180° refocusing pulses is used in an FSE pulse
sequence. Filling multiple lines of k-space in one TR period. Your system allows 2 to 32
refocusing pulses to be prescribed. Prescribing the pulses is done by manipulating the
echo train length (ETL).
In Figure 12-4, four 180° pulses follow the initial 90° pulse. Using this example, four
lines of k-space would fill in one TR period.

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© 2004 General Electric Company. All rights reserved.
 FSE

Figure 12-4 FR-FSE Pulse Sequence Filling K-Space

FSE also makes it practical to conduct high resolution examinations with a variety of
frequency and phase combinations. By filling multiple lines of k-space, you can
drastically reduce your overall acquisition time compared to a SE acquisition time.

Multi Echo
One or two Effective TEs may be acquired with scan time being directly related to the
number of echoes acquired. A single echo acquisition is twice as fast as a dual echo
acquisition. A dual echo acquisition may be acquired with either a full echo train or a
split echo train.
The full echo train method completes all echo trains for Effective TE1 before Effective
TE2 is initiated. The phase encoding process is altered to place the central phase
encodings at the selected Effective TE1 or TE2. If a 16 ETL was used, all 16 echoes
would contribute to the Effective TE1 or TE2. The full echo train method allows flexible
selection of both Effective TE1 and TE2 and any multiple of the minimum echo space
can be used for either TE. The resulting image contrast is similar to that of a single echo
acquisition for a long TR/short TE and long TR/long TE. The term "effective" is used
because the phase encoding producing the echoes with the largest signal occur at this
echo time.
The selection of Effective TE is not as flexible with the split train method as it is with a
full echo train because the Effective TE1 must occur during the first half of the echo
train and the Effective TE2 during the second half. Although, with all scan parameters
the same, the Effective TE1 should exhibit less blurring and increased relative proton
density weighting in the split echo train method.

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© 2004 General Electric Company. All rights reserved.
 FSE

Figure 12-5 FSE Dual Echo Acquisition with Full Echo Train

The split echo train method uses the same number of echoes in the same total
acquisition time as an equal full echo train, however, each echo train is halved. The
echoes in the first half of the echo train contribute to k-space for the Effective TE1 and
the echoes in the second half contribute to the Effective TE2. A phase encoding
scheme is employed so that the central phase encodes occur at the selected echo time
(Effective TE1) for the first half and then are re-centered for the selected echo time
(Effective TE2) for the second half of the echo train. If a 16 ETL was used, only 8
echoes contribute to the effective T1 or T2.
Figure 12-6 FSE Dual Acquisition with Split Echo Train

Generally, the contrast with a split echo train sequence is closer to the contrast in a
conventional variable echo pulse sequence rather than a full echo train. The split echo
train sequence combines data from fewer echoes to form the image.

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© 2004 General Electric Company. All rights reserved.
 FSE

FSE-XL
An adaptation of the FSE pulse sequence is FSE-XL. It is an enhanced 2D FSE pulse
sequence designed to reduce examination times and improve FSE image quality. This
is accomplished by:
• RF modification techniques which decrease the echo space, resulting in reduced
edge blurring and improved tissue contrast
• the ability to prescribe, and acquire in one series, multiple groups in sequential
acquisitions, at different angles
• the availability of ZIP 512 reconstruction
Figure 12-7 FSE-XL vs. Conventional FSE

As the ESP gets longer, the signals are collected over a greater part of the T2 decay
curve, resulting in more T2 contrast and fewer slices per acquisition. FSE-XL shortens
the ESP, thus allowing a higher ETL in comparison to an FSE acquisition. The result is
a shorter scan time, less edge blurring, and potentially less motion. FSE-XL is used as
a default FSE PSD. The operator does not need to select FSE-XL in this system.

Imaging Characteristics
FSE images are less sensitive to magnetic field inhomogeneities and paramagnetics
than SE images because of the multiple 180º pulse, making areas of the brain
containing iron darker on SE than FSE. FSE can have 2 to 32, 180° pulses with varied
phase encoding, each phase encoding echo exhibits different T2 decay. This can
increase fat signal in late echo images due to contribution from phase encoded echoes
occurring early in T2 decay.
Fat is brighter on FSE images because of an effect called J-coupling. Also
Cerebrospinal fluid (CSF) and other long T2 tissues are brighter on T2 and Proton
Density (PD) FSE images than on SE images.

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 FSE

Figure 12-8 Image Comparisons of SE and FSE

The drawback to using an FSE sequence instead of a SE sequence is FSE images are
affected by edge blurring related to the echo spacing (ESP) and echo train (Figure
12-9).
Figure 12-9 T2 Decay Affects FSE Images as a Result of ETL

Short ETL captures less of the T2 decay curve and motion. Short ETL (left).
Long ETL (right).

Phase encoding across T2 decay can also produce image blurring, especially when the
selected TE is short. This occurs where the T2 decay curve is the steepest. The blurring
decreases as the number of phase encodings is increased. It is practically unnoticeable
at 512 phase encodings
One option to help reduce edge blurring would be to keep ETLs short. FSE with an
ETL > 4 may not be effective for T1-weighted images because the middle lines of
k-space are acquired during the greatest period of T2 decay. The lines with the most
signal have the most variation due to decay, producing blurring. As the selected ETL
increases, the number of echoes contributing to T2 decay increases. Increasing the
ETL decreases acquisition time, affects the resulting contrast for the selected Effective
TE, and decreases the number of slices available. As the ETL lengthens (increased
number of echoes), the time per slice is increased since it increases the number of
echoes generated and takes up more of the TR time.
Another option would be to use FSE/FIR Blurring Cancellation. By changing data
acquisition ordering, blurring cancellation reduces T2 decay effect. Please refer to
.Imaging Options.

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© 2004 General Electric Company. All rights reserved.
 FSE

To control FSE image characteristics, imaging parameters TE, TR, and ETL play
important roles. TR regulates the level of saturation or T1 contribution. The repetition
rate of the excitation pulse and the T1 relaxation time of the tissue affect the amount of
recovery that occurs between each excitation pulse. When TR decreases, saturation
and T1 effects increase. When TR increases, saturation and T1 effects decrease.
Figure 12-10 Signal Intensity Over Time as TR Decreases

Signal
Intensity

Tissues with
a shorter T1
have a
stronger signal
TR period as TR
Time decreases.

Effective TE and ETL regulate the level of dephasing or T2 contribution. The timing of
the rephasing pulse and the T2 relaxation time of the tissue affect the amount of
dephasing that occurs before the echo signal is read. As the Effective TE increases,
dephasing and T2 effects increase. As the ETL increases, dephasing and T2 effects
increase.
Figure 12-11 Signal Intensity Over Time as TE Increases

Signal Tissues with a

Intensity longer T2
have a
stronger signal
as TE
increases.
TE period
Time

FSE contrast is determined by the varying combinations of TE, TR, and ETL times.
Table 12-2 FSE Contrast Weighting

Timing PD-Weighting T2-Weighting T1-Weighting

TR Long, > 2000 ms Long, > 2000 ms Short, < 500 ms
TE Short, < 30 ms Long, > 90 ms Short, < 20 ms
Up to maximum
ETL Short, < 8 ETL Short, < 4 ETL
system allowed.
NOTE: As field strength decreases, TR & TE decrease. As field strength increases, T1
time increase.

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© 2004 General Electric Company. All rights reserved.
 FSE

Acquisition Scheme
Another characteristic of FSE is the sequential slice ordering scheme. With
conventional FSE, if multiple acquisitions are being acquired the system defaults to
acquiring slices in an interleaved fashion. For example, if two acquisitions are acquired
for twenty slices, slices 1, 3, 5...19 are acquired in the first acquisition and slices 2, 4,
6...20 are acquired in the second acquisition. Normally, two acquisitions are required to
collect axial slices of the liver with appropriate slice thicknesses. If the patient holds
his/her breath such that one acquisition is completed per breath-hold, the default slice
acquisition scheme acquires axial slices covering the entire liver in each breath-hold,
interleaving the slices from subsequent breath-holds. Because it is impossible for the
patient to hold his/her breath at exactly the same location on each breath-hold, the liver
will be at different actual locations in the scanner during each breath-hold. Thus, axial
slices from subsequent breath-holds are not correctly interleaved relative to the slices
acquired in the first breath-hold.
Figure 12-12 FSE Acquisition Scheme

If an oblique scan plane is selected, FSE/FRFSE/FSE-IR allows slice acquisition using

either an interleaved or sequential mode. In oblique plane with “Sequential mode“, a
group of contiguous slices can be acquired, starting with the first group located at the
top of the liver (Figure 12-12, right). Each subsequent group is located progressively
more inferior until the entire liver is covered.
The Scan Mode is selected from the User Control Variables (User CV) window.
Selecting “Interleaved“ results in a Multi- Slice Multi- Angle Oblique (MSMA) scan and
selecting “Sequential“ results in a Multi-Group Multi-Angle (MGMA) scan.
NOTE: The groups can also be acquired starting from the bottom of the liver and
progressing to the top over subsequent breath-holds.

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© 2004 General Electric Company. All rights reserved.
 FSE

Pase Correction
FSE has some types of phase corrections. These are as follows in the order of
importance.
– Phase Correction button (Default is on)
– USER CV12=0 or 1 (Default value is 0)
– Retro PC (Operator input PSD. Default is off)
– USER CV11=0 or 1 (Default value is 0)
– USER CV4=0 or 1 (Default value is 0)
If banding artifact occurs in default case, please move patient location close to magnet
center. If inefficient, please swap freq direction, input CV12=1 or turn phase correction
button off.
If ETL is more than 16 and ghost occurs, please select retro PC PSD.
If SpSat is on to remove motion artifact, please input CV11=1.
If freq direction wrap around (annefact) artifact occurs, please input CV4=1.

Operator Input PSDs

Retrospective Phase Correction(RPC) is to compensate phase difference between
each echo train. RPC decreases the ghosting of long ETL case. To turn it on, please
input “fse-rpc“(FSE, FRFSE, FSE-IR, T2 FLAIR) or “t1flair-rpc“(T1FLAIR) in “Psd
Name“. Then USER CV 14 is indicated in USER CV screen. USER CV14 is a number
of reference data sets and 1 is normally used. If scan time is very long, USER CV14=2
is beneficial. Please refer to table 8-1 for USERCV 14.
Classical Fat Sat is available with FSE. Please input “fse-xlc“(FSE, FRFSE, FSE-IR,
T2FLAIR) or “t1flairc“(T1FLAIR) in “Psd Name“. Please input “fsec-rpc“(FSE, FRFSE,
FSE-IR, T2 FLAIR) or “t1flairc-rpc“(T1FLAIR) in “Psd Name“ to make Classic and RPC
available at the same time. Then select Fat Sat button in SAT screen. Please refer to
Chemical SAT in detail.

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 FSE

Scan Parameters
The following scan parameters may produce signal loss and/or ghosting in spine
images:
• FSE PSD
• Sagittal Plane
• CTL Array and other spine coils
• Flow Compensation
• Swap Phase and Frequency

Considerations
With FSE, FRFSE, and T1 FLAIR the number of acquisitions in a series is determined
by the number of angles prescribed and the number of slices allowed in each group.
When FSE, FRFSE, and T1 FLAIR are used to prescribe two orthogonal images, e.g.,
axial and coronal, the coronal images may appear flipped upside down and /or
sideways. This orientation occurs because the system views the coronal images as an
angled axial plane. To view the coronal in the normal manner, use the Flip/Rotate key
on the Viewer or Mini Viewer desktop.
In addition, the slice locations on the flipped images represent the center of the FOV
and do not change from image to image. To find the correct slice location for the flipped
image, deposit a crosshair cursor and view the cursor annotation. The cursor
annotation notes the correct slice position, which changes from image to image.
FSE images may exhibit a fine line artifact. The suspected cause of this artifact is
production of an FID outside the FOV. Using an even NEX can decrease, and often
eliminate, the artifact. However, 2 NEX with NPW is truly a 1 NEX acquisition. It is
recommended the NPW be turned off whenever possible. When not possible, other
parameter changes can be made to obtain an even NEX scan with NPW on.The
following two trade-offs are the result of software modifications that have been made to
reduce fine line artifact:
• If the FOV is ≤ 16 and the slice thickness is ≤ 5, then the echo spacing may increase
and there may be fewer slices per acquisition.
• If an odd NEX is selected, it may (although it is unlikely), result in reduced spatial
resolution in comparison to the same scan parameters with an even NEX.

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 FSE

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 12-3, an X indicates the imaging options available for use with the FSE
pulse sequence.
Table 12-3 FSE Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

X Cardiac Gating/Triggering X Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

Classic Sequential

DE Prepared X Single Quadrature Fat imaging

X Extended Dynamic Range X Single Quadrature Water imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

X FSE/FIR Blurring Cancellation Tailored RF

X Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

Multi-Phase ZIP x 4

Multi Station X ZIP 512

Navigator X ZIP 1024

NOTE: The Imaging Options shown in Table 12-3 may not always be compatible with
each other.

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 FSE

Keep in mind, Flow Compensation (FC) can only be applied in the slice select or
frequency direction with FSE. Swapping phase and Frequency on a sagittal spine
places frequency in the A/P direction. Flow, in the form of pulsatile CSF, takes place in
the S/I direction of the sagittal spine. If frequency is in the A/P direction, it is ineffective.
Also it is applied in only one direction, frequency or slice. You must select the axis on
which FC is applied. FSE with FC does not correct for pulsatile flow and may not
provide benefits to the degree seen with conventional FC SE. Swapping phase and
frequency with FSE may be the best alternative for sagittal spine imaging. ETL, TR,
RBw, and echo spacing affect the CSF signal intensity and motion artifacts. If echo
spacing remains short (for example, 16 msec or less), then Swapping phase and
frequency may not be necessary.
Concatenated acquisitions can be used with FSE. Fractional echo is not allowed with
FSE-XL, if the selected TE is less than the ESP, the Effective TE increases to the ESP
value.

Applications
FSE can be used for various imaging acquisitions. It’s main use is to shorten the
acquisition timing for long TR T2-weighted sequences. FSE combined with a short ETL
can be used to acquire T1-weighted images. Use FSE in spine imaging to enhance the
myelographic effects.
Turn on Blurring Cancellation to decrease ghosting, particularly in abdominal
examinations.

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© 2004 General Electric Company. All rights reserved.
 FSE

How Do I...
This section provides the step-by-step instructions for prescribing the family of FSE
imaging pulse sequences. Specifically, it describes how to:
• Prescribe a FSE Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions.
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.

12-16
© 2004 General Electric Company. All rights reserved.
 FSE

Prescribe a FSE Sequence

The FSE sequence can be used for various imaging applications to shorten the
acquisition timing for long TR T2-weighted sequences.
The decision matrix (Table 12-4) is only for prescribing an FSE scan. The following
example protocol is for prescribing an oblique FSE scan of the head.
Table 12-4 2D FSE Protocol Example (T2 Brain)

FSE Protocol Example (T2 Brain)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a Allows Graphic Rx to become available so you can

localizer series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Allows you to begin prescribing your new series if the
Position] Patient Protocol window becomes active.
Patient Position

Head

Patient Position Supine An FSE pulse sequence is compatible with any patient
position and entry.
Patient Entry Head First
Coil Head Allows selection of the coil from which the signal is
transmitted and received. Use a coil that produces the
optimum coverage and SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

12-17
© 2004 General Electric Company. All rights reserved.
 FSE

FSE Protocol Example (T2 Brain)

What You Select Selection Notes
Imaging Parameters

Plane Oblique Defines the scan plane of the acquisition. Compatible with
any scan plane. Select the plane that best meets your
clinical need.
Mode 2D Prescribes a two-dimensional sequence. FSEopt is only
compatible with 2D.
Pulse Seq FSE To select FSE with 2D mode, type fse in the Pulse Seq
text box (do not type it in the PSD Name text box). If you
open the PSD window, FSE is grayed out but the radio
button is selected. To select FSE with 3D mode, select
FSE from the PSD window. Click [Accept] to register the
selection.
Imaging Options VBw, Fast, Select imaging options that optimize SNR, spatial
ZIP512 resolution, the number of slices and reduce motion
artifacts. Click [Accept] to register the selections. Full
Echo Train is for a dual echo FSE scan only. The Full Echo
Train option completes all echo trains for Effective TE1
before Effective TE2 is initiated. If you are acquiring a dual
echo acquisition and do NOT select Full Echo Train, the
system uses a split echo train method.
PSD Name N/A Type-in fse-xlc to use classic Fat Sat. Type-in fse-rpc to
use retrospective Phase Correction. Type in fsec-rpc to
use both classical Fat Sat and retrospective Phase
Correction.
Protocol N/A

12-18
© 2004 General Electric Company. All rights reserved.
 FSE

FSE Protocol Example (T2 Brain)

What You Select Selection Notes
Scan Timing

# of echoes 1 Select 1 echo for a T1, PD, or T2-weighted acquisition.

Select 2 echoes for a PD/T2-weighted acquisition.
TE 85 Short TEs increase T1 and PD contrast, SNR, and with
multi-planar acquisitions, the number of slices. Minimum
TE changes as RBw changes. The minimum TE is the
echo space. If the selected TE is less than the ESP, the
Effective TE increases to the ESP value.
Eff TE2
TR 4,000 Short TRs decrease SNR and the number of slices in
multi-planar acquisitions. They increase T1 contrast and
decrease scan time. Long TRs increase SNR, the number
of slices, PD/T2 contrast, and scan time. TR is not
selectable with gated scans. The TR is determined by the
RR intervals on the Gating Additional Parameters screen.
Changes made to FSE timing factors are likely to result in
a decrease in the maximum number of slice locations
allowed per TR. As a result, acquisitions may double, if the
number of slices exceed the maximum TR. To avoid
double acquisition decrease the number of slices by one.
Inv. Time N/A
Flip Angle N/A

12-19
© 2004 General Electric Company. All rights reserved.
 FSE

FSE Protocol Example (T2 Brain)

What You Select Selection Notes
Echo Train Length 8 Long ETLs decrease scan time and the number of slices,
while increasing edge blurring and the signal from fat. The
value selected is dependent on whether or not the Full
Echo Train option is selected and if you are acquiring a
dual echo FSE or two single echo FSE scans. Typically 2
to 4 ETL is used with a T1-weighted acquisition. Odd
numbered ETLs can be collected only when doing a single
echo acquisition or when using the Full Echo Train
imaging option. This is because an odd number of echoes
cannot be evenly distributed between two images.
Bandwidth 31.25 RBw can only be changed if it was selected from the
Imaging Options window. As the RBw decreases, the SNR
increases, chemical shift artifact increases, and the
minimum TE increases, which can potentially decrease the
number of slices and increase motion artifact.
Bandwidth 2 N/S Only 1 RBw is allowed with FSE with one echo.
Scanning Range

FOV 22 Select a FOV that covers the anatomy of interest. Anatomy

outside the FOV in the phase direction results in aliasing.
Small FOVs increase resolution, decrease SNR, and can
increase the minimum TE value. If the FOV is ≤ 16 and the
slice thickness is ≤ 5, then the echo spacing may increase
and there may be fewer slices per acquisition
Slice Thickness 5.0 Thin slices increase resolution and decrease SNR.
Spacing 1.5 Select a spacing that reduces cross-talk between slices
(typically 20% of the slice thickness) If your scan is a dual
acquisition with no concatenated SAT pulse, 0 spacing is
allowed.
Start, End Locations Typically the start and end locations are programmed from
the Graphic Rx program.
# Slices 23 The maximum number of slices available is determined by
the TR, TE, ETL, SAR, and gradient stress.

12-20
© 2004 General Electric Company. All rights reserved.
 FSE

FSE Protocol Example (T2 Brain)

What You Select Selection Notes
Acquisition Timing

Freq 256 Increasing the frequency matrix produces: increased

resolution, decreased SNR, and decreased # of slices.
Phase 128 Phase controls scan time and resolution. Increasing phase
steps may decrease edge blurring. Valid phase matrix
values are from 128 to 512 in increments of 32 with echo
train lengths between 16 and 8.
NEX 2.0 Select a NEX value that produces sufficient SNR.
Phase FOV 1.00 Select 0.75 or 0.5 to reduce phase steps and thus
decrease scan time, decreasing FOV in the phase
direction, and decreasing SNR slightly. The phase FOV
dimension is displayed next to the phase FOV factor.
Freq DIR R/L The direction displayed is the default frequency direction
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak that is set during prescan.
Flow Comp DIR N/A Flow Comp direction can only be selected when Flow
Comp is active. The default direction is based on the
selected scan plane except with oblique which has no
default.
Autoshim On Select Autoshim when using fat SAT or an FOV off center,
and on the first series of each exam.
Phase Correct On Phase correct helps correct for artifacts occurring in the
phase direction. It is optional, but recommended for this
sequence.
# of Acqs/Locs Before 0
Pause

12-21
© 2004 General Electric Company. All rights reserved.
 FSE

FSE Protocol Example (T2 Brain)

What You Select Selection Notes
Additional Parameters - User CV

1.00

Acq Order 1 Select an acquisition order. Sequential is MSMG

(Multi-slice multi-group) and Interleaved is MSMA
(multi-slice multi-angle). MSMG prescriptions take longer
than MSMA prescriptions.
Accept [Accept] Confirms the User CV selections and closes the window.
Additional Parameters - SAT
I 40 SAT pulses may decrease the number of slices per
acquisition. Fat SAT is frequently used with T2-weighted
scans acquired with long ETLs.
Additional Parameters - User CVs

Acq. Order Enter 0 for interleaved or 1 for sequential group order.

12-22
© 2004 General Electric Company. All rights reserved.
 FSE

FSE Protocol Example (T2 Brain)

What You Select Selection Notes
Blurring Cancellation 0.00 Enter 0 to keep blurring cancellation off or 1 to turn on
blurring cancellation.
Adaptive Phase Array Enter 0 to turn off APA, 1 for automatic APA, or enter a
number between 2 and 4 for the number of receivers.
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and remove
cursor. slices. Position the slices to cover anatomy of interest and
view the Advisory Panel to note the maximum number of
slices per acquisition and the number of acquisitions you
are prescribing. The scan time increases as the number of
acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.

12-23
© 2004 General Electric Company. All rights reserved.
 FSE

FSE Protocol Example (T2 Brain)

What You Select Selection Notes
Rx Manager
Prepare to Scan [Prepare to Downloads the series.
Scan]
Scan Operations
Scan [Scan] Initiates the acquisition.

12-24
© 2004 General Electric Company. All rights reserved.
 FSE-IR

Chapter 13
FSE-IR

Introduction
This chapter explains the pulsing components and timing factors directly related to the
Fast Spin Echo-Inversion Recovery (FSE-IR) pulse sequence. This chapter explains
the concepts of each and the step-by-step instructions to help you learn how to:
• Prescribe a FSE-IR Sequence

13-1
© 2004 General Electric Company. All rights reserved.
 FSE-IR

What Do I Need to Know About...

This section presents the concepts necessary to understand IR pulse sequences.
Specifically, you need to understand:
• FSE-IR
• Imaging Characteristics
• Supported Features
• Applications

FSE-IR
The FSE-IR pulse sequence is a modified version of FSE. FSE-IR employs the same
technique used in FSE to speed up scan time, with an added IR technique that is
primarily used for nulling the signal from fat in abdominal and extremity images.
Typically a short TE (40 ms), short TI (80 to 100 ms), and a long TR (3000 ms) is used
to nullify fat signal. Like a conventional IR sequence, the TI value is based on the
recovery of fat to the null point and changes as the field strength changes. As field
strength increases, the TI is longer.
Figure 13-1 displays a diagram of the FSE-IR pulse sequence.
Figure 13-1 FSE-IR Pulse Sequence Diagram

13-2
© 2004 General Electric Company. All rights reserved.
 FSE-IR

Imaging Characteristics
FSE-IR has the same general image characteristics as FSE. T1-weighted images have
improved contrast and more signal-to-noise ratio (SNR) than FSE images, fat
suppressed images have more uniform fat suppression than chemical saturation
because FSE-IR is less sensitive to magnetic field inhomogeneities and off-center FOV
effects.
The echo train length (ETL) selected for FSE-IR affects the image contrast as does the
echo space, the effective TE, TR, motion, chemical shift, flow, SNR, and resolution.
Increasing the ETL decreases acquisition time, affects the resulting contrast for the
selected Effective TE, and decreases the number of slices available. As the ETL
lengthens (increased number of echoes), the time per slice is increased since it
increases the number of echoes generated and takes up more of the TR time.
Since FSE-IR can have 2 to 32, 180° pulses with varied phase encoding, each phase
encoding echo exhibits different T2 decay. This can increase signal in late echo images
due to contribution from phase encoded echoes occurring early in T2 decay.
Increasing the number of refocusing radio frequency (RF) pulses, increases the specific
absorption rate (SAR) to the patient, which can limit the number of slices allowable for
any given TR.
Phase encoding across T2 decay can also produce image blurring, especially when the
selected TE is short. This occurs where the T2 decay curve is the steepest. The blurring
decreases as the number of phase encodings is increased. It is practically undetectable
at 512 phase encodings.

Fast Recovery (FRFSE-IR)

The Fast Recovery Pulse has been added to FSE-IR pulse sequences to increase the
signal from T1 or T2 components. FRFSE applies an additional RF pulse at the end of
the echo train to drive the recovery of longitudinal magnetization.
An additional +90° or -90° FR (Fast Recovery) pulse following 180° refocusing pulses is
applied after the last echo in the FSE echo train is acquired. The +90° or -90° FR pulse
is used to drive the refocused magnetization back into the longitudinal axis slowly or
rapidly, instead of allowing it to recover via the T1 process. The FRFSE sequence
therefore, allows for shorter TR values and thus shorter scan times.

13-3
© 2004 General Electric Company. All rights reserved.
 FSE-IR

With the introduction of the +90º FR pulse for Short TI contrast, the net contrast is
enhanced as the long T1 and/or T2 signals are forcibly changed from negative
longitudinal magnetization. With the introduction of the -90º FR pulse for Long TI
contrast, net contrast is enhanced as the long T1 and/or T2 signals are forcibly changed
from positive longitudinal magnetization. Select 600 mm or more for TI when using
Long TI with FSE-IR.

User CVs screen: CV9 for FSE-IR

• FR Pulse:
– [O] for FR off: the additional FR pulse is not applied.
– [1] for short TI on: +90º FR pulse is added.
– [2] for long TI on: -90º FR pulse is added.

13-4
© 2004 General Electric Company. All rights reserved.
 FSE-IR

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 13-1, an X indicates the imaging options available for use with the
FSE-IR pulse sequence.
Table 13-1 FSE-IR Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

X Cardiac Gating/Triggering X Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

Classic X Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

X FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

Multi-Phase ZIP x 4

Multi-Station X ZIP 512

Navigator X ZIP 1024

NOTE: The Imaging Options shown in Table 13-1 may not always be compatible with
each other.
The Sequential Imaging Option is automatically selected with FSE-IR, even
though an interleaved acquisition method is used when multiple groups are
prescribed.

13-5
© 2004 General Electric Company. All rights reserved.
 FSE-IR

FSE-IR with Flow Compensation (FC) may not provide benefits to the degree seen with
conventional SE and FC. Therefore, swapping phase and frequency may be desirable
to minimize motion artifact. If echo spacing remains short (for example, 16 msec or
less), then swapping phase and frequency may not be necessary. When FSE-IR is
selected in the Imaging Parameters area, the Inversion Time parameter becomes
active in the Scan Timing area. The maximum allowed value for TE2 in a FSE-IR
sequence may not match the maximum shown adjacent to the TE text box in the Scan
Timing area. This is due to the fact that the system cannot allow for all possible
parameter selections which affect the maximum TE for FSE-IR. Therefore, you may find
the actual TE2 exceeds the posted maximum.
You must select the axis on which FC is applied.

Applications
FSE-IR is used to suppress competing signal from tissues that obscure pathology or
structures of interest. FSE-IR has shorter scan times and more efficient slice
interleaving than IR.
FSE-IR is an excellent alternative for a more uniform fat suppression for large FOV or
off-center FOV. Do not use IR techniques with contrast studies, enhancing pathology
could be suppressed if the contrast shortened T1 corresponds to the null point.

13-6
© 2004 General Electric Company. All rights reserved.
 FSE-IR

How Do I...
This section provides the step-by-step instructions for prescribing a FSE-IR imaging
pulse sequence. Specifically, it describes how to:
• Prescribe a FSE-IR Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs which occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions.
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

WARNING:Hearing protection is required for all people in the scan room during a
scan to help prevent hearing impairment. Acoustic noise levels may
exceed 99 db(A).

13-7
© 2004 General Electric Company. All rights reserved.
 FSE-IR

Prescribe a FSE-IR Sequence

FSE-IR sequences are helpful when you need a more uniform fat suppression for large
FOV or off-center FOV imaging. FSE-IR suppresses competing signal from tissues that
obscure pathology or structures of interest.
The decision matrix (Table 13-2) is only for prescribing an FSE-IR sequence. The
following example protocol is for prescribing an extremity scan with FSE-IR.
Table 13-2 FSE-IR Protocol Example (Extremity)

FSE-IR Protocol Example (Extremity)

What you Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series if the
Patient Protocol window becomes active.
Patient Position

Coil
Illustration

Large Knee

Patient Position Supine An FSE-IR pulse sequence is compatible with any patient
position and entry.
Patient Entry Feet First
Coil Large Knee Allows selection of the coil from which the signal is
transmitted and received. Use a coil that produces
optimum coverage and SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default description with the selected scan mode,
PSD, and selected imaging options.

13-8
© 2004 General Electric Company. All rights reserved.
 FSE-IR

FSE-IR Protocol Example (Extremity)

What you Select Selection Notes
Imaging Parameters

Plane Oblique Defines the scan plane of the acquisition. Compatible with
any scan plane. Select the plane that best meets your
clinical need.
Mode 2D Prescribes a two-dimensional sequence. FSE-IR is only
compatible with 2D.
Pulse Seq FSE-IR Activates the FSE-IR pulse sequence. Click [Accept] to
register the selection.
Imaging Options No Phase Wrap, Select imaging options that optimize SNR, spatial
Sequential, resolution, the number of slices, and reduce motion
ZIP512, Variable artifacts. Refer to Table 13-1 for a complete list of
Bandwidth compatible options. Click [Accept] to register the
selections.
PSD Name N/A Refer to FSE to use fse-rpc or fse-xlc.
Protocol N/A

13-9
© 2004 General Electric Company. All rights reserved.
 FSE-IR

FSE-IR Protocol Example (Extremity)

What you Select Selection Notes
Scan Timing

# of echoes 1 Select 1 or 2 echoes.

TE MinFull Short TEs increase T1 contrast and SNR. Minimum TE
changes as RBw changes.
TE2 N/A The maximum allowed TE2 value in a FSE-IR sequence
may not match the maximum shown adjacent to the TE
text box in the Scan Timing area. This is due to the
system not allowing for all possible parameter selections,
which affect the maximum TE for FSE-IR. Therefore, you
may find the actual TE2 exceeds the posted maximum.
TR 4000 Long TRs increase SNR, the number of slices, and scan
time. TR is not selectable with gated scans. The TR is
determined by the RR intervals on the Gating Additional
Parameters screen.
Inv. Time 90 Select a TI to suppress the signal from fat.
Flip Angle N/A
Echo Train Length 6 Long ETLs decrease scan time and the number of slices,
while increasing edge blurring and the signal from fat.
Bandwidth 15.63 As the RBw decreases, the SNR, chemical shift artifact,
the minimum TE increase. An increase in TE can
potentially decrease the number of slices and increase
motion artifact.
Bandwidth2 N/A Only selectable with a double-echo acquisition.

13-10
© 2004 General Electric Company. All rights reserved.
 FSE-IR

FSE-IR Protocol Example (Extremity)

What you Select Selection Notes
Scanning Range

FOV 16 Select a FOV that covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results in
aliasing. Small FOVs increase resolution, decrease SNR,
and can increase the minimum TE value. If the FOV is ≤
16 and the slice thickness is ≤ 5, then the echo spacing
may increase and there may be fewer slices per
acquisition.
Slice Thickness 4 Thin slices increase resolution and decrease SNR.
Spacing 1.0 Select a spacing that reduces crosstalk between slices
(typically 20% of the slice thickness). If your scan is a
dual acquisition with no concatenated SAT pulse, zero
spacing is allowed.
Note: Do not select 0 for spacing. More than 20% of the
slice thickness or interleaved must be selected.
Start, End Locations Typically the start and end locations are programmed
from the Graphic Rx program.
# Slices 22 The maximum number of slices available is determined
by the TR, TE, TI, SAR, and gradient stress.

13-11
© 2004 General Electric Company. All rights reserved.
 FSE-IR

FSE-IR Protocol Example (Extremity)

What you Select Selection Notes
Acquisition Timing

Freq 384 Increasing the frequency matrix increases echo space

and resolution, while decreasing SNR and the number of
slices.
Phase 224 Phase controls scan time and resolution. Increasing
phase steps may decrease edge blurring.
NEX 2.0 Select a NEX value that produces sufficient SNR.
Phase FOV N/A Select 0.75 or 0.5 to reduce phase steps and thus
decrease scan time, FOV in the phase direction, and
SNR slightly. The phase FOV dimension is displayed next
to the phase FOV factor.
Freq DIR Unswap The direction displayed is the default frequency direction,
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak to be set during prescan.
Flow Comp DIR N/A Flow Comp DIR can only be selected when Flow Comp is
active. The default direction is based on the selected
scan plane, except with oblique which has no default.
Autoshim On Select Autoshim when using Fat SAT, an off-center FOV,
and on the first series of each examination.
Phase Correct On By turning phase correct on this helps to correct any
artifact occurring in the phase direction.
# of Acqs Before Pause N/A

13-12
© 2004 General Electric Company. All rights reserved.
 FSE-IR

FSE-IR Protocol Example (Extremity)

What you Select Selection Notes
Additional Parameters - User CVs

Acq. Order Enter 0 for interleaved or 1 for sequential group order.

Also refer to FSE.
Accept [Accept] Confirms your User CV selections and closes the window.
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and
cursor. remove slices. Position the slices to cover anatomy of
interest and view the Advisory Panel to note the
maximum number of slices per acquisition and the
number of acquisitions you are prescribing. The scan time
increases as the number of acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.

13-13
© 2004 General Electric Company. All rights reserved.
 FSE-IR

FSE-IR Protocol Example (Extremity)

What you Select Selection Notes
Scan Operations
Scan [Scan] Initiates the acquisition.

13-14
© 2004 General Electric Company. All rights reserved.
 SSFSE and SSFSE-IR

Chapter 14
SSFSE and SSFSE-IR

Introduction
This chapter explains the pulsing components and timing factors directly related to the
Single Shot Fast Spin Echo (SSFSE) and Single Shot Fast Spin Echo - Inversion
Recovery (SSFSE-IR) pulse sequences. This chapter explains the concepts of each
and the step-by-step instructions to help you learn how to:
• Prescribe a SSFSE Sequence
• Prescribe a SSFSE-IR Sequence

14-1
© 2004 General Electric Company. All rights reserved.
 SSFSE and SSFSE-IR

What Do I Need to Know About...

This section presents the concepts necessary to understand the SSFSE pulse
sequences. Specifically, you need to understand:
• SSFSE and SSFSE-IR Basics
– Scan Parameters
– Imaging Considerations
• SSFSE
– Supported Features
– Applications
• SSFSE-IR
– Supported Features
– Applications

SSFSE and SSFSE-IR Basics

SSFSE and SSFSE-IR are two-dimensional (2D) ultrafast scanning techniques that
acquire a data set within a single radio frequency (RF) excitation period that allows for
significantly shorter echo spaces (ESP). Single-shot means that all phase encodings
are acquired within one TR period, so it is not a selectable parameter. SSFSE and
SSFSE-IR are similar to Fast Spin Echo (FSE) and Fast Spin Echo-Inversion Recovery
(FSE-IR) with one major difference, all lines of k-space are filled within one repetitive
time (TR) period. This allows for faster acquisition times. Scan timing calculations for
each FSE and SSFSE are described in Equation 14-1 and Equation 14-2.
Equation 14-1 FSE Scan Time

TR x (phase matrix/ETL) x NEX

Equation 14-2 SSFSE and SSFSE-IR Scan Time

(Acquisition Rate + SAR Delay) x # of slices

NOTE: The phase matrix, phase FOV, and the selected TE are used by the system to
calculate the echo train length (ETL). The Acquisition Rate is the product of the
ETL times the ESP.

14-2
© 2004 General Electric Company. All rights reserved.
 SSFSE and SSFSE-IR

Additional differences between conventional FSE and SSFSE are listed in Table 14-1.
Table 14-1 FSE and SSFSE Differences

FSE SSFSE and SSFSE-IR

Only 1,2,3 or 4 NEX are allowed. If 2 NEX or greater is
selected, a 10 second TR is used to allow for longitudinal
magnetization to regrow between excitations. Scan time will
Selectable NEX values be calculated on the NEX times the Ky fraction selected in
CV 1. Scan time for multi-slice acquisitions will indicated the
total time for acquisition of all the slices (scan time for a
single slice times number of slices).
SSFSE uses a new RF pulse design that allows for
RF pulse design results significantly shorter ESP. The minimum TE no longer
in a longer ESP than equates to the ESP. The shortened ESP allows acquisition
SSFSE of all phase encodings within a single RF excitation period
with a minimum of edge blurring artifacts.
An SAR delay time is added to the acquisition time for each
slice. For example, if the SAR delay time is 200 ms and the
The number of slices
acquisition time is 500 ms, the total acquisition time (the only
allowed in acquisition
time you see) is 700 ms. Since the SAR delay may vary
may be limited by the
because of patient weight, the acquisition time may vary
SAR.
from one patient to the next even though the scan
parameters are identical.

0.5 NEX
Partial Fourier phase encoding or Fractional NEX (0.5 NEX) is a technique in which only
a fraction of the phase encodings is performed. The remaining encodings and the
resulting data needed to complete k-space are computed via a mathematical process. If
more than half of the phase encodings gradient amplitudes are used (phase encoding
step -128 to +8), as is the case with SSFSE, the data calculated to complete k-space
are the complex conjugate (mirror image) of the actual signals generated and sampled.
Figure 14-1 NEX and K-Space

The figure on the left in Figure 14-1 is representative of the applied phase encoding
steps and accompanying transversal of k-space when 0.5 NEX is used. The figure on
the right is representative of 1 NEX.

14-3
© 2004 General Electric Company. All rights reserved.
 SSFSE and SSFSE-IR

When minor phase variations in the compensated data are corrected, the image
resolution remains constant, but the SNR is decreased because there are fewer phase
encodings to average together.
Fractional NEX (0.5 NEX) has been combined with SSFSE and SSFSE-IR to produce
faster data acquisition. The fewer actual phase steps acquired, the faster the scan time.
The acquisition method in SSFSE and SSFSE-IR contributes to edge blurring which
can be lessened by decreasing Phase Field of View (FOV), increasing the matrix, or
increasing the receive bandwidth (RBw). All of these parameters contribute to
decreased signal-to-noise ratio (SNR).

Scan Parameters
Several scan parameters can be adjusted to optimize the SSFSE sequences. The
parameters include:
• Flexible TE Range
• User Control Variables

Flexible TE Range
The flexible TE range allows for two different methods of transversing k-space: Linear
Phase Encoding and Reverse Phase Encoding. Both SSFSE pulse sequences select
the phase encoding scheme according to the prescribed TE. Linear Phase Encoding is
used for short to medium range TEs. Reverse Phase Encoding is used for long range
TEs. Loss of SNR from a long TE scan is minimized with Reverse Linear Phase
Encoding, since it acquires more echoes earlier in the echo train compared to Linear
Phase Encoding.
Refer to the following guidelines when acquiring a standard T2 SSFSE image.
• Select a value listed for TE. Any TE selection between the values listed in the Min.
and Max. TE1 columns ensure Linear View Ordering (Figure 14-2) is applied.
Figure 14-2 Linear View Phase Ordering Scheme

Linear View Ordering

TE Range

Refer to the following guideline when acquiring a MRCP or myelogram image.

• Select the minimum TE value. This ensures Reverse View Ordering is applied.

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 SSFSE and SSFSE-IR

• When selecting the maximum TE value, consider using high matrix values, a Phase
FOV of 1, and the smallest allowable bandwidth.
Figure 14-3 Reverse View Phase Ordering Scheme

Reverse View Ordering

TE2 Range

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 SSFSE and SSFSE-IR

User Control Variables

SSFSE-IR introduces a User CVs pop-up window needed for scan proscription.

• CV1 Ky fraction [0.5]

For TE=Maximum

• CV1 Ky fraction [0.5, 0.75, 1.0]

CV1 is used to set the amount of K-space to be filled in the phase direction (Ky) for the
acquisition. As the Ky fraction increases, SNR for the acquisition as well as scan time
will increase.

• CV2 Fast Recovery off=0 on=1

When selecting [SSFSE], CV2 is displayed. [1] is used to turn [Fast Recovery] ON.
NOTE: When [Fast Recovery] is turned ON and NEX greater than 2 is selected, 7
second TR is used.

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 SSFSE and SSFSE-IR

Imaging Considerations
Consider the following when prescribing SSFSE or SSFSE-IR sequences:
• Due to slice crosstalk and SNR, contrast of a sequential acquisition is less than an
interleaved acquisition. Select sequential to eliminate the image shift often observed
in interleaved breath-hold abdominal scanning when those images are acquired for
MIP post processing.
• When performing an SSFSE or SSFSE-IR breath-hold acquisition, the system
divides the total number of prescribed slices into equal partitions based on the
maximum number of slices which can be acquired within the selected time (the time
resulting from entering a value for # of Locs Before Pause). The system divides the
prescribed number of slice locations equally between the total number of
breath-holds needed to complete the prescribed number of slices.
• To lessen the edge blurring that occurs with SSFSE or SSFSE-IR (except for
maximum TE selection), increase the RBw and decrease the Phase FOV at the
expense of reduced SNR.
• For axial scans, if your goal is to reduce scan time and your patient does not fill the
FOV in the phase direction, use a sagittal localizer to determine an offset for the
FOV in the anterior/posterior (A/P) direction. Program the offset and then select a
Phase FOV that reduces the FOV without resulting in phase wrap.

SSFSE
SSFSE creates T2-weighted images. TR controls the saturation or T1 effects in image
contrast. The longer the TR, the less the T1 effects. For complete T1 relaxation from all
structures, TR would need to be approximately 20 seconds long. A standard FSE pulse
sequence uses long TRs in the range 2000 ms to 6000 ms. Even though these
repetitive TR periods are long, they still result in some saturation effects for tissues with
very long TI relaxation rates.
SSFSE collects all phase encodings per slice after a single RF excitation pulse and in
effect, has an infinite TR when NEX is 1 or less. The excitation pulse changes the
unsaturated longitudinal magnetization to the transverse plane and acquires all the
signal information. Since there is no wait period or TR for longitudinal regrowth to occur,
there is no T1 effect in the image contrast. This means that an SSFSE image can be
more heavily T2-weighted in comparison to an FSE image. As the TE increases, the
image becomes more T2-weighted.

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 SSFSE and SSFSE-IR

Figure 14-4 Image Comparison of FSE and SSFSE

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 SSFSE and SSFSE-IR

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise (in motion/flow artifacts). In Table 14-3, an X indicates the options available for
use with the SSFSE pulse sequences.
Table 14-2 SSFSE Compatible Imaging Options

Imaging Options
X None Real Time

ASSET Respiratory Compensation

ASSET Calibration X Respiratory Gating/Triggering

Blood Suppression X Sequential

X Cardiac Gating/Triggering SmartPrep

CCOMP Spectral Spatial RF

Classic Square Pixel

DE Prepared Tailored RF

X Extended Dynamic Range T2 Prep

Flow Compensation X Variable Bandwidth

Fluoro Trigger ZIP x 2

fMRI ZIP x 4

Full Echo Train X ZIP 512

IR Prepared ZIP 1024

Magnetization Transfer X FSE/FIR Blurring cancellation

Multi-Phase Single Quadrature Water imaging

Multi Station Real Time Blurring Cancellation

Navigator Single Quadrature Fat imaging

No Phase Wrap

NOTE: ASSET™ and FC is not available.

SSFSE is not compatible with concatenated SAT.

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 SSFSE and SSFSE-IR

Applications
SSFSE sequences can be used in standard imaging to reduce motion artifacts and
imaging times. With shorter scan times, breath-hold abdominal imaging can be
achieved. By using long TE scans, images can also be acquired of the colon, pancreas,
gallbladder, and billiary tree. Figure 14-5 displays a SSFSE Magnetic Resonance
Cholangiopancreatographiy (MRCP) image acquired in a 4-second breath-hold.
Figure 14-5 SSFSE MRCP

SSFSE-IR
In a SSFSE-IR sequence (Figure 14-6), the TI value controls the contrast and produces
either T1-weighted, fat or fluid suppressed images.
Figure 14-6 SSFSE-IR Image

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 SSFSE and SSFSE-IR

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 14-3, an X indicates the imaging options available for use with the
SSFSE-IR pulse sequences.
Table 14-3 SSFSE-IR Compatible Imaging Options

Imaging Options
X None Real Time

ASSET Respiratory Compensation

ASSET Calibration X Respiratory Gating/Triggering

Blood Suppression X Sequential

X Cardiac Gating/Triggering SmartPrep

CCOMP Spectral Spatial RF

Classic Square Pixel

DE Prepared Tailored RF

X Extended Dynamic Range T2 Prep

Flow Compensation X Variable Bandwidth

Fluoro Trigger ZIP x 2

fMRI ZIP x 4

Full Echo Train X ZIP 512

IR Prepared ZIP 1024

Magnetization Transfer X FSE/FIR Blurring cancellation

Multi-Phase Single Quadrature Water imaging

Multi Station Real Time Blurring Cancellation

Navigator Single Quadrature Fat imaging

No Phase Wrap

NOTE: ASSET™ and FC is not available.

SSFSE-IR is not compatible with concatenated SAT.

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 SSFSE and SSFSE-IR

Applications
SSFSE-IR sequences are most commonly used acquire T1-weighted, fat or fluid
suppressed images with reduced motion artifacts and imaging times. With shorter scan
times, breath-hold abdominal and cardiac imaging can be achieved.

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 SSFSE and SSFSE-IR

How Do I...
This section provides the step-by-step instructions for prescribing the SSFSE and
SSFSE-IR imaging pulse sequences. Specifically, it describes how to:
• Prescribe a SSFSE Sequence
• Prescribe a SSFSE-IR Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions.
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.

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 SSFSE and SSFSE-IR

Prescribe a SSFSE Sequence

SSFSE sequences are helpful in imaging uncooperative patients or for breath-hold
abdominal and cardiac imaging due to short scan times. By using long TEs with these
sequences, images can be acquired of the gallbladder and billiary tree.
The decision matrix (Table 14-4) is only for prescribing a SSFSE sequence. The
following example protocol is for prescribing a thick slab MRCP scan with SSFSE.
Table 14-4 SSFSE Protocol Example (MRCP)

SSFSE Protocol Example (MRCP)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series if the
Patient Protocol window becomes active.
Patient Position

Coil
Illustration

Patient Position Supine A SSFSE pulse sequence is compatible with any patient
position and entry. SSFSE sequences are primarily used
Patient Entry Head First in neuro and body scanning, so the patient position and
coil selections should reflect that. These values reflect a
abdomen scan.
Coil Open Body Select a coil that produces the optimum coverage and
SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

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 SSFSE and SSFSE-IR

SSFSE Protocol Example (MRCP)

What You Select Selection Notes
Imaging Parameters

Plane Oblique Defines the scan plane of the acquisition. Compatible

with any scan plane, except 3-Plane. Select the plane
that best meets your clinical need.
Mode 2D Prescribes a two-dimensional sequence. SSFSE is only
compatible with 2D.
Grad Mode N/A
Pulse Seq SSFSE Activates the SSFSE pulse sequence. Click [Accept] to
register the selection. SSFSE is typically used for T2
weighted images.
Imaging Options SS Select imaging options that optimize SNR, spatial
resolution, the number of slices, and reduce motion
artifacts. Interleaved acquires first the odd slices and
then the even slices. Sequential acquires the slices in
numerical order. If you do not select Sequential, an
interleaved technique is used. Select Sequential to
eliminate the image shift often observed in interleaved
breath-hold abdominal scanning when the images are
acquired for MIP post processing. Sequential can result
in a decrease in SNR and contrast in comparison to an
interleaved acquisition. Refer to Table 14-2 for a
complete list of compatible options. Click [Accept] to
register the selections.
PSD Name N/A
Protocol N/A

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 SSFSE and SSFSE-IR

SSFSE Protocol Example (MRCP)

What You Select Selection Notes
Scan Timing

# of echoes N/S
TE Maximun For a T2-weighted SSFSE image, select a TE between
the Min and Max values listed next to the TE text box.
The long TE maximum is used for MIP post processing
exams such as MRCP.
Eff TE2 N/A
TR N/A
Inv Time N/A
Flip Angle N/A
Echo Train Length N/A
Bandwidth 31.25 Select a bandwidth between 2 and 31.2 kHz. As RBw
increases, the ESP decreases (which is desirable) and
SNR decreases. Compensate for the loss in SNR that
occurs by increasing the slice thickness or FOV.
Bandwidth 2 N/A

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 SSFSE and SSFSE-IR

SSFSE Protocol Example (MRCP)

What You Select Selection Notes
Scanning Range

FOV 34 Select a FOV that covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results
in aliasing. Small FOVs increase resolution, decrease
SNR, and can increase the minimum TE value.
Slice Thickness 40 Thin slices increase resolution and decrease SNR.
Spacing 0.0 If acquiring multiple slices, select a spacing that reduces
crosstalk between slices (typically 20 % of the slice
thickness).
Start, End Locations Typically the start and end locations are programmed
from the Graphic Rx program.
# Slices The (# of slices) x TR determines the total scan time.
Select the number of slices based on the anatomical
coverage needed.

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 SSFSE and SSFSE-IR

SSFSE Protocol Example (MRCP)

What You Select Selection Notes
Acquisition Timing

R/L

Freq 256 Increasing the frequency matrix increases the echo

space and resolution, while decreasing SNR.
The frequency can be changed from 128 to 512 at 32
step intervals.
Phase 160 Phase controls scan time and resolution.
The phase matrix variable range is from 128 to 256 at 32
step intervals.
NEX 1.0 Select a NEX value that produces sufficient SNR.
Phase FOV 1.0 The phase FOV range is from 0.5 to 1.0. This range of
values allows you to choose the best phase FOV to
image desired anatomy, without sacrificing too much
signal from your image.
Freq DIR R/L Typically select the default frequency direction.
Auto Center Freq Peak Select the CF peak that is set during prescan.
Flow Comp DIR N/A Flow Comp is not compatible with SSFSE.
Autoshim On Select Autoshim when using fat SAT or an FOV off
center, and in the first series of each examination.
Phase Correct On Phase correct helps correct for artifacts occurring in the
phase direction. It is optional, but recommended for this
sequence.
# of Acqs/Locs Before 1 This is typically selected for abdominal breath-hold
Pause examinations. If none is selected the images are
acquired within one "block". If another value is selected,
then the scan range is divided into multiple "blocks"
where one block of images can be scanned before the
next block of scans, in sequential order.

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 SSFSE and SSFSE-IR

SSFSE Protocol Example (MRCP)

What You Select Selection Notes
Additional Parameters - User CV

Ky fraction 0.5 The default setting is 0.5. When a maximum TE is

selected, 0.75 and 1 is available. As the Ky fraction
increases, SNR for the acquisition as well as scan time
will increase.
Fast Recovery 0.0 When 2 NEX or greater is selected, scan time becomes
shorter due to turning Fast Recovery On.

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 SSFSE and SSFSE-IR

SSFSE Protocol Example (MRCP)

What You Select Selection Notes
Additional Parameters - SAT window
I 80 Spatial and spectral saturation pulses are compatible
with SSFSE and SSFSE-IR. Due to their very fast scan
times, SAT pulse may not be necessary to suppress
flow.
S 80

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 SSFSE and SSFSE-IR

SSFSE Protocol Example (MRCP)

What You Select Selection Notes
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and
cursor. remove slices. Position the slices to cover anatomy of
interest and view the Advisory Panel to note the
maximum number of slices per acquisition and the
number of acquisitions you are prescribing. The scan
time increases as the number of acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Scan [Scan] Initiates the acquisition.

Frequently Asked Question Why is the annotated TR so long?

Questions
Answer The annotated value for the TR is the scan time, the
actual TR is infinite.
Question The same values for two different patients have
been programmed and yet the scan time varies.
Why?
Answer A dead time or blank time is added to the
acquisition time for each slice to keep SAR values
within the required limits. Since the SAR may vary
because of patient weight, the acquisition time may
vary from one patient to the next even though the
scan parameters are identical.

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 SSFSE and SSFSE-IR

Prescribe a SSFSE-IR Sequence

SSFSE-IR sequences are most commonly used acquire T1-weighted, fat or fluid
suppressed images with reduced motion artifacts and imaging times. With shorter scan
times, breath-hold abdominal and cardiac imaging can be achieved.
The decision matrix (Table 14-4) is only for prescribing a SSFSE-IR sequence. The
following example protocol is for prescribing a short TI abdomen scan with SSFSE-IR.
Table 14-5 SSFSE-IR Protocol Example (Abdomen)

SSFSE-IR Protocol Example (Abdomen)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series if the
Patient Protocol window becomes active.
Patient Position

Coil
Illustration

Patient Position Supine A SSFSE-IR pulse sequence is compatible with any

patient position and entry. SSFSE-IR sequences are
Patient Entry Head First primarily used in neuro and body scanning, so the
patient position and coil selections should reflect that.
These values reflect an abdominal scan.
Coil Open Body Select a coil that produces the optimum coverage and
SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

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 SSFSE and SSFSE-IR

SSFSE-IR Protocol Example (Abdomen)

What You Select Selection Notes
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. Compatible

with any scan plane, except 3-Plane. Select the plane
that best meets your clinical need.
Mode 2D Prescribes a two-dimensional sequence. SSFSE-IR is
only compatible with 2D.
Grad Mode N/A
Pulse Seq SSFSE-IR Activates the SSFSE-IR pulse sequence. Click [Accept]
to register the selection. SSFSE-IR is used for either T1,
short TI IR, or FLAIR images.
Imaging Options Select imaging options that optimize SNR, spatial
resolution, the number of slices, and reduce motion
artifacts.Interleaved acquires first the odd slices and
then the even slices. Sequential acquires the slices in
numerical order. If you do not select Sequential, an
interleaved technique is used. Select Sequential to
eliminate the image shift often observed in interleaved
breath-hold abdominal scanning when the images are
acquired for MIP post processing. Sequential can result
in a decrease in SNR and contrast in comparison to an
interleaved acquisition. Click [Accept] to register the
selections.
PSD Name N/A
Protocol N/A

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 SSFSE and SSFSE-IR

SSFSE-IR Protocol Example (Abdomen)

What You Select Selection Notes
Scan Timing

# of echoes N/S
TE Minimum
TE2 N/A
TR N/A
Inv Time 130 Select a TI value only if SSFSE-IR was selected.
Typically use a TI of 400 for T1-weighted images and
130 for short TR IR.
Flip Angle N/A
Echo Train Length N/A
Bandwidth 31.25 Select a bandwidth between 2 and 31.2 kHz. As RBw
increases, the ESP decreases (which is desirable) and
SNR decreases. Compensate for the loss in SNR that
occurs by increasing the slice thickness or FOV.
Bandwidth 2 N/A

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 SSFSE and SSFSE-IR

SSFSE-IR Protocol Example (Abdomen)

What You Select Selection Notes
Scanning Range

FOV 34 Select a FOV that covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results
in aliasing. Small FOVs increase resolution, decrease
SNR, and can increase the minimum TE value.
Slice Thickness 70 Thin slices increase resolution and decrease SNR.
Spacing 0.0 If acquiring multiple slices, select a spacing that reduces
crosstalk between slices (typically 20 % of the slice
thickness).
Start, End Locations Typically the start and end locations are programmed
from the Graphic Rx program.
# Slices The (# of slices) x TR determines the total scan time.
Select the number of slices based on the anatomical
coverage needed.

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 SSFSE and SSFSE-IR

SSFSE-IR Protocol Example (Abdomen)

What You Select Selection Notes
Acquisition Timing

Freq 256 Increasing the frequency matrix increases the echo

space and resolution, while decreasing SNR.
The frequency can be changed from 128 to 512 at 32
step intervals.
Phase 160 Phase controls scan time and resolution.
The phase matrix variable range is from 128 to 256 at 32
step intervals.
NEX 1.0 Select a NEX value that produces sufficient SNR.
Phase FOV 1.0 The phase FOV range is from 0.5 to 1.0. This range of
values allows you to choose the best phase FOV to
image desired anatomy, without sacrificing too much
signal from your image.
Freq DIR R/L Typically select the default frequency direction.
Auto Center Freq Peak Select the CF peak that is set during prescan.
Flow Comp DIR N/A Flow Comp is not compatible with SSFSE-IR.
Autoshim On Select Autoshim when using fat SAT or an FOV off
center, and in the first series of each examination.
Phase Correct On Phase correct helps correct for artifacts occurring in the
phase direction. It is optional, but recommended for this
sequence.

# of Acqs/Locs Before 0 This is typically selected for abdominal breath-hold

Pause examinations. If none is selected the images are
acquired within one "block". If another value is selected,
then the scan range is divided into multiple "blocks"
where one block of images can be scanned before the
next block of scans, in sequential order.

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 SSFSE and SSFSE-IR

SSFSE-IR Protocol Example (Abdomen)

What You Select Selection Notes
Additional Parameters - User CV

Ky fraction 0.5 The default setting is 0.5. When a maximum TE is

selected, 0.75 and 1 is available. As the Ky fraction
increases, SNR for the acquisition as well as scan time
will increase.

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 SSFSE and SSFSE-IR

SSFSE-IR Protocol Example (Abdomen)

What You Select Selection Notes
Additional Parameters - SAT window
I 80 Spatial and spectral saturation pulses are compatible
with SSFSE and SSFSE-IR. Due to their very fast scan
times, SAT pulse may not be necessary to suppress
flow.
S 80

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 SSFSE and SSFSE-IR

SSFSE-IR Protocol Example (Abdomen)

What You Select Selection Notes
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and
cursor. remove slices. Position the slices to cover anatomy of
interest and view the Advisory Panel to note the
maximum number of slices per acquisition and the
number of acquisitions you are prescribing. The scan
time increases as the number of acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Scan [Scan] Initiates the acquisition.

Frequently Asked Question Why is the annotated TR so long?

Questions
Answer The annotated value for the TR is the scan time, the
actual TR is infinite.
Question The same values for two different patients have
been programmed and yet the scan time varies.
Why?
Answer A dead time or blank time is added to the
acquisition time for each slice to keep SAR values
within the required limits. Since the SAR may vary
because of patient weight, the acquisition time may
vary from one patient to the next even though the
scan parameters are identical.

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 SSFSE and SSFSE-IR

14-30
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 3DFSE and 3DFRFSE

Chapter 15
3DFSE and 3DFRFSE

Introduction
This chapter explains the pulsing components and timing factors directly related to the
3D Fast Spin Echo (3DFSE) and 3D Fast Recovery Fast Spin Echo (3D FRFSE) pulse
sequences. This chapter explains the concepts of each and the step-by-step
instructions to help you learn how to:
• Prescribe a 3DFSE Sequence
• Prescribe a 3DFRFSE Sequence

15-1
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 3DFSE and 3DFRFSE

What Do I Need to Know About...

This section presents the concepts necessary to understand the 3DFSE pulse
sequences. Specifically, you need to understand:
• 3DFSE and 3DFRFSE Basics
– Scan Parameters
– Supported Features
– Applications
• 3DFRFSE / 3DSSFRFSE
– Supported Features
– Applications

3DFSE and 3DFRFSE Basics

The 3DFSE scanning is used in fluid enhancement applications such as MR
cholangio-pancreatography (MRCP) studies. And, the fast recovery (FR) feature is
designed to enhance the intensity of fluids that have long T2 relaxation times, while
using a shortened TR time.
A sequential view-ordering scheme can be used with the 3DFSE and 3DFRFSE
sequences. This acquisition mode is called the Single Shot mode. It fills an entire
Ky(phase) and Kx(frequency) plane of k-space in a single shot for each value of
Kz(slice) and is not interleaved with Kz. Scan timing calculations for 3DFSE, 3DFRFSE,
3D Single Shot FSE(SSFSE) and 3D Single Shot FRFSE (SSFRFSE) are described in
Equation 15-1 and Equation 15-2.
Equation 15-1 3DFSE and 3DFRFSE Scan Time

TR x (phase matrix/ETL) x NEX x (number of locations) x (number of slabs)

Equation 15-2 3DSSFSE and 3DSSFRFSE Scan Time

TR x NEX x (number of locations) x (number of slabs)

NOTE: The phase matrix, phase FOV, and the selected TE are used by the system to
calculate the echo train length (ETL) with 3DSSFSE and 3DSSFRFSE.

Scan Parameters
Several scan parameters can be adjusted to optimize the 3DFSE and 3DFRFSE
sequences. The parameters include:
• Flexible TE Range in Single Shot mode

15-2
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 3DFSE and 3DFRFSE

• User Control Variables

Flexible TE Range in Single Shot mode

The flexible TE range allows for two different methods of transversing k-space: Linear
Phase Encoding and Reverse Phase Encoding. Both 3DSSFSE and 3DSSFRFSE
pulse sequences select the phase encoding scheme according to the prescribed TE.
Linear Phase Encoding is used for short to medium range TEs. Reverse Phase
Encoding is used for long range TEs. Loss of SNR from a long TE scan is minimized
with Reverse Linear Phase Encoding, since it acquires more echoes earlier in the echo
train compared to Linear Phase Encoding.
Refer to the following guidelines when acquiring a standard T2 3DSSFSE image.
• Select a value listed for TE. Any TE selection between the values listed in the Min.
and Max. TE columns ensure Linear View Ordering (Figure 15-1) is applied.
Figure 15-1 Linear View Phase Ordering Scheme

Linear View Ordering

TE Range

Refer to the following guideline when acquiring a MRCP or myelogram image.

• The minimum or maximum TE is available only in 3DSSFSE / 3DFRSSFSE.
• Select the maximum TE value. This ensures Reverse View Ordering is applied.
• When selecting the maximum TE value, consider using high matrix values, a Phase
FOV of 1, and the smallest allowable bandwidth.
NOTE: In 3D SSFSE or 3D SSFRFSE, when 0.75 or 1 Ky is selected on UserCV Screen
(CV9 Ky fraction with SINGLE_SHOT[0.5, 0.75, 1.0]), TE is automatically set to
maximum and TE is grayed out.

15-3
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

Figure 15-2 Reverse View Phase Ordering Scheme

Reverse View Ordering

TE Range

User Control Variables

Figure 15-3 displays the User Control Variables (User CVs) screen that appears with a
3DFSE/3DFRFSE sequence. Table 15-1describes each User CV.
Figure 15-3 3DFSE/3DFRFSE User CVs Screen

Table 15-1 SSFSE User CV Descriptions

User CV Mode Description

Slices to discard is number of kiss-off slices. Slices to
Slices to discard discard help to remove signal-loss images at out side
0 to 8
(0...8) of slab. The number of slices displayed is calculated
as “Loca/slab”-2 x "slice to discards".
Single Shot Ky view ordering scheme acquires all
SINGLE_SHOT
phase encoding lines (ky) in a single shot for each
Ky View
0:OFF, 1:ON “locs per slab” and is not interleaved with kz. The
Ordering 0:OFF,
Single Shot Ky mode helps in achieving faster scans.
1:ON
Maximum Yres is 256 when Single Shot Ky is set.

15-4
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

User CV Mode Description

In shingle shot mode, This CV is used to set the
Ky fraction with amount of K-space to be filled in the phase
SINGLE_SHOT 0.5, 0.75, 1.0 direction(Ky) for the acquisition. As the Ky fraction
[0.5, 0.75, 1.0] increase, SNR for the acquisition as well as scan time
will increase.
SINGLE_SHOT
Enhancement BC. Should be BC on, Ky frac=on,
average type 0:OFF, 1:ON
Shingle shot mode.
BC 0:OFF 1:ON

Fractional Ky / Fractional NEX

Partial Fourier phase encoding or Fractional NEX (0.5 NEX) is a technique in which only
a fraction of the phase encodings is performed. The remaining encodings and the
resulting data needed to complete k-space are computed via a mathematical process. If
more than half of the phase encodings gradient amplitudes are used (phase encoding
step -128 to +8), as is the case with single shot mode, the data calculated to complete
k-space are the complex conjugate (mirror image) of the actual signals generated and
sampled.
Figure 15-4 NEX and K-Space

The figure on the left in Figure 15-4 is representative of the applied phase encoding
steps and accompanying transversal of k-space when 0.5 NEX is used. The figure on
the right is representative of 1 NEX.
When minor phase variations in the compensated data are corrected, the image
resolution remains constant, but the SNR is decreased because there are fewer phase
encodings to average together.
Fractional NEX (0.5 NEX) has been combined with 3DSSFSE and 3DSSFRFSE to
produce faster data acquisition. The fewer actual phase steps acquired, the faster the
scan time. The acquisition method in 3DSSFSE and 3DSSFRFSE contributes to edge
blurring which can be lessened by decreasing Phase Field of View (FOV), increasing
the matrix, or increasing the receive bandwidth (RBw). All of these parameters
contribute to decreased signal-to-noise ratio (SNR).

15-5
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise (in motion/flow artifacts). In Table 15-3, an X indicates the options available for
use with the 3DFSE pulse sequences.
Table 15-2 3DFSE / 3DSSFSE Compatible Imaging Options

Imaging Options
X None Real Time

ASSET Respiratory Compensation

ASSET Calibration X Respiratory Gating/Triggering

Blood Suppression Sequential

Cardiac Gating/Triggering SmartPrep

CCOMP Spectral Spatial RF

Classic X Square Pixel

DE Prepared Tailored RF

X Extended Dynamic Range T2 Prep

X Flow Compensation X Variable Bandwidth

Fluoro Trigger ZIP x 2

fMRI ZIP x 4

Full Echo Train X ZIP 512

IR Prepared ZIP 1024

Magnetization Transfer X FSE/FIR Blurring cancellation

Multi-Phase Single Quadrature Water imaging

Multi Station Real Time Blurring Cancellation

Navigator Single Quadrature Fat imaging

X No Phase Wrap

NOTE: No Phase Wrap and Flow Compensation options are only available with 3DFSE.
Flow Compensation Slice (FCs) is not available.

15-6
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

Applications
3D FSE sequences can be used to acquire heavily T2-weighted images, such as
MRCPs or myelograms with shingle shot mode. The reduced imaging times allow for
breath-hold acquisitions or free breathing techniques acquired with Respiratory
Gating/Triggering. 3D FSE may also be used for other T2 applications, such as spine
and IAC imaging.

15-7
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

3DFRFSE / 3DSSFRFSE

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 15-3, an X indicates the imaging options available for use with the
3DFRFSE / 3DSSFRFSE pulse sequences.
Table 15-3 3DFRFSE / 3DSSFRFSE Compatible Imaging Options

Imaging Options
X None Real Time

ASSET Respiratory Compensation

ASSET Calibration X Respiratory Gating/Triggering

Blood Suppression Sequential

Cardiac Gating/Triggering SmartPrep

CCOMP Spectral Spatial RF

Classic X Square Pixel

DE Prepared Tailored RF

X Extended Dynamic Range T2 Prep

X Flow Compensation X Variable Bandwidth

Fluoro Trigger ZIP x 2

fMRI ZIP x 4

Full Echo Train X ZIP 512

IR Prepared ZIP 1024

Magnetization Transfer X FSE/FIR Blurring cancellation

Multi-Phase Single Quadrature Water imaging

Multi Station Real Time Blurring Cancellation

Navigator Single Quadrature Fat imaging

X No Phase Wrap

NOTE: No Phase Wrap and Flow Compensation options are only available with
3DFRFSE.
Flow Compensation Slice (FCs) is not available.

15-8
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

Applications
SSFRFSE sequences, are most commonly used acquire T1-weighted, fat or fluid
suppressed images with reduced motion artifacts and imaging times. With shorter scan
times, breath-hold abdominal and cardiac imaging can be achieved.
The fast recovery (FR) feature is designed to enhance the intensity of fluids that have
long T2 relaxation times, while using a shortened TR time.

15-9
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

How Do I...
This section provides the step-by-step instructions for prescribing the 3DFSE,
3DSSFSE, 3DFRFSE and 3DSSFRFSE imaging pulse sequences. Specifically, it
describes how to:
• Prescribe a 3DFSE Sequence
• Prescribe a 3DFRFSE Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions.
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.

15-10
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

Prescribe a 3DFSE Sequence

The 3DFSE sequence can be used for various imaging applications to shorten the
acquisition timing for long TR T2-weighted sequences. The 3DSSFSE scanning is used
in fluid enhancement applications such as MR cholangio-pancreatography (MRCP)
studies.
The decision matrix (Table 15-4) is only for prescribing a 3DFSE sequence. The
following example protocol is for prescribing a Head T2 weighted scan with 3DFSE.
Table 15-4 3DFSE Protocol Example

3DFSE Protocol Example

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series if the
Patient Protocol window becomes active.
Patient Position

Patient Position Supine The 3DFSE pulse sequence is compatible with any
patient position and entry
Patient Entry Head First
Coil HEAD Select a coil that produces the optimum coverage and
SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

15-11
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

3DFSE Protocol Example

What You Select Selection Notes
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. Compatible

with any scan plane, except 3-Plane and Oblique. Select
the plane that best meets your clinical need.
Mode 3D Prescribes a three-dimensional sequence.
Pulse Seq FSE Activates the FSE pulse sequence. Click [Accept] to
register the selection.
Imaging Options Fast Select imaging options that optimize SNR, spatial
resolution, the number of slices, and reduce motion
artifacts. Refer to Table 15-2 for a complete list of
compatible options. Click [Accept] to register the
selections.
PSD Name N/A
Protocol N/A

15-12
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

3DFSE Protocol Example

What You Select Selection Notes
Scan Timing

# of echoes N/S
TE 100 For a T2-weighted 3D FSE image, select a TE between
the Min and Max values listed next to the TE text box. A
minimum/maximum TE is available only in Single Shot
mode.
TE2 N/A
TR 4000 Select a TR between the minimum value and 15,000 ms.
And, minimum value depends on the protocols.
Inv Time N/A
Flip Angle N/A
Echo Train Length 16 Echo Train Length is not available with single shot mode.
Bandwidth 31.25 Select a bandwidth between 2.0 and 31.2 kHz. As RBw
increases, the ESP decreases (which is desirable) and
SNR decreases. Compensate for the loss in SNR that
occurs by increasing the slice thickness or FOV.
Bandwidth 2 N/A

15-13
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

3DFSE Protocol Example

What You Select Selection Notes
Scanning Range

FOV 34 Select a FOV that covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results
in aliasing. Small FOVs increase resolution, decrease
SNR, and can increase the minimum TE value.
Slice Thickness 3 Thin slices increase resolution and decrease SNR.
Spacing 28 Select the number of location per slab based on the
anatomical coverage needed.
Start, End Locations Typically the start and end locations are programmed
from the Graphic Rx program.
# Slabs Select the number of slabs based on the anatomical
coverage needed.

15-14
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

3DFSE Protocol Example

What You Select Selection Notes
Acquisition Timing

A/P

Freq 256 Increasing the frequency matrix increases the echo

space and resolution, while decreasing SNR.
Phase 160 Phase controls scan time and resolution. The minimum
value of phase matrix is 128 and maximum value of
phase matrix is 512 for 3DFSE/3DFRFSE and 256 for
single shot mode.
NEX 1.0 Select a NEX value that produces sufficient SNR.
Phase FOV 1.0 The phase FOV range is from 0.5 to 1.0. This range of
values allows you to choose the best phase FOV to
image desired anatomy, without sacrificing too much
signal from your image.
Freq DIR A/P Typically select the default frequency direction.
Auto Center Freq Peak Select the CF peak that is set during prescan.
Flow Comp DIR N/A Flow Comp direction can only be selected when Flow
Comp is active.
Autoshim On Select Autoshim when using fat SAT or an FOV off
center, and in the first series of each examination.
Phase Correct On Phase Correct: Corrects artifacts occurring in the phase
direction. It is optional, but recommended for this
sequence.
# of Acqs/Locs Before N/A
Pause

15-15
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

3DFSE Protocol Example

What You Select Selection Notes
Additional Parameters - User CV

Slices to discard is number of kiss-off slices. Slices

Slices to discard to discard help to remove signal-loss images at out
2
(0...8) side of slab. The number of slices is calculated as
“Loca/slab”-2 x "slice to discards".
Single Shot Ky view ordering scheme acquires all
phase encoding lines (ky) in a single shot for each
SINGLE_SHOT Ky
“locs per slab” and is not interleaved with kz. The
View Ordering 0:OFF, 0
Single Shot Ky mode helps in achieving faster
1:ON
scans. Maximum Yres is 256 when Single Shot Ky
is set.
Ky fraction with
Without Single Shot mode, Ky fraction does not
SINGLE_SHOT [0.5, 0.5
work and the value is restricted to 0.5.
0.75, 1.0]
SINGLE_SHOT
Enhancement BC. Should be BC on, Ky frac=1.0,
average type BC 0
Shingle shot mode=on.
0:OFF 1:ON

15-16
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

3DFSE Protocol Example

What You Select Selection Notes
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and
cursor. remove slices. Position the slices to cover anatomy of
interest and view the Advisory Panel to note the
maximum number of slices per acquisition and the
number of acquisitions you are prescribing. The scan
time increases as the number of acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Scan [Scan] Initiates the acquisition.

15-17
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

Prescribe a 3DFRFSE Sequence

The 3D FRFSE sequence can be used for various imaging applications to shorten the
acquisition timing for long TR T2-weighted sequences. The 3DSSFRFSE scanning is
used in fluid enhancement applications such as MR cholangio-pancreatography
(MRCP) studies. And, the fast recovery (FR) feature is designed to enhance the
intensity of fluids that have long T2 relaxation times, while using a shortened TR time.
The decision matrix (Table 15-5) is only for prescribing a 3DFRFSE sequence. The
following example protocol is for prescribing MRCP with SSFRFSE.
Table 15-5 3DFRFSE / 3DSSFRFSE Protocol Example (Abdomen)

3DFRFSE (Single Shot Mode) Protocol Example

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series if the
Patient Protocol window becomes active.
Patient Position

Coil
Illustration

Open Body

Patient Position Supine A 3DFRFSE pulse sequence is compatible with any

patient position and entry.
Patient Entry Head First
Coil Open Body Select a coil that produces the optimum coverage and
SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

15-18
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

3DFRFSE (Single Shot Mode) Protocol Example

What You Select Selection Notes
Imaging Parameters

Plane Coronal Defines the scan plane of the acquisition. Compatible

with any scan plane, except 3-Plane and Oblique. Select
the plane that best meets your clinical need.
Mode 3D Prescribes a three-dimensional sequence. .
Pulse Seq FRFSE Activates the FRFSE pulse sequence. Click [Accept] to
register the selection.
Imaging Options Fast, FR Select imaging options that optimize SNR, spatial
resolution, the number of slices, and reduce motion
artifacts. Refer to Table 15-3 for a complete list of
compatible options. Click [Accept] to register the
selections.
PSD Name N/A
Protocol N/A

15-19
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

3DFRFSE (Single Shot Mode) Protocol Example

What You Select Selection Notes
Scan Timing

Maximum

# of echoes N/S
TE Maximum For a T2-weighted 3DFRFSE image, select a TE
between the Min and Max values listed next to the TE
text box. And, minimum/maximum TE is only available
with Single Shot mode.
TE2 N/A
TR 4000 Select a TR between the minimum value and 15,000 ms.
And, minimum value depends on the protocols.
Inv Time N/A
Flip Angle N/A
Echo Train Length N/A Echo Train Length is not available with single shot mode.
Bandwidth 15.6 Select a bandwidth between 2.0 and 31.2 kHz. As RBw
increases, the ESP decreases (which is desirable) and
SNR decreases. Compensate for the loss in SNR that
occurs by increasing the slice thickness or FOV.
Bandwidth 2 N/A

15-20
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

3DFRFSE (Single Shot Mode) Protocol Example

What You Select Selection Notes
Scanning Range

FOV 34 Select a FOV that covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results
in aliasing. Small FOVs increase resolution, decrease
SNR, and can increase the minimum TE value.
Slice Thickness 3 Thin slices increase resolution and decrease SNR.
Locs per Slab 28 Select the number of location per slab based on the
anatomical coverage needed.
Start, End Locations Typically the start and end locations are programmed
from the Graphic Rx program.
# Slabs Select the number of slabs based on the anatomical
coverage needed.

15-21
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

3DFRFSE (Single Shot Mode) Protocol Example

What You Select Selection Notes
Acquisition Timing

S/I

Freq 256 Increasing the frequency matrix increases the echo

space and resolution, while decreasing SNR.
Phase 160 Phase controls scan time and resolution. The minimum
value of phase matrix is 128 and maximum value of
phase matrix is 512 for 3DFSE/3DFRFSE and 256 for
single shot mode.
NEX 1.0 Select a NEX value that produces sufficient SNR.
Phase FOV 1.0 The phase FOV range is from 0.5 to 1.0. This range of
values allows you to choose the best phase FOV to
image desired anatomy, without sacrificing too much
signal from your image.
Freq DIR S/I Typically select the default frequency direction.
Auto Center Freq Peak Select the CF peak that is set during prescan.
Flow Comp DIR N/A Flow Comp is not compatible with 3DFSE-IR.
Autoshim On Select Autoshim when using fat SAT or an FOV off
center, and in the first series of each examination.
Phase Correct On Phase correct helps correct for artifacts occurring in the
phase direction. It is optional, but recommended for this
sequence.

# of Acqs/Locs Before N/A

Pause

15-22
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

3DFRFSE (Single Shot Mode) Protocol Example

What You Select Selection Notes
Additional Parameters - User CV

Slices to discard is number of kiss-off slices. Slices

Slices to discard to discard help to remove signal-loss images at out
2
(0...8) side of slab. The number of slices is calculated as
“Loca/slab”-2 x "slice to discards".
Single Shot Ky view ordering scheme acquires all
phase encoding lines (ky) in a single shot for each
SINGLE_SHOT Ky
“locs per slab” and is not interleaved with kz. The
View Ordering 0:OFF, 1
Single Shot Ky mode helps in achieving faster
1:ON
scans. Maximum Yres is 256 when Single Shot Ky
is set.
In shingle shot mode, This CV is used to set the
Ky fraction with amount of K-space to be filled in the phase
SINGLE_SHOT [0.5, 0.5 direction(Ky) for the acquisition. As the Ky fraction
0.75, 1.0] increase, SNR for the acquisition as well as scan
time will increase.
SINGLE_SHOT
Enhancement BC. Should be BC on, Ky frac=1.0,
average type BC 0
Shingle shot mode=on.
0:OFF 1:ON

15-23
© 2004 General Electric Company. All rights reserved.
 3DFSE and 3DFRFSE

3DFRFSE (Single Shot Mode) Protocol Example

What You Select Selection Notes
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and
cursor. remove slices. Position the slices to cover anatomy of
interest and view the Advisory Panel to note the
maximum number of slices per acquisition and the
number of acquisitions you are prescribing. The scan
time increases as the number of acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Scan [Scan] Initiates the acquisition.

15-24
© 2004 General Electric Company. All rights reserved.
 FRFSE

Chapter 16
FRFSE

Introduction
This chapter explains the pulsing components and timing factors directly related to the
Fast Recovery Fast Spin Echo (FRFSE) pulse sequence. This chapter explains the
concepts and the step-by-step instructions to help you learn how to:
• Prescribe a FRFSE Sequence

16-1
© 2004 General Electric Company. All rights reserved.
 FRFSE

What Do I Need to Know About...

This section presents the concepts necessary to understand FRFSE pulse sequences.
Specifically, you need to understand:
• FRFSE
– User Control Variables
– User Control Variables
• Imaging Characteristics
• Supported Features
• Applications

FRFSE
The FRFSE is available for two-dimensional (2D) or three-dimensional (3D) sequences.
The 3D FRFSE pulse sequence is built on the foundation of the 3D FSE pulse
sequence and has been developed primarily to enable high-resolution images for MR
cholangiopancreatography (MRCP) studies. For 3D FRFSE, refer to 3DFSE and
3DFRFSE.
With a basic FSE sequence, transverse magnetization is still present at the end of the
echo train. In FRFSE, the remaining transverse magnetization is refocused to the
longitudinal axis by applying a -90° pulse. By refocusing transverse magnetization in
this manner, the apparent T1 effect is shortened in protons consisting of long T2
characteristics.
Figure 16-1 FRFSE Pulse Sequence Diagram

180

90

ESP
-90

TR

16-2
© 2004 General Electric Company. All rights reserved.
 FRFSE

Figure 16-2 FRFSE Refocusing

User Control Variables

There are several User Control Variables (CV) in the FRFSE sequence. Figure 16-3
displays the User CVs screen. Table 16-1 describes each User CV.
Figure 16-3 FRFSE User CVs Screen

Table 16-1 FSE User CV Descriptions

User CV Mode Description

0= Interleaved
Acquisition Sequential is MSMG (Multi-slice multi-group) and
1 = Sequential
Order Interleaved is MSMA (multi-slice multi-angle).
Group

16-3
© 2004 General Electric Company. All rights reserved.
 FRFSE

Imaging Characteristics
FRFSE produces images that are T2-weighted with enhanced T2 components
compared to conventional FSE images. Images can be acquired with long ETLs, thus
reducing the overall image time and dramatically enhancing the signal from fluid.
Compare the contrast-to-noise ratio (CNR) in the cerebrospinal fluid (CSF) areas of the
spines in Figure 16-4. The image on the left is a conventional FSE and the image on the
right is a FRFSE.
Figure 16-4 Image Comparison of Conventional FSE and FRFSE

With the introduction of the -90° RF pulse, resulting images have less saturation effects
and more T2-weighting and improved SNR.
There are two factors you should consider when using the FRFSE sequence:
• For axial acquisitions, both superior (S) and inferior (I) SATs should be selected in
order to place a group of SAT bands at the limits of each group of slices. SAT bands
should also be concatenated.

16-4
© 2004 General Electric Company. All rights reserved.
 FRFSE

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 16-2, an X indicates the imaging options available for use with the
FRFSE pulse sequence.
Table 16-2 FRFSE Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

X Cardiac Gating/Triggering X Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

Classic Sequential

DE Prepared X Single Quadrature Fat imaging

X Extended Dynamic Range X Single Quadrature Water imaging

Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

X Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

Multi-Phase ZIP x 4

Multi Station X ZIP 512

Navigator X ZIP 1024

NOTE: The Imaging Options shown in Table 16-2 may not always be compatible with
each other.

16-5
© 2004 General Electric Company. All rights reserved.
 FRFSE

Applications
Some suggested applications for 2D FRFSE are breath-held abdominal imaging and
any area where rapid T2-weighting is desired.
Use Blurring Cancellation to minimize image ghosting. Lower TRs can be used at no
expense to CNR. This helps to reduce overall scan timing.

16-6
© 2004 General Electric Company. All rights reserved.
 FRFSE

How Do I...
This section provides the step-by-step instructions for prescribing the FRFSE imaging
pulse sequences. Specifically, it describes how to:
• Prescribe a FRFSE Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions.
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.

16-7
© 2004 General Electric Company. All rights reserved.
 FRFSE

Prescribe a FRFSE Sequence

The FRFSE sequence can be used to acquire breath-hold scans in the abdomen or any
area where rapid T2-weighting is desired.
The decision matrix (Table 16-3) is only for prescribing a 2D FRFSE sequence. The
following example protocol is for prescribing a sagittal FRFSE scan of the lumbar spine.
Table 16-3 2D FRFSE Protocol Example (Lumbar Spine)

2D FRFSE Protocol Example (Lumbar Spine)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series if the
Patient Protocol window becomes active.
Patient Position

Coil
Illustration

Patient Position Supine An FRFSE pulse sequence is compatible with any

patient position and entry.
Patient Entry Head First
Coil Lumbar CTL Allows selection of the coil from which the signal is
transmitted and received. Use a coil that produces the
optimum coverage and SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

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 FRFSE

2D FRFSE Protocol Example (Lumbar Spine)

What You Select Selection Notes
Imaging Parameters Area

Plane Oblique Defines the scan plane of the acquisition. Compatible

with any scan plane, except 3-Plane. Select the plane
that best meets your clinical need.
Mode 2D Prescribes a two-dimensional sequence. FRFSE is
compatible with 2D or 3D.
Pulse Seq FRFSE Activates the FRFSE pulse sequence. Click [Accept] to
register the selection.
Imaging Options Variable Select imaging options that optimizes SNR, spatial
Bandwidth, ZIP resolution, number of slices and reduce motion artifacts.
1024 Refer to Table 16-2 for a complete list of compatible
options. Click [Accept] to register the selections.
PSD Name N/A Refer to FSE to use fse-rpc, fse-xlc or fsec-rpc.
Protocol N/A

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 FRFSE

2D FRFSE Protocol Example (Lumbar Spine)

What You Select Selection Notes
Scan Timing

# of echoes 1 Select 1 echo or 2 echoes.

TE 35 Short TEs (Minimum or Min Full) produce PD contrast.
Long TEs (> 90) increase T2 contrast. As the TE
increases, the SNR decreases. Consider selecting an
effective TE that is close to the midpoint of the TE
Min/Max range to minimize FSE blurring.
Eff TE2 N/A Only available if 2 echoes have been selected.
TR 1675 Long TRs increase SNR, provide more slices, and
lengthen scan time. Typical value for PD contrast =
2000. Typical values for T2 contrast = 2000 to 2500.
Inv. Time N/A
Flip Angle N/A
Echo Train Length 10 Long ETLs decrease scan time and the number of slices,
while increasing edge blurring and the signal from fat.
Long ETLs also reduce Fast Recovery effect. Typical
values for PD contrast = 4 to 10. Typical values for T2
contrast = 8 to 16.
Bandwidth 31.25 As the RBw decreases, the following occurs: increased
SNR, increased chemical shift artifact, increased
minimum TE which can potentially decreases number of
slices and increased motion artifact.

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 FRFSE

2D FRFSE Protocol Example (Lumbar Spine)

What You Select Selection Notes
Bandwidth 2 N/A RBW2 is only selectable with a double echo acquisition.
Scanning Range

FOV 24 Select a FOV that covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results
in aliasing. Small FOVs increase resolution, decrease
SNR, and can increase the minimum TE value. If the
FOV is less than 16 and the Slice Thickness is less than
5, the echo spacing may increase and you may get fewer
slices per acquisition.
Slice Thickness 3 Thin slices increase resolution and decrease SNR.
Spacing 1.0 Select a spacing that reduces cross-talk between slices
(typically 20% of the slice thickness or interleave) 0
spacing is not allowed.
Start, End Locations Typically the start and end locations are programmed
from the Graphic Rx program.
# Slices 12 The maximum number of slices available is determined
by the TR, TE, SAR, and gradient stress.

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 FRFSE

2D FRFSE Protocol Example (Lumbar Spine)

What You Select Selection Notes
Acquisition Timing

S/I

Water

Freq 224 Increasing the frequency matrix increases echo spacing,

increases resolution, decreases SNR, and decreases
the number of slices. For high resolution frequency
values of 512, the echo space increases. The combined
effect of a higher echo space results in a significant
increase in TE. TE is not directly selected, but is
determined by several scan parameters, including the
frequency matrix value
Phase 224 Phase controls scan time and may control resolution.
Increasing phase steps may decrease edge blurring.
NEX 2.0 Select a NEX value that produces sufficient SNR.
Phase FOV 0.75 Select 0.75 or 0.5 to reduce phase steps and thus
decrease scan time, decreasing FOV in the phase
direction, and decreasing SNR slightly. Always use 0.75
FOV to maximize efficiency, when the FOV is large
enough to result in no phase aliasing.The phase FOV
dimension is displayed next to the phase FOV factor.
Freq DIR S/I The direction displayed is the default frequency direction
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak that is set during prescan.
Flow Comp DIR Slice Flow Comp direction can only be selected when Flow
Comp is active. The default direction is based on the
selected scan plane except with oblique which has no
default.
Autoshim On Select when using fat SAT or an FOV off center, and on
the first series of each examination.
Phase Correct On
# of Reps Before Pause Select appropriate value to insert a breathing time
between acquisitions for a multi-acquisition prescription.

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 FRFSE

2D FRFSE Protocol Example (Lumbar Spine)

What You Select Selection Notes
Additional Parameters - User CV

Acq Order 1.0 Select an acquisition order. Sequential is MSMG

(Multi-slice multi-group) and Interleaved is MSMA
(multi-slice multi-angle). MSMG prescriptions take longer
than MSMA prescriptions.
Accept [Accept] Confirms the User CV selections and closes the window.
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and
cursor. remove slices. Position the slices to cover anatomy of
interest and view the Advisory Panel to note the
maximum number of slices per acquisition and the
number of acquisitions you are prescribing. The scan
time increases as the number of acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
SAT Rx A40 SAT pulses may decrease the number of slices per
acquisition.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Scan [Scan] Initiates the acquisition.

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 FRFSE

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 GRE and SPGR

Chapter 17
GRE and SPGR

Introduction
This chapter explains the pulsing components and timing factors directly related to the
Gradient Echo (GRE) and Spoiled Gradient Echo (SPGR) pulse sequences. It explains
the concepts of each, and the step-by-step instructions to help you learn how to:
• Prescribe a GRE Sequence
• Prescribe a SPGR Sequence

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 GRE and SPGR

What Do I Need to Know About...

This section presents the concepts necessary to understand GRE and SPGR pulse
sequences. Specifically, you need to understand:
• Gradient Echo
– Imaging Characteristics
– Supported Features
– Applications
• Spoiled Gradient Echo
– Imaging Characteristics
– Supported Features
– Applications

Gradient Echo
Gradient Echo (GRE) is a pulse sequence that reverses frequency encode after RF
excitation pulse to rephase protons and form echoes. This is unlike conventional Spin
Echo (SE) imaging, which involves the use of a 180° radio frequency (RF) pulse to
refocus the echo and generally entails relatively long repetition times (TR) for
longitudinal relaxation of the spins. GRE sequences use a variable excitation pulse
(less than 90° flip angle) to create magnetization in the transverse plane, followed by a
gradient reversal frequency encode pulse, which rephases the magnetization to
produce gradient echo signals.
TE is the time between the start of the RF pulse and the maximum signal. TR is
measured from the variable excitation pulse to the next variable excitation pulse. Figure
17-1 displays the GRE pulse sequence.
Figure 17-1 GRE Pulse Sequence Diagram

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 GRE and SPGR

No. Description
1 Gradient Recalled Echo Pulse Sequence
2 Gradient Recalled Echo
3 Dephased FID
4 Frequency Gradient GX
5 Phase Gradient GY
6 2D Slice Selective Gradient GZ
7 RF excitation pulse
8 Rewinder Gradient
3D Slab Selective Gradient GZ and the slice encoding
9
gradient

GRE sequences are generally used to create images with T2* contrast.
Two-dimensional (2D) sequential or three-dimensional (3D) GRE scan times are
calculated using Equation 17-1.
Equation 17-1 2D or 3D GRE Scan Times

(TR) x (NEX) x (# Phase Steps) x (# Slice Locations)

Gradient echoes are more sensitive to any process which causes T2* dephasing, such
as static field inhomogeneties, intravoxel dephasing cancellation due to chemical shift,
and magnetic susceptibility artifacts. Depending on the TEs used, dark outlines
separate fat from other tissues. Choose TE times carefully to place fat and water in or
out of phase.
In 3D imaging, a wide RF pulse is delivered to excite an entire scan volume or slab.
Spatial encoding must then be done in the phase, frequency, and slice axes. Phase and
frequency encoding occur just as they do in 2D pulse sequences. A third slice-select
gradient is applied to create areas with a slightly different phase, relative to gradient
isocenter.
3D offers increased signal-to-noise ratio (SNR) and contiguous thin slices without
interference from crosstalk. Crosstalk affects SNR when the slice spacing is not large
enough to eliminate RF excitation effects on adjacent slices. Sequential GRE
acquisitions eliminate crosstalk because all the data for one slice location is obtained
before moving on to the next location.
Isotropic voxels are important if the data set is to be used for reformatting into additional
planes. To determine voxel size, first calculate pixel size, as shown in Equation 17-2.
Equation 17-2 Pixel Size

FOV/matrix = pixel size

FOV = 24 cm, matrix = 256x256

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 GRE and SPGR

(240 mm/256) x (240 mm/256) = 0.9 mm x 0.9 mm pixels

To achieve an isotropic voxel in this example, program a 0.9 mm slice thickness. This
results in a voxel with all dimensions (height, width, and depth) equal.

Imaging Characteristics
GRE sequences can produce T1, T2, and Proton Density (PD)-weighted images in
shorter scan times than SE and FSE. Unfortunately, they are more sensitive to
magnetic field inhomogeneties and paramagnetics than SE and FSE because of
gradient rephasing. Gradient rephasing does not eliminate the affects of T2* dephasing.
Air/tissue interfaces and bone/tissue interfaces, where tissues are magnetized to
different degrees, experience magnetic susceptibility artifacts. Possible signal voids
occur at air/tissue interfaces, for example, bowel or sinuses (due to magnetic
susceptibility), which increase as TE increases. Increasing GRE/SPGR signal can be
achieved by using a surface or extremity coil, more NEX, or 3D mode.
In GRE sequences, the TR and flip angle control the level of saturation. Fractional Echo
(Min TE) controls the level of dephasing and T2 contribution. Min TE decreases SNR
because only part of the echo is sampled. However, this is offset by an increase in SNR
resulting from decreased T2 decay and the likelihood of decreased motion and
susceptibility artifacts.There are several GRE sequences that can be acquired, they
are: 2D GRE sequential, 2D GRE non-sequential, and 3D GRE sequential.
For proper contrast weighting, use Table 17-1 to select your desired imaging
parameters.
Table 17-1 Contrast Weighting

Weighting
T1 T2 or T2* PD T2/T1
TR 200 or less 200 or less 200 or less 20 - 50
Sequential
TE min - 15 30 - 60 min - 15 min -15
Flip 45 - 90 5 - 30 5 - 30 30 - 60
TR 200 - 600 200 - 600 200 - 600
Non-Sequential TE min - 15 30 - 60 min - 15
Flip 45 - 90 5 -30 5 - 30

2D Non-sequential GRE is also called Multi-Planar Gradient Recalled (MPGR). It uses

a Multi-Planar data acquisition mode with longer TR times. The long TR times allow for
multiple slice acquisitions and through time, ruins the build up of residual transverse
magnetization. Combine the above TR and flip angles with a short TE and the result is
PD-weighted or T1-weighted images. Lengthen the TE and the result is T2-weighted
images.

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 GRE and SPGR

Several examples of GRE images are shown in Figure 17-2.

Figure 17-2 GRE Images

The images in Figure 17-2 demonstrate the different types of contrast available with the
MPGR pulse sequence. Image A shows the PD effect associated with low flip angle
MPGR. Notice the myelographic effect between the cerebrospinal fluid (CSF) and the
spinal cord and the T2* effect on the vertebral bodies. In image B, the T1-weighting is
obtained with large flip angle MPGR. Notice the darkening of the vertebral bodies (T2*
effect). Image C shows the T2 effect associated with long TE MPGR. These images
display improved T2* contrast between the CSF and spinal cord, as well as severe
darkening of the vertebral bodies due to these effects.
As a general rule, SNR within a GRE pulse sequence increases as:
• TR increases
• TE decreases
NOTE: TR and TE changes have a greater affect on SNR as compared to similar changes
in SE sequences.
Due to blood’s brightness caused by fresh flow of spins, flow motion artifacts may occur
in 2D Sequential even if Flow Compensation (FC) is used. These artifacts appear as
bright circular areas across the image in the phase direction.

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 GRE and SPGR

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. The X in Table 17-2 indicates the imaging options available for use with the GRE
pulse sequence.
Table 17-2 GRE Imaging Options

Imaging Options
X None Navigator

ASSET X No Phase Wrap

ASSET Calibration Real Time

Blood Suppression X Respiratory Compensation

X Cardiac Gating/Triggering Respiratory Gating/Triggering

X CCOMP X Sequential

Classic SmartPrep

DE Prepared Spectral Spatial RF

X Extended Dynamic Range X Square Pixel

X Flow Compensation Tailored RF

Fluoro Trigger T2 Prep

fMRI X Variable Bandwidth

Full Echo Train ZIP x 2

IR Prepared ZIP x 4

Magnetization Transfer X ZIP 512

Multi-Phase ZIP 1024

Multi Station POMP

FSE/FIR Blurring Cancellation Real Time Blurring Cancellation

Single Quadrature Water imaging Single Quadrature Fat Imaging

NOTE: The Imaging Options shown in Table 17-2 may not always be compatible with
each other.
Sequential, Cardiac Compensation (CCOMP), Respiratory Compensation,
Chem Sat, and Cardiac Gating/Triggering are not compatible with 3D GRE.

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 GRE and SPGR

Applications
GRE sequences are used to acquire quick localizers. They are used for T1, T2, and PD
contrast weighting. Typically, use a GRE pulse sequence when increased sensitivity to
paramagnetics is desired, such as when looking for iron deposits that occur with stroke.
The PD or T2* sequences can also be used to acquire images of the extremities, joints,
cartilage, and meniscus. Also, 3D GRE is used throughout the body, for thin contiguous
imaging, with increased SNR. These sequences are most useful in areas of the body
that don’t produce a lot of motion. Sequentially acquired sequences work well for
breath-holds of the chest, abdomen, and pelvis.
The use of a particular pulse sequence varies with specific patient needs and
constraints. Table 17-3 shows the most common applications for GRE sequences.
These are not to be considered recommendations by GE Medical Systems.
Table 17-3 Common Applications for GRE

2D Non-Sequential GRE
2D Sequential GRE 3D GRE
(MPGR)
PD or T2* joints, cartilage
PD or T2* breath-holds of PD or T2* thin slice, high
and meniscus, extremities,
chest, abdomen and pelvis resolution spine images
spines
Thin slice, high resolution
PD or T2* musculoskeletal Use to replace longer PD
T2* joint/musculoskeletal
images and T2 SE sequences
imaging
Abdomen and chest
Reformat into additional
imaging to obtain PD or T2*
planes to eliminate the
Quick localizers weighting with use of
need for additional
respiratory compensation
acquisitions
and gating
Imaging of cardiac phases
when used with CINE
mode

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 GRE and SPGR

Spoiled Gradient Echo

Spoiled Gradient Echo (SPGR) is a pulse sequence which employs an initial RF spoiler
gradient to destroy any residual transverse magnetization before each RF excitation.
With SPGR, T2 dependence is almost completely eliminated (although the T2*
dependence introduced between excitation and echo readout is still present). SPGR
spoiling is accomplished by adding a phase shift to each successive RF excitation
pulse. This results in shifting the residual transverse components out of phase with
each other to prevent build-up of a steady state component, thus reducing T2*
contribution. The result is excellent uniformity of contrast and less gradient stress as
compared to GRE. There are two sequences included in the SPGR family: 2D SPGR
sequential and 3D SPGR. Both produce T1 contrasted images. Figure 17-3 displays a
SPGR pulse sequence diagram.
Figure 17-3 SPGR Pulse Sequence Diagram

No. Description
1 SPGR pulse sequence diagram
2 Frequency Gradient GX
3 Phase Gradient GY
4 Slice Select Gradient GZ
5 RF excitation pulse which is phase shifted
6 Spoiler Gradient

With 2D SPGR pulse sequences, slice data is acquired sequentially, one location at a
time. Scan time represents the time it takes to gather the data for one location. If
multiple locations are prescribed, the result is a multiple acquisition. The scan time
formula is shown in Equation 17-3.
Equation 17-3 SPGR Scan Time Formula

(TR) x (NEX) x (# of Phase Steps) x (# of Slice Locations)

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 GRE and SPGR

For a 3D SPGR acquisition the formula would be the same. 3D SPGR sequences are
acquired using the same method used when acquiring a 3D GRE sequence. The entire
volume is excited and thin contiguous slices can be produced from this.

Imaging Characteristics
SPGR sequences produce T1-weighted images with relatively short scan times. A
drawback is the SPGR image is subject to air/tissue and bone/tissue interfacing
artifacts. A comparison of SPGR (on the left) and SE (on the right) images is shown in
Figure 17-4. Notice the brighter signal of the brain white matter in the SPGR image.
Figure 17-4 SPGR Image vs. SE Image

SPGR images are subject to the same magnetic susceptibility artifacts as any other
GRE sequence. However, they are excellent for demonstrating increased sensitivity to
paramagnetics such as iron deposits that occur with strokes.
The TR and flip angle play a big part in demonstrating image contrast. TR represents
the rate of the excitation pulse and the T1 relaxation time of tissue allowed to recovery.
As TR decreases, saturation and T1 effects increase. When TR is increases, saturation
and T1 effects decrease. Figure 17-5 illustrates the relationship between time and
signal intensity.
Figure 17-5 T1 Effects

Signal
Intensity
Tissues with
a shorter T1
have a stronger
signal as TR
decreases.
TR period
Time

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 GRE and SPGR

Flip angle affects the amount of recovery that occurs between each excitation pulse.
The higher the flip angle, the more saturation and T1 effects are seen in the image. The
lower the flip angle, the less saturation and T1 effects are seen in the image. Figure
17-6 helps illustrate the flip angle concept.
Figure 17-6 Flip Angle
As the flip angle increases, the nuclei have farther to
recover, and saturation effects result.

35° Flip Angle 50° Flip Angle

The axial SPGR head images in Figure 17-7 demonstrate that, at different TR times,
different flip angles results in optimal images.
Figure 17-7 SPGR Images with Different TRs and Flip Angles
(A) 24 TR and a 30° flip
(B) 24 TR and a 45° flip
(C) 50 TR and a 30° flip
(D) 50 TR and 60° flip
NOTE:At the 24 TR time, the 30° flip is
better than the same flip angle at 50 TR.

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 GRE and SPGR

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. The X in Table 17-4 indicates the imaging options available for use with the
SPGR pulse sequence.
Table 17-4 SPGR Imaging Options

Imaging Options
X None Navigator

ASSET X No Phase Wrap

ASSET Calibration Real Time

Blood Suppression X Respiratory Compensation

Cardiac Gating/Triggering Respiratory Gating/Triggering

X CCOMP X Sequential

Classic SmartPrep

DE Prepared Spectral Spatial RF

X Extended Dynamic Range X Square Pixel

X Flow Compensation Tailored RF

Fluoro Trigger T2 Prep

fMRI X Variable Bandwidth

Full Echo Train ZIP x 2

IR Prepared ZIP x 4

Magnetization Transfer X ZIP 512

Multi-Phase ZIP 1024

Multi Station POMP

FSE/FIR Blurring Cancellation Real Time Blurring Cancellation

Single Quadrature Water Imaging Single Quadrature Fat Imaging

NOTE: The Imaging Options shown in Table 17-4 may not always be compatible with
each other.
Sequential, CCOMP, Chem Sat, and Respiratory Compensation, are not
compatible with 3D SPGR.

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 GRE and SPGR

Applications
Like GRE sequences, SPGR sequences are good for quick localizers, as well as
demonstrating iron deposits on images. These sequences are most useful when a quick
T1-weighted image throughout the body is desired.
The use of a particular pulse sequence varies with specific patient needs and
constraints. Table 17-5 shows the most common applications for SPGR sequences.
These are not to be considered recommendations by GE Medical Systems.
Table 17-5 Common Applications for SPGR

2D Sequential SPGR 3D SPGR

Brain, to accentuate gray/white matter High resolution T1 joint and
contrast musculoskeletal images
Thin slice, high resolution T1 pituitary and
T1 breath-hold of abdomen and pelvis
IAC imaging
As a contrast enhanced T1 alternative Thin slice, high resolution T1 spine imaging
Reformat into additional planes to eliminate
To obtain dark CSF or bright fat
the need for additional acquisitions

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 GRE and SPGR

How Do I...
This section provides the step-by-step instructions for prescribing GRE imaging pulse
sequences. Specifically, it describes how to:
• Prescribe a GRE Sequence
• Prescribe a SPGR Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs which occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions:
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.

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 GRE and SPGR

Prescribe a GRE Sequence

The GRE sequence can be used to acquire quick localizers or T1, T2, and PD contrast
weighted scans. The PD or T2* sequences can also be used to acquire images of the
extremities, joints, cartilage, and meniscus.
The decision matrix (Table 17-6) is only for prescribing a 2D GRE scan. The following
example protocol is for prescribing a multi-planar axial knee GRE T2* scan.
Table 17-6 2D MPGR Protocol Example (Extremity)

2D Multi-Planar GRE Protocol Example (Extremity)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a Allows Graphic Rx to become available so you can

localizer series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Allows you to begin prescribing your new series when the
Position] Patient Protocol window becomes active.
Patient Information
Table Entry Center GRE is compatible with any table entry position.
Patient Position

Coil
Illustration

Large Knee

Patient Position Supine A GRE pulse sequence is compatible with any patient
position and entry.
Patient Entry Feet First
Coil Large Knee Select the coil that produces the optimum coverage and
SNR.

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 GRE and SPGR

2D Multi-Planar GRE Protocol Example (Extremity)

What You Select Selection Notes
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.
Imaging Parameters

Plane Oblique Defines the scan plane of the acquisition. 2D sequential

GRE is compatible with any scan plane, except 3-Plane.
3D GRE does not allow 3-Plane and oblique. Select the
plane which best meets your clinical needs.
Mode 2D Prescribes a two-dimensional sequence. Select 2D for a
sequential gradient echo or 3D for thin contiguous images.
Pulse Seq GRE Activates the GRE pulse sequence. Click [Accept] to
register the selection.
Imaging Options Variable Select Sequential to acquire one slice at a time. Do not
Bandwidth select Sequential for 3D nor 2D multi-planar. Select
imaging options which optimize SNR, spatial resolution,
and reduce motion artifacts. Refer to Table 17-2 for a
complete list of all compatible options. Click [Accept] to
register the selections.
PSD Name N/A
Protocol N/A

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 GRE and SPGR

2D Multi-Planar GRE Protocol Example (Extremity)

What You Select Selection Notes
Scan Timing

# of echoes 1 Only one echo is allowed for 2D sequential and 3D GRE.

Two echoes are allowed for 2D GRE multi-planar scans.
TE 15 Increase the TE to increase T2* contrast, decrease SNR,
and increase magnetic susceptibility effects. TE values
typically do not exceed 30 ms. Minimum is a fractional
echo and may compromise SNR.
TE2 N/A TE2 is selectable only with a double echo GRE
multi-planar acquisition.
TR 675 Increase the TR to increase SNR and scan time. 2D
Sequential and multi-planar values vary based on the
clinical application. Typical 3D values are 40 to 60 ms.
TI N/A
Flip Angle 20 Typical 2D Flip Angle values: 5 to 30° for T2* scan. Typical
3D flip angles range from 5 to 8°. If you decrease the flip
angle you increase T2* weighting and decrease SNR.
Echo Train Length N/A
Bandwidth 7.81 As the RBw decreases, SNR increases, chemical shift
artifact increases, and the minimum TE increases, which
can potentially decrease the number of slices and
increase motion artifact.

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 GRE and SPGR

2D Multi-Planar GRE Protocol Example (Extremity)

What You Select Selection Notes
Bandwidth 2 N/A RBw2 is only selectable with a double echo GRE
multi-planar acquisition. The value for RBw2 is for the
second echo and typically lower than RBw1.
Scanning Range

FOV 14 Select a FOV to cover the anatomy of interest. Anatomy

outside the FOV in the phase direction results in aliasing.
Small FOVs increase resolution, decrease SNR, and can
increase the minimum TE value.
Slice Thickness 4 Thin slices increase resolution and decrease SNR.
Spacing 1.0 Interslice crosstalk is eliminated on sequential gradient
echoes. Typical spacing is 0 to 20% of the slice thickness.
Start, End Locations Typically, the start and end locations are programmed from
the Graphic Rx program.
# Slices 22 For 2D MPGR, the number of slices indicates the number
of locations acquired within a single acquisition (usually).
For 2D GRE Sequential, each acquisition only acquires a
single image. Therefore, the number of slices indicates the
number of locations and acquisitions prescribed.

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 GRE and SPGR

2D Multi-Planar GRE Protocol Example (Extremity)

What You Select Selection Notes
Acquisition Timing

Freq 256 Increasing the frequency matrix increases resolution,

decreases SNR, and decreases # of slices per TR period.
Phase 224 Phase controls scan time and resolution.
NEX 2.00 Select a NEX value which produces sufficient SNR. Low
NEX values are needed for breath-hold 2D acquisitions.
Phase FOV 1.00 Select 0.75 or 0.5 to reduce phase steps and decrease
scan time, decreasing FOV in the phase direction, and
decreasing SNR slightly.
Freq DIR A/P The direction displayed is the default frequency direction
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak to be set during prescan.
Flow Comp DIR N/A Flow Comp direction can be selected only when Flow
Comp is active.
Autoshim On Select Autoshim when using fat SAT, an off-center FOV,
and on the first series of each examination.
Phase Correct N/A
# of Acqs/Locs Before None Prescribe an automatic pause in the scan for multiple
Pause location 2D sequential. Pause scanning at predetermined
points for breath-hold, joint motion, or contrast studies.

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 GRE and SPGR

2D Multi-Planar GRE Protocol Example (Extremity)

What You Select Selection Notes
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and remove
cursor. slices. Position the slices to cover anatomy of interest and,
in a 2D sequential acquisition, view the Advisory Panel to
note the maximum number of slices per acquisition. Scan
time increases as the number of acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
SAT Rx 140 SAT pulses may increase the minimum TR and TE.
S40
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the Scan Prescription window, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Downloads the series.
Scan]
Scan Operations
Scan [Scan] Initiates the acquisition.

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 GRE and SPGR

Prescribe a SPGR Sequence

The SPGR sequence can be used to demonstrate iron deposits on images or is useful
for achieving a quick T1-weighted image throughout the body.
The decision matrix (Table 17-7) is only for prescribing a SPGR scan. The following
example protocol is for prescribing a 3D SPGR brain scan.
Table 17-7 3D SPGR Protocol Example (Brain)

3D SPGR Protocol Example (Brain)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a Allows Graphic Rx to become available so you can

localizer series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Allows you to begin prescribing your new series when the
Position] Patient Protocol window becomes active.
Patient Information
Table Entry Center SPGR is compatible with any table entry position.
Patient Position

Patient Position Supine A SPGR pulse sequence is compatible with any patient
position and entry.
Patient Entry Head First
Coil Head Select the coil that produces the optimum coverage and
SNR.

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 GRE and SPGR

3D SPGR Protocol Example (Brain)

What You Select Selection Notes
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. 3D SPGR does
not allow 3-plane and oblique. Select the plane that best
meets your clinical need.
Mode 3D Prescribes a three-dimensional sequence. Select 2D for a
sequential gradient echo or 3D for thin contiguous images.
Pulse Seq SPGR Activates the SPGR pulse sequence. Click [Accept] to
register the selection.
Imaging Options Variable Select Sequential to acquire one slice at a time. Do not
Bandwidth select Sequential for 3D nor 2D multi-planar. Select
imaging options that optimize SNR, spatial resolution, and
reduce motion artifacts. Click [Accept] to register the
selections.
PSD Name N/A
Protocol N/A

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 GRE and SPGR

3D SPGR Protocol Example (Brain)

What You Select Selection Notes
Scan Timing

# of echoes 1 Only 1 echo is allowed.

TE Minimum Increase the TE to increase T2* contrast, decrease SNR,
and increase magnetic susceptibility effects. TE values
typically do not exceed 30 ms. Minimum is a fractional
echo and may compromise SNR.
TR 50
TE2 N/A
TI N/A
Flip Angle 40 Typical 2D Flip Angle values: 40 to 60°. Typical 3D flip
angles range from 25 to 45°. If you decrease the flip angle,
T2*-weighting increases and SNR decreases.
Echo Train Length N/A
Bandwidth 12.50 As the RBw decreases, the SNR, chemical shift artifact,
and minimum TE increase, which can potentially decrease
the number of slices and increase motion artifact.
Bandwidth 2 N/S

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 GRE and SPGR

3D SPGR Protocol Example (Brain)

What You Select Selection Notes
Scanning Range

FOV 16 Select a FOV that covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results in
aliasing. Small FOVs increase resolution, decrease SNR,
and can increase the minimum TE value.
Slice Thickness 2.0 Thin slices increase resolution and decrease SNR.
Locs per Slab 32 Choose the number of locations desired within each 3D
Slab.
Start, End Locations Typically, the start and end locations are programmed from
the Graphic Rx program.
# Slabs 1 Determined by the number of scan locations and the
desired range of anatomy to be covered.
Acquisition Timing

Freq 256 Increasing the frequency matrix increases resolution,

while decreasing the SNR and number of slices.
Phase 192 Phase controls scan time and may control resolution.
NEX 1.00 Select a NEX value that produces sufficient SNR. low NEX
are needed for breath-hold 2D acquisitions.

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 GRE and SPGR

3D SPGR Protocol Example (Brain)

What You Select Selection Notes
Phase FOV 1.00 Select 0.75 or 0.5 to reduce phase steps and thus
decrease scan time, decreasing FOV in the phase
direction, and decreasing SNR slightly. The phase FOV
dimension is displayed next to the phase FOV factor.
Freq DIR S/I The direction displayed is the default frequency direction
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak that is set during prescan.
Flow Comp DIR N/A Flow Comp direction can be selected only when Flow
Comp is active.
Autoshim On Select Autoshim when using fat SAT or an FOV off center,
and on the first series of each exam.
Phase Correct N/A
# of Acqs/Locs Before N/A
Pause
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and remove
cursor. slices. Position the slices to cover anatomy of interest. The
scan time increases as the number of acquisitions
increase. 3D graphic Rx can only be done in L-I-P
direction for orthogonal planes (note that oblique scan
planes are not allowed with 3D GRE).
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Downloads the series.
Scan]
Scan Operations
Scan [Scan] Initiates the acquisition.

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 Fast GRE and Fast SPGR

Chapter 18
Fast GRE and Fast SPGR

Introduction
This chapter explains the pulsing components and timing factors directly related to the
Fast Gradient Echo (Fast GRE) and Fast SPoiled Gradient Echo (Fast SPGR) pulse
sequences. This chapter explains the concepts of each and the step-by-step
instructions to help you learn how to:
• Prescribe a 2D Fast GRE Sequence
• Prescribe a 3D Fast SPGR Sequence
• Prescribe a 3D FAME Sequence

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 Fast GRE and Fast SPGR

What Do I Need to Know About...

This section presents the concepts necessary to understand Fast GRE and Fast SPGR
pulse sequences. Specifically, you need to understand:
• Fast Gradient Echo Family Basics
– Imaging Considerations
– Applications
• Fast GRE
– Imaging Considerations
– Supported Features
• Fast SPGR
– Supported Features

Fast Gradient Echo Family Basics

Fast GRE can be subdivided into two families: Fast GRE and Fast SPGR. Both
sequences use variable flip angles to excite protons, then rephases them by means of
gradients. Compared to conventional GRE/SPGR sequences, Fast GRE/SPGR
sequences use a shorter duration excitation RF pulse and a wider receive bandwidth
that shortens the duration of the readout time. This implementation allows the
prescription of shorter TRs and TEs, causing shorter total scan times.
Figure 18-1 Fast GRE Pulse Sequence Diagram

The Fast SPGR sequence plays out just as a conventional SPGR sequence with the
exception of fractional RF excitation (Alpha) pulses within the TR period.
Like GRE and SPGR, Fast GRE and Fast SPGR can be acquired by using
two-dimensional (2D) sequential, 2D multi-planar, and three-dimensional (3D)
sequences. 2D sequential is a technique that collects data one slice at a time. One

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 Fast GRE and Fast SPGR

phase encoding step is performed for one slice per TR. All phase encoding steps are
completed for a slice before additional slices are initiated. Total scan time is directly
related to the number of locations prescribed. Fast multi-plane SPGR acquires multiple
slice locations within the same TR, using longer TRs to accommodate more locations.
3D Fast SPGR and Fast GRE provide the benefits of 3D acquisition which are
increased signal-to-noise ratio (SNR) and contiguous slices without crosstalk, while still
allowing faster scan times.
The FGRE/FSPGR sequences result in reduced SNR when compared to non-fast
GRE/SPGR. The SNR decrease results from the use of: higher bandwidths, ultra-short
TR values, fractional NEX, and fractional echo.

Imaging Considerations
In the Scanning Range area, the number of reconstructed slices is the "Slice Location"
text value multiplied by the Slice ZIP factor. Although Slice ZIP is a very useful 3D scan
feature for improving resolution, it is possible to select slices that are too thick. Gibbs
ringing artifacts can result when the slice thickness gets too large (typically 2 mm or
greater in the head, or 4 mm or greater in the body). This ringing artifact can occur in
both the phase and slice direction. It is often most apparent on a reformatted image
when the artifact occurs in the slice direction. When decreasing slice thickness, the
number of discarded end slices are automatically doubled or quadrupled if you select
Slice ZIP.
ZIP 512 enhances the apparent image resolution. It can make truncation (Gibbs)
artifacts more noticeable. Increasing the phase matrix value up to 256 or decreasing the
field of view (FOV) can reduce this artifact.
A Slice ZIP x 4 only gives a marginal improvement in effective resolution over a Slice
ZIP x 2. Slice ZIP x 4 images are overlapped by 75% of the slice thickness instead of
50% of the slice thickness. The marginal improvement in the effective resolution comes
at the expense of an additional factor of 2 in reconstruction time.
Due to the short TRs used with standard Fast SPGR/GRE, saturation effects occur
resulting in a reduction in SNR and contrast-to-noise ratio (CNR). For short TRs, flip
angle must be optimized as same as Ernst angle to manipulate image contrast. Ernst
angle can be defined by cos(Ernst angle)=exp(-TR/T1).

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 Fast GRE and Fast SPGR

Effects of chemical shift may become apparent in two ways:

• With very short TEs, this occurs in an image when a voxel contains both fat and
water. If the echo is collected with fat and water in phase, the fat and water signal
combine and generate a larger signal as compared to an echo collected with fat and
water out of phase. This should not be confused with the spatial mis-registration that
occurs in spin echo images exhibiting chemical shift effects.
• The images are often characterized by a low-intensity boundary between fat and
tissues which contain mainly water. If voxels contain both fat and water, partial
voluming can occur. This can cause an almost complete signal void in these voxels.
This boundary effect can be advantageous in determining the division between
adipose tissue and pathology but disadvantageous when evaluating the boundaries
between organs. Because of this effect, the shortest TE available for the Fast
SPGR/GRE sequences may not produce the desired image contrast. Select the
shortest echo time allowed by a a TE that guarantees fat and water are in phase.
When Respiratory Trigger is on, the available imaging time is segmented by the Min
TR. It is used to acquire as many phase and slice encodings as possible that fit in the
available imaging time for one respiratory interval.

Applications
Some suggested Fast GRE and Fast SPGR are quick localizers and anywhere in the
body for producing quick T1, T2 and PD enhanced images. Fast GRE and Fast SPGR
increases sensitivity to paramagnetics, such as iron deposits. This is helpful when
imaging strokes. Use multiphase with Fast GRE and/or Fast SPGR for dynamic
contrast imaging or kinematic studies.
Table 18-1 lists applications for Fast GRE and SPGR sequences.
These are not to be considered recommendations by GE Medical Systems.

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 Fast GRE and Fast SPGR

Table 18-1 Fast GRE and SPGR Applications

Sequence Applications
• T1 and T2* Breath-hold abdomen and pelvis imaging
• Contrast enhanced T1 abdomen and pelvis
2D Sequential
• Ultra-fast localizers
Fast GRE/SPGR
• Breath-hold cardiac/aortic arch imaging when used with Fast
GRE/SPGR and gating (FastCard)
• Temporally resolved contrast studies
Multi-Phase
• Joint motion studies of the knee, TMJ, and wrist
Fast SPGR
• Flexion and Extension studies of the cervical spine
• IR: Suppresses signal from a selective tissue or organ such as the
IR Prepared
liver or spleen
Fast GRE
• IR: Free breathing abdomen
• Multiple slice locations of the abdomen or pelvis in a single
2D Multi-Planar
breath-hold
FMPFGR
FMSPGR • Contrast enhanced T1 images of the abdomen and pelvis
• To improve SNR over sequential fast sequences
• High resolution T1 or T2* joint and musculoskeletal images when
faster scan times are desired
• Reformat into multiple planes to eliminate need for additional
3D Fast acquisitions
GRE/SPGR • Breath-hold abdominal and breast imaging.
• Multi-Phase contrast enhanced volume imaging. Use Slice ZIP or
ZIP x2 or ZIP x4 to increase spatial resolution without increasing
scan time.

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 Fast GRE and Fast SPGR

Fast GRE
Fast GRE sequences produce the same image characteristics as standard gradient
sequences. The use of rewinder pulses in Fast GRE sequences generally enhance
T2-weighting within images. In T2*-weighted Fast GRE images, tissues with short T2
are dark and tissues with long T2 are bright. In the brain cerebrospinal fluid (CSF)
produces the brightest signal on moderate to late TE images. Just like standard GRE
images air-tissue and bone-tissue interfaces may have signal voids due to magnetic
susceptibility artifacts.
If excessive ghosting is present within a 3D Fast GRE/SPGR image when using 1 NEX
and No Phase Wrap (NPW), increase the NEX to 2 to help eliminate it.
Figure 18-2 Fast GRE Axial Brain

Imaging Considerations
Fast GRE contrast may be manipulated with the use of Magnetic Resonance Imaging
(MRI) contrast agents or the available tissue preparation sequences.
When using Respiratory Triggering with Fast Spin Echo (FSE), the available imaging
time is used to collect data from all of the slices (TR time). In Fast GRE 3D, the
available imaging time is segmented by the Min TR (set by selected imaging
parameters). It is used to acquire as many phase and slice encodings as possible that
fit in the available imaging time for one respiratory interval. Because the 3D data set is
acquired over multiple respiratory intervals, use a larger trigger window (~60%) so as
much data as possible is acquired between respiration. This is done to minimize
respiratory motion.

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 Fast GRE and Fast SPGR

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 18-2 and Table 18-3, an X indicates the imaging options available for
use with the 2D Fast GRE and 3D Fast GRE pulse sequence.
Table 18-2 2D Fast GRE Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration X Real Time

Blood Suppression Real Time Blurring Cancellation

X Cardiac Gating/Triggering Respiratory Compensation

X CCOMP Respiratory Gating/Triggering

Classic X Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

X IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

X Multi-Phase ZIP x 4

Multi Station X ZIP 512

Navigator ZIP 1024

NOTE: The Imaging Options shown in Table 18-2 may not always be compatible with
each other.
IR Prepared and Multi Phase are only available if Sequential is selected first.

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 Fast GRE and Fast SPGR

Table 18-3 3D Fast GRE Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Real Time Blurring Cancellation

X Cardiac Gating/Triggering Respiratory Compensation

CCOMP X Respiratory Gating/Triggering

Classic Sequential

DE Prepared X Single Quadrature Fat Imaging

X Extended Dynamic Range X Single Quadrature Water Imaging

Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

X IR Prepared X Variable Bandwidth

Magnetization Transfer X ZIP x 2

X Multi-Phase X ZIP x 4

X Multi Station X ZIP 512

Navigator X ZIP 1024

NOTE: The Imaging Options shown in Table 18-3 may not always be compatible with
each other.

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 Fast GRE and Fast SPGR

Fast SPGR
Spoiler pulses are used in Fast SPGR sequences to enhance T1-weighting in images.
Tissues with short T1 are bright and tissues with long T1 are dark. For Fast SPGR
images in the brain, white matter is brighter then gray matter and CSF is dark.
Figure 18-3 Fast SPGR Axial Brain

Increasing NEX to improve SNR may not be an option when using a Fast SPGR pulse
sequence because of the resulting increase in scan time. However, the multi-planar
option can be used to improve SNR with Fast SPGR.

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 Fast GRE and Fast SPGR

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 18-4 and Table 18-5, an X indicates the imaging options available for
use with the 2D Fast SPGR and 3D Fast SPGR pulse sequences.
Table 18-4 2D Fast SPGR Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration X Real Time

Blood Suppression Real Time Blurring Cancellation

X Cardiac Gating/Triggering Respiratory Compensation

X CCOMP Respiratory Gating/Triggering

Classic X Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

X IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

X Multi-Phase ZIP x 4

Multi Station X ZIP 512

Navigator ZIP 1024

NOTE: The Imaging Options shown in Table 18-4 may not always be compatible with
each other.
IR Prepared and Multi Phase are only available if Sequential is selected first.

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 Fast GRE and Fast SPGR

Table 18-5 3D Fast SPGR Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Real Time Blurring Cancellation

X Cardiac Gating/Triggering Respiratory Compensation

CCOMP X Respiratory Gating/Triggering

Classic Sequential

DE Prepared X Single Quadrature Fat Imaging

X Extended Dynamic Range X Single Quadrature Water Imaging

Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

X IR Prepared X Variable Bandwidth

Magnetization Transfer X ZIP x 2

X Multi-Phase X ZIP x 4

X Multi Station X ZIP 512

Navigator X ZIP 1024

NOTE: The Imaging Options shown in Table 18-5 may not always be compatible with
each other.

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 Fast GRE and Fast SPGR

How Do I...
This section provides the step-by-step instructions for prescribing Fast GRE and Fast
SPGR imaging pulse sequences. Specifically, it describes how to:
• Prescribe a 2D Fast GRE Sequence
• Prescribe a 3D Fast SPGR Sequence
• Prescribe a 3D FAME Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions.
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.

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 Fast GRE and Fast SPGR

Prescribe a 2D Fast GRE Sequence

The 2D Fast GRE/SPGR sequence can be used to acquire ultra-fast localizers and T1
and T2* body images. This sequence can also be performed with the patient holding his
or her breath during abdominal imaging.
The decision matrix (Table 18-6) is only for prescribing a 2D Fast GRE scan. The
following example protocol is for prescribing an axial 2D Fast GRE of the lumbar spine.
Table 18-6 2D Fast GRE Protocol Example (Axial Lumbar Spine)

Fast GRE Protocol Example (Axial Lumbar Spine)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Allows you to begin prescribing your new series if the
Position] Patient Protocol window becomes active.
Patient Position

Coil
Illustration

Patient Position Supine A Fast GRE or Fast SPGR pulse sequence is compatible
with any patient position and entry.
Patient Entry Head First
Coil Lumbar CTL Allows selection of the coil from which the signal is
transmitted and received. Use a coil that produces the
optimum coverage and SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

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 Fast GRE and Fast SPGR

Fast GRE Protocol Example (Axial Lumbar Spine)

What You Select Selection Notes
Imaging Parameters

Plane Oblique Defines the scan plane of the acquisition. 2D Fast GRE is
compatible with any scan plane, except 3-Plane. Select
the plane that best meets your clinical need.
Mode 2D Prescribes a two-dimensional sequence. Select 2D for a
sequential acquisition or 3D for thin contiguous images.
Pulse Seq Fast GRE Activates the Fast GRE pulse sequence for a T1 contrast
appearance. Select Fast GRE for T2* image contrast.
Click [Accept] to register the selection.
Imaging Options Flow Comp, No Select imaging options that optimize SNR, Spatial
Phase Wrap resolution, and reduce motion artifacts. Click [Accept] to
register the selections.
PSD Name N/A
Protocol N/A

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 Fast GRE and Fast SPGR

Fast GRE Protocol Example (Axial Lumbar Spine)

What You Select Selection Notes
Scan Timing

NOTE: The maximum time most patients can hold their breath is 20 to 25 seconds. Keep this in
mind when selecting parameters that affect scan time, if performing a breath-hold
sequence.
# of echoes N/S Only 1 echo is allowed.
TE Min Full Short TEs increase T1 contrast and SNR. Increase the TE
to increase the T2* contrast and the magnetic
susceptibility effects, while decreasing the SNR and signal
changes at fat/water interfaces. Longer TEs are
compatible with narrower RBws. Wide RBw and fractional
echo may decrease SNR.
TR 400 Short TRs decrease SNR and scan time, while increasing
the T1 contrast. Long TRs increase SNR and scan time.
2D Fast Multi-Plane SPGR for T1 contrast uses longer
TRs (60 to 100 ms) and allows larger flip angles (40 to
60°), which can improve SNR.

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Fast GRE Protocol Example (Axial Lumbar Spine)

What You Select Selection Notes
Prep Time N/A Prep Time only appears if IR Prep is selected. Prep time is
available when IR prep pulse is being used. This sets the
time between the last prep pulse and the RF excitation
pulse for IR. Tissue contrast varies as inversion time
varies.
IR Prep Time Tissue Suppressed
200-400 Liver
80-130 Fat
400-600 Spleen
700-800 CSF

TI2 N/A
Flip Angle 20 Given a constant TR (200 - 400 ms), increasing the flip
angle increases T1-weighting. Typical 2D flip angle values
are 20 to 30°. Typical 3D values range from 40 to 60°.
Decreasing the flip angle, increases T2*-weighting and
decreases SNR.
Echo Train Length N/A
Bandwidth 20.83 As the RBw decreases, the SNR increases, chemical shift
artifact increases, and the minimum TE increases, which
can potentially decrease the number of slices and
increase motion artifact. Generally, wider bandwidths are
used with fast sequences to keep minimum TEs and TRs.
Bandwidth 2 N/A
Scanning Range

FOV 36 Select a FOV that covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results in
aliasing. Small FOVs increase resolution, decrease SNR,
and can increase the minimum TE value.
Slice Thickness 7 Thin slices increase resolution and decrease SNR.
Spacing 1.0 Interslice crosstalk is eliminated on sequential gradient
echoes. Typical spacing is 0 to 20% of the slice thickness.

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Fast GRE Protocol Example (Axial Lumbar Spine)

What You Select Selection Notes
Start, End Locations Typically the start and end locations are programmed from
the Graphic Rx program.
# Slices 12 Sequential scans one slice per acquisition. The number of
slices actually indicates the number of locations
prescribed and the number of acquisitions.
Acquisition Timing

Freq 256 As the Frequency matrix increases, resolution increases,

SNR decreases, and minimum TR and TE values
increase. A frequency matrix from 128 to 512 can be
selected in increments of 32.
Phase 224 Phase controls scan time and may control resolution.
NEX 2.00 Select a NEX value that produces sufficient SNR.
Breath-hold acquisitions may require lower NEX values to
decrease scan time. SNR also decreases.
Phase FOV N/S A PFOV less than 1 (range from 0.5 to 1.0) can be
selected if it does not result in anatomy outside the PFOV.
The selected value is rounded to the nearest 1/16 FOV.
Freq DIR R/L The direction displayed is the default frequency direction,
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak that is set during prescan.
Flow Comp DIR N/A
Autoshim On Select Autoshim when using fat SAT or an FOV off center,
and on the first series of each exam.
Phase Correct N/S

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 Fast GRE and Fast SPGR

Fast GRE Protocol Example (Axial Lumbar Spine)

What You Select Selection Notes
# of Acqs/Locs Before N/S If the slice number you prescribe results in multiple
Pause acquisitions, you can program a pause time to allow the
patient to breathe. This is not available if a value other
than Minimum is selected at the Multi-Phase screen.
Pause scanning at predetermined points for breath-hold,
joint motion, or contrast time resolved studies.

Additional Parameters- Multi Phase

Phases per Location 3 Phases per Location: Enter the number of images/phases
desired at each prescribed location at the Phases per
Location text box. (Slices/Location) x (Number of
Slices)cannot exceed 512.
Phases Acquisition Interleave Phases Acquisition Order: Select Interleave to obtain the
Order first "phase" at each location, followed by the second
phase at each location and so on. Select Sequential to
obtain all images fro the first location before moving on to
the next locations. Select Rapid Frame to obtain kinematic
or DSA images.

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 Fast GRE and Fast SPGR

Fast GRE Protocol Example (Axial Lumbar Spine)

What You Select Selection Notes
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and remove
cursor. slices. Position the slices to cover anatomy of interest and
in a 2D sequential acquisition, view the Advisory Panel to
note the maximum number of slices per acquisition and
the number of acquisitions you are prescribing. The scan
time increases as the number of acquisitions increase.
The width of the tick line represents the number of slices
prescribed, which includes the discard slices.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
SAT Rx A
P
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Downloads the series.
Scan]
Scan Operations
Scan [Scan] Initiates the acquisition.

Rapid Frame
Rapid Frame is used primarily for kinematic or DSA imaging. Rapid Frame employs
data sharing in centric K-space to decrease acquisition time for each image (frame).
Lines of k-space are shared (copied) with the next image or frame to reduce the time
required to complete data acquisition for each image.
K-space is divided into 1, 2, 3 or 4 segments depending on [Number of Segments]
value selected from the [Multi-Phase] in Additional Parameters window.
All of K-space is collected for the first frame. For each subsequent frame, the center of
K-space is collected and one of the segments. The remaining data needed to fill
K-space is copied from the prior frame.

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 Fast GRE and Fast SPGR

Data is collected in a centric fashion starting with high frequency phase encoding steps
and filling center last.

Data acquisition for a Rapid Frame acquisition with 2 segments selected is as seen in
diagram below:

Rapid Frame is enabled by selecting 2D, Fast GRE or Fast SPGR pulse sequence with
Sequential and Multi-Phase imaging options turned on. Select [Rapid Frame] as the
Phase Acquisition Order on the Multi-Phase pop-up window.

Considerations:
• Fractional NEX or multi NEX is available. When selecting [No Phase Wrap], odd
NEX cannot be used.
• As the number of segments increases, image blurring increases.
• Frame rate in seconds per frame is displayed near ÅgActual EndÅh in the Scanning
Range window.
• Maximum slice thickness is 100 mm.
• As the number of segments increases, frame rate and temporal resolution are
increased. As the data from K-space is collected from acquisitions at different time
frames producing combined images, ghosting may occur due to nonconsecutive
data.
• Two or three segmentations are recommended.

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 Fast GRE and Fast SPGR

Prescribe a 3D Fast SPGR Sequence

Fast GRE and Fast SPGR sequences are helpful when imaging strokes due to
increased sensitivity to paramagnetics, such as iron deposits. These sequences can
also be used to acquire fast. high resolution T1 or T2* joint and musculoskeletal images
and breath-hold abdominal and breast imaging.
The decision matrix (Table 18-7) is only for prescribing a 3D Fast GRE/SPGR scan.
The following example protocol is for prescribing a coronal 3D Fast SPGR of the brain.
Table 18-7 3D Fast SPGR Protocol Example (Brain)

3D Fast SPGR Protocol Example (Brain)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Allows you to begin prescribing your new series if the
Position] Patient Protocol window becomes active.
Patient Position

Patient Position Supine A Fast GRE or Fast SPGR pulse sequence is compatible
with any patient position and entry.
Patient Entry Head First
Coil Head Allows selection of the coil from which the signal is
transmitted and received. Use a coil that produces the
optimum coverage and SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

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 Fast GRE and Fast SPGR

3D Fast SPGR Protocol Example (Brain)

What You Select Selection Notes
Imaging Parameters

Plane Coronal Defines the scan plane of the acquisition. Select the plane
that best meets your clinical need.
Mode 3D Prescribes a three-dimensional sequence. Select 2D for a
sequential acquisition or 3D for thin contiguous images.
Pulse Seq Fast SPGR Activates the Fast SPGR pulse sequence for a T1 contrast
appearance. Select Fast GRE for T2* image contrast.
Click [Accept] to register the selection.
Imaging Options Fast Multi-Phase can be selected to acquire multiple images at
the same location for temporal resolution. Sequential must
be selected for Multi-Phase acquisitions. Select a Prep
pulse with a Fast GRE sequential pulse sequence to vary
the contrast effects: IR Prepared to obtain T1 weighting.
Select ZIP512 to improve in-plane resolution with a
minimal decrease in SNR, but with a trade-off in
reconstruction time and disc storage (the image is stored
as a 512x512 slice image data set). Select a Slice ZIP
factor to increase the number of slices (by a factor of 2 or
4), without increasing the scan time. For example, with a
ZIP x 2, the slices are overlapped by half the slice
thickness. Select imaging options that optimize SNR,
spatial resolution, and reduce motion artifacts. Click
[Accept] to register the selections.
PSD Name N/A
Protocol N/A

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 Fast GRE and Fast SPGR

3D Fast SPGR Protocol Example (Brain)

What You Select Selection Notes
Scan Timing

# of echoes 1 Only 1 echo is allowed.

TE Minimum Short TEs increase T1 contrast and SNR. Increase the TE
to increase the T2* contrast and the magnetic
susceptibility effects, while decreasing the SNR and signal
changes at fat/water interfaces. Longer TEs are
compatible with narrower RBws. Wide RBw and fractional
echo may decrease SNR.
TR 30 TR is not selectable with Tissue Prepared.
Prep Time N/A Prep Time only appears if IR Prep are selected. Prep time
is available when IR Prep pulse is being used. This sets
the time between the last prep pulse and the RF excitation
pulse for IR. Tissue contrast varies as inversion time
varies.
TI2 N/A
Flip Angle 30 T1 Contrast: Middle flip angles can be used when paired
with short TR and TE. Typical values range from 30 to 60.
T2* Contrast: lower flip angles can be used when paired
with long TR and TE. Typical 3D flip angles range from 5
to 15. If you decrease flip angle, you increase
T2*-weighting and decrease SNR.
Echo Train Length N/A

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 Fast GRE and Fast SPGR

3D Fast SPGR Protocol Example (Brain)

What You Select Selection Notes
Bandwidth 31.25 As the RBw decreases, the SNR increases, chemical shift
artifact increases, and the minimum TE increases, which
can potentially decrease the number of slices and
increase motion artifact. Generally, wider bandwidths are
used with fast sequences to keep minimum TEs and TRs.
Bandwidth 2 N/A
Scanning Range

FOV 22 Select a FOV that covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results in
aliasing. Small FOVs increase resolution, decrease SNR,
and can increase the minimum TE value.
Slice Thickness 3.0 Thin slices increase resolution and decrease SNR.
Locs per Slab 40 Choose the number of locations desired within each 3D
Slab. Increasing the locations per slab in the volume
increases SNR, scan time, and range of coverage. No
interscan spacing is required with 3D.
Start, End Locations Start and end locations are programmed from the Graphic
Rx program when the 3D box is deposited. 3D explicit or
graphic Rx can be done in either L-I-P or R-S-A direction.
# Slabs 1 Determined by the number of scan locations and the
desired range of anatomy to be covered. If Slice ZIP is
turned on, multi-slab is not compatible.

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 Fast GRE and Fast SPGR

3D Fast SPGR Protocol Example (Brain)

What You Select Selection Notes
Acquisition Timing

Freq 256 As the Frequency matrix increases, resolution increases,

SNR decreases, and minimum TR and TE values
increases. A frequency matrix from 128 to 512 can be
selected in increments of 32.
Phase 192 Phase controls scan time and resolution.
NEX 1.00 Select a NEX value that produces sufficient SNR.
Breath-hold acquisitions may require lower NEX values to
decrease scan time. SNR also decreases.
Phase FOV 1.00 A PFOV less than 1 (range from 0.5 to 1.0) can be
selected if it does not result in anatomy outside the PFOV.
The selected value is rounded to the nearest 1/16 FOV.
Freq DIR S/I The direction displayed is the default frequency direction,
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak that is set during prescan.
Flow Comp DIR N/A
Autoshim On Select Autoshim when using fat SAT or an FOV off center,
and on the first series of each exam.
Phase Correct N/A
# of Acqs/Locs Before None If the slice number you prescribe results in multiple
Pause acquisitions, you can program a pause time to allow the
patient to breathe. This is not available if a value other
than Minimum is selected at the Multi-Phase screen.
Pause scanning at predetermined points for breath-hold,
joint motion, or contrast time resolved studies.
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.

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 Fast GRE and Fast SPGR

3D Fast SPGR Protocol Example (Brain)

What You Select Selection Notes
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and remove
cursor. slices. Position the slices to cover anatomy of interest.
The scan time increases as the number of acquisitions
increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Downloads the series.
Scan]
Scan Operations
Scan [Scan] Initiates the acquisition.

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 Fast GRE and Fast SPGR

Prescribe a 3D FAME Sequence

A rapid 3D T1-weighted acquisition technique, Fast Acquired Multi-phase Enhanced
Fast GRE (FAME), can be used to acquire full coverage abdomen scans. This 3D
sequence is a Fast SPGR with Slice ZIP interpolation.
The decision matrix (Table 18-7) is only for prescribing a 3D FAME scan. The following
example protocol is for prescribing an axial 3D FAME of the abdomen.
Table 18-8 3D FAME Protocol Example

3D FAME Protocol Example (Abdomen)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Allows you to begin prescribing your new series if the
Position] Patient Protocol window becomes active.
Patient Position

Coil
Illustration

Patient Position Supine A Fast GRE or Fast SPGR pulse sequence is compatible
with any patient position and entry.
Patient Entry Feet First
Open Body Allows selection of the coil from which the signal is
Coil transmitted and received. Use a coil that produces the
optimum coverage and SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

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 Fast GRE and Fast SPGR

3D FAME Protocol Example (Abdomen)

What You Select Selection Notes
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. Select the plane
that best meets your clinical need.
Mode 3D Prescribes a three-dimensional sequence. Select 2D for a
sequential acquisition or 3D for thin contiguous images.

Pulse Seq Fast TOF SPGR Activates the Fast TOF SPGR pulse sequence for a T1
contrast appearance. Click [Accept] to register the
selection.
Imaging Options Fast, Variable Select a Slice ZIP factor to increase the number of slices
Bandwidth, (by a factor of 2 or 4), without increasing the scan time.
ZIP x 2, For example, with a ZIP x 2, the slices are overlapped by
MultiPhase half the slice thickness. Select Multi Phase if acquiring
multiple phases of the same location. Select imaging
options that optimize SNR, spatial resolution, and reduce
motion artifacts. Click [Accept] to register the selections.
PSD Name N/A
Protocol N/A

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 Fast GRE and Fast SPGR

3D FAME Protocol Example (Abdomen)

What You Select Selection Notes
Scan Timing

# of echoes 1 Only 1 echo is allowed.

TE Minimum Short TEs increase T1 contrast and SNR. Increase the TE
to increase the T2* contrast and magnetic susceptibility
effects, while decreasing the SNR and signal changes at
fat/water interfaces. Longer TEs are compatible with
narrower RBws. Wide RBw and fractional echo may
decrease SNR.
TR N/S
TI2 N/A
Flip Angle 30 Middle flip angles can be used when paired with short TR
and TE to produce a T1-weighted contrast.
Echo Train Length N/A
Bandwidth 15.63 As the RBw decreases, the SNR, chemical shift artifact,
and the minimum TE increase, which can potentially
decrease the number of slices and increase motion
artifact. Generally, wider bandwidths are used with fast
sequences to keep minimum TEs and TRs.

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 Fast GRE and Fast SPGR

3D FAME Protocol Example (Abdomen)

What You Select Selection Notes
Scanning Range

FOV 40 Select a FOV that covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results in
aliasing. Small FOVs increase resolution, decrease SNR,
and can increase the minimum TE value.
Slice Thickness 6 Thin slices increase resolution and decrease SNR.
Locs per Slab 20 Choose the number of locations desired within each 3D
Slab. Increasing the locations per slab in the volume
increases SNR, scan time, and range of coverage. No
interscan spacing is required with 3D.
Start, End Locations Start and end locations are programmed from the Graphic
Rx program when the 3D box is deposited. 3D explicit or
graphic Rx can be done in either L-I-P or R-S-A direction.
# Slabs 1 Determined by the number of scan locations and the
desired range of anatomy to be covered. If Slice ZIP is
turned on, multi-slab is not compatible.

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 Fast GRE and Fast SPGR

3D FAME Protocol Example (Abdomen)

What You Select Selection Notes
Acquisition Timing

Freq 256 As the Frequency matrix increases, resolution increases,

SNR decreases, and minimum TR and TE values
increases. A frequency matrix from 128 to 512 can be
selected in increments of 32.
Phase 160 Phase controls scan time and resolution.
NEX 1.00 Select a NEX value that produces sufficient SNR.
Breath-hold acquisitions may require lower NEX values to
decrease scan time. SNR also decreases.
Phase FOV 1.00 A PFOV less than 1 (range from 0.5 to 1.0) can be
selected if it does not result in anatomy outside the PFOV.
The selected value is rounded to the nearest 1/16 FOV.
Freq DIR R/L The direction displayed is the default frequency direction,
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak that is set during prescan.
Flow Comp DIR N/A
Autoshim On Select Autoshim when using fat SAT or an FOV off center,
and on the first series of each exam.
Phase Correct N/A
# of Acqs/Locs Before If the slice number you prescribe results in multiple
Pause acquisitions, you can program a pause time to allow the
patient to breathe. This is not available if a value other
than Minimum is selected at the Multi-Phase screen.
Pause scanning at predetermined points for breath-hold,
joint motion, or contrast time resolved studies.

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 Fast GRE and Fast SPGR

3D FAME Protocol Example (Abdomen)

What You Select Selection Notes
Additional Parameters - User CVs

Reverse Elliptical 0.00 Fills k-space from the outside to the center of the volume.
Centric The advantage of using this ordering technique is that you
start scanning before the contrast arrives to the area.
Elliptical Centric 0.00 Acquires contrast sensitive information (center lines)
simultaneously in the Ky and the Kz axes, in a very short
period of time, at the beginning of the sequence.
Centric 0.00 Fills k-space by starting at the center and working
outward, while alternating between positive and negative
gradient values. The sequence acquires the contrast
sensitive information along the Ky axis at the beginning of
the scan, then the higher spatial resolution data.
Reverse Centric 0.00 Allows you to start the scan acquisition at the first station
even before you begin the contrast injection. This is due to
the contrast being in the vascular system for a shorter
period of time.
Accept [Accept] Confirms your User CV selections and closes the window.

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 Fast GRE and Fast SPGR

3D FAME Protocol Example (Abdomen)

What You Select Selection Notes
Additional Parameters - Multi-Phase

Phases per Location 5 Phases per Location: Enter the number of images/phases
desired at each prescribed location at the Phases per
Location text box. (Slices/Location) x (Number of Slices)
cannot exceed 512.
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and remove
cursor. slices. Position the slices to cover anatomy of interest.
The scan time increases as the number of acquisitions
increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
SPECIAL Special Select SPECIAL to apply fat suppression.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.

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 Fast GRE and Fast SPGR

3D FAME Protocol Example (Abdomen)

What You Select Selection Notes
Additional Parameters - Image Enhance Options

SCIC None
Filter Choise None
Accept [Accept] Confirms your selection and closes the Image Enhance
Options window.

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 Fast GRE and Fast SPGR

3D FAME Protocol Example (Abdomen)

What You Select Selection Notes
Additional Parameters - Vascular Time of Flight

Projection Image 0 Set projection images to 0 if using 3D Fast TOF SPGR.

Collapse Off Turn off Collapse if using 3D Fast TOF SPGR.
Accept [Accept] Confirms your selections and closes the Vascular Time of
Flight window.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Downloads the series.
Scan]
Scan Operations
Scan [Scan] Initiates the acquisition.

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 Fast GRE and Fast SPGR

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 3D SSFP

Chapter 19
3D SSFP

Introduction
This chapter explains the 3D Steady State Free Precession (3DSSFP) that produces
heavy T2-weighted images by generating gradient-refocused spin echoes rather than
gradient-refocused FIDs. It explains the concepts of each, and the step-by-step
instructions to help you learn how to:
• Prescribe a 3D SSFP Sequence

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 3D SSFP

What Do I Need to Know About...

This section presents the concepts necessary to understand 3D SSFP. Specifically, you
need to understand:
• 3DSSFP Basics
– Background
– Apprications
– Considerations
– Supported Features

3DSSFP Basics
Steady State Free Precession (SSFP) is a 3D acquisition technique that produces
heavy T2-weighted images by generating gradient-refocused spin echoes rather than
gradient-refocused FIDs.

TR

The type-in for Steady State Free Precession is SSFP and is not case sensitive.
Images are annotated mode/SSFP/flip angle.

Background
The foundation of SSFP lies in the fact that all RF pulses have some 90, and
180-degree componets.The 90-degree component moves the magnetization into the
transverse plane, and the 180-degree component causes a limited amount of
refocusing. After any two pulses, whether two 90-degree pulses, an echo can be
created.
At time zero, an excitation pulse is applied, and time TR, that excitation pulse is
repeated. This second excitation pulse refocuses the FID created by the first excitation
pulse, and an echo appears. The echo occurs at 2x TR, which is inconvenient because

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 3D SSFP

the third excitation pulse needs to shift the formation of the echo and makes the
refocusing occur before the third excitation pulse. The amount the echo is shifted from
the third RF pulse can be calculated by using the following formula: 2xTR-TE. The
gradient refocusing introduces some sensitivity to susceptibility and chemical shift and
inhomogeneity artifacts, which are reduced because of the RF pulse used to refocus
the spins.
SSFP uses short TRs, shorter than the T2 of the tissues, and small to medium flip
angles, both of which create a steady state of transverse magnetizatioin and decrease
the T1 component. The amplitude difference between the steady-state FID and the
steady-state echo is the T2 decay, which has occured between the FID and echo.

SSFP results in heavy T2-weighting due to the long TE, and reduced magnetic
susceptibility and chemical-shift artifacts in comparison to T2*-weighted Gradient
Echoes.
SSFP relies on the formation of a steady state. Non-steady state tissues, like those
associated with flow, will have a different appearance depending upon the anatomical
area. For the high velocity flow found in arteries, there may be a signal void attributed to
high-velocity signal loss; for slower flow, there may be some brightening, some signal
loss and some phase smearing. In the case of CSF, the intensity may vary due to
varying rates of motion and flow.

Apprications
SSFP can be used for:
• Studies of the joints in the sagittal and coronal planes.
• Heavy T2-weighted studies for the head.

Considerations
• SSFP is very sensitive to flow and motion. Flow Compensation is automatically built
into the 3D SSFP pulse sequence in the frequency direction.
• TE selections are [Minimum] and [Min Full]. TE is calculated by the system based
on TR and other imaging parameters selected.
• SNR may be reduced in long-TR, heavily T2-weighted images.
• More sensitive to flow than other pulse sequences.

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 3D SSFP

• With a low flip angle in an SSFP study, the images may exhibit low SNR with a very
high signal from fluid. The result can be high contrast-to-noise between anatomical
structures, for example, between the knee and fluid.

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. The X in Table 19-1 indicates the imaging options available for use with the
SSFP pulse sequence.
Table 19-1 SSFP Imaging Options

Imaging Options
X None Navigator

ASSET X No Phase Wrap

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

Cardiac Gating/Triggering Respiratory Gating/Triggering

CCOMP Sequential

Classic SmartPrep

DE Prepared Spectral Spatial RF

X Extended Dynamic Range X Square Pixel

Flow Compensation Tailored RF

Fluoro Trigger T2 Prep

fMRI X Variable Bandwidth

Full Echo Train ZIP x 2

IR Prepared ZIP x 4

Magnetization Transfer X ZIP 512

Multi-Phase ZIP 1024

Multi Station POMP

FSE/FIR Blurring Cancellation Real Time Blurring Cancellation

Single Quadrature Water imaging Single Quadrature Fat Imaging

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 3D SSFP

How Do I...
This section provides the step-by-step instructions for prescribing 3DSSFP imaging
pulse sequences. Specifically, it describes how to:
• Prescribe a 3D SSFP Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs which occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions:
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.

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 3D SSFP

Prescribe a 3D SSFP Sequence

The 3D SSFP sequence can be used to produce heavy T2-weighted images by
generating gradient-refocused spin echoes rather than gradient-refocused FIDs.
Table 19-2 3D SSFP Protocol Example

3D SSFP Protocol Example

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a Allows Graphic Rx to become available so you can

localizer series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Allows you to begin prescribing your new series when the
Position] Patient Protocol window becomes active.
Patient Information
Table Entry Center 3D SSFP is compatible with any table entry position.
Patient Position

Coil
Illustration

Patient Position Supine A 3D SSFP pulse sequence is compatible with any patient
position and entry.
Patient Entry Feet First
Coil Large Knee Select the coil that produces the optimum coverage and
SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

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 3D SSFP

3D SSFP Protocol Example

What You Select Selection Notes
Imaging Parameters

Plane Coronal Defines the scan plane of the acquisition. 3D SSFP does
not allow oblique and 3-Plane. Select the plane which best
meets your clinical needs.
Mode 3D Prescribes a three-dimensional sequence.
Pulse Seq SSFP Activates the SSFP pulse sequence. Click [Accept] to
register the selection.
Imaging Options Variable Select Sequential to acquire one slice at a time. Do not
Bandwidth select Sequential for 3D nor 2D multi-planar. Select
imaging options which optimize SNR, spatial resolution,
and reduce motion artifacts. Refer to Table 19-1 for a
complete list of all compatible options. Click [Accept] to
register the selections.
PSD Name N/A
Protocol N/A

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 3D SSFP

3D SSFP Protocol Example

What You Select Selection Notes
Scan Timing

# of echoes 1 Only one echo is allowed for 3D SSFP.

TE Mimimum Only MinFull and Minimum TE is allowed. Minimum is a
fractional echo and may compromise SNR.
TE2 N/A
TR N/A TR is calculated automatically based on other imaging
parameters selected.
TI N/A
Flip Angle 70 Typical flip angles range from 60 to 80°.
Echo Train Length N/A
Bandwidth 12.50 As the RBw decreases, SNR increases, chemical shift
artifact increases, and the minimum TE increases, which
can potentially decrease the number of slices and
increase motion artifact.
Bandwidth 2 N/A

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 3D SSFP

3D SSFP Protocol Example

What You Select Selection Notes
Scanning Range

FOV 14 Select a FOV to cover the anatomy of interest. Anatomy

outside the FOV in the phase direction results in aliasing.
Small FOVs increase resolution, decrease SNR, and can
increase the minimum TE value.
Slice Thickness 1.4 Thin slices increase resolution and decrease SNR.
Locs per Slab 80 Choose the number of locations desired within each 3D
Slab.
Start, End Locations Typically, the start and end locations are programmed
from the Graphic Rx program.
# Slices The maximum number of slices available is determined by
the TR, TE, SAR, and gradient stress.

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 3D SSFP

3D SSFP Protocol Example

What You Select Selection Notes
Acquisition Timing

Freq 128 Increasing the frequency matrix increases resolution,

while decreasing SNR and the number of slices.
Phase 128 Phase controls scan time and resolution.
NEX 2.00 Select a NEX value which produces sufficient SNR.
Phase FOV 1.00 Select 0.75 or 0.5 to reduce phase steps and thus
decrease scan time, FOV in the phase direction, and SNR
slightly. The phase FOV dimension is displayed next to the
phase FOV factor.
Freq DIR S/I The direction displayed is the default frequency direction
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Peak Select the CF peak to be set during prescan.
Flow Comp DIR N/A Flow Comp is automatically built into the 3D SSFP pulse
sequence in the frequency direction.
Autoshim On Select Autoshim when using fat SAT or an FOV off center,
and on the first series of each examination.
Phase Correct N/A
# of Acqs/Locs Before N/A
Pause

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 3D SSFP

3D SSFP Protocol Example

What You Select Selection Notes
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Click the image to display the line cursor. Allows you to
display the line prescribe slices for graphic prescription. Select the
cursor. adjustment handles to angle, draw, and remove slices.
Position the slices to cover anatomy of interest and view
the Advisory Panel to note the maximum number of slices
per acquisition and the number of acquisitions you are
prescribing.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
SAT Rx SSFP is not compatible with Sp Sat.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the Scan Prescription window, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Downloads the series.
Scan]
Scan Operations
Scan [Scan] Initiates the acquisition.

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 3D SSFP

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 Echo Planar Imaging (EPI)

Chapter 20
Echo Planar Imaging (EPI)

Introduction
This chapter explains the pulsing components and timing factors directly related to the
Spin Echo (SE) Echo Planar Imaging (EPI) and Gradient Echo (GRE) EPI pulse
sequences.
This chapter explains the concepts of each, and the step-by-step instructions to help
you learn how to:
• Prescribe a Spin Echo EPI Sequence
• Prescribe a Gradient Echo EPI Sequence

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 Echo Planar Imaging (EPI)

What Do I Need to Know About...

This section presents the concepts necessary to understand the EPI pulse sequences.
Specifically, you need to understand:
• EPI Basics
– Scan Time
– Spatial Resolution
– Signal-to-Noise Ratio (SNR)
– Multi-Phase, Multi-Repetition
– Acquisition Type
– User Control Variables
– Imaging Considerations
• Spin Echo EPI
– Supported Features
– Applications
• Gradient Echo EPI
– Supported Features
– Applications

EPI Basics
EPI is similar to a Fast Spin Echo (FSE) sequence, except it uses gradients (which take
less time to turn on and off) instead of radio frequency (RF) pulses to produce echoes.
The efficiency of a gradient versus RF pulse to produce the echo results in reduced
Specific Absorption Rates (SAR) and increased number of slices in comparison to an
FSE acquisition.
Like FSE, EPI uses an echo train (ET) to produce numerous echoes within a TR period
filling k-space rapidly and dramatically reducing scan time. EPI sequences can only be
acquired in the two-dimensional (2D) imaging mode.
EPI, combined with Spin Echo (SE) or Gradient Echo (GRE), is an option primarily used
to produce T2- or T2*-weighted images. Inversion Recovery (IR) EPI is used for T1 and
IR contrast weighting.

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 Echo Planar Imaging (EPI)

Scan Time
To understand how EPI affects scan time, a review of k-space is required. K-space is
the domain that contains the Magnetic Resonance (MR) raw data, which after
undergoing a Fourier transformation, becomes the image. Several key points about
k-space include:
• K-space must be at least 60% filled to produce an image.
• The manner in which k-space is filled (top to bottom, middle to edges) has an affect
on the contrast.
• The position of information within k-space does not correlate to a spatial position
within the image.
• The phase gradient’s amplitude determines the strength of the signal echoed back.
Low phase gradient amplitudes produce strong echoes and fill the middle of
k-space, while high phase gradient amplitudes produce weaker echoes with high
spatial information and fill the edges of k-space.
Figure 20-1 displays each line of k-space corresponding to one TR interval.
Figure 20-1 K-Space – Single Line/TR

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 Echo Planar Imaging (EPI)

Figure 20-2 shows multiple lines of k-space being filled within each TR period.
Figure 20-2 K-Space – Multiple Lines/TR

The number of shots is a Scan Timing parameter, which must be completed for an EPI
scan. The number of shots is the number of TR periods used to complete the
acquisition. EPI protocols that use more than one shot to complete the acquisition are
called multi-shot acquisitions. EPI protocols that use only one shot to complete the
acquisition are referred to as single-shot or snap-shot acquisitions.
Equation 20-1 SE Scan Time

TR x Phase Steps X NEX = SE Scan Time

Equation 20-2 EPI Scan Time

TR x Number of Shots X NEX = EPI Scan Time

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 Echo Planar Imaging (EPI)

Spatial Resolution
An EPI trade-off from using gradients versus RF to refocus the spins, is that the EPI
image becomes very sensitive to off-resonance artifacts (frequency difference between
fat and water protons). After the initial RF excitation pulse, a spin that is precessing
off-resonance gradually accumulates a phase error. This phase error builds over the
course of the echo train and leads to a geometric distortion in the phase encoding
direction. The longer it takes to sample the echo, the more time the off-resonant spins
have to accumulate phase shifts and the greater the geometric distortion.
Geometric distortion can be reduced by:
• Using the shortest possible echo spacing (keep the RBw as wide as possible and
frequency matrix as small as possible).
• Using multi-shot vs. single shot EPI to reduce echo space (ESP). The higher the
shots the less the distortion but the longer the scan time.
• Using smaller values for frequency encoding to reduce ESP. Your protocol may
have higher phase steps (512) than frequency (256) steps. Remember, EPI scan
time is not affected by phase steps.
All EPI pulse sequences are sensitive to field inhomogeneities (opposed to an FSE
which virtually eliminates those effects). Therefore, pathologies that cause disruptions
in the local magnetic field have a higher potential for contrast visualization in an EPI
image.

Signal-to-Noise Ratio (SNR)

EPI images typically use very large receive bandwidths so echo spacing can be as
short as possible and reduce geometric distortion. The trade-off for a large receive
bandwidth (RBw) is an increased amount of noise and lower signal-to-noise ratio
(SNR).
The loss of SNR can be gained by either increasing the NEX value or changing scan
parameters that affect resolution (matrix, slice thickness, FOV). As the RBw gets larger,
the minimum FOV increases, which reduces the spatial resolution but gains the SNR
lost to the wide RBw. To increase SNR with EPI images, consider decreasing the
frequency matrix (enlarges pixel size for more SNR and decreases geometric
distortion), while keeping the phase matrix unchanged. For example, use a 256-phase
matrix with a 128-frequency matrix.

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 Echo Planar Imaging (EPI)

Multi-Phase, Multi-Repetition
EPI offers great flexibility when applications call for multiple passes and/or phases that
need extremely short scan times and high temporal resolution. Possible EPI
acquisitions include:
• Multi-pass, single-slice
• Multi-pass, multi-slice
• Multi-slice, single-phase, single pass
• Multi-slice, single-phase, multi-pass
When more than one slice location is being acquired over more than one pass (a
multi-phase multi-pass exam), understanding the difference between pass (or rep) and
phase is important.
• Pass: One trip through the slice or slices within a given TR period. For example, if
15 slices can be acquired within a TR of 2000 msecs (and 15 slices have been
prescribed) then one pass covers the 15 slices in 2000 msec. Very often the terms
repetition or rep are used instead of pass.
• Phase: A particular image that is part of a group of images at the same location.
These phases could be cardiac phases or phases of contrast uptake or phases of
task activation. Any sequence in which the same slice location is imaged more than
once, can be termed a multi-phase sequence.

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 Echo Planar Imaging (EPI)

Acquisition Type
You should be familiar with two acquisition types:
• Interleaved: all the slice locations go through a single phase for a single pass
before moving to the next phase.
• Sequential: all the phases for one slice location are collected before moving on to
the next location.
For motion studies, where a particular slice location needs to be viewed while moving, a
sequential acquisition is often the choice to make. However, when viewing contrast
uptake over time through multiple slice locations (a common application in EPI), then an
interleaved acquisition is better suited.
Figure 20-3 shows the difference between interleaved and sequential acquisitions.
Figure 20-3 Sequential and Interleaved Acquisitions

User Control Variables

Figure 20-4 displays the User CVs available for SE and GRE EPI PDSs. Table 20-1
describes each User CV.

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 Echo Planar Imaging (EPI)

Figure 20-4 SE and GRE EPI User CV Screen

Table 20-1 FSE User CV Descriptions

User CV Mode Description

Chemcal Shift You can control the maximum chemical shift.
Limit(mm) for You can change other scan parameters if
MS-EPI estimated chemical shift does not exceed CV1.
CV5 limits the region for reference scan. If
Region
patient position is rather off-centered in phase
Restricted Ref 0=Off, 1=On
encoding direction, this option may reduce
Scan
ghosting artifacts.

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 Echo Planar Imaging (EPI)

Imaging Considerations
Table 20-2 lists the effects of changing several imaging parameters with the EPI pulse
sequence.
Table 20-2 EPI Parameter Trade-Offs

Parameters Image Effect

Echo Scan Geometric
SNR Resolution
Spacing Time Distortion
Increase Gradient
Decrease — — — Decrease
Slew Rate
Increase Receive
Decrease Decrease — — Decrease
Bandwidth
Increase # of Shots Decrease Increase — Increase Decrease
Increase Frequency
Increase Decrease Increase — Increase
Encoding Steps
Increase Phase
— Decrease Increase — —
Encoding Steps
Increase Frequency
Decrease Increase Decrease — Decrease
FOV
Increase Phase
— Increase Decrease — Increase
FOV
Increase Field
— Increase — — Increase
Strength

Even though Short TI Inversion Recovery is thought of as an Inversion Recovery (IR)

pulse sequence, SE EPI is the pulse sequence selected for an IR-EPI scan.
EPI images are always fat suppressed due to the off-resonance effects of fat spins.
Off-resonance effect is the frequency difference between protons bound in water versus
in fat molecules. The spins accumulate a phase shift during the EPI echo train which
results in this loss of signal and chemical shift artifact in the phase direction. Areas near
tissue-air interfaces result in water protons accumulating a phase shift or off-resonance
effect. These areas of interface produce a geometric image distortion. In EPI
acquisitions, the system automatically conducts a reference scan after prescan if the
Phase Correct prescan option has been selected.

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 Echo Planar Imaging (EPI)

EPI produces more slices per TR as compared to FSE because of the efficiency of
gradient generated echoes vs. RF pulse generated echoes. A reduced SAR is the
result. dB/dt refers to the rate of change in gradient magnetic fields to time which is
expressed in Tesla/seconds. dB/dt and SAR levels for patients are based on current
scientific literature related to safety. The level of exposure shall be a medical judgment
as to the patient’s potential risk versus benefit.

CAUTION: Patients who complain of Peripheral Nerve Stimulation (PNS) during an

EPI sequence should have the series stopped and replaced with another
pulse sequence. If the PNS occurs with a non-EPI sequence, the patient
should be removed from the magnet and the incident reported to GE
Medical Systems. Submission forms are in the Working Safely Chapter.

CAUTION: Peripheral nerve stimulation is not harmful. The potential for inducing
peripheral nerve stimulation is kept within limitations. In the US, the
Signa system is limited from operating above 66% of the PNS
threshold by the software (unless the system is operating in research
mode). The point at which 50% of a population experiences PNS is the
PNS threshold. PNS has been described as a light “touching” sensation
felt on various areas of the skin surface. These areas vary depending
upon which gradient axis is in use. Some common areas for the
sensations are the bridge of the nose, arms, chest, and upper abdomen.
Hands clasped together increase the potential for stimulation by
approximately 65%. The potential for PNS is low, but it exists for all
sequences in all gradient configurations.

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 Echo Planar Imaging (EPI)

Spin Echo EPI

EPI uses multiple oscillating gradient “pulses” within a TR period, rather than RF to
create the echo. A SE EPI protocol produces contrast similar to a standard SE image
with the same TR and TE.
SE EPI is typically used to acquire T2-weighted scans. It can also be combined with IR
Prep (accessed from the Imaging Options window) to acquire T1-weighted or Short TI
IR (STIR) images.
In an IR scan, the system first applies a 180° pulse to invert the magnetization along the
negative Z-axis. Then, after a brief period called Inversion Time (TI), it applies a 90°
pulse. As a result, the regrowth of longitudinal magnetization moves to the transverse
plane. Another 180° pulse rephases the transverse magnetization and results in a spin
echo. The pulse sequence is diagramed in Figure 20-5. These scans are acquired by
selecting a SE EPI pulse sequence and IR Prep to create an IR EPI pulse sequence.
Figure 20-5 IR EPI Pulse Sequence

The TI determines the image contrast. Figure 20-6 displays longitudinal magnetization
in an IR pulse sequence, plotted as a function of interpulse interval TI for a short T1
(e.g., fat) and a long T1 (e.g., brain).
Figure 20-6 TI and Contrast

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 Echo Planar Imaging (EPI)

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 20-3, an X indicates the options available for use with the SE pulse
sequences.
Table 20-3 SE EPI Compatible Imaging Options

Imaging Options
X None No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Real Time Blurring Cancellation

X Cardiac Gating/Triggering Respiratory Compensation

CCOMP Respiratory Gating/Triggering

Classic X Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

X IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

X Multi-Phase ZIP x 4

Multi Station X ZIP 512

Navigator ZIP 1024

NOTE: The Imaging Options shown in Table 20-3 may not always be compatible with
each other.

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 Echo Planar Imaging (EPI)

Applications
SE EPI applications include the following:
• To acquire very fast T2-weighted images when a short scan time is imperative; e.g.,
to minimize breathing motion or motion from patients that cannot hold still.
• Imaging pathologies which cause disruptions in the static magnetic field because
they have a higher potential for contrast visualization with EPI sequences.
• Cardiac imaging for single-slice, multi-phase, non-gated, single shot acquisitions
imaged at a single location over a period of a few seconds.
• Single or multi-slice, multi-phase using cardiac gating taken within a single
breath-hold.
SE EPI with IR Prep can be used to acquire very fast T1-weighted images. It uses a
long TR (2000 ms), a TI to produce T1 contrast (700 to 800 ms), and a short TE. These
images have a fat suppression appearance due to the fat suppression technique, which
is common to all GE EPI acquisitions. It is typically used in both head and extremity
imaging. Figure 20-7 displays a multi-shot SE-EPI with IR Prep.

Figure 20-7 Multi-Shot SE EPI (3500 TR, 35 TE, 800 TI, 256x256)

The images are annotated IR/EPI with a TI time annotated on the image.

Gradient Echo EPI

Like FSE, EPI uses a gradient echo train to produce numerous echoes within a TR
period to fill k-space rapidly. However, EPI produces these echoes in a manner very
similar to a standard gradient echo sequence. Instead of a series of 180° RF pulses,
EPI produces a series of oscillating gradient reversals. The differences between EPI
and a standard GRE include:
• EPI uses more than one gradient echo within a TR.
• EPI uses gradients which have both a positive and negative polarity to produce both
odd and even echoes.

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 Echo Planar Imaging (EPI)

GRE EPI is used to acquire T2*-weighted images, producing similar contrast to a

standard GRE with the same flip angle, TR, and TE.

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 20-4, an X indicates the options available for use with the GRE EPI
pulse sequences.
Table 20-4 GRE EPI Compatible Imaging Options

Imaging Options
X None No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Real Time Blurring Cancellation

X Cardiac Gating/Triggering Respiratory Compensation

CCOMP Respiratory Gating/Triggering

Classic X Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

X Multi-Phase ZIP x 4

Multi Station X ZIP 512

Navigator ZIP 1024

NOTE: The Imaging Options shown in Table 20-4 may not always be compatible with
each other.

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 Echo Planar Imaging (EPI)

Applications
GRE EPI with Multi-phase can be used to acquire task activation studies. GRE EPI
sequences are also applicable in imaging of the brain to produce cerebral-blood volume
maps to aid in diagnosis of recurrent tumor versus edema in post- therapy patients.

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 Echo Planar Imaging (EPI)

How Do I...
This section provides the step-by-step instructions for prescribing EPI pulse sequences.
Specifically, it describes how to:
• Prescribe a Spin Echo EPI Sequence
• Prescribe a Gradient Echo EPI Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions:
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.

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 Echo Planar Imaging (EPI)

Prescribe a Spin Echo EPI Sequence

SE EPI is typically used to acquire T2-weighted scans. It can also be combined with IR
Prep to acquire T1-weighted images.
The decision matrix (Table 20-5) is only for prescribing a SE EPI sequence. The
following example is for a brain SE EPI scan.
Table 20-5 SE EPI Protocol Example (Brain)

Spin Echo EPI Protocol Example (Brain)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series when the
Patient Protocol window becomes active.
Patient Position

Patient Position Supine An EPI pulse sequence is compatible with any patient
position and entry.
Patient Entry Head First NOTE: Hands clasped together may increase the
potential for PNS.
Coil Head/Neck > Allows selection of the coil from which the signal is
Head transmitted and received.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

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 Echo Planar Imaging (EPI)

Spin Echo EPI Protocol Example (Brain)

What You Select Selection Notes
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. EPI is

compatible with any scan plane.
Mode 2D Prescribes a two-dimensional sequence. EPI is only
compatible with the 2D imaging mode.
Grad Mode Zoom Activates the gradient mode of operation.
Pulse Seq Spin Echo EPI Activates the Spin Echo EPI pulse sequence. Spin Echo
EPI can provide T2-weighted contrast (with some T2*
effects) or it can be used with IR Prepared for T1 or STIR
contrast. Click [Accept] to register the selection.
Imaging Options IR Prepared, Select imaging options to optimize SNR and spatial
Variable resolution. Select IR Prepared for either an IR,
Bandwidth T1-weighted, or short TI IR contrast. Click [Accept] to
register the selections.
PSD Name N/A
Protocol N/A

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 Echo Planar Imaging (EPI)

Spin Echo EPI Protocol Example (Brain)

What You Select Selection Notes
Scan Timing

16

100

# of shots 16 As the number of shots increases, the susceptibility

artifacts decrease, however the scan time increases.
TE 100 SE EPI: Select parameters for T2-weighted contrast,
typically TE 80 to 120 ms. For multi-shot EPI, several
set-up pulses are applied before the system collects data
to insure proper amounts of longitudinal magnetization.
The set-up shots keep the contrast consistent, from one
TR period to the next.
IR EPI: Select parameters for T1-weighted contrast,
typically TE Minimum. Select parameters for short TI IR
weighting, typically TE 40 ms.
TR 2500 Typically, select a TR > 6000 ms. As the TR increases, the
scan time increases.
Inv Time 800 Typically select 800 for T1-weighted contrast or 150 to
170 for Short TI IR-weighted contrast. IR Prepared must
have been selected from the Imaging Options window for
this text box to be active.
Flip Angle N/A
Echo Train Length N/A

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 Echo Planar Imaging (EPI)

Spin Echo EPI Protocol Example (Brain)

What You Select Selection Notes
Bandwidth 32.5 As the RBw increases, the SNR, chemical shift artifact,
and minimum TE decrease (which means the ESP
decreases). As ESP decreases, geometric distortion
decreases. Typically, a 32 kHz RBw is used with 16 or
more shots.
Bandwidth 2 N/A
Scanning Range

FOV 25 Select a FOV to cover the anatomy of interest. Anatomy

outside the FOV in the phase direction results in aliasing.
A small FOV increases resolution and can increase the
minimum TE value, while decreasing SNR. The shortest
possible ESP is desirable for a single-shot acquisition.
Therefore, consider increasing the FOV.
The larger FOV the larger image distortion.
Slice Thickness 5.0 Thin slices increase resolution and decrease SNR.
Spacing 2.5 Enter a spacing which reduces cross-talk between slices
(typically 20% of the slice thickness).
Start, End Locations Typically the start and end locations are programmed from
the Graphic Rx program.
# Slices The maximum number of slices available is determined by
the TR, TE, TI, SAR, and gradient stress.

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 Echo Planar Imaging (EPI)

Spin Echo EPI Protocol Example (Brain)

What You Select Selection Notes
Acquisition Timing

256 A/P

192

1.0

Freq 256 Frequency value choices range from 64 to 512 in steps of

8. As the frequency matrix increases, the ESP increases.
Typically on a single shot, keep the frequency matrix as
low as possible to keep the ESP as short as possible.
Finding the right balance between ESP and resolution is
critical. Typically a 256 frequency matrix is used with 16
shots or more and RBw 25 to 42 kHz. For 512 frequency
matrix, increase the shots and RBw.
Phase 192 As phase matrix increases, the resolution increases, and
the number of slices decreases, but the scan time does
not change (scan time = shots x TR). Phase may be larger
than the frequency value in an EPI sequence.
NEX 2.0 Select a NEX value which produces sufficient SNR. As the
NEX increases, the SNR and scan time increase.
Phase FOV 1.0 The PFOV ranges from 0.5 to 1 in steps of 0.25. Select a
volume which does not result in anatomy outside the
phase FOV. As PFOV decreases, geometric distortion
decreases.
Freq DIR A/P In the head coil, axial, axial oblique, coronal, and coronal
oblique planes automatically have the phase and
frequency swapped in comparison to non-EPI scans. This
is to lessen the presentation of geometric distortion and to
reduce the potential for peripheral nerve stimulation
Auto Center Freq Water Select Water since EPI is always fat suppressed. Current
CF can be used if the previous series used the correct
center frequency and Autoshim is not in use.
Flow Comp DIR N/A
Autoshim On Select Autoshim on the first EPI scan in each plane. Turn
AutoShim off if a high order shim was performed prior to
this acquisition.

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 Echo Planar Imaging (EPI)

Spin Echo EPI Protocol Example (Brain)

What You Select Selection Notes
Phase Correct On Always select Phase Correct with EPI scans so the
system can run a reference scan prior to data acquisition.
If a 1 NEX acquisition is programmed, the reference scan
can take as long as the EPI scan, but it is imperative to run
phase correct in order to have optimum image quality. The
reference scan automatically occurs after a successful
prescan. It makes calculations and corrections for
centering the echo underneath the frequency gradient.
# of Locs Before Pause N/A
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and remove
cursor. slices. Position the slices to cover anatomy of interest and
in a 2D sequential acquisition, view the Advisory Panel to
note the maximum number of slices per acquisition and
the number of acquisitions you are prescribing. The scan
time increases as the number of acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Auto Prescan [Auto Prescan] Prescans the acquisition and allows the reference scan to
be activated, which consists of a 1 or 2 shot sequence.
The reference scan automatically occurs after a
successful prescan.
Scan [Scan] Initiates the acquisition.

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 Echo Planar Imaging (EPI)

Prescribe a Gradient Echo EPI Sequence

The GRE EPI sequence can be used to acquire T2*-weighted images.
Table 20-6 provides a brief look at an example protocol. The parameters may vary
depending on your needs.
Table 20-6 GRE EPI Protocol Example (Brain)

Parameter Selection What You Select Parameter Selection What You Select
Imaging Parameters Acquisition Timing
Patient Position Supine Freq 96
Patient Entry Head First Phase 96
Coil Head NEX 3.0
Plane Oblique Phase FOV 1.0
Mode 2D Freq DIR A/P
Pulse Sequence Gradient Echo EPI Auto Center Freq Water
Imaging Options Variable Flow Comp DIR N/A
Bandwidth
Autoshim On
Scan Timing Phase Correct Off
# of Shots 16 # of Locs Before N/A
Pause
TE < 65 ms
TR 200 to 700 Additional Parameters - User CVs
Flip Angle 15 to 30 CV1 10
Bandwidth 15.63 to 31.25 CV5 0
Scanning Range
FOV 25 NOTE: The Grad text box is only available
Slice Thickness 7
if your system has Twin gradients.

Spacing 2.5 Phase and Frequency are

automatically swapped to lessen
Start/End Location Determined by geometric distortion and reduce
Graphic Rx.
the potential for PNS.
# of Slices Determined by For a complete list of compatible
Graphic Rx. imaging options, refer to Table
20-4.

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 Echo Planar Imaging (EPI)

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 Time of Flight (TOF)

Chapter 21
Time of Flight (TOF)

Introduction
This chapter explains the pulsing components and timing factors directly related to the
Time of Flight (TOF) pulse sequences. It explains the concepts of each and the
step-by-step instructions to help you learn how to:
• Prescribe a 2D TOF Sequence
• Prescribe a 3D TOF Sequence

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 Time of Flight (TOF)

What Do I Need to Know About...

This section presents the concepts necessary to understand TOF pulse sequences.
Specifically, you need to understand:
• TOF Basics
• 2D TOF
– Imaging Parameters
– Imaging Characteristics
– Supported Features
– Applications
• 3D TOF
– Ramp Pulse
– Imaging Parameters
– Supported Features
– Applications

TOF Basics
There are several different pulse sequences within the vascular TOF family, as shown
in Figure 21-1.They are all related to the Gradient Echo (GRE) family of pulse
sequences.
Figure 21-1 Vascular TOF Family Tree

TOF GRE and SPoiled Gradient Echo (TOF-SPGR) imaging are based on conventional
gradient echo scanning with Flow Compensation (FC). These imaging techniques rely
primarily on flow-related enhancements to distinguish moving from stationary spins in
creating Magnetic Resonance Angiograms (MRA).

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 Time of Flight (TOF)

TOF acquires one phase encoding value per TR period in a two-dimensional (2D) or
three-dimensional (3D) mode. A variable angle radio frequency (RF) excitation pulse,
gradient rephasing, and flow compensation are used in these sequences.
MRA images are created by repeatedly exciting a predefined volume of anatomy until
the stationary tissue is partially saturated and the signal from the tissue is suppressed.
Blood flowing into the predefined volume of anatomy is not saturated, but fully
magnetized by the main magnetic field and yields a stronger signal. In the resulting
image, the blood appears bright and the stationary tissue is suppressed. This flow
related enhancement phenomena is called Time Of Flight (TOP), shown in Figure 21-2.
Figure 21-2 Flow-Related Enhancement

TOF-SPGR uses RF spoiling to minimize residual transverse magnetization to optimize

T1-weighting. TOF-GRE uses a non-RF spoiled gradient echo technique and increased
T2* effects may be noted.
Both PSDs can produce Maximum Intensity Projection (MIP) and reconstructed images.
• Magnitude, collapsed, and projection images can be generated.
• Reconstruction is done after the acquisition is complete.
NOTE: Patient motion can result in misregistration of the acquired slices when viewed
in projection.

2D TOF
2D TOF is a fast technique that completes data acquisition for one slice before moving
on to subsequent slice locations. Images can be acquired using a TOF-SPGR or
TOF-GRE sequence.
The advantages of 2D TOF include:
• Sensitivity to slow flow or moderate flow
• Minimal saturation effects at normal flow velocities
• Speed

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 Time of Flight (TOF)

2D TOF is relatively insensitive to in-plane blood flow, which can simulate a vascular
lesion. A long minimum TE makes the acquisition insensitive to very fast in-plane and
turbulent blood flow. Programming a thin slice combined with FC increases the
minimum TE value.
Spatial SAT pulses are generally used to decrease signal from unwanted flow. When
prescribing SAT bands in the slice direction, select only the SAT direction. The system
sets the spacing and slab thickness. The SAT band starts 20 mm from the slice being
acquired.
Slice direction SAT bands concatenate, that is they move along with the slices, unless a
change is made to the SAT band thickness and/or spacing.
2D TOFX is a PSD type-in for the TOF pulse sequence (type 2dtofx) with optimized
SAT thickness and gap to improve background suppression. The optimized thickness is
80 mm and the gap is 10 mm.
In regions of highly pulsatile flow (e.g., popliteal, iliac) a narrow SAT gap can result in
pulsatile artifacts due to saturation of retrograde flow.
2D TOF acquisitions have the potential for overestimating stenosis because the
minimum TE is relatively long in comparison to 3D TOF. Simulated flow-related
enhancements can result from short T1 substances like methemoglobin in subacute
hematomas.
TOF images are annotated “TOF/SPGR/Flip Angle, TOF/GR/Flip Angle, 2dtofx/Flip
Angle”.

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 Time of Flight (TOF)

Imaging Parameters
Table 21-1 lists the effects of several imaging parameters with TOF imaging.
Table 21-1 Effects of Imaging Parameters

Scan Parameter Effect of Scan Parameter

Short TE
Decreases signal loss and artifacts.
(fractional/partial)
Suppresses the signal from stationary tissue and maximizes
Short TR
the vessel contrast due to flow-related enhancements.
Maximizes in-flow enhancement and reduces the effects of
Thin Slices
in-plane flow.
Flip Angle Saturates stationary tissues without compromising
approximately 60° intravascular signal intensity.
Image plane Prevents saturation of flowing spins due to multiple RF
perpendicular to flow pulses.
Eliminates signal from overlapping vascular structures. For
example, apply the SAT pulse superior to the scanning range
to minimize signal from the jugular vein, or apply the SAT
Sat Pulse
pulse inferior to emphasize the jugular vein. Use a superior
SAT pulse to selectively image the pelvic vein. Do not modify
the defaulted SAT thickness or gap.
When FC is used with minimum TE, flowing spins are
Flow Compensation
rephased, resulting in increased vascular signal.
MRI Contrast Agents Shortens the T1 of blood.

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 Time of Flight (TOF)

Imaging Characteristics
Vessel signals are inherently low in signal-to-noise ratio (SNR). Intra-voxel phase
dispersion (Figure 21-3) decreases vessel signals and is affected by voxel size,
sequence timing, and flow dynamics. Intra-voxel dispersion is coherence loss suffered
by phases within the imaging voxel. Using smaller voxels and/or a smaller flip angle can
usually minimize the consequent reduction in signal intensity. On the other hand,
smaller voxel increases noise and can result in low SNR. Smaller flip angle increases
signals from stationary tissues and can result in low Contrast. Please take care of the
trade-off between signal, noise and contrast.
Figure 21-3 Intra-Voxel Phase Dispersion
Strong signal Weak signal

Voxel size also affects spatial resolution and the ability to visualize small vessels, as
shown in Figure 21-4.
Figure 21-4 Voxel Size and Spatial Resolution

Images with flowing nuclei are bright while stationary nuclei are dark. Stagnant, slow
flow or in-plane flow produces decreased signal as it becomes saturated.

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 Time of Flight (TOF)

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. The X in Table 21-2 indicates the imaging options available for use with the 2D
TOF pulse sequence.
Table 21-2 2D TOF Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

Cardiac Gating/Triggering Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

Classic X Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

Multi-Phase ZIP x 4

Multi Station X ZIP 512

Navigator ZIP 1024

NOTE: The Imaging Options shown in Table 21-2 may not always be compatible with
each other.

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 Time of Flight (TOF)

Applications
2D TOF GRE or SPGR sequences are used for:
• Demonstrating the carotid bifurcation or venous anatomy
• Evaluating suspected basilar artery occlusive disease
• Imaging pelvic and lower extremity vasculature
• Mapping cortical veins
• Evaluating suspected intra-cranial venous thrombosis

3D TOF
3D TOF uses a volume acquisition to obtain image data. Either TOF-SPGR or
TOF-GRE can be used in the 3D mode.
Advantages of 3D TOF include:
• Improved SNR, contrast-to-noise ratio (CNR), and high spatial resolution
• Relatively short scan times
• Sensitivity to fast and intermediate flow
• Very short TEs, which reduce the amount of spin dephasing
• Generation of source, collapsed, and projection images
• Less overestimation of stenosis than with 2D TOF, because of low dephasing
• The use of multiple slab acquisitions to decrease saturation affects of slow moving
and in-plane blood
• Flexible frequency matrix and Phase FOV selections
– Enhances resolution with no increase in scan time
– Increases flexibility to match the patient size with the FOV size through more
Phase FOV choices
• Shorter TRs especially with Magnetization Transfer, resulting in improved vessel to
background contrast
• Improved FC
• An increase in the fraction of the echo sample and a special reconstruction
technique resulting in improved SNR and image quality of vessels in regions of high
susceptibility (e.g., in vessels near the sinuses).

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 Time of Flight (TOF)

Ramp Pulse
Ramp Pulse is an RF pulse which uses a variable flip angle over the imaging volume to
reduce saturation of incoming flow. Ramped flip angle excitation combines the benefits
of custom-designed, minimum phase RF pulses with the flow selectivity and increased
background suppression of larger flip angles. Ramp pulses are selected from the
Vascular Additional Parameters screen.
Figure 21-5 illustrates an example of a 30° flip angle ramped RF pulse. At slice number
1, the flip angle is 20° (20° RF pulse: 30 - (1/3 x 30) = 20). At slice number 60, the flip
angle is 40° (40° RF pulse: 30 + (1/3 x 30) = 40).
Figure 21-5 Ramp Pulse

30°

A ramped flip angle excitation pulse with slope of 2 has a flip angle that doubles from
entry to exit slice. The pulse center flip angle is prescribed; the entry and exit slice flip
angles are 2/3 and 4/3 of the center flip angle, respectively. Spatially varying excitation
flip angles prevents saturation of slowly flowing blood at the entry (low flip angle) part of
the slab and provides suppression of venous flow with the large flip angle (exit) portion
of the slab. These effects allow improved visualization of slow, in-plane, and tortuous
flow, and eliminate the need for a spatial presaturation pulse to cancel venous signal.
Table 21-3 can help you determine the ramp pulse direction, depending on the direction
of the blood flow and whether you need to see bright blood or dark blood.
Table 21-3 Ramped Pulses

Ramped Pulse Direction Blood Flow Direction Signal Intensity

I-S Bright
I-S
S-I Dark

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 Time of Flight (TOF)

Ramped Pulse Direction Blood Flow Direction Signal Intensity

I-S Dark
S-I
S-I Bright

Do not use Ramp Pulse when the flip angle in your protocol is between 46 and 90. In
general, choose flip angles in the 20 to 45° range with Ramp Pulses.
Ramp Pulse offers the following image quality improvements:
• Improved slab profile by reducing wrap and improving image quality away from the
center of the slab
• Reduced saturation of blood flow increasing the visibility of arteries
• Reduced sensitivity to venous signal
• Shortened minimum TE
Select the Ramp Pulse flow direction based on the scan plane selected. Refer to Table
21-4 for guidance.
Table 21-4 Flow Direction

Scan Plane Ramp Pulse Flow Direction

Axial [I→S Flow] and [S→I Flow]
Sagittal [L→R Flow] and [R→L Flow]
Coronal [P→A Flow] and [A→P Flow]
Oblique [I→S / P→A / L→R Flow] and [S→I / A→P / R→L Flow]

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 Time of Flight (TOF)

Sloped Flip Angle

Sloped Flip Angle can be also prescribed for Multi slab acquisitions from the User CVs
window. Sloped Flip Angle is designed to acquire strong flow signal from vascular
scans. When selecting [Ramp Pulse], the flip angles in each slab varies at the entry and
exit slice. Selecting [Sloped Flip Angles] results in the flip angle in each slab not to vary
spatially.
Figure 21-6 Ramp Pulse and Slopped Flip Angle

At CV2, select [1] to set Multi slab sloped flip angle and at CV3, select [35] for Flip angle
for end slab. For Flip angle, select 45.
Figure 21-7 User CVs

NOTE: Selecting [Ramp Pulse] is not recommended when using thin slabs.
Additional 3DTOF benefits:
– An increase in the fraction of the echo sample and a special reconstruction
technique resulting in improved image quality of vessels in regions of high
susceptibility (e.g., in vessels near the sinuses).
– Improved SNR due to the increase in the fraction of the echo sample.
– Improved vessel to background contrast with MT-TOF.

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 Time of Flight (TOF)

Imaging Parameters
Several factors must be considered when using a TOF pulse sequence. Table 21-5
shows several scan parameter effects on TOF images.
Table 21-5 Imaging Considerations

Scan Parameter Effect

Reduces spin dephasing due to flow.
Provides greater saturation of the stationary tissues if the TR
Short TE is shortened to 40 ms. If the TR is shorter than 40 ms, spins
flowing into the volume become saturated, resulting in a loss
of intravascular signal intensity.
Slab orientation
Reduces partial saturation of flowing spins.
perpendicular to flow
Suppresses stationary spins if the flip angle is 15 to 20°. The
Short flip angles larger the flip angle, the more saturated stationary tissue
approximately 20° becomes. Large flip angles can affect the arterial flow,
resulting in a lower signal intensity.
Reduces phase dispersion and maximizes intravascular signal
Flow Compensation
when using the shortest TE possible.
Thin slices Minimizes the effects of intravoxel dephasing.
Ramp pulses and
Increases small intracranial vessel conspicuity when
Magnetization
combined with a high-resolution acquisition.
Transfer (in heads)
MRI contrast agents Visualizes venous anatomy.

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 Time of Flight (TOF)

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. The X in Table 21-6 indicates the imaging options available for use with the 3D
TOF pulse sequence.
Table 21-6 3D TOF Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

Cardiac Gating/Triggering Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

Classic Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

X Magnetization Transfer X ZIP x 2

Multi-Phase X ZIP x 4

Multi Station X ZIP 512

Navigator X ZIP 1024

NOTE: The Imaging Options shown in Table 21-6 may not always be compatible with
each other.
Combine 3D TOF with Magnetization Transfer (MT) to improve contrast between blood
flow and surrounding tissue. Combine with Ramped RF to increase conspicuity of
intracranial arteries.

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 Time of Flight (TOF)

Applications
Uses for 3D TOF GRE or TOF SPGR include:
• Rule out (R/O) Arteriovenous malformations (AVMs), aneurysms in the Circle of
Willis, or intracranial carotid occlusive disease
• Imaging venous angiomas using contrast material
• Imaging vessels near the sinuses where magnetic susceptibility can be a problem
• Use with Slice ZIP to increase coverage without increasing scan time
• Use with MT to improve contrast between blood flow and surrounding tissue.
• Use with Ramped RF, to increase conspicuity of intracranial arteries.
• Imaging vessels near the sinuses, where magnetic susceptibility can be a problem.
The comparison in Figure 21-8 illustrates how Slice ZIP allows equivalent coverage with
increased overlaps in the same scan time. It also displays how the stair-step artifact is
reduced with Slice ZIP.
Figure 21-8 3D TOF Slice ZIP Comparison

There are several factors you should consider when using a 3D TOF pulse sequence:
• 3D TOF is less sensitive to in-flow effects, due to spins becoming saturated as they
pass through the imaging volume. The use of Ramp Pulses can offset some of
these saturation effects.
• 3D TOF provides lower blood-background CNR.
• 3D TOF is effective only for relatively small volumes.
• 3D TOF is not completely reliable for imaging venous anatomy without MR contrast.
• Short T1 structures appear bright, simulating flow enhancement with 3D TOF.

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 Time of Flight (TOF)

When using multi-slab 3D TOF sequences, consider the following:

• Ramped Pulses produce images with a variation in background suppression from
entry to exit slice and flow speed selectivity as a function of location within the slab.
• Slab boundary artifacts are more prominent with Ramped Pulses.
• Acquisition order influences the visibility of slow or in-plane flowing blood or blood
flowing in tortuous vessels. Slab acquisition order is opposite of blood flow
(counter-current), which improves visibility of these vessels. This allows the
saturated blood to flow away from the next imaging volume. For example, a carotid
artery examination prescribed superior to inferior, has improved vertebral and
basilar artery conspicuity. Do not apply the superior spatial presaturation pulse with
counter-current acquisitions.
• If no overlap is prescribed between adjacent slabs, a substantial inter-slab boundary
artifact (venetian blind) is created due to the decrease in blood-background
signal-to-noise. An overlap of 25% is recommended, with uniform flip angle
excitations to minimize the artifact.
Figure 21-9 is an example of a three-slab TOF sequence.
Figure 21-9 TOF Sequence with Three Slabs

When using uniform flip angle excitation and 16 slices per slab, optimal slab overlap is
four slices (~ 25%). Because the slab excitation profiles are not perfect, it is necessary
to remove two slices on the end of each slab; these contain 3D wraparound artifacts.
Overlapping slices first are combined using the MIP technique, so the maximum signal,
whether background or vessel, is saved in the combined image.

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 Time of Flight (TOF)

How Do I...
This section provides the step-by-step instructions for prescribing TOF imaging pulse
sequences. Specifically, it describes how to:
• Prescribe a 2D TOF Sequence
• Prescribe a 3D TOF Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions:
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Hearing protection is required for all people in the scan room to prevent
hearing impairment. Acoustic levels may exceed 99 dB(A).

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 Time of Flight (TOF)

Prescribe a 2D TOF Sequence

2D TOF sequences can be used to acquire scans demonstrating carotid or venous
anatomy, as well as to image the pelvic and lower extremity vasculature. Images can be
acquired using a TOF-GRE or TOF-SPGR sequence.
The decision matrix (Table 21-7) is only for prescribing a 2D TOF sequence. The
following example is for a carotid 2D TOF-SPGR scan.
Table 21-7 2D TOF Protocol Example (Carotids)

2D TOF-SPGR Protocol Example (Carotids)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series when the
Patient Protocol window becomes active.
Patient Position

Coil
Illustration

Patient Position Supine A 2D TOF pulse sequence is compatible with any patient
position and entry.
Patient Entry Head First
Coil NV Array Allows selection of the coil from which the signal is
transmitted and received. Use a coil which produces the
optimum coverage and SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

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 Time of Flight (TOF)

2D TOF-SPGR Protocol Example (Carotids)

What You Select Selection Notes
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. 2D TOF is

compatible with any scan plane, except 3-Plane. Select
the plane which best meets your clinical needs.
Maximum flow-related enhancement occurs when blood
flow is perpendicular to the imaging plane.
Mode 2D Prescribes a two-dimensional sequence.
Pulse Seq TOF SPGR Activates the TOF SPGR pulse sequence. TOF SPGR
typically reduces the signal from fat more than TOF GRE,
but you may also select TOF GRE. Click [Accept] to
register the selection.
Imaging Options Flow Select Sequential. Flow Compensation may increase
Compensation, the signal from blood by rephasing the moving spins, but
Sequential it also increases the minimum TE. Select other imaging
options which optimize SNR and spatial resolution. Refer
to Table 21-2 for a complete list of all compatible options.
Click [Accept] to register the selections.
PSD Name To use 2DTOFX, type 2dtofx (lower case) in the PSD
Name text box for a TOF pulse sequence with
optimized SAT thickness and gap to improve background
suppression, otherwise a type-in PSD is not necessary.
Protocol N/A

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 Time of Flight (TOF)

2D TOF-SPGR Protocol Example (Carotids)

What You Select Selection Notes
Scan Timing

# of echoes 1 Only 1 echo is allowed for vascular sequences.

TE Minimum Use the minimum TE for minimal dephasing effects.
Minimum TE changes as RBw changes.
TR Minimum TRs in the range of 40 to 50 ms are generally used to
adequately decrease signal from stationary tissue. The
minimum TR with MT is shorter with transmit/receive
coils other than the body coil.
Inv. Time N/A
Flip Angle 60 Choose a flip angle which suppresses stationary tissue
without decreasing signal from blood, usually 45 to 60°
for SPGR, 20 to 40° for GRE. As the flow gets faster, the
flip angle may be increased. Due to reduced minimum
TR values (in particular with MT), the flip angle may be
decreased to minimize saturation of small vessels.
Echo Train Length N/A
Bandwidth 15.63 RBw can only be changed if it was selected from the
Imaging Options window. As the RBw decreases, SNR
and chemical shift artifact increase, as does the minimum
TE which can potentially decrease the number of slices
and increase motion artifact.
Bandwidth 2 N/A

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 Time of Flight (TOF)

2D TOF-SPGR Protocol Example (Carotids)

What You Select Selection Notes
Scanning Range

FOV 36 Select a FOV which covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results
in aliasing. A small FOV increases resolution and can
increase the minimum TE value, while decreasing SNR.
Slice Thickness 2.0 Thin slices increase flow-related enhancement and
resolution, and reduce effects of in-plane flow, and
decrease SNR.
Spacing 0
Start, End Locations Typically the start and end locations are programmed
from the Graphic Rx program. As many slices as needed
to cover the desired anatomy may be prescribed. As the
number of locations increase, total scan time increases.
# Slices 76 The number of slices is one per acquisition. This area
indicates the number of locations prescribed. The system
actually acquires two extra slices on either end of the
imaging volume and discards them due to slice aliasing.
Acquisition Timing

Freq 256 Increasing the frequency matrix increases resolution and

decreases SNR.
Phase 192 Phase controls scan time and may control resolution.

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 Time of Flight (TOF)

2D TOF-SPGR Protocol Example (Carotids)

What You Select Selection Notes
NEX 2.00 Select a NEX value which produces sufficient SNR.
Phase FOV 0.75 Select 0.5 or 0.75 to reduce phase steps and thus
decrease scan time, decreasing FOV in the phase
direction, and decreasing SNR slightly. The phase FOV
dimension is displayed next to the phase FOV factor.
Freq DIR R/L The direction displayed is the default frequency direction
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak. It will be set during prescan.
Flow Comp DIR N/A
Autoshim On Select Autoshim when using an off-center FOV, and on
the first series of each examination.
Phase Correct N/A
# of Acqs/Locs Before 0 Although this text box is available, pauses are generally
Pause not used with TOF scans. Breath-hold examinations are
usually not done.
Additional Parameters - Vascular Options

Projection Images 19 Select 19 or 37 to automatically create projection images.

Selecting 0 projections substantially increases the
reconstruction speed. This can be useful when combined
with a 512 matrix and Slice ZIP.
Collapse On Produces a collapsed view in the plane of acquisition.
Accept [Accept] Confirms the selected value and closes the Vascular
Time of Flight Additional Parameter screen.

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 Time of Flight (TOF)

2D TOF-SPGR Protocol Example (Carotids)

What You Select Selection Notes
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and
cursor. remove slices. Position the slices to cover anatomy of
interest and in a 2D sequential acquisition, view the
Advisory Panel to note the maximum number of slices
per acquisition and the number of acquisitions you are
prescribing. The scan time increases as the number of
acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
SAT Rx S Select spatial SAT pulses perpendicular to the flow and
in a direction that reduces unwanted flow. To suppress
arterial flow above the heart, use a superior SAT pulse,
and to suppress arterial flow below the heart, use an
inferior SAT pulse.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Scan [Scan] Initiates the acquisition.

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 Time of Flight (TOF)

Prescribe a 3D TOF Sequence

The 3D TOF sequences can be used to acquire MR angiogram images demonstrating
intracranial arteries or veins. Images can be acquired using a TOF-GRE or TOF-SPGR
sequence.
The decision matrix (Table 21-8) is only for prescribing a 3D TOF sequence. The
following example is for a 3D TOF-SPGR scan of the head to image intracranial
arteries.
Table 21-8 3D TOF-SPGR Protocol Example (Circle of Willis)

3D TOF-SPGR Protocol Example (Circle of Willis)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series when the
Patient Protocol window becomes active.
Patient Position

Patient Position Supine A 3D TOF pulse sequence is compatible with any patient
position and entry.
Patient Entry Head First
Coil Head Allows selection of the coil from which the signal is
transmitted and received. Use a coil which produces the
optimum coverage and SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

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 Time of Flight (TOF)

3D TOF-SPGR Protocol Example (Circle of Willis)

What You Select Selection Notes
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. 3D TOF is

compatible with any scan plane, except 3-Plane. Select
the plane which best meets your clinical needs. Maximum
flow-related enhancement occurs when blood flow is
perpendicular to the imaging plane.
Mode 3D Prescribes a three-dimensional sequence.
Pulse Seq TOF SPGR Activates the TOF SPGR pulse sequence. You may also
select TOF GRE. Click [Accept] to register the selection.
Imaging Options Extended Flow Compensation may increase the signal from blood
Dynamic Range by rephasing the moving spins. Magnetization Transfer
is not necessary but improves visualization of vessels.
Select ZIP 512 to enhance in-plane resolution with only a
small decrease in SNR, but with a trade-off in
reconstruction time and disk storage (the image is
reconstructed and stored as a 512x512 image data set).
Select a Slice ZIP factor, ZIP x 2 or ZIP x 4, to increase
the number of slices (by a factor of 2 or 4) without
increasing the scan time. Selecting Slice ZIP improves
MIP and reformat image quality. Select other imaging
options which optimize SNR and spatial resolution. Refer
to Table 21-6 for a complete list of compatible options.
Click [Accept] to register the selections.
PSD Name N/A
Protocol N/A

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 Time of Flight (TOF)

3D TOF-SPGR Protocol Example (Circle of Willis)

What You Select Selection Notes
Scan Timing

# of echoes 1 Only one echo is allowed for vascular sequences.

TE Minimum Select the minimum TE for minimum dephasing effects.
TE is not selectable when Flow Compensation is off.
Alternatively, select Flow Comp with TE = 6.9 to reduce
the fat signal. Minimum TE changes as RBw changes.
TE2 N/A Long TEs decrease the number of slices and SNR, while
increasing the T2 contrast.
TR 40 Minimum TR may be as low as 30 ms. As TR decreases,
background tissue saturation increases and signal from
blood can decrease as it moves through the imaging
volume. Selection of TR that is too short (< 33 ms) can
result in suppression of smaller vessels.
TI N/A
Flip Angle 20 Stationary spins are suppressed if the flip angle is 15 to
20°. The larger the flip angle, the more saturated
stationary tissue becomes. However, large flip angles can
effect the arterial flow, resulting in lower signal intensity.
Due to low minimum TR values (in particular with MT), the
flip angle may be decreased to minimize saturation of
small vessels.
Echo Train Length N/A

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 Time of Flight (TOF)

3D TOF-SPGR Protocol Example (Circle of Willis)

What You Select Selection Notes
Bandwidth 15.63 As the RBw decreases, SNR increases and minimum TE
increases. Choose a RBw which is a compromise
between SNR and short TE requirements. A wider RBw is
allowed with a 512 frequency matrix.
Bandwidth 2 N/A
Scanning Range

FOV 24 Select a FOV which covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results in
aliasing. A small FOV increases resolution, decreases
SNR, and can increase the minimum TE value.
Slice Thickness 1.0 Increasing slice thickness increases SNR, coverage, and
saturation of flowing spins as they move through the
volume, while decreasing resolution.
Overlap Locs 4 Typically prescribe an overlap which represents 25% of
the number of scan locations. The overlap decreases
inter-slab boundary artifact (venetian blind).
Locs per Slab 16 Choose a value from 8 to 128 in multiples of 2. There are
always two slices on either end of the slab which are
discarded. Factor these four slices into the selection.
Start, End Locations This area indicates the first and last location of the
deposited slabs or volumes and includes two discarded
slices on either end of the slabs. Graphic Rx must be used
to deposit the slabs.
# Slabs 1 This value is entered automatically when slabs are
deposited in Graphic Rx. Multiple, smaller slabs decrease
saturation of slow moving and in-plane flow. Increasing
the number of slabs increases the scan time. Prescription
of slabs outside the localizer FOV is not allowed.
Multi-slab scans are not allowed with ZIP 512 or Slice ZIP.

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 Time of Flight (TOF)

3D TOF-SPGR Protocol Example (Circle of Willis)

What You Select Selection Notes
Acquisition Timing

Freq 256 As the frequency matrix increases, the resolution

increases and SNR decreases. A frequency matrix from
128 to 512 can be selected in increments of 32.
Phase 224 As phase matrix increases, so does the resolution and
scan time, while SNR decreases.
NEX 1.00 Select a NEX value which produces sufficient SNR.
Phase FOV 0.75 A PFOV less than 1 (range from 0.5 to 1.0) can be
selected if it doesn’t result in anatomy outside the phase
FOV. PFOV is automatically rounded to the nearest 1/16.
Freq DIR A/P The direction displayed is the default frequency direction
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak. It will be set during prescan.
Flow Comp DIR N/A
Autoshim On Use Autoshim to improve homogeneity.
Phase Correct N/A
# of Acqs/Locs Before N/A
Pause

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 Time of Flight (TOF)

3D TOF-SPGR Protocol Example (Circle of Willis)

What You Select Selection Notes
Additional Parameters - Vascular Options

Projection Images 19 Enter 19 or 37 to automatically create projection images.

Leave this text box empty to create projection images in
IVI.
Collapse On Select to get a collapsed view in the plane of acquisition.
Ramp Pulse I to S Select a ramp pulse that is in the direction of the flow. If an
I to S Ramp Pulse is on and blood flow is I to S, the signal
is bright, and if the blood flow is S to I, the signal is dark.
Accept [Accept] Confirms the selected value and closes the Vascular Time
of Flight Additional Parameter screen.
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe a volume for graphic prescription.
display the Position the slabs to cover anatomy of interest and select
volume. the adjustment handles to angle the volume. Consider
using an offset to center the anatomy in the middle of the
screen so you can use a PFOV less than 1 and reduce
scan time. For Multi-slab, move the crosshair cursor to the
desired location for the center of the volume of the first
slab. Click and hold the mouse button until a box appears
on the localizer image. The cursor turns into a pointer.
Drag the pointer across the image to the desired end
location. As the cursor is dragged across the image,
multiple 3D volumes are deposited. The number of
volumes is based on the FOV, slab thickness, overlap,
and the number of locations per slab. To adjust the
location of the slab, place the cursor over one of the slabs,
then click and drag the set of slabs to a new location.

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 Time of Flight (TOF)

3D TOF-SPGR Protocol Example (Circle of Willis)

What You Select Selection Notes
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
SAT Rx S Use a superior SAT pulse to decrease flow artifact.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Downloads the series.
Scan]
Scan Operations
Scan [Scan] Initiates the acquisition.

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 Time of Flight (TOF)

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 Fast Time of Flight (Fast TOF)

Chapter 22
Fast Time of Flight (Fast TOF)

Introduction
This chapter explains the pulsing components and timing factors directly related to the
Fast Time of Flight (Fast TOF) pulse sequences. This chapter explains the concepts of
each and the step-by-step instructions to help you learn how to:
• Prescribe a 2D Gated Fast TOF Sequence
• Prescribe a 3D Fast TOF Sequence

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 Fast Time of Flight (Fast TOF)

What Do I Need to Know About...

This section presents the concepts necessary to understand Fast TOF pulse
sequences. Specifically, you need to understand:
• Fast TOF Basics
• 2D Fast TOF
– Gated Fast Time of Flight
– User Control Variables
– Imaging Characteristics
– Supported Features
– Applications
• 3D Fast TOF
– User Control Variables
– Supported Features
– Applications

Fast TOF Basics

There are several different pulse sequences within the vascular TOF family, as shown
in Figure 22-1. They are all related to the Gradient Echo (GRE) family of pulse
sequences.
Figure 22-1 Vascular TOF Family Tree

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 Fast Time of Flight (Fast TOF)

2D Fast TOF
Like TOF, Fast TOF imaging is based on conventional GRE scanning with flow
compensation. This imaging technique relies primarily on flow-related enhancements to
distinguish moving from stationary spins in creating Magnetic Resonance Angiograms
(MRA). The two-dimensional (2D) Fast TOF sequence can be acquired with a Fast
GRE or a Fast SPoiled Gradient Echo (Fast SPGR). The pulse sequence is diagramed
in Figure 22-2.
Fast TOF uses fractional echo, fractional radio frequency (RF), and wide receive
bandwidths to obtain shorter TR and TE than standard TOF. By using a fractional RF,
the duration of the excitation pulse and the readout time is shortened, thus shorting the
overall total time required to play out the sequence.
Figure 22-2 Fast TOF Pulse Sequence Diagram
Fractional Echor
Fractional RF Fractional RF

TE

TR

Gradient Rephasing Pulse

Gated Fast Time of Flight

Gated 2D Fast TOF is a Fast GRE pulse sequence designed to reduce pulsatile flow
artifact for peripheral MRA exams. This is achieved by synchronizing the data
acquisition with the heart rate and segmenting k-space within the cardiac cycle in a
manner which optimizes image contrast (makes blood brighter).
Gated 2D Fast TOF introduces a new definition for the gating parameter Delay After
Trigger (Figure 22-3). Delay After Trigger is the parameter used by the system to
determine when the center of k-space is acquired. The center of k-space contributes
primarily to image signal and contrast while the outer edges of k-space contribute
primarily to the image resolution (edge detail). Select a Delay After Trigger time to occur
at the end of the systolic phase, which is when the blood flow is fastest.
Selections are made at the Gating screen for Gated TOF imaging. Either
(electrocardiogram) ECG or peripheral gating (PG) leads can be used, depending on
the area of interest.

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 Fast Time of Flight (Fast TOF)

Views-per-segment (VPS), one of the gating scan parameters, is used to increase scan
time by collecting multiple views (k-space lines) which contribute to a single image. If
the number of VPS results in the available imaging time are being exceeded, a
message appears directing you to reduce the number of VPS or shorten the Trigger
Window.
Figure 22-3 Trigger Delay

Program a delay time when blood flow is fastest — typically at end systole for the area
of interest. Center lines of k-space are filled during this data acquisition time. Selecting
a Delay After Trigger time to coincide with the peak flow of the area of interest produces
the best contrast between blood and background. To determine the optimum time, use
a 2D FastCard acquisition and the MIROI display program:
• Acquire a 2D FastCard image set of the vessels of interest with reconstruction of
flow direction images. For example, for a gated TOF of the carotid arteries, you can
acquire a 2D FastCard set of axial images with a S/I flow direction selected. Blood in
the images is bright for flow.
• Select the F2D FastCard images and enter the MIROI program.
Figure 22-4 ROI in Vessel on Axial Magnitude Image

2D FastCard can help determine the trigger delay for a Gated 2D TOF sequence.
Figure 22-4 displays an axial magnitude image with a ROI placed within a vessel.

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 Fast Time of Flight (Fast TOF)

To Determine Trigger Delay:

1. Select an image from the 2D FastCard image set and click MIROI.
2. Place ROI inside a vessel of interest and click [Accept].
3. Each point on the graph (Figure 22-5) represents a slice within the series.
Figure 22-5 Peak Flow Graph

4. Note the image number that is before the highest peak.

5. View the image and note the TDEL (time of delay) of the image number. Enter this
time for the Trigger Delay on the Gating screen during your gated TOF prescription.
If the time delay you enter is smaller than the minimum value allowed you will have
to use the minimum value. For example, if the time delay noted in the MIROI
program shows the peak systolic time to be 155 msec but the minimum delay you
can enter is may be 177 msec, then you must use 177 msec.

User Control Variables

The SAT Gap User Control Variable (User CV) appears with all Fast TOF sequences.
Figure 22-6 displays the SAT Gap User CV. Table 22-1 describes each User CV.

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 Fast Time of Flight (Fast TOF)

Figure 22-6 Fast TOF User CV Screen

Table 22-1 Fast TOF User CV Descriptions

User CV Mode Description

Off = 0 A signal suppression technique used with spatial
SAT Gap On = 10.00, saturation pluses, or FAT SAT pulses, to
20.00, or 30.00 suppress the signal from fat.

Imaging Characteristics
Fast TOF sequences exhibit the same image characteristics as conventional TOF
images, they are inherently low in SNR. Intra-voxel phase dispersion decreases SNR
and is affected by voxel size, sequence timing, and flow dynamics.
Images with flowing nuclei are bright while stationary nuclei are dark. Stagnant, slow
flow, or in-plane flow produces a decreased signal as it becomes saturated.

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. The X in Table 22-2 indicates the imaging options available for use with the 2D
Fast TOF pulse sequences.
Table 22-2 2D Fast TOF GRE/SPGR Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

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 Fast Time of Flight (Fast TOF)

Imaging Options (Continued)

X Cardiac Gating/Triggering Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

Classic X Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

X IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

Multi-Phase ZIP x 4

Multi Station X ZIP 512

Navigator ZIP 1024

NOTE: The Imaging Options shown in Table 22-2 may not always be compatible with
each other.
Sequential cannot be turned off.

Applications
Gated Fast 2D TOF can be used when you need to reduce artifacts due to pulsatile flow
when acquiring scans of the carotids, aortic bifurcation, iliacs, and popliteal vessels.
Figure 22-7 demonstrates the aortic bifurcation and iliac images acquired with a
standard TOF and a gated TOF.
Projection images created by selecting 19 or 37 at the Vascular screen during series
prescription appear distorted or elongated when a slice overlap or gap has been
prescribed. To avoid the image distortions, do not use an overlap or gap, or use IVI to
create the projection images.

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 Fast Time of Flight (Fast TOF)

Figure 22-7 Standard TOF vs. Gated Fast TOF Images

This sequence can also be used to acquire popliteal artery images, carotid images, and
images of the carotid arteries (Figure 22-8).
Figure 22-8 Standard TOF vs. Gated Fast TOF Carotid Images

3D Fast TOF
Three-dimensional (3D) Fast TOF is a Fast GRE or SPGR sequence designed for use
in vascular imaging. 3D Fast TOF provides the benefits of a 3D acquisition with the use
of faster TRs and TEs to decrease imaging time.
You are able to choose a desired TE selection from the Scan Timing area. Your choices
include:
• Minimum: performs a fractional echo sequence.
• Minimum Full: performs a full echo sequence.
• In Phase: automatically fits the TE into a fat/water in-phase range.
• Out-of-Phase: automatically fits the TE into a fat/water out-of-phase range.

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 Fast Time of Flight (Fast TOF)

With either fat/water in phase or out-of-phase, the system uses a full echo if the
minimum TE for the appropriate range can be achieved with a full echo. Otherwise, the
system uses a fractional echo with the shortest possible TE.
Due to shorter TRs, 3D Fast TOF results in less SNR when compared to non-fast 3D
TOF. Depending on the sequence selected, the system automatically determines the
minimum TR based on other parameter values.
3D Fast TOF images are annotated “3D/TOF/FSPGR/Flip Angle”.
Due to rapid changing of gradients, there is an increased noise level.
When using SAT, some restrictions apply:
• SAT cannot be applied on more than one axis.
• Two SAT bands cannot lie on the same axis at two different thicknesses.
• The system does not allow prescribing one SAT band graphically and another
explicitly. This limitation is due to timing constraints within the pulse sequence to
allow for short TRs.
3D Fast TOF GRE/SPGR T1-weighting depends on the parameters selected. In
general, T1-weighting increases as flip angle increases and TR and TE decrease. A
smaller flip angle and a low TE result in proton density (PD)-weighted images. With 3D
Fast TOF GRE/SPGR, the flip angle is limited to 60°.

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 Fast Time of Flight (Fast TOF)

User Control Variables

The Fast TOF pulse sequences include several control variables accessed via the User
CVs screen (Figure 22-9) located in the Additional Parameters area.
Figure 22-9 Fast 3D TOF User CVs

Table 22-3 3D Fast TOF User CV Descriptions

User CV Mode Description

Reverse Elliptical 0 = Off Fills the center lines and slices of k-space during
Centric 1 = On the last 1/9 of the total scan time.
0 = Off Fills the center lines and slices of k-space during
Elliptical-Centric
1 = On the first 1/9 of the total scan time.
Fills k-space by starting at the center and works
0 = Off
Centric outward, while alternating between positive and
1 = On
negative gradient values.
0 = Off Fills the outer lines of k-space for all slices
Reverse Centric
1 = On during the last 1/2 of the total scan time.

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 Fast Time of Flight (Fast TOF)

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. The X in Table 22-4 indicates the imaging options available for use with the 3D
Fast TOF pulse sequences.
Table 22-4 3D Fast TOF GRE/SPGR Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

X Cardiac Gating/Triggering X Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

Classic Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

Flow Compensation X SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

X IR Prepared X Variable Bandwidth

Magnetization Transfer X ZIP x 2

X Multi-Phase X ZIP x 4

X Multi Station X ZIP 512

Navigator X ZIP 1024

NOTE: The Imaging Options shown in Table 22-4 may not always be compatible with
each other.

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 Fast Time of Flight (Fast TOF)

Applications
3D Fast TOF sequences are commonly used to acquire MR angiogram scans
demonstrating intracranial vessels. They provide the shortest TE and TR times possible
for uncooperative or pediatric patients. These sequences can also be used with
SmartPrep to acquire signal change over time to evaluate vascular disease.

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 Fast Time of Flight (Fast TOF)

How Do I...
This section provides the step-by-step instructions for prescribing Fast TOF imaging
pulse sequences. Specifically, it describes how to:
• Prescribe a 2D Gated Fast TOF Sequence
• Prescribe a 3D Fast TOF Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions:
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Hearing protection is required for all people in the scan room to prevent
hearing impairment. Acoustic noise levels can exceed 99 db(A).

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 Fast Time of Flight (Fast TOF)

Prescribe a 2D Gated Fast TOF Sequence

2D Gated Fast TOF sequences can be used when you need to reduce artifacts due to
pulsatile flow when acquiring scans of the carotids, aortic bifurcation, iliacs, and
popliteal vessels. Images can be acquired using a Fast TOF-GRE or a Fast TOF-SPGR
sequence.
The decision matrix (Table 22-5) is only for prescribing a 2D Fast TOF sequence. The
following example is for a 2D Fast TOF scan of the carotids.
Table 22-5 2D Gated Fast TOF Protocol Example

2D Gated Fast TOF Protocol Example

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series when the
Patient Protocol window becomes active.
Patient Position

Coil
Illustration

Patient Position Supine A Gated Fast 2D TOF pulse sequence is compatible with
any patient position and entry.
Patient Entry Head First
Coil NVArray Allows selection of the coil from which the signal is
transmitted and received. Use a coil which produces the
optimum coverage and SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

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 Fast Time of Flight (Fast TOF)

2D Gated Fast TOF Protocol Example

What You Select Selection Notes
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. Fast 2D TOF is
compatible with any scan plane, except 3-Plane. Select
the plane which best meets your clinical needs. Maximum
flow-related enhancement occurs when blood flow is
perpendicular to the imaging plane.
Mode 2D Prescribes a two-dimensional sequence.
Pulse Seq Fast TOF SPGR Activates the Fast TOF SPGR pulse sequence. Fast TOF
SPGR typically reduces the signal from fat more than
Fast TOF GRE, but you may also select Fast TOF GRE.
Click [Accept] to register the selection.
Imaging Options Flow Select Cardiac Gating/Triggering and Sequential. Flow
Compensation, Compensation may increase the signal from blood by
Cardiac rephasing moving spins, but it increases the minimum TE.
Gating/Triggering Select other imaging options which optimize SNR and
Sequential spatial resolution. Click [Accept] to register the
selections.
PSD Name N/A
Protocol N/A

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 Fast Time of Flight (Fast TOF)

2D Gated Fast TOF Protocol Example

What You Select Selection Notes
Scan Timing

# of echoes 1 Only 1 echo is allowed.

TE Minimum Use the minimum TE for minimal dephasing effects.
Minimum TE changes as RBw changes.
TR 34 Use the minimum TR to allow the largest number of
Views Per Segment, which can reduce the scan time.
Inv. Time N/A
Flip Angle 60 As the flow gets faster, the flip angle may be increased.
Increased Flip Angles increase T1 contrast and SNR.
Echo Train Length N/A
Bandwidth 31.25 As Receive Bandwidth increases, the minimum TE and
SNR decrease. Choose a RBw which is a compromise
between SNR, TE, and Views Per Segment.
Bandwidth 2 N/A

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 Fast Time of Flight (Fast TOF)

2D Gated Fast TOF Protocol Example

What You Select Selection Notes
Scanning Range

FOV 24 Select a FOV which covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results in
aliasing. Small FOVs increase resolution, decrease SNR,
and can increase the minimum TE value.
Slice Thickness 4.0 Thin slices increase flow-related enhancement and
resolution, reduce effects of in-plane flow, and decrease
SNR. Consider the anatomy to be covered.
Overlap 1.0 An overlap is prescribed to reduce partial volume effects.
Decreasing the overlap decreases scan time since fewer
slices are needed to cover the desired anatomy.
However, increased partial volume artifacts result as
overlap decreases.
Start, End Locations Typically the start and end locations are programmed
from the Graphic Rx program. As many slices as needed
to cover the desired anatomy may be prescribed. As the
number of locations increases, total scan time increases.
# Slices 16 This text box indicates the number of locations
prescribed.

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 Fast Time of Flight (Fast TOF)

2D Gated Fast TOF Protocol Example

What You Select Selection Notes
Acquisition Timing

Freq 256 Increasing the frequency matrix increases resolution and

decreases SNR.
Phase 224 Phase controls scan time and resolution.
NEX 1.00 Select a NEX value which produces sufficient SNR. As
NEX increases so does the SNR and scan time.
Phase FOV 0.75 Select 0.5 or 0.75 to reduce phase steps and thus
decrease scan time, decreasing FOV in the phase
direction, and decreasing SNR slightly. The phase FOV
dimension is displayed next to the phase FOV factor.
Freq DIR R/L The direction displayed is the default frequency direction
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak. It will be set during prescan.
Flow Comp DIR N/A
Autoshim On Use Autoshim to improve the homogeneity.
Phase Correct N/A
# of Acqs/Locs Before None Although this text box is available, pauses are generally
Pause not used with TOF scans. Breath-hold exams are usually
not done due to differences in anatomical location from
slice to slice.

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 Fast Time of Flight (Fast TOF)

2D Gated Fast TOF Protocol Example

What You Select Selection Notes
Additional Parameters - Vascular Options

Projection Images 19 Choose 19 or 37 to automatically create projection

images. When a slice overlap or gap is prescribed, the
automatic projections appear distorted or elongated. This
is not a problem, but is a result of the projection program
used by image reconstruction. To avoid image distortions,
do not use an overlap or gap, or use the IVI program to
create the projection images. If IR-Prep is selected with a
non-gated Fast TOF GRE/SPGR, you cannot select
projection images. Projection and vascular images are
not generated because abdominal imaging is the
intended application for IR-Prep with Fast TOF
GRE/SPGR.
Collapse On Provides a collapsed view in the plane of acquisition.
Ramp Pulse N/A
Accept [Accept] Accepts the parameters and closes the window.

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 Fast Time of Flight (Fast TOF)

2D Gated Fast TOF Protocol Example

What You Select Selection Notes
Additional Parameters - User CVs

SAT Gap 10.00 Increase the SAT Gap as the area to be scanned gets
farther away from the heart. A 10 mm SAT Gap is
typically used for carotid and iliac vessel exams and a
20 mm SAT Gap is typically used for distal femoral and
popliteal vessel examinations.
Accept [Accept] Accepts the parameters and closes the window.
Additional Parameters - Gating/Triggering

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 Fast Time of Flight (Fast TOF)

2D Gated Fast TOF Protocol Example

What You Select Selection Notes
Trigger Type Auto Use ECG for all regions except carotids. PG may be used
ECG-II for carotids including the aortic arch. Use the Auto lead to
allow the system to choose the best ECG lead. Select PG
for Peripheral gating.
Trigger Window Auto Auto Trigger Window adjusts the “waiting for the next
R-wave” window based on the patient’s cardiac rhythm.
Trigger Delay 184 Choose the Trigger Delay to coincide with the peak flow
of the area of interest.
# of Card. Phases to 20
Reconstruct
Views Per Segment 8 As the number of VPS increases, scan time decreases.
Typically the shortest scan time with the most slices
possible is desirable. If the number of VPS results in the
available imaging time being exceeded, a message is
posted directing either the number of VPS be reduced or
the trigger window be shortened.
Heart Rate (bpm) [update Rate] Click [update Rate] to let the system obtain an automatic
reading of the current heart rate or the bpm may be
manually entered by observing the monitor.
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and
cursor. remove slices. Position the slices to cover anatomy of
interest. The scan time increases as the number of
acquisitions increase. To optimize flow-related
enhancement, prescribe the slices I to S when imaging
arterial flow below the heart, and from S to I when
imaging above the heart. Consider using an offset to
center the anatomy in the middle of the screen so that
you can use a PFOV less than 1 and reduce the scan
time.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
SAT Rx I40 Select spatial SAT pulses perpendicular to the flow and in
a direction that reduces unwanted flow. To suppress
arterial flow above the heart, use a superior SAT pulse,
and to suppress arterial flow below the heart, use an
inferior SAT pulse. Only use the User CV screen to alter
the SAT pulse location (gap). Entering a new location in
the SAT area eliminates Concatenated SAT.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.

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© 2004 General Electric Company. All rights reserved.
 Fast Time of Flight (Fast TOF)

2D Gated Fast TOF Protocol Example

What You Select Selection Notes
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Scan [Scan] Initiates the acquisition.

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© 2004 General Electric Company. All rights reserved.
 Fast Time of Flight (Fast TOF)

Prescribe a 3D Fast TOF Sequence

The 3D Fast TOF sequences can be used to acquire MR angiogram scans
demonstrating intracranial vessels. These sequences provide the shortest TE and TR
times possible. Images can be acquired using a Fast TOF-GRE or a Fast TOF-SPGR
sequence.
The decision matrix (Table 22-6) is only for prescribing a 3D Fast TOF sequence. The
following example is for a 3D Fast TOF scan of the head to image intracranial arteries.
Table 22-6 3D Fast TOF Protocol Example

3D Fast TOF Protocol Example (Circle of Willis)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series when
the Patient Protocol window becomes active.
Patient Position

Patient Position Supine A 3D Fast TOF pulse sequence is compatible with any
patient position and entry.
Patient Entry Head First
Coil Head Allows selection of the coil from which the signal is
transmitted and received. Use a coil which produces the
optimum coverage and SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

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© 2004 General Electric Company. All rights reserved.
 Fast Time of Flight (Fast TOF)

3D Fast TOF Protocol Example (Circle of Willis)

What You Select Selection Notes
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. Fast 3D TOF
is compatible with any scan plane, except 3-Plane.
Select the plane which best meets your clinical needs.
Maximum flow-related enhancement occurs when blood
flow is perpendicular to the imaging plane.
Mode 3D Prescribes a three-dimensional sequence.
Pulse Seq Fast TOF GRE Activates the Fast TOF GRE pulse sequence. You may
also select Fast TOF SPGR. Click [Accept] to register
the selection.
Imaging Options EDR Flow Compensation and Magnetization Transfer are not
allowed; these options result in increased TE and TR
values. Select ZIP 512 to enhance in-plane resolution
with only a small decrease in SNR, but with a tradeoff in
reconstruction time and disk storage (the image is
reconstructed and stored as a 512x512 image data set).
Select a Slice ZIP factor, ZIP x 2 or ZIP x 4, to increase
the number of slices (by a factor of 2 or 4) without
increasing the scan time. Selecting a Slice ZIP improves
MIP and reformat image quality. Select other imaging
options which optimize SNR and spatial resolution.
Refer to Table 22-4 for a complete list of compatible
options. Click [Accept] to register the selections.
PSD Name N/A
Protocol N/A

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© 2004 General Electric Company. All rights reserved.
 Fast Time of Flight (Fast TOF)

3D Fast TOF Protocol Example (Circle of Willis)

What You Select Selection Notes
Scan Timing

# of echoes 1 Only one echo is allowed for vascular sequences.

TE Minimum Use the minimum TE for minimum dephasing effects.
Select F/W out-of-phase to decrease fat signal. Higher
TEs may increase minimum TR and increase scan time.
Minimum TE changes as RBw changes.
TE2 N/A Long TEs decrease the number of slices and SNR, while
increasing the T2 contrast.
TR N/S The minimum TR is set by the system based on other
parameters such as TE, RBw, FOV, and Matrix.
Inv. Time N/A
TI2 (Prep Time) N/A Only becomes active if IR Prep is selected as an
Imaging Option is selected.
Flip Angle 20 Choose a Flip Angle to produce the desired contrast.
Due to reduced minimum TR values, the Flip Angle may
be decreased to minimize saturation of small vessels.
Echo Train Length N/A
Bandwidth 10.42 RBw can only be changed if it was selected from the
Imaging Options window. As the RBw decreases, SNR,
chemical shift artifact, and minimum TE increase (which
can increase the minimum TR).
Bandwidth 2 N/A

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© 2004 General Electric Company. All rights reserved.
 Fast Time of Flight (Fast TOF)

3D Fast TOF Protocol Example (Circle of Willis)

What You Select Selection Notes
Scanning Range

FOV 24 Select a FOV which covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results
in aliasing. Small FOVs increase resolution, decrease
SNR, and can increase the minimum TE value.
Slice Thickness 1.5 Increasing slice thickness increases SNR, coverage,
and saturation of flowing spins as they move through the
volume. It decreases resolution.
Overlap Locs N/A
Locs per Slab 90 Enter a value from 16 to 128 in multiples of 2. There are
two slices on either end of the slab which are discarded.
Factor these four slices into the selection.
Start, End Locations This text box indicates the first and last location of the
deposited slabs or volumes and includes two discarded
slices on either end of the slabs. Graphic Rx must be
used to deposit the slabs.
# Slabs 1

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© 2004 General Electric Company. All rights reserved.
 Fast Time of Flight (Fast TOF)

3D Fast TOF Protocol Example (Circle of Willis)

What You Select Selection Notes
Acquisition Timing

Freq 256 As the frequency matrix increases, the resolution

increases and SNR decreases.
Phase 192 Phase controls scan time and resolution.
NEX 2.00 Select a NEX value which produces sufficient SNR, yet
does not compromise scan time.
Phase FOV 1.00 Select 0.5 or 0.75 to reduce phase steps and decrease
scan time, FOV in the phase direction, and SNR slightly.
The phase FOV dimension is displayed next to the
phase FOV factor.
Freq DIR A/P The direction displayed is the default frequency
direction, which is typically the long axis of the image. To
swap phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak. It will be set during prescan.
Flow Comp DIR N/A
Autoshim On Select Autoshim to improve homogeneity.
Phase Correct N/A
# of Acqs/Locs Before N/A
Pause

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 Fast Time of Flight (Fast TOF)

3D Fast TOF Protocol Example (Circle of Willis)

What You Select Selection Notes
Additional Parameters - Vascular

Projection Images 19 Enter 19 or 37 to automatically create projection images.

Collapse On Select On to get a collapsed view in the plane of
acquisition.
Ramp Pulse N/A Ramp pulse is not available.
Accept [Accept] Accepts the parameters and closes the Vascular Time of
Flight window.

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© 2004 General Electric Company. All rights reserved.
 Fast Time of Flight (Fast TOF)

3D Fast TOF Protocol Example (Circle of Willis)

What You Select Selection Notes
Additional Parameters - User CV

Reverse Elliptical 0.00

Centric
Elliptical Centric 1.0 Turn On to fill the center lines and center slices of
k-space first.
Centric 0.0 Turn On to fill the center lines of k-space first. Centric
k-space filling is compatible with SPECIAL.
Reverse Centric 0.00
Accept [Accept] Accepts the parameters and closes the User CVs
window.

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© 2004 General Electric Company. All rights reserved.
 Fast Time of Flight (Fast TOF)

3D Fast TOF Protocol Example (Circle of Willis)

What You Select Selection Notes
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe a volume for graphic
display the volume. prescription. Select the adjustment handles to angle the
volume. The size of the volume is based on the FOV,
slice thickness, and number of locations per slab. To
adjust the location of the volume, place the cursor over
the slab, then click and drag the slab to a new location.
Consider using an offset to center the anatomy in the
middle of the screen so that you can use a PFOV less
than 1, and reduce the scan time.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
SAT Rx S40 Use SAT to decrease signal from unwanted flow, such
as venous flow when imaging the Circle of Willis.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Scan [Scan] Initiates the acquisition.

22-30
© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

Chapter 23
Line Scan Diffusion-Weighted
Imaging (LSDI)

Introduction
This chapter explains the pulsing components and timing factors directly related to Line
Scan Diffusion-Weighted Imaging (LSDI). This chapter explains the concepts and the
step-by-step instructions to help you learn how to:
• Prescribe a LSDI Sequence

23-1
© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

What Do I Need to Know About...

This section presents the concepts necessary to understand Spin Echo (SE) and
Inversion Recovery (IR) pulse sequences. Specifically, you need to understand:
• Line Scan Diffusion-Weighted Imaging
• Diffusion Options
• Supported Features

Line Scan Diffusion-Weighted Imaging

LSDI is a Spin Echo (SE) pulse sequence designed to create images that differentiate
tissues with restricted diffusion from normal diffusion.
LSDI can be selected by selecting DW Line Scan in the Pulse Sequence window, or by
entering DWL in the Pulse Seq text box.
Figure 23-1 LSDI Pulse Sequence Diagram

LSDI is a SE sequence with a diffusion sensitizing gradient referred to as a motion

probing gradient (MPG). In a standard SE sequence, the effective excitation plane of
the 90° and 180° RF pulses are the same. However, in LSDI, the effective plane of the
90° and 180° excitation pulses are tilted, resulting in the excitation of a cylinder or
volume of tissue at their intersection in the slice plane.

23-2
© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

Figure 23-2 Excitation method for LSDI

Table 23-1 Description of Figure 23-2

Callout # Description
1 Excitation method for Line Scan Diffusion Imaging
2 Plane refocused by 180° RF pulse
3 Plane excited by 90° RF pulse
4 Effective slice thickness

The echo produced from this cylinder of excited data is frequency-encoded. A

one-dimensional Fourier Transformation (1D FT) is performed on the line of data. Lines
(cylinders) of data are excited and 1D FTs are performed for the number of phase
encoding steps prescribed and combined to form a 2D image. One line of data is
acquired per one TR period.
Figure 23-3 LSDI Data Acquisition Method

23-3
© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

Table 23-2 Description of Figure 23-3

Callout # Description
1 Acquisition method for Line Scan Diffusion Imaging.
Cylinders or columns of data excited and reconstructed in each pass
2
across the FOV.
Phase Matrix 64 resulting in 64 columns of data excited and 1D FT
3
performed to create a line of data.

LSDI is designed to dephase the spins of fast-moving molecules in living tissue. When
the MPG is applied, the signal from protons bound in highly mobile water molecules
should dephase in the direction the gradient is applied, producing no signal. The signal
produced from protons in these tissues should appear dark or hypo-intense in the
images.
Protons that are bound in molecules that are not moving will not be dephased. The
signal produced from these motionless protons should appear bright, or hyper-intense,
relative to the highly mobile protons.
The end result of a LSDI acquisition should be a contrast difference between tissues
with free diffusion, such as gray matter or cerebrospinal fluid (CSF), and tissues with
restricted diffusion, such as white matter or dead tissue.
In LSDI, a gradient pulse sensitizes the Magnetic Resonance image (MRI) to the motion
of extra-cellular water. More motion produces a darker image.
The MPG can be applied in frequency, phase and slice directions for the scan plane
selected.
Figure 23-4 Diffusion Tissue Samples

23-4
© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

Diffusion Options
Selecting DW Line Scan on the Pulse Sequence window activates the DWI icon in the
Additional Parameters area, which opens the Diffusion Options (Figure 23-5) window.
Figure 23-5 Diffusion Options Window

The following parameters need to be completed in the Diffusion Options window.

• The B-value to define the diffusion weighting of the image. As the B-value is
increased, the SNR of the acquisition will decrease as the image becomes more
heavily diffusion weighted.
• Diffusion Direction - The direction in which the MPG is applied for the acquisition.
There are four choices for the Diffusion Direction.
• S/I - MPG is applied only in the S/I direction.
• A/P - MPG is applied only in the A/P direction.
• R/L - MPG is applied only in the R/L direction.
• ALL - MPG is applied in all three directions.

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 23-3, an X indicates the imaging options available for use with the LSDI
pulse sequence.
Table 23-3 LSDI Compatible Imaging Options

Imaging Options
X None No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

Cardiac Gating/Triggering Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

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© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

Imaging Options (Continued)

Classic Sequential

DE Prepared Single Quadrature Fat imaging

X Extended Dynamic Range Single Quadrature Water imaging

Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

Multi-Phase ZIP x 4

Multi Station ZIP 512

Navigator ZIP 1024

NOTE: The Imaging Options shown in Table 23-3 may not always be compatible with
each other.

23-6
© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

How Do I...
This section provides the step-by-step instructions for prescribing a LSDI sequence.
Specifically, it describes how to:
• Prescribe a LSDI Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions.
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

WARNING:Hearing protection is required for all people in the scan room during a
scan to help prevent hearing impairment. Acoustic noise levels may

23-7
© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

Prescribe a LSDI Sequence

The LSDI sequence can be used to create images that differentiate tissues with
restricted diffusion from normal diffusion.
This decision matrix (Table 23-4) is only for prescribing a LSDI sequence. The following
example protocol is for prescribing a LSDI sequence of the brain.
Table 23-4 LSDI Protocol Example (Brain)

LSDI Protocol Example (Brain)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series if the
Patient Protocol window becomes active.
Patient Position

Patient Position Supine A SE pulse sequence is only compatible with center patient
entry.
Patient Entry Head First
Coil Head Only the Head coil is compatible with LSDI pulse
sequences.
Series Enter a series Allows you to enter a brief description of the series being
description in the text prescribed. If you do not enter a description, the system
box. enters a default series description with the selected scan
mode, PSD, and selected imaging options.

23-8
© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

LSDI Protocol Example (Brain)

What You Select Selection Notes
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. Compatible with
any scan plane except Oblique. Select the plane that best
meets your clinical need.
Mode 2D Prescribes a two-dimensional sequence.
Pulse Seq Line Scan Activates the line scan diffusion pulse sequence. Select
DW Line Scan from the Pulse Sequence menu. Click
[Accept] to register the selection.
Imaging Options Select imaging options that optimize SNR, spatial
resolution, the number of slices, and reduce motion
artifacts. Click [Accept] to register the selections.
PSD Name
Protocol N/A

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© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

LSDI Protocol Example (Brain)

What You Select Selection Notes
Scan Timing

# of echoes 1
TE Min Full Short TEs increase T1 and PD contrast, SNR, and the
number of slices with multi-planar acquisitions. Minimum
TE changes as RBw changes. TE selection is variable with
Minimum and Min Full options in the pull-down menu.
TR 334 Short TRs decrease SNR, the number of slices in
multi-planar acquisitions, and scan time. They increase T1
contrast. Long TRs increase SNR, the number of slices,
PD/T2 contrast, and scan time. Changes made to SE
timing factors are likely to result in a decrease in the
maximum number of slice locations allowed per TR. As a
result, acquisitions may double if the number of slices
exceed the maximum TR. To avoid a double acquisition,
decrease the number of slices.
TI N/A
Flip Angle N/A
Echo Train Length N/A
Bandwidth 2.02 As RBw decreases, SNR increases, chemical shift artifact
increases, and minimum TE increases, which can
potentially decrease slices and increase motion artifact.
Bandwidth 2 N/A

23-10
© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

LSDI Protocol Example (Brain)

What You Select Selection Notes
Scanning Range

FOV 26 Select a FOV that covers the anatomy of interest. Anatomy

outside the FOV in the phase direction results in aliasing.
Small FOVs increase resolution, decrease SNR, and can
increase the minimum TE value.
Slice Thickness 7 Thin slices increase resolution and decrease SNR.
Spacing 1 Select a spacing that reduces cross-talk between slices
(typically 20% of the slice thickness).
Start, End Typically the start and end locations are programmed from
Locations the Graphic Rx program.
# Slices The maximum number of slices available is determined by
the TR, TE, SAR, and gradient stress.
Acquisition Timing

Freq 96 Increasing the frequency matrix increases resolution, while

decreasing SNR and the number of slices. Frequency can
be set in steps of 16, between 64 and 128.
Phase 80 Phase controls scan time and may control resolution.
Phase can be set in steps of 32.
NEX N/S NEX is automatically set to 1 for LDSI.

23-11
© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

LSDI Protocol Example (Brain)

What You Select Selection Notes
Phase FOV 0.75 Select 0.75 or 0.5 to reduce phase steps and thus
decrease scan time, FOV in the phase direction, and SNR
slightly. The phase FOV dimension is displayed next to the
phase FOV factor.
Freq DIR A/P The direction displayed is the default frequency direction
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Sets this CF peak during prescan.
Flow Comp DIR N/A
Autoshim
Phase Correct N/A
# of Acqs/Locs N/A
Before Pause
Additional Parameters - Diffusion Options
B-value 700 As the B-value increases, the diffusion weighting increases
and SNR decreases (due to longer TE).To use a B-value
between 300 and 1,000, Optimize TE must be selected
Diffusion Direction S/I Select All to get a combined image from the diffusion image
data at the expense of time. Select a specific direction for a
faster scan at the expense of having the image represent
diffusion effects in only one direction.
Accept [Accept] Registers your selections and closes the Diffusion Options
window.
Additional Parameters - Graphic Rx
[+] Next and [-] [+] and [-] Allows you to page through the localizer images to check
Prior the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and remove
cursor. slices. Position the slices to cover anatomy of interest and
view the Advisory Panel to note the maximum number of
slices per acquisition and the number of acquisitions you
are prescribing. The scan time increases as the number of
acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of a prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Additional Parameters - SAT Window
None ChemSAT pulses are not allowed in LSDI.

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© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

LSDI Protocol Example (Brain)

What You Select Selection Notes
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Scan [Scan] Initiates the acquisition.

23-13
© 2004 General Electric Company. All rights reserved.
 Line Scan Diffusion-Weighted Imaging (LSDI)

23-14
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

Chapter 24
T1 FLAIR and T2 FLAIR

Introduction
This chapter explains the pulsing components and timing factors directly related to the
FLuid Attenuated Inversion Recovery (FLAIR) pulse sequences. This chapter explains
the concepts of each and the step-by-step instructions to help you learn how to:
• Prescribe a T1 FLAIR Sequence
• Prescribe a T2 FLAIR Sequence

24-1
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

What Do I Need to Know About...

This section presents the concepts necessary to understand the FLAIR pulse
sequences. Specifically, you need to understand:
• FLAIR Basics
• T1 FLAIR
– Supported Features
– Applications
• T2 FLAIR
– Supported Features
– Applications

FLAIR Basics
The FLAIR pulse sequence is a Fast Inversion Recovery (IR) technique. Like Fast Spin
Echo-Inversion Recovery (FSE-IR), it consists of an initial 180° inversion pulse prior to
the 90° excitation pulse. Figure 24-1 displays the FLAIR pulse sequence diagram.
Figure 24-1 FLAIR Pulse Sequence Diagram
180 180 180 180 180 180

90

TI TE ES
TR

The Inversion Time (TI) determines the contrast in a FLAIR acquisition. There are two
types of FLAIR acquisitions:
• T1 FLAIR: the TI is based on the desired T1 contrast.
• T2 FLAIR: the TI is based on the null point of CSF.
Table 24-1 lists approximate TI and TR times for T1 and T2 FLAIR sequences.
Table 24-1 FLAIR TI and TR Times

TI Time TR Time
T1 FLAIR 700 to 800 ms 2000 to 2400 ms
T2 FLAIR 2000 to 2300 ms 8,000 to 10, 000 ms

24-2
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

T1 FLAIR
With T1 FLAIR sequences, the TI is based on the desired T1 contrast. The TR must be
sufficiently long enough to allow for spins to return to their equilibrium state.
T1 FLAIR weighted images have improved image contrast and more SNR than
T1-weighted Spin Echo (SE) images. Both pulse sequences are less sensitive to
magnetic field inhomogeneities and off-center field of view (FOV) effects. Figure 24-2
displays a comparison between T1 FLAIR and SE images in an axial brain.
Figure 24-2 Image Comparison of T1 FLAIR and T1 SE

T1 FLAIR SE

24-3
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 24-2, an X indicates the imaging options available for use with the T1
FLAIR pulse sequences.
Table 24-2 T1 FLAIR Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

Cardiac Gating/Triggering Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

Classic Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

X FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

Multi-Phase ZIP x 4

Multi Station X ZIP 512

Navigator X ZIP 1024

NOTE: *Sequential cannot be turned on. Neither Multi Slice Multi Angle Oblique (MSMA)
nor Multi Group Multi Angle Oblique (MGMA) is available with T1FLAIR. Only
Multi Slice Same Angle Oblique is available.

24-4
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

Applications
T1 FLAIR pulse sequences are designed to scan the same number of slices as the
T1-weighted SE sequence in the same or shorter scan time and achieve better tissue
contrast-to-noise as well as signal-to-noise ratios.
When performing a T1 FLAIR with contrast, if the T1 shortening of contrast corresponds
to the null point of the enhancing lesion, contrast enhancement could be suppressed.
Note the differences in lesion enhancement on the Sagittal T1 cervical spine images
shown in Figure 24-3.
Figure 24-3 Image Comparison of T1 FLAIR and T1 SE with Contrast

T1 FLAIR Spin Echo

Pausing a FLAIR acquisition during scanning may cause image artifacts and should be
avoided.

Fast Recovery (FR TIFLAIR)

The Fast Recovery Pulse has been added to T1 FLAIR pulse sequences to increase
the signal from T1 or T2 components. FRFSE applies an additional RF pulse at the end
of the echo train to drive the recovery of longitudinal magnetization.
An additional -90° FR (Fast Recovery) pulse following 180° refocusing pulses is applied
after the last echo in the FSE echo train is acquired. The -90° FR pulse is used to drive
the refocused magnetization back into the longitudinal axis, instead of allowing it to
recover via the T1 process. The FRFSE sequence therefore, allows for shorter TR
values and thus shorter scan times.
With the introduction of the -90° FR pulse for Long TI contrast, net contrast is enhanced
as the long T1 and/or T2 signals are forcibly changed from positive longitudinal
magnetization.

24-5
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

Figure 24-4 User CV 10

– [O] for FR off: an additional FR pulse is not applied.

– [1] for short TI on: -90o FR pulse is added.

T2 FLAIR
The T2 FLAIR pulse sequence is acquired using an interleaved technique and nulls the
cerebrospinal fluid (CSF) signal while maintaining T2 contrast.
CSF artifacts arises when non-inverted CSF is able to flow into the imaging slice. CSF
artifacts appear either as non-nulled (bright) CSF and/or CSF ghosts replicated along
the phase encode direction. In order to minimize these affects, the width of the inversion
slice is made wider than the width of the imaging slice whenever possible. This
widening of the inversion pulse attempts to invert CSF that flows into the imaging slice
during the TI interval. To maintain CSF nulling, the TR must be at least 3 to 4 times the
value of the TI. If you choose a TR that is significantly lower than 3 times the TI, the
quality of the CSF nulling is degraded.

24-6
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

Figure 24-5 Wide Inversion Pulse

If, for example, a slice gap is chosen, the inversion slice thickness is automatically
widened to include the imaging slice thickness plus the slice gap.
Another way to cause an increase in the thickness of the inversion pulse is to prescribe
multiple acquisitions. Usually the scan software uses multiple acquisitions only if the
number of slice locations requested is larger than the number of locations that can fit
into one acquisition. With T2 FLAIR, however, you can force the scan software to use
multiple acquisitions no matter the number of requested slice locations. This is done by
choosing Minimum Acqs on the Additional Parameters User CV screen.
By selecting three acquisitions, for example, the scan software divides the total set of
prescribed slices into three different acquisitions. The inversion slice thickness for each
acquisition increases by a factor of three. Whenever multiple acquisitions are used, the
inversion thickness is again widened, reducing the CSF artifacts. For two-acquisition
exams, the inversion thickness is approximately three times as thick as the imaging
slice. For maximum suppression of CSF ghosting artifacts, you are encouraged to use
two- or three-acquisition protocols.

24-7
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 24-3, an X indicates the imaging options available for use with the T2
FLAIR pulse sequences.
Table 24-3 T2 FLAIR Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

Cardiac Gating/Triggering Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

Classic Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

X FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

Multi-Phase ZIP x 4

Multi Station X ZIP 512

Navigator ZIP 1024

NOTE: Sequential cannot be turned on. Neither Multi Slice Multi Angle Oblique (MSMA)
nor Multi Group Multi Angle Oblique (MGMA) is available with T2FLAIR. Only
Multi Slice Same Angle Oblique is available.

24-8
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

User Control Variables

Figure 24-6 displays the User CVs available for FSE PSDs. Table 24-4 describes each
User CV.
Figure 24-6 T2 FLAIR User CV Screen

Table 24-4 T2 FLAIR User CV Descriptions

User CV Mode Description

Force the scan software to use multiple
acquisitions no matter how many scan locations
Minimum
1 are prescribed. Prescribing multiple acquisitions
Acquisition
increases the thickness of the inversion pulse,
reducing the motion artifact for CSF.

Applications
T2 FLAIR images have improved image contrast and more signal-to-noise ratio (SNR)
than FSE images. Both pulse sequences are less sensitive to magnetic field
inhomogeneities and off-center FOV effects. With the FLAIR sequence, bright signal is
suppressed from CSF on T2-weighted images and structures adjacent to fluid filled
structures become more apparent. FLAIR sequences are most commonly used for T2
neurological applications where nullification of the CSF signal is desired.

24-9
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

Figure 24-7 T2 FLAIR Image

24-10
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

How Do I...
This section provides the step-by-step instructions for prescribing the FLAIR imaging
pulse sequences. Specifically, it describes how to:
• Prescribe a T1 FLAIR Sequence
• Prescribe a T2 FLAIR Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions.
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.
NOTE: Since the acoustic noise of the Ovation does not exceed 92.2 dBA, ear protection
is not required, but is recommended.

24-11
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

Prescribe a T1 FLAIR Sequence

T1 FLAIR sequences are designed to reduce the T1-weighted imaging scan time, as
compared to T1-weighted SE imaging scan times.
The decision matrix (Table 24-5) is only for prescribing a T1 FLAIR sequence. The
following example protocol is for prescribing an axial T1 FLAIR of the brain.
Table 24-5 T1 FLAIR Protocol Example (Brain)

T1 FLAIR Protocol Example (Brain)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series if the
Patient Protocol window becomes active.
Patient Position

Patient Position Supine A FLAIR pulse sequence is compatible with any patient
position and entry.
Patient Entry Head First
Coil Head Allows selection of the coil from which the signal is
transmitted and received. Use a coil that produces the
optimum coverage and SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected
scan mode, PSD, and selected imaging options.

24-12
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

T1 FLAIR Protocol Example (Brain)

What You Select Selection Notes
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. Compatible

with any scan plane, except 3-Plane. Select the plane
that best meets your clinical need.
Mode 2D Prescribes a two-dimensional sequence. FLAIR is only
compatible with 2D.
Pulse Seq T1 FLAIR Activates the T1 FLAIR pulse sequenceor FSE-IR for t1
FLAIR. Click [Accept] to register the selection.
Imaging Options Variable Select imaging options that optimize SNR, spatial
Bandwidth, resolution, the number of slices, and reduce motion
artifacts. Refer to Table 24-2 for a complete list of
compatible options. Click [Accept] to register the
selections.
PSD Name N/A Refer to FSE to use t1flair-rpc, t1flairc or t1flairc-rpc.
Protocol N/A

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 T1 FLAIR and T2 FLAIR

T1 FLAIR Protocol Example (Brain)

What You Select Selection Notes
Scan Timing

# of echoes N/S
TE 24
TE2 N/A
TR 2400 Keep the TR 3 to 4 times longer than the TI time of CSF,
for optimum CSF suppression for T2 FLAIR. Reducing
the TI and TR together, allows reduced scan time and
CSF nulling, but it also reduces the grey/white matter
contrast. TR changes by field strength.
Inv. Time 750 Inversion time is the time from the inversion pulse to the
excitation pulse. It is critical that this value is properly
programmed for T1 contrast with T1 FLAIR.
Flip Angle N/A
Echo Train Length 3 The echo spacing (ESP) is automatically calculated. It is
not the minimum TE value displayed next to the TE text
box.
Bandwidth 31.25 As RBw increases, the minimum TE decreases, which
means the ESP decreases (this is desirable − as ESP
decreases, ETL increases, and scan time decreases).
Bandwidth 2 N/A

24-14
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

T1 FLAIR Protocol Example (Brain)

What You Select Selection Notes
Scanning Range

FOV 24 Select a FOV that covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results
in aliasing. Small FOVs increase resolution, decrease
SNR, and can increase the minimum TE value. If the
FOV is less than 16 and the Slice Thickness is less than
5, then the echo spacing may increase and there may
be fewer slices per acquisition.
Slice Thickness 5 Thin slices increase resolution and decrease SNR.
Spacing 1.5 Select a spacing that reduces cross-talk between slices
(typically 20% of the slice thickness).
Start, End Locations Typically the start and end locations are programmed
from the Graphic Rx program.
# Slices The maximum number of slices available is determined
by the TR, TE, TI, SAR, and gradient stress.

24-15
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

T1 FLAIR Protocol Example (Brain)

What You Select Selection Notes
Acquisition Timing

Freq 320 Increasing the frequency matrix increases the echo

space and resolution, while decreasing the SNR and
number of slices.
Phase 256 Phase controls scan time and resolution.
NEX 2.0 Select a NEX value that produces sufficient SNR.
Phase FOV 0.75 Select 0.75 or 0.5 to reduce phase steps and thus
decrease scan time, decreasing FOV in the phase
direction, and decreasing SNR slightly. The Phase FOV
dimension is displayed next to the phase FOV factor.
Freq DIR A/P The direction displayed is the default frequency direction
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak that is set during prescan.
Flow Comp DIR N/A Flow Comp direction should match the direction of the
flowing protons.
Autoshim On Select Autoshim when using fat SAT or an FOV off
center, and in the first series of each examination.
Phase Correct On By turning phase correct on this helps to improve image
quality on T1 FLAIR.
# of Acqs/Locs Before N/A
Pause

24-16
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

T1 FLAIR Protocol Example (Brain)

What You Select Selection Notes
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to
check the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and
cursor. remove slices. Position the slices to cover anatomy of
interest and view the Advisory Panel to note the
maximum number of slices per acquisition and the
number of acquisitions you are prescribing. The scan
time increases as the number of acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Scan [Scan] Initiates the acquisition.

24-17
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

Prescribe a T2 FLAIR Sequence

T2 FLAIR sequences are most commonly used for T2 neurological applications, where
nullification of the CSF signal is desired.
The decision matrix (Table 24-6) is only for prescribing a T2 FLAIR sequence. The
following example protocol is for prescribing a T2 FLAIR axial brain scan.
Table 24-6 Axial T2 FLAIR Protocol Example (Brain)

T2 FLAIR Protocol Example (Brain)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can

series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series if the
Patient Protocol window becomes active.
Patient Position

Patient Position Supine A FLAIR pulse sequence is compatible with any patient
position and entry.
Patient Entry Head First
Coil Head Allows selection of the coil from which the signal is
transmitted and received. Use a coil that produces the
optimum coverage and SNR.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected
scan mode, PSD, and selected imaging options.

24-18
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

T2 FLAIR Protocol Example (Brain)

What You Select Selection Notes
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. Compatible

with any scan plane, except 3-Plane. Select the plane
that best meets your clinical need.
Mode 2D Prescribes a two-dimensional sequence. FLAIR is only
compatible with 2D.
Pulse Seq T2 FLAIR Activates the T2 FLAIR pulse sequence. Click [Accept]
to register the selection.
Imaging Options Flow Select imaging options that optimize SNR, spatial
Compensation, resolution, the number of slices, and reduce motion
artifacts. Refer to Table 24-3 for a complete list of
compatible options. Click [Accept] to register the
selections.
PSD Name N/A Refer to FSE to use fse-rpc, fse-xlc or fsec-rpc.
Protocol N/A

24-19
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 T1 FLAIR and T2 FLAIR

T2 FLAIR Protocol Example (Brain)

What You Select Selection Notes
Scan Timing

# of echoes N/S
TE 120 The effective TE changes are as the field strength
changes.
TE2 N/A
TR 8,000 Keep the TR 3 to 4 times longer than the TI time of CSF
for optimum CSF suppression. Reducing the TI and TR
together, allows reduced scan time and CSF nulling, but
it also reduces the gray/white matter contrast.
Inv. Time 2,000 Inversion time is the time from the inversion pulse to the
excitation pulse. It is critical that this value is properly
programmed for CSF suppression for T2 FLAIR.
Flip Angle N/A
Echo Train Length 14
Bandwidth 25.00 As RBw increases, the minimum TE decreases, which
means the ESP decreases (this is desirable - as ESP
decreases, ETL increases, and scan time decreases).
Bandwidth 2 N/A

24-20
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

T2 FLAIR Protocol Example (Brain)

What You Select Selection Notes
Scanning Range

FOV 24 Select a FOV that covers the anatomy of interest.

Anatomy outside the FOV in the phase direction results
in aliasing. Small FOVs increase resolution, decrease
SNR, and can increase the minimum TE value. If the
FOV is less than 16 and the Slice Thickness is less than
5, then the echo spacing may increase and there may
be fewer slices per acquisition.
Slice Thickness 5.0 Thin slices increase resolution and decrease SNR.
Spacing 1.5 Select a spacing that reduces cross-talk between slices
(typically 20% of the slice thickness).
Start, End Locations Typically the start and end locations are programmed
from the Graphic Rx program.
# Slices The maximum number of slices available is determined
by the TR, TE, TI, SAR, and gradient stress.
Acquisition Timing

Freq 256 Increasing the frequency matrix increases the echo

space and resolution, while decreasing the SNR and the
number of slices.
Phase 224 Phase controls scan time and resolution.
NEX 1.0 Select a NEX value that produces sufficient SNR.

24-21
© 2004 General Electric Company. All rights reserved.
 T1 FLAIR and T2 FLAIR

T2 FLAIR Protocol Example (Brain)

What You Select Selection Notes
Phase FOV N/A
Freq DIR A/P The direction displayed is the default frequency direction
which is typically the long axis of the image. To swap
phase and frequency, select the other direction.
Auto Center Freq Water Select the CF peak that is set during prescan.
Flow Comp DIR Slice Flow Comp direction should match the direction of the
flowing protons.
Autoshim On Select Autoshim when using fat SAT or an FOV off
center, and in the first series of each exam.
Phase Correct On By turning phase correct on this helps to improve image
quality on a FLAIR.
# of Acqs/Locs Before N/A
Pause
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to
check the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and
cursor. remove slices. Position the slices to cover anatomy of
interest and view the Advisory Panel to note the
maximum number of slices per acquisition and the
number of acquisitions you are prescribing. The scan
time increases as the number of acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Scan [Scan] Initiates the acquisition.

24-22
© 2004 General Electric Company. All rights reserved.
 Diffusion-Weighted Echo Planar Imaging

Chapter 25
Diffusion-Weighted Echo
Planar Imaging

Introduction
This chapter explains the pulsing components and timing factors directly related to the
Diffusion-Weighted Echo Planar Imaging (DW EPI) pulse sequence. DW EPI
sequences acquire images whose contrast is sensitive to microscopic motion of water
molecules to create images that differentiate tissues with restricted diffusion from
tissues with normal diffusion.
This chapter explains the concepts and the step-by-step instructions to help you learn
how to:
• Prescribe a DW EPI Sequence

25-1
© 2004 General Electric Company. All rights reserved.
 Diffusion-Weighted Echo Planar Imaging

What Do I Need to Know About...

This section presents the concepts necessary to understand Echo Planar pulse
sequences. Specifically, you need to understand:
• DW EPI Basics
– User Control Variables
– Diffusion Options
• Supported Features
• How Do I...

DW EPI Basics
DW EPI is designed to create images that differentiate tissues with restricted diffusion
from tissues with normal diffusion. DW EPI is a single-shot Spin Echo (SE) EPI
sequence that uses a motion probing or diffusion gradient in SI direction to dephase
moving nuclei.
The extra-cellular water in normal brain tissue diffuses freely, resulting in a dark signal.
The extra-cellular water in dead brain tissue does not diffuse, resulting in a bright signal
(Figure 25-1).
Figure 25-1 Normal vs. Restricted Diffusion

In a DW EPI sequence, the prescribed B-value can be achieved with different

combinations of gradient amplitude and duration. The gradient duration directly affects
the minimum TE for a DW EPI sequence. As gradient amplitude increases, the duration
needed to obtain the prescribed B-value can be decreased. The peak gradient
amplitude is limited by the constraints of the gradient subsystem. There is a limit to the
minimum TE and the maximum B-values that can be achieved for a given MRI system.
Figure 25-2 shows some diffusion images with varying B-values.
Higher B-values may help eliminate T2 shine-through, improve visualization of white
matter tracks, and may be useful in differentiation of sub-acute versus chronic infarcts.

25-2
© 2004 General Electric Company. All rights reserved.
 Diffusion-Weighted Echo Planar Imaging

Figure 25-2 Varying B-Value Diffusion Images

The gradient configuration of the system determines the maximum B-value. The peak
gradient amplitude is limited by the constraints of the gradient subsystem; therefore,
there is a limit to the minimum TE and the maximum B-values that can be achieved for
a given Magnetic Resonance Imaging (MRI) system. Table 30-1 can be used to
determine the maximum value for a system with or without Optimize TE enabled.
Table 25-1 Maximum B-Values

TE Maximum B-value
Approximately 140 ms

(Minimum TE is used and is based 1,000 (s/mm2)

on the prescribed B-Value.)

Diffusion images are annotated “DW EPI”, with the diffusion direction and the B-value.
For example, 1000 s/mm2 S/I.

User Control Variables

Figure 25-3 displays the User CVs available for DW EPI. Table 25-2 describes each
User CV. You can access User CVs by clicking on the User CVs Screen icon in the
Additional Parameters area.

25-3
© 2004 General Electric Company. All rights reserved.
 Diffusion-Weighted Echo Planar Imaging

Figure 25-3 DW EPI User CVs Screen

Table 25-2 DW EPI User CV Descriptions

User CV Mode Description

CV4 is available with Single Shot EPI. When
Reduced ESP
On(1) is selected, the echo space(ESP) is
mode for Single 0=Off, 1=On
shortened and geometric distortion is reduced but
Shot
slight Ringing artifacts may occur.
CV5 limits the region for reference scan. If the
Region
positioning of patients is rather off-centered in
Restricted Ref 0=Off, 1=On
phase encoding direction this option may reduce
Scan
the ghosting artifacts.

Diffusion Options
The DWI icon in the Additional Parameters area (Figure 25-4) allows you to define the
diffusion options in the DW EPI sequence.
Figure 25-4 Diffusion Option Screen

25-4
© 2004 General Electric Company. All rights reserved.
 Diffusion-Weighted Echo Planar Imaging

Table 25-3 Diffusion Options

Mode Description
Allows you to manually enter a B-value. The maximum
B-Value value depends on the slice thickness. If the selected
B-value cannot be achieved, an error message posts.

25-5
© 2004 General Electric Company. All rights reserved.
 Diffusion-Weighted Echo Planar Imaging

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 25-5, an X indicates the options available for use with the DW EPI pulse
sequence.
Table 25-4 DW EPI Compatible Imaging Options

Imaging Options
X None No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Real Time Blurring Cancellation

X Cardiac Gating/Triggering Respiratory Compensation

CCOMP Respiratory Gating/Triggering

Classic X Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

X IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

X Multi-Phase ZIP x 4

Multi Station X ZIP 512

Navigator ZIP 1024

25-6
© 2004 General Electric Company. All rights reserved.
 Diffusion-Weighted Echo Planar Imaging

How Do I...
This section provides the step-by-step instructions for prescribing a DW EPI pulse
sequence. Specifically, it describes how to:
• Prescribe a DW EPI Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions:
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.
Signa Ovation does not support isotropic diffusion that eliminates anisotropy of
diffusion. Image results will depend on the area of interest. Only diffusion weighted
images are acquired in a DW-EPI series. The MPG (Motion Probing Gradient) pulses or
diffusion gradients are always applied in the S/I direction.
Susceptibility artifact may occur at the interface of bone and air, especially at skull base.
Signal concentration may produce high signal intensity area on diffusion images due to
field in-homogeneity.
In some cases ghosting artifacts might appear. In that case, the larger FOV should be
set in order to avoid overlap with concerned region.
For single-shot DW-EPI, adjust the Head Holder and Head pads so that the scanned
volume is located as close as possible to magnet center.

25-7
© 2004 General Electric Company. All rights reserved.
 Diffusion-Weighted Echo Planar Imaging

When high B-value (600 or larger) are selected, phase shift,ghosts or geometric
distortion may be increased. This is caused by eddy current induced by MPG pulses.
[IR Prepared] and Fat SAT(Chem SAT) can be used to suppress signal from fat.
However, the signal from fat may not be completely suppressed due to changes in the
magnetic field caused by the patient.
It is recommended to select [Gating] for single-shot DW-EPI acquisitions. Gating can
reduce artifacts created by CSF flow and brain motion. Use [Recommended] for the
Trigger Delay.
CSF flow artifacts can occur especially when small b-value(600 or less)are selected.
Using peripheral gating can minimize the artifacts produced by CSF pulsation.

25-8
© 2004 General Electric Company. All rights reserved.
 Diffusion-Weighted Echo Planar Imaging

Prescribe a DW EPI Sequence

DW EPI is a single-shot sequence designed to create images that differentiate tissues
with restricted diffusion from tissues with normal diffusion.
The decision matrix (Table 25-5) is only for prescribing a DW EPI sequence. The
following example is for a brain DW EPI scan.
Table 25-5 DW EPI Protocol Example (Brain)

DW EPI Protocol Example

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Icon [New Patient] Allows you to enter new patient information.
Scan Rx Acquire a localizer Allows Graphic Rx to become available so you can
series. prescribe slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Position] Allows you to begin prescribing your new series when the
Patient Protocol window becomes active.
Patient Information
Table Entry Center DW EPI is only compatible with the center table position.
Patient Position

Patient Position Supine An EPI pulse sequence is compatible with any patient
position and entry.
Patient Entry Head First NOTE: Hands clasped together may increase the
potential for peripheral nerve stimulation (PNS).

25-9
© 2004 General Electric Company. All rights reserved.
 Diffusion-Weighted Echo Planar Imaging

DW EPI Protocol Example

What You Select Selection Notes
Head Allows selection of the coil from which the signal is
transmitted and received. DW EPI is only compatible with
Coil the Head Coil. Adjust the head holder and pads so that
the scanned volume is located as close as possible to the
magnet center.
Series Enter a series Allows you to enter a brief description of the series being
description in the prescribed. If you do not enter a description, the system
text box. enters a default series description with the selected scan
mode, pulse sequence database (PSD), and selected
imaging options.
Imaging Parameters

Plane Axial Defines the scan plane of the acquisition. DW EPI is

compatible with any scan plane, except 3-Plane. Select
the plane that best meets your clinical need. Oblique is
available, but multi-angle obliques cannot be prescribed.
Mode 2D Prescribes a two-dimensional sequence. DW EPI is only
compatible with the 2D imaging mode.
Pulse Seq DW EPI Activates the DW EPI pulse sequence. Click [Accept] to
register the selection.
Imaging Options Variable Select imaging options to optimize SNR and spatial
Bandwidth resolution. Click [Accept] to register the selections.
PSD Name
Protocol N/A

25-10
© 2004 General Electric Company. All rights reserved.
 Diffusion-Weighted Echo Planar Imaging

DW EPI Protocol Example

What You Select Selection Notes
Additional Parameters - User CVs

1.00 Available with Single Shot EPI. When On(1) is

Reduced ESP mode selected, the echo space(ESP) is shortened and
for Single Shot geometric distortion is reduced but slight Ringing
artifacts may occur.
0 Limits the region for reference scan. If the
Region Restricted positioning of patients is rather off-centered in phase
Ref Scan encoding direction this option may reduce the
ghosting artifacts.
Accept [Accept] Confirms selection of the User CV and closes the screen.

25-11
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 Diffusion-Weighted Echo Planar Imaging

DW EPI Protocol Example

What You Select Selection Notes
Additional Parameters - Diffusion Options

B-value 900 As the B-value increases, the diffusion weighting

increases and SNR decreases.
Accept [Accept] Confirms selection of the options and closes the screen.

25-12
© 2004 General Electric Company. All rights reserved.
 Diffusion-Weighted Echo Planar Imaging

DW EPI Protocol Example

What You Select Selection Notes
Scan Timing

# of Echoes 1 Only 1 echo is allowed for DW-EPI sequences.

TE Minimum The minimum TE is automatically selected.
TR 8,000 Select a long TR (8,000 to 10,000 ms) to minimize T1
effects and to accommodate the number of slices. TR
must be four times longer than the Inversion Time.
TI N/A
Flip Angle N/A
Echo Train Length N/A
Bandwidth 31.25 RBw can only be changed inf the User CV Ramp
Sampling is turned Off. As the RBw increase, the SNR,
chemical shift artifact, and the minimum TE decrease
(which means the echo space decreases). As echo space
decreases, geometric distortion decreases.
Bandwidth 2 N/A

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 Diffusion-Weighted Echo Planar Imaging

DW EPI Protocol Example

What You Select Selection Notes
Scanning Range

FOV 25 Select an FOV to cover the anatomy of interest. Anatomy

outside the FOV in the phase direction results in aliasing.
A small FOV increases resolution and can increase the
minimum TE value, while decreasing SNR. The larger
FOV, the larger image distortion.
Slice Thickness 10 Thin slices increase resolution and decrease SNR. The
available slice thickness is 2.7 to 20 mm.
Spacing 0.0 Select a spacing that reduces cross-talk.
Start, End Locations Typically the start and end locations are programmed
from the Graphic Rx program.
# Slices The maximum number of slices available is determined by
the TR, TE, TI, SAR, and gradient stress.

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 Diffusion-Weighted Echo Planar Imaging

DW EPI Protocol Example

What You Select Selection Notes
Acquisition Timing

Freq 64 The frequency matrix is fixed to 64.

Phase 64 As phase matrix increases, the resolution increases, and
the number of slices decreases, but the scan time does
not change (scan time = shots x TR). Phase may be
larger than the frequency value in an EPI sequence.
NEX 1.00 Select a NEX value that produces sufficient SNR.
Multi-NEX values are permitted. As the NEX increases,
the SNR and scan time also increase.
Phase FOV 1.00 The phase field of view (PFOV) ranges from 0.5 to 1, in
steps of 0.1. Select a volume which does not result in
anatomy outside the phase FOV. As PFOV decreases,
geometric distortion decreases.
Freq DIR A/P Frequency A/P improves image quality. PNS has not
been observed at this field strength using the A/P
frequency direction.
Auto Center Freq Water Select Water since EPI is always fat suppressed. Current
CF can be used if the previous series used the correct
center frequency and Autoshim is not in use.
Flow Comp DIR N/A
Autoshim On Select Autoshim on the first EPI scan in each plane.
Phase Correct On For single shot, Phase Correct is automatically on. A
reference scan automatically occurs after a successful
prescan to make calculations and corrections for placing
the echo underneath the frequency gradient.

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 Diffusion-Weighted Echo Planar Imaging

DW EPI Protocol Example

What You Select Selection Notes
# of Locs Before Pause N/A Always select Phase Correct with EPI scans so the
system can run a reference scan prior to data acquisition.
If a 1 NEX acquisition is programmed, the reference scan
can take as long as the EPI scan, but it is imperative to
run phase correct in order to have optimum image quality.
The reference scan automatically occurs after a
successful prescan. It makes calculations and corrections
for placing the echo underneath the frequency gradient.
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check
the position of the prescription.
Image Viewport Click the image to Allows you to prescribe slices for graphic prescription.
display the line Select the adjustment handles to angle, draw, and
cursor. remove slices. Position the slices to cover anatomy of
interest and view the Advisory Panel to note the maximum
number of slices per acquisition and the number of
acquisitions you are prescribing. The scan time increases
as the number of acquisitions increase.
Copy Rx [Copy Rx] Copies the exact locations of the prior series if you had
(optional) previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
SAT Rx Fat Fat SAT is automatically on during a DW EPI sequence to
suppress the signal from fat. However, the signal from fat
may not be completely suppressed due to changes in the
magnetic field caused by the patient. Spatial SAT pulses
are not needed when acquiring a single-shot EPI
sequence due to the fast scanning time. You cannot turn
Fat SAT off on this sequence.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD
(prescribed).
Rx Manager
Prepare to Scan [Prepare to Scan] Downloads the series.
Scan Operations
Auto Prescan [Auto Prescan] Prescans the acquisition and allows the reference scan to
be activated, which consists of a 1- or 2-shot sequence.
The reference scan automatically occurs after a
successful prescan.
Scan [Scan] Initiates the acquisition.

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 3D FIESTA / FIESTA-C

Chapter 26
3D FIESTA / FIESTA-C

Introduction
The Fast Imaging Employing STeady-state Acquisition (FIESTA) is a fully balanced
steady-state coherent imaging pulse sequence designed to produce high
signal-to-noise ratio (SNR) images at very short sequence times (TRs).
This chapter explains the pulsing components and timing factors directly related to the
3D FIESTA and FIESTA-C imaging pulse sequence. It also explains the concepts and
the step-by-step instructions to help you learn how to:
• Prescribe a 3D FIESTA Sequence
• Prescribe a 3D FIESTA-C Sequence

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© 2004 General Electric Company. All rights reserved.
 3D FIESTA / FIESTA-C

What Do I Need to Know About...

This section presents the concepts necessary to understand imaging with the 3D
FIESTA pulse sequence. Specifically, you need to understand the following concepts:
• 3D FIESTA Basics
– Imaging Effects
• 3D FIESTA
– Imaging Consideration
– Supported Features
– User Control Variables
– Applications
• 3D FIESTA-C
– Imaging Consideration
– Supported Features
– User Control Variables

3D FIESTA Basics
The FIESTA pulse sequence uses fully balanced gradients to re-phase the transverse
magnetization at the end of each TR interval. For very short TR sequences, the
resulting signal intensity is independent of TR and related to (T2/T1). Short TRs are
essential to maintain spin phase coherence, which is required to maintain coherent
transverse magnetization and eliminate artifacts generated by magnetic susceptibility
induced phase shifts. The advantages of FIESTA can only be realized with very short
TR where (TR << T2) and (TR << 1/b) where b is the local frequency shift caused by
inhomogeneity (<< indicates “much less than”). A diagram of the pulse sequence is
shown in Figure 26-1.
Figure 26-1 3D FIESTA Pulse Sequence Diagram

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 3D FIESTA / FIESTA-C

There are three types of sequences you can acquire with the 3D FIESTA pulse
sequence:
• 3D FIESTA: Can be used for whole body imaging
• 3D FIESTA-C: Can be used for any clinical application requiring high spatial
resolution and contrast differentiation between tissues of low and high signal
intensity ratios

Imaging Effects
The sequence parameters have different effects that contribute to 3D FIESTA images.
Table 26-1 summarizes the imaging effects relating to 3D FIESTA and is provided to
help you understand the trade-offs that occur when you change the values for a
particular parameter.
Table 26-1 Imaging Effects with 3D FIESTA

Contrast Temporal Spatial Scan

Parameters SNR Artifacts
(T2/Ts) Resolution Resolution Time
TR ⇓ ⇑ ⇑ N/A ⇑ ⇓ ⇓
TE ⇓ ⇑ N/A N/A ⇑ ⇓ ⇓
Flip Angle ⇑ ⇑ N/A N/A ⇑ N/A N/A
RBw ⇑ ⇑ ⇑ N/A ⇓ ⇓ ⇓
VPS ⇑ N/A ⇑ N/A N/A ⇓ ⇑
Matrix ⇑ N/A N/A ⇑ ⇓ ⇑ N/A
Slice
N/A N/A ⇑ ⇓ N/A N/A
Thickness ⇓
FOV ⇓ N/A N/A ⇑ ⇓ N/A *

NOTE: *There is not always a direct correlation between field of view (FOV) and artifacts.
In certain instances, when the anatomical size is greater than the FOV, wrap
artifact may occur.

3D FIESTA
The sequence is used for whole body imaging and in clinical applications that benefit
from the differentiation of contrast between tissues of low T2/T1 ratios (low signal
intensity) and high T2/T1 ratios (high signal intensity). The 3D FIESTA technique is
used for, but not limited to, imaging structures in motion such as abdominal imaging of
the bile ducts or for rapid acquisition of static structures with high spatial resolution such
as the cochlea or joint imaging.

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 3D FIESTA / FIESTA-C

Tissue contrast is generated based on the ratio of the spin-spin relaxation time (T2) and
the spin-lattice relaxation time (T1). The pulse sequence accentuates the contrast of
spins with high T2/T1 ratios (such as cerebral-spinal fluid, water, and fat) while
suppressing signal from tissues with low T2/T1 ratios (such as muscle and
myocardium).
3D FIESTA sequences produce high signal to noise images with enhanced contrast
and temporal resolution. This sequence provides excellent contrast between soft
tissues and fluids with reduced repetition times to minimize motion artifacts.

Imaging Consideration
• Only [Center] can be selected for Table Entry.
• To produce optimum image quality, a homogeneous static magnetic field (B0) is
needed.
• Banding artifact may occur with long TR. Use TR value less than or equal to 10ms
with minifull TE.
• Banding artifact may occur when there is any metal on or in the patient.
• Typically use on an area of interest within the following from magnet center:
A/P+/-75mm, S/I+/-100mm, R/L+/-100mm
• FIESTA can not be performed within an area of 30mm distance from the surface of
the coil.
• Remember that the patient, due to his or her inherent magnetic susceptibility, can
be the cause of banding artifact.
• When using phase correction for FIESTA, use [Water] for Auto Center Frequency
on the Acquisition Timing window. [Peak] is defaulted.
• If the scan time is too long in FIESTA, banding artifact occurs. Please make scan
time shorter than a couple of minutes.
• Available coils are as follows; Head, Large knee, Small knee, Open Body, NV, and
CTL.
• Using 512 ZIP or Slice ZIP with a phased array coil needs a longer reconstruction
time.

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 26-2, an X indicates the imaging option available for use with the 3D
FIESTA pulse sequence.
Table 26-2 3D FIESTA Compatible Imaging Options

Imaging Options
None X No Phase Wrap

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 3D FIESTA / FIESTA-C

Imaging Options (Continued)

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

X Cardiac Gating/Triggering X Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

Classic Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

Magnetization Transfer X ZIP x 2

Multi-Phase X ZIP x 4

Multi Station X ZIP 512

Navigator X ZIP 1024

NOTE: The Imaging Options shown in Table 26-2 may not always be compatible with
each other. SAT is not compatible with FIESTA.

User Control Variables

The 3D FIESTA User Control Variable (User CV) appears with all 3D FIESTA
sequences.

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 3D FIESTA / FIESTA-C

Figure 26-2 3D FIESTA User CV Screen

6.00

Table 26-3 3D FIESTA User CV Descriptions

User CV Mode Description

Number of kiss-off slices. When # of Scan
Slices to Location is N and CV7 is n, reconstructed
6.00
discard images are (N-2*n) slices. Slices to discard help
to remove signal-loss images at out side of slab.
Only effective with Phase Correction on and
Multi Coil is setting. MC selection is 0(default
mode), phase correction works for each slice by
MC selection 0=each, 1=same the receiver coil, which has the largest signal.
With MC selection on, after original multi coil
selection, the most selected receiver coil is used
in phase correction scan over all slices.

Applications
3D FIESTA imaging is intended for the whole body. Imaging applications for 3D FIESTA
include screening of the spine for spinal disk hernias or disk intrusions into the spinal
canal (spinal cord block), level of obstruction in hydrocephalus, biliary obstruction,
cholangio-pancreatography, and visualization of the internal auditory canals (IACs).
Figure 26-3 3D FIESTA Image of the IACs

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 3D FIESTA / FIESTA-C

3D FIESTA-C
The Fast Imaging Employed Steady-sTate Acquisition - Phase Cycled (FIESTA-C)
sequence is an additional enhancement to the 3D FIESTA sequence. This sequence
acquires multiple FIESTA images with a cycling of the RF phase to reduce the banding
artifacts and improve image homogeniety.
3D FIESTA-C collects two images at different receiver phases and then generates a
Maximum Intensity Projection (MIP) image across the phase cycles for each location in
the 3D acquisition. The MIP images are saved in the Browser. The RF phase cycling
allows for use of longer TR values than 3D FIESTA, while maintaining the same
benefits of FIESTA excellent contrast differentiation between structures of low signal
intensity and high signal intensity.

Imaging Consideration
• Only [Center] can be selected for Table Entry.
• To produce optimum image quality, a homogeneous static magnetic field (B0) is
needed.
• Banding artifact may occur with long TR. Use TR value less than or equal to 20ms
with minifull TE.
• If the scan time is too long in FIESTA-C, banding artifact occurs. Please make scan
time shorter than a couple of minutes.
• Using 512 ZIP or Slice ZIP with a phased array coil needs a longer reconstruction
time.

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 26-4, an X indicates the imaging option available for use with the 3D
FIESTA-C pulse sequence.
Table 26-4 3D FIESTA-C Compatible Imaging Options

Imaging Options
None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

X Cardiac Gating/Triggering X Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

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 3D FIESTA / FIESTA-C

Imaging Options (Continued)

Classic Sequential

DE Prepared X Single Quadrature Fat Imaging

X Extended Dynamic Range X Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

Magnetization Transfer X ZIP x 2

Multi-Phase X ZIP x 4

Multi Station X ZIP 512

Navigator X ZIP 1024

NOTE: The Imaging Options shown in Table 26-4 may not always be compatible with
each other. SAT is not compatible with FIESTA-C.

User Control Variables

The 3D FIESTA-C User Control Variable (User CV) appears with all 3D FIESTA-C
sequences.
Figure 26-4 3D FIESTA-C User CV Screen

6.00

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 3D FIESTA / FIESTA-C

Table 26-5 3D FIESTA-C User CV Descriptions

User CV Mode Description

DFT 0=off, 1=on CV5 applies an FID conversion of the data, if
necessary. Application of the Discreet Fourier
Transfer (DFT) affects the shading map. Image
quality improves with the use of DFT and high
flip angle. CV6 applies a method of combining
data for each NEX after acquiring the data at
different phases. “Ave” (1) represents the
average of the addition of the data, “SS” (2)
represents the sum of the square of the data,
“MIP” (3) represents the maximum intensity
1=Ave, 2=SS, projection, and “SGS”(4) represents the sum of
3=MIP, 4=SGS SSFP and FID factors of the data.
It is recommended that CV5 is set to on (1) and
CV6 to SGS (4). Setting CV6 to 4 reduces
artifacts caused by residual SSFP and FID
factors when setting DFT to On at CV5. When
selecting 1 to CV5 at FIESTA-C, only 4 is
available for CV6. Fat/Water Separation Option
can available when CV5 is set to on (1) and CV6
is set to SGS (4).
Number of kiss-off slices. When # of Scan
Slices to Location is N and CV7 is n, reconstructed
6.00
discard images are (N-2*n) slices. Slices to discard help
to remove signal-loss images at out side of slab.
Only effective with Phase Correction on and
Multi Coil is setting. MC selection is 0(default
mode), phase correction works for each slice by
MC selection 0=each, 1=same the receiver coil, which has the largest signal.
With MC selection on, after original multi coil
selection, the most selected receiver coil is used
in phase correction scan over all slices.

Applications
FIESTA-C can be used in any clinical application that demands relatively high spatial
resolution and the differentiation of contrast between tissues of low T2/T1 ratios (low
signal intensity) and high T2/T1 ratios (high signal intensity). For example, FIESTA-C
can be used for acquiring images of inter-vertebral discs, hydrocephalus obstructions,
biliary tree dilation, cholangio-pancreatography, and IAC applications.
Table 26-5 displays a 3D FIESTA-C axial image of the cervical spine.

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 3D FIESTA / FIESTA-C

Figure 26-5 3D FIESTA-C Cervical Spine

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© 2004 General Electric Company. All rights reserved.
 3D FIESTA / FIESTA-C

How Do I...
This section provides the step-by-step instructions for prescribing 3D FIESTA imaging
pulse sequences. Specifically, it describes how to:
• Prescribe a 3D FIESTA Sequence
• Prescribe a 3D FIESTA-C Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions.
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

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 3D FIESTA / FIESTA-C

Prescribe a 3D FIESTA Sequence

3D axial images of the IAC can be acquired with the FIESTA sequence. The 3D
FIESTA pulse sequence accentuates cerebral spinal fluid, water, and fat, while
suppressing muscle tissue.
The decision matrix (Table 26-6) is only for prescribing a 3D FIESTA scan. The
following example protocol in the matrix is for a 3D axial IAC examination.
Table 26-6 3D FIESTA Protocol Example (Axial IAC)

3D FIESTA Protocol Example (Axial IAC)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Icon [New Patient] Allows you to enter new patient information.
Scan Rx Acquire a Allows Graphic Rx to become available so you can prescribe
localizer series slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Allows you to begin prescribing your new series when the
Position] Patient Protocol window becomes active.
Patient Information
Table Entry Center 3D FIESTA is compatible with any table entry position.
Patient Position

Patient Position Supine Compatible with any patient position.

Patient Entry Head First Compatible with head or feet first entry.
Coil Head Use a coil that produces the optimum coverage and SNR.
Series Description Enter a series If you do not enter a description, the system enters one for
description in you. The description default is the selected scan mode,
the text box. pulse sequence database (PSD), and imaging options.

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 3D FIESTA / FIESTA-C

3D FIESTA Protocol Example (Axial IAC)

What You Select Selection Notes
Imaging Parameters

Plane Oblique Compatible with any scan plane, except 3-plane. Select the
plane that best meets your clinical need.
Mode 3D Allows prescription of a three-dimensional FIESTA
sequence.
Pulse Sequence FIESTA Allows prescription of a FIESTA pulse sequence.
Imaging Options Select imaging options that optimize SNR, spatial resolution,
number of slices and reduce motion artifacts. Refer to Table
32-2 for a list of compatible Imaging Options.
PSD Name N/A
Protocol N/A

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 3D FIESTA / FIESTA-C

3D FIESTA Protocol Example (Axial IAC)

What You Select Selection Notes
Scan Timing

# of echoes N/S One echo is automatically selected.

TE Min Full Select the Min Full TE value.
TE2 N/A
TR N/S The shortest TR is selected automatically. The calculated TR
is the minimum TR attainable and is based on SAR
restrictions. The TR may be adjusted through changes to
any the following parameters; Frequency Matrix, FOV, Slice
Thickness, and Flip Angle.
Inv Time N/A
TI2 N/A
Flip Angle 80 Select a flip angle between 60 to 90°. In general, the greater
flip angle value improve image contrast. The FIESTA
sequence becomes SAR limited when the greater flip angle,
increasing the TR.
Echo Train Length N/A
Bandwidth 15.63 Select the RBw between 2-41 kHz so that the TE becomes
minimum.
Bandwidth2 N/A

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 3D FIESTA / FIESTA-C

3D FIESTA Protocol Example (Axial IAC)

What You Select Selection Notes
Scanning Range

FOV 16 Select a FOV that covers the anatomy of interest. Anatomy

outside the FOV in the phase direction results in aliasing.
Small FOVs produce increased resolution, decreased SNR,
and can increase the minimum TE value.
Slice Thickness 2.0 The typical slice thickness value for a 3D spine is 2 to 3 mm.
Thin slices produce increased resolution and decreased
SNR.
# of Scan Locs 32 Available selections are 8 to 128 locations. There are always
number of CV7 slices on either end of the slab that are
discarded.
Start, End Locations The start and end locations are programmed from the
Graphic Rx program after the slabs are prescribed.
# Slabs 1 Determined by the number of scan locations and the desired
range of anatomy to be covered.
Acquisition Timing

S/I

Freq 160 Increasing the frequency matrix increases resolution, TE,

and TR, while decreasing SNR and the number of slices.

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 3D FIESTA / FIESTA-C

3D FIESTA Protocol Example (Axial IAC)

What You Select Selection Notes
Phase 192 Phase controls scan time and resolution. The phase value
can be larger than the frequency value when No Phase
Wrap or Square Pixel is turned off.
NEX 2.0 Select two NEX for sufficient SNR.
Phase FOV 1.0 Select a phase FOV of one to prevent wrapping of anatomy.
Freq DIR S/I The direction displayed is the default frequency direction,
which is typically the long axis of the image. Leave the
frequency direction unswapped.
Auto Center Freq Water Select water to improve the contrast of the scan.
Flow Comp DIR N/A
Autoshim On Turn Autoshim on when using an off-center FOV and on the
first series of an examination.
Phase Correct On Phase Correction works for the compensation of phase error
between FID echo and SSFP echo and increase prescan
time.
# of Acqs Before Pause N/A
Additional Parameters - User CVs

6.00

Slices to discard is number of kiss-off slices. When #of

Scan Location is N and CV7 is n, reconstructed images
Slices to discard 6.00 are (N-2*n) slices. Slices to discard help to remove
signal-loss images at out side of slab.
Only effective with Phase Correction on and Multi Coil
is setting. MC selection is 0(default mode), phase
correction works for each slice by the receiver coil,
0=each,
MC selection which has the largest signal. With MC selection on,
1=same
after original multi coil selection, the most selected
receiver coil is used in phase correction scan over all
slices.
Accept [Accept] Confirms selection of the User Control Variable (CV) and
closes the screen.

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 3D FIESTA / FIESTA-C

3D FIESTA Protocol Example (Axial IAC)

What You Select Selection Notes
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check the
position of the prescription.
Image Viewport Click the image Allows you to prescribe the slab for graphic prescription.
to display the Select the adjustment handles to angle, draw, and remove
line cursor. slabs. Position the volume to cover anatomy of interest and
view the Advisory Panel to note the maximum number of
slabs per acquisition and the number of acquisitions you are
prescribing.
Copy Rx [Copy Rx] Allows you to copy the exact locations of a prior series if you
(optional) had previously graphically prescribed a series with the same
plane, FOV, and slice thickness.
Erase Group [Erase Group] Eliminates the graphic prescription from the screen and
(If necessary) allow you to start over.
Accept [Accept] Confirms the cursor position and close Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD
(prescribed).
Rx Manager
Prepare to Scan [Prepare to Downloads the series.
Scan]
Scan Operations
Scan [Scan] Initiates the acquisition.

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 3D FIESTA / FIESTA-C

Prescribe a 3D FIESTA-C Sequence

FIESTA-C can be used in any clinical application that demands relatively high spatial
resolution and the differentiation of contrast between tissues of low and high signal
intensities, such as acquiring images of inter-vertebral discs of the cervical spine.
Table 26-7 provides a brief look at an example protocol. The parameters may vary
depending on your needs.

Table 26-7 3D FIESTA-C Example Protocol (Cervical Spine)

Parameter What You Select Parameter What You Select

Imaging Parameters # of Slabs 1
Patient Position Supine Acquisition Timing
Patient Entry Head First Freq 224
Plane Oblique Phase 224
Mode 3D NEX 4 (See note below.)
Pulse Sequence FIESTA-C Phase FOV 1
Imaging Options NPW Freq DIR Unswap
Scan Timing Auto Center Freq Water
TE Min Full Autoshim On
TR N/S Phase Correct Off
Flip Angle 60 Additional Parameters
Bandwidth 32 User CV5 1
Scanning Range User CV6 4
FOV 20 cm User CV7 6
Slice Thickness 2 mm User CV9 0
Locs per Slab 48
Start Use Graphic Rx to
determine start and
End end locations.

NOTE: NEX is limited more than 2. For combination with No Phase Wrap, NEX is limited
more than 4. And odd NEX NPW is not allowed.
FIESTA-C is not compatible with saturation techniques.
For a complete list of compatible imaging options, refer to Table 26-4.

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 2D FIESTA / FIESTA-C

Chapter 27
2D FIESTA / FIESTA-C

Introduction
The Fast Imaging Employing STeady-state Acquisition (FIESTA) is a fully balanced
steady-state coherent imaging pulse sequence designed to produce high
signal-to-noise ratio (SNR) images at very short repetition times (TRs).
This chapter explains the pulsing components and timing factors directly related to the
2D FIESTA and FIESTA-C imaging pulse sequence. It also explains the concepts and
the step-by-step instructions to help you learn how to:
• Prescribe a 2D FIESTA Sequence
• Prescribe a 2D FIESTA-C Sequence

27-1
© 2004 General Electric Company. All rights reserved.
 2D FIESTA / FIESTA-C

What Do I Need to Know About...

This section presents the concepts necessary to understand imaging with the 2D
FIESTA pulse sequence. Specifically, you need to understand the following concepts:
• 2D FIESTA Basics
– Imaging Effects
• 2D FIESTA
– Imaging Consideration
– Supported Features
– User Control Variables
– Applications
• 2D FIESTA-C
– Imaging Consideration
– Supported Features
– User Control Variables
– Applications

2D FIESTA Basics
The Fast Imaging Employing STeady-state Acquisition (FIESTA) sequence is a fully
balanced steady-state coherent imaging pulse sequence designed to produce high
SNR images at very short TRs. The pulse sequence uses fully balanced gradients to
re-phase the transverse magnetization at the end of each TR interval. For very short TR
sequences, the resulting signal intensity is independent of TR and related to (T2/T1).
More importantly, the short TRs are essential to maintain spin phase coherence. Phase
coherence is required to maintain coherent transverse magnetization and eliminate
artifacts generated by magnetic susceptibility induced phase shifts. Thus, the
advantages of FIESTA can only be realized with very short TR where (TR << T2) and
(TR << 1/b) where b is the local frequency shift caused by inhomogeneity.
NOTE: << indicates “much less than”
Tissue contrast is generated based on the ratio of the spin-spin relaxation time (T2) and
the spin-lattice relaxation time (T1). Hence, the pulse sequence accentuates the
contrast of spins with high T2/T1 ratios (such as cerebral-spinal fluid, water, and fat)
while suppressing signal from tissues with low T2/T1 ratios (such as muscle and
myocardium).

27-2
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 2D FIESTA / FIESTA-C

Imaging Effects
The sequence parameters have different effects that contribute to the 2D FIESTA
images. Table 27-1 summarizes the imaging effects relating to 2D FIESTA and is
provided to help you understand the trade-offs that occur when you change the values
for a particular parameter.
Table 27-1 Imaging Effects with 2D FIESTA

Contrast Temporal Spatial Scan

Parameters SNR Artifacts
(T2/T1) Resolution Resolution Time
TR ⇓ ⇑ ⇑ N/A ⇑ ⇓ ⇓
TE ⇓ ⇑ N/A N/A ⇑ ⇓ ⇓
Flip Angle ⇑ ⇑ N/A N/A ⇑ N/A N/A
RBw ⇑ ⇑ ⇑ N/A ⇓ ⇓ ⇓
VPS ⇑ N/A ⇑ N/A N/A ⇓ ⇑
Matrix ⇑ N/A N/A ⇑ ⇓ ⇑ N/A
Slice
N/A N/A ⇑ ⇓ N/A N/A
Thickness ⇓
FOV ⇓ N/A N/A ⇑ ⇓ N/A *

NOTE: *There is not always a direct correlation between FOV and artifacts. In certain
instances, with anatomical size and FOV, some artifacts can occur (wrap). In
most other circumstances, there will not be a correlation.
FIESTA sequence keeps the gradient moment null status over 1TR, and we can see
that in this case the FID and the SSFP echo coincide. When flow compensation option
is selected, the gradient moment null status over 1TE, too. A diagram of the pulse
sequence in shown in Figure 35-1.

27-3
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 2D FIESTA / FIESTA-C

Figure 27-1 2D FIESTA Pulse Sequence Diagram

2D FIESTA
2D FIESTA is acquired using a 2D sequential technique. This can also be used with an
ECG-gated, for segmented k-space acquisition. The sequence combines both high
temporal resolution with excellent image contrast. 2D FIESTA can be used in clinical
applications that benefit from the differentiation of contrast between tissues of low
T2/T1 ratios (low signal intensity) and high T2/T1 ratios (high signal intensity). This type
of acquisition sequence can be useful for imaging cardiac function in which clear
delineation between the blood (bright) and the myocardium (dark) is needed.
The 2D FIESTA technique uses balanced gradients, which are designed to maintain
phase coherence of the transverse magnetization at each radio frequency (RF)
excitation. Most other fast scan techniques use phase spoiling to eliminate phase
coherence.

Imaging Consideration
• Only [Center] can be selected for Table Entry.
• To produce optimum image quality, a homogeneous static magnetic field (B0) is
needed.
• Banding artifact may occur with long TR. Use TR value less than or equal to 10ms
with minifull TE.
• Banding artifact may occur when there is any metal on or in the patient.
• Typically use on an area of interest within the following from magnet center:
A/P+/-75mm, S/I+/-100mm, R/L+/-100mm

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 2D FIESTA / FIESTA-C

• FIESTA can not be performed within an area of 30mm distance from the surface of
the coil.
• Remember that the patient, due to his or her inherent magnetic susceptibility, can
be the cause of banding artifact.
• When using phase correction for FIESTA, use [Water] for Auto Center Frequency
on the Acquisition Timing window. [Peak] is defaulted.
• If the scan time is too long in FIESTA, banding artifact occurs. Please make scan
time shorter than a couple of minutes.
• Available coils are as follows; Head, Large knee, Small knee, Open Body, NV, and
CTL
• Using 512 ZIP with a phased array coil needs a longer reconstruction time.

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 27-2, an X indicates the imaging options available for use with the 2D
FIESTA pulse sequence.
Table 27-2 2D FIESTA Compatible Imaging Options

Imaging Options
None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

X Cardiac Gating/Triggering Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

Classic X Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

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 2D FIESTA / FIESTA-C

Imaging Options (Continued)

Magnetization Transfer ZIP x 2

Multi-Phase ZIP x 4

Multi Station X ZIP 512

Navigator ZIP 1024

NOTE: The Imaging Options shown in Table 27-2 may not always be compatible with
each other.

User Control Variables

The 2D FIESTA User Control Variable (User CV) appears with all 2D FIESTA
sequences.
Figure 27-2 2D FIESTA User CV Screen

Table 27-3 2D FIESTA User CV Descriptions

User CV Mode Description

Overlap is off (default mode), slice space can be
set. With Overlap on (1), slice overlap can be
overlap 0=off, 1=on
set. Overlap helps to get smoother reformat
images.
Only effective with Phase Correction on and
Multi Coil is setting. MC selection is 0(default
mode), phase correction works for each slice by
MC selection 0=each, 1=same the receiver coil, which has the largest signal.
With MC selection on, after original multi coil
selection, the most selected receiver coil is used
in phase correction scan over all slices.

27-6
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 2D FIESTA / FIESTA-C

Applications
2D FIESTA imaging can be used in clinical applications that benefit from the
differentiation of contrast between tissues of low T2/T1 ratios (low signal intensity like
the myocardium) and high T2/T1 ratios (high signal intensity like blood). This type of
acquisition sequence can be useful for imaging, but not limited to, structures in motion
such as the heart, which needs clear delineation between the blood and the
myocardium. Other 2D FIESTA applications include cardiac wall motion evaluation,
quantitative analysis, evaluation of the great vessels, and valvular morphology. The
improved blood pool myocardium contrast allows for better delineation of the
myocardial boundaries and hence expedites the determination of the ventricular
volumes at end-systole and end-diastole.
A Cardiac short or long axis scan can be acquired with a 2D FIESTA pulse sequence to
image the heart. This sequence provides improved blood-pool myocardium contrast for
better delineation of the myocardial boundaries. Figure 27-3 shows long and short axis
images of the heart acquired with 2D FIESTA sequences.
Figure 27-3 2D FIESTA Acquisitions

WARNING:Ear plugs are required for any person staying inside the scan room
during 2D FIESTA scans due to its acoustic noise.

2D FIESTA-C
The Fast Imaging Employed Steady-sTate Acquisition - Phase Cycled (FIESTA-C)
sequence is an additional enhancement to the 2D FIESTA sequence. This sequence
acquires multiple FIESTA images with a cycling of the RF phase to reduce the banding
artifacts and improve image homogeniety.

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 2D FIESTA / FIESTA-C

Imaging Consideration
• Only [Center] can be selected for Table Entry.
• To produce optimum image quality, a homogeneous static magnetic field (B0) is
needed.
• Banding artifact may occur with long TR. Use TR value less than or equal to 10ms
with minifull TE.
• If the scan time is too long in FIESTA-C, banding artifact occurs. Please make scan
time shorter than a couple of minutes.
• Using 512 ZIP with a phased array coil needs a longer reconstruction time.

Supported Features
Imaging Options provide alternatives for enhancing anatomical features or reducing
noise. In Table 27-4, an X indicates the imaging options available for use with the 2D
FIESTA-C pulse sequence.
Table 27-4 2D FIESTA-C Compatible Imaging Options

Imaging Options
None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

X Cardiac Gating/Triggering Respiratory Gating/Triggering

CCOMP Real Time Blurring Cancellation

Classic X Sequential

DE Prepared X Single Quadrature Fat Imaging

X Extended Dynamic Range X Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

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 2D FIESTA / FIESTA-C

Imaging Options (Continued)

Multi-Phase ZIP x 4

Multi Station X ZIP 512

Navigator ZIP 1024

NOTE: The Imaging Options shown in Table 27-4 may not always be compatible with
each other.

User Control Variables

The 2D FIESTA-C User Control Variable (User CV) appears with all 2D FIESTA-C
sequences.
Figure 27-4 2D FIESTA-C User CV Screen

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 2D FIESTA / FIESTA-C

Table 27-5 2D FIESTA User CV Descriptions

User CV Mode Description

DFT 0=off, 1=on CV5 applies an FID conversion of the data, if
necessary. Application of the Discreet Fourier
Transfer (DFT) affects the shading map. Image
quality improves with the use of DFT and high
flip angle. CV6 applies a method of combining
data for each NEX after acquiring the data at
different phases. “Ave” (1) represents the
average of the addition of the data,”SS” (2)
represents the sum of the square of the data,
“MIP” (3) represents the maximum intensity
1=Ave, 2=SS, projection, and “SGS”(4) represents the sum of
3=MIP, 4=SGS SSFP and FID factors of the data.
It is recommended that CV5 is set to on (1) and
CV6 to SGS (4). Setting CV6 to 4 reduces
artifacts caused by residual SSFP and FID
factors when setting DFT to On at CV5. When
selecting 1 to CV5 at FIESTA-C, only 4 is
available for CV6. Fat/Water Separation Option
can available when CV5 is set to on (1) and CV6
is set to SGS (4).
Overlap is off (default mode), slice space can be
set. With Overlap on (1), slice overlap can be
overlap 0=off, 1=on
set. Overlap helps to get smoother reformat
images.
Only effective with Phase Correction on and
Multi Coil is setting. MC selection is 0(default
mode), phase correction works for each slice by
MC selection 0=each, 1=same the receiver coil, which has the largest signal.
With MC selection on, after original multi coil
selection, the most selected receiver coil is used
in phase correction scan over all slices.

Applications
2D FIESTA-C imaging can be used in the case of long TE/TR protocol. This sequence
acquires multiple FIESTA images with a cycling of the RF phase to reduce the banding
artifacts and improve image homogeniety.
2D FIESTA-C imaging is applicable for scanning the following anatomical areas: lung
vasculature, MRCP, internal auditory canals (IACs) nerve, and wrist.
Figure 27-5 shows lung vasculature and wrist acquired with 2D FIESTA-C sequences.

27-10
© 2004 General Electric Company. All rights reserved.
 2D FIESTA / FIESTA-C

Figure 27-5 2D FIESTA-C Acquisitions

27-11
© 2004 General Electric Company. All rights reserved.
 2D FIESTA / FIESTA-C

How Do I...
This section provides the step-by-step instructions for prescribing a 2D FIESTA imaging
pulse sequence. Specifically, it describes how to:
• Prescribe a 2D FIESTA Sequence
• Prescribe a 2D FIESTA-C Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions.
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.

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 2D FIESTA / FIESTA-C

Prescribe a 2D FIESTA Sequence

The 2D FIESTA sequence is useful for imaging structures in motion such as the heart,
which needs clear delineation between the blood and the myocardium.
The decision matrix (Figure 27-6) is only for prescribing a 2D FIESTA scan. The
following example protocol is for prescribing a short axis cardiac scan.
Table 27-6 2D FIESTA Protocol Example (Short Axis Cardiac)

2D FIESTA Protocol Example (Short Axis Cardiac)

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a Allows Graphic Rx to become available so you can prescribe

localizer series slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Allows you to begin prescribing your new series if the Patient
Position] Protocol window becomes active.
Patient Position

Coil
Illustration

Patient Position Supine Although compatible with any patient position and entry,
supine and head first are recommended. This ensures
Patient Entry Head First accurate cardiac gating/triggering and patient safety by
ensuring proper routing of gating cables out of the bore, and
proper routing of the coil cable to its attachment point on the
coil port carriage.
Coil Open Body Use a coil that produces the optimum coverage and SNR.
Series Description Enter a series If you do not enter a description, the system enters one for
description in you. The series description default is the selected scan
the text box. mode, pulse sequence database (PSD), and selected
imaging options.

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 2D FIESTA / FIESTA-C

2D FIESTA Protocol Example (Short Axis Cardiac)

What You Select Selection Notes
Imaging Parameters

Plane Oblique Compatible with any scan plane. Select the plane that best
meets your clinical need. For cardiac short or long axis
imaging, select oblique for proper angle through the heart.
Mode 2D Prescribes a two-dimensional sequence.
Pulse Sequence FIESTA Prescribes a FIESTA pulse sequence.
Imaging Options Cardiac Sequential acquires one slice at a time and multiple cardiac
Gating phases. For a list of all compatible options refer to Table
Triggering, 27-2.
Flow Comp,
and
Sequential
PSD Name N/A
Protocol N/A

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 2D FIESTA / FIESTA-C

2D FIESTA Protocol Example (Short Axis Cardiac)

What You Select Selection Notes
Scan Timing

# of echoes N/S One echo is selected automatically.

TE Min Full Select Min Full to give you the shortest TE value without
acquiring a fractional echo. If Minimum TE is selected, TR
must be set to less than 5ms.
TE2 N/A
TR N/S The TR is selected automatically. The calculated TR is the
minimum TR attainable and is based on SAR restrictions.
The TR may be adjusted through changes to the frequency
matrix, FOV, slice thickness, or flip angle. In general, the
optimum image quality is with the shortest TR. Shading
artifact may occur with long TR times.
Inv Time N/A
TI2 N/A
Flip Angle 45 The typical cardiac flip angle value is 40 to 45° to reduce flow
artifacts. In general, the greater flip angle value improve
image contrast. The FIESTA sequence becomes SAR
limited when the greater flip angle, increasing the TR.
Echo Train Length N/A
Bandwidth 31.25 Select the RBw between 2-41 kHz so that the TE becomes
the minimum.

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 2D FIESTA / FIESTA-C

2D FIESTA Protocol Example (Short Axis Cardiac)

What You Select Selection Notes
Bandwidth2 N/A
Scanning Range

FOV 40 Select a FOV that covers the anatomy of interest, about

40 cm for the chest. Anatomy outside the FOV in the phase
direction results in aliasing. Small FOVs increase resolution,
decrease SNR, and can increase the shortest TE value.
Slice Thickness 7.0 The typical slice thickness value for the heart is 7 to 8 mm.
Thin slices increase resolution and decrease SNR.
Spacing/Overlap 0.0 Zero spacing is allowed. Slices are acquired sequentially
and crosstalk is not a problem. If overlap is turned on, you
can set overlap.
Start, End Locations The start and end locations are programmed from the
Graphic Rx program after the slices are prescribed.
# Slices Sequential scans one slice per acquisition. The number of
slices indicates the number of acquisitions prescribed.

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 2D FIESTA / FIESTA-C

2D FIESTA Protocol Example (Short Axis Cardiac)

What You Select Selection Notes
Acquisition Timing

Freq 192 Increasing the frequency matrix increases resolution,

decreases SNR, and decreases the number of slices.
Phase 224 The phase value can be larger than the frequency value
when No Phase Wrap or Square Pixel is turned off. Making
phase greater than frequency may help avoid phase wrap
and flow artifacts with swapping phase and frequency
directions. As the phase value increase, so does the scan
time. The increased scan time can be compensated for by
increasing the VPS.
NEX 2.0 One NEX for sufficient SNR and a reasonable scan time.
Phase FOV 1.0 Select a phase FOV to prevent wrapping of anatomy.
Choices are 1.0, 0.75, and 0.5. Reducing the phase matrix
decreases scan time, FOV in the phase direction, and SNR
(slightly).
Freq DIR S/I The direction displayed is the default frequency direction
which is typically the long axis of the image. Leave the
frequency direction unswapped.
Auto Center Freq Water The CF peak that will be set during prescan.
Flow Comp DIR N/A
Autoshim On Autoshim can improve image quality and is recommended
for this sequence.
Phase Correct Off Phase Correction works for the compensation of phase error
between FID echo and SSFP echo and increase prescan
time.
# of Locs Before Pause 1 After you prescribe the slices, return to this area and
prescribe an automatic pause in the scan at predetermined
points for breath-hold studies.

27-17
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 2D FIESTA / FIESTA-C

2D FIESTA Protocol Example (Short Axis Cardiac)

What You Select Selection Notes
Additional Parameters - Gating/Triggering

Trigger Type Select the best When ECG gating, use the lead that provides the best
lead. signal.
# of RR Interval N/A
Arrhythmia Rejec. 20 Values around 20% are most commonly used to allow a
Window reasonable latitude. If the patient’s heart rate is irregular,
increase this value and the TW, then the time available to
collect data decreases.
Trigger Delay Minimum The most minimum TD is desired to cover the full R-R
Interval.
Inter-Seq. Delay N/A
Cardiac Phases N/A
# of Cardiac Phases to 20 Sets the number of cardiac phases to be reconstructed.
Reconstruct
Views per Segment 8 The typical range of values is 8 to 16 VPS. Heart Rate = 50,
select 16 VPS. Heart Rate = 70, select 8 VPS.
Heart Rate [update Rate] Lets the system obtain an automatic reading of the current
heart rate. Updates the rate prior to beginning the scan.
Accept [Accept] Confirms the selected values and closes Gating/Triggering
Additional Parameter screen.

27-18
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 2D FIESTA / FIESTA-C

2D FIESTA Protocol Example (Short Axis Cardiac)

What You Select Selection Notes
Additional Parameters - User CVs

Manual Arrhythmia 0.0 When manual Arrhythmia monitoring is off (default mode),
Monitoring no heart beats are rejected. Scan time is not elongated, but
image quality can be compromised. With the manual
Arrhythmia monitoring on (1), the system aborts the scan if
too many triggers are detected outside the ARW. When it is
on, it may increase image quality.
overlap 0=off, 1=on When Overlap is off(default mode), slice space can be set.
With Overlap on(1), slice overlap can be set. Overlap helps
to get smoother reformat images.
MC selection 0=each, 0: MC selection is only effective with Phase Correction on
1=same and Multi Coil is setting. MC selection is 0(default mode),
phase correction works for each slice by the receiver coil
which has the largest signal. With MC selection on, after
original multi coil selection, the most selected receiver coil is
used in phase correction scan over all slices.
Accept [Accept] Confirms selection of User CV and closes the screen.
Additional Parameters - Graphic Rx

[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check the
position of the prescription.

27-19
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 2D FIESTA / FIESTA-C

2D FIESTA Protocol Example (Short Axis Cardiac)

What You Select Selection Notes
Image Viewport Click the image Prescribe slices from the cardiac base to the apex for
to display the graphic prescription. Select the adjustment handles to angle,
line cursor. draw, and remove slices. Position the slices to cover
anatomy of interest and view the Advisory Panel to note the
maximum number of slices per acquisition and the number
of acquisitions you are prescribing. The scan time increases
as the number of acquisitions increase.
Copy Rx [Copy Rx] If you had previously graphically prescribed a series with the
(optional) same plane, FOV, and slice thickness, the prescription can
be copied to the exact locations of the prior series.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Reset Center [Reset Center] Re-establishes the FOV center on a different localized slice.
(if necessary)
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD
(prescribed).
Rx Manager
Prepare to Scan [Prepare to Downloads the series.
Scan]
Scan Operations
Prep Scan [Prep Scan] Performs Auto Prescan and readies the system for data
acquisition. Select for breath-hold acquisitions.
Scan [Scan] Initiates the acquisition. Instruct the patient to hold his or her
breath as long as possible or until the scan stops.

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 2D FIESTA / FIESTA-C

Prescribe a 2D FIESTA-C Sequence

The 2D FIESTA-C sequence is useful for imaging structures in long TR, which causes
banding artifact with 2D FIESTA.
The decision matrix (Table 27-7) is only for prescribing a 2D FIESTA scan-C. The
following example protocol is for prescribing a wrist scan.

Table 27-7 2D FIESTA-C Example Protocol (Wrist)

Parameter What You Select Parameter What You Select

Imaging Parameters Acquisition Timing
Patient Position Supine Freq 256
Patient Entry Head First Phase 192
Coil Wrist NEX 6 (See note below.)
Plane Oblique Phase FOV 1
Mode 2D Freq DIR A/P
Pulse Sequence FIESTA-C Auto Center Freq Water
Imaging Options Sequential, ZIP Autoshim On
512, VBW, EDR,
NPW
Scan Timing Phase Correct Off
TE Min Full # of Scan 8
Location
Flip Angle 70 Before Pause 0
Bandwidth 20.8 Additional Parameters
Scanning Range User CV5 1
FOV 14 cm User CV6 4
Slice Thickness 4 mm User CV7 6
Space (Overlap) 1.0 User CV9 0

NOTE: NEX is limited more than 2. For combination with No Phase Wrap, NEX is limited
more than 4. And odd NEX NPW is not allowed.

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 2D FIESTA / FIESTA-C

27-22
© 2004 General Electric Company. All rights reserved.
 FastCard

Chapter 28
FastCard

Introduction
FastCard is a fast, 2D, Gradient Echo sequence that acquires multiple phases of the
cardiac cycle at single or multiple locations. This chapter explains the pulsing
components and timing factors directly related to the FastCard pulse sequence.

28-1
© 2004 General Electric Company. All rights reserved.
 FastCard

What Do I Need to Know About...

This section presents the concepts necessary to understand GRE and SPGR pulse
sequences. Specifically you need to understand:
• FastCard
– FastCard Sequential
– FastCard Non-Sequential
• Arrhythmia Rejection
• Image Characteristics
• Supported Features
• Applications

FastCard
FastCard is a fast, 2D GRE sequence that acquires multiple phases of the cardiac cycle
at single or multiple locations. Two forms of FastCard are available: sequential and
non-sequential. Each can be acquired utilizing FastCard GRE or FastCard SPGR.
In standard CINE acquisitions, one view per cardiac trigger is obtained. An entire image
(256x128) requires 128 heartbeats to acquire all the necessary k-space data. FastCard
segments the number of views into groups of views per segment, with each group of
views acquired after a cardiac trigger. Views per segment are the number of K-space
lines acquired per cardiac phase, during one RR period. The views per segment choice
affects the temporal resolution, blurring and scan time of a fast cardiac scan. As the
views per segment increase, scan time decreases, the number of cardiac phases
decreases and blurring increases.
Figure 28-1 ECG RF Phase 1 Data Acquisitions

A Trigger Window of up to 50 percent is allowed. FastCard calculates the phases based

on the heart rate, minimum TR, Trigger Window, and views per segment.

28-2
© 2004 General Electric Company. All rights reserved.
 FastCard

Uniform TR, or “Continuous RF,” is a technique designed to eliminate the lightning-flash

artifact that makes the cardiac phase appear brighter than subsequent cardiac phases.
With Uniform TR, RF is played at regular intervals throughout the scan, even during the
trigger window. Gradient waveforms are also played continuously, so that gradient eddy
currents maintain a steady state. Fast GRE acquisitions feature minimum TE/TR.

FastCard Sequential
Fastcard Sequential acquires prospectively gated data with a continuous RF excitation
on the same location.
Figure 28-2 FastCard Sequential Diagram

A multi-slice scan can be acquired one image at a time with the option to pause after
completion of each slice.
The TR and TE values are much shorter than standard cine, less than 5 ms for TE and
less than 14 ms for TR, and 2 to 98 views are collected for each trigger. This allows a
complete acquisition, up to 12 phases of the cardiac cycle, to be acquired in a single
breath-hold.
Delay after trigger and intersequence delay are set to the minimum available time to
maintain the fastest acquisition time possible.
Fastcard Sequential has short TR and the continuous RF excitation on the same slice,
creates a strong T1 saturation.
Reduces the Time of Flight effect, especially for slow flows or in-plane flows.

28-3
© 2004 General Electric Company. All rights reserved.
 FastCard

FastCard Non-Sequential
Rather than applying RF excitation pulses at the same slice location throughout the
cardiac cycle, the non-sequential acquisition acquires data from different slice locations.
Figure 28-3 FastCard Non-Sequential Diagram

The effective repetition time (TR) for each slice is essentially an RR interval. The Time
of Flight effect now depends on the RR interval and not on the TR. In the diagram
above, slice #1 is excited during the first segment with four views, then nothing happens
on this slice until the next R-wave, same phase.
T1 contrast is attained by the use of a short preparation RF pulse. FastCard differs from
a conventional Cine acquisition in that several successive TRs are grouped or views to
form a segment.
This sequence is more sensitive either to very slow flow or almost in-plane flow and can
be used to acquire data in the longitudinal axis in addition to cross-section.

Arrhythmia Rejection
Arrhythmia rejection is available with 2D gradient echo pulse sequences (GRE and
SPGR), when the Fast and Gating options are selected. It is accessed through the
Additional Parameters screen as a User CV screen.
It’s function is to improve image quality by rejecting data with an incorrect trigger. If a
trigger is detected outside of the Trigger Window, the scan continues, but discards data
from the arrhythmia trigger. The data is re-acquired on the next R-wave. The system
displays an error message after the scan is complete.

28-4
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 FastCard

Image Characteristics
With FastCard images, flowing nuclei are bright while stationary nuclei are dark.
Stagnant, slow flow or in-plane flow produces decreased signal as it becomes
saturated.
Figure 28-4 FastCard Image

Gated 2D TOF is a combination of FastCard and 2D TOF. The portion responsible for
FastCard allows multi-phase imaging at single or multiple slice locations; the gated
portion is responsible for reducing pulsatile effects.
Gated 2D TOF collects the center lines of k-space at the trigger delay which allows you
to control where in the RR-interval the center lines are collected. The center lines of
k-space have the greatest effect on contrast. If the center lines of k-space are collected
during peak flow, flow enhancement effects are improved.
Figure 28-5 Non-Gated vs. Gated Image Comparison

Non-Gated Gated

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 FastCard

• Unless the heart rate varies and causes a trigger outside of the Trigger Window, the
RF signal is not maintained through the QRS complex.
• If the system does not detect the expected signal, it pauses.
• Effective TR and trigger delay are not available with FastCard.
• The total number of phases to be acquired is dependent on the patient’s heart rate.
• The number of cardiac phases is posted on the Scan Operations (prescan) area.
FastCard Sequential always gives poor flow contrast when used in the long axis where
in-plane flow is predominant.
FastCard Non-sequential:
• Since slices are acquired at different instants or phases of the cardiac cycle, some
slices show almost no flow-related enhancements whereas, other slices present a
bright flow signal.
• Increasing the number of acquisitions to two, splits the slices into two acquisitions
and decreases the crosstalk artifact and slice to slice flow artifact.
• Long time intervals between two successive data segments on the same slice
results in a strong signal from the background tissue.
Views Per Segment:
• The VPS must be 1 or an even number between two and 98 (e.g., 2,4, 6, 8...98).
• VPS selection only appears with FastCard SPGR or FastCard GRE.
• Increasing VPS decreases overall scan time, but reduces the number of cardiac
phase images allowed. This occurs because acquisition time is used to collect
views rather than cardiac phases. The trade-off is temporal resolution for speed.
Arrhythmia Rejection: If too many arrhythmias occur, the scan aborts and the system
posts a message.

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 FastCard

Supported Features
In Table 28-1, an X indicates the option available for use with the FastCard GRE/SPGR
pulse sequences.
Table 28-1 FastCard Compatible Imaging Options

Imaging Options
X None X No Phase Wrap

ASSET PONP

ASSET Calibration Real Time

Blood Suppression Real Time Blurring Cancellation

X Cardiac Gating/Triggering Respiratory Compensation

CCOMP X Respiratory Gating/Triggering

Classic X Sequential

DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

X Flow Compensation SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

IR Prepared X Variable Bandwidth

Magnetization Transfer ZIP x 2

Multi-Phase Zip x 4

Multi Station ZIP 512

Navigator ZIP 1024

NOTE: The Imaging Options shown in Table 28-1 may not always be compatible with
each other.

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 FastCard

Applications
FastCard Sequential:
• It allows imaging of the full RR interval to acquire images at the end-diastolic
cardiac phase.
• It is used for breath-hold cardiac imaging.
• Flow Comp with FastCard achieves a gated examination with blood of high signal
intensity, which is especially useful for imaging sagittal spines with a myelographic
effect.
• Multiple NEX with FastCard removes the motion in pediatric studies because
breath-hold cannot be enforced in pediatric cases.
• It is used with Fat SAT for coronary arteries.
• This technique is well suited for cross-sectional studies of the cardiac chambers or
the aortic arch.
FastCard Non-sequential:
• It is used to image the upper torso, and the peripheral and abdominal vasculature.
• It is used to acquire a large number of thin and contiguous slices over a wide region
of interest.
FastCard GRE makes blood brighter and FastCard SPGR makes the myocardium
brighter.

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 CINE Pulse Sequences

Chapter 29
CINE Pulse Sequences

Introduction
CINE acquisitions use the cardiac waveform to perform retrospective processing of the
image data. In a CINE acquisition, the cardiac cycle is monitored and data acquisition
takes place throughout the cycle.
This chapter explains the pulsing components and timing factors directly related to the
CINE pulse sequences. This chapter explains the concepts of each, and the
step-by-step instructions to help you learn how to:
• Prescribe a CINE Sequence

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 CINE Pulse Sequences

What Do I Need to Know About...

This section presents the concepts necessary to understand CINE pulse sequences.
Specifically you need to understand:
• CINE Basics
– CINE Screen
– Imaging Considerations
• CINE GRE
– Image Characteristics
– Supported Features
– Applications
• CINE SPGR
– Supported Features
– Applications
• CINE PC
– Supported Features
– Applications
• Flow Analysis
– Scan Parameters
– Applications

CINE Basics
CINE is an optional GRE acquisition that acquires data continuously throughout the
cardiac cycle. CINE scans employ a short TR GRE pulse sequence that produces a
bright blood and dark myocardium image with fairly high contrast. CINE images are
acquired using retrospective gating techniques.
CINE is allowed when CINE is selected as the MODE in the Imaging Parameters area.
Either GRE or SPGR can be selected at the Pulse Sequence window. When CINE is
selected as the scan mode, the CINE Screen icon (Figure 29-1) is available in the
Additional Parameters area.
Figure 29-1 CINE Screen Icon

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 CINE Pulse Sequences

CINE Screen
Clicking the CINE Screen icon opens the CINE Screen (Figure 29-2).
Figure 29-2 CINE Screen

Table 29-1 describes the functions of the parameters on the CINE Screen.
Table 29-1 CINE Screen Parameters

Selection Description
Defines the gating sensor used on the patient. ECG I, ECG II and
Trigger Type ECG III are the lead selections when electrodes are attached to the
patient. PG is for use with the Peripheral Gating sensor.
Heart Rate Acquires an update of the patient's current heart rate in beats per
(update BPM) minute and displays the value.
Selects the number of slice locations to acquire in each acquisition.
Locations per
Up to 64 images per acquisition with 16 contiguous scan locations
Acquisition
are allowed.
# of Phases to Defines the number of cardiac phases to obtain. Up to 32 phases
Reconstruct per cardiac cycle for each slice are allowed.

Trigger Type
Select ECG I, ECG II, ECG III when cardiac gating with electrodes attached to the
patient. PG is for use with the Peripheral Gating sensor and is allowed in CINE.
• ECG gating is recommended for the most accurate trigger detection for cardiac
imaging. With PG, there is a delay from the actual trigger to when it is detected in
the extremity.
• In ECG Gating/Triggering, observe the waveform from each lead (ECG I, II and III).
Select the lead that produces the least noise and the highest R-wave.

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 CINE Pulse Sequences

• If a lead loses signal during data acquisition, Signa automatically switches to an

alternate lead. If ECG II loses signal, Signa switches to ECG III. If ECG III loses
signal, Signa switches to ECG II.
• A new lead can be selected from the Gating Control window after the series has
been downloaded or during data acquisition. This can be done before data
acquisition has started or during data acquisition.
An ECG series does not need to be Copy/Pasted to change the lead selection.
Once a gated sequence is complete, simply open the Gating Control window and
make the lead change. Selecting Scan again at this point repeats the series with the
new lead selection.
• The lead selection can be changed from PG to ECG (and vice versa) after series
download or during data acquisition. When changing from ECG to PG, the ECG
cable does not need to be disconnected at the magnet enclosure.
• DO NOT rely on Auto for lead selection. Auto chooses the lead with the strongest
signal. This is not necessarily the best waveform; the signal could be strong as a
result of noise. It is recommended that you observe all leads and choose the
waveform that results in the most accurate trigger.
• If the system detects a total loss of trigger, during either download or data
acquisition, the system may pause and display a message. Correct the problem or
stop the scan completely by pressing Stop Scan.

Locations per Acquisition

The number of locations per acquisition affects scan time, the effective TR, and contrast
between blood and muscle tissue. As the number of locations/acquisition increases, the
effective TR increases and blood/tissue contrast decreases. For example, the locations
per acquisition with an eight slice prescription and a 25 ms TR are:
• 2 Locations per Acquisition: the system acquires two locations in four acquisitions.
The effective TR is 50 ms.
• 4 Locations per Acquisition: the system acquires four locations in two acquisitions.
The effective TR is 100 ms. This scan is performed in half the time as 2 locations
per acquisition, and the longer TR decreases the contrast between blood and
tissue.
Two slice locations per acquisition produce images exhibiting the best compromise
between image quality and scan time. However, it takes twice as long to cover the
anatomy.

Number of Cardiac Phases to Reconstruct

The number of phases to reconstruct determines the temporal resolution of the image
reconstruction process. The temporal resolution of the image reconstruction process
can be independent of the temporal resolution of the acquisition.
CINE uses an interpolation process to reconstruct the number of cardiac phases. The
two data points closest to the desired phase contribute to the image, based on a
weighting algorithm.

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 CINE Pulse Sequences

Figure 29-3 Phase Image

Interpolated cardiac
phase image

Actual data points

used to interpolate

It is important not to enter too few or too many phases to reconstruct because:
• if not enough phase images are reconstructed, portions of the cardiac cycle are not
sampled. If too many images are reconstructed, Flow analysis cannot use the
excess information to make it’s calculations and, consequently, the images are a
waste of disk space and processing time.
• the time between phase images is roughly equal to the RR-interval divided by the
number of phases to be reconstructed. The actual delay after trigger of each image
varies from acquisition to acquisition. Usually, the first image occurs at 33 ms and
each subsequent image follows at the interval calculated above.
• each phase image is interpolated from the two data points closest to the desired
time for the phase image to occur.
• the SNR is the same regardless of the number of phases to be reconstructed. Each
image is a snapshot in time during the cardiac cycle.
• as the number of phases reconstructed is reduced, the larger the portion of the RR
interval the individual phase image represents.
Since image quality may deteriorate with higher numbers, 16 cardiac phases are a
typical standard. It is a compromise between image quality and the need for an
adequate number of phases. The numbers recommended are based on Equation 29-1.
Equation 29-1 Number of Cardiac Phases
60000ms
Number of Phases = -------------------------- /(TR msec x loc per acq)
BPM

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 CINE Pulse Sequences

The following tables provide recommended number of phase selections per acquisition.
Figure 29-4 Recommended Number of Phases at 1 Location per Acquisition.

Figure 29-5 Recommended Number of Phases at 2 Locations per Acquisition

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 CINE Pulse Sequences

Figure 29-6 Recommended Number of Phases at 3 Locations per Acquisition

Figure 29-7 Recommended Number of Phases at 4 Locations per Acquisition

Update BPM
Update BPM updates the display of the patient’s current heart rate in beats-per-minute
(BPM). To change the heart rate that the system uses, enter the desired heart rate over
the displayed heart rate. The average heart rate represents the patient’s heart rate
during the actual scan and is independent of the downloaded heart rate. The
downloaded heart rate is the rate sampled by the system when the transition is made
from the Rx Manager to the Scan Operations area. This feature is used before starting
the scan to insure the best trigger.
Use the patient’s actual heart rate before starting to scan to insure the best trigger. The
system gives one of the following lead status messages:
• OK if the peripheral pulse or ECG signal is adequate.
• Missing if a pulse or lead is not adequate.
• Cardiac initializing if the system is still in Trigger Window calculations.

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 CINE Pulse Sequences

Imaging Considerations
Consider the following when using CINE sequences:
• CINE is not synchronized with the cardiac cycle and does not use Gating from the
Imaging Options area.
• For gradient echo CINE, as the flip angle is increased beyond 30 degrees, the
images tend to become more heavily T1-weighted. The signal from blood remains
unchanged, but the myocardial signal may decrease until wall motion evaluation
becomes increasingly difficult.
• CINE entails the same tradeoffs as any other gradient-recalled pulse sequence,
including reduced SNR, increased susceptibility to artifacts, and loud operation.
• The greater the number of slice locations per acquisition, the shorter the scan time.
The system cannot acquire more than four slices per acquisition. The closer the
slices are to each other, the weaker the signal from the blood, because the blood
becomes saturated.
• As the number of locations per acquisition increases, the effective TR increases,
causing the signal from the myocardium to increase. As a result, contrast between
blood and the heart decreases with multiple locations/acquisitions.
• Auto Pause may engage during a CINE study, especially with a one- memory-board
configuration. The memory holds 60 to 240 images. Should it become full, this
message appears: Scan paused because acquisition memory is full. The system
prompts when its ready to resume with this message: Press the Start Scan button.
• CINE studies abort if:
– [Stop Scan] is selected.
– [Move to Scan] is inadvertently selected.
– During a multiple acquisition scan with low bpm, a scan setup is followed by a
bpm increase of more than 25 percent at scan time.
– If a scan stops, the system reconstructs any available images.
– Stop a CINE study if the clock runs longer than 30 seconds after zero, and the
heartbeat is weak. If there is a reasonable ECG signal on the Waveform Display,
continue the scan. This is a normal arrhythmia rejection process.
– A CINE scan may finish before the clock counts down, if the patient’s heart rate
increases.

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 CINE Pulse Sequences

CINE GRE
CINE images are acquired using retrospective gating techniques and differ from
conventional gated examinations in that:
• CINE scans employ a short TR GRE pulse sequence that produce a bright blood
and dark myocardium image with fairly high contrast.
• Certain processes, like high-velocity flow through orifices, such as vascular
regurgitation, cause signal loss due to turbulence.
• CINE scans execute pulse sequences continuously rather than waiting for triggers.
In CINE imaging, effective TR is a function of the number of slices and the time between
excitations. For example, a TR of 25 ms with one slice per acquisition has an effective
TR of 25 ms. If two slices per acquisition are acquired, the system excites the first
location, then the second, and the effective TR doubles to 50 ms.
The patient’s RR interval changes during the scan, as do the actual number of samples
acquired during each RR interval. The first data acquisition point in each RR interval
occurs at a slightly different point after the QRS trigger. The system considers this factor
as it sorts data for reconstruction.
Figure 29-8 RR Interval

CINE GRE sequences are annotated “CINE/GR/XXX”, where XXX equals the flip angle,
the flow axes, and VENC.

Image Characteristics
CINE is a white blood imaging sequence. In CINE images, flowing nuclei are bright
while stationary nuclei are dark. Stagnant, slow flow or in-plane flow produces
decreased signal as it becomes saturated. Signal from the myocardium may increase
as the number of slices per acquisition increases or the selected TR increases.

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 CINE Pulse Sequences

Supported Features
In Table 29-2, an X indicates the option available for use with the CINE GRE pulse
sequence.
Table 29-2 CINE GRE Compatible Imaging Options

Imaging Options
X None Navigator

ASSET X No Phase Wrap

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

X Cardiac Gating/Triggering Respiratory Gating/Triggering

CCOMP X Sequential

X Classic SmartPrep

DE Prepared Spectral Spatial RF

X Extended Dynamic Range X Square Pixel

X Flow Compensation Tailored RF

Fluoro Trigger T2 Prep

fMRI X Variable Bandwidth

Full Echo Train ZIP x 2

IR Prepared ZIP x 4

Magnetization Transfer X ZIP 512

Multi-Phase ZIP 1024

Multi Station POMP

FSE/FIR Blurring Cancellation Real Time Blurring Cancellation

Single Quadrature Water imaging Single Quadrature Fat Imaging

NOTE: The Imaging Options shown in Table 29-2 may not always be compatible with
each other.

Applications
CINE GRE generates images that can be displayed in a movie loop, temporal mode, for
dynamic views of the heart or vasculature.

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 CINE Pulse Sequences

Figure 29-9 CINE Image

CINE SPGR
CINE can be combined with SPGR which uses RF excitation pulses instead of
gradients to spoil the residual signal in preparation for subsequent excitations. SPGR
acquires T1-weighted scans, making tissue with short T1 times, like fat, brighter. CINE
compliments this capability by employing a short TR pulse sequence to produce images
exhibiting bright blood and dark myocardium.
Figure 29-10 CINE SPGR

Table 29-3 Descriptions for Figure 29-10

Number Description
1 RF
2 Gz
3 Flow Comp
4 Spoiler
5 Gy
6 Rewinder
7 Gx

NOTE: For CINE SPGR, the higher the flip angle and the lower the TE and effective TR,
the greater the T1-weighting.

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 CINE Pulse Sequences

Supported Features
In Table 29-4, an X indicates the option available for use with the CINE pulse
sequences.
Table 29-4 CINE SPGR Compatible Imaging Options

Imaging Options
X None Navigator

ASSET X No Phase Wrap

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

X Cardiac Gating/Triggering Respiratory Gating/Triggering

CCOMP X Sequential

X Classic SmartPrep

DE Prepared Spectral Spatial RF

Extended Dynamic Range Square Pixel

X Flow Compensation Tailored RF

Fluoro Trigger T2 Prep

fMRI X Variable Bandwidth

Full Echo Train ZIP x 2

IR Prepared ZIP x 4

Magnetization Transfer X ZIP 512

Multi-Phase ZIP 1024

Multi Station POMP

FSE/FIR Blurring Cancellation Real Time Blurring Cancellation

Single Quadrature Water Imaging Single Quadrature Fat Imaging

NOTE: The Imaging Options shown in Table 29-4 may not always be compatible with
each other.

Applications
CINE SPGR is used for dynamic views of anatomy, such as the liver, brain, or heart,
and examining cardiac anatomy rather than blood flow.

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 CINE Pulse Sequences

CINE PC
CINE with Phase Contrast (CINE PC) captures vascular information at different phases
of the cardiac cycle. On CINE PC images, signal is proportional to flow velocity for each
phase of the cardiac cycle and the direction of the flow. For example, select [R/L Flow]
and blood flowing from right to left appears bright, while blood flowing from left to right
appears dark.
During CINE PC, TR remains constant and each phase encoding step is initiated by the
ECG trigger. Flow encoding is done via bipolar gradients similar to those used in a
non-gated 2D PC study. The CINE GRE pulse sequence includes these gradients.
CINE PC scan data can be acquired in Multi-slice or projection/slab formats. Up to 32
cardiac phases can be created and displayed, just like conventional CINE. Magnitude
and weighted-phase images can be generated for each phase in the cardiac cycle.
There are two different types of CINE PC flow reconstruction:
• Phase Difference: provides black and white directional flow information.
Background noise is suppressed. Use phase difference when the images are
intended for temporal analysis.
• Complex Difference: does not provide black and white flow direction information.
Use complex difference when the images are intended for temporal diagnosis
regardless of slice thickness.
Figure 29-11 demonstrates the importance of temporal resolution. This is a
representation of the impact that temporal resolution has on the measurement of
pulsatile flow. Each dot shows where the waveform was sampled for that phase
encoding step.
Figure 29-11 Temporal Resolution

The lower example in Figure 29-11 has twice the temporal resolution and more
accurately demonstrates the true flow pattern. The more often the vessel is sampled,
the more accurate the results. For the best temporal resolution, acquire only one
location per acquisition and increase the number of cardiac phases.

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 CINE Pulse Sequences

When a single flow axis is prescribed, CINE PC scans produce directional images.
Select All for the flow axis and Phase Diff for the flow recon type, and then additional
flow images can be selected.
Consider the following when scanning with CINE PC:
• A reduction in temporal accuracy can occur with an increase in the effective TR or
the reconstruction of an insufficient number of phases.
• More than one location per acquisition can greatly reduce the temporal resolution of
the acquisition.
• CINE PC is limited to eight slices per scan. CINE PC can produce signal loss.
• Enter the real heart rate or update the rate because:
– arrhythmia rejection is used to eliminate irregular heart beats. Any heart beat that
is more or less than 20 percent of the average RR interval is rejected. Two good
heart beats are required before the system starts accepting heart beats again.
– if, during a CINE PC acquisition, the patient’s heart rate increases by more than
25 percent of the downloaded heart rate, the system displays the message The
patients RR-interval too long. Image quality may suffer.
Arrhythmia rejection may not correct for this problem because the patient’s heart
rate may be slowed down by more than 25 percent from the downloaded heart
rate, but still remain constant throughout the acquisition.
• Patients with arrhythmias do not produce good quality CINE PC or CINE
acquisitions.
• If using more than one location per acquisition, the temporal resolution of the
acquisition is greatly reduced, doubling the effective TR in the case of one of one
location per acquisition, or quadrupling the TR in the case of four locations per
acquisition.
• When the effective TR is increased, the acquisition’s sensitivity to pulsatile flow is
reduced. The less often the flow in the vessel is sampled, the more the
measurements are averaged (reduced).
• The more pulsatile the flow pattern is in the vessel, the more important is the
temporal resolution of the acquisition.
• The scan time is reduced when more than one location per acquisition is done.
• Two locations per acquisition may be satisfactory if the flow in the vessel is not
pulsatile.
• If the flow is pulsatile, acquiring two locations per acquisition may result in different
flow and velocity values because of changes in the patient’s heart rate or blood
pressure. This happens because the acquisitions are done sequentially. Acquiring
two locations per acquisition does not result in different flow and velocity values,
because the acquisition is acquired in an interleaved fashion.
• If too many images are reconstructed, Flow Analysis can not use the excess
information to make its calculations and, consequently, the images are a waste of
disk space and processing time.

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 CINE Pulse Sequences

Supported Features
In Table 29-5, an X indicates the option available for use with the CINE PC pulse
sequences.
Table 29-5 CINE PC Compatible Imaging Options

Imaging Options
None Navigator

ASSET No Phase Wrap

ASSET Calibration Real Time

Blood Suppression Respiratory Compensation

X Cardiac Gating/Triggering Respiratory Gating/Triggering

CCOMP X Sequential

X Classic SmartPrep

DE Prepared Spectral Spatial RF

Extended Dynamic Range X Square Pixel

Flow Compensation Tailored RF

Fluoro Trigger T2 Prep

fMRI Variable Bandwidth

Full Echo Train ZIP x 2

IR Prepared ZIP x 4

Magnetization Transfer X ZIP 512

X Multi-Phase ZIP 1024

Multi Station POMP

FSE/FIR Blurring Cancellation Real Time Blurring Cancellation

Single Quadrature Water Imaging Single Quadrature Fat Imaging

NOTE: The Imaging Options shown in Table 29-5 may not always be compatible with
each other.

Applications
CINE PC is used to acquire images for the following applications:
• assessing blood flow in the aorta

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 CINE Pulse Sequences

• imaging triphasic flow in the arteries of the legs

• imaging regions with complex flow patterns that vary throughout the cardiac cycle,
for example the carotid bulb or aneurysms

Flow Analysis
The accuracy of Flow Analysis measurements depends on the quality of the Phase
Contrast acquisitions used to acquire the image set. This section explains how the scan
parameters can impact the quality of the data sets used with Flow Analysis.
Three Phase Contrast PSDs are suitable for Flow Analysis processing:
• CINE Phase Contrast (CINE-PC)
• 2D Phase Contrast (2D PC)
• 3D Phase Contrast (3D PC)

Scan Parameters
TR
The TR in a Phase Contrast acquisition for Flow Analysis has the same influence on
image contrast, SNR, and acquisition time, as it would in any other acquisition. In
addition, the TR is important for Flow Analysis because shorter TRs influence the
number of samples acquired. Generally, the more often the flow in the vessel is
sampled, the more accurate the results. Keep in mind that:
• Short TRs reduce acquisition times in 2D and 3D Phase Contrast acquisitions.
• Short TRs increase the number of data points collected in an RR interval on
CINE-PC acquisitions. This improves the acquisition’s potential for accurately
measuring pulsatile flow.
In general, the TR should be the minimum TR allowed. Extremely short TRs could
cause some problems in 2D PC acquisitions on patients with very slow heart rates. In
this situation, the acquisition is acquired over a small number of heart beats. The image
contrast is based on when the center of k-space is acquired during the cardiac cycle.
The echoes collected at the center of k-space have the most influence on the resulting
image. If the center of k-space is acquired during systole, the average velocity and flow
rates are weighted towards systolic values. If the center of k-space is collected during
diastole, the average velocity and flow rates are weighted more towards diastolic
values.

TE
Use the Minimum TE to minimize the effects of intravoxel dephasing.

Flip Angle
Moderate flip angles of 20 to 40° work well for CINE PC and 2D PC Flow Analysis
acquisitions. Use the standard flip angle for 3D PC acquisitions.

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 CINE Pulse Sequences

When selecting a flip angle, keep in mind that:

• Moderate flip angles improve signal in flowing vessels and improve the background
vessel contrast.
• The flow is always through the plane for Flow Analysis acquisitions. Because the
saturation caused by in-plane flow is reduced, SNR can be increased for higher
resolution.
• Increased flip angles increase the effects of partial voluming.
• In areas of very slow flow, high flip angles may saturate the flow in vessel and
reduce background-to-vessel contrast.
• In areas of high flow, large flip angles may cause pixel overranges and reduce the
measured flow rate and velocity. A reduced flip angle may be used as a way to
correct this problem.
• Larger flip angles may increase the severity of pulsatile flow artifacts.

Slice Thickness and Position

Use the thinnest practical slice thickness. Slices 3 to 5 mm thick work well for most 2D
PC and CINE PC acquisitions. Slices 1 to 3 mm thick work well for 3D PC acquisitions.
The slice should not be placed in an area of complex or extremely high velocity flow.
When choosing a slice thickness remember that:
• Thin slices reduce the effects of partial voluming.
• Thin slices reduce the effect of intravoxel dephasing.
• The penalty for thin slices in s/b is an increase in TR.
• Flow Analysis does not process slices thicker than 20 mm.
• For the best results, place the slice proximal or distal to an area of complex or high
velocity flow.
• In areas of high flow, thick slices may cause pixel overranges and reduce the
measured flow rate and velocity. Use a reduced slice thickness to correct this
problem.
Orient slices perpendicular to the flow direction in the vessel. As the slice thickness or
angle away from perpendicular increases, the overestimation of the area of the vessel
increases.

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 CINE Pulse Sequences

Figure 29-12 Slice Orientation

Consider the following when prescribing slices:

• To accurately measure the velocity of the flowing protons the direction of movement
must be along the axis of the gradient.
• Partial voluming effects due to the slice thickness are minimized if the slice is
perpendicular to the vessel.
• The minimum TR increases with oblique acquisitions.
• An oblique acquisition increases the penalties for thin slices and small FOVs.
• If the vessel is less than ten degrees away from perpendicular to an orthogonal slice
plane, the benefits of an orthogonal acquisition may outweigh the benefits of an
oblique slice.
• If possible, place the slice location at a position in the vessel where the flow is
perpendicular to an orthogonal plane.
• A cross section area of the vessel increases as angle away from perpendicular
increases. This tends to overestimate flow.
• The measured velocity is reduced as the angle away from perpendicular increases.
This tends to underestimate velocity.
• Multi-slice multi-angle CINE PC scan prescriptions are not allowed.

Matrix and FOV

Selecting a FOV for Flow Analysis acquisitions is similar to that of other vascular
acquisitions. It is a balance of acquisition time, SNR, resolution and the impact on the
other important scan parameters such as TR and TE. The left illustration in Figure
29-13 demonstrates a Vessel Voxel Size = 2 sq. mm, Total Flow Area = 42 sq. mm, and
21 voxels are flow or partial flow. The right illustration demonstrates the Voxel Size =
0.5 sq. mm, Total Flow Area = 32 sq. mm, and 64 voxels are flow or partial flow.

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 CINE Pulse Sequences

Figure 29-13 Vessel Voxel Size

Figure 29-13 demonstrates the impact resolution can have on Flow Analysis
measurements. The darkest voxels represent stationary tissue. The gray voxels
represent voxels with both flow and stationary tissue. Finally, the clear voxels represent
voxels that are all flow. Voxels that contain part flow and part stationary tissue show up
as clear voxels. This results in the area of the vessel being overestimated.
For example, the two vessels shown here are of equal size. Assuming that the ROI for
this vessel is at the vessel wall, any of the pixels within or touching the ROI are
included. The result is that the area of flow rate would be substantially overestimated in
the vessel on the left. When available, the Asymmetric FOV options can be used to
reduce scan times while maintaining resolution.
When available, the Asymmetric FOV options can be used to reduce scan time while
maintaining resolution.
The benefits include:
• The smaller the voxel size, the more accurate the measurements, provided that
adequate SNR is maintained.
• Small voxels reduce the effects of intravoxel dephasing.
• Small voxels reduce the effect of partial voluming.
• Small voxels reduce the effect of chemical shift in vessels embedded in fat.
• Accuracy increases as the number of voxels contained within the vessel measured
increase.
The trade-offs include:
• Increasing the resolution of the acquisition costs SNR and acquisition time.
• Increased resolution does little without accurately defining the edge of the vessel.
• In areas of high flow, large voxels may cause pixel overranges, and reduce the
measured flow rate and velocity. Use reduced FOV or a larger matrix selection to
correct this problem.

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 CINE Pulse Sequences

VENC
For best results, enter a VENC value as close as possible to, but never less than, the
peak velocity in the vessel. Velocity aliasing reverses the direction of flow that exceeds
the VENC. This causes the flow rate and peak velocity to be underestimated in the
vessel with aliased voxels.
Consider the following when prescribing a VENC:
• Velocity aliasing is unacceptable for Flow Analysis image sets.
• If the VENC is substantially higher than the velocities in the vessel, the acquisition is
not sensitive to the slow flow in the vessel. This may cause the flow in the vessel to
be underestimated because the acquisition does not see the voxels with slow flow.
The result of a VENC value that is too high is a decreased signal.
• As the VENC value is reduced, the stress on the flow-encoding gradients is
increased, causing the minimum TR and TE to increase.
• As the VENC is increased, the overall SNR of the acquisition is increased.
• Acquisitions with a VENC greater than 50 cm/sec and a slice thickness of less than
10 mm is scaled back during reconstruction, to prevent voxel overranges. This
reduction in scale reduces the dynamic range of the gray scale. This may result in a
smoother appearance of background (stationary) tissue, but should not alter the
results of Flow Analysis measurements.

Vessel Motion
Vessel motion is a source of error in Flow Analysis acquisitions because of the partial
voluming that may occur. Common sources of motion include respiratory motion,
voluntary patient motion, peristalsis, and vessel translation.
Consider the following when dealing with vessel motion:
• Respiratory motion can be controlled with a breath-held 2D PC acquisition.
• Respiratory motion can be compensated for by using Resp Comp on CINE-PC
acquisitions.
• Voluntary patient motions cannot be compensated for. Acquisitions with patient
motion should be re-acquired.
• For body applications, motion of vessels due to peristalsis or bowel motion may
have errors due to partial voluming effects.
• Vessel translation due to cardiac-induced motion, is a potential source of error in 2D
and 3D PC acquisitions.
• CINE PC acquisitions compensate for cardiac-induced motion.

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 CINE Pulse Sequences

Flow Encoding Axis

Choose the flow-encoding axis, or acquisition flow direction, that is perpendicular to the
slice plane. For Flow Analysis image sets, the flow-encoding axis MUST include the
direction perpendicular to the slice plane. For example:
• An axial slice flow-encoding axis must be S/I.
• A coronal slice flow-encoding axis must be A/P.
• A sagittal slice flow-encoding axis must be R/L.
• An oblique slice flow-encoding axis must be Slice.
Only the through-plane images may be processed if All is selected. For example, if
acquiring an axial slice and All flow encoding direction is selected, only the S/I flow
images can be processed. The R/L and A/P images are rejected by Flow Analysis.
Do not use the All flow-encoding axis option when acquiring Flow Analysis image sets.
There is no benefit to selecting All for Flow Analysis images sets, from a quantification
standpoint, because:
• Blood flowing from posterior to anterior is black
• Blood flowing from left to right is black
• Blood flowing from inferior to superior is black
Selecting All flow-encoding axis instead of a single axis reduces, by half, the rate at
which the flow is sampled in a vessel. It also cuts the temporal resolution of a CINE PC
acquisition in half. This can cause the user to miss important pulsatile flow information.

Additional Images
When a single flow-encoding axis is selected, flow direction images are automatically
reconstructed. Choose Magnitude if desired. If All was selected, additional images must
be selected that contain flow perpendicular to the scan plane.

Reconstruction Type
The Flow Analysis option on the vascular options screen should always be selected for
Flow Analysis acquisitions. Selecting the Flow Analysis option enables a phase
difference reconstruction and turns off phase correction. Phase correction is an
algorithm used to correct for shading across an image. This correction could cause
errors in velocity measurements.
Flow Analysis only accepts images that have been reconstructed using the Flow
Analysis or Phase Diff reconstruction methods. Phase difference acquisitions can be
processed with Flow Analysis if a proper background correction is done.

Flow Compensation
Flow Compensation is helpful in vessels with pulsatile flow. Flow Compensation
improves the quality of acquisitions in most applications by reducing the flow artifacts.
This helps the user define the edges of the vessels. Flow Compensation increases the
minimum TR and TE allowed, but the benefits outweigh these negatives in most cases.
In cases of non-pulsatile flow, Flow Compensation is of reduced benefit.

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 CINE Pulse Sequences

Applications
Flow Analysis is used to generate flow and velocity information that may be useful in
evaluating flow/velocity patterns, quantifying collateral flow, planning therapy or
quantifying the effectiveness of therapy.
Flow Analysis is not a substitute for standard cardiac and vascular analysis procedures.
It may not be directly comparable to Ultrasound data.

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 CINE Pulse Sequences

How Do I...
This section provides the step-by-step instructions for prescribing a CINE pulse
sequence. Specifically, it describes how to:
• Prescribe a CINE Sequence

Decision Matrix
A decision matrix is used in this section to provide examples of what values could be
selected for prescribing a particular sequence. The purpose of the decision matrix is to
help you understand the trade-offs that occur when you change the values for a
particular parameter and to provide a framework with which you may build your own
unique protocol.
The example protocols provide information on what could be used for these pulse
sequences and are not to be considered recommendations by GE Medical Systems.
For specific protocols, refer to the protocols in the GE Library on your system.
In addition to listing the information you need to select on the system, the “What You
Select” column of the matrix uses two other conventions.
• N/A indicates the imaging parameter is not applicable to the pulse sequence
example.
• N/S indicates the imaging parameter is not selectable in the pulse sequence
example. The system automatically selects these imaging parameters.

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.

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 CINE Pulse Sequences

Prescribe a CINE Sequence

CINE produces images that show flowing nuclei bright and stationary nuclei dark.
Stagnant, slow flow or in-plane flow produces decreased signal as it becomes
saturated. CINE GRE generates images that can be displayed in a movie loop,
temporal mode, for dynamic views of the heart or vasculature.
The decision matrix (Table 29-6) is only for prescribing a CINE sequence.
Table 29-6 CINE Protocol Example

CINE Protocol Example

What You Select Selection Notes
Scan Rx Desktop

Scan Rx Acquire a Allows Graphic Rx to become available so you can prescribe

localizer series slices graphically on the localized image.
Rx Manager [New Series] Adds an additional series to the patient’s examination.
Patient Protocol [Patient Allows you to begin prescribing your new series if the Patient
Position] Protocol window becomes active.
Patient Position

Coil
Illustration

Open Body

Patient Position Supine Although compatible with any patient position and entry,
supine and feet first are recommended.
Patient Entry Feet First
Coil Open Body Use a coil that produces the optimum coverage and SNR.
Series Description Enter a series If you do not enter a description, the system enters one for
description in you. The series description default is the selected scan
the text box. mode, PSD, and selected imaging options.

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 CINE Pulse Sequences

CINE Protocol Example

What You Select Selection Notes
Imaging Parameters

Plane Oblique Compatible with any scan plane except for 3-plane. Select
the plane that best meets your clinical need. For cardiac
short or long axis imaging, select oblique for proper angle
through the heart.
Mode N/A
Grad Mode Whole Activates the gradient mode of operation. This text box is
only available if your system has Twin gradients.
Pulse Sequence GRE Select GRE for T2* contrast or SPGR for more T1 contrast.
Click [Accept] to register the selection.
Imaging Options Variable Select imaging options that optimize SNR, spatial resolution,
Bandwidth, and reduce motion artifacts. Flow Comp may increase signal
Flow Comp, from blood. Use ECG or PG leads but do not select Gating.
Extended Click [Accept] to register the selections.
Dynamic
Range
PSD Name N/A
Protocol N/A

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 CINE Pulse Sequences

CINE Protocol Example

What You Select Selection Notes
Scan Timing

# of echoes 1 Only 1 echo is allowed.

TE Minimum Increase the TE to increase T2* contrast, decrease SNR,
and increase magnetic susceptibility artifacts. Short TEs
increase T1 contrast and increase SNR. Minimum is a
fractional echo and may compromise SNR.
TE2 N/A
TR 20 Short TRs decrease SNR and decrease scan time.
Inv Time N/A
TI2 N/A
Flip Angle 30 Given a constant TR, if Flip Angle is increased T1-weighting
increases. If Flip Angle is decreased, T2*-weighting
increases.
Echo Train Length N/A
Bandwidth 16 As the RBw decreases, the SNR increases, chemical shift
artifact increases, and the minimum TE increases which can
potentially decreases the number of slices and increased
motion artifact.
Bandwidth2 N/A

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 CINE Pulse Sequences

CINE Protocol Example

What You Select Selection Notes
Scanning Range

FOV 24 Select a FOV that covers the anatomy of interest. Anatomy

outside the FOV in the phase direction results in aliasing.
Small FOVs produce: increased resolution, decreased SNR,
and can increase the minimum TE value.
Slice Thickness 7.0 Thin slices increase resolution and decrease SNR. Select a
thickness based on SNR, resolution, and coverage.
Spacing 2.0 Interslice crosstalk is eliminated on sequential gradient
echoes. Typical spacing is 0 to 20% of the slice thickness.
Start, End Locations The start and end locations are programmed from the
Graphic Rx program after the slices are prescribed.
# Slices 4
Acquisition Timing

Peak

Freq 256 Increasing the frequency matrix increases resolution and

decreases SNR.
Phase 128 Phase controls scan time and resolution.
NEX 1.0 Select a NEX value that produces sufficient SNR.
Breath-hold acquisitions may require lower NEX values to
decrease scan time. SNR also decreases.

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 CINE Pulse Sequences

CINE Protocol Example

What You Select Selection Notes
Phase FOV 1.0 Select 0.75 or 0.5 to reduce phase steps and thus decrease
scan time, decrease FOV in the phase direction, and
decrease SNR slightly. The phase FOV dimension is
displayed next to the phase FOV factor.
Freq DIR R/L The direction displayed is the default frequency direction
which is typically the long axis of the image. To swap phase
and frequency, select the other direction
Auto Center Freq Peak The CF peak that will be set during prescan.
Flow Comp DIR N/A
Autoshim On Autoshim can improve image quality and is recommended
for this sequence.
Phase Correct N/A
# of Locs Before Pause N/A
Additional Parameters - CINE Screen

Trigger Type ECG-II Either PG or ECG can be used. ECG provides a more
accurate waveform for cardiac imaging and anatomy near
the heart. If Auto Lead is selected with an ECG set-up, the
system looks for signal from all leads (ECGI, II, or III), if the
signal is lost during acquisition.
Locations per 2 Increasing the number of locations increases the Effective
Acquisition TR, decreases scan time, and decreases blood/myocardium
contrast.
# of Cardiac Phases to 16 Increasing the number of phases increases temporal
Reconstruct resolution, but decreases image quality. Up to 32 phases is
allowed, but the maximum for any given acquisition is
dependent on the selected TR and RR interval.
Heart Rate [update Rate] Lets the system obtain an automatic reading of the current
heart rate. Updates the rate prior to beginning the scan.
Accept [Accept] Confirms the selected values and closes the Cine screen.

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 CINE Pulse Sequences

CINE Protocol Example

What You Select Selection Notes
Additional Parameters - Graphic Rx
[+] Next and [-] Prior [+] and [-] Allows you to page through the localizer images to check the
position of the prescription.
Image Viewport Click the image Prescribe slices from the cardiac base to the apex for
to display the graphic prescription. Select the adjustment handles to angle,
line cursor. draw, and remove slices. Position the slices to cover
anatomy of interest and view the Advisory Panel to note the
maximum number of slices per acquisition and the number
of acquisitions you are prescribing. The scan time increases
as the number of acquisitions increase.
Copy Rx [Copy Rx] If you had previously graphically prescribed a series with the
(optional) same plane, FOV, and slice thickness, the prescription can
be copied to the exact locations of the prior series.
Erase All [Erase All] Eliminates the graphic prescription from the screen and
(If necessary) allows you to start over.
Reset Center [Reset Center] Re-establishes the FOV center on a different localized slice.
(if necessary)
Accept [Accept] Confirms the cursor position and closes Graphic Rx.
Series Control
Save Series [Save Series] Closes the scan prescription screen, accepts the
prescription, and saves it in the Rx Manager as RXD.
Rx Manager
Prepare to Scan [Prepare to Downloads the series.
Scan]
Scan Operations
Scan [Scan] Initiates the acquisition. Instruct the patient to hold his/her
breath as long as possible, until the scan stops, if able.

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 CINE Pulse Sequences

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 Imaging Options

Chapter 30
Imaging Options

Introduction
This chapter focuses on scan parameters and how imaging options can control
artifacts, enhance contrast and resolution, and minimize motion. This chapter provides
a foundation to help you to make decisions about when to use the different imaging
options to achieve the desired image characteristics. The chapter highlights key
concepts and provides brief guidelines for selecting imaging options. It contains
information to help you learn how to:
• Imaging Options
• Controlling Artifacts
• Minimizing the Effects of Motion
• Enhancing or Altering Contrast
• Saturating Specific Signals
• Enhancing or Altering Contrast
• Balancing SNR
• Additional Imaging Options

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 Imaging Options

What Do I Need to Know About...

This section presents the concepts necessary to understand the types of imaging
options. The imaging options have been divided into sections according to their use in
Magnetic Resonance (MR) imaging. Specifically, you need to understand:

• Imaging Options • Additional Imaging Options

• Controlling Artifacts – Extended Dynamic Range
– No Phase Wrap – Phase Offset Multi-Planar (POMP)
– Variable Bandwidth – Full Echo Train
– FSE/FIR Blurring Cancellation (BC) – Multi Phase
– Real Time Blurring Cancellation – Multi Station
(RTBC) – Real Time
• Minimizing the Effects of Motion – Sequential
– Cardiac Compensation – SmartPrep
– Cardiac Gating and Triggering
– Flow Compensation
– Respiratory Compensation
– Respiratory Gating/Triggering
• Enhancing or Altering Contrast
– Classic
– IR Prepared
– IR Prepared
• Saturating Specific Signals
– Magnetization Transfer
– Single Quadrature Fat/Water
Imaging (Option)
• Enhancing or Altering Contrast
– Square Pixel
– ZIP x 2 and ZIP x 4
– ZIP 512 and ZIP 1024
• Balancing SNR

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 Imaging Options

Imaging Options
Imaging options provide imaging processing techniques for enhancing anatomical
features or reducing noise. You can access the Imaging Options window (Figure 30-1)
from the Imaging Parameters area on the Scan Rx Desktop. The Imaging Options
window lists all of the imaging options. The availability of each imaging option is
determined by the pulse sequence and your system configuration.
Figure 30-1 Imaging Options Window

Refer to Imaging Options Annotation for a list of system Imaging Option annotation
abbreviations.

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 Imaging Options

Controlling Artifacts
MR images are affected by a number of artifacts that require careful management to
improve image quality. Some artifacts inherent to MR include aliasing (wrap around)
and chemical shift artifacts. The following options are available to help control or
eliminate artifacts while scanning:
• No Phase Wrap
• Tailored RF
• Variable Bandwidth
• FSE/FIR Blurring Cancellation (BC)
• Real Time Blurring Cancellation (RTBC)

No Phase Wrap
No Phase Wrap (NPW) prevents phase wraparound artifacts. The phase wraparound
artifact, or aliasing, occurs when anatomy extends beyond the imaging field of view
(FOV) in the phase direction. Signal from the anatomy outside of the FOV is artificially
reconstructed in the opposite side of the image. This happens because the radio
frequency (RF) pulses delivered also excite the nuclei outside the area of interest,
causing them to emit signals.
The system collects this data and mismaps the signal, folding it back into the
reconstructed image as seen in Figure 30-2 of the sagittal image of the brain acquired
without NPW.
Figure 30-2 Sagittal Brain without NPW

NPW is designed to eliminate wrap-around artifact by doubling the FOV in the phase
encoding direction. The new enlarged FOV should now encompass all anatomy. When
NPW is selected, the system automatically saves the central half of this larger image
and discards data collected from the outside of the specified FOV. Although you are
acquiring a FOV twice the size as you prescribed, you only see your prescribed FOV in
the final image (Figure 30-3).

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 Imaging Options

Figure 30-3 Display vs. Acquired FOV in NPW

When using NPW, both the FOV and number of phase encoding steps are doubled, so
the pixel size remains constant. Doubling the number of phase encoding steps would
double the acquisition time, so the number of excitations (NEX) value is halved.
Therefore, no change in resolution, signal-to-noise, or acquisition time occurs.
NOTE: NPW is compatible with most pulse sequences. However, it is not compatible
with Square Pixel, Echo Planar Imaging (EPI), Phase FOV less than one, or
Respiratory Compensation high-sort method.

Applications
Use NPW when the FOV selected in the phase direction is smaller than the anatomy
being scanned. Common applications include pituitary, coronal hips or shoulders, and
axial spine imaging.
Swapping phase and frequency on a sagittal or coronal image places phase in the long
axis of the body, resulting in aliasing. NPW can help to correct the problem.
There are several factors you should consider when using NPW:
• Motion artifacts are somewhat more noticeable when using NPW. Increased NEX
values average the data and help to reduce motion artifacts. When NPW is turned
on, the programmed NEX value is cut in half (e.g., 2 is cut to 1, 4 is cut to 2), losing
the benefit of data averaging that comes with higher NEX values (2, 4, 6). An
alternative is to keep the NEX value greater than 1 or to position saturation (SAT)
pulses next to the FOV instead of using NPW to reduce the aliasing.
• NPW with 1 NEX extends the scan time slightly.
• The NEX value with NPW must be greater than or equal to one.

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 Imaging Options

Tailored RF
Tailored RF modifies the echo train in Fast Spin Echo (FSE) sequences. It stabilizes the
echo amplitudes to reduce the T2 contribution and geometric blurring in the short echo
time (TE) scans. By varying the flip angle of the first two refocusing pulses and keeping
the remaining focusing pulses the same, the echo amplitudes can be made fairly
constant. The result is a reduction of blurring.
Both specific absorption rate (SAR) and RF amplitude requirements are lessened with
the reduced flip angles on the refocusing pulses. This improves the safety threshold
and increases the number of slices per TR period when the sequence would otherwise
be SAR limited. This is because the 180° refocusing pulses are decreased to
approximately 160°.
The lower amplitude refocusing pulses also create a reduction of echo space (ESP) due
to their lower pulse widths. Lower ESP and reduced SAR increases efficiency in the
pulse sequence. Because of the lower ESP, higher echo train lengths (ETLs) obtain
equivalent contrast as lower ETL FSE scans. This, coupled with the increased slices
afforded by the reduction of SAR, results in the same coverage.

Applications
Tailored RF is primarily applied to FSE sequences using short TEs, T1-weighted, or
Proton Density-weighted (PD) imaging sequences. Tailored RF can be used to reduce
the brightness of cerebral spinal fluid (CSF) and geometric blurring on PD FSE
sequences, as well as decrease blurring on off-center FOV examinations, such as the
shoulder.
Tailored RF produces images with:
• less blurring
• slightly less signal-to-noise ratio (SNR)
• flatter contrast for T2s
• potentially more slices per TR
The images in Figure 30-4 represent the same FSE protocol with an exception of
Tailored RF being applied to the image on the left.

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 Imaging Options

Figure 30-4 PD FSE Images with and without Tailored RF

Because the flip angles are less than 180°, the contrast for a FSE acquisition
sequenced with Tailored RF pulses may be slightly different than a FSE acquisition
without Tailored RF.

Variable Bandwidth
Variable bandwidth (VBw) affects chemical shift and SNR by adjusting the range of
frequencies read by the system. An image’s receive bandwidth (RBw) defines how
many frequencies the image encompasses. It is the number of frequencies the system
hears on either side of the center frequency, which is set during prescan.
Note in Figure 30-5 that a narrow RBw reads the same amount of signal as a wide
RBw, with less noise incorporated.
Figure 30-5 Narrow versus Wide Bandwidth

As RBw decreases, the rate at which the echo is sampled is slowed down by the
readout gradient. Figure 30-6 illustrates that a ±32 kHZ RBw samples much faster than
a ±16 kHz RBw.

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 Imaging Options

Figure 30-6 Echo Rate Decreased by Readout Gradient

The RBw affects the appearance of chemical shift artifacts. Chemical shift results from
different chemical environments of fat and water. Fat and water protons precess at
slightly different frequencies. The shifting is from the difference in the frequencies. The
chemical shift increases as the field strength increases (Table 30-1).
Table 30-1 Chemical Shift Changes with Field Strength

Field Strength Chemical Shift

0.35T 52 Hz
0.7T 105 Hz
1.5T 220 Hz

As RBw increases, the pixel shift between fat and water nuclei decreases. Black
banding at fat/water interfaces in the frequency direction can be caused by chemical
shift, which can increase or decrease due to the RBw value.
Pixel shift depends on bandwidth and the frequency matrix. For example, if an image is
acquired at ±16 kHz (32,000 Hz) across a 256x256 matrix, there are 32,000 ÷ 256, or
125 Hz per pixel. Fat and water at 0.35T resonate 52 Hz apart, and therefore their
signals are not contained in one pixel. Their signals are displayed as chemical shift
within the image. Notice the black banding in Figure 30-7 at the fat and water interfaces
in the frequency direction.

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 Imaging Options

Figure 30-7 Black Banding with Pixel Shift Increase

Table 30-2 summarizes how a RBw at a fixed matrix values effects various parameters.
Table 30-2 VBw Summary Table

Assume 256 Image Width Chemical Readout % Increase

Hz/ Pixel
Matrix RBw in Hz Shift (Pixels) Time in SNR
±16 kHz 32 kHz 125 0.35T = 0.4 8 ms -
±13 kHz 24 kHz 94 0.35T = 0.5 10 ms 12%
±8 kHz 16 kHz 62.5 0.35T = 0.8 16 ms 40%
±4 kHz 8 kHz 31 0.35T = 1.6 32 ms 100%
±2 kHz 4 kHz 16 0.35T = 3.2 64 ms 180%

NOTE: VBw is available under most circumstances. Certain protocols require a specific
bandwidth and VBw is locked out.

Applications
Decrease the RBw to increase SNR at the expense of the following disadvantages:
• Sampling time increases, which increases the TE, leading to a decreased number
of slices allowed.
• Motion artifacts may appear as signal the readout time increases. Like the exposure
time of a camera, if the exposure time is increased and the subject moves, the
image blurs.
• Increased chemical shift artifact.
Cutting the RBw in half is equivalent in SNR gain to doubling the NEX. In particular, this
can be used to increase SNR for T2-weighted acquisitions.
Table 30-3 Effects as RBw Decreases

SNR Sampling TIme MinTE # of Slices Motion Chem Shift

As RBw ⇓ ⇑ ⇑ ⇑ ⇓ ⇑ ⇑

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 Imaging Options

Increase the RBw to decrease the minimum TE, which minimizes the readout time, and
thus blurring for FSE and EPI scans.

FSE/FIR Blurring Cancellation (BC)

FSE/FIR Blurring Cancellation reduces image blurring seen in Fast Spin Echo and Fast
inversion Recovery sequences.
Because multiple echoes (ETL) contribute to the contrast of an image in a FSE, FRFSE,
FSE-IR, T1FLAIR, T2FLAIR, SSFSE or SSFRFSE sequence, the phase ghosts
generated from the multiple echoes in these sequences cause image blurring. Blurring
Cancellation uses a symmetric K-space filling and multi-nex technique to reduce image
blurring by reducing phase ghosting.
The type-in option is BC. Images are annotated BC.

Applications
• Long TE FSE acquisitions (e.g. MR cholangiogram).
• FSE-IR acquisitions such as FLAIR.
• Large FOV acquisitions where phase and frequency are swapped.

Something to Think About...

• NEX must be 2 or greater. If [No Phase Wrap] is selected, NEX must be 3 or
greater.
• NEX must be even number when [SSFSE] and [SSFRFSE] are selected.
• Compatible with Phase FOV.
• Any ETL can be used (ETL=32 when BC is ON. ETL=16 when BC is OFF.)
• Use with FLAIR sequences to reduce ghosting artifacts from CSF flow.

Real Time Blurring Cancellation (RTBC)

Real Time Blurring Cancellation reduces image blurring by minimizing artifacts caused
by nuclei precessing at higher or lower frequencies than the resonant frequency. The
result is ghost free images. Also RTBC is useful to get uniform fat suppression under
considerable center frequency change during scan.

Data correction for RTBC with 2 different echoes acquired:

• Center Frequency Tracking Correction uses the navigator echoes as a method to
track or monitor lower frequency changes caused by gradient coil heating.

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 Imaging Options

Figure 30-8 Diagram of Data correction for RTBC with given echoes acquired

RTBC can be acquired in 2D GRE, SPGR, FSE, FRFSE, FSE/IR, FLAIR, T1Flair,
T2Flair and 3D GRE, SPGR, TOF-GRE, and TOF-SPGR.
The type-in option is rtbc and is not case sensitive. Images are annotated rtBC.

Center Frequency Tracking Correction

For Center Frequency Tracking Correction (realtime correction), the given navigator
echoes for tracking/monitoring are produced real time. After the phase and frequency
shifts are computed, they are used to update phase and frequency data in the next TR.
Center Frequency Tracking Correction requires entries for two User CVs:
• Extra Scan Time field entered as a TR ratio (%). It is added per acquisition.
• Tracking Slice Position, which is added for each slice or the center slice.

User CVs
When 2D is selected, the following CV window appears. For CV1 or CV7, enter the
extra scan time as a%, and for CV2 or CV8, select tracking slice position with 0 (each)
or 1 (center).

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 Imaging Options

Figure 30-9 User CV

Table 30-4 User CV Descriptions

User CV Mode Description

1%: 1% of scan time per acquisition increases
for realtime correction. Phase ghost correction is
also performed.
Extra Scan
% 5, 10, 15 %: 5% or more (increments of 5) of
Time
scan time per acquisition is increased for
realtime correction. Phase ghost correction is
also performed.
Use the following guidelines when selecting the
Tracking Slice Position.
0 is recommended for sagittal/coronal scans.
0=each slice (signal intensity from each slice is
the same.)
1 is recommended for axial scans.
Tracking Slice 1=center slice (signal intensity from center slice
0:each, 1:center is greater than that from edge slice.)
Position
Coil

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 Imaging Options

When 3D is selected, the following CV window appears. Enter the extra scan time as
a% for CV1.
Figure 30-10 User CV (When 3D is selected)

Table 30-5 User CV Descriptions (When 3D is selected)

User CV Mode Description

The following explanations describe the CV1
options (Extra Scan Time, or the desired ratio of
the compensation scan per TR):
1%: 1% of scan time per acquisition is increased
Extra Scan
% for realtime correction.
Time
5, 10, 15%: 5% or more (increments of 5) of
scan time per acquisition is increased for
realtime correction.

Applications
• Decreases blurring or ghost artifact on FSE scans e.g., cervical and lumbar sagittal
scans.
• More uniform image quality with less flow artifact.
• More uniform fat suppression in case that total scan time is longer than 5 minutes.

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 Imaging Options

Something to Think About...

• Cine, SSFP, Fractional NEX, Respiratory Compensation, Gating, Respiratory
Triggering and Multi Echo are not compatible with RTBC.
• When using GRE pulse sequences, Minimum TE is increased by 1.0 to 2.0 ms
because the navigator echo (approximately 1 ms) is acquired before imaging data
acquisition.
• When using FSE pulse sequences, Flow Compensation in slice direction is not
compatible with RTBC.
• Minimum TR may be increased or the number of slices may be decreased as
navigator echo acquisition is executed.
• Knee Array Coil Large, Knee Array Coil Small, Shoulder Array Coil and NV-Head
Coil are applicable with RTBC among multi coils.
• When Narrow BW is selected using GRE/SPGR, some blurring cannot be reduced
by RTBC

Minimizing the Effects of Motion

Almost all motion of significant amplitude gives rise to artifacts in MR imaging. The
following imaging options helps decrease or avoid motion artifacts:
• Cardiac Compensation
• Cardiac Gating and Triggering
• Flow Compensation
• Respiratory Compensation
• Respiratory Gating/Triggering

Cardiac Compensation
Cardiac Compensation (CCOMP) uses the cardiac cycle to sort the phase encoding
data to minimize pulsatile motion. CCOMP is very similar to Respiratory Compensation
(RC). CCOMP uses the cardiac waveform as input for sorting the phase encoding order
during data acquisition. The cardiac signal is used to identify the best phase encoding
order for motion-reduced imaging. Phase steps acquired during the diastolic phase (the
quieter phase of the cardiac cycle when flow is slower) fill the most critical, center lines
of k-space. Phase steps acquired during the systole fill the outer edges of k-space.
Figure 30-11 displays comparison images of the liver acquired without and with the
CCOMP imaging option. Note the pulsatile ghosting on the image without CCOMP.

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 Imaging Options

Figure 30-11 Image Comparisons with CCOMP

NOTE: CCOMP is only available with 2D GRE/SPGR and Fast GRE/SPGR pulse
sequences.

Applications
Use CCOMP to decrease the pulsatile flow artifact from the aorta on abdominal images.
There are several things you should consider when using CCOMP:
• Vessels have a bright appearance with reduced motion artifact.
• CCOMP may result in more slices per acquisition than the same parameters with no
CCCOMP and SAT pulses turned on.
• CCOMP is not a substitute for cardiac gating.

Cardiac Gating and Triggering

Cardiac and Peripheral Gating/Triggering allows the same data to be collected at the
same points of the cardiac cycle for each repetition of the pulse sequence. The benefit
is that the motion is always the same and is essentially "frozen" — allowing motion
artifacts to be reduced, or sometimes eliminated.
Refer to the Gating and Triggering chapter for additional information on Cardiac Gating
and Triggering.

Flow Compensation
Gradient moment nulling or flow compensation (FC) uses gradient pulses to correct the
phase value of flowing nuclei and minimize artifacts caused by the flow of slow-moving
blood and CSF. Flowing nuclei experience phase shifts and mis-map in the phase
direction. FC resets the phase value to the original value.
When acquiring sagittal or coronal images and selecting FC, do not swap phase and
frequency. Reducing motion from slow moving protons only occurs when protons are
moving in the direction to which the FC gradient is applied.
• For Spin Echo (SE) or GRE, the FC direction is slice and frequency.
• For FSE, the FC direction is slice or frequency.

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 Imaging Options

Figure 30-12 displays flow, in the frequency direction, being compensated in the left
image. Flow, moving in the phase direction, is not compensated in the right image.
Figure 30-12 Frequency Direction

A maximum of two echoes can be used with FC. FC increases the minimum TE, which
in turn decreases T1-weighting when acquiring short TR/TE scans and the number of
allowable slices.

Applications
FC reduces motion artifacts when slow moving protons are flowing in the direction the
FC gradient is applied. Use FC to reduce the flow artifact from slow to moderate flow:
• In-plane flow has high signal.
• Through-plane flow has moderate signal.
FC can improve the myelographic effect on T2-weighted spines as shown in Figure
30-13. FC makes blood and CSF signal appear brighter, while reducing vascular and
CSF pulsatile flows. Only use FC if the frequency direction is superior/inferior (S/I).
Figure 30-13 Sagittal Cervical Spine with FC

FC is frequently used with 2D and 3D TOF applications. You can also use FC,
combined with SAT pulses perpendicular to the flow, to produce:
• A grey appearance in CSF, at the superior edge of a sagittal FOV, or blood vessels.
• Optimal suppression of motion artifacts.

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 Imaging Options

Respiratory Compensation
Respiratory Compensation (RC) uses the respiratory waveform to sort the phase
encoding data to minimize respiratory ghosting. Without RC, the body wall creates
ghosts in the phase direction (Figure 30-14).
Figure 30-14 Image Without RC

RC uses bellows to track the motion of the body wall during image acquisition and the
waveform (Figure 30-15) displays on the personal computer (PC) monitor.
Figure 30-15 RC Waveform

RC then sorts the data during reconstruction using two methods, low order and high
order sort.
Low sort reorders how k-space is filled. Instead of acquiring the lines of k-space
sequentially, it stores them so the same lines correspond with the same part of the
respiration cycle. With 1 NEX, the system uses low sort (Figure 30-16) and places the
ghosts close to the body wall.
Figure 30-16 RC – Low Sort

High sort doubles the FOV in the phase direction. In order to maintain image resolution,
it doubles the number of phase-encoding steps it acquires. Since this alone would
double the scan time, the NEX is halved to keep the scan time the same. The top and
bottom data are then discarded from the resultant image, and the motion artifact from
the patient's respiration is reduced.
With 2 NEX and 4 NEX, the system uses a high sort (Figure 30-17) mode. High sort
places ghosts outside the reconstructed FOV. You cannot prescribe a NEX value
greater than 4.
Figure 30-17 RC – High Sort

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 Imaging Options

Use high sort on patients with deep

breathing patterns.
Increased vessel motion may occur with
2 or 4 NEX because the system halves
the NEX value, which decreases the
benefits of motion averaging.

Table 30-6 RC Parameter Selection

What You Select What the System Acquires

Desired FOV Doubles the FOV in the phase direction
Desired Phase Matrix Value Doubles the phase matrix to maintain resolution
Desired NEX Cuts the NEX in half to maintain scan time

NOTE: RC is compatible with most pulse sequences, with the exception of FSE. You
cannot use RC with a rectangular FOV.

Applications
Use RC to reduce the effects of breathing motion when respiratory triggering or
breath-holding is not possible when scanning in the chest or abdomen. Figure 30-18
displays images axial abdominal images acquired without and with RC.
Figure 30-18 Image Comparisons with RC

There are several factors you should consider when using RC:
• Do not use the respiratory waveform display for patient monitoring.
• RC slightly lengthens scan time.
• RC is more effective with shorter TR scan prescriptions.
• RC requires patients to have a consistent breathing pattern during the acquisition.
Look for the Resp OK message. If the system scans without the message Resp OK,
there are no RC benefits.

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 Imaging Options

Respiratory Gating/Triggering
Respiratory Gating and Triggering uses a bellows sensor that detects the motion of the
abdominal wall. The respiratory waveform represents the excursion of the abdominal
wall throughout the course of inspiration and expiration. The waveform is a pattern of
the patient’s breathing. The pulse sequence determines whether the system uses
gating or triggering, however, Respiratory Triggering is not available for most
sequences.
NOTE: Refer to the Gating and Triggeringchapter for additional information on
Respiratory Gating and Triggering.

Enhancing or Altering Contrast

Although pulse sequences are the major determinants of image contrast, certain
imaging options can also affect image contrast. This section introduces various imaging
parameters that enhance contrast and quality in your images. The following options
alter or enhance image contrast:
• Classic
• IR Prepared
• IR Prepared

Classic
Classic is an option that can be used with an SE-based pulse sequence, and is very
sensitive to center frequency adjustment. Classic minimizes the signal from the
off-center frequency nuclei to increase the signal variations between muscle and fat. It
also reduces the annefact for FSE sagittal spine imaging.
Note the variance between muscle and fat signal in the following SE sequence of the
orbits with Classic (Figure 30-19).
Figure 30-19 Image Comparisons with Classic

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 Imaging Options

Applications
Classic is effective on SE pulse sequences with long TEs. Use Classic to:
• Produce images with a lower signal from fat in anatomy such as orbits or
extremities.
• Look for a larger variance between muscle and fat signal. Its effects can be
emphasized via center frequency adjustment.
There are several factors you should consider when using Classic:
• Classic slightly decreases SNR.
• Classic produces lower signal intensities from a wide range of frequencies. If you
want to see many shades of grey, do not use Classic.
• Classic is sensitive to center frequency choice.
– Centering on fat decreases water signal.
– Centering on water decreases fat signal.
– Centering on midpoint decreases both fat and water signal.
• Classic is not a substitute for chemical saturation.
– Classic with FSE-based sequences may experience signal drop-off at the edge
of the FOV.
– Only effective if imaging FOV is homogeneous.

IR Prepared
Inversion Recovery Preparation (IR Prepared) or IR Prep uses a 180° RF preparation
pulse (Figure 30-20) delivered prior to the imaging sequence to enhance T1-weighting.
Figure 30-20 IR Prep Diagram

The initial 180° RF pulse is followed by a waiting period (prep time), where the desired
contrast is allowed to evolve before the RF excitation pulse is applied. The prep time
allows for longitudinal magnetization (T1) differences to occur similar to the 180°
inversion pulse in an IR sequence.

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 Imaging Options

Centric phase encoding is used to take advantage of the contrast that evolves during
the prep time before a steady-state condition develops. Figure 30-21 illustrates axial
images of the liver with IR Prep.
Figure 30-21 Axial Liver Images with IR Prep

NOTE: IR Prep is available with 2D Fast GRE or Fast Time of Flight (TOF) GRE/SPGR,
if Sequential is selected. IR Prep is also available with 3D Fast GRE/SPGR or
Fast TOF GRE/SPGR.

Applications
IR Prep can be applied to images to enhance T1 contrast or to suppress signals from
selective tissues.Table 30-7 lists the approximate preparation times for selected tissue
suppression. As field strength increases, use longer preparation times.
Table 30-7 IR Prep Time

IR Prep Time Tissue Suppressed

200 - 400 Liver
80 - 130 Fat
400 - 600 Spleen
700 - 800 CSF

Some degree of blurring may occur due to varying amounts of T1 relaxation as the
protons recover from the initial 180° prep pulse. Centric phase encoding helps reduce
blurring.

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 Imaging Options

Saturating Specific Signals

There are several saturation techniques available to saturate and therefore, suppress
specific signals in your images. The imaging options that specifically uses saturation
techniques include:
• Magnetization Transfer
• Single Quadrature Fat/Water Imaging (Option)
NOTE: Other saturation techniques are available through the SAT icon (Spatial
Saturation, Chemical Saturation (Option), SPECIAL) in the Additional
Parameters area.

Magnetization Transfer
Magnetization Transfer (MT) is available with 3D TOF GRE/SPGR, 3D GRE/SPGR, 2D
SE, pulse sequences. In 3D TOF GRE/SPGR, MT improves contrast between blood
flow and surrounding tissue by saturating tissues containing significant amounts of
protein (e.g., grey/white brain matter and skeletal muscle), thereby improving vessel
delineation. This is achieved by applying a large saturation pulse around 800 to 1,200
Hz off center frequency (CF). The applied MT RF pulse is modified.
MT takes advantage of an energy exchange process that occurs between bound and
unbound water nuclei (Figure 30-22).
Figure 30-22 MT RF Pulse off CF
Approximate signal saturation to expect
in tissues when using MT:
• Skeletal muscle, 60%
• White brain matter, 40%
• Grey brain matter, 30%
• Blood, 15%

3D TOF GRE/SPGR with MT is compatible with ramped RF pulses. Ramped RF pulses

apply a linear-increase RF flip angle throughout the 3D imaging volume. Table 30-8
displays the signal intensities that can result from specific ramped RF pulses.
Table 30-8 Ramped RF Pulse Signal Intensities

Ramped Pulse Blood Flow Direction Signal Intensity

I–S I–S bright
I–S S–I dark
S–I I–S dark
S–I S–I bright

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 Imaging Options

2D SE with an MT preparation technique can be used to augment the MR contrast

agent enhancement seen on post-contrast T1-weighted brain images. Similar to the MR
angiography application, the MT preparation pulse is used to suppress brain
parenchyma signal relative to the contrast-laden blood.
There are several User Control Variables (CVs) available with the MT option: MT
Frequency Offset.
Magnetization Transfer (MT) frequency offset can be selected when using SE or 3D
TOF pulse sequences. CV10 is defaulted to OFF. If CV10 is turned ON, then select a
frequency offset value (CV11).

Applications
Use MT to improve contrast between blood flow and surrounding tissue in 3D TOF
GRE/SPGR imaging (Figure 30-23).
Figure 30-23 3D TOF with MT

MT preparation techniques have been in routine clinical use in MR Angiography as a

means of suppressing non-vascular signal (brain parenchyma) relative to vascular
blood.

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 Imaging Options

Use MT with 2D SE to reduce signal from tissues with high protein content and increase
the conspicuity of pathology or gadolinium enhanced structures. Figure 30-24 displays
SE images acquired with and without MT.
Figure 30-24 SE Comparisons with MT

There are several things you should consider when using MT:
• The minimum TR is increased in 3D TOF GRE/SPGR and 3D GRE/SPGR
sequences with MT.
• MT cannot be used for imaging patients whose weight is less than 22 pounds
(10 kg).
• The off-resonance RF pulse increases peak SAR, which requires increasing
minimum TR when using FC and spatial saturation pulses.

Single Quadrature Fat/Water Imaging (Option)

Fat/Water Imaging is a single point quadrature technique that is designed to generate
images in which the signal component(s) is/are fat and/or water.
Selection/distinguishing of fat or water is based on the phase difference that exists
between fat and water because of their different precession frequencies (3.3 - 3.5 ppm).
The amount of phase difference is related to the TE value selected.
Fat and water protons precess at different rates in a magnet field due to their chemical
make up. This difference in precessional frequency means that the fat and water
protons will be at different phases compared to one another depending upon the TE
selected. At time zero, fat and water are in phase, in other words, they are starting at
the same point. At 10ms, they oppose one another or can be said to be out of phase
and their signals would subtract from one another. At a TE time of around 5ms, the fat
and water protons would be at 90° to one another and present with the greatest phase
difference between the two signals. This phase difference can be detected and in
reconstruction the system can separate the signals from fat and water. The result is an
image comprised of the signal from fat with the water signal suppressed or an image
comprised of signal from water with the fat signal suppressed as seen in the diagram
below.

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 Imaging Options

Figure 30-25 Diagram of Single Quadrature Fat/Water Imaging technique

During post-processing, the system reconstructs Water suppressed images and/or Fat
suppressed images.
When selecting Fat or Water Imaging, either a fat or water image in addition to the
original image will be generated. When selecting Fat and Water Imaging, both fat and
water images in addition to the original image will be generated.
When using FSE or FRFSE, select 2NEX, Blurring Cancellation, and then [Single
Quadrature Fat Imaging] and/or [Single Quadrature Water Imaging]. [Single Quadrature
Fat Imaging] and/or [Single Quadrature Water Imaging] can also be selected with 2D
SE, 2D FSE/FRFSE, 2D/3D FIESTA-C, 2D/3D GRE/SPGR, 3D Fast GRE/SPGR, 3D
Fast TOF GRE/SPGR.
The type-in option is fww or fwf. Images are annotated "FWw" or "FWf".

Something to Think About...

• Only [Center] can be selected for Table Entry.
• When using FSE, follow a procedure below:
a) Select 2 or greater for NEX.
b) Select [FSE/FIR Blurring Cancellation] for Imaging Option.
c) Select Single Quadrature Fat/Water Imaging for Imaging Option.
• To produce optimum image quality, a homogeneous static magnetic field (B0) is
needed. Because of this factor, it is important to note that the further away from
isocenter (off magnet center) the slice locations are, the more uneven the fat or
water suppression will be within the slice.
• Fat/Water separation may not be performed properly when there is any metal on or
in the patient.
• Typically use optimized Fat/Water separation on an area of interest within 100 mm
from isocenter.

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 Imaging Options

• Fat/Water separation can not be performed within an area of 30mm distance from
the surface of the coil.
• Remember that the patient, due to his or her inherent magnetic susceptibility, can
be the cause of uneven suppression.
• Due to the special reconstruction process for Fat/Water separation, it takes 5-6
seconds before the images are displayed in the AUTOVIEW window. When using
3D FIESTA with Slice ZIP, it takes around 1 minutes.
• [No Phase Wrap] is compatible with Single Quadrature Fat/Water Imaging and
should be used to prevent wrap-around of structures outside the FOV. Select 4 or
greater NEX using [No Phase Wrap] with FSE/FIR Blurring Cancellation.
• [POMP] is not available when SE is selected.
• Selecting it with [Respiratory Compensation], artifacts sometimes occurs.
• When using [FIESTA] for Fat and/or Water Imaging, use only [Water] for Auto
Center Frequency on the Acquisition Timing window. [Peak] is defaulted.
• SAT is not compatible with [FIESTA].
• When using 3D Fast TOF GRE/SPGR, Auto Collapse and Projection MIP cannot be
selected.
• Fat/Water Separation introduces a user CVs window needed for FIESTA-C scan
prescription. It is recommended that CV5 is set to on (1) and CV6 to SGS (4).
Setting CV6 to 4 reduces artifacts caused by residual SE and GRE factors when
setting DFT to On at CV5. When selecting 1 to CV5 at [FIESTA-C], only 4 is
available for CV6.
• In anatomical areas where both fat and water tissue may not exist, fat and water will
not be perfectly separated.
• Misregistration of the Fat/Water signal may occur at the spine, combined tissues in
the breasts, and fatty kidney or liver where the same amount of fat and water is
contained in a pixel.
• Fat/Water separation may not be performed properly if the FOV covers different
body parts, such as 2 axial legs. This is due to improper phase estimation caused
by discontinuity of body parts.
• Fat/Water separation may not be performed properly when scan area is like
abdomen or breast where motion occurs.
• Misregistration of the Fat/Water signal may occur at the oral and nasal cavities due
to the large magnetic susceptibility (rapid change in phase shift) seen in these
areas.
• Using a SAT pulse in the area of the oral nasal cavities can improve Fat/Water
separation for other structures near these anatomical areas.
• Misregistration of the Fat and Water signal may occur at the area where a SAT
pulse is applied. Make sure that SAT pulses are not placed too close to the area of
interest when Fat/Water Imaging is performed.

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 Imaging Options

• If the scan time is too long in FIESTA/FIESTA-C, banding artifact occurs and
misresistration of Fat and Water signal may occur. Please make scan time shorter
than a couple of minutes.
• Available coils are as follows;
– Head
– Neurovascular (NV-Head, NV-Neck)
– 9-INCH GP
– Open Body
– Knee Array Small
– Knee Array Large
– Knee Foot Array
– Shoulder

Enhancing Spatial Resolution

This section focuses on imaging options that may be used to help produce consistent,
high quality examinations by enhancing the resolution of the images. The following
imaging options are available to enhance resolution:
• Square Pixel
• ZIP x 2 and ZIP x 4
• ZIP 512 and ZIP 1024

Square Pixel
The Square Pixel Imaging Option maintains a square pixel within a rectangular FOV
due to the selection of asymmetrical matrix values. Pixel size is determined by the FOV
divided by the frequency axis of the matrix (Equation 30-1).
Equation 30-1 Pixel Size
FOV
Pixel Size = -----------------------------------------------------
FrequencyMatrix
Square Pixel scales the FOV by the ratio of the phase to frequency value. If the matrix
is not balanced, an asymmetrical FOV results. Selecting Square Pixel results in
resolution based on the selected frequency axis combined with a reduced phase matrix
for a shorter scan time.
To calculate the size of the phase FOV, divide the phase matrix value by the frequency
matrix value (e.g., 192 ÷ 256 = 0.75, the new phase FOV is 75% of a full FOV).

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 Imaging Options

Figure 30-26 demonstrates that with Square Pixels, the FOV decreases with varied
matrix choices but the resolution is unchanged.
Figure 30-26 Square Pixels
1. 256x256, 24 cm x 24 cm FOV,
Square Pixels
2. 256x192, 24 cm x 18 cm FOV,
Square Pixels

NOTE: Square Pixel is compatible with most pulse sequences. NPW is not compatible
with Square Pixel.

Applications
Use the Square Pixel imaging option to increase spatial resolution with reduced scan
times when an asymmetrical FOV is acceptable. The resolution is determined by the
frequency axis of the matrix, and the scan time by the phase axis. Only apply this option
when the anatomy in the phase direction is smaller than the new reduced FOV.
Common examinations include:
• Sagittal and coronal cervical spines and knees
• Sagittal thoracic and lumbar spines
• Axial and coronal heads
• Axial abdomens and chests
There are several things you should consider when using the Square Pixel option:
• Aliasing occurs if anatomy is outside the FOV.
• As the phase FOV gets smaller, the SNR is decreased.

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 Imaging Options

ZIP x 2 and ZIP x 4

Through-plane spatial resolution, Slice Zerofill Interpolation Processing (ZIP),
interpolates new slice locations in a 3D volume. It changes the slice center, but not the
slice thickness (Figure 30-27). This technique improves through-plane resolution by
interpolating the acquired scan data to create new images with no penalties in scan
time or SNR.
Figure 30-27 Slice ZIP Technique

The Slice ZIP imaging options are available with the following pulse sequences:
• 3D FGRE/SPGR
• 3D TOF
• 3D Fast TOF
• SmartPrep
• 3D FIESTA / FIESTA-C
Slice thickness must be evenly divisible by:
• 0.2 when using ZIP x 2
• 0.4 when using ZIP x 4

Applications
Use Slice ZIP to:
• Increase through-plane resolution.
• Smooth reformations or Interactive Vascular Imaging (IVI) projections.
• Reduce partial volume artifact due to the position of the anatomy within the slice.
• Reduce the number of acquired slices in a 3D volume and resulting scan time.
• Enhance Fast GRE 3D imaging for muskuloskeletal, breath-hold abdomens, breast,
and Magnetic Resonance Angiography (MRA) imaging.
If your primary goal is to increase the resolution of your multiple image projections
(MIP), select ZIP x 2 to increase the number of reconstructed slices within your
prescribed range by a factor of 2 (or 4 with ZIP x 4). This results in an increased number
of slices overlapped through your prescribed scanning range.

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 Imaging Options

There are several factors you should consider when using Slice ZIP:
• Slice ZIP has no effect on SNR. It comes at the expense of an additional factor in
reconstruction time.
• The number of overlapped slices and discarded end slices automatically are
doubled or quadrupled if you select slice ZIP. Keep this in mind if slice thickness is
decreased; desired anatomy may be discarded.
• In the Scanning Range area, the Slice Location value multiplied by the Slice ZIP
factor equals the actual number of reconstructed slices minus the discarded slices.
• Although Slice ZIP is useful for improving 3D image resolution, it is possible to
select slices that are too thick. Gibbs ringing artifacts can result when the slice
thickness gets too large, typically greater than or equal to 2 mm in the head, or
greater than or equal to 4 mm in the body. This ringing artifact can occur in both the
phase and the slice direction. It is most often apparent on reformatted images when
the artifact occurs in the slice direction.
• ZIP x 4 only gives a marginal improvement in effective resolution over ZIP x 2.
ZIP x 4 images are overlapped by 75% of the slice thickness instead of 50%. The
marginal improvement in effective resolution comes at the expense of an additional
factor of 2 in reconstruction time.

ZIP 512 and ZIP 1024

In-plane spatial resolution Matrix Zero-fill Interpolation Processing (ZIP) uses zero filling
to reconstruct images in a 512x512 or 1024x1024 format even if acquired in a different
format. Zero-filling enhances the apparent image resolution; it does not create
additional resolution.
In Figure 30-28, a 256x256 acquisition matrix is reconstructed in a 512x512 display
matrix. Alternate lines are filled with zeroes to expand the larger display format.
Figure 30-28 ZIP 512 Reconstruction Technique

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 Imaging Options

Matrix ZIP increases the visibility of resolution inherent in the image — note the
increased sharpness of the liver vessel edges in Figure 30-29.
Figure 30-29 Matrix ZIP Increased Resolution

NOTE: EPI, 2D TOF GRE/SPGR, and Phase Contrast,are not compatible with 512 ZIP.
NPW is not compatible with ZIP 1024. ZIP 1024 images cannot be transferred to
and displayed on a non-LX system.

Applications
Matrix ZIP (ZIP 512 or ZIP 1024) can be used to better visualize the available in-plane
resolution. This option can be used to enhance resolution without an increase in scan
time if you keep the pixel size (phase matrix and FOV) the same as your routine
protocol. Increasing the FOV or decreasing the phase matrix, with ZIP 512 or 1024,
allows you to increase SNR to recover some of the loss in spatial resolution.
There are several things you should consider when using the Matrix ZIP options:
• ZIP 512 produces a small decrease in SNR as compared to a 256x256 matrix.
However, the SNR of a scan with ZIP 512 is much higher than the same scan with a
512x512 acquisition matrix.
• ZIP 1024 produces a small decrease in SNR as compared to a 512x512 matrix.
• ZIP 512 images take longer to reconstruct and require more disk storage space
than 256 images. This additional reconstruction time and required storage space is
identical to an acquired 512 image.
• ZIP 1024 images take longer to reconstruct and requires more disk storage space
than a 256x256 or a 512x512 image.
• ZIP 512 and 1024 enhance apparent image resolution. It can make truncation
(Gibbs) artifacts more noticeable. Increasing the phase matrix value up to 256, or
decreasing the FOV, can reduce this artifact.
• If a frequency matrix > 256 is selected (e.g., 512, 384, etc.), then selecting ZIP 512
has no effect since 512 reconstruction is already used.
• You may experience increased processing times with IVI and Reformat with ZIP
1024 images.

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 Imaging Options

Balancing SNR
All imaging options affect SNR in some way; however, VBw is the most frequently
adjusted parameter used to compensate for other factors that reduce SNR.
SNR is a balance between scan time and spatial resolution (Figure 30-30).
Figure 30-30 SNR Balancing

NOTE: The integrated SNR indicator in the Scan Operations area allows you to
understand the SNR impact of various parameter changes to assure more optimal
scan prescriptions.

Additional Imaging Options

There are also other imaging options available for use while scanning to help improve
your image quality and efficiency. These include the following:
• Extended Dynamic Range
• Phase Offset Multi-Planar (POMP)
• Full Echo Train
• Multi Phase
• Multi Station
• Real Time
• Sequential
• SmartPrep

Extended Dynamic Range

Extended Dynamic Range (EDR) is an imaging enhancement technique that allows 32
bit data processing instead of the conventional 16 bits to slightly improve SNR. The
system prompts for EDR after prescan if the system determines EDR will improve SNR.

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 Imaging Options

NOTE: Compatible with virtually all pulse sequence and imaging options.

Applications
EDR improves SNR in some applications, such as 3D acquisition imaging.
There are several factors you should consider when using EDR:
• EDR uses twice as much memory as a conventional acquisition, which can limit the
number of available slices. This especially occurs with 3D acquisitions.
• EDR may cause auto pause to engage if a large number of slices are prescribed.

Phase Offset Multi-Planar (POMP)

[POMP] doubles the slice coverage by exciting two slice locations at the same time.
Multiple RF pulses are used to excite two adjacent slice locations at once, using a pulse
combining two frequency bands that are out of phase with one another.

1. POMP Reconstruction
2. Acquisition FOV and phase steps are doubled to provide
k-space for reconstruction.

During reconstruction, the slices are phase shifted from each other and separate to
create two images. In order to achieve this, the acquired FOV is doubled in the phase
direction and the NEX is halved to maintain the same imaging time.
Table 30-9 POMP Parameter Selection

What You Select What the System Acquires

Desired FOV Doubles the FOV in the phase direction
Desired Phase Matrix Value Doubles the phase matrix to maintain resolution
Desired NEX Cuts the NEX in half to maintain scan time

NOTE: [POMP] is compatible with SE sequences only. The images are annotated PM.
The type-in command is PO and is not case sensitive.

Applications
• Use POMP to increase the number of slice locations on short TR T1W sequences
instead of increasing the TR and reducing contrast.

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 Imaging Options

Something to Think About...

POMP is incompatible with:
• Sequential imaging option.
• A phase FOV less than 1.
• Square Pixel imaging option.
• NPW imaging option.
• 0.5 and 0.75 NEX.
• Odd number of slices.
• When [POMP] and [Flow Compensation] are combined, the Flow Comp gradient is
only applied to the second echo, therefore the early echo is not compromised.
• Not recommended for studies where wraparound can be a problem.
• Two-echo maximum.
• Images may exhibit flatter contrast. Use TR and TE values that enhance T1 contrast
when [POMP] is used.
• Increased motion artifacts may occur because [POMP] halves the selected NEX
and, therefore, decreases the benefits from motion averaging when NEX values are
less than 2.
• [Respiratory Compensation] with [POMP] is only compatible with 1 or 2 NEX.
• Aliasing and motion artifacts from one slice may be propagated across POMP
images in the phase direction.
• If [POMP] is used with ECG gating, there are two sets of images with the same
timing annotation, since two images are acquired for each excitation.

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 Imaging Options

Full Echo Train

Full Echo Train (ET) is available when the pulse sequence is a FSE and two echoes are
selected. The full ET method completes all echo trains for effective TE1 before the
effective TE2 is initiated. The phase encoding process is altered to place the central
phase encodings at the selected effective TE1 or TE2.
Figure 30-31 8 ETL Split ET
When 2 echoes are selected, the system
automatically splits the programmed
ETL (8) between the two echoes. In this
example, a 4 ETL is used for the first
echo and a 4 ETL is used for the second
echo.

Figure 30-32 8 ETL Full ET

When two echoes are selected, the
Full ET option must be selected to
acquire full trains of each echo.

The resulting contrast of using a full ET is similar to that of a single echo acquisition for
a long TR/short TE and long TR/long TE. A full ET is always used for single echo, FSE
acquisitions.
NOTE: Full ET is only available when two echoes are selected.

Applications
Select the Full ET option when more effective contrast weighting is desired on a dual
echo acquisition. Using Full ET can result in a decrease in the number of available
slices per acquisition. To compensate for the loss of slices, increase the TR.
NOTE: The resulting contrast may be more varied than desired. An alternative is to
acquire two separate acquisitions, each with an effective TE and ET programmed
to produce the desired contrast and time results.

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 Imaging Options

Multi Phase
The Multi Phase option allows imaging of the same slice locations or volume at different
times (phases) using the same imaging parameters. The Multi Phase Screen icon
(Figure 30-33) becomes active in the Additional Parameters area when Multi Phase is
selected on the Imaging Options window. When you click the icon, the Multi Phase
screen (Figure 30-34) opens.
Figure 30-33 Multi Phase Screen Icon

Figure 30-34 Multi Phase Screen

The following additional parameters become available:

• Phases per Location – indicates the number of phases to be acquired at one
location. The (slices/location) x (number of slices) cannot exceed 512.
• Acquisition Order (Interleaved, Sequential, or Rapid Frame)
– In sequential mode, the system acquires all of the slices at the first slice location
(pass 1) before moving on to the second (pass 2). Sequential is recommended
for kinematic range of motion studies.
– In interleaved mode, the system acquires the first phase at each location (pass
1) and then goes back and acquires the second phase at each location (pass 2)
and so on. Interleaved is recommended for contrast studies.
– In rapid frame, the system acquires slices like sequential mode. However,
K-space is segmented and shared between phases. The number of
segmentation indicates the number of k-space segmentation. In this case, Delay
after acquisition is automatically minimum.

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 Imaging Options

• Delay after Acquisition – indicates the length of delay after every acquisition. The
system resumes scanning automatically after the prescribed delay. Delay after
acquisition times available are 20 ms to 20 seconds. Alternatively, the Locs Before
Pause may be selected from the Acquisition Timing area instead of programming a
delay after acquisition from the Multi Phase Screen. If so, the delay after acquisition
should be minimum on the Multi Phase screen.
Figure 30-35 is a series of axial liver images acquired with Multi Phase.
Figure 30-35 Axial Liver Images with Multi Phase

NOTE: In the 2D mode, Multi Phase is compatible with Fast GRE, Fast SPGR, SE EPI,
and GRE EPI. It is also compatible with Fast GRE, Fast SPGR, and Fast TOF
GRE/SPGR in the 3D mode.

Applications
Use the Multi Phase option for joint motion studies of the knee, TMJ, and wrist. It is also
useful for dynamic contrast studies to repeat the same slice locations at different
vascular phases.
NOTE: Images acquired at a single location with multiple phases (SSMP) may appear
shifted upon display. This is most noticeable when these images are loaded into
a paging-loop mode.

Multi Station
Multi Station, also known as SmartStep, is a feature that provides automatic table
movement and switching of coils between stations. SmartStep is used with 3D Fast
TOF GRE/SPGR, 3D Fast GRE/SPGR, and 3-Plane.
Refer to the Bolus Chasing chapter for additional information on Multi Station.

Real Time
The Real Time, or iDrive, option is a real-time interactive acquisition that can be used
for navigating through patient anatomy for rapid visualization, monitoring temporal
physiological events. Real-time interactive images can also be used for directly
prescribing scan planes of other series in the examination.

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 Imaging Options

Refer to the Imaging Real Time chapter for additional information.

Sequential
Sequential is a data acquisition mode that collects one image at a time, in a numerical
order. All of the excitation pulses (number of phase steps x NEX x TR) are delivered for
one location before the process is repeated at another location. The total number of
slices equals the number of acquisitions.
Equation 30-2 Sequential Scan Time

Scan Time = TR x Phase Matrix x NEX x Number of Slices

Sequential paired with an IR pulse sequence may produce more slices than a
non-sequential sequence for TIs less than 250 ms.
NOTE: 2D Fast GRE is compatible with Sequential and either DE-Prepared or
IR-Prepared. 2D Fast SPGR is compatible with Sequential and IR-Prepared. In
both cases, the DE-Prepared or IR-Prepared options are not available unless
Sequential is also selected.
Sequential is also compatible with TOF and IR pulse sequences.

Applications
Use the Sequential option during 2D acquisitions to eliminate cross-talk between slices,
for breath-hold abdominal or chest scans, or for quick localizer scans.
NOTE: Acquiring a number of 2D sequential scans through an area may take longer than
a 3D acquisition. Always compare the scan times of both acquisition modes and
the tradeoffs between 2D and 3D to make a decision that best fits the patient’s
needs.

SmartPrep
SmartPrep Infusion Angiography (IA) is an imaging technique that uses a tracking pulse
sequence to continuously monitor the MR signal coming from a prescribed volume of
interest in the patient to detect contrast arrival and automatically begin the acquisition.
Refer to the Bolus Triggering chapter for additional information on SmartPrep.

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 Gating and Triggering

Chapter 31
Gating and Triggering

Introduction
This chapter contains information needed for successful cardiac gating/triggering and
respiratory gating/triggering on your Magnetic Resonance (MR) system. It provides a
foundation that enables you to make decisions about when to use gating and triggering
to eliminate the effects of heart and breathing motion. This chapter highlights key
concepts and contains step-by-step instructions to help you learn how to:
• Use Cardiac Gating/Triggering
– Position the Electrodes
– Set up the Gating Control Parameters
– Position the Patient and Coil
– Set up the Cardiac Gating/Triggering Parameters
• Use Respiratory Gating/Triggering
– Place the Bellows and Route the Tubing
– Set up the Gating Control Parameters
– Set up the Respiratory Gating/Triggering Parameters

CAUTION: Performing electrocardiogram (ECG) and peripheral cardiac gated

examinations require thorough knowledge of gating and surface coil
safety issues. Please refer to the safety guide.

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 Gating and Triggering

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete the
cardiac/respiratory gating and triggering processes. Specifically, you need to
understand:
• Gating and Triggering Basics
– Gating
– Triggering
• Cardiac Gating/Triggering
– ECG
– Peripheral
• Respiratory Gating/Triggering
• Cable Connection Ports
• Gating Control Window
– Advanced ECG Gating
– ECG Lead Selection
– Cardiac Trigger Level
• Waveform Display
• Cardiac and Respiratory Gating/Triggering Window
– Cardiac Gating/Triggering Parameters
– Respiratory Gating and Triggering Parameters
• Combined Cardiac and Respiratory Gating/Triggering
– Combined Gating/Triggering Guide
• Frequently Asked Cardiac Questions

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 Gating and Triggering

Gating and Triggering Basics

The Signa® system provides cardiac and respiratory gating and triggering. This allows
the same data to be collected at the same points of the cardiac and/or respiratory cycle
for each repetition of the pulse sequence. The benefit is that the motion is always the
same and is essentially "frozen" — allowing motion artifacts to be reduced, or
sometimes eliminated.
• Cardiac Gating/Triggering uses a signal generated by the electrical impulses of the
heart though applied electrodes or uses a signal generated by the mechanical flow
of blood in the vascular bed via a photopulse sensor. Thus, the pulsatile cardiac
motion is reduced by synchronizing the data acquisition to the cardiac cycle.
• Respiratory Gating/Triggering uses a signal generated by the motion of the
abdominal wall to reduce respiratory motion by synchronizing data acquisition to the
quiet period of the respiratory cycle.
Cardiac and respiratory gating/triggering function in the same manner. The difference is
the signal used in the process: the cardiac waveform or the respiratory waveform.
The pulse sequence determines whether the system uses gating or triggering, however,
Respiratory Triggering is not available for most sequences. It is not necessary to
remember which process is used with which sequence. Choose the desired pulse
sequence and select Cardiac or Respiratory Gating/Triggering at the Imaging
Options window and the system automatically performs the appropriate process.

Gating
Gating monitors the cardiac or respiratory cycle, but does not use a trigger to initiate
radio frequency (RF) application. RF is applied throughout the cycle at the defined
repetition time (TR) and data is acquired when the desired physiological event occurs.

Triggering
Triggering is a technique that turns RF application and image acquisition on and off
based on a trigger detected within the cardiac or respiratory cycle. Triggering
synchronizes data acquisition with the waveform cycle, and all image data is acquired
at the same phase in the cycle for each slice prescribed.

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 Gating and Triggering

Cardiac Gating/Triggering
When you select Cardiac Gating/Triggering from the Imaging Options window, the
system automatically performs the appropriate process of gating or triggering
depending on your pulse sequence selection. The imaging option selection also
activates the Gating/Triggering icon in the Additional Parameters area, where you can
select supplementary parameters and the type of gating to perform.
There are two types of cardiac gating/triggering:
• ECG, which uses the electrical activity of the patient’s heart as reported by the
ECG.
• Peripheral, which uses a photopulse sensor that detects the mechanical action of
blood pulsing through the patient’s body.
Cardiac gating monitors the cardiac cycle by applying RF throughout the cycle at a
constant TR time, which you define. In this sequence, you also define the time, called
the Trigger Window (TW), when the data is acquired. Figure 31-1 illustrates a cardiac
gated acquisition. Note the programmed TW and that the TR does not change as the
cardiac cycle changes.
Figure 31-1 Cardiac Gated Acquisition

Cardiac triggering turns RF application and image acquisition on and off based on a
trigger (R-wave) detected within the cardiac cycle. Triggering synchronizes data
acquisition with the waveform cycle, and all image data is acquired at the same phase
in the cycle for each slice prescribed. Figure 31-2 illustrates a cardiac triggered data
acquisition.
Figure 31-2 Cardiac Triggered Acquisition

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 Gating and Triggering

Table 31-1 describes the components of cardiac gating versus cardiac triggering.
Table 31-1 Cardiac Gating vs. Triggering

Components Cardiac Gating Cardiac Triggering

Stops data acquisition and allows the
system a window in which to look for
and detect the next R-wave. You
Stops data acquisition and allows the
program this value as a percentage of
system a window in which to look for
Trigger Window the cardiac cycle for FastCard, 2D
and detect the next R-wave. You
(TW) and 3D FIESTA sequences. An
program this value to occur at the end
Arrhythmia Rejection Window
of the cardiac cycle.
appears for FastCINE, 3D
FGRE/SPGR, and 3D Fast TOF
GRE/SPGR, and 2D FIESTA.
Applied on and off based on the
Applied at the TR time (you define) trigger (R-wave) in the cardiac cycle.
throughout the cardiac cycle, The RF is applied synchronous to the
RF
including the TW. The RF is applied cardiac cycle. RF is not applied and
asynchronous to the cardiac cycle. data acquisition does not take place
during the TW or the TD.
Based on the RR Interval. Triggering
is synchronized to the cardiac cycle,
You program this value. The value
therefore, TR can be nonuniform if
remains constant; it does not change
the cycle timing varies, e.g., if the
TR as the cardiac cycle changes.
heart rate decreases or increases.
Uniform TR is beneficial for short TR
The effects of non-uniform TR, e.g.,
acquisitions.
image contrast inconsistencies,
decrease at longer TRs.
FastCard, FastCINE, 3D Fast
GRE/SPGR, 3D Fast TOF 2D SE, 2D FSE, SSFSE, EPI, and
PSDs
GRE/SPGR, 2D FIESTA, and 3D Multi-Planar 2D GRE/SPGR.
FIESTA
Occurs after the R-wave is detected
and data acquisition begins. RF
Trigger Delay
N/A application and data acquisition are
(TD)
initiated following detection of the
trigger.
Values defined
Number of Respiratory Intervals,
at the Cardiac
Trigger Window, TR Trigger Point, Trigger Window, and
Gating/Triggering
Inter-Sequence Delay
Screen

NOTE: Gating and triggering can elongate the scan time. If the gating signal is lost for
more than 30 seconds during a scanning acquisition, the scan aborts.
The ECG and peripheral gating devices are safe for patients due to the fiber-optic
technology.

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 Gating and Triggering

ECG
The electrical activity of the heart can be detected by measuring the voltage difference
between electrodes attached to the patient. Each lead represents the anatomy
connected by two electrodes. MR cardiac gating/triggering uses a three-lead technique
that consists of four electrodes and four lead-wires:
• The white electrode/lead wire is positioned for the right arm.
• The black electrode/lead wire is positioned for the left arm.
• The red electrode/lead wire is positioned for the left leg.
• The green electrode/lead wire is positioned for the right leg.
Proper preparation of the patient and placement of the ECG leads are an integral part of
any cardiac gated acquisition. If either of these procedures is done improperly, the ECG
waveform may not be detected accurately. This can affect the results of the
examination in terms of poor image quality and the inability to complete a cardiac gated
examination due to lack of a proper cardiac waveform for detection of the triggers.
Recommended electrode placement is anterior as shown in Figure 31-3. However,
slight adjustments to these positions may be needed based on the patient’s body
habitus and the extent of cardiac disease.
Figure 31-3 Recommended Electrode Placement

• ECG I measures the voltage between the right

arm (white) and the left arm (black).
• ECG II measures the voltage between the
right arm (white) and the left leg (red).
• ECG III measures the voltage between the left
arm (black) and the left leg (red).
NOTE:ECG II and III are measured signals, while
ECG I represents a calculated signal (calculated
from the average of the sums of ECG II and
ECG III).

WARNING:This waveform can only be used for cardiac gating and should not be
used for patient monitoring. The patient’s condition may not be
reflected, resulting in improper emergency treatment.

WARNING:Do not use expired or dried electrodes. They do not properly conduct
the signal, which can lead to image degradation, create intermittent
triggering, and can cause burns to the patient.

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 Gating and Triggering

CAUTION: Patient and cable positioning tips.

Position the cable in a fashion such that the cable is not looped and a
minimum length of cable remains within the bore of the magnet.
Place the patient in the center of the table to reduce the possibility of
patient burns.
Keep cardiac cables from touching the patient, coil cables, or magnet
bore. Cables need to exit the bore down the center of the table.
Make certain the lead wires and cables are undamaged.
Keep surface coils and their cables away from the ECG cables/wires.

IMPORTANT!:The following are important tips for ECG lead placement:

• Attach electrodes no more than 5 to 10 minutes before a scan.
• Avoid placing the electrodes over bony areas such as the sternum or clavicle. Bone
can interfere with signal detection.
• For women with large breasts, the left breast should be raised and the red electrode
placed as close to the position indicated in the ECG lead placement illustration.
• The electrodes should not be placed more than 10 to 15 cm apart.
• Be sure to place the left leg (red) electrode over the apex of the heart.
• On normal volunteers, ECG ll generally provides the best signal.
• The heart may present itself in a different orientation within the thorax of a patient
with heart disease. In these patients, ECG l or lll may provide the best signal.

Waveform
Electrical impulses cause the heart to contract and, therefore, blood to flow throughout
the body. The electrical activity of the heart can be mapped by an ECG and the
resulting ECG waveform can be used during cardiac gating/triggering to reduce
pulsatile cardiac motion by synchronizing data acquisition to the cardiac cycle.
The ECG waveform represents the electrical activity of the heart that correlates to heart
motion. Figure 31-4 displays a normal ECG pattern of the waves in the cardiac cycle.
Figure 31-4 ECG Waveform

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 Gating and Triggering

The waveform elements critical to cardiac gating are explained in Table 31-2.
Table 31-2 Cardiac Waveform Elements

Waveform
Description
Element
P-Wave Represents depolarization of the atria, resulting in contraction or
systole of the atria. A normal P-wave is no more than 3 mm high and
0.12 seconds in duration. It is difficult, and sometimes impossible, to
see the P-wave on an ECG acquired when the patient is in the bore of
the magnet. This contraction is not normally seen in FastCard
acquisitions, due to the application of the TW.
PR Interval
Represents the time between the onset of the P-wave and the onset
of the QRS complex. The normal duration of a PR interval is 0.12 to
0.20 seconds. Anything greater than 0.20 seconds is abnormal.

QRS Complex
Represents depolarization of the ventricles, resulting in contraction or
systole of the ventricles. The normal duration of a QRS complex is
about 0.08 to 0.11 seconds. A longer complex may indicate a
ventricular conduction defect, such as a left bundle branch block.

ST Segment
Represents the time between the completion of a depolarization and
the beginning of repolarization of the ventricle. An elevated or
depressed ST segment could indicate ischemia or an infarction.

T-Wave Represents re-polarization of the ventricles, resulting in relaxation or

diastole of the ventricles (recovery phase after ventricular
contraction). Flowing blood in the body makes an artifact in the ECG
that obscures the normal T-wave when the patient is inside the
magnet, rendering the ST segment invalid for evaluation of infarction
or ischemic events. In cases of heart injury, the T-wave may be
inverted.
RR Interval
Represents the time between one heartbeat and the next, based on
the R-wave of the QRS complex. Each RR interval corresponds to a
full cardiac cycle. The R-wave is used for triggering because of its
strong electrical signal and correlation of the muscle activity of the
heart.

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 Gating and Triggering

In addition to the cardiac waveform elements, the cardiac phases (systole and diastole)
also play an important role in cardiac gating. The phases are described in Table 31-3.
Table 31-3 Cardiac Phases

Cardiac Phase Description

Systole

Cardiac contraction is called systole. Systole is the remaining

portion of the cardiac cycle after the R-wave. It is the period
between the R-wave’s peak and the end of the T-wave when the
heart is contracting and expelling blood.

Diastole

Cardiac relaxation is called diastole. Diastole is the period

between the end of the T-wave and the peak of the following
R-wave. It is during diastole that the ventricles fill with blood.

NOTE: There is a difference between electrical diastole and mechanical diastole.

Electrical end-diastole occurs at the P-wave. Mechanical end-diastole occurs at
the R-wave. Figure 31-4 shows mechanical end-diastole. Mechanical diastole is
used in Signa cardiac imaging.

Applications
ECG cardiac gating/triggering with is useful during the following applications:
• Heart imaging for structure or function
• Thorax imaging
Figure 31-5 Cardiac ECG Gating/Triggering Images
Cardiac gating/triggering can
eliminate motion by using the
heart’s electrical activity as
reported by the ECG to trigger
the RF data acquisition.
NOTE:ECG cardiac
gating/triggering is annotated
“EG” for ECG gating.

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 Gating and Triggering

There are several factors you should consider when using ECG gating/triggering:
• The T-wave may increase in height once the patient is in the magnet because of the
Magnetohydrodynamic Effect. Repositioning the electrodes, positioning the patient
feet-first, or using another lead selection, may minimize this effect.
• Eliminate as many noise sources as possible, including ECG cable motion, patient
movement, and breathing motion artifacts if the patient is in a head first position and
the ECG cable rests on the patient’s abdomen.
• When prescribing a series, complete the gating window in Additional Parameters
area after the patient has been placed in the magnet. This diminishes the chances
of a heart rate increase (common for some people as they first enter the magnet),
which may result in a reduction in the number of slices allowed per acquisition.
• Do not press on the center portion of the electrode. This can flatten the conductive
gel and weaken electrical impulse detection, which may result in intermittent or
missing QRS detection.
• Should the ECG signal degrade during data acquisition, Signa automatically
switches to another lead (trigger type selection).
• If there is a problem with the LL (left leg/red) electrode or lead wire, neither EGG II
nor ECG III provides a good trace. The ECG I trace is calculated from the sums of
EGG II and III, therefore, the ECG I trace is also affected. It may be necessary to
check the electrode and lead attachment followed by reinitializing cardiac gating.
• If the waveform is not a clean trace, cycle through the leads on the Gating Control
window. Visually inspect the traces to find the best waveform. As the lead selection
is changed, click the [Update] button to display the R-peak amplitude. Use the
combination of a visual inspection of the waveform and the R-peak amplitude to
determine the best lead for gating. Performing only a visual inspection of the
waveform is not sufficient because Signa autoscales the waveform even if the
R-peak amplitude is very low. A high R-peak amplitude in combination with a
"clean" waveform ensures successful of triggers.
• DO NOT rely on Auto for lead selection. Auto chooses the lead that has the
strongest signal, but not necessarily the lead that produces the best waveform. The
signal could be strong due to noise in the waveform.

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 Gating and Triggering

Peripheral
Peripheral gating uses a photopulse sensor (Figure 31-6) to detect blood flow in the
vascular bed of the patient’s finger or toe.
Figure 31-6 Photopulse Sensor on Finger
The following are important tips for peripheral gating/triggering:
• Make sure the anatomy where the sensor is placed remains
cool and dry during the entire examination.
• Attach the sensor to a toe or finger with minimal callous to
ensure a good reading.
• Keep the cable entering the magnet bore to a minimum. Do not loop the cable.
• Ask the patient to keep the sensor very still during the study. To minimize motion,
rest the patient’s arms at his or her sides, rather than on the chest or stomach.
• Keep the photosensor away from isocenter and the area being imaged to minimize
the RF or gradient interference.

Waveform
The photopulse waveform represents blood flow, not the electrical activity of the heart.
Peak blood flow occurs at the peak of the waveform, the R-wave. Peripheral gating
begins the acquisition by recognizing the arrival of the R-wave. The TR available is
governed by the patient's heart rate.
Figure 31-7 RR Interval in Photopulse Waveform
Figure 31-7 shows the RR Interval, from one
peak waveform to the next, in a photopulse
waveform.

Applications
Use peripheral gating during head or cervical/thoracic spine imaging to minimize
pulsatile motion of CSF on T2 or T2* scans.
Figure 31-8 Frozen Pulsatile Motion
Figure 31-8 displays how
peripheral gating can
"freeze" the effects of
pulsatile motion on brain
and spine images.
NOTE:Peripheral gating is
annotated “PG”.

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 Gating and Triggering

Respiratory Gating/Triggering
Respiratory gating/triggering uses the Respiratory Bellows to reduce breathing artifacts.
When you select Respiratory Gating/Triggering from the Imaging Options window,
the system automatically performs the appropriate process of gating or triggering
depending on your pulse sequence selection. The imaging option selection also
activates the Gating/Triggering icon in the Additional Parameters area, where you can
select supplementary parameters.
Respiratory gating uses the respiratory waveform to determine the quiescent (most
quiet) period of the respiratory cycle to acquire data. This is at the valley of the cycle,
end-expiration/beginning-inspiration. TR is applied continuously throughout the
respiratory cycle.
Figure 31-9 Respiratory Gated Acquisition

Respiratory triggering works in the same fashion as cardiac triggering, using the
respiratory cycle to initiate RF application and data acquisition. The delivery of RF is
synchronized with the respiratory cycle. It uses the patient's inspiration to trigger data
acquisition.
Figure 31-10 Respiratory Triggered Data Acquisition

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 Gating and Triggering

Table 31-4 describes the components of respiratory gating versus respiratory triggering
processes.
Table 31-4 Respiratory Gating vs. Triggering

Component Respiratory Gating Respiratory Triggering

Stops data acquisition and
allows the system a window in
which to look for and detect the
next inspiration peak (trigger
Trigger Window
N/A point). You program this value as
(TW)
a percentage of the respiratory
cycle. Data acquisition and RF
application does not take place
during the TW.
Applied continually throughout Applied on and off based on the
the entire respiratory cycle at trigger (peak inspiration) in the
the timed TR, however, data respiratory cycle. The RF is
acquisition takes place only applied synchronous to the
RF
during the data acquisition respiratory cycle. RF is not
window. Continuous RF results applied and data acquisition
in a more uniform contrast and does not take place during the
is better suited for short TRs. TW or the TD.
Due to long TRs that generally
result from respiratory triggering
You program this value. The (based on the patient’s
value remains constant; it does respiratory rate), it is not usually
TR not change as the respiratory possible to achieve TR values
cycle changes. used to obtain T1 image
contrast.The minimum TR is
restricted by the patient's
inspiration to expiration cycle.
Data acquisition is generally
Triggering is synchronous to the
performed during the
respiratory cycle and is most
quiescent period of the
Data Acquisition applicable to long TR
respiratory cycle. This is at the
applications. Data acquisition
valley of the cycle, end-expir-
stops during the Trigger Window.
ation/beginning-inspiration.
Data acquisition is begun A point in the respiratory cycle
Trigger Point
when a user-defined Trigger used to initiate RF application
(TP)
Point is reached. and data acquisition.
FastCard, FastCINE, 3D Fast
2D FSE pulse sequences,
Compatible PSDs GRE/SPGR, and 3D Fast TOF
SSFSE, and 3DFSE.
GRE/SPGR,
Values defined
Respiratory Intervals, Trigger
at the Respiratory Trigger Point and Trigger
Point, Trigger Window, and Inter-
Gating/Triggering Window
Sequence Delay
Screen

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 Gating and Triggering

Respiratory Bellows
Respiratory gating/triggering uses a bellows sensor that detects the motion of the
abdominal wall. The respiratory bellows is used with the Respiratory Gating/Triggering
and Respiratory Compensation (RC) options.
The respiratory bellows is placed over the area being scanned (Figure 31-11), where
the greatest breathing motion occurs on the patient.
Figure 31-11 Respiratory Bellows Placement

The bellows is fastened with Velcro® straps. Placement of the bellows should be snug,
but stretched as little as possible.
• The bellows should expand and contract with the patient's breathing. Expansion
should be ½ to 1 inch.
• The signal may not be detected if the bellows is too loose.
• If the bellows is too tight, the system sets the respiratory gain too high and the
signal may not be detected accurately.
Figure 31-12 illustrates different expansion levels of the bellows.
Figure 31-12 Expansion of Bellows

• A – Correctly stretched bellows

• B – Breathing signal may not be detected with bellows set too loose
• C – Stretching the bellows too tight results in the gain set too high

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 Gating and Triggering

There is a respiratory light-emitting diode (LED) on the magnet enclosure. If the

respiratory signal is adequate, the LED should rise and fall with patient's breathing. The
LED should move over the bottom one-third of the display.
Figure 31-13 Respiratory LED
The LED on your system may be
as seen in the illustration on the
left or the right (Figure 31-13).
The illuminated amplitude of the
LED display should be 30% of
the window.

Do not detach the respiratory bellows from the connection port. Unplugging the bellows
allows air to enter the tubing, decreasing the system’s ability to detect a change in air
pressure when attached to the patient.
Deep breaths, coughing, movement, and talking affects the signal. The resulting
waveform exhibits all of these conditions.

Waveform
The respiratory waveform represents the excursion of the abdominal wall throughout
the course of inspiration and expiration. The waveform (Figure 31-14) is a pattern of the
patient’s breathing.
Figure 31-14 Respiratory Waveform

A respiratory interval is known as the maximum inspiration to the next maximum

inspiration. This is know as one respiratory cycle. Maximum inspiration occurs at the
peak of the waveform.
If the bellows is too tight, a waveform with a high gain may result. This is indicated by
waveform B in Figure 31-15 and the LEDs on the Physiologic Acquisition Controller
(PAC) or magnet enclosure reaching the extreme on the indicator. Loosening the
bellows helps to achieve a normal waveform. Oppositely, a low gain waveform display
(waveform B) can result if the bellows is too loose, indicating the LEDs on the PAC or
magnet enclosure reaching the low end. In this case, the bellows should be
repositioned or tightened. Waveform A demonstrates a normal waveform gain.

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 Gating and Triggering

Figure 31-15 Waveform Gain

WARNING:The respiratory bellows is intended for use solely in acquiring MR

images using respiratory compensation/triggering, not for
physiological monitoring.

Applications
You can use respiratory gating and triggering to acquire Proton Density (PD) or
T2-weighted images, where the TR is comparable to or longer than the respiratory
interval. You can also use these options as an alternative to RC or breath-hold on very
sick patients who cannot hold their breath or have an inconsistent breathing pattern.
Figure 31-16 Axial Abdomen with Respiratory Trigger
Respiratory Trigger minimizes phase ghosting in
Figure 31-16 by collecting data during the quiet phase
of the respiratory cycle.

There are several factors you should consider when using Respiratory Trigger:
• Respiratory arrhythmia rejection is not employed.
• It is not used during Prescan. During the Scan TR pass, the PSD sets TR to the
estimated effective TR.

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 Gating and Triggering

Cable Connection Ports

The gating cables and respiratory bellows are connected to the PAC. The ECG,
photopulse sensor, respiratory bellows, and the Patient Alert cables plug into these
ports (Figure 31-17).
Figure 31-17 PAC Port Plugs

Each cable has a unique connector and cannot be accidentally plugged into the wrong
port. The connection ports are used to collect triggering information for cardiac and
respiratory data acquisition. A routing device is attached to the PAC unit to keep the
cables separated.

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 Gating and Triggering

Gating Control Window

The Gating Control window (Figure 31-18) is used to set up parameters applied for
displaying the cardiac and respiratory waveforms, selecting the gating algorithm to be
used by Signa, and to change the lead selection during data acquisition. You can also
reset the gating waveforms and adjust the volume of the audio trigger in this window.
Figure 31-18 Gating Control Window

Table 31-5 describes the areas of the Gating Control window and the selections to
assist you in setting up and viewing gating waveforms.

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 Gating and Triggering

Table 31-5 Gating Control Selections

Area Selection Description

Displays the waveform for the selected ECG lead. A numeric
value, displayed in beats per minute (bpm), appears to the left of
the waveform display. The speed at which the waveform is
displayed can be adjusted by defining the Cardiac Sweep Rate.
Cardiac

Helps reduce the effect of gradient noise on the ECG signal, while
increasing the minimum TD by a minimum of 18 ms. In addition,
Waveform Display

when the ECG Noise Filter is on and is used in conjunction with

ECG Noise
Advanced ECG Gating, the Trigger Delay is increased further.
Filter
Therefore, using the ECG Noise Filter for all cardiac gated
examinations is not recommended. Use the ECG Noise Filter in
instances when the correct trigger is not properly detected.
Observes both positive slope and the amplitude to detect which
Advanced
component of the QRS complex is the correct trigger (the
ECG
R-Wave). Advanced ECG Gating is not compatible with PG. Refer
Gating
to Advanced ECG Gating for additional information.
Displays the waveform for the respiratory bellows. A numeric
value, displayed in breaths per minute (bpm), appears to the left
of the display.
Respiratory

PG Display Displays the waveform for the peripheral gating sensor.

NOTE: If the patient is connected to ECG leads, the respiratory bellows, and the
peripheral gating device, you can toggle between any of the three
waveforms. Therefore, you can decide which device produces the best
waveform: ECG or PG.
Defines the rate at which the cardiac or peripheral waveform is
Cardiac Sweep Rate

displayed. The default is 41 mm/sec. The sweep rate can be

10 mm/sec
changed at any time, without affecting a scan in progress. This
21 mm/sec
adjusts the cardiac sweep rate only; it does not affect the sweep
41 mm/sec
rate for the respiratory waveform. The respiratory waveform
sweep rate is 5 mm/second, and cannot be changed.
Sync
Synchronizes the selected cardiac waveform with the respiratory
Sweep
waveform.
Rates

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Area Selection Description

ECG I
Allows selection of a specific lead when Cardiac is selected in the
ECGII
Lead Display

Waveform Display area. View the R-peak amplitude to determine

ECGIII
which lead produces the strongest signal. Refer to ECG Lead
PG
Selection for additional information.
Auto
Provides the ability to invert the orientation of the cardiac
Inversion waveform. An alternative method of inverting the waveform is to
swap the red (LL) and white (RA) leads.
Allows adjustment of the trigger threshold the system uses to
Trigger Level

50% "look" for triggers. It is expressed as a percent of the QRS

Cardiac

60% complex. The amplitude of the signal must rise above the defined
70% threshold to be detected. The default Trigger Level is Auto, which
Auto sets the trigger level to 65% for ECG Gating and 50% for PG.
Refer to Cardiac Trigger Level for additional information.
Turns a visual horizontal marker, indicating the location of the
Cardiac Trigger
trigger level in relation to the waveform display, on or off. This can
Level Annotation
only be used when Advanced ECG Gating is off.
Allows adjustments of the audio signal that indicates trigger
Audio
detection. Moving the slider to the right increases volume. The
Trigger Volume
range is from 0 (off) to 10.
Re-initializes the processing of all physiological waveforms.
Select when:
• The waveform is noisy
• Triggers are being missed
• The waveform is inverted
• The system is unable to find valid triggers due to patient
activity, such as sudden motion
• The system is having communication problems with the PAC
[Gating Reset] Gating Reset does not correct for problems caused by inadequate
lead connections. It has no effect during data acquisition; reset
gating after advancing the patient to the scanning plane and
before scanning begins. When the button is clicked, you lose
triggers for approximately 2 seconds.
When Advanced ECG Gating is on, perform a gating reset with
the patient completely out of the magnet bore to eliminate the
effects of the magnetic field on the waveform. It is only necessary
to do this with Advanced ECG Gating turned on because this
mode "looks" at both slope and amplitude of the waveform.
Records the ECG waveform for 10 seconds. The button changes
to an inactive state during the recording session. The recording is
[Recording ECG]
saved to a Service directory, where a GE Service Engineer can
retrieve the data and analyze the waveform.

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 Gating and Triggering

Area Selection Description

Provides a measurement, in millivolts (mV), of the R-wave peak
voltage level of the patient for the chosen ECG lead. It indicates
whether the signal is adequate for gating. ECG gating is most
effective when the R-peak voltage is at least 1.0 mV. If the
reading is below 1.0 mV, choose a different lead or reposition the
[Update]
electrodes. The waveform and millivoltage displays become
yellow to indicate that the signal is below 0.8 mV. In some
patients (e.g., heart failure patient’s), it may not be possible to
obtain the desired level. In these instances, gating success may
be severely compromised.

Advanced ECG Gating

A cardiac gating algorithm is a process used by Signa to identify the correct portion of
the QRS complex (cardiac waveform) to be used for cardiac gating or triggering. Two
algorithms are available: Advanced ECG Gating ON, and Advanced ECG Gating OFF.
Advanced ECG Gating defaults on upon entering the Gating Control Window. It may
improve trigger detection in ECG Gated/Triggered examinations by observing both the
positive slope and the amplitude to detect which component of the QRS complex is the
correct trigger (the R-wave). Advanced ECG Gating contains a stringent test for
matching known slope and amplitude during the first 45% of the waveform, after a
recognized R-wave. The slope is measured during cardiac initialization. It is critical that
the patient remain outside of the magnet, and stay still and quiet during cardiac
initialization. This test helps reduce false triggering on T-waves and gradient noise. In
addition, when this option is on the Trigger Delay is increased to 13 ms (the usual 5 ms,
plus an additional 8 ms) and you cannot manually enter a Cardiac Trigger Level.
Advanced ECG Gating may not always be the best choice for a patient with a bigeminy
or couplet waveform. Advanced ECG Gating could effectively double the heart rate in
these patients because it does not employ a lock-out window (Figure 31-19). It is
recommended to turn Advanced ECG Gating off for patients with these conditions.
With Advanced ECG Gating turned off, the system reverts to the standard gating
algorithm, in which the trigger is detected solely by looking for the peak within the QRS
complex that has the greatest, positive amplitude.
This mode contains a lock-out window of 45% of the RR Interval (Figure 31-19). This
means after an R-Wave has been detected, Signa does not look for another R-Wave for
45% of the estimated RR Interval. This gating algorithm is suitable for patients with a
bigeminy or couplet waveform, and patients with significant T-swell.
Figure 31-19 Lock-Out Window

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 Gating and Triggering

ECG Lead Selection

Even though an ECG lead is selected at the Gating Control Window, you must define
the Trigger Type (lead) at the Cardiac and Respiratory Gating/Triggering Window
during scan set-up. Once this has been done, the lead selection can be changed from
either the Gating Control window or the Combined Cardiac and Respiratory
Gating/Triggering Screen. This can be done at any point in the scan set-up process or
during data acquisition. When the lead selection is changed, the waveform display
updates to reflect the change. The MOST RECENT ECG lead selection is the lead
used for data acquisition.
If you have problems with the gating signal during a scan, you can select any one of the
gating selections (ECG I, ECG II, ECG III, or PG) in the Gating Control window to
change the lead selection while scanning. This selection overrides the choice made on
the Cardiac and Respiratory Gating/Triggering window.
There are several factors you should consider:
• DO NOT rely on Auto for lead selection. Auto chooses the lead with the strongest
signal, but does not necessarily choose the lead with the best waveform. The signal
may be strong due to noise.
• Because the lead selection can be changed from both the Gating Control window
and the Combined Cardiac and Respiratory Gating/Triggering Screen during series
prescription, view the waveforms and verify the lead selection at the Gating Control
window after the series has been downloaded.

Cardiac Trigger Level

The Cardiac Trigger Level can be decreased if the waveform is good but triggers are
being missed. Increase the trigger level if the system is triggering off of T-waves (or
P-waves). When Advanced Gating is turned off, you can choose one of three trigger
level options to set the level:
• Select one of the preset values of 50%, 60%, or 70%
• Use the level automatically chosen by the system
• Manually enter a level between 40 to 90%
The trigger level can be changed at any time during scan set-up, prescan, or data
acquisition.
To understand the Cardiac Trigger Level, imagine a line running horizontally across the
waveform (Figure 31-20). With the trigger level set at 50%, that line runs through the
center of the display window. Any part of the QRS complex above that line is seen by
the system as a potential trigger.

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 Gating and Triggering

Figure 31-20 Imaginary Trigger Level Line

The tic marks at the bottom of the waveform indicate where the system is "seeing" a
trigger. Every tic mark is a potential trigger. If tic marks display at the wrong portion of
the waveform, adjust the trigger level. Increasing the trigger level decreases the range
in which the system looks for triggers. Decreasing the trigger level increases the range.
It does not matter if the trigger is an R-wave, T-wave, or another variation of the
patient’s ECG waveform. An abnormal wave could be used as a trigger, starting data
acquisition at an incorrect point in the cardiac cycle. Figure 31-21 shows a waveform
with tic marks annotating both R-waves and T-waves.
Figure 31-21 Tic Marks Triggering off R- and T-Waves

Tips for Adjusting the Gating Trigger Level in ECG Gating

If triggers are not being detected properly:
• Lower the Cardiac Trigger Level to 50%.
• Confirm that the tic marks appear on the waveform.
– If no tic marks are seen, reduce the Trigger Level to 45%.
– It is possible to set the Cardiac Trigger Level to a value that is too low. When this
occurs, the system can trigger off T-waves resulting in a heart rate that appears
to be double the actual heart rate.
• If too many triggers are detected (e.g., the system is posting triggers under
T-waves);
– Increase the Trigger Level to a value above 65%.
– Confirm the tic marks are seen only under the desired R-waves.

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 Gating and Triggering

Waveform Display
The waveform is displayed on the secondary monitor. Three waveforms can be
displayed simultaneously. The number of waveforms displayed is determined by the
selections made from the Gating Control window.
The millivolt value and the waveform are updated in real time; when either changes, the
new millivolt value or new waveform are displayed. If the millivolt value falls below 0.8,
the color of the waveform changes from green to yellow. Typically, if the millivoltage is
below 1.0, the ECG leads need to be repositioned or checked to make sure the leads
are properly connected to the patches.
Figure 31-22 Waveform Display

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 Gating and Triggering

Cardiac and Respiratory Gating/Triggering Window

The Cardiac and Respiratory Gating/Triggering window is used to enter parameters for
gating/triggering acquisitions. This window is accessed from the Additional Parameters
area of the Scan Rx Desktop.
Figure 31-23 Gating/Triggering Icon
The Gating/Triggering icon (Figure 31-23) in the Additional Parameters
area of the Scan Rx desktop becomes available when Cardiac
Gating/Triggering or Respiratory Gating/Triggering is selected on the
Imaging Options window.

The combined Cardiac and Respiratory Gating/Triggering window (Figure 31-24)

appears after selecting the Gating/Triggering icon. At this window, you can select the
Cardiac Gating/Triggering Parameters and/or the Respiratory Gating and Triggering
Parameters. The available parameters depend on the selected PSD.
Figure 31-24 Cardiac and Respiratory Gating/Triggering Window

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 Gating and Triggering

Cardiac Gating/Triggering Parameters

The combined Cardiac and Respiratory Gating/Triggering Window is used to control
parameters for cardiac gating/triggering. Table 31-6 describes the functions of the
parameters in the Cardiac Gating/Triggering area.
Table 31-6 Cardiac Gating/Triggering Parameters

Selection Description
Defines the gating sensor used on the patient. ECG I, ECG II,
and ECG III are the lead selections when electrodes are attached
to the patient; PG is available for use with the photopulse senor.
Do not rely on Auto for lead selection. Auto chooses the lead
Trigger Type with the strongest signal, not necessarily the best waveform.
Observe all leads and select the waveform resulting in the most
accurate trigger. The selection made from this window overrides
the selection made from the Gating Control window. Refer to
Trigger Type for additional information.
Defines the effective TR for SE, FSE, SSFSE, EPI, and 2D
GRE/SPGR acquisitions. Select the number of intervals that yield
# of RR Interval an effective TR within the appropriate range for your desired
contrast. Refer to Number of RR Interval for additional
information.
Instructs the system when to stop acquiring data and to begin
"looking" for the next R-wave trigger. The window includes a
Trigger Window period of time, set as a percentage of the RR Interval, before the
(TW) expected trigger. Values from 0 to 50 are allowed. Available for
FastCard, FSE, SE, EPI, 2D/3D FIESTA, and MPGR sequences.
Refer to Trigger Window for additional information.
Detects triggers that occur prior to the TW and stops data
collection until a trigger is detected as expected. The RF
application continues to maintain uniform TR and image contrast.
An arrhythmia, as interpreted by the system, is a trigger detected
Arrhythmia Rejec.
outside the ARW when data acquisition is active. The ARW is a
Window
percentage of the RR Interval, in which image data is discarded if
(ARW)
a trigger is detected. It includes a window of time before and after
the expected trigger. Available for FastCINE and FIESTA CINE
pulse sequences. Refer to Arrhythmia Rejection Window for
additional information.
Determines the delay time from detection of the R-wave (the
trigger) to the start of data acquisition. Minimum is the absolute
least amount which is required by the system to detect the trigger
Trigger Delay and initiate data acquisition (13 to 15 seconds). Recommended
(TD) sets the delay as calculated by the system based on the imaging
options for the best image quality. The text box can also be used
to manually enter a delay time longer than the minimum. Refer to
Trigger Delay for additional information.

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 Gating and Triggering

Selection Description (Continued)

Determines the time, in milliseconds, between each slice location
or cardiac phase.
• Minimum – sets the least
possible delay time between
slices.

Inter-Seq. Delay
(ISD) • Even – calculates the delay
time required to evenly space
slices within the Available
Imaging Time (AIT).
You can also manually enter any value larger than the minimum
value in the text box. As the ISD increases, the AIT and the
number of slices allowed decreases.
Determines if slice locations are acquired at one or more phases
of the cardiac cycle.
• Single – each slice is acquired at a unique phase of the
cardiac cycle and is only acquired at that phase. Available for
Cardiac Phases FSE sequences. Allows acquisition of several slice locations.
• Multi – acquires one or more slice locations with each slice
represented by multiple phases of the cardiac cycle. Available
for SE and MPGR sequences when 1 x RR Interval is defined.
Once Multi is selected, the Phases text box is available.
In Multi Phase, this defines the number of phases of the cardiac
cycle to be acquired at the same slice location. The maximum
number of phases depends on the patient's heart rate and the
number of slices prescribed. Once the phases have been
Phases defined, the Slices text box is automatically filled with the
number of slices prescribed at the Scanning Range area. This
number cannot be changed. The number of phases divided by
the number of slices must equal 1, 2, or 3. A message posts if the
phases entered are incorrect. Not available with FSE sequences.
In Multi Phase, the number of slice locations to be acquired when
Slices Multi is performed. This is automatically entered with the number
of slice locations prescribed at the Scanning Range area.
Defines the number of cardiac phases to obtain. To perform a
FastCard sequence, FastCard-SPGR, FastCard-GRE, or 2D
# Card. Phases to
FIESTA with Gating must be chosen as the pulse sequence and
Reconstruct
Auto must be selected. The maximum number of phases is
automatically calculated.
Views per In FastCard, the number of k-space lines acquired per cardiac
Segment phase during one RR period. Refer to Views Per Segment.

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 Gating and Triggering

Selection Description (Continued)

Acquires an update of the patient’s current heart rate in bpm and
displays the value. If appropriate to the pulse sequence, the
Heart Rate
effective TR, based on the heart rate and the number of RR
[update Rate]
Intervals, is also displayed. Update the heart rate before
beginning the data acquisition to ensure accurate triggering.

Available Imaging Time

The Available Imaging Time (AIT) is the time frame in which data acquisition can take
place. The AIT affects the maximum number of slices that can be acquired (Equation
31-1). The AIT is not selected directly on the Cardiac and Respiratory Gating/Triggering
Window, but is affected by the RR Interval, TW or ARW, and TD.
Equation 31-1 AIT in Cardiac Gating/Triggering

AIT = (RR Interval -TW) - TD

The AIT and the minimum ISD determine the maximum number of slices allowed as
defined in Equation 31-2.
Equation 31-2 Maximum Number of Slices Allowed in Cardiac Gating/Triggering

Trigger Type
ECG gating is recommended for the most accurate trigger detection for cardiac
imaging. With peripheral gating, there is a delay from the actual trigger to when it is
detected in the extremity. Observe the waveforms from each lead (ECG I, II, and III).
Select the lead that produces the least noise and the highest R-wave. If a lead loses
signal during data acquisition, Signa automatically shifts to an alternate lead. If ECG II
loses signal, it switches to ECG III. If ECG III loses signal, Signa switches to ECG II.
ECG I is a calculated signal based on the average sums from ECG II and III. Therefore,
If ECG I is lost, Signa checks II and III to locate a valid signal to continue the sequence.
If a valid signal is not found, the sequence aborts. The loss of signal from ECG I is
commonly caused by a problem with the LL (red) electrode or the LL lead wire.
A new ECG lead can be selected or changed from PG to ECG from the Gating Control
Window after the series has been downloaded or during data acquisition. An ECG
series does not need to be copied and pasted to change the lead selection. Once a
gated sequence is complete, simply open the Gating Control window and make the lead
change. Clicking the [Scan] button again at this point repeats the series with the new
lead selection. In addition, the ECG cable does not need to be disconnected at the
magnet enclosure when switching from PG to ECG (or vice versa).

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 Gating and Triggering

Number of RR Interval
The time between R-peaks and the RR Interval together determine the effective TR.
The effective TR is determined by Equation 31-3. The effective TR is based on the
patient’s heart rate. Therefore, you cannot control the actual TR value other than
through the number of RR Interval selection. For example, 60,000 ÷ 60 bpm = 1000 ms.
The effective TR is 1000 ms when 1 RR is selected, 2000 ms with 2 RR, and so on.
Equation 31-3 Effective TR in Cardiac Triggering

Figure 31-25 RR Interval Example

Figure 31-25 shows the RR Intervals
for a heart rate of 60 bpm and the
effective TR at 1 RR, 2 RR, and 3
RR. Twelve slice locations are seen,
indicating how they might be
acquired across three RR Intervals
achieving an effective TR of 3000
ms. The TW is indicated prior to the
fourth R-wave.
Keep in mind that increasing the RR Interval increases the effective TR, SNR, scan
time, PD or T2-weighted contrast, and the maximum number of slices per acquisition.

Trigger Window
You should define the Trigger Window (TW) based on the regularity of the heart rhythm.
Keep the following points in mind when defining the TW.
• Larger values are generally used as the heart rate becomes more irregular.
• Auto allows the system to determine the TW value. The system determines the
value based on the imaging options selected. It is recommended that Auto be
selected, then add 5% to the Auto TW value. This seems to provide an optimal TW
for most patients.
• For most patients, an 18 to 20% TW removes much of the risk of missed triggers.
Although patients with greatly fluctuating heart rates may require a 30 to 40% TW.
• As the TW increases, the maximum number of slices allowed decreases (because
the AIT decreases), but the probability of missing an R-wave decreases. The AIT is
the time frame within the cardiac cycle in which the system is able to collect data.
• When a trigger occurs too soon due to an increase in the heart rate, image data is
not collected as expected following the missed trigger. Scan time extends in order to
obtain the missed image data.
• Should a trigger occur before the TW, data acquisition may still be taking place. In
this instance, data is being acquired at an unexpected point in the cardiac cycle
resulting in a decrease in image quality.

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 Gating and Triggering

Figure 31-26 Trigger Occurring Before TW

For example, Figure 31-26 illustrates a
cardiac waveform of a patient with a 60
bpm heart rate (1) and a 20% TW (3)
defined. The heart rate increases to
100 bpm (2) and the next trigger occurs
before the TW. If a trigger is missed, it is
possible that data acquisition was taking
place when that trigger (R-wave) occurred.

Arrhythmia Rejection Window

The size of the Arrhythmia Rejection Window (ARW) is a percentage of the RR Interval,
outside of which the system rejects data if a trigger is detected.
Figure 31-27 Arrhythmia Rejection Window Size
Typically, the ARW is double the
TW value for the same patient.
This is because the ARW takes
place before and after the
expected trigger, while the TW is
a period of time after the
expected trigger. For example,
in Figure 31-27 the TW value is
25% and the ARW is 50%.
Widening the window is recommended for patients with irregular heart rates. If too
many rejections occur, the scan aborts (when Manual Arrhythmia Monitoring is off).
Arrhythmia Rejection can be turned on or off at the User CV screen when a FastCard
,Fast CINE,FastCard FIESTA, or FIESTA CINE is the selected pulse sequence. The
User CV screen is accessed in the Additional Parameters area of the Scan Rx Desktop.
Arrhythmia Rejection is turned off by default.

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 Gating and Triggering

Trigger Delay
There are several factors you should consider when programming a TD:
• The TD can be used to image at a particular moment in the cardiac cycle, e.g., you
can set the delay time to obtain images during the diastolic portion of the cycle.
• Increasing the TD reduces the AIT and the number of slices allowed. The AIT is the
time frame within the cardiac cycle in which the system is able to collect image data.
• As the TD increases, image data is not collected during the early portion of the
cardiac cycle.
• The combination of the minimum TD and saturation (SAT) can create a band of
small hash marks in the image. These hash marks follow the phase direction and
increase in intensity as the TD is increased.
• Using the recommended TD, when SAT pulses are used (including Fat and Water),
places the temporal pre-saturation pulse closer to the excitation pulse, making the
SAT pulse more effective. The excitation pulse occurs after the trigger is detected.
Figure 31-28 illustrates how selecting a the minimum or recommended TD can change
the placement of the applied SAT.
Figure 31-28 TD and SAT Pulses
A – The minimum TD applies the
SAT pulse before the expected
trigger.

B – The recommended TD applies

the SAT pulse after the trigger,
where the SAT is more effective.

Views Per Segment

Views per Segment (VPS) is the number of k-space lines acquired per cardiac phase
during one RR period. A view is a discrete step in the phase encoding gradient. SE
sequences collect one view per slice per TR period, while FSE collects many views per
TR period based on the echo train length (ETL). However, with FastCard and Fast 2D
PC sequences, multiple views per TR are collected, allowing the views to be
segmented to produce a phase image. The number of segments is not defined, but is a
function of the RR Interval and the value set for the VPS.

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 Gating and Triggering

A phase image is a temporal look at a slice, i.e., a look at that slice at some point in
time. With this in mind:
• Decreasing VPS improves temporal resolution. As the VPS decreases, there are a
smaller number of views contributing to an image.
• Increasing VPS decreases the overall scan time because the required number of
views needed to fill k-space is increased per TR, filling k-space more quickly.
• Increasing the VPS reduces the number of cardiac phase images allowed. This is
because acquisition time is used to collect views rather than cardiac phases. The
trade-off is temporal resolution for speed.
Table 31-7 can be used as a guide for setting the VPS in order to obtain optimal
temporal resolution and image quality based on the patient’s heart rate.
Table 31-7 VPS Guide for Temporal Resolution

Heart Rate (BPM) Views Per Segment (VPS)

≤ 60 8
61 – 95 6
96 – 125 4
126 – 155 2
> 156 1

NOTE: This parameter is available with FastCard, FastCINE, FastCard FIESTA,and

FIESTA CINE.

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Respiratory Gating and Triggering Parameters

The combined Cardiac and Respiratory Gating/Triggering Window is also used to
control parameters for respiratory gating/triggering. Table 31-8 describes the functions
of the parameters in the Respiratory Gating/Triggering area.
Table 31-8 Respiratory Gating/Triggering Selections

Selection Description
Defines the repetition time (effective TR) for the prescribed pulse
sequence. This value is specified in multiples of the respiratory rate,
e.g., 1 RR, 2 RR, 3 RR, etc.
A respiratory interval is the
time from one maximum
inspiration to the next
maximum inspiration, known
# of Resp as one respiratory cycle.
Interval The number of respiratory intervals selected determines the
effective TR, which is displayed to the right of this text box. To
increase the effective TR and the number of slices, select a multiple
of the respiratory cycle. For example, if one respiratory cycle occurs
every 4,000 ms, the effective TR is 4,000 ms for 1 RR and 8,000 ms
for 2 RR. To determine the time span from peak to peak, divide
60,000 by the respiratory rate (in breaths per minute). This
selection is available with FSE sequences.
Defines the point in the respiratory cycle at which imaging begins.
The goal is to set the TP (along with the TW) so the imaging
window occurs at the quiescent portion of the breathing cycle. This
value is specified as a percentage of the respiratory cycle, with an
allowable range of 10 to 50%.
If the respiratory cycle is 5,000
ms from maximum inspiration
Trigger Point
to the next maximum
(TP)
inspiration and a 20% TP is
selected, data collection
begins 1,000 ms after
maximum inspiration.
The TP does not affect available imaging time. It is simply the point
at which data acquisition is to begin. Refer to Setting the Trigger
Point and Trigger Window for additional information.
Defines the time period set aside to stop data collection and allow
for variations in the breathing pattern before the next TP occurs.
During this time, the system waits for the next maximum inspiration
peak, which initiates a new sequence of data acquisition. The TW is
Trigger Window
set as a percentage of the respiratory cycle, with an allowable
(TW)
range of 10 to 60%. Increasing the TW decreases the number of
allowable slices because the AIT decreases. If the respiratory cycle
shortens, images might be acquired in the TW. If the respiratory
cycle shortens by more than the TW, the next TP could be missed.

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Selection Description
Defines the time, in milliseconds, between each slice location in the
respiratory cycle. The ISD determines how image acquisition is
spread across the AIT.

• Minimum – images the

slices as quickly as possible
Inter-Seq. Delay within the AIT.
(ISD)

• Even Spacing – spreads

slice acquisition time evenly
across the AIT.
Type in the ISD value if minimum or even spacing is not desired.
The type-in value must be larger than the minimum spacing value.
Acquires an update of the patient’s current respiratory rate in
Resp Rate
breaths per minute and displays the value. Update the respiratory
[update Rate]
rate before beginning the acquisition to ensure accurate triggering.

Available Imaging Time

Available Imaging Time (AIT) determines the maximum number of slice locations
allowed. AIT is not selected directly on the Cardiac and Respiratory Gating/Triggering
Window, but is affected by the respiratory interval and TW.
The AIT acquisition window is generally placed at the quiescent portion of the
respiratory cycle to reduce phase ghosting.

Setting the Trigger Point and Trigger Window

Figure 31-29 is an example for determining the data acquisition window in respiratory
gating/triggering. The TP and TW determine the location of the data acquisition window.
Typically, the goal is to set the TP and TW so that the imaging window occurs at the
quiescent portion of the cycle. The TW should be greater or equal to the TP.
Figure 31-29 Respiratory Cycle

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Table 31-9 Defined Respiratory Cycle

Respiratory The entire respiratory cycle takes place from peak inspiration
1
Interval to peak inspiration. This time period is considered 100%.
2 Peak Inspiration Peak inspiration, the beginning of the cycle, is 0%.
The TP, which you define, tells the system when data
acquisition should begin and is expressed as a percentage of
3 Trigger Point
the total respiratory cycle. In this example, when 30% of the
cycle completes, data acquisition begins.
The TW, which you define, tells the system at which point in
the respiratory cycle data acquisition should not take place.
4 Trigger Window This value is calculated based on the TP and the point in the
cycle data acquisition is to stop. See the following explanation
for determining the size of the TW.
Data
The data acquisition window is the time period when image
5 Acquisition
data is collected.
Window

To calculate the TW:

• Determine the point in the cycle at which data acquisition is to begin. This is the TP.
• Determine the point at which data acquisition is to stop. In this example, it is at
approximately 70%.
• Subtract, 100% - 70%. This is the total cycle minus the end point of the data
acquisition window; 30%.
• Add that 30% to the non-acquisition time of the next cycle. In other words, add the
TP value of 30%. This combines the non-acquisition time from the end of the first
cycle and the beginning of the next cycle. The result is a total TW time of 60%; 30%
+ 30%. Enter this value as the TW.
Although the data acquisition window is generally at the quiescent point of the cycle, it
is possible to set the TW and TP to place the data acquisition window at any point in the
cycle, such as peak inspiration. To obtain this in the above diagram, the TP would be
set at 90% and the TW at 80%.

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Combined Cardiac and Respiratory Gating/Triggering

Some sequences are better acquired using a breath-hold technique, such as in cardiac
imaging. Breath-held acquisitions eliminate artifacts caused by respiratory motion.
However, there may be patients who cannot hold their breath. In these cases,
respiratory gating/triggering is recommended.
When needed, respiratory gating/triggering can be performed simultaneously with
cardiac gating/triggering. The following pulse sequences allow the use of combined
cardiac and respiratory gating/triggering: 3D Fast TOF, and 3D Fast GRE/SPGR,
FastCard GRE/SPGR, and FastCard GRE/SPGR sequences.
Both cardiac and respiratory parameters must be entered in the Cardiac and
Respiratory Gating/Triggering Window. Respiratory gating is performed, while triggering
is the cardiac process employed.
The defined respiratory parameters are Trigger Point and Trigger Window. These
parameters determine the data acquisition window. When the system determines the
data acquisition window has been reached (based on the respiratory cycle), data is
collected in the same fashion as a cardiac gated sequence.
If a valid ECG trigger is detected within the respiratory data acquisition window,
scanning begins. When the end of the data acquisition window is reached, scanning
stops. Note that RF application is continuous, being applied at the TR time throughout
the entire respiratory cycle, even when the data acquisition window is closed.
In Figure 31-30, the data acquisition window opens at the TP, which is 30%. If a cardiac
trigger is detected within the data acquisition window, scanning begins. In this example,
seven slice locations are acquired before the end of the data acquisition is reached at
the start of the TW, 70%. When the data acquisition closes, scanning stops until the
next TP is reached and the acquisition window opens again.
Figure 31-30 Combined Cardiac and Respiratory Gating/Triggering Diagram

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While using combined cardiac and respiratory gating/triggering, consider the following:
• Scanning is only started if a valid ECG trigger is detected during the respiratory data
acquisition window.
• Both ECG and PG can be used.
• The scan terminates if a respiratory cycle is lost and cannot be detected within
10 seconds. This prevents the sequence from being caught in continuous loop
"looking" for the correct conditions to begin data acquisition.
• In cardiac gated/triggered 3D sequences, Reverse Loop Order can be defined in the
Additional Parameters User CV screen. Loop order tells the system to run in either a
normal or reverse loop order: Type 0 for Reverse Loop Order off, which is the
default for 3D sequences; 1 for Reverse Loop Order on.

Combined Gating/Triggering Guide

This guide can be used to determine possible TP and TW values to be used for
combined cardiac and respiratory gating/triggering in FastCard sequences. Three
tables are provided, one each for obtaining image data within 2, 2.5, or 3 RR intervals of
the cardiac cycle. Increasing the number of RR intervals acquired in the data acquisition
window decreases scan time, but is likely to degrade image quality.
The objective of the following tables is to help you prescribe the correct respiratory TP
and TW in order to obtain image data at the most quiescent period of the respiratory
cycle. Each table is labeled with the approximate number of RR intervals to be included
in the AIT of the respiratory cycle. This is demonstrated as N = 2, N = 2.5, and N = 3.
The heart rate values run horizontally, and the respiratory rate runs vertically. Find the
intersection of the patient’s heart rate and respiratory rate on the desired chart. The
percent value shown at that intersection can be entered as the Trigger Point on the
Cardiac and Respiratory Gating/Triggering Window. Multiply the TP value times two to
obtain the Respiratory TW.
Use the following tables as a guide:
• N = 2.0 Trigger Point Table (Trigger Window = Trigger Point x2)
• N = 2.5 Trigger Point Table (Trigger Window = Trigger Point x2)
• N = 3.0 Trigger Point Table (Trigger Window = Trigger Point x2)

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Table 31-10 N = 2.0 Trigger Point Table (Trigger Window = Trigger Point x2)

Resp Heart Rate

Rate 40 45 50 55 60 65 70 75 80 85 90 95
10 25% 28% 30% 32% 33% 35% 36% 37% 38% 38% 39% 39%
11 23% 26% 28% 30% 32% 33% 34% 35% 36% 37% 38% 38%
12 20% 23% 26% 28% 30% 32% 33% 34% 35% 36% 37% 37%
13 18% 21% 24% 26% 28% 30% 31% 33% 34% 35% 36% 36%
14 15% 19% 22% 25% 27% 28% 30% 31% 33% 34% 34% 35%
15 13% 17% 20% 23% 25% 27% 29% 30% 31% 32% 33% 34%
16 10% 14% 18% 21% 23% 25% 27% 29% 30% 31% 32% 33%
17 8% 12% 16% 19% 22% 24% 26% 27% 29% 30% 31% 32%
18 5% 10% 14% 17% 20% 22% 24% 26% 28% 29% 30% 30%
19 3% 8% 12% 15% 18% 21% 23% 25% 26% 28% 29% 30%
20 0 6% 10% 14% 17% 19% 21% 23% 25% 26% 28% 29%
21 0 3% 8% 12% 15% 18% 20% 22% 24% 25% 27% 28%
22 0 1% 6% 10% 13% 16% 19% 21% 23% 24% 26% 27%
23 0 0 4% 8% 12% 15% 17% 19% 21% 23% 24% 26%
24 0 0 2% 6% 10% 13% 16% 18% 20% 22% 23% 25%
25 0 0 0 5% 8% 12% 14% 17% 19% 21% 22% 24%

Table 31-11 N = 2.0 Trigger Point Table (Trigger Window = Trigger Point x2)
(continued)

Resp Heart Rate

Rate 100 105 110 115 120 125 130 135 140 145 150
10 40% 40% 41% 41% 41% 42% 42% 43% 43% 43% 43%
11 39% 40% 40% 40% 42% 41% 42% 42% 42% 42% 43%
12 38% 39% 39% 40% 41% 40% 41% 41% 41% 42% 42%
13 37% 38% 38% 39% 40% 40% 40% 40% 41% 41% 41%
14 36% 37% 37% 38% 39% 39% 39% 40% 40% 40% 41%
15 35% 36% 36% 37% 38% 38% 38% 39% 39% 40% 40%
16 34% 35% 35% 36% 37% 37% 38% 38% 39% 39% 39%
17 33% 34% 35% 35% 36% 36% 37% 37% 38% 38% 39%
18 32% 33% 34% 34% 35% 36% 36% 37% 37% 38% 38%
19 31% 32% 33% 33% 34% 35% 35% 36% 36% 37% 37%
20 30% 31% 32% 33% 33% 34% 35% 35% 36% 36% 37%
21 29% 30% 31% 32% 33% 33% 34% 34% 35% 36% 36%
22 28% 29% 30% 31% 32% 32% 33% 34% 34% 35% 35%
23 27% 28% 29% 30% 31% 32% 32% 33% 34% 34% 35%
24 26% 27% 28% 29% 30% 31% 32% 32% 33% 33% 34%

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Resp Heart Rate (Continued)

Rate 100 105 110 115 120 125 130 135 140 145 150
25 25% 26% 27% 28% 29% 30% 31% 31% 32% 33% 33%
Table 31-12 N = 2.5 Trigger Point Table (Trigger Window = Trigger Point x2)

Resp Heart Rate

Rate 40 45 50 55 60 65 70 75 80 85 90 95
10 19% 22% 25% 27% 29% 31% 32% 33% 34% 35% 36% 37%
11 16% 19% 23% 25% 27% 29% 30% 32% 33% 34% 35% 36%
12 13% 17% 20% 23% 25% 27% 29% 30% 31% 32% 33% 34%
13 9% 14% 18% 20% 23% 25% 27% 28% 30% 31% 32% 33%
14 6% 11% 15% 18% 21% 23% 25% 27% 28% 29% 31% 32%
15 3% 8% 13% 16% 19% 21% 23% 25% 27% 28% 29% 30%
16 0 6% 10% 14% 17% 19% 21% 23% 25% 26% 28% 29%
17 0 3% 8% 11% 15% 17% 20% 22% 23% 25% 26% 28%
18 0 0 5% 9% 13% 15% 18% 20% 22% 24% 25% 26%
19 0 0 3% 7% 10% 13% 16% 18% 20% 22% 24% 25%
20 0 0 0 5% 8% 12% 14% 17% 19% 21% 22% 24%
21 0 0 0 2% 6% 10% 13% 15% 17% 19% 21% 22%
22 0 0 0 0 4% 8% 11% 13% 16% 18% 19% 21%
23 0 0 0 0 2% 6% 9% 12% 14% 16% 18% 20%
24 0 0 0 0 4% 7% 10% 13% 15% 17% 18% 20%
25 0 0 0 0 0 2% 5% 8% 11% 13% 15% 17%

Table 31-13 N = 2.5 Trigger Point Table (Trigger Window = Trigger Point x2)
(continued)

Resp Heart Rate

Rate 100 105 110 115 120 125 130 135 140 145 150
10 38% 38% 39% 39% 40% 40% 40% 41% 41% 41% 42%
11 36% 37% 38% 38% 39% 39% 39% 40% 40% 41% 41%
12 35% 36% 36% 37% 38% 38% 38% 39% 39% 40% 40%
13 34% 35% 35% 36% 36% 37% 38% 38% 38% 39% 39%
14 33% 33% 34% 35% 35% 36% 37% 3% 38% 38% 38%
15 31% 32% 33% 34% 34% 35% 36% 36% 37% 37% 38%
16 30% 31% 32% 33% 33% 34% 35% 35% 36% 36% 37%
17 29% 30% 31% 32% 32% 33% 34% 34% 35% 35% 36%
18 28% 29% 30% 30% 31% 32% 33% 33% 34% 34% 35%
19 26% 27% 28% 29% 30% 31% 32% 32% 33% 34% 34%
20 25% 26% 27% 28% 29% 30% 31% 31% 32% 33% 33%

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Resp Heart Rate (Continued)

Rate 100 105 110 115 120 125 130 135 140 145 150
21 24% 25% 26% 27% 28% 29% 30% 31% 31% 32% 33%
22 23% 24% 25% 26% 27% 28% 29% 30% 30% 31% 32%
23 21% 23% 24% 25% 26% 27% 28% 29% 29% 30% 31%
24 20% 21% 23% 24% 25% 26% 27% 28% 29% 29% 30%
25 19% 20% 22% 23% 24% 25% 26% 27% 28% 28% 29%
Table 31-14 N = 3.0 Trigger Point Table (Trigger Window = Trigger Point x2)

Resp Heart Rate

Rate 40 45 50 55 60 65 70 75 80 85 90 95
10 13% 17% 20% 23% 25% 27% 29% 30% 31% 32% 33% 34%
11 9% 13% 17% 20% 23% 25% 26% 28% 29% 31% 32% 33%
12 5% 10% 14% 17% 20% 22% 24% 26% 28% 29% 30% 31%
13 1% 7% 11% 15% 18% 20% 22% 24% 26% 27% 28% 29%
14 0 3% 8% 12% 15% 18% 20% 22% 24% 25% 27% 28%
15 0 0 5% 9% 13% 15% 18% 20% 22% 24% 25% 26%
16 0 0 2% 6% 10% 13% 16% 18% 20% 22% 23% 25%
17 0 0 0 4% 8% 11% 14% 16% 18% 20% 22% 23%
18 0 0 0 1% 5% 8% 11% 14% 16% 18% 20% 22%
19 0 0 0 0 3% 6% 9% 12% 14% 16% 18% 20%
20 0 0 0 0 0 4% 7% 10% 13% 15% 17% 18%
21 0 0 0 0 0 2% 5% 8% 11% 13% 15% 17%
22 0 0 0 0 0 0 3% 6% 9% 11% 13% 15%
23 0 0 0 0 0 0 1% 4% 7% 9% 12% 14%
24 0 0 0 0 0 0 0 2% 5% 8% 10% 12%
25 0 0 0 0 0 0 0 0 3% 6% 8% 11%

Table 31-15 N = 3.0 Trigger Point Table (Trigger Window = Trigger Point x2)
(continued)

Resp Heart Rate

Rate 100 105 110 115 120 125 130 135 140 145 150
10 35% 36% 36% 37% 38% 38% 38% 39% 39% 40% 42%
11 34% 34% 35% 36% 36% 37% 37% 38% 38% 39% 41%
12 32% 33% 34% 34% 35% 36% 36% 37% 37% 38% 40%
13 31% 31% 32% 33% 34% 34% 35% 36% 36% 37% 39%
14 29% 30% 31% 32% 33% 33% 34% 34% 35% 36% 38%
15 28% 29% 30% 30% 31% 32% 33% 33% 34% 34% 38%
16 26% 27% 28% 29% 30% 31% 32% 32% 33% 33% 37%

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Resp Heart Rate (Continued)

Rate 100 105 110 115 120 125 130 135 140 145 150
17 25% 26% 27% 28% 28% 30% 30% 31% 32% 32% 36%
18 23% 24% 25% 27% 27% 28% 29% 30% 31% 31% 35%
19 22% 23% 24% 25% 26% 37% 28% 29% 30% 30% 34%
20 20% 21% 23% 24% 25% 26% 27% 28% 29% 29% 33%
21 19% 20% 21% 23% 24% 25% 26% 27% 28% 28% 33%
22 17% 19% 20% 21% 23% 24% 25% 26% 26% 27% 32%
23 16% 17% 19% 20% 21% 22% 23% 24% 25% 26% 31%
24 14% 16% 17% 19% 20% 21% 22% 23% 24% 25% 30%
25 13% 14% 16% 17% 19% 20% 21% 22% 23% 24% 29%

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 Gating and Triggering

Frequently Asked Cardiac Questions

Why are my acquisitions taking longer than expected?
This may be an indication that the scan may not be triggering correctly. Confirm that the
gating tic marks can still be seen on the ECG waveform during data acquisition. If the tic
marks are not seen, before the next breath-hold acquisition, try opening the Gating
Control Window and adjusting the Trigger Level up or down to produce more consistent
triggering. (Remember, Auto trigger sets the level at 65%).

What do I do if the R-wave is inverted?

If the R-wave is inverted, select Inverted on the Gating Control Window (if this option is
available on your system). If ECG Inversion is not available on your system or inversion
does not correct the problem, it may be necessary to swap the position of the leads for
the right arm and the left leg.
NOTE: If the electrophysiological gating system is being used, unplug the gating cable
from the PAC connection ports, wait several seconds, and then reconnect the
cable. This often corrects the problem.

A T-swell has doubled the heart rate. How can I compensate for the T-swell?
When the patient is advanced into the MR scanner, contamination of the ECG
waveform causes the T-wave to elevate. The ECG records the electric potential from
the heart net dipole. The T-wave swells due to a blood flow dipole that is created by the
main magnetic field, perpendicular to the flowing blood. There are several things that
you can try to work around this.
• If scanning with Advanced ECG Gating on, turn it off. Sometimes the lock-out
window (used when Advanced ECG Gating is off) helps eliminate the effects of
T-swell.
• Auto lead selection searches for the largest delta between the R-wave and the
T-wave. Switch to Auto on the Gating Control Window and see which lead Signa
recommends. Try using the lead selected by Auto.
• Increase the Trigger Level on the Gating Control Window. Auto trigger sets the level
at 65%.

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How does changing the lead selection on the Gating Control window impact data
acquisition?
The Gating Control allows the scanning lead selection to be changed, either while
scanning, or between acquisitions of the same series. It permits this in the following
fashion:
• When scan parameters are chosen for a series, whichever lead is chosen on the
Cardiac and Respiratory Gating/Triggering Window in the Additional Parameters
area of the scan page, is the lead that Signa uses when it scans that series.
• Once Prepare to Scan is selected and that series is downloaded, the status
changes from RXD (prescribed) in the Rx Manager to ACT (active). The lead may
now be changed on the series that you are about to scan, simply by changing it on
the Gating Control Window. This may be done either before the scan is started, or
during the scan acquisition.
• This feature means that you no longer have to perform a copy and paste operation,
view and edit a series that you want to repeat with a different lead selection. Once
the acquisition is completed, simply open the Gating Control Window, change the
lead to the one that you want, and click the [Scan] button again.
As soon as the next series is downloaded from the Rx Manager (by clicking the
[Prepare to Scan] button), Signa scans whichever lead selection was made on the
Gating Control window in the Additional Parameters area of the scan page.
Must the ECG cable be disconnected if I switch the lead selection to PG, at the
Gating Control window?
• The ECG gating cable does not need to be disconnected when switching from ECG
to PG. It is only necessary to select PG as the Lead Display from the Gating Control
Window. Making this selection tells Signa that peripheral gating is to be performed.
• On Signa Ovation systems, the ECG cable must be disconnected from the
connection port on the magnet enclosure to perform PG.
• After selecting PG on the Gating Control Window, PG must also be selected at the
Cardiac and Respiratory Gating/Triggering Window (accessed from the Additional
Parameter’s area of the Scan Rx Desktop) during series prescription.

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What if I have a good waveform, but I am still missing triggers?

1. Check the Arrhythmia Rejection Window (the TW, if applicable). The window may
be too small and triggers are being missed due to fluctuation in the heart rate.
2. If performing combined cardiac and respiratory gating/triggering, check the
respiratory Trigger Point and Trigger Window. The AIT may be too small. The lower
the sum of the TR and TW, the greater the AIT.
3. If the waveform is good but triggers are still missing, try opening the Gating Control
Window and reducing the trigger level to 50%. (Auto trigger is the default, and sets
the trigger level at 65%.) The range is 30 to 90%.
4. Confirm that tic marks are now appearing on the trace. If not, the Trigger Level may
need to be further reduced (e.g., 45%).
NOTE: If the trigger level is reduced to a value that is too low, triggering may occur off
the T-wave. At this point, the patient’s heart rate would appear to double.
5. If the ECG trace is still noisy, make sure that Advanced ECG Gating is turned on in
the Gating Control Window and also turn on the ECG Noise Filter. With the patient
outside of the gantry, wait approximately 10 to 15 seconds for gating to initialize.
The Cardiac Initializing message disappears when complete.
– The ECG Noise Filter is used in conjunction with Advanced ECG Gating. Use of
the noise filter results in a greater delay (approx. 18 ms) from the time the QRS
complex is generated and Signa detects the signal.
– The use of ECG Noise Filter can often improve gating results.
– If the trace now looks good, confirm that it is triggering (that is, check that there is
a little white tic mark appearing under each R-wave passing across the screen).
– If there still is a good waveform and there are no tic marks indicating a trigger, try
turning Advanced ECG Gating off.
6. If you are still having trouble obtaining a good trace or triggers, click the [Gating
Reset] button. Remember, if Advanced ECG Gating is on, [Gating Reset] should be
performed with the patient outside the bore of the magnet. This ensures accurate
measurement of the R-wave slope.
7. If, at this point, the ECG trace is still noisy or missing triggers, consider repositioning
the electrodes and/or lead placement.

Why does the number of available slices decrease with several pulse sequences?
A limit to the number of scan locations may be seen on FastCard, FastCINE and
FIESTA sequences. This is due to factors such as patient heart rate, sequence
parameters and internal software parameters.
Some sequence parameters that affect the number of slices allowed include the total
number of images (the number of phases multiplied by the number of slices), VPS, and
Arrhythmia Rejection Window/Trigger Window (ARW/TW). To obtain more slices, try
one of the following:

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• Decrease the number of phases (if allowed for the pulse sequence).
• Increase the Views per Segment (if allowed for the pulse sequence).
• Decrease the ARW/TW. Note that a decrease in the ARW/TW may result in scan
aborts if too many triggers fall outside the window.

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How Do I...
This section provides the step-by-step instructions for setting up and optimizing scans
with cardiac and respiratory gating/triggering. Specifically, it describes how to:
• Use Cardiac Gating/Triggering
– Position the Electrodes
– Set up the Gating Control Parameters
– Position the Patient and Coil
– Set up the Cardiac Gating/Triggering Parameters
• Use Respiratory Gating/Triggering
– Place the Bellows and Route the Tubing
– Set up the Gating Control Parameters
– Set up the Respiratory Gating/Triggering Parameters

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.

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Use Cardiac Gating/Triggering

Position the Electrodes
Use this procedure to prepare your patient for an ECG gated cardiac examination. To
perform a successful gated examination, it is very important to follow these steps for
proper ECG lead placement and cable routing.
1. If necessary, shave the chest.
2. Prepare the patient.
Š Use an appropriate ECG electrode abrasive gel (e.g., Nuprep®) on the area
where the electrodes are placed. Apply the gel to a cotton swab or gauze and rub
lightly on the skin.
Š Remove the excess gel when complete. Make sure the skin is completely dry
before attaching the electrodes.

3. Attach the electrodes to the patient over the prepared area.

Š Anterior placement is recommended and should be used when possible
(Recommended Electrode Placement).
Š Use non-metallic, (MR compatible) pre-gelled electrodes, DO NOT use expired
electrodes.
Š DO NOT use electrodes that have been removed from the package for a long
period of time. The gel dries over time and this results in high impedance and
subsequently, a poor ECG trace.
Š If available, use an impedance meter to check the contact impedance with the
patient outside the magnet. Contact impedance is should be less than 20 K.
4. Position the patient on the table.
Š Use feet-first orientation whenever possible.

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5. Connect the leads to the electrodes.

Š The white electrode/lead wire is positioned for the right arm.
Š The black electrode/lead wire is positioned for the left arm.
Š The red electrode/lead wire is positioned for the left leg.
Š The green electrode/lead wire is positioned for the right leg.

NOTE: Do not press down on the center of the patch when connecting the leads to the
electrodes. Doing so can damage the connection.

Quick Steps: Use Cardiac Gating/Triggering – Position the Electrodes

1. If necessary, shave the chest.
2. Prepare the patient.
3. Attach the electrodes to the patient over the prepared area.
4. Position the patient on the table.
5. Connect the leads to the electrodes.

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Use Cardiac Gating/Triggering

Set up the Gating Control Parameters
Use this procedure to set up the gating controls to minimize motion of the heart on your
images for an ECG gated cardiac examination.
1. Click [Gating Control] in the Rx Manager.
Š The Gating Control Window opens.
2. Select Cardiac.
Š The cardiac waveform displays.
Š Advanced ECG Gating defaults on.
Š A Cardiac Initializing message posts. It
takes 16 heartbeats, approximately 10 seconds,
to complete initialization. The message
disappears when initialization is complete.
3. View each ECG trace and R-peak Amplitude display to select the lead that has the
cleanest ECG trace and largest amplitude value.
Š Do not use Auto considering it selects the lead with the strongest signal, which
could be caused by a high noise level.
Š The R-peak Amplitude should read greater than 1.0 mV.
– If it is less than 1.0 mV, repeat the patient-prep procedure and/or reposition
the electrodes.
– Amplitudes of 1.0 mV may not be possible for patients with heart failure.
Successful cardiac gating may be compromised in these situations.
Š Verify proper R-wave detection by checking the position of the tic marks on the
cardiac waveform display.

– The tic marks indicate a peak is detected and that peak is a potential trigger. If
tic marks are not seen, the system is not finding potential triggers.
– A tic mark beneath a T-wave indicates the system sees that peak as a
potential trigger.
– If the ECG waveform is noisy or missing triggers, refer to the FAQ What if I
have a good waveform, but I am still missing triggers?

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Quick Steps: Use Cardiac Gating/Triggering – Set up the Gating Control

Parameters
1. Click [Gating Control] in the Rx Manager.
2. Select Cardiac.
3. View each ECG trace and R-peak Amplitude display to select the lead that has the
cleanest ECG trace and largest amplitude value.

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 Gating and Triggering

Use Cardiac Gating/Triggering

Position the Patient and Coil
Use this procedure to position the patient and the imaging coil for an ECG gated cardiac
examination.
1. After the electrodes are in place, position the patient to enter the magnet feet first.
Š The positioning of the cardiac coil requires a feet-first entry.
2. Place a pillow case around the leads.
Š This helps to prevent the leads from rubbing against the patient’s skin and helps
to reduce coil motion.
3. Position the coil, making sure the anterior and posterior coils align with each other, if
applicable.
Š The cardiac coil is recommended, with the patient’s arms by his or her sides.
Š If a torso coil is being used, place the patient’s arms above his or her head.
a) Place the top of the posterior coil at the scapular spine or the top part of the
scapula.
b) Place the top of the anterior coil at the level of the clavicles.
c) Place a wedge shaped sponge under the clavicle area to allow the anterior coil to
lie flat on barrel chested patients.
d) Make sure the anterior and posterior coils do not touch.
– They should be positioned so the distance between the coils is half the coil
diameter.
– Use sponges or blankets placed between the patient and coil to achieve this
distance for small patients.
e) For very tall patients, offset the anterior and posterior coils.
– Position the anterior coil to cover from the heart apex to below the diaphragm.
– Position the posterior coil to cover the top of the aortic arch.

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 Gating and Triggering

4. Explain to the patient what will happen during the examination and the importance
of lying very still.
5. Provide the patient with ear plugs.
6. Place the Respiratory Bellows on the patient to ensure that breath-holding
instructions are followed.
7. Check for proper ECG signal again on the Gating Control Window.
8. Move the patient into the magnet and landmark in the mid-chest area.
Š Use the anatomical marker on the coil to help position the landmark.
9. Route the ECG cable down the center of the table.
10. Check for proper ECG signal prior to starting the imaging acquisition.

Quick Steps: Use Cardiac Gating/Triggering – Position the Patient and Coil
1. After the electrodes are in place, position the patient to enter the magnet feet first.
2. Place a pillow case around the leads.
3. Position the coil, making sure the anterior and posterior coils align with each other,
if applicable.
4. Explain to the patient what will happen during the examination and the importance
of lying very still.
5. Provide the patient with ear plugs.
6. Place the Respiratory Bellows on the patient to ensure that breath-holding
instructions are followed.
7. Check for proper ECG signal again on the Gating Control Window.
8. Move the patient into the magnet and landmark in the mid-chest area.
9. Route the ECG cable down the center of the table.
10. Check for proper ECG signal prior to starting the imaging acquisition.

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Use Cardiac Gating/Triggering

Set up the Cardiac Gating/Triggering Parameters
Use this procedure to adjust the contrast of an image during a cardiac gated or
triggered examination. The contrast parameters are found on the Cardiac and
Respiratory Gating/Triggering Window in the Additional Parameters area.
1. Click the Gating/Triggering icon in the Additional Parameters area.
Š The Cardiac and Respiratory Gating/Triggering Window appears.
2. Select a lead in the Trigger Type text box.
Š Determine the best signal; that is the least noise and the highest R-wave. This
may have already been determined from Step 3 when setting up the Gating
Control parameters.
NOTE: Lead selection can be made from either the Gating Control window or the
Gating/Triggering Additional Parameters. The MOST RECENT lead selection is
the lead used for data acquisition and for the display waveform on the PC.
3. Select the number of RR intervals in the # of RR Interval text box.
Š Select a predefined value that yields an effective TR within the appropriate range
for the desired contrast. The effective TR is displayed to the right of the text box.
Š The more RR intervals selected, the higher the effective TR. The higher the
effective TR, the longer the scan time, the higher the SNR, the more T2-weighted
contrast, and more slices.
– For a MPGR, select [1] RR.
– For FSE-IR with Blood Suppression, select [2] RR.
Š To increase the effective TR and the number of slices, select a multiple of the
cardiac cycle (RR x 2, RR x 3, etc.).
Š Refer to Number of RR Interval for additional information.
4. Select the Trigger Window.
Š Click Auto and the system selects the optimum TW based on the imaging
options selected.
Š Alternatively, type in any value from 0 to 50.
– For most patients, a 15% TW removes much of the risk of missed triggers.
– For anxious or excitable patients with greatly fluctuating heart rates, 20 to
30% may be required.
– As the TW increases, the number of slices decrease, and the probability of
missing an R-wave decreases.
Š Refer to Trigger Window for additional information on setting this value.

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5. Select the Trigger Delay.

Š Minimum sets the minimum possible delay of 13 ms to 15 ms.
Š Recommended sets the recommended delay as calculated by the system based
on the imaging options for the best image quality.
Š The Trigger Delay text box can be used to manually enter a delay time longer
than minimum.
6. Select the Inter Seq. Delay.
Š Minimum spaces the images as closely together as possible.
Š Even Spacing evenly spaces the slices within the AIT.
Š The Inter-Seq. Delay text box can be used to manually enter a delay time longer
than minimum.
7. Select the number of Cardiac Phases.
Š The Cardiac Phases are only available when the pulse sequence is a SE, EPI,
MPGR, or FSE.
Š When scanning the heart, your selection is based on the clinical history and the
radiologist’s request.
Š Typically, select Single for anatomy outside the heart or for a SE sequence.
8. Select the # of Card. Phases to Reconstruct.
Š The # Card. Phases to Reconstruct is available for FastCard sequences.
Š Selecting Auto results in a FastCard sequence.
Š The maximum number of phases is affected by the VPS.
9. Select the number of Views per Segment.
Š Views Per Segment is available with FastCard and Fast 2D PC sequences.
10. Click [Update Rate] to acquire and display the current heart rate.
Š Update the heart rate before beginning the data acquisition to insure accurate
triggering.
11. Click [Accept] to register your selections and close the window.

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Quick Steps: Use Cardiac Gating/Triggering – Set up the Cardiac

Gating/Triggering Parameters
1. Click the Gating/Triggering icon in the Additional Parameters area.
2. Select a lead in the Trigger Type text box.
3. Select the number of RR intervals in the # of RR Interval text box.
4. Select the Trigger Window.
5. Select the Trigger Delay.
6. Select the Inter Seq. Delay.
7. Select the number of Cardiac Phases.
8. Select the # of Card. Phases to Reconstruct.
9. Select the number of Views per Segment.
10. Click [Update Rate] to acquire and display the current heart rate.
11. Click [Accept] to register your selections and close the window.

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Use Respiratory Gating/Triggering

Place the Bellows and Route the Tubing
Use this procedure to prepare your patient for a respiratory gated/triggered
examination. To perform a successful respiratory gated examination, it is very important
to follow these steps for proper bellows placement and tube routing.
1. Ask the patient to remain still while proceeding with set-up, alignment, landmarking,
and scanning.
Š Ask the patient to refrain from talking or moving.
Š This is especially important during the first 20 seconds of the scan when the
system is evaluating the waveform.
2. Observe the motion of the patient's chest and abdomen during normal breathing.
Š Place your hands over these areas to determine where the greatest motion
occurs during breathing.
3. Place the bellows over the area being scanned.
Š Position it where the greatest breathing motion occurs.

4. Fasten the bellows with the Velcro® straps.

Š Make the bellows snug, but stretch it as little as possible.
Š The bellows should expand and contract with the patient's breathing.
– Expansion should be ½ to 1 inch (Figure 31-12).
5. Once the bellows is in place, give the system about 60 seconds to stabilize, then
check the respiratory LED on the magnet enclosure.
Š If the signal is adequate, the LED should rise and fall with patient's breathing.
The LED should move over the bottom one-third of the display. (Figure 31-13).
Š If the LED consistently moves to the top of the display during normal breathing,
the bellows is probably stretched too much and it should be loosened slightly.
Š If the LED does not move across the bottom one-third of the LED, the bellows
may not be stretched enough. Tighten the bellows and make sure there is ½ to 1
inch expansion and contraction during patient breathing.

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6. If the patient is a very deep breather, place a stiff foam pad or several folded sheets
over the patient's abdomen, adjacent to the costal margin.
Š Do not place the padding over bellows.
Š When the patient exhales, fasten standard wide compression bands tightly over
the pad.
7. Route the bellows tubing down the center of the table to the connection ports.
Š Be careful of the table and cradle edges.
Š Do not bend or kink the bellows. This results in loss of signal detection.

Quick Steps: Respiratory Gating/Triggering – Place the Bellows and Route

the Tubing
1. Ask the patient to remain still while proceeding with set-up, alignment,
landmarking, and scanning.
2. Observe the motion of the patient's chest and abdomen during normal breathing.
3. Place the bellows over the area being scanned.
4. Fasten the bellows with the Velcro® straps.
5. Once the bellows is in place, give the system about 60 seconds to stabilize, then
check the respiratory LED on the magnet enclosure.
6. If the patient is a very deep breather, place a stiff foam pad or several folded
sheets over the patient's abdomen, adjacent to the costal margin.
7. Route the bellows tubing down the center of the table to the connection ports.

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Respiratory Gating/Triggering
Set up the Gating Control Parameters
Use this procedure to set up the gating control for a respiratory gated/triggered
examination to minimize breathing motion on the images.
1. Click [Gating Control] in the Rx Manager.
Š The Gating Control Window opens.
2. Select Respiratory.
Š Displays the respiratory waveform on the PC
monitor.
3. View the signal on the PC monitor.
Š A numeric value appears to the left of the
waveform window, indicating the number of breaths per minute.

4. Verify that the trigger marks appear on the waveform.

Š The triggers indicate the system is adequately detecting the respiratory pattern.
Š The trigger marks appear when the respiratory parameters are entered at the
Cardiac and Respiratory Gating/Triggering Window.
5. Check the messages in the system status display area.
Š The Resp OK message indicates the system is detecting the respiratory signal
and the gain is properly set. You should receive this message before continuing
with scanning.
Š The Resp Missing message indicates the signal is not being detected. This
may be due to a kink or bend in the tubing, disconnected tubing or a leak in the
tubing, or a change in the patient's breathing pattern. The patient's breathing
may have quieted and the bellows need to be adjusted to compensate for the
change.

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Quick Steps: Use Respiratory Gating/Triggering – Set up the Gating Control

Parameters
1. Click [Gating Control] in the Rx Manager.
2. Select Respiratory.
3. View the signal on the PC monitor.
4. Verify that the trigger marks appear on the waveform.
5. Check the messages in the system status display area.

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Use Respiratory Gating/Triggering

Set up the Respiratory Gating/Triggering
Parameters
Use this procedure to set up the respiratory parameters to adjust image contrast during
a respiratory gated/triggered examination. The Respiratory Gating/Triggering
imaging option minimizes ghosting artifacts from respiratory motion.
1. Click the Gating/Triggering icon in the Additional Parameters area.
Š The Cardiac and Respiratory Gating/Triggering Window opens.
Š The system automatically displays the patient’s bpm in the Resp Rate text box.
2. Select the number of respiratory intervals in the # of Resp Interval text box.
Š Select a number that yields an effective TR within the appropriate range for the
desired contrast.
Š The more respiratory intervals selected, the higher the effective TR and SNR.
Scan time, PD or T2-weighted contrast, and the number of slices also increase.
Š To increase the effective TR and the number of slices, select a multiple of the
respiratory cycle (Resp x 2, Resp x 3, etc.)
Š Refer to # of Resp Interval for additional information.
3. Select a Trigger Point so that imaging begins in the valley of the waveform or
quietest part of the respiratory cycle.
Š As TP increases, images are acquired later in the respiratory cycle but the
increase does not affect the AIT.
Š A range of 10 to 50% is allowed.
Š Refer to Trigger Point for additional information.
Š When performing combined cardiac and respiratory gating refer to the Combined
Gating/Triggering Guide.
4. Select a Trigger Window greater than or equal to the TP.
Š As TW increases, the number of slices decrease and the probability of missing a
respiratory wave decrease.
Š A range of 10 to 60% is allowed.
Š Refer to Trigger Window for additional information.

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5. Select the Inter Seq. Delay.

Š Minimum spacing acquires images as quickly as possible within the available
imaging time.
Š Even spacing spreads the slice acquisition time evenly across the available
imaging time.
Š The Inter-Seq. Delay text box can be use to manually type in a value if minimum
or even spacing is not desired. This value must be larger than the minimum
value.
6. Click [Update] to acquire and display the most current respiratory rate.
Š Update the heart rate before beginning the data acquisition to ensure accurate
triggering.
7. Click [Accept] to register your selections and close the window.

Quick Steps: Use Respiratory Gating/Triggering – Set up the Respiratory

Gating/Triggering Parameters
1. Click the Gating/Triggering icon in the Additional Parameters area.
2. Select the number of respiratory intervals in the # of Resp Interval text box.
3. Select a Trigger Point so that imaging begins in the valley of the waveform or
quietest part of the respiratory cycle.
4. Select a Trigger Window greater than or equal to the TP.
5. Select the Inter Seq. Delay.
6. Click [Update] to acquire and display the most current respiratory rate.
7. Click [Accept] to register your selections and close the window.

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 Bolus Triggering

Chapter 32
Bolus Triggering

Introduction
Bolus triggering is a technique used in imaging vasculature, where you or a bolus of a
contrast medium activates the scan and sequentially image the bolus as it moves
through the vessels. It can be performed using the purchasable SmartPrep option.
This chapter explains the bolus triggering process. The focus is on automated bolus
detection and acquisition triggering for contrast-enhanced Magnetic Resonance
Angiography (CEMRA). It contains key concepts and step-by-step instructions to help
you learn how to:
• Scan with SmartPrep
– Set up a SmartPrep Series
– Prescribe the Tracker and Imaging Volume
– Scan the SmartPrep Series

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 Bolus Triggering

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete the bolus
triggering processes. Specifically, you need to understand:
• Bolus Triggering Basics
– K-Space View Ordering
– User Control Variables
• SmartPrep
– Tracker Volume
– Imaging Volume
– Threshold
– Phases of SmartPrep
– Supported Features
– Applications

Bolus Triggering Basics

Bolus triggering is a technique used in imaging vasculature, where you or a bolus of
contrast activates a scan and the contrast bolus is sequentially imaged as it moves
through the vessels. It is not always possible to estimate the start of image acquisition
with the arrival of the bolus because of patient variations such as heart rate, cardiac
output, age, blood pressure, and severity of vascular pathology. If the data acquisition
starts before the arrival of the bolus in the arterial system, the effectiveness of the
contrast injection is diminished or missed. If the data acquisition starts too late, the
contrast bolus may have passed, and there may be filling of the venous structures,
complicating the image analysis. The SmartPrep option can reduce those occurrences
when the bolus is not captured due to patient physiologic variations and inaccurate
predictions. Bolus triggering is designed to optimize CEMRA examinations by
synchronizing bolus arrival and image acquisition. It eliminates the need for
time-consuming test bolus injections.

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K-Space View Ordering

The raw data of MR images are sampled as spatial frequencies before mathematical
manipulation (Fourier Transform) calculates the MR images. The commonly used
variable for spatial frequency is k, therefore, the space where MR raw data are acquired
is referred to as k-space. Basic k-space knowledge is important because how it is filled
can have an impact on the appearance of the image.There are various methods of
k-space filling, which allow us to optimize the scanning prescription for the application of
contrast material in CEMRA examinations. These methods include:
• Centric
• Elliptical-Centric
• Reverse Centric
• Reverse Elliptical Centric
In order to choose a suitable imaging technique and perform it accurately, we also need
to be aware that the various methods exhibit trade-offs between spatial and temporal
resolution, field of view (FOV), and signal-to-noise ratio (SNR). The outer lines of
k-space determine image resolution, as the center lines of k-space determine the SNR
and contrast in the image .
Generally, the phase encoding process is done sequentially. Sequential view ordering
fills k-space from top to bottom and is the default setting when not using SmartPrep.
Figure 32-1 K-space Filling

Table 32-1 describes the available k-space view ordering techniques.

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Table 32-1 K-Space View Ordering Techniques

K-Space
Description
Technique
Fills the center lines of k-space first. Thus, the sequence acquires
the contrast sensitive information along the Ky axis at the
beginning of the scan, then the higher spatial resolution data. All
the data is collected at each Ky increment along Kz, as with the
sequential pattern. This technique allows a relatively long
Centric
acquisition to achieve the image contrast associated with the
moment when central k-space data are acquired. So it is critical to
time the acquisition of central k-space data during peak arterial
contrast enhancement to prevent a ringing artifact. This is the
default setting when using SmartPrep.
Fills the center lines (contrast sensitive information) and center
slices of k-space first in a very short period of time at the
beginning of the sequence. The center lines should be acquired
Elliptical-Centric
during peak contrast enhancement, just as with centric filling, to
prevent a ringing artifact. This technique increases contrast
between the intravenous (IV) contrast and background tissue.
Fills k-space from the outside lines to the center lines. This
technique is applicable when performing a four station peripheral
Reverse Centric run-off studies. Use this option for your first station so the scan
can be started before the arrival of the contrast. This technique is
not recommended for SmartPrep.
Fills k-space from the outside to the center of the volume. The
Reverse advantage of using this technique is that it allows you to start
Elliptical Centric scanning before the contrast arrives to the area. This technique is
not recommended for SmartPrep.

It is essential that the central k-space data are acquired while the contrast concentration
is high in the arteries but relatively lower in the veins to have an arterial phase image in
which the arteries are bright and the veins are dark. The presence of contrast is not as
important for acquisition of peripheral k-space data. Figure 32-2 displays an image
where the central k-space data was acquired at peak contrast enhancement.

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 Bolus Triggering

Figure 32-2 Central K-Space Data Acquired at Peak Enhancement

If the center lines of k-space are filled during the steep slope of the contrast curve,
ringing artifacts result.
The ringing artifact in Figure 32-3 is due to the contrast changing dramatically from one
line of k-space to another. The center lines of k-space were filled during steep portion of
contrast uptake, not at peak enhancement.
Figure 32-3 Ringing Artifact

The k-space view ordering technique can be selected on the User Control Variables
(User CVs) window during series prescription of a SmartPrep data acquisition.

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 Bolus Triggering

User Control Variables

When SmartPrep is selected as an imaging option, the User CVs icon becomes
available in the Additional Parameters area of the Scan Rx desktop. Clicking this icon
opens a User Control Variables (User CV) window allowing you to enter additional
parameters specific to your sequence prescription.

SmartPrep
The SmartPrep User CV window (Figure 32-4) allows you to enter additional
parameters specific to a SmartPrep imaging sequence. Table 32-2 describes these
parameters.
Figure 32-4 SmartPrep User CV Window

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 Bolus Triggering

Table 32-2 SmartPrep User CV Parameters

Mode or
User CV Description
Value
The time allowed for the system to monitor the
patient for the inflow of contrast. If, for some
reason, the signal never reaches the system
Maximum Monitor defined and fixed threshold, the system
10 to 400
Period begins to scan when this pre-programmed
time has passed. The suggested range is
from 45 to 120 seconds. Use a longer monitor
time for patients with poor cardiac output.
The time delay after the start of the detection
Image Acquisition of contrast that allows you to give the patient
1 to 100
Delay breathing instructions. This time should
generally be 5 seconds or less.
Reverse Elliptical 0 = Off Fills outer lines and outer slices of k-space
Centric 1 = On first.
0 = Off Fills the center lines and center slices of
Elliptical Centric
1 = On k-space first.
0 = Off
Centric Fills the center lines of k-space first.
1 = On
0 = Off
Reverse Centric Fills the outer lines of k-space first.
1 = On

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SmartPrep
SmartPrep Infusion Angiography (IA) uses a tracking pulse sequence to continuously
monitor the MR signal coming from a volume of interest in the patient that you
prescribe. As the signal increases, due to an injected contrast material (e.g.,
gadolinium), the pulse sequence checks to see if the signal amplitude exceeds a
contrast dose-dependent threshold. When the measured signal exceeds the system
defined and fixed threshold, the preselected protocol is automatically initiated. To
maximize image contrast, k-space can be filled in a Centric or Elliptical-Centric order.
The contrast mechanism used in SmartPrep procedures is gadolinium and not flow
enhancement. Gadolinium has a T1 shortening effect, which shortens the T1 of blood
from 1,200 ms to approximately 100 ms. By using contrast, slice locations can be
prescribed so the vessels run in plane and not through plane, resulting in fewer slice
locations and shorter scan times.

Tracker Volume
SmartPrep uses a tracker volume, also called a tracker pulse, to monitor a region of
interest for the arrival of a contrast bolus. The tracker volume (Figure 32-5) is a
two-dimensional (2D) object that is graphically prescribed and represented on the
imaging screen by a cross bar. The purpose of this tracker volume is to monitor the
selected region of interest for the arrival of a contrast bolus.
Figure 32-5 Tracker Volume

Use the Rotate handles to turn the tracker prescription or click the volume and drag it to
move the tracker.
The length of the tracker prescription can be adjusted by entering a value, in
millimeters, in the Tracker Length (mm) text box or by selecting the value from the
provided list. You can change the thickness of the tracker prescription by entering a
value or selecting the value from the list in the Tracker Thickness (mm) text box.

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 Bolus Triggering

Figure 32-6 displays an example of the SmartPrep tracker prescribed on an axial

localizer.
Figure 32-6 Axial Localizer with SmartPrep Tracker

Imaging Volume
An imaging volume is the area which is scanned. SmartPrep uses a 3D imaging volume
in order to acquire images. With 3D volumetric imaging, data is acquired from the entire
volume instead of by separate slices. This means instead of exciting just one slice at a
time, the entire imaging volume of tissue is excited.
Figure 32-7 Sagittal Localizer with 3D Imaging Volume

By acquiring images in this manner, you have the advantage of very thin slices being
seen, thus improving the demonstration of very small lesions or vessels. Another
advantage of using 3D imaging is by exciting the entire volume, SNR is greatly
improved, and fewer number of excitations (NEX) may be used. 3D volume imaging can
also be reconstructed to look at the images in any plane. A disadvantage to using this
type of imaging is 3D imaging is very sensitive to patient motion. Keep in mind that
during graphic prescription, the width of the deposited volume represents the number of
slices prescribed, including the discarded slices.

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Threshold
A threshold is defined as a level at which something occurs. SmartPrep uses this theory
by basing the level of change on the changes in pixel intensities. Your MR system uses
two thresholds that differ by 5%. The amount entered for contrast determines the active
threshold.
• The lower threshold is used for a bolus of 20 cc or less in which the system looks for
a 15% change in pixel intensity.
• The higher threshold is used for a bolus of greater than 20 cc in which the system
looks for a 20% change in pixel intensity.
Both threshold levels use three standard deviations. This deviation check is meant to
reduce the effect of respiratory-induced signal changes, which happen independent of
contrast injection. With the correct contrast amount entered, the system automatically
chooses the correct threshold value. The tracker pulse monitors the signal intensity in
the prescribed region of interest. When the contrast bolus arrives, the signal intensity in
the region of interest increases. Once the signal intensity has increased enough to
exceed the system defined minimum threshold, the acquisition is initiated (Figure 32-8).
Figure 32-8 Threshold Level in SmartPrep Acquisition

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 Bolus Triggering

Phases of SmartPrep
A SmartPrep acquisition consists of three phases.
• Baseline phase: the system samples the tracker volume to determine the threshold
signal. No contrast is injected at this time.
• Monitor phase: the system samples the imaging volume to "look" for the contrast
bolus. Contrast is injected at the start of the monitor phase.
• Scan phase: the image data is acquired. A trigger delay (TD) may be included in
the scan phase to allow time for patient breathing instructions.
Figure 32-9 SmartPrep Phases

NOTE: The scan phase is triggered by the arrival of the contrast bolus or by the system
default value, if no contrast is detected.

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 Bolus Triggering

Supported Features
The SmartPrep Imaging Option is compatible with the 3D imaging mode and Fast Time
of Flight (TOF) Gradient Echo (GRE) and SPoiled Gradient Echo (SPGR) pulse
sequences. In addition, SmartPrep is compatible with the features listed in Table 32-3.
Table 32-3 SmartPrep Compatibility

Compatible Not Compatible

IR Prepared Cardiac Compensation
Multi Phase Cardiac Gating/Triggering
Multi Station Classic
No Phase Wrap DE Prepared
Spatial SAT Extended Dynamic Range
Square Pixels Flow Compensation
Variable Bandwidth Full Echo Train
ZIP x 2 Magnetization Transfer
ZIP x 4 Real Time
ZIP 1024 Respiratory Compensation
ZIP 512 Respiratory Gating/Triggering
Sequential
Tailored RF
fMRI
Blood Suppression
Fluoro Trigger
Spectral Spatial RF
T2 Prep
ASSET
POMP
FSE/FIR Blurring cancellation
Real Time Blurring Cancellation
Single Quadrature Water imaging
Fat/Water Suppression
SPECIAL
Single Quadrature Fat imaging

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Applications
SmartPrep IA is designed to increase the accuracy of synchronizing image acquisition
with the arrival of a contrast bolus. This option has the ability to automatically track a
bolus of contrast and then automatically trigger the 3D CEMRA acquisition without
requiring further input from you, the operator. This feature also contains a quiet
acquisition delay time, where you can provide your patient breathing instructions.
Common CEMRA applications (Figure 32-10) include:
• Pulmonary arteries
• Aorta and great vessels
• Renal arteries
• Iliac arteries
• Peripheral vascular runoffs
Figure 32-10 SmartPrep Applications

When SmartPrep is used with the Multi Phase Imaging Option, the acquisition of both
the arterial and venous phases of the contrast bolus is achievable.
There are several things to consider when using this technique:
• Disrupted flow due to pathology may require an increase in Image Acquisition Delay
time.
• If contrast is not injected quickly enough to create a bolus effect, the peak may not
be detected during the Maximum Monitor Period.
• Most patients can hold their breath for 20 to 25 seconds. Scan times longer than
that are at great risk for breathing motion artifacts due to patient breathing.
• Deselecting projection images (i.e., selecting 0 projections) substantially increases
the reconstruction speed. This can be useful with ZIP 512 and Slice ZIP.
• In Graphic Rx, the width of the deposited volume represents the number of slices
prescribed, including the discarded slices.

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 Bolus Triggering

How Do I...
This section provides the step-by-step instructions for bolus triggering. Specifically, it
describes how to:
• Scan with SmartPrep
– Set up a SmartPrep Series
– Prescribe the Tracker and Imaging Volume
– Scan the SmartPrep Series

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.

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 Bolus Triggering

Scan with SmartPrep

Set up a SmartPrep Series
Use this procedure to set up a SmartPrep series. With SmartPrep, the system prompts
you to begin giving the patient contrast and automatically starts the scan for you. This
takes the guesswork out of CEMRA timing, reducing the chances of missed boluses.
You should already know how to set up a protocol for your system; only a brief review is
explained. The rest of this procedure guides you through the SmartPrep setup process.
1. Select the appropriate coil.
2. Position the patient comfortably and immobilize the area of interest with sponges.
3. Set up the patient IV catheter, contrast, saline, and power injector (optional).
Š Follow your physician’s or facility’s guidelines.
4. Landmark the patient.
5. Press Move to Scan to move patient to the landmarked location inside the bore.
6. Acquire an appropriate localizer series.
Š More than one localizer may be needed to ensure proper volume coverage.
7. Click [New Series].
8. Click the Pt Position icon on the Scan Rx desktop.
9. Select the Imaging Parameters.
a) Select Plane > Oblique.
b) Select Mode > 3D.
c) Select Fast TOF GRE or Fast TOF SPGR in the PSD window.
– Fast TOF SPGR provides better background suppression.

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 Bolus Triggering

10. Select SmartPrep and other options to optimize SNR and image resolution in the
Imaging Options window.

– Select ZIP 512 to enhance in-plane resolution, with only a small decrease in
SNR but with a trade-off in reconstruction time and disk storage.
– Select a Slice ZIP factor (ZIP x 2 or ZIP x 4) to increase the number of slices
without increasing scan time. Also improves MIP and reformat image quality.
– Select Multi-Phase to capture both the arterial and venous phase.
11. Complete the scan prescription.
a) Select the Scan Timing parameters.
b) Select the FOV, matrix, and slice thickness to balance spatial resolution and
SNR.
c) Minimize scan time to allow for breath-held acquisitions.
12. Select Contrast in the Acquisition Timing area and enter the correct dosage in the
Amnt text box.
Š The trigger Threshold depends on the contrast volume entered on the system.
The system uses one threshold for a volume of 20 cc or less and a threshold (5%
higher) for a volume greater than 20 cc.
13. Click the Vascular icon in the Additional Parameters area.
Š The Vascular Time of Flight window opens.

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 Bolus Triggering

14. Enter the Vascular parameters.

a) Select 0 Projection Images.
– Image reconstruction time is saved with no projections selected. The images
can later be post processed to get rotation projections, if desired.
b) Select On for Collapse.
– Provides a MIP image of the vessels.
c) Click [Accept] to close the window.

15. Click the User CVs icon in the Additional Parameters area.
Š The SmartPrep User CV Window opens.
16. Complete the parameters on the User Control Variables window.
a) Set the maximum time period for the system to monitor the patient for the in3ow
of contrast.
– Enter a Maximum Monitor Period between 45 to 120 seconds. Use a longer
monitor time for patients with poor cardiac output.
b) Expand the delay time.
– Enter an Image Acquisition Delay time, which is usually less than 9 seconds.
c) Set the desired type of k-space filling.
– Refer to K-Space View Ordering for additional information in choosing a
k-space filling pattern.
d) Click [Accept] to close the User CV window.

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 Bolus Triggering

Quick Steps: Scan with SmartPrep – Set up a SmartPrep Series

1. Select the appropriate coil.
2. Position the patient comfortably and immobilize the area of interest with sponges.
3. Set up the patient IV catheter, contrast, saline, and power injector (optional).
4. Landmark the patient.
5. Press Move to Scan to move patient to the landmarked location inside the bore.
6. Acquire an appropriate localizer series.
7. Click [New Series].
8. Click the Pt Position icon on the Scan Rx desktop.
9. Select the Imaging Parameters.
10. Select SmartPrep and other options to optimize SNR and image resolution in the
Imaging Options window.
11. Complete the scan prescription.
12. Select Contrast in the Acquisition Timing area and enter the correct dosage in the
Amnt text box.
13. Click the Vascular icon in the Additional Parameters area.
14. Enter the Vascular parameters.
15. Click the User CVs icon in the Additional Parameters area.
16. Complete the parameters on the User Control Variables window.

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 Bolus Triggering

Scan with SmartPrep

Prescribe the Tracker and Imaging Volume
After the SmartPrep series has been setup, use this procedure to place the SmartPrep
tracker and imaging volume.
1. Click the Graphic Rx icon in the Additional Parameters area.
2. Select the appropriate series and image.
Š Sometimes it is best to use the coronal or sagittal slice to place the tracker. This
way you can see the anterior and posterior portion of the vessel you are placing
the tracker in.
3. Click [Tracker].
Š Recommended typical Tracker Volume is 2x2x2 cm. This helps to minimize
tracker movement.
Š The tracker size needs to be appropriate for the vessel. While it should allow for
some vessel movement due to pulsation, it should not include surrounding tissue
or as little static tissue as possible.
4. Click the image to place the tracker.
Š The tracker appears on the three viewports if the images intersect with the
location of the deposited tracker.
Š Place the tracker over the entry/main vessel by clicking, no farther than ¼ the
distance above or below the center of the FOV.
Š Gradient field non-linearity affects the actual position of the tracker pulse and
becomes worse as the distance from isocenter increases. A tracker pulse placed
at the edge of the FOV shifts, once imaging begins, and will probably not lie over
the vessel due to the non-linear effects of the gradients.
Š The tracker should be contained completely inside the vessel.
5. Click the Graphic Rx icon.
6. Select the appropriate series and image to prescribe the imaging volume.
Š The prescribed Imaging Volume can be tailored to match the coverage area.
Š Prescribe any even number of slices to balance coverage with scan time.

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 Bolus Triggering

7. Click on the image to place your 3D imaging volume.

Š A midline slice is best for setting up your imaging
volume, unless your patient is off center inside the
magnet.
Š To reposition your volume place the cursor over the
“x” in the center of the 3D volume and click and drag
to move the volume to your desired location.
8. Adjust the angle of the volume to ensure proper
coverage of anatomy.
Š The angle can only be adjusted in the oblique plane.
Š To reposition your angle place the cursor over the
angle adjustment anchor then click and drag.
Š The tracker should be contained completely inside imaging volume.
– Failure to include tracker completely inside the imaging volume results in
SmartPrep failing to detect the bolus.
9. Click [Accept] to close the Graphic Rx screen.
Š The placement of the tracker and 3D volume prescription is accepted and the
Graphic Rx closes.
10. Click [Save Series] to accept the scan prescription.
Š The series is saved in the Rx Manager as RXD.

Quick Steps: Scan with SmartPrep – Prescribe the Tracker and Imaging
Volume
1. Click the Graphic Rx icon in the Additional Parameters area.
2. Select the appropriate series and image.
3. Click [Tracker].
4. Click the image to place the tracker.
5. Click the Graphic Rx icon.
6. Select the appropriate series and image to prescribe the imaging volume.
7. Click on the image to place your 3D imaging volume.
8. Adjust the angle of the volume to ensure proper coverage of anatomy.
9. Click [Accept] to close the Graphic Rx screen.
10. Click [Save Series] to accept the scan prescription.

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 Bolus Triggering

Scan with SmartPrep

Scan the SmartPrep Series
Use this procedure to scan the SmartPrep series. The set up of the SmartPrep series
and the tracker and volume prescription must be done prior to scanning the series.
1. Click the Message Log in the upper left corner of the Scan Rx desktop.
Š The Message Log window opens.
2. Click [Clear] to erase the messages.
Š Clearing the message log allows you to see the new SmartPrep messages as
they appear.
3. Click [OK].
Š The message log is cleared.
4. Click [Close].
5. Click [Prepare to Scan] to download the series.
6. Click [Auto Prescan].
Š The automatic prescan program is initiated and the system is readied for data
acquisition.
7. Click [Scan] to initiate the acquisition.
8. Watch the message window area. Begin injecting contrast when you see the
Inject Contrast message appear in the Message area.
Š Do not inject contrast
until prompted.
Š The first message to
appear is Acquiring
Baseline Data. This
message is followed by
Begin Contrast
Injection.
9. Instruct your patient to hold breath when the Bolus Detected message appears
and you hear the gradients go silent.
Š You will hear the gradients through all SmartPrep phases up until the bolus is
detected or the maximum monitor period expires. Then you should notice the
gradients go quiet.
Š Quiet delay time allows you to easily give your patient breath-holding
instructions.
10. Allow scan to complete. Instruct patient to resume breathing.

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 Bolus Triggering

Quick Steps: Scan with SmartPrep – Scan the SmartPrep Series

1. Click the Message Log in the upper left corner of the Scan Rx desktop.
2. Click [Clear] to erase the messages.
3. Click [OK].
4. Click [Close].
5. Click [Prepare to Scan] to download the series.
6. Click [Auto Prescan].
7. Click [Scan] to initiate the acquisition.
8. Watch the message window area. Begin injecting contrast when you see the
Inject Contrast message appear in the Message area.
9. Instruct your patient to hold breath when the Bolus Detected message appears
and you hear the gradients go silent.
10. Allow scan to complete. Instruct patient to resume breathing.

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 Bolus Chasing

Chapter 33
Bolus Chasing

Introduction
Bolus Chasing is a technique used in imaging a bolus of contrast as it travels through
the vessels. It can be performed using the Multi Station option and is usually done in
conjunction with a bolus triggering technique.
This chapter explains the automated multi-station technique for contrast enhanced
peripheral vascular angiography. It contains the step-by-step instructions to help you
learn how to:
• Prepare the Patient
• Scan the Localizer Series
• Set up the Scan Parameters
• Set up the Graphic Parameters
• Scan the SmartStep Series
• Copy and Paste a SmartStep Series
• Scan Using the saved Protocol
NOTE: The words Multi Station and SmartStep are used interchangeably throughout this
chapter.

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 Bolus Chasing

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete the SmartStep
process. Specifically, you need to understand:
• Multi Station
• Meta-Series
– Rx Manager
– Acquisition Types
• User Control Variables
• Supported Features
• Applications

Multi Station
Multi Station (SmartStep) is an optional feature that provides automated table
movement and switching of prescribed coils between stations, including body to phased
array, and/or between phased array elements, for peripheral vascular runoffs.
SmartStep allows you to prescan at multiple stations to optimize image quality and
properly annotates image locations based on the landmark. Therefore, this option
allows imaging of multiple phases of contrast enhancement at multiple anatomical
locations typically with one contrast injection.
SmartStep is used to chase a bolus of contrast down the lower extremities,
automatically stepping with the contrast movement. In Contrast-enhanced Magnetic
Resonance Angiography (CEMRA), the mechanism used is the T1 shortening effect of
gadolinium and not flow enhancement. Gadolinium shortens the T1 of blood from
1,200 ms to approximately 100 ms. Consequently, slice locations can be prescribed so
the vessels run in plane and not through plane. In Figure 33-1, images are displayed of
both flow (through plane) and contrast (in plane) enhancements.
Figure 33-1 Flow vs. Contrast Enhanced Images

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 Bolus Chasing

Meta-Series
The SmartStep sequence is acquired following the acquisition of a localizer
meta-series. A meta-series consists of multiple series linked together. The SmartStep
series can be prescribed off of any localizer series; however, a 3-Plane Localizer
meta-series is most often used. The localizer meta-series acquires several series, at
different locations, acquired across the anatomy of interest. The localizer images are
used for defining the scan locations for the sequence. You can link up to four series
together at one time. By doing so, the scanner automatically moves the table after each
series to the next pre-determined point as well as switches on and off the appropriate
coils you selected at the time of set up. But as a notice, the body coil cannot receive
signal when sending/receiving signal coil is connected. The Multi Station Imaging
Option must be selected for the system to automatically create a meta-series. Once the
first series is saved, subsequent stations are listed in the Rx Manager and you are able
to edit the parameters for those stations.
The SmartStep sequence is also a meta-series with unique scan locations. During
series prescription, you have the ability to select scan parameters unique for each
station, with the exception of Scan Mode and Pulse Sequence. While prescribing the
first series in the SmartStep meta-series, you can define the Number of Stations at the
SmartStep User CVs Window. This value indicates the number of separate series that
will be scanned during the SmartStep series. When you save the first series, the Rx
Manager and Series List lists additional new series identical to the series just saved.
Once the first series in the meta-series is saved, the Number of Stations cannot be
edited. This includes the first, as well as additional series in the meta-series.
Once all series within the meta-series are prescribed and saved, all the series are then
prescanned. The prescan values are saved by the system until the station associated
with those prescan values is ready to be scanned. The meta-series is pre-scanned in
reverse order, the last series is pre-scanned first and the first series last. When prescan
has completed, the table is then at the location needed for station one and no table
movement is required when the sequence is ready to begin. You can select the desired
meta-series and continue with the scan process as needed. The Rx Manager changes
the series state from RXD (prescribed) to PSCD (prescanned) after any of the stations
have been prescanned. If a station has not been prescanned, it is listed as RXD as long
as it has been saved. When a station is in the PSCD state, the scan parameters can not
be edited.
You initiate the acquisition of the meta-series with the AutoStep feature at the time of
contrast injection. The first station, can be started using SmartPrep, which tracks the
contrast bolus. When the bolus is detected, the 3D volume at Station 1 is acquired.
Upon completion of the first station, the table moves and the volume at Station 2 is
acquired. The system automatically moves the table and initiates data acquisition until
all stations are acquired. Until all the stations are listed as SCND (scanned), you are not
able to save a second meta-series in an examination.

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 Bolus Chasing

The SmartStep meta-series can be saved as a protocol. If your site uses a protocol with
a different number of stations, save one protocol for each scenario. For example, save
a protocol for a three station SmartStep and save another for a four-station SmartStep.
Once a protocol is saved with the Multi Station option and a set number of stations, the
number of stations value cannot be changed.
The copy/paste function can be performed for a SmartStep meta-series. The entire
meta-series is copied and pasted into the Rx Manager. You can not copy/paste a single
station.
NOTE: The Multi Station Imaging Option cannot be turned off after it has been saved in
a series. Therefore, if you try to turn it off after performing a copy/paste or after
loading a protocol that has it on, an error message appears.

Rx Manager
Figure 33-2 displays an example of a Series List in the Rx Manager of a three-station
meta-series for a 3-Plane Localizer. Figure 33-2 displays an example of a Series List in
the Rx Manager of a four-station meta-series with Venous and Mask for a 3d Fast GRE.
The Series List of the Rx Manager (Figure 33-2) displays the state, series number, and
a description of the series associated with the meta-series for the current examination.
Table 33-1 describes the columns in the Series List area for a three-station meta-series.
Figure 33-2 Rx Manager and Series List

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 Bolus Chasing

L/1
L/2
L/3

Table 33-1 Rx Manager Series List Descriptions

Column Description
Displays the current state of each series. The states include:
• NEW – the series has just been created; nothing has
been altered.
• INRX – the series is currently in the view/edit mode.
State • RXD – the series has been prescribed.
• ACT – the series is in an active state and has been
downloaded.
• PSCD – the series has been prescanned.
• SCND – the series has been scanned.
Displays the series number for each station of the
# (Series Number) meta-series. Figure 33-2 displays a 1 in this column,
signifying the first series.

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 Bolus Chasing

Column Description (Continued)

Displays the acquisition type and the station (meta-series)
number with a shortened version of the series description
you entered in the Patient Position area. There are three
acquisition types for 3d Fast/Fast-TOF GRE/SPGR:
• M – Mask Acquisition
• A – Arterial Acquisition
Series Description
• V – Venous Acquisition
• L – Localizer (Only for 3-plane)
If a description has not been entered, the system
automatically enters one for you, including the coil type and
the scan plane. You can change the series description for
each station once you are in view/edit mode for that station.

Acquisition Types
There are three acquisition types that can be used with SmartStep for 3d Fast/Fast-TOF
GRE/SPGR.
• Mask – scans the prescribed stations prior to administration of contrast.
• Arterial – scans all prescribed stations for contrast in the arterial phase.
• Venous – scans all prescribed stations for contrast in the venous phase.
The [AutoStep] button provides automatic table movement and scan initialization for
data acquisitions containing more than one station until all stations are acquired. This
button becomes available on the Rx Manager with the Multi Station Imaging Option
selected. All prescribed stations in the meta-series must be saved and prescanned
before clicking the [AutoStep] button to initiate the acquisition.
The acquisition order of the SmartStep meta-series is listed in Table 33-2.
Table 33-2 Meta-Series Acquisition Order

Meta-Series Order of Scan

Prescan Bottom, middle, top
Mask Top, middle, bottom
Arterial Top, middle, bottom
Venous Bottom, middle, top

When you are ready to initiate prescan for the Mask or Arterial meta-series, you select
the last station of the meta-series and click the [Prescan All] button, then all
meta-series are prescanned automatically. The meta-series is prescanned in reverse
order, the last series is prescanned first and the first series is prescanned last. When
prescan has completed, the table is at the location needed for Station 1 and no table
movement is needed when the sequence is ready to begin.

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 Bolus Chasing

When you click the [Prescan] button, only selected series is prescanned.
NOTE: The mask and venous series will not appear in the Rx Manager until after the
prescan has been completed for the meta-series. The Rx Manager automatically
updates and posts all acquisition types you selected from the SmartStep User
CVs Window.

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 Bolus Chasing

User Control Variables

There are several User Control Variables (User CVs) located on the SmartStep User
CVs window. The number of options is dependent on several factors: the gradient
configuration, selected Imaging Options, and whether the prescription is for the first or
subsequent stations. Figure 33-3 displays the User CV options available with the
SmartStep feature with SmartPrep prior to selection of number of stations.
Figure 33-3 SmartStep User CVs Window

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 Bolus Chasing

Table 33-3 describes the SmartStep and SmartPrep User CV parameters.

Table 33-3 SmartStep User CV Parameters

User CV Mode or Value Description

Indicates the number of separate series that will
Number of Stations 1, 2, 3, or 4
be scanned during the SmartStep series.
The time allowed for the system to monitor the
patient for the inflow of contrast with SmartPrep
option. If, for some reason, the signal never
reaches the system defined and fixed threshold,
Maximum Monitor
10 to 400 the system begins to scan when this
Period
pre-programmed time has passed. The
suggested range is from 45 to 120 seconds.
Use a longer monitor time for patients with poor
cardiac output.
The time delay after the start of the detection of
contrast that allows you to give the patient
Image Acquisition
1 to 100 breathing instructions with SmartPrep option.
Delay
This time should generally be 5 seconds or
less.
Fills the center lines and slices of k-space
Reverse Elliptical 0 = Off during the last 1/9 of the total scan time. This
Centric 1 = On CV is available only with 3D Fast-TOF
GRE/SPGR.
Fills the center lines and slices of k-space
0 = Off during the first 1/9 of the total scan time. This
Elliptical Centric
1 = On CV is available only with 3D Fast-TOF
GRE/SPGR.
Fills the center lines of k-space for all slices
0 = Off
Centric during the fist 1/2 of the total scan time. This CV
1 = On
is available only with 3D Fast-TOF GRE/SPGR.
Fills the outer lines of k-space for all slices
0 = Off during the last 1/2 of the total scan time. This
Reverse Centric
1 = On CV is available only with 3D Fast-TOF
GRE/SPGR.
0 = Off Scans the prescribed stations prior to
Mask Acquisition
1 = On administration of contrast.
0 = Off Scans all prescribed stations for contrast in the
Venous Acquisition
1 = On venous phase.

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 Bolus Chasing

Supported Features
The Multi Station Imaging Option is compatible with the 3D imaging mode and the
following pulse sequences:
• Fast Time of Flight Gradient Echo (Fast TOF GRE)
• Fast Time of Flight SPoiled Gradient Echo (Fast TOF SPGR)
• Fast GRE/SPGR
In addition, Multi Station for 3D Fast/Fast-TOF GRE/SPGR is compatible with the
features listed in Table 33-4.
Table 33-4 Multi Station Compatibility

Imaging Options
X None X No Phase Wrap

ASSET POMP

ASSET Calibration Real Time

Blood Suppression Real Time Blurring Cancellation

X Cardiac Gating/Triggering Respiratory Compensation

CCOMP X Respiratory Gating/Triggering

Classic Sequential

X DE Prepared Single Quadrature Fat Imaging

X Extended Dynamic Range Single Quadrature Water Imaging

Flow Compensation X SmartPrep

Fluoro Trigger Spectral Spatial RF

fMRI X Square Pixel

FSE/FIR Blurring Cancellation Tailored RF

Full Echo Train T2 Prep

X IR Prepared X Variable Bandwidth

Magnetization Transfer X ZIP x 2

X Multi-Phase X ZIP x 4

X Multi Station X ZIP 512

Navigator X ZIP 1024

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 Bolus Chasing

Applications
A single, slow, or bi-phasic contrast injection can be used to obtain 3D Fast TOF data
sets of the arterial system from the descending aorta to the feet.
Figure 33-4 SmartStep Peripheral Runoff
Figure 33-4 provides an image of a three station peripheral
vascular run-off acquired with SmartStep.
The SmartPrep tracker option can be used with SmartStep to
detect/trigger the bolus at the first station and initiate data
acquisition for the first station of the bolus meta-series.
The Mask and Venous acquisition types can be used with 3D
Fast TOF GRE/SPGR sequences. A Mask meta-series can be
acquired to create subtraction images at both arterial and venous
phases. The venogram option can be used to obtain a
meta-series with venous phase information. The Mask and
Venous options are enabled through the User Control Variables.

There are several things to consider when using this technique:

• Image reconstruction for SmartStep sequences may be longer than other
sequences.
• Because of the rapid contrast transit time and the need for high signal and spatial
resolution of the lower station (lower legs), it is recommended to use the Elliptic
Centric option for the lower station. Scan times of 40 to 50 seconds is possible with
little venous contamination in the arterial phase due to the efficient k-space filling
scheme.
• For TOF sequences with SmartPrep, bolus tracking is used only at the first station.
SmartPrep tracking is not used for the mask and venous meta-series.

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 Bolus Chasing

How Do I...
This section provides the step-by-step instructions for bolus chasing using SmartStep.
Specifically, it describes how to:
• Prepare the Patient
• Scan the Localizer Series
• Set up the Scan Parameters
• Set up the Graphic Parameters
• Scan the SmartStep Series
• Copy and Paste a SmartStep Series
• Scan Using the saved Protocol
NOTE: The first five procedures must be followed in the order provided above to
successfully perform a SmartStep examination.

CAUTION: Provide all patients with ear protection prior to any scan to help avoid
possible hearing impairment. Acoustic noise levels can exceed 99 dbA
in the magnet bore.

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 Bolus Chasing

Prepare the Patient

Use this procedure to perform a SmartStep scan with the Multi Station option. With Multi
Station, the system automatically advances the table and starts the next prescribed
series.
You should already know how to setup a protocol for your system; only a brief review is
provided. This procedure guides you through preparing your patient for a SmartStep
examination.
NOTE: It is suggested you use SmartPrep if you have it on your system. This option takes
the guesswork out of bolus timing.
1. Select the appropriate coil.
Š The Body coil or the Body-Flex coil (over the lower legs) can be used for a bolus
chasing examination.
2. Position the patient feet first.
Š The patient’s feet should be at the level of the table docking latch.
Š Feet first positioning ensures the patient’s head is close to the magnet entrance,
making it easier to give breathing instructions.
Š Feet first positioning is mandatory.
3. Elevate the patient’s legs with sponges so that they are parallel to the table.
4. Place Respiratory Bellows on the patient (optional).
Š The Respiratory Bellows are helpful in detecting when and how long your patient
is suspending respirations during breath holding techniques.
5. As directed by your physician, set up the patient IV catheter.
Š Follow your physician’s or facility’s guidelines.
Š The patient’s right arm is typically used, which has the shortest path to the heart.
6. Prepare the power injector (optional).
Š Follow your power injector specifications.
Š If a power injector is not used, follow your facility’s procedure for administering
rapid bolus injections.

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 Bolus Chasing

7. Bring your patient’s arms above his or

her head.
Š This minimizes the chance for a
wrap around artifact.
Š If the patient’s arms cannot be
placed above the head, elevate the
arms on cushions.
8. Landmark your patient at the level of
the xiphoid.
Š Landmark for your first station only.
Š Right, Anterior Superior (RAS)
coordinates based on the original landmark of S (Superior) 0.
9. Record offsets of remaining stations you wish to scan.
Š It is recommended you use the suggested offsets.
Š Use the align light to record the location of any additional offsets.
10. Press Move to Scan to move the patient to the landmarked location inside the bore.

Quick Steps: Prepare the Patient

1. Select the appropriate coil.
2. Position the patient feet first.
3. Elevate the patient’s legs with sponges so that they are parallel to the table.
4. Place Respiratory Bellows on the patient (optional).
5. As directed by your physician, set up the patient IV catheter.
6. Prepare the power injector (optional).
7. Bring your patient’s arms above his or her head.
8. Landmark your patient at the level of the xiphoid.
9. Record offsets of remaining stations you wish to scan.
10. Press Move to Scan to move the patient to the landmarked location inside the
bore.

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 Bolus Chasing

Scan the Localizer Series

Use this procedure after you have prepared the patient for the examination. This
procedure guides you through setting up and scanning a meta-series localizer.
1. Click the Patient Position icon on the Scan Rx desktop.
2. Enter the Patient Position information.
a) Select Coil > Body Flex.
b) Enter a description in the Series Description text box.
– Suggested description: Top Loc.
3. Select the Imaging Parameters.
a) Select Plane > 3 Plane.
b) Select Mode > 2D.
c) Select Localizer in the Pulse Sequence window.
d) Select No Phase Wrap and Multi Station from the Imaging Options window.
– No Phase Wrap prevents aliasing of anatomy inside a prescribed field of FOV.
4. Enter the Number of Stations on userCV screen.
5. Enter the Scanning Range parameters.
Š Suggested parameters are in parenthesis.
a) Choose a FOV to cover desired anatomy (40 cm).
b) Select the Slice Thickness and Spacing (7 mm/2 mm for top, 10 mm/5 mm for
middle and bottom stations).
c) Type values into the Center FOV text boxes (0 S/I, 0 A/P, and 0 R/L).
d) Select the # Slices Per Plane (7).
– You can enter only an odd number of slices, for example 1, 3, 5, 7, or 9.
– Entering no more than three slices ensures scan times are kept short for
breath-holding techniques.
6. Enter the remaining imaging parameters.
a) Select the Frequency and Phase matrix values (256x128).
b) Select the NEX (2).
c) Select Autoshim on.
7. Click [Save Series].
8. Select the second station localizer and click [View Edit].

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 Bolus Chasing

9. Change the description of the series.

Š Suggested description: Mid Loc for second series.
Š This allows you to distinguish the localized meta-series at a glance within the Rx
Manager area.
10. Change coil type, if necessary.
11. Change Center FOV offset to I380.
Š Establishes second station center FOV.
Š If you did not use the suggested offset, when scanning with the Body coil, enter
desired offset now.
12. Click [Save Series].
Š Closes the view/edit mode and changes series status to RXD.
13. Repeat steps 8 to 12 for third and any additional stations. Make series description
and offset changes, as necessary.
Š Suggested third station series description: Bot Loc.
Š Suggested offset for third station: I760.
14. Select the first (or subsequent) station in Rx Manager.
Š The first series is labeled “Top Loc”.
Š If you are on the second or third localizer, the second station is labeled “Mid Loc”
and the third is labeled “Bot Loc”.
15. Click [Prepare to Scan].
16. Click [Auto Prescan].
17. Provide breathing instructions to your patient.
Š Instruct the patient to suspend breathing until the table starts to move to the
second station.
Š If your patient has difficulty suspending their breath, follow your facility’s
guidelines on breath-holding techniques.
18. Click [Scan].
Š Initiates the first series acquisition.
Š Only the highlighted series is scanned.
19. Repeat steps 14 to 18 for each localizer scan.
Š Advance the table as needed.
NOTE: When acquiring a SmartStep scan, the [Auto Scan] button is automatically turned
off after the 3-Plane Localizer is acquired. You must manually start the next
acquisition.

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 Bolus Chasing

Quick Steps: Scan the Localizer Series

1. Click the Patient Position icon on the Scan Rx desktop.
2. Enter the Patient Position information.
3. Select the Imaging Parameters.
4. Enter the Scanning Range parameters.
5. Enter the remaining imaging parameters.
6. Click [Save Series].
7. Select the second station localizer and click [View Edit].
8. Change the description of the series.
9. Change coil type, if necessary.
10. Change Center FOV offset to I380.
11. Click [Save Series].
12. Repeat steps 8 to 12 for third and any additional stations. Make series description
and offset changes, as necessary.
13. Select the first (or subsequent) station in Rx Manager.
14. Click [Prepare to Scan].
15. Click [Auto Prescan].
16. Provide breathing instructions to your patient.
17. Click [Scan].
18. Repeat steps 14 to 18 for each localizer scan.

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 Bolus Chasing

Set up the Scan Parameters

Use this procedure after you have prepared your patient and scanned the localizer
series. This procedure guides you through setting up the scan parameters of a
SmartStep series with the SmartPrep option.
1. Click [New Series].
Š Opens a new, blank scan prescription.
2. Enter the Patient Position information.
Š Patient entry must match the entry of the localizer series.
a) Change the coil type, if necessary.
b) Enter 3D Top in the Series Description text box.
3. Enter the Imaging Parameters.
a) Select Plane > Oblique.
b) Select Mode > 3D.
c) Select Fast TOF SPGR in the Pulse Sequence window.
d) Select Multi Station, SmartPrep, ZIP x2, and ZIP 512 in the Imaging Options
window.
– All imaging options listed above can be used, but are not required, with the
exception of Multi Station. Multi Station must be selected in order to perform a
bolus chasing procedure. Refer to Supported Features for a list of all
compatible options.
– Selecting ZIP 1024 may require too much system memory and is not
recommended.
NOTE: SmartPrep is only present in the first station of the Arterial acquisition meta-series.
4. Enter all remaining imaging parameters.
Š Suggested parameters: Minimum TE, 45° Flip Angle, 40 FOV, 3 Slice Thickness,
32 to 40 locations, 256x128 matrix, 0.8 Phase FOV, 1 NEX, and AutoShim on.
5. Select Contrast in the Acquisition Timing area and enter the correct dosage in the
Amnt text box.
Š The correct amount is needed to establish an accurate Threshold for the patient.
6. Click the Vascular icon in the Additional Parameters area.

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 Bolus Chasing

7. Enter the Vascular parameters.

a) Select 0 Projection Images.
– Image reconstruction time is saved with no projections. The images can later
be post processed to get rotation projections, if desired.
b) Select On for Collapse.
– Provides a multiple image projection (MIP) image of the vessels.
c) Click [Accept].
8. Click the User CVs icon in the Additional Parameters area.
9. Enter the User CV parameters.
a) Enter the desired Number of Stations (3).
– The Number of Stations can be a value from 1 to 4.
b) Enter the Max. monitor period (50 seconds).
– The recommended Maximum Monitor Period is a 50 second delay to allow
sufficient time for the system to detect the bolus.
c) Enter the Image acq. delay (5 seconds).
– The Image Acquisition Delay should reflect adequate time to give patient
breathing instructions. A 5- to 8-second delay is recommended.
d) Set the desired type of k-space filling.
– Top station = Centric filling
– Middle station = Centric filling
– Bottom and any remaining stations = Elliptical-Centric filling
e) Turn on Mask and/or Venous acquisition options.
– A Mask Acquisition should be acquired whenever performing this type of
scan. This ensures correct volume placement and helps to improve image
quality when subtraction post processing techniques are used.
– A Venous Acquisition can be used to obtain venous phase information.
f) Click [Accept].
10. Proceed to the Set up the Graphic Parameters procedure.

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 Bolus Chasing

Quick Steps: Set up the Scan Parameters

1. Click [New Series].
2. Enter the Patient Position information.
3. Enter the Imaging Parameters.
4. Enter all remaining imaging parameters.
5. Select Contrast in the Acquisition Timing area and enter the correct dosage in the
Amnt text box.
6. Click the Vascular icon in the Additional Parameters area.
7. Enter the Vascular parameters.
8. Click the User CVs icon in the Additional Parameters area.
9. Enter the User CV parameters.
10. Proceed to the Set up the Graphic Parameters procedure.

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 Bolus Chasing

Set up the Graphic Parameters

Use this procedure after you have prepared your patient, scanned the localizer series,
and set up scan parameters. This procedure guides you through setting up the graphic
prescription parameters of a SmartStep series.
1. Click the Graphic Rx icon in the Additional Parameters area.
2. Click [Select Series].
3. Select the Top Loc series.
Š This is your first station of the localizer meta-series.
4. Click [OK for All].
5. If using SmartPrep, click [Tracker] and position the Tracker on the top localizer.
6. Place the cursor over the desired localizer image and click to deposit your 3D
imaging volume.
Š Adjust angle and the left-right, anterior-posterior, and center locations to ensure
proper coverage of anatomy.
Š Be careful to keep the center FOV at S/I 0 mm, which is represented by the
horizontal reference line.
7. Click [Accept] to register the graphic options into your current acquisition.
8. Click [Save Series].
Š The meta-series is displayed in the Rx Manager.
9. Double-click the next station in the meta-series.
Š The second series opens into view/edit mode.
10. Enter 3D Mid in Series Description text box.
Š You may choose to enter any description. The description allows you to
distinguish the localized meta-series at a glance within the Rx Manager.
11. Change coil type, if necessary.

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 Bolus Chasing

12. Click the User CVs icon to change your k-space filling option.
Š It is recommended you change your filling option for each station. By doing so,
you improve your probability of catching the bolus at each station.
Š For middle station, keep Centric filling and for the bottom station, deselect
Centric by changing it to 0.00, then turn Elliptical Centric on by changing it to
1.00.
– Top station = Centric filling
– Middle Station = Centric filling
– Bottom and any remaining stations = Elliptical-Centric filling
13. Click [Accept] to register your User CV selections.
14. Click the Graphic Rx icon in the Additional Parameters area.
15. Click [Select Series].
Š The first meta-series is displayed in the Rx Manager.
16. Select the Mid Loc series.
Š This is the second station of the localizer meta-series.
17. Click [OK for All].
18. Place the cursor over the desired localizer image and click to deposit your 3D
imaging volume.
Š Adjust angle and the left-right, anterior-posterior, and center locations to ensure
proper coverage of anatomy.
19. Click [Accept] to register the graphic options into your current acquisition.
20. Click [Save Series].
Š The second meta-series is displayed in the Rx Manager.
21. Repeat steps 9 to 20 for all remaining stations.
Š Change third station series description to 3D Bot.
22. Proceed to the Scan the SmartStep Series procedure.

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 Bolus Chasing

Quick Steps: Set up the Graphic Parameters

1. Click the Graphic Rx icon in the Additional Parameters area.
2. Click [Select Series].
3. Select the Top Loc series.
4. Click [OK for All].
5. If using SmartPrep, click [Tracker] and position the Tracker on the top localizer.
6. Place the cursor over the desired localizer image and click to deposit your 3D
imaging volume.
7. Click [Accept] to register the graphic options into your current acquisition.
8. Click [Save Series].
9. Double-click the next station in the meta-series.
10. Enter 3D Mid in Series Description text box.
11. Change coil type, if necessary.
12. Click the User CVs icon to change your k-space filling option.
13. Click [Accept] to register your User CV selections.
14. Click the Graphic Rx icon in the Additional Parameters area.
15. Click [Select Series].
16. Select the Mid Loc series.
17. Click [OK for All].
18. Place the cursor over the desired localizer image and click to deposit your 3D
imaging volume.
19. Click [Accept] to register the graphic options into your current acquisition.
20. Click [Save Series].
21. Repeat steps 9 to 20 for all remaining stations.
22. Proceed to the Scan the SmartStep Series procedure.

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 Bolus Chasing

Scan the SmartStep Series

Use this procedure after you have prepared your patient, scanned the localizer series,
set up of scan and graphic prescription parameters. This procedure guides you through
scanning the SmartStep series using the SmartPrep option.
1. Skip to step 9 if NOT performing a Mask meta-series.
2. Select the first station of Mask meta-series.
Š If you prescribed a Mask meta-series, the cursor should highlight PSCD M/1.
NOTE: You can highlight any series you wish to start scanning. For example, if the patient
is claustrophobic and you decide to skip the Mask meta-series, select the first
station of the arterial series to begin there.
3. Select the 3D Bot Mask series in the Rx Manager.
4. Click [Prepare to Scan].
5. Click [Prescan All].
Š This prescans all stations in the meta-series in reverse order, from bottom to top.
Š All series prescanned displays PSCD in the status area of the Rx Manager.
Š When a station is in the PSCD state, scan parameters cannot be edited.
6. Click [Prepare to Scan].
Š This downloads the acquisition and moves the table to its starting position.
7. Click [AutoStep].
Š If you have entered a delay before the acquisition, the clock counts down the
delay time. This allows you to give breathing instructions to your patient.
Š Initiates the first highlighted meta-series acquisition. All stations within the Mask
meta-series are scanned from top to bottom.
NOTE: The system stops after all the Mask meta-series are acquired. This allows you to
prepare for the contrast injection.
8. Prepare the manual or power injector.
9. Select the first station of the Arterial meta-series.
Š If no mask meta-series was prescribed, the cursor should highlight PSCD A/1.
10. Click [Prepare to Scan].
Š This downloads the acquisition and moves the table to its starting position.

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 Bolus Chasing

11. Click [AutoStep].

Š Initiates the first highlighted meta-series acquisition.
Š The system initiates SmartPrep.
12. Upon bolus detection with SmartPrep, instruct the patient to hold his or her breath
during the delay time, then the scan will begin.
Š The system scans the top, middle, and bottom arterial stations, moving the table
automatically between stations.
Š Once the first station is done scanning, the patient can resume breathing.
Š After all three stations are completed, the table begins scanning the venous
meta-series from bottom to top.

Quick Steps: Scan the SmartStep Series

1. Skip to step 9 if NOT performing a Mask meta-series.
2. Select the first station of Mask meta-series.
3. Select the 3D Bot Mask series in the Rx Manager.
4. Click [Prepare to Scan].
5. Click [Prescan All].
6. Click [Prepare to Scan].
7. Click [AutoStep].
8. Prepare the manual or power injector.
9. Select the first station of the Arterial meta-series.
10. Click [Prepare to Scan].
11. Click [AutoStep].
12. Upon bolus detection with SmartPrep, instruct the patient to hold his or her breath
during the delay time, then the scan will begin.

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 Bolus Chasing

Copy and Paste a SmartStep Series

The Copy and Paste function allows you to repeat a scan prescription that was already
listed in the Rx Manager. The entire meta-series is copied and pasted. You cannot
copy/paste a single station.
Also note that the Multi Station imaging option cannot be turned off after a copy/paste
of a Multi Station protocol or when using a library Multi Station protocol. In addition, any
meta-series copied and pasted is labeled as A (Arterial) regardless of whether the
copied series was Mask, Arterial, or Venous. Each NEW Multi Station series is viewed
as a new prescription for a Multi Station meta-series. This is expected behavior.
Use this procedure to copy and paste a SmartStep series.
1. Select the first station of the arterial series.
Š The series highlights in the Rx Manager.
2. Right-click and select Copy.
Š This copies the arterial series.
3. Select the first station of the venous series.
Š The series highlights in the Rx Manager.
Š The copied series is placed immediately below the selected (highlighted) series.
4. Right-click and select Paste.
Š This places the arterial series at the bottom of the list in the Rx Manager.
5. Prescan the pasted series.
Š This places the mask and venous series appropriately in the Rx Manager.
6. Proceed with scanning as usual.

Quick Steps: Copy and Paste a SmartStep Series

1. Select the first station of the arterial series.
2. Right-click and select Copy.
3. Select the first station of the venous series.
4. Right-click and select Paste.
5. Prescan the pasted series.
6. Proceed with scanning as usual.

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Scan Using the saved Protocol

The SmartStep meta-series can be saved as a protocol.
If your site uses a protocol with a different number of stations, save one protocol for
each scenario. For example, save a protocol for a three station SmartStep and save
another for a four-station SmartStep.
Because once a protocol is saved with the Multi Station option and a set number of
stations, the number of stations value cannot be changed after protocol loading.
But Mask and Venous can be selected after protocol loading.

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 Bolus Chasing

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 Imaging Real Time

Chapter 34
Imaging Real Time

Introduction
The iDrive™ Pro Plus is an optional software. The iDrive™ Pro Plus feature uses is a
real-time imaging acquisition that can be used to navigate through patient anatomy for
rapid visualization and monitoring of temporal physiological events, kinematic studies,
and bolus activity. This feature provides a flexible, real-time imaging environment.
This chapter explains how to image real-time with iDrive Pro Plus. It provides key
concepts regarding acquisition, tools, image review options, and application tips on
where to use interactive imaging. This chapter also contains the step-by-step
instructions to help you learn how to:
• Prescribe a Real Time Sequence
• Use the Movement Tools
• Manage Home Images
• Manage Bookmarks
• Use the Graphic Tools
• Adjust Image Contrast
• Prescribe Series Locations
• Time a Bolus
• Review Real Time Images
• Scan Complex Anatomy

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 Imaging Real Time

What Do I Need to Know About...

This section presents the concepts necessary to successfully acquire real-time image
acquisitions with iDrive Pro Plus. Specifically, you need to understand:
• Real Time Imaging Basics
– Image Acquisition
– Frame Rate
• Acquire Tab
– Home Images
– Bookmark
– Image Buffer
– Multi-Slice Mode
• Acquire Tab Tools
– Movement Tools
– Orientation Tools
– Contrast Tools
– Graphic Tools
– Parameter Tools
– Interactive Graphic Prescription Tools
• Review Tab
– Review Images
– Image Slider
• Applications
• Troubleshooting Tips

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 Imaging Real Time

Real Time Imaging Basics

Real-time imaging allows you to navigate through your patient’s anatomy for rapid
visualization and monitoring of temporal physiological events. This includes, but is not
limited to, patient breathing, kinematic studies, and bolus activity. Real-time images can
also be used for directly prescribing scan planes of other series in the examination. A
real-time scan can be prescribed using the Real Time Imaging Option. Once the series
has been prescanned, starting the series with the [Scan] button initiates a scan
interface with controls unique to the real-time imaging feature. After imaging in
real-time, a [Close] button allows you to return to the Scan Rx Desktop.Real Time
Imaging Basics
You can use iDrive Pro Plus to interactively manipulate the scan plane and image
contrast. Images you acquire with iDrive Pro Plus can be used to prescribe scan planes
and locations for other series in the exam once the correct plane and locations have
been determined.
Table 34-1 describes the feature of the Real Time Imaging Option.
Table 34-1 Feature

iDrive ProPlus
Feature
(Optional)
Fast GRE/SPGR, Fast
Compatible PSDs GRE ET, Spiral
GRE/SPGR
Pan, Rotate, Tilt,
Movement Tools Translate and the
Drive and Step Modes
Axial, Sagittal,
Orientation Tools
Coronal, Normal
IR, SAT, FatSAT,
Contrast Tools
SPGR, and FC
Center, Draw Line,
Graphic Tools
2 Point Tool, 3 Point
(Cut Plane Tools)
Tool, Stack and mm
FOV, Flip Angle, and
Parameter Tools
Slice Thickness
Save, apply, and
IGRx Tools retrieve start, center,
and end locations
Save yes
Timer yes
Image Buffer up to 960 images
Review yes

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 Imaging Real Time

Real Time is compatible with Flow Compensation, No Phase Wrap, and Square Pixels.

Image Acquisition
To use the real-time interactive features, you must first prescribe a single-slice series at
the Scan Rx Desktop. This series must have Real Time selected on the Imaging
Options window. The real-time series can be saved as a stand-alone protocol or as part
of a larger protocol with an existing batch series. It can be cut, copied, or pasted using
the Rx Manager tools and can be used in a protocol that is being automatically
scanned.
When you start the scan, there is a slight pause (less than six seconds) before the
system is ready to display the images. The tools and functions available on the Acquire
Tab help you manipulate the scan plane and contrast of the images. These actions are
a combination of button selections and cursor manipulations on the image screen itself.
While the images are being acquired, the imaging plane can be tilted and/or rotated.
This allows for instantaneous visualization of anatomy in orthogonal, off axis, or double
oblique planes. The shape, configuration, and function of the cursor changes
depending on the area of the window in which the cursor is located, allowing for
different functions. The Movement tools are always displayed in iDrive Pro Plus.
Real-time imaging also allows the tissue contrast of the acquired images to be modified
for iDrive Pro Plus acquisitions. This is achieved with selectable pulse sequences and
imaging options.
When the real-time application is launched, Archive, Network, and Filming operations
are automatically paused by the system. However, there is no notification of the pause
status. These processes automatically resume when the real-time application is closed.
Images acquired real-time are not automatically saved to the system disk. The [Save
Image] button on the Acquire tab is used to save a single image to the disk when that
image is displayed in the Acquire tab Main Viewer. Images cannot be saved with the
standard iDrive feature.
Data acquisition can be paused by clicking the [Pause Scanning] button on the
Acquire tab or by pressing the Pause Scan hard key on the keyboard. If the keyboard
is used to pause scanning, the Acquire tab [Pause Scanning] button appears
depressed. Scanning can be initiated again with the Start Scan hard key or by selecting
the [Pause Scanning] button on the Acquire tab. When scanning is paused, most of
the Acquire tab controls become unavailable.

Frame Rate
The Advisory panel of the Scan Rx Desktop displays the number of images acquired in
one second, based on the current series parameters. This is shown in the frames per
second (FPS) status area. The gradient platform and array processor configuration

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 Imaging Real Time

effect the maximum number of images, or frames per second, that can be generated.
Another factor effecting the frame rate is the number of receive coils. The use of a
phased array coil may decrease the frame rate as compared to a single receive coil.
In addition, parameter selection also effects frame rate. Table 34-2 provides a quick
guide to help you understand parameter selection effects on frame rate and Table 34-3
describes the effects in greater detail.
Table 34-2 Parameter Selection Effects on Frame Rate

Parameter Frame Rate

⇑ TR ⇓
⇑ NEX ⇓
⇑ Frequency Matrix ⇓
⇑ Phase Matrix ⇓
⇑ Phase FOV ⇓
⇑ Bandwidth ⇑
⇑ FOV ⇑
⇑ Slice Thickness ⇑

When imaging with iDrive Pro Plus, the phase and frequency matrix selections are the
predominant factors effecting the FPS in non-Spiral acquisitions. In Spiral scans, the
number of arms and number of points are the predominant factors effecting the FPS.

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 Imaging Real Time

Table 34-3 Factors that Effect Frame Rate

Parameter Effects on Frame Rate

Effects the scan time per image. As the TR increases, scan time
increases and frame rate decreases. The minimum TR displayed
TR represents the smallest TR possible for the selected imaging
parameters. Only “minimum” is available in the TR shortcut menu
because, in most cases, you want to scan as fast as possible.
Effects the number of times each phase encoding step is collected,
therefore effecting the scan time per image. A number of
NEX excitations (NEX) of 2 collects each phase encoding step twice. As
NEX increases, scan time increases and frame rate decreases.
Keep NEX at a minimum.
Effects the echo readout time. As the frequency matrix increases,
Frequency the system must read more samples during the echo, which
Matrix increases the minimum TR. The lower the frequency matrix, the
faster the acquisition.
Determines the total number of phase encoding steps that must be
acquired. For example, a phase matrix of 256 and a phase FOV of
Phase Matrix
0.8 require 206 phase encoding steps to be acquired. The system
and Phase
carries out the pulse sequence once for each phase encoding step.
FOV
As the phase matrix and phase FOV increase, the scan time also
increases. The lower the phase matrix, the faster the acquisition.
Effects the echo readout time. As bandwidth decreases, the system
Bandwidth samples slower during the echo; this, in turn, increases the
minimum TR.
Effects the workload of the gradients. A small FOV requires a steep
gradient magnetic field across a small area, reducing the maximum
FOV frame rate. Larger FOVs generally decrease the minimum TR and
thus increase the imaging frame rate. Smaller FOVs may require
smaller bandwidth.
Effects the workload of the gradients. A thin slice requires a steep
Slice gradient magnetic field across a small area, reducing the maximum
Thickness frame rate. Thicker slices result in both higher signal-to-noise ratio
(SNR) and faster frame rates.

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 Imaging Real Time

Acquire Tab
The Acquire tab displays when the [Scan] button is clicked on the Scan Rx Desktop in
a real-time prescription. Data acquisition begins and three Home Images are acquired,
one image in each orthogonal plane.
Figure 34-1 Acquire Tab

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 Imaging Real Time

Table 34-4 Acquire Tab Descriptions

Selection Description
[Delete Deletes all bookmark thumbnails currently displayed. Individual
Bookmarks] bookmarks cannot be deleted.
Saves the plane, location, and image contrast of the current
[Add
image as a Bookmark thumbnail for later recall. Up to 12 images
Bookmarks]
can be bookmarked.
Copies the image in the Main Viewer to the Scout Viewer (the
[Define Scout]
viewer directly under the [Define Scout] button).
Contains a static 256x256 image that can be used with the Draw
Scout Viewer Line tool to prescribe orthogonal real-time image planes. This
viewer is empty when real-time scanning begins.
Displays the Interactive Graphic Prescription Tools (IGRx) for
[Rx Center] centering. The IGRx tools are used to save or retrieve locations
for defining additional real-time and/or non-real-time sequences.
Returns the real-time image to the state prior to the most recent
change, undoing the most recent scan plane or image contrast
change. It can also be used if iDrive Pro Plus has been exited.
• Selecting the [Undo] button upon re-entering iDrive Pro Plus,
the last location scanned in the prior real-time session will be
[Undo] acquired provided the ID, Landmark and Patient Position have
not changed.
• In Drive mode, it undoes all Drive functions returning the image
to its original state before any Drive tools were applied.
• In the Step mode, it undoes all Step functions returning the
image to its original state before any Step tools were applied.
Enables the Multi-Slice Mode. The stack values are shown in
Stack
millimeters in the range of 10 to 100.
Allows changes in the prescribed slice thickness by moving the
Slice Thickness
slider or by entering a value in the text box.
Allows changes in the prescribed flip angle by moving the slider or
Flip Angle
by entering a value in the text box.
Automatically pauses the real-time data acquisition when the Real
[Pause When
Time Image Buffer is full. The progress bar provides a graphic
Full]
display of the image buffer capacity.
Displays the real-time images as real-time data acquisition is
Main Viewer taking place. This image is also used with the Movement Tools
and Graphic Tools for defining new scan planes.
Becomes visible on the real-time image when the Draw Line tool
is selected. It is used to initiate the scan plane change when a line
[GO]
is drawn on the real-time image. Alternatively, right-click
anywhere on the image to initiate data acquisition.

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 Imaging Real Time

Selection Description (Continued)

Acquires new Home Images. The new home images are acquired
[Define New
in three orthogonal planes based on the real-time image currently
Home]
displayed in the main viewer.
Saves the current real-time image to the system disk and lists the
[Save Image] image in the Browser. Saved images can be used in Graphic Rx
in subsequent series.
Enables Interactive Graphic Prescription Tools (IGRx). The IGRx
[Rx Locations] tools are used to save or retrieve locations for defining additional
real-time and/or non-real-time sequences.
Cancels the most recent Undo operation. The real-time image
[Redo]
returns to its previous state.
Turns the on-image time display on or off. The on-image timer
shows the scan time for a single image. When the timer is on, the
[Timer] scan timer on the Personal Computer (PC) is set to zero. The
timer readout updates with each new image acquired and
displayed.
Contains Movement Tools used to define the on-image scan
Movement
plane manipulation features.
Contains Orientation Tools used to quickly return the scan plane
to any orthogonal orientation, at the current FOV center, by
selecting the [Axial], [Sagittal], or [Coronal] buttons. The
Orientation [Normal] button adjusts the image to a normal anatomic
presentation. The image is presented such that right, anterior,
superior (RAS) coordinates are in their normal positions in the
viewer.
Contains the Contrast Tools used to adjust image contrast
Contrast parameters. The contrast tools available are based on the pulse
sequence selected.
Provides access to the Graphic Tools that provide alternate
Tools
methods used for manipulating the scan plane.
Allows changes in the prescribed FOV by moving the slider or by
FOV
entering a value in the text box.
Specifies the number of images to be averaged to create the
real-time image. This improves SNR, as well as motion averaging.
Average Averaging occurs as long as the real-time image location and
contrast setting are not changed. A value of 1 effectively means
no averaging. The maximum allowable value is 8.
Swaps the phase and frequency matrix directions based on the
[Swap
original series prescription.This is not available for Real Time
Phase/Freq]
Spiral Imaging.

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 Imaging Real Time

Selection Description (Continued)

Stops real-time data acquisition. The Acquire tab remains open.
[Pause
Selecting the [Pause Scanning] button again resumes data
Scanning]
acquisition.
Pauses scanning and moves the display to the Review Tab. The
[Review] Review tab is used to view and save recently acquired real-time
images.
Conveys error and warning messages. Messages displayed are
Message Area
cleared when any action is performed within the user interface.
Selecting the double arrows displays a dialog box with a scrollable
list of messages that have been displayed for the current real-time
session.
Exits the Acquire tab, stops the current real-time session, and
[Close] returns to the Scan Rx Desktop. Once you close iDrive, you
cannot access images that have not been saved.

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 Imaging Real Time

Home Images
The three orthogonal images acquired upon initialization of a real-time series are
displayed in the three vertical viewers along the right side of the Acquire Tab Main
Viewer (Figure 34-2). These images are called Home Images. The Home Images
created are axial, sagittal, and coronal, based on the locations prescribed at the Scan
Rx Desktop during the real-time series prescription. The Home Images are
automatically saved to the system disk.
Figure 34-2 Home Images
Home Images are displayed in the following order:
• The top-most Home Image is the same imaging plane as
prescribed in the scan parameters during protocol prescription.
• The prescribed image plane and selected frequency direction
determine the ordering of the orthogonal home image planes.
Table 34-5 describes the order of the Home Images acquired in
orthogonal image planes.
Table 34-5 Home Image Ordering of Orthogonal Planes

Prescribed Frequency Direction Home Image Order

Image Plane (SPF or No SPF) (top to bottom)
Axial No SPF Axial, Sagittal, Coronal
Sagittal No SPF Sagittal, Coronal, Axial
Coronal No SPF Coronal, Sagittal, Axial
Axial SPF Axial, Coronal, Sagittal
Sagittal SPF Sagittal, Axial, Coronal
Coronal SPF Coronal, Axial, Sagittal

During the real-time session, cut-lines display on the Home Images indicating where the
current real-time image intersects the Home Images. As the scan plane is manipulated,
the cut-lines update to indicate the new scan plane.

Defining a Scan Plane Based on Home Images

The Home Images are essentially a three-plane localizer used to define orthogonal
scan planes. You can also use your Home Images to reset your current scan plane by
clicking on any one of the Home Images to obtain a real-time image in that scan plane.

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 Imaging Real Time

Defining New Home Images

You also have the ability to replace your Home Images with new images. When you
decide that new Home Images are desired at the location of the current real-time image,
click the [Define New Home] button. The first time you define new Home Images
during an acquisition, a message displays (Figure 34-3) informing you that your current
home image locations will be replaced by new Home Images.
Figure 34-3 Define New Home Message

If this is your intent, click the [OK] button. The system then acquires and displays three
orthogonal images based on the location of the real-time image. This includes the RAS
offsets of the current real-time image.

Bookmark
An image can be bookmarked to recall at a later time. A recall can be performed to
obtain the scan plane and image contrast from that image. When an image is
bookmarked, it is displayed as a thumbnail image in the Bookmark Viewers. The
viewers are black when that viewer does not contain a Bookmark thumbnail.
Figure 34-4 Bookmark Viewers

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 Imaging Real Time

A single thumbnail image can be enlarged from a 64x64 to a 128x128 pixel display by
leaving the cursor on the image for longer than one second (Figure 34-5). When you
move your cursor off of the enlarged thumbnail image, it immediately returns to its
original size. An enlarged thumbnail can be selected for scan by clicking it. This updates
the image in the Main Viewer to the contrast and slice view of the Bookmark.
Figure 34-5 Enlarged Bookmark

Bookmarks are not automatically saved to the image disk. If a real-time application is
exited and re-entered, the Bookmark thumbnails from the prior real-time session are
saved only if the Patient ID, Landmark, and Patient Position have not changed.
If all thumbnail viewers are filled and the [Add Bookmarks...] button is clicked, a
message posts telling you to right-click on an occupied viewer to replace that thumbnail
with the current image. All thumbnail images in RTCAs can be deleted by clicking the
[Delete Bookmarks] button.

Image Buffer
The Image Buffer holds all of the images acquired with Real Time. If the buffer is filled
and scanning continues, the first images placed into the buffer are deleted to make
room for the current real-time images using the First In, First Out (FIFO) method. FIFO
buffer images are not automatically saved. You can review images in the Image Buffer
and save individual images or an entire range of images. You can also select an image
from the buffer and resume scanning at that location.Think of the Image Buffer as
fluoroscopy. Nothing is saved unless you “spot film.”
RTCAs imaged with iDrive Pro Plus can hold up to 960 real-time images. The actual
number of images in the buffer depends on the image size of the reconstructed image.
For example, a Fast GRE sequence may allow only 250 images, while Spiral may allow
up to 960. These images are held in the Real Time Image Buffer and the buffer capacity
is indicated by the progress bar (Figure 34-6).

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 Imaging Real Time

Figure 34-6 Image Buffer Progress Bar

The [Pause When Full] button can be toggled on to halt real-time data acquisition
when the buffer becomes full. This indicates that no images acquired from this point
forward are to be discarded. When the number of images acquired equals the capacity
of the Image Buffer, scanning is paused. The progress bar (Figure 34-6) provides a
graphic display of the Image Buffer capacity. To clear the buffer, click the [Pause When
Full] button. The progress bar indicator clears, indicating that the buffer has been reset.
When the [Pause When Full] button is toggled off, the progress bar is inactive.
When the Real Time Image Buffer becomes 85% full or greater, the [Define New
Home] button becomes non-functional when the [Pause When Full] button is enabled.
If you request new home images to be defined while the buffer is nearing 85% full, the
system may not collect the new home images as you requested. In this case, you must
empty the Image Buffer before you are able to define new home images.
The arrow button beside or below the Image Buffer progress bar can be used to purge
the buffer at any time. Alternatively, the images can be reviewed, saved, and purged
from the Review Tab.
If the Real Time application is closed, the images in the Image Buffer are held in the
buffer until a change has been made to the Patient ID, Patient Position, or Landmark.
Therefore, if the Real Time application is re-entered for the current patient, the real-time
images from the prior session remain in the Image Buffer.

Multi-Slice Mode
Multi-slice mode can be used with iDrive Pro Plus to visualize a multiple-slice, or "stack"
acquisition during RTCAs. This may be useful to visualize the start and end locations
before applying the locations to a series in the Rx Manager. The Stack check box and
the mm (millimeter) text box (Figure 34-7) are used in conjunction with the Draw Line
tool to use Multi-slice mode.

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 Imaging Real Time

Figure 34-7 Multi-Slice Mode Enable Area

The Stack option is NOT used to acquire a volume (stack) in iDrive Pro Plus; it only
designates the stack thickness to use for the Draw Line tool. The range of thickness is 0
to 480 mm. When you change the stack thickness value, the locations are updated on
the real-time image in the Main Viewport to reflect the new stack thickness entry.

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 Imaging Real Time

Acquire Tab Tools

The Acquire Tab contains tools for you to change the sequence parameters, move the
acquisition, change the graphic location, enhance real-time image contrast, as well as
set up and enable a graphic prescription.
Figure 34-8 Conventional Axis Used to Describe Tools
Figure 34-8 displays the orientation of the
real-time scan plane of the real-time image
relative to you and the conventional axis used to
describe the real-time control tools.

The following sets of tools are contained on the Acquire tab:

• Movement Tools
• Orientation Tools
• Contrast Tools
• Graphic Tools
• Parameter Tools
• Interactive Graphic Prescription Tools

Movement Tools
The scan plane can be manipulated using the Movement tools accessed in both the
Drive and Step modes. Each Movement tool is activated by an on-screen (on-image)
icon on the real time Main Viewer. These Movement tools enable you to navigate the
location of the real time image.
The tool icons are used to access the Movement tools in RTCAs imaged with iDrive Pro
Plus. When the cursor is moved into one of the four corners of the Main Viewer, the
cursor displays the icon associated with that tool accessed in that corner. Table 49-7
illustrates the Movement tools for RTCAs imaged and provides a description of each.

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 Imaging Real Time

Table 34-6 Movement Tool Descriptions

Tool Description
Activated by clicking in the upper-left corner. Panning is used to
Pan scroll the image in the X and Y directions in the viewer; left and
right (X), up and down (Y). The FOV center is changed with no
changes to the scan plane obliquity or orientation. When in Step
mode, movement occurs in increments based on the value set in
the Movement tools text box. This value is displayed in
millimeters.
Rotate Activated by clicking in the upper-right corner. Rotate turns the
image in a clockwise or counter-clockwise motion. The FOV
center in the X and Y directions does not change. When in Step
mode, movement occurs in increments based on the value set in
the Movement tools text box. This value is displayed in degrees.

Tilt
Activated by clicking in the lower-left corner. Tilt rolls (obliques)
the image in the direction of the arrow on the cursor. Movement
occurs along the X-axis, the Y-axis, or both. When in Step mode,
movement occurs based on the value set in the deg text box.

Activated by clicking in the lower-right corner. The image is rolled

Translate
(moved forward/backward) along the Z-axis, tilting toward or
away from you with no change in the angle of the image. No
movement occurs in the X or Y directions. When in Step mode,
movement occurs based on the value set in the mm text box. As
movement begins, the arrow changes to display the direction of
the translation.

The same Movement tools are available for both the Drive and Step modes. The mode
simply determines the manner in which the scan plane changes are applied.

Drive Mode
The scan plane is navigated in Drive mode by clicking and dragging the mouse in the
Main Viewer. The cursor indicates the direction of movement as the cursor is moved. As
you drag the mouse, the extent of movement is annotated in the lower right corner of
the real-time image. The scan plane updates when you release the mouse button.
In Drive mode, the direction of mouse movement effects the direction of the cursor
movement. The cursor icon changes to indicating the direction of movement.
NOTE: The Movement tool text boxes indicating the millimeter and degree of movement
are not available in Drive mode. They can only be changed in Step mode.

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 Imaging Real Time

Step Mode
The scan plane is navigated by clicking the mouse button. As the mouse button is
released, the scan plane changes as determined by the increments set in the
Movement tools mm and deg text boxes. The location of the cursor on the image
determines the direction of movement when that tool is used at that point on the image.
When the Step mode is active, you can click and hold and an on-image counter
displays. The display indicates the millimeter or degree of the scan plane change that
takes place as long as the mouse button is held down. The counter display increases
until the mouse button is released. When the mouse button is released, the value on the
counter is the change applied to the real-time image. The scan plane change depends
on the active Movement tool when the mouse button was depressed.
In Step mode, the cursor indicates the direction of movement, but movement direction
changes depending on the location of the cursor in the Main Viewer.
The Pan and Tilt tools divide the Main Viewer into 12 zones (Figure 34-9), numbered
clockwise from 1 to 12. Each area corresponds to a different movement direction,
depending on which tool is selected. Placing the cursor in the viewer and clicking shows
location of the cursor at the time the mouse button was clicked. It also determines the
movement for that zone and the cursor reflects the direction of that movement.
Figure 34-9 Control Zones and Location of Scan Controls

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 Imaging Real Time

The Rotate tool vertically divides the Main Viewer into two zones. The cursor indicates
the direction of movement. Clicking in the right half of the viewer results in clockwise
movement. Clicking in the left half of the viewer results in counter-clockwise movement.
The Translate tool horizontally divides the Main viewer into two zones. The cursor
indicates the direction of movement. Clicking the cursor in the upper half of the viewer
results in movement away from you. Clicking in the lower half of the viewer results in
movement toward you.
NOTE: When in Step mode, using the right mouse button to initiate the on-image tools
results in the opposite effect of using the left mouse button.

Orientation Tools
The orientation tools (Figure 34-10) quickly move the real-time image to the specified
orthogonal orientation.
Figure 34-10 Orientation Tools

For example, when the [Axial] button is clicked, the real-time imaging plane moves to
the axial plane at the current image center point. The [Normal] button moves the
real-time image to a normal viewing orientation at the current image center point. The
image is presented such that RAS coordinates are in their normal positions in the
Viewer.

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 Imaging Real Time

Contrast Tools
The Contrast tools (Figure 34-11) allow you to interactively make tissue contrast
changes to the real-time image. These tools apply tissue-specific techniques. The
Contrast tools available are based on the iDrive software package and pulse sequence.
Figure 34-11 Contrast Tools

The [SAT], [FatSAT], [SPGR], and [FC] buttons are toggle buttons. When turned
on, they remain on until they are turned off.
Table 34-7 describes the Contrast tools.
Table 34-7 Contrast Tools

Tool Description
Available with Fast GRE. The single-shot inversion recovery (IR) pulse is
[IR] applied once with the push button and an image is acquired with the IR
pulse. The image then returns to its pre-IR pulse contrast.
Available with Fast GRE. Applies spatial saturation (SAT) slabs in the
[SAT] slice-select direction. The slabs are automatically concatenated and track
the real-time image plane.
[FatSAT] Available with Fast GRE. Fat suppression nulls the signal from fat.
Available with Fast GRE and Spiral sequences. A GRE sequence can be
[SPGR]
changed to a SPGR (RF spoiling) sequence.
Available with Fast GRE. Flow Compensation (FC) is used for gradient
[FC]
moment nulling to decrease flow artifacts.
[SS] Spectral Spatial (SS) is not currently available for any pulse sequence.

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 Imaging Real Time

There are several factors you should consider when using the Contrast tools:
• In Fast GRE sequences with Real Time, FC, SAT selections (Fat Suppression and
Spatial SAT) can be made from the SAT screen during series prescription. The
corresponding button is depressed when the Acquire tab opens. These options can
be turned on and off at the Acquire tab during real-time data acquisition.
• SAT is applied in the slice select direction. When SAT is turned on at the SAT
screen, only SAT pulses in the slice-select direction are allowed.
• Selecting Spatial SAT in an iDrive series results in unique SAT behavior. If the
series is prescribed with a SAT pulse pair (e.g., S and I, R and L, A and P), toggling
SAT off and on at the Acquire tab after iDrive has been initiated, turns both the SAT
pulses off and on. Likewise, if no SAT pulses are defined during series prescription,
selecting SAT during real-time imaging turns on a SAT pulse pair. You do not have
the option of selecting a single Spatial SAT pulse from the RTIA Acquire tab.
• The displayed SAR values differ when a single SAT pulse versus a SAT pulse pair
is prescribed. During series prescription, the SAR for a single SAT pulse is less than
that for a SAT pulse pair. When no SAT pulses are selected in series prescription,
the SAR value displayed is based on a worst case scenario of parameter selections.
This scenario assumes a SAT pulse pair is selected during iDrive imaging.
• The Contrast tools are NOT available for Fast GRE ET Real Time sequences.
However, FC and Fat SAT can be selected during series prescription. They cannot
be turned off at the Acquire tab.
• Only SPGR is available for Real Time Spiral sequences. Spectral Spatial RF
(SSRF) or Fat SAT can be used with Real Time Spiral, but they must be selected
during series prescription and they cannot be turned off or on at the Acquire tab.
• Disregard the error message that occurs when selecting Concatenated SAT in an
oblique iDrive scan prescription: Concat SAT not allowed for obliques.
iDrive sequences automatically use Concantenated SAT.

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 Imaging Real Time

Graphic Tools
The Graphic tools provide a means by which you can define a new real-time image
location by graphically prescribing cut planes through the imaging volume. The Graphic
tools available include: Center, Draw Line, 2 Point Tool, and 3 Point Tool (Figure
34-12).
Figure 34-12 Graphic Tools

Center
Center changes the FOV center of the real-time image to the location of a cursor placed
on the real-time image. This can be accomplished by clicking the [Center] button,
placing the cursor on the new FOV center, and clicking to deposit the cursor. The
real-time image updates to reflect a FOV center at the point of the cursor. Once the new
FOV center is defined, the Center tool turns off automatically.

Draw Line
Draw Line is used to define a new acquisition plane by drawing a line on the current
real-time image in the Main Viewer or on the scout image. Draw Line can also be used
to define a stack in Multi-slice mode.
If no scout image has been defined, clicking the [Draw Line] button automatically
deposits a line on the real-time image in the Main Viewer. If a scout image has been
defined, the cursor must be placed on either the scout or real-time image, then clicking
the mouse. The line is deposited at the center of the image. Figure 34-13 illustrates a
line defining the scan plane that runs along the optic nerve. The image plane becomes
the plane defined by the line.
Figure 34-13 Draw Line Defining a Scan Plane

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 Imaging Real Time

There are three applications for the Draw Line tool.

• Draw Line for the real-time image Main Viewer
• Draw Line for the Scout Viewer
• Draw Line for Multi-slice Mode
Draw Line for the real-time image Main Viewer draws a line onto the real-time image to
implement a change to the real-time scan plane and acquires an image at the plane of
that line. The line (Figure 34-14) deposited on the image is not an indicator of the
selected FOV.
Figure 34-14 Real Time Image Main Viewer Line Tool
The line has three handles that are used to adjust
the location and obliquity of the line.
• The middle handle (the crosshair) is used to drag
the line in horizontal and vertical directions.
• The two end handles (two circles) are used to
rotate the line.

Once the line has been adjusted, you can click the [GO] button to initiate the scan plane
change. Alternately, right-click anywhere on the real-time image in the Main or Scout
Viewer to initiate the scan plane change.
Draw Line for the Scout Viewer is used to prescribe a real-time scan plane orthogonal
to the current scout image. With the [Draw Line] button on, clicking the Scout Viewer
displays a line. The real-time scan plane moves to that location. The line (Figure 34-14)
displays and operates the same as the line tool for the real-time image Main Viewer.
The line handles are used to position the line segment at the desired location on the
Scout Viewer. The Real Time Main Viewer tracks the position of the line and updates
the real-time image as the line is adjusted. Draw Line remains active until it has been
toggled off, another graphic tool is clicked, or a click is performed on the real-time
image in the Main Viewer.
When the Stack box is checked, the Multi-Slice Mode is enabled. This mode is used to
visualize the extent of a multiple slice (stack) acquisition.
In the Multi-slice mode, Draw Line can be used on the Main Viewer real-time image or
in the Scout Viewer. When a line is dropped on an image, two additional line segments
are displayed (smaller than the main line). The small line segment with the two notches
at either end designates the first slice in the stack. The second small line segment
indicates the last location in the stack. The mm text box to the right of the Stack check
box determines the distance between the two small line segments in millimeters.

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 Imaging Real Time

2 Point Tool
The 2 Point tool allows you to define an acquisition plane by depositing two points on
the current real-time image or on two different real-time images. The on-image
Movement tools are used to navigate the real-time image to deposit a point on a second
image. The plane resulting from the two points is positioned midway between the
points, and perpendicular to the line defined by the points.
Figure 34-15 illustrates the 2 Point tool defining the scan plane perpendicular to the
optic nerve. The optic nerve will be viewed on end in the resulting image of this
example.
Figure 34-15 2 Point Tool Defining a Scan Plane

3 Point Tool
The 3 Point tool allows you to define an acquisition scan plane by depositing three
points at selected locations on one, two, or three images. The on-image Movement
tools are used to navigate the real-time image to deposit a point on a second or third
image. The plane resulting from these three points contains all three points. The 3 Point
tool is typically used with complex anatomy that requires you to work with multiple
images in a prescription. Figure 34-16 illustrates the 3 Point tool defining a scan plane
along the thoracic aorta.
Figure 34-16 3 Point Tool Defining a Scan Plane

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 Imaging Real Time

Parameter Tools
The Parameter tools allow you to interactively make parameter changes to the real-time
image. The Parameter tools available are based on the iDrive software package.
iThe FOV, slice thickness, flip angle, and number of averages can be changed
interactively from the Acquire tab for RTCAs. The RTCA Parameter tools (Figure
34-17) available depend on the selected pulse sequence.
Upon entering the iDrive Pro Plus Acquire Tab, these parameters are set to the values
prescribed at the Scan Rx Desktop. The sliders can be used to make the change or a
value can be entered in the text boxes.
Figure 34-17 Parameter Tools

Each parameter can be changed within the limits described in Table 34-8. If you enter a
value that exceeds either the minimum or maximum allowed value, a default entry is
made automatically. The default entry is either the minimum or maximum value,
whichever is closer to the value you entered.
Annotation on the real-time image indicates the parameters with which that image was
acquired, including those parameters changed at the Acquire tab.
Table 34-8 Parameter Tool Limits

Tool Limits
The FOV can be changed to a minimum of 50% and a maximum of
150% of the prescribed value. The change cannot exceed the minimum
and maximum values based on the pulse sequence, series
FOV prescription, and system limitations. The slider and text box are based
on millimeter changes (not centimeter) and when the slider is moved,
changes occur in 10 mm increments. The FOV slider is not available
for Fast GRE ET Real Time sequences.

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 Imaging Real Time

Tool Limits (Continued)

The slice thickness can be changed to a minimum of 50% and a
maximum of 150% of the prescribed value. The change cannot exceed
Slice
the minimum and maximum values based on the pulse sequence,
Thickness
series prescription and system limitations.The slider changes the slice
thickness in increments of 0.1 mm.
The flip angle can be altered to 50% above and below the prescribed
value. The flip angle cannot exceed the minimum and maximum values
Flip Angle
as determined by the pulse sequence. The slider changes the flip angle
in increments of 1°.
The average value defines the number of reconstructed images that
are averaged to create one real-time image for each new scan plane.
As averages increase, SNR increases and the frame rate may
decrease due to a decrease in reconstruction time. This is not the
Average
same as NEX. The allowable range for image averaging is one to eight.
One means that image averaging will not be performed. The value
steps in increments of one. Image averaging occurs as long as the
interactive scan plane and contrast settings are not changed.

Interactive Graphic Prescription Tools

The Interactive Graphic Prescription (IGRx) tools can be used to:
• Save start and end locations to acquire them at a later time in the real-time session.
• Apply start and end locations to a series in the Rx Manager that have been scanned
and saved to the IGRx tools area during a real-time session.
• Retrieve the start and end locations from a series (2D, 3D, or Real Time) in the
Rx Manager that can then be acquired at a later time in the real-time session.
You may also use the Center IGRx tool to:
• Apply the center of a stack to a series in the Rx Manager. The stack center is used
by the series to determine the start and end locations based on the coordinates of
the center of the stack and the slice thickness and spacing of the series.
• Retrieve the center location of a 3D series to use in the current real-time session.
NOTE: The series you wish to prescribe must be in the Rx Manager prior to starting the
RTCA.
Two methods of defining imaging locations can be performed, prescribing the start and
end locations and prescribing the center location. It is not possible to retrieve slice
locations from an Rx Manager series in which the slice locations have been graphically
prescribed. Attempting to enter the Graphic Rx screen of a series in which a RTIA or
RTCA was used to apply locations results in the locations erasing.

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 Imaging Real Time

Prescribing Start and End Locations

When the [Rx Locations] or the [Rx Start/End] button is clicked, the IGRx tools
(Figure 34-18) allow image locations to be defined from a start and end perspective.
The start and end locations displayed are the RAS coordinates of the center point of the
image.
Figure 34-18 IGRx Tools

Table 34-9 IGRx Tools and Descriptions

Tool Description
[Rx Start/End] Accesses the IGRx tools in the Rx Start/End mode.
[Rx Center] Changes the IGRx tools area to the Rx Center mode.
[Rx Locations] Accesses the IGRx tools.
Saves the current position of the real-time image as the first
[Set Start] location of another series or to be used to acquire a real-time
image at that location. The saved start coordinates are displayed.
Saves the current position of the real-time image as the last
[Set End] location of another series or to be used to acquire a real-time
image at that location. The saved end coordinates are displayed.
Prompts the real-time imaging application to scan an image at the
[Acquire at
locations defined by the [Set Start] button. This button is
Start]
unavailable if a start location has not been defined.
Prompts the real-time imaging application to scan an image at the
[Acquire at
locations defined by the [Set End] button. This button is
End]
unavailable if an end location has not been defined.

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 Imaging Real Time

Tool Description (Continued)

Sends the current Start/End locations to the currently selected
[Apply series in the Rx Manager. These locations become the prescribed
Locations] slice locations for that series. Slice locations already prescribed
are overwritten.
Pulls the start and end slice locations from a series in the Rx
Manager. The RAS coordinates of the start/end locations are
[Retrieve
displayed below the [Set Start] and [Set End] buttons in the IGRx
Locations]
tools area. These locations can then be used to obtain real-time
images at those locations.
Saves the prescribed series in the Rx Manager. The series is then
[Save Series]
labeled as RXD in the Rx Manager.

When defining locations using the IGRx tools, consider the following:
• The start and end locations can be redefined by clicking the [Set Start] and [Set
End] buttons. If the start and end locations have been defined and one of the
buttons is clicked to redefine a location, the other location responds in one of the
following fashions.
– If the plane of the new location and the old location remain parallel, the old
location remains as defined.
– If the plane of the new location and the plane of the old location are consistent,
the old location is deleted. A message posts to notify you of this action.
• Start and end locations can be the same location. This may be done when the
locations are to be applied to a real-time series in the Rx Manager.
• When using the [Apply Locations] button, the applied start and end locations may
be rejected if the plane of the locations do not match the plane of the series to which
they are being applied. For example, locations can be applied oblique to oblique,
axial to axial, etc. An error message posts if an incompatibility exists.
• If the number of slice locations being applied (when using Apply Locations) exceeds
the maximum number of acquisitions for the selected series in the Rx Manager, an
error message results stating, Scn: Incompatible Scan Range. Apply
Ignored.
• When using the [Retrieve Locations] button, if the Rx Manager series does not
contain prescribed slices, the start and end coordinates remain clear.

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 Imaging Real Time

Prescribing Center Locations

When the [Rx Center] button is clicked during a RTCA, the IGRx tools allow image
locations to be defined from a center of the stack perspective (Figure 34-19).
Figure 34-19 Center IGRx Tools

Table 34-10 describes the tools available in Center IGRx.

Table 34-10 Center Tools and Descriptions

Tool Description
[Rx Start/End] Changes the IGRx tools area to the Rx Start/End mode.
[Rx Center] Accesses the Rx Center IGRx tools.
Saves the current position of the real-time image for use as the
center location for a series in the Rx Manager, or to be used to
[Set Center] acquire a real-time image at that location. The coordinates are
displayed and the current stack value is entered as the Stack
Thickness on the IGRx tools area.
Allows you to change the stack thickness after the [Set Center]
button has been clicked. Enter a new value in the Stack text box
[Set Thickness] and click the [Set Thickness] button. The stack value currently in
the Stack text box is entered as the Stack Thickness in the IGRx
tools area.
[Acquire Obtains a real-time image at the location displayed in the Rx
Center] Center tools area.

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 Imaging Real Time

Tool Description (Continued)

Sends the stack locations to the currently highlighted series in the
[Apply Rx Manager. These locations become the prescribed slice
Locations] locations for that series. Slice locations already prescribed are
overwritten.
Pulls the slice locations from a series in the Rx Manager. The
center slice of the series is used as the center of the stack and the
[Retrieve
thickness is based on the start/end locations of the series. The
Locations]
center location and thickness are displayed in the IGRx tools area
and can be used to obtain real-time images at those locations.
Saves the prescribed series in the Rx Manager. The series is
[Save Series]
labeled “RXD” in the Rx Manager.

When defining locations using the Center IGRx tools in RTCAs, consider the following:
• By convention, when the center slice and stack thickness are used to define
locations, the start location in that stack is the location nearest you in the Real Time
Viewer. The end location in the stack is the furthest away form you.
• It is possible for a stack to be applied to a series in the Rx Manager and a double
acquisition results for that series. For example, the series slice thickness is 5 mm,
spacing is 1 mm, and the maximum number of locations per acquisitions is 11. If the
applied stack is 80 mm thick, a double acquisition is required to scan the entire
stack. The series can only acquire 66 mm in a single acquisition.

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 Imaging Real Time

Review Tab
The Review tab is used to view and save real-time images residing in the Image Buffer.
Viewing images can be done in a cine-style, movie mode, or a single image at a time.
The defined image range determines the images available to be viewed.
Selecting the Review tab on the lower left corner of the Acquire Tab accesses the
Review tab. The Review tab takes longer to open as the Image Buffer becomes more
full. If the Review tab is selected while data acquisition is taking place, scanning
pauses. When the Review tab opens, the image displayed is the last image displayed
in the Main Viewer on the Acquire tab.
Figure 34-20 Review Tab

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 Imaging Real Time

Table 34-11 Review Tab Descriptions

Selection Description
Deletes all Bookmark thumbnails currently displayed. Note that
[Delete
bookmarks created on the Acquire tab are shown on the
Bookmarks]
Review tab. Individual bookmarks cannot be deleted.
The plane, location, and image contrast of the image currently in
[Add the Review tab viewer is saved as a bookmark thumbnail for
Bookmarks] later recall. Bookmarks can be created and deleted in both the
Acquire and Review tabs.
Pushes the image in the Main Viewer to the Scout Viewer (the
viewer directly under the [Define Scout] button). The new scout
[Define Scout]
is also applied to the Scout Viewer on the iDrive Pro Plus
Acquire Tab.
The plane, location, and image contrast of the image currently in
the Review tab viewer is saved as a Bookmark thumbnail for
[Book...]
later recall. Bookmarks can be created and deleted in both the
Acquire and Review tabs.
[Define New
Inactive on the Review tab.
Home]
Automatically pauses the real-time data acquisition when the
[Pause When
Real Time Image Buffer is full. The progress bar provides a
Full]
graphic display of the image buffer capacity.
Saves the image in the Review tab Main Viewer to the system
[Save Image] disk. When a saved image is displayed, the word “Saved” is
seen below this button.
Allows you to move through the images to change the image
Image Slider
currently displayed in the viewer.
Play Back
Button: Play Starts a movie in a forward play motion. The images are
Forward displayed in movie playback in ascending image number order,
starting at the first image in the defined range. The Image Slider
updates to reflect the image that is currently being viewed.

Play Back
Button:
Stop Play Stops the movie playback. You can also stop playback by
clicking the selected toggle that started play.

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 Imaging Real Time

Selection Description (Continued)

Play Back
Button: Play Starts a movie in a backward play motion. The images are
Backward displayed in movie playback in descending image number order,
starting at the last image number defined in the image range.
Play continues according to the temporal or spatial play mode.

Plays the movie images in a continuous loop from first to last.

When the end of the range is reached, play wraps to the first
[Temporal]
image again. For example, an image set consisting of four
images appears in the following order: 1, 2, 3, 4, 1, 2, 3, 4, etc.
Plays the movie images forward, then backward in a repeating
loop. Image play effectively recoils off the end of the range in a
[Spatial]
forward and backward direction. For example, an image range of
four images appears in the following order:1, 2, 3, 4, 3, 2, 1, etc.
Frames per Second (FPS) defines the rate of movie playback.
The valid range is 1 to 60 FPS. If you enter a value higher than
FPS
the system allows, the maximum allowed value of 60 is
displayed.
Defines the first image to be included in a range, or set of
[Set Range First]
images for displaying in movie mode.
Defines the last image to be included in a range, or set of images
[Set Range Last]
for displaying in movie mode.
[Full Displays all image annotation in the main viewer. Otherwise,
Annotation] only partial annotation is displayed.
Displays a line on the main image. The length and angle of the
[Measure
line can be adjusted by dragging either end. The line length and
Distance]
angle from vertical is displayed on the image.
Saves the range of images currently defined on the Review tab
[Save Range] to the system disk. When a saved image is displayed, the word
"Saved" is seen below the [Save Image] button.
Returns the display to the Acquire Tab and begins data
[Acquire at
acquisition at the image location currently displayed in the
Current]
Review tab Main Viewer.
[Acquire] Returns the display to the Acquire Tab.
Message Area
Displays messages at the bottom of the Review tab. Click the
button to display a message list for the current real-time session.

Exits the Review tab, stops the current real-time session, and
[Close]
returns to the Scan Rx Desktop.

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 Imaging Real Time

Review Images
Real-time images are not automatically saved to the system disk. The [Save Image]
button is used to save a single image to the disk when that image is displayed in the
Acquire tab Main Viewer, or via the [Save Image] or [Save Range] buttons on the
Review tab. When a saved image is displayed in the Review tab, the word "Saved"
appears below the [Save Image] button. This is not true when displaying images in the
Acquire tab.
Bookmarks in the Review tab cannot be used to initiate data acquisition as can be done
in the Acquire tab.
Annotation on the real-time image indicates the parameters with which that image was
acquired, including those parameters changed at the Acquire tab. Partial annotation
(Table 34-12) is displayed, unless you click the [Full Annotation] button.
Table 34-12 Partial Annotation Selections

Partial Annotation Selections

System
Hospital
Time
Magnification, Filtering, and Rotation Factors
PSD
Sequence Parameters
Slice Thickness and Spacing

Image Slider
Images currently in the Real Time Image Buffer can be displayed using the Image
Slider (Figure 34-21). The Image Slider is set to the number of the last real-time image
acquired before pausing. The image displayed on the viewer is the same image. The
slider can define or redefine the image range that is used for saving or playing real-time
images.
Figure 34-21 Image Slider

There are four ways to move through the images in the Review tab and select an image
number for display:
• Dragging the slider. As the slider moves, the image in the viewer updates to the
image on the slider.

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 Imaging Real Time

• Clicking the arrows at either end of the slider.

• Clicking the slider background. This displays the image associated with that point
on the slider.
• Pressing the Page Up and Page Down keys on the keyboard.
Within review, the operations of playing and saving images are applied to a single
defined range of images within the Image Buffer. The number of the image currently
shown in the viewer is labeled above the slider, as well as, on the image. At both ends
of the slider the range of images is also displayed. Upon entering the Review tab, the
range of images indicates all the images in the buffer. The image numbers shown
indicate how many images have been acquired during the real-time session; they may
be numbered in the hundreds or thousands.
The background of the slider is shaded to indicate the range of images defined by the
Set Range buttons. Initially, the background is completely shaded. If the range of
images is changed, only the area of the slider associated with the image range is
shaded. If an attempt is made to set the first image in the range to a value greater than
the currently defined last image in the range, the first and last images are swapped.

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 Imaging Real Time

Applications
Real-time imaging consists of a continuous high-temporal-resolution acquisition,
reconstruction, and display of low spatial resolution images. This allows you to
instantaneously view anatomy and interactively make contrast adjustments and
prescribe scan planes. Real-time imaging works well to monitor temporal physiological
events.
Use real-time imaging to:
• Navigate through patient anatomy for orientation.
• Rapidly localize anatomical landmarks of interest.
• Define the boundaries of an imaging region.
• Localize complex anatomy or anatomical anomalies that lie in double oblique
planes.
• Monitor temporal events such as the passage of a contrast timing bolus.
• Image dynamic joint studies.
• Know what the scan looks like before investing the scan time.

Troubleshooting Tips
The following section gives you tips for troubleshooting errors when scanning RTCAs
with iDrive Pro Plus.
If you click the [Scan] button too quickly following pressing the Stop Scan hard key and
closing the RTCA interface, iDrive is not prepared to begin data acquisition. An error
message posts, Prep action failed, please try again.
For example, the following scenario may result in the failure to start a real-time data
acquisition.
1. A real-time acquisition is paused by selecting the [Pause Scan] button at the
Acquire tab.
2. The Stop Scan hard key on the keyboard is pressed.
3. The [Close] button is selected at the Acquire tab and the Real Time interface
closes.
4. The [Scan] button is clicked at the Scan Rx Desktop quickly after the Real Time
interface closes.
At this time, the real-time data acquisition should be initiated. Instead, the error
message posts because iDrive is not ready to begin the data acquisition.

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 Imaging Real Time

Error messages posted in the message log also include:

• Proc: scn Error: XXXXXXXXXX
• Unexpected allocDone packet received from IFCC for sequence
number XX. Proc: NSP Error: XXXXXXXXXX
• An unexpected CERD Network packet was received by ASC Data
Acquisition during acquisition.
• Internal software error, please retry the acquisition!
Should it be necessary for you to stop a scan and close iDrive as stated in the steps
above, it is recommended the real-time series be copied and pasted and the data
acquisition be started from the new series. Alternatively, wait a period of time before
selecting the [Scan] button and re-starting the real-time acquisition. The exact amount
of time needed for iDrive to be ready is not known. It is recommended that you wait at
least five seconds before restarting the acquisition.
NOTE: IVI, FuncTool, Reformat, and 3D should be closed when returning to the Scan
Rx Desktop to scan with iDrive. Should these features remain open, the
application will shut down automatically when iDrive is opened.
This occurs due to system allocation restrictions. iDrive can not be open
concurrently with high level display functions.

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How Do I...
This section provides the step-by-step instructions for imaging real-time with iDrive Pro
Plus. Specifically, it describes how to:
• Prescribe a Real Time Sequence
• Use the Movement Tools
– Drive Through an Image Volume
– Step Through an Image Volume
• Manage Home Images
– Define a Scan Plane
– Define New Home Images
• Manage Bookmarks
– Create a Bookmark
– Recall a Bookmark
– Enlarge a Thumbnail to Apply for Scan
• Adjust Image Contrast
• Use the Graphic Tools
– Change the FOV Center
– Draw a Line in the Main Viewer
– Draw a Line in the Scout Viewer
– Draw a Line in the Multi-Slice Mode
– Apply the 2 Point Tool
– Apply the 3 Point Tool
• Prescribe Series Locations
• Time a Bolus
• Review Real Time Images
– Playback Images
– Save Images
• Scan a 3-Plane Localizer
• Scan Complex Anatomy
NOTE: Close all other applications, such as the viewers, Reformat, 3D, Edit Patient,
Add/Sub, MIROI, IVI, Func Tool, and Clari View before starting iDrive. Allowing
these applications to remain open could significantly affect iDrive performance.

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 Imaging Real Time

Prescribe a Real Time Sequence

The Real Time Imaging Option can be used for real-time acquisitions to navigate
through your patient’s anatomy for rapid visualization and monitoring of temporal
physiological events. Real-time images can also be used for prescribing scan planes of
other series in the examination.
Use this procedure to prescribe a real-time sequence. The pulse sequence you select
determines which values in each area need entered. You need to enter a value in all
active fields.
1. Click [New Series] in the Rx Manager.
2. Enter the Patient Position parameters.
Š Patient Position
Š Patient Entry
Š Coil
– Real Time is compatible with all coils.
– The use of a phased array coil may decrease the frame rate as compared to a
single receive coil.
Š Series Description
3. Enter the Imaging Parameters.
Š Plane
– Real Time can be initiated in any orthogonal plane.
– Oblique planes may be prescribed using an explicit coordinate entry or from
localizer images using Graphic Rx tools.
Š Mode
– 2D is the only valid mode with Real Time.
Š Gradient Mode
– Real Time is compatible with any gradient mode.
Š Pulse Sequence
– PSDs available : Fast GRE, and Fast SPGR, Fast GRE ET, Spiral GRE, and
Spiral SPGR
Š Imaging Options
– Real Time must be selected to enter the feature.
– Other compatible options are Flow Compensation and No Phase Wrap.

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 Imaging Real Time

4. Enter the Scan Timing parameters.

Š TE
Š TR
Š Flip Angle
Š Echo Train Length
Š Bandwidth
5. Enter the Scanning Range parameters.
Š FOV
Š Slice Thickness
– This value can be changed during iDrive Pro Plus data acquisitions.
Š Start and End Locations
– Only one slice location is allowed for real-time sequences.
6. Enter the Acquisition Timing parameters.
Š Frequency Matrix or Points
Š Phase Matrix or Arms
Š Phase FOV
Š Freq DIR
Š Auto Center Frequency
7. Click [Save Series].
Š The scan prescription screen closes and the series is saved in the Rx Manager
as RXD (prescribed).
8. Click [Prepare to Scan].
Š The series is downloaded.
9. Click [Scan].
Š Auto Prescan is initiated and the Acquire Tab opens.
Š The Home Images are acquired.

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 Imaging Real Time

Quick Steps: Prescribe a Real Time Sequence

1. Click [New Series] in the Rx Manager.
2. Enter the Patient Position parameters.
3. Enter the Imaging Parameters.
4. Enter the Scan Timing parameters.
5. Enter the Scanning Range parameters.
6. Enter the Acquisition Timing parameters.
7. Click [Save Series].
8. Click [Prepare to Scan].
9. Click [Scan].

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Use the Movement Tools

Drive Through an Image Volume
The scan plane of your RTCA can be manipulated and you can navigate through an
image volume using the Movement Tools. Each movement tool is activated by an
on-image icon on the Real Time Main Viewer. RTCAs begin in the Drive Mode with the
Translate tool active.
1. Move the mouse over the real-time image in the Main Viewer until the cursor
changes shape.
2. Click in the Tool Selection area of desired tool.
Š The cursor icon indicates the function of the tool.
– Clicking in the upper-left corner of the viewport activates the Pan tool to scroll
the image in the X and Y directions.
– Clicking in the upper-right corner of the viewport activates the Rotate tool to
turn the image in a clockwise or counter-clockwise motion.
– Clicking in the lower-left corner of the viewport activates the Tilt tool to roll the
image in the direction of the arrow on the cursor.
– Clicking in the lower-right corner of the viewport activates the Translate tool to
move forward/backward the image along the Z axis, tilting the image away
from you.
3. Click and drag on the real-time image in the Main Viewer.
Š Your cursor indicates the direction of movement by
displaying the icon associated with that tool accessed
in that corner and the image moves in the direction of
the cursor.
Š The extent of movement is annotated in the
lower-right corner of the real-time image.
4. Release the mouse button to update the scan plane of
the real-time image.
Š There will be a short delay before the image moves.
NOTE: Click [Undo] to cancel the location changes all the way back to the start of motion,
at the last mouse click.

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 Imaging Real Time

Quick Steps: Use the Movement Tools – Drive Through an Image Volume
1. Move the mouse over the real-time image in the Main Viewer until the cursor
changes shape.
2. Click in the Tool Selection area of desired tool.
3. Click and drag on the real-time image in the Main Viewer.
4. Release the mouse button to update the scan plane of the real-time image.

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 Imaging Real Time

Use the Movement Tools

Step Through an Image Volume
The scan plane can also be manipulated using the Movement Tools accessed in the
Step Mode for RTCAs in iDrive Pro Plus. In the Step mode, the cursor indicates the
direction of movement, but movement direction changes depending on the location of
the cursor in the Main Viewer.
1. Click [Step].
Š Your cursor location determines the direction of movement.
Š The movement direction changes when a specific tool is used at that point on the
image.
2. Click in the Tool Selection area of desired tool.
Š The cursor indicates the direction of motion
that will be induced.
3. Click and hold on the real-time image in the
Main Viewer.
Š An on-image counter is displayed, indicating
the millimeters or degrees of the scan plane
change that takes place as long as the
mouse button is held down.
Š Click in one of the twelve zones on the
image in the Main Viewer.
– Activates the Pan and Tilt tools to move the image in the X and Y directions
based on the value in the mm or the degrees text box, respectively.
Š Click in the right-half of the Main Viewer to move clockwise or in the left-half to
move counter-clockwise.
– Activates the Rotate tool to turn the image based on the value set in the
degrees text box.
Š Click in the upper-half of the Main Viewer to move the image away from you or in
the lower-half to move the image toward you.
– Activates the Translate tool to move forward/backward the image along the Z
axis, moving the image away or toward you based on the value set in the mm
text box.
4. Release the mouse button to update the scan plane of the real-time image.
Š The value on the counter is applied to move the scan plane of the real-time
image that amount.
NOTE: Click [Undo] to cancel the location changes all the way back to last mouse click.

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 Imaging Real Time

Quick Steps: Use the Movement Tools – Step Through an Image Volume
1. Click [Step].
2. Click in the Tool Selection area of desired tool.
3. Click and hold on the real-time image in the Main Viewer.
4. Release the mouse button to update the scan plane of the real-time image.

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 Imaging Real Time

Manage Home Images

Define a Scan Plane
Home Images are the three orthogonal images acquired upon initialization of a real-time
series that are displayed in the vertical viewers along the right side of the Acquire Tab
Main Viewer. The Home Images are created axially, sagittally, and coronally, based on
the locations prescribed at the Scan Rx Desktop during the real-time series
prescription. These images can be used to define an orthogonal scan plane and reset
your current scan plane.
Use this procedure to define a scan plane based on the Home Images.
1. Prescribe a real-time sequence.
2. Click [Scan].
Š The iDrive and iDrive Pro Plus Acquire Tab or the iDrive Pro Plus Acquire Tab
opens., depending on your software configuration.
Š The Home Images are acquired.
3. Click one of the Home Images.
Š The system obtains a real-time image in the scan plane of the selected Home
Image.

Quick Steps: Manage Home Images – Define a Scan Plane

1. Prescribe a real-time sequence.
2. Click [Scan].
3. Click one of the Home Images.

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Manage Home Images

Define New Home Images
Home Images are the three orthogonal images acquired upon initialization of a real-time
series that are displayed in the vertical viewers along the right side of the Acquire Tab
Main Viewer. The Home Images are created axially, sagittally, and coronally, based on
the locations prescribed at the Scan Rx Desktop during the real-time series
prescription. You have the ability to define new Home Images.
Use this procedure to replace your Home Images with new images at the desired at the
location of the current real-time image.
1. Display the desired real-time image in the Main Viewer.
Š Use the Movement Tools, if necessary.
2. Click [Define New Home] in the top-right corner of the Acquire tab.
Š The system informs you that if you define new Home Images, your current home
locations will be replaced.
3. Click [OK].
Š The system acquires and displays three new Home Images.
– The images are perpendicular to the location of the real-time image in the
Main Viewer.
– The images include the RAS offsets of the real-time image in the Main Viewer.

Quick Steps: Manage Home Images – Define New Home Images

1. Display the desired real-time image in the Main Viewer.
2. Click [Define New Home] in the top-right corner of the Acquire tab.
3. Click [OK].

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 Imaging Real Time

Manage Bookmarks
Create a Bookmark
Real-time images can be saved as a Bookmark to recall at a later time. A bookmarked
thumbnail obtains the scan plane and image contrast from that image and stores it in
the Bookmark Viewers ( iDrive Pro Plus Bookmark Viewers).
Use this procedure to create a Bookmark.
1. Display the desired real-time image in the Main Viewer.
Š Use the Movement Tools, if necessary.
2. Click [Add Bookmark].
Š A bookmark thumbnail of the current image is created in the Main Viewer.
NOTE: If all Thumbnail Viewers are filled, a message posts, telling you to right-click an
occupied Bookmark to replace the thumbnail image with the current image in the
Main Viewer.

Quick Steps: Manage Bookmarks – Create a Bookmark

1. Display the desired real-time image in the Main Viewer.
2. Click [Add Bookmark].

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Manage Bookmarks
Recall a Bookmark
A recall can be performed on a Bookmark to obtain the scan plane and image contrast
from that image. The bookmarks are held in the Acquire Tab when the current real-time
session is closed and upon re-entry into the real-time acquisition, those bookmark
thumbnails are displayed as long as the Patient ID, Landmark, and Patient Position
have not changed.
Use this procedure to recall a Bookmark.
1. Click [Scan].
Š The iDrive Pro Plus Acquire Tab opens., depending on your software
configuration.
2. Click the desired bookmark thumbnail image.
Š The system scans the new image based on the scan plane and image contrast of
the thumbnail image.

Quick Steps: Manage Bookmarks – Recall a Bookmark

1. Click [Scan].
2. Click the desired bookmark thumbnail image.

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Manage Bookmarks
Enlarge a Thumbnail to Apply for Scan
A single Bookmark thumbnail image acquired during a RTCA with iDrive Pro Plus can
be enlarged from a 64x64 to 128x128 pixel display. This enlarged thumbnail can be
applied for scanning in the Real Time Main Viewer.
Use this procedure, while the iDrive Pro Plus Acquire Tab is opened, to enlarge a
bookmark thumbnail to apply for scanning.
1. Place the cursor over the desired thumbnail image.
Š Leave cursor over thumbnail for at least one second.
– The image enlarges.

Š The thumbnail image returns to its original size when the cursor is moved off the
Thumbnail Viewer.
2. Click the enlarged image.
Š The system begins scanning the image.

Quick Steps: Manage Bookmarks – Enlarge a Thumbnail to Apply for Scan

1. Place the cursor over the desired thumbnail image.
2. Click the enlarged image.

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 Imaging Real Time

Adjust Image Contrast

You may need to adjust the real-time image contrast to better visualize the anatomy.
These steps explain how to manipulate image contrast by using different pulse
sequences and imaging options.
1. Click [SPGR] to switch between Fast GRE and Fast SPGR or Spiral GRE and
Spiral SPGR.
Š GRE accentuates T2/T2* contrast.
Š SPGR accentuates T1 contrast.
NOTE: A window without a message opens when you Copy/Paste a RTIA prescription
and change the PSD from Fast GRE to Fast SPGR. Click [OK] and you can
proceed with the prescription.
2. Select additional types of contrast altering techniques from the Contrast Tools with
Fast GRE sequences.
Š Click [FatSAT] to suppress the signal from fat with Fast GRE sequences.
Š Click [SAT] to reduce flow artifacts and obtain black flow information. Two SAT
bands are applied, parallel to the slice.
Š Click [FC] to reduce flow artifacts and obtain bright flow information. Flow
Compensation and Spatial Saturation can be used together.
– Flow that receives a SAT pulse before entering the image volume remains
black because it has no signal to rephase.
– Flow that does not receive a SAT pulse before entering the imaging volume is
bright due to gradient re-phasing.
Š Click [IR] to apply a single shot inversion pulse. The system applies one 180° RF
pulse.
NOTE: The use of the [FatSAT], [SAT], and [FC] buttons slow down image acquisition.
As you increase number of options, you decrease frame rate.

Quick Steps: Adjust Image Contrast

1. Click [SPGR] to switch between Fast GRE and Fast SPGR or Spiral GRE and
Spiral SPGR.
2. Select additional types of contrast altering techniques from the Contrast Tools with
Fast GRE sequences.

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 Imaging Real Time

Use the Graphic Tools

Change the FOV Center
The Graphic Tools provide a means by which you can define a new real-time image
location. The Center tool in changes the FOV center of the real-time image of a RTCA
to a new location. This Graphic tool is located in the Tool area of the iDrive Pro Plus
Acquire Tab.
Use this procedure to change the FOV center of the real-time image to the location of a
cursor placed on the real-time image.
1. Display the desired real-time image in the Main Viewer.
Š Use the Movement Tools, if necessary.
2. Click [Center].
3. Place the cursor at the desired FOV center.
Š This point will be the center of your new image location.
4. Click the real-time image.
Š The real-time image is updated to reflect the new FOV center at the point of the
cursor.
NOTE: The Center tool turns off automatically.

Quick Steps: Use the Graphic Tools – Change the FOV Center
1. Display the desired real-time image in the Main Viewer.
2. Click [Center].
3. Place the cursor at the desired FOV center.
4. Click the real-time image.

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Use the Graphic Tools

Draw a Line in the Main Viewer
The Draw Line tool allows you to draw a line on the current real-time image in the Main
Viewer to acquire an image at the plane of the line. The Graphic Tools are located in the
Tool area of the iDrive and iDrive Pro Plus Acquire Tab or the iDrive Acquire Tab.
Use this procedure to draw a line on the real-time image in the Main Viewer to define a
new scan plane.
1. Display the desired real-time image in the Main Viewer.
Š Use the Movement tools, if necessary.
2. Click [Draw Line].
Š A line appears on the image in the Main Viewer.
– If a line does not appear, click on the
real-time image.
3. Move the line to the desired position.
Š Click and drag the middle handle of the line.
– The line moves in the horizontal and vertical directions.
4. Rotate the line to the desired position.
Š Click and drag one of the circle handles of the line.
– The line rotates clockwise or counter-clockwise.
5. Click [GO].
Š Alternatively, you may right-click anywhere on the real-time image.
Š An image is acquired at the plane defined by the line.
NOTE: Draw Line remains active until you toggle it off, or click another Graphic tool, or
a click on the Scout image.

Quick Steps: Use the Graphic Tools – Draw a Line in the Main Viewer
1. Display the desired real-time image in the Main Viewer.
2. Click [Draw Line].
3. Move the line to the desired position.
4. Rotate the line to the desired position.
5. Click [GO].

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 Imaging Real Time

Use the Graphic Tools

Draw a Line in the Scout Viewer
The Draw Line tool for the Scout Viewer in iDrive Pro Plus allows you to prescribe a
new acquisition plane orthogonal to the current Scout image. The Graphic Tools are
located in the Tool area of the iDrive Pro Plus Acquire Tab.
Use this procedure to draw a line on the real-time image in the Scout Viewer.
1. Display the desired real-time image in the Main Viewer.
Š Use the Movement Tools, if necessary.
2. Click [Define Scout].
Š The image in the Main Viewer is copied to the Scout Viewer.
3. Click [Draw Line].
4. Click the image in the Scout Viewer.
Š A line appears on the image in the Scout Viewer.
Š The real-time image scan plane moves to that location.
5. Click and drag the middle handle of the line to move the line to the desired position.
Š The line moves in the horizontal and vertical directions.
6. Click and drag one of the circle handles of the line to rotate the line to the desired
position.
Š The line rotates clockwise or counter-clockwise.
NOTE: Draw Line remains active until you toggle it off, click another Graphic tool, or a
click on the real-time image in the Main Viewer.

Quick Steps: Use the Graphic Tools – Draw a Line in the Scout Viewer
1. Display the desired real-time image in the Main Viewer.
2. Click [Define Scout].
3. Click [Draw Line].
4. Click the image in the Scout Viewer.
5. Click and drag the middle handle of the line to move the line to the desired
position.
6. Click and drag one of the circle handles of the line to rotate the line to the desired
position.

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 Imaging Real Time

Use the Graphic Tools

Draw a Line in the Multi-Slice Mode
Multi-Slice Mode is used to visualize the extent of a multiple slice (stack) RTCA in iDrive
Pro Plus. Drawing a line in the Multi-slice mode can be performed in the Main Viewer or
in the Scout Viewer. The Graphic Tools are located in the Tool area of the iDrive Pro
Plus Acquire Tab and the Stack option is located below the tools.
Use this procedure to draw a line in the Multi-slice mode to visualize the distance of a
multi-slice acquisition.
1. Display the desired real-time image in the Main Viewer.
Š Use the Movement tools, if necessary.
2. Select Stack.
Š The Multi-slice mode is enabled.
3. Click [Draw Line].
4. Click the image in the Main or Scout Viewer.
Š A line appears on the real-time image.
Š Two smaller line segments display (smaller than the main line).
– The small line segment with two notches at either end indicates the first slice
in the stack.
– The second small line segment indicates the last location of the stack.
5. Enter a value in the mm text box and press the Enter key.
Š Acceptable values are 10 to 100.
Š This value determines the distance between the two small line segments.

Quick Steps: Use the Graphic Tools – Draw a Line in the Multi-Slice Mode
1. Display the desired real-time image in the Main Viewer.
2. Select Stack.
3. Click [Draw Line].
4. Click the image in the Main or Scout Viewer.
5. Enter a value in the mm text box and press the Enter key.

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 Imaging Real Time

Use the Graphic Tools

Apply the 2 Point Tool
The 2 Point Tool allows you to define an acquisition plane by depositing two points on
the current real-time image or on two different real-time images. The plane resulting
from the two points is positioned midway between the points and orthogonal to the line
defined by the points. The Graphic Tools are located in the Tool area of the iDrive and
iDrive Pro Plus Acquire Tab or the iDrive Pro Plus Acquire Tab.
Use this procedure to define an acquisition plane perpendicular to a line deposited by
two points.
1. Display the desired real-time image in the Main Viewer.
Š Use the Movement Tools, if necessary.
2. Click [2 Point Tool].
Š Two toggle buttons appear.
– Point 1 (toggled on)
– Point 2
3. Place the cursor at the point you wish to deposit Point 1 on the real-time image.
4. Click the real-time image.
Š Point 1 is deposited.
Š The [Point 1] button is toggled off.
– Clicking [Point 1] again allows the point to be repositioned.
5. Navigate to the desired image plane for Point 2.
Š Use the Movement tools, if necessary.
6. Click [Point 2].
7. Place the cursor at the point you wish to deposit Point 2 on the real-time image.
8. Click the real-time image.
Š Point 2 is deposited.
Š An image is acquired perpendicular to the line connecting the two points and the
new image is displayed.
NOTE: The 2 Point Tool turns off automatically.

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 Imaging Real Time

Quick Steps: Use the Graphic Tools – Apply the 2 Point Tool
1. Display the desired real-time image in the Main Viewer.
2. Click [2 Point Tool].
3. Place the cursor at the point you wish to deposit Point 1 on the real-time image.
4. Click the real-time image.
5. Navigate to the desired image plane for Point 2.
6. Click [Point 2].
7. Place the cursor at the point you wish to deposit Point 2 on the real-time image.
8. Click the real-time image.

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 Imaging Real Time

Use the Graphic Tools

Apply the 3 Point Tool
The 3 Point Tool allows you to define an acquisition scan plane by depositing three
points at selected locations on one, two, or three images. The image plane resulting
from these three points contains all three points. The Graphic Tools are located in the
Tool area of the iDrive Pro Plus Acquire Tab.
Use this procedure to define a cut plane when you need to use more than one image
location and you want an image plane along the plane defined by the points.
1. Display the desired real-time image in the Main Viewer.
Š Use the Movement Tools, if necessary.
2. Click [3 Point Tool].
Š Three toggle buttons appear.
– Point 1 (defaults on)
– Point 2
– Point 3
3. Place the cursor at the point you wish to deposit Point 1 on the real-time image.
4. Click the real-time image.
Š Point 1 is deposited.
Š The [Point 1] button is toggled off.
– Clicking [Point 1] again allows the point to be repositioned.
5. Navigate to the desired image plane for Point 2.
Š Use the Movement tools, if necessary.
6. Click [Point 2].
7. Place the cursor at the point you wish to deposit Point 2 on the real-time image.
8. Click the real-time image.
Š Deposits Point 2.
Š The [Point 2] button is toggled off.
– Clicking [Point 2] again allows the point to be repositioned.
9. Navigate to the desired image plane for Point 3.
Š Use the Movement tools, if necessary.
10. Click [Point 3].

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 Imaging Real Time

11. Place the cursor at the point you wish to deposit Point 3 on the real-time image.
12. Click the real-time image.
Š Point 3 is deposited.
Š The new image is acquired and displayed.
NOTE: The 3 Point Tool turns off automatically.

Quick Steps: Use the Graphic Tools – Apply the 3 Point Tool
1. Display the desired real-time image in the Main Viewer.
2. Click [3 Point Tool].
3. Place the cursor at the point you wish to deposit Point 1 on the real-time image.
4. Click the real-time image.
5. Navigate to the desired image plane for Point 2.
6. Click [Point 2].
7. Place the cursor at the point you wish to deposit Point 2 on the real-time image.
8. Click the real-time image.
9. Navigate to the desired image plane for Point 3.
10. Click [Point 3].
11. Place the cursor at the point you wish to deposit Point 3 on the real-time image.
12. Click the real-time image.

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 Imaging Real Time

Prescribe Series Locations

You may want to use the exact same locations from the real-time images for
non-real-time imaging. The following steps help you prescribe the real-time start and
end locations for a series.
NOTE: The series needs to be in the Rx manager before the real-time series is started.
1. Access the prescription tools.
Š Click [Rx Start/End].
2. Use the Movement Tools to move through the image set.
Š Use the Pan, Rotate, Tilt, and Translate on-screen cursors with the Drive or
Step mode.
Š To recall start and end positions from a different series, select the series and
click [Retrieve Locations]. Then go to step 6.
3. Move the real-time image location to the desired start location and click [Set Start].
4. Move the real-time image to the desired end location and click [Set End].
Š Click [Apply at Start] to re-check the start location and click [Apply at End] to
re-check the end location.
5. Select the desired series from the Rx Manager.
Š You can load orthogonal or oblique scan locations into an oblique series, but you
cannot load oblique scan locations into an orthogonal series.
6. Click [Apply Locations].
Š The protocol to which you are linking (series) should be oblique and a non-iDrive
scan. If you do not see [Applied Locations], check to see that you have an
oblique series.
7. Click [Save Series].
Š The series is saved in the Rx Manager as RXD.
Š The number of slice locations and acquisitions are posted on the Acquire tab.

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Quick Steps: Prescribe Series Locations

1. Access the prescription tools.
2. Use the Movement Tools to move through the image set.
3. Move the real-time image location to the desired start location and click [Set Start].
4. Move the real-time image to the desired end location and click [Set End].
5. Select the desired series from the Rx Manager.
6. Click [Apply Locations].
7. Click [Save Series].

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 Imaging Real Time

Time a Bolus
Real-time imaging can be used to monitor temporal events such as the passage of a
contrast timing bolus. Use this procedure to accurately time when the bolus arrives with
real-time imaging.
Define the appropriate real-time location.
Š Use the Graphic Tools to help you locate your desired area of interest.
1. Click [Pause When Full].
Š This allows the real-time data acquisition to automatically pause when the Real
Time Image Buffer is full.
2. Click [SAT] to suppress bright flow signal.
Š A spatial SAT is applied in the slice-select direction.
3. Simultaneously inject a test bolus of contrast and click [Timer].
Š The scan continues while monitoring the images for contrast uptake.
Š The amount of the test bolus should be prescribed by a physician.
4. Click [Pause Scanning] after the contrast has washed out.
5. Select the Review tab.
6. Review the time stamped on the images to determine the scan delay time for a
dynamic bolus injection series.
Š This time is generally based on when the contrast is first seen on the image.
NOTE: Do not allow real-time imaging to pause scanning for more than 15 minutes. If
you think this will happen (e.g., you are reviewing and saving images from the
Review tab), apply locations to a series in the Rx Manager to ensure that the
slice locations are saved.
During a real-time session, if scanning is paused for more than 15 minutes, the
gradients and RF amplifier go into a standby mode and scanning cannot be
resumed. The real-time slice locations can be lost when the system is in standby
and you are in the Review tab or you enter the Review tab while the system is
in standby.

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Quick Steps: Time a Bolus

1. Define the appropriate real-time location.
2. Click [Pause When Full].
3. Click [SAT] to suppress bright flow signal.
4. Simultaneously inject a test bolus of contrast and click [Timer].
5. Click [Pause Scanning] after the contrast has washed out.
6. Select the Review tab.
7. Review the time stamped on the images to determine the scan delay time for a
dynamic bolus injection series.

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 Imaging Real Time

Review Real Time Images

Playback Images
Real-time images residing in the Image Buffer can be viewed in the Review Tab.
Images can be viewed cine-style, in a movie mode, or by a single image at a time. The
Review tab is accessed on the lower left corner of the Acquire tab and can be opened
while scanning is taking place.
Use this procedure to playback images in the Image Buffer.
1. Click the Review tab.
Š Scanning pauses and the Review tab opens.
2. Define the range of images for movie playback.
Š All images in the buffer can be viewed. If this is desired, continue with step 3.
a) Click and drag the Image Slider to the first image.
b) Click [Set Range First].
c) Click and drag the Image Slider to the last image.
d) Click [Set Range Last].
3. Select the movie mode.
Š Click [Temporal] to play images in a continuous loop.
Š Click [Spatial] to play images forward, then backward.
4. Enter a value in the FPS text box.
Š FPS defines the rate of movie playback.
Š Valid entries are 1 to 60.
5. Click the Play Forward or the Play Backward icon.
Š This starts movie playback in ascending or descending order, respectively.

6. Click the Stop icon to stop movie playback.

Š At this point, another range of images can be defined.

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Quick Steps: Review Real Time Images – Playback Images

1. Click the Review tab.
2. Define the range of images for movie playback.
3. Select the movie mode.
4. Enter a value in the FPS text box.
5. Click the Play Forward or the Play Backward icon.
6. Click the Stop icon to stop movie playback.

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 Imaging Real Time

Review Real Time Images

Save Images
Real-time images are not automatically saved to the system disk. Real-time images
residing in the Image Buffer can be saved in the Review Tab. An image group or a
single image can be saved at one time. The Review tab is accessed on the lower left
corner of the Acquire tab and can be opened while scanning is taking place.
Use this procedure to save images in the Image Buffer.
1. Click the Review tab.
Š Scanning pauses and the Review tab opens.
2. Define the range of images for saving.
Š All images in the buffer can be saved. If this is desired, continue with step 3.
a)Click and drag the Image Slider to the first image.
b)Click [Set Range First].
c)Click and drag the Image Slider to the last image.
d)Click [Set Range Last].
3. Click [Save Range].
Š A confirmation message appears showing the number of images to be saved.
Š The images are saved to the Browser list.
Š Alternatively, images can be saved one at a time by the following method:
a)Display images in the viewer.
b)Click [Save Image].
NOTE: Do not save more than 999 real-time images. System performance is not
guaranteed when more than 999 real-time images are saved.
When more than 999 real-time images are saved to the Signa® image database,
the Browser and viewer performance are affected. The system performance may
dramatically slowdown. In addition, image transfer problems are likely to occur
when sending images to systems on the Genesis (non-LX or MR/i) platform.

Quick Steps: Review Real Time Images – Save Images

1. Click the Review tab.
2. Define the range of images for saving.
3. Click [Save Range].

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 Imaging Real Time

Scan a 3-Plane Localizer

In addition to selecting 3-Plane Loc from the Scan Rx Desktop, real-time imaging can
be a quick method to obtain a customized 3-Plane Localizer.
Use this procedure to obtain a 3-Plane Localizer with real-time imaging.
1. Start the real-time series in an axial plane.
2. Use the Movement Tools to drive the level of anatomy of interest.
Š In iDrive Pro click [Tilt/Translate].
Š In iDrive Pro Plus use the Pan, Rotate, Tilt, and Translate on-screen cursors
with the Drive or Step mode.
3. Acquire three optimized double or single oblique localizer images.
4. Click [Save Image] to save each image.
Š The [Save Image] option in real-time imaging is only available in iDrive Pro and
iDrive Pro Plus.
5. Click [Close] to exit the real-time application.
6. Use the real-time localizer images for prescribing regular graphic prescriptions.

Quick Steps: Scan a 3-Plane Localizer

1. Start the real-time series in an axial plane.
2. Use the Movement Tools to drive the level of anatomy of interest.
3. Acquire three optimized double or single oblique localizer images.
4. Click [Save Image] to save each image.
5. Click [Close] to exit the real-time application.
6. Use the real-time localizer images for prescribing regular graphic prescriptions.

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 Imaging Real Time

Scan Complex Anatomy

IAC Application
This application acquires direct axial and coronal planes to symmetrically image the
Internal Auditory Canals (IACs) bilaterally. The imaging sequences recommended to
use include: an oblique axial T1, an oblique axial 3D Fast Spin Echo (FSE), and an
oblique coronal T1.
NOTE: If you open the Graphic Rx window during real-time imaging, all locations are lost.
1. Start the real-time series in an axial plane.
2. Use the Movement Tools to move through the image set.
Š Use the Pan, Rotate, Tilt, and Translate on-screen cursors with the Drive or
Step mode.
3. Drive inferior or superior to the level of the IAC.
4. Click [Draw Line] and draw a line parallel to the IAC from right to left.
Š The resulting image is a direct coronal plane.
5. Click [Bookmark] to recall this image at a later time.
6. Determine the scanning range for oblique coronal T1 series.
a) Click [Rx Locations].
b) Use the Movement tools and drive posterior 20 mm.
c) At desired start location, click [Set Start].
d) Drive anterior 40 mm and click [Set End].
7. Select the oblique coronal T1 series in Rx Manager and click [Apply Locations].
8. Click [Save Series].
9. Retrieve the bookmarked coronal image of the IAC.
10. Click [Draw Line] and draw a line parallel through the IAC from right to left.
Š The resulting image is a direct axial plane.
11. Click [Bookmark].
12. Determine the scanning range for the oblique axial T1 series.
a) Use the Movement tools and drive inferior 20 mm.
b) At desired start location, click [Set Start].
c) Drive superior 40 mm and click [Set End].
13. Select the oblique axial T1 series from the Rx Manager and click [Apply
Locations].

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 Imaging Real Time

14. Click [Save Series].

15. Retrieve the axial bookmarked image.
16. Determine the scanning range for the oblique 3D FSE series.
a) Change the Translate or Step increment to 15 mm.
b) Drive inferior, click once and then click [Set Start].
c) Drive superior, click twice, and then click [Set End].
17. Select the oblique 3D FSE series in the Rx Manager and click [Apply Locations].
18. Click [Save Series].
19. Click [Close] to stop the real-time session, review each series, and begin scanning.

Quick Steps: Scan Complex Anatomy – IAC Application

1. Start the real-time series in an axial plane.
2. Use the Movement Tools to move through the image set.
3. Drive inferior or superior to the level of the IAC.
4. Click [Draw Line] and draw a line parallel to the IAC from right to left.
5. Click [Bookmark] to recall this image at a later time.
6. Determine the scanning range for oblique coronal T1 series.
7. Select the oblique coronal T1 series in Rx Manager and click [Apply Locations].
8. Click [Save Series].
9. Retrieve the bookmarked coronal image of the IAC.
10. Click [Draw Line] and draw a line parallel through the IAC from right to left.
11. Click [Bookmark].
12. Determine the scanning range for the oblique axial T1 series.
13. Select the oblique axial T1 series from the Rx Manager and click [Apply
Locations].
14. Click [Save Series].
15. Retrieve the axial bookmarked image.
16. Determine the scanning range for the oblique 3D FSE series.
17. Select the oblique 3D FSE series in the Rx Manager and click [Apply Locations].
18. Click [Save Series].
19. Click [Close] to stop the real-time session, review each series, and begin
scanning.

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 Imaging Real Time

Scan Complex Anatomy

Orbit Application
This application acquires an oblique axial plane to image the optic nerves. Use an
oblique axial Fast Spin Echo - Inversion Recovery (FSE-IR) series to obtain the images.
1. Start the real-time series in a sagittal plane.
2. Use the Movement Tools to drive left or right to visualize the optic nerve.
Š Use the Pan, Rotate, Tilt, and Translate on-screen cursors with the Drive or
Step mode.
3. Once the optic nerve is in view, click [Bookmark].
4. Click [Draw Line] and draw a line parallel to the optic nerve.
Š The resulting image is an oblique sagittal.
5. Click [Center] to re-center (fallback) the image.
Š The center of the image should be on the optic chiasm.
6. Click [Bookmark].
7. Determine the scanning range for the oblique axial FSE-IR
series.
a) Click [Rx Locations].
b) Change the Translate or Step value to 5 mm.
c) Drive inferior to the lower orbital rim and click [Set Start].
d) Drive superior to the upper orbital rim and click [Set End].
8. Select the oblique axial FSE-IR series in the Rx Manager and click [Apply
Locations].
9. Click [Save Series].
Š The series is saved in the Rx Manager as RXD.
10. Click [Close] to stop the real-time session, review each series, and begin scanning.

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Quick Steps: Scan Complex Anatomy – Orbit Application

1. Start the real-time series in a sagittal plane.
2. Use the Movement Tools to drive left or right to visualize the optic nerve.
3. Once the optic nerve is in view, click [Bookmark].
4. Click [Draw Line] and draw a line parallel to the optic nerve.
5. Click [Center] to re-center (fallback) the image.
6. Click [Bookmark].
7. Determine the scanning range for the oblique axial FSE-IR series.
8. Select the oblique axial FSE-IR series in the Rx Manager and click [Apply
Locations].
9. Click [Save Series].
10. Click [Close] to stop the real-time session, review each series, and begin
scanning.

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Scan Complex Anatomy

TMJ Application
This application acquires oblique coronal and sagittal planes to image the
temporomandibular joint (TMJ) for T1 and kinematic acquisitions. This application uses
an oblique coronal T1, oblique sagittal FSE Proton Density (PD), and a Fast GRE
sequence to obtain the images.
1. Select the real-time series in an axial plane.
2. Use the Movement Tools to drive inferior or superior to visualize the mandibular
condyle.
Š Use the Pan, Rotate, Tilt, and Translate on-screen cursors with the Drive or
Step mode.
3. Click [Bookmark].
Š This axial image will be used in step 9 to obtain a sagittal image.
4. Click [Draw Line] and draw a line parallel to the mandibular condyles.
Š The resulting image is an oblique coronal.
5. Click [Bookmark].
6. Determine the scanning range to cover the TMJ.
a) Click [Rx Locations].
b) Change the Translate or Step value to 5 mm.
c) Drive to the posterior limit of the TMJ and click [Set Start].
d) Drive anterior to the limit of the TMJ and click [Set End].
7. Select the oblique coronal T1 series in the Rx Manager and click [Apply
Locations].
8. Click [Save Series].
9. Retrieve the axial bookmarked image.
10. Click [Draw Line] and draw a parallel line on the mandibular body.
Š The resulting image is an oblique sagittal.
11. Click [Bookmark].
Š This sagittal image will be used in step 15 to prescribe the kinematic GRE series.

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 Imaging Real Time

12. Determine the scanning range for the oblique sagittal FSE PD.
a) Change the Translate or Step value to 3 mm.
b) Drive lateral and click [Set Start].
c) Drive medial and click [Set End].
13. Select the sagittal FSE PD series in the Rx Manager and click [Apply Locations].
14. Click [Save Series].
15. Retrieve the sagittal bookmarked image.
16. Determine the scanning range for the oblique sagittal kinematic GRE series.
a) Drive medial or lateral, whichever is best to view the TMJ, and click [Set Start].
b) Drive back until out of the TMJ and click [Set End].
17. Select the kinematic GRE series in the Rx Manager and click [Apply Locations].
18. Click [Save Series].
19. Click [Close] to end the real-time session, review each series, and begin scanning.

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 Imaging Real Time

Quick Steps: Scan Complex Anatomy – TMJ Application

1. Select the real-time series in an axial plane.
2. Use the Movement Tools to drive inferior or superior to visualize the mandibular
condyle.
3. Click [Bookmark].
4. Click [Draw Line] and draw a line parallel to the mandibular condyles.
5. Click [Bookmark].
6. Determine the scanning range to cover the TMJ.
7. Select the oblique coronal T1 series in the Rx Manager and click [Apply
Locations].
8. Click [Save Series].
9. Retrieve the axial bookmarked image.
10. Click [Draw Line] and draw a parallel line on the mandibular body.
11. Click [Bookmark].
12. Determine the scanning range for the oblique sagittal FSE PD.
13. Select the sagittal FSE PD series in the Rx Manager and click [Apply Locations].
14. Click [Save Series].
15. Retrieve the sagittal bookmarked image.
16. Determine the scanning range for the oblique sagittal kinematic GRE series.
17. Select the kinematic GRE series in the Rx Manager and click [Apply Locations].
18. Click [Save Series].
19. Click [Close] to end the real-time session, review each series, and begin scanning.

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 Imaging Real Time

Scan Complex Anatomy

Spine Application
This application acquires an oblique sagittal plane to demonstrate the intervertebral
foramen in a T2-weighted FSE sequence. Use the oblique sagittal FSE series to obtain
the images in real-time imaging.
1. Start the real-time series in an axial plane.
2. Use the Movement Tools to drive inferior or superior to visualize the mid C4-5
vertebral bodies.
Š Use the Pan, Rotate, Tilt, and Translate on-screen cursors with the Drive or
Step mode.
3. Click [Bookmark].
4. Click [Draw Line] to define a line through the vertebral foramen/lateral mass at a
45° angle off from the coronal.
5. Click [Bookmark].
6. Determine the scanning range for the sagittal spine series.
a) Click [Rx Locations].
b) Change the Translate or Step value to 4 mm.
c) Drive posterior to the limit of the spinal canal and click [Set Start].
d) Drive anterior to the opposite limit and click [Set End].
7. Select the oblique sagittal FSE series in the Rx Manager and click
[Apply Locations].
8. Click [Save Series].
Š The series is saved in the Rx Manager as RXD.
9. Click [Close] to end the real-time session, review the series, and begin scanning.

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Quick Steps: Scan Complex Anatomy – Spine Application

1. Start the real-time series in an axial plane.
2. Use the Movement Tools to drive inferior or superior to visualize the mid C4-5
vertebral bodies.
3. Click [Bookmark].
4. Click [Draw Line] to define a line through the vertebral foramen/lateral mass at a
45° angle off from the coronal.
5. Click [Bookmark].
6. Determine the scanning range for the sagittal spine series.
7. Select the oblique sagittal FSE series in the Rx Manager and click
[Apply Locations].
8. Click [Save Series].
9. Click [Close] to end the real-time session, review the series, and begin scanning.

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Scan Complex Anatomy

Knee Application
This application acquires an oblique sagittal plane to optimize the Anterior Cruciate
Ligament (ACL) in real-time knee imaging. This application uses an oblique sagittal T2
series to obtain images of the ACL in plane.
1. Start the real-time series in an axial plane.
2. Use the Movement Tools to drive inferior or superior to visualize the inter-condylar
fossa.
Š Use the Pan, Rotate, Tilt, and Translate on-screen cursors with the Drive or
Step mode.
3. Click [Bookmark].
4. Click [Draw Line] and define a line bisecting the inter-condylar fossa and parallel to
the lateral femoral condyle.
Š The resulting image is an oblique sagittal.
5. Click [Bookmark].
6. Enter 3 in the degrees text box to adjust the tilt.
Š Adjusting the tilt in small increments should help you locate the ACL.
7. Click [Tilt/Translate] or use the Tilt function to change the obliquity until the ACL is
optimally seen.
8. Click [Bookmark].
9. Determine the scanning range for the ACL image.
a) Click [Rx Locations].
b) Drive medial to the limit of the medial condyle and click [Set Start].
c) Drive lateral to the limit of the lateral condyle and click [Set End].
10. Select the oblique sagittal T2 series in the Rx Manager and click [Apply
Locations].
11. Click [Save Series].
Š The series is saved in the Rx Manager as RXD.
12. Click [Close] to end the real-time session, review the series, and begin scanning.

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 Imaging Real Time

Quick Steps: Scan Complex Anatomy – Knee Application

1. Start the real-time series in an axial plane.
2. Use the Movement Tools to drive inferior or superior to visualize the inter-condylar
fossa.
3. Click [Bookmark].
4. Click [Draw Line] and define a line bisecting the inter-condylar fossa and parallel
to the lateral femoral condyle.
5. Click [Bookmark].
6. Enter 3 in the degrees text box to adjust the tilt.
7. Click [Tilt/Translate] or use the Tilt function to change the obliquity until the ACL is
optimally seen.
8. Click [Bookmark].
9. Determine the scanning range for the ACL image.
10. Select the oblique sagittal T2 series in the Rx Manager and click [Apply
Locations].
11. Click [Save Series].
12. Click [Close] to end the real-time session, review the series, and begin scanning.

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 Imaging Real Time

Scan Complex Anatomy

Shoulder Application
This application acquires an oblique coronal and oblique sagittal plane in real-time
imaging to optimize the rotator cuff. This application uses an oblique coronal FSE T1
and an oblique sagittal FSE series to obtain the images.
1. Start the real-time series in an axial plane.
2. Use the Movement Tools to drive inferior or superior to visualize the glenoid.
Š Use the Pan, Rotate, Tilt, and Translate on-screen cursors with the Drive or
Step mode.
3. Click [Bookmark].
Š This image will be recalled for use in Step 11 for obtaining an oblique sagittal.
4. Click [Draw Line] and define a line perpendicular to the glenoid fossa.
Š The resulting image is an oblique coronal.
5. Click [Bookmark].
6. Enter 3 in the degrees text box to adjust the tilt.
Š Adjusting the tilt in small increments should help you locate the rotator cuff.
7. Click [Tilt/Translate] or use the Tilt function to change the obliquity until the rotator
is optimally seen.
8. Determine the scanning range to cover the humeral head.
a) Click [Rx Locations].
b) Drive posterior to the limit or the humeral head and click [Set Start].
c) Drive anterior to the limit of the humeral head and click [Set End].
9. Select the oblique coronal FSE T1 series in the Rx Manager and click [Apply
Locations].
10. Click [Save Series].
Š The series is saved in the Rx Manager as RXD.
11. Retrieve the bookmarked axial image.
12. Click [Draw Line] and define a line parallel to the glenoid fossa.
Š The resulting image is an oblique sagittal.
13. Click [Bookmark].

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 Imaging Real Time

14. Determine the scanning range for the oblique sagittal FSE series.
a) Drive medial to the mid-glenoid level and click [Set Start].
b) Drive lateral to the limit of the humeral head and click [Set End].
15. Select the oblique sagittal FSE series in the Rx Manager and click
[Apply Locations].
16. Click [Save Series].
Š The series is saved in the Rx Manager as RXD.
17. Click [Close] to end the real-time session, review each series, and begin scanning.

Quick Steps: Scan Complex Anatomy – Shoulder Application

1. Start the real-time series in an axial plane.
2. Use the Movement Tools to drive inferior or superior to visualize the glenoid.
3. Click [Bookmark].
4. Click [Draw Line] and define a line perpendicular to the glenoid fossa.
5. Click [Bookmark].
6. Enter 3 in the degrees text box to adjust the tilt.
7. Click [Tilt/Translate] or use the Tilt function to change the obliquity until the rotator
is optimally seen.
8. Determine the scanning range to cover the humeral head.
9. Select the oblique coronal FSE T1 series in the Rx Manager and click [Apply
Locations].
10. Click [Save Series].
11. Retrieve the bookmarked axial image.
12. Click [Draw Line] and define a line parallel to the glenoid fossa.
13. Click [Bookmark].
14. Determine the scanning range for the oblique sagittal FSE series.
15. Select the oblique sagittal FSE series in the Rx Manager and click
[Apply Locations].
16. Click [Save Series].
17. Click [Close] to end the real-time session, review each series, and begin scanning.

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 Imaging Real Time

Scan Complex Anatomy

Abdomen Application
This application acquires a coronal plane for optimal imaging of the aorta for a dynamic
3D abdominal aortagram and renal arteries and for a single slice, multi-phase
acquisition to monitor test bolus contrast injections. This application uses an oblique
coronal 3D Fast SPGR and an axial Fast SPGR series to obtain the images.
1. Start the real-time series in an axial plane.
2. Click [FC] in the Contrast Tools area to better visualize blood flow in the aorta.
Š This applies the Flow Compensation Imaging Option.
3. Use the Movement Tools to drive inferior or superior to visualize the level of the
renal arteries.
Š Use the Pan, Rotate, Tilt, and Translate on-screen cursors with the Drive or
Step mode.
4. Click [Sagittal] in the Orientation Tools area.
Š The real-time image is moved to the sagittal plane at the current image center
point.
5. Enter 5 in the mm text box to adjust the translate movement increment.
6. Drive left or right for optimal visualization of the aorta.
7. Click [Draw Line] and define a line parallel and through the aorta.
Š The resulting image is an oblique coronal.
8. Click [Bookmark].
9. Determine the scanning range for the abdominal aorta and renal arteries.
a) Click [Rx Locations].
b) Drive posterior so the most posterior elements of the kidneys are seen and click
[Set Start].
c) Drive anterior to the anterior limit of the aorta and click [Set End].
10. Select the coronal 3D FGRE series in the Rx Manager and click [Apply Locations].
11. Click [Save Series].
12. Click [Close] to end the real-time session, review the series, and begin scanning.
13. Set up a real-time series in the sagittal plane.
14. Drive medially or laterally, which ever direction is best to visualize the aorta.

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 Imaging Real Time

15. Click [Pause When Full].

Š This automatically pauses the real-time data acquisition when the Real Time
Image Buffer is full.
16. Simultaneously inject a test bolus of contrast and click [Timer].
Š The scan continues while monitoring the images for contrast uptake.
Š The amount of the test bolus should be prescribed by a physician.
17. Click [Pause Scanning] after the contrast has washed out.
18. Select the Review tab.
19. Review the time stamped on the images to determine the scan delay time for a
dynamic bolus injection series.
Š This time is generally based on when the contrast is first seen on the image.
20. Click [Set First] and [Set Last] for the range of images to save to the database.
21. Click [Close] to end the real-time session, review the series, and begin scanning.

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 Imaging Real Time

Quick Steps: Scan Complex Anatomy – Abdomen Application

1. Start the real-time series in an axial plane.
2. Click [FC] in the Contrast Tools area to better visualize blood flow in the aorta.
3. Use the Movement Tools to drive inferior or superior to visualize the level of the
renal arteries.
4. Click [Sagittal] in the Orientation Tools area.
5. Enter 5 in the mm text box to adjust the translate movement increment.
6. Drive left or right for optimal visualization of the aorta.
7. Click [Draw Line] and define a line parallel and through the aorta.
8. Click [Bookmark].
9. Determine the scanning range for the abdominal aorta and renal arteries.
10. Select the coronal 3D FGRE series in the Rx Manager and click [Apply Locations].
11. Click [Save Series].
12. Click [Close] to end the real-time session, review the series, and begin scanning.
13. Set up a real-time series in the sagittal plane.
14. Drive medially or laterally, which ever direction is best to visualize the aorta.
15. Click [Pause When Full].
16. Simultaneously inject a test bolus of contrast and click [Timer].
17. Click [Pause Scanning] after the contrast has washed out.
18. Select the Review tab.
19. Review the time stamped on the images to determine the scan delay time for a
dynamic bolus injection series.
20. Click [Set First] and [Set Last] for the range of images to save to the database.
21. Click [Close] to end the real-time session, review the series, and begin scanning.

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 Imaging Real Time

Scan Complex Anatomy

Heart and 3D Aortagram Application
This application acquires double oblique long and short axis images to demonstrate the
complex cardiac planes and an oblique sagittal plane for a dynamic injected 3D Fast
GRE aortagram. The sequences used in this procedure include a long axis FastCard, a
short axis FastCard, and a sagittal 3D Aortagram to obtain the images.
1. Start the real-time series in a sagittal plane.
2. Click [FC] in the Contrast Tools area to better visualize blood flow in the aorta.
Š This applies the Flow Compensation Imaging Option.
3. Use the Movement Tools, such as [Tilt/Translate] or the Pan, Rotate, and Tilt
on-screens cursors, to drive inferior or superior to visualize the heart.
Š Use the Pan, Rotate, Tilt, and Translate on-screen cursors with the Drive or
Step mode.
4. Click [Draw Line] and define a line
that bisects the heart from superior
to inferior at an angle through the
apex and mitral valve plane.
Š The resulting image is a long
axis view of the heart.
5. Click [Bookmark].
Š This image will be recalled in
Step 9 for obtaining a short axis scan.
6. Determine the scanning range for the long axis image of the heart.
a) Click [Rx Locations].
b) Drive to the posterior limit of the heart and click [Set Start].
c) Drive to the anterior limit and click [Set End].
7. Select the long axis Fast Card series in the Rx Manager and click
[Apply Locations].
8. Click [Save Series].
Š The series is saved in the Rx Manager as RXD.
9. Retrieve the long axis bookmarked image.

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 Imaging Real Time

10. Click [Draw Line] and draw a line

perpendicular to the
inter-ventricular septum at the
level of the mitral valve.
Š The resulting image is a short
axis view of the heart.
11. Click [Bookmark].
12. Determine the scanning range for the short axis image of the heart.
a) Drive superior to the upper level of the mitral valve and click [Set Start].
b) Drive inferior to the apex and click [Set End].
13. Select the short axis Fast Card series in the Rx Manager and click
[Apply Locations].
14. Click [Save Series].
Š The series is saved in the Rx Manager as RXD.
15. Click the axial home image and drive to the level of the aortic root.
16. Use the [3 Point Tool] to define a view of the arch.
a) Click [3 Point Tool] and
deposit point 1 on the
aortic root.
b) Select point 2 and deposit
it on the thoracic aorta.
c) Drive inferior 70 mm and
select point 3.
d) Deposit it on the aorta.
– The resulting image is a view of the aortic arch.
17. Click [Bookmark].
18. Determine the scanning range of the aortic arch.
a) Drive lateral to the extent of the thoracic aorta and click
[Set Start].
b) Drive medial to the extent of the ascending aorta and click [Set End].
19. Select the 3D aortagram series in the Rx Manager and click [Apply Locations].
20. Click [Save Series].
Š The series is saved in the Rx Manager as RXD.
21. Click [Close] to end the real-time session, review the series, and begin scanning.

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 Imaging Real Time

Quick Steps: Scan Complex Anatomy – Heart and 3D Aortagram Application

1. Start the real-time series in a sagittal plane.
2. Click [FC] in the Contrast Tools area to better visualize blood flow in the aorta.
3. Use the Movement Tools, such as [Tilt/Translate] or the Pan, Rotate, and Tilt
on-screens cursors, to drive inferior or superior to visualize the heart.
4. Click [Draw Line] and define a line that bisects the heart from superior to inferior at
an angle through the apex and mitral valve plane.
5. Click [Bookmark].
6. Determine the scanning range for the long axis image of the heart.
7. Select the long axis Fast Card series in the Rx Manager and click
[Apply Locations].
8. Click [Save Series].
9. Retrieve the long axis bookmarked image.
10. Click [Draw Line] and draw a line perpendicular to the inter-ventricular septum at
the level of the mitral valve.
11. Click [Bookmark].
12. Determine the scanning range for the short axis image of the heart.
13. Select the short axis Fast Card series in the Rx Manager and click
[Apply Locations].
14. Click [Save Series].
15. Click the axial home image and drive to the level of the aortic root.
16. Use the [3 Point Tool] to define a view of the arch.
17. Click [Bookmark].
18. Determine the scanning range of the aortic arch.
19. Select the 3D aortagram series in the Rx Manager and click [Apply Locations].
20. Click [Save Series].
21. Click [Close] to end the real-time session, review the series, and begin scanning.

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 Sorting Patient Data

Chapter 35
Sorting Patient Data

Introduction
When working with a list of examinations or images, it can be helpful to sort the list by a
particular criteria, such as the scan date or a number. This chapter explains the process
of sorting patient data. It contains the step-by-step instructions to help you learn how to:
• Sort Examinations
• Sort Series
• Sort Images

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 Sorting Patient Data

What Do I Need to Know About...

This section presents the concepts necessary to successfully sort patient data.
Specifically, you need to understand the following concepts:
• Sorting Basics
• Sorting Examinations
• Sorting Series
• Sorting Images

Sorting Basics
Sorting allows you to set up groups of patient data on the basis of common
characteristics. For example, you can have separate groups of patient data arranged
according to the patient’s name, date, modality, examination number, etc. Figure 35-1
displays the Sort Menu, listing all available ways to sort the patient data on your system.
Figure 35-1 Sort Menu

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 Sorting Patient Data

Sorting Examinations
When you look at the patient list on the Browser, you want to know what examinations
have been completed. If you spend time looking for a patient to view, you may want to
organize your list to help you find examinations quickly. The list can be organized in
many different ways. The most common method is to sort the examinations by date.

Sort Examinations by Examination Number

This option sorts the examinations by number. The oldest exam is listed at the top and
the most recent exam is listed at the bottom of the Examination window.

Sort Examinations by Patient Name

This option sorts the examinations by patient name. The patients are listed in
alphabetical order, starting with A at the top of the list.

Sort Examinations by Date

This option sorts the examinations by the date and time on which they were scanned.
This method is used most often since it always lists the most recent patient scanned at
the top of the list. All of the other patients are listed in the order in which they were
scanned.

Sort Examinations by Modality

This option sorts the list alphabetically by modality.

Sort Examinations by Archived Status

This option sorts the examinations by the archived status. It may be useful to arrange
the patient list so that all of the archived examinations are at the top of the list and the
unarchived examinations are at the bottom of the list.

Sort Examinations by PPS Status

If your facility has purchased the ConnectPro Plus (PPS) option, you can sort
examinations by PPS status. You can determine the status of the examinations by
arranging them by completed, deferred, discontinued, or cancelled status.

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 Sorting Patient Data

Sorting Series
A single examination can contain multiple series. You can arrange these series in
different ways according to your needs. The most common series sorting method is by
series number, but if your system has the ConnectPro Plus PPS option, sorting by PPS
status helps determine the status of each series in an examination.

Sort Series by Series Number

This options sorts the list by series number. It arranges the series in the order they were
acquired by the series number with the smallest number first.

Sort Series by PPS Status

If your facility has purchased the ConnectPro Plus PPS option, you can sort series by
PPS status. You can determine the status of the examinations by arranging them by
completed, deferred, discontinued, or cancelled status.

Sorting Images
Image organization is very important to the doctor when reviewing examinations. It may
be helpful to find out the order in which each doctor wants to view the images. The most
common method is to sort the images by their number, so the images are displayed in
order that they were acquired.

Sort Images by Image Number

This option sorts the images by image number and is used most often. The image list
places the lowest number at the top of the list and the highest number at the bottom.

Sort Images by Location

This option sorts the images by the table location. This is a good method to use when
you scan out of order and you want to sort the images by the location that was scanned.

Sort Images by Echo

This method is used for MR images that have more than one echo.

Sort Images by Trigger

This method sorts the MR images by trigger delay.

Sort Images by Scan Time

This option sorts the MR images in a series by the scan time. The most recent scan
time is at the top of the list.

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 Sorting Patient Data

How Do I... Anchor

This section provides the step-by-step instructions for sorting examinations and sorting
images. Specifically, it describes how to:
• Sort Examinations
• Sort Series
• Sort Images

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 Sorting Patient Data

Sort Examinations
Use this procedure to change the order in which the examinations are listed on your
system.
1. Select Sort from the Browser menu bar.
Š This is located at the top of the Browser on both the Display and Image
Management desktops.

2. Select the desired examination sort option from the Sort list.
Š Sort examinations by examination number
Š Sort examinations by patient name
Š Sort examinations by date
Š Sort examinations by modality
Š Sort examinations by archived status
Š Sort examinations by PPS status

Quick Steps: Sort Examinations

1. Select Sort from the Browser menu bar.
2. Select the desired examination sort option from the Sort list.

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 Sorting Patient Data

Sort Series
Use this procedure to change the order in which the series are listed on your system.
1. Select Sort from the Browser menu bar.
Š This is located at the top of the Browser on both the Display and Image
Management desktops.

2. Select the desired series sort option from the Sort list.
Š Sort series by series number
Š Sort series by PPS status

Quick Steps: Sort Series

1. Select Sort from the Browser menu bar.
2. Select the desired series sort option from the Sort list.

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 Sorting Patient Data

Sort Images
Use this procedure to change the order in which the images are listed on your system.
1. Select Sort from the Browser menu bar.
Š This is located at the top of the Browser on both the Display and Image
Management desktops.

2. Select the desired image sort option from the Sort list.
Š Sort images by image number
Š Sort images by location
Š Sort images by echo
Š Sort images by trigger
Š Sort images by scan time

Quick Steps: Sort Images

1. Select Sort from the Browser menu bar.
2. Select the desired image sort option from the Sort list.

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 Displaying Images

Chapter 36
Displaying Images

Introduction
This chapter explains the image display process, including an overview of the Display
Desktop, Viewer, and Mini Viewer. It provides key concepts and brief guidelines for
displaying and manipulating images.
This chapter also contains the step-by-step instructions to help you learn how to:
• Select an Image to Display
• Display Images in Viewer
• Control the Viewports
• Page Through an Image Set
• Compare Images
• Manipulate Images
• Annotate Images
• Apply Mattes to Images
• Measure
• Enhance Images
• Cross-Reference a Series
• Set Up User Preferences

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 Displaying Images

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete the image
display and manipulation process. Specifically, you need to understand:
• Display Desktop
– Browser
– Series Data Types
– Navigating Between Windows and the Browser
– Display Applications
• Viewer
– Viewport Control
– Organization
– Window/Level Control
• Mini Viewer
• Display Tools
– Paging
– Format
– Reference Image
– Measuring
– Magnifying Images
– Save State
– Cross-Reference Lines
• Annotation
– Image Annotation
– Imaging Options Annotation
– Pulse Sequence Annotation
• User Preferences
– Annotation
– Tick Marks
– Grid Preferences
– Right Mouse Button
– Series Binding
– Square Viewports
– Presets

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 Displaying Images

• Text Pages
– Exam Text Page
– Series Text Page

Display Desktop
You can access the Browser and Display Desktop by clicking the Display Desktop icon
(Figure 36-1) in the control panel.
Figure 36-1 Display Desktop Icon

The Browser (Figure 36-2) opens, which allows you to choose the patient, series and
images to display.

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 Displaying Images

Browser
The Browser allows you to view (browse) the contents of the disk and select images for
display or manipulation functions. Using the Browser is the best way to view the list of
examinations and select them for utility functions, such as archiving or removing. The
Browser also provides access to advanced post-processing features. The Browser has
three primary functions:
• It displays the examination, series, and image lists of the patients that are currently
on the system hard drive
• It contains the display applications available on your system
• It launches various menu functions allowing you to manage the Browser and
images
Figure 36-2 Display Browser
Examination List Menu Functions

Series List

Display
Applications

Image List

Table 36-1 describes the Browser menu functions.

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 Displaying Images

Table 36-1 Browser Menu Selections

Selection Description
Allows you to refresh the contents displayed in the Browser. The
patient list is updated automatically once the images are
Application
reconstructed. If this does NOT happen automatically, you can refresh
the list manually.
Allows selection of all examinations, all series within an examination,
Selection images within a series, unarchived examinations, or archived
examinations.
Remove Removes examinations, series, or images from the system hard drive.
Allows you to sort the examination numbers, series numbers, or image
Sort order. Refer to Sorting Patient Data for additional information on the
available sorting methods.
Allows various network functions to be performed. Refer to Managing
Network
Images.
Allows various archive functions to be performed. Refer to Managing
Archive
Images.
Applies to those who have purchased the ConnectPro Plus (PPS)
PPS option and those who have the HIS/RIS system connected to their MR
system.
Allows you to view one of the three queues (Archive, Network, or
Filming) to look at the examinations in the backlog. If a series is listed
Queue
in a queue, it cannot be deleted or edited until it is cleared from the
queue.
Provides the capability of electronically erasing the patient’s name
Utilities
from all images in the examination, series, or from an individual image.
Services Applies to service personnel.
Messages Displays existing system messages related to image display.

Series Data Types

You should become familiar with several series data types that can be listed in the
Series List of the Browser. The types of series include:
• PROSP: (prospective) acquired data that can be viewed, window and leveled (W/L),
filtered, post-processed, measured, etc.
• COMB: (combined) result of a combination of image data that can be W/L
• SSAVE: (screen save) post-processed data that can be W/L
• PJN: (projection) post-processed data that can be W/L, and filtered
• RFMT: (reformat) post-processed data that can be W/L, filtered, and measured
• 3D: (three-dimensional) post-processed data that can be W/L

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 Displaying Images

Navigating Between Windows and the Browser

You are able to navigate between the Browser and a window that may be covering the
Browser, such as the Viewer, Mini Viewer, or a display application. To move the window
or the Browser to the foreground or background, position the cursor over the window to
be moved (forward or backward) and press Alt + F3 keys.
You can also move a window (not the Browser) forward or backward by positioning the
cursor over an image in the Viewer, Mini Viewer and pressing the Ctrl + F (forward) or
Ctrl + B (backward) keyboard keys.

Display Applications
The Browser applications buttons, on the right, launch various software applications
that can view or manipulate the images. This chapter concentrates on Viewer and Mini
Viewer display applications. The other display applications are discussed in other
chapters of this guide. After you have selected the patient, series, images you want to
display, click the [Viewer] or [MiniViewer] button to the display the images.

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 Displaying Images

Viewer
The Viewer (Figure 36-3) has a variety of display tools and contains a large viewing
area to display images. The left side contains a variety of viewing tools; the right side
displays the images.
Figure 36-3 Viewer

Viewport Control
The viewport is the section of the viewing screen that contains an image. For example,
if there are four images on the viewing screen, there are also four viewports. Viewports
can either be active or inactive and primary or secondary. The default is for the upper
left viewport to be primary and active, while the remaining viewports are secondary and
active. Active viewports are affected by display functions, while inactive viewports are
not. The primary viewport is the one first affected by the display function. Secondary
and active viewports are connected to the primary viewport and can be affected by
display functions. For example, if you window and level on the primary viewport, the
same window and level appear on the secondary and active viewports.

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 Displaying Images

A single click on a viewport makes that viewport primary and active, and the other
viewports are now secondary and active. A double-click on a viewport makes that the
primary viewport and all others become secondary and inactive. Triple-clicking in a
viewport makes that the primary viewport and the others become secondary and active
viewports.
The border around the image for primary and active viewports is blue, or bright white if
you have a black and white monitor. Secondary and active viewports borders are
yellow, or bright if you have a black and white monitor. Inactive viewports have either no
borders or black borders. Figure 36-4 displays primary, secondary, and inactive
viewports.
Figure 36-4 Viewer Borders

Primary
Active
Viewport
Secondary
Active
Viewports

Inactive
Viewport

Organization
The Viewer can display images in several ways: through cross-referencing a series
(displaying slice locations on a localizer image), displaying distances, and magnifying
images. The left column contains multiple buttons to perform the manipulations. Some
of the buttons are simple on/off buttons; others have menus or windows that allow for
choices in the manipulation process. This chapter gives detailed instructions on how to
perform these functions.

Window/Level Control
The window and level values are adjusted to control which pixel values are visible in
images, and the degree of contrast. The window level is an image adjustment, which is
somewhat similar to the brightness adjuster on a television. The window width is
defined as twice the number of intensities above and below the currently set level.

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 Displaying Images

Middle Mouse Button

Window/Level (W/L) contrast changes are controlled by the middle mouse button. If all
viewports are connected, the W/L change to an image in one viewport is applied to all
images within the series. There is one exception to this rule. If the series is a dual echo
acquisition, changing the W/L of a first echo image only changes all first echo images
and not all images within the series. Changing the W/L of a second echo image only
changes the second echo images and not all the images within the series. This W/L
method allows for independent image adjustment for first and second echo images
when they are displayed side-by-side.

Keyboard Keys
The top row of the computer keyboard is composed of keys labeled F1 through F12.
These keys are often called accelerator or function (F) keys (Figure 36-5). These keys
have preset filming and window/level functions associated with them.
Keys F5 through F11 are used for adjusting the window/level of an image. The F5 key
corresponds to the most recently set window/level values. Keys F6 through F11
correspond to the preset values, which can be customized in User Preferences.
Figure 36-5 Keyboard Function Keys

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Table 36-2 describes the function of the F5 though F11 keys.

Table 36-2 Function Keys

Key Description
F5 Resets the window level to the previous level.
F6 Uses the Predefined 1 W/L setting.
F7 Uses the Predefined 2 W/L setting.
F8 Uses the Predefined 3 W/L setting.
F9 Uses the Predefined 4 W/L setting.
F10 Uses the Predefined 5 W/L setting.
F11 Uses the Predefined 6 W/L setting.
Shift + F6 Changes the Predefined 1 W/L setting to those of the active viewport.
Shift + F7 Changes the Predefined 2 W/L setting to those of the active viewport.
Shift + F8 Changes the Predefined 3 W/L setting to those of the active viewport.
Shift + F9 Changes the Predefined 4 W/L setting to those of the active viewport.
Shift + F10 Changes the Predefined 5 W/L setting to those of the active viewport.
Shift + F11 Changes the Predefined 6 W/L setting to those of the active viewport.

You can also use the up and down arrow keys (Figure 36-6) on the keyboard to adjust
the W/L values.
• The up and down arrows increase or decrease the window level
• The left and right arrow keys increase or decrease the window width
Figure 36-6 Arrow Keyboard Keys

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Mini Viewer
You can also open a smaller viewer called a Mini Viewer (Figure 36-7) by clicking the
[Mini Viewer] button in the display applications area of the Display Browser.
Figure 36-7 Mini Viewer

Four Mini Viewers can be open at the same time. Each Mini Viewer can display a
unique examination or series.

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Display Tools
The Viewer and Mini Viewer contain numerous display tools that allow you to perform
various functions while viewing and filming your images. The Display Tool area for the
Viewer is shown in Figure 36-8. The selections are described in Table 36-3.
Figure 36-8 Display Tools

Table 36-3 Display Tool Descriptions

Selection Description
[Browser] Opens the Browser.
[Film Composer] Opens the Film Composer.
Pages through images in as if you were viewing a moving picture.
[Paging]
Paging is accessible from either the Viewer or the Mini Viewer.
Displays two series on the screen simultaneously from the same
or different examinations. The following display functions are
active in Compare Mode: Magnify, Scroll, Annotate, Rectangular
[Compare]
Matte, Grid, Display Normal, Cursors, and Measuring. Compare
mode is not available in the Mini Viewer or for Cross-References.
You cannot film images using MID (F3 key).

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Selection Description (Continued)

[Image Analysis] Allows you to select additional display applications.
Allows you to select several predetermined values for window
[Presets]
widths and window levels in the Viewer or the Mini Viewer.
Recalls the previous (-) or next (+) examination in the Browser
Exam [-] [+]
list.
Recalls the previous (-) or next (+) series of that patient’s
Series [-] [+]
examination that is listed in the Browser.
Replaces the images in the Viewer or Mini Viewer with a full new
set of images. For example, with a 4-on-1 format, if images 1, 2,
Image [-] [+]
3, and 4 are displayed, clicking the [+] button displays images 5,
6, 7, and 8.
Image text box Allows you to enter a specific image number in the text box or
and Slider scroll through the images in the series using the slider.
Zoom text box Allows you to enter a magnification factor in the text box or
and Slider magnify the images by dragging the slider.
Magnifying Glass
Magnifies a square region of view with 2X magnification. Use the
mouse to move the Magnifying Glass about the image in the
Viewer or Mini Viewer.

Scroll Moves the image within the viewport and to move the area of
interest to the center of the viewport. Image scrolling can be
accessed from either the Viewer or the Mini Viewer and can be
applied to any image.
Erase Annotation
Erases the selected annotation or graphic on the image.

Annotate
Allows you to add an annotation to the image in the Viewer or
Mini Viewer. Annotation includes an on-screen arrow for pointing
out specific structures and the ability to add text to the image.

Places a rectangular matte over the image to eliminate unwanted

information or artifacts on or around an image before it is
[Rect. Matte]
displayed or filmed. The matte size can easily be adjusted to fit
the size of the area of interest.
Grid
Applies a grid over an image. The size of the grid can be
adjusted using the Grid Preferences.

Erase All Erases all the added annotation, mattes, and graphics.

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Selection Description (Continued)

Temporarily hides the image graphics. The button changes to
Hide/Show
[Show]. Clicking the [Show] button redisplays the graphics.
Allows you to obtain information, distances, and areas of
[Measure] anatomy or pathology on the Viewer or the Mini Viewer. Refer to
Measuring for the available measuring tools.
Applies a smooth or edge enhancement filter to the images. It
[Image Enhance]
does not create a new series for the filtered images.
Removes the following display features from the connected
viewports: Flip/Rotate, Zoom, Image Enhance, and Scroll.
[Display Normal] Display Normal has no effect on Rectangular Matte, Annotation,
or Graphic operations. Use the [Erase All] button to remove
these elements from the image.
Sets the viewing format for images in the Viewer and Mini
[Format]
Viewer. Refer to Format for additional information.
Allows you to insert an image into a small viewport on the Viewer
[Reference
or Mini Viewer to identify the slice location of the main image.
Image]
Refer to Reference Image for additional information.
[Flip Rotate] Flips or rotates the images in the Viewer or Mini Viewer.
[Film Series Loads and prints all the images in a single series with just one
<F4>] keystroke. The cursor can be in any image on the screen.
Loads an entire page (all of the displayed images in the viewing
Film Page <F2>
application) of images into the Film Composer.
Film MID <F3> Loads multiple image displays (MID) into one frame on the film.
Allows you to select a Exam Text Page or a Series Text Page to
Text Page
display related patient information.
Saves any image, including manipulated images, to a new series
in the same examination. Save Screen is available in the Viewer,
but not the Mini Viewer. The new series is available on the
Browser as SSAVE with a series number of 99. If additional
[Save Screen] images are saved they are added to this series and the number
of images increases by one. The W/L and zoom values are still
adjustable. Any annotation that is on the image cannot be
removed once the screen has been saved; it is a “snapshot” of
the screen and cannot be altered.
Allows you to modify a number of system-defined defaults to
[User customize the display based on your site’s preferences. These
Preferences] functions can only be set from the Viewer, not the Mini Viewer
although the effect can be seen on the Mini Viewer.
Additional options not on the Display Desktop can be accessed in
Accelerator Line the Accelerator Line at the bottom of the display tools. Refer to
the Accelerator Line Commands appendix.

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Paging
Access the Paging window (Figure 36-9) by clicking the [Paging] button from either the
Viewer or the Mini Viewer. This function allows you to page through images as if you
were viewing a a moving picture.
Figure 36-9 Paging Window

Table 36-4 Paging Window Selections

Selection Description
Allows you to select a number to begin the paging sequence. You
Start can select a start number by entering an image number in the text
box, using the slider, or clicking the arrow buttons.
Allows you to select a number to finish the paging sequence. You
End can select an end number by entering an image number in the text
box, using the slider, or clicking the arrow buttons.
Allows you to select the viewing speed of the images in frames per
FPS second (FPS). You can select a rate by entering a number in the
text box, using the slider, or clicking the arrow buttons.
Allows you to view how images taken at the same location change
over time. This gives you the effect of motion. In this mode, the
Temporal images continuously advance from first to last image, without
pausing. For example, an image set consisting of four images
appears in the following order: 1, 2, 3, 4, 1, 2, 3, 4, etc.
Allows you to view images taken at different locations throughout
the body. The system advances sequentially through the images,
then moves backward to the first image. The Spatial function
Spatial
demonstrates the motion of a joint or structure in two directions.
For example, an image set consisting of four images appears in
the following order: 1, 2, 3, 4, 3, 2, 1, etc.
[Select Series] Allows selection of a specific series to load into the Paging window.
[Cancel] Stops the paging mode and closes the Paging window.
Go
Begins the paging sequence.

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Paging can load up 256 images in the series in up to 60 FPS. Paging has the control to
set up the “movie” and control the speed of the “movie.” The default rate is 10 FPS for
each viewport. Image annotation is available but effects the frame rate’s performance.
Table 36-5 lists the maximum FPS for 512x512 pixel images without annotation.
Table 36-5 Paging Frame Rate

Number of Viewports Maximum FPS

1 60 FPS
2 30 FPS
4 15 FPS

The only valid formats for paging are 1-on-1, 2-on-1, and 4-on-1 with the Viewer and
1-on-1 with the Mini Viewer. Each viewport has the control of the frame rate, temporal
versus spatial looping, as well as parameters specific to an individual viewport.
Whether the paging mode is temporal or spatial, the same mode is applied to all paging
viewports simultaneously.

Format
The system defaults to a 4-on-1 format in the Viewer, and a 1-on-1 format in the
MiniViewer. The display format can be changed by clicking the [Format] button and
selecting a format icon from the Format menu (Figure 36-10).
Figure 36-10 Format Menu

You can also select a format by using the type-in commands in the Accelerator Line.
Refer to the Accelerator Line Commands appendix for a complete list of format type-in
commands.

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Reference Image
The Reference Image function (Figure 36-11) allows you to insert an image into a small
viewport on the Viewer or Mini Viewer.
Figure 36-11 Reference Image Menu

The inserted (referenced) image (Figure 36-12) identifies the slice location of the main
image.
Figure 36-12 Reference Image

The reference image must be in another plane from the main image. The two images
(the main image and the reference image) must be from the same examination and
must have the same horizontal landmark, same patient position, and same patient
entry. When using Reference Image in the Viewer, the valid screen formats are 1-on-1,
2-on-1, 4-on-1, 6-on1, and 9-on-1. The Reference Image cannot be used on viewing
formats larger than 9-on-1, but can be filmed with any film format. If you use Reference
Image in the Mini Viewer, 1-on-1 is the only valid screen format.
The following is a list of things you can do to a referenced image:
• Window/Level (all methods)
• Select images using the selection buttons (Image +/-)
• Zoom
• Display Normal
• Flip/Rotate
• Pan
• Scroll

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All Reference Image viewports display the same image. You cannot put unique images
within separate or different viewports. If you change the image in one Reference Image
viewport, all other Reference Image viewports are updated to the same image.
Consider the following when using Reference Images:
• When no series or image is selected for the Reference Image, the system
determines the Reference Image by scan and graphic prescription guidelines: the
system uses the series and image used to prescribe the scan of the non-reference
image, and starts with the lowest numbered series and image.
• The viewport image and the Reference Image cannot be a Screen Save, a 3D
Rendered Image, or a member of the Combined Images set.
• Inverse Video affects both the main image and the Reference Image.
• Series Binding should not be applied to the Reference Image.
• Reference Images cannot be moved from the lower-right corner of the viewport.
Select a new series for the Reference Image in the Accelerator Line. The Series [+/-]
buttons on the Viewer are NOT available for series selection of the Reference Image.
When filming, the main image and the Reference Image are filmed as displayed. If you
have the Reference images displayed in all of the viewports and press the F4 (Film
Series) key, references images are printed. If a Reference Image is not displayed in all
viewports, no reference images are printed. The Reference Image and its cutlines
appear only if:
• The series displayed includes images scanned in an intersecting plane.
• The Image Scroll has not scrolled the intersection out of the Reference Image port.
• The Reference Image’s cutline is not magnified out of the Reference Image port.
When you select the [Image] button on the Print Options window, both the Reference
Image and the Primary Image appear within a film format cell. Note the size relationship
between the Primary and the Reference Image is not indicative of what the images look
like when the film is printed. The Reference Image is larger than it appears on the film.

Measuring
You can use the Measure tools to obtain information, distances, and areas of anatomy
or pathology. The Measure feature:
• Reports the cursor to record a point on the image.
• Calculates the linear distance between two points on an image.
• Measures any anatomical structure or pathology on an image.
• Measures an angle and lists the angle measurement of a line between two points.
• Measures a rectangular area, a curved area, an elliptical area, a curved area, and a
free draw area.

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You are able to select the desired method of measuring from the Measuring menu
(Figure 36-13).
Figure 36-13 Measuring Menu

Table 36-6 Measure Tools

Tool Description
X Cursor Allows you to deposit a cursor over the area of interest to display
the coordinates (A/P, I/S, and L/R locations) of a particular
location.

Straight Line Allows you to draw a straight line region of interest (ROI) on an
image to measure the distance in millimeters between two points
of interest.

Angle
Allows you to adjust an angular ROI on an image to obtain an
angle measurement.

Rectangle
Allows you to size a rectangular ROI on an image to obtain the
standard deviation, mean, and area.

Measurement
Curve Allows you to create a curved line ROI with adjustable points and
measurement marks. The tick marks on the measurement curve
are equal to the tick marks on the image ruler.

Smooth Curve Allows you to create an irregular, curved line ROI with adjustable
points on an image to obtain the standard deviation, mean, and
area.

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Tool Description (Continued)

Ellipse
Allows you to size an elliptical ROI on an image to obtain the
standard deviation, mean, and area.

Free Hand
Trace Allows you to freely trace around an object of interest to obtain
the standard deviation, mean, and area. You can move the ROI
once it is drawn, but you cannot resize it.

The Measure tool displays up to three measurements in the lower right corner of the
viewport. If you wish to record statistics from more than three measurements, type tpr
in the Accelerator Line. This displays a Text Page ROI, which lists all the
measurements taken.

Magnifying Images
You can enlarge or reduce the size of the images using the Zoom control (Figure
36-14). You can use Zoom to better visualize an area of interest. Zoom is found on both
the Viewer and the Mini Viewer.
Figure 36-14 Zoom Control

The initial Zoom factor of the image varies depending the display format (1-on-1,
4-on-1, etc.) and the image matrix size. The minimum Zoom factor is 0.1 and the
maximum factor is approximately 8.0 to 9.99 (dependent on FOV). The value can be
changed in 0.1 increments. The Zoom factor is displayed in the text box to the right of
Zoom and in the upper right corner of the image.
Table 36-7 shows examples of the Zoom factors for a 256x256 image.
Table 36-7 Zoom Factors

Display Format Zoom Factor

1x1 4.0
2x1 2.0
4x1 2.0
3x4 1.0

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Figure 36-15 displays sagittal spine images in a 2-on-1 format. The first image set is
displayed at normal magnification. The second image set is magnified by 2 to fill the
display area.
Figure 36-15 Zoom Images

If necessary, the operator’s console automatically reduces the quantity of annotation

when magnifying the image size. This is to avoid overflowing the display area. If all
annotation is not visible when viewing an image, reducing the image displays more
annotation.
When an image is magnified you can activate the Scroll function to move the image
around in its frame, centering over the area of interest.
Zoom is applied to all images in the series if you have your view selection as primary,
followed by secondary. It applies only to the primary if you de-select the other views.

Save State
The Save State feature allows you to save parameters that are recalled every time the
current series or images are viewed on the same operator’s console. You can access
this feature by typing ss in the Accelerator Line. The following parameters are saved
with the Save State feature: image orientation, W/L values, and graphics (including the
user-added annotation, mattes, and measurements).
The Save State parameters are stored locally on the operator’s console only. The Save
State parameters are not archived or transferred with networked images.
The last state saved is the state that is recalled, i.e., you can type ss in the Accelerator
Line any time and the new state overrides the old state.
The Save State function cannot be used when the Scroll feature is active. To save the
state on a scrolled image, deactivate the Scroll feature by clicking on the Scroll icon.

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Cross-Reference Lines
Cross-reference Accelerator Line commands display lines on a view that represent
where one series intersects another plane. Cross-reference is used during filming or
viewing to provide an anatomical reference to the images acquired on an intersecting
plane. You can cross-reference an entire series, the first and last image of a series, a
single image, or a range of images within a series by typing in a single command in the
Accelerator Line. Cross-referencing can be done either in the Viewer or the Mini
Viewer. Figure 36-16 displays an image with all the cross-reference lines for that series.
Figure 36-16 Cross-Reference Lines

The cross-reference lines may overlap annotations. Take this into consideration when
filming. You cannot cross-reference more than one non-consecutive image with a single
command.
Table 36-8 provides examples of Cross-reference line commands. Be sure to enter
commands exactly as shown below, including the spaces.

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Table 36-8 Cross-Reference Accelerator Commands

Command Description
xr 3 Displays the slices for series 3
Displays the slices for series 3 starting with image 5 through
xr 3/5-%
(/) the last slice number of the series (%).
Displays the slices for series 3 starting with image number 10
xr 3/10-60:5 and ending with image number 60, with an interval (:) of 5
slices.
Deactivates the cross-reference mode (removes the
noxr
Cross-reference lines).
Appends an image to the cross-reference display. For
example, xra 2 11, where 2 represents the series and 11
xra
represents the image (displays the cross reference of a
single slice).
xr #(series number) Displays only the first and last slices of a series. For example,
extrema xr 3 extrema displays the first and last slice of series 3.

A 3D data set with projection (PJN) images does not post the first and last slice with the
cross-reference type in the command xr # extrema. You must use the
cross-reference type-in command for images with a gap. For example, a 3D data set
(series 3) with 1 collapsed image, 19 projection images, and 60 total slices would use
the type-in command xr 3/21-60:39 to display the cross-reference without the PJN
images.
Non-consecutive images require several commands. For example, to cross-reference
slices 2, 5, 6, 8 and 12 of series 3, the commands required are:
Table 36-9 Non-Consecutive Cross-Reference Commands

Commands Resultant Cutline

xr 3 2 3/2-------------
xr 3 5-6 3/5-------------
3/6-------------
xra 3 8 3/8-------------
xra 3 12 3/12-----------

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Annotation
Image annotation is the text that appears on the image. Annotation is either
system-supplied text or text and graphics that have been added by an operator.
System-supplied text is the data identifying the patient, hospital, physician, and image
parameters. System-supplied text can be hidden from the screen only, from the film
only, or both. The next section about User Preferences discusses this in more depth.
Figure 36-17 illustrates the location of system-supplied annotation and is a composite of
all possible parameters. Actual image annotation varies depending on the acquisition
parameters and the customized screen annotations that were chosen.
Figure 36-17 System Annotation

The annotation information displayed uses abbreviations; the following tables list
annotation abbreviations:
• Image Annotation
• Imaging Options Annotation
• Pulse Sequence Annotation

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Image Annotation
Table 36-10 Image Annotation

Abbreviation Description
A --> P Ramped Pulse Direction (annotation may vary due to direction)
/F Fast Receiver was used for this scan
8/04:18/0: 01 Number of scan/total scan time/pause time
AS Autoshim (series text page only)
C Contiguous slice (0 mm slice spacing)
CS Contiguous slice
DT Trigger delay with MultiPhase imaging option (gated scan only)
ES Echo space
ES Echo Spacing (EPI only) (Text page only)
ET Echo Train
FL Flip (Left to Right - FL:L/R, Top to Bottom - FL:T/B)
FV Flow Velocity (phase contrast only)
GSE Grayscale enhancement
I Interleaved slices
L Level (mid-gray pixel value)
LR Left/Right Flip
M3D Multi-Slab 3D
MF Magnification Factor
Number of slice locations on each end of slab that overlap the
Ov
neighboring slab
PC Phase Correction (series text page only)
Ph Number of phases (gated scans only)
PscOpts Prescan options (series text page only)
ROT Rotated image
RT Rectangular FOV
SH Number of Shots (EPI only)
Sl Number of 3D slabs x slice locations per slab
SP Spacing between slices
SPF Swap Phase and Frequency

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Abbreviation Description (Continued)

St Saturation parameters
TB Top/bottom flip
TD Trigger delay without Multi Phase imaging option (gated scans only)
Th Thickness of slice
UNORIGINAL
Indicates the image is a combination of multiple images
IMAGE
v^ Frequency direction
VS Views per Segment
W Window (pixel value range)

Imaging Options Annotation

Table 36-11 Imaging Options Annotation

Abbreviation Description
CC Cardiac Compensation
CL Classic
ED Extended Dynamic Range
EG Cardiac Gating/Triggering with ECG Gating
FC Flow Compensation
FCf Flow Compensation in the frequency direction (FSE scans only)
FCs Flow Compensation in the slice direction (FSE scans only)
FT Full Echo Train
MP Multi Phase
MT Magnetization Transfer
NP No Phase Wrap
PG Cardiac Gating/Triggering with Peripheral Gating
RC Respiratory Compensation
RTr Respiratory Gating/Triggering
SQ Sequential
SqP Square Pixel
TrF Tailored RF
trig Respiratory trigger point as a percent of maximum

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Abbreviation Description (Continued)

VB Variable Bandwidth
Z1024 ZIP 1024
Z2 ZIP x 2
Z4 ZIP x 4
Z512 ZIP 512

Pulse Sequence Annotation

Table 36-12 Pulse Sequence Annotation

Abbreviation Description
2D/FSE 2D Fast Spin Echo
2D/FSEIR 2D Fast Spin Echo, Inversion Recovery
3D/FGR¹ 3D Fast Gradient Echo
3D/FSE 3D Fast Spin Echo
3D/FSEIR 3D Fast Spin Echo, Inversion Recovery
3D/FSPGR¹ 3D Fast Spoiled Grass
3D/GR¹ 3D Gradient Echo
3D/PC/GR¹ 3D Phase Contrast
3D/SPGR¹ 3D Spoiled Grass
3D/TOF/FGR¹ 3D Time-of-Flight Fast Grass
3D/TOF/FSPGR¹ 3D TIme-of-Flight Fast Spoiled Grass
3D/TOF/GR¹ 3D Time-of-Flight
3D/TOF/MT 3D Time-of-Flight with Magnetization Transfer
3D/TOF/SPGR 3D Time-of-Flight Spoiled Grass
2D Fast Multi Planar Gradient Echo, both sequential and
FMPGR¹
non-sequential
FMPIR Fast Spin Echo, Inversion Recovery
2D Fast Multi Planar Spoiled Grass, both sequential and
FMPSPGR¹
non-sequential
FSE Fast Spin Echo
FSE/V Fast Spin Echo Variable Echo
¹ Includes Flip Angle Annotation.

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Abbreviation Description (Continued)

GR¹ Gradient Echo, both sequential and non-sequential
GRE/EPI Gradient Echo, Echo Planar Imaging
IR Inversion Recovery
LOC 3-Plane Localizer
PC/GR¹ 2D Phase Contrast
SE Spin Echo
SE/EPI Spin Echo, Echo Planar Imaging
SE/V Variable Echo, Spin Echo
SPGR/EPI Spoiled Grass, Echo Planar Imaging
SPGR¹ 2D Spoiled Grass
SPRG/EPI Spoiled Grass, Echo Planar Imaging
TOF/GR¹ 2D Time-of-Flight
TOF/SPGR 2D Time-of-Flight Spoiled Grass
TOFX 2D Time-of-Flight with SAT Gap
¹ Includes Flip Angle Annotation.

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User Preferences
User Preferences allow you to customize display functions to suit your site’s preference.
You may choose to apply customized selections to a current examination in view only or
to save your selections as the default. These display functions include:
• Annotation
• Tick Marks
• Grid Preferences
• Right Mouse Button
• Series Binding
• Square Viewports
• Presets
You can access the User Preferences window (Figure 36-18) by clicking the [User
Prefs] button on the display tools area in the Viewer.
Figure 36-18 User Preferences Window

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Annotation
The User Preferences Window allows you to control two levels of annotation:
annotation as it appears in the screen and annotation as it appears on the film.
The No annotation option displays nothing except the tick marks on the images. Full,
partial, or custom annotation give you the option to choose the amount of annotation
shown on the film or the screen. When Full Annotation is selected, all annotation
appears on the images. Partial Annotation displays ONLY patient name, exam date,
exam/series/image numbers, center coordinates, and window/level. These parameters
cannot be changed.
When Custom Annotation is selected, only the selected annotation appears on the
film or screen. Clicking the [Customize...] button opens the Screen Annotation Groups
window, which allows you to choose options for annotation display on the screen or film.
Figure 36-19 Screen Annotation Groups

The left, right, top, or bottom options remove or display the FOV location. For example,
on an axial image annotated with A200, P198, R200, and L198, selecting to remove left,
removes the L198 annotation from the film or screen.
When filming with the F3 key, be careful of the annotation on the film. If the film
annotation is set to Full annotation and filmed with the F3 key, the films have only partial
annotation. This is to prevent annotation from overlaying anatomy. If you want anything
other than the default annotation to appear (when filming with F3) you need to click the
[Customize...] button in the Film area and select the annotation that you want to
appear on the film.

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When filming, be sure the film annotation is set to the desired annotation level. Setting
the film and screen annotation to the same level ensures that what you see on the
screen is what you will see on your films.

Tick Marks
Tick marks, both vertical and horizontal, are used for measuring. Tick marks are a ruler
shown either on the right side of the image, the bottom of the image, or in both places.

Grid Preferences
Grids can be used to measure anatomy or pathology on an image. The grid
measurements are in millimeters and the relative size of the grid changes with the
display FOV. You can customize the grid display by clicking the [Customize...] button
in the Grid Prefs area of the User Preferences Window.
Figure 36-20 Grid Preferences Window

Customizing allows for a number a ways to display a grid on an image.

• Matrix lines: the matrix lines form the grid pattern around the central vertical and
horizontal line. They can be turned on or off.
• Line style: the lines can appear as dotted or solid lines on the grid.
• Grid Spacing: the spacing between the grid lines, in millimeters, can be selected by
typing a number in the text box.
• Tick spacing: the space between the tick marks, in millimeters, can be selected by
typing a number in the text box.
• Tick Length: the length of the tick marks, in millimeters, can be selected by typing a
number in the text box.

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Right Mouse Button

The primary control of the right mouse button can be set to either Scroll or use a
Magnifying Glass on the selected image in the Viewer or Mini Viewer. Figure 36-21
displays an image with the Magnifying Glass applied.
Figure 36-21 Magnifying Glass

Series Binding
Series Binding can be used when viewing images. With Series Binding on, when you
reach the last image of a series, the next image displayed is the first image of the next
series. With the Series Binding option off, when you reach the last image in a series the
next image displayed is the first image of that same series.

Square Viewports
Whether you have the Square Viewports option on or off, when the selected viewer
format is larger than 4-on-1. For example, viewing with a 12-on-1 screen format, the
viewports are rectangular when the Square Viewports option is off; the images do not fill
the entire viewport. With the Square Viewports option on, the images are displayed as
they appear on the film; each image fills the viewport and the entire format display is
rectangular. It is recommended that you have Square Viewports on to help you select
the correct magnification factor without overlapping annotation when filming magnified
images.

Presets
Presets allow you to create several predetermined values for W/L values in the Viewer
or the Mini Viewer. Using preset W/L values allows you to quickly adjust the brightness
and contrast of a displayed image. You can program up to six different settings for your
system. If your console is networked with a CT system, you can have a separate set of
six preset values for CT images.

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Text Pages
Text pages contain patient information including examination or series descriptions.
Text pages are filmable and can be accessed from the Viewer or the Mini Viewer.

Exam Text Page

The Exam Text Page (Figure 36-22) lists all the information entered on the Patient
Information screen and all the series, with scan parameter information, completed on
this patient.
Figure 36-22 Exam Text Page

0.35T

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 Displaying Images

Series Text Page

The Series Text Page (Figure 36-23) lists all the patient information entered on the
Patient Information screen and lists the images (image numbers, locations, plane and
other parameters). The series text pages also list the prescan values for that series.
Figure 36-23 Series Text Page

0.35T

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How Do I...
This section provides the step-by-step instructions for displaying and manipulating
images. Specifically, it describes how to:
• Select an Image to Display
• Display Images in Viewer
• Control the Viewports
• Page Through an Image Set
• Compare Images
• Manipulate Images
– Magnify Images (Zoom)
– Apply the Magnifying Glass
– Scroll an Image
– Apply a Grid
– Erase, Hide, and Show Annotation or Graphics
– Reference Images
– Flip/Rotate Images
• Annotate Images
• Apply Mattes to Images
• Measure
• Enhance Images
• Cross-Reference a Series
• Set Up User Preferences
– Customize System-Supplied Annotation
– Display Tick Marks
– Customize Grid Preferences
– Control the Right Mouse Button
– Control Series Binding
– Apply Square Viewports
– Customize the Window/Level Presets

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Select an Image to Display

The Browser allows you to browse the contents of the disk and select images for
display or manipulation.
Use this procedure to access the Browser to view the Patient List.
1. Click the Display Desktop icon in the control panel.

Š The Browser opens.

2. Select the desired examination from the Examination List.

Š Click and drag the vertical slider up or down on the right side of the list to scroll
through the Examination List.

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3. Select the desired series from the Series List.

Š The series belonging to the selected examination are displayed to the left of the
Examination List.
Š Click and drag the vertical slider up or down on the right side of the list to scroll
through the Series List.
4. Select the image you want to view from the Image List, if necessary.
Š The images belonging to the selected series are displayed under the
Examination and Series lists.
Š If you do not select an image, the first image in the series you selected will be
displayed in the first viewport.
5. Click [Viewer] or [Mini Viewer].
Š The series or image of the desired patient that you selected is displayed in the
chosen viewer.
Š The Mini Viewer has all the functions of the Viewer but has:
– No Compare Mode
– No Film Series
– No Save Screen
– No User Preferences

Quick Steps: Select an Image to Display

1. Click the Display Desktop icon in the control panel.
2. Select the desired examination from the Examination List.
3. Select the desired series from the Series List.
4. Select the image you want to view from the Image List, if necessary.
5. Click [Viewer] or [Mini Viewer].

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Display Images in Viewer

There are many ways that you can move from one examination, series, or images to
another. This procedure describes the way to change this information using the Display
Tools in the Viewer or Mini Viewer.
1. Select an Image to Display.
2. Click [Format] and select the desired display format.
Š You can Format to display one or more images on the screen.
3. Click [+] or [-] to move to a prior or next examination,
series or image.
Š A limited number of examinations can be accessed in
the Viewer when using the Exam [+] or [-] buttons.
Therefore, select an examination in the Browser as the
start or reference point and use the Series [+] or [-]
buttons to navigate around that examination.
Š Alternatively, type the desired image number in the
Image text box or click and drag the Image slider to page through the images.
Š The order in which the images are displayed is dependent on how the
examinations and images are sorted in the Browser.
4. Change the Window/Level Control to the desired contrast.
Š With the mouse cursor in the viewport, click and drag using the middle mouse
button, in a diagonal direction and release once you achieve the desired
window/level setting. Moving the mouse L/R changes the window width and
moving the mouse Up/Down changes the window level.
Š Alternatively, press the right or left arrow key on the keyboard to increase or
decrease (respectively) the width in increments of 2 and press the down or up
arrow key to increase or decrease (respectively) the level in increments of 2.
Holding the arrow key down continuously provides accelerated changes until the
key is released. The change is applied to the primary view first, then to the other
views once you have stopped pressing the arrow key for a few moments.
Š Alternatively, use the Accelerator Line to enter ww and the value to change the
width, and enter wl and the value to change the level. For example, enter ww
800 and wl 250 to set specific values for window width and level.
Š Alternatively, click [Presets] or one of the Function Keys and select a desired
predetermined W/L setting.

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Quick Steps: Display Images in Viewer

1. Select an Image to Display.
2. Click [Format] and select the desired display format.
3. Click [+] or [-] to move to a prior or next examination, series or image.
4. Change the Window/Level Control to the desired contrast.

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Control the Viewports

If you have more than one image displayed, you can set any viewport to be your
primary viewport. Once a window has become the primary viewport and the others have
become inactive, you can magnify and perform other image manipulations without
affecting other images currently displayed on the screen.
Primary viewports can also be linked to secondary viewports. A change in one of the
viewports is reflected in the other viewport. For example, changing the W/L values in
the primary image also changes the W/L values on the secondary focused image.
1. Display two or more images in a multi-format setting.
Š Refer to Display Images in Viewer.
2. Place your cursor in the viewport you want to make the primary viewport and
double-click.
Š Other viewports are secondary and inactive. This allows you to perform zoom,
image enhance, scroll, flip/rotate, and W/L adjustments only on the image in the
primary viewport.
Š The frame around the primary viewport turns blue (or white if you have black and
white monitor).

Primary
Active
Viewport
Secondary
Active
Viewports

Inactive
Viewport

3. Place the cursor on a different viewport to give that viewport secondary focus, then
click once to connect the isolated viewport.
Š This image now has a blue (or white) frame and the previous selected image has
a yellow (or black) frame around it.
4. Click on the image to which you want to give primary focus again.
Š The blue (or white) frame is the primary focus and the yellow (or black) frame is
the secondary focus.
5. Triple-click on any viewport to connect all the images within the series.
Š This allows you to change the W/L, Scrolling, and Zoom (magnification) functions
for all the viewports in unison.

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Quick Steps: Control the Viewports

1. Display two or more images in a multi-format setting.
2. Place your cursor in the viewport you want to make the primary viewport and
double-click.
3. Place the cursor on a different viewport to give that viewport secondary focus,
then click once to connect the isolated viewport.
4. Click on the image to which you want to give primary focus again.
5. Triple-click on any viewport to connect all the images within the series.

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Page Through an Image Set

The Paging function allows you to page through images as if you viewing a moving
picture. Suggested applications for Paging include kinematic studies of the
temporomandibular joint (TMJ) or knee, heart motion studies, and cerebrospinal fluid
(CSF) flow studies.
Follow these steps to use the Paging function.
1. Select the desired series in the Browser for paging.
2. Click [Viewer] or [Mini Viewer].
Š Paging is accessible from either the Viewer or the Mini Viewer.
3. Click [Format] and select either a 1-on-1, 1-on-2, or 4-on-1 format.
Š The selected Format determines the number of movies you can view
simultaneously.
4. Click [Paging].
Š The Paging window opens.
Š All images in a series are automatically loaded into the Paging window.

5. Select the image you want to start the paging sequence.

Š Click and drag on the Start slider to set the desired first image in the movie loop.
Š Use the right Start arrow to advance the start image number.
Š Type in the image number in the Start text box and press Enter.
6. Select the image you want to end the paging sequence.
Š Click and drag the End slider to set the desired last image in the movie loop.
Š Use the right End arrow to advance the end image.
Š Type in the image number in the End text box and press Enter.

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7. Set the FPS.

Š Click and drag the FPS slider to the desired rate.
Š Use the FPS scroll arrows to set the FPS.
Š Type a value in the FPS text box and press Enter.
8. Click on the Temporal or Spatial arrow to set the movie viewing order.
Š Temporal views images as 1, 2, 3, 4, 1, 2, 3, 4.
Š Spatial views images as 1, 2, 3, 4, 3, 2, 1.
9. If more than one viewport is displayed, load additional series to view in the paging
mode, if desired.
a) Click in the desired viewport to load images into another viewport for paging.
b) Click [Select Series] to return to the Browser.
c) Select the examination and series desired for paging.
d) Click [Viewer].
10. Click the Go icon to start the movie loop.

Š The Go icon becomes the Stop icon while the movie loop is running. Click the
Stop icon to stop the movie loop.
Š There is a slight pause while the images are loaded before the movie loop starts.
11. To change the images in a viewport or change the FPS, make that viewport the
primary focus, then repeat steps 5 to 8.
12. Click [Cancel] to exit the Paging mode.

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Quick Steps: Page Through an Image Set

1. Select the desired series in the Browser for paging.
2. Click [Viewer] or [Mini Viewer].
3. Click [Format] and select either a 1-on-1, 1-on-2, or 4-on-1 format.
4. Click [Paging].
5. Select the image you want to start the paging sequence.
6. Select the image you want to end the paging sequence.
7. Set the FPS.
8. Click on the Temporal or Spatial arrow to set the movie viewing order.
9. If more than one viewport is displayed, load additional series to view in the paging
mode, if desired.
10. Click the Go icon to start the movie loop.
11. To change the images in a viewport or change the FPS, make that viewport the
primary focus, then repeat steps 5 to 8.
12. Click [Cancel] to exit the Paging mode.

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Compare Images
The Compare function allows you to compare images to one another. The images you
compare can be from the same series, or a different series in the current examination,
or you can even compare another examination or patient to the current one displayed.
Use this procedure to compare two images.
1. Select the first examination, series, and image that you want to compare.
2. Click [Viewer] to load the images.
Š Compare is only available in the Viewer.
3. Click [Format] and select a 2-on-1 or 4-on-1 display format.
Š Only the 2-on-1 or 4-on-1 formats are valid for comparing.
4. Click [Compare].
Š The Browser opens with a message directing you to select the examination,
series, and images that you wish to compare.

5. Select the second examination, series, and image that you want to compare with
the first set of images.

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 Displaying Images

6. Click [Viewer].
Š The Viewer returns with the Compare mode activated.
Š The monitor is divided into two separate Viewers. If you want to make changes to
the first examination, click on that image to make it the primary viewport. Make
your changes, then click on the opposite viewport to make it the primary viewport
and make the changes to that side.

7. Click the Left Series or Right Series up and down arrows to move through the
image set that is displayed on the left side of the Viewer or the right side of the
Viewer.
Š If you want to move both series at the same time, use the Page Up or Page
Down keys on the keyboard.

8. When you are finished comparing the images, click [Cancel Compare].

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Quick Steps: Compare Images

1. Select the first examination, series, and image that you want to compare.
2. Click [Viewer] to load the images.
3. Click [Format] and select a 2-on-1 or 4-on-1 display format.
4. Click [Compare].
5. Select the second examination, series, and image that you want to compare with
the first set of images.
6. Click [Viewer].
7. Click the Left Series or Right Series up and down arrows to move through the
image set that is displayed on the left side of the Viewer or the right side of the
Viewer.
8. When you are finished comparing the images, click [Cancel Compare].

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Manipulate Images
Magnify Images (Zoom)
Use the Zoom Control to better visualize an area of interest in the Viewer or the Mini
Viewer. The Zoom factor is displayed in the text box to the right of Zoom and in the
upper right corner of the image.
Use this procedure to magnify an image.
1. Display the desired images.
Š The Zoom controls can be accessed in the Viewer or the Mini Viewer.

2. Enter a magnification factor in the Zoom text box.

3. Press the Enter key.
Š Alternatively, click the arrows to zoom in or out of the image in increments of 0.1
or use the slider to obtain the desired magnification.
Š The images are magnified to the set factor.

4. Click [Display Normal] to return to the original image size, if necessary.

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Quick Steps: Manipulate Images – Magnify Images (Zoom)

1. Display the desired images.
2. Enter a magnification factor in the Zoom text box.
3. Press the Enter key.
4. Click [Display Normal] to return to the original image size, if necessary.

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Manipulate Images
Apply the Magnifying Glass
The Magnifying Glass allows you to magnify a square region of view with 2X
magnification. The Magnifying Glass is moved about the image by moving the mouse.
This function can be applied with an image in the Viewer or Mini Viewer.
Use this procedure to magnify a specific area of an image.
1. Click the Magnifying Glass icon.

2. Place the cursor on the image of interest.

3. Click and hold the right mouse button to activate the Magnifying Glass.

4. Right-click and drag the mouse to move the Magnifying Glass around the image.
5. Release the right mouse button to deactivate the Magnifying Glass.
NOTE: You can set the Right Mouse Button, using User Preferences, to default as the
Magnifying Glass without first clicking the Magnifying Glass icon.

Quick Steps: Manipulate Images – Apply the Magnifying Glass

1. Click the Magnifying Glass icon.
2. Place the cursor on the image of interest.
3. Click and hold the right mouse button to activate the Magnifying Glass.
4. Right-click and drag the mouse to move the Magnifying Glass around the image.
5. Release the right mouse button to deactivate the Magnifying Glass.

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Manipulate Images
Scroll an Image
Scrolling allows you to move the image within the viewport and to move the area of
interest to the center of the viewport. Image Scrolling can be accessed from either the
Viewer or the Mini Viewer and can be applied to any image.
Use this procedure to scroll an image to reset its center point.
1. Click the Scroll icon.

2. Place the cursor on the image of interest.

3. Right-click and drag to move the image.
Š The image follows the cursor.

4. Click [Display Normal] to return the image to its original state.

NOTE: You can set the Right Mouse Button to default to the Scroll function without first
clicking the Scroll icon.
If you have used a matte, the Scroll function scrolls your matted image within the
viewport. It does not “pan” outside the matte.

Quick Steps: Manipulate Images – Scroll an Image

1. Click the Scroll icon.
2. Place the cursor on the image of interest.
3. Right-click and drag to move the image.
4. Click [Display Normal] to return the image to its original state.

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 Displaying Images

Manipulate Images
Apply a Grid
A Grid allows you to place a grid (matrix) over the primary image to measure anatomy
or pathology on an image.
NOTE: To activate this feature, refer to Grid Preferences.
Use this procedure to apply a grid to an image.
1. Place the image of interest in the primary viewport.
2. Click the Grid icon.

Š A grid is applied over the image.

3. Click the Grid icon again to turn the grid off.

Quick Steps: Manipulate Images – Apply a Grid

1. Place the image of interest in the primary viewport.
2. Click the Grid icon.
3. Click the Grid icon again to turn the grid off.

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Manipulate Images
Erase, Hide, and Show Annotation or Graphics
You can erase selected user-added annotation or graphics from an image or
temporarily hide the annotation.
1. Place the image of interest in the primary viewport.
2. Select the annotation or graphic so it is active.
Š The selected text or graphic appears blue.

3. Click [Hide] to temporarily hide the selected annotation or graphic.

Š The selected annotation or graphic disappears.

4. Click [Show] to redisplay the annotation or graphic.

Š The selected annotation or graphic reappears.

5. Click the Erase Annotation icon to permanently erase the selected annotation or
graphic.
Š The selected annotation or graphic is removed from the image.
Š Alternatively, press Ctrl + X on the keyboard.

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Quick Steps: Manipulate Images – Erase, Hide, and Show Annotation or

Graphics
1. Place the image of interest in the primary viewport.
2. Select the annotation or graphic so it is active.
3. Click [Hide] to temporarily hide the selected annotation or graphic.
4. Click [Show] to redisplay the annotation or graphic.
5. Click the Erase Annotation icon to permanently erase the selected annotation or
graphic.

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Manipulate Images
Reference Images
The Reference Image function allows you to insert an image into a small viewport on
the Viewer or Mini Viewer. This image identifies the slice location of the main image.
The inserted Reference Image must be in another plane from the main image. The two
images (the main image and the Reference Image) must be from the same
examination, have the same horizontal landmark, same patient position, and same
patient entry.
Use this procedure to insert Reference Images on your images.
1. Open the desired series in the Viewer or Mini Viewer.
2. Click [Format] and select the desired display format.
Š References images can be viewed on 1-on-1, 2-on-1, 4-on-1, and 9-on-1 formats
in the Viewer.
Š References images can be only be viewed on a 1-on-1 format in the Mini Viewer.
3. Click [Reference Image].
Š Predefined reference image selections open on the Reference Image menu.
4. Select the desired option from the menu.
Š All On places the reference image on all the viewports.
Š All Off takes the reference image off all the viewports.
Š Selected On places the reference image on only the selected
viewports.
Š Selected Off places the reference image off only the selected
viewports.

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 Displaying Images

NOTE: The system automatically chooses a reference image for you. If you would like
to use a different image for the reference do one of the following:
To change the reference image on a specific viewport, select (as you would to
set the primary viewport) the reference image viewport and type ri 3 7 in the
Accelerator Line. The example ri 3 7 represents series 3 image 7 as the
reference image (ri).
To change the reference image on all viewports, select all reference image
viewports (as you would to set the secondary viewport) and type ria 3 7 in the
Accelerator Line. The example ria 3 7 represents series 3 image 7 Reference
Image All (ria).

Quick Steps: Manipulate Images – Reference Images

1. Open the desired series in the Viewer or Mini Viewer.
2. Click [Format] and select the desired display format.
3. Click [Reference Image].
4. Select the desired option from the menu.

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Manipulate Images
Flip/Rotate Images
You can flip or rotate the displayed images. Once you flip or rotate the images, they are
annotated with the flip direction and the rotation. This annotation is on the top right of
the image. If the images are not flipped (FL) or rotated (ROT) there is no annotation
following the FL: or ROT: annotation.
Use this procedure to flip or rotate an image.
1. Place the image of interest in primary viewport.
2. Click [Flip Rotate].
Š The flip/rotate menu opens.

3. Select the desired manipulation.

Š Flips the image left to right and annotates the film as FL: L/R.
Š Flips the image top to bottom and annotates the film as FL: T/B.
Š Rotates the image counterclockwise and annotates the film as ROT: 270.
Š Rotates the image clockwise and annotates the film as ROT: 90.

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Quick Steps: Manipulate Images – Flip/Rotate Images

1. Place the image of interest in primary viewport.
2. Click [Flip Rotate].
3. Select the desired manipulation.

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Annotate Images
You can add annotation to the image to make comments or observations, to draw
attention to a specific area of interest, or for labeling purposes. Multiple areas of
annotation can be added to an image and then later deleted. Annotation includes an
on-screen arrow for pointing out specific structures as well as making text entries. The
annotation function can be done using either the Viewer or the Mini Viewer.
Use this procedure to annotate images.
1. Place the desired image in the primary viewport.
2. Click the Annotate icon.

Š A text box and arrow are positioned in the middle of the image.
3. Move the cursor to the image and enter the desired text.
Š The text is automatically placed inside of the displayed box.
Š Press the Enter key to create a new line of text.

4. Drag the box and arrow to the desired location.

5. Click and drag the arrowhead (now a pencil) to change the direction and length of
the line.
Š Click and drag the arrowhead into the text box to hide the arrow, or type arrow
off in the Accelerator Line. Typing arrow on turns it back on.
Š Click the cursor outside the text box (or press Ctrl + X) to erase the text box
lines.
Š Click the cursor on the text to make the text box lines reappear.
6. Enter prop all in the Accelerator Line to propagate the text to all the images of
the series.
NOTE: Select the active text box and arrow and click the Erase Annotate icon to erase
a single area of annotation. Click [Erase All] to remove all areas of annotation.

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Quick Steps: Annotate Images

1. Place the desired image in the primary viewport.
2. Click the Annotate icon.
3. Move the cursor to the image and enter the desired text.
4. Drag the box and arrow to the desired location.
5. Click and drag the arrowhead (now a pencil) to change the direction and length of
the line.
6. Enter prop all in the Accelerator Line to propagate the text to all the images of
the series.

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 Displaying Images

Apply Mattes to Images

The Matte function eliminates unwanted information or artifacts on or around an image
before displaying or filming images. There are two types of matte: rectangular and
elliptical. The size of the matte can easily be adjusted to fit the size of the area of
interest.
1. Place the image of interest in the primary viewport.
2. Click [Rect. Matte].

Š A rectangular matte appears on your image.

Š To apply an elliptical matte instead of rectangular matte, type the command
ematte in the Accelerator Line.

3. Click the lower right edge of the matte and drag it to position the matte.
Š The lower right corner of the matte is the anchor point.
4. Click the blue dot in the top left corner of the matte and drag it to resize the matte.
Š The blue dot controls the size and shape of the matte.

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5. Click the Scroll icon and right-click to move the matted object to the center of the
viewport.

Š It does not “pan” the image area outside the matte.

6. Enter prop all in the Accelerator Line to propagate the matte to all the images in
the series.
Š Make sure the blue dot appears in the upper left corner of the matte, indicating
the matte is in the active state.
NOTE: To copy the matte, press Ctrl + C. Select the new image and press Ctrl + V to
paste the matte.

Quick Steps: Apply Mattes to Images

1. Place the image of interest in the primary viewport.
2. Click [Rect. Matte].
3. Click the lower right edge of the matte and drag it to position the matte.
4. Click the blue dot in the top left corner of the matte and drag it to resize the matte.
5. Click the Scroll icon and right-click to move the matted object to the center of the
viewport.
6. Enter prop all in the Accelerator Line to propagate the matte to all the images
in the series.

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Measure
You can use the Measuring feature a number of ways to obtain information, distances,
and areas of anatomy or pathology. It can report the cursor to record a point on an
image, calculate the linear distance between two points, measure the area of anatomy
or pathology, and list the angle of the line between the two points.
Use this procedure to obtain measurements of an area of interest.
1. Place the image of interest in the primary viewport.
2. Click [Measure].
Š The Measure menu opens.

3. Select the desired measurement method.

Š The cursor starting point is placed in the center of the image.
4. Click and drag the measurement tool to the desired start location and size it over the
area of interest.
Š X Cursor
– The cursor location and pixel value is reported.
Š Straight Line
a) Click and drag the endpoint to resize the line. The opposite endpoint stays
fixed.
b) Click anywhere on the line except on the endpoints and drag to the desired
area to measure angle and distance.
Š Angle
a) Click and drag the endpoints to change the angle.
b) Click the line to reposition.

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Š Rectangle
a) Click and drag the small boxes in the corner to change the size and shape of
the rectangle or on the tick marks to rotate the rectangle.
b) Click and drag anywhere on the rectangle, except on the small (corner) box or
the tick marks, to move the rectangle over the area of interest.
Š Measurement Curve
a) To add the next point to the curve, move the cursor pointer to the desired
location, press the Shift key, and click.
b) Continue to press the Shift key and click to add points until the desired
measurement is reached.
c) If you are measuring the perimeter of an object, press the Ctrl key and click.
The ends of the outline are connected.
Š Smooth Curve
a) To add the next point to the curve, move the cursor to the desired location,
press the Shift key and click.
b) Continue to press the Shift key and click to add points to outline the area of
interest.
c) Click and drag on a point to resize it (all other points stay stationary).
d) To close the endpoints of the curve, add the last point near (but not on top of)
the first point. Then, click the last point and drag it on top of the first point.
e) To move the curve over the area of interest, click and drag anywhere on the
curve (except on the points or boxes).
f) To delete a point, press the Shift key and click on the point to be deleted.
g) Click anywhere on the image to hide the points. Click the curve to show points.
Š Ellipse
a) Click and drag the small box to change the size and shape of the ellipse.
b) Click and drag the tick marks to rotate the ellipse.
Š Free Hand Trace
a) Press the Shift key then click and drag the small box. Or, to define a series of
segments, press the Shift key and click on each desired endpoint location.
b) To remove the most recently created segment, press the Backspace key.
NOTE: Click [Erase] to erase the active (blue) result. If more than one result is on the
image, continue to click [Erase].
5. Record the desired reported measurements.

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Quick Steps: Measure

1. Place the image of interest in the primary viewport.
2. Click [Measure].
3. Select the desired measurement method.
4. Click and drag the measurement tool to the desired start location and size it over
the area of interest.
5. Record the desired reported measurements.

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Enhance Images
Image Enhance provides a menu of filters and grayscale changes. The filters are used
for edge or lung enhancement or to smooth an image. The grayscale enhancement
adjusts the grayscale to one of three different levels. The enhancement increases the
image contrast so the image has a more black and white appearance.
Use this procedure to apply an image filter to enhance images.
1. Place the desired image in the Viewer or Mini Viewer.
Š Image Enhance can be accessed through the Viewer or the Mini Viewer.
2. Click [Image Enhance].
Š The Image Enhance menu opens, listing the choices
for Image Enhancement.
3. Select the desired grayscale or filter.
Š Grayscale enhancement: g1 results in the smallest
contrast change while g3 has the most contrast
change. Grayscale Enhancement is generally used
more for CT images than MR images.
Š Filters: those labeled s3 to s1 are smoothing filters,
those labeled e3 to e1 are edge enhancing filters.
The filter labeled lu is for lung enhancement and is
primarily used for CT lung images.
NOTE: Images are annotated on the middle right side of the
image. For example, FLT: s2 or FLT: e1. Filters can
apply only one filter at a time to an image.
4. Click [Display Normal] to display the image without the filter.
NOTE: Image Enhance filters are not additive. Only one filter may be applied to an image
at a time. Applying a new filter negates the previously applied values.
The Image Enhance grayscales and filters are applied to image data only. They
are not applied to graphics, image annotation, or user-added annotation.

Quick Steps: Enhance Images

1. Place the desired image in the Viewer or Mini Viewer.
2. Click [Image Enhance].
3. Select the desired grayscale or filter.
4. Click [Display Normal] to display the image without the filter.

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 Displaying Images

Cross-Reference a Series
The Cross-Reference Lines are used for filming or viewing to provide an anatomical
reference to the images acquired on an intersecting plane. You can cross-reference an
entire series, the first and last image of a series, a single image, or a range of images
within a series by typing in a single command in the Accelerator Line.
1. Place the image of interest in the primary viewport.
Š Cross-referencing can be done in the Viewer or the Mini Viewer.
2. Enter the desired Cross-Reference Accelerator Commands.
Š You cannot cross-reference more than one non-consecutive image with a single
command.
Š To cross-reference all image lines in a series, enter xr followed by the series
number. For example, xr 2.

Š To cross-reference a range of images in a series, enter xr followed by a forward

slash (/) and the first image-last image. For example, xr 2/1-6.

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Š To cross-reference images with an interval in between them, enter xr followed

by the series number, the colon symbol (:), and the interval number. For
example, xr 2:3.

Š To cross-reference only the first and last slices, enter xr followed by the series
number and the word extrema. For example, xr 2 extrema.

Quick Steps: Cross-Reference a Series

1. Place the image of interest in the primary viewport.
2. Enter the desired Cross-Reference Accelerator Commands.

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 Displaying Images

Set Up User Preferences

Customize System-Supplied Annotation
You can modify a number of system-defined default annotations to customize the
display based on your site’s preferences. Annotation levels can be controlled as they
appear in the screen and as they appear on the film.
Use this procedure to change and customize the system annotations as they appear on
the screen (viewer) and film.
1. Display an image in the Viewer.
Š User Preferences are not available in the Mini Viewer, although the effect of the
preferences can be seen.
2. Click [User Prefs].
Š The User Preferences window opens.

3. Select the desired source of annotation to customize.

Š The Screen (viewer) or the Film; the process is the same for both.
4. Select the desired annotation option.
Š Select No annotation, Partial annotation, Full annotation, or Custom
annotation to turn on that option.
Š Custom annotation displays whatever options are selected in the custom
annotation window.
5. To change custom annotation options go to step 6. Go to step 9 if you are not
changing the custom annotation options.
6. Click [Customize...] to customize your user preferences for the selected
annotation.
Š The Screen Annotation Groups window opens.

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7. Select the desired custom options.

Š Turn on or off any of the options by selecting an option to set the amount of
annotation on the screen (or film).
8. Click [Ok] to accept the changes to the annotation and close the window.
9. Click [Save as defaults] to permanently save the selections.
Š Alternatively, click [Apply] to apply the selected options. This is a temporary
application and applies only to the currently displayed images.

Quick Steps: Set Up User Preferences – Customize System-Supplied

Annotation
1. Display an image in the Viewer.
2. Click [User Prefs].
3. Select the desired source of annotation to customize.
4. Select the desired annotation option.
5. To change custom annotation options go to step 6. Go to step 9 if you are not
changing the custom annotation options.
6. Click [Customize...] to customize your user preferences for the selected
annotation.
7. Select the desired custom options.
8. Click [Ok] to accept the changes to the annotation and close the window.
9. Click [Save as defaults] to permanently save the selections.

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Set Up User Preferences

Display Tick Marks
Tick Marks are a ruler shown either on the right side of the image, at the bottom of the
image, or in both places used for measuring.
Use this procedure to have Tick Marks turned on by default.
1. Display an image in the Viewer.
Š User Preferences are not available in the Mini Viewer, although the effect of the
preferences can be seen.
2. Click [User Prefs].
Š The User Preferences window opens.
3. Select Vertical or Horizontal to turn on the Tick Marks.
Š Select both options to turn on both rulers.

4. Click [Save as defaults] to permanently save the selections.

Š Alternatively, click [Apply] to apply the selected options. This is a temporary
selection and applies only to the currently displayed images.

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Quick Steps: Set Up User Preferences – Display Tick Marks

1. Display an image in the Viewer.
2. Click [User Prefs].
3. Select Vertical or Horizontal to turn on the Tick Marks.
4. Click [Save as defaults] to permanently save the selections.

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Set Up User Preferences

Customize Grid Preferences
The grid measurements are in millimeters and the size of the grid changes with the
display FOV. The Grid Preferences allow you to control the grid spacing and grid
appearance.
Use this procedure to change the grid spacing and appearance to your site’s
preference.
1. Display an image in the Viewer.
Š User Preferences are not available in the Mini Viewer, although the effect of the
preferences can be seen.
2. Click [User Prefs].
Š The User Preferences window opens.
3. Click [Customize...] from the Grid Prefs area.

Š The Grid Preferences window opens.

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4. Select your desired options.

Š Matrix Lines: turns on or off the lines that form a grid pattern about the central
vertical and horizontal lines.
Š Line Style: changes the grid lines to solid or dotted.
Š Grid Spacing: changes the space between the grid lines in millimeters.
Š Tick Spacing: changes the space between the tick marks in millimeters.
Š Tick Length: changes the length of the tick marks in millimeters.
5. Click [Ok] to save the changes.
Š Click [Cancel] to exit without saving the Grid Preferences.
6. Click [Save as defaults] to permanently save the selections.
Š Alternatively, click [Apply] to apply the selected options. This is a temporary
selection and applies only to the currently displayed images.

Quick Steps: Set Up User Preferences – Customize Grid Preferences

1. Display an image in the Viewer.
2. Click [User Prefs].
3. Click [Customize...] from the Grid Prefs area.
4. Select your desired options.
5. Click [Ok] to save the changes.
6. Click [Save as defaults] to permanently save the selections.

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Set Up User Preferences

Control the Right Mouse Button
The primary control of the Right Mouse Button can be set to either Scroll or use a
Magnifying Glass on the selected image. This allows you control the default setting for
the right mouse button in the Viewer or Mini Viewer.
1. Display an image in the Viewer.
Š User Preferences are not available in the Mini Viewer, although the effect of the
preferences can be seen.
2. Click [User Prefs].
Š The User Preferences window opens.
3. In the Right mouse button area, select the desired function for the right mouse
button.

Š The standard right mouse function is Scrolling.

Š Magnify glass is the alternate option.
4. Click [Save as defaults] to permanently save the selections.
Š Alternatively, click [Apply] to apply the selected options. This is a temporary
selection and applies only to the currently displayed images.

Quick Steps: Set Up User Preferences – Control the Right Mouse Button
1. Display an image in the Viewer.
2. Click [User Prefs].
3. In the Right mouse button area, select the desired function for the right mouse
button.
4. Click [Save as defaults] to permanently save the selections.

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Set Up User Preferences

Control Series Binding
Series Binding is a function used when viewing images to continuously move forward or
backward to the next or prior series by clicking Image [+] or [-].
Use the following procedure to turn Series Binding on or off.
1. Display an image in the Viewer.
Š User Preferences are not available in the Mini Viewer, although the effect of the
preferences can be seen.
2. Click [User Prefs].
Š The User Preferences window opens.
3. Select Series binding ON or OFF.

Š With Series binding on, you can click Image [+] or press the Page Down key
after the last slice in the series to display the first slice of the next series.
Š With Series binding off, you can click Image [+] or press the Page Down key
after the last slice in the series to display the first slice in the same series. It does
not automatically advance to the next series.
4. Click [Save as defaults] to permanently save the selections.
Š Alternatively, click [Apply] to apply the selected options. This is a temporary
selection and applies only to the currently displayed images.

Quick Steps: Set Up User Preferences – Control Series Binding

1. Display an image in the Viewer.
2. Click [User Prefs].
3. Select Series binding ON or OFF.
4. Click [Save as defaults] to permanently save the selections.

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Set Up User Preferences

Apply Square Viewports
Square Viewports affect the shape of the image viewports and the selected Format in
the Viewer. To achieve the correct magnification factor, be sure Square Viewports are
on.
Use this procedure to turn Square Viewports on.
1. Display an image in the Viewer.
Š User Preferences are not available in the Mini Viewer, although the effect of the
preferences can be seen.
2. Click [User Prefs].
Š The User Preferences window opens.
3. Select Square viewports ON.

Š The system displays the images in the Viewer exactly as they appear on the film
with Square viewports on.
Š If Square viewports are turned off, filming problems can occur when you magnify
the image.
4. Click [Save as defaults] to permanently save the selections.
Š Alternatively, click [Apply] to apply the selected options. This is a temporary
selection and applies only to the currently displayed images.

Quick Steps: Set Up User Preferences – Apply Square Viewports

1. Display an image in the Viewer.
2. Click [User Prefs].
3. Select Square viewports ON.
4. Click [Save as defaults] to permanently save the selections.

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Set Up User Preferences

Customize the Window/Level Presets
Customizing the Presets in the User Preferences window allows you to preset the W/L
values to quickly adjust the brightness and contrast of a displayed image. You can
program up to six different settings for your system.
Use this procedure to set the W/L preset values.
1. Display Images in Viewer.
Š User Preferences are not available in the Mini Viewer, although the effect of the
preferences can be seen.
2. Click [User Prefs] at the bottom left of the Viewer.
3. Select Modality > MR.

4. Double-click the text you want to change in the title area and press the Delete key.
Š This allows you to enter a unique name in the title area for your preset values.
5. Enter a unique name in the first title text box.
Š For example, Brain T1.
6. Enter the desired values in the w/width and w/level text boxes.
Š Alternatively, you can click [Set Current] to set the W/L values to that of a
displayed image in the Viewer.
7. Click [Save as defaults] to replace the current setting with the new setting and
save it for future use as a preset.
Š Predefined presets 1 to 6 correspond to the Keyboard Keys F6 through F11.
Š Alternatively, click [Apply] to apply the new settings only on the displayed image
without saving the settings.
8. Click [Presets] in the Viewer Display Tools and select an option to recall the preset
W/L value.

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Quick Steps: Set Up User Preferences – Customize the Window/Level Presets

1. Display Images in Viewer.
2. Click [User Prefs] at the bottom left of the Viewer.
3. Select Modality > MR.
4. Double-click the text you want to change in the title area and press the Delete key.
5. Enter a unique name in the first title text box.
6. Enter the desired values in the w/width and w/level text boxes.
7. Click [Save as defaults] to replace the current setting with the new setting and
save it for future use as a preset.
8. Click [Presets] in the Viewer Display Tools and select an option to recall the preset
W/L value.

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 Filming Images

Chapter 37
Filming Images

Introduction
This chapter explains how to film images from the Signa® workstation. You can send
images that have been displayed, analyzed, and manipulated to a laser camera for film
output or to a printer for paper output. This chapter contains the concepts and the
step-by-step instructions to help you learn how to:
• Set Up the Film Composer
• Load with Drag and Drop
• Load with the Function Keys
• Load Text Pages
• Erase an Image from the Film Composer
• Print Images
• Select a Remote Printer
• Check the Print Queue

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 Filming Images

What Do I Need to Know About...

This section presents the concepts necessary to successfully film images. Specifically,
you need to understand:
• Film Composer
– Setting the Film Parameters
– Setting the Print Options
– Loading the Images
– Printing
• Film Composer Status
• Print Queue
• Remote Printer

Film Composer
The Film Composer (Figure 37-1) is the interface with your camera that allows you to
choose a print format and send images to the camera for film output or to a printer for
paper output. The system must be linked to the appropriate output device. You can
place images from multiple viewing applications, and therefore multiple studies, on the
same film. The Film Composer can be accessed from the Viewer, Mini Viewer, or
Browser.

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 Filming Images

Figure 37-1 Film Composer

Table 37-1 Film Composer Selections

Selection Description
Allows you to select the arrangement of images on a sheet of
Formats
film. Format selections depend on your camera settings.
Camera Displays the name of your camera.
Allows you to customize your Film Composer by selecting
[Options]
desired Print Options.
[Clear] Clears the current images displayed in the Film Composer.
[Print] Manually prints the images displayed in the Film Composer.
Allows configuration (additions, deletions, changes) of a camera
[Configure]
or printer to communicate with your system.
[Quit] Closes the Film Composer, erases the images.
Iconize Minimizes the Film Composer and retains the images and image
icon label if it is currently active.

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 Filming Images

There are four primary steps to the filming process:

• Setting the Film Parameters
• Setting the Print Options
• Loading the Images
• Printing

Setting the Film Parameters

Setting the film parameters means communicating to the workstation:
• The number of images to print on the film (typically up to 20). This is selected in the
Formats area of the Film Composer.
– The available film formats may vary depending on the laser camera or printer
being used.
– Use a 2x2 display format (4-on-1 screen) on the Viewer for filming, otherwise the
magnification factor is different between the Viewer and the film.
• The number of copies of each film to print.

Setting the Print Options

A number of print options (Figure 37-2) are available on the Film Composer and can be
customized for your filming protocols. When you select these options, the settings are
maintained in your system but may adjusted at any time.
Figure 37-2 Print Options

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 Filming Images

Table 37-2 Print Options

Option Description
Images produced in slide format can be helpful for
presentations or teaching files. If your camera is set up for
Slide Format slides, you can select On for this option to print slides or Off to
print regular films. If the selected output device does not
support the slide format, this function is not available to select.
The Grayscale is a vertical bar that displays varying shades of
gray from white to black. If Grayscale is On, it appears on the
Grayscale
left side of the image. If your system does not support
Grayscale, this function is not available.
If this option is On, the system automatically sends the film to
the printer when all the frames of the film are filled. If you select
Auto Printing
Off, the film will not be sent to the printer and you have to click
the [Print] button on the Film Composer to manually send it.
If this option is On, the frames of the film (in the Film
Composer) are automatically cleared once the film is sent to
Auto Clear Page
the printer. If selected Off, you need to clear the film manually
by clicking the [Clear] button on the Film Composer.
Images can be displayed in several ways in the frames of the
Film Composer. This allows you to keep track of what has
been placed on the film in the Film Composer. Selecting E/S/I
shows the exam number/series number/image number in the
Icon Labels
frame. The Image selection displays a small picture of the
image being printed in that frame.This only changes the way
images are displayed in the Film Composer, not on the printed
film.
The order in which the images are loaded when using the
Function keys can be changed. The Left/Right/Top/Bottom
selection exposes the images from left to the right and from the
Expose Order
top to the bottom of the film. The Right/Left/Bottom/Top
selection exposes the images from right to the left and from the
bottom to the top.
This feature allows you to print multiple copies. Click the up or
No. of Copies down arrows to increase or decrease the number. You can
also enter a number in the text box, then press Enter.
Messages are posted in this area to keeps you informed of
various conditions in the filming process (print queue empty,
printing, film supply low, output device not connected, etc.).
Status Area
This area cannot be changed. If an arrow appears in the
lower-right corner of this area, click on it to see additional
information about the filming status.
[Done] Closes the option window and saves your selections.

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 Filming Images

Loading the Images

Loading the images simply means displaying images from one or more viewing
applications, indicating where each image is to be placed on the film.

Drag and Drop Method

Loading with the Drag and Drop method allows you to place only one image in a frame
on the film. Viewing and film formats do not need to be the same. With this method, you
can place your cursor over an image, then drag and drop the image in the appropriate
frame on the Film Composer.

Function Key Method

The top row of the computer keyboard (Figure 37-3) is composed of keys labeled F1
through F12. Function keys F1 through F4 have special functions in the Film Composer.
Using the function key method helps to accelerate the manual filming process.
Selecting the appropriate key places the images on the film with one keystroke.
Figure 37-3 Function Keys

The F5 through F11 keys may each be programmed for different window width and
window level (W/L) settings. This allows you to use a single key to adjust the W/L of an
image. The W/L values may be programmed through User Preferences to adjust the
settings according to your facility’s preferences.

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 Filming Images

The function of each key is described in Table 37-3.

Table 37-3 Function Key Descriptions

Function
Description
Key
Loads a single image in the first available frame on the Film Composer.
F1
The cursor must be on the desired image to be filmed.
Loads an entire page (all of the displayed images in the viewing
application) of images into the Film Composer. If the viewing application
and the Film Composer format are different, the Film Composer format
F2 automatically changes to match the viewing application’s format. The
cursor can be on any image on the Viewer or Mini Viewer. The Film
Composer must be empty to use the F2 key. If it is not empty, click the
[Clear] button on the Film Composer.
Loads multiple image displays (MID) into one frame on the film. The
F3 images must be viewed in the arrangement you want them on the film
(e.g., the screen divided vertically one image occupying each side).
Loads and prints all the images in a single series with just one keystroke.
F4
The cursor can be on any image on the screen.

Printing
After you have set up the film parameters and loaded the images, you can transfer
those images to film. The Print Series function, (available from the Viewer, the Mini
Viewer and as an Accelerator Command), allows you to set up and print the series you
are currently viewing.

Print Page
You can print a single page by using the Drag and Drop Method or the F1 key. After
placing the images in the Film Composer, click the [Print] button to print the page.
You can also press the F2 key to print an entire page.

Print Multiple Image Displays

Using the F3 key, you can print MID. The images must be magnified by a factor of 2 for
them to fill the frame on the film. Scroll images if necessary. Since all the images are
placed in a single frame, the resolution of a MID film is not as good as that of a film
obtained when the same set of images is filmed using page filming. Single-image
frames and MID frames can be mixed on the same film. You cannot skip frames using
the F3 key.
NOTE: Filming using the F3 key may result in partial annotation (site name, patient
identification (ID), system ID, and lower left corner annotation missing) on the
film. To prevent this, select Custom Film Annotation in the User Preferences to
select the Annotation (typically select Full Annotation) you want to appear.

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 Filming Images

Print Series
You can print an entire series using the F3 function key or by typing print_series in
the Accelerator Line. When printing a series, all the images are filmed with the same
window and level values. The Auto Printing and Auto Clear Page options can be turned
off and the system continues to print and clear each film until it has filmed all images in
the selected series.
When a print series command is executed, the Print Series window opens (Figure
37-4). This window allows you to make specific selections regarding the printing options
for that series.
• Format: Film Composer or Viewer format. For example, if the Viewer format is
12-on-1, then the film format will also be 12-on-1.
• Interval: Print all images or images in a selected interval.
• Print Last Sheet: Yes or No. There may be times when you do not want the last
sheet to automatically print, i.e., when you want to add a series or text page to the
patient’s printed examination. In this instance, you must manually print the last
sheet by clicking the [Print] button.
• Image Selection: Move the slider to include the number of images to be printed.
• Current Job Status: Displays messages about the print job currently being
executed and gives you the option to cancel the print job.
Figure 37-4 Print Series Window

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 Filming Images

Film Composer Status

The Film Composer status area is located directly below the desktop icons. It indicates
the status of the examination, series, and images currently being filmed.
Figure 37-5 Film Composer Status

Print Queue
The Print Queue displays the jobs that are waiting to be printed. The queues for the
laser camera (printer) and any remote (network) cameras can be accessed from the
Print Queue. You can also stop a job from printing. For example, to stop a duplicate
film.
Figure 37-6 Print Queue

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 Filming Images

Remote Printer
The remote printer is networked to your system and serves as a secondary option for
printing. This allows you to continue printing if your laser camera is not functioning. For
example, when your camera or processor is shut down for maintenance or cleaning.
Only one printer at a time can be used for a print job.
The initial set up of a remote printer requires the assistance of a GE Service Engineer
and your facility’s Information Systems Network personnel.

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 Filming Images

How Do I...
This section provides the step-by-step instructions for filming images. Specifically, it
describes how to:
• Set Up the Film Composer
• Load with Drag and Drop
• Load with the Function Keys
• Load Text Pages
• Erase an Image from the Film Composer
• Print Images
• Select a Remote Printer
• Check the Print Queue

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 Filming Images

Set Up the Film Composer

Use the Film Composer to print images on film (or paper). There are a number of
options you can use when filming, such as film format, number of copies, auto print, and
auto clear.
Use this procedure to set up print options on the Film Composer.
1. Click [Film Composer] in the Viewer, Mini Viewer, or Browser.

Š The Film Composer opens.

2. Click the desired film format icon in the Formats area.
Š The available film formats may vary depending on the laser camera or printer
being used.
Š Use a 2x2 display format (4-on-1 screen) on the Viewer for filming, otherwise the
magnification factor is different between the Viewer and the film.

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 Filming Images

3. Click [Options] to open the Print Options window.

4. Select your desired print options.

Š Refer to the Print Options table for decorations of each option.
5. Click [Done] to close the Print Options window and save all settings.

Quick Steps: Set Up the Film Composer

1. Click [Film Composer] in the Viewer, Mini Viewer, or Browser.
2. Click the desired film format icon in the Formats area.
3. Click [Options] to open the Print Options window.
4. Select your desired print options.
5. Click [Done] to close the Print Options window and save all settings.

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 Filming Images

Load with Drag and Drop

Loading the Film Composer using the Drag and Drop Method allows you to choose the
exact location on the film to place your image (allowing you to skip frames if desired).
Loading with drag and drop also allows you to place only one image into a frame on the
film. Viewing and film formats do not need to be identical.
Use this procedure to load images with the Drag and Drop method.
1. Display the images to be loaded in the Viewer or Mini Viewer.
2. Click [Film Composer] in the Viewer or Mini Viewer.

Š The Film Composer opens.

3. Click the desired film format icon in the Formats area.
Š The available film formats may vary depending on the laser camera or printer
being used.
Š Use a 2x2 display format (4-on-1 screen) on the Viewer for filming, otherwise the
magnification factor is different between the Viewer and the film.

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 Filming Images

4. Place the cursor on the desired image.

5. Click and drag the image to the desired frame in the Film Composer.
Š If you selected Image for your icon label, a reproduction of the image appears in
the frame.
Š If you selected E/S/I for your icon label, the exam, series, and image appear in
the frame.
6. Move the cursor to the next image and repeat the drag and drop process as
needed.
Š It is not necessary to place images in consecutive frames or fill all the frames on
the film.
NOTE: You must click [Print] if all the film frames are not filled or if Auto Printing is off.
Also, you need to click [Clear] if Auto Clear Page is off.

Quick Steps: Load with Drag and Drop

1. Display the images to be loaded in the Viewer or Mini Viewer.
2. Click [Film Composer] in the Viewer or Mini Viewer.
3. Click the desired film format icon in the Formats area.
4. Place the cursor on the desired image.
5. Click and drag the image to the desired frame in the Film Composer.
6. Move the cursor to the next image and repeat the drag and drop process as
needed.

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 Filming Images

Load with the Function Keys

The F1 through F4 keys along the top of the computer keyboard are accelerator keys
for filming. Selecting the appropriate key places the images on the film with one
keystroke.
Use this procedure to load images into the Film Composer with the Function Key
Method.
1. Display the images to be loaded in the Viewer or Mini Viewer.
2. Click [Film Composer] in the Viewer or Mini Viewer.

Š The Film Composer opens.

3. Click the desired film format icon in the Formats area.
Š Depending on the function key you use, the view and film formats may need to
be the same.

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 Filming Images

4. Move the cursor onto an image in the Viewer and press the desired function key.

Š The images are loaded into the frames of the Film Composer in the order they
are selected.
Š F1 – Places a single image in the first available frame on the Film Composer.

Š F2 – Loads an entire page of image (all of the displayed images in the viewing
application) onto the Film Composer.

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 Filming Images

Š F3 – Films multiple images into one frame on the film.

Š F4 – Films all the images in a single series.

Quick Steps: Load with the Function Keys

1. Display the images to be loaded in the Viewer or Mini Viewer.
2. Click [Film Composer] in the Viewer or Mini Viewer.
3. Click the desired film format icon in the Formats area.
4. Move the cursor onto an image in the Viewer and press the desired function key.

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 Filming Images

Load Text Pages

Text pages contain patient data. You may decide to have a frame on the film that
displays this information. You can load an Exam Text Page or a Series Text Page to
add to your images in the Film Composer.
1. Display the images to be loaded in the Viewer or Mini Viewer.
2. Select the desired type of Text Page.

Š Select Exam Page to display the Exam Text Page.

Š Select Series Page to display the Series Text Page.
Š Alternatively, you can enter the Accelerator command for the desired Text Page.
– Enter te in the Accelerator Line for the Exam Text Page.
– Enter ts in the Accelerator Line for the Series Text Page.
3. Press the F1 key to load the Text Page on the Film Composer.
Š The cursor must be in the Exam or Series Text Page.
Š Alternatively, you can click [Film] on the bottom of the text page. Both methods
of filming the Text Page place it in the next available frame in the Film Composer.

Quick Steps: Load Text Pages

1. Display the images to be loaded in the Viewer or Mini Viewer.
2. Select the desired type of Text Page.
3. Press the F1 key to load the Text Page on the Film Composer.

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 Filming Images

Erase an Image from the Film Composer

While filming, you may decide to remove an image from a frame on the Film Composer.
The Film Composer must be open with at least one image in a frame.
Use this procedure to erase an image from the Film Composer.
1. Click the image frame you wish to erase on the Film Composer.
Š A message appears, asking you if you really want to discard this image.
Š If you want to erase all the images on the film, click [Clear].
2. Click [Yes] to discard the image.
Š You can click [No] to exit without erasing the image from the film.
Š If you want to discard all the images on the film and close Film Composer, click
[Quit].

Quick Steps: Erase an Image from the Film Composer

1. Click the image frame you wish to erase on the Film Composer.
2. Click [Yes] to discard the image.

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 Filming Images

Print Images
Printing is the process of sending the images to the Print Queue and from there to the
laser camera (or paper printer) to get printed on the film (or paper). If you have the Auto
Printing option on, the film prints automatically when the frames are full. Turn Auto
Printing off if you want to check your film before it leaves the Film Composer. This
procedure assumes Auto Printing is off.
1. Place all the desired images on the Film Composer.
2. Click [Print] to print the contents of the Film Composer.
Š The Status area at the bottom of the Film Composer changes to display
Printing..., and the image data is sent to the print queue. The output device
prints the data when it reaches the top of the print queue.
Š If Auto Clear Page is on, the Film Composer is automatically cleared.
3. Manually clear the Film Composer if Auto Clear Page is off.
a) Click [Clear].
– A confirmation message appears.
b) Click [OK].
– Selecting [Cancel] exits without clearing the film.
4. Click [Quit] when you are finished filming to close the Film Composer.
Š This also clears any images left in the frames.
Š To close the Film Composer without losing any images in the frames, click on the
Film Composer iconize button in the upper right corner of the Film Composer.

5. Click [OK] to quit Film Composer and discard the images.

Quick Steps: Print Images

1. Place all the desired images on the Film Composer.
2. Click [Print] to print the contents of the Film Composer.
3. Manually clear the Film Composer if Auto Clear Page is off.
4. Click [Quit] when you are finished filming to close the Film Composer.
5. Click [OK] to quit Film Composer and discard the images.

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 Filming Images

Select a Remote Printer

A Remote Printer is a printer, either a laser camera or paper printer, located outside of
your immediate area that can be used as a secondary printer. This printer can be
networked to your system and used as an additional or backup printer.
Use this procedure to select a remote printer.
1. Click [Film Composer] in the Viewer, Mini Viewer, or Browser.
Š The Film Composer opens.
2. Click [Configure].
Š The Remote Printer Configuration window opens.

3. Click an option to [Add], [Update], or [Delete] printers.

Š At this point you will need the assistance of your facility’s Information Technology
Department for printer names, etc.
4. Click [Done] to exit.

Quick Steps: Select a Remote Printer

1. Click [Film Composer] in the Viewer, Mini Viewer, or Browser.
2. Click [Configure].
3. Click an option to [Add], [Update], or [Delete] printers.
4. Click [Done] to exit.

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 Filming Images

Check the Print Queue

The Print Queue is the holding area for films that are waiting to go the laser camera or
networked printers. In the Print Queue, you can view films waiting to be printed and, if
desired stop jobs from being printed.
1. Select Queue > Filming from the Browser menu bar.

Š The Filming Queue opens, displaying two queues.

– The top half of the screen displays the Laser Camera Queue, and the bottom
half of the screen displays the Network Film Queue.
Š The job at the top of the list is the job currently being printed.

Š If there are no jobs in the Print Queue, a message appears indicating this.
– Click [OK] to confirm.

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 Filming Images

2. Select a queue option.

Š Click [Pause All] to temporarily pause all jobs in the Queue.
– The word Pause appears after each job.
Š Click [Resume All] to restart all jobs in the queue.
– The word Active or Pending appears after each job. Active jobs are in the
process of being printed or networked (depending on the queue the job is in)
and pending jobs are those waiting to be printed or networked.
Š Click on a specific job to pause only that job.
– The word Pause appears after the job name.
Š Click on a specific job to resume only that job.
– The word Active or Pending appears after the job name.
Š Click on one or more jobs and select [Clear] to remove them from the queue.
3. Click [Refresh] to update the queue and display the current status of the jobs.
Š Both queues are updated.
4. Click [Quit] to exit the queue.

Quick Steps: Check the Print Queue

1. Select Queue > Filming from the Browser menu bar.
2. Select a queue option.
3. Click [Refresh] to update the queue and display the current status of the jobs.
4. Click [Quit] to exit the queue.

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 Managing Images

Chapter 38
Managing Images

Introduction
This chapter explains the process of managing images. It highlights key concepts and
provides brief guidelines for creating an anonymous patient as well as, saving,
restoring, deleting, and networking images. This chapter also contains the step-by-step
instructions to help you:
• Create an Anonymous Patient
• Archive Image Data
• Remove Image Data
• Configure a Remote Host
• Network Images to Alternate Locations
• Assign Image Storage

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 Managing Images

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete the process of
managing image data. Specifically, you need to understand:
• Feature Status Area
• Anonymous Patient
• Archiving
– Selecting an Archive Device
– Archiving Media
– Labeling the Storage Media
– Saving Images
– Restoring Images from Local Archive Media
– Archive Queue
• Managing Disk Space
– System Disk Space
– Removing Images from the System Disk
• Networking
– Network Queues
– Remote Host
• Auto Archiving and Networking Functions
– Mode
– Auto Archive
– Auto Transfer by Exam
– Auto Transfer by Series
• Assigning Image Storage

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 Managing Images

Feature Status Area

The Feature Status area displays a status message to the right of the four image
management icons. From left to right, the icons are for image reconstruction, filming,
archiving, and network functions.
A continuously updated status message appears to the right of each icon (Figure 38-1).
Figure 38-1 Feature Status Area

• Scan Reconstruction Status: text to the right of this icon indicates exam, series,
and image numbers being reconstructed.
• Filming Status: text to the right of this icon indicates filming status of the images
being filmed.
• Archive Status: text to the right of this icon indicates the archive status of the
images being archived.
• Network Status: text to the right of this icon indicates the status of the system’s
networking functions.

Anonymous Patient
There may be times when you want the name of a patient to be kept confidential. You
can do this using the anonymous patient feature. This feature changes the patient
name on the images to “Anonymous,” while displaying the examination number.
Some situations for using this feature are when:
• Your radiologist wants to take the films to a conference.
• You have scanned a test patient or volunteer and do not want the name displayed.
• You want to use the films in a display or at a show.
An anonymous patient can be created by examination, series, or a single image.

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 Managing Images

Archiving
Archiving allows you to save and restore images to and from a media storage device or
remote host. The archive system uses a Magnetic Optical Disk (MOD) or a Digital
Imaging and COmmunications in Medicine (DICOM) networked remote device for
storage. The DICOM networked devices archived to your system are listed in the
archive windows as remote devices.

Selecting an Archive Device

Before saving or restoring image data, the archive device must be selected. The
archive function can be accessed from the Image Management or the Display Desktop.
• The archive devices on your system depend on your site’s unique configuration.
• To save images, the archive device can be the local MOD or a DICOM networked
remote device (Remote Host).
• To restore images, the selected archive device must be the local MOD.
NOTE: Remote archive devices must be configured through the network. In addition, the
network to that device must be active to save images to the desired remote
archive host. Refer to Configure a Remote Host to configure a remote archive
device and select a remote archive host for saving images.
The Archive Device Selection window (Figure 38-2) allows you to select the archive
media to use for saving or restoring image data.
Figure 38-2 Archive Device Selection Window

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 Managing Images

Archiving Media
Your MR system equipped with the archiving option has a 5 ¼" MOD archive device.
The archiving software is indicated by the presence of the Archive selection on the
Browser menu bar.
Images stored on MOD are off-line, meaning that in order to display the images, you
must first restore them to the system disk. The MOD is considered a local archive
device. Communication from your system to the MOD is in a DICOM format, so the
MOD is listed in the archive window as a DICOM_MOD.
The MOD automatically detaches if there is no archive activity for 60 minutes. This
feature is designed to minimize the potential for MOD corruption if the system is
shutdown without performing a detach. When the system detaches the MOD, the
message MOD Detached appears in the archive status area.
The MOD automatically re-attaches if:
• You have auto archive active. The system automatically re-attaches the MOD as
soon as images appear in the archive queue.
• Archive Pause is active. An attach is automatically performed when the [Resume]
button is clicked from the Archive Queue window.
• You are manually archiving. An attach is automatically performed when an
examination, series, or image is saved.

Labeling the Storage Media

Brand new MODs must be labeled before they can be used on the system. MODs that
contain data which is not needed anymore can also be relabeled. When an MOD is
relabeled, all existing data on it is permanently erased.
Once the labeling process is complete, the media identification (ID), format type,
number of images on the media, and percent of media used are displayed at the bottom
of the Browser.
Archive media on remote archive devices cannot be labeled from your MR system.

Saving Images
Archive images from the system disk on a regular basis. Archive as soon as an
examination is complete to provide a back-up in case of a disk crash. The time to store
an image using MOD media is approximately 2 seconds per 512x512 image. Before
attempting to save images on a MOD, be sure to be in compliance with the Restrictions
for Saving Images.

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 Managing Images

Remote Device Archiving

When saving images to a remote archive device such as a Picture Archiving and
Communication System (PACS), items queued to be saved to the device are listed in
the Archive Queue under the Remote device list.
When a system crash/reboot occurs, it may be necessary to resume the archive queue.
A reboot pauses any active archive process.

Restrictions for Saving Images

The ability to save images depends on the archive device type and the initial source of
images.
• The following archive devices can be used to save data:
– The local MOD labeled on Signa.
– DICOM networked remote archive devices.
• Images stored as DICOM are the only images that can be saved on the EXCITE™
system.
The Archive window appears as (Saved image) if other items are already in the process
of being saved or restored, but the window is still available. Requests are saved in a
queue and executed as soon as the prior requests are completed.
Items being saved cannot be deleted from the workstation system disk until the save
process is complete. This is indicated by the gray Remove selection on the Browser
whenever items being saved are selected.

Restoring Images from Local Archive Media

When restoring from archive media, the system makes a copy of the image data and
does not remove the image data from the archive media. Images must be restored to be
viewed, you cannot view images directly from archive media. The time it takes to
retrieve an image using MOD media is approximately 2 seconds per 512x512 image.
Before attempting to restore images to the workstation, be sure to be in compliance with
the restrictions listed below.

Restrictions for Restoring Images from Archive Media

The ability to restore images to your MR system depends on the media type and image
format.
Media types unavailable to restore image data to workstation:
• MOD labeled on Signa as Advantage MOD media.
• MOD labeled on any Genesis OC/IC as Advantage MOD media.
• MOD labeled on Advantage Workstationsas Advantage MOD media.

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 Managing Images

Images can only be restored from these DICOM MOD media:

• LX 8.3 to EXCITE 11.0 systems
• OpenSpeed™ systems
• 3.0T systems
• Ovation system (0.35T)
• Contour system (0.5T)
• Profile system (0.2T)
Image data cannot be restored from remote archive devices.
The following condition occurs when a patient is entered from the Worklist (HIS/RIS
system) and two examinations are acquired with the same patient name and ID: if the
two examinations are archived to MOD and then restored, they appear as one
examination on the MOD Browser although they will be restored as two examinations.
Although networking of most EXCITE images is supported, the images still remain as
DICOM format images. There is an impact to post processing due to this change. The
following compatibility problems will exist:
• FuncTool – processing available if image is supported by database. However,
annotations may be missing.
• IVI/Voxtool – processing available if image is supported by database. However,
annotations may be missing.

Archive Queue
The Archive Queue contains a list of images transferring to or from an archive medium.
The Archive Queue has both save and restore queues, therefore, it is not necessary to
wait for one save or restore request to be carried out before setting up the next one.
When a save request is set up, it is sent to the save queue. When a restore request is
set up, it is sent to the restore queue.
If there are save and/or restore requests being processed, the Local Archive or Remote
Archive window opens. The window that opens depends on which device (local or
remote) has active/pending requests.
• The Local Archive window (Figure 38-3) displays both the Archive Save Queue and
the Archive Restore Queue.
• The Remote Archive window displays only the Remote Archive Save Queue.
(Restore functions cannot be performed through remote devices.)

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 Managing Images

Figure 38-3 Local Archive Window

Each line in a queue represents a job to be executed as shown in Table 38-1.

Table 38-1 Archive Queue Entries

Job Representation
Entire Exam Exam number
Entire Series Exam number/series number
Single Image Exam number/series number/image number

All jobs are followed by the archive device name in parentheses. After the display of the
archive device, a status message follows.
• (Active) indicates the job is currently being executed.
• (Pending) indicates the job is waiting to be executed.
• (Paused) indicates the job is temporarily paused.
Jobs in the Restore Queue have priority over jobs in the Save Queue. Save jobs are
started once the Restore Queue is empty. If an entire examination or series is being
saved or restored, only one job is executed for the entire examination or series,
respectively. If only a certain series in an examination or a certain image in a series is
being saved or restored, a separate job is executed for each series or image,
respectively.

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 Managing Images

The Restore and Save Queues are maintained on system shutdown or by selecting
Detach from the Archive menu.
When a system reboot occurs, it may be necessary to resume the archive queue. A
system reboot pauses any active arhive process.

Managing Disk Space

The system disk contains all of the operating software as well as the image data. The
system disk is intended for temporary storage of image data for reviewing and filming.
Once those tasks have been completed, you should archive the images and remove
them from the system disk.

System Disk Space

Available disk space is always shown in the System Status Display area (Figure 38-4),
located in the upper left corner of the screen. It reports how much space is available for
256x256 and 512x512 images and a percentage of how full the system disk actually is.
Figure 38-4 System Status Display Area

The system posts messages when the disk space is low or at a critical level.
• The Low Image Space message warns that image space is becoming limited and
recommends that you remove archived examinations.
• The Critical Image Space message warns that image space is insufficient for the
current acquisition and you must remove archived examinations in order to
continue.
If image space is less than the predefined minimum, these messages continue to be
displayed after each completed examination.
To keep the system performing at normal speed, delete images before the disk space
reaches 65% capacity. As the disk space reaches maximum capacity, all system
features slow down.
NOTE: Your system has three 36 gigabytes disks; one is for the system software, the
other two are for image data. This allows a maximum number of 400,000 images
in 256x256 format.

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 Managing Images

Removing Images from the System Disk

Eventually you want to remove an image, series, or entire examination from the system
image disk to make room for others. This function is performed by using the Remove
selection located on the Browser menu bar.
Once you have deleted an examination, series, or image from the system disk, it is
permanently removed. Use care in making your decisions. Do not delete images which
have been networked or filmed until you verify that these tasks have been successfully
completed. The Remove menu title appears in gray and cannot be used if a selected
item is in use by the Viewer or Mini Viewer, a network “Push” operation, or an archiving
“Save” operation.

Networking
Networks link image acquisition systems and workstations together. By connecting
these compatible devices to your scanner, you now have the ability to quickly and easily
transfer images between your scanner, remote workstations, and other image
acquisition systems. With networking systems, you may view images supported by your
scanner from any station or view images from other stations on your scanner.
Advantages to this capability include:
• Increased productivity of your medical imaging system. You can routinely off-load
display, manipulation, and filming activities from your scanner to another
workstation. The scanner is free to continue scanning patients. This also eliminates
the problems associated with the hand-delivery of films.
• Increased accessibility to images and patient examinations. You can have any
images supported by your scanner available for additional review at any station on a
network when needed.
• A quicker access of images to the radiologist. Images can quickly be networked to
another station (such as a GE workstation), to allow radiologist review prior to your
patient getting off the scan table.
Table 38-2 contains several terms associated with the process of networking.
Table 38-2 Networking Terms

Term Definition
Image acquisition or workstation connected to the
Remote Host
network. Each host has its own network address.
Transfer The moving of imaging data between stations.
Transmit/Push The act of sending images from one station to another.
Receive/Get The act of retrieving images from another station.
Auto Transfer by Exam Automatic image transfer of a newly completed exam.
Auto Transfer by Series Automatic image transfer of a newly completed series.

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 Managing Images

Network Queues
A Network Queue contains a list of images transferring to or from a network medium.
The Network Queue has both send and receive queues, therefore, it is not necessary to
wait for one send or receive request to be carried out before setting up the next one.
When a transmit request is set up, it is sent to the send queue, and when a receive
request is set up, it is sent to the receive queue. To view the requests waiting in the
queues, access the respective Network Queue (Figure 38-5).
Figure 38-5 Network Queue

The Network Queue window opens, displaying network servers currently performing
transfers in DICOM. Other servers not currently performing transfers are not displayed.
• The Send Images window displays the examinations, series, or images that are
currently being transmitted from your MR system.
• The Receive Images window displays the examinations, series, or images that are
currently being retrieved from another workstation.

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 Managing Images

Each line in a queue represents a job to be executed as shown in Table 38-3.

Table 38-3 Network Queue Entries.

Job Representation
Entire Exam Exam number
Entire Series Exam number/series number
Single Image Exam number/series number/image number

All jobs are followed by the remote server name in parentheses. A status message
follows the server name.
• (Active) indicates the job is currently being executed.
• (Pending) indicates the job is waiting to be executed.
• (Paused) indicates the job is temporarily paused.
There are several factors you should consider when networking:
• Before receiving images, check to see that there is enough room on the image disk
to accommodate the images being transferred.
• Your MR system does not always inform you if the system has failed to completely
transfer all the data requested. Therefore, check with the source or destination host
to verify that the data has been transferred successfully. (The system tells you if the
network is active.)
• Images cannot be retrieved from Advantage Workstation (AW) to your MR system if
the AW is operating with version 1.2, 2.0, 3.x, or 4.x (they lack the DICOM Query
Provider to enable retrieval). To network images created from an AW 4.1 system to
a Signa 8.3 system or higher, use the Network DICOM protocol.
• When images are being sent from one Signa workstation to another Signa
workstation, the receiving station shows the job in the DICOM Receive Queue. This
is also shown in the Feature Status area.
• Signa images may not translate properly when “lossy” compression of images data
is performed by a PACS system. Only loss-less compression or no compression
should be used when Signa images are transferred to a PACS system.
• The following conditions occur when a patient is entered from the Worklist (HIS/RIS
system) and two examinations are acquired with the same patient name and ID.
– When they are networked to another station such as a PAC system, they will be
combined into a single examination number. For example, if Jane Doe is
scanned in Examination 1, Series 1, 2, and 3 then scanned again in examination
2, Series 1, 2, and 3, when her examinations are networked to PACs, they
appear as Examination 1, Series 1, 1, 2, 2, 3, 3.

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 Managing Images

Remote Host
A remote host is any image acquisition or workstation (other than the one you are
working on), that is connected to your system network. Each host has its own network
address.
Remote hosts are configured through Remote Host Selection window (Figure 38-6).
The hosts are generally configured by your GE Service Engineer or your site’s network
personnel. Consult your GE Service Engineer or network personnel for a list of hosts
and their assigned host names. Hosts cannot be added or deleted from the Auto
Transfer Node Lists in Scan Modes.
Figure 38-6 Remote Host Selection Window

While your MR system allows you to remove host names from the Remote Host
Selection window, you should do so with caution. When a host name is removed, it is
permanently deleted. If a host name is inadvertently deleted from a configuration file,
your GE Service Engineer or network personnel should restore it.
Figure 38-7 displays the Remote Host Parameters window and Table 38-4 describes
the available selections.

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 Managing Images

Figure 38-7 Remote Host Parameters Window

Table 38-4 Remote Host Parameter Selections

Selection Description
The name you choose to give your remote host. Using this name
Host name
is how you select a station from which to push or get images.
The location of the host within the network. You must enter the
Network address
address correctly or the connection can not be made.
What the system specifies as the communicating language
Network protocol
between the your MR system and the host.
A predetermined number that is specific to the type of host and
Port number
the protocol used.
AE Title A predetermined title.
Allows you enter information that may be helpful in the
distinction of two or more closely-related host names. For
Comment
example, if your site has two MR systems, you may specify one
as MR#2 Outpatient Unit.

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Selection Description (Continued)

Allows selection of a remote host to be used to archive remotely.
Archive Node Yes specifies the network station is an archive device. No
specifies the network station is not an archive device.
Access to local Allows selection for the remote host to access the local host to
host send images and query or retrieve images.
Allows selective query by name, patient ID, exam number,
accession number, and exam date.

Custom search

[Save] Saves changes to Remote Host Parameters window.

[Cancel] Cancels changes to the Remote Host Parameters window.

Post Processing Networked Images

EXCITE images remain as DICOM images when they are networked to other GE MR
systems. There may be some issues when post processing these images on
non-EXCITE systems. The following compatibility issues will occur:
• FuncTool allows post processing if the database is supported, but some annotation
may be missing.
• IVI and Reformat allows post processing if the database is supported, but some
annotation may be missing.
For the above reasons, it is best to perform post processing of EXCITE images on the
EXCITE system.

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Auto Archiving and Networking Functions

The [Scan Modes] button in the Rx Manager opens a Scan Modes window (Figure
38-8), which allows Auto Archive and Auto Transfer functions to be set.
Figure 38-8 Scan Modes Window

Mode
Mode selects the operation mode of the system; Clinical or Research. Clinical mode is
the normal operation mode for most systems and is the only selection available unless
there is an agreement between the site and GE Medical Systems to enable the
Research mode.

Auto Archive
Auto Archive automatically saves examinations to the MOD as they are completed
(when the [End Exam] button has been clicked). The Auto Archive feature state is
maintained after a system reboot.

Auto Transfer by Exam

The Auto Transfer by Exam function automatically sends the entire examination from
the operator’s console to a single remote host upon completion of an examination for
review, image manipulation, or storage.
Auto Transfer by Exam can be used simultaneously with Auto Transfer by Series. You
must turn Auto Transfer by Exam on and specify a remote host through the Auto
Transfer Node List (Figure 38-9).

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Figure 38-9 Auto Network by Exam Node List

This feature must be activated and a host must be defined before you click the [End
Exam] button. The examination is not sent unless you click the [End Exam] button first.

Auto Transfer by Series

The Auto Transfer by Series function automatically sends images from the operator’s
console to as many as three remote hosts for review, image manipulation, or storage.
Auto Transfer by Series can be used simultaneously with Auto Transfer by Exam. The
feature can be enabled or disabled as needed. A remote host, or hosts, must be
specified through the Auto Transfer by Series Node List. The entire series is transferred
upon successful completion of the scan. If another scan is completed without selecting
New Series, the entire series is automatically transferred when scanning is complete.
Hosts can be prioritized to specify in which order the hosts receive the images. Priority
is specified by entering any number from 1 (highest) to 3 (lowest) in the Priority text
box on the Auto Transfer by Series Node List (Figure 38-10). A blank text box is
considered the lowest priority. Equal priority can be given to remote hosts. The order in
which the images are sent is at the discretion of the system. Once a priority number has
been entered for a host, the text box holds that number until it has been deleted or
changed.

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Figure 38-10 Auto Transfer by Series Node List

For image transfer to take place, Auto Transfer by Series must be fully enabled before
the scan process has completed. Auto Transfer functions cannot be saved as part of a
pre-defined protocol. Auto Transfer by Series remains on until it is turned off.
Remote hosts are configured through Network and hosts cannot be added or deleted
from the Auto Transfer Node Lists in the Scan Modes window.

Assigning Image Storage

You can decide the meaning of the “Y” or “N” label in the archive column displayed on
the Browser’s examination list. If you have a PACS, you can set the archive column of
the Browser, such that “Y” means the images have been successfully transferred to the
PACS. The archive column can also be set to mean that the images have successfully
transferred to the MOD.
• Currently, there is no mechanism for labeling both the successful transfer of images
to MOD and PACs system.
• The archive destination selection (Local or Remote) must synchronize with the
archive label (Yes or No) selected from the Remote Host Selection window.
• If Remote is selected as the archive destination device, verify the PACs system is
not on the Auto Transfer by Exam or Series list of nodes. The PACs system should
not be an end destination for both Auto Archive and Auto Transfer.

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How Do I...
This section provides the step-by-step instructions for handling image data with archive
media, managing available disk space, and networking image data to alternate
locations. Specifically, it describes how to:
• Create an Anonymous Patient
• Archive Image Data
– Select an Archive Device
– Label Storage Media
– Save Images
– Restore Images from Local Archive Media
– Check the Archive Queues
– Detach Storage Media
• Remove Image Data
• Configure a Remote Host
– Add a Host
– Remove a Host
– Update a Host
• Network Images to Alternate Locations
– Automatically Transfer Images
– Manually Transfer Images
– Get Images from a Remote Host
– Check the Network Queue
• Assign Image Storage

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Create an Anonymous Patient

Use this procedure to change the patient name of a completed examination to
Anonymous. The following steps guide you through changing your patient’s name to
Anonymous.
1. Click the Display Desktop icon on the control panel.

Š If you have just started your system, the Scan Rx Desktop is the default desktop.
Š The patient list appears on the Browser after entering the Display Desktop.
2. Select the patient you want to be anonymous from the patient list in the Browser.
Š If you want only specific series or images to be anonymous, carefully select only
those series or images desired.
3. Select Utilities > Create anonymous patient by exam, series, or image from the
Browser menu bar.

Š The create box appears, prompting a selection to continue the creation process
or to cancel the process.

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4. Click [OK] to begin the create process.

Š The listed name changes to an anonymous exam number followed by the
examination number.
Š The patient ID changes to an anonymous exam number.
Š The accession number and date of birth are removed.
Š The patient’s sex and age are maintained.

Quick Steps: Create an Anonymous Patient

1. Click the Display Desktop icon on the control panel.
2. Select the patient you want to be anonymous from the patient list in the Browser.
3. Select Utilities > Create anonymous patient by exam, series, or image from the
Browser menu bar.
4. Click [OK] to begin the create process.

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Archive Image Data

Select an Archive Device
Use this procedure to select the archive device before saving or restoring image data.
To save images, the archive device can be the local MOD or a DICOM networked
remote device. To restore images the selected archive device must be a local MOD.
Use these steps to guide you through selecting an archive device for your system.
1. Click the Image Management Desktop icon on the control panel.

Š The Browser can also be accessed from the Display Desktop.

2. Select Archive > Selected Archive Device from the Browser menu bar.

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Š The Archive Device Selection window opens.

3. Select the Archive Destination.

Š Local accesses the MOD.
Š Remote saves images to a remote device.
4. Select the desired archive device.
Š Select the Archive Device List for local devices.
Š Select the Remote Archive Host List for remote devices.
5. Click [Ok].
Š The selection enables and the Archive Device Selection window closes.

Quick Steps: Archive Image Data – Select an Archive Device

1. Click the Image Management Desktop icon on the control panel.
2. Select Archive > Selected Archive Device from the Browser menu bar.
3. Select the Archive Destination.
4. Select the desired archive device.
5. Click [Ok].

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Archive Image Data

Label Storage Media
Use this procedure to label a new MOD for use on your MR system or erase a used
MOD in preparation for reuse. Brand new MODs must be labeled before they are able
to store image data. You can also use this procedure to relabel an MOD that contains
data that is no longer needed.
1. Insert the MOD, desired side up, in the MOD drive.

2. Click the Image Management Desktop icon on the control panel.

Š The Browser can also be accessed from the Display Desktop.

3. Select Archive > Label from the Browser menu bar.

Š The Format Window opens, displaying the archive device name in the upper left
corner. The name reflects the MOD drive. This is set up during installation and
requires no intervention.

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4. Enter an identification number in the Media ID text box.

Š This value is the MOD label.
5. Enter notes or remarks in the Comment text box.
Š Typically, information about the type of images, MOD side, or pertinent
information is entered.
– The entered text appears at the bottom of the Archive Browser during
selection of images to be restored from this MOD side.
– The maximum number of characters allowed in this text box is 160.

6. Click [Label].
Š The labeling process begins.
Š One of the following messages displays:
– If this is a new MOD, a confirmation message asks you to Please refer
to the Operator Guide for limitations regarding archive
media exchange between GE Products.
Š If there is no media in the drive, an attention message is displayed.
Š If the MOD has previously been labeled, an Erase message is posted,
Selecting OK will erase the contents of the disk. Are you
sure you want to relabel the disk?
7. Click [OK] to acknowledge the message and continue the labeling process.
Š Once the labeling process is complete, the Media ID, format type, number of
images on the media, and percent of media used are displayed at the bottom of
the Browser.

Quick Steps: Archive Image Data – Label Storage Media

1. Insert the MOD, desired side up, in the MOD drive.
2. Click the Image Management Desktop icon on the control panel.
3. Select Archive > Label from the Browser menu bar.
4. Enter an identification number in the Media ID text box.
5. Enter notes or remarks in the Comment text box.
6. Click [Label].
7. Click [OK] to acknowledge the message and continue the labeling process.

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Archive Image Data

Save Images
Use this procedure to save images on an MOD. The archiving feature allows you to
save large amounts of image data onto the local MOD or remote archiving hosts. When
saving/writing to archive media, the system makes a copy of the image data and does
not remove the image data from the main system disk.
Use this procedure to save images to an MOD.
1. Make sure you have an MOD in the drive or insert the desired MOD.
Š If the MOD is a new media, follow the Label Storage Media procedure.
2. Click the Image Management Desktop icon on the control panel.

Š The Browser can also be accessed from the Display Desktop.

3. Select the desired patient examinations, series, or images to be saved from the
Browser patient list.
Š You can select images for saving by:
– Single or multiple examinations.
– Single or multiple series within an examination.
– Single or multiple images within a series.
NOTE: Using the Shift key selects all the entries between the first and second click.
Using the Ctrl key selects only those items you select.

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4. Select Archive > Save examination, Save series, or Save image from the
Browser menu bar.

Š The Save message appears requesting confirmation to save the requested

examinations, series, or images.
5. Click [OK] to acknowledge the message and continue the save request.

Š The Feature Status area displays

Saved image in the lower left
corner beside the Archive icon.
Š All items selected on the patient
list for saving are written onto the
media in the selected archive
device.
Š The Archive window remains available for additional requests.
Š The archive status is displayed on the Browser.
– The letter Y (yes) appears in the A (archive) column of its respective entry in
the images list. Y displays when an image is archived on the local system or
restored from an MOD on the system.

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– N displays in the A column if the exam contains images created on the system
but have not been archived.
– U displays in the A column when the exam is networked from another system.

6. Select Archive > Detach.

7. Push the eject button on the MOD drive.
Š The archive media detaches from its drive.

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Quick Steps: Archive Image Data – Save Images

1. Make sure you have an MOD in the drive or insert the desired MOD.
2. Click the Image Management Desktop icon on the control panel.
3. Select the desired patient examinations, series, or images to be saved from the
Browser patient list.
4. Select Archive > Save examination, Save series, or Save image from the Browser
menu bar.
5. Click [OK] to acknowledge the message and continue the save request.
6. Select Archive > Detach.
7. Push the eject button on the MOD drive.

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Archive Image Data

Restore Images from Local Archive Media
This procedure guides you through the restoration process of images from local archive
media. When reading or restoring from archive media, the system makes a copy of the
image data and does not remove the image data from the archive media. Images must
be restored to be viewed; you cannot view images directly from archive media.
Use these steps to restore desired images from an MOD.
1. Determine which side of the MOD contains the images to be restored (side A or side
B) and insert in the MOD drive accordingly.
Š Refer to Load an MOD, if necessary.
2. Click the Image Management Desktop icon on the control panel.

Š The Browser can also be accessed from the Display Desktop.

3. Select Archive > Restore from the Browser menu bar.

Š The Archive Browser opens, displaying the examinations, series, and images on
the media of the selected device.

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4. Select the desired exams, series, or images to be restored from the disk.
Š If necessary, use the Sort menu and Selection menu on the Archive Browser
menu bar to quickly find the information you are looking for by doing one of the
following:
– Select Selection > Select all examinations, Select all series, or Select all
images.

– Select Sort > a sort method.

Š You can select multiple entries by selecting one entry and pressing and holding
the Shift key or the Ctrl key on the keyboard.
– Using the Shift key selects all the entries between the first and second click.
– Using the Ctrl key selects only those items you select.
Š If you select multiple examinations, you cannot select specific series or images.
Š If you select multiple series, you cannot select specific images.

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5. Select Restore > Restore Examination, Restore Series, or Restore Images,

depending on which is to be restored.
Š The Restore message appears requesting confirmation to restore selected
examinations, series, images.

6. Click [OK] to acknowledge the message and begin restoring the data.
Š The Feature Status area displays
Saved image in the lower left corner
beside the Archive icon.
Š The Archive window remains
available for additional requests.
Requests are saved in a queue and
executed as soon as the preceding requests are completed. To close the Archive
window, select Application > Quit.
Š Once requests are completed, the Feature Status area shows the last restored
selection beside the Archive icon.
Š All restored images appear on the Browser images list with Y (yes) in the A
column.
7. Select Application > Quit.
Š Allows you to exit the Archive Browser without detaching the media.
8. Select Archive > Detach from the Browser menu bar.

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9. Push the eject button on the MOD drive.

Š The archive media detaches from its drive.

Quick Steps: Archive Image Data – Restore Images from Local Archive Media
1. Determine which side of the MOD contains the images to be restored (side A or
side B) and insert in the MOD drive accordingly.
2. Click the Image Management Desktop icon on the control panel.
3. Select Archive > Restore from the Browser menu bar.
4. Select the desired exams, series, or images to be restored from the disk.
5. Select Restore > Restore Examination, Restore Series, or Restore Images,
depending on which is to be restored.
6. Click [OK] to acknowledge the message and begin restoring the data.
7. Select Application > Quit.
8. Select Archive > Detach from the Browser menu bar.
9. Push the eject button on the MOD drive.

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Archive Image Data

Check the Archive Queues
Use this procedure to check the status of images waiting to be archived. When a save
request is set up, it is sent to the Archive Save queue. When a restore request is set up,
it is sent to the Archive Restore queue. The following steps guide you through viewing,
pausing, resuming and deleting jobs in the archive queue.
1. Click the Image Management Desktop icon on the control panel.

Š The Browser can also be accessed from the Display Desktop.

2. Select Queue > Archive from the Browser menu bar.

Š The Archive Queue opens with up-to-date content. To subsequently update the
status of the queues, click [Refresh].

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3. Select a queue function from the Archive Queue.

Š Click [Pause All] to temporarily suspend execution of all requests in a queue.
– All jobs now have the (Paused) status.
Š Select an entry and click [Pause] to temporarily suspend the execution of a
single request.
– One job in the queue has the (Paused) status.
Š Click [Resume All] to continue the execution of a paused queue.
– All jobs return to their original status and execution continues.
Š Select an entry and click [Resume] to continue the execution of a single job in
the queue.
– The selected job in the queue returns to its original status and execution
continues.
Š Select an entry and click [Clear] to permanently remove a job from the queue.
– The Cancel message appears requesting confirmation to clear the requested
jobs in the queue.

– Click [OK] to proceed and clear the requested queue.

4. Click [Quit] to close the Archive Queue.

Quick Steps: Archive Image Data – Check the Archive Queues

1. Click the Image Management Desktop icon on the control panel.
2. Select Queue > Archive from the Browser menu bar.
3. Select a queue function from the Archive Queue.
4. Click [Quit] to close the Archive Queue.

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Archive Image Data

Detach Storage Media
Use this procedure to detach an archive media from its drive. Once a local archive
media has been used for save and restore operations, it cannot be ejected from the
drive unless you first detach it, or if it has automatically been detached. Before using
this procedure to detach the MOD, allow all archive jobs to complete.
1. Confirm that examinations have been archived.
Š Check the Archive Queue.
Š Check the archive status on the Browser patient list.
2. Select Archive > Detach from the Browser menu bar.

Š A message displays in the Feature Status area when the detach is complete.
Š You cannot detach a remote archive media.
3. Push the eject button on the MOD drive.
Š The archive media detaches from its drive.

NOTE: If the Detach option on the Archive window appears in gray lettering, this means
the archive media is already detached.

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Quick Steps: Archive Image Data – Detach Storage Media

1. Confirm that examinations have been archived.
2. Select Archive > Detach from the Browser menu bar.
3. Push the eject button on the MOD drive.

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Remove Image Data

Use this procedure to remove an image, series, or entire examination from the system
image disk to make room for others. Before deleting images which have been
networked, filmed, or saved via archive, verify that these tasks have been successfully
completed.
Use this procedure to delete images from your system disk.
1. Click the Image Management Desktop icon on the control panel.

Š The Browser can also be accessed from the Display Desktop.

2. Verify examinations to be removed have been archived.
Š This is very important. Once you have deleted an examination, it is permanently
gone from the system.
Š Check the archive status in the patient list of the Browser.
– The archived status column is represented by an A. Archive status is
indicated by a Y (yes), N (no), or U (unknown).

3. Select the examinations, series, or images on the that you wish to remove.
Š To select non-consecutive images, press and hold the Ctrl key on your keyboard
as you individually select the examinations, series, or images.
Š To select sequential images, select the first examination, series, or image from
the patient list, then press the Shift before selecting the last. All examinations,
series, or images in between are selected.

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4. Select Remove > Remove examination, Remove series, or Remove image.

Š The Remove message appears requesting a confirmation to remove the selected

examinations, series, or images.

5. Click [OK] to acknowledge the message and continue the removing process.
Š The system removes the selected item from the system disk and automatically
updates the patient lists.

Quick Steps: Remove Image Data

1. Click the Image Management Desktop icon on the control panel.
2. Verify examinations to be removed have been archived.
3. Select the examinations, series, or images on the that you wish to remove.
4. Select Remove > Remove examination, Remove series, or Remove image.
5. Click [OK] to acknowledge the message and continue the removing process.

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Configure a Remote Host

Add a Host
Use this procedure to add a remote host to your MR system to enable the networking
features. This procedure is usually carried out by the networking personnel at your
facility or your local GE Service Engineer. This personnel usually has the necessary
information needed for the network set-up procedure.
1. Click the Image Management Desktop icon on the control panel.

Š The Browser can also be accessed from the Display Desktop.

2. Select Network > Selected remote host from the Browser menu bar.

Š This allows you to configure a new host on your system.

Š The Remote Host Selection window opens.

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3. Click [Add] to select additional parameters.

Š The Remote Host Parameters Window window opens.
4. Enter the parameter information that corresponds with the host you are adding.
Š Refer to Table 38-4, Remote Host Parameter Selections for additional
information.
Š Your service engineer does know the specific parameter details required.
5. Click [Save] to save all the selections added.
6. Select Network > Ping DICOM host.

Š If the selected host is configured Yes for Archive Node but it is not a valid archive
node, the system displays the message DICOM Host Alive but it is not
an Archive Node as currently configured.
Š The system recognizes the archive state of the selected host and notifies you
that the node is defined incorrectly. The system does not change the configured
node.

Quick Steps: Configure a Remote Host – Add a Host

1. Click the Image Management Desktop icon on the control panel.
2. Select Network > Selected remote host from the Browser menu bar.
3. Click [Add] to select additional parameters.
4. Enter the parameter information that corresponds with the host you are adding.
5. Click [Save] to save all the selections added.
6. Select Network > Ping DICOM host.

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Configure a Remote Host

Remove a Host
Before deleting a host, make sure this is what you want to do. There is no "undo" button
to correct a removal made by mistake. Contact your GE Service Engineer or your
facility’s network personnel prior to any removal. Once you are sure you want to delete
a remote host from your system, use the following procedure.
1. Click the Image Management Desktop icon on the control panel.

Š The Browser can also be accessed from the Display Desktop.

2. Select Network > Selected remote host from the Browser menu bar.

Š The Remote Host Selection window opens.

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3. Select the host you would like to remove.

4. Click [Remove].
Š The Remove Host confirmation message appears.

5. Click [OK] to acknowledge the message and continue to remove the host.
6. Click [OK] to close the Remote Host Selection window.

Quick Steps: Configure a Remote Host – Remove a Host

1. Click the Image Management Desktop icon on the control panel.
2. Select Network > Selected remote host from the Browser menu bar.
3. Select the host you would like to remove.
4. Click [Remove].
5. Click [OK] to acknowledge the message and continue to remove the host.
6. Click [OK] to close the Remote Host Selection window.

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Configure a Remote Host

Update a Host
Use this procedure to update a Remote Host configured on your system. An update
could include any modifications that were previously added or left off the Remote Host
Parameters Window. Contact your GE Service Engineer or your facility’s networking
personnel prior to any updates.
Use this procedure to update a remote host.
1. Click the Image Management Desktop icon on the control panel.

Š The Browser can also be accessed from the Display Desktop.

2. Select Network > Selected remote host from the Browser menu bar.

Š The Remote Host Selection window opens.

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3. Select the host you would like to update.

4. Click [Update].
Š The Remote Host Parameters Window window opens so you can update the
selected host.
5. Make necessary changes or additions to the remote host parameters.
Š Refer to Remote Host Parameter Selections for additional information on the
specific parameters.
6. Click [Save] to close the window and update the remote host information.

Quick Steps: Configure a Remote Host – Update a Host

1. Click the Image Management Desktop icon on the control panel.
2. Select Network > Selected remote host from the Browser menu bar.
3. Select the host you would like to update.
4. Click [Update].
5. Make necessary changes or additions to the remote host parameters.
6. Click [Save] to close the window and update the remote host information.

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Network Images to Alternate Locations

Automatically Transfer Images
Use this procedure to network images from the Scan Rx Desktop to another host. It is
very important to remember that you can only push images to another host from the
Scan Rx Desktop. Using this feature, you can program your MR system to Auto Archive
images after each examination or to Auto Transfer after each examination or series.
1. Click the Scan Rx Desktop icon on the control panel.

Š If you have just booted up your system, the Scan Rx Desktop is the default
desktop.
2. Click [Scan Modes] in the Rx Manager.
Š The Scan Modes window opens.

3. Select a transfer option.

Š Select Auto Transfer by Exam to automatically send the entire examination
from your MR system to a single remote host upon exam completion.
Š Select Auto Transfer by Series to automatically send the series from your MR
system to as many as three remote hosts upon series completion.

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4. Specify a remote host destination.

Š Select a remote host for Auto
Transfer by Exam from the Auto
Network by Exam Node List
window.

Š Select up to three remote hosts for

Auto Transfer by Series from the
Auto Transfer by Series Node
List.
– You can prioritize to specify in
which order the hosts receive
the images.

5. Click [Accept] to enable your selections and close the window.

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Quick Steps: Network Images to Alternate Locations – Automatically

Transfer Images
1. Click the Scan Rx Desktop icon on the control panel.
2. Click [Scan Modes] in the Rx Manager.
3. Select a transfer option.
4. Specify a remote host destination.
5. Click [Accept] to enable your selections and close the window.

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Network Images to Alternate Locations

Manually Transfer Images
Use this procedure to manually send images from your system to a Remote Host.
Transfer or send is the action taken when pushing images from one station to another.
1. Click the Image Management Desktop icon on the control panel.

Š The Browser can also be accessed from the Display Desktop.

2. Select Network > Selected remote host from the Browser menu bar.

Š The Remote Host Selection window opens.

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3. Select the host that will receive the images you send.
4. Click [Ok] to confirm your selection of the requested host and close the Remote
Host Selection window.
5. Select the desired examinations, series, or images to transfer from the Browser.
Š To select individual entries, select the examinations, series or images you want
to transfer.
Š To select a predetermined set, choose Selection > Select all examinations,
Select all series, Select all images, Select archived exams, or Select
unarchived exams.

Š Typing ss at the type-in command line of the Viewer transfers your modified W/L
values along with the images.

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6. Select Network > Send Examination, Send Series, or Send Image.

Š The Send message displays requesting a confirmation to send selected data to

the remote host.
7. Click [OK] to acknowledge the message and send the selected data.
Š During the transmitting process, status of the process is displayed next to the
Network status icon in the Feature Status area of the control panel.

Quick Steps: Network Images to Alternate Locations – Manually Transfer

Images
1. Click the Image Management Desktop icon on the control panel.
2. Select Network > Selected remote host from the Browser menu bar.
3. Select the host that will receive the images you send.
4. Click [Ok] to confirm your selection of the requested host and close the Remote
Host Selection window.
5. Select the desired examinations, series, or images to transfer from the Browser.
6. Select Network > Send Examination, Send Series, or Send Image.
7. Click [OK] to acknowledge the message and send the selected data.

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 Managing Images

Network Images to Alternate Locations

Get Images from a Remote Host
Use this procedure to retrieve images from another selected Remote Host to your
system. To get describes the act of receiving images from one station to another
station. The following steps guide you through the process of getting images.
1. Click the Image Management Desktop icon on the control panel.

Š The Browser can also be accessed from the Display Desktop.

2. Select Network > Selected remote host from the Browser menu bar.

Š The Remote Host Selection window opens.

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 Managing Images

3. Select the destination host you from where you want to retrieve the images.
4. Click [Ok] to confirm your selection of the requested host.
5. Select Network > Receive from the Browser menu bar.

Š The Remote Browser of the selected host opens, listing the examinations, series,
and images found on the host.
6. Find the patient you want to retrieve.
Š Click [Sort] and select one of the sort methods (patient ID or name, date, exam
numbers, etc.). The remote Browser is sorted according to your selection.
Š Alternatively, click [Search] and enter a text string in any or all of the text boxes
on the window. If you are uncertain of the patient’s complete name, enter text
followed by an asterisk (*). The system displays all names beginning with the text
string you entered. For example, type Smith* and all patients with the last name
of Smith are displayed. Click [OK] to start the search.
7. Select the examinations, series, or images to retrieve.
Š To select individual entries, select the examination, series, or images you want to
transfer.
Š To select a predetermined set, select Selection > Select all examinations,
Select all series, or Select all images.

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 Managing Images

8. Select Get > Get Exam, Get Series, or Get Image.

Š The Get message appears requesting confirmation of the pull transaction.

9. Click [OK] to acknowledge the message and transfer the selection from the remote
host to your system.
Š The Browser patient lists update automatically to reflect the arrival of newly
transferred items.
Š During the retrieval process, status of the process is displayed next to the
Network status icon in the Feature Status Control area of the desktop control
panel. For example, the following figure shows the Network status of exam 1207.
Exam 1207 has been pulled from the remote MRI-2 workstation to main
workstation successfully.

10. Select Application > Quit from the Browser menu bar.
Š A message appears requesting confirmation to quit.
11. Click [OK] to close the Remote Browser.

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Quick Steps: Network Images to Alternate Locations – Get Images from a

Remote Host
1. Click the Image Management Desktop icon on the control panel.
2. Select Network > Selected remote host from the Browser menu bar.
3. Select the destination host you from where you want to retrieve the images.
4. Click [Ok] to confirm your selection of the requested host.
5. Select Network > Receive from the Browser menu bar.
6. Find the patient you want to retrieve.
7. Select the examinations, series, or images to retrieve.
8. Select Get > Get Exam, Get Series, or Get Image.
9. Click [OK] to acknowledge the message and transfer the selection from the
remote host to your system.
10. Select Application > Quit from the Browser menu bar.
11. Click [OK] to close the Remote Browser.

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Network Images to Alternate Locations

Check the Network Queue
Use this procedure to check the status of images waiting to be transferred. Each send
or receive operation is placed into the Network Queue. The queue is used to view the
network requests waiting to be carried out. The following steps guide you through
viewing, pausing, resuming, and deleting jobs in the network queue.
1. Click the Image Management Desktop icon on the control panel.

Š The Browser can also be accessed from the Display Desktop.

2. Select Queue > Network from the Browser menu bar.

Š If transfers are in progress, the Network Queue opens with up-to-date content.
To subsequently update the status of the queues, click [Refresh].

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 Managing Images

NOTE: If there are no transfers in progress, the message All Network Queues are
Empty appears. Click [OK] to acknowledge the message.
3. From the Dicom Send or the Dicom Receive queues, select a network function.
Š Click [Pause All] to temporarily suspend execution of all requests in a queue.
– All jobs now have the (Paused) status.
Š Select an entry and click [Pause] to temporarily suspend the execution of a
single request.
– One job in the queue has the (Paused) status.
Š Click [Resume All] to continue the execution of a paused queue.
– All jobs return to their original status and execution continues.
Š Select an entry and click [Resume] to continue the execution of a single job in
the queue.
– The selected job in the queue returns to original status and the job is
executed.
Š Select an entry and click [Clear] to permanently remove a job from the queue.
– The Cancel message appears requesting confirmation to clear the requested
jobs in the queue.

– Click [OK] to proceed and clear the requested network queue.

4. Click [Quit] to close DICOM Queue window.

Quick Steps: Network Images to Alternate Locations – Check the Network

Queue
1. Click the Image Management Desktop icon on the control panel.
2. Select Queue > Network from the Browser menu bar.
3. From the Dicom Send or the Dicom Receive queues, select a network function.
4. Click [Quit] to close DICOM Queue window.

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 Managing Images

Assign Image Storage

You can decide the meaning of the Y or N label in A (archive) column displayed on the
Browser’s examination list. If you have a PACS, you can set the A column of the
Browser, such that Y means the images have been successfully transferred to the
PACS or MOD.
1. Select Network > Selected remote host from the Browser menu bar.

Š The Remote Host Selection window opens.

2. Select one entry from the Remote Host list.

3. Click [Update].
Š The Remote Host Parameters Window opens.

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 Managing Images

4. Select an option in the Archive Node area of the Remote Host Parameters window.
Š Select Yes to have the archive “Y” label represent the successful transfer of
images to the PACs system.
Š Select No to have the archive “Y” label represent the successful transfer of
images to the MOD.
5. Click [Save] to save your changes and close the window.
6. Select Archive > Selected archive device from the Browser menu bar.

Š The Archive Device Selection Window displays.

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 Managing Images

7. Select an archive destination.

Š Select Remote as the archive destination if you want the archive label “Y” to
represent that an examination has successfully transferred to the PACs system.
Š Select Local as the archive destination if you want the archive label “Y” to
represent that an examination has successfully transferred to a MOD.
NOTE: If you have a Remote and Local archive devices, you must define one as the
default device. For example, if you want Auto archive to archive to the Local
device, select the Local device and click [Set Default Device].
8. Click the Scan Rx Desktop icon.
9. Click [Scan Modes] in the Rx Manager.
Š The Scan Modes window opens.

10. Select OFF to turn on Auto Archive.

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Quick Steps: Assign Image Storage

1. Select Network > Selected remote host from the Browser menu bar.
2. Select one entry from the Remote Host list.
3. Click [Update].
4. Select an option in the Archive Node area of the Remote Host Parameters
window.
5. Click [Save] to save your changes and close the window.
6. Select Archive > Selected archive device from the Browser menu bar.
7. Select an archive destination.
8. Click the Scan Rx Desktop icon.
9. Click [Scan Modes] in the Rx Manager.
10. Select OFF to turn on Auto Archive.

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 Filtering Images

Chapter 39
Filtering Images

Introduction
Image Filter is a post-processing feature which can improve image quality of viewed
and/or filmed images. Image Filter is a retrospective filter which applies an algorithm
that can reduce noise and/or the edges of MR images.
This chapter presents the concepts necessary to successfully complete image filtering
using the Image Filter process. It provides the purpose and benefits of Image
Enhancement. It contains the step-by-step instructions to help you learn how to:
• Activate the Image Filter
• Display Preview Images
• Save a Filtered Series
• Filter and Save an Examination

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 Filtering Images

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete image filtering
using the Image Filter process. Specifically, you need to understand:
• The Purpose and Benefits of Image Enhancement
• Saving Filtered Images
– Series Number Assignment
– Image Filter Annotation
• The Image Filter Screen
• SCIC (Surface Coil Intensity Correction)
– Image SCIC Annotation

The Purpose and Benefits of Image Enhancement

The Image Filter feature filters MR images to improve signal to noise, contrast, and
edge sharpness. Image Filter makes the image more aesthetically pleasing, but does
not improve the diagnostic quality of the image.
The Filter Exam does not filter 3D Surface (OBJ) or screen saved types of images. If
these types of images exist in an exam, the Filter Exam skips them during the process.
You may want to use preview first, and apply a few different filters to pick the filter that
works best for that image.
Smoothing algorithms are used to remove graininess from high resolution and low
signal images. Grainy images such as 512 x 512 matrix head, abdomen, or extremities
would be good for Image Filter’s smoothing algorithm.
Sharpening algorithms help define structural edges in images with high signal and low
noise.
Within the filter window are the six specific Image Filter controls:
• 8 filter types, from minimum setting (01) to maximum setting (08)
• the filter setting
• the filter process by image series or exam
• the filter process
• to a different images or series
• image filtering by selecting a set of desired images or series by clicking and
dragging the mouse.
The eight filter levels provide varying amounts of filtering. Levels of filtering are shown
in Table 39-1.

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 Filtering Images

Table 39-1 Filter Selections

Filter Number Filter Amount

minimum smoothing with
1,2
moderate edge enhancement
moderate smoothing with
3,4,5, and 6
moderate edge enhancement
maximum smoothing with
7,8
minimal edge enhancement

The eight filter levels provide varying amounts of filtering. Images can be refiltered. The
system informs you if the series has already been filtered, however another level or the
same level can be selected and the series is filtered again.
There are several thing to consider when using Image Enhancement:
• Image filtering does not improve the diagnostic quality of the image.
• Image Filter is available for images with a maximum image display matrix of 512 x
512.
• Image Filter is NOT available for:
– Screen saved images
– 64 X 64, 128 x 128, or 1024 x 1024 matrix images
– CT images
– 3D surface (OBJ) images
• Individual images are saved as a series.
• Previewing temporarily assigns a new series number.
• A previewed image does not use the same window/level as the original image.

Saving Filtered Images

The filtered (enhanced) images created by the Image Filter feature are saved to a new
series. The unenhanced images remain in the original series in the Browser, while the
new filtered series receives a new series number.

Series Number Assignment

Clicking the [Series] button or the [ Exam] button generates and installs images to new
series files. In other words, the images do not get added or appended to the original
series. The filtered images are assigned to a new unique 3-series number. This number
is created by adding a value of 100 to the original series.

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 Filtering Images

For example, if the original series is annotated as 01, the filtered series would then be
annotated as 101. If the original series is annotated as 02, the filtered series would then
be annotated as 102, etc..
NOTE: Filtering an original series more than once is permitted and image and series text
annotation will reflect the filter applications.
For example, if the original series is annotated as 04, the first filtered series would then
be annotated 104. If you then refilter that original series, it would then be annotated as
204, increasing by 100 each time it is refiltered.

Image Filter Annotation

Previewed images created by clicking the [Preview] button have filter annotation
displayed in the lower left corner of the image. The annotation is appended to the pulse
sequence name annotation.

CAUTION: If this image is zoomed or scrolled, the image filter annotation may not
be visible. The image with invisible annotation may lead to a diagnosis
error by the physician.

Do not perform clinical diagnosis from the filter window for this reason.
Use the [Viewer] or [Mini viewer] in the Browser for such purposes.
The Series Description text box on the Browser menu indicates filter annotation text for
each series filtered at the front of the series description line.
Filtering of an already filtered image is also permitted. The image annotation will reflect
the filter setting applied. Table 39-2 describes the effects on filtering annotation when a
series is refiltered.

Table 39-2 Refiltering Annotation Effects

Original Filter Pass Filter Pass 1 + 2

Filter Pass 1 + 2
Series No. 1 +3
Series
05 105 205 305
Number
Image psd/FL:xx/yy/
psd (name) psd/FL:xx psd/FL:xx/yy
Annotation zz

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 Filtering Images

Original Filter Pass Filter Pass 1 + 2

Filter Pass 1 + 2
Series No. 1 +3
Series
description FL/xx/dscrp FLyy/FLxx/dscrp FLyy/FLxx/FLzz
Annotation

The Image Filter Window

The Image Filter window (Figure 39-1) is accessible from the Additional Parameters
area. Table 39-3 describes the selections on the Image Filter window.
Figure 39-1 Image Filter Window

Table 39-3 Image Filter Window Selections

Selection Description
Image Slider Allows you to select different images to preview. You can click and drag
the slider to the right or left to select images.

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 Filtering Images

Selection Description (Continued)

Image Arrows Allows you to move to the next or prior image by clicking the arrows.
Series Arrows Allows you to move to the next or prior series by clicking the arrows.
Zoom Slider Allows you to select a magnification factor to be applied to the images.
You can click and drag the slider to the right or left to select a zoom
factor.
[Display Normal] Returns the image to its original form and normal size.
Filter Setting Allows you to select the desired filter setting.
SCIC Allows you to apply a SCIS filter to an image to correct the low spatial
frequency intensity modulations, reduces noise, and enhances contrast in
the image.
[Preview] Allows you to preview the filtered image without saving it. Previewing
temporarily assigns a new series number. A previewed image may not
use the same window/level (W/L) as the original image.
Filter and Save to The buttons in this area allow you to apply the selected filter to an entire
Database Area image, series, or exam and to save the new filtered images. The system
counts the number of images or series completed during the filtering
process. This count is shown in the area above the [Done] button.
[Done] Closes or exits the Image Filter window.

SCIC (Surface Coil Intensity Correction)

Surface Coil Intensity Correction (SCIC) is feature that can improve the quality of
images acquired using surface coils. An image created using a surface coil has an
intensity fall-off determined by the coil properties. This intensity fall-off causes
distracting artifacts and makes it difficult to film images at a single window/level setting.
The SCIC feature is a post-processing technique which corrects the low spatial
frequency intensity modulations, reduces noise, and enhances contrast in the image. It
produces a series of filtered images with decreased intensity near the coil, reducing the
areas of bright spots. It is part of the Image Filter option.
There are 8 levels of correction, [A] to [H]. Level [A] has the weakest level of
correction, while level [H] has the strongest level of correction.
SCIC can be applied by image, series or exam. The SCIC option is located in the Image
Filter window on the Display Desktop.
Within the Image Filter window, the following SCIC options are available:
• Apply 8 correction levels, [A] to [H]
• Preview the correction level
• Apply the correction process by image series or by exam
• Abort the filter process
• Select a different image or series

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 Filtering Images

• Choose selective application of the SCIC filter by selecting a set of desired images
or series in the Browser

Image Annotation
SCIC level is annotated after the Image Filter level the PSD name. Image Filter level is
annotated as FL01 through FL08. The SCIC level is noted with corresponding
alphabetical letter, A through H. An image filtered at level 3 for Image Filter and level A
for SCIC would be annotated as FL03A. If [None] is selected for the SCIC level, no
alphabetical letter is annotated. If none is selected for the Image Filter level, filter level
is noted as FL00 with alphabetical letter for SCIC level selected.
Processed images are registered in a series number which is the original number plus
100. If this number has been already used, another 100 added number is used for the
image.

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 Filtering Images

How Do I...
This section provides the step-by-step instructions for applying Image Filter.
Specifically, it describes how to:
• Activate the Image Filter
• Display Preview Images
• Save a Filtered Series
• Filter and Save an Examination

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 Filtering Images

Activate the Image Filter

Use this procedure to activate the Image Filter to enhance the images.
1. Select the desired exam and series in the Browser.
2. Click [Image Filter] in the Browser to open Image Filter window.
Š The middle image number of the selected series is displayed on the window.
3. Click [</>] to select a different image or series.

Quick Steps: Activate the Image Filter

1. Select the desired exam and series in the Browser.
2. Click [Image Filter] in the Browser to open Image Filter window.
3. Click [</>] to select a different image or series.

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 Filtering Images

Display Preview Images

You may want to preview your images first and apply a few different filters to choose the
filter that works best for a particular image.
1. Select the desired images in the series displayed to be filtered by using the image
[</>] buttons.
2. Select the desired filter level from the Filter pull-down menu.
3. Click [Preview] to preview the image with the selected filter level.
Š The filtered image appears next to the original image.
Š If you prefer to preview a different filter setting, repeat steps 1-3.
NOTE: Using [Preview] does not save or create a new series. [Preview] is used to
review the effects of the filter on the image.

Quick Steps: Display Preview Images

1. Select the desired images in the series displayed to be filtered by using the image
[</>] buttons.
2. Select the desired filter level from the Filter pull-down menu.
3. Click [Preview] to preview the image with the selected filter level.

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 Filtering Images

Save a Filtered Series

Use this procedure to save a previewed filtered series.

1. Select the desired exam and series on the Browser to filter.

2. Click [Image Filter].
3. Select the desired filter level from the Filter pull-down menu.
4. Click [Preview].
Š The filtered image appears next to the original image.
Š If unsatisfied with the filter level, repeat steps 1-4 until the desired effect is
achieved.
5. Click [Series]
Š If needed , click [Image] to filter the image with the latest filter selection.
Š The images count down in the Filter window until the filter task is complete.
Š As image filtration continues, the system lists the images in the Browser.
Š If needed, click [Stop] to abort the image filter process.
6. Click [Done] to exit the Image Filter window.
NOTE: Image Filter is compatible with prospective source images, prospective MIP and
IVI MIP generated images.

Quick Steps: Save a Filtered Series

1. Select the desired exam and series on the Browser to filter.
2. Click [Image Filter].
3. Select the desired filter level from the Filter pull-down menu.
4. Click [Preview].
5. Click [Series].
6. Click [Done] to exit the Image Filter window.

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 Filtering Images

Filter and Save an Examination

After selecting a desired filter level setting, an entire exam may be filtered. Use this
procedure to filter and save an entire exam.

1. Select the desired exam to filter from the Browser.

2. Click [Image Filter].
3. Select the desired filter level from the Filter pull down-menu.
4. Click [Preview].
Š The filtered image appears next to the original image.
Š If unsatisfied with the filter level, repeat steps 1-4 until the desired effect is
achieved.
5. Click [Exam] to save the entire exam with the latest filter selection.
Š The displayed series is then filtered along with the remaining valid series in the
exam. Any previously filtered series in that exam will be skipped.
Š An image countdown is displayed in the filter window as each series in the exam
are filtered.
Š If needed, click [Stop] to abort the image filter process.
6. Click [Done] to exit the Image Filter window.

Quick Steps: Filter and Save an Examination

1. Select the desired exam to filter from the Browser.
2. Click [Image Filter].
3. Select the desired filter level from the Filter pull down-menu.
4. Click [Preview].
5. Click [Exam] to save the entire exam with the latest filter selection.
6. Click [Done] to exit the Image Filter window.

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 Enhancing Images with Auto Filter

Chapter 40
Enhancing Images with Auto
Filter

Introduction
This chapter explains image enhancement processes. Auto Filter is a processing
feature that allows you to apply an image filter and/or Surface Coil Intensity Correction
(SCIC) factor during scan prescription. Auto Filter can improve the image quality of
viewed and filmed images.
This chapter highlights key concepts and contains step-by-step instructions to help you
learn how to:
• Apply an Auto Filter
• Apply an Auto SCIC Filter

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 Enhancing Images with Auto Filter

What Do I Need to Know About...

This section presents the concepts necessary to successfully enhance images using
Auto Filter. Specifically, you need to understand:
• Auto Filter
– Image Enhance Additional Parameter
– Image Filters
– Surface Coil Intensity Correction
• Image Annotation

Auto Filter
The Auto Filter feature filters magnetic resonance (MR) images to improve
signal-to-noise ratio (SNR), contrast, and edge sharpness. Auto Filter makes the image
more aesthetically pleasing, but does not improve the diagnostic quality of the image.
Smoothing algorithms are used to remove graininess from high-resolution and
low-signal images. Grainy images such as 512x512 matrix head, abdomen, or
extremities would be good candidates for Auto Filter’s smoothing algorithm.
Sharpening algorithms help define structural edges in images with high signal and low
noise.
The filter in Auto Filter is applied to all images in a series. Image filter and SCIC
selections can be saved as part of a series protocol.

Image Enhance Additional Parameter

The filters in Auto Filter, including the SCIC filter, are accessed through the Image
Enhance icon in the Additional Parameters area.
Figure 40-1 Image Enhance Additional Parameter Icon

Clicking the Image Enhance icon opens the Image Enhance Options window (Figure
40-2). In this window, you can choose to use the SCIC option or one of the eight filters
of the Auto Filter feature.

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 Enhancing Images with Auto Filter

Figure 40-2 Image Enhance Options

Image Filters
Within the Image Enhance Options window, eight Auto Filter filter levels are available: 1
thru 8. Table 40-1 lists the available filters and suggested applications.
Table 40-1 Auto Filter Filters

Filter Number Filter Amount

minimum smoothing with
1,2
moderate edge enhancement
moderate smoothing with
3,4,5, and 6
moderate edge enhancement
maximum smoothing with
7,8
minimal edge enhancement

Surface Coil Intensity Correction

The Surface Coil Intensity Correction (SCIC) feature is part of the Auto Filter option.
SCIC can improve the quality of images acquired using surface coils. An image created
using a surface coil has an intensity fall-off determined by the coil properties. This
intensity fall-off causes distracting artifacts and makes it difficult to film images at a
single window/level setting. The SCIC feature is an automatic processing technique that

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 Enhancing Images with Auto Filter

corrects the low spatial frequency intensity modulations, reduces noise, and enhances
contrast in the image. It produces a series of filtered images with decreased intensity
near the coil, reducing the areas of bright spots.
There are 8 levels of correction, [A] to [H]. Level [A] has the weakest level of
correction, while level [H] has the strongest level of correction.
When you select Surface Coil Intensity Correction on the Image Enhance Options
window, the Image Enhance icon is annotated “SCIC.”
Figure 40-3 Image Enhance Icon Annotated SCIC

SCIC Applications
• Excessive brightness near a coil is a direct result of the anatomy's proximity to the
coil. Its signal is amplified compared to that of more distant anatomy. SCIC can be
applied to reduce these areas of high signal. Use SCIC to minimize the bright signal
intensity from fatty tissues on any images acquired.
• Figure 40-4 displays two images of the liver. The image on the left was acquired
without SCIC using the Torso coil and the right image was acquired with SCIC in the
Torso coil. Note the increase in uniform signal intensity on the image acquired with
SCIC.
Figure 40-4 Image Comparisons with SCIC

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 Enhancing Images with Auto Filter

Image Annotation
The Auto Filter and SCIC levels are annotated on the reconstructed image following the
PSD name. The annotation uses the following rules:
• Prospectively filtered images using Auto Filter are annotated with a uppercase “A-H”
(for SCIC) or a “01” to “08” for an image filter.
• Retrospectively filtered images using the Image Enhancement option are annotated
with an uppercase “A-H” (for SCIC) or a “01” to “08” for an image filter.
Figure 40-5 displays an example of image annotation. The “a” and “s” indicate that an
Auto Filter was applied during reconstruction as part of a protocol. The “B” indicates the
filter was applied using the post-processing enhancement feature.
Figure 40-5 Filter Image Annotation

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 Enhancing Images with Auto Filter

How Do I...
This section provides the step-by-step instructions for applying an image filter.
Specifically, it describes how to:
• Apply an Auto Filter
• Apply an Auto SCIC Filter

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 Enhancing Images with Auto Filter

Apply an Auto Filter

The filters in Auto Filter can be used to enhance the sharpness and smoothing of an
image by removing graininess and defining structural edges.
Use this procedure to apply an Auto Filter to enhance the images during scanning.
1. Click [New Series] in the Rx Manager.
2. Enter the prescription parameters for the scan.
Š Patient Position
Š Imaging Parameters
Š Scan Timing
Š Scanning Range
Š Acquisition Timing
3. Click the Image Enhance icon.

Š The Image Enhance Options window opens.

4. Click Filter Choices.

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 Enhancing Images with Auto Filter

5. Select a filter from the list.

6. Click [Accept].
Š The Image Enhance icon is now labeled with your selected filter.

7. Click [Save Series].

Š The Scan Prescription screen closes and the series is saved in the Rx Manager
as RXD (prescribed).
8. Click [Prepare to Scan].
Š The series is downloaded.
9. Click [Scan].
Š The series is acquired and the images are updated in the Browser.
NOTE: When applying an Auto Filter, only the filtered series is created in the Browser.
If you want to try different filters on your images prior to applying a specific filter
to your protocol, use the post-processing enhancement option to compare the
images without a filter and with various filter levels.

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 Enhancing Images with Auto Filter

Quick Steps: Apply an Auto Filter

1. Click [New Series] in the Rx Manager.
2. Enter the prescription parameters for the scan.
3. Click the Image Enhance icon.
4. Click Filter Choices.
5. Select a filter from the list.
6. Click [Accept].
7. Click [Save Series].
8. Click [Prepare to Scan].
9. Click [Scan].

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 Enhancing Images with Auto Filter

Apply an Auto SCIC Filter

SCIC can improve the quality of images acquired using surface coils. It produces a
series of filtered images with decreased intensity near the coil, leveling the areas of
bright spots. Use SCIC to minimize the intensity of the bright signal from fatty tissues.
Use this procedure to activate SCIC to enhance the images.
1. Click [New Series] in the Rx Manager.
2. Enter the prescription parameters for the scan.
Š Patient Position
Š Imaging Parameters
Š Scan Timing
Š Scanning Range
Š Acquisition Timing
3. Click the Image Enhance icon.

Š The Image Enhance Options window opens.

4. Select Surface Coil Intensity Correction to activate SCIC.

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 Enhancing Images with Auto Filter

5. Select the desired SCIC level, A - H.

6. Click [Accept].
Š The Image Enhance button is now labeled with “SCIC:”, followed by the letter
corresponding to your SCIC level selection.

7. Click [Save Series].

Š The scan prescription screen closes and the series is saved in the Rx Manager
as RXD.
8. Click [Prepare to Scan].
Š The series is downloaded.
9. Click [Scan].
Š The series is acquired and the images are updated in the Browser.
NOTE: When applying an Auto Filter SCIC filter, only one series is created in the Browser.
This series has SCIC applied to all images in that series. If you want to try SCIC
on your images prior to applying it to your protocol, use the post-processing
enhancement feature so you can compare the images with and without SCIC.

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 Enhancing Images with Auto Filter

Quick Steps: Apply an Auto SCIC Filter

1. Click [New Series] in the Rx Manager.
2. Enter the prescription parameters for the scan.
3. Click the Image Enhance icon.
4. Select Surface Coil Intensity Correction to activate SCIC.
5. Select the desired SCIC level, A - H.
6. Click [Accept].
7. Click [Save Series].
8. Click [Prepare to Scan].
9. Click [Scan].

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 Editing Patient Information

Chapter 41
Editing Patient Information

Introduction
This chapter explains the process for editing patient information. Editing allows you to
correct improperly entered patient information (e.g., wrong patient identification) and
you can add information that was previously unavailable at the time the patient data
was entered into the system. This chapter contains the step-by-step instructions to help
you learn how to:
• Edit Patient Data
• View the Patient Log

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 Editing Patient Information

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete the edit
process. Specifically, you need to understand:
• Editing Basics
– Edit Patient Data Window
– Annotation
• Editable Data
• Patient Information Edit Log

Editing Basics
The Edit Patient feature allows you to correct improperly entered patient information or
add information that was previously unavailable at the time the patient data was entered
into the system. Once the patient information data is edited, a new examination is
created that replaces the old examination. If the original examination resides on archival
media or another workstation, you may want to remove it to avoid confusion or duplicate
examination numbers.

Edit Patient Data Window

You can edit or update data using the Edit Patient Data window (Figure 41-1). If the text
box is empty, click in the text box, and type in the new data. If the text box already
contains data, place your cursor in the text box and select the text you want to change.
Once the text is selected, either press the Delete key or immediately begin typing in
new data. If you make an error, you can reset the individual text box or all the text boxes
using the [Reset Selected Value] button or the [Reset All Values] button.

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 Editing Patient Information

Figure 41-1 Edit Patient Data Window

The Exam Number text box is the ONLY text box displayed that CANNOT be edited.
The patient weight is not displayed and therefore cannot be edited.
When entering data in the Birthdate text box, the month, day, and year can be
separated by a dash (-), slash (/), comma (,), or period (.). The year must contain four
digits (2004).

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 Editing Patient Information

Annotation
Edited examinations have specific annotations indicating that the patient data has been
updated. This annotation is displayed in the Examination List (Figure 41-2) of the
Display and Image Management Browsers, and in the Exam Description text box of the
Series or Exam Text Page.
Figure 41-2 Examination List

An edited examination is annotated with:

• A prefix (e).
• A + (plus) or - (minus) sign to indicate that the examination’s date and time has
been increased or decreased. The system determines the + or - by the time of day
the examination number was edited. Any original examination that is edited after
11:55 PM on the date the scan was completed has a - (minus) sign.
• The number of times the data was edited. For example, e+3, for data that was
edited three times.
NOTE: The total number of edits allowed is 300.
When examinations are sorted by date in the Display or Image Management Browsers
and multiple versions of the examination are in the database, examinations with the e+
annotation are sorted with the latest version appearing first. This is reversed for
examinations with the e-annotation, the most recent version is sorted last.

Editable Data
You can edit almost all of the patient information that was entered in the Patient
Information area, except the patient weight and examination number. The following is a
list of conditions which must be met before an examination can be edited:
• The edits must be done on the same workstation as the one on which the original
information was entered.
• Only one examination number can be selected.
• There must be sufficient disk space.
• The examination must not be active.
• The examination edit time limit of two weeks must not be expired.

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 Editing Patient Information

You cannot edit patient data when the following conditions exist:
• The examination is “locked,” which means the examination is either:
– In the archive, network, or film queues
– Displayed in the Viewer or Mini Viewer
– Still in scan mode (the [End Exam] button has not yet been selected)
– Still reconstructing
• The examination has not been created on that system. For example, the hospital
name, system identification (ID), or host ID do not match that of the system on
which you are trying to edit patient data.
• The examination is too “old.” This parameter is set under Guided Install > Edit
Patient Data. Fourteen days is the default.
• The images are not in Digital Imaging and COmmunications in Medicine (DICOM)
format.
• You have started the edit process and the number of images in the examination
changes before the data is updated. This could happen if you start to edit the patient
data, then enter the Add/Subtract function and add images to the examination.
When the edits are accepted, an error message appears. Exit the edit function and
try again.
NOTE: If your facility has purchased the ConnectPro Plus (PPS) feature and the patient
information you are editing originated from the HIS/RIS Worklist Browser, the
patient information at the local workstation will NOT match the patient information
in HIS/RIS. Although it is NOT recommended to edit patient information gathered
from the HIS/RIS, the ConnectPro feature does NOT lock the examination and
prevent it from being edited.
There are several factors you should consider when editing patient data:
• You can edit the patient data on an examination containing a 3D model, however,
the 3D model series will not be part of the new examination. If you select a 3D
series, the edit process ends with an error.
• All images and post-processing (screen saves, reformat, 3D surface) should be
done before editing. All images created after the edit do NOT contain the edited
information.

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 Editing Patient Information

Patient Information Edit Log

The Patient Information Edit Log (Figure 41-3) is a list of all patients whose information
has been edited. Each log file is composed of two rows. The top row contains the
original information and the bottom row contains the new information. The log lists the
same examination as many times as it has been edited.
Vertical and horizontal sliders allow you to completely view the log. The vertical slider
allows you to scroll through the list of the examinations that have been edited, while the
horizontal slider allows you to view the changes made to individual text boxes for a
specific examination. You must use the horizontal slider to view the text box edits since
the log does not entirely fit in the viewing area.
Figure 41-3 Patient Information Edit Log

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 Editing Patient Information

How Do I...
This section provides the step-by-step instructions for editing patient information.
Specifically, it describes how to:
• Edit Patient Data
• View the Patient Log

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 Editing Patient Information

Edit Patient Data

Use this procedure to change or update patient information. For example, editing allows
you to correct an inaccurately entered patient ID number and add information that was
previously unavailable.
Be aware that certain conditions must be met in order to successfully complete the edit
process. Refer to Editable Data for specific conditions.
Use this procedure to edit patient data.
1. Click the Display Desktop icon in the control panel.

2. Select the examination to be edited.

3. Click [Edit Patient] on the right side of the Browser.

Š The Edit Patient Applications window opens.

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 Editing Patient Information

4. Click [Edit Patient Data] to access the Patient Information window.

CAUTION: A caution message appears reminding you of the precautions you

should follow.
Š All network and archive copies
of the original exam are NOT
automatically removed and
replaced with the new exam.
Š All filmed copies of the original
exam should be replaced.
Š If there have been previous edits
to this exam, all edits should be
made to the most recent version
of the exam.
Š 3D Models in this exam are
deleted in the edited exam.

NOTE: Once editing is completed, the original examination is removed from the Browser
and is no longer accessible.

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 Editing Patient Information

5. Click [Accept] to continue.

Š The Edit Patient Data window appears.
6. Enter the desired changes in the
appropriate text box or boxes and press the
Enter key.
Š If you make a mistake you can:
– Click [Reset Selected Values] to
reset the system to the previous
value in the active text box.
– Click [Reset All Values] to reset all
the changed values to the previous
values.
7. Enter three characters in the Edited by text
box.
Š You must enter data in this text box.
8. Click [Accept] to save the changes.
Š A confirmation message appears
requesting that you accept the changes.

Š This saves the changes in a new examination.

9. Click [Accept] to confirm the message.
Š A status window appears and remains open displaying the edit save status as a
percentage of the edit completed. Depending on the size of the examination, it
may take several minutes to complete.
Š Clicking [Cancel] on the confirmation message returns you to the Edit Patient
Data screen without saving the changes, a new examination is NOT created.

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 Editing Patient Information

Quick Steps: Edit Patient Data

1. Click the Display Desktop icon in the control panel.
2. Select the examination to be edited.
3. Click [Edit Patient] on the right side of the Browser.
4. Click [Edit Patient Data] to access the Patient Information window.
5. Click [Accept] to continue.
6. Enter the desired changes in the appropriate text box or boxes and press the
Enter key.
7. Enter three characters in the Edited by text box.
8. Click [Accept] to save the changes.
9. Click [Accept] to confirm the message.

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 Editing Patient Information

View the Patient Log

The Patient Information Edit Log is a list of all examinations that have been edited. The
Patient Information Edit Log is for viewing purposes only and CANNOT be used for
editing the patient data.
Use this procedure to view the examinations that have been edited.
1. Click the Display Desktop icon in the control panel.

2. Click [Edit Patient] on the right side of the Browser.

Š The Edit Patient Applications window opens.

3. Click [View Edit Log] to view the Patient Information Edit Log.

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 Editing Patient Information

4. Click and drag the vertical and horizontal sliders to view all the patient’s data in the
log.

5. Click [Cancel] to exit the Patient Information Edit Log.

Quick Steps: View the Patient Log

1. Click the Display Desktop icon in the control panel.
2. Click [Edit Patient] on the right side of the Browser.
3. Click [View Edit Log] to view the Patient Information Edit Log.
4. Click and drag the vertical and horizontal sliders to view all the patient’s data in the
log.
5. Click [Cancel] to exit the Patient Information Edit Log.

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 Combining Images

Chapter 42
Combining Images

Introduction
This chapter explains image combination, including addition, subtraction, pixel
extraction, and binding processes. These processes allow you to perform various
operations on one or two sets of images and place the resulting images in a new series.
This chapter contains the step-by-step instructions to help you learn how to:
• Add One or Two Sets of Images
• Subtract Two Images Within the Same Set or Two Sets of Images
• Extract Minimum or Maximum Pixel Values
– One Set of Images
– Two Sets of Images
• Bind Images
• Post-Process Three Station Runoffs
– Subtractions
– Acquire Collapsed Images with IVI
• Bind Multiple Series into a Single Series

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 Combining Images

What Do I Need to Know About...

This section presents the concepts necessary to successfully complete image
combination using various processes. Specifically, you need to understand:
• Image Combination Basics
– Adding Images
– Subtracting Images
– Extracting Maximum Pixels
– Extracting Minimum Pixels
– Binding Images
• Image Combination Window
– Saving a Series
– Sliding the Ratio Bar
– Accepting Negative Pixels

Image Combination Basics

The Image Combination function allows you to perform various operations on one or
two sets of images selected on the Browser and place the resulting images in a new
series.
The following functions are available with Image Combination:
• Adding Images
• Subtracting Images
• Extracting Maximum Pixels
• Extracting Minimum Pixels
• Binding Images
There are several factors you should consider when selecting image sets.
• One or two sets of images must be selected.
• If only one set is selected, each operation performed produces one resulting image.
• If two sets are selected, images in the two sets are paired according to physical
location in the patient’s body. Unpaired images in either set are ignored. Each
operation performed produces one resulting image per pair.

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 Combining Images

Adding Images
Image Addition (Figure 42-1) creates a new series by adding the corresponding signal
intensity values pixel by pixel from one or two sets of images.
There are two types of image addition possible:
• Addition performed on one set of images, where the signal intensity values of all
images are added, pixel by pixel, and then divided by the number of images in the
set. The resulting image is an average of all the signal intensity values.
• Addition performed on two sets of images, where the images are paired by location
and signal intensity values are added pixel by pixel. A weighting factor can be used
by adjusting the ratio slider described later in this chapter.
The order of set selection does not matter for addition unless a weighting factor is used.
For example, (100+300) and (300+100) both yield the same result of 400 because of
the commutative property of addition.
Figure 42-1 Image Addition

Subtracting Images
Image Subtraction (Figure 42-2) creates a new series by subtracting the corresponding
signal intensity values, pixel by pixel, from two sets of images. The two sets can be
images from the same series, or images from two different series.
Two types of image subtraction are possible:
• Subtraction performed on two images within the same set, where the signal
intensity values of the second image are subtracted, pixel by pixel, from the signal
intensity values of the first image.
• Subtraction performed on two sets of images, where the images are paired by
location, and the signal intensity values of the second set of images are subtracted,
pixel by pixel, from the first set of images. A weighting factor can be used by
adjusting the ratio slider discussed later in this chapter.

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 Combining Images

The set selection order for subtraction is important. For example, (100 - 300) and (300 -
100) do not yield the same result because the commutative property does not apply to
subtraction. Negative pixel values are set to zero, unless you explicitly accept them
during the subtraction process.
Figure 42-2 Image Subtraction

Extracting Maximum Pixels

The maximum pixel value extraction function (Figure 42-3) finds the highest
corresponding signal intensity value, pixel by pixel.
There are two types of maximum pixel value extraction:
• Extraction performed on one set of images, where the highest signal intensity value
is selected, pixel by pixel, from all images.
• Extraction performed on two sets of images, where the images are paired by
location, and the highest signal intensity value is selected, pixel by pixel, between
the two images.
Figure 42-3 Maximum Pixel Extraction

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 Combining Images

Extracting Minimum Pixels

The minimum pixel value extraction function (Figure 42-4) finds the lowest
corresponding signal intensity value, pixel by pixel.
There are two types of minimum pixel value extraction:
• Extraction performed on one set of images, where the lowest signal intensity value
is selected, pixel by pixel, from all images.
• Extraction performed on two sets of images, where the images are paired by
location, and the lowest signal intensity value is selected, pixel by pixel, between the
two images.
Figure 42-4 Minimum Pixel Extraction

Binding Images
Binding creates a new series set which consists of copies of images from one or more
existing series. For example, series 2 with 10 images can be “bound” to series 4 with 15
images to create a new series with 25 images.

Image Combination Window

When you click the [Add/Sub] button from the Browser (or Viewer), the Image
Combination window (Figure 42-5) opens.
Various functions within this window allow you to add, subtract, extract, or bind one or
two sets of images and place the resulting images in a new series. When an image
combination function is performed, the resulting images are annotated with the day on
which the examination was performed.

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 Combining Images

Figure 42-5 Image Combination Window

Saving a Series
To differentiate combined or processed images from others in an examination, the
resulting images are assigned a series number and starting image number by the
Current Save Series indicator in the upper right corner of the Image Combination
window. By default, images resulting from subsequent operations are added onto the
end of the same series.
To place images resulting from subsequent operations into a new series, you must click
the [New Save Series] button.
This increments the save series number by one and displays the Save Series and
Save Image text boxes in the upper right corner of the Image Combination window. You
can accept these numbers or delete them using the Delete or Backspace keys, then
enter the new numbers.
The series resulting from image combination operations are distinguished from other
series in the Browser via one of the following two indicators in the Browser Series List
Type column:
• “PROC” appears in the Browser Series List Type column if the images in the series
are the result of processing pairs of images having identical locations in the patient’s
body.
Since “PROC” series contain images resulting from processing pairs of images
having identical locations in the patient’s body, such series can be used like any
other series of acquisition images, for example, geometric measurements,
reformatting, 3D reconstruction, etc.
• “COMB” appears in the Type column if the images in the series are the result of a
combination of images having different locations in the patient’s body.

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 Combining Images

CAUTION: Since “COMB” series contain images resulting from a combination of

images from different locations in the patient’s body, the absolute
anatomical coordinates accompanying these series (shown both in the
Browser and on the displayed images) are not accurate. Only relative
geometric measurements (distance, angle, or area) are accurate.
Figure 42-6 displays the Browser Series List.
Figure 42-6 Browser Series List

Sliding the Ratio Bar

The Ratio slider is available on the Image Combination Window during addition and
subtraction when both [Select Set] buttons are selected.
• Moving the Ratio slider to the left increases the pixel weighting of the image (or
images) on the left (first) image set.
• Moving the Ratio slider to the right increases the pixel weighting of the image (or
images) on the right (second) image set.
• The Ratio slider defaults to the middle to apply equal weighting.
NOTE: The pixel weighting can be adjusted on only one set of images, not both.

Accepting Negative Pixels

This option allows negative pixel values in the resulting images. If this function is not
enabled, all negative pixel values are set to zero.
This operation is useful on pre- and post-contrast studies of the same slice location.

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 Combining Images

How Do I...
This section provides step-by-step instructions for combining images. Specifically, it
describes how to:
• Add One or Two Sets of Images
• Subtract Two Images Within the Same Set or Two Sets of Images
• Extract Minimum or Maximum Pixel Values
– One Set of Images
– Two Sets of Images
• Bind Images
• Post-Process Three Station Runoffs
– Subtractions
– Acquire Collapsed Images with IVI
– Bind Multiple Series into a Single Series

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 Combining Images

Add One or Two Sets of Images

The following steps explain Adding Images between one or two sets of images. This
type of image combination adds the image intensity values, pixel by pixel, of all images
between the two selected sets corresponding to the same physical location in the
patient’s body.
Use this procedure to add one or two sets of images.
1. Click the Display Desktop icon on the desktop control panel to open the Browser.

2. Click [Add/Sub] on the right side of the Browser.

Š The Image Combination Window opens.

3. Select the desired images from the Browser images list.

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 Combining Images

4. Click [Clear Selection].

Š The selections are cleared to ensure that both Select Set buttons have no prior
values associated with them.
5. Click the left [Select Set] button.
Š The first image set is defined.
Š If you are adding two sets of images, select the second set of images and click
the right [Select Set] button.
– The second image set is defined.
Š By default, equal weighting is applied to the two pixels in each pair, but you can
change the weighting via the Sliding the Ratio Bar. In all cases, for normalization
purposes, each resulting pixel value is divided by two.
6. Click [New Save Series].
Š The images are saved in the Browser in a new series.
Š If you do not select this option, the images are saved in the current saved series.
7. Click [+].
Š The addition mode is enabled.
8. Click [=].
Š The addition operation is performed and the new images are generated.
Š The new series appears in the Browser when the function is complete.

Quick Steps: Add One or Two Sets of Images

1. Click the Display Desktop icon on the desktop control panel to open the Browser.
2. Click [Add/Sub] on the right side of the Browser.
3. Select the desired images from the Browser images list.
4. Click [Clear Selection].
5. Click the left [Select Set] button.
6. Click [New Save Series].
7. Click [+].
8. Click [=].

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 Combining Images

Subtract Two Images Within the Same Set or Two

Sets of Images
The following steps explain Subtracting Images between images within one or two sets.
This type of image combination subtracts the image intensity values, pixel by pixel, of
the second image or image set selected in the Browser.
Use this procedure to perform image subtraction on images within the same set or in
two sets.
1. Click the Display Desktop icon on the desktop control panel to open the Browser.

2. Click [Add/Sub] on the right side of the Browser.

Š The Image Combination Window opens.

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 Combining Images

3. Click [Clear Selection].

Š The selections are cleared to ensure that both Select Set buttons have no prior
values associated with them.
4. Select the images or image set and click the left [Select Set] button.
Š If you are subtracting two images within the same set, select the two images you
wish to use from the Browser, and click the left most [Select Set] button.
Š If you are subtracting two sets of images, select the image set you wish to use
and click the left [Select Set] button. Repeat for the second set, this time clicking
the right [Select Set] button.
5. Click [New Save Series].
Š The images are saved in a new series in the Browser.
Š If you do not select this option, the images are saved in the current saved series.
6. Click [-].
Š The image subtraction mode is enabled.
7. Click [Accept Negative Pixels].
Š This allows negative pixel values in the resulting images.
– If this function is not enabled, all negative pixel values are set to zero.
8. Click [=].
Š The subtraction operation is performed and the new images are generated.
Š The new series appears in the Browser when the function is complete.

Quick Steps: Subtract Two Images Within the Same Set or Two Sets of
Images
1. Click the Display Desktop icon on the desktop control panel to open the Browser.
2. Click [Add/Sub] on the right side of the Browser.
3. Click [Clear Selection].
4. Select the images or image set and click the left [Select Set] button.
5. Click [New Save Series].
6. Click [-].
7. Click [Accept Negative Pixels].
8. Click [=].

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 Combining Images

Extract Minimum or Maximum Pixel Values

One Set of Images
The following steps explain Extracting Minimum Pixels or Extracting Maximum Pixels
on one image set. Depending your on selection, this type of extraction finds the
minimum or maximum pixel intensity, pixel by pixel, in all the images selected. To
perform this operation:
1. Click the Display Desktop icon on the desktop control panel to open the Browser.

2. Click [Add/Sub] on the right side of the Browser.

Š The Image Combination Window opens.

3. Click [Clear Selection].
Š The selections are cleared to ensure that both Select Set buttons have no prior
values associated with them.
4. Select the desired images on the Browser and click the left [Select Set].
Š The image set is defined.
5. Click [New Save Series].
Š The images are saved in a new series in the Browser.
Š If you do not select this option, the images are saved in the current saved series.

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 Combining Images

6. Click [Min] or [Max].

Š Click [Min] to select the minimum pixel value extraction mode.
Š Click [Max] to select the maximum pixel value extraction mode.
7. Click [=].
Š The minimum or maximum pixel extraction operation is performed and the new
images are generated.
Š The new series appears in the Browser when image extraction is complete.

Quick Steps: Extract Minimum or Maximum Pixel Values – One Set of Images
1. Click the Display Desktop icon on the desktop control panel to open the Browser.
2. Click [Add/Sub] on the right side of the Browser.
3. Click [Clear Selection].
4. Select the desired images on the Browser and click the left [Select Set].
5. Click [New Save Series].
6. Click [Min] or [Max].
7. Click [=].

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 Combining Images

Extract Minimum or Maximum Pixel Values

Two Sets of Images
The following steps explain Extracting Minimum Pixels or Extracting Maximum Pixels
between two sets of images. This type of extraction finds the minimum or maximum
pixel intensity values, pixel by pixel, of all pairs of images in the two selected sets
corresponding to the same physical location in the patient’s body. To perform this
operation:
1. Click the Display Desktop icon on the desktop control panel to open the Browser.

2. Click [Add/Sub] on the right side of the Browser.

Š The Image Combination Window opens.

3. Click [Clear Selection].
Š The selections are cleared to ensure that both Select Set buttons have no prior
values associated with them.
4. Select the first set of images in the Browser and click the left [Select Set] button.
Š The first image set is defined.
5. Select the second set of images on the Browser, and click the right [Select Set]
button.
Š The second image set is defined.

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 Combining Images

6. Click [New Save Series].

Š The images are saved in the Browser in a new series.
Š If you do not select this option, the images are saved in the current saved series.
7. Click [Min] or [Max].
Š Click [Min] to select the minimum pixel value extraction mode.
Š Click [Max] to select the maximum pixel value extraction mode.
8. Click [=].
Š The minimum or maximum pixel extraction operation is performed and the new
images are generated.
Š The new series appears in the Browser when image extraction is complete.

Quick Steps: Extract Minimum or Maximum Pixel Values – Two Sets of

Images
1. Click the Display Desktop icon on the desktop control panel to open the Browser.
2. Click [Add/Sub] on the right side of the Browser.
3. Click [Clear Selection].
4. Select the first set of images in the Browser and click the left [Select Set] button.
5. Select the second set of images on the Browser, and click the right [Select Set]
button.
6. Click [New Save Series].
7. Click [Min] or [Max].
8. Click [=].

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 Combining Images

Bind Images
The following steps explain Binding Images together. You can create a new series
which consists of copies of selected images from one or more existing series. Follow
these steps to bind images together.
1. Click the Display Desktop icon on the desktop control panel to open the Browser.

2. Click [Add/Sub] on the right side of the Browser.

Š The Image Combination Window opens.

3. Click [Clear Selection].

Š The selections are cleared to ensure that both Select Set buttons have no prior
values associated with them.

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 Combining Images

4. Select the desired set of images in the Browser and click the left [Select Set]
button.
Š The first image set is defined.
5. Select the desired set of images to bind in the Browser and click the right [Select
Set] button.
Š The second image set is defined.
6. Click [New Save Series].
Š The images are saved in the Browser in a new series.
Š If you do not select this option, the images are saved in the current saved series.
7. Click [Bind].
Š The series binding mode is enabled.
8. Click [=].
Š The binding operation is performed and the new images are generated.
Š The new series appears in the Browser when image binding is complete.
NOTE: You can concatenate copies of images from other series to the end of the new
series by following the same procedure, being sure to set up the New Save Series
values correctly prior to clicking the [=] button.

Quick Steps: Bind Images

1. Click the Display Desktop icon on the desktop control panel to open the Browser.
2. Click [Add/Sub] on the right side of the Browser.
3. Click [Clear Selection].
4. Select the desired set of images in the Browser and click the left [Select Set]
button.
5. Select the desired set of images to bind in the Browser and click the right [Select
Set] button.
6. Click [New Save Series].
7. Click [Bind].
8. Click [=].

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 Combining Images

Post-Process Three Station Runoffs

Subtractions
After performing a three station runoff with bolus chasing using Multi Station
(SmartStep), it is possible to merge the top, middle, and bottom images together for
filming. There are three separate steps to follow. The first step involves subtracting the
arterial images from the mask images. The second step involves acquiring a collapsed
image projection with the use of Interactive Vascular Imaging (IVI). The last step is
binding them into one series which also aligns the three stations for filming.
To perform the first function of subtracting the runoffs, follow these steps.
1. Click the Display Desktop icon on the desktop control panel to open the Browser.

2. Select the arterial images from the upper station.

Š Select the first image of the upper station in the Browser Image List, press the
Shift key, and select the last image in the upper station.
3. Click [Add/Sub] on the right side of the Browser.

Š The Image Combination Window opens.

4. Click [-].
Š The subtraction mode is enabled.
5. Click the left [Select Set] button.
Š The upper station arterial images are defined as the first image set.

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 Combining Images

6. Select the mask images from the upper station in the Browser Image List.
Š Select the first image of the mask upper station in the Browser Image List, press
the Shift key, and select the last image in the mask upper station.
7. Click the right [Select Set] button.
Š The upper station mask images are defined as the second image set.
8. Click [Accept Negative Pixels].
Š This allows negative pixel values in the resulting images.
– If this function is not enabled, all negative pixel values are set to zero.
9. Click [=].
Š The subtraction operation is performed and the new images are generated.
Š The subtraction images from the upper station are Series 100.
10. Click [Clear Selection].
Š The selection values are cleared to ensure both Select Set buttons have no prior
values to create new values for the middle station image subtractions.
11. Click [New Save Series].
Š A new series is saved and the middle station runoff series number moves up one
increment to Series 101.
12. Select the arterial images from the middle station.
Š Select the first image of the middle station in the Browser Image List, press the
Shift key, and select the last image in the middle station.
13. Click the left [Select Set] button.
Š The middle station arterial images are defined as the first image set.
14. Select the mask images from the middle station in the Browser Image List.
Š Select the first image of the mask middle station in the Browser Image List, press
the Shift key, and select the last image in the mask middle station.
15. Click the right [Select Set] button.
Š The middle station mask images are defined as the second image set.
16. Click [Accept Negative Pixels].
Š This allows negative pixel values in the resulting images.
– If this function is not enabled, all negative pixel values are set to zero.
17. Click [=].
Š The subtraction operation is performed and the new images are generated.
Š The subtraction images from the middle station are Series 101.

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 Combining Images

18. Click [Clear Selection].

Š The selection values are cleared to ensure both Select Set buttons have no prior
values to create new values for the lower station image subtractions.
19. Click [New Save Series].
Š A new series is saved and the lower station runoff series number increments by
one and becomes Series 102.
20. Select the arterial images from the lower station.
Š Select the first image of the lower station in the Browser Image List, press the
Shift key, and select the last image in the lower station.
21. Click the left [Select Set] button.
Š The lower station arterial images are defined as the first image set.
22. Select the mask images from the lower station in the Browser Image List.
Š Select the first image of the mask lower station in the Browser Image List, press
the Shift key, and select the last image in the mask lower station.
23. Click the right [Select Set] button.
Š The lower station mask images are defined as the second image set.
24. Click [Accept Negative Pixels].
Š This allows negative pixel values in the resulting images.
– If this function is not enabled, all negative pixel values are set to zero.
25. Click [=].
Š The subtraction operation is performed and the new images are generated.
Š The subtraction images from the lower station are in Series 102.
Š The three new series (100, 101, and 102) appear in the Browser when
subtraction is complete.
NOTE: Proceed to the next step, Acquire Collapsed Images with IVI.

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 Combining Images

Quick Steps: Post-Process Three Station Runoffs – Subtractions

1. Click the Display Desktop icon on the desktop control panel to open the Browser.
2. Select the arterial images from the upper station.
3. Click [Add/Sub] on the right side of the Browser.
4. Click [-].
5. Click the left [Select Set] button.
6. Select the mask images from the upper station in the Browser Image List.
7. Click the right [Select Set] button.
8. Click [Accept Negative Pixels].
9. Click [=].
10. Click [Clear Selection].
11. Click [New Save Series].
12. Select the arterial images from the middle station.
13. Click the left [Select Set] button.
14. Select the mask images from the middle station in the Browser Image List.
15. Click the right [Select Set] button.
16. Click [Accept Negative Pixels].
17. Click [=].
18. Click [Clear Selection].
19. Click [New Save Series].
20. Select the arterial images from the lower station.
21. Click the left [Select Set] button.
22. Select the mask images from the lower station in the Browser Image List.
23. Click the right [Select Set] button.
24. Click [Accept Negative Pixels].
25. Click [=].

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 Combining Images

Post-Process Three Station Runoffs

Acquire Collapsed Images with IVI
Use the following steps to acquire collapsed images with IVI for three station runoffs.
1. Select the upper station subtraction series.
Š The upper station subtraction images are in Series 100 in the Browser.
2. Click [IVI] on the right column of the Browser.
Š The Interactive Vascular Imaging (IVI) program opens.
3. Right-click the collapsed image and select Save Image.
Š The collapsed image is in the upper left corner.
Š The new saved image is listed in the Browser Series List as a “PJN” series.
4. Select File > New Model > Yes.
Š Selecting a new model gives you the ability to obtain the middle station images.
5. Select the middle station subtraction images.
Š The middle station subtraction images are in Series 101 in the Browser.
6. Click [Load Slices].
7. Right-click the collapsed image and select Save Image.
Š The collapsed image is in the upper left corner.
Š The new saved image is listed in your Browser Series List as a “PJN” series.
8. Select File > New Model > Yes.
Š Selecting a new model gives you the ability to obtain the lower station images.
9. Select the lower station subtraction series.
Š The lower station subtraction images are in Series 102 in the Browser.
10. Click [Load Slices].
11. Right-click on the collapsed image and select Save Image.
Š The collapsed image is the image in the upper left corner.
Š The new saved image is listed in your Browser Series List as a “PJN” series.
12. Select File > Quit.
Š The IVI program closes.
Š There should be three PJN series in the Browser Series List.
NOTE: You may now proceed to the Bind Multiple Series into a Single Series steps.

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 Combining Images

Quick Steps: Post-Process Three Station Runoffs - Acquire Collapsed

Images with IVI
1. Select the upper station subtraction series.
2. Click [IVI] on the right column of the Browser.
3. Right-click the collapsed image and select Save Image.
4. Select File > New Model > Yes.
5. Select the middle station subtraction images.
6. Click [Load Slices].
7. Right-click the collapsed image and select Save Image.
8. Select File > New Model > Yes.
9. Select the lower station subtraction series.
10. Click [Load Slices].
11. Right-click on the collapsed image and select Save Image.
12. Select File > Quit.

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 Combining Images

Post-Process Three Station Runoffs

Bind Multiple Series into a Single Series
To perform the third step, binding multiple series into a single series for three station
runoffs, use the following procedure.
1. Select the upper station PJN series.
Š Select the first PJN series (100) in the Browser Series List.
2. Click [Add/Sub] on the right side of the Browser.
Š The Image Combination Window appears.
3. Click [New Save Series].
Š Series 100 is the default number.
4. Change Series 100 to Series 103.
Š Clicking [New Save Series] multiple times increases the series number.
5. Click [Bind].
Š The series binding mode is enabled.
6. Click the left [Select Set] button.
Š The first image set is defined.
7. Select the middle station PJN series.
Š Select the second PJN series (101) in the Browser Series List.
8. Click the right [Select Set] button.
Š The second image set is defined.
9. Click [=].
Š The binding operation is performed and the new images are generated.
10. Click [Clear Selection].
Š The selections are cleared to ensure that both Select Set buttons have no prior
values associated with them.
11. Click [New Save Series].
12. Change the series number to 104.
Š Clicking [New Save Series] multiple times increases the series number.
13. Select all the images from the bound Series 103.
Š Select series 103 in the Browser Series List.

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 Combining Images

14. Click the left [Select Set] button.

Š The first image set is defined.
15. Select the lower station PJN series.
Š Select the third PJN series (102) in the Browser Series List.
16. Click the right [Select Set] button.
Š The second image set is defined.
17. Click [=].
Š The binding operation is performed and the new images are generated.
18. Click [Quit].
Š The Add/Sub program and the Image Combination window close.

Quick Steps: Post-Process Three Station Runoffs – Bind Multiple Series into
a Single Series
1. Select the upper station PJN series.
2. Click [Add/Sub] on the right side of the Browser.
3. Click [New Save Series].
4. Change Series 100 to Series 103.
5. Click [Bind].
6. Click the left [Select Set] button.
7. Select the middle station PJN series.
8. Click the right [Select Set] button.
9. Click [=].
10. Click [Clear Selection].
11. Click [New Save Series].
12. Change the series number to 104.
13. Select all the images from the bound Series 103.
14. Click the left [Select Set] button.
15. Select the lower station PJN series.
16. Click the right [Select Set] button.
17. Click [=].
18. Click [Quit].

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 Combining Images

Post-Process Three Station Runoffs

Film the Runoff Images
After you have binded the images, use the following procedure to film the runoff images
in a multiple image display (MID) format.
1. Select series 104 in the Browser Series List.
Š The series should contain three PJN images.
2. Click [Viewer] on the right side of the Browser.
3. Type format 3 1 in the Accelerator Line and press Enter.
Š The Accelerator Line is a command text box located in the lower left corner of
your Viewer.
Š This command places the projection images in order from top to bottom.
4. Align the images using the scroll feature.
5. Click [Film Composer].
6. Select a 1x1 filming format.
7. Press F3 to film using the MID function.
Š This places the three images together horizontally, in one frame.

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 Combining Images

Quick Steps: Post-Process Three Station Runoffs – Film the Runoff Images
1. Select series 104 in the Browser Series List.
2. Click [Viewer] on the right side of the Browser.
3. Type format 3 1 in the Accelerator Line and press Enter.
4. Align the images using the scroll feature.
5. Click [Film Composer].
6. Select a 1x1 filming format.
7. Press F3 to film using the MID function.

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 Appendix A
Accelerator Line Commands

Introduction
The Accelerator Line allows commands to be typed which can perform certain
functions. The accelerator line appears as a rectangular text box at the bottom of the
Viewer and Mini Viewer. A flashing I- beam cursor appears when the mouse cursor is
placed in this area. Typing commands can act as a shortcut to opening additional
menus to access a function. When a command is typed, and the Enter key is pressed
on the keyboard, that command will be applied to all viewports in focus. As next and
prior images are selected, the commands are applied to all those images as well.
These commands are listed in the following table. The commands are divided into
sections according to their function. For each command, the command name is listed
first, the second column lists what should be typed on the Accelerator Line, and the last
column provides an explanation.

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© 2004 General Electric Company. All rights reserved.
Accelerator Line Commands
Type-in
Command Description
Abbreviation
Opens a list of all accelerator commands with
? ?
abbreviations and descriptions.
Paging
Allows you to set the interval for paging. The pa
Paging interval pi <interval> command must be used prior to setting paging
interval.
Allows you to set the interval for paging. The pa
pia
Paging interval all command must be used prior to setting paging
<interval>
interval.
pm Allows you to change the mode for paging.
<spatial> Selecting temporal displays the images in a
Paging mode
or “loop” mode. Spatial displays images in a “back
<temporal> and forth” mode.
Activates CINE paging. For the start and end
values, enter the first and last images you want
to page thru. For rate, enter the number of
pa [<start>
images per second to page through, with the
Cine paging <end>]
maximum being 60. For example, pa 1 20 10,
[<rate>]
where 1 and 20 define the slices in the movie
loop and 10 represents the frames per second
(FPS).
Series Selection
e <exam
Displays the first image of the specified exam,
number>
Exam series, or image in the selected viewport. When
s <series
Series no e/s/i letters are specified, priority goes to
number>
Image image number, series, and then the exam. For
i <image
example, 12/13 means series12/image13.
number>
Displays the first image of the next exam in the
Next exam ne selected viewport. Next is determined by the sort
function applied to the Browser list.
Displays the first image of the next series from
Next series ns
the displayed exam in the selected viewport.
Displays the first image of the previous exam in
Previous exam pe the selected viewport. Previous is determined by
the sort function applied to the Browser list.
Displays first image of the previous series of the
Previous series ps
displayed exam in the selected viewport.

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© 2004 General Electric Company. All rights reserved.
 Type-in
Command Description
Abbreviation
Turns series binding on or off. With series
binding on, the next image is defined as the next
image in the entire exam; at the end of any
particular series, the next image is the first
sb <on> or image of the next series. At the end of the exam,
Series binding
<off> a ‘next’ command will loop back to the first
image of the exam. With series binding off, at
the end of a particular series, a ‘next’ command
will loop back to the first image of the current
series.
Annotation Level/Groups
Removes all annotation from the image
Annotation none an
displayed.
Applies partial annotation to the image displayed
Annotation partial ap
as defined by the User Preferences.
Annotation full af Restores full annotation to the image displayed.
Applies custom annotation to the image
Annotation
ac displayed as defined by the User Preferences
custom
settings.
Selectively turns on or off specific image
annotations on the screen. The N number
Annotation
agp corresponds to the annotation in the customize
groups
setting for annotation in the User Preferences.
You can type more than one number at a time.
Film annotation Removes all annotation from the images being
fan
none filmed.
Film annotation Applies partial annotation to the images being
fap
partial filmed as defined by the User Preferences.
Film annotation Restores full annotation to the images being
faf
full filmed.
Film annotation Applies custom annotation to the images filmed
fac
custom as defined by the User Preferences.
Selectively turns on or off specific image
annotations for filming. The N number
Film annotation fagp <on> or
corresponds to the annotation in the customize
groups <off> <N>
setting for annotation in the User Preferences.
You can type more than one number at a time.

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© 2004 General Electric Company. All rights reserved.
 Type-in
Command Description
Abbreviation
Image Manipulation
Returns to the autofit zoom factor. For example,
Autofit autofit
autofit.
Flip horizontal fh Flips the image horizontally (top to bottom).
Flip left right flr Flips the image vertically (left to right).
Flip vertical fv Flips the image vertically (left to right).
Flip top bottom ftb Flips the image horizontally (top to bottom)
Sets the display format to a maximum of five
Format fo
rows and five columns. For example, fo 3 5.
Rotate left rl Rotates the image left 90°.
Rotate right rr Rotates the image right 90°.
Restores the image display to normal orientation
Normal no
and zoom.
Formats the display screen as specified by rows
format
and columns. The display format maximum is 5
Format <rows>
rows and 5 columns. For example, format 3
<columns>
5.
Reset rs Resets the initial display parameters.
wl <desired Applies specified window level setting to the
Window width
level> display. For example, wl 250.
ww <desired Applies specified window width setting to the
Window level
width> display. For example, ww 800.
Captures the selected image exactly as it is
displayed and creates a new image in series
Screen Save scnsave number 99 on the system disk that includes all
graphics and display factors applied to the
image and/or viewport at the time of capture.
Moves the image in the viewport as you click
Scroll scroll
and drag the mouse.
Set initial Applies default window width and level setting to
siw
windowing the display.
Sets the magnification factor.
Zoom zo
For example, zo 2.
Invert inv Inverts the video.
fi <filter Turns on the specified filter. For example, fi
Filter
name> edge1.

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© 2004 General Electric Company. All rights reserved.
 Type-in
Command Description
Abbreviation
Increases the apparent contrast of the image
Gray scale gse <filter without changing the window/ level settings.
enhance name> Filter names are g1, g2, g3, and off. For
example, gse g1.
Graphics
Turns on the reference image for one image. For
Reference image ri example, ri 2 1, where 2 represents the series
number and 1 represents the image number.
Reference image Turns the reference image on for all of the
ria
all images.
Reference image Turns off the reference image for the selected
nori
off image.
Reference image
noria Turns off the reference image for all l images.
all off
Report cursor rc Creates a report cursor graphic.
Displays a 4x4 mm cursor that can be
dragged to a new location. When the
Report pixel rp cursor is deposited, the mean,
standard deviation, and area are
displayed.
Angle ang Creates an angle type measurement cursor.
Ellipse el Creates an ellipse type measurement cursor.
Rectangle rect Creates a rectangular type measurement cursor.
Display cross referenced scan plane lines on a
scout image. This command allows explicit
xr <series
description of lines and their intervals to be
number>
posted by series, image set, or intervals. For
Cross reference <image set>:
example, images im1 - im2 from the series s(xr
<interval>
s#), or from imx-% (the last image in the series:
xr s# # %), or from the first and last images
only within the series xr s# extrema.
Cross reference Removes cross reference lines from the image
noxr
off display.
xra <series Used to add additional cross referenced groups
cross reference number> or series to a scout which already has a cross
append <image set>: reference on it. Cross reference lines can be
<interval> added by series, image set, or intervals.

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© 2004 General Electric Company. All rights reserved.
 Type-in
Command Description
Abbreviation
Creates a report cursor graphic. For example,
click report cursor from the help menu, and then
report cursor
press the [Enter] key when the cursor is
positioned in the Accelerator Line.
Displays a 4x4 mm cursor that can be dragged
to a new location. When the cursor is deposited,
the mean, standard deviation (sd) and area are
report pixel displayed. For example, click report pixels from
the help menu and then press the [Enter] key
when the cursor is positioned in the Accelerator
Line.
tm <on> or Displays or removes both horizontal and vertical
tick marks
<off> tick marks (rulers) along the border of the image.
tmv <on> or Displays or removes vertical tick marks (rulers)
tick mark vertical
<off> only along the border of the image.
tick mark tmh <on> or Displays or removes horizontal tick marks
horizontal <off> (rulers) only, along the border of the image.
grid <on> or
grid Displays or removes a ruled grid on the image.
<off>
Removes selected graphics from the selected
erase graphics eg
image.
erase all graphics eag Removes all graphics from the selected image.
Hides all graphics on the selected image. The
hide graphics hg
undo function is show graphics.
Shows, or re-displays all graphics on the
show graphics sg selected image which were hidden with the hide
graphics command.
Filming
print page pp Captures a page for filming.
Opens the Print Series window for the selected
viewport. By specifying options, a sequence of
print series prs
images may be sent automatically to the printer,
or current print jobs may be cancelled.
text page exam te Displays text page for the exam.
text page series ts Displays text page for the exam/series.
Displays a text page for the image, which lists all
text page roi tpr
the ROI cursors and their statistics.

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© 2004 General Electric Company. All rights reserved.
 Type-in
Command Description
Abbreviation
Miscellaneous
mm <scroll> Sets mouse right button mode to either image
mouse mode
or <zoom> scroll or magnifying glass.
user prefs up Displays the User Preferences window.
Automatically displays an annotation box so the
user text page utp selected viewport can be used as a user text
page.
quit quit Closes the Viewer or the Mini Viewer.
Saves the image orientation, W/L values,
ss [<first
graphics, filter, and gse values of a range of
save state image> <last
images that you can set. Typing ss by itself
image>]
saves settings for the entire series.

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© 2004 General Electric Company. All rights reserved.
 Appendix B
Glossary of Terms and
Acronyms

Introduction
This appendix defines the MR terms necessary for a working understanding of Pulse
Sequence Databases. We could in no way list all terms associated with MR as it relates
to General Electric (GE) Medical Systems equipment, but choose to include a few that
may prove helpful when reading the next few chapters.
This glossary also provides the identification of the various acronyms used in this guide.
The phrase is written out in full, followed by the acronym enclosed in parentheses, e.g.
Pulse Sequence Database (PSD).

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© 2004 General Electric Company. All rights reserved.
Glossary
3D Multi Slab: An image mode used in Time-of Flight vascular imaging for acquiring
multiple overlapping 3D slabs.

90° Pulse: A pulse that rotates the magnetization vector 90° from longitudinal static
magnetic field direction. This converts the longitudinal magnetization into
transverse magnetization.

A/P: See Anterior/Posterior.

AFOV: See Asymmetric Field of View.

AIT: See Available Imaging Time.

Anterior/Posterior (A/P): A patient positioning selection designating the coronal

plane alignment in order to ensure that the center of the region of interest is as
close as possible to isocenter. The coronal plane divides the body into anterior
(front) and posterior (back) sections.

Artifact: An error in the reconstructed image that does not correspond to the patient.
There are three major forms of artifacts that can occur in MR imaging and
contribute to poor image quality: geometric distortion, inhomogeneous signal
intensity, and spurious signal.

Asymmetric Echo: An echo whose peak, at TE, is not centered in the sampling
window. Also called fractional echo or partial echo.

Asymmetric Field of View (AFOV): 1. An FOV in which the vertical and horizontal
dimensions are not equal. Simular to the rectangular FOV selected. 2. An imaging
enhancement activated by choosing one of two FOV options: square pixel or
variable FOV. Asymmetric FOV is useful for any scan which has anatomy smaller
than the FOV in the phase direction. See FOV and square pixels.

Available Imaging Time (AIT): In cardiac gating, the time during which data can be
collected by the MR system.

Average Flow: An Flow Analysis measurement. Summation of voxel values in a

given flow region (ml/min), reflecting the volume per minute passing through the
defined flow region of a specified cardiac phase or cycle.

Average Velocity: A Flow Analysis measurement. Flow Q (expressed in cm3/sec)

divided by the cross-sectional area A (expressed cm2) of a vessel: V = Q/A
(cm/sec); 1/2 Vmax for laminar flow.

Averaging: A SNR-enhancing technique in which the same MR signal is added up,

and then the sum is divided by the number of signals acquired.

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© 2004 General Electric Company. All rights reserved.
 Bandwidth: A range within a band of frequencies that an MRI system is "tuned" to
receive. The receive bandwidth of an image determines the number of
frequencies encompassed in the image. The system’s bandwidth choice depends
on the TE, matrix, and FOV you select.

Beats per Minute (bpm): The average heart rate as shown by the cardiac waveform
display.

Bipolar Flow-Encoding Gradients: Two gradient pulses of identical shape, but

opposite polarity. Used in order to encode velocities as changes of phase, as used
in Phase Contrast angiography.

BPM: See Beats per Minute.

Cardiac Phase Images: Images demonstrating different times or phases within a

cardiac cycle.

Cine: Generated images for dynamic views of anatomy such as the heart. This option
employs retrospective gating techniques and a Gradient Echo pulse sequence.

CNR: See Contrast-to-Noise Ratio.

Collapsed: A Maximum Intensity Projection (MIP), also called Maximum Pixel

Projection (MPP) from TOF magnitude images, or PC weighted-phase images.
The collapsed image is the MIP in the slice direction.

Complex Difference: A flow reconstruction type for Phase Contrast Vascular

Imaging providing control of the Slab Dephasing Gradient and Phase Correction.
Complex Difference reconstructions have the Dephase Gradient off and Phase
Correction on.

Contrast Resolution: An image function providing the ability to differentiate

anatomical density differences with respect to surrounding anatomical regions.

Contrast-to-Noise Ratio (CNR): Ratio of the absolute difference in intensities

between two regions to the level of fluctuations in intensity due to noise.

Coronal: The horizontal plane along the longitudinal axis of the body dividing it into
anterior (front) and posterior (back) halves.

Decubitus Position: Describes the position of a patient lying on the left or right side.

Diastole: The period between the end of the T-wave and the beginning of the R-wave
in the cardiac cycle. Also called ventricular filling.

Dynamic-Range Compression: A method of enhancing Phase Contrast image

quality by applying a projection Dephasing Gradient to suppress signal from
stationary tissues.

Echo Rephasing: Re-establishment of spin phase coherence, accomplished via a

180 degree RF pulse or gradient switching. See Refocusing.

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© 2004 General Electric Company. All rights reserved.
 Echo Time: See Time to Echo (TE).

Echo Train Length (ETL): The number of 180° refocusing pulses played out during
one TR period.

EDR: See Extended Dynamic Range.

Effective R-R interval (RR): The inverse of bpm (Beats per Minute) measured in
msec: RR = 60,000 divided by bpm.

Effective TR: The "average" repetition time, or TR, in cardiac gating. Measured as
the number of RR intervals between successive excitations of a particular slice
location - e.g., RR, 2xRR, 3xRR, 4xRR.

Effective value: A typical or average value - for example, effective TR. Since you can
not control your patients heart rate, you can not control true TR in a gated study.
You can control the effective TR by telling the system not to trigger at every beat.

ETL: See Echo Train Length.

Even-Echo Rephasing: Rephasing of moving spins on symmetric, even echoes

(e.g., 2, 4, or 6) in Multi-Echo sequences.

Extended Dynamic Range (EDR): An imaging enhancement that uses 32-bit

processing instead of the conventional 16-bits to improve SNR.

F/W: See Fat/Water Suppression.

Fast Cardiac Gating (FastCard): A 2D Time-of Flight, gradient recalled,

single-breath PSD for acquiring multiple phases of the cardiac cycle at a single
slice location.

Fat/Water Suppression (F/W): An imaging enhancement technique that suppresses

signal within the imaging volume from either fat or water by applying a
frequency-selective saturation pulse.

FID: See Free Induction Decay.

Field of View (Acquisition FOV): The area of the anatomy being imaged, usually
expressed in centimeters. FOV image size is a function of the acquisition matrix
times the pixel size.

First-Order Phase Correction: Phase errors in a Phase Contrast image can be

modeled as a linear shading across the image in the x and y direction. In first
order Phase Correction, the slopes of the x and y shading are determined to
reduce the shading.

Flip Angle: Flip angle is the rotational angle of the magnetization vector produced by
a RF pulse relative to the longitudinal axis of the static magnetic field. Flip angle
adjusts contrast.

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 Flow Analysis: A flow reconstruction type for Cine-PC and 2D PC providing control
of the Slab Dephasing Gradient and Phase Correction. Flow Analysis
reconstructions have the Dephase Gradient off and Phase Correction off.

Flow Axis: The orthogonal axis (S/I, R/L, A/P) for which flow has been encoded in a
flow image.

Flow Compensation (Flow Comp): An imaging enhancement using the system’s

gradients to put flowing protons into phase with stationary protons, thereby
reducing flow artifacts. Applied in the slice and frequency directions.

Flow Encoding: A technique used in MR to measure or display motion such as blood

flow within vessels.

Flow Image Set: An image type produced by Phase Contrast scans. Flow images are
phase images that may or may not be magnitude weighted. If magnitude
weighted, a multiplicative magnitude mask for noise suppression is applied to the
phase image. Phase correction and scaling for velocity encoding may also be
applied to the image. The default is for correction to take place, but correction can
be turned off by selecting the Flow Analysis reconstruction mode on the vascular
options screen.

Flow Recon Type: A user-selectable option for selecting a Slab Dephasing Gradient
and a Phase Correction technique. See Phase Difference, Complex Difference,
and Flow Analysis.

Flow-Related Enhancement: A process by which the signal intensity of moving

fluids, like blood or CSF, can be increased compared with the signal of stationary
tissue. Occurs when unsaturated, fully magnetized spins replace saturated spins
between RF pulses.

FOV Center: The center of a scan image, which is ideally located at the magnet’s
isocenter.

Fractional Echo: A feature instructing the system to collect just part of the data it
normally would. Reduces susceptibility and flow artifacts.

Fractional NEX: A feature instructing the system to use about half or exactly
three-quarters of the phase encoding acquired in conventional imaging.
Decreases scan time significantly.

Free Induction Decay (FID): The measurable magnetic resonance signal that occurs
as the transverse magnetism, produced by the application of the 90° pulse,
decays toward zero.

Frequency: The scanning direction associated with the frequency gradient. Usually
corresponds to the image’s long axis.

Gating: An MR technique for imaging rapidly moving anatomy such as the heart.
Uses equipment such as a standard electrocardiograph to trigger data acquisition.

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 GMN: See Gradient Moment Nulling.

Gradient Echo Imaging: A pulse sequence that reverses gradient polarity to rephase
protons and form echoes. Permits short TRs and flip angles of less than 90° to
excite only a portion of the longitudinal magnetization.

Gradient Echo: A basic Fast Scan pulse sequence that uses pulses of 1° to 180° to
excite the protons of interest and rephase them. Gradient Echo uses gradients
rather than conventional RF pulses.

Gradient Moment Nulling (GMN): The application of gradients to correct phase

errors caused by velocity, acceleration or other motion. First-order gradient nulling
is the same as Flow Compensation.

Gradient Moment: In MR angiography, the first moment describes a gradient’s effect

on the phase of a spin with constant velocity; the second moment, its effect on
spins experiencing acceleration; the third moment, its effect on spins experiencing
jerk.

Gradient-Recalled Acquisition in the Steady State (GRASS): See Gradient Echo

and MPGR Gradient Echo.

GRASS: See Gradient-Recalled Acquisition in the Steady State.

Gx, Gy, Gz: Symbols for MR gradients. Subscripts indicate the spatial direction of
each gradient.

Intersequence Delay: The time between each image in the cardiac cycle.

Intravoxel Spin-Phase Dispersion: A loss of phase coherence and therefore, signal

intensity that can result when a wide spectrum of flow velocities exist, when higher
orders of motion like acceleration are present, or when there are minor variations
in magnetic field homogeneity.

Inversion Recovery (IR): A pulse sequence that inverts the magnetization and then
measures the recovery rate as the nuclei return to equilibrium. This rate of
recovery depends on T1.

Inversion Time (TI): The time between the center of the first (180°) inverting pulse
and the beginning of the second (90°) refocusing pulse in an IR pulse sequence.

IR: See Inversion Recovery.

Isocenter: The point at which the three gradient planes cross.

Isochromats: Spins sharing the same phase and frequency at a given point in time.

Isometric Contraction: The time immediately after the R-wave when the heart
prepares for contraction but does not change in volume.

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 J-Coupling: Also called Spin-Spin Coupling. The interaction between multiple lines
and nuclei. When this interaction takes places the nuclei split their energy levels
according to J (the spin-spin coupling constant).

Magnetic Field Gradient: A device for varying the strength of the static magnetic
field at different spatial locations. This is used for slice selection and determining
the spatial locations of protons being imaged. Also used for Velocity Encoding,
Flow Comp, and in place of RF pulses during Gradient Echo acquisitions to
rephase spins. Commonly measured in gauss per centimeter.

Magnetic Resonance (MR): The absorption or emission of electromagnetic energy

by nuclei in a static magnetic field after excitation by a suitable RF pulse.

Magnetic Resonance Imaging (MRI): The creation of images using the magnetic
resonance phenomenon. The current application involves imaging the distribution
of hydrogen nuclei (protons) in the body. The image brightness in a given region
usually depends jointly on the spin density and the relaxation times. Image
brightness is also affected by motion such as blood flow.

Magnetic Resonance Signal: The electromagnetic signal (in the radio frequency
range) produced by the precession of the transverse magnetization of the spins.
The rotation of the transverse magnetization induces a voltage in the coil. This
voltage is amplified by the receiver.

Magnetization Transfer: A technique that improves contrast by saturating the short

T2 component of tissue such as gray/white matter and skeletal muscle.

Maximum Intensity Projection (MIP): A technique for producing multiple projection

images from a volume of image data (i.e., 3D volume or a stack of 2D slices). The
volume of image data is processed along a selected angle and the pixel with the
highest signal intensity is projected onto a two-dimensional image.

MIP: See Maximum Intensity Projection.

MPGR: See Multi-Planer Gradient Echo.

MR: See Magnetic Resonance.

MRI: See Magnetic Resonance Imaging.

MSMP: See Multi-Slice, Multi-Phase Imaging.

MSSP: See Multi-Slice, Single-Phase Imaging.

Multi-Planer Gradient Echo (MPGR): A pulse sequence that represents a

combination of Gradient Echo and Spin Echo sequences. Acquires data
sequentially rather than slice-by-slice.

Multi-Slice, Multi-Phase (MSMP) Imaging: Multi-slice, multi-phase cardiac gating

pulse sequence that produces images at multiple heart locations and several
different cardiac phases at each location.

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 Multi-Slice, Single-Phase (MSSP) Imaging: Multi-slice, single-phase cardiac gating
pulse sequence that produces images at multiple heart locations, each at a
different phase of the cardiac cycle.

NEX: See Number of Excitations.

Number of Excitations (NEX): The number of times a pulse sequence is repeated in

a given acquisition.

PD-Weighted: See Proton Density-Weighted.

Phase Difference: A flow reconstruction type for Phase Contrast Vascular imaging
providing control of the Slab Dephasing Gradient and Phase Correction. Phase
difference reconstructions have the Dephase Gradient off and Phase Correction
on.

Phase Encoding: The act of localizing an MR signal by applying a gradient pulse to

alter the phase of spins before signal readout.

Phase FOV: The Phase Field of View option provides faster scans by scaling down
the size of the field of view in the phase direction by 3/4 or 1/2. The phase FOV
option is not compatible with some PSD and imaging options.

Projection Dephasing Gradient: A gradient applied to diminish signal from

stationary tissues in thick slab 2D Phase Contrast angiography.

Proton Density-Weighted (PD-weighted): PD-weighted images have contrast that

is primarily due to the number of protons in the structures. PD-weighted images
result when scan timing parameters are selected that minimize the T1 (long TRs)
and the T2 (short TEs) contrast effects.

PSD: See Pulse Sequence Database.

Pulse Length or Width: The duration of a pulse, expressed in milliseconds.

Pulse Sequence Database (PSD): A series of RF and gradient pulses and the
intervals between them used in conjunction with gradient magnetic fields to
produce magnetic resonance images.

Radio Frequency (RF): The frequency (intermediate between audio and infrared
frequencies) used in magnetic resonance systems to excite nuclei to resonance.

Radiofrequency Pulse (RF Pulse): A burst of RF energy which, if it is at the correct

Larmor frequency, will rotate the macroscopic magnetization vector by a specific
angle, dependent on the amplitude and duration of the pulse.

Ramp Pulse: An RF excitation pulse that has smaller flip angles for spins flowing into
the slab. As spins penetrate deeper into the slab, the flip angle increases. For
example, a 2:1 Ramp Pulse, with a nominal flip angle of 20°, provides the entry
slices with a flip angle of about 13°, and the exit slices with a flip of about 27°.

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© 2004 General Electric Company. All rights reserved.
 Readout Gradient: A gradient pulse, applied when an MR signal is collected, used
for frequency encoding.

Refocusing: The re-establishment of phase coherence via gradient or RF pulse. See

Echo Rephasing, Gradient Echo, and Gradient Moment Nulling.

Relaxation Time: The time required for 63% of the nuclei to revert to their original
state in the magnetic field after the RF pulse is turned off.

Repetition Time (TR): The time between successive excitations of a slice. That is,
the time from the beginning of one pulse sequence to the beginning of the next. In
conventional imaging, it is a fixed value equal to a user-selected value. In
cardiac-gated studies, however, it can vary from beat to beat depending on the
patient’s heart rate.

Rephasing Gradient: A gradient applied in the opposite direction of a recent

selective excitation pulse, in order to correct for gradient-induced phase shifts.

RF: See Radio Frequency.

R-R Interval: That part of an ECG waveform representing the heart’s electrical
activity showing the time between the peak of one R-wave and the peak of the
next one. Each R-R interval represents the length of one cardiac cycle.

Saturation Pulse: A slice-selective RF pulse applied, often followed by a Dephasing

Gradient, to saturate spins and therefore minimize their signal. Used, for example,
to minimize signal from flowing blood in the slice direction.

Saturation: Repeated application of radio frequency pulses in a time that is short

compared to the T1 of the tissue, producing incomplete realignment of the net
magnetization with the static magnetic field.

Scan Time: The amount of time needed to acquire data.

Sequential IR: An Inversion Recovery sequence in which the system applies the
180°/90°/180° pulses a slice at a time. With the alternative, non-sequential, the
system applies the initial 180° pulse to all slices, then returns to each slice to
complete the sequence.

Signal-to-Noise Ratio (SNR): The ratio of signal amplitude to noise - i.e., the
amplitude of signal emitted by the patient’s protons, divided by the amount of
patient noises and electronic noise inherent in any electronic instrument.

Slice Select: The scanning direction associated with the slice-select gradient. Usually
corresponds to the direction of the scanning range.

SNR: See Signal-to-Noise Ratio.

Spatial Encoding: A method by which data is collected in order to formulate a

three-dimensional image in a two-dimensional plane.

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© 2004 General Electric Company. All rights reserved.
 SPGR: See Spoiled Gradient Echo.

Spin Echo imaging: A magnetic resonance imaging technique in which the Spin
Echo magnetic resonance signal rather than the Free Induction Decay is used.

Spin-Spin Coupling: See J-Coupling.

Spoiled Gradient Echo (SPGR): A Gradient Echo pulse sequence designed for
acquiring T1-weighted images in 2D or 3D mode.

Spoiler Pulse: A gradient pulse applied to dephase spins and to minimize or

eliminate residual signal.

SSFP: See Steady State Free Precession.

Steady State Free Precession (SSFP): 1. A Gradient Echo pulse sequence

designed for acquiring T2-weighted images in 3D mode. 2. A condition achieved
by repeatedly exciting an MR sample with phase-coherent RF pulses at a
repetition rate (TR) which is shorter than T2.

T1: The characteristic time constant for the magnetization’s return to the longitudinal
axis after being excited by an RF pulse. Also called Spin Lattice or Longitudinal
Relaxation Time.

T1-Weighted: Scan protocols that allow the T1 effects to predominate over the other
relaxation effects.

T2*: The characteristic time constant for loss of transverse magnetization and MR
signal due to T2 and local field inhomogeneties. Since such inhomogeneities are
not compensated for by gradient reversal, contrast in gradient-echo images
depends on T2*.

T2*-Weighted: Scan protocols that allow the T2* effects to predominate over the
other contrast effects. There are three primary gradient echo pulse sequences
that can be used to produce varying T2*-weighted images: Gradient Echo, SPGR,
and SSFP.

T2: The characteristic time constant for loss of phase coherence among spins,
caused by their interaction, and the resulting loss in the transverse-magnetization
MR signal. Also referred to as Spin-Spin or Transverse Relaxation Time.

T2-Weighted: Scan protocols that allow the T2 effects to predominate over the other
contrast effects.

TE Min: The shortest possible TE time for a given prescription, used to minimize flow
dephasing and T2 effects.

TE: See Time to Echo.

TE1: The time from the middle of the first excitation pulse to the middle of the first
readout in an Asysmmetrical Spin Echo pulse sequence.

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© 2004 General Electric Company. All rights reserved.
 TE2: The time between the middle of the first excitation pulse and the middle of the
second readout in an Asysmmetrical Spin Echo pulse sequence.

Threshold: A technique for setting the desired pixel signal intensity values the system
uses to process an image.

Throughplane: A flow-encoding direction which is perpendicular to the imaging

plane.

TI: See Inversion Time.

Time to Echo (TE): The time between the center of the excitation pulse and the peak
of the echo, which usually occurs at the center of the readout.

Time-of-Flight (TOF) Angiography: A 2D or 3D imaging technique that relies

primarily on flow-related enhancement to distinguish moving from stationary spins
in creating MR angiograms. Blood that has flowed into the slice will not have
experienced RF pulses and will therefore appears brighter than stationary tissue.

TOF Angiography: See Time-of-Flight Angiography.

TR: See Repetition Time.

Trigger Delay: The time between the occurrence of the triggering pulse and the
actual onset of imaging.

Trigger Window (TW): In cardiac gating, a period during which no further data can be
acquired. During this period, the system waits for the next R-wave trigger, which
initiates a new sequence of data acquisition.

Trigger: In cardiac/respiratory gating, signal sent by the cardiac/respiratory monitor to

activate data acquisition.

TW: See Trigger Window.

Variable Bandwidth (VB): An imaging option that lets you narrow the system’s
receiver bandwidth to increase SNR. Narrowing the bandwidth forces the system
to detect signals from a small range of frequencies. This means the system
discards more random electronic noise, improving SNR. The system narrows the
Variable Bandwidth only as much as the selected TE allows.

VB: See Variable Bandwidth.

Velocity Encoding (VENC): A value entered to prescribe the highest velocities to be

encoded without aliasing in Phase Contrast angiography.

VENC: See Velocity Encoding.

Very Selective Saturation (VSS): Used in spectroscopy.

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 Volume Imaging: An acquisition technique in which signal is collected from an entire
volume rather than individual slices. Permits reconstruction of extremely thin
slices, and usually enhances SNR.

VSS: See Very Selective Saturation.

Water Suppression: The suppression of the water signal in a MR spectrum, usually

by a specialized excitation sequence.

Weighted-Phase Images: Images that present flow data. Directional-flow images

demonstrate flow along a single axis; speed-flow images combine all flow
information into a single presentation.

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© 2004 General Electric Company. All rights reserved.