KNOBOLOGY. Jamie Ternes, RVT William Beaumont Hospital Royal Oak, Michigan. From the Beginning
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1 KNOBOLOGY Jamie Ternes, RVT William Beaumont Hospital Royal Oak, Michigan From the Beginning Power On/Off Patient information Presets Probe selection Scan 1
2 Modalities /Gray scale/2d Pulse Wave Doppler Color Doppler Power Doppler /Gray Scale/2D 2 Dimensional Real time imaging Brightness mode Weaker reflections-darker gray/black Stronger reflections-brighter/whiter 2
3 Pulse Wave Doppler Measures velocity/speed & direction of flow Doppler frequency/doppler shift - change in frequency cm/s- centimeters per second Aliasing - Nyquist limit Higher frequency probe improves signal strength (scattering) Pulse Wave Doppler Parallel to flow/ parallel to vessel wall (consistency) Angle dependant Range ambiguity Sample volume/gate - exact location & size of sample Quantitative - spectral Doppler display 3
4 Color Doppler Converts velocities into color Identifies blood flow and direction Qualitative Average/mean velocities Flow direction- Positive Doppler shift/towards transducer Negative Doppler shift/away from transducer Flow Variance Laminar flow Turbulent flow Power Doppler Only identifies the presence of a Doppler shift Does not evaluate speed Reflects amplitude of the signal Increased sensitivity to low velocities/low flow No aliasing Smaller effect of angle Low frame rates Susceptible to movement 4
5 Map Focal Zones Number Position Depth Automatic Tissue Optimization TGC (Time Gain) or DGC (Depth Gain) Compensation Gain Dynamic Range Harmonics Line density Zoom Scan area Tint maps Frame Average Rejection Multiple aperture steering Extended field of view Virtual Convex 5
6 Objective Contrast Distinguish between lumen and tissue Make same structures looks similar Make different structures look different Gray Map Example Map 1 Example Map 2 6
7 Focal Zones - Number Many One ` Focal Zones-Position Inappropriate Appropriate 7
8 Depth Inappropriate Appropriate Automatic Tissue Optimization OFF ON 8
9 TGC/DGC Inappropriate Appropriate Overall Gain Inappropriate Appropriate 9
10 Dynamic Range 36dB 96dB OFF-Fundamental Harmonics ON-Harmonics 10
11 Line Density 0 4 OFF Zoom ON 11
12 Scan area Larger Smaller Tint Maps Gray map Tint Map 12
13 Tint map Gray map Tint map Frame Average
14 Rejection 0 5 Multiple Aperture Steering OFF ON 14
15 Multiple Aperture Steering LOW MAX Extended Field of View 15
16 Speckle Reduction 0 4 Virtual Convex 16
17 3D 2D 3D Pulse Wave Doppler image proportion to spectral analysis Scale/PRF Gain Automatic optimization B-pause/update/ simultaneous Sample volume size Sample volume position 17
18 Pulse Wave Doppler Doppler angle- Steer Angle correct Tint Map Sweep Speed Baseline Wall Filter Calipers Auto Manual PW proportionate to Spectral analysis 1/3 2/3 18
19 PW Scale/PRF Inappropriate Appropriate ALIASING PW Automatic optimization OFF ON 19
20 PW B-Pause/Update/Simultaneous Simultaneous B Paused PW Sample Volume Size
21 PW Sample Volume Position Inappropriate Appropriate PW Doppler Angle-Steer Inappropriate Appropriate 21
22 PW Doppler angle-fine angle correct Inappropriate Appropriate PW Tint Map Tint map ex. 1 Tint map ex. 2 22
23 PW Sweep Speed Fast-1 Slow-7 PW Baseline Inappropriate Appropriate Aliasing 23
24 PW Wall filter High Low PW Calipers Manual Auto 24
25 Color Doppler Gain Scale/PRF Map Line density Packet size Threshold Region of Interest (ROI) Size Position/angle steer Color Gain Inappropriate Appropriate 25
26 Color Scale/PRF Inappropriate Appropriate Color Map Map 1 Map 2 26
27 Color ROI-Size Larger Smaller Color ROI-Position/Angle steer Inappropriate Appropriate 27
28 Color Line Density 4 0 Color Packet Size Lower Higher 28
29 Color Threshold 10% 90% Power Doppler Gain Map 29
30 Power Gain Inappropriate Appropriate Power Map Map 1 Map 2 30
31 Knobology TIPS Tip#1 Image too grainy Increase Dynamic Range Increase Frame Average Harmonics 31
32 Tip#2 Image too noisy Decrease Gain Decrease Dynamic Range Increase Frame Average Tip#3 To Improve Image Uniformity Increase number of Focal zones Adjust TGC Decrease ROI 32
33 KNOBOLOGY Conclusion Contact your application specialist regarding marketing terms that apply to the technology Allow yourself time to get familiar Don t be afraid! Re-select your preset to start over Experiment and have FUN! 33
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