AORTA CTA VPMC-12419
Workflow Overview: The Aorta can be post-processed in various ways. Auto Bone Removal and Vessel Pick provide a quick overview of the entire Aorta. Vessel Probe creates a centerline of the vessel and extend will allow the user to add vessels. The Organ tool adds additional organs. A single click changes the 3D from VR (volume rendered) to MIP. 3D batch rotations and snapshots are easily created for export to PACS. The Steps: Load the data and select the Vascular Aorta CT protocol on the Gallery page. Select Automatically remove bone on the Gallery page. Select 3D Analysis and Pick to process the aorta. The Viewer tab displays the aorta. Click Remove Fragments to remove background noise. Click Vessel Pick and manually segment vessels when the Hounsfield Unit density is too low for auto segmentation. Click Trim to remove anatomy on the MPR views. Click Window/level and Ruler tools to aid diagnosis. Select Vessel Probe to generate a centerline of the vessel and Extend to add vessels. Edit the Centerline if needed. Click the Organ tool to add the kidneys or additional anatomy. Create 3D Batch Rotation of the aorta with Semi-Transparent Bone. Create 3D Batch Rotation of the aorta in MIP rendering. Create and Export snapshots and batches. 2
Aorta CTA - Load the Dataset Launch VES Double-click the Aorta Applications thumbnail. Automatically Remove Bone is enabled. OR Select the Series tab and choose a specific data set. Click Advanced Viewer. 3
Aorta CTA - Auto Bone Removal Select Protocol Vascular Aorta CT. Ensure Automatically remove bone is checked. Select 3D Analysis. Click Pick. Try using the window/level tool to remove background noise. Click Remove Fragments. The background noise will appear blue. Click Smaller or Larger to adjust the size of the selected fragments. Click Add To. The Recycle Bin is added to Anatomy Management area. 4
Aorta CTA - Snapshot Click Snap. Press S on the keyboard will also activate the camera. Move the camera into the 3D or 2D image and Click to create the snapshot. Tip: Remember to take a snapshot. Only a snapshot can be restored at a later date to continue post processing. 5
Aorta CTA - Manual Segmentation Select Protocol Vascular Aorta CT. Select 3D Analysis. Click Pick. Select Viewer to process manual segmentation of the aorta. Click the expand icon next to Vessel and click Pick. Tip: When the HU contrast density is too low, auto bone segmentation will not adequately display the aorta. You will need to manually segment the aorta. 6
Aorta CTA - Vessel Pick Click on the contrast in the aorta. Click More or Less to change the range of Hounsfield Units or drag the arrows next to the HU range. Click More or Less will change the HU range by 20 in both directions. All vessels within the HU range will be tinted blue. Verify findings by holding down the right mouse to scroll through the 2D data. Vessel Pick does not generate a centerline of the vessel. Use Vessel Probe to generate a centerline. 7
Aorta CTA - Vessel Pick Click Keep Vessels. A Vessels category displays in the Anatomy area. 8
Aorta CTA - VR and MIP Clear Base. Select or highlight the anatomy option Vessels. Select MIP from the Preset Selector options. The 3D drop down rendering options will also provide a MIP view. Select MIP. 9
Aorta CTA Window Level Ruler Tools Click Trim tool and drag the yellow lines on the MPR to remove the table or anatomy. Click Win/Lev and drag in the view to adjust settings. Click Ruler and drag across the vessel. Delete Ruler with a rightclick on the measurement. The line will turn purple. Select Delete or Delete All. Tip: The Trim tool will remove the table or unwanted anatomy on the MPR views. You can window/level the MIP view and add simple rulers to 2D or MPR views. 10
Aorta CTA - Vessel Probe Analysis Click Select under Vessel Analysis. Click on 2D or 3D Aorta. Vessel Probe will generate a center line. Click Extend. Click proximal or distal on the 2D or 3D. This extends the visualized vessel. Extend will not go beyond the point you select. Use this process to add any additional vessels as needed. 11
Aorta CTA - Vessel Probe Add Vessels Click Select to add vessels. Click on a renal artery. Click Extend to extend the visualized vessel. Click the opposite renal artery to extend Vessel Probe. 12
Aorta CTA - Centerline Editing Right-click in the CPR view. The Edit Centerline tool is active. Click and deposit points to adjust the center line in either longitudinal view. Click Apply to save the edits. Click Close to end. Alternatively Click and drag the red line to edit. The yellow line is the centerline. The red line is the corrected centerline. 13
Aorta CTA - Organ Tool Click Organ in Segment Anatomy. Click on the anatomy. The area of interest is tinted blue. Click until the entire organ is included. Scroll through the entire data set. Continue to add additional organs. Create a name in Multi- Pick Organ. Select the drop down menu and choose a name or type a name. Click AddTo. The Anatomy management area displays the new folder. 14
Aorta CTA - Transparent Bone Clear the box next to Bone in the Anatomy management area. Slide the Transparency bar to the right to adjust Bone transparency to desired level. These steps display 3D transparent bone and provides bony landmarks. The result is based on the percentage of Transparency. 15
Aorta CTA 3D Batch Rotation Select Batch to create a 3D Batch rotation. Select the degree of rotation and select the direction of the rotation. Move the slider bar to the desired number of images or degrees between images. As you increase number of images the step size decreases. Click Batch for PACS. Click Movie to create an.avi file for presentations. 16
Aorta CTA Export Select Report tab. Each Snapshot and Batch is displayed in the Findings tray. Click and hold CTRL to add additional images. Click Export to transfer to PACS. 17
Aorta CTA Export Export to display the available PACS destinations. Click the appropriate one. Click Export. 18
Aorta CTA Workflow for the Abdominal Aorta include a variety of post processing tools depending on the area of interest. The Features most commonly used: Automatic Bone Removal. Vessel Pick to manually display vascular anatomy. Vessel Probe to display the vessel lumen. Organ tool to add additional anatomy to your volume rendered image. 3D Batch Rotation of aorta with Semi-Transparent Bone. 3D Batch Rotation of aorta in MIP rendering. Create snapshots and Batch images. Export to multiple destinations. 19