Siemens MAGNETOM Avanto Operator's Manual
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Siemens MAGNETOM Avanto Operator's Manual

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MAGNETOM Avanto,
MAGNETOM Verio
Operator Manual – MR System
syngo MR E11

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Summary of Contents for Siemens MAGNETOM Avanto

  • Page 1 MAGNETOM Avanto, MAGNETOM Verio Operator Manual – MR System syngo MR E11...
  • Page 3 MAGNETOM Avanto, MAGNETOM Verio Operator Manual – MR System syngo MR E11...
  • Page 4 Legend Indicates a hint Provides information on how to avoid operating errors or information emphasizing important details Indicates the solution to a problem Provides troubleshooting information or answers to frequently asked questions Indicates a list item Indicates a prerequisite A condition that has to be fulfilled before starting a particular operation Indicates a single-step operation Indicates steps within operating sequences Italic...
  • Page 5 WARNING consists of the following elements: ◾ Information about the nature of a hazardous situation ◾ Consequences of not avoiding a hazardous situation ◾ Methods of avoiding a hazardous situation MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 6 Legend MR System | Operator Manual Print No. MR-01501G.621.02.02.02...

  • Page 7: Table Of Contents

    Access to the examination room 2.3.3 Noise development 2.3.4 Patient care 2.3.5 Interventional procedures 2.3.6 Artifacts and imaging errors 2.3.7 Maintenance/repair 2.3.8 Signs and symbols 2.3.9 System owner-related advices 2.3.10 Coils/quality assurance MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 8 Table of contents In case of emergency 2.4.1 Emergency switches 2.4.2 Medical emergency 2.4.3 Coolant accidents 2.4.4 Fire/Fire fighting 3 MR system components Overview system 3.1.1 About function 3.1.2 Super-conducting magnet 3.1.3 Electronics cabinets 3.1.4 RF coils syngo Acquisition Workplace 3.2.1 Host 3.2.2...
  • Page 9 Shutting down the syngo MR Workplace 5.2.4 Starting/ending Standby Preparing the MR system 5.3.1 Connecting the squeeze bulb and the headset 5.3.2 Setting tunnel conditions Preparing the patient 5.4.1 Informing the patient MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 10 Table of contents Physiological effects 5.5.1 Operating modes 5.5.2 SAR: Exposure to RF electromagnetic fields 5.5.3 Stimu: Exposure to low frequency electromagnetic fields Starting/Stopping the measurement 5.6.1 Starting the measurement 5.6.2 Stopping the measurement 6 Maintenance Cleaning 6.1.1 Cleaning system components 6.1.2 Cleaning accessories 6.1.3...

  • Page 11: Introduction

    Availability The Instructions for Use are made available mainly in electronic form. Internet All operator manuals for your system are available online as PDF files in the Document Library: MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 12: Contents

    To find out what hardware and software is available for your system, contact your Siemens Sales Organization. The graphics, figures, and medical images used in the documentation are examples only.

  • Page 13: Accessing The Operator Manuals On The Internet

    The MAGNETOM system is not a device with measuring function  as defined in the Medical Device Directive (MDD). Quantitative measured values obtained are for informational purposes and cannot be used as the only basis for diagnosis. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 14: Authorized Operating Personnel

    In addition, the user has to have read and understood the contents of the operator manual. Please contact Siemens Service for more information on available training options and suggested duration and frequency of such training.

  • Page 15: Information About Branding

    This change also does not impact any legal obligations. This new brand name is reflected on newly created product labeling (for example, user and technical manuals). Already existing material will not bear the new brand name. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 16 Introduction MR System | Operator Manual Print No. MR-01501G.621.02.02.02...

  • Page 17: Safety

    MR system, if the MR system is not used in accordance with the instructions for use (Operator Manual, System Owner Manual). Siemens is also not responsible for any direct or indirect damages caused by incorrect operation. This includes, but is not limited to, accidents with ferromagnetic objects.

  • Page 18: Common/Permanently Existing Hazards

    Safety Common/permanently existing hazards The frequency at which the potential hazards mentioned in this section lead to accidents is still too high. Therefore, it is especially important to observe the instructions on how to avoid these dangerous situations. The most significant hazards include: ◾...

  • Page 19: Safety Instructions On The Static Magnetic Field

    The list of objects in this chapter is not exhaustive. It only serves as an illustration of objects that present hazards in the presence of magnetic forces. ◆ Only use equipment specified or recommended for use in the controlled access area. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 20 Use only MR Safe or MR Conditional tools and devices. ◆ Service work on the MR system may only be performed by Siemens Service. ◆ Ensure that only authorized personnel enter the controlled access area (0.5 mT exclusion zone), for example, electricians or cleaning personnel trained in MR safety.

  • Page 21: Safety Instructions On Rf And Gradient Fields

    Current loops and bore wall Dangerous current loops may be generated when parts of the contact patient's body touch. These loops may lead to burns or increase the probability of stimulation. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 22 Safety Current loops are also generated when the patient's skin contacts the tunnel lining or RF coil cables. Ensure to prevent potential current loops as shown in the red  labeled illustration. Ensure the patient is positioned with proper distance (5 mm) to magnet tunnel as well as proper distance between parts of the body as shown in the green labeled illustration.
  • Page 23 Ensure sufficient ventilation.  CAUTION Heating up/ignition of synthetic blankets via the RF field during the measurement! Patient burns ◆ Use only covers made of paper, cotton or linen. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 24: Contraindications

    Safety  CAUTION Heating up of RF blankets or shields used to avoid aliasing artifacts! Patient burns ◆ Never use RF blankets or other conductive sheets within the magnet bore. 2.2.4 Contraindications This chapter contains very important information about MR safety: In principle, a qualified physician must evaluate the risk/ ...
  • Page 25 To obtain these specific conditions the MR operator may refer to the labeling of the implantable medical device or contact the device manufacturer. Siemens MR does not assume responsibility or liability for the operation of the MR system with any implantable medical device.

  • Page 26: Mechanical Hazards

    Safety  CAUTION Eddy currents induced by low-frequency magnetic fields! Patient burns ◆ Do not examine patients with electrically conducting implants or prostheses.  CAUTION Electrically conducting objects! Injury to patient due to warming Incorrect diagnosis due to artifacts ◆ Request that the patient removes all electrically conducting objects, e.g.
  • Page 27 Keep the patient under visual or acoustic control. ◆ In case of hazardous conditions, press the Table Stop button. ◆ Explain the significance of protocol-controlled table movements to the patient. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 28: Compatibility

    3 T systems. See also MR-conditional: ( Page 28 Labeling) ◆ Contact Siemens Service prior to combining the MR system with other devices. Interferences Peripheral equipment (e.g. patient monitoring, life support or emergency care equipment) which is not specified or recommended...

  • Page 29: What Else Must Be Observed

    The patient’s ability to dissipate surplus heat is increasingly affected temperature as the room temperature and relative humidity increase. ◆ Ensure that the room temperature is at or below 22°C and the relative humidity does not exceed 60%. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 30: Access To The Examination Room

    Adequate attenuation levels can be achieved by using, for example, ear plugs. Ear plugs offering sufficient hearing protection can be found in the Siemens Accessories catalog. MR System | Operator Manual Print No. MR-01501G.621.02.02.02...

  • Page 31: Patient Care

    Patients must be informed about the hazards and safety measures during MR examinations. Before doing so, it must be confirmed that an MR examination is permissible and/or checked if increased precautions are necessary. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 32 Safety  CAUTION Patient received insufficient information! Injury to patient ◆ Explain to the patient how to behave during the procedure and what to expect, as well as the risks involved. ◆ Inform the patient about the monitoring and communication equipment e.g.

  • Page 33: Interventional Procedures

    Patient-related artifacts/imaging errors ◾ User-related artifacts/imaging errors, see: Software operator manual User-related and patient-related artifacts/imaging errors can be largely avoided through patient instructions and proper conduct of patient and personnel. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 34 The MR image may show system-related artifacts/imaging errors imaging errors despite careful preparation. ◆ If the same artifact/imaging error appears repeatedly, document and submit it to Siemens Service. Stripe artifacts  CAUTION RF-signal interference caused by incompatible accessories e.g. patient monitoring devices! Streaks and bright spots in the MR image ◆...
  • Page 35 MR image ◆ Go through a distortion correction. ◆ Position the region to be examined as close to the magnet isocenter as possible. ◆ Use phantoms for the control measurements. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 36 Safety Localization errors due to  CAUTION distortion Incorrect localization data due to spatial non-linearity of the gradient field and inhomogeneity of the static magnetic field! Incorrect diagnosis ◆ Take localization errors into account while planning interventions or biopsies. Potato chip artifact ...

  • Page 37: Maintenance/Repair

    High voltage and currents inside the electronics cabinets! Risk of death by electrocution ◆ Electronics cabinets should only be opened by Siemens Service. Daily checks Windows, doors, and emergency flaps must not be blocked. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 38: Signs And Symbols

    Maintenance For detailed information about maintenance of the MR system, see: System owner manual Serious malfunctions In case of serious malfunctions, shut down the MR system immediately and notify Siemens Service. Signs and symbols 2.3.8 Warning signs Magnetic field RF field...
  • Page 39 The following objects are prohibited in the examination room: Open flames, no smok- Implants susceptible to Metallic implants and Mechanical watches electromagnetic effects other metallic objects and electronic data car- inside the body riers MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 40: System Owner-Related Advices

    Safety Metal parts, e.g. tools Fire extinguishers with Electronic data carriers magnetizable metal housing Implants susceptible to electromagnetic effects Unauthorized access Further symbols Sign requiring mandatory hear- Protective class symbol B for Protective class symbol BF for ing protection application parts application parts System owner-related advices 2.3.9...

  • Page 41: Coils/Quality Assurance

    Table Stop Motorized table movement is stopped In case of accidents or injury due to table movement In case of emergency, the relevant switch should be pressed. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 42 Safety (1) Magnet Stop switch (2) Emergency Shut-down/System Off switch (3) Table Stop button Magnet Stop switch The Magnet Stop switch triggers a controlled magnet quench (shutting down the magnetic field). The MR system is not disconnected from the power. There are two different versions of the Magnet Stop switch on the MR system: as an individual switch or as an integral part of the alarm box.
  • Page 43 The MAG STOP or WARNING LED will light up and an alarm signal will sound.  As a rule, Siemens Service must be called following a quench. The magnet must only be put back into operation by Siemens Service personnel.
  • Page 44 Immediately remove the patient from the magnet. ◆ Restrict the access to the examination room. ◆ Notify Siemens Service. Typically there are two Emergency Shut-down switches installed: Emergency Shut-down switch (MAGNETOM Avanto) one near the alarmbox and another one in the examination room.
  • Page 45 (red button). As soon as the button is activated, table movement and the current measurement are stopped immediately. Stop symbol and variants of the Table Stop button on the control units of the different systems Stop symbol: MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 46: Medical Emergency

    Safety Medical emergency 2.4.2  WARNING Medical emergency during MR measurements! Risk of death to patients ◆ Terminate the measurement immediately. ◆ Remove patients from the examination room for treatment unless it is certain that the medical equipment required is appropriate for use inside an MR room.

  • Page 47: Fire/Fire Fighting

    Fire/Fire fighting 2.4.4 The following devices/materials may be used for fire fighting: ◾ Non-magnetic CO extinguisher ◾ Self-contained, anti-magnetic compressed-air breathing apparatus (or hose connection) ◾ Airtight chemical protective suit MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 48 Safety MR System | Operator Manual Print No. MR-01501G.621.02.02.02...

  • Page 49: Mr System Components

    MR system is equipped with active super-conducting shielding. Gradient system The gradient system provides precise localizing slice positions. For details on the gradient system, please refer to the System owner manual. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 50: Electronics Cabinets

    MR system, for example, the MARS (measurement and reconstruction system). The control cabinet includes a sequence-programmable, optical trigger signal output which can be made externally accessible by Siemens Service via installation of a fiber optic cable. MR System | Operator Manual Print No. MR-01501G.621.02.02.02...

  • Page 51: Rf Coils

    The use of devices connected to the optical trigger signal output must comply with any applicable governmental or local hospital Institutional Review Boards (IRBS). Siemens will not be held responsible for the use of any device and resulting consequences in connection with the optical trigger signal output.

  • Page 52: Syngo Acquisition Workplace

    MR system components syngo Acquisition Workplace The workplace (desk) in the control room is known as the syngo Acquisition Workplace (syngo Acq WP) and is used to operate the software. It includes the host processor with the operating elements monitors, keyboard, and mouse. An additional component of the syngo Acquisition Workplace is the intercom.

  • Page 53: Monitor

     Do not touch the surface of the screen using sharp, pointed objects. Follow the cleaning instructions, see chapter Cleaning. As the monitors are optimally configured by Siemens Service, all monitor adjustments are blocked. 3.2.4 Keyboard The syngo Acquisition Workplace is equipped with a specially labeled Siemens keyboard.

  • Page 54: Mouse

    MR system components Function Original Siemens key Windows key Page forth/back in the examination 8 / 7 Page forth/back in the series 5 / 4 Page forth/back image by image 2 / 1 Open patient registration Selecting the Patient Browser...

  • Page 55: Syngo Mr Workplace (Optional)

    You can use the system control to operate the system and the patient table. It comprises control units and the table display. Example: System control on the MAGNETOM Avanto MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 56: Control Units

    Optionally, additional control units are located at the rear side of the magnet. Control unit on the MAGNETOM Avanto (A) and on the MAGNETOM Verio (B) (1) Table Stop button (2) Laser-Light Localizer button...
  • Page 57 Direction arrows for vertical table movement Locking mechanism for exchangeable tabletop Exchangeable tabletop (optional) and trolley (optional) Overheating brake (10) Patient on table (11) Error codes patient table (12) Coil socket assignments MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 58: Patient Table

    MR system components Text output line The text output line of the table display shows the following information: ◾ Brightness of tunnel lighting, fan for tunnel ventilation, volume of intercom and of headphones ◾ Name of the last connected coil (displays briefly after establishing the connection) ◾...
  • Page 59 The tabletop can be moved horizontally into the magnet bore. When moved completely out of the magnet, the tabletop may be moved vertically as well. Max. patient weight: This label is located on the patient table. Coil sockets MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 60 MR system components For more information about assignment of the coil sockets, see: Coil operator manual  Make sure that no liquids such as contrast medium, blood, or cleaning agents get into the table connections. Connections The following connections are located at the foot end of the patient table: (1) Vacuum cushion (2) Headphones...

  • Page 61: Operation

    Distance between the slice marked with the light localizer and the magnet isocenter The relative position and the actual tabletop movement are shown on the table display.  For some measurements, the tabletop is moved automatically. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 62 MR system components Moving the patient table Table Stop button: The tabletop stops immediately; both movement arrows of the current table movement on the table display flash alternately Table Up/Inward button: Raising the patient table/Moving into the magnet bore Table Down/Outward button: Lowering the patient table/ Moving out of the magnet bore Speed button: Moving the tabletop at increased speed Center Position button: The tabletop moves into the magnet bore...
  • Page 63 Rescue without emergency unlocking mechanism Press the Table Stop button. Pull the tabletop out of the magnet using the handle at the foot end. Rescue the patient. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 64 MR system components Rescue with emergency unlocking mechanism (1) Unlocking handle (2) Reset button Pull the unlocking handle outward up to the end stop. A reset button moves out of the unlocking handle. The Table Stop function is released and the Table Stop button glows.

  • Page 65: Laser-Light Localizer

    Press the Laser-light Localizer button on the control unit. The laser-light localizer is switched on. A crosshair is visible. Move the tabletop so that the crosshairs point precisely to the region of interest. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 66: Alarm Box

    MR system components The slice for measurement is marked. The display shows the relative tabletop position of the marked slice. If the laser is correctly positioned, press the Center Position button to move the table into the magnet isocenter. The tabletop moves to the selected position and the laser shuts off automatically.

  • Page 67: Checks

    Voltage supply of MR system is satisfactory HELIUM LEVEL Helium fill level is too low MAG STOP Magnet Stop switch is pressed / quench triggered Error in the Magnet Stop circuit MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 68 In case of an alarm, press the ACKNOWLEDGE button to silence the alarm, and notify Siemens Service. Verify that the LINE POWER LED is green. If the LINE POWER LED is not on: Check the power supply of the MR system.
  • Page 69 14 days. During this time, the magnet can still be quenched i.e. the magnetic field can be shut down by pressing the Magnet Stop switch in case of emergency. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 70: Intercom

    MR system components Remote monitoring After installing remote monitoring, various error messages can be output centrally (e.g. to the front door or gate): ◆ Please contact Siemens Service regarding questions about remote monitoring. Intercom Description 3.7.1 The intercom allows personnel and patients to communicate during the examination.
  • Page 71 Listen button on the intercom.  Patients, for example, sedated patients, who may not be able to alert the personnel must be monitored by a person present in the examination room. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 72: Operating The Intercom

    MR system components Operating the intercom 3.7.2 Intercom operation is partially software based. For detailed information regarding the operation of the software, see: Software operator manual As the intercom is the “terminal device”, always ensure that the necessary function is activated in the software. For example, adjusting the volume at the intercom does not work if the loudspeakers are switched off in the software.
  • Page 73 The connections for audio equipment are located at the central unit of the intercom in back of the syngo Acquisition Workplace. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 74 MR system components (1) X10 (input, physiological monitoring signals) (2) Music in (audio device connection) (3) CV in (input for automatic voice output) (4) Mic out (voice output to PC) (5) Line out (output, active loudspeaker) ◆ Connect a suitable cable to the Music in connection of the central unit and the Line out output of an analog audio source.
  • Page 75 The volume of the trigger pulses can be set to three different levels: ◾ ◾ Average ◾ High ◆ Use the Trigger signal volume control to set the trigger pulse volume. The trigger pulses are transmitted at the desired volume. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 76: In-Room Syngo Acquisition Workplace

    MR system components In-Room syngo Acquisition Workplace 3.8.1 Description The In-Room syngo Acquisition Workplace (In-Room syngo Acq WP) is an additional operating console in the examination room. It is used for image viewing and MR system operation. The In-Room syngo Acq WP is connected with the host processor and facilitates the examination process by allowing the operating personnel to remain inside the examination room between procedures.

  • Page 77: Operating The In-Room Syngo Acquisition Workplace

    The keys have the same functions as those of the mouse. Roll the trackball to move the pointer on the program interface. Press the keys to execute a specific application. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 78 MR system components Adjusting the monitor tilt The monitor height and tilt can be adjusted for easy and comfortable operation. Release the locking lever by turning it counter-clockwise by 90°. Press lightly against the upper or lower edge of the display to move the monitor into the desired tilt position.

  • Page 79: Other Components And Accessories

    In case of a malfunction, the measurement is stopped and an alarm message is issued.  After 1 minute the system will be automatically switched to Standby. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 80 (1) Scanner hardware error Automatic shutdown! Evacuate patient immediately from the examination room! To prevent further damage, the system will be switched to Standby within 1 minute! Call Siemens Service immediately. Immediately move the patient out of the magnet bore by pressing the Home Position button.

  • Page 81: Magnacoil Tm Headset System

    The MagnaCoil Headset System is an MR Conditional headphone. You can use it as an alternative headphone (for example, in head coils). The headset reduces the noise and can be used for communicating with the patient. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 82 MR system components (1) MagnaCoil Headset System incl. table plug and MagnaCoil Coupler for MagnaPlugs (2) MagnaPlugs (two sizes available: standard and mini) (3) MagnaCoil Coupler for MagnaPlugs  The MagnaPlugs are for single-use only. Dispose of the MagnaPlugs after use. Applying the headset Connect the headphone to the corresponding connector at the foot end of the patient table.
  • Page 83 MR image may occur due to aliasing and folding back. The position of the artifact in the MR image may deviate from its actual location! MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 84 MR system components MR System | Operator Manual Print No. MR-01501G.621.02.02.02...

  • Page 85: Physiological Imaging

    The trigger time is defined by the trigger delay. Prospective triggering can be used for ECG, pulse, or respiratory signal curves as well as for external trigger signal curves. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 86: Retrospective Gating

    There are two versions of the PMU. In case of differences, they are each identified - but operation is nearly the same for both. Usually the graphics include PMU version 2 and the MAGNETOM Avanto, but they also apply to the PMU version 1 and the other MR systems.
  • Page 87 (1) ECG leads with clips (2) Transmitter unit (3) Control LEDs (4) Plug for respiration cushion (5) Connector, charger The ECG electrodes and respiratory cushion are connected to the PERU. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 88 Physiological imaging  To prevent skin irritations, the PERU has to be located in the application cushion during the examination. (1) Application cushion (2) Respiratory cushion with pressure hose (3) Respiratory belt Because of the PERU shape, the application cushion looks different for PERU version 1.
  • Page 89 The connections for the trigger input/output are located on the cover of the MR system. Trigger input/output are galvanically isolated with respect to the MR system. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 90 Page 92 Control LEDs (PMU version 2))  Use only the charger included with delivery. Charging the units with non-Siemens equipment may destroy the PERU and PPU. If the rechargeable batteries can no longer be properly charged, please contact Siemens Service, as the rechargeable batteries can only be replaced by Siemens.
  • Page 91 LED begins to light ◾ LED goes out: Battery is fully charged Red LED ◾ LED flashes: (Electrode error) ECG electrodes or pulse sensor were not applied correctly or fell off MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 92 Physiological imaging Control LEDs (PMU version 2) The transmitter unit includes three green LEDs for signaling the battery status and one red LED as fault indicator (for example, insufficient skin contact of the ECG electrodes). (1) 3 Green LEDs (battery status) (2) 1 Red LED (fault) (3) Transmitter unit If the battery is not in the charging station, the green LEDs flash...

  • Page 93: General Operation

    Scroll Speed button: Setting the write speed for the curves You can choose from three different write speeds: Level 1, 2, and 3. ◾ Acoustic Signal button: Activating/deactivating the acoustic signal MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 94 Physiological imaging  WARNING Physiological displays are not approved to monitor vital parameters! Anomalies of the vital parameters may not be recognized or recognized too late ◆ Never use the physiological displays (either at the system or at the computer) to monitor the vital parameters of a patient. ◆...

  • Page 95: Ecg Triggering

    A number of special sequences support retrospective gating. ECG leads The ECG leads are selected according to the potential difference between the connected electrodes. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 96 Physiological imaging The positions of the ECG leads shown here are examples only. The best position for the electrodes must be decided for each patient individually. The two leads I and II are used and acquired in parallel via the ECG channels.

  • Page 97: Performing

     Shave the patient outside the examination room to prevent accidents. Thoroughly clean the patient's skin at the locations involved. However, do not use solutions containing alcohol. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 98 Physiological imaging Then dry the skin with a paper towel. Use a suitable gel to prepare the skin for better signal transmission. Applying ECG electrodes Finding the best position for the electrodes is a matter of trial and error. ( Page 95 Description) ...

  • Page 99: Pulse Triggering

    When using the pulse sensor on a toe, ensure that the exit side of the light is located on the underside of the toe. Ensure that the pulse sensor is attached properly. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 100: Respiratory Triggering

    Physiological imaging The red LED (fault) at the PPU is flashing (for version 1) or  flashing rapidly (for version 2)? No analyzable signal is available. ◆ Ensure that the pulse sensor is attached correctly. Performing the examination ✓ The pulse sensor is attached. ◆...
  • Page 101 Connecting the respiratory ✓ The respiratory cushion is attached. cushion Use the application cushion and position it together with the PERU on the patient. ( Page 94 Attaching the PERU) MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 102: External Triggering

    Physiological imaging For respiratory triggering alone, position the electrode leads loosely on the respiratory belt. Connect the plug for the respiratory cushion to the appropriate socket on the PERU. Ensure that the pressure hose of the respiration cushion is not crimped or bent.

  • Page 103: Performing

    The external trigger signal can be supplied via the connections in the magnet cover. Performing 4.6.2 Connect the source of the external trigger signal to the cinch jack trigger input (magnet cover, left). Perform external triggering. See: Software operator manual MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 104 Physiological imaging MR System | Operator Manual Print No. MR-01501G.621.02.02.02...

  • Page 105: Mr System Operation

    Check if all warning symbols and signs are present inside and outside the examination room. Check the examination room, control room, and equipment room for liquid spills and puddles on the floor. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 106: Starting Up And Shutting Down The Mr System

    MR system operation Ensure that no magnetizable materials or objects such as vacuum cleaners, carts, ladders, and tools are present in the examination room. Ensure that the outlet of the exhaust vent line is not obstructed. Ensure that any contrast medium residue has been cleaned off the patient table.

  • Page 107: Starting The System (System On)

    Coils comprising several parts (for example, head coils) are closed. SYSTEM ON at the different versions of the alarm box Turn the keyswitch to the right. Press the SYSTEM ON button. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 108: Shutting Down The System (System Off)

    If a dialog box is displayed at the syngo Acquisition Workplace informing you that the helium fill level is too low: Close the dialog box and notify Siemens Service or have the magnet refilled. Check all Table Stop buttons (at the intercom and at the control units).
  • Page 109 The computer system shuts down.  The software does not respond? ◆ Simultaneously press the Ctrl, Alt, and S keys on the keyboard and shut down the system with the System Manager. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 110: Shutting Down The Syngo Mr Workplace

    MR system operation The System Manager cannot be opened?  You can shut down the syngo Acquisition Workplace via the Windows platform, which can cause data loss. ◆ Simultaneously press the Ctrl, Alt, and Del keys on the keyboard and choose the shutdown option. ...

  • Page 111: Starting/Ending Standby

    Connect the headset to the corresponding connector at the foot end of the patient table. Setting tunnel conditions 5.3.2 Use the switches at the control unit to set the conditions in the magnet tunnel. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 112 MR system operation Control units at the MAGNETOM Avanto and MAGNETOM Verio (1) Toggle switch Room – music volume (2) Toggle switch Headphones – music volume (3) Toggle switch Tunnel ventilation (4) Toggle switch Tunnel lighting ◆ Press the + or– symbol of the respective switch.

  • Page 113: Preparing The Patient

    Ensure that the patient holds the squeeze bulb in his/her hand during the measurement. Physiological effects Due to the presence of alternating electromagnetic fields, patients may experience various physiological effects during MR measurements: MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 114: Operating Modes

    MR system operation ◾ SAR: warming of body tissue through RF fields of the RF transmitter coil ( Page 116 SAR: Exposure to RF electromagnetic fields) ◾ Stimu: peripheral nerve stimulation through low-frequency fields of the gradient coils ( Page 121 Stimu: Exposure to low frequency electromagnetic fields) These physiological effects can be evaluated by the technical quantities dB/dt (stimulations) and SAR (warming) respectively.
  • Page 115 Ensure medical monitoring of the patient (as required by the IEC standard). Also consider the need for breaks during the measurements, to allow the patient to cool off, for example. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 116: Sar: Exposure To Rf Electromagnetic Fields

    MR system operation  CAUTION Stereotactic frames and similar devices: tips of screws may heat up considerably, especially if MR examinations are performed in the First Level Controlled Operating Mode! Localized burns of the patient ◆ Please observe the recommendations and notes of the manufacturer of the stereotactic frame.
  • Page 117 MR examination (if the SAR limits described below are maintained). Nevertheless, according to the IEC safety standard the following temperature limits must be observed. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 118 MR system operation Before starting the examination, the following maximum core temperatures of the patient apply: ◾ If the patient is allowed to be examined only in the Normal Operating Mode, the maximum core temperature of the patient (before starting the examination) is 38.5 °C. ◾...
  • Page 119 Acquisition Workplace: SAR Limit(s) Exceeded!  To ensure accurate calculation of the SAR values, the weight and height of the patient must be entered correctly during registration. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 120 MR system operation The dialog box offers examination parameters that you can adapt to allow the examination to continue. You can also change the operating mode using the button provided.  In the First Level Controlled Operating Mode, often only minor modifications (if any) may be required.

  • Page 121: Stimu: Exposure To Low Frequency Electromagnetic Fields

    Look Ahead monitoring: Prior to starting an MR measurement protocol, the stimulation monitor checks whether the stimulation limits may be exceeded. If so, the measurement cannot be started. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 122: Starting/Stopping The Measurement

    MR system operation To perform the examination, the parameters of the measurement sequence must be adjusted accordingly. Online monitoring: If the stimulation limit is exceeded while a measurement is in progress, the active measurement is aborted. Operating modes The MR system can be operated in two operating modes which differ with respect to different levels of stimulation.

  • Page 123: Stopping The Measurement

    ✓ The MR measurement is active. ◆ Press the Start/Stop button on the control unit. ( Page 55 System control) The measurement is stopped. The table display is activated. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 124 MR system operation MR System | Operator Manual Print No. MR-01501G.621.02.02.02...

  • Page 125: Maintenance

    Do not immerse in cleaning or disinfectant liquid. Do not rinse with water. For information regarding cleaning of RF coils, see: Operator Manual Coils MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 126: Cleaning System Components

    Maintenance Cleaning system components 6.1.1  WARNING Flammable cleaning or disinfection agents may cause fire or explosion! Injury to patient ◆ Disinfect the system components with commercial disinfecting materials. However, do not use flammable solvents such as undiluted alcohol, benzine, or acetone. Follow the manufacturer’s instructions.
  • Page 127 But if the monitor/display is under hot running conditions, please wait till the monitor/display is chilled (this can take up to one hour). Clean the monitor/video display using a microfiber cloth. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 128: Cleaning Accessories

    Maintenance If the LCD monitor/video display cannot be effectively cleaned with the microfiber cloth: use window cleaner. Do not use window cleaner on the monitor housing. Immediately remove any water drops from the LCD monitor/video display. Avoid scratching the surface area of the LCD monitor/video display. Avoid impacts to the LCD monitor/video display.

  • Page 129: Care And Cleaning Of Floors

    Cleaning or care products with substances that release ammonia ◾ Cleaning or care products that destroy the anti-static properties of the floor covering ◆ Use commercially available cleaning or care products for the floor. Follow manufacturer's instructions. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...

  • Page 130: Return And Disposal

    Ensure that only trained personnel disassemble the MR system because the system includes a pressurized container and cryogenic helium. Contact Siemens Service in case of questions about returning and disposing the MR system and/or its components and accessories. Observe national regulations.

  • Page 131: Appendix: Regulatory Information

    Please note that this manual may also contain information about  medical devices that are NOT legally manufactured by Siemens. These medical devices are either only distributed by Siemens, or only mentioned for additional information. In the following table you will find information about the medical device, the corresponding legal manufacturer and, if applicable, the authorized representative.

  • Page 132: Ce For Physiological Measurement Unit (Pmu)

    Appendix: regulatory information CE for Physiological Measurement Unit (PMU) The PMU (PPU, PERU, and its receivers) bears a CE marking effective from June 12th 2017 in accordance with the provisions of regulation 2014/53/EU (RED) from April 16th 2014 for radio equipment. FCC and IC for Physiological Measurement Unit The following statements apply for the US and for Canada.

  • Page 133: Index

    Compatibility 28 Emergency switches In-Room syngo Acq WP Safety information 28 Emergency Shut-down 44 Description 76 Safety information 41 Computer system Operation 77 System Off 44 Shutting down 108 Intercom MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 134 Index Description 70 Online monitoring 121 Description 58 Operation 72 SAR monitoring 119 Displays 56 Operation 61 MR system Operating modes 106 PERU 87 Shutting down the syngo MR Keyboard Physiological effects WP 110 syngo Acquisition Workplace 53 Description 113 Shutting down the system 108 First Level Controlled Operating Starting the syngo MR WP 108...
  • Page 135 Starting/ending Standby 111 Static magnetic field Device malfunctions 21 Safety instructions 19 Super-conducting magnet Description 49 syngo Acquisition Workplace Description 52 Host processor 52 Keyboard 53 Monitor 53 Mouse 54 MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 136 This page has been intentionally left blank. MR System | Operator Manual Print No. MR-01501G.621.02.02.02...
  • Page 137 This page has been intentionally left blank. MAGNETOM Avanto, MAGNETOM Verio | syngo MR E11 Print No. MR-01501G.621.02.02.02...
  • Page 138 This page has been intentionally left blank. MR System | Operator Manual Print No. MR-01501G.621.02.02.02...
  • Page 140 Please note: For products that are not legally manufactured This device bears a CE mark in accordance with the by Siemens but distributed, please refer to the Appendix of provisions of Council Directive 93/42/EEC of June 14, 1993 this manual!

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