Siemens MAGNETOM Series Operator's Manual
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Siemens MAGNETOM Series Operator's Manual

Siemens MAGNETOM Series Operator's Manual

Syngo mr e11
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MAGNETOM Family
Operator Manual – MR System
syngo MR E11

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Summary of Contents for Siemens MAGNETOM Series

  • Page 1 MAGNETOM Family Operator Manual – MR System syngo MR E11...
  • Page 3 MAGNETOM Family 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 Legend WARNING Indicates a hazardous situation which, if not avoided, could result in death or serious injury. WARNING consists of the following elements: ◾ Information about the nature of a hazardous situation ◾ Consequences of not avoiding a hazardous situation ◾...
  • Page 6 Legend MR System | Operator Manual Print No. MR-02501G.621.03.02.02...

  • Page 7: Table Of Contents

    Contents Accessing the operator manuals on the Internet Intended use Authorized operating personnel 1.4.1 Definitions of different persons Information about branding 1.5.1 Siemens Healthineers 2 Safety Preface about safety 2.1.1 Hazards and risks 2.1.2 Common causes of accidents 2.1.3 Responsibility Common/permanently existing hazards 2.2.1...
  • 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 Table of contents 3.10 Other components and accessories 3.10.1 MagnaCoil Headset System 3.10.2 Gradient supervision 4 Physiological imaging Triggering methods 4.1.1 Prospective triggering 4.1.2 Retrospective gating Physiological Measurement Unit (PMU) 4.2.1 Description 4.2.2 Preparing the measurement ECG triggering 4.3.1 Description 4.3.2 Performing Pulse triggering...
  • 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

    (3T)  Not all MR systems are released for all countries! Contact your Siemens Sales Organization about the systems available in your country. In order to operate the MR system accurately and safely, the operating personnel must have the necessary expertise as well as knowledge of the complete operator manual.

  • Page 12: Documentation Overview

    Internet All operator manuals for your system are available online as PDF files in the Document Library: ◾ http://www.siemens.com/MedImaging-Manuals For detailed information, see: ( Page 13 Accessing the operator manuals on the Internet) Other media Additionally, the software-related operator manuals are provided on a digital medium, for example, CD-ROM or USB flash drive.

  • Page 13: 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 14: Intended Use

    Introduction Follow the instructions given on the website. After logging on, you will find further support in the Imaging & Therapy Document Library help. Search and filter for the required document. Intended use Your MAGNETOM MR system is indicated for use as a magnetic resonance diagnostic device (MRDD) that produces transverse, sagittal, coronal and oblique cross sectional images, spectroscopic images and/or spectra, and that displays the internal structure and/or...

  • Page 15: 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 16: Information About Branding

    Information about branding 1.5.1 Siemens Healthineers Siemens has recently reorganized its organizational group structure. The healthcare business now is a separate legal entity. This is manifested in our new brand name: While we have adopted this new brand name, the legal name of our company and the name of the Legal Manufacturer do not change.

  • 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

    Safety Static magnetic field/controlled The static basic field is generated by a superconductive magnet and access area may extend beyond the examination room (walls, ceilings). In order to minimize the hazards mentioned, the controlled access area of the basic field is identified on the floor (0.5 mT line). Outside the controlled access area, the magnetic flux density is less than 0.5 mT.
  • 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

    Safety  CAUTION Dizziness, light-headedness or metallic taste in the patient‘s mouth during measurements and/or table movements in a 3- Tesla magnetic field! Reaction of fear by the patient ◆ Prior to the examination, inform the patient about the possible occurrence of these symptoms. Device malfunctions Magnetic flux densities exceeding 0.5 mT can interfere with electronic implants or other devices.
  • Page 22 Safety 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 Safety  WARNING The patient is wearing electrically conductive material! Incorrect patient positioning! Formation of electric current loops Peripheral nerve stimulation of the patient ◆ Ensure that the patient does not wear clothing that is wet or dampened by perspiration. ◆...

  • 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 Cover of the table lifting column is defective; access to moving parts is possible! Risk of severe contusion during vertical movement ◆ Complete the current examination and then shut down the system. ◆ Notify Siemens Service. MAGNETOM Family | syngo MR E11 Print No. MR-02501G.621.03.02.02...
  • Page 28 Safety  WARNING Vertical and horizontal movement of the patient table! Injury to patient and other persons Damage to the patient table ◆ Ensure that there are no obstacles (e.g. extending or overhanging body parts, hair, clothing, straps) between table and the magnet, or that the additional equipment (e.g.

  • Page 29: Compatibility

    Safety  WARNING Improper patient transport with the dockable patient table, improper use of the side rails! Injury to the patient Damage to the patient table ◆ Carefully transport the patient on the dockable patient table. Secure the patient if necessary. ◆...
  • Page 30 3 T systems, and vice versa. See also MR Conditional: ( Page 30 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 31: What Else Must Be Observed

    Safety Technical data Detailed information on B values, gradient and RF data, as well as graphic representations of the spatial distributions are included in the MR compatibility data sheet. See: System Owner Manual What else must be observed? Ambient conditions 2.3.1 As the ambient conditions and SAR have a considerable effect on the patient’s body temperature, you must regularly check the ambient...
  • Page 32 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. The standard Siemens headphones are intended for communication with the patient and can be used in combination with ear plugs. ◾...

  • Page 33: Patient Care

    Safety Patient care 2.3.4 Patient information 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.  CAUTION Patient received insufficient information! Injury to patient ◆...

  • Page 34: Interventional Procedures

    Safety All patients should receive at least routine monitoring. For some  (e.g. sedated, physically unstable) patients, monitoring of the vital parameters is mandatory. In the First Level Controlled Operating Mode medical supervision is also mandatory.  CAUTION Incompatible monitoring devices! Patient burns ◆...

  • Page 35: Artifacts And Imaging Errors

    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 36 Safety Variations in brightness  CAUTION Local variation in the sensitivity of local coils! Continuous fluctuations in MR image brightness ◆ Whenever possible, use a local coil with transmit characteristics that are more suitable for the field of view desired. ◆...
  • Page 37 Safety Distortions/signal obliteration  WARNING along the edges Spatial non-linearity of the gradient field and inhomogeneity of the static magnetic field! Pin-cushion and barrel-shaped distortions and/or loss of signal in the margins of the MR image ◆ Go through a distortion correction. ◆...
  • Page 38 ◆ Prior to the examination, inform patients about movements and their negative effects on the measurement. ◆ Use Siemens scan protocols with motion correction. ◆ Monitor the patient to ensure that the task is performed correctly. MR System | Operator Manual...

  • Page 39: Maintenance/Repair

    2.3.7  WARNING 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. Safety-relevant accessories The following safety-relevant accessories should be checked: ◾...
  • Page 40 Safety Potential injury to persons Laser radiation Risk of injury Maximum load side rails Risk of breaking Refilling with liquid nitrogen and helium Laser (for the US only) Laser Prohibition signs The following objects are prohibited in the examination room: Open flames, no smok- Implants susceptible to Metallic implants and...
  • Page 41 Safety Metal parts, e.g. tools Fire extinguishers with Electronic data carriers magnetizable metal housing Implants susceptible to electromagnetic effects Unauthorized access Further symbols Non-ionizing radiation Sign requiring mandatory hear- ing protection Protective class symbol B for Protective class symbol BF for application parts application parts MAGNETOM Family | syngo MR E11...

  • Page 42: System Owner-Related Advices

    Safety System owner-related advices 2.3.9 Some safety instructions address the system owner. They are included as “Safety information” in a separate operator manual, see: System owner manual. This manual also contains the technical description of the system. Coils/quality assurance 2.3.10 Safety instructions covering the intended use of coils and measurement phantoms are included in a separate operator manual.
  • Page 43 The quench process, that you trigger by the Magnet Stop, is  irreversible and has several consequences. As one rule, Siemens Service must be called following a quench. The magnet must only be put back into operation by Siemens Service personnel. MAGNETOM Family | syngo MR E11 Print No. MR-02501G.621.03.02.02...
  • Page 44 In other situations, for example, attraction of a metal object  to the magnet without any risk to persons, please contact Siemens Service. Note that in some emergency situations it may be sufficient to switch off the electric power of the entire MR system. In this case, you should use the Emergency Shut-down.
  • Page 45 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 one near the alarmbox and another one in the examination room.

  • Page 46: Medical Emergency

    Safety Table Stop button A button to stop table movement is located on the intercom and on the patient table (red button, indicated by the stop symbol). As soon as the button is activated, table movement and the current measurement are stopped immediately. 2.4.2 Medical emergency ...

  • Page 47: Coolant Accidents

    Safety Coolant accidents 2.4.3 First aid in case of shortness of During a quench, a person might become unconscious due to severe shortness of breath: breath Remove unconscious persons immediately from the examination room. Start adequate first aid measures and contact a physician immediately.
  • Page 48 Safety MR System | Operator Manual Print No. MR-02501G.621.03.02.02...

  • Page 49: Mr System Components

    MR system components MR system components Overview system 3.1.1 About function A detailed specification of the systems hardware and software is provided in the Info dialog box (main menu Help > Info). The Info dialog can be used in combination with the information provided in the System Owner Manual (MR compatibility data sheet) to determine the specification of the static magnetic field, the gradients and the RF.
  • Page 50 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-02501G.621.03.02.02...

  • Page 51: Rf Coils

    The use of devices connected to the optical trigger signal output has to 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: Host

    MR system components Host 3.2.1 Among other things, the host processor includes the following functions: ◾ Patient management ◾ Image selection and storage ◾ Measurement sequence management Measured MR images may be transferred to other systems or  computers via the network connection (for example, PACS or RIS systems).

  • Page 53: Keyboard

     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 image by image 2 / 1 Open patient registration Selecting the Patient Browser Copy to film sheet Enter Highlight Send to node 1 If the computer system is connected to a clinic-wide processor network (HIS/RIS), use the Examination task card to send images to other network addresses via node 1.

  • Page 55: Syngo Mr Workplace (Optional)

    MR system components ◾ Center mouse button/wheel: – Changing the window values of patient images – Scrolling (for example, through the Patient list) ◾ Right mouse button: – Opening the context menu (depending on the position of the mouse pointer) syngo MR Workplace (optional) 3.2.6 The syngo MR Workplace allows for evaluation, documentation and...
  • Page 56 MR system components Control units The control units are located at the right and the left side of the patient table at the front of the magnet cover. Optionally, additional control units are located at the back of the magnet. Each control unit consists of a jogwheel and several additional buttons.
  • Page 57 MR system components The optional control units at the back of the magnet additionally comprise a Table Stop button. Dot display The Dot (Day Optimized Throughput) display provides status information as well as several tools. The display is located above the magnet bore opening at the front of the magnet cover.

  • Page 58: Operating The Dot Display

    MR system components Table overview Displays the current table position as well as the patient orientation Physio data Displays the physiological data of the patient Table lock/Table unlock Activates/Deactivates the table lock function for inter- ventional examination (toggle icon) Start Starts a prepared measurement, during the measure- ments, the display will be shut off Info...

  • Page 59: Patient Table

    MR system components Turn the jogwheel to navigate through the icons. Press the jogwheel to confirm the selection. If necessary, adjust your settings by turning and pressing the jogwheel. Patient table 3.4.1 Description The patient table is used for positioning the patient and the coils. The table comprises several sockets and connections.
  • Page 60 MR system components (1) Tabletop (2) Head end (3) Table Stop button (4) Handle to pull out the table top in case of emergency (5) Emergency release 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.
  • Page 61 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) Headphones (2) Vacuum cushion...

  • Page 62: Operating The Patient Table

    MR system components Holder for infusion bottles To use the holder for infusion bottles, position the rod on the right side at the head end of the patient table. When the holder is not in use, it can be clamped in the attachments at the side of the table. Operating the patient table 3.4.2 The patient table can be controlled via the movement buttons and...
  • Page 63 MR system components For interventional examinations, a table lock function is available via the Dot display. ( Page 57 Dot display)  For some measurements, the tabletop is moved automatically. Using the jogwheel Keep the jogwheel turned to move the patient table up/into or down/out of the magnet bore.
  • Page 64 MR system components The Table Up/Inward and the Table Down/Outward button can be pressed in two stages for horizontal movements. Pressing the  button softly moves the table slowly. Pressing the button forcefully moves the table more quickly. Pressing one of these buttons during an automatic table movement (e.g., to the Home Position) stops the table immediately.
  • Page 65 MR system components Press the Home Position button. The tabletop moves completely out of the magnet. Rescue the patient. Rescuing the patient manually In case of power failure and/or defective motorized drive, pull the tabletop manually out of the magnet bore. ...

  • Page 66: Dockable Patient Table

    MR system components ✓ Resetting the Emergency The error regarding the power supply and/or the motorized drive release has been removed. Press the Emergency release back into its original position while shifting the tabletop slightly in any direction until it audibly locks into position.
  • Page 67 MR system components (1) Side rails (2) Docking station (3) Lateral pedal (4) Emergency undocking handle (5) Pedals (6) Handle at the foot end Max. total weight (patient + patient table): This label is located on the dockable patient table. Pedals If the table is removed from the system, you can use the pedals to lift and lower the table manually.

  • Page 68: Operating The Dockable Patient Table

    MR system components Identification label The label at the foot end of the dockable table indicates on which system your table can only be operated. Operating the dockable patient table 3.5.2 If the table is docked to the system, you use the same controls as for the standard table to operate the table.
  • Page 69 MR system components ✓ Undocking the table The tabletop is in Home Position. ✓ Brake for the castors is released. ◆ Step completely on the left pedal to undock the table. The table is removed from the system and can be moved in any direction.
  • Page 70 MR system components Move the table using the handle at the foot end of the table.  If the dockable patient table is not in use, make sure not to move it to the back of the magnet. ✓ Docking the table Guiding wheel is activated.
  • Page 71 MR system components Press the right pedal down fully with your foot to lock the table to the MR system - in doubt press the pedal twice. Wait for the table to get ready after docking. The “Wait” message at the display disappears and the tabletop moves into the reference position.
  • Page 72 MR system components Table does not move horizontally Check that the side rails are fully stored in the carrying frame - oth- erwise no table movement is possible. Troubleshooting: Problems Pedal cannot be pressed and the table is not pushed away from during undocking the MR System Set the lateral pedal to the middle position to deactivate the brake...

  • Page 73: Laser-Light Localizer

    MR system components Laser-light localizer The laser-light localizer facilitates correct patient positioning. The laser-light localizer is located on top at the entrance to the magnet bore (blue arrow in the picture). All laser-relevant locations at the MR system are identified by warning labels affixed directly next to the laser opening.

  • Page 74: Alarm Box

    MR system components Press the Laser-Light Localizer button on the control unit. The laser-light localizer is switched on. A crosshair is visible directly below the area. Move the tabletop so that the crosshairs point precisely to the region of interest. The slice for measurement is marked.

  • Page 75: Checks

    Hazardous conditions for patients ◆ Note the sounding alarm and signal. ◆ Do not perform MR examinations. ◆ Notify Siemens Service. Checking the LEDs (1) WARNING LED (2) POWER LED (3) SYSTEM ON LED LEDs light up to indicate WARNING Error message, e.g.

  • Page 76: Intercom

    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 3.8.1 Description The intercom allows personnel and patients to communicate during the examination.
  • Page 77 MR system components (1) Stop button (2) Talk button (3) Reset Patient Alert button (4) Listen button (5) Physio Signal button (6) Audio connection (7) Reset Stop button Patient alert Patients may use the squeeze bulb to alert the operating personnel (patient alert): ◾...

  • Page 78: Operating The Intercom

    MR system components Operating the intercom 3.8.2 The intercom operation is partially software-based. The Patient Comfort Configuration dialog box allows for several settings, for example, Active Noise Cancellation can be activated, that reduces background noise from the system. For detailed information regarding the operation of the software, see: Software operator manual...

  • Page 79: In-Room Syngo Acquisition Workplace

    MR system components Transmitting music To play music in the examination room, an audio device can be connected at the intercom. Connect a suitable cable to the audio device and to the connection at the intercom. Adjust the final volume to the desired level using the control unit at the magnet or the Patient Comfort Configuration dialog box.

  • Page 80: Operating The In-Room Syngo Acquisition Workplace

    MR system components (1) LCD monitor (2) Tray with trackball and keys (3) Foot switch (optional) As an alternative, the monitor can be suspended from the ceiling. For this option, the tray with trackball and keys is not available. Operating the In-Room syngo Acquisition Workplace 3.9.2 The In-Room syngo Acquisition Workplace (In-Room syngo Acq WP) is operated via the trackball and three keys.
  • Page 81 MR system components Operating the trackball and the keys (1) Keys (2) Trackball (3) Handle 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. Adjusting the monitor tilt The monitor height and tilt can be adjusted for easy and comfortable operation.
  • Page 82 MR system components Turn the wheel counter-clockwise to lower the monitor. Operating the footswitch The footswitch is used to start and stop the MR measurement in the examination room. (1) Hose (2) Hose connector (3) Pushbutton unit (4) Footswitch Start/Stop For additional support, labels can be affixed to the footswitches.

  • Page 83: Other Components And Accessories

    MR system components  As an alternative, you can start and end the measurement via the In-Room syngo Acq WP or the syngo Acq WP. Press the Stop footswitch to end the measurement. 3.10 Other components and accessories MagnaCoil Headset System 3.10.1 Overview The MagnaCoil Headset System is an MR Conditional headphone.
  • Page 84 MR system components  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. Attach the plug to the coupler and check that the plug is firmly inserted.

  • Page 85: Gradient Supervision

    (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 86 Dialog box at the syngo Acquisition Workplace (1) Scanner hardware malfunction Functional problem within automatic shutdown mechanism. Please restart software of MeasRecon. If the problem persists, please call Siemens Service immediately. ◆ Call Siemens Service.  The supervision sensitivity is potentially affected, but the operation of your MR scanner is still possible.

  • Page 87: Physiological Imaging

    Physiological imaging Physiological imaging Triggering methods MR imaging procedures are sensitive to patient movement. Images may exhibit artifacts in the form of smears when motion times - for instance, during respiration or heartbeat - are short compared to measurement times. In particular, this problem occurs as a result of the patient's heartbeat during cardiac examinations or as a result of the patient's breathing during abdominal examinations.

  • Page 88: Retrospective Gating

    Physiological imaging Retrospective gating 4.1.2 Retrospective gating fundamentally differs from prospective triggering. No actual triggering is taking place. The physiological signal and data acquisition times are recorded simultaneously. The measurement is performed completely independently of the patient’s heartbeat or pulse. A temporal assignment of images to the corresponding phase (e.g.
  • Page 89 Physiological imaging Only one PERU or PPU can be located in the examination room!  Two ECG and respiratory sensors in the examination room interfere with one another in signal transmission. It is not possible to determine the results. Patient monitoring systems are optional accessories and are not part of the PMU.
  • Page 90 Physiological imaging (1) Application cushion (2) Respiratory cushion with pressure hose (3) Respiratory belt The respiratory cushion is attached to the patient using the respiratory belt. Wireless pulse sensor (PPU) The PPU acquires the patient's peripheral pulse. It consists of a transmitter unit, a fiber-optic sensor and a removable finger adapter (available in different sizes).
  • Page 91  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 92 Physiological imaging (1) 3 Green LEDs (battery charge level) (2) 1 Red LED (fault) (3) Transmitter unit Battery charge level and faults are also indicated on the Dot display and the Physiological Display dialog window. If the battery is not in the charging station, the green LEDs flash regularly and simultaneously.

  • Page 93: Preparing The Measurement

    Physiological imaging Additionally, battery charge level and electrode/application fault are indicated on the display. Physiological Display (at the Acquisition Workplace) On the Physiological Display at the syngo Acquisition Workplace you can view the patient's physiological signals. For details about software operation, see: Software operator manual 4.2.2 Preparing the measurement...
  • Page 94 Physiological imaging Informing the patient Ask the patient to lie still during the measurement. Inform the patient that the knocking sounds during the measurement are caused by switching the gradients on and off. The PERU may also vibrate slightly.  Knocking sounds may affect the heart rate of patients, either consciously or subconsciously.

  • Page 95: Ecg Triggering

    Physiological imaging Align the PERU on the patient in the direction of the patient’s feet. For the special case of triggered flow measurements/flow quantification in the head region, please position the PERU next to the patient's head (as shown in the picture) to reduce gradient interference.
  • Page 96 Physiological imaging ECG leads The ECG leads are selected according to the potential difference between the connected electrodes. The three leads I, II and III are used and acquired in parallel via the ECG channels. All curves display a prominent R wave when the ECG electrodes and leads are correctly attached.

  • Page 97: Performing

    Physiological imaging Performing 4.3.2 Image quality The quality of the ECG signal for triggered measurements is enhanced ◾ Proper placement of the electrodes ◾ Good skin contact of the electrodes ◾ Reduction of interference signals caused by electromagnetic induction. – Due to cable loops –...
  • 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 96 ECG leads) ...

  • Page 99: Pulse Triggering

    Physiological imaging The red LED (fault) at the PERU is flashing rapidly?  No analyzable signal is available. ◆ Ensure that the ECG electrodes are attached correctly. Pulse triggering Description 4.4.1 Pulse triggering uses the patient's pulse to trigger the measurement. A pulse sensor is connected to the patient's toe or finger.

  • Page 100: Respiratory Triggering

    Physiological imaging Respiratory triggering 4.5.1 Description To keep respiratory artifacts to a minimum, respiratory triggering is primarily used in abdominal imaging. Data acquisition for respiratory triggering begins when the respiratory signal reaches a predefined level (approx. 20 % of the maximum value). Respiratory movement is minimal in this range.

  • Page 101: External Triggering

    Physiological imaging  Women and athletes are usually thoracic breathers. Men and obese patients are usually abdominal breathers. If the patient is an abdominal breather, place the respiration belt around his abdomen. – or – If the patient is a thoracic breather, place the respiration belt around his chest.
  • Page 102 Physiological imaging Voltage-tim diagram for external triggering of the PMU Name Value 0 V ... 0.8 V 2.5 V ... 5 V (min.) 10 ms (min.) 10 ms Input current min. 5 mA Input voltage max. ± 5 V Internal contact External contact The measurement sequence is triggered by the rising edge of the external signal.

  • Page 103: Performing

    Physiological imaging 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 Family | syngo MR E11 Print No. MR-02501G.621.03.02.02...
  • Page 104 Physiological imaging MR System | Operator Manual Print No. MR-02501G.621.03.02.02...

  • Page 105: Mr System Operation

    ◆ Shut down the computer system and power off the MR system (SYSTEM OFF). ◆ Notify Siemens Service. Check the LEDs on the alarm box. Check if all warning symbols and signs are present inside and outside the examination room.

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

    MR system operation  CAUTION Leaking hydraulic system! Slipping hazard ◆ Check the area around the patient table for hydraulic fluids on the floor. Check the examination room, control room, and electronics room for liquid spills and puddles on the floor. Ensure that no magnetizable materials or objects such as vacuum cleaners, carts, ladders, and tools are present in the examination room.

  • Page 107: Starting The System (System On)

    MR system operation The operating modes can be selected by pressing the corresponding button on the alarm box or by using the System Manager in the syngo MR software. See: Software operator manual Additionally a main circuit breaker is located in the control room which should NOT be used during proper functioning of the MR system.
  • Page 108 If a dialog box is displayed at the syngo Acquisition Workplace informing you that the helium fill level is too low: Close the dialog and notify Siemens Service or have the magnet refilled. Check all Table Stop buttons (at the intercom and at the patient table).

  • Page 109: Shutting Down The System (System Off)

    MR system operation Check if communication with the patient in the examination room works properly. Check if image transmission of the video systems works properly. Check if the contact spring connectors at the door frame and the door to the examination room are free of residues, such as cleaning agents, oil, grease, paint splatters, blood drops, etc.

  • Page 110: Shutting Down The Syngo Mr Workplace

    MR system operation Select the Shutdown System option. 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. The System Manager cannot be opened? ...

  • Page 111: Starting/Ending Standby

    MR system operation Save your data. At the syngo MR Workplace, select System > End session. The End Session dialog window is displayed. Select the Shutdown System option. The computer system shuts down.  In case of problems during shutting down, see troubleshooting information: (...

  • Page 112: Preparing The Mr System

    MR system operation Preparing the MR system 5.3.1 Connecting the squeeze bulb and headphones (1) Connection for headphones (2) Connection for squeeze bulb Connect the hose connector of the squeeze bulb to the corresponding connector at the foot end of the patient table. Connect the headphone to the corresponding connector at the foot end of the patient table.

  • Page 113: Preparing The Patient

    MR system operation Preparing the patient  CAUTION Heat development during the examination! Patient burns ◆ Instruct patients to press the squeeze bulb in case of strong heat sensations.  WARNING Use of unapproved fMRI stimulation devices for the given magnetic field strength! Injury to patient and operating personnel ◆...

  • 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 MR system operation A fetus is especially sensitive to potential thermal events during the first three months of pregnancy. Therefore, avoid scanning pregnant patients in the first three months of pregnancy and avoid scanning patients with unknown pregnancy status. First Level Controlled In the First Level Controlled Operating Mode, patients may Operating Mode experience noticeable stress levels depending on the measurement...

  • 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 system operation The Specific Absorption Rate (SAR), expressed as W/kg, serves as a stress indicator. Unacceptably high local SAR values may lead to RF burns. High global SAR values (head, exposed part of the body, whole body) may lead to overstress the patient’s thermoregulation and the cardiovascular system.
  • 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 MR system operation Depending on the medical question, different coils are used for the RF transmission (for example, head, extremity or body coil). The different coils lead to different RF exposure situations for the patient. Therefore, different SAR quantities and corresponding limits have been established (for example, head SAR, whole body SAR, local SAR, and SAR of the exposed part of the body).
  • Page 120 MR system operation The dialog box offers examination parameters that you can adapt to allow the examination to continue.  In the First Level Controlled Operating Mode, often only minor modifications (if any) may be required. Online monitoring: The system constantly measures the transmit power and ensures that the appropriate limit values are observed.

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

    MR system operation First Level Controlled Operating Mode: In the First Level Controlled Operating Mode, patients may experience noticeable stress levels depending on the measurement programs selected. This usually includes perspiration accompanied by an increase in pulse rate. Patients with reduced thermoregulatory capability and higher sensitivity toward increases in body temperature (e.g.

  • 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: Starting The Measurement

    MR system operation Starting the measurement 5.6.1 ✓ The measurement protocol is loaded. ✓ No MR measurement is active. ◆ Select the Start icon at the Dot display. ( Page 57 Dot display) The measurement begins. The display is deactivated. 5.6.2 Stopping the measurement ✓...
  • Page 124 MR system operation MR System | Operator Manual Print No. MR-02501G.621.03.02.02...

  • Page 125: Maintenance

    Maintenance Maintenance Cleaning All instructions in the operator manual regarding cleaning and, when applicable, regarding disinfecting and sterilization must be always observed.  WARNING Improper cleaning of the MR system (including coils and accessories)! Risk of electric shock Damage to the equipment ◆...

  • 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 Maintenance Cleaning the patient table, the The following table lists classes of active agents that have been tested control unit, the straps, the and are approved. The detergents listed under “not approved” must plugs and connectors not be used. Approved Not approved ◾...

  • Page 128: Cleaning Accessories

    Maintenance Avoid impacts to the LCD monitor/video display.  The LCD monitor/video display are highly sensitive to mechanical damage. Cleaning the camera lens ◆ Carefully clean the camera lens with a lint-free cloth and lens cleaner. 6.1.2 Cleaning accessories Cleaning the PMU The following table lists classes of active agents that have been tested and are approved.

  • Page 129: Care And Cleaning Of Floors

    Maintenance Approved Not approved ◾ Aldehydes ◾ Benzine undiluted ◾ Guanidine derivatives ◾ Acetone ◾ Peroxide compounds ◾ Phenols ◾ Pyridine derivatives ◾ Alcohol solution (for exam- ple, 70% isopropyl alcohol ◾ Chloro derivatives and 30% water) ◾ Commercially available clean- ◾...

  • 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

    Index Cleaning 127 Emergency Emergency switches 42 Contraindications Accessories Rescuing the patient in an Implants 24 Safety instructions 39 emergency 64 Safety information 24 Accidents Emergency buttons Control cabinet Burns 21 Magnet Stop 43 Description 50 Coils 42 Table Stop 46 Coolant accidents 47 Control units 56 Emergency Shut-down...
  • Page 134 Index Static magnetic field 19 Measurement phantoms Operation Accidents 42 Dot display 58 Headphone Connection 112 Mechanical hazards Safety instructions 26 Host Description 52 Monitor Patient care Cleaning 127 Patient instructions 33 In-Room syngo Acq WP 80 Patient monitoring 33 syngo Acquisition Workplace 52 Patient monitoring Implants...
  • Page 135 Performing 99 Static magnetic field Device malfunctions 21 Safety instructions 19 Super-conducting magnet Quality Assurance Description 49 Coils 42 syngo Acquisition Workplace Description 51 Host processor 52 Repair Keyboard 53 Safety information 39 Monitor 52 Rescuing the patient in an Mouse 54 emergency 64 syngo MR WP...
  • Page 136 This page has been intentionally left blank. MR System | Operator Manual Print No. MR-02501G.621.03.02.02...
  • Page 137 This page has been intentionally left blank. MAGNETOM Family | syngo MR E11 Print No. MR-02501G.621.03.02.02...
  • Page 138 This page has been intentionally left blank. MR System | Operator Manual Print No. MR-02501G.621.03.02.02...
  • 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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