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1. Activating deactivating the acoustic signal MAGNETOM Trio System Manual Physiological imaging Physiological Measurement Unit optional Selecting the ECG lead You can choose from six ECG leads I Il IIl AVR AVL and AVF lt Press the ECG Lead button until the correct lead has been set The ECG lead selection returns to lead once you have reached the AVF lead o Setting the write speed You can choose from three write speeds Level 1 2 and 3 lt gt Press the Scroll Speed button until the correct write speed has been set Activating deactivating the lt gt Press the Acoustic Signal button to activate deactivate acoustic signal the acoustic signal syngo MR 2004A F 2 7 Revision 03 Physiological Measurement Unit optional Physiological imaging F 2 8 MAGNETOM Trio System Manual CHAPTER ECG triggering F3 Description ECG triggering is a method for measuring heart sequences including dynamic studies It can also be used for studies where pulse flow causes artifacts Examples for using ECG triggering include sagittal images of the cervical thoracic spine or sagittal knee studies Disposable ECG electrodes Siemens approved disposable ECG electrodes are required for ECG triggering New disposable ECG electrodes can be purchased from 1 Siemens Merchandise Division Med amp Mehr catalog Product no 9715335 Product name Disposable ECG electrodes syngo MR 2004A F 3 1 Revision 03 ECG
2. G 6 10 MAGNETOM Trio System Manual CP Head Description Design The CP Head consists of the following components CP Head 1 CP Head upper part 2 Removable clamps 3 Release knob covered 4 CP Head lower part syngo MR 2004A G 7 1 Revision 03 CP Head Examination RF coils Functionality O The CP Head is used on a stand alone basis O The CP Head is a transceiver coil Qj The upper part of the CP Head can be removed for patient positioning G 7 2 MAGNETOM Trio System Manual Examination RF coils CP Head Mirror A mirror is mounted to the upper part of the CP Head The mirror allows the patient to see the examination room from inside the magnet bore during the examination Upper part of the CP Head with mirror 1 CP Head upper part 2 Mirror syngo MR 2004A G 7 3 Revision 03 CP Head Examination RF coils Hemovable clamps The CP Head is delivered with removable clamps They are used to secure the head of the patient during the examination Positioning aids 14 Head cushion 1 2wedges G 7 4 MAGNETOM Trio System Manual Examination RF coils CP Head Use WARNING Exposure to RF electromagnetic fields Burns regarding infants small children Do not examine infants small children using the RF coil while ECG leads or active ECG electrodes are attached Preparing the measurement Preparing the measurement using the CP Head includes the foll
3. Patient s head positioned in the 8 Channel Head on the patient table 1 Double mirror 2 Receiver 3 Coil plug 4 Locking mechanism syngo MR 2004A G 6 7 Revision 03 8 Channel Head optional Examination RF coils Performing the measurement WARNING Laser beam of the laser light localizer Eye injury caused by laser beam Use of controls or adjustments or performance of proce dures other than those specified herein may result in haz ardous radiation exposure lt Inform patients of this risk and ask them to keep their eyes closed during the positioning procedure lt Ensure that helpless patients keep their eyes closed during the positioning procedure lt Use the laser light localizer as described only lt Have the laser light localizer checked regularly by Siemens Service G 6 8 MAGNETOM Trio System Manual Examination RF coils 8 Channel Head optional lt Secure the patient s head using the clamps Align the laser light localizer with the center marking of the receiver Even slight head movements during the measurement will degrade image quality o lt Start the measurement syngo MR 2004A G 6 9 Revision 03 8 Channel Head optional Examination RF coils Opening the coil Push the clamps outward to the end stop lt Release the locking mechanism at the receiver lt gt Slide the receiver back Patient on the patient table with 8 Channel Head open
4. The screen menu displays the current monitor settings Video display 2 with screen menu 1 Screen menu 2 Field 1 3 Field 2 4 Field 3 5b Field 4 The current monitor settings are displayed in the fields 1 2 3 and 4 of the screen menu You can also display the hours of operation of the video display since starting up the MR system syngo MR 2004A B 8 7 Revision 03 Video system optional Setting the brightness Setting the contrast B 8 8 MR system components Brightness and contrast V The monitor does NOT display the screen menu Press the Mode button once The screen menu is displayed Press button 1 to increase the brightness lt Press button 2 to reduce the brightness V The monitor does NOT display the screen menu Press the Mode button once The screen menu is displayed Press button 3 to increase the contrast lt gt Press button 4 to reduce the contrast MAGNETOM Trio System Manual MR system components Video system optional Black saturation and color saturation Setting the black saturation Y The monitor does NOT display the screen menu lt gt Press the Mode button twice The screen menu is displayed lt Press button 1 to increase the black saturation lt Press button 2 to reduce the black saturation Setting the color saturation Y The monitor does NOT display the screen menu Press the Mode button twice The screen menu is displayed Press b
5. The software does not respond lt Simultaneously press the Ctrl Alt and S keys on the key board This opens the syngo MR System Manager lt gt Shut down the software properly MAGNETOM Trio System Manual MR system operation Switching the MR system on and off on o pa o The System Manager cannot be opened You can shut down the MR satellite console using the Windows platform Be aware that this may cause data loss lt gt Simultaneously press the Ctrl Alt and Del keys on the keyboard The Windows NT Security window is displayed lt gt Click the Shut Down button The computer is shut down System Manager and Windows do not respond If the System Manager cannot be started and Windows does not respond your only option is to switch off the MR satellite console Be aware that this may cause data loss lt Switch off the MR satellite console C 2 19 syngo MR 2004A Revision 03 Switching the MR system on and off MR system operation C 2 20 MAGNETOM Trio System Manual Physiological effects Due to the presence of strong alternating electromagnetic fields patients may experience various physiological effects during MR examinations Qj Peripheral nerve stimulation through low frequency fields of the gradient coils Q Warming of body tissue through RF fields of the RF trans mitter coil Operating mode To prevent health risks during MR examinations several
6. Alarm box 1 Magnet Stop switch 2 Magnet Stop LED A 2 16 MAGNETOM Trio System Manual Safety Personal safety information Magnet Stop switch in the examination room syngo MR 2004A Revision 03 Examination room 1 Magnet Stop switch A 2 17 Personal safety information Safety Magnet Stop switch A 2 18 MAGNETOM Trio System Manual Safety In case of emergency syngo MR 2004A Revision 03 Personal safety information Examples of situations requiring a Magnet Stop Q Fire 4 Accidents involving the risk of metallic components being propelled into the magnet and causing personal injury The Magnet Stop function quickly reduces the magnetic field strength to a low level As a result magnetic field energy is con verted into heat energy The helium coolant boils off suddenly during this process and is released via an exhaust vent line Lowering the magnetic field strength to 20 mT takes less than 20 seconds lt gt Open the cover of the Magnet Stop switch and press the Magnet Stop switch The alarm is activated at the alarm box The Magnet Stop LED will light up and an alarm signal will sound lt Rescue patients immediately lt Be aware of the dangers involving helium and strong mag netic fields lt The magnet may be put back into operation only by Siemens personnel A 2 19 Personal safety information Safety Emergency shut down switch electrical sys
7. MAGNETOM Trio Operating Instructions Version syngo MR 2004A SIEMENS medical 0123 Manufacturer s notes This product bears a CE marking in accordance with the provi sions of regulation 93 42 EEC of June 14 1993 for medical prod ucts The CE marking applies only to medico technical products medi cal products introduced in connection with the above mentioned comprehensive EC regulation O Siemens AG 2004 All rights reserved Siemens AG Wittelsbacherplatz 2 80333 M nchen Germany Contact Information Siemens AG Medical Solutions Magnetic Resonance HenkestraBe 127 91052 Erlangen Germany Telephone 49 9131 84 0 www SiemensMedical com DokuMR Q med siemens de Print No M3 030 621 19 01 02 Printed in Germany AG 07 04 MAG Tio Overview of contents Safety MH system components MH system operation Patient transport Preparing the examination Physiological imaging Examination RF coils Quality assurance syngo MR 2004A isi 3 Revision 0 O O m Documentation Accessories Maintenance Technical Data Index MAGNETOM Trio System Manual MAG Tio Table of contents A Safety A 1 General safety information A 2 Personal safety information A 3 Device related safety information B MH system components B 1 B 2 B 3 B 4 B 5 B 6 B 7 B 8 Super conducting magnet RF coils some are optional Electronics cabinets MR console In Room MRC optional Alarm box Interco
8. Physiological imaging Respiratory triggering Attaching the respiratory X The plug of the respiratory belt is not connected pelt Determine whether the patient is a thoracic or abdominal breather Women and athletes are usually thoracic breathers EO Men and obese patients are usually abdominal breathers lt For patients with abdominal breathing attach the respira tory belt at kidney level around the patient s abdomen so that the collar lies to the side and moves freely For patients with thoracic breathing attach the respiratory belt around the patient s chest so that the collar lies to the side and moves freely Determine the area of maximum inspiration expiration 4 Position the patient on the patient table gt Slightly retighten the respiratory belt when it is attached to the patient If the respiratory belt is too tight the patient cannot breathe freely and the detectable amplitude will decrease o lt Connect the plug for the respiratory belt to the appropriate socket on the PMU gt Page F 2 2 PMU Frontend syngo MR 2004A F 6 5 Revision 03 Respiratory triggering Physiological imaging lt Ensure that the hose of the respiratory belt is not crimped or bent uh lt a Patient with respiratory belt on the patient table 1 Respiratory belt With quiet patients a periodic signal will appear on screen F 6 6 MAGNETOM Trio System Manual Physiological imaging Respi
9. Table operation Once positioned on the tabletop the patient may be moved into the magnet isocenter The tabletop may be moved into and out of the magnet bore The tabletop cannot be moved into the magnet bore unless the patient table is at the correct height examination height Similarly the patient table can only be lowered if the tabletop is completely moved out of the magnet bore The following input methods are used to control the motorized table movement L1 Joystick T Buttons T Home Position Q Center Position Table Stop button For some measurements the tabletop is moved automatically The joystick is used for continuous vertical movement of the patient table and continuous horizontal movement of the table top D 1 17 Patient table Patient transport The Home Position and Center Position buttons let you directly navigate to four different table positions 14 Home Position tabletop outside the magnet bore Qj Last Scan Position relative tabletop position for the last measurement W Default Position center of the CP Head is positioned in the magnet isocenter W Center Position the region of interest is positioned in the magnet isocenter The Table Stop button is used to stop the movement of the patient table or tabletop WARNING Risk of injury when moving the patient table along the X and Z axes Injury to patient lt Do not reach under the tabletop lt Use the sliding ha
10. com PS Click to check your recording syngo MR 2004A B 7 13 Revision 03 Intercom MR system components Connecting the squeeze lt Connect the hose connector of the squeeze bulb to the red bulb and demonstrating its connector at the foot end of the patient table use s MR Zubeh r verwenden Siemens MR accessories vent les accessoires IRM Siemens Foot end of patient table 1 Connection for squeeze bulb Show the patient how to activate the patient alert by press ing the squeeze bulb lt Ensure that the patient holds the squeeze bulb in his her hand during the measurement B 7 14 MAGNETOM Trio System Manual MR system components Stopping the patient table movement Stopping the measurement sequence Replying to patient alerts syngo MR 2004A Revision 03 Intercom Press the Table Stop button The table movement is stopped immediately Press the Table Stop button twice The measurement is aborted V The patient alert is activated An acoustic signal sounds at the intercom The Squeeze bulb alert active LED flashes Press the Speak button The acoustic signal stops The patient alert is deactivated The transmission from the examination room is activated The oper ating personnel can communicate with the patient B 7 15 Intercom Listening to physiological monitoring signals B 7 16 MR system components The operating personnel may use the intercom to listen to
11. o A 2 12 MAGNETOM Trio System Manual Safety Personal safety information Emergency shut down switch The MR system has three types of emergency shut down switches 1 Magnet Stop switch J Emergency shut down switch 14 Table Stop buttons Overview showing the location of the emergency shut down switches sample installation 1 Magnet Stop switch 2 Emergency shut down switch 3 Table Stop buttons 4 Table Stop button optional syngo MR 2004A A 2 13 Revision 03 Personal safety information Safety For the MR system several Emergency shut down switches have to be installed on site to shut off system voltage The room installation has to comply with VDE 0107 Depending on site requirements the Magnet Stop and Emer gency shut down switches may also be installed in other places at the MR system A 2 14 MAGNETOM Trio System Manual Safety Personal safety information Magnet Stop switch magnetic field Location of the MagnetStop There are two Magnet Stop switches available in the control room on the alarm box near the operating switches console the switch is located under a plexiglass cover Q in the examination room next to the door Display and functionality of the alarm box gt Page B 6 1 Description Magnet Stop switch in the control room 1 Control room 1 Magnet Stop switch on the alarm box syngo MR 2004A A 2 15 Revision 03 Personal safety information Safety
12. syngo MR 2004A Revision 03 Use Preparing the measurement Preparing the measurement using the Breast Array includes the following steps LJ Positioning the Breast Array Q Positioning the patient n Breast Array with positioning aids on the patient table 1 Wedge cushion abdominal support 2 Head support G 4 3 Breast Array optional Examination RF coils Position cushion 1 at the foot end of the patient table Place the wedge cushion abdominal support flush with cushion 1 on the patient table Position the Breast Array on the patient table 4 Place the head support at the head end of the patient table lt Connect the coil plug of the Breast Array to coil socket 3 on the patient table G 4 4 MAGNETOM Trio System Manual Examination RF coils Breast Array optional Positioning the patient P E Patient with Breast Array on the patient table Position the patient in the prone position on the patient table with the head toward the magnet bore lt Use the positioning aids for the head and the lower abdo men to position the patient as comfortably as possible syngo MR 2004A G 4 5 Revision 03 Breast Array optional Examination RF coils Performing the measurement Align the laser light localizer with the center marking of the Breast Array 4 Start the measurement G 4 6 MAGNETOM Trio System Manual Cardiac Array optional Description
13. High risk of eye injury lt gt Carefully remove clothing from the affected area Rinse frozen tissue with cold water Cover frozen tissue with a sterile bandage Call a physician immediately syngo MR 2004A A 2 49 Revision 03 Personal safety information Safety Potential points of injury through mechanical components WARNING Risk of injury when moving the patient in and out Injury to patient lt With respect to patients with long hair ensure that the patient s hair is not pulled under the movable patient table Use a hairnet kerchief paper cap etc Secure the patient s arms with belt straps so that the patient is not caught between the table and the magnet cover Use belt straps to secure restless and traumatized patients lt Be aware of additional points of potential injury when work ing with RF coils lt Move the patient table only if all possible points of injury can be monitored lt When docking the patient trolley ensure that the patient s extremities hair or clothing do not get caught lt Explain table movements to the patient when using proto col controlled table movements A 2 50 MAGNETOM Trio System Manual Safety Personal safety information syngo MR 2004A Revision 03 WARNING Helpless patients Injury to helpless patients caused by falling off the table or getting caught between the tunnel and the table lt Always use belt straps to secure help
14. Qj Right mouse button Displaying a context sensitive menu depending on the position of the mouse pointer Operation If you are unfamiliar with mouse operation refer to Basics for Beginners in the software user manual syngo MR Operator Manual B 4 19 MR console MR system components B 4 20 MAGNETOM Trio System Manual CHAPTER B 5 In Hoom MRC optional Description The In Room MRC is an additional operating console in the examination room It is used for image viewing and MR system operation The In Room MRC facilitates the examination proc ess by allowing the operating personnel to remain inside the examination room between procedures Uses The In Room MRC is used for the following purposes L Display for MR guided procedures m Quickly adjusting patient positioning for survey measure ments 1 Immediately starting the measurement after administering contrast medium The constant presence of operating personnel inside the exam ination room allows uninterrupted patient care and quick inter vention in case of complications B 5 1 syngo MR 2004A Revision 03 In Room MRC optional MR system components The In Room MRC is not designed for diagnostic purposes In Room MRC 1 LCD monitor 2 Tray with trackball and keys B 5 2 MAGNETOM Trio System Manual MR system components In Room MRC optional The In Room MRC is located in the examination room Tray with trackball
15. support syngo MR 2004A J 1 13 Revision 03 Accessories for patient positioning Accessories Cardiac Array Accessories Name Cushion Cardiac Trio J 1 14 MAGNETOM Trio System Manual Accessories Accessories for patient positioning 8 Channel Head Accessories Name 2 blue positioning aids syngo MR 2004A J 1 15 Revision 03 Accessories for patient positioning Accessories CP Head Accessories Name Head cushion 2 head wedges J 1 16 MAGNETOM Trio System Manual Accessories Accessories for patient positioning CP Extremity Accessories Name Cushion insert Leg support syngo MR 2004A J 1 17 Revision 03 Accessories for patient positioning Accessories CP Wrist Accessories Name Wrist arm support wide Wrist arm support narrow Wrist cushion 1 J 1 18 MAGNETOM Trio System Manual Accessories Accessories for patient positioning Accessories Name Wrist cushion 2 syngo MR 2004A J 1 19 Revision 03 Accessories for patient positioning Accessories J 1 20 MAGNETOM Trio System Manual Vacuum cushions optional syngo MR 2004A Revision 03 Description An optional set of vacuum cushions is available for comfortable and stable patient positioning The set consists of three cush ions for different types of examinations The head and spine cushions may be combined J 2 1 Vacuum cushions optional Accessorie
16. 1 G 7 1 G 7 2 G 7 3 G 7 4 G 7 4 G 7 5 G 7 5 G 7 9 G 3 syngo MR 2004A Revision 03 Examination RF coils G 8 CP Extremity optional G 8 1 Description G 8 1 Design G 8 1 Functionality G 8 2 Positioning aids G 8 2 Use G 8 3 Preparing the measurement G 8 3 Performing the measurement G 8 7 Opening the coil G 8 7 G 9 CP Wrist optional G 9 1 Description G 9 1 Positioning aids G 9 2 Use G 9 2 Preparing the measurement G 9 2 Performing the measurement G 9 9 G 4 MAGNETOM Trio System Manual Overview of RF coils Name Application areas Examination Spine Array Spine Page G 2 3 Use Body Array Abdomen pelvis lung gt Page G 3 4 Use Breast Array Cardiac Array 8 Channel Head CP Head CP Extremity CP Wrist Breast Heart Head cranial vessels neurological head examinations Vessel examinations e g course of the cartoids to the aortic arch head to neck imaging Knee joint Wrist finger hand elbow for petite patients Page G 4 3 Use Page G 5 4 Use Page G 6 3 Use Page G 7 5 Use Page G 8 3 Use Page G 9 2 Use syngo MR 2004A Revision 03 G 1 1 Overview of RF coils Examination RF coils Coil sockets Arrangement of coil sockets 1 Coil socket 1 2 Coil socket 2 3 Coil socket 3 4 Coil socket 4 G 1 2 MAGNETOM Trio System Manual Spine Array optional Description Design Spine Array 1 Support cushion 2
17. 3 8 MAGNETOM Trio System Manual MR system operation Physiological effects Warming of body tissue The heat that builds up during MR examinations is dissipated by the thermoregulation mechanisms of the patient e g through increased perspiration and bloodflow The body temperature increases if the patient absorbs more energy per unit of time than can be dissipated through ther moregulation The longer this condition lasts the greater the increase in temperature The increase in core body tempera ture is usually well below 1 C during the course of the MR examination if the SAR limits described below are maintained To date there is no scientific proof that MR examinations are harmless for pregnant women or that RF exposures are harm less for pregnant operating personnel o Noticeable effects on the patient During the MR examination patients experience heat sensa tions on the skin and may begin to perspire Their pulse rates may increase as well The individual effects vary from patient to patient The intensity of these effects depends on the measure ment program selected Following the examination the body will cool off and the pulse rate will return to normal syngo MR 2004A C 3 9 Revision 03 Physiological effects MR system operation C 3 10 o SAR limits To ensure that the prescribed SAR limits are maintained the SAR values are computed on the basis of the most unfavorable values including all
18. CP Head Performing the measurement Performing the measurement using the CP Head includes the following steps 1 Positioning the head for examinations involving the base of the skull Positioning the head for cerebral examinations d Performing the measurement Positioning the head for ex lt Position the patient s head as far inside the coil as possible aminations involving the base of the skull Positioning the head for lt 4 Position the patient s head so that the eyebrows are lined cerebral examinations up with the center marking Performing the measure lt Secure the patient s head using the clamps ment Even slight head movements during the measurement will degrade image quality o lt Align the laser light localizer with the center marking of the upper part of the CP Head 4 Start the measurement syngo MR 2004A G 7 9 Revision 03 CP Head Examination RF coils G 7 10 MAGNETOM Trio System Manual CP Extremity optional syngo MR 2004A Revision 03 Description Design The CP Extremity consists of the following components CP Extremity 1 2 3 4 5 6 7 CP Extremity upper part Release Locking mechanism Base CP Extremity lower part Coil plug Leg support G 8 1 CP Extremity optional Examination RF coils Functionality Qj The CP Extremity can be positioned directly on the patient table or on a cushion Q The CP Extremity can be positioned an
19. Design The Cardiac Array consists of the following components Cardiac Array 1 Cardiac Array Anterior 2 Cardiac Array Base Plate Posterior syngo MR 2004A G 5 1 Revision 03 Cardiac Array optional Examination RF coils Cardiac Array Anterior The Cardiac Array Anterior consists of the following compo nents Cardiac Array Anterior 1 Center marking 2 Coil plug G 5 2 MAGNETOM Trio System Manual Examination RF coils Cardiac Array optional Cardiac Array Base Plate Posterior The Cardiac Array Base Plate Posterior consists of the follow ing components Cardiac Array Base Plate Posterior 1 Coil plug 2 Straps 3 Center marking Positioning aids Cushion Cardiac Trio syngo MR 2004A G 5 3 Revision 03 Cardiac Array optional Examination RF coils Use Preparing the measurement Preparing the measurement using the Cardiac Array includes the following steps Q Positioning the Cardiac Array Base Plate Posterior Qj Positioning the Cardiac Array Anterior G 5 4 MAGNETOM Trio System Manual Examination RF coils Cardiac Array optional Positioning the Cardiac Ar p ray Base Plate Posterior Patient table with Cardiac Array Base Plate Posterior 1 2 3 4 4 PS syngo MR 2004A Revision 03 Head insert Back head support Cardiac Array Base Plate Posterior Coil socket 1 The patient table is prepared Place the head
20. End Session at the syngo MR console tersystem The End Session dialog box is displayed End Session Shutdown System Restart System Restart Application Hibernate End Session dialog box lt Select the Shut Down System option If you select Restart System the MR console is restarted mmo If you select Log Off you can log on with a different user name This may be useful for obtaining specific access privi leges syngo MR 2004A C 2 11 Revision 03 Switching the MR system on and off MR system operation C 2 12 Click OK The following message is displayed at the MR satellite console Message from MRCS to MRSC9 on 1 14 2003 9 39 01 AM The Main Console will go down in a few seconds Please save your unsaved data now fterward ls itis required to shutdown this Satellite Console using the System End menu entry Othenwise retrieving data from the Main Database is not possible Message displayed at the MR satellite console The Shut Down System window is displayed at the MR con sole Shut Down System ve OU Shut Down System window lt gt Click Yes lt After the system has been shut down you switch off the MR console MAGNETOM Trio System Manual MR system operation Switching the MR system on and off ox on o syngo MR 2004A Revision 03 lt gt Switch off the MR satellite console The software does not respond lt Simultaneous
21. Examination RF coils G 1 Overview of RF coils G 1 1 Coil sockets G 1 2 G 2 Spine Array optional G 2 1 Description G 2 1 Design G 2 1 Functionality G 2 2 Positioning aids G 2 2 Use G 2 3 Preparing the measurement G 2 3 Performing the measurement G 2 6 G 3 Body Array optional G 3 1 Description G 3 1 Design G 3 1 Body Array Anterior G 3 2 Body Array Posterior G 3 3 Positioning Aids G 3 4 Use G 3 4 Preparing the measurement G 3 4 Performing the measurement G 3 14 syngo MR 2004A G 1 Revision 03 Examination RF coils G 4 Breast Array optional G 4 1 Description G 4 1 Design G 4 1 Functionality G 4 2 Positioning aids G 4 2 Use G 4 3 Preparing the measurement G 4 3 Performing the measurement G 4 6 G 5 Cardiac Array optional G 5 1 Description G 5 1 Design G 5 1 Cardiac Array Anterior G 5 2 Cardiac Array Base Plate Posterior G 5 3 Positioning aids G 5 3 Use G 5 4 Preparing the measurement G 5 4 Performing the measurement G 5 8 G 2 MAGNETOM Trio System Manual Examination RF coils G 6 8 Channel Head optional Description Design Functionality Removable clamps Positioning aids Use Preparing the measurement Performing the measurement Opening the coil G 7 CP Head Description Design Functionality Mirror Removable clamps Positioning aids Use Preparing the measurement Performing the measurement G 6 1 G 6 1 G 6 1 G 6 2 G 6 2 G 6 2 G 6 3 G 6 3 G 6 8 G 6 10 G 7 1 G 7
22. MR 2004A A 1 19 Revision 03 General safety information AN A 1 20 Safety CAUTION Selection of unsuitable evaluation parameters Incorrect diagnosis due to artifacts in spectroscopy results Interactive evaluations should be performed by specialists only CAUTION Incorrect flow or volume results because of improper selection of velocity range for a specific vessel organ physiological velocity is outside the selected velocity range Incorrect diagnosis lt Ensure that the proper parameter range is selected for the organ to be examined MAGNETOM Trio System Manual Safety General safety information CAUTION Incorrect ventricular analysis due to inaccurate specification of heart contours Incorrect diagnosis lt Ensure that the contours are specified accurately on all images CAUTION Improper selection of pixels when determining the arterial input function Incorrect calculation of parameter map result images lt Only experienced users should select the image pixels for determining the arterial input function syngo MR 2004A A 1 21 Revision 03 General safety information Safety WARNING Image distortions when using geometric measurement values for diagnosis Incorrect diagnosis lt Use the original images for diagnosis Do not use geometric measurement values as the sole basis for diagnosis WARNING Viewing composite images Image Composing function for diagnosi
23. MR system components syngo MR 2004A Revision 03 Intercom Operation The intercom is used for the following purposes q q L D DO D DO 0 Transmitting patient s comments from the examination room Transmitting live announcements to the examination room Transmitting automatic voice output to the examination room Playing music inside the examination room Playing automatic voice output and music Stopping the patient table movement Stopping the measurement sequence Replying to patient alerts Listening to physiological monitoring signals Intercom operation is partially software based All relevant information is included in the instructions below The software operation is described in detail in the syngo MR Operator Man ual B 7 3 Intercom AN Transmitting patient s com ments from the examination room o B 7 4 MR system components CAUTION Incorrect monitoring due to switched off intercom Risk of injury to patient because emergencies cannot be communicated Always keep the Listen mode of the intercom on lt Press the Listen button Patient announcements and sounds from the examination room are transmitted to the control room Listen mode lt gt Adjust the volume control for Listen mode on the control unit of the MR console Press the Listen button again to end the transmission The Listen function should always be enabled for better patient monitoring MAGNETO
24. Revision 03 Video system optional Activating the brightness reduction Deactivating the brightness reduction B 8 12 MR system components Brightness reduction lt gt Press button 4 The brightness reduction is active V The brightness reduction is active Press button 1 The brightness reduction is not active Displaying the hours of operation V The monitor does NOT display the screen menu Press the Mode button five times The hours of operation of the video display since starting up the MR system are displayed MAGNETOM Trio System Manual MR system components syngo MR 2004A Revision 03 Video system optional Video display 3 Description Video display 3 1 Control panel The video display 3 displays the images taken by the video camera A control panel is located on the right side of the video display Use the control panel to adjust the settings via the menus of the on screen display OSD The control panel contains two LEDs B 8 13 Video system optional B 8 14 MR system components LEDs The LEDs on the control panel indicate the current status of the video transmission Description of LED status LED Status of video transmission Steady red Video display connected but no video sig nal Steady green Video display in operation Flashinggreen Automatic brightness reduction active Automatic brightness reduction To extend the life of the video disp
25. Set of positioning aids Accessories J 1 7 Shielding Magnet B 1 2 Signs Laser A 2 65 System specific signs A 3 7 Warning and prohibition signs A 3 8 Sound pressure level Technical data L 1 5 Spine Array Accessories J 1 11 MAGNETOM Trio System Manual Index syngo MR 2004A Revision 03 Description G 2 1 Use G 2 3 Squeeze bulb Connect B 7 14 Operating B 7 14 Standby mode MR system operating modes C 2 1 T Table display Patient table D 1 4 Status of the laser light localizer D 1 9 Table Stop Safety information A 2 22 Tabletop Center Position D 1 25 Current movement D 1 10 Default Position D 1 28 Home Position D 1 27 Last Scan Position D 1 26 Relative position D 1 9 Releasing the table stop D 1 29 Triggering the table stop D 1 29 Technical data MR system L 1 1 Physiological Measure ment Unit L 2 1 Temperature control Safety information A 3 6 Technical data L 1 6 Triggering ECG triggering with active electrodes Description F4 1 ECG triggering with active electrodes Performing F 4 4 ECG triggering without active electrodes Descrip tion F 3 1 ECG triggering without active electrodes Perform ing F 3 2 External triggering Description F 7 1 External triggering Per forming F 7 2 Physiological Measure ment Unit Technical data L 2 1 Pulse triggering Descrip tion F 5 1 Pulse triggering Perform ing F 5 2 Index Respiratory triggering Descript
26. and keys 1 Keys 2 Trackball 3 Operating panel 4 Handle to move the In Room MRC 5 Cover syngo MR 2004A B 5 3 Revision 03 In Room MRC optional MR system components The pointer is moved across the surface of the program by roll ing the trackball The keys have the following functions 1 Left key WD Selecting or moving objects 1 Starting applications 1 Executing commands 1 Center key Changing the window values of patient images Q Right key Opening the context menu B 5 4 MAGNETOM Trio System Manual MR system components In Room MRC optional Footswitch The footswitch is used to start and stop the MR measurement in the examination room Footswitch syngo MR 2004A B 5 5 Revision 03 In Room MRC optional MR system components Operation The In Room MRC is operated via trackball and three keys The same software functions as those on the MR operating console are available The monitor height and tilt can be adjusted for easy and com fortable operation WARNING A Diagnosis on the In Room MRC Incorrect diagnosis Do not use the In Room MRC for diagnostic purposes CAUTION A Carelessly routed cables Injury to patient and operating personnel lt Route the cables of the interventional components so that they do not create obstacles B 5 6 MAGNETOM Trio System Manual MR system components In Room MRC optional Adjusting the monitor height Set wheel to a
27. assurance H 2 MAGNETOM Trio System Manual Quality of the RF coils A deterioration in MR image quality may indicate a malfunction in the RF coil A quality measurement is conducted for each RF coil in order to verify proper operation Quality measurement Measurement phantoms are used for the quality measure ments These measurement phantoms contain fluid and simu late the patient that is the weight and tissue characteristics of the human bogy The quality measurement is performed by running the quality program from the MR console The help feature of the quality assurance program provides step by step instructions for the quality assurance procedure For additional information about phantom positioning please refer to the quality assurance documentation as well Quality measurement MAGNETOM Trio syngo MR 2004A H 1 1 Revision 03 Quality of the RF coils Quality assurance The program checks the signal to noise ratio for all RF coils In addition it checks the artifact behavior for the body coil The MR system automatically recognizes the connected RF coil and performs automatic adjustments o The fluid in the measurement phantoms presents a health haz ard Follow the safety regulations in case of phantom fluid spills o H 1 2 MAGNETOM Trio System Manual Phantom fluid spills It is critical that you follow the safety measures described in the Safety chapter The EC safety data she
28. be required C 3 11 Physiological effects MR system operation C 3 12 Online monitoring The system constantly measures the transmit power and ensures that the appropriate limit values are observed Exami nations in progress will be aborted if the limit is exceeded Limit values The SAR limits used by the Look Ahead monitoring function are set at the time of syngo MR installation according to the coun try specific approval guidelines Normal Operating Mode In Normal Operating Mode the patient barely notices the effects of the RF field The stress on the cardiovascular system is negligible MAGNETOM Trio System Manual MR system operation Physiological effects syngo MR 2004A Revision 03 First Level Controlled Operating Mode In First Level Controlled Operating Mode patients may experi ence noticeable stress levels depending on the measurement program selected This usually includes perspiration accompa nied by an increased pulse rate Patients with reduced ther moregulation capability and higher sensitivity towards increase in body temperature e g patients with fevers or cardiac decompression patients with perspiratory impairments or pregnant women may experience additional effects Display of SAR values The current SAR values grouped according to body region can be accessed at any time C 3 13 Physiological effects MR system operation C 3 14 MAGNETOM Trio System Manual Patient trans
29. coil embedded in epoxy resin for structural rein forcement and noise insulation W Coil and amplifier water cooled for fast and gradient inten sive applications Q Digital eddy current compensation QJ Digital gradient waveform definition L 1 2 MAGNETOM Trio System Manual Technical Data MAGNETOM Trio syngo MR 2004A Revision 03 RF system and surface coils 1 Completely digital RF transmitting and receiving system 1 Air cooled power amplifier 35 KW protons only for reliable performance and failsafe operation d Water cooled power amplifier 8 KW broadband optional Qj 10 MHz signal rate with a resolution of 100 nsec Q Dynamic range up to 128 dB depending on bandwidth set ting Qj RF coils with integrated pre amplifiers noise factor 0 55 dB 1 Multinuclear spectroscopy including spin decoupling optional L 1 3 MAGNETOM Trio Technical Data MRC host computer D D O O L New state of the art CPU generation 2 GB RAM primary storage High resolution graphics 1280 x 1024 pixels 3 hard drives operating system database and image data storage Intuitive Windows interface supports multitasking for fast operation Image processor ovo L 1 4 New state of the art CPU generation 2 GB RAM primary storage 5 hard disks operating system and raw data Image reconstruction for FFT 256 in 5 msec MAGNETOM Trio System Manual Technical Data MAGNETOM Trio MRSC New st
30. dangerous increases in temperature The use of medical products such as transdermal patches may lead to skin burns Persons and parts of the patient s body inside or near the mag net bore may be affected by these side effects Improper positioning of the patient may result in the generation of dangerous current loops If parts of the patient s body touch high current densities are present at the points of contact which may result in stimulations as well as RF burns A 2 37 Personal safety information Safety Impairment of active implants WARNING Implants susceptible to electromagnetic effects e g pacemak ers medication pumps Risk of patient death lt Do not perform MR examinations on patients with implants that are affected by electronic fields for example cardiac pacemakers lt gt Observe the 0 5 mT exclusion zone During intracardial interventions do not use metallic or electrically conducting objects RF fields may impair the functionality of electronic circuitry in active implants e g cardiac pacemakers Conductive implants and Under certain circumstances electrical eddy currents may be inclusions induced in the material of larger implants Eddy currents may be generated in all conductive material not only in ferromagnetic material They may result in local increases in temperature A 2 38 MAGNETOM Trio System Manual Safety Personal safety information Heating up of electrically
31. insert in the space between the coil sockets on the patient table Position the Cardiac Array Base Plate Posterior so that it is touching the head insert Connect the coil plug to coil socket 1 Place the back head support on top of the head insert G 5 5 Cardiac Array optional Examination RF coils Position cushions 1 and 2 at the foot end of the patient table Positioning cushion 5 thin 1 Cushion 5 thin lt Place cushion 5 thin on top of the Cardiac Array Base Plate Posterior lt Place the knee wedge on the patient table G 5 6 MAGNETOM Trio System Manual Examination RF coils Cardiac Array optional Positioning the Cardiac Ar Position the patient in the supine position with the head ray Anterior toward the magnet bore lt Position the Cardiac Array Anterior on top of the patient s thorax so that the center of the Cardiac Array Anterior is located over the patient s heart Ensure that the Cardiac Array Anterior does not push against the patient s chin lt Connect the plug of Cardiac Array Anterior to coil socket 4 lt Use the two straps to secure the Cardiac Array Anterior to the Cardiac Array Base Plate Posterior Patient positioned on patient table with Cardiac Array 1 Coil socket 4 syngo MR 2004A G 5 7 Revision 03 Cardiac Array optional Examination RF coils Performing the measurement CAUTION The coil cable of the Cardiac Array runs fully through
32. lt Use suitable positioning aids G 9 4 MAGNETOM Trio System Manual Examination RF coils CP Wrist optional Positioning the patient lt Position the patient in the prone position with the head toward the magnet bore lt Position the hand to be examined on the Wrist arm sup port wide in the CP Wrist Patient in the prone position with the hand in the CP Wrist on the patient table syngo MR 2004A G 9 5 Revision 03 CP Wrist optional Examination RF coils Examining the hand in the supine position Preparing the hand examination in the supine position includes the following steps right hand in this example Q Positioning the CP Wrist Q Positioning the patient Positioning the CP Wrist Patient table with CP Wrist here examination of the right hand in the supine position 1 Wrist arm support narrow 2 CP Wrist 3 Base plate G 9 6 MAGNETOM Trio System Manual Examination RF coils CP Wrist optional V The patient table is prepared lt gt Position cushions 1 2 3 and 4 as well as the head insert on the patient table Position the base plate on the patient table so that the lon gitudinal guide is facing the side of the hand to be exam ined Position the CP Wrist in the longitudinal guide of the base plate lt Place the Wrist arm support narrow in the CP Wrist lt Connect the coil plug of the CP Wrist to coil socket 1 on the patient table syngo MR 2004A G
33. marked Do not obstruct escape routes Refilling the magnet with cryogens may be performed only by Siemens Service Ensure that patients are outside the room during the refill ing procedure When filling the magnet with coolant perform the necessary tasks carefully and accurately observing all regulations Keep flammable materials away from cryogen containers A 2 46 MAGNETOM Trio System Manual Safety Personal safety information Siemens is not responsible for potential damages in the event non authorized personnel perform the refilling of coolant Helium gas may escape due to improper use or various mal functions that do not allow user intervention The helium coolant has an extremely low boiling point of 269 C It boils off very quickly at room temperature with an abrupt expansion in vol ume displacing the air oxygen in the room The resulting haz ardous condition may lead to suffocation WARNING Improper storage of coolant containers Risk of asphyxiation lt 4 Have experienced personnel check the coolant containers regularly according to manufacturer specifications lt Do not use ferromagnetic containers for refilling coolant in the examination room lt Remove coolant containers from the examination room prior to readmitting patients Do not block escape routes and passageways with coolant containers syngo MR 2004A A 2 47 Revision 03 Personal safety information Safety Safety
34. measures in the event of helium accidents WARNING Helium gas leaks Risk of asphyxiation Frostbite lt Ensure that rooms are well ventilated lt Turn on air conditioning lt Ensure that escape routes for the building are established and well marked Do not obstruct escape routes Refilling the magnet with cryogens may be performed only by Siemens Service Ensure that patients are outside the room during the refill ing procedure WARNING Improper handling of liquid helium Frostbite lt gt Never rub frostbitten skin A 2 48 MAGNETOM Trio System Manual Safety Personal safety information Risk of asphyxiation Sudden leakage of helium displaces the oxygen in the room e g a pipe break Breathing becomes difficult when oxygen levels fall below 11 96 Therefore rooms must be well venti lated the air conditioning must be switched on and functioning Escape routes for the building must be established and well marked Escape routes must not be obstructed A copy of the following measures should be displayed in the examination room in a conspicuous area If a person cannot breathe Immediately remove the unconscious person from the room lt gt Start CPR immediately lt gt Call a physician immediately Frostbite Endangered areas include skin surfaces covered with body hair and body regions covered by permeable clothing They prevent the liquid gas from flowing off causing frostbite
35. monitoring Safety information A 2 55 Risks due to monitoring devices A 2 58 SAR monitoring C 3 11 Video system Overview B 8 1 Mouse Description B 4 18 Operation B 4 19 MR coils Overview B 2 1 MR console Keyboard Description B 4 9 Keyboard Operation B 4 14 Mouse Description B 4 18 Mouse Operation B 4 19 Overview B 4 1 MR satellite console Restarting C 2 17 Shutting down C 2 16 Starting C 2 4 MR system Operating modes C 2 1 Restarting the MR satellite console C 2 17 Shutting down the MR sat ellite console C 2 16 Shutting down the system C 2 10 MAGNETOM Trio System Manual Index Starting the MR satellite Operating consoles syngo MR 2004A console C 2 4 Starting the system C 2 2 Starting ending Host Standby C 2 8 Switching on off C 2 1 MRC Host computer Technical data L 1 4 MRSC Technical data L 1 5 Music Playing B 7 7 N Nerve stimulation Examination with low fre quency fields C 3 4 Network connection Description B 4 4 O Online monitoring Examination with low fre quency fields C 3 5 SAR monitoring C 3 12 In Room MRC Descrip tion B 5 1 In Room MRC Operation B 5 6 MR console Description B 4 1 Shutting down the MR sat ellite console C 2 16 Starting the MR satellite console C 2 4 Operating mode Level 1 operating mode C 3 2 Normal Operating Mode C 3 2 Power limits for examina tion with low frequency fields C 3 6
36. movement arrows 1 Table movement arrow Moving into the magnet bore Lift ing the patient table 2 Table movement arrow Moving out of the magnet bore Lowering the patient table D 1 30 MAGNETOM Trio System Manual Patient transport Patient table The horizontal movement changes to vertical movement and vice versa without having to operate the joystick again After a quick stop the patient table or tabletop automatically changes direction The speed of the horizontal tabletop movement is influenced by the following factors 1 Excursion of the joystick 1 Status of the laser light localizer The tabletop moves slowly if the laser light localizer is activated and fast if it is not activated syngo MR 2004A D 1 31 Revision 03 Patient table Patient transport D 1 32 MAGNETOM Trio System Manual Patient transport trolley Description The patient transport trolley is used to transport immobile patients directly to the patient table in the examination room Patient transport trolley 1 Head end 2 Pedal for height adjustment 3 Brake pedal syngo MR 2004A D 2 1 Revision 03 Patient transport trolley Patient transport Operation Operating the patient transport trolley includes the following steps d a d a Engaging the brake Adjusting the height of the tabletop Adjusting the tilt of the head end Securing the patient Safety information Do NOT use the patient transport troll
37. patient positioning Set of positioning aids The positioning aid set from the standard accessories includes the following parts Accessories Name 1 knee wedge 1 positioning roll 1 back head support syngo MR 2004A J 1 7 Revision 03 Accessories for patient positioning Accessories Accessories Name 2 large triangles 2 small triangles 1 wedge J 1 8 MAGNETOM Trio System Manual Accessories Accessories for patient positioning Accessories Name 1 Lordosis cushion syngo MR 2004A J 1 9 Revision 03 Accessories for patient positioning Accessories Coil accessories The following coils have specific positioning aids to ensure safe and comfortable patient positioning d Uoooveoo J 1 10 Spine Array Body Array Breast Array Cardiac Array 8 Channel Head CP Head CP Extremity CP Wrist MAGNETOM Trio System Manual Accessories Accessories for patient positioning Spine Array Accessories Name Table pad syngo MR 2004A J 1 11 Revision 03 Accessories for patient positioning Accessories Body Array Accessories Name Cushion Body large Distance holder Cushion Body small J 1 12 MAGNETOM Trio System Manual Accessories Accessories for patient positioning Breast Array Accessories Name Cushion support Head support _ E f Eas i E f TN TU i i ER i Wedge cushion abdominal
38. secure positioning of various body regions The patient can use the headphones to listen to announce ments or music during the measurement They also provide hearing protection for the patient The squeeze bulb allows the patient to get the attention of per sonnel by triggering an audible signal during the measurement An audible signal sounds at the intercom when the patient squeezes the bulb Patient table Patient transport Table display The table display shows the status of the functions executed from the control units 1 Magnet bore with patient table 1 Table display at the front of the magnet The table display is located above the magnet bore opening at the front of the magnet D 1 4 MAGNETOM Trio System Manual Patient transport syngo MR 2004A Revision 03 1 2 Patient table 12 11 10 3 4 5 6 Table display 1 2 3 4 5 6 7 8 9 Text field for displaying status messages Coil socket assignments Start Stop Status of laser light localizer Table Stop Center Position Home Position Current tabletop movement 10 Relative position of the tabletop 11 Tunnel ventilation 12 Tunnel lighting D 1 5 Patient table Patient transport The table display provides the following information Qj Coil socket assignments Start and Stop Status of the laser light localizer Relative position of the tabletop Current tabletop move
39. the trigger pulses of the physiological monitoring signals The trigger pulse volume can be set to four different levels d d d d gt Off Low Medium High Use the appropriate volume control to set the trigger pulse volume The trigger pulses are transmitted at the desired volume MAGNETOM Trio System Manual CHAPTER Video system optional B 8 Overview An optional video system can be installed for the purpose of patient monitoring The video system consists of a color video camera and a video display video display 3 or the previous version video display 2 syngo MR 2004A B 8 1 Revision 03 Video system optional MR system components Video camera The orientation of the video camera ensures the best possible view of the patient The video camera is installed at the end of the magnet bore Video camera at the end of the magnet bore 1 Back side of the magnet 2 Video camera 3 Magnet bore B 8 2 MAGNETOM Trio System Manual MR system components Video system optional Video display 2 Description Video display 2 1 LED LCD video display 2 displays the images taken by the video camera An LED is located in the lower left corner of the video display Buttons for adjusting the video display settings are located in back syngo MR 2004A B 8 3 Revision 03 Video system optional MR system components LED The LED shows the current status of the video transmissi
40. the imag ing volume Patient burns lt Ensure that the Cardiac Array is positioned in the volume to be examined Align the laser light localizer with the center marking of the Cardiac Array Anterior 4 Start the measurement G 5 8 MAGNETOM Trio System Manual 8 Channel Head optional Description Design The 8 Channel Head consists of the following components 2 8 Channel Head 1 Double mirror 2 Receiver 3 Removable clamps 4 Coil plug for coil socket 3 5 Coil plug for coil socket 4 6 Locking mechanism 7 Head support syngo MR 2004A G 6 1 Revision 03 8 Channel Head optional Examination RF coils Functionality The 8 channel technology provides increased sensitivity for neurological examinations As a result the resolution is greater Hemovable clamps The 8 Channel Head is delivered with removable clamps They are used to secure the head of the patient during the examination Positioning aids 14 2 blue positioning aids G 6 2 MAGNETOM Trio System Manual Examination RF coils 8 Channel Head optional Use Preparing the measurement Preparing the measurement using the 8 Channel Head includes the following steps Qj Positioning the 8 Channel Head W Positioning the patient Positioning the 8 Channel Head Patient table with 8 Channel Head 1 8 Channel Head 2 Coil plug for coil socket 4 3 Coil plug for coil socket 3 4 Locking mec
41. tolerance margins MR examinations range from locally concentrated exams to general exams of parts of the body and complete body exami nations Different types of RF coils are used to cover these areas As a result patients will experience different effects dur ing the MR examination Taking this factor into consideration different SAR limits have been established for the different types of examinations Deciding which limit is appropriate essentially depends on the transmitter coil selected and its size in relation to the patient MAGNETOM Trio System Manual MR system operation Physiological effects syngo MR 2004A Revision 03 o SAR monitoring SAR limits are monitored by a software monitoring function Look Ahead monitoring Prior to each measurement the expected SAR values are auto matically and precisely calculated and compared with the limit values established If one of the calculated SAR values exceeds the corresponding limit the measurement cannot be started The following message will appear in a dialog window on the console SAR Limit s Exceeded This dialog window includes suggested changes to the exami nation parameters which allow the examination to continue In addition a button in the dialog window may be used to change the operating mode The software operation is described in detail in the syngo MR User Manual In First Level Controlled Operating Mode only minor modifica tions if any may
42. 1 Pulse sensor F 5 2 MAGNETOM Trio System Manual Physiological imaging Pulse triggering il The middle finger provides the best signal for pulse triggering or lt gt When attaching the pulse sensor to a toe make sure that the exit side of the light is located below the toe Performing the examination The pulse sensor is attached lt gt Perform the measurement as described in the syngo MR Operator Manual syngo MR 2004A F 5 3 Revision 03 Pulse triggering Physiological imaging F 5 4 MAGNETOM Trio System Manual CHAPTER Respiratory triggering F6 Description Respiratory triggering is used to keep respiratory artifacts in the MR image to a minimum The respiratory signal is measured via a respiratory cushion or a respiratory belt optional The respiratory cushion is attached to the patient using the res piratory belt The option has to be determined beforehand through Siemens Service o syngo MR 2004A F 6 1 Revision 03 Respiratory triggering F 6 2 Physiological imaging Performing The respiratory cushion respiratory belt has to be connected before starting examinations using respiratory triggering CAUTION Erroneous MR image due to disconnected respiratory belt Incorrect diagnosis Insert the plug of the respiratory cushion respiratory belt into the appropriate socket after completing all other steps Background information gt Page F 6 7 Artifacts caused by und
43. 1 7 J 1 10 J 1 11 J 1 12 J 1 13 J 1 14 J 1 15 J 1 16 J 1 17 J 1 18 J 2 1 J 2 1 J 2 4 J 2 4 J 2 5 J 2 6 J 1 Accessories J 2 MAGNETOM Trio System Manual Accessories for patient positioning Standard accessories The standard accessories for patient positioning include the fol lowing parts q L DL D D DO D D DL D D D D O syngo MR 2004A Revision 03 Cushion 1 Cushion 2 Cushion 3 Cushion 4 Cushion 5 thin Cushion 6 thin Head insert 1 paper roll holder 4 straps Head wedges Straps Sandbags Multipurpose insert cushions 1 positioning aid set separate table J 1 1 Accessories for patient positioning Accessories Accessories Name Cushion 1 Cushion 2 Cushion 3 J 1 2 MAGNETOM Trio System Manual Accessories Accessories for patient positioning syngo MR 2004A Revision 03 Accessories Name Cushion 4 Cushion 5 thin Cushion 6 thin LUE Accessories for patient positioning Accessories Accessories Name Head insert 1 paper roll holder 4 straps J 1 4 MAGNETOM Trio System Manual Accessories Accessories for patient positioning Accessories Name Head wedges Sandbags syngo MR 2004A J 1 5 Revision 03 Accessories for patient positioning Accessories Accessories Name Multipurpose insert cush ions Air cushion J 1 6 MAGNETOM Trio System Manual Accessories Accessories for
44. 1 Hz Connection 100 kVA voltage On site protec 125A tion Internal line lt 0 12 Q at 380 V impedance For all products line power must be supplied via an on site sys tem contactor or via another multipole shut down mechanism The room installation must be in compliance with VDE 0107 In all countries other than the Federal Republic of Germany local and national legal regulations must be complied with However we strongly recommend compliance with the regulations described herein to the extent permitted by relevant local and national laws in order to ensure the safety of operating personnel patients and third parties L 1 8 MAGNETOM Trio System Manual Technical Data syngo MR 2004A MAGNETOM Trio General classifications Protection class Application parts protection class Patient table Local coils ECG electrodes IP protection class according to IEC 60529 Explosion protection Operating mode Sterilization method recep tors Disinfection Receptors system compo nents Type B Type B Type BF IP XO The MR system is not intended for operation in areas prone to explosion e g highly flammable mixtures of anaesthesia gases with air or oxygen or nitrous oxide Continuous operation duty type Gas sterilization Disinfectants without alco hol ether L 1 9 MAGNETOM Trio Technical Data Electromagnetic Compatibility EMC All information regarding electr
45. 3 Revision 03 Alarm box Checking the helium fill lev lt gt el and the magnet stop Switching the MR system on and off B 6 4 MR system components Check the Helium Level and Magnet Stop LEDs for alarm indications An alarm is indicated if the Magnet Stop or Helium Level LED lights up and an acoustic alarm is heard In case of an alarm press the Alarm Silence button to silence the acoustic alarm and notify Siemens Service Switch the MR system on off Page C 2 1 Switching the MR system on and off MAGNETOM Trio System Manual CHAPTER Intercom B 7 Description The intercom allows personnel and patients to communicate during the examination In addition personnel may play music or automatic voice out puts for the patient The intercom consists of the following components 1 The central unit located in back of the MR console 4 Loudspeakers headphones microphone and volume con trol in the examination room Control unit on the MR console syngo MR 2004A B 7 1 Revision 03 Intercom MR system components Intercom control unit 1 Patient instructions volume control 2 Listen mode volume control 3 CV CBT switch 4 Trigger signal volume control 5 Table Stop button 6 Microphone 7 Listen LED 8 Listen button 9 Music On LED 10 Play Music button 11 Squeeze bulb announcement active LED 12 Speak button 13 Speaker B 7 2 MAGNETOM Trio System Manual
46. 3 Tunnel ventilation medium setting 4 Tunnel ventilation highest setting syngo MR 2004A D 1 13 Revision 03 Patient table Patient transport Control units Several control units are available to operate the patient table They are located on the right and left side of the patient table at the magnet bore opening Magnet bore with patient table 1 Control unit on the left side of the patient table 2 Control unit on the right side of the patient table D 1 14 MAGNETOM Trio System Manual Patient transport Patient table Control unit Control unit 1 2 3 4 5 6 7 syngo MR 2004A Revision 03 Intended for future use Measurement Start Stop button Wall speaker volume control Tunnel Ventilation button Tunnel Lighting button Joystick Table Stop button D 1 15 Patient table Patient transport D 1 16 8 Home Position button 9 Headphones volume control 10 Center Position button 11 Laser Light Localizer button The control unit provides the following functions d L D D L D deo Controlling the patient table movement Starting stopping the measurement Adjusting the playback volume for the headphones Adjusting the playback volume for the wall speaker Adjusting the tunnel lighting Adjusting the tunnel ventilation Switching the laser light localizer on off MAGNETOM Trio System Manual Patient transport Patient table o syngo MR 2004A Revision 03
47. 5 mT 5 Gau Injury to patient lt Clearly identify the critical magnetic field zone where the field strength exceeds 0 5 mT exclusion zone e g with markings on the floor or barriers gt Ensure that persons with implants inclusions that are metallic or susceptible to electromagnetic effects remain outside the exclusion zone lt Ensure that the field strength outside the exclusion zone does not exceed 0 5 mT syngo MR 2004A A 2 33 Revision 03 Personal safety information Safety WARNING Magnetizable inclusions implants introduced into the magnetic field may become dislodged Injury to patient lt Ask patients whether they have any metallic or electri cally conducting implants and inclusions as a result of war injuries or accidents for example or pacemakers During intracardial interventions do not use metallic or electrically conducting objects Do not perform MR examinations on patients with metallic and electrically conducting implants or inclusions lt Do not examine patients with intracranial aneurysm clips unless the physician can ensure that the clip is not magnet izable A 2 34 MAGNETOM Trio System Manual Safety syngo MR 2004A Revision 03 Personal safety information Malfunctions of devices implants susceptible to electromagnetic effects The functionality of electronic or mechanical components of implanted devices for example cardiac pacemakers and med icat
48. 9 7 Revision 03 CP Wrist optional Examination RF coils Positioning the patient Position the patient in the supine position with the feet toward the magnet bore Position the hand to be examined on the Wrist arm sup port narrow in the CP Wrist Patientin the supine position with the right hand in the CP Wrist on the patient table G 9 8 MAGNETOM Trio System Manual Examination RF coils CP Wrist optional Performing the measurement WARNING Electric current loops caused by improper patient positioning Patient burns 4 syngo MR 2004A Revision 03 Ensure that the patient does not wear clothing that is wet or dampened by perspiration Ensure sufficient ventilation during the examination Avoid direct contact between the patient s skin and the tun nel lining Use positioning aids e g blankets or dry material that is permeable to air and at least 5 millimeters thick Align the laser light localizer with the center marking of the CP Spine Start the measurement G 9 9 CP Wrist optional Examination RF coils G 9 10 MAGNETOM Trio System Manual Quality assurance H 1 Quality of the RF coils H 1 1 Quality measurement H 1 1 H 2 Phantom fluid spills H 2 1 Measures in case of phantom fluid spills H 2 3 First aid in case of contact with phantom fluid H 2 4 Mandatory reporting in case of fire H 2 5 Disposal as special waste H 2 6 syngo MR 2004A H 1 Revision 03 Quality
49. Addresses Ordering Disposable ECG electrodes F 3 1 Accessories J 1 15 Description G 6 1 Use G 6 3 Return and disposal K 2 2 Alarm A Safety information A 2 19 Accessories Alarm box syngo MR 2004A Revision 03 Patient positioning J 1 1 Patient positioning Coil accessories J 1 10 Patient positioning Stand ard accessories J 1 1 Safety relevant A 1 8 Set of positioning aids J 1 7 Accidents Firefighting H 2 5 A 2 52 Frostbite A 2 49 Helium accidents A 2 48 Measurement phantoms Safety information A 2 66 Phantom fluid spills H 2 1 Phantom fluid Disposal of H 2 6 Phantoms First aid H 2 4 Reporting accidents A 1 5 Checking the monitoring and alarm signals B 6 2 Daily functionality check B 6 2 Description B 6 1 Operation B 6 2 Announcement Automatic voice output B 7 6 Live announcement B 7 5 Recording automatic voice commands B 7 13 Artifact Patient related artifacts A 1 29 Repiratory triggering F 6 7 System related artifacts A 1 13 User related artifacts A 1 19 Index M 2 Body Array Accessories J 1 12 Description G 3 1 Positioning Aids G 3 4 Use G 3 4 Body coil Description B 1 3 Body temperature Technical data L 1 7 Brake Patient transport trolley D 2 5 Triggering releasing the table stop D 1 29 Breast Array Accessories J 1 13 Description G 4 1 Use G 4 3 Brightness reduction Video display 2 Adjusting B 8 12 Video display 2 Descrip
50. D is continuously lit in green for rewritable MOD or yellow WORM MOD while the MOD is being read MAGNETOM Trio System Manual Documentation Reading data Removing the MOD Press the Eject button The magneto optical drive ejects the MOD lt Remove the MOD The magneto optical drive fails to eject the MOD ox9 The magneto optical drive is defective or there has been a power failure Notify Siemens Service syngo MR 2004A I 2 11 Revision 03 Reading data Documentation Background information Magneto optical drive operating modes The magneto optical drive has two operating modes depending on the MOD that is inserted Q Mode 0 rewritable MOD Q Mode 1 WORM MOD Indication of operating modes by the status LED LED status dis Operating mode play Flashing orange Overheating of the drive Flashing yellow Rewritable MOD is loaded Flashing green WORM MOD loaded Steady yellow Access to rewritable MOD Steady green Access to WORM MOD 1 2 12 MAGNETOM Trio System Manual Accessories J 1 Accessories for patient positioning Standard accessories Set of positioning aids Coil accessories Spine Array Body Array Breast Array Cardiac Array 8 Channel Head CP Head CP Extremity CP Wrist J 2 Vacuum cushions optional Description Operation Combining head and spine cushions Positioning the vacuum cushions Evacuating venting the vacuum cushions syngo MR 2004A Revision 03 J 1 1 J 1 1 J
51. Ensure that helpless patients keep their eyes closed during the positioning procedure lt Use the laser light localizer as described only lt gt Have the laser light localizer checked regularly by Siemens Service syngo MR 2004A D 1 23 Revision 03 Patient transport Patient table Press the Laser Light Localizer button on the control unit Laser Light Localizer button The laser light localizer is switched on A crosshair is visible directly below the area Use the joystick to move the tabletop so that the crosshairs point precisely to the region of interest lt Press the Laser Light Localizer button The laser light localizer is switched off The laser light localizer shuts off automatically after 60 seconds without table movement o The slice for measurement is marked The table display shows the relative tabletop position of the marked slice D 1 24 MAGNETOM Trio System Manual Patient transport Patient table Moving the tabletop into the Center Position V The slice for measurement is marked with the laser light localizer V The laser light localizer is switched off lt Press the Center Position button on the control unit Center Position button The tabletop moves into the magnet bore until the slice for measurement is located in the magnet isocenter The tabletop is not moving Bm The functions of the Center Position button are locked The fol lowing message appears
52. GNETOM Trio is a diagnostic imaging device It generates cross sectional images in any orientation tomo grams representing the internal structure of the patient s body head MR images indicate the spatial distribution of hydrogen nuclei protons in the tissue When interpreted by a physician with MR training these MR images provide diagnostic informa tion The MR system is not a measurement device Measured values obtained are for informational purposes and cannot be used as the basis for diagnosis For the USA only The device is limited by Federal Law to inves tigational use for indications not in the Indications Statement For the USA only Federal law restricts this device to sale dis tribution and use by or on the order of a physician vii Overview Image contrasts are influenced by a combination of the follow ing parameters W Proton density Spin lattice relaxation time T4 Spin spin relaxation time To Flow e g blood flow Chemical shift CO LU do viii MAGNETOM Trio System Manual Overview eee MAGNETOM Trio manuals The multi volume operator manual for the MR system includes the following manuals 1 System Manual 1 System Owner Manual The following operator manual are available on CD ROM 1 syngo MR Operator Manual 1 ARGUS Operator Manual 1 Spectroscopy Operator Manual syngo MR 2004A ix Revision 03 Overview Helease notes Revision 01 This manual is a revised edition All
53. Head support 3 Coil plug 4 Coil elements 1 and 2 5 Coil elements 3 and 4 6 Coil elements 5 and 6 7 Coil elements 7 and 8 8 Coil elements 9 and A 9 Coil elements B and C syngo MR 2004A G 2 1 Revision 03 Spine Array optional Examination RF coils Functionality W The Spine Array can be used to examine the entire spine without having to reposition the patient Q The Spine Array is fitted to the patient table With a few exceptions it can remain installed for all examinations 14 Up to eight coil elements can be used simultaneously 1 The signal to noise ratio is improved by two smaller coil elements in the region of the cervical spine Positioning aids 1 Support cushion G 2 2 MAGNETOM Trio System Manual Examination RF coils Spine Array optional Preparing the Spine Array syngo MR 2004A Revision 03 Use Preparing the measurement Preparing the measurement using the Spine Array includes the following steps Q Preparing the Spine Array W Positioning the patient Patient table with Spine Array 1 Plug for coil socket 2 2 Plug for coil socket 3 3 Plug for coil socket 4 4 Spine Array 5 Support cushion G 2 3 Spine Array optional Examination RF coils V The patient table is prepared Position the Spine Array on the patient table by placing the head end of the Spine Array between the two connector units and sliding it as far as possible toward the ma
54. M Trio System Manual MR system components Intercom Transmitting live announce lt Adjust the volume using the Patient instructions volume ments to the examination control on the control unit of the MR console eee Press and hold the Speak button The Squeeze bulb announcement active LED lights up Both music playback and automatic voice output are stopped Speak into the microphone from a distance of approx 30 to 40 cm The patient can hear the announcement via the headphones and the speaker lt Release the button to end the transmission syngo MR 2004A B 7 5 Revision 03 Intercom Transmitting automatic voice output to the exami nation room B 7 6 4 MR system components The Play music button is switched off the Music on LED is off Set the CV CBT switch to CV Set the Patient instructions volume control on the control unit of the MR console to maximum volume Select Option Configuration Exam UI in the Exam task card Increase the volume using the volume control in the menu window until the desired maximum volume is set in the examination room Decrease the volume to the desired level using the Patient instructions volume control on the control unit of the MR console Click to play back the automatic voice output The automatic voice output starts MAGNETOM Trio System Manual MR system components Intercom Playing music inside the ex The connections for audio equipment are loc
55. Press the Right button A confirmation message is displayed lt gt Confirm by pressing the Right button All settings in the PICTURE submenu are restored to their default values Press the OK button The main menu is displayed lt Select SETUP gt LANGUAGE lt gt Select the desired language B 8 19 syngo MR 2004A Revision 03 Video system optional MR system components Changing the OSD menu ar lt gt Press the OK button RAPIT The main menu is displayed lt Select SETUP gt OSD SETUP gt DESIGN lt Select the desired display mode tile or cascade The menu arrangement selected is indicated by a dot inside a circle Changing the OSD colors lt Press the OK button The main menu is displayed lt Select SETUP gt OSD SETUP gt COLORS Select the correct value The color selected is indicated by a dot inside a circle Changing the OSD display Press the OK button ume The main menu is displayed lt Select SETUP gt OSD SETUP gt TIME Select the correct value The display time selected is indicated by a dot inside a circle B 8 20 MAGNETOM Trio System Manual MR system components Video system optional Displaying the current run Press the OK button Hinigottne video display The main menu is displayed Select INFO The current value is displayed next to RUNTIME Displaying system informa lt gt Press the OK button Honor me viden eispiy The main menu is displa
56. Structure of this manual This manual consists of multiple parts Part A Part B etc A comprehensive table of contents can be found at the beginning of each part Part A Safety always has to be followed in your daily routine o The other parts contain descriptive and instructive chapters The descriptive chapters explain the design usage and func tion of the individual MR system components The instructive chapters explain the operation of the individual components xii MAGNETOM Trio System Manual syngo MR 2004A Revision 03 o mo Overview Important symbols Information regarding the optimal use of the MR system Information provided to facilitate tasks for the user 4 Prerequisites for the subsequent operating steps lt Step 1 List item Language conventions Male and female patients are referred to as the patient for the sake of simplicity References to Siemens Service include service personnel authorized by Siemens xiii Overview xiv MAGNETOM Trio System Manual PART syngo MR 2004A Revision 03 A 1 Safety General safety information Overview Structure of the warning notices Legal regulations Technical safety checks Regular maintenance Product safety System related artifacts User related artifacts Patient related artifacts A 2 Personal safety information Overview Emergency precautions Safety measures in the examination room Emergency shut down s
57. Switching C 3 2 Operating modes MR system C 2 1 Operation MR system C 2 1 Ordering Disposable ECG elec trodes F 3 1 M 9 Index P Patient transport trolley Brake D 2 5 Cleaning K 1 2 Patient alert Replying B 7 15 Description D 2 1 Operation D 2 2 Safety information A 2 61 Patient monitoring Safety information D 2 2 Intercom Description B 7 1 Securing the patient D 2 8 Intercom Operation B 7 3 Phantom fluid Risks due to monitoring Disposal H 2 6 devi cam doa First aid H 2 4 serotonina A255 Phantom fluid spills H 2 1 Video system Overview Physiological effects B 8 1 C Description C 3 1 Patient positioning Level 1 operating mode Coil accessories J 1 10 C 3 2 Performing E 1 7 Low frequency fields C 3 3 Safety information A 2 41 Monitoring for examina Standard accessories tion with a low frequency J 1 1 field C 3 5 Patient table Normal Operating Mode C 3 2 Connection D 1 2 Operating mode C 3 1 Control unit D 1 15 P 3 RF fields C 3 8 SAR limits C 3 10 SAR monitoring C 3 11 Description D 1 1 Joystick control D 1 22 Operation D 1 17 Table display D 1 4 M 10 MAGNETOM Trio System Manual syngo MR 2004A Switching between operat ing modes C 3 2 Warming of body tissue C 3 9 Physiological Measurement Unit Description F 2 1 Description of Physiologi cal Display F 2 5 Operation F 2 6 PMU Display F 2 3 PMU Frontend F 2 2 Technical data L 2 1 Position
58. able Patient transport Current tabletop movement The following icons on the table display indicate the current tab letop movement Tabletop is moved using the joystick Tabletop is moved out of the magnet bore D 1 10 MAGNETOM Trio System Manual Patient transport Patient table syngo MR 2004A Revision 03 Tabletop is moved into the Center Position The Table Stop button has been pressed Status messages The text field on the table display shows the following informa tion 1 Name of the last connected coil displays briefly after establishing the connection 14 Error indications l4 Help text for service purposes D 1 11 Patient table Patient transport Tunnel lighting adjustment When you press the Tunnel Lighting button the current illumi nance is indicated on the table display The display disappears within seconds 1 2 3 4 Display icons tunnel illuminance 1 Tunnel lighting off 2 Tunnel lighting lowest setting 3 Tunnel lighting medium setting 4 Tunnel lighting highest setting D 1 12 MAGNETOM Trio System Manual Patient transport Patient table Tunnel ventilation adjustment When you press the Tunnel Ventilation button the current ventilation level is indicated on the table display The display dis appears within seconds 1 2 3 4 Display icons tunnel ventilation level 1 Tunnel ventilation off 2 Tunnel ventilation lowest setting
59. ac Array G 5 4 CP Extremity G 8 3 CP Head G 7 5 CP Wrist G 9 2 Preparation E 1 1 Spine Array G 2 3 External triggering Description F 7 1 Performing F 7 2 F Field lines Safety information A 3 3 Fire Firefighting A 2 52 Mandatory reporting H 2 5 Safety information A 2 52 First aid Contact with phantom fluid H 2 4 Footswitch Description B 5 5 Operation B 5 9 Full operation MR system operating modes C 2 1 Functionality check Checking the functionality and cleanliness C 1 1 Daily C 1 1 M 5 G General classifications Technical data L 1 9 Gradient cabinet Description B 3 2 Gradient system Magnet B 1 2 Technical Data L 1 2 H Hazards Coolant A 2 44 Magnetic field A 2 28 Risk of injury A 2 50 Host computer Description B 4 5 Technical data L 1 4 Host standby MR system operating modes C 2 1 Image processor Technical data L 1 4 Implants Active implants Hazards A 2 38 Malfunctions in the mag netic field A 2 35 Metallic implants Hazards A 2 32 In Room MRC Description B 5 1 Operation B 5 6 Uses B 5 1 Intercom Description B 7 1 Operation B 7 3 J Joystick Controlling the patient table D 1 22 K Key combinations MR console B 4 13 Keyboard Description B 4 9 Operation B 4 14 MAGNETOM Trio System Manual Index L Magnetic field syngo MR 2004A Laser light localizer Marking the slice for meas urement D 1 23 Safety information A 2 62 Legal regula
60. ace 2 Write protection 3 Sliding cover Only hold MOD s by the handling surface lt Do not expose the MOD to direct sunlight excessive heat and or dampness lt Make sure that the sliding cover moves freely syngo MR 2004A 1 2 7 Revision 03 Reading data Documentation Make sure that the MOD is free of dirt fingerprints etc Do not smoke eat or drink when handling MOD s Do not store more than ten MOD s in one stack gt 999 Use the original packaging for long term storage Inserting the MOD Magneto optical drive 1 LED status display 2 Cartridge slot 1 2 8 MAGNETOM Trio System Manual Documentation Reading data The magneto optical drive reads two types of MOD s Q Rewritable MOD s 11 WORM MOD s Write Once Read Many Slide the MOD into the magneto optical drive with the side to be read facing up The status LED lights up in green or yellow until the mag neto optical drive is ready for reading The status LED flashes green or yellow on An incorrect MOD was inserted n Mode 0 use only rewritable MOD s in Mode 1 use only WORM MOD s syngo MR 2004A 1 2 9 Revision 03 Reading data Documentation Reading MODs 1 2 10 The magneto optical drive cannot be used to write data to MOD s Status LED on the MOD drive 1 LED status display lt Use the software to initiate the data read process gt syngo MR Operator Manual The status LE
61. after it has been success fully demonstrated that they are approved and compatible with this MR system syngo MR 2004A Revision 03 General safety information Safety CAUTION Unapproved software System error Only use software authorized by Siemens Only qualified personnel should install software on the host computer CAUTION The MR application does not recognize images from other modalities Incorrect diagnosis lt Do not load images from other modalities into MR applica tions Exceptions Argus Vessel View and Colonography support both MR and CT images A 1 10 MAGNETOM Trio System Manual Safety Product safety Repairs Modifications syngo MR 2004A Revision 03 General safety information Modifications or additions to the product have to comply with legal regulations As a supplier Siemens will not be held responsible for the safety reliability and performance of the system in the following particular cases L Installations additions adjustments modifications and repairs to the system or changes to the software were not performed by Siemens Service 1 Safety relevant components were not replaced with OEM parts 1 The electrical wiring in the room does not meet the require ments of VDE regulation 0107 or applicable national laws Q The MR system is not used in accordance with the operat ing instructions Siemens is not responsible for repairs performed without express wri
62. ap o G 3 12 MAGNETOM Trio System Manual Examination RF coils Body Array optional When tightening the straps ensure that Body Array Poste rior and Anterior bend enough to prevent the coil from com ing into contact with the tunnel wall Patient on patient table with secured Body Array Anterior in this case Examination of the thorax and the upper abdomen 1 Coil socket 1 2 Body Array Anterior syngo MR 2004A G 3 13 Revision 03 Body Array optional Examination RF coils Performing the measurement CAUTION The coil cable of the Body Array runs fully through the imaging volume Patient burns lt Ensure that the Body Array is positioned in the volume to be examined Align the laser light localizer with the center marking of the Body Array 4 Start the measurement G 3 14 MAGNETOM Trio System Manual Breast Array optional Description Design The Breast Array consists of the following components Breast Array 1 Cushion support 2 Coil plug 3 Coil syngo MR 2004A G 4 1 Revision 03 Breast Array optional Examination RF coils Functionality 1 Both sides of the breast can be displayed simultaneously to allow for comparative evaluations Positioning aids Q Cushion support 149 Head support LY Wedge cushion abdominal support G 4 2 MAGNETOM Trio System Manual Examination RF coils Breast Array optional Positioning the Breast Ar ray
63. ar gt syngo MR Operator Manual D 1 27 Patient table Patient transport Moving the tabletop into the Default Position V The laser light localizer has NOT been used to mark a slice since the system has been switched on or the table has last been in the Home Position V The CP Head is installed lt gt Press the Center Position button on the control unit Center Position button The tabletop moves into the magnet bore until the center of the CP Head is located in the magnet isocenter D 1 28 MAGNETOM Trio System Manual Patient transport Patient table Triggering releasing the table stop Triggering the table stop lt gt Press the Table Stop button Table Stop button The table stop is activated The tabletop comes to an immediate stop The two arrows on the table display indicating the current table movement flash alternately The patient table or tabletop movement can also be stopped from the intercom No After the table stop has been triggered the tabletop may be moved horizontally using the handle at the foot end No Releasing the table stop lt gt Push the joystick all the way up lt gt Pull the joystick all the way down Bring the joystick back to the middle position The table move arrows stop flashing The table stop is released syngo MR 2004A D 1 29 Revision 03 Patient table Patient transport Background information Joystick functionality Joystick with table
64. art rate of patients either consciously or subconsciously The resulting irregular cardiac cycles adversely affect image quality lt Perform the measurement as described in the syngo MR Operator Manual Background information Image quality The ECG signal as well as the image quality of the triggered measurement can be enhanced by 1 Correct positioning of the electrodes 1 Good skin contact of the electrodes 14 Avoiding noise caused by electromagnetic induction from L1 cable loops 1 interferences from electrical potentials caused by muscle movement MAGNETOM Trio System Manual ECG triggering using active ECG electrodes optional Description Active ECG electrodes 1 MRI interface 2 Amplifier Battery LED 3 Electrode Contact LED 4 ECG Lead button 5 On Off button 6 Fiber optic cable 7 ECG amplifier 8 Disposable electrodes 9 Electrode holder 10 Connection plug syngo MR 2004A F 4 1 Revision 03 ECG triggering using active ECG electrodes optional Physiological imaging F4 2 New disposable ECG electrodes can be purchased from 1 Siemens Merchandise Division Med amp Mehr catalog Product no 9715335 Product name Disposable ECG electrodes Gradient system coupling impacts the recording of the ECG sig nals The result may be steep peaks in the ECG as well as trig gering errors This effect is frequently seen with fast sequences Triggering errors can be practical
65. ate of the art CPU generation 2 GB RAM primary storage High resolution graphics 1280 x 1024 pixels 2 hard disks operating system and database ODOC O Intuitive Windows interface supports multitasking for fast operation Acoustic noise The effective sound pressure level is measured according to IEC 60 601 2 33 Hearing protection is required for the patient whenever the sound pressure level exceeds the IEC 60 601 2 33 standard or the OSHA guidelines 1 Applicable norm in Europe 2 Applicable norm in the US syngo MR 2004A L 1 5 Revision 03 MAGNETOM Trio Technical Data L 1 6 Ambient conditions With integrated cabinet temperature control 15 30 C Specific absorption rates The specific absorption rates and the rates of change of the magnetic field are in full compliance with the IEC 60 601 2 33 standard MAGNETOM Trio System Manual Technical Data MAGNETOM Trio syngo MR 2004A Revision 03 o Room body temperature If the limits for room temperature and relative humidity are exceeded while up to 3 W kg max allowable value for whole body operation are applied at the same time the body temper ature may increase by more than 1 C established limit Cooling system Heat dissipation to cooling water lt 50 KW L 1 7 MAGNETOM Trio Technical Data Line power supply Variable Values Toler ance Voltage 380 V 400 V 420 V 440 V t 10 480 V Frequency 50 Hz 60 Hz
66. ated at the central amination room unit of the intercom in back of the MR console 1 Connections at the central unit of the intercom 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 an audio device such as a CD player or walkman to the Music in jack syngo MR 2004A B 7 7 Revision 03 Intercom MR system components lt Ensure that you are using the proper cables and select the headphones output or the Line Out output at the audio device Press the Play Music button The Music On LED lights up lt Switch on the audio device and start the playback The music plays through the patient s headphones or the speaker inside the examination room If the Listen button is not pressed the music is transmitted to the control room as well If additional active speakers are connected to the Line Out jack the music is also played back inside the control room Set the volume control for the headphones and the loud speaker at the control unit on the patient table at the high est volume possible lt Increase the volume at the audio device until the desired maximum volume is set in the examination room B 7 8 MAGNETOM Trio System Manual MR system components Intercom lt gt Use the volume controls on the control unit of the patient table t
67. ble DOCO O O Squeeze bulb Checking the functionality and cleanliness lt 4 Check the functionality of the monitoring and alarm signals of the alarm box Check if all warning symbols and signs are present inside and outside the examination room lt Check the examination room control room and electronics room for liquid spills and puddles on the floor syngo MR 2004A C 1 1 Revision 03 Daily functionality checks MR system operation lt Ensure that no magnetizable materials or objects such as vacuum cleaners carts ladders and tools are present in the examination room lt gt Ensure that the outlet of the exhaust vent line is not obstructed lt Ensure that any contrast medium residue has been cleaned off the patient table CAUTION A Squeeze bulb is defective Risk of injury to patient because emergencies cannot be communicated lt 4 Check the functionality of the squeeze bulb on a daily basis Check the functionality of the squeeze bulb The patient has to be able to trigger the patient alert using the squeeze bulb C 1 2 MAGNETOM Trio System Manual Switching the MR system on and off There are three operating modes 1 System On full operation All MR system components are switched on Measure ments may be performed 1 Host standby standby operation In Host Standby all measurement related components of the MR system e g measurement unit and patient table are
68. care Store RF coils so that they are protected against mechan ical damage Only lift and carry RF coils using the lower part of the coils lt Always use the necessary positioning aids and cushions with the RF coils lt When covering the positioning aids and cushions with crepe paper ensure that the crepe paper does not enter the coil contacts Do not compress or stretch the coil cables lt Select RF coils that ensure the smallest possible distance between the coil and the object This is important for obtaining an optimal signal to noise ratio lt Wear hearing protection during the measurement E 2 5 Installing the RF coils Preparing the examination E 2 6 MAGNETOM Trio System Manual PART syngo MR 2004A Revision 03 F1 F2 F3 F4 Physiological imaging Triggering methods Physiological Measurement Unit optional Description PMU Frontend PMU Display optional Description of Physiological Display Operation ECG triggering Description Disposable ECG electrodes Performing Image quality ECG triggering using active ECG electrodes optional Description Performing F1 1 E2 1 F 2 1 F 2 2 F 2 3 F 2 5 F 2 6 F 3 1 F 3 1 F 3 1 F 3 2 F 3 10 F 4 1 F 4 1 F 4 4 F 1 F 2 F5 Pulse triggering Description Performing F6 Respiratory triggering Description Performing Artifacts caused by underpressure F7 External triggering Description P
69. cked by items of clothing or blankets E 1 10 MAGNETOM Trio System Manual Preparing the examination Patient preparation and positioning syngo MR 2004A Revision 03 EO Patients who are unable to walk may be transported to the patient table on a patient transport trolley made of non mag netizable material gt Position the patient so that he can easily be monitored from the control room Use positioning aids and table pads to position the patient as comfortably as possible If you are performing a triggered measurement you should position the patient in the supine position Under normal circumstances position the patient with the head toward the magnet bore If you are performing an examination in the area of the pel vis or the lower extremities position the patient with the feet toward the magnet bore Inform the patient about the possible effects of quick head movements when inside the magnet bore Static magnetic fields of 3 T may cause patients to experience dizziness or a metallic taste E 1 11 Patient preparation and positioning Preparing the examination For claustrophobic patients examinations of the lower lumbar spine may also be performed with the patient s feet toward the magnet bore o If the patient is positioned with the feet toward the magnet bore make sure that the feet are located between the coil sockets o If this is not possible for medical reasons the feet can be pos
70. conducting objects WARNING Heating up of electrically conducting objects or articles of cloth ing Injury to patient Ask patients to remove all electrically conducting objects e g necklaces rings retainers pierced jewelry lt Have patients remove all articles of clothing with electri cally conducting material e g brassiere support wires syngo MR 2004A A 2 39 Revision 03 Personal safety information Safety CAUTION Electrically conducting jewelry tattoos nicotine patches cos metics and cosmetic eyelid surgery Local burns to patients Incorrect diagnosis due to image artifacts lt gt Ask patients about permanent make up and tattoos prior to the examination Inform patients that eyeliners and tattoos may contain ingredients causing artifacts or skin irritations during MR examinations In some cases patients have been burned Instruct patients to remove make up prior to the examina tion to prevent injuries Instruct patients to seek medical attention in case of dis comfort during or following the MR examination A 2 40 MAGNETOM Trio System Manual Safety Personal safety information Risk of stimulation and RF burns caused by improper patient positioning WARNING Electric current loops caused by improper patient positioning Patient burns lt When positioning patients ensure that the arms and legs are not touching Maintain a distance of at least 5 cm between the extremit
71. cting magnet Super conducting means that electricity flows without resist ance For this purpose the magnet is cooled with liquid helium Liquid helium has the following characteristics 1 Odorless Non flammable m 1 Non toxic m Extremely cold causes frostbite upon contact A 2 44 MAGNETOM Trio System Manual Safety o Personal safety information Quenching the magnet During a quench the super conductivity of the magnet is sus pended The liquid helium coolant boils off during this process and is released via the exhaust vent line The energy of the magnetic field is converted into heat A quench may be triggered by d a Magnet Stop 4 an accident earthquake fire etc A magnet quench generates a considerable amount of noise hissing etc because large amounts of helium gas are released into the open Always check to ensure that the exhaust vent line is clear gt Page C 1 1 Daily functionality checks WARNING Formation of droplets due to condensation during quenching Frostbite caused by touching the exhaust vent line lt Keep clear of the exhaust vent lines syngo MR 2004A Revision 03 A 2 45 Personal safety information Safety Refilling helium WARNING A Helium gas leaks Risk of asphyxiation Frostbite gt gt gt Ensure that rooms are well ventilated Turn on air conditioning Ensure that escape routes for the building are established and well
72. d at the audio device until the desired maximum volume is set in the examination room If the automatic voice output is drowned out by the music decrease the music volume at the audio device B 7 11 Intercom MR system components Decrease the volume for music and automatic voice output using the volume controls on the patient table until the desired level is set When combining automatic voice output and music the volume for the automatic voice output can no longer be set using the Patient instructions volume control on the control unit of the MR console o lt 4 Click to play back the automatic voice output The automatic voice output starts B 7 12 MAGNETOM Trio System Manual MR system components Intercom Recording voice com V No patient is registered mands Set the CV CBT switch to CBT gt gt Select Queue gt Voice Output gt Organize in the Exam task card Select the desired language Click New to create a new file gt gt Assign a new file name lt gt Click Record The Record Voice menu is displayed Press and hold the Speak button on the control unit of the intercom The Squeeze bulb announcement active LED lights up The volume setting on the control unit does not affect the recording volume o Click l Speak into the microphone Click t when you are finished recording gt gt gt gt Release the Speak button on the control unit of the inter
73. d gradients B 3 2 MAGNETOM Trio System Manual MR system components syngo MR 2004A Revision 03 o Electronics cabinets Control cabinet The control cabinet contains the electronics for the Q4 Measurement sequence control 4 Radio frequency generation 1 Shim current generation The control cabinet contains the complete power supply and the magnet monitoring system In addition the control cabinet contains a sequence program mable optical trigger signal output which can be made exter nally accessible by Siemens Service via installation of a fiber optic cable Please note that Siemens provides the optical trigger signal output to customers for research purposes only No devices connected to this output have been tested by Siemens Before connecting devices to the MR system using the optical trigger signal output they have to be tested for safety by trained per sonnel B 3 3 Electronics cabinets MR system components Before using devices in the proximity of the magnet their non magnetic properties and clinical operation in the magnetic field have to be confirmed The use of devices connected to the optical trigger signal output has to comply with any applicable governmental or local hospi tal Institutional Review Boards IRBS Siemens will not be held responsible for the use of any device and resulting consequences in connection with the optical trig ger signal output B 3 4 MAGNETOM Trio System Manua
74. datory signs A 3 11 syngo MR 2004A A 3 Revision 03 A 4 Safety MAGNETOM Trio System Manual CHAPTER A 1 syngo MR 2004A Revision 03 General safety information Overview The following general safety information must be strictly adhered to 1 Legal regulations Technical safety checks Regular maintenance Product safety System related artifacts User related artifacts L DO D D D O Patient related artifacts A 1 1 General safety information A WARNING CAUTION A 1 2 Safety Structure of the warning notices WARNING Source of danger Consequences lt gt Countermeasure Warning and safety instructions are especially labeled as such verbal signals indicate the level of risk Warning regarding risks that may result in death or serious physical injury Warning regarding risks that may result in minor physical injury or material damage MAGNETOM Trio System Manual Safety General safety information Legal regulations The following regulations are in effect in the Federal Republic of Germany L1 Medical Devices Act MPG 1 Electromagnetic Compatibility Act EMVG 1 Medical Device Operator Regulations MPBetreibV 1 Accident Prevention Regulations UVV The Accident Prevention Regulations also define the accepta ble noise levels to which users and patients may be exposed If required the RF source has to be registered with local author ities Regulations for pres
75. ding a magneto optical disk 1 2 6 Reading CDs 1 2 1 Reading data 1 2 1 Accessories J 1 18 Description G 9 1 Use G 9 2 Recording data 1 1 1 D E ECG lead Disinfection Receptors K 1 3 Selecting for ECG trigger ing with active electrodes Display F 4 8 Table display D 1 4 System components K 1 3 Selecting for ECG trigger ing without active elec Video display 2 Adjusting trodes F 3 7 B 8 5 Video display 3 Adjusting ECG triggering B 8 15 Description With active Video display 3 Descrip Apeirodes Ea tion B 8 13 B 8 3 Video display Cleaning K 1 1 Performing with active electrodes F 4 4 Without active electrodes Disposable ECG electrodes Descriplonirar Without active electrodes Ordering sed Performing F 3 2 Disposal Electromagnetic Compatibil Addresses K 2 1 ity Phantom fluid H 2 6 Technical data L 1 10 Documentation Electronics cabinets Data recording Overview B 4 3 Description B 3 1 M 4 MAGNETOM Trio System Manual Index syngo MR 2004A Revision 03 Emergency Emergency precautions A 2 6 Emergency shut down switch A 2 13 Emergency precautions Safety information A 2 6 Emergency shut down Safety information A 2 20 Emergency shut down switch Emergency shut down A 2 20 Magnet Stop A 2 15 Safety information A 2 13 Table Stop A 2 22 EMC Technical data L 1 10 Examination 8 Channel Head G 6 3 Body Array G 3 4 Breast Array G 4 3 Cardi
76. djust the height in back of the In Room MRC 1 Set wheel lt gt Turn the wheel clockwise to raise the monitor lt gt Turn the wheel counter clockwise to lower the monitor syngo MR 2004A B 5 7 Revision 03 In Room MRC optional MR system components Adjusting the monitor tilt Stop lever in back of the monitor 1 Stop lever lt Release the locking lever by turning it counter clockwise by 90 Press lightly against the upper or lower edge of the dis play to move it in the desired tilt position B 5 8 MAGNETOM Trio System Manual MR system components In Room MRC optional MR measurement using the footswitch Performing the MR measurement using the footswitch includes the following steps d Connecting the hose to the two pad unit 4 Starting the measurement 1 Stopping the measurement syngo MR 2004A B 5 9 Revision 03 In Room MRC optional MR system components Connecting the hose to the lt gt Push the hose plug into the retaining rings of the two pad two pad unit unit Footswitch 1 Hose 2 Hose connector 3 Two pad unit 4 Push buttons B 5 10 MAGNETOM Trio System Manual MR system components In Room MRC optional Starting the measurement Press the Start footswitch button O If the footswitch fails the measurement can be started and il stopped using the In Room MRC or the MRC in the control room Stopping the measurement lt Press the Stop footswitch butto
77. e a blinking reflex for other reasons must be protected from the laser beam The laser light localizer switches off automatically after one minute without patient table movement MAGNETOM Trio System Manual Safety Warning labels except U S A Warning labels U S A only syngo MR 2004A Revision 03 Personal safety information Warning signs and labels The laser relevant locations on the MR system are marked with the following labels underneath the display A 2 65 Personal safety information o Risk due to aerosol forma tion A 2 66 Safety Accidents involving MR measurement phantoms When measurement phantoms are used as intended within the scope of quality measurement of RF coils there is no physical contact with measurement phantom fluids The fluids are sealed in the measurement phantoms Phantoms are filled with water based nickel sulfate solutions or oil Other components may include sodium chloride sodium phosphate buffers as well as lactates acetates or dye If phantom fluid has escaped inhalable droplets aerosols con taining nickel may form in the event of a fire or atomization caused by strong air currents Carcinogenic effects cannot be ruled out if these aerosols are absorbed by the body MAGNETOM Trio System Manual Safety Personal safety information CAUTION Contact with phantom fluid spills Injury to operating personnel Wear protective clothing gloves wo
78. e activated card is in the foreground All user input is applied to this card 4 4 Activate the desired card e g the System parameter card using the CTRL or CTRL gt keys Moving to the left in the card stack Press the SHIFT CTRL lt keys Moving to the right in the card stack Press the SHIFT CTRL gt keys The activated card is in the foreground All user input is applied to this card MAGNETOM Trio System Manual MR system components Entering data Deleting data syngo MR 2004A Revision 03 MR console Entering and deleting data lt 4 Activate the desired input area lt Enter text and values using the keyboard keys Deleting the character in front of the cursor Press the Backspace key lt Deleting the character behind the cursor or the highlighted text Press the Delete button B 4 17 MR console B 4 18 MR system components Mouse Description The MR system comes with a three button mouse The mouse is connected directly to the computer not the keyboard gt Mouse 1 Hand rest 2 Mouse buttons MAGNETOM Trio System Manual MR system components syngo MR 2004A Revision 03 MR console The mouse provides the following functions 1 Left mouse button Q Selecting or moving objects Q Selecting syngo MR functions from the menus 1 Center mouse button Medical windowing of patient images by setting contrast and brightness
79. econdary control unit with a Table Stop button can be installed in back of the magnet 1 The Table Stop button on the intercom syngo MR 2004A A 2 23 Revision 03 Personal safety information Safety Control unit Control unit with the Table Stop button 1 Table Stop button A 2 24 MAGNETOM Trio System Manual Safety Personal safety information lt Push the Table Stop button in case of accident or risk of injury due to table movements The Table Stop symbol will appear on the table display The Table Stop button has been pressed The brakes are released and the patient table may be moved horizontally by hand syngo MR 2004A A 2 25 Revision 03 Personal safety information Safety Intercom Table movement can be stopped from the control room using the intercom Intercom with the Table Stop button 1 Table Stop button lt Press the Table Stop button on the intercom The brakes are released and the patient table may be moved horizontally by hand A 2 26 MAGNETOM Trio System Manual Safety Personal safety information Table movement in the The electric brakes of the patient table are released in the event event of a power failure of a power failure or following a Table Stop The patient table and patient can then be manually pulled out of the magnet bore For this purpose use the handle at the foot end of the patient table Releasing the Table Stop After the danger has been identified and eliminat
80. ect the ECG lead with the most prominent R wave in the ECG syngo MR 2004A F 3 7 Revision 03 ECG triggering F 3 8 o Physiological imaging In most cases ECG lead II is the best choice because the dipole vector LL RA is equivalent to the heart axis for patients with a normal heart position The patient s heart position may be determined from the survey protocol The measurement will produce a prominent R wave on the PMU display or in the Physiological Display dialog window ECG curve with prominent R wave R High amplitude wave HP Cardiac cycle T Wave ES End systolic phase ED End diastolic phase MAGNETOM Trio System Manual Physiological imaging ECG triggering Is the R wave not prominent ox9 Selecting the incorrect ECG lead will result in ECG signals that cannot be used for triggering lt Select a different ECG lead You do not receive a correct ECG signal even after you selected a different ECG lead ox9 lt gt Increase the distance between the electrodes Increasing the distance between the electrodes syngo MR 2004A F 3 9 Revision 03 ECG triggering Preparing the patient o Performing the examina tion F 3 10 Physiological imaging lt Ask the patient to lie still during the measurement lt Inform the patient that the knocking sounds during the measurement are caused by switching the gradients on and off Knocking sounds may affect the he
81. ed patient table operation may be resumed lt gt Push the joystick on the control unit all the way in the direc tion of the magnet bore lt gt Push the joystick all the way in the opposite direction Return the joystick to the home position The Table Stop is now released syngo MR 2004A A 2 27 Revision 03 Personal safety information Safety Hazards inside the magnetic field The following sources of danger are caused by the operating field strength of the magnet 1 Attraction and rotation of ferromagnetic objects 2 Magnetic effects e g forces torques on metallic implants inclusions W Malfunctions in devices and implants susceptible to elec tromagnetic effects 1 Hazards relating to low and radio frequency fields Q Dizziness when exposed to 3 Tesla magnetic fields The magnetic field force exerted on ferromagnetic objects is proportional to the mass of the object The force increases as the distance between the object and the magnet isocenter decreases This applies to ferromagnetic objects inside and outside the body External ferromagnetic objects accelerate through the air like projectiles and may cause serious injury Ferromagnetic implants or materials may shift or turn inside the body causing significant internal injury A 2 28 MAGNETOM Trio System Manual Safety syngo MR 2004A Revision 03 o Personal safety information Electronic implants exhibit interference if the ma
82. em compo nents If the system is shut down using the MR console while the MR satellite console is on a message is displayed on the monitor of the MR satellite console x Message from MRC9 to MRSC9 on 1 14 2003 9 39 01 AM The Main Console will go down in a few seconds Please save your unsaved data now Afterwards it is required to shutdown this Satellite Console using the System End menu entry Othenwise retrieving data from the Main Database is not possible Soa Message displayed at the MR satellite console lt Save your data MAGNETOM Trio System Manual MR system operation Switching the MR system on and off lt Select System gt End Session at the syngo MR console The End Session dialog box is displayed End Session Shutdown System Restart System Restart Application Hibernate End Session dialog box Select the Shut Down System option If you select Restart System the MR satellite console is restarted mmo If you select Log Off you can log on with a different user name This may be useful for obtaining specific access privileges syngo MR 2004A C 2 17 Revision 03 Switching the MR system on and off MR system operation o C 2 18 Click OK The Shut Down System window is displayed at the MR satel lite console Shut Down System ve Oo Bep Shut Down System window 4 Click Yes lt gt Switch off the MR satellite console
83. erform ance by Siemens Service Therefore the Menu and Enter but tons on the side of the monitor are disabled No The monitor is switched on and off as part of the overall MR sys tem syngo MR 2004A B 4 7 Revision 03 MR console MR system components Operation CAUTION Static and or stationary brightness errors on the LCD monitor Incorrect diagnosis lt 4 Switch images to determine if the errors persist Check bright objects for afterglow 4 Always look straight at the center of the LCD monitor Switching on the monitor The monitor is switched on and off as part of the entire system lt Always keep the monitor switched on B 4 8 MAGNETOM Trio System Manual MR system components MR console so Keyboard Description The MR system comes with an original Siemens keyboard This keyboard is a modified Windows keyboard where the numeric keys have been replaced with symbol keys Overview of the original Siemens keyboard 1 Function keys 2 Typewriter keys 3 Cursor keys 4 Symbol keys syngo MR 2004A B 4 9 Revision 03 MR console MR system components Function keys The F6 F7 and F8 function keys let you access the individual task cards The F1 function key lets you access the help topics Typewriter keys These keys are used to enter text and data Cursor keys The four arrow keys move the cursor between individual menu items within the function window B 4 10 MAGNETOM Trio S
84. erforming Physiological imaging F5 1 F 5 1 F 5 2 F6 1 F 6 1 F 6 2 F 6 7 E7 1 F 7 1 F 7 2 MAGNETOM Trio System Manual CHAPTER F 1 Prospective triggering syngo MR 2004A Revision 03 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 This problem occurs in par ticular as a result of the patient s heartbeat during cardiac examinations or as a result of the patient s breathing during abdominal examinations Two different procedures are used to avoid motion artifacts These procedures are known as prospective triggering and ret rospective gating Both procedures are based on the correlation of the measurement and the physiological signal e g ECG signal respiratory signal pulse signal Prospective triggering or antegrade triggering uses a signal derived from the patient s physiological signal to trigger the measurement This signal is usually defined based on the time period during which organ movement is as brief as possible For example an image of the heart should begin during the relaxa tion diastolic phase For respiratory triggering during abdomi nal examinations it is recommended to start the measurement at the end of the respiration period F 1 1 Triggering methods Retrospective gating Physiological ima
85. erpressure MAGNETOM Trio System Manual Physiological imaging Respiratory triggering Attaching the respiratory X The plug of the respiratory cushion is not connected cushion and Belt Determine whether the patient is a thoracic or abdominal breather Women and athletes are usually thoracic breathers EO Men and obese patients are usually abdominal breathers lt gt For patients with abdominal breathing place the respira tory belt around his abdomen lt For patients with thoracic breathing place the respiratory belt around his chest Determine the area of maximum inspiration expiration Position the patient on the patient table 4 lt gt Slide the respiratory cushion underneath the respiratory belt lt gt Slightly retighten the respiratory belt once it is attached to the patient If the respiratory belt is too tight the patient cannot breathe freely and the detectable amplitude will decrease o lt Connect the plug for the respiratory cushion to the appro priate socket on the PMU Page F 2 2 PMU Frontend syngo MR 2004A F 6 3 Revision 03 Respiratory triggering Physiological imaging lt Ensure that the hose of the respiratory belt is not crimped or bent Patient with respiratory cushion respiratory belt on the patient table 1 Respiratory cushion 2 Respiratory belt With quiet patients a periodic signal will appear on screen F 6 4 MAGNETOM Trio System Manual
86. errors Do not overlay MR images When planning surgical stereotactic invasions or biopsies for the patient notify the respective department or person nel at Siemens WARNING Incorrect MR image due to external RF field Incorrect diagnosis lt Keep the door to the examination room closed A 1 14 MAGNETOM Trio System Manual Safety General safety information CAUTION Incorrect MR image Incorrect diagnosis lt f you are not sure about the accuracy of the MR image perform a second orthogonal slice measurement CAUTION Incorrect MR image due to distortions Incorrect diagnosis lt 4 Check if the gradient field loses linearity at the edge of the image field syngo MR 2004A A 1 15 Revision 03 General safety information Safety CAUTION Incorrect MR image due to spatial non linearity of the gradient field and inhomogeneity of the static magnetic field Incorrect diagnosis lt Check the MR image for system related slice distortion Check if the edge of the MR image field exhibits indenta tions pixel coordinates are offset out of the plane as com pared to an ideal image Distortions along the image margins of the MR image when planning stereotactic invasions This applies in partic ular to graphic slice positioning GSP and other graphic slice displays as well as slice positioning data independent of the use of distortion correction CAUTION Incorrect MR image due to varying signal intens
87. espective Siemens Service office and the responsible environmental protection officer or the responsible local authorities lt If you have further questions contact Siemens Service H 2 6 MAGNETOM Trio System Manual Documentation L1 Recording data 1 1 1 L2 Reading data 12 1 Reading CDs 1 2 1 Reading a magneto optical disk optional 1 2 6 Magneto optical drive operating modes 1 2 12 syngo MR 2004A 1 1 Revision 03 Documentation 2 MAGNETOM Trio System Manual Recording data The following instructions apply to other CD burners as well NO Only CD Rs Recordable labeled Medical Grade are suitable for documenting data for medical purposes They are available from Siemens Service CAUTION Laser beam inside the CD drive Injury to cornea mmo lt Never disassemble the CD drive Handling CDs Store the CD in its protective case Do not store the CD in the upright position Do not expose the CD to direct sunlight excessive heat and or dampness lt gt Hold the CD by the edge from above using all fingers Do not scratch the upper or lower surface of the CD gt Use a soft pen and only label the CD on the upper surface lt gt Use only special cleaning agents to clean the CD syngo MR 2004A 1 1 1 Revision 03 Recording data Documentation Inserting a CD into the CD burner CD burner 1 DISK status LED 2 Eject button 3 CD tray Press the Eject but
88. ets and legal regulations do not explic itly mention possible hazards relating to phantom fluids CAUTION Contact with phantom fluid spills Injury to operating personnel Wear protective clothing gloves work coat and goggles Wear a mask with a filter for anorganic vapors if aerosols inhalable droplets are formed Do not use damaged phantoms Avoid skin contact with phantom fluid Change contaminated clothing immediately Do not eat drink or smoke Ensure that phantom fluid does not enter the waste water gt gt oo gt gt Dispose of phantom fluid in compliance with local and national regulations syngo MR 2004A H 2 1 Revision 03 Phantom fluid spills Quality assurance WARNING Phantom oil with low oral and dermal toxicity Injury to patient and operating personnel lt Do now swallow phantom oil Incase phantom oil is swallowed do NOT induce vomiting n case phantom oil is swallowed ensure that the person lies still and provide medical attention immediately H 2 2 MAGNETOM Trio System Manual Quality assurance Phantom fluid spills Measures in case of phantom fluid spills lt Put on protective clothing goggles overalls and disposa ble gloves lt Absorb the fluid immediately using absorbent material such as sand sawdust etc lt gt Collect the fluid in a plastic bucket lt Prevent phantom fluid from entering the waste water sys tem lt gt Change conta
89. exam CAUTION Exposure to low frequency electromagnetic fields Peripheral nerve stimulation of the patient Ensure that the patient s arms are aligned with the torso lt gt Ensure that the hands do not touch MAGNETOM Trio System Manual Preparing the examination Patient preparation and positioning WARNING Exposure to RF electromagnetic fields Patient burns Enter the patient s exact weight during patient registration lt gt Ensure that the patient s arms are aligned with the torso 4 Ensure that the hands do not touch WARNING Exposure to RF electromagnetic fields in First Level Controlled Operating Mode Patient burns lt gt Monitor the patient carefully during the examination e g via squeeze bulb syngo MR 2004A E 1 9 Revision 03 Patient preparation and positioning Preparing the examination WARNING Electric current loops caused by improper patient positioning Patient burns lt Ensure that the patient does not wear clothing that is wet or dampened by perspiration lt Ensure sufficient ventilation during the examination lt Avoid direct contact between the patient s skin and the tun nel lining lt Use positioning aids e g blankets or dry material that is permeable to air and at least 5 millimeters thick CAUTION Activation of elevated SAR limits in First Level Controlled Oper ating Mode Injury to patient Ensure that the heat dissipation is not blo
90. ey if one of the following applies d OvOD D 2 2 Visible oil traces at the hydraulic cylinder chassis or under the trolley The brake does not work Involuntary lowering of the head end or the tabletop Visible cracks on bearings Notify Siemens Service MAGNETOM Trio System Manual Patient transport Patient transport trolley The patient transport trolley complies with the requirements for electrical safety of DIN VDE 0750 Part 1 IEC 601 Part 1 Patient transport trolley 1 Tabletop max load capacity 160 kg 2 Head end max load capacity 60 kg Do not exceed the maximum load of the patient transport trolley syngo MR 2004A D 2 3 Revision 03 Patient transport trolley Patient transport Risk of breaking A warning sign on the back of the head end indicates the risk of breaking the head end No sitting prohibition sign WARNING Breaking of head end Injury caused by falls Never allow the patient to sit on the head end WARNING Tipping over of patient transport trolley Injury to patient Ensure that the patient transport trolley always remains level when patients are getting on and off Engage the brake D 2 4 MAGNETOM Trio System Manual Patient transport Patient transport trolley Engaging the brake Chassis of patient transport trolley 1 Brake pedal Engaging the brake lt Depress the brake pedal The patient transport trolley cannot be moved Releasi
91. f the CP Extremity off and remove G 8 4 MAGNETOM Trio System Manual Examination RF coils CP Extremity optional Positioning the patient Patient with knee positioned in the lower part of the CP Extrem ity on the patient table Position the patient in the supine position with the feet toward the magnet bore lt Ensure that the joint to be examined is positioned in the center marking of the CP Extremity lt Use suitable positioning aids gt Page J 1 1 Accessories for patient positioning mmobilize the joint to be examined by placing the air cush ion on top lt Place the leg support under the second leg next to the lower part of the CP Extremity syngo MR 2004A G 8 5 Revision 03 CP Extremity optional Examination RF coils Closing the CP Extremity lt gt Place the upper part of the CP Extremity on the lower part of the CP Extremity so that the two parts interlock lt 4 For optimal image quality position the CP Extremity as closely as possible to the center of the lower part C Patient with CP Extremity closed on the patient table G 8 6 MAGNETOM Trio System Manual Examination RF coils CP Extremity optional Performing the measurement Align the laser light localizer with the center marking of the CP Extremity lt gt Start the measurement Opening the coil Press the releases on the upper part of the CP Extremity lt Lift the upper part of the CP Ext
92. fy Siemens Service or have the magnet refilled Check the Table Stop buttons at the intercom and the con trol units right and left side of the patient table at the mag net Move the patient table and press one of the Table Stop buttons The table has to come to a complete stop Check all three buttons one after the other Check if pressing the squeeze bulb triggers the patient alert Check if communication with the patient in the examination room works properly Check if the image transmission of the video system 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 drops of blood etc C 2 7 Switching the MR system on and off MR system operation o To start Host Standby with the MR system switched off To start Host Standby from System On C 2 8 Host Standby Host Standby can be started from System On or with the MR system switched off Host Standby allows you to switch the MR system to System On or to switch it off completely You can also use the syngo MR System Manager to switch between Host Standby and System On gt syngo MR Operator Manual Starting Host Standby Turn the keyswitch at the alarm box to the right The MR system is unlocked lt Press Host Standby The host computer is booting up lt Press Host Standby at the alarm box All components exce
93. ging To determine the start time for the measurement an acquisition window is defined based on the signal form e g R wave in ECG minimum of respiratory curve For example the size of the acquisition window is approx 80 of the R R interval for ECG measurements The acquisition window defines the range in which the measurement can be triggered The trigger time is defined by the trigger delay Prospective triggering can be used for ECG pulse or respira tory signal curves as well as for external trigger signal curves Retrospective gating differs fundamentally from prospective triggering No actual triggering is taking place The physiologi cal signal and data acquisition times are recorded simultane ously The measurement is performed completely independent of the patient s heartbeat or pulse A temporal assignment of images to the corresponding phase e g heart stimulation is performed after the measurement retrospectively Retrospective gating is used in particular to acquire images of the beating heart This technique is especially useful for dis playing the late diastole compared to measurements using pro spective triggering The temporal resolution may be freely selected higher or lower than for the measurement Retrospective gating can be used for ECG pulse or external trigger signal curves MAGNETOM Trio System Manual CHAPTER F2 syngo MR 2004A Revision 03 Physiological Measurement Unit opti
94. gnet lt Connect the plugs to coil sockets 2 3 and 4 lt gt Position cushion 1 at the foot end of the patient table Position the support cushion on the Spine Array Positioning the patient Position the patient in the supine position and as straight as possible in the center of the coil lt Ensure that the patient s shoulders are flush with the head support lt Secure the patient s head using the head stabilization wedges G 2 4 MAGNETOM Trio System Manual Examination RF coils Spine Array optional lt Place the knee wedge under the patient s legs so that the spine lies flat on the table Patient with Spine Array positioned for spine examination syngo MR 2004A G 2 5 Revision 03 Spine Array optional Examination RF coils Performing the measurement lt Select the region of interest Align the laser light localizer with the center of the region of interest lt Select the desired measurement configuration at the con sole 4 Start the measurement 4 Observe the additional information for using the Spine Array G 2 6 MAGNETOM Trio System Manual Body Array optional Description Design The Body Array consists of the following components Body Array 1 Body Array Anterior 2 Body Array Posterior synpg MR2004A S 84 Revision 03 Body Array optional Examination RF coils Body Array Anterior The Body Array Anterior consists of the followi
95. gnetic field strength exceeds 0 5 mT Patients who have been exposed to metal splinters at work or through other activities may have microscopic splinters e g in their eyes without knowing it lt Patients should be asked if they have been exposed to metal splinters In addition to the general warning specific examples are pro vided for objects that must not enter the safety zone This list is not exhaustive It only serves as an illustration of objects for which magnetic forces present a hazard A 2 29 Personal safety information Safety Attraction of ferromagnetic materials WARNING Magnetizable objects introduced into the magnetic field become projectiles Injury to patient and operating personnel lt Use only non magnetic tools and devices lt Do not use transport trolleys or mobile hospital beds with magnetizable parts lt Do not use traction devices gas tanks or similar devices Do not wear or carry any magnetizable objects on your per son for example watches pens scissors etc lt 4 Service work on the MR system may be performed only by Siemens Service A 2 30 MAGNETOM Trio System Manual Safety Personal safety information o syngo MR 2004A Revision 03 WARNING Magnetizable objects introduced into the magnetic field become projectiles Injury to patient and operating personnel lt Operating personnel must be aware of the increased force exerted on ferromagnetic pa
96. go MR 2004A Revision 03 L 1 MAGNETOM Trio Magnet Gradient system general RF system and surface coils MRC host computer Image processor MRSC Acoustic noise Ambient conditions Specific absorption rates Room body temperature Cooling system Line power supply General classifications Electromagnetic Compatibility EMC L 2 Physiological Measurement Unit PMU Input for external trigger signal Output for external trigger signal L 1 1 L 1 1 L 1 2 L 1 3 L 1 4 L 1 4 L 1 5 L 1 5 L 1 6 L 1 6 L 1 7 L 1 7 L 1 8 L 1 9 L 1 10 L 2 1 L 2 1 L 2 2 L 1 Technical Data L 2 MAGNETOM Trio System Manual MAGNETOM Trio Magnet Q 3 0T with lt 0 3 ppm volumenys 24 plane plot innomoge neity over 40 cm DSV Helium cooled super conducting magnet Compact patient friendly design with 40 cm FoV Simple design and active shielding for easy installation D O O O Integrated external interference shielding provides perma nent protection against potential interferences through fer romagnetic objects moved into the proximity of the magnet syngo MR 2004A L 1 1 Revision 03 MAGNETOM Trio Technical Data ES Z oeo y g i Gradient system general W Complete active shielding with low gradient fringe field and best linearity Q 40 mT m field strength with fast scalable rise times Q Active shim across 8 channels 3 linear 5 non linear with 52 coil circuits up to 2nd order Q Gradient
97. hanisms one on each side syngo MR 2004A G 6 3 Revision 03 8 Channel Head optional Examination RF coils G 6 4 The patient table is prepared Position the 8 Channel Head at the head end of the patient table Position cushions 1 2 and 3 at the foot end of the patient table Position the 8 Channel Head so that the side of the 8 Chan nel Head facing the foot end rests on the table pad Connect the coil plugs of the 8 Channel Head to coil sock ets 3 and 4 on the patient table Use positioning aids suitable for the examination MAGNETOM Trio System Manual Examination RF coils 8 Channel Head optional Positioning the patient WARNING Patient s head positioned too high Injury to patient lt Ensure that the receiver does not touch the patient s head Install the removable clamps at the desired position on the dedicated mounting and push them outward to the end stop Release the locking mechanism at the receiver syngo MR 2004A G 6 5 Revision 03 8 Channel Head optional Examination RF coils Slide the receiver back Open 8 Channel Head positioned on the patient table Position the patient s head in the head support Slide the receiver over the patient s head Lock the receiver in place G 6 6 MAGNETOM Trio System Manual Examination RF coils 8 Channel Head optional Position the double mirror so that the patient has a view of the examination room
98. he Eject button The CD tray opens The READ ON status LED on the CD drive flashes lt Remove the CD from the CD tray lt Place the CD in a protective cover 1 2 4 MAGNETOM Trio System Manual Documentation Reading data Press the Eject button The CD tray closes The READ ON status LED flashes until the CD tray is closed The CD tray fails to open on The CD drive is defective or there has been a power failure lt Shut down and switch off the computer Manual push button for opening the CD tray lt Using a long thin object press the button next to the Eject button lt Carefully pull out the CD tray lt Remove the CD from the CD tray syngo MR 2004A 1 2 5 Revision 03 Reading data Documentation o Handling a magneto optical disk MOD 1 2 6 Reading a magneto optical disk optional The magneto optical disk drive is used to read medical images stored on magneto optical disks The MOD is protected against magnetic effects and X rays for example airport baggage screening Background information gt Page 1 2 12 Magneto optical drive operating modes To protect against dirt and mechanical damage the mag neto optical disk is enclosed in a cassette It meets ISO and ANSI standards MAGNETOM Trio System Manual Documentation Reading data Scratches and grooves may damage the magneto optical disk o Magneto optical disk MOD 1 Handling surf
99. he examination room temperature of 24 C and a maximum relative humidity of 60 96 in the examination room Depending on climatic conditions the use of an air conditioning system and or appropriate measurement devices may be nec essary to ensure these ambient conditions If the room temperature and or relative humidity is higher than the levels specified above compliance with the SAR limits according to IEC or FDA regulations may no longer be guaran teed FDA Federal Food and Drug Administration USA IEC International Electrotechnical Commission The operator is responsible for monitoring the functionality of the air conditioning system as well as the temperature and rel ative humidity inside the examination room o A 3 6 MAGNETOM Trio System Manual Safety Device related safety information System specific signs Name plate and safety cer The labels are located on the magnet cover tificate SIEMENS Model No Serial No MADE IN GERMANY Name plate label This product complies with DHHS regulations 21 CFR Subchapter J applicable at date of manufacture Manufactured Siemens Aktiengesellschaft Wittelsbacherplatz 2 D Muenchen Germany Safety certificate label USA syngo MR 2004A A 3 7 Revision 03 Device related safety information Safety Installing the map Map A 3 8 Warning and prohibition signs Map The following list of warning and prohibition signs has to be insta
100. he time varying magnetic fields of the gradients Assuming all other conditions remain constant the strength of the electrical field is directly proportional to the change of the magnetic flow dB dt syngo MR 2004A C 3 3 Revision 03 Physiological effects MR system operation C 3 4 Peripheral nerve stimulation Stimulation threshold The electrical field has an effect on patients If the strength of the electrical field exceeds a certain threshold stimulation threshold the patient will experience peripheral nerve stimula tion This can include tickling or tingling sensations or mild mus cle twitching In addition the cardiovascular system of the patient may be affected Depending on physiological condi tions the stimulation threshold may vary greatly from patient to patient Stimulation limits So called stimulation limits were determined by averaging the individual stimulation thresholds of test subjects during an extensive clinical trial Based on the statistical distribution it can be expected that up to 50 of all patients will experience at least mild stimulations after reaching this stimulation limit MAGNETOM Trio System Manual MR system operation Physiological effects syngo MR 2004A Revision 03 Monitoring The MR system software includes a monitoring feature stimu lation monitor which monitors the stimulation limit The information window of the stimulation monitor displays how close patie
101. hysiological imaging ECG triggering using active ECG electrodes optional Attaching the active ECG V The Electrode Contact LED flashes lectr electiopes lt 4 Attach the electrode holder to the patient s chest directly above the heart The Electrode Contact LED stops flashing The Electrode Contact LED keeps flashing on The active ECG electrodes have lost skin contact ECG acqui sition is interrupted This may cause triggering errors and the display of elevated heart rates lt gt Ensure that the active ECG electrodes make good skin contact The Electrode Contact LED flashes for 10 minutes or more on The active ECG electrodes switch off automatically lt Press the On Off button at the MRI interface to switch the active ECG electrodes back on syngo MR 2004A F 4 5 Revision 03 ECG triggering using active ECG electrodes optional Physiological imaging Positioning the ECG ampli fier A F4 6 WARNING Active ECG electrodes Skin irritations on the patient during prolonged use lt Place absorbent textiles made of natural materials between the skin and the ECG amplifier connection cable to the electrode holder MAGNETOM Trio System Manual Physiological imaging ECG triggering using active ECG electrodes optional lt Position the ECG amplifier so that it is located outside the region of interest and is pointing from the electrode holder toward the patient s feet j Example pos
102. i tioned above the coil sockets using suitable positioning aids e g wedge E 1 12 MAGNETOM Trio System Manual Preparing the examination Patient preparation and positioning Positioning the head using the back head support The system has to know the exact position of the patient for reli able calculations of the SAR value The back head support has to be positioned as described if used to support the patient s head Positioning the head with lt Position the back head support on the head support of the the back head support patient table so that it is flush with the edge marking of the head support syngo MR 2004A E 1 13 Revision 03 Patient preparation and positioning Preparing the examination Position of the back head support on the patient table 1 Back head support 2 Edge marking of the head insert Position the patient s head on the back head support E 1 14 MAGNETOM Trio System Manual Installing the RF coils Safety information All RF coils are equipped with protective electronic circuits The active component of the protective electronics receives signals via the coil plug The RF coil must be connected before the measurement The MR system automatically recognizes the connected RF coils Using RF coils from other MAGNETOM systems for measure ments with MAGNETOM Trio is not permitted o WARNING Coil cables plugs not connected Patient burns Severe damage to RF coil lt Al
103. ies Use positioning aids e g blankets syngo MR 2004A A 2 41 Revision 03 Personal safety information A 2 42 Safety adii V 4 o Ay af 1 S as WY V 4 m Y V 7 Examples of skin contact that may lead to large surface current loops Ensure that patients are not positioned as shown in the illustration MAGNETOM Trio System Manual Safety Temporary feeling of dizzi ness A A syngo MR 2004A Revision 03 Personal safety information Dizziness when exposed to 3 Tesla magnetic fields The high basic field may cause patients to temporarily experi ence slight dizziness or sensory irritations CAUTION Dizziness of the patient during table movement inside the mag netic field Startle reflex of the patient lt Prior to moving patients into the magnetic field inform them that they may experience temporary dizziness CAUTION Numbness dizziness or metallic taste during measurements in 3 Tesla magnetic field Startle reflex of patient lt Prior to the examination inform patients about the possible occurrence of these symptoms A 2 43 Personal safety information Safety Hazards associated with coolants WARNING Helium gas leaks Bodily injury Risk of fire in the examination room caused by condensa tion of oxygen in the air on ultra cold helium Avoid open flames lt gt Do not smoke This MR system contains a super condu
104. ing Accessories Patient posi tioning J 1 1 Patient positioning E 1 7 Positioning aids Coils J 1 10 Positioning aids Standard J 1 1 Safety information A 2 41 With back head support E 1 13 Positioning aids Vacuum cushion Opera tion J 2 4 Index Vacuum cushions Description J 2 1 Vacuum cushions Use of J 2 2 Precautions Safety information A 2 4 Preparation MR examination E 1 1 MR system E 1 4 Patient For MR examina tion E 1 1 Preparing the examination Positioning the patient E 1 7 Pulse triggering Description F 5 1 Performing F 5 2 Purpose MR system 0 0 vii Q Quality measurement RF coil quality H 1 1 R Regulations Safety information A 1 3 Index Repiratory triggering Description F 6 1 Performing F 6 2 S Safety distances Devices in the magnetic field A 3 2 Safety information Device related safety infor mation A 3 1 Emergency shut down switch A 2 13 Fire safety A 2 52 General safety information A 1 1 Patient positioning E 1 7 Patient transport trolley D 2 2 Personal safety informa tion A 2 1 RF coils E 2 1 Safety measures Emergency precautions A 2 6 Examination room A 2 8 SAR Limit values Safety infor mation A 3 6 Limit values Examination with RF fields C 3 10 Monitoring C 3 11 Patient positioning E 1 13 Scan Starting and ending with footswitch B 5 9 Securing Patient on the transport trolley D 2 8
105. inter national organizations e g IEC and various national health organizations have published guidelines and limit values In compliance with country specific approval guidelines they are the basis for the monitoring functions integrated in the MR sys tem with respect to stimulation and warming effects Two different operating modes are available depending on the patient s maximum tolerance 1 Normal Operating Mode 1 First Level Controlled Operating Mode syngo MR 2004A C 3 1 Revision 03 Physiological effects MR system operation C 3 2 Normal Operating Mode Normal Operating Mode can be safely used for all patients First Level Controlled Operating Mode In First Level Controlled Operating Mode patients may experi ence noticeable stress levels depending on the measurement program selected We recommend establishing a procedure to ensure medical monitoring of the patient Switching between operating modes To switch from Normal to First Level Controlled Operating Mode the user has to explicitly select and confirm the change A corresponding prompt will appear in the dialog window of the MR console In First Level Controlled Operating Mode the patient has to be medically monitored MAGNETOM Trio System Manual MR system operation Physiological effects Examination with low frequency electromagnetic fields Background information During the measurement patients are exposed to an electrical field through t
106. ion The ratio of patients affected by peripheral nerve stimula tion is therefore less than 1 when fully utilizing the power limit First Level Controlled Operating Mode In the First Level Controlled Operating Mode the power limits are determined directly from the statistically determined stimu lation limits Accordingly up to 50 of all patients may experi ence mostly mild stimulations when fully utilizing the power limit a smaller portion may experience significant stimulation We recommend establishing a procedure to ensure medical monitoring of the patient The decision to change to the First Level Controlled Operating Mode has to be based on the potential risks and benefits for the patient C 3 7 Physiological effects MR system operation Examination with RF electromagnetic fields Background information During the course of an MR examination the patient s body absorbs energy from the RF field of the transmitter coil Depending on the type of transmitter coil used the absorption is either concentrated locally when using so called non volume coils or relatively uniform across the part of the body examined when using volume coils e g Extremity or body coil The Specific Absorption Rate SAR indicated in W kg serves as a stress indicator A high local SAR may resultin RF burns A high SAR evenly distributed across the entire body exerts stress on the patient s cardiovascular and thermoregulation system C
107. ion F 6 1 Respiratory triggering Performing F 6 2 Tunnel lighting Adjusting E 1 5 Table display D 1 12 Tunnel ventilation Adjusting E 1 6 Table display D 1 13 V Vacuum cushion Combining head and spine cushions J 2 4 Description J 2 1 Evacuating J 2 6 Operation J 2 4 Positioning J 2 5 Use J 2 2 Venting J 2 7 Video camera Cleaning K 1 2 Description B 8 2 Video display Cleaning K 1 1 Video display 2 Adjustment B 8 5 Automatic brightness reduction B 8 4 Description B 8 3 Video display 3 Adjustment B 8 15 Automatic brightness reduction B 8 14 Description B 8 13 Video system Overview B 8 1 Video camera B 8 2 Voltage Technical data L 1 8 Volume Acoustic noise L 1 5 Adjusting Headphones and wall speaker E 1 4 Automatic voice output B 7 6 Listen volume B 7 4 Live announcement B 7 5 Music B 7 7 MAGNETOM Trio System Manual Index W Warming Examination with RF fields C 3 9 Hazards Electrically con ducting objects A 2 39 Warning notices Structure A 1 2 Verbal signals A 1 2 Warning signs Laser A 2 65 Warning and prohibition signs A 3 8 syngo MR 2004A M 15 Revision 03 Index MAGNETOM Trio System Manual
108. ion pumps Verbotszeichen Elektromagnetisch beeinflussbare Implantate z B Herzschrittmacher Defibrillatoren H rger te Insulinpumpen Medikamentendosierger te Prohibition Signs Danger of Electromagnetic Disturbances Implantations e g Cardiac Pacemaker Defibriliators Hearing Instruments Insulin Pumps Dosage Devices for Medication Panneaux d avertissement l ments implant s sensibles aux interf rences lectro magn tiques par ex stimulateurs cardiaques d fibrillateurs aides auditives pompes insuline doseurs de m dicaments S mbolos de prohibici n Implantes sensibles a los campos electromagn ticos p ej marcapasos desfibriladores aud fonos bombas de insulina dosificadores de medicamentos Segnali di divieto impianti suscettibili agli effetti elettromagnetici ad es pacemaker cardiaci defibrillatori apparecchi acustici pompe per l insulina dispositivi per la somministrazione di farmaci Descriptive prohibition sign Implants susceptible to electro magnetic effects A 3 12 MAGNETOM Trio System Manual Safety Device related safety information Prohibition sign for open flame no smoking Prohibition sign for metallic implants and other metallic objects inside the body e g splinters S Prohibition sign for mechanical watches electronic media such as calculators digital watches etc A 3 13 syngo MR 2004A Revision 03 Device related safety informa
109. ion pumps may be affected or disrupted by a magnetic field The operator is responsible for ensuring that persons with implanted cardiac pacemakers or other implants susceptible to electromagnetic effects are not endangered by the magnetic field The necessary protective measures have to be taken for zones with a magnetic field strength greater than 0 5 mT safety zones have to be marked in accordance with applicable official rec ommendations and access has to be controlled A 2 35 Personal safety information Safety WARNING Implants susceptible to electromagnetic effects e g pacemak ers medication pumps Risk of patient death lt Do not perform MR examinations on patients with implants that are affected by electronic fields for example cardiac pacemakers lt gt Observe the 0 5 mT exclusion zone During intracardial interventions do not use metallic or electrically conducting objects A 2 36 MAGNETOM Trio System Manual Safety syngo MR 2004A Revision 03 Personal safety information Hazards relating to low and radio frequency fields During MR examinations patients are exposed to low and radio frequency electromagnetic fields As an unavoidable side effect eddy currents are induced in the patient s body These depending on their strength and fre quency may cause stimulation low frequency fields or heat radio frequency fields In particular metallic implants inclusions may cause
110. ionality checks V All coils on the patient table are connected to the coil sock ets and operational V Coils consisting of several parts e g head coil have to be closed This requirement also applies if you have to restart the system during an examination syngo MR 2004A C 2 3 Revision 03 Switching the MR system on and off MR system operation Turn the keyswitch to the right lt Press the System On button The System On LED lights up The MR system is switched on The computer system boots up automatically The software is started at the MR console The MR satellite console uses a separate power supply As a result it has to be started separately from the MR console Press the Power On switch at the computer of the MR sat ellite console The software is started at the MR satellite console C 2 4 MAGNETOM Trio System Manual MR system operation Switching the MR system on and off The following screens appear on the displays of the MR con sole Screen display at the MR console syngo MR 2004A C 2 5 Revision 03 Switching the MR system on and off MR system operation Screen display at the MR satellite console C 2 6 MAGNETOM Trio System Manual MR system operation Switching the MR system on and off Checking the MR system components syngo MR 2004A Revision 03 If a message is displayed at the MR console informing you that the helium fill level is too low close the window and noti
111. isplay 1 2 ECG Lead button Scroll Speed button 3 Acoustic Signal button syngo MR 2004A Revision 03 F 2 3 Physiological Measurement Unit optional Physiological imaging Button functions on the PMU Display Key Function ECG lead Selecting the ECG lead Scroll Speed Setting the write speed for the curves Acoustic Signal Activating deactivating the acoustic heartbeat signal F 2 4 MAGNETOM Trio System Manual Physiological imaging syngo MR 2004A Revision 03 No Physiological Measurement Unit optional Description of Physiological Display The Physiological Display dialog window lets you view the patient s physiological signals Eile Edit WAM BA 2ndTack ecem _ Statistics Reset Stat Ready Physiological Display dialog window This dialog window can display one or two signal curves See the syngo MR Operator Manual for information about using the Physiological Display dialog window F 2 5 Physiological Measurement Unit optional Physiological imaging F 2 6 Operation EKG HF 121 AVF Puls PF 86 Resp A Nao J e RF 16 1 HI IIl mm sec t Ss E N 1 2 3 PMU Display 1 ECG Lead button 2 Scroll Speed button 3 Acoustic Signal button The touch screen on the PMU Display offers the following func tionality Q Selecting the ECG lead Q Setting the write speed for the curves
112. ition of the ECG amplifier toward the head end Positioning the ECG amplifier within the region of interest may cause image artifacts o syngo MR 2004A F4 7 Revision 03 ECG triggering using active ECG electrodes optional Physiological imaging Selecting the ECG lead The ECG leads are selected using the ECG Lead button at the MRI interface Quickly press the ECG Lead button repeatedly if neces sary until the correct lead has been set You can choose from three ECG leads Il and III The ECG lead selection returns to lead once you have reached lead III o The ECG lead can also be set using the Physiological Display dialog window at the operating console o Performing the examina lt Perform the measurement as described in the syngo MR tion Operator Manual F 4 8 MAGNETOM Trio System Manual CHAPTER F5 syngo MR 2004A Revision 03 Pulse triggering Description Pulse triggering uses the patient s pulse to trigger the measure ment A pulse sensor is connected to the patient s toe or finger F5 1 Pulse triggering Physiological imaging rr e Performing The pulse sensor has to be connected before starting examina tions using pulse triggering Attaching the pulse sensor The pulse sensor can be attached to a finger or a toe When attaching the pulse sensor to a finger make sure that the exit side of the light is located below the finger Pulse sensor attached
113. ity Incorrect diagnosis lt Check to see if the brightness of the image field displayed differs from that along the image margin A 1 16 MAGNETOM Trio System Manual Safety General safety information CAUTION Susceptibility of low bandwidth images to artifacts and image interference Incorrect diagnosis lt Use low bandwidth images as a reference only after they have been checked very carefully CAUTION Incorrect MR image due to RF field inhomogeneities Incorrect diagnosis lt gt Check the MR image for system related regional variations in image intensity and or left right asymmetries syngo MR 2004A A 1 17 Revision 03 General safety information Safety CAUTION Brightness artifacts during body examinations with 3 Tesla sys tems due to patient dependent RF field inhomogeneities Incorrect diagnosis Note brightness artifacts during image evaluation A 1 18 MAGNETOM Trio System Manual Safety General safety information User related artifacts CAUTION Artifacts caused by 3 Tesla magnetic fields Incorrect diagnosis lt MR images may be interpreted only by a physician trained in MR He has to be trained in artifacts related to a 3 Tesla magnetic field WARNING Modification of safety relevant data Incorrect diagnosis lt gt Change safety relevant data during the examination only to correct erroneous inputs Safety relevant data include i e the weight and patient orientation syngo
114. iver coil and the body region to be measured is reduced No syngo MR 2004A B 2 1 Revision 03 RF coils some are optional MR system components HF coils The following RF coils are strictly receiver coils Q Spine Array W Body Array 1 Breast Array Q Cardiac Array Q 8 Channel Head The following RF coils are transceiver coils Q CP Head Q CP Extremity Q CP Wrist B 2 2 MAGNETOM Trio System Manual MR system components RF coils some are optional Measurement phantoms Test measurements are designed to ensure the quality of the RF coils Measurement phantoms are used during these test measurements to simulate the patient s body Load phantoms simulate the weight while coil phantoms simulate the tissue of the patient syngo MR 2004A B 2 3 Revision 03 RF coils some are optional MR system components B 2 4 MAGNETOM Trio System Manual Electronics cabinets The electronics cabinets are installed in the electronics room If there is no electronics room the electronics cabinets are located in the control room Electronics cabinets 1 Cooling system cabinet 2 Gradient cabinet 3 Control cabinet syngo MR 2004A B 3 1 Revision 03 Electronics cabinets MR system components Cooling system cabinet The cooling system cabinet contains the cooling for the system components Gradient cabinet The gradient cabinet contains the power electronics for gener ating the magnetic fiel
115. l MH console Overview Control room 1 Window to examination room 2 Monitor 3 MR console syngo MR 2004A B 4 1 Revision 03 MR console MR system components The MR console is used to control and monitor the main func tions of the MR system Qj Patient registration MR imaging Image reconstruction Image display Evaluation OC COC O O do Documentation The noise level at the MR console MRC of the MR system does not exceed the accepted international limits o The MR console is located in the control room MR satellite console optional The MR satellite console is primarily used for evaluating docu menting and post processing the images measured The MR satellite console cannot be used for measurements The MR satellite console is located in the vicinity of the MR con sole The MR satellite console accesses the same database as the host computer of the MR console The MR satellite console is not connected to the MR scanner or the image processor B 4 2 MAGNETOM Trio System Manual MR system components MR console Computer system The computer system comprises a host computer an image processor and an MR scanner The host computer is located in the control room next to the console table the image processor is housed in the electronics room the MR imaging components are located in the electronics cabinet Data recording The MR system provides the following modules for data
116. l buckle by two hooks 4 gt K 1 2 To remove the metal latch press the loop together and pull it out through the gap between the two hooks Wash the belt straps Hook the metal latches back into the loop MAGNETOM Trio System Manual Maintenance Cleaning Cleaning and disinfecting lt Do notuse cleaners or disinfectants containing alcohol or the receptors ether lt Do notuse hard or sharp objects e g knives or tweezers to remove residue lt gt Clean the receptors with a commercially available cleaner Follow manufacturer s instructions lt Use a dampened cloth for cleaning Do not submerge the receptors in cleaning liquid o lt 4 Disinfect the receptors with a commercially available disin fecting agent Follow manufacturer s instructions Disinfecting system compo lt Disinfect the system components with a commercially nents available disinfecting agent Follow manufacturer s instruc tions Siemens does not test phenol alkylamine and alkaline based disinfectants for harmful effects on surfaces Therefore we do not recommend their use o syngo MR 2004A K 1 3 Revision 03 Cleaning Maintenance Care and cleaning of floors K 1 4 Do not use the following cleaning or care products d d a Sprays Silicon based cleaning or care products Cleaning or care products with substances that release ammonia Cleaning or care products that destroy the anti static prop e
117. lay the brightness is reduced automatically after approx 50 minutes without screen changes The flashing green LED indicates brightness reduction The original brightness is automatically restored with the next Screen change It is also possible to manually reduce increase the brightness level MAGNETOM Trio System Manual MR system components Video system optional Adjustment Video display 3 can be adjusted using the control panel on the right side of the screen Changes are saved after exiting the on screen display OSD Video display 3 control panel 1 Left button 2 Up button 3 OK button 4 Right button 5 Down button syngo MR 2004A B 8 15 Revision 03 Video system optional MR system components Functions of control panel buttons Key Function OK 1 Opens the OSD main menu 1 Exits the OSD main menu 1 Closes the submenu Right 1 Opens a submenu L Increases the selected value Left 11 Decreases the selected value Up Qj Selects the previous menu item may toggle from the first to the last menu item Disables brightness reduction Down 1 Selects the next menu item may tog gle from the last to the first menu item q Enables brightness reduction B 8 16 MAGNETOM Trio System Manual MR system components Activating deactivating brightness reduction Switching active input Displaying active input on start up syngo MR 2004A Revision 03 Video system optional Pre
118. lean the system with a damp cloth only Cleaning the monitor video The monitor at the operating console and the video monitor monitor Screen are cleaned the same way gt Clean the monitor video screen every two months lt gt Wipe the monitor video screen with a microfiber cloth lt gt Ifthe monitor video screen is heavily soiled use a window cleaner lt gt Remove water drops on the monitor video screen immedi ately gt Avoid scratching the surface of the monitor video screen lt gt Avoid impact to the monitor video screen The monitor video screen is highly susceptible to mechanical e damage syngo MR 2004A K 1 1 Revision 03 Cleaning Maintenance Cleaning the video camera Cleaning the plugs and con lt nectors Cleaning the patient trans port trolley Clean the video camera housing with a clean damp cloth Clean the video camera optics with a lint free cloth or lens cleaning paper Dampen a soft cloth with water or a diluted household cleaner solution Do not use organic solvents such as alcohol or acetone Carefully wipe the plugs and connectors with the cloth Do not touch the contacts Clean the stainless steel parts of the patient transport trol ley with a commercially available stainless steel cleaner Cleaning the belt straps The belt straps can be washed at a temperature of 95 C The metal latches have to be removed first The loop of the strap is attached to the meta
119. less patients A 2 51 Personal safety information Safety Fire safety General prerequisites for In the event of fire the fire has to be extinguished with methods firefighting appropriate to the surroundings Fire fighters have to be able to take appropriate actions immediately For this purpose the fire department has to be familiar with the MR system and its loca tion Before initial start up of the MR system the operator is respon sible for informing the fire department about the MR system and the structural conditions on site o A 2 52 MAGNETOM Trio System Manual Safety Personal safety information Fighting a fire The following devices materials may be used for firefighting Q4 Non magnetic CO extinguisher 1 Self contained anti magnetic compressed air respiratory apparatus or hose connection d Airtight chemical protective suit The operator must ensure that firefighting equipment is availa ble WARNING Heating up ignition of synthetic blankets due to radio frequency during the measurement Patient burns lt gt Use only blankets made of linen cotton or paper syngo MR 2004A A 2 53 Revision 03 Personal safety information Safety WARNING A Helium gas leaks Bodily injury Risk of fire in the examination room caused by condensa tion of oxygen in the air on ultra cold helium lt gt Avoid open flames lt gt Do not smoke A 2 54 MAGNETOM Trio System Manual Safety Personal safet
120. lled in a clearly visible location at eye level in the vicinity of the MR system MAGNETOM List of warning and prohibition signs MAGNETOM Trio System Manual Safety Affixing warning signs Warning signs syngo MR 2004A Revision 03 Device related safety information Warning signs Affix warning signs in a clearly visible location at eye level in the vicinity of the MR system NMR magnetic field warning sign RF field warning sign Observe operating instructions warning sign A 3 9 Device related safety information Safety Warning sign for potential point of injury Refilling with liquid nitrogen and helium A 3 10 MAGNETOM Trio System Manual Safety Device related safety information Prohibition and mandatory signs Installing prohibition and Install prohibition and mandatory signs in a clearly visible loca mandatory signs tion at eye level near the points of access to the MR system and the exclusion zone Prohibition signs Unerlaubtes Betreten verboten Unauthorized approach entry forbidden D fense d entrer sans autorisation Prohibida la entrada sin permiso Divieto di accesso senza autorizzazione Sign prohibiting unauthorized access syngo MR 2004A A 3 11 Revision 03 Device related safety information Safety Prohibition sign for implants susceptible to electromagnetic effects e g cardiac pacemakers defibrillators hearing aids insulin pumps medicat
121. ly active cardiac pacemakers implanted drug pumps The correct functioning of the implants may be affected by the magnetic and electromagnetic fields 1 Patients with intracranial aneurysm clips unless the physi cian can ensure that the aneurysm clip is not ferromag netic Personal safety information needs to be adhered to in the fol lowing areas situations Emergency precautions Safety measures in the examination room Emergency shut down switch Hazards inside the magnetic field Hazards associated with coolants Potential points of injury through mechanical components Fire safety Patient monitoring Laser light localizer L DO D D D D COCO O Accidents involving MR measurement phantoms syngo MR 2004A A 2 1 Revision 03 Personal safety information Safety WARNING Medical emergency during MR measurement Risk of patient death lt Stop measurement immediately lt 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 lt Do not store or operate oxygen tanks defibrillators or other reanimation devices in the MR examination room CAUTION Insufficient information regarding potential risks when working with MR systems Personal injury property damage lt Ensure that all authorized operating personnel are regu larly informed about the potential risks when working with MR systems and the relevan
122. ly eliminated by using active ECG electrodes Their electronic and geometrical design mini mizes interaction with the gradient system MAGNETOM Trio System Manual Physiological imaging ECG triggering using active ECG electrodes optional The ECG amplifier is powered by a battery This battery cannot be recharged If the Amplifier Battery LED atthe MRl interface flashes the battery is almost completely discharged The active ECG electrodes may be used for another 100 hours before they need to be replaced o Use of the batteries in weeks 7 14 21 28 35 Battery capacity diagram syngo MR 2004A F 4 3 Revision 03 ECG triggering using active ECG electrodes optional Physiological imaging Performing Performing ECG triggering using active ECG electrodes includes the following procedures Q Connecting and switching on the active ECG electrodes LY Attaching the active ECG electrodes Q Positioning the ECG amplifier Q Selecting the ECG lead d Performing the examination Connecting and switching lt Connect the plug of the active ECG electrodes to the ECG on the active ECG elec connection at the PMU Frontend Modes lt Check the expiration date of disposable ECG electrodes and use new ones if necessary Clip the three disposable ECG electrodes to the electrode holder lt Press the On Off button at the MRI interface The Electrode Contact LED flashes F 4 4 MAGNETOM Trio System Manual P
123. ly press the Ctrl Alt and S keys on the key board This opens the syngo MR System Manager Shut down the software properly The System Manager cannot be opened You can shut down the MR console using the Windows plat form Be aware that this may cause data loss lt Simultaneously press the Ctrl Alt and Del keys on the keyboard The Windows NT Security window is displayed lt Click the Shut Down button The computer is shut down C 2 13 Switching the MR system on and off MR system operation System Manager and Windows do not respond ox9 If the System Manager cannot be started and Windows does not respond your only option is to switch off the MR console Be aware that this may cause data loss o lt Switch off the MR console C 2 14 MAGNETOM Trio System Manual MR system operation Switching the MR system on and off Switching off the MR sys tem at the alarm box Alarm box System Off 1 System Off button 2 Keyswitch Y The computer system has been shut down lt Press the System Off button The System On LED goes off The MR system is switched off Turn the keyswitch to the left The MR system is locked syngo MR 2004A C 2 15 Revision 03 Switching the MR system on and off MR system operation C 2 16 do Shutting down the MR satellite console In System On operating mode the MR satellite console can be shut down without affecting the remaining MR syst
124. m Video system optional C MR system operation C 1 C 2 C 3 syngo MR 2004A Revision 03 Daily functionality checks Switching the MR system on and off Physiological effects D Patient transport D 1 Patient table D 2 Patient transport trolley E Preparing the examination E 1 Patient preparation and positioning E 2 Installing the RF coils F Physiological imaging F1 Triggering methods F2 Physiological Measurement Unit optional F 3 ECG triggering F 4 ECG triggering using active ECG electrodes optional F 5 Pulse triggering F 6 Respiratory triggering F 7 External triggering iv MAGNETOM Trio System Manual G Examination RF coils G 1 Overview of RF coils G 2 Spine Array optional G 3 Body Array optional G 4 Breast Array optional G 5 Cardiac Array optional G 6 8 Channel Head optional G 7 CP Head G 8 CP Extremity optional G 9 CP Wrist optional H Quality assurance H 1 Quality of the RF coils H 2 Phantom fluid spills Documentation 1 1 Recording data 1 2 Reading data syngo MR 2004A V Revision 03 J Accessories J 1 Accessories for patient positioning J 2 Vacuum cushions optional K Maintenance K 1 Cleaning K 2 Return and disposal L Technical Data L 1 MAGNETOM Trio L 2 Physiological Measurement Unit PMU M Index vi MAGNETOM Trio System Manual MAG Trio Overview syngo MR 2004A Revision 03 o o o Purpose of MR system MA
125. magnet of the MR system is equipped with active super conducting shielding To prevent feedback from external magnetizable objects the MR system magnet is also equipped with the super conducting E I S External Interference Shield system These super con ducting shield coils are automatically discharged once a day Regular discharge ensures consistently high image quality Gradient system Slice positions can be precisely localized with the gradient sys tem MAGNETOM Trio System Manual MR system components Super conducting magnet Body coil Uses The main function of the body coil is to generate a homogene ous RF magnetic field for the excitation of the nuclear spins The body coil functions as a transmitter coil during all measure ments Exception when using local transceiver coils As a receiver coil for MR signals the body coil is used only for survey measurements because its signal to noise ratio is signi ficantly lower than that of local coils located close to the body Design The body coil is the innermost shell of the three field generating components magnet gradient coil and RF transmitter coil It is an integral part of the magnet The support tube of the body coil functions as the inside lining of the magnet bore It has guide rails for the patient table and together with other components is responsible for reducing noise syngo MR 2004A Revision 03 Super conducting magnet MR system comp
126. major malfunctions always shut the system down completely Notify Siemens Service WARNING High voltage and currents inside the electronics cabinets Risk of death by electrocution Electronics cabinets should be opened only by Siemens Service syngo MR 2004A A 1 7 Revision 03 General safety information Safety Safety relevant accessories The following safety relevant accessories should be checked d a d d d All coils for the transmitting and receiving system ECG cables for clip on electrodes Disposable electrodes for clip on cables Pulse receptor Non ferromagnetic patient transport trolley MAGNETOM Trio System Manual Safety Combination with other systems o General safety information Product safety If the MR system is combined with other systems or compo nents it has to be ensured that the planned combination does not affect the safety of patients personnel or the environment lt gt If the system is to be combined with other devices verify compatibility with Siemens Service and observe the respective instructions lt Ensure that the connection cables are MR compatible Hazards may also arise from MR compatible devices To avoid potential hazards the operating instructions of the manufac turer have to be read WARNING Unapproved accessories Property damage Accessories parts subject to wear and tear and disposa ble articles should be used only
127. ment Status messages Tunnel lighting adjustment L D DL DL D D L Tunnel ventilation adjustment D 1 6 MAGNETOM Trio System Manual Patient transport Patient table Coil socket assignments The current coil socket assignments are indicated by the corre sponding icons on the table display The following assignments apply 0 0 Q9 4 5 Display icons Coil socket assignments 1 Coil socket 1 2 Coil socket 2 3 Coil socket 3 4 Coil socket 4 5 Not used syngo MR 2004A D 1 7 Revision 03 Patient table Patient transport Arrangement of coil sockets 1 Coil socket 1 2 Coil socket 2 3 Coil socket 3 4 Coil socket 4 Blinking icons indicate coil malfunctions D 1 8 MAGNETOM Trio System Manual Patient transport Patient table o syngo MR 2004A Revision 03 Status of the laser light localizer When you activate the laser light localizer the corresponding icon appears on the table display It disappears once the laser light localizer is deactivated Display icons laser light localizer activated Relative position of the tabletop The relative position of the tabletop measures the distance between a slice marked with the laser light localizer and the magnet isocenter The unit of measure is millimeters 0000 mm on the display indicates that the slice to be measured is positioned in the magnet isocenter This is a prerequisite in obtaining optimal image quality Patient t
128. minated clothing lt gt Clean your hands thoroughly using soap and water syngo MR 2004A H 2 3 Revision 03 Phantom fluid spills Quality assurance First aid in case of contact with phantom fluid Skin contamination lt Immediately remove the clothing covering the contami nated area lt Immediately wash the skin using soap and water Eye contamination lt Immediately consult an ophthalmologist Swallowing of aqueous Drink plenty of water and induce vomiting immediately hantom solution ri Immediately consult a physician Swallowing of oil lt Do NOT induce vomiting Ensure that the person lies still lt Immediately consult a physician Inhalation Leave the building immediately to get some fresh air lt Immediately consult a physician H 2 4 MAGNETOM Trio System Manual Quality assurance Phantom fluid spills E Mandatory reporting in case of fire lt Inform the fire department about the contents of the meas urement phantoms lt gt Inform the fire department about the health hazards caused by aerosols containing nickel syngo MR 2004A H 2 5 Revision 03 Phantom fluid spills Quality assurance Disposal as special waste V Soaked up or wiped up measurement phantom fluid has been collected in a plastic bucket for disposal Label the container accordingly 4 Hire an authorized special waste company for disposal lt gt Itis recommended that you contact the r
129. mmunicate potential overheating effects e g small children seriously ill para lyzed unconscious sedated or handicapped patients E 1 2 MAGNETOM Trio System Manual Preparing the examination Patient preparation and positioning WARNING Use of unapproved fMRI stimulation devices for low and medium field systems 0 2 1 5 T Injury to patient and operating personnel lt Ensure that stimulation devices are approved for use with 3 Tesla systems CAUTION Exposure to low frequency electromagnetic fields Peripheral nerve stimulation of the patient lt gt Ensure that the patient is free of metallic rings chains or electrically conducting materials worked into items of clothing e g brassiere support wires Informing the patient lt gt Inform the patient about the possible effects of MR exami nations and the risks associated with the magnetic field gt Page C 3 1 Physiological effects gt Page A 1 1 General safety information syngo MR 2004A E 1 3 Revision 03 Patient preparation and positioning Preparing the examination Adjusting the music volume of the headphones and the wall speaker o Preparing the MR system The following settings have to be performed at the control unit of the patient table Page D 1 15 Control unit to prepare the MR system for the patient Q Adjusting the music volume of the headphones and the wall speaker QJ Adjusting the tunnel lighting W Adju
130. n syngo MR 2004A B 5 11 Revision 03 In Room MRC optional MR system components B 5 12 MAGNETOM Trio System Manual Alarm box Description The alarm box has the following functions Q Displays monitoring and alarm signals Q Switches the MR system on and off Alarm box 1 System On LED 2 Line LED 3 Magnet Stop LED 4 Helium Level LED 5 Alarm Silence button The alarm box is installed near the MRC syngo MR 2004A B 6 1 Revision 03 Alarm box B 6 2 MR system components Operation The functionality of the monitoring and alarm signals of the alarm box has to be checked before switching on the MR sys tem Checking the monitoring and alarm signals WARNING MR system malfunction Danger for patients lt Pay attention to alarm sounds and signals Do not perform examinations Notify Siemens Service MAGNETOM Trio System Manual MR system components Alarm box Checking the power supply 4 Check if the Line LED is on lt If the Line LED is not illuminated check the power supply of the MR system op The Line LED is off although the power supply is functioning O e properly Notify Siemens Service After a power failure the battery powers the magnet monitoring system for another 7 days During this time the magnet may still be quenched i e the magnet can be ramped down by pressing the Magnet Stop button in case of emergency o syngo MR 2004A B 6
131. n EPI images Incorrect spatial localization of activated brain region lt Do not use activation maps and result images from corre sponding MR images for spatial localization especially when performing stereotactic brain surgery WARNING Use of the AutoAlign function for patients younger than 17 years of age or for patients with abnormal brain structures e g Alz heimer s MS or large brain tumors Malfunction of AutoAlign function lt Use the AutoAlign function with patients 17 years old and older lt Do not use the AutoAlign function for patients with abnor mal brain structures A 1 26 MAGNETOM Trio System Manual Safety General safety information WARNING Inaccurate specification of vascular contours Incorrect vascular analysis lt Ensure that the contours are correctly drawn in the image prior to confirming a measurement or flag syngo MR 2004A Revision 03 WARNING Inaccurate specification of flag position Incorrect vascular analysis lt gt Ensure that the flag is positioned correctly in the image prior to confirming a measurement lt Ensure that a stenotic flag is always positioned in the area of maximum vascular stenosis A 1 27 General safety information Safety CAUTION Use of mosaic images to display slice position Erroneous diagnosis caused through incorrect display of slice position and or angle lt Do not use mosaic images for displaying the slice positi
132. n Room MRC optional Description Uses Footswitch Operation MR measurement using the footswitch Alarm box Description Operation Checking the monitoring and alarm signals Intercom Description Operation B 4 6 B 4 6 B 4 8 B 4 9 B 4 9 B 4 14 B 4 18 B 4 18 B 4 19 B 5 1 B 5 1 B 5 1 B 5 5 B 5 6 B 5 9 B 6 1 B 6 1 B 6 2 B 6 2 B 7 1 B 7 1 B 7 3 MAGNETOM Trio System Manual MR system components syngo MR 2004A Revision 03 B 8 Video system optional Overview Video camera Video display 2 Description Adjustment Video display 3 Description Adjustment B 8 1 B 8 1 B 8 2 B 8 3 B 8 3 B 8 5 B 8 13 B 8 13 B 8 15 B 3 B 4 MR system components MAGNETOM Trio System Manual CHAPTER Super conducting magnet B 1 Magnetic field The super conducting magnet produces a strong homogene ous magnetic field with a field strength of 3 0 Tesla Cooling system The magnet is filled with liquid helium as a coolant Following installation it is adjusted to the desired operating field strength The ramped up magnet does not require additional electric power to maintain the magnetic field However since the liquid helium boils off slowly it must be refilled by Siemens Service about once a year syngo MR 2004A B 1 1 Revision 03 Super conducting magnet B 1 2 MR system components Shielding To minimize the effects of the magnetic fringe field on the envi ronment the
133. ndles to push the table back after it has been moved in the longitudinal direction lt Do not wrap your fingers around the ends of the tabletop D 1 18 MAGNETOM Trio System Manual Patient transport Patient table WARNING Risk of collision due to horizontal vertical movements of the patient table Risk of injury lt gt Ensure that neither the RF coil nor the patient or his cloth ing extend beyond the patient table lt Ensure that no straps are hanging from the patient table lt n case of emergency push the Table Stop button WARNING Risk of collision due to horizontal vertical movements of the patient table Bodily injury Damage to patient table lt gt Ensure that all personnel stands clear of the table s danger zone lt Ensure that there are no objects within the table s danger zone syngo MR 2004A D 1 19 Revision 03 Patient table Patient transport WARNING Risk of collision due to horizontal vertical movements of the patient table Bodily injury Maintain visual and acoustic contact with the patient espe cially when examining children or patients who are uncon Scious paralyzed seriously ill or have a fever WARNING Crimped IV tube or pulled out IV needle Injury to patients with IV s lt Ensure that the IV tube does not get caught and that the IV needle remains in the patient during table movement D 1 20 MAGNETOM Trio System Manual Patient trans
134. ng components Body Array Anterior 1 Coil plug 2 Center marking G 3 2 MAGNETOM Trio System Manual Examination RF coils Body Array optional Body Array Posterior The Body Array Posterior consists of the following compo nents Body Array Posterior 1 Coil plug 2 Straps syngo MR 2004A G 3 3 Revision 03 Body Array optional Examination RF coils Positioning Aids Q Cushion Body large 11 Distance holder Q Cushion Body small Use Preparing the measurement Preparing the measurement using the Body Array includes the following steps Q Positioning the Body Array Posterior Q Positioning the Body Array Anterior G 3 4 MAGNETOM Trio System Manual Examination RF coils Body Array optional Positioning the Body Array Posterior Examining the thorax and the upper abdomen Patient table with Body Array Posterior 1 Cushion Body large 2 Cushion Body small 3 Body Array Posterior 4 Back head support 5 Coil socket 4 6 Head insert syngo MR 2004A G 3 5 Revision 03 Body Array optional Examination RF coils V The patient table is prepared Place the head insert in the space between the coil sockets on the patient table Place the Cushion Body large on the patient table so that the cable guide points to the head of the patient table and the cushion itself rests against the head insert Position cushion 1 at the foot end of the patient table P
135. ng devices syngo MR 2004A A 2 59 Revision 03 Personal safety information Safety Visual and acoustic patient monitoring Video monitoring An optional video camera may be installed on the back of the magnet bore to monitor patients CAUTION Startle reflex of the patient Injury to patient Inform patients about the monitoring and communication equipment Carefully instruct patients on proper behavior and associ ated risks Intercom An intercom system is available that allows operating personnel to communicate with patients A 2 60 MAGNETOM Trio System Manual Safety Patient alert Monitoring by operating personnel syngo MR 2004A Revision 03 o Personal safety information Patients may use the squeeze bulb to alert the operating per sonnel patient alert m Visually 1 LED display on the intercom m Acoustically 1 Continuous tone over the intercom Brief feedback signal via the patient s headset and wall speaker in the examination room Operating personnel can monitor patients acoustically provid ing instructions via speaker or headphones in the examination room Patients who may not be able to alert the operating personnel in the event of an emergency for example young children sedated patients must be monitored by a person present in the examination room In order to ensure optimal patient monitoring keep the Listen mode on in the examination room A 2 61 Personal
136. ng the brake lt Pull up the brake pedal with your foot The patient transport trolley can now be moved syngo MR 2004A D 2 5 Revision 03 Patient transport trolley Patient transport Adjusting the height of the tabletop Chassis of patient transport trolley 1 Pedal for height adjustment Lifting the tabletop lt Depress the pedal several times if necessary until the tabletop has reached the desired height Lowering the tabletop lt Pull up the pedal with your foot until the tabletop has reached the desired height D 2 6 MAGNETOM Trio System Manual Patient transport Patient transport trolley Adjusting the tilt of the head end Head end of patient transport trolley 1 Bracket 2 Handle lt Hold the head end by the handle bar lt Pull the handle toward the handle bar This releases the locking mechanism The head end can be moved freely Adjust the tilt as necessary Release the handle The head end is locked syngo MR 2004A D 2 7 Revision 03 Patient transport trolley Patient transport Securing the patient V The patient is positioned on the patient transport trolley lt Route the belt straps across the patient lt Hook the metal buckles into the standard profile rails on the side of the patient transport trolley lt Tighten the belt straps Patient secured with belt strap on patient transport trolley 1 Metal buckle D 2 8 MAGNETOM Trio System Manual P
137. nts are to the stimulation limit during the examina tion Look Ahead monitoring Prior to starting the MR examination the stimulation monitor checks whether the stimulation limits are exceeded If so the measurement cannot be started To perform the examination the parameters of the measurement sequence have to be adjusted accordingly Online monitoring If the stimulation limit is exceeded while a measurement is in progress the active measurement is aborted and the gradient currents are reduced C 3 5 Physiological effects MR system operation Operating modes The MR system can be operated in two operating modes which differ with respect to the gradient power limits The power limits are based on stimulation models from the sta tistically determined stimulation limits Stimulation models The following stimulation models are used 4 dB dt model Q SAFE model empirical With the dB dt model the country specific guidelines apply exclusively The SAFE model additionally takes into considera tion the relation between the stimulation effect and the param eters of the measurement sequence rise time amplitude number of axes repetition rate etc C 3 6 MAGNETOM Trio System Manual MR system operation Physiological effects syngo MR 2004A Revision 03 Normal Operating Mode In Normal Operating Mode the power limits are based on stim ulation limits including a statistically determined standard devi at
138. o decrease the volume to the desired level lt gt Set the CV CBT switch to CBT to disable music playback inside the examination room lt gt Turn the volume control on the control unit of the MR con sole all the way to the left syngo MR 2004A B 7 9 Revision 03 Intercom MR system components Playing automatic voice The connections for audio equipment are located at the central output and music unit of the intercom in back of the MR console 1 Connections at the central unit of the intercom 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 an audio device such as a CD player or walkman to the Music in jack B 7 10 MAGNETOM Trio System Manual MR system components syngo MR 2004A Revision 03 4 Intercom Ensure that you are using the proper cables and select the headphones output or the Line Out output at the audio device Press the Play Music button The Music On LED lights up Set the CV CBT switch to CV Switch on the audio device and start the playback Set the volume control for the headphones and the loud speaker at the control unit on the patient table at the high est volume possible Select Option gt Configuration gt Exam UI in the Exam task card Increase the volume levels in the menu window an
139. ody Array Posterior lt Connect the plug to coil socket 4 lt Place the back head support on the head insert syngo MR 2004A G 3 9 Revision 03 Body Array optional Examination RF coils Positioning cushion 5 thin 1 Cushion 5 thin Place cushion 5 thin on Body Array Posterior Place the knee wedge on the patient table G 3 10 MAGNETOM Trio System Manual Examination RF coils Body Array optional Positioning the Body Array Anterior Position the patient in the supine position with the head toward the magnet bore Place the Distance holder on the patient over the region to be examined Patient positioned on patient table with distance holder involv ing in this case Examination of the thorax and the upper abdo men 1 Distance holder syngo MR 2004A G 3 11 Revision 03 Body Array optional Examination RF coils lt Place the Body Array Anterior on top of the Distance holder so that it is flush with the Body Array Posterior 4 Connect the coil plug of the Body Array Anterior to coil Socket 1 lt Secure the Body Array Anterior using the two straps of the Body Array Posterior lt Ensure that Body Array Anterior does not push against the patient s chin lt Secure the straps tight enough so that the edges of Body Array Anterior and Body Array Posterior do not overlap To prevent measurement errors the edges of Body Array Pos terior and Anterior should not overl
140. ogical Measurement Unit optional are located on the patient table For controlling the patient table two control panels are located to the right and left of the table at the magnet bore aperture An optional control unit can be installed in back of the magnet A table display indicates the status of the functions per formed via the control units The tabletop is used to position the patient during the measure ment and while positioning the required coil The tabletop is moved into the magnet bore to position the patient in the magnetic field syngo MR 2004A D 1 1 Revision 03 Patient table Patient transport D 1 2 Connections The following connections for components or functions are located at the foot end of the patient table 0 2 3 4 5 6 7 8 Connections at the foot end of the patient table 1 2 3 4 5 6 7 8 ECG Pulse sensor Respiratory belt Input for external trigger signal Output for external trigger signal Vacuum cushion Headphones Squeeze bulb MAGNETOM Trio System Manual Patient transport Patient table syngo MR 2004A Revision 03 The ECG pulse sensor and respiratory belt receptors as well as the external signal are necessary for measurements using physiological triggering The receptor connections are located at the PMU Frontend Physiological Measurement Unit at the foot end of the patient table The vacuum cushions are used for comfortable and
141. omagnetic compatibility is based on IEC 60601 1 2 1993 and EN 60601 1 2 1994 standards Emitted interference Radiated interference Class B Conducted interference Class B Interference immunity Electrostatic Discharge ESD Contact discharge 6kV Airborne discharge 8kV RF radiation ISM bands 3 V m L 1 10 MAGNETOM Trio System Manual Technical Data MAGNETOM Trio Quick transient disturbances bursts AC supply lines 2kV Other connecting lines t1kV Surges AC supply lines 2kV syngo MR 2004A L 1 11 Revision 03 MAGNETOM Trio Technical Data L 1 12 MAGNETOM Trio System Manual Physiological Measurement Unit PMU Input for external trigger signal The external signal has to meet the following specifications Voltage time diagram for external triggering of the PMU Name Value UL 0V 0 8V Uy 2V 15V tj min 10 ms ty min 10 ms Input current min 2 mA Input voltage max t 20V Internal contact External contact The measurement sequence is triggered with the rising edge of the external signal syngo MR 2004A L 2 1 Revision 03 Physiological Measurement Unit PMU Technical Data ESSE C G lt G lt E sc Output for external trigger signal This software version does not support an output for an external trigger signal L 2 2 MAGNETOM Trio System Manual Index 8 Acoustic noise Technical data L 1 5 8 Channel Head
142. on CAUTION BOLD post processing of image data generated with Numaris 3 or 3 5 Erroneous diagnosis through incorrect superposition of anatomical and functional image lt Do not use syngo MR for BOLD post processing of image data generated with either Numaris 3 or 3 5 A 1 28 MAGNETOM Trio System Manual Safety General safety information Patient related artifacts CAUTION Uncooperative patient behavior movement not following para digm Incorrect diagnosis due to artifacts in spectroscopy results lt gt Inform patients about the effects of movement on the measurement prior to the examination lt Monitor the patient during the examination CAUTION Noticeable patient movement during the examination Statistics may cause ambiguous result images lt gt Inform patients about the effects of movement on the measurement prior to the examination Use Siemens measurement protocols with enabled motion correction syngo MR 2004A A 1 29 Revision 03 General safety information Safety CAUTION Patient does not or only incorrectly performs task for functional measurement Statistics may cause ambiguous result images Monitor patient to ensure task is performed properly A 1 30 MAGNETOM Trio System Manual CHAPTER Personal safety A 2 information Overview In the following instances MR examinations are not permitted 1 Patients with implants that are electrically magnetically or mechanical
143. on Description of LED status LED Status of video transmission Steady red Video display connected but no video sig nal Steady yellow Wrong camera connected Steady green Video display in operation Flashinggreen Automatic brightness reduction active Automatic brightness reduction To extend the life of the video display the brightness is automat ically reduced after approx 50 minutes without screen changes The original brightness is automatically restored after subsequent screen changes It is also possible to manually reduce increase the brightness level B 8 4 MAGNETOM Trio System Manual MR system components Video system optional Adjustment Video display 2 can be adjusted using the buttons on the back side of the screen Buttons on the back side of video display 2 1 2 3 4 5 6 syngo MR 2004A Revision 03 Mode button Button 1 Button 2 Button 3 Button 4 On Off button B 8 5 Video system optional B 8 6 MR system components The Mode button lets you select from the following menu options d C D O Setting brightness contrast Setting color saturation black saturation video offset Setting vertical horizontal screen position Setting red blue contrast Activating deactivating brightness reduction Buttons 1 2 3 and 4 are used to adjust the corresponding set tings MAGNETOM Trio System Manual MR system components Video system optional
144. on into the head coil so that the hose points toward the foot end of the patient table lt gt Position the patient on the patient table with the head on the head cushion 4 Close the head coil J 2 5 Vacuum cushions optional Accessories Ereeoeoeo Se Evacuating venting the vacuum cushions Evacuating the vacuum V The vacuum cushion is vented cushions lt Connect the hose of the vacuum cushion to the corre sponding connection at the foot end of the patient table 1 1 m P cos ua Ls E os e s Foot end of patient table 1 Connection for vacuum cushion The vacuum cushion is evacuated lt During evacuation fit the vacuum cushion so that it sup ports the corresponding part of the body J 2 6 MAGNETOM Trio System Manual Accessories Vacuum cushions optional Venting the vacuum cush Y The vacuum cushion is evacuated eH lt Disconnect the hose of the vacuum cushion from the con nection at the patient table The vacuum cushion is vented syngo MR 2004A J 2 7 Revision 03 Vacuum cushions optional Accessories J 2 8 MAGNETOM Trio System Manual Maintenance K 1 Cleaning K 1 1 K 2 Heturn and disposal K 2 1 Addresses for Oxford Magnet Technology and authorized representatives K 2 2 syngo MR 2004A K 1 Revision 03 Maintenance K 2 MAGNETOM Trio System Manual Cleaning WARNING Electric shock when cleaning the system Risk of death lt gt C
145. on the table display The required center position is out of range lt Reposition the patient syngo MR 2004A D 1 25 Revision 03 Patient table Patient transport Moving the tabletop into the Last Scan Position lt If the tabletop was moved since the last measurement however not to the home position press the Center Posi tion button Center Position button lt Ifthe tabletop was most recently moved into home position using the Home Position button press the Center Posi tion button twice in rapid succession The tabletop moves into the position of the last scan The tabletop does not move into the Last Scan Position 033 The tabletop has been last moved into the Home Position using the joystick The Last Scan Position is therefore no longer stored lt Select a new tabletop position D 1 26 MAGNETOM Trio System Manual Patient transport Patient table o syngo MR 2004A Revision 03 Moving the tabletop into the Home Position 4 No examinations are in progress lt Press the Home Position button on the control unit Home Position button The tabletop moves completely out of the magnet bore Any measurement in progress is aborted when the tabletop is moved into the Home Position The images of the current patient measured to this point are no longer displayed in the image area of the examination card The series icons of the application steps already completed dis appe
146. onal Description The Physiological Measurement Unit PMU consists of the PMU Frontend and the PMU Display optional The PMU Fron tend is located under the cover on the left at the foot end of the patient table The PMU Display is integrated into the magnet cover During physiological imaging the measurement sequences are triggered by the patient s physiological signals The physiologi cal signals are received by receptors directly connected to the patient The measured data can be viewed at the PMU Display and in the Physiological Display window at the MR console F 2 1 Physiological Measurement Unit optional Physiological imaging F 2 2 PMU Frontend The PMU Frontend is used to connect the receptors for the physiological signals Utitlisie Receptor connections at the PMU Frontend 1 ECG 2 Pulse sensor 3 Respiratory belt 4 Input for external trigger signal 5 Output for external trigger signal 6 Symbol for Electrically Isolated Patient Connection MAGNETOM Trio System Manual Physiological imaging Physiological Measurement Unit optional PMU Display optional The PMU Display provides information regarding q Oococoeoo Electrode connection and position ECG signal and frequency Pulse signal and frequency Respiratory signal and frequency External trigger signal ECG lead specified S I I m mm sec 1 2 3 PMU D
147. onents Functionality As a transmitter coil the body coil aided by resonant current loops produces an alternating magnetic field The frequency of this magnetic field corresponds to the operating frequency of the MR system The strength of the magnetic field is selected So that the nuclear spins are excited according to the require ments of the selected MR measurement The body coil is detuned for receiving As a result the body sig nals are optimally received by all other transceiver coils without interference from the body coil Magnet bore During the measurement the patient table is moved into the magnet bore The control units at the bore entrance are used to control the lighting and ventilation inside the magnet bore MAGNETOM Trio System Manual CHAPTER HF coils B 2 some are optional MR imaging makes great demands on the RF coils The transmitter coil excites the hydrogen atoms in the region to be examined as homogeneously as possible All affected spins should have the same level of excitation The receiver coil is to receive an MR signal with as little noise as possible Among other things the signal to noise ratio depends on the excited volume in the coil and on the distance between the receiver coil and the body region to be measured The closer the receiver coil is to the object to be measured the stronger the signal received As a result the signal to noise ratio improves as the distance between the rece
148. osition the Body Array Posterior into the recess of Cush ion Body large so that is lies flush at the head end Position Cushion Body small at the foot end of Body Array Posterior lt Connect the plug to coil socket 4 G 3 6 MAGNETOM Trio System Manual Examination RF coils Body Array optional lt Place the back head support on top of the head insert Positioning the cushion 5 thin 1 Cushion 5 thin lt Place cushion 5 thin on Body Array Posterior lt Place the knee wedge on the patient table syngo MR 2004A G 3 7 Revision 03 Body Array optional Examination RF coils Examining the pelvis hip and the lower abdomen Patient table with Body Array Posterior 1 Cushion Body large 2 Body Array Posterior 3 Cushion Body small 4 Back head support 5 Coil socket 4 6 Head insert G 3 8 MAGNETOM Trio System Manual Examination RF coils Body Array optional V The patient table is prepared lt Place the head insert in the space between the coil sockets on the patient table lt Place the Cushion Body large on the patient table so that the cable guide points to the head of the patient table and the cushion itself rests against the head insert Position cushion 1 at the foot end of the patient table lt Position the Body Array Posterior into the recess of Cush ion Body large so that is lies flush at the foot end Position Cushion Body small at the head end of B
149. owing steps 1 Positioning the CP Head WD Positioning the patient syngo MR 2004A G 7 5 Revision 03 CP Head Examination RF coils Positioning the CP Head Lower part of the CP Head on the patient table 1 CP Head lower part V The patient table is prepared Position the CP Head at the head end of the patient table lt Connect the coil plug of the CP Head to coil socket 1 on the patient table lt Simultaneously press both release knobs inside the recessed handles of the upper part of the CP Head lt gt Lift off the upper part of the CP Head by the recessed han dles and remove G 7 6 MAGNETOM Trio System Manual Examination RF coils CP Head Positioning the patient lt Use suitable positioning aids Page J 1 1 Accessories for patient positioning lt gt Place the head cushion provided in the lower part of the CP Head Install the removable clamps and push them outward to the end stop WARNING Patient s head positioned too high Injury to patient lt gt Ensure that the upper part of the RF coil does not touch the patient s head 4 Position the patient s head in the lower part of the CP Head syngo MR 2004A G 7 7 Revision 03 CP Head Examination RF coils Place the upper part of the CP Head on the lower part of the CP Head Make sure it locks into place Patient with CP Head on the patient table G 7 8 MAGNETOM Trio System Manual Examination RF coils
150. pages are labeled with revi sion no 01 The body coil described in this revision is not included with the syngo 2002B delivery It is included in anticipation of the syngo 2003T software version All references to the body coil should be interpreted accordingly Hevision 02 The following changes have been implemented with software version syngo 2003T Q New Removable tabletop with trolley New Body coil New Spine Array New 8 Channel Head New CP Wrist New CP Extremity New Coil accessories for above mentioned RF coils LD DLDLUDU LDcLZ ZLrL New Preparations for quality assurance now included in separate supplemental document for QA Trio L Changed Technical Data MAGNETOM Trio System Manual Overview syngo MR 2004A Revision 03 Revision 03 The following changes have been implemented with software version syngo MR 2004A q L DO D D D D O LU New In Room MRC Changed Video system and video display Removed Removable tabletop with trolley New Body Array New Breast Array New Cardiac Array New Coil accessories for above mentioned RF coils Removed 12 optical disk Changed Technical data xi Overview Using this manual Proper safe operation of the MR system requires technical knowledge on the part of the operating personnel and a high degree of familiarity with the operating instructions Read these operating instructions carefully prior to the start up of the MR system
151. port D 1 Patient table Description Connections Table display Control units Control unit Table operation Using the joystick to control table movement Marking the slice for measurement with the laser light localizer Moving the tabletop into the Center Position Moving the tabletop into the Last Scan Position Moving the tabletop into the Home Position Moving the tabletop into the Default Position Triggering releasing the table stop Joystick functionality D 2 Patient transport trolley Description Operation Safety information Engaging the brake Adjusting the height of the tabletop Adjusting the tilt of the head end Securing the patient syngo MR 2004A Revision 03 D 1 1 D 1 1 D 1 2 D 1 4 D 1 14 D 1 15 D 1 17 D 1 22 D 1 23 D 1 25 D 1 26 D 1 27 D 1 28 D 1 29 D 1 30 D 2 1 D 2 1 D 2 2 D 2 2 D 2 5 D 2 6 D 2 7 D 2 8 D 1 Patient transport D 2 MAGNETOM Trio System Manual Patient table Description The patient table is used for the following purposes md Positioning the patient for the measurement 1 Securing and positioning the coils used for the measure ment Positioning the patient in the magnet isocenter The patient table consists of a table and a movable tabletop securely attached to the table The table is installed directly at the magnet and the tabletop may be moved into the magnet bore The coil sockets and the connections for the receptors of the Physiol
152. port Patient table Risk of injury Zones with a higher than normal potential for injuries are indi cated by the following symbol Warning sign for potential point of injury syngo MR 2004A D 1 21 Revision 03 Patient table Patient transport Using the joystick to control table movement Background information gt Page D 1 30 Joystick functionality Lifting the patient table lt Push the joystick upward moving the tabletop into the The patient table moves upward until it has reached the exam magnet bore ination height The tabletop moves completely into the magnet bore in the hor izontal direction Moving the tabletop out of Pullthe joystick downward the magnet bore lowering t the patient table The tabletop moves completely out of the magnet bore The patient table moves vertically into the lower end position D 1 22 MAGNETOM Trio System Manual Patient transport Patient table Marking the slice for measurement with the laser light localizer V The patient is positioned on the tabletop V The patient table has been moved to measurement height WARNING Laser beam of the laser light localizer Eye injury caused by laser beam lt Use of controls or adjustments or performance of proce dures other than those specified herein may result in haz ardous radiation exposure lt 4 Inform patients of this risk and ask them to keep their eyes closed during the positioning procedure lt
153. pt for the host computer and the image processor are switched off The System On LED goes off MAGNETOM Trio System Manual MR system operation Switching the MR system on and off To end Host Standby and switch to System On To end Host Standby and switch off the MR system syngo MR 2004A Revision 03 Ending Host Standby lt Press System On at the alarm box The measurement related components of the MR system are started The System On LED lights up V The software at the host computer has been shut down lt Press System Off at the alarm box The MR system is switched off lt Turn the keyswitch at the alarm box to the left The MR system is locked C 2 9 Switching the MR system on and off MR system operation UU Switching off System Off Shutting down the system includes the following steps Q Shutting down the computer system at the MR console and switching it off Q Switching off the MR system at the alarm box The MR satellite console uses a separate power supply As a result it has to be shut down separately from the MR console To avoid data loss the MR satellite console should be shut down before the MR console o If the user is logged on the system has to be shut down using System Control or End Session to avoid data loss o C 2 10 MAGNETOM Trio System Manual MR system operation Switching the MR system on and off Shutting down the compu lt Select System gt
154. ratory triggering Performingthe Examination The respiratory cushion respiratory belt is attached Perform the measurement as described in the syngo MR Operator Manual Background information Artifacts caused by underpressure Measuring two patients in sequence Underpressure may be caused by connecting the respiratory cushion respiratory belt prior to attaching it to the patient The resulting image artifacts distort the measurement results of the Second measurement syngo MR 2004A F 6 7 Revision 03 Respiratory triggering Physiological imaging F 6 8 MAGNETOM Trio System Manual CHAPTER External triggering F 7 Description External digital triggering signals are used for research pur poses The external triggering signal may be supplied at the PMU Frontend Page F 2 6 Operation The technical prerequisites for the external triggering signal are described in the Physiological Measurement Unit PMU chap ter gt Page L 2 1 Physiological Measurement Unit PMU syngo MR 2004A F 7 1 Revision 03 External triggering Physiological imaging Performing Patient Connection Electrically Isolated indi 4 PMU Frontend 1 Input for external trigger signal 2 Output for external trigger signal Connect the source of the external triggering signal to the PMU Frontend lt Perform the external triggering as described in the syngo MR Operator Manual F 7 2 MAGNETOM Trio System Manual
155. re that warning and prohibition signs are legible and clearly visible Informational signs The operator has to ensure that informational signs for safety purposes are available in sufficient quantities and installed for easy visibility The operator is also responsible for correctly identifying individual areas with informational signs Accidents resulting in per All accidents resulting in personal injury have to be reported sonal injury immediately to the appropriate authorities or the employer s lia bility insurance carrier Explosion protection The MR system is not intended for operation in areas prone to explosion syngo MR 2004A A 1 5 Revision 03 General safety information Safety Technical safety checks Daily checks gt Page C 1 1 Daily functionality checks Annual checks The annual technical safety inspections are listed in the System Owner Manual and may be performed only by Siemens Serv ice A 1 6 MAGNETOM Trio System Manual Safety General safety information Regular maintenance Maintenance In the interest of the safety of patients operating personnel and third parties it is strongly recommended that only authorized personnel perform the maintenance procedures prescribed by Siemens System checks should be conducted more frequently if the system is operated under extreme conditions lt Please inform Siemens Service if a maintenance contract does not exist Serious malfunctions lt gt Inthe event of
156. reasons e g small children A 2 6 MAGNETOM Trio System Manual Safety Personal safety information Among other things the procedures must define the fastest way for removing the patient from the examination room in case of emergency If necessary the MR system has to be shut down using the Magnet Stop switch gt Page A 2 15 Magnet Stop switch magnetic field syngo MR 2004A A 2 7 Revision 03 Personal safety information A 2 8 Safety Safety measures in the examination room WARNING Magnetic field in the examination room Personal injury lt Ensure that unauthorized persons e g electricians or cleaning personnel do not enter the examination room unless accompanied by an authorized person lt Keep the door to the MR area closed MAGNETOM Trio System Manual Safety Personal safety information WARNING Implants e g pacemakers with a magnetic field stronger than 0 5 mT 5 Gau Injury to patient lt Clearly identify the critical magnetic field zone where the field strength exceeds 0 5 mT exclusion zone e g with markings on the floor or barriers gt Ensure that persons with implants inclusions that are metallic or susceptible to electromagnetic effects remain outside the exclusion zone lt gt Ensure that the field strength outside the exclusion zone does not exceed 0 5 mT syngo MR 2004A A 2 9 Revision 03 Personal safety information Safety CAUTION Noise during
157. record ing 1 CD ROM drive CD burner 1 magneto optical disk drive for 5 1 4 disks optional A printer interface is available as well syngo MR 2004A B 4 3 Revision 03 MR console MR system components Network connection Information about network connections is displayed in the Info dialog box No Measured MR images may be transferred to other systems or computers via the network connection MR images from other systems or computers can also be received via the network B 4 4 MAGNETOM Trio System Manual MR system components syngo MR 2004A Revision 03 MR console Host computer The host computer is responsible for m Patient management L1 Image retrieval and image storage Q Measurement sequence management The host computer runs the Windows xP Professional oper ating system and includes one hard disk for the operating sys tem and one for patient images If required several hard disks can be used for storing patient images The host computer is used when working with the syngo MR user software Starting stopping the host computer Page C 2 1 Switching the MR system on and off B 4 5 MR console MR system components Monitor Description The MR images and all interactive dialog boxes are displayed on a high resolution 18 LCD color monitor Monitor B 4 6 MAGNETOM Trio System Manual MR system components MR console The monitor has already been configured for optimal p
158. remity off and remove syngo MR 2004A G 8 7 Revision 03 CP Extremity optional Examination RF coils G 8 8 MAGNETOM Trio System Manual CP Wrist optional Description CP Wrist 1 CP Wrist 2 Coil plug 3 Base plate 4 Guide narrow side 5 Guide broad side syngo MR 2004A G 9 1 Revision 03 CP Wrist optional Examination RF coils Positioning aids d Wrist cushion W Wrist arm support wide W Wrist arm support narrow Use Preparing the measurement Examining the hand in the prone position The following steps are required for preparing the hand exami nation in the prone position right hand in this example Positioning the CP Wrist Q Positioning the patient G 9 2 MAGNETOM Trio System Manual Examination RF coils CP Wrist optional Positioning the CP Wrist Patient table with CP Wrist here examination of the hand in the prone position 1 Wrist arm support wide 2 CP Wrist 3 Base plate V The patient table is prepared lt 4 Position cushions 1 2 3 and 4 as well as the head insert on the patient table Center the base plate of the CP Wrist at the head end of the patient table syngo MR 2004A G 9 3 Revision 03 CP Wrist optional Examination RF coils Center the CP Wrist on the base plate 4 Place the Wrist arm support wide in the CP Wrist lt Connect the coil plug of the CP Wrist to coil socket 1 on the patient table
159. reparing the examination E 1 Patient preparation and positioning Preparation Preparing the patient Preparing the MR system Positioning General safety information Positioning the head using the back head support E 2 Installing the RF coils Safety information General remarks syngo MR 2004A Revision 03 E 1 1 E 1 1 E 1 1 E 1 4 E 1 7 E 1 7 E 1 13 E 2 1 E 2 1 E 2 5 E 1 Preparing the examination E 2 MAGNETOM Trio System Manual Patient preparation and positioning Preparation The following preparations are necessary to ensure a safe and comfortable MR examination for the patient 1 Preparing the patient 1 Preparing the MR system Preparing the patient CAUTION Startle reflex of the patient caused by peripheral nerve stimula tion Injury to patient Inform patients of possible stimulations muscle twitching tingling sensation before the examination syngo MR 2004A E 1 1 Revision 03 Patient preparation and positioning Preparing the examination WARNING Heat generation during the examination Patient burns Instruct the patient to use the squeeze bulb in case of intense heat sensations WARNING Exposure to RF electromagnetic fields in First Level Controlled Operating Mode Patient burns Do not examine patients with restricted thermoregulation capability e g small children older sick or medicated patients Do not examine patients unable to co
160. rk coat and goggles lt gt Wear a mask with a filter for anorganic vapors if aerosols inhalable droplets are formed Do not use damaged phantoms Avoid skin contact with phantom fluid Change contaminated clothing immediately Do not eat drink or smoke Ensure that phantom fluid does not enter the waste water 99999259 Dispose of phantom fluid in compliance with local and national regulations syngo MR 2004A A 2 67 Revision 03 Personal safety information Safety WARNING Phantom oil with low oral and dermal toxicity Injury to patient and operating personnel lt Do now swallow phantom oil Incase phantom oil is swallowed do NOT induce vomiting n case phantom oil is swallowed ensure that the person lies still and provide medical attention immediately CAUTION Improper handling of measurement phantoms Damage to measurement phantoms Risk of fire due to lens effect lt Store measurement phantoms at 20 C in a safe place lt Do not drop measurement phantoms Do not modify measurement phantoms gt Do not expose stored measurement phantoms to sunlight A 2 68 MAGNETOM Trio System Manual CHAPTER A 3 Qualified personnel syngo MR 2004A Revision 03 Device related safety information Overview System specific safety information must be adhered to in the following areas situations q OOOD Effects of the magnetic field on devices Effects of the RF field on de
161. rties of the floor covering Use commercially available cleaning or care products for the floor Follow manufacturer s instructions MAGNETOM Trio System Manual Return and disposal Background information gt Page K 2 2 Addresses for Oxford Magnet Technology and authorized representatives Only authorized personnel can disassemble the super conduct ing magnet of the MR system Unprofessional disassembly may lead to explosions o WARNING Unauthorized work on the magnet Bodily injury Damage to system lt gt Only authorized personnel Oxford Magnet Technology or Siemens may perform work on the magnet lt Do not remove the safety valves and burst disks of the helium containers Do not change the standard configuration lt Please contact Siemens Service with questions regarding the return or disposal of the MR system or its components syngo MR 2004A K 2 1 Revision 03 Return and disposal Maintenance Background information Addresses for Oxford Magnet Technology and authorized representatives Great Britain Oxford Magnet Technology Ltd Phone 44 1865 880 880 Fax 44 1865 850 174 USA Oxford Superconducting Technology Phone 1 732 541 1300 Fax 41 732 541 7769 Japan Oxford Instrument KK Phone 81 3 5245 3261 Fax 81 3 5245 4472 Germany Siemens Headquarter Support Center Phone 49 9191 18 8080 Fax 49 9191 18 9944 K 2 2 MAGNETOM Trio System Manual Technical Data syn
162. rts or implants by 3 Tesla sys tems WARNING Objects inside the magnetic field are magnetizable Injury to patient and operating personnel lt Do not use resuscitation systems for example defibrilla tors or oxygen bottles in the examination room Ensure that the devices used in the examination room are com patible with the field strength of the MR system Devices com patible with 1 5 T systems may be unsuitable for 3 T systems A 2 31 Personal safety information A 2 32 Safety Magnetic effects on metallic implants inclusions The force exerted by the magnetic field may cause implants for example surgical clamps or even larger prostheses to move in the tissue resulting in injury The operator is responsible for ensuring that persons with metallic implants do not enter the examination room Examples of metallic implants inclusions d d d d L Artificial anus anus praeter with magnetic closure Implanted insulin pumps Artificial heart valves with steel parts Steel implants vascular clips hip prostheses bone pins dental fillings Hearing aids MAGNETOM Trio System Manual Safety Personal safety information WARNING Eddy currents induced by strong magnetic fields changing over time Patient burns lt Do not perform MR examinations on patients with electri cally conducting implants or prostheses WARNING Implants e g pacemakers with a magnetic field stronger than 0
163. s Use of vacuum cushions Vacuum cushion Area of application Small cushion Hands elbows ankles Head cushion Head neck Spine cushion Torso Head and spine cushions Whole body combined Small cushion J 2 2 MAGNETOM Trio System Manual Accessories Vacuum cushions optional Head cushion Spine cushion syngo MR 2004A J 2 3 Revision 03 Vacuum cushions optional Accessories ETC TrO T7T YJA ooS ce g E E Operation Operating the vacuum cushions includes the following steps Q Combining the vacuum cushions if applicable only for head and spine cushion Q Positioning the vacuum cushions Q Evacuating venting the vacuum cushions Combining head and spine cushions An additional valve located on the spine cushion allows you to combine it with the head cushion lt Open the additional valve by removing the plug lt Connect the head cushion to the open valve J 2 4 MAGNETOM Trio System Manual Accessories Vacuum cushions optional mmo Positioning the small cush ion spine cushion Positioning the head cush ion syngo MR 2004A Revision 03 Positioning the vacuum cushions The vacuum cushions may be positioned both on the inside or outside of a coil lt Place the vacuum cushion where needed lt 4 Fit the vacuum cushion to the shape of the body region V The head coil is positioned on the patient table lt Open the head coil lt Place the vacuum cushi
164. s of physiological structures Incorrect diagnosis lt Use the original images for diagnosis A 1 22 MAGNETOM Trio System Manual Safety General safety information WARNING Dislodging during manual adjustment of images Incorrect diagnosis lt Use the original images for diagnosis WARNING Distortions when using the Pixel Lens function Incorrect diagnosis lt gt Use the Pixel Lens function in the center of the image only syngo MR 2004A A 1 23 Revision 03 General safety information Safety WARNING Varying coordinate data with the Pixel Lens function Incorrect diagnosis lt Do not use the Pixel Lens function to compare coordinates between images with distortion correction and those with out WARNING Incorrect coordinate data with the Pixel Lens function Incorrect diagnosis lt Coordinates for the Pixel Lens function refer only to the table position in the image below right A 1 24 MAGNETOM Trio System Manual Safety General safety information WARNING Use of hardcopy documentation for diagnosis Incorrect diagnosis lt Do not use hardcopy print outs for diagnostic purposes WARNING A Distortions in EPI images Incorrect spatial allocation when overlaying anatomical and statistical image data lt Do not use overlay images for localizing brain activation syngo MR 2004A A 1 25 Revision 03 General safety information Safety WARNING A Distortions i
165. s thoroughly using a damp cloth F 3 3 ECG triggering AN F3 4 Physiological imaging WARNING Hot ECG cables Patient burns Skin irritation lt Place absorbent textiles made of natural materials between the ECG cable and the patient s skin If possible route the ECG cable parallel to the patient s spine and away from the magnet MAGNETOM Trio System Manual Physiological imaging ECG triggering lt Attach the electrodes Anterior electrode positioning example 1 RA white 2 RL green 3 LA black 4 LL red syngo MR 2004A F 3 5 Revision 03 ECG triggering Physiological imaging Posterior electrode positioning example 1 LA black 2 LL red 3 RA white 4 RL green Patients with an offset heart axis e g dilatative cardiomyopa thy may require a different orientation than parallel to the spine o F 3 6 MAGNETOM Trio System Manual Physiological imaging ECG triggering Selecting the ECG lead The ECG leads are selected according to the potential differ ence between the connected electrodes The following poten tial differences are measured between the four electrodes Measurable potential differences Potential differ Lead ence between LA RA LL RA II LL LA I RA LA LL AVR augmented unipolar right arm LA RA LL AVL augmented unipolar left arm LL RA LA AVF augmented unipolar right foot lt gt Sel
166. safety information Safety Laser light localizer The laser light localizer on the magnet facilitates correct patient positioning The laser light localizer contains two Class ll lasers WARNING Laser beam of the laser light localizer Eye injury caused by laser beam Use of controls or adjustments or performance of proce dures other than those specified herein may result in haz ardous radiation exposure lt Inform patients of this risk and ask them to keep their eyes closed during the positioning procedure lt Ensure that helpless patients keep their eyes closed during the positioning procedure lt Use the laser light localizer as described only lt Have the laser light localizer checked regularly by Siemens Service A 2 62 MAGNETOM Trio System Manual Safety Personal safety information WARNING Defective laser light localizer Injury to cornea caused by laser beam lt gt Check that the laser light localizer appears in the form of crosshairs on the patient table If the laser light localizer takes the form of a spot switch the laser light localizer off and notify Siemens Service CAUTION Incorrect MR image due to patient movements Incorrect diagnosis lt Ensure that patients do not move between positioning and measurement syngo MR 2004A A 2 63 Revision 03 Personal safety information Increased risk o A 2 64 Safety Anesthetized patients or patients who do not hav
167. se inside an MR room lt Donotstore or operate oxygen tanks defibrillators or other reanimation devices in the MR examination room Monitoring sedated patients Sedated patients have to be monitored by an anesthesiologist syngo MR 2004A A 2 57 Revision 03 Personal safety information Risks and complications due to patient monitoring devices Safety Risks due to monitoring devices Patient monitoring devices have to be suitable for use in an MR examination room However even MR compatible devices may cause injury Fol low manufacturer s instructions particularly with regard to cable routing The following risks and complications may occur due to the additional devices used for patient monitoring 2 Heating up of device cables Effects on magnetizable materials in monitoring devices d Q Interference with MR image quality da Interference with monitoring devices WARNING System cables of non MR compatible monitoring devices heat up Patient burns lt Use only MR compatible monitoring devices A 2 58 MAGNETOM Trio System Manual Safety Personal safety information CAUTION Erroneous MR image due to non MR compatible monitoring devices Incorrect diagnosis lt Use only MR compatible monitoring devices WARNING Magnetizable components of monitoring devices introduced into the magnetic field become projectiles Injury to patient and operating personnel Use only MR compatible monitori
168. ss the Down button to activate brightness reduction The brightness is reduced lt Press the Up button to deactivate brightness reduction The original brightness is restored The INPUTS submenu can be used to set the active monitor input to BNC or LWL Press the OK button The main menu is displayed lt gt Select INPUTS Select the correct input option The input selected is indicated by a dot inside a circle Press the OK button The main menu is displayed lt Select SETUP gt SIGNAL INFO lt Enable SIGNAL INFO by pressing the Left or Right but ton The active input is displayed upon start up B 8 17 Video system optional MR system components Changing display quality You can change the following display parameters Parameters Function CONTRAST Display contrast BRIGHTNESS Display brightness COLOR Display color saturation BACKLIGHT Backlight brightness H OFFSET Horizontal offset V OFFSET Vertical offset Press the OK button The main menu is displayed lt Select PICTURE Select the correct parameter Adjust the setting accordingly B 8 18 MAGNETOM Trio System Manual MR system components Restoring default display settings Changing the OSD lan guage Video system optional All settings in the PICTURE submenu can be restored to their default values Press the OK button The main menu is displayed lt Select SETUP gt RESET lt gt
169. ss to ensure medical supervision Pregnancy To date there is no scientific proof that MR examinations are e harmless for pregnant women or that RF exposures are harm less for pregnant operating personnel Emergency shut down Before working with the MR system familiarize personnel with switch the function and location of the following emergency switches Qj Magnet Stop switch m Emergency shut down switch 11 Table Stop buttons syngo MR 2004A A 2 5 Revision 03 Personal safety information Safety Emergency precautions The operator of the MR system has to define and provide pro cedures that ensure the patient s safety in case of emergency Special consideration must be given to MR specific hazards For example the operator of the MR system has to consider the risks associated with the magnetic field and ensure that patients are treated immediately in the following situations Q in case of emergency 1 when the patient suddenly feels ill during an examination 1 when the patient is injured during the examination Special precautionary measures as well as a plan for using emergency equipment outside the examination room must be in place for patients with a higher than normal risk factor such as Q patients with heart problems Qj patients with epileptic seizures or claustrophobic symp toms Qj patients who are seriously ill unconscious anesthetized or confused or who are not able to communicate normally for other
170. st setting Press the Tunnel Ventilation button at the control unit on the patient table repeatedly if necessary until the desired ventilation level is set Tunnel Ventilation button The current ventilation level is indicated on the table display o If the tunnel ventilation is set at the highest level and you press the Tunnel Ventilation button again ventilation is gradually decreased E 1 6 MAGNETOM Trio System Manual Preparing the examination Patient preparation and positioning Positioning General safety information WARNING A Breaking of patient table Injury caused by falls lt The patient has to always get on and off at the center of the table Note the warning labels identifying particularly critical areas on the table WARNING Magnetizable patient transport trolley Injury to patient and operating personnel Ensure that the patient transport trolley does not contain magnetizable parts syngo MR 2004A E 1 7 Revision 03 Patient preparation and positioning Preparing the examination WARNING Incorrect data entry Incorrect diagnosis lt Always compare the data entered for the patient including patient orientation and patient registration with the origi nal Ensure that the correct patient name has been entered lt Correct the data entered for patient orientation prior to the MR examination especially when the patient will be respo sitioned during the
171. stem Manual Safety Device related safety information Magnetic field lines The illustration shows lines of the same magnetic flux density about the magnet isocenter at a magnetic field strength of 30T The magnetic field lines in the side view of the magnet are axi ally symmetrical to the Z axis X m 0 5 mT 4 0 1mT 3mT 5 mT 10 mT 20 mT 2 0 40 mT LIKE 6 0 4 0 2 0 2 0 4 0 6 04 Magnetic field lines side view of the magnet syngo MR 2004A Revision 03 2 0 4 0 6 0 Z m A 3 3 Device related safety information 3mT x 5mT 10 mT S 2 02 Safety 2 0 4 0 2 0 4 0 Y m Magnetic field lines viewed in the direction of the magnet axis A 3 4 MAGNETOM Trio System Manual Safety Device related safety information Effects of the HF field on devices CAUTION RF field in the examination room Interference with external electronic devices lt gt Keep the door to the examination room closed syngo MR 2004A A 3 5 Revision 03 Device related safety information Safety Ambient conditions Effect on patients The patient s ability to dissipate surplus heat is increasingly affected as the room temperature and relative humidity increase lt Ensure that the room temperature does not exceed 24 C and that the relative humidity does not exceed 60 Temperature control inside The automatic SAR limit of the MR system is set for a maximum t
172. sting the tunnel ventilation Use the volume controls on the control unit of the patient table to continuously adjust the volume of the headphones and the wall speaker Jd Symbol wall speaker volume lt gt Turn the knob clockwise to increase the volume lt gt Turn the knob counterclockwise to decrease the volume The setting of the music volume has no effect on the voice vol ume of patient announcements MAGNETOM Trio System Manual Preparing the examination Patient preparation and positioning Adjusting the tunnel light The tunnel lighting can be set to the following four levels ing 1 Tunnel lighting off 1 Tunnel lighting lowest setting 1 Tunnel lighting medium setting Q Tunnel lighting highest setting lt Press the Tunnel Lighting button at the control unit of the patient table repeatedly if necessary until the desired illu minance is set Tunnel Lighting button The current illuminance is indicated on the table display If the illuminance is set at the highest level and you press the Tunnel Lighting button again illuminance is gradually decreased o syngo MR 2004A E 1 5 Revision 03 Patient preparation and positioning Preparing the examination Adjusting the tunnel venti The tunnel ventilation can be set to the following four levels lation a d a d 4 Tunnel ventilation off Tunnel ventilation lowest setting Tunnel ventilation medium setting Tunnel ventilation highe
173. sure The super conducting magnet is a pressure device The devices national guidelines for starting up and operating pressure devices have to be observed In Europe Pressure Equipment Directive 97 23 EG regulates the sale of pressure devices syngo MR 2004A A 1 3 Revision 03 General safety information Medical Devices Book Country specific regula tions Safety In Germany both the Pressure Equipment Directive and the Guidelines for Operating Safety BetrSichV during system start up and operation apply The Guidelines for Operating Safety regulate that the user perform a test prior to start up This test comprises regulatory tests as well as tests based on the safety equipment and installation site Other tests are required when the pressure device is put out of operation The MR system may be operated only by qualified trained per sonnel who are listed by name in a Medical Devices Book Keeping a Medical Devices Book is the responsibility of the cus tomer It is not provided by Siemens In countries other than the Federal Republic of Germany local and national legal regulations have to be observed MAGNETOM Trio System Manual Safety General safety information WARNING A Missing hazard labels Personal injury property damage lt gt Affix adequate warning and prohibition signs comply with national and local regulations Mark critical system areas with warning and prohibition signs lt Ensu
174. switched off to save energy Only the host computer and the image processor are switched on Only host com puter software that does not interact with measurement components can be used No measurements can be per formed Host Standby is useful for patient evaluations on the computer after performing an examination 1 System Off out of service All MR system components are switched off The operating mode can be selected by pressing the corre sponding button on the alarm box In some cases the operating mode can be selected using the System Manager in the syngo MR software syngo MR Operator Manual If the user is logged on the system has to be shut down using System Control or End Session to avoid data loss o syngo MR 2004A C 2 1 Revision 03 Switching the MR system on and off MR system operation UU Switching on System On Starting the system includes the following steps Q Switching on the MR system at the alarm box LY Checking the MR system components Do NOT perform preliminary examination steps e g moving the patient table connecting coils at the MR system while start ing the system o C 2 2 MAGNETOM Trio System Manual MR system operation Switching the MR system on and off Switching on the MR sys tem at the alarm box Alarm box System On 1 Keyswitch 2 System On button 3 System On LED 4 The daily functionality checks have been completed Page C 1 1 Daily funct
175. t safety provisions A 2 2 MAGNETOM Trio System Manual Safety Personal safety information CAUTION Improper handling of the RF coils Patient burns lt Carefully read the safety information regarding RF coils in the individual coil chapters CAUTION Startle reflex of the patient Injury to patient lt gt Inform patients about the monitoring and communication equipment lt 4 Carefully instruct patients on proper behavior and associ ated risks syngo MR 2004A A 2 3 Revision 03 Personal safety information Safety Additional attention The following patients require additional attention 1 Patients susceptible to cardiovascular collapse Patients with a high risk of heart attack Unconscious patients Seriously ill patients Children Pregnant women LD D D L UL Patients practicing professions or activities that may result in involuntary intake of ferromagnetic material or who may have metal fragments from military duty in their bodies W Patients with limited thermoregulation capability e g new borns underweight infants certain cancer patients Q Patients with metallic implants which may cause magnetic field distortions resulting in diagnostic image artifacts Q Patients with prosthetic heart valve implants A 2 4 MAGNETOM Trio System Manual Safety Personal safety information Medical supervision The following procedures are recommended m Routine patient monitoring 1 Determining a proce
176. tem without magnet Location of the Emergency Atleast one Emergency shut down switch is installed in each shut down switch of the following rooms at eye level next to the entry exit doors O Control room Q Examination room 1 Electronics room Emergency shut down switch lt Before the MR system is started up familiarize personnel with the location of the Emergency shut down switches A 2 20 MAGNETOM Trio System Manual Safety In case of emergency o A syngo MR 2004A Revision 03 Personal safety information In case of emergency push the Emergency shut down switch The entire MR system is disabled immediately The magnet remains at field WARNING Fire or electrical accidents Bodily injury Damage to the MR system Push the Emergency shut down switch lt Notify the fire department A 2 21 Personal safety information Safety Table Stop button WARNING Malfunction of the Table Stop button Injury to patient Damage to system Push the Emergency shut down switch immediately Call Siemens Service A 2 22 MAGNETOM Trio System Manual Safety Personal safety information Location of the Table Stop There are two Table Stop buttons for stopping the motorized button movement of the patient table in case of emergency 1 The Table Stop button on the control units on the right and left side of the patient table at the magnet Table Stop button As an available option a s
177. the MR examination Injury to patient hearing damage lt Inform patients about the noise generated during the examination lt Use hearing protection headset and ear plugs to protect patients against injury lt Ensure that personnel in the examination room wears hearing protection during the examination The usual hearing protection headphones cannot be used when examining infants or using head coils The operating per sonnel require training in providing patients with alternative hearing protection e g ear plugs o A 2 10 MAGNETOM Trio System Manual Safety Personal safety information WARNING Failure to observe safety measures when MR system is switched off Property damage and personal injury lt The exclusion zone and corresponding safety measures have to be observed even with the system switched off CAUTION Discharge of 120 C hot air from the rear of the amplifier Risk of burns lt Do not store objects behind the amplifier lt Do not touch the back of the amplifier syngo MR 2004A A 2 11 Revision 03 Personal safety information Safety Exposure of personnel to static and time varying magnetic fields as well as noise may be regulated by local laws o lt Comply with maximum allowed exposure times Due to increased anxiety the permissible sound level can be cause for concern for pregnant women and the fetus new borns infants and small children as well as seniors
178. tion B 8 4 Video display 3 Adjusting B 8 17 Video display 3 Descrip tion B 8 14 Burns Frostbite A 2 49 Safety information A 2 41 C Cardiac Array Accessories J 1 14 Description G 5 1 Use G 5 4 CD Burning l 1 1 Reading 1 2 1 Checks Daily functionality checks C 1 1 Technical safety checks A 1 6 Clamps 8 Channel Head G 6 2 CP Head G 7 4 Cleaning Belt straps K 1 2 Connections K 1 2 MAGNETOM Trio System Manual Index syngo MR 2004A Revision 03 Floor K 1 4 Monitor video screen K 1 1 MR system K 1 1 Patient transport trolley K 1 2 Receptors K 1 3 Video camera K 1 2 Coil sockets CurrentassignmentsD 1 7 Overview G 1 2 Coils Accessories J 1 10 Coil sockets G 1 2 Installing E 2 1 Overview G 1 1 Quality measurement Overview H 1 1 Safety information RF coils E 2 1 Combination With other devices Safety information A 1 9 Compatibility Safety information A 1 9 Computer system Description B 4 3 Host computer B 4 5 Logging off and back on C 2 11 Shutting down C 2 10 Starting C 2 2 Connection Cleaning K 1 2 Patient table D 1 2 Control cabinet Description B 3 3 Control unit Patient table D 1 15 Coolant Hazards A 2 44 Cooling system Magnet B 1 1 Technical data L 1 7 Cooling system cabinet Description B 3 2 CP Extremity Accessories J 1 17 Description G 8 1 Use G 8 3 CP Head Accessories J 1 16 Description G 7 1 Use G 7 5 Index CP Wrist rea
179. tion Safety A 3 14 Prohibition sign for fire extinguishers with magnetic metallic housing Prohibition sign for metallic components and medical instru ments of all kinds MAGNETOM Trio System Manual Safety Device related safety information Prohibition sign for electronic media such as credit cards debit cards and identification cards with magnetic strips and mag netic tapes No sitting prohibition sign syngo MR 2004A A 3 15 Revision 03 Device related safety information Safety Mandatory sign Mandatory sign for hearing protection A 3 16 MAGNETOM Trio System Manual PART syngo MR 2004A Revision 03 B 1 B 2 B 3 B 4 MH system components Super conducting magnet Magnetic field Cooling system Shielding Gradient system Body coil Uses Design Functionality Magnet bore HF coils some are optional RF coils Measurement phantoms Electronics cabinets Cooling system cabinet Gradient cabinet Control cabinet MR console Overview MR satellite console optional Computer system Data recording Network connection Host computer B 1 1 B 1 1 B 1 1 B 1 2 B 1 2 B 1 3 B 1 3 B 1 3 B 1 4 B 1 4 B 2 1 B 2 2 B 2 3 B 3 1 B 3 2 B 3 2 B 3 3 B 4 1 B 4 1 B 4 2 B 4 3 B 4 3 B 4 4 B 4 5 B 1 B 2 B 5 B 6 B 7 MR system components Monitor Description Operation Keyboard Description Operation Mouse Description Operation I
180. tions Safety information A 1 3 Line power supply Technical data L 1 8 Look Ahead monitoring Examination with low fre quency fields C 3 5 SAR monitoring C 3 11 M Magnet Cooling system B 1 1 Description B 1 1 Gradient system B 1 2 Magnet bore B 1 4 Magnetic field B 1 1 Shielding B 1 2 Technical data L 1 1 Magnet Stop Safety information A 2 15 Attraction of ferromagnetic materials A 2 30 Device implant malfunc tions A 2 35 Dizziness A 2 43 Effects of the RF field on devices A 3 5 Effects on devices A 3 2 Field strength B 1 1 Hazards A 2 28 Hazards Low and radio frequency field A 2 37 Impairment of active implants A 2 38 Metallic implants A 2 32 Physiological effects Low frequency fields C 3 3 Physiological effects RF fields C 3 8 Magneto optical disk Reading 1 2 6 Maintenance MR system K 1 1 Safety information A 1 7 Malfunctions Devices implants in the magnetic field A 2 35 Safety information A 1 7 M 7 Index Measurement Canceling Intercom B 7 15 Measurement phantoms Accidents Safety informa tion A 2 66 Description B 2 3 Monitor Cleaning K 1 1 In Room MRC Monitor settings B 5 6 MR console B 4 6 Operation B 4 8 Monitoring Acoustic monitoring Safety information A 2 60 Intercom Description B 7 1 Intercom Operation B 7 3 Look Ahead monitoring C 3 5 Online monitoring C 3 5 Patient monitoring Safety information A 2 55 Physiological
181. ton The CD tray opens Place the CD in the CD tray with the printed side facing up 1 1 2 MAGNETOM Trio System Manual Documentation Recording data Burning CDs o syngo MR 2004A Revision 03 Press the Eject button The CD tray closes The DISK status LED lights up when the CD burner is ready for writing The burning process can take several minutes a na mr ma CD burner 1 WRITE status LED 1 1 3 Recording data Documentation lt gt Start the burning process using the software syngo MR Operator Manual The WRITE status LED lights up orange The CD tray opens as soon as the burning process has been successfully completed The CD tray does not open after the burning process 053 CD burner malfunction lt Ifthe CD tray needs to be opened manually after the burn ing process WRITE status LED off press the Eject but ton The CD tray opens 1 1 4 MAGNETOM Trio System Manual Documentation Recording data Removing a CD from the CD burner CD burner 1 Eject button 2 CD tray syngo MR 2004A 1 1 5 Revision 03 Recording data Documentation Remove the CD from the CD tray Label the CD lt Place the CD in a protective cover Press the Eject button The CD tray closes 1 1 6 MAGNETOM Trio System Manual Reading data Reading CDs The CD drive is used for the following purposes 1 Reading medical images 1 Installing new soft
182. triggering Physiological imaging Performing Performing ECG triggering includes the following procedures 1 Connecting the ECG cable Q Attaching the electrodes Q Selecting the ECG lead 1 Preparing the patient a Performing the examination WARNING Unapproved ECG electrodes Patient burns lt Use only Siemens ECG cables active ECG electrodes and disposable ECG electrodes that are MR compatible and approved by Siemens Background information gt Page F 3 10 Image quality F 3 2 MAGNETOM Trio System Manual Physiological imaging Connecting the ECG cable Attaching the electrodes o syngo MR 2004A Revision 03 ECG triggering lt Connect the plug of the ECG cable to the ECG connection at the PMU Frontend The correct positioning of the electrodes is determined for each measurement through trial and error lt gt Check the expiration date of disposable ECG electrodes and order new ones if necessary lt 4 Position the electrodes on the patient s abdomen and back on areas with little muscle and fat presence Attach the electrodes so that interferences from electrical potentials caused by muscle movement and baseline drifts are minimized Choose contact points with very little muscle and fat tissue lt gt If the patient is hirsute shave the points where you intend to attach the electrodes Shave the patient outside the examination room to prevent accidents lt Clean the shaved spot
183. tten consent All work additions and modifications to the MR system or to the installation site must be checked by Siemens in advance to ensure their compatibility with the functionality of the MR sys tem A 1 11 General safety information Safety The person performing the work must be asked to provide a certificate describing the nature and extent of work performed This certificate must include information about changes to the nominal data or work area along with the date name of com pany and signature Upon request Siemens Service will provide technical docu ments for the MR system However this does not constitute authorization for repairs o A 1 12 MAGNETOM Trio System Manual Safety General safety information System related artifacts With magnetic resonance imaging it is not uncommon for MR images to exhibit artifacts despite careful preparations If the same artifact appears repeatedly document and submit it to Siemens Service Artifacts caused by the system must be detected in order to pre vent incorrect diagnoses CAUTION Artifacts caused by 3 Tesla magnetic fields Incorrect diagnosis MR images may be interpreted only by a physician trained in MR He has to be trained in artifacts related to a 3 Tesla magnetic field syngo MR 2004A A 1 13 Revision 03 General safety information Safety CAUTION A Local image distortion Incorrect diagnosis due to local shifts and localization
184. utton 3 to increase the color saturation lt Press button 4 to reduce the color saturation syngo MR 2004A B 8 9 Revision 03 Video system optional MR system components Screen position Setting the horizontal V The monitor does NOT display the screen menu sersan position lt Press the Mode button three times The screen menu is displayed Press button 1 to move the monitor screen to the right lt gt Press button 2 to move the monitor screen to the left Setting the vertical screen V The monitor does NOT display the screen menu position lt Press the Mode button three times The screen menu is displayed lt 4 Press button 3 to move the monitor screen down lt Press button 4 to move the monitor screen up B 8 10 MAGNETOM Trio System Manual MR system components Video system optional Blue and red contrast By changing the blue and red contrast you can compensate for color cast on screen Setting the blue contrast Y The monitor does NOT display the screen menu lt Press the Mode button four times The screen menu is displayed lt Press button 1 to increase the blue contrast lt Press button 2 to reduce the blue contrast Setting the red contrast Y The monitor does NOT display the screen menu lt Press the Mode button four times The screen menu is displayed lt Press button 3 to increase the red contrast lt Press button 4 to reduce the red contrast syngo MR 2004A B 8 11
185. vices Ambient conditions System specific signs Warning signs Prohibition signs The operator must ensure that all personnel working with the MR system are qualified and have received the appropriate MR system training The use of a keyswitch prevents unauthorized persons from switching on the MR system A 3 1 Device related safety information Safety Effects of the magnetic field on devices Products and magnetizable data carriers for example storage disks magnetic tapes diskettes credit cards and precision devices for example watches pagers hearing aids may be damaged by the magnetic field o Safety distances This table shows the effects of the magnetic fringe field on devices located in the vicinity of the magnet and the safety dis tances required Observe the minimum distances to be main tained from the center of the magnet s X Y and Z axes Magnetic flux density Minimum distances Devices affected x y radial z axial 3 mT x 2 2m Small motors watches cameras z 3 9m credit cards magnetic media 1mT x 2 8m Oscilloscopes computers disk z 5 0m drives shielded color monitors 0 5 mT x 3 1m B W monitors magnetic media car z 6 0m diac pacemakers insulin pumps 0 2 mT x 3 5m Siemens CT systems z 7 5m 0 1 mT x 3 7m Siemens linear accelerators z 9 2m 0 05 mT x 7 3m X ray L I 1 1 image intensifiers z 11 2m gamma cameras third party linear accelerators A 3 2 MAGNETOM Trio Sy
186. ware versions Qj Reading user documentation Users can listen to audio CDs using appropriate headphones connected to the headphone jack on the CD drive o The following instructions apply to other CD drives as well CAUTION Laser beam inside the CD drive Injury to cornea o lt Never disassemble the CD drive syngo MR 2004A 1 2 1 Revision 03 Reading data Documentation Inserting a CD into the CD drive CD drive 1 READ ON status LED 2 CD tray 3 Eject button Press the Eject button The CD tray opens The READ ON status LED on the CD drive flashes Place the CD in the CD tray with the printed side facing up 1 2 2 MAGNETOM Trio System Manual Documentation Reading data lt Press the Eject button The CD tray closes The READ ON status LED continues to flash until the CD tray is closed and the CD drive is ready to read The status LED for READ ON continues to flash even after the CD tray is closed on CD is dirty or damaged lt gt Remove the CD from the CD tray Clean the CD or replace it with a new one Reading data lt gt Start the data read process using the software gt syngo MR Operator Manual The READ ON status LED is continuously lit while the CD is being read syngo MR 2004A 1 2 3 Revision 03 Reading data Documentation Removing a CD from the CD drive CD drive 1 READ ON status LED 2 CD tray 3 Eject button Press t
187. ways connect the RF coil to the system lt Remove disconnected RF coils from the patient table syngo MR 2004A E 2 1 Revision 03 Installing the RF coils Preparing the examination WARNING Hot coil cables due to temperature increase during the exami nation Patient burns lt Never route coil cables over the patient s head WARNING Incorrect MR image due to incorrect display of slice position Incorrect diagnosis lt Make sure to adjust the frequency before each measure ment E 2 2 MAGNETOM Trio System Manual Preparing the examination Installing the RF coils WARNING A Damaged HF coils coil cables Patient burns lt Do not use damaged HF coils coil cables WARNING Arcing caused by coil cable loops Risk of patient death lt gt Avoid cable loops syngo MR 2004A E 2 3 Revision 03 Installing the RF coils Preparing the examination WARNING Damage to RF coil due to improper handling Injury to patient lt Do not use RF coils with mechanical damage lt Contact Siemens Service WARNING A Heating up of coil cable Patient burns lt Avoid direct contact between the coil cable and the patient lt Place absorbent textiles made of natural materials between the patient and the coil cable E 2 4 MAGNETOM Trio System Manual Preparing the examination Installing the RF coils syngo MR 2004A Revision 03 General remarks lt Handle RF coils with
188. witch Magnet Stop switch magnetic field Emergency shut down switch electrical system without magnet Table Stop button A 1 1 A 1 1 A 1 2 A 1 3 A 1 6 A 1 7 A 1 9 A 1 13 A 1 19 A 1 29 A 2 1 A 2 1 A 2 6 A 2 8 A 2 13 A 2 15 A 2 20 A 2 22 Safety Hazards inside the magnetic field A 2 28 Attraction of ferromagnetic materials A 2 30 Magnetic effects on metallic implants inclusions A 2 32 Malfunctions of devices implants susceptible to electromagnetic effects A 2 35 Hazards relating to low and radio frequency fields A 2 37 Dizziness when exposed to 3 Tesla magnetic fields A 2 43 Hazards associated with coolants A 2 44 Quenching the magnet A 2 45 Refilling helium A 2 46 Safety measures in the event of helium accidents lt A 2 48 Potential points of injury through mechanical components A 2 50 Fire safety A 2 52 Patient monitoring A 2 55 Physiological patient monitoring A 2 55 Risks due to monitoring devices A 2 58 Visual and acoustic patient monitoring A 2 60 Laser light localizer A 2 62 Warning signs and labels A 2 65 Accidents involving MR measurement phantoms A 2 66 MAGNETOM Trio System Manual Safety A 3 Device related safety information A 3 1 Overview A 3 1 Effects of the magnetic field on devices A 3 2 Effects of the RF field on devices A 3 5 Ambient conditions A 3 6 System specific signs A 3 7 Warning and prohibition signs A 3 8 Map A 3 8 Warning signs A 3 9 Prohibition and man
189. y information Patient monitoring Physiological patient monitoring The operator is responsible for the use of physiological monitor ing and or measurement devices Monitoring vital parameters The vital parameters have to be monitored during MR examina tions of seriously ill unconscious or physically unstable patients Patients who are sedated or under anesthesia also have to be monitored with MR compatible monitoring devices Vital parameters Vital parameters include q ECG pulse and temperature Oxygen saturation of arterial blood Respiratory volume and possibly respiratory pressure m L1 Blood pressure m L1 Analysis of expiratory gas syngo MR 2004A A 2 55 Revision 03 Personal safety information Safety WARNING Improper patient monitoring due to non MR compatible moni toring devices Risk of patient death lt Use only MR compatible ECG cables and pulse sensors WARNING Incorrect monitoring of vital parameters due to inappropriate monitoring devices Injury to patient lt Use only MR compatible auxiliary devices for monitoring vital parameters of unstable patients A 2 56 MAGNETOM Trio System Manual Safety Personal safety information WARNING Medical emergency during MR measurement Risk of patient death lt Stop measurement immediately lt Remove patients from the examination room for treatment unless it is certain that the medical equipment required is appropriate for u
190. yed Select INFO gt SYSTEM System information for the video display is displayed syngo MR 2004A B 8 21 Revision 03 Video system optional MR system components B 8 22 MAGNETOM Trio System Manual MH system operation C 1 Daily functionality checks Checking the functionality and cleanliness C 2 Switching the MR system on and off Switching on System On Host Standby Starting Host Standby Ending Host Standby Switching off System Off Shutting down the MR satellite console C 3 Physiological effects Operating mode Normal Operating Mode First Level Controlled Operating Mode Switching between operating modes Examination with low frequency electromagnetic fields Background information Peripheral nerve stimulation Monitoring Operating modes syngo MR 2004A Revision 03 C 1 1 C 1 1 C 2 1 C 2 2 C 2 8 C 2 8 C 2 9 C 2 10 C 2 16 C 3 1 C 3 1 C 3 2 C 3 2 C 3 2 C 3 3 C 3 3 C 3 4 C 3 5 C 3 6 C 1 MR system operation C 2 Examination with RF electromagnetic fields C 3 8 Background information C 3 8 Warming of body tissue C 3 9 Noticeable effects on the patient C 3 9 SAR limits C 3 10 SAR monitoring C 3 11 MAGNETOM Trio System Manual Daily functionality checks Before using the MR system the functionality and or cleanli ness of the following parts and areas has to be checked LJ Alarm box Warning signs Floor Magnetizable materials Exhaust vent Patient ta
191. you are unfamiliar with keyboard operation refer to Basics for Beginners in the software user manual gt syngo MR Operator Manual Accessing executing functions You can use symbol keys and key combinations to execute fre quently used functions more quickly than if using the mouse Assignment of symbol keys gt Page B 4 11 Symbol keys and frequently used key combinations Page B 4 13 Key combi nations MAGNETOM Trio System Manual MR system components MR console Executing functions using lt Press the symbol key assigned to the selected function symbol keys Executing functions using Press the key combination assigned to the selected func key combinations tion e g CTRL S for saving lt Press Alt the underlined letter of the selected menu item Activating areas or control lt gt Moving forward from the highlighted area Press the TAB elements of the Exam task key card lt Moving backward from the highlighted area Press the SHIFT TAB keys The activated area is highlighted All user input is applied to this area syngo MR 2004A B 4 15 Revision 03 MR console Browsing card stacks in the task card Browsing cards in a subdi vided card B 4 16 4 MR system components Activate the desired card stack in the task card using the TAB key Moving to the left in the card stack Press the CTRL keys Moving to the right in the card stack Press the CTRL gt keys Th
192. ystem Manual MR system components Symbol keys MR console The symbol keys are used to access frequently used functions Functions and keys overview Function Original Siemens key Increase image brightness I su N set window position Decrease image brightness set window position Decrease contrast decrease window width Increase contrast increase window width Automatically set contrast and bright ness Previous examination Next examination SEE Windows key NUM B 4 11 syngo MR 2004A Revision 03 MR console MR system components Function Original Siemens key Windows key Previous series 4 Next series 5 Previous image 1 Next image 2 Open patient registration Ins Open patient browser Del Copy to film sheet Enter Highlight 3 B 4 12 MAGNETOM Trio System Manual MR system components MR console Function Original Siemens key Windows key Send to node 1 Key combinations The following functions can be accessed in combination with the ALT or CTRL key Function Key combination Close active window ALT F4 Switch active task card Browse CTRL TAB through cards Copy CTRL C Cut CTRL X Paste CTRL V Save CTRL S Import data CTRL 1 Save window values CTRL W syngo MR 2004A B 4 13 Revision 03 MR console B 4 14 MR system components Operation The following is a brief summary of keyboard operation func tions lt If
193. ywhere within the length of the coil cable from the coil socket Q The CP Extremity must be moved so that both the left and the right extremity can be examined as necessary Positioning aids 1 Cushion insert Q Leg support LJ Air cushion G 8 2 MAGNETOM Trio System Manual Examination RF coils CP Extremity optional Use Preparing the measurement Preparing the examination using the CP Extremity includes the following steps W Preparing the patient table and positioning the CP Extrem ity W Positioning the patient Q Closing the CP Extremity Preparing the patient table and positioning the CP Ex tremity OR M CP Extremity on the patient table here examination of the right knee syngo MR 2004A G 8 3 Revision 03 CP Extremity optional Examination RF coils V The patient table is prepared 4 Position the CP Extremity including base directly on the patient table or on a cushion close to the patient s knee Position cushions 1 and 3 at the foot end of the patient table 4 Align the CP Extremity so that the Magnet labeling on the coil is facing the magnet bore lt Connect the coil plug of the CP Extremity to coil socket 1 on the patient table Slide the CP Extremity on the base until it is positioned cor rectly Secure the CP Extremity on the base using the locking mechanism Press the releases on the upper part of the CP Extremity Lift the upper part o

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