SE Viewer

The Stress Echo (SE) feature within the Cerebrum DICOM Viewer II is a powerful tool for comparing cardiac images at rest and during recovery. By default, the viewer opens in Protocol mode, which is designed to display matched pairs of rest and recovery images, as selected by the technician during the exam. This allows for a direct and efficient comparison of heart function under stress.

Dual-Window Functionality

When the Stress Echo mode is launched, a regular echo mode screen will always open alongside it. This second window contains all resting and stress images available for individual, one-by-one review and for taking measurements. Users can easily toggle between the stress comparison window and the regular review window as needed.

Viewing Modes

The SE Viewer offers several modes to review the acquired images, each tailored for a specific purpose.

• Protocol View: This is the default view. It displays matched pairs of images for standard cardiac views, such as 2-Chamber (2CH), 4-Chamber (4CH), and Parasternal Long-Axis (PLAX), allowing for side-by-side comparison.
• Main View: Displays a single, primary pair of matched pre- and post-stress images that were selected by the technician on the machine.
• Rest View: This mode displays only the rest images. It typically includes all rest images from the Protocol view, plus any additional rest images captured by the technician.
• Review Mode: This comprehensive mode shows all images selected by the technician, which generally includes all protocol images plus several extra images taken post-exercise.
• Extra View: Displays only the additional images.

Controls and Navigation

Image Playback Control

• Speed Adjustment: The playback speed of the cine loops can be easily modified using the "Speed" scroll bar found in the Control menu.
• Cine Checkbox: This is checked by default and ensures the continuous looping of the images. Unchecking this box will pause the playback.

Navigating Through Images

The viewer provides multiple ways to navigate through the image sets:

• Sequential Navigation: Use the "prev" and "next" buttons or the mouse scroll wheel to cycle through the image pairs one by one.
• Jump to Ends: To navigate to the very beginning of the image set, click the "<< " icon. To jump to the very end, click the ">> " icon.

• Direct Selection: Users can click on any image thumbnail on the left-hand side of the screen to jump directly to that specific view.

Key Features

• Anonymity of Patient Information: This feature allows patient information to be hidden from view. This is particularly useful for teaching, presentations, or any scenario where patient data confidentiality is a priority. Simply click the feature to toggle the patient information on or off.

• Assign Image to Protocol: If an image in the default protocol is not ideal, the viewer allows you to replace it. Simply find a better image from the "Extra View," right-click on it, and select "Assign to Protocol" to make the substitution.

Post-Processing Options and Functions

The SE Viewer includes several tools to enhance image quality and focus on specific details.

• Windowing: Adjust the image contrast and brightness in a linear fashion. Hold the left mouse button and move the cursor up/down and left/right to modify the view.
• Gamma: Similar to Windowing, this adjusts contrast by holding the left mouse button and moving the cursor. However, Gamma adjusts the intensity in a non-linear fashion.

• Sharp: This option enhances the endocardial definition, making the borders of the heart muscle clearer for review.

• Crop: Allows you to zoom in on a specific region of interest. Click the "Crop" button, select the area, and click "Crop" again to return to the original display.

• Systole Only: This feature isolates and plays only the early portion of the cine loop corresponding to systole. A slider is available to lengthen or shorten the viewed portion. Deselect the option to view the entire cardiac cycle (QRS).

• Colour Map: Applies a color overlay to the images, which can help enhance visual details.