IHE Cardiology Technical Framework Supplement Cardiac Imaging ...

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IHE Cardiology Technical Framework Supplement – Cardiac Imaging Report Content (CIRC)______________________________________________________________________________● NoAcquisitionparameters:Echocardiography(Recommended—TTE/TEE)Acquisitionparameters: Contrastuse(Recommended)If TTE or TEE was performed, indicate theacquisition parameter used. Choose allapplicable from the following:● M-mode and 2-D● 3-D● Spectral Doppler● Doppler—color● Perfusion● Tissue Doppler● OtherList all contrast/imaging agents used:● Radionuclide—F-18 FDG for viability—Rubidium-82 perfusion—Nitrogen-13 ammonia perfusion—Tc-99m tetrofosmin (Myoview)—Tc-99m sestamibi (Cardiolite)—Tl-201● Echo contrast—Optison (Perflutren)—Definity (Perflutren Lipid Microsphere)—Agitated saline—Iodinated contrast● High osmolar contrast media (ionic)—Diatrizoate meglumine and diatrizoatesodium (Renografin, etc.)—Ioxithalamate (Telebrix)—Iothalamate dimeglumine (Conray)● Low osmolar nonionic contrast media—Iopamidol (Isovue)—Iohexol (Omnipaque)—Ioversol (Optiray)—Ioxaglate (Hexabrix)—Iomeprol (Iomeron)—Iopromide (Ultravist)● Iso-osmolar nonionic contrast media—Iodixanol (VisiPaque)● Paramagnetic agent—Gadopentetate dimeglumine (Magnevist)—Gadodiamide (Omniscan)—Gadoversetamide (Optimark)—Gadobenate dimeglumine (MultiHance)Procedure description section2.16.840.1.113883.10.20.18.2.2(ProcNote)Procedure description section2.16.840.1.113883.10.20.18.2.2(ProcNote)__________________________________________________________________________20Rev. 1.0 – 2011-04-22Copyright © 2011: IHE International, Inc.
IHE Cardiology Technical Framework Supplement – Cardiac Imaging Report Content (CIRC)______________________________________________________________________________● NoneAcquisitionparameters forSPECT or PET:Radionuclide dose(Recommended)Acquisitionparameters: Gating(Recommended—CCT, CMR, SPECT,PET)Acquisitionparameters:Attenuationcorrection(Recommended—SPECT, PET)Acquisitionparameters for CCT:Number of slices(Recommended)Acquisitionparameters for CCT:Temporal resolution(Optional)Acquisitionparameters for CCT:Contrast volume(Recommended)Acquisitionparameters for CCT:Radiation exposureIf radionuclide was used during the study,indicate the dose of eachradiopharmaceutical in mCi.If a nuclear, CCT, or CMR study wasperformed, indicate whether gating wasused.Choose 1 of the following:● Yes—Prospective—Retrospective—Both● NoIf a SPECT/PET study was performed,indicate whether attenuation correctionwas used for the nuclear imaging study.Choose 1 of the following:● Yes● NoIf CCT was the study performed, indicate ifthe number of “slices” was greater than orequal to 64.Choose 1 of the following:● Yes● NoIf CCT was the study performed, indicatethe gantry rotation speed in milliseconds.If iodinated or paramagnetic contrast wasused during the study, indicate the volumeof contrast used, in milliliters (ml) or notused.If a CCT was performed, indicate the totalradiation exposure in mGy cm (the doselengthproduct).Procedure description section2.16.840.1.113883.10.20.18.2.2(ProcNote)Procedure description section2.16.840.1.113883.10.20.18.2.2(ProcNote)Procedure description section2.16.840.1.113883.10.20.18.2.2(ProcNote)Procedure description section2.16.840.1.113883.10.20.18.2.2(ProcNote)Procedure description section2.16.840.1.113883.10.20.18.2.2(ProcNote)Procedure description section2.16.840.1.113883.10.20.18.2.2(ProcNote)Procedure description section2.16.840.1.113883.10.20.18.2.2(ProcNote)__________________________________________________________________________21Rev. 1.0 – 2011-04-22Copyright © 2011: IHE International, Inc.
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