S-Scan User Manual R11 EVO20

S-scan
User Manual
350003100 Rev. 11
Esaote S.p.A.
Genoa
Edition
March 2020
Guarantee
The information in this document are the exclusive property of Esaote
S.p.A. and are reserved. Reproduction or distribution in any form is
strictly prohibited. All rights reserved.
No translations of this documentation are allowed without the consent of
Esaote S.p.A.
The information contained in this documentation is subject to change
without prior notice.
Trademarks
All brand names and trademarks are property of the respective owners
and are used exclusively for identification purposes.
Manufacturer’s Address
Esaote S.p.A.
Via Enrico Melen, 77
16152 Genoa, Italy
Important Information
S-scan, S-scan X, S-scan C and S-scan eXP conform to the Medical
Devices Directive 93/42/EEC and bear the CE mark.
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VIGILANCE SYSTEM
The equipment is subject to a supervision system (post-sales
supervision), which ESAOTE S.p.A., all associates and authorized
distributors apply to products issued onto the market, in relation to real or
potential hazards that may arise for the patient or operator during normal
use of the equipment, to ensure optimal solutions in the most efficient and
prompt manner possible.
Therefore, in the event of malfunctions, defective performance of the
equipment, or inadequate instructions, which may constitute a hazard to
the patient or operator, the user must notify ESAOTE S.p.A., associate
company or authorized distributor in writing, providing the information as
specified in the form below. Equipment data are found on the relative
identification plate.
On receipt of the notification Esaote S.p.A. will immediately activate the
process of examination and resolve the non-conformity that has been
reported.
ACCIDENT REPORT FORM

To: Esaote S.p.A.
Quality Assurance Service
Via E. Melen, 77
16152 Genova, Italy
Email: qa@esaote.com
[or associate]
[or authorized distributor]
Name of ESAOTE equipment/system..................................................

Code (REF) ....................................................................................
Serial Number (S/N)........................................................................
Description of accident or potential accident........................................
....................................................................................................
Comments or suggestions ................................................................
....................................................................................................
Person / department to contact .........................................................
Address .........................................................................................
Telephone ................................ Fax .............................................
Date .......................................
Signature ................................
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PRODUCT TRACEABILITY
To guarantee product traceability according to specifications of the
standard EN ISO 13485, and the European directive on medical
equipment 93/42/EEC (1993) and subsequent amendments, original
owners, in the event of equipment transfer to third parties, are requested
to notify ESAOTE S.p.A., associate company or authorized distributor of
the said transfer by means of the following form, duly compiled, or written
notification with the same data as specified in the form. Equipment data
are found on the relative identification plate.
PRODUCT TRACEABILITY FORM

To: Esaote S.p.A.
Quality Assurance Service
Via E. Melen, 77
16152 Genova, Italy
Email: qa@esaote.com
[or associate]
[or authorized distributor]
Name of ESAOTE equipment/system..................................................

Code (REF) ....................................................................................
Serial Number (S/N)........................................................................
Name and address of original owner ..................................................
....................................................................................................
Name and address of new owner .......................................................
....................................................................................................
Signature ................................
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INDEX
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Chapter 1 - Essential Prescribing Information

Description of the system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
New Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Intended Use. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Contraindications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
General Warning and Precautions. . . . . . . . . . . . . . . . . . . . . . . . . . 3
MR Examinations of Infants and Pregnant Women . . . . . . . . . . . . . . 4
Maintaining Device Efficiency. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Chapter 2 - Manual Requirements

Safety Information: conventions . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Specific terms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Chapter 3 - Instructions for Safe Use

Operator Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Personnel Qualifications and Training . . . . . . . . . . . . . . . . . . . 2
Operating environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Controlled access area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Peripheral equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Projectiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Artifacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .9
Peripheral equipment compatibility test . . . . . . . . . . . . . . . . . . . . . 11
Patient area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Pre-screening of patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Pre-screening of MR Personnel. . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Emergency medical procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Monitoring the Patient during Examinations. . . . . . . . . . . . . . . . . . . 18
Operating Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
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Personnel and patient exposure to the acoustic noise . . . . . . . . . . . . 19
Excessive noise . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Special precautions against acoustic noise . . . . . . . . . . . . . . . 20
Personnel and patient exposure to the static magnetic field . . . . . . . 20
MR personnel and patient . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Fringe magnetic field . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Main magnetic field and main magnetic field gradient. . . . . . . . 25
Personnel and patient exposure to a time-varying magnetic field . . . . 27
MR personnel and patient exposure to the RF magnetic field . . . . . . . 31
MR personnel and patient exposure to contact currents . . . . . . . . . . 32
Precautions against localized cutaneous heating . . . . . . . . . . . . . . . 33
Special Precautions for Patient Positioning . . . . . . . . . . . . . . . . . . . 35
Precautions against mechanical hazards . . . . . . . . . . . . . . . . . . . . . 39
Precautions when using the contrast agent in MR examinations. . . . . 40
Precautions against electric shock . . . . . . . . . . . . . . . . . . . . . . . . . 42
Fire and explosion precautions. . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Disinfecting and cleaning the system . . . . . . . . . . . . . . . . . . . . . . . 44
Periodic maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Quality Assurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
System life cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Lifetime . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Maintainability Time . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Disposal at the end of product lifetime . . . . . . . . . . . . . . . . . . 49
Correct management and privacy of patient data. . . . . . . . . . . . . . . 50
Conformance to standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
Equivalence between European and international standards . . . 52
Chapter 4 - Installation
Structural Requirements of the Installation Area . . . . . . . . . . . . . . . 1
Electromagnetic requirements in the installation environment . . . . . . 2
Electromagnetic compatibility (EMC) . . . . . . . . . . . . . . . . . . . 2
Recommended distances between radio (RF) communication
systems and S-Scan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
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Magnetic Disturbance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
RF Disturbances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Power Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Indicator lights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Safety Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Thermal stability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Index
Environmental requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Temperature and humidity requirements . . . . . . . . . . . . . . . . 15
Other requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Patient routine monitoring requirements . . . . . . . . . . . . . . . . . . . . 16
Installation procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Controlled access area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Warning signs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
Environmental conditions for transport and storage . . . . . . . . . . . . . 19
Special storage and transport conditions . . . . . . . . . . . . . . . . 19
Packaging symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
Chapter 5 - Technical description

System architecture. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Operating console . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Monitor specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
System electronics. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Computer functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Magnetic unit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Technical specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Imaging system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Magnetic system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Dedicated gradient system . . . . . . . . . . . . . . . . . . . . . . . . . . 13
Radiofrequency transmission and acquisition system . . . . . . . . 14
Patient positioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16
Installation site characteristics . . . . . . . . . . . . . . . . . . . . . . . 16
Power supply . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
Overall dimensions and weights . . . . . . . . . . . . . . . . . . . . . . 18
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Service equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19
Chapter 6 - Patient table

Description of the standard patient table . . . . . . . . . . . . . . . . . . . . 1
Safety belts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Limb protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Description of the compact patient table . . . . . . . . . . . . . . . . . . . . . 6
Limb protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Back support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Step for patient positioning on the table . . . . . . . . . . . . . . . . . . . . . 12
Instructions for the use of the patient’s table . . . . . . . . . . . . . . . . . 13
Chapter 7 - Shielding and insulating parts

Description of the shielding box . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Precautions for using the shielding apparatus . . . . . . . . . . . . . . . . . 4
Chapter 8 - Coils
Solenoid coils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Description of shoulder coil 1. . . . . . . . . . . . . . . . . . . . . . . . . 2
Description of the flexible coils 6 and 11 . . . . . . . . . . . . . . . . . 3
Description of cervical spine coil 9 . . . . . . . . . . . . . . . . . . . . . 7
Description of TMJ Coil 15 . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Dual Phased Array Coils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Description of Knee Coil 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Description of Hand/Wrist Coil 3 . . . . . . . . . . . . . . . . . . . . . . 13
Description of Foot/Ankle Coil 4 . . . . . . . . . . . . . . . . . . . . . . . 14
Description of Shoulder Coil 7 . . . . . . . . . . . . . . . . . . . . . . . . 15
Description of Lumbo-sacral DPA Coil 10. . . . . . . . . . . . . . . . . 17
Description of DPA cervical spine coil 14 . . . . . . . . . . . . . . . . . 20
Multi-channel coils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
Description of 4-channel lumbar spine coils 17 and 18 . . . . . . . 25
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Description of 2-channels TMJ coil 19 . . . . . . . . . . . . . . . . . . 29
Description of 3-channels Shoulder coil 20 . . . . . . . . . . . . . . . 31
Description of Head coil 16 . . . . . . . . . . . . . . . . . . . . . . . . . 34
Precautions when using the coils . . . . . . . . . . . . . . . . . . . . . . . . . 36
Phantoms . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
ACR phantom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Index
Chapter 9 - Cushion Set
Cushions for patient table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Dedicated cushions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
General use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
Chapter 10 - Turning the system on and off

Turning on the system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Turning off the system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Emergency stop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Chapter 11 - Positioning protocols

Size constraints of the S-scan system . . . . . . . . . . . . . . . . . . . . . . 1
Centering the Coil and the Anatomy to be Examined . . . . . . . . . . . . 6
Image Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Removing the patient in an emergency . . . . . . . . . . . . . . . . . . . . . 8
Chapter 12 - Knee examinations

Usable coils. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Patient Positioning Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Chapter 13 - Thigh and Calf Area Examinations

Usable coils. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
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Chapter 14 - Examination of the foot-ankle region
Usable coils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Ankle examination: standard patient positioning procedure. . . . . . . . 2
Chapter 15 - Hand-Wrist examinations

Usable coils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter 16 - Elbow examinations

Usable coils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter 17 - Arm and forearm examinations

Usable coils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter 18 - Shoulder Examinations

Usable coils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Chapter 19 - Hip examinations.

Usable coils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Patient positioning procedure for examinations using coil 6 or 11 . . . 2
Patient positioning procedure for examinations using coil 17 or 18. . . 7
Chapter 20 - Examination of the spinal column

Usable coils . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Patient positioning procedure for examinations using coil 10 . . . . . . . 3
Patient positioning procedure for examinations using coil 17 or 18. . . 8
Prone patient positioning procedure . . . . . . . . . . . . . . . . . . . . . . . . 13
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Chapter 21 - Examination of the thoracic spine
Usable coils. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Recommended patient positioning procedure . . . . . . . . . . . . . . . . . 4
Patient positioning procedure starting from lumbar spine . . . . . . . . . 6
Patient positioning procedure starting from cervical spine. . . . . . . . . 15
Index
Chapter 22 - Examination of the cervical spine
Usable coils. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Positioning procedure for examinations using coil 10 . . . . . . . . . . . . 8
Chapter 23 - Examination of the temporomandibular

joint
Usable coils. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Bilateral examination: patient positioning procedure . . . . . . . . . . . . 2
Unilateral examination: patient positioning procedure . . . . . . . . . . . 6
Chapter 24 - Examination of the head

Head indications for use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Usable coils. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Chapter 25 - Control panel

Control panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Real time positioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Turning the control panel on and off . . . . . . . . . . . . . . . . . . . 2
Appendix A - General Principles of Magnetic Resonance

Imaging
The nuclear spin system . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
The role of RF pulse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Relaxation times . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
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From signal to image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
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CHAPTER 1
Essential Prescribing Information
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The information in this manual about the S-scan system also applies to
the S-scan X, S-scan C and S-scan eXP systems.
Warning
Federal law restricts this device to sale, distribution and use by or on
the order of a physician.
The device is limited by Federal law to investigational use for
indications not in the Intended Use/Indications statement.
Description of the system

S-scan is a Magnetic Resonance (MR) system, which produces images of
the internal structures of the patient’s limbs, joints and spinal column.
The system comprises four main parts:
1 Patient Table (A Standard or E Compact in the figure below)
2 Magnetic Unit, containing a permanent magnet (B in figure below)
3 Console (C in figure below), comprising a PC, keyboard, mouse,
monitor and operating table
4 Electronic box (D in the figure below)
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fig. 1.1 - The S-scan system
New Information
The user manual has been divided into three parts (User Manual, Image
Quality and Sequences Manual, User Interface Manual). These combined
provide all instructions necessary for safe and efficient use of the system.
The system offers a choice of two patient table configurations: the
standard version and the compact version. The user specifies the type of
patient table required at the time of ordering the system.
The system is equipped with a new electronic system.
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Intended Use
S-scan is a Magnetic Resonance (MR) system that produces transversal,
sagittal and coronal and oblique cross-section images of the head, limbs,
joints and spinal column. It is intended for imaging the head, imaging
portions of the upper limb, including the hand, wrist, forearm, elbow, arm
and shoulder, imaging portions of the lower limb, including the foot, ankle,
calf, knee, thigh and hip, imaging the temporomandibular joint and
imaging the cervical, the thoracic and the lumbosacral sections as
portions of the spinal column.
MR images produced by S-scan correspond to the spatial distribution of
protons (hydrogen nuclei) that verify the properties of magnetic
resonance and depend on the MR parameters, including spin-lattice
relaxation time (T1), spin-spin relaxation time (T2), nucleus density, flow
speed and “chemical shift”. When interpreted by a medical expert trained
in use of MR equipment, the images can provide diagnostically useful
information.
Contraindications
Use of the S-scan is contraindicated:
☛ for patients with implants or internal devices that are electrically,
magnetically or mechanically activated
☛ for patients who rely on electrically, magnetically or mechanically
activated life support systems
☛ for patients with implanted surgical clips or metal objects in the cranial,
ocular and vascular areas, unless the supervising physician has
ascertained that the implant/device is labeled as MR Conditional.
(See chapter 3, “Instructions for Safe Use”).
General Warning and Precautions

The user must establish a controlled access area around the S-scan
system, to ensure that the magnetic fringe field outside this area does not
exceed 0.5 mT and that the level of electromagnetic interference complies
with Standard EN 60601-1-2 and subsequent amendments.
It is also necessary that the user establishes adequate rules for access to
the controlled area, by patients, operators, personnel and persons in
general, in order to restrict undesired exposure of the latter to the
magnetic fields and RF.
☛ Never allow persons whose condition and characteristics lead to
contraindications on exposure to the magnetic field and RF generated by
S-scan, to enter the controlled access area.
☛ All metal objects must be kept clear of the 0.5 mT controlled access
area limit.
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☛ Use only peripheral equipment, including patient monitoring, life
support and emergency care equipment, that is recommended for use in
the controlled access area.
The MR examination requires special precautions:
☛ for patients with surgical clips (haemostatic clips) or other
ferromagnetic implants labeled as MR Conditional
☛ for patients with implanted prosthetic heart valves labeled as MR
Conditional
☛ for patients with non-ferromagnetic metal implants labeled as MR
Conditional
☛ for patients who due to their professional activity or personal history
(e.g. war injuries), may have embedded ferromagnetic material or metal
fragments
☛ for patients with body tattoos or permanent (tattooed) eye-liner or
patients wearing cosmetics on their eyes and/or eyelashes
☛ for patients with greater than normal potential for cardiac arrest
☛ for patients who are likely to develop epileptic seizures or
claustrophobic reactions
☛ for de-compensated cardiac patients, febrile patients or patients with
impaired perspiration ability
☛ for patients with compromised thermoregulatory systems (e.g.
newborn babies, low birth weight infants, certain cancer patients)
☛ for unconscious patients, sedated patients or patients in a state of
mental confusion with whom no reliable communication can be
maintained.
MR Examinations of Infants and Pregnant Women

☛ for newborn babies or infants
☛ for pregnant women (especially during the first three months of the
pregnancy).
The safety of magnetic resonance imaging for newborn babies, infants,
embryos, and fetuses has not been demonstrated.
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Maintaining Device Efficiency
To avoid degradation of image quality and/or lost time for re-establishing
magnet temperature, do not disconnect the main power supply to the
system except for emergency stops, maintenance or other necessary
procedures.
Allow only Esaote-authorized service personnel to perform maintenance,
modification and repair procedures on S-scan systems.
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CHAPTER 2
Manual Requirements
••••••
This user manual 350003100 Rev. 11 constitutes only a part of the

instructions required for safe and correct use of all configurations of the
S-scan system.
The following manuals, supplied with the device for user consultation, are
an integral part of the instructions required for use of the S-scan system.
• Image Quality and Sequence Manual
• User Interface Manual
• LCD TFT Monitor User Manual supplied with the product
• CD/DVD drive User Manual supplied with the product
The original language of all the S-scan User Manuals is Italian. Esaote
S.p.A. has translated these manuals into English and German.
Safety Information: conventions

The following labeling conventions are used in this manual to identify
safety related information:
CONTRAINDICATION
This information notifies the user of a condition in which the system must
not be used.
The reason for this is that the risk involved clearly outweighs the benefits
of using the system in such conditions.
WARNING
A warning message alerts the user to a situation which, if not avoided,
could result in death or serious injury to the patient, the user or others.
It may also describe potentially serious adverse reactions and safety
hazards.
CAUTION
A caution message or the term “precaution” alerts the user to a situation
which, if not avoided, could result in moderate injury to the patient, the
user or others or damage to the equipment or property.
This message could also be used to alert the user regarding unsafe
procedures.
NOTE
A note message refers to information regarding installation, operation or
maintenance, which are important but do not generate hazards.
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Most warning and caution messages are found in the subsequent chapters
“Instructions for Safe Use” and “Installation”. Other warning and caution
messages appear in the relative procedures in the relevant
paragraph/chapter.
The User must carefully read, understand, and observe all Warnings and
Cautions throughout the entire manual.
This symbol refers to different system configurations or the use of optional
system accessories. If the user does not have the accessory referred to by
the symbol, the relative description can be ignored.
The term “Service”, when used in S-scan manual, always refer to the
service personnel authorized by Esaote S.p.A..
Specific terms
The purpose of this section is to provide a list of “specific terms”
frequently used in the manual, even though each of these terms has
already been defined in the part of the manual where the associated
concept and/or function is described in detail.
APPARATUS/OPERATOR INTERFACE – Means by which the operator and
apparatus communicate.
ARTIFACTS – False features in the image produced by the imaging process
and that do not correspond to the spatial distribution of tissues in the
slice.
B1 RMS – Root mean square (RMS) of B1: the radio frequency magnetic
induction. It is an indication of the RF magnetic field intensity.
BANDWIDTH – Range of frequencies to which the receiver is sensitive.
COIL – Electrical conductor comprised of single or multiple windings
designed either to produce a magnetic field from current flowing through the
coil, or to detect a changing magnetic field by voltage induced in the coil.
CONTRAST – The relative difference in signal intensity between two types
of tissues. Essential criterion used to differentiate pathological and
healthy tissues.
CONTROLLED ACCESS AREA – Area around the system, outside which the
magnetic fringe field must not exceed 0.5 mT and the level of
electromagnetic interference complies with Standard EN 60601-1-2 and
subsequent amendments. Outside the controlled access area, the level of
exposure to the static magnetic field is considered safe for persons.
dB/dt – Rate of temporal variation of the magnetic field.
DEDICATED GRADIENT SYSTEM – Gradient system designed for use in
special purpose MR systems.
An example of a special purpose gradient system is one that can be
incorporated in an MR system to enable special examinations of the
patient’s head.
ECG – Electrocardiogram
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EER – Acronym for Early Enhancement Rate, indicating the speed of
captation of the contrast agent.
EFFECTIVENESS – Accuracy and completeness with which the operator
Manual Requirements
reaches set objectives.
EFFICIENCY – Resources used in relation to the accuracy and
completeness with which the operator reaches set objectives.
FERROMAGNETISM- A large positive magnetic susceptibility in a
substance, such as iron.
FIELD GRADIENT – A magnetic field which changes in strength in a given
direction. Used to select the imaging region and selective excitation in MR.
Also used to encode the MR signal received from the region examined,
with spatial information. Measured in T/m.
FIELD OF VIEW – The area of the slice from which the system acquires
information.
FREQUENCY – The number of repetitions of a periodic process per unit of
time. For electromagnetic radiation is measured in Hz.
GAUSS – The old unit of measure of the magnetic field.
GEOMETRIC DISTORTION – Deviation of the spatial position of the
structure displayed with respect to the expected real position of the
object.
GRADIENT – The amount and direction of the rate of change in space of
some quantity, such as magnetic field strength.
GRADIENT COIL – Current-carrying coils designed to produce a desired
magnetic field (so that the magnetic field will be stronger in some
locations than in others). Correct design of the size and configuration of
the coils is necessary to produce a controlled and uniform gradient.
GRADIENT OUTPUT – Parameter that measure regarding gradient
performance as a percentage of the variation in magnetic field intensity,
or the electric field induced by one or more gradients in a certain positions
and in specific conditions.
GX, GY, GZ – Conventional symbols for the gradients of the magnetic field:
x, y, and z denote the spatial direction of the gradient component, i.e.,
direction along which the field changes.
HOMOGENEITY – Uniformity. In MR, the homogeneity of the static
magnetic field is an important criterion of the quality of the magnet.
HOMOGENEITY REGION (OF THE MAGNET) – 250 mm, diameter sphere,
centered in the isocenter of the magnet, in which the magnetic field is
homogeneous.
IMPROPER USE – Intentional acts or omissions by the head of the
organization or the operator as the result of behavior that goes beyond
any reasonable control of risks as specified by the manufacturer.
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INHOMOGENEITY – Degree of lack of homogeneity. For example, the
fractional deviation of the local magnetic field from the average value of
the field.
LONGITUDINAL MAGNETIZATION – Component of the macroscopic
magnetization vector along the static magnetic field.
LOWER LIMB – Includes foot, ankle, calf, knee, thigh and hip.
MAGNETIC GRADIENT FIELD – A magnetic field the intensity of which
varies in proportion to the distance from the magnet isocenter. Used to
select the imaging region and encode the MR signal with spatial
information. Such a gradient field is superimposed on the main magnetic
field.
MAGNETIC RESONANCE (MR) – The absorption or emission of
electromagnetic energy by nuclei in a static magnetic field, after
excitation by a suitable RF magnetic field. The resonance frequency is
proportional to the magnetic field, and is given by Larmor equation. Only
nuclei with a non-zero spin exhibit nuclear magnetic resonance (NMR).
MAGNETIC RESONANCE IMAGING – Creation of images of the human
body using Magnetic Resonance. The intensity of an image of a specific
zone depends mainly on the density of the spin and tissue relaxation
times.
MAGNETIZATION – The magnetic polarization of a material produced by a
magnetic field.
MATRIX (RAW DATA) – Matrix whose dimensions (rows x columns) are
determined by the number of readout sampling points (frequency) and by
the number of phase encoding steps. Serves to obtain the desired spatial
resolution.
MAXIMUM DISPLAYED IMAGE – The maximum size of the displayed image
is a 250 mm x 250 mm square in order to minimize the area displayed
external to the homogeneity region.
MR ENVIRONMENT – This term refers to the environment in the
immediate vicinity of the MR system. In particular it refers to the area
within the line at 0.5 mT.
MR MARKER – A marker that is visible in magnetic resonance images that
can be placed on the surface of a patient’s body to delineate, or serve as a
landmarks with respect to the tissue to be examined.
MR PERSONNEL – persons who, for professional reasons, must enter the
controlled access area or the magnetic resonance system.
NOISE – A statistic fluctuation of signal intensity that does not contribute
to image information. The factors that determine noise include presence
of the patient in the magnet, electric noise generated by the RF reception
system and external electromagnetic noise.
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NOT SAFE FOR USE IN MR ENVIRONMENT – This indicates that a device
generates known risks in any MR environment.
The icon has a black text on a white background with a red border, and the
Manual Requirements
text has a red strike-through line; alternatively it may be shown in white
and black.
OPERATOR – The physician or technologist who operates the S-scan
system during patient examination.
OPERATOR PROFILE – Summary of mental, physical and demographic
features of operators, as well as any special characteristics that may be
relevant, such as professional skills or work requirements.
ORIENTATION – A suggested standard orientation for the presentation of
MR images is:
1) Transverse. On the image: patient’s right side on the left, patient’s’ at
the top.
2) Coronal. On the image: patient’s right side on the left, patient’s head at
the top.
3) Sagittal. On the image: patient’s head at the top, patient’s anterior on
the left.
R (right), L (left), P (posterior), A (anterior), H (head), F (foot) should be
shown on the screen, as appropriate.
PERMANENT MAGNET – A magnet whose magnetic field originates from
permanently magnetized material.
PHANTOM – An artificial object of known dimensions and properties. Used
to test the S-scan system.
PHASE – In a periodic function (such as rotational or sinusoidal motion),
the position relative to a particular part of the cycle.
PRIMARY OPERATIVE FUNCTIONS – Functions requiring interaction with
the operator, which may be frequently used and related to basic safety or
essential performance of the equipment during normal use.
PULSE – Waveform signal that rises abruptly, maintains a relatively flat
top for an extremely short interval and then rapidly falls to zero.
PULSE 180° – RF pulse designed to rotate the macroscopic magnetization
vector 180° in space.
PULSE 90° – RF pulse designed to rotate the macroscopic magnetization
vector 90° in space.
PULSE SEQUENCE – Train of RF and gradient pulses used to excite the MR
response signal and encode it with spatial information.
RE – Acronym for Relative Enhancement indicating the relative captation
of the contrast agent.
RECEIVING COIL – Coil of the RF receiver: captures the MR signal.
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RESPONSIBLE ORGANIZATION – Organizational aspects of safety are the
remit of the RESPONSIBLE ORGANIZATION. This role encompasses
defining: appropriate training for personnel, the rules governing access to
the MR system, personnel qualification for decisions related to safety,
medical responsibility and specific requirements for personnel when the
patient is inside or in the vicinity of the MR system.
In the following pages of the User Manual, the responsible organization is
indicated as the USER (see definition below) as the user’s tasks includes
those of the responsible organization.
RF – Radiofrequency
SAFE FOR USE IN MR ENVIRONMENT – This indicates that a device does
not generate known risks in any MR environments. Devices that are safe
for use in an MR environment include non-conductive and non-magnetic
devices, such as plastic Petri dishes.
The first of the two icons has a white text on a green background, while
the second has a green text on a white background with a green border;
alternatively both icons may be shown in white and black.
SAFE FOR USE IN MR ENVIRONMENTS IN SPECIFIC CONDITIONS – This
indicates that a device, when used in specific conditions in the MR
environment, does not generate additional risks.
The conditions that define a specific MR environment include the intensity
of the static magnetic field, the magnetic gradient field, the rate of
variation of the magnetic field, radiofrequency fields and the SAR (specific
absorption rate).
The icon has a black text on a yellow background with a black border;
alternatively it may be shown in white and black.
SAR – Acronym for Specific Absorption Rate. Indicates the RF power
absorbed by an object per mass unit (W/kg). PARTIAL BODY SAR means
that the average SAR calculated on the body mass of the patient is
exposed to the volume of the RF transmission coil for the specified time
interval.
SCOUT (SCOUT SEQUENCE) – Short pulse sequence for evaluating the
correct centering of the area being examined with respect to the magnet
isocenter. It is compulsory to acquire a Scout sequence when starting an
examination.
SCOUT IMAGES – Images of the three orthogonal slices positioned along
the main axis of the magnet and through its center, produced by the Scout
sequence.
SIGNAL-TO-NOISE RATIO (S/N) – Ratio used as measurement of image
quality. It describes the relative contributions to the detected signal of the
true signal intensity and superimposed background noise.
SLICE THICKNESS – Is the spatial depth of each slice into which the
anatomical region to be examined is divided.
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SPATIAL RESOLUTION – The system’s ability to display closely spaced
points as separate and distinct. Spatial resolution depends on the voxel
size: the smaller the voxel, the better the spatial resolution.
Manual Requirements
SUPERVISING PHYSICIAN – A medical doctor who is responsible for
determining that C-scan patient examinations can be and are conducted
safely and effectively, and for interpreting the results of examinations.
TESLA – The unit of measure of the magnetic field.
TRANSVERSE MAGNETIZATION – Component of the macroscopic
magnetization vector at right angles to the static magnetic field.
UPPER LIMB – Includes hand, wrist, forearm, elbow, arm and shoulder.
USER – Any person or entity that owns or controls a S-scan system, or is
responsible for the maintenance, safe, effective and appropriate use of
that system. The USER safety tasks includes those of the RESPONSIBLE
ORGANIZATION.
VOXEL – Volume element. The element of 3D space corresponding to a
pixel, for a given slice thickness.
WEEE – Waste electrical and electronic equipment
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CHAPTER 3
Instructions for Safe Use
••••••
The S-scan User Manual provides the information required for safe and
effective use of the system by properly trained and qualified personnel.
Esaote S.p.A. assumes no responsibility for personal injury or property
damage arising from the user’s failure to observe the following conditions.
☛ The system is used in compliance with the instructions in the User
Manual (and relative Appendices), which must be available to the
operating personnel intact and in legible conditions.
☛ A system that is faulty, damaged and/or with missing parts must not be
used.
☛ The assembly, maintenance, extensions, adjustments, modifications,
and repairs are carried out exclusively by authorized Esaote personnel
and with original Esaote specified parts.
☛ The installation area conforms with the safety measures specified in the
User Manual and in the Service Manuals.
☛ The installation and use of the system complies with all local, federal
and/or state regulations regarding the operation of MR equipment and the
safety of patients, personnel and others.
Caution
This product may only be used with original Esaote S.p.A. accessories
or accessories distributed by Esaote authorized third-parties.
Caution
Failure by the user to observe the safety information in this document
and/or in other relative documentation is to be considered improper
use of the system.
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Operator Profile
Personnel Qualifications and Training

Safe and efficient use of S-scan requires patient examinations to be
supervised and performed by qualified personnel, who are licensed and
certified by appropriate local, state, or federal authorities.
Esaote provides on-site training, by Esaote representatives, or by
authorized third-party personnel, following system installation or major
system modifications.
Certain hazards are inherent in the use of MRI equipment. To safeguard
patients, operators and others, the user must understand and be familiar
with safety and emergency procedures, with the operating instructions
and user interface, and with preventive maintenance procedures.
It is important that the user be able to recognize hazards or potential
hazards and take adequate precautions to protect the patient and others.
Although no adverse biological effects have been demonstrated to date at
the levels of magnetic and RF field intensity and exposure times used by
the S-scan system, the User should be familiar with current scientific
literature on this topic.
Evaluation of the potential hazards and the risk/benefits considerations
associated with S-scan examinations is the responsibility of the
supervising physician.
Minimum physical requirements:

☛ The operator user must meet the following requirements, both in
normal and in emergency procedures.
• Ability to manipulate the various controls of the apparatus; fine
motor skills are required
• Visual acuity adequate to distinguish shades of gray
• Hearing acuity adequate to hear instructions requests made in a
normal voice.
• The necessary strength to physically assist patients during
positioning manoeuvres; must be able to push and pull the patient
table with the patient on top.
• The ability of walking, sitting, standing, bending as associated with
the patient examination procedure.
• The ability to use hands for positioning of the patient.
☛ The physician user must meet the following requirements.
• Visual acuity adequate to assess image quality on both film and
computer displays.
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• The audio visual condition to allow routine monitoring and medical
supervision of the patient.

Operating environment
The operating environment is defined as the actual environment and
conditions in which the user interacts with the system.
S-scan is designed to be used:
☛ in a public or private hospital environment
☛ in medical clinics located in a commercial environment.
Warning
S-scan is not intended for use in emergency situations outside a
healthcare or hospital environment.
S-scan is not intended to be used as the sole diagnostic system in
emergency departments of healthcare or hospital environments or
medical clinics.
Controlled access area

The user must define a controlled access area around the S-scan system,
so that outside this area:
☛ the magnetic fringe field does not exceed 0.5 mT
☛ the level of electromagnetic interference complies with Standard
EN 60601-1-2 and subsequent amendments.
The user is further advised to use warning and prohibitive signs and labels
and establish adequate rules for the controlled access area for patients,
operators and others, to appropriately restrict entry.
Restrictions to public access begin at the limits of the controlled access
area.
The controlled access area restrictions are important safety measures:
☛ to reduce exposure of patients and others to risks associated with the
S-scan magnetic field
☛ to prevent the introduction of ferromagnetic objects or tools
☛ to prevent the use of peripheral equipment that is not recommended for
use in the controlled access area.
It is the user’s responsibility to ensure observation of federal, state and/or
regulations governing entry to the controlled access area.
See the chapter “Installation” in this manual.
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Warning
Do not allow any persons, who have the conditions and
characteristics for which exposure to the S-scan magnetic and RF
fields is contraindicated, to enter the 0.5 mT restricted area.
Warning
Users are advised to affix the warning and prohibition labels provided
with the equipment on all of the doors of the S-scan examination room.
Users are advised to mark the 0.5 mT line on the floor around the
S-scan installation area using the yellow adhesive tape that is
provided with the equipment.
The following system parts are located inside the controlled access area:
the magnetic unit and patient table.
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fig. 3.1 - Case 1 – Installation inside the Opera/S-scan shielded box
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fig. 3.2 - Case 2 – Installation inside the S-scan compact shielded box
When the system is installed inside a shielded rectangular room - with RF

attenuation properties equal to or greater than those of the shielding box
(see “chapter 5”, paragraph “Technical specifications” sub-section
“Accessories”of this document).
The minimum dimensions of the shielded rectangular room are 367 cm x
385 cm.
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fig. 3.3 - Case 3: Installation inside the rectangular shielded room
Peripheral equipment
The peripheral equipment used inside the controlled access area must be
labeled as MR Safe or MR Conditional.
This equipment guarantees that:
☛ no known risks are generated in any MR environment, or when used in
specific conditions
☛ the quality of diagnostic information supplied by the S-scan system is
not altered by peripheral equipment
☛ operation of peripheral equipment is not altered by that of the S-scan
system.
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Peripheral equipment labeled as MR Safe or MR Conditional also
guarantees minimized probability of induced currents caused by
connection of the equipment and the RF transmission coil of the S-scan
system can generate excessive heating or burns of the patient’s skin.
As the patient’s skin is conductive, closed conductive loops can form
between the patient and terminals (e.g. ECG electrodes) or cables of the
peripheral equipment, in which induced currents circulate with the risks
mentioned above.
Before using the peripheral equipment, the user must ensure electrical
insulation of conductive materials, except for those that must guarantee
electrical contact with the patient (e.g. ECG electrodes). Also the
conductive material of the peripheral equipment should be thermally
insulated if it comes into contact with the patient.
Never use ECG electrodes after the expiry date specified by the
manufacturer.
Warning
Never use peripheral equipment, including monitoring equipment
and/or RF coils, that has not been specifically tested and approved for
use in MR environments.
Interaction of monitoring equipment (above all regarding ECG
electrodes) and/or RF coils with the S-scan can cause burns or other
injuries to the patient.
If using monitoring equipment (e.g. ECG electrodes) and/or RF coils
declared and marked as MR safe or MR conditional, the relative
instructions for use must be strictly observed, with special regard to
electrode positioning, in order to avoid injury to the patient.
Any application performed on the patient using auxiliary equipment
(e.g. physiological monitoring) must be carried out under the
exclusive supervision and responsibility of the user.
The user must ensure suitable selection and correct use of monitoring
equipment (e.g. of ECG electrodes), RF coils and/or other devices
located in the vicinity of or above the patient.
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Projectiles

Ferromagnetic objects (e.g., tools, keys, scissors, hospital equipment,
pens, etc.) are attracted by the magnetic field, and may be forcefully
drawn in the direction of the S-scan gantry.
Similarly, ferromagnetic parts of peripheral equipment located within the
controlled access area may be drawn towards the gantry: for this reason,
only peripheral equipment classed as MR Safe or MR Conditional may be
positioned in the controlled access area.
Warning
All metal objects must be kept well away from the controlled access
area.
Ferromagnetic objects can become projectiles that may cause serious
injury to patients, operators and others.
Artifacts
Large moving ferromagnetic objects, such as for example a patient trolley,
may disturb the uniformity of the magnetic field, causing artifacts to
appear in the displayed image.
Elevators, ambulances, trains, subways and similar objects, if particularly
close to the magnet, can cause significant alterations to images due to
fluctuations of the static magnetic field.
Peripheral equipment, including monitoring equipment and RF coils can
generate RF interference and/or disturbance to the uniformity of the
magnetic field if not labeled as MR Safe or MR Conditional.
See the chapter “Installation” in this manual.
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Warning
Stretchers, wheelchairs and/or other hospital equipment, if
ferromagnetic, must not enter the controlled access area during
patient examinations.
S-scan must not be installed in areas subject to high levels of
magnetic disturbance or in the vicinity of areas in which elevators,
large trucks, ambulances, trains, subways etc. operate.
Peripheral equipment, including monitoring equipment and RF coils
used inside the controlled access area must be labeled as MR Safe or
MR Conditional.
Magnetic and RF disturbance can cause artifacts to appear on images
and therefore can lead to incorrect diagnosis of the latter.
Artifacts on images can be caused by loss in efficiency of the shielding

elements and possible magnetic compensation of the S-Scan system.
The loss in efficiency of the shielding elements and possible magnetic
compensation can be caused by:
☛ external magnetic and RF disturbance exceeding the specified limits of
the shielding elements and possible magnetic compensation were taken
into account during the pre-installation phase
☛ deterioration of shielding elements
In this case, the user should contact Esaote-authorized service personnel
for assistance.
Warning
Artifacts on images may be caused by a loss of efficiency of the
shielding elements and possible magnetic compensation: in this
event, contact Esaote authorized service personnel for assistance.
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Peripheral equipment compatibility test

The manufacturer of the peripheral equipment can assess the influence of
the S-scan system on the relative device using the special protocol
“susceptibility test”, the procedure of which is described in the chapter
“System management” in the user interface manual.
The test is aimed at assessing susceptibility to electromagnetic
disturbance of the peripheral equipment located in the vicinity of the
S-scan system; the test does not provide guarantees regarding correct
operation of the peripheral device.
This test also enables the user to verify the susceptibility of the S-scan
system to electromagnetic disturbance caused by peripheral equipment
located in the vicinity.
The “susceptibility test” protocol has been drawn up to enable operation of
the S-scan system with a high RF transmission field and high bandwidth
and gradient response speeds. The test can be carried out as per standard
procedure on the system.
The test configuration envisages the use of:
☛ Knee Coil 2:
☛ geometric phantom. The geometric phantom is filled with a water
solution of NiCl2 and NaCl.
☛ Susceptibility protocol, containing the sequences:
• Spin Echo 18, to assess susceptibility of peripheral equipment to
electromagnetic disturbance caused by the system. The parameters
are: TE = 18 ms, TR = 530 ms, FOV = 100*100, acquisition matrix
= 256*256, number of slices = 14, slice thickness = 2 mm, gap =
1 mm, number of excitations = 6.
• Gradient Echo 10, to assess susceptibility of the system to
electromagnetic disturbance caused by peripheral equipment. The
parameters are: TE = 10 ms, TR = 500 ms, FOV = 200*200,
acquisition matrix = 256*256, number of slices = 11, slice
thickness = 5 mm, gap = 0 mm, number of excitations = 6.
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Warning
If the geometric phantom leaks solution or breaks, the following
precautions must be taken:
- use gloves, goggles, safety clothing and footwear to handle the
leaked solution
- use inert material (sand or earth, for example) to absorb the material
and clean the area with water
- collect the contaminant material and dispose of in accordance with
current national, federal and/or local standards.
If the solution in the phantom comes into contact with the skin, it may
cause an allergic reaction to the nickel and, in contact with the eyes,
may cause irritation.
Patient area
The patient area is defined as the area in which intentional and/or
unintentional contact can occur between the patient and system parts, or
between the patient and other persons touching system parts.
On the S-scan system, the patient area coincides with the shielding box or
the shielded rectangular room where the system is installed.
Inside the patient area, the system guarantees a safety level comparable
to that supplied by electro-medical equipment conforming to the standard
EN 60601-1 and subsequent amendments.
Caution
The interior of the shielding box or room can house the magnetic unit,
patient table, and an accessory cabinet (if required); any other object
and/or equipment must be kept outside this area to avoid interference
with or damage to the S-scan system.
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Pre-screening of patients

The user must make a careful evaluation of the risks associated with the
personal and clinical history of patients, their psychological and physical
conditions and profession before performing an examination using the
S-scan system.
The evaluation should identify any contraindications that would preclude
the examination and any special precautions that should be taken before
or during the examination.
CONTRAINDICATIONS
MR examination is contraindicated:
☛ for patients with implants or internal devices that are electrically,
magnetically or mechanically activated
☛ for patients who rely on electrically, magnetically or mechanically
activated life support systems
☛ for patients with implanted surgical clips or metal objects in the cranial,
ocular and vascular areas, unless the supervising physician has
ascertained that the implant/device is labeled as MR Conditional.
Warning
Never examine patients with pacemakers, neurostimulators, infusion
pumps, cochlear implants or other active systems.
Never allow these patients to enter the controlled access area.
Magnetic and RF fields produced by S-scan may interfere with
electrically, magnetically or mechanically activated devices.
Magnetic and RF field interference may result in serious injury and
may damage or alter the proper functioning of the devices.
Warning
Do not examine patients who have intracranial aneurysm clips, ocular
and vascular implants or other implanted ferromagnetic objects,
unless the supervising physician has ascertained that they are MR
Conditional.
Never allow these patients to enter the controlled access area.
The magnetic field exerts a force of attraction on ferromagnetic
objects within the field.
This force may move or dislodge surgical clips or other ferromagnetic
implants, causing serious injury or death.
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SPECIAL PRECAUTIONS: PATIENTS WITH METAL
OBJECTS IN THE BODY
☛ for patients with surgical clips (haemostatic clips) or other
ferromagnetic implants labeled as MR Conditional
☛ for patients with implanted prosthetic heart valves labeled as MR
Conditional
☛ for patients with non-ferromagnetic metal implants labeled as MR
Conditional
☛ for patients who due to their professional activity or personal history
(e.g. war injuries), may have embedded ferromagnetic material or metal
fragments
☛ for patients with body tattoos or permanent (tattooed) eye-liner or
patients wearing cosmetics on their eyes and/or eyelashes
Warning
Always compare the values indicated by the manufacturer of the
implant in its accompanying documentation to the values reported
below in this User Manual:
1) static magnetic field (see chap. 5, paragraph “Technical
specifications - magnetic system”)
2) Gradient magnetic fields (see chap. 5, paragraph “Technical
specifications - Dedicated gradient system”)
3) maximum SAR (see this chapter, paragraph “Operating mode”)
to establish if the implant can be used safely within the controlled
access area.
The safety of an implant outside of the marked MR conditions is not
known.
All the implants labeled as MR Unsafe must not be examined and must
not enter the 0.5 mT restricted area.
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Warning
Do not examine patients with metal or ferromagnetic implants and do
not allow such patients to enter the controlled access area, unless the
supervising physician has ascertained that the implants are MR
Conditional.
The effect of eddy currents in large metal implants may cause local
heating of the body tissue.
Caution
Ferromagnetic and non-ferromagnetic metal implants may cause
artifacts.
The physician must be made aware of the implants in order to
correctly evaluate the possible artifacts and thus avoid an incorrect
interpretation of the images.
Warning
Never examine patients suspected of having microscopic metal
fragments in the eyes and do not allow them to enter the controlled
access area, unless the supervising physician has identified the
fragments and approved that it is safe to proceed.
Examination of patients who have metal fragments in their eyes may
cause eye injury and/or irritation.
Caution
Never examine patients with tattoos and/or permanent eye-liner and
prohibit entry of the latter in the controlled access area, unless the
supervising physician has identified the tattoos and/or permanent
eye-liner and approved that it is safe to proceed.
These materials may cause skin irritation and cutaneous swelling
during the MR examination.
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Caution
To avoid eye irritation, patients must remove all make-up, particularly
eye make-up, that may contain ferromagnetic particles.
SPECIAL PRECAUTIONS: PREGNANT OR INFANT

PATIENTS
☛ for newborn babies or infants
☛ for pregnant women (especially during the first three months of the
pregnancy)
Warning
Pregnant women and newborn babies must be examined by the
supervising physician before entry in the controlled access area, to
evaluate the benefits of magnetic resonance with respect to
alternative procedures.
The safety of magnetic resonance imaging for newborn babies,
infants, embryos, and fetuses has not been demonstrated.
SPECIAL PRECAUTIONS: HIGH RISK PATIENTS

☛ for patients with greater than normal potential for cardiac arrest
☛ for patients who are likely to develop epileptic seizures or
claustrophobic reactions
☛ for de-compensated cardiac patients, febrile patients or patients with
impaired perspiration ability
☛ for patients with compromised thermoregulatory systems (e.g.
newborn babies, low birth weight infants, certain cancer patients)
☛ for unconscious patients, sedated patients or patients in a state of
mental confusion with whom no reliable communication can be
maintained.
Warning
High risk patients, and in general all patients for whom the MR
examination may require special precautions, must be continuously
monitored by the physician during the examination.
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Pre-screening of MR Personnel

The user must make a careful evaluation of the risks associated with the
personal and clinical history of MR personnel, their psychological and
physical condition and their professional role before allowing them to
enter the controlled access area.
This evaluation should identify any contraindications that would preclude
access of the MR personnel to the controlled access area and therefore
examinations, and any special precautions that should be taken before
and/or during the examination.
MR personnel are subject to the same conditions as regards
contraindications and/or special precautions as specified for the patients
(see paragraph “Pre-screening of patients” in this chapter).
Emergency medical procedure

The User must define and be prepared to implement emergency medical
procedures to assist patients during MR examinations. The procedure
must take into account the presence of magnetic and RF fields and/or
implement a method to quickly remove the patient from the magnetic and
RF field area.
In the event of an emergency the radio frequency impulses and
generation of the magnetic field can be blocked in three ways as follows.
1 Via software, by clicking with the right mouse button in the Info Area
o Scanning of the user interface and selecting End o All in the menu
that appears: all scans queued will be interrupted.
2 Press the S-scan system ON button on the front of the electronic box
to start up system electronics
3 Turn off the wall-mounted main switch. In this case the equipment is
completely de-activated and therefore the thermal control is also
turned off; to re-activate the equipment it is necessary to turn on the
mains switch and the system switch and wait for the magnet to return
to its working temperature.
After performing one of the above procedures, the user should remove the
patient from potential influence of the magnetic field as described in the
procedure in the chapter “Positioning protocols”, paragraph “Removing
the patient in an emergency” in this manual.
Note
If the emergency stop procedures requiring switching off the PC are
used, the file system may be damaged and data, images or programs
may be lost.
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Warning
The S-scan magnet is a permanent magnet and its static magnetic field
cannot be de-activated in an emergency.
Never use resuscitation devices such as defibrillators, oxygen tanks,
etc., within the controlled access area.
Remove the patient from the influence of the magnet, following the
procedure described in the chapter “Positioning protocols” in this
document.
Warning
During an examination, if an anomalous shutdown of the OPI -
Operator Interface program occurs, the user must turn off the S-scan
system main switch at the front of the electronic box, or the external
wall-mounted mains switch, to stop the radio-frequency impulse and
generation of the magnetic field gradient.
Monitoring the Patient during Examinations.

During an S-scan examination it is important to maintain communication
with the patient and to monitor the patient’s well being.
Users are advised to limit the examination time to 45 minutes. The
supervising physician is responsible for the evaluation of each case with
respect to potential hazards and risk / benefit trade-offs.
Operating Mode
The S-scan operating mode for all supported sequences is the Normal
Operating Mode as defined by the EN60601-2-33:2002 and subsequent
amendments.
This means that the values of static magnetic field, gradient output and
SAR measured on the S-scan system do not exceed the limits specified by
the standard for Normal Operating Mode and consequently no specific
information or measurements are displayed on the system user interface.
These limits are based on current literature regarding the safety of levels
of exposure to static magnetic fields, time-varying magnetic fields and
radio frequency.
In accordance with standard EN 60601-2-33, the S-scan gradient system
is a dedicated gradient system. Therefore the gradient output is
expressed as an electric field E and the limit on operating mode is
determined using the calculation method as defined in the standard.
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In accordance with the standard EN 60601-2-33, the SAR to be measured
on the S-scan system is the partial body SAR. The limit value for normal

operating conditions is determined using the calculation method defined
in the standard for a patient of 75 kg, in the following environmental
conditions: temperature of 26 °C and relative humidity of 80%, which are
the environmental operating limits for the S-scan system.
Normal operating mode limits
Static Magnetic Field d2 T(*)
Gradient output for dedicated d3.3 V/m

gradient systems
Partial body SAR d6.4 W/kg
Head SAR d3.2 W/kg
The following values: a) nominal B0, b) maximum gradient of the static

magnetic field, c) nominal frequency range per nuclei, d) maximum
gradient output and e) maximum B1 RMS are listed in the ’About’ function
of the Operator Interface (main toolbar).
Personnel and patient exposure to the acoustic noise
Excessive noise
☛ The weighted sound pressure level (LAeq, 1 h) generated by the S-scan
system, measured according to paragraph 26 of standard
EN60601-2-33:2002, is below 99 dB(A).
☛ The non-weighted sound pressure level (Lp) generated by the S-scan
system, measured according to paragraph 26g of standard
EN60601-2-33:2002, is less than 140 dB.
system at the Operator console – daily exposure of MR operator to noise –
is below 80 dB(A).
system within the controlled access area is below 80 dB(A).
The user is advised that some federal, state or local laws regarding
exposure of employees to noise may apply.
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The user is advised – when the weighted sound pressure level (LAeq, 8 h)
in the controlled access area exceeds the limits as specified by federal,
state and local laws governing the exposure of employees to noise – to
instruct personnel to wear the appropriate ear protection devices when
located in the controlled access area during examinations.
Special precautions against acoustic noise
Warning
During the examination of sedated patients (for which special
precautions has been taken, as indicated in the previous paragraph
“Pre-screening of patients”) - even if the generated noise level always
remains within the limits set by International Standards - ear plugs or
ear protectors have to be used in order to prevent possible temporary
or permanent hearing impairment.
Personnel and patient exposure to the static magnetic field

The issues related to safety to be considered as regards the static
magnetic field, are the biological effects, projectile effects, safety and
compatibility of implanted medical devices and the compatibility of the
peripheral equipment.
MR personnel and patient

☛ Biological effects.
There is no definitive proof that relates short and acute exposure to static
magnetic fields – to an intensity of 2.0 T – and the occurrence of an
irreversible or hazardous bio-effect in a person.
☛ Projectile effect.
The potential risk of the projectile effect of an object in ferromagnetic
material, within a magnetic field, is described in the paragraph “Controlled
access area”, sub-section “Projectiles” in this chapter.
☛ Implanted medical devices.
A strong magnetic field can influence medical devices implanted in the
body of a person (operator, patient or others) exposed to this field. The
issues regarding implanted medical devices are dealt with in the
paragraph “Pre-screening of patients” in this chapter.
☛ Peripheral equipment.
The static field can interfere with peripheral equipment containing
ferromagnetic components. The issues regarding compatibility of
monitoring equipment are dealt with in the paragraphs “Controlled access
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area”, sub-section “Peripheral equipment”, and “Peripheral equipment
compatibility test” in this chapter.

Do not put cash machine cards or credit cards, mechanical wrist-watches,
floppy disks, magnetic tapes etc. near the magnet. The user must ensure
that these objects remain outside the controlled access area.
exposure of employees to magnetic fields may apply.
The user must also bear in mind that the limits of MR personnel exposure
to the static magnetic field may not apply to pregnant women.
In some nations, there may be a requirement that the fetus is not exposed
to a static magnetic field exceeding the limit specified for the public.
In any event, the user is recommended to apply special precautions for
pregnant employees, even though there is currently no epidemiological
proof of harmful effects.
MR Personnel
Exposure to the static magnetic field can be minimized by staying away
from the magnet and avoiding rapid movements of the head when inside
the static magnetic field.
It is generally accepted that no published evidence supporting the
occurrence of cumulative and/or long-term effects after exposure to EMF
emitted by the MR systems exists.
As the maximum magnetic field and maximum magnetic field gradient
regions are located in correspondence with the edges are of the upper and
lower parts (poles) of the magnet (see chap. “Installation”, paragraph
“Main magnetic field and gradient of main magnetic field”), we advise that
the MR operator remains near the magnet and moves around it slowly.
The variation in the magnetic field over time is given by the product of the
speed multiplied by the gradient, and so the maximum speed of motion, in
order to not exceed a dB/dt value of 3 T/s is 1.5 m/s, which is a speed of
motion unlikely to be reached by an MR operator moving around the
system during the patient positioning procedure.
Fringe magnetic field

The figure below shows the maps of the magnetic fringe on the following
planes:
1 The plane passing through the isocenter of the magnet and
perpendicular to the magnetic field (parallel to the floor of the
installation site); see fig. 3.4
2 The plane passing through the isocenter of the magnet and parallel to
the magnetic field (parallel plane to the lateral plane of the magnet);
see fig. 3.5
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3 The plane passing through the isocenter of the magnet and parallel to
the magnetic field (parallel plane to the front plane of the magnet);
see fig. 3.6
Each plot contains the iso-magnetic contours with values of 0.5 - 1 – 2 - 3
- 5 - 10 - 20 - 40 mT.
fig. 3.4 - Top view
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fig. 3.5 - Side view
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fig. 3.6 - Front view
Caution
The measured magnetic flux density may vary from the contour plots
due to factors such as concentrating effects of nearby ferrous objects
and ambient fields, including the earth’s magnetic field.
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Main magnetic field and main magnetic field gradient

In the position in which the spatial gradient of the main magnetic field is
maximum, the force exerted on a ferromagnetic object saturated by the
spatial gradient of the main magnetic field is maximum.
In the position in which the product of the amplitude of the main magnetic
field multiplied by the spatial gradient of the main magnetic field is
maximum, the force exerted on a diamagnetic or paramagnetic object, or
a ferromagnetic material, is maximum.
On the S-scan system:
☛ the position in which the spatial gradient of the main magnetic field is
maximum, and
☛ the position in which the product of the amplitude of the main magnetic
field multiplied by the spatial gradient of the main magnetic field is
maximum,
coincide.
The spatial coordinates of this position are:
☛ X = 10±5 cm, Y = -20±5 cm, Z = 40±5 cm with respect to the magnet
isocenter.
The symmetry of the magnet with respect to spatial axes Y and Z means
that three other spheres must be taken into consideration:
☛ X = 10±5 cm, Y = -20±5 cm, Z = 40±5 cm with respect to the magnet
isocenter.
☛ X = 10±5 cm, Y = -20±5 cm, Z = -40±5 cm with respect to the magnet
isocenter.
☛ X = 10±5 cm, Y = 20±5 cm, Z = -40±5 cm with respect to the magnet
isocenter.
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fig. 3.7 - Standard patient table: regions of maximum magnetic field and
magnetic field gradient
fig. 3.8 - Compact patient table: regions of maximum magnetic field and
magnetic field gradient
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The values measured in the defined regions are as follows:
☛ Maximum main magnetic field: B0 = 57 mT

☛ Maximum spatial gradient of main magnetic field: 2000 mT/m
☛ Maximum result: (B0) x (spatial gradient B0) = 114000 mT2/m.
Personnel and patient exposure to a time-varying magnetic field

A time-varying magnetic field induces an electric field E according to
Faraday’s Law. The gradient coils in MR systems generate a time-varying
magnetic field, and therefore the body of the patient is exposed to an
induced electric field. This electric field can stimulate the heart, the
peripheral nervous system and the muscles, with thresholds that vary
according to frequency. The stimulation of the peripheral nervous system
(PNS) is induced by the minor gradient output values. Protection of the
patient from stimulation of the peripheral nervous system also serves to
prevent cardiac stimulation (CS).
Patient
The field intensity increases as you approach the upper wall of the gantry,
where the gradient coils are located, and therefore – during examinations
of larger patients – it is necessary to minimize the dB/dt influence on
parts of the body not being examined, but which are close to the gantry
walls during the examination.
Warning
To avoid excessive dB/dt exposure of the chest during shoulder or
spinal column examinations, especially for larger patients, place the
multipurpose cushion - thickness 3 cm (see chapter 9, “Cushion Set”
in this manual) - between the chest of the patient and the upper part of
the gantry.
MR Personnel
In the worst conditions, MR personnel are exposed to an electric field E
value equal to the gradient output limit, i.e. 3.3 V/m.
exposure of employees to electromagnetic fields may apply.
to electromagnetic fields may not apply to pregnant women.
In some countries, there may be a requirement that the fetus is not
exposed to electromagnetic fields exceeding the limit specified for the
public.
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Conformance to directive 2013/35/EC requires that fields induced by the
gradient do not exceed a threshold dependent on the frequency, defined
as the action level.
This action level is a decreasing function of the frequency up to 10 Mhz.
However, for the S-scan system, the most rapid variation possible, which
corresponds to the current rising edge, has a estimated maximum
frequency of 5 kHz, which determines action values of the fields induced
by the gradient equal to 0.1 mT for the whole body and head and 0.3 mT
for the limbs.
The following graphs show the spatial distribution of the field gradient
along the X axis of the magnet (front/rear axis relative to the front view of
the magnet).
fig. 3.9 - Spatial distribution of the magnetic field gradient along the X axis
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fig. 3.10 - Spatial distribution of the magnetic field gradient along the X axis:
detail showing correspondence with system covers
Exposure of the operator falls below the action values of:

☛ 0.1 mT - for whole body and head - at approximately 15 cm from the
front cover of the magnet
☛ 0.3 mT - for the limbs - at approximately 6 cm from the front cover of
the magnet.
The following graphs show the spatial distribution of the field gradient
along the Z axis of the magnet (right/left axis relative to the front view of
the magnet).
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fig. 3.11 - Spatial distribution of the magnetic field gradient along the Z axis
fig. 3.12 - Spatial distribution of the magnetic field gradient along the Z axis:
detail showing correspondence with system covers
Exposure of the operator falls below the action values of:

☛ 0.1 mT - for whole body and head - at approximately 17 cm from the
side cover of the magnet
☛ 0.3 mT - for the limbs - at approximately 8 cm from the side cover of
the magnet.
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MR personnel and patient exposure to the RF magnetic field

Heating is a major consequence of exposure to the RF frequencies used in
M.R. Many biological effects of acute exposure to radio frequency are
consistent with responses to induced heating that results from rises in
tissue or body temperature of about 1° or more, or with responses for
minimizing the total heat load.
Patient
The SAR can be directly compared with the heat that is induced by the
radio frequency.
Caution
The supervising physician must carefully monitor patients examined
when the temperature in the examination room exceeds 24 °C and
relative humidity exceeds 60%.
MR Personnel
The maximum transmission of the RF magnetic field in the isocenter of the
magnet is B12(0) equal to 22.08 µT.
The maximum transmission of the RF magnetic field in the
accessible/relevant positions for MR personnel during examination are
shown in the graph of B12 normalized with respect to its value at the
isocenter
fig. 3.13 - B12 normalized with respect to value at isocenter
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Conformance to the directive 2013/35/EC requires that SAR values do not
exceed a threshold, defined as the exposure limit value, of 10 W/kg fore
the head and trunk and 20 W/kg for the limbs.
The exposure limit value for parts of the body with the S-scan system is
less than or equal to 6.4 W/kg,while for the head it is less than or equal to
3.2 W/kg (as reported in the paragraph “Operating mode” in this chapter).
The graph in the previous figure also shows how that the SAR, starting
from a value already below the exposure limit, decreases as the distance
from the magnet increases. This means that the exposure limit values
prescribed by the directive are never exceeded.
exposure of employees to the RF magnetic field may apply.
to electromagnetic fields may not apply to pregnant women.
In some countries, there may be a requirement that the fetus is not
exposed to electromagnetic fields exceeding the limit specified for the
public.
MR personnel and patient exposure to contact currents

Contact current is the current produced when a person comes into contact
with conductor with a different electrical potential within a
electro-magnetic field.
Conformance to the directive 2013/35/EC requires not to exceed a
threshold, defined as the action level, determined by the frequency.
Taking into consideration the set of frequencies at which the S-scan
system operates, the action level is 1.0 mA.
S-scan is however designed in conformance with the standard
IEC 60601-1, which establishes an upper limit for contact currents of
100 µA (0.1 mA) in normal operation, and of 500 µA (0.5 mA) in single
fault conditions.
This means that the action levels prescribed by the directive are never
exceeded.
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Precautions against localized cutaneous heating

In general, when a patient subject to an MR examination creates closed
conductive loops (and thereby of electrical circuits) via the parts of the
body (hands touching the body or thigh-thigh, calf-calf, hand-hand,
ankle-ankle contact), localized cutaneous heating may occur in the
vicinity of contact points.
Closed conductive loops may also be created through contact between the
patient and the receiving coil cable and/or ECG terminals.
Currents caused by radio frequency circulate in the loops created by
passing through the contact surfaces: the smaller the surface area, the
greater the RF heating felt by the patient on the skin.
In fact possible burns/irritations are caused by the density of current
which increases in proportion to the decrease in size of the contact surface
passed through by the current.
Other factors may increase the likelihood of excessive local RF heating:
☛ parts of the body in contact with the surface of the transmission coil (for
this purpose, use standard cushions placed between the anatomy
examined and the coil surface)
☛ the presence of disconnected receiving coils or electric cables inside the
gantry during examinations
☛ the formation of a loop by the receiving coil cable: the cable is twisted
around itself.
☛ presence of garments containing threads or metal components inside
the gantry
☛ presence of damp clothing
☛ presence of metal objects such as watches, coins, keys, etc. inside the
gantry.
☛ use of transdermal plasters containing medical substances, which can
cause burns on the skin under the plaster.
Before positioning the patient inside the gantry, the user must check that
the latter has removed any clothing containing metal fibers or
components, damp clothing, metal objects and/or transdermal plasters.
The user must pay special attention during examinations of sedated or
unconscious patients or patients not sensitive in the anatomical regions to
be examined, who therefore cannot alert the user in the event of
excessive cutaneous heating.
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Caution
Remove any clothing containing metal fibers or components, damp
clothing, metal objects and/or transdermal plasters from the patient.
Instruct the patient inside the gantry not to touch parts of the body
with the hands and direct contact between the thighs, knees, calves,
ankles or hands.
This type of contact can generate closed conductive loops with the
consequent risk of localized cutaneous heating.
The user can decide to insert standard cushions between parts of the
body inside the gantry, which can easily come into contact due to the
position of the patient.
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Special Precautions for Patient Positioning

When used properly for examinations within the scope of its intended use,
S-scan can be used safely and effectively for most patients. However, the
compact design of the system implies a number of dimensional
restrictions that may limit or exclude the possibility of patient
examinations.
☛ Dimensional limits of the gantry and the receiving coils - see chapters 6,
8 and 12
Caution
It is the full responsibility of the user to ensure that the dimensions of
the anatomical region of the patient to be examined are compatible
with that of the gantry and the coil required for the examination.
It is also the full responsibility of the user to verify that the examination
can be performed without excessive vascular or nervous pressure, or
impaired patient comfort and well-being.
The user should ask the patient if he or she has any nerve-related
impairments or back or leg problems prior to deciding how to position
the patient. The presence of such conditions may cause the user to
decide that it is not appropriate to use the system.
Warning
If the coil is too small with respect to the size of the limb, it may exert
pressure on the nerves and blood vessels of the limb under
examination.
In particular, when performing knee examinations, the User is advised
to use caution in order to avoid compression of the postero-lateral site
of the external sciatic-popliteal nerve, especially the area
corresponding to the proximal tibial-fibular joint.
Sciatic-popliteal nerve compression may cause temporary or
permanent impairment of the leg.
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☛ Positioning of the head the receiving coils on the patient’s head - see
chapters 6, 8 and 24.
Caution
When inserting the head coil in the coil housing, have great care to
avoid to harm the patient - especially on the nose, ears and head’s top
- and to pull the patient’s hair: inserting the coil in the coil housing
implies inserting the coil around the patient’s head.
☛ Size constraints of the magnet homogeneity region. See chapters

“Positioning protocols” further on in this manual, “Image Quality in MR”
and “Examination protocols and sequences” in the manual Image Quality
and Sequences.
Warning
To avoid possible misinterpretation of images, it is the user’s
responsibility to verify that the anatomy to be examined is correctly
positioned in the center of homogeneity region of the magnet, by
using the Scout sequence and observing the initial scans.
Warning
Because of displayed image constraints, S-scan is not recommended
for use in evaluation of diffuse pathologies that may extend beyond
the homogeneity region.
Users are advised to conclusively determine that tumors or other
diffuse pathologies are entirely within the homogeneity region, before
attempting to assess or diagnose them.
It may be not possible to assess or diagnose pathologies that extend
beyond the homogeneity region. The size of the pathology may not be
known and important diagnostic structures may not be visible.
☛ Removing the patient at the end of an examination Refer to chapters 13

to 21 regarding patient positioning.
Warning - Compact patient table

Before carrying out any further operations, disconnect the coil
connector from the top of the magnet to avoid breaking the cable.
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Warning - Standard patient table
Before any other operation, detach the connector of the coil from the
upper section of the magnet; otherwise the system will not enable
movement of the patient table.
☛ Limitations in the examination of the lumbar and cervical section of the

spinal column - see chapters 20 and 22 in this document.
Warning
Users are advised to perform only targeted examinations of
lumbosacral and cervical section of the spinal column with the S-scan
system. An MR marker may be applied to patient’s skin to delineate the
area to be examined and verify correct positioning.
It may not be possible to examine the entire lumbosacral section of the
spinal column in a single acquisition because the anatomical
structure of this area may extend beyond the S-scan homogeneity
region.
☛ Limitations in the examination of the thoracic section of the spinal

column - see chapter 21 in this document.
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Warning
Users are advised to perform only targeted examinations of thoracic
section of the spinal column with the S-scan system.
The entire thoracic section of the spinal column cannot be examined
in a single acquisition because the anatomical structure of this area
may extend beyond the S-scan homogeneity region.
Users are advised to perform the examination of the thoracic section
of the spinal column taking care to clearly define the anatomical
landmarks, in order to avoid any problems related to the correct
identification of the area to be examined.
The entire thoracic section of the spinal column can be examined by
performing two or more examinations, but physical repositioning of
the patient is required.
Due to the physical repositioning of the patient, the two or more
examinations can not be merged with stitching software technique,
but will instead have to be evaluated individually.
It is the responsibility of the user to draw his/her own conclusions on
the entire thoracic section through evaluation of the individual
examinations.
☛ Limitations in the examination of the head - see chapter 24 in this

document.
Warning
Because of the absence of particular sequences (e.g. DWI,
diffusion-weighted imaging), it may not be possible to assess some
head conditions (e.g. stroke, MRA, MRV, seizures and others) with the
S-scan system.
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Precautions against mechanical hazards

In compliance with standard EN60601-1:1990 and subsequent
amendments, all parts of the S-scan system are mechanically stable. It is
advisable, however to take some precautions.
☛ Standard / compact patient table (see chapter 6 in this document)
Warning
The maximum load for the patient table is 200 kg (441 lb). Never
exceed this limit. Overloading may cause mechanical failure of the
table, with possible injury to the patient or operator.
Warning
Ensure that the arms, hands, legs and feet of the patient remain
positioned above the table throughout the examination. Limbs
protruding from the sides of the table may be trapped during manual
movement of the table.
Caution
Do not allow anyone to approach the system, from the front, rear or
side, during motorized movement of S-scan, rotation of the system to
avoid possible injury and/or entrapment of the limbs.
☛ If S-scan is installed within the Shielding Box the following precautions

should also be taken:
Warning
The top of the Shielding Box is not designed to support weights.
Placing objects or body weight on the Shielding Box may cause
mechanical failure of the structure. Both of the above actions can
cause structural mechanical failure.
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☛ S-scan is equipped with a step to help the patient get on and off the
table. The following precautions must be taken when using this
component:
Warning
The maximum load capacity of the step for patient positioning is
200 kg (approx. 440 lb). Never exceed this limit. Overloading may
cause mechanical failure of the step, with possible injury to the patient
or operator.
Do not stand on the step for prolonged periods.
Check that all four feet of the step are resting on the floor.
Tell patients about the step and how to use it correctly to get up and
down from the table.
☛ S-scan is equipped with three optional coils - cervical 14, lumbar 17 and
lumbar 18 - comprised of a fixed lower section and an upper section that
can be removed to make it easier and more comfortable to position the
patient.
Warning
When refitting the removable upper section of cervical coil 14 and
lumbar coils 17 and 18, take great care to avoid trapping the patient’s
skin between the coil connectors and/or the fixed and removable
sections of the coil.
Also check that the upper section of the coil does not press against
the patient’s neck (cervical coil 14) or chest and/or abdomen (lumbar
coils 17 and 18) and create breathing difficulties.
Precautions when using the contrast agent in MR examinations.

During an examination using the dynamic acquisition method, it is normal
practice to use paramagnetic contrast agents, which reduce the T1 value
of certain tissues, thereby increasing their contrast with adjacent tissues.
As paramagnetic contrast means are, to all effects and purposes,
pharmaceuticals, a number of precautions should be taken before use.
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Warning
Before using any contrast agent, refer to the information provided by
the manufacturer.
Contrast agents may cause serious adverse effects such as
anaphylactic reactions, or other side effects such as rashes.
Warning
Use exclusively paramagnetic contrast agents (gadolinium
compounds) approved by competent Regulation Authorities for use in
magnetic resonance imaging.
Before using any contrast agent, refer to the information provided by
the manufacturer.
Contrast agents may cause serious adverse effects such as
anaphylactic reactions, or other side effects such as rashes.
Warning
Patients with serious renal insufficiency, on administration of a
gadolinium based contrast agents may develop a potentially fatal and
debilitating illness known as nephrogenic systemic fibrosis (NSF).
Also patients who have recently undergone or are about to undergo a
liver transplant, or patients with chronic liver disease, are at risk of
developing NSF if suffering from renal insufficiency to any degree.
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Precautions against electric shock
All installation, maintenance or repair procedures must be carried out by
Esaote authorized service personnel.
If the equipment operates abnormally in any way, switch off the console
and the main power supply so that the thermostat is also disconnected.
Contact Esaote authorized service personnel and provide as much
information about the irregularity as possible. Service personnel will call
for inspection and any necessary repairs.
Warning
Do not attempt to open or remove the external system covers.
Touching the exposed internal wiring or circuitry can result in
electrical shock.
Keep all liquids away from the system. Conductive liquids, such as
drinks, or water, could easily be knocked over and spill into the active
components of the circuits, causing an electrical shock hazard.
The connection of the S-scan system to peripheral equipment must be

made by authorized Esaote S.p.A. technical assistance personnel.
Warning
Peripheral devices connected to the S-scan must comply with:
- safety standard EN 60601-1 and subsequent amendments.
or
If the devices comply with the safety standard EN 60950-1 they should
be installed away from the patient’s area, as foreseen by the safety
standard EN 60601-1-1 and subsequent amendments.
The peripheral devices connected to the S-scan must also comply with
EN 60601-1-2 safety standard and subsequent amendments or the
electromagnetic compatibility provisions of 89/336/EEC Directive and
subsequent amendments.
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Warning
Do not touch the patient and any peripheral device connection at the
same time.
Doing so may cause an electric shock to the patient and/or operator.
Fire and explosion precautions

The precautions to be adopted in the event of fire and/or explosion must
be discussed with the local fire-fighting department.
The user is responsible for taking adequate fire prevention measures in
the area of installation and to establish an emergency procedure in case of
fire and/or explosion.
Warning
Use liquid and spray cleaning agents with caution. Conductive liquids
that drip on to the equipment components may cause a short circuit
and a risk of fire.
Never use organic solvents to clean the system or use the system in
the presence of such substances if flammable. The use above or in the
vicinity of the system may lead to explosion or fire.
Ensure that flammable liquids, vapors, powders and explosive gases
are kept away from the area of installation. Electrical circuits can ignite
such substances.
An extinguisher, specifically tested and approved for use in magnetic
resonance, should be kept on site; ensure that this extinguisher is not
exchanged or replaced with others – with steel cylinders – during
maintenance.
Using the wrong type of fire extinguisher can cause electric shock, fire
or projectile effects.
In the event of prolonged disuse of the system, cover with a
waterproof sheet.
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Disinfecting and cleaning the system
Before describing the procedure for disinfecting and cleaning the system,
the user must be familiar with the following definitions:
DETERSION- Mechanical procedure for removing a high percentage of
microorganisms and organic/inorganic material.
DETERGENT - Substance that reduces surface tension between dirt and
surface to aid removal.
DISINFECTION - Chemical or physical process that reduces the degree of
microbic contamination in the vegetative phase on inert material.
DISINFECTANT - Chemical process able to destroy pathogenic agents in
the phase of development (bacteria, fungi, viruses). This term indicates
products to be applied on inanimate objects (e.g. surfaces).
At the end of each examination during which potentially infected blood or
organic liquids have come into contact with the surfaces of the S-scan
system (receiving coils, patient table, upper internal section of the
gantry), the following procedure should be carried out:
1 clean contaminated surfaces thoroughly using neutral pH factor
detergent
2 treat surfaces with a detergent solution with electrolytic chloroxidant
base and 1.15% of active chlorine (e.g. AMUCHIN£A), diluted to 5%.
Apply the product by means of soaked and wrung gauze, taking great
care that the solution does not drip onto electrical contacts (cables,
connectors) of the receiving coils and/or patient table. The product
must be diluted by 5% in purified water or other water with similar
properties.
3 leave the disinfectant solution to act for 15 minutes
4 rinse the disinfected surfaces with a clean cloth dampened in purified
water, taking great care that the solution does not drip onto electrical
contacts (cables, connectors) of the receiving coils and/or patient
table
5 clean all surfaces involved in the procedure thoroughly.
Before each examination cover the table and cushions with a disposable
paper sheet.
Warning
Never touch any part of the system, in particular the control panel, PC
keyboard or mouse, when the hands are contaminated with blood or
other organic fluids.
To maintain the condition and appearance of S-scan, it is recommended

that the exterior surfaces of the equipment be thoroughly cleaned at least
every two weeks.
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All external surfaces of the magnetic and electronic unit and operating
console must be cleaned with solvent-free neutral pH detergent and dried

thoroughly.
Surfaces that are likely to become soiled from direct contact with the
patient or the operator are:
☛ the gantry walls, the coils, the patient positioning table and the
cushions. All these surfaces must be cleaned with a neutral pH factor
detergent and dried thoroughly
☛ the keyboard and mouse, which must be cleaned with suitable spray
detergents (do not use other products that may damage electrical
contacts of the keyboard and mouse) and dried thoroughly
☛ the monitor, which must be cleaned according to the instructions in the
user manual supplied
☛ the surface of the operator table and, above all, the mouse mat, which
must be cleaned with a neutral pH factor detergent and dried thoroughly;
the accumulation of dust and other dirt on the mouse mat and
consequently on the track ball may impair correct operation of the mouse.
Warning
Switch off the system before all cleaning and disinfection operations.
Ensure that the detergent and/or disinfectant used does not come into
contact with connectors/electric cables of the system (in particular the
patient table and receiving coils).
Make sure that detergent has completely dried before switching the
system on.
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Periodic maintenance
S-scan requires certain periodic maintenance procedures that are to be
performed by Esaote authorized service personnel. Maintenance
operations and their frequency are specified in the following table:
Maintenance Minimum frequency
system calibration check every six months
transmission coil check every six months
create a backup copy of the system every six months
cleaning the gantry every six months
cleaning the receiving coils and checking correct insertion into the every six months
gantry
checking the condition and number of cushions every six months
cleaning and checking the functioning of the cooling fans (with the every six months
exception of the MTCM board and TPM module fans)
removal of dust inside the PC and electronic unit every six months
calibration of the receiving coils every six months
checking the ground connections, cables, connectors inside the PC, every six months
the electronics box and magnetic unit and the filters panel
checking the condition of the safety symbols every six months
checking the functionality of the control panel (RTK) and the every six months
firmware installed
checking the functionality and integrity of the patient table every six months
checking the functionality and integrity of the wheel brakes every six months
checking the functionality and structural integrity of the shielding every six months
box and the doors
checking condition of finger strips on the doors of the shielding box every six months
and electronic box
cleaning the LCD monitor, keyboard and mouse every six months
shimming parameter check every year
checking the condition of the power supply cable every year
checking the of functioning the warning lights every year
system insulation check every year
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Quality Assurance

The image quality test, described in the chapter “System Management”,
has been designed to measure the Signal and Noise (S/N) ratio of a
standard image and to check for any deterioration in the quality of the
system image.
This test is accessible to the user and should be performed on each
system start-up. It is performed periodically by Esaote technical
personnel during the maintenance procedures.
The test configuration envisages:
☛ Knee Coil 2
☛ the large uniform phantom filled with an aqueous solution of NiCl2 and
NaCl.
☛ the sequence Test S/N - a Spin Echo sequence the parameters of
which are described in the chapter “Technical description” in the user
manual Image Quality and Sequences.
S/N ratio calculation: after performing the test sequence, the system
evaluates the signal as the average value of the region of interest (ROI) in
the center of the image (center of phantom) and the noise as a standard
deviation of four ROIs positioned outside the image.
The area of the signal ROI is 20x20 pixel and the area of each noise ROI is
20 x 20 pixel.
The S/N ratio is calculated as the ratio between the signal value and the
noise value defined above.
As regards the aqueous solution in the phantom, only the NiCl2 is
potentially hazardous, but the concentration in the solution is extremely
low.
Warning
If the uniform phantom leaks some solution or breaks, the following
precautions should be taken:
leaked solution
- use inert material (sand or earth, for example) to absorb the material
cause an allergic reaction to the nickel and, in contact with the eyes,
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System life cycle
Lifetime
Safety and efficiency of the S-scan system is guaranteed for at least ten
years from the date of purchase, provided it is used in observance of the
conditions specified below:
☛ The system is used in compliance with the instructions in the User
Manual (and relative Appendices), which must be available to the
operating personnel intact and in legible conditions.
☛ The assembly, maintenance, extensions, adjustments, modifications,
and repairs are carried out exclusively by authorized Esaote personnel
and with original Esaote specified parts.
☛ The installation area conforms with the safety measures specified in the
User Manual and in the Service Manuals.
☛ The installation and use of the system complies with all local, federal
and/or state regulations regarding the operation of MR equipment and the
safety of patients, personnel and others.
As the expiration of this ten-year period approaches, the user is advised to
contact the authorized Esaote technical personnel or to visit the website
www.esaote.com for updated information regarding the end of the
product lifetime and/or agree upon the most suitable solution for safe
disposal.
Maintainability Time
Esaote S.p.A. guarantees safety and efficiency of the S-scan system for
ten years from the date of purchase.
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Disposal at the end of product lifetime

S-scan is classified within the field of application as stated in the Directive
2002/96/CEE WEEE (on the disposal of electrical and electronic
equipment).
Therefore the main system dataplate bears the symbol shown below,
clearly stating that the equipment must be disposed off as classified waste
separately from urban waste and that the product was issued onto the
market after 13 August 2005.
fig. 3.14 - “Dust bin with cross” symbol
When disposing of any parts of the system, the user must consider the
following points:
☛ any recyclable parts of the system and/or packaging are marked with
the relative symbol
☛ with the exception of the protection barrier, all packaging components
can be recycled and/or reused.
Caution
The system and relative consumables should be disposed of
according to state, federal and/or local regulations and the end of their
lifetime.
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Correct management and privacy of patient data
Modifications to personal data of patients (see chapter “Image Viewer” of
the user interface manual, section “Correcting and adding patient data”)
are highly critical operations as they may constitute a breach of patient
privacy or lead to an incorrect diagnosis of images as described below.
Warning
Modifications to personal patient data may lead to incorrect diagnosis
of images, caused by:
- discrepancy between images and relative personal data (for example,
accidental substitution of patient data with those of another person)
- discrepancy between patient data stored on images - and modified –
on the system and data present on the same printed images, sent via
the network, saved on removable media and/or stored on PACS prior
to data modifications.
The operation of exporting images acquired with S-Scan onto removable

media (see chapter “Removable media management” of the user interface
manual), also enables the user to save a file – with the extension .csv –
containing the list of the patient data related to the examinations
exported.
This file can then be displayed and modified using Microsoft Excel.
Warning
It is the exclusive responsibility of the user to conserve the .csv file
containing patient data, to guarantee correct management of these
data and respect of patient privacy.
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Conformance to standards

☛ S-scan complies with the Medical Equipment Directive 93/42/EEC and is
CE marked .
☛ S-scan is a device in Class IIA according to directive 93/42/EEC (1993)

and subsequent amendments.
☛ S-scan is a Class I device and its parts are classified type B according to
the standard EN 60601-1 and subsequent amendments.
☛ S-scan must be permanently connected to the electrical mains.
☛ S-scan is designed for continuous operation.
☛ S-scan is non-protected with respect to harmful ingress of water.
☛ S-scan is not designed for use in the presence of an anesthetic
flammable mixture with air or oxygen or with nitrogen protoxide.
☛ S-scan complies with EN 60601-1-1 and subsequent amendments.
☛ the parts of the S-scan system that come into contact with the patient
comply with EN ISO 10993-1, in the category of devices subject to
superficial contact of limited duration (d 24h)
☛ S-scan complies with EN 60601-2-33 and subsequent amendments,
and its operating mode is Normal Operating Mode.
☛ S-scan complies with EN 114971 and subsequent amendments
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European and international standards
Reference and title of the Standard (and reference document)
EN 60601-1:2006
Medical electrical equipment — Part 1: General requirements for basic safety and essential
performance
IEC 60601-1:2005
EN 60601-1:2006/AC:2010
EN 60601-1:2006/A1:2013
IEC 60601-1:2005/A1:2012
EN 60601-1-1:2001
Medical electrical equipment — Part 1-1: General requirements for safety — Collateral
standard: Safety requirements for medical electrical systems
IEC 60601-1-1:2000
EN 60601-1-2:2015
Medical electrical equipment - Part 1-2: General requirements for basic safety and essential
performance – Collateral standard: Electromagnetic disturbances – Requirements and tests
IEC 60601-1-2:2014
EN 60601-1-4:1996
Medical electrical equipment — Part 1-4: General requirements for safety — Collateral
standard: Programmable electrical medical systems
IEC 60601-1-4:1996
EN 60601-1-4:1996/A1:1999
IEC 60601-1-4:1996/A1:1999
EN 60601-1-6:2010
Medical electrical equipment - Part 1-6: General requirements for basic safety and essential
performance – Collateral standard: Usability
IEC 60601-1-6:2010
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Reference and title of the Standard (and reference document)

EN 60601-2-33:2010
Medical electrical equipment - Part 2-33: Particular requirements for the basic safety and
essential performance of magnetic resonance equipment for medical diagnosis
IEC 60601
IEC 60601-2-33: 2010
EN 60601-2-33:2010/A1:2015
IEC 60601-2-33:2010/A1:2013
EN 60601-2-33:2010/A2:2015
IEC 60601-2-33:2010/A2:2015
EN 60601-2-33:2010/AC:2016-03
EN 60601-2-33:2010/A12:2016
EN ISO 10993-1:2009
Biological evaluation of medical devices — Part 1: Evaluation and testing within a risk
management process (ISO 10993-1:2009)
EN ISO 10993-1:2009/AC:2010
EN 60950-1:2006+A11:2009+A12:2011+A1:2010+A2:2013
Information technology equipment - Safety - Part 1: General Requirements
IEC 60950-1:2005+A1:2009+A2:2013
EN ISO 14971:2012
Medical devices — Application of risk management to medical devices (ISO 14971:2007,
Corrected version 2007-10-01)
EN 62304:2006
Medical device software - Software life cycle processes
IEC 62304:2006
EN 62304:2006/AC:2008
EN ISO 13485:2016
Medical devices — Quality management systems — Requirements for regulatory purposes
(ISO 13485:2016)
EN ISO 13485:2016/AC:2016
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CHAPTER 4
Installation
••••••
Installation of the S-scan system must be carried out exclusively by

technical assistance personnel authorized by Esaote S.p.A.
To ensure efficient and safe operation of the S-scan system, the
installation procedures specified in this chapter must be strictly observed
as well as all instructions in the Service Manual.
System installation should comply with any applicable federal, state and
local regulations regarding medical devices.
Caution
A preliminary inspection by an authorized Esaote S.p.A. technician is
required to verify minimum installation requirements.
Caution
The User is recommended to define - in agreement with all the relevant
parties involved - a safety site readiness check list which lists all
safety related aspects for the installation before operation of the
system starts.
Structural Requirements of the Installation Area

Standard patient table
The minimum recommended clearances to assure that patients can be
accommodated comfortably and for the user to properly operate the
equipment is an area of around 4.5 x 4.0 m2 (around 14.76 x 13.12 square
feet).
Compact patient table

The minimum recommended clearances to assure that patients can be
accommodated comfortably and for the user to properly operate the
equipment is an area of around 3.2 x 3.2 m2 (around 10.50 x 10.50 square
feet).
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Room/box height
The minimum height of the room/box required for installation is 2.4 m
(approx. 7.87 feet).
Floor
The floor must have sufficient load bearing capacity to support the weight
of the system, i.e. approx. 7000 kg (approx. 15,435 pounds) including
two people: the operator and patient.
If the system is installed with the Opera/S-scan shielding box, 1300 kg
(approx. 2860 pounds) should be added to the above weight – which also
includes the operator console and three persons - for a total weight of
8300 kg (approx. 18,298 pounds).
If the system is installed with the S-scan compact shielding box, 550 kg
(approx. 1210 pounds) should be added to the above weight – which also
includes the operator console and three persons - for a total weight of
7550 kg (approx. 16,645 pounds).
Caution
If the load capacity of the installation area floor is inadequate, it must
be reinforced to achieve the required capacity.
Electromagnetic requirements in the installation environment
Electromagnetic compatibility (EMC)

The S-scan system requires special precautions regarding
electromagnetic compatibility and installation and set-up must be
according to the EMC instructions provided in this section.
The configuration of S-scan required to guarantee compliance with
electromagnetic compatibility requirements is as follows:
1 the magnetic unit must be installed inside the modular shielding box
or a shielded rectangular booth, which must feature RF attenuation
properties equal to or greater than those of the modular shielding box.
2 the cables required for connection of the system to the mains, to a
digital printer and the system modem to the telephone line must have
the properties described below.
• LAN connection: Ethernet cable, length less than or equal to 5 m,
with load impedance of 100 Ohm
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2 / 22 •• Chapter 4
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Warning
Use of a shielded booth and/or connection cables other than as
specified above may cause an increase in emissions or a decrease in
immunity of the S-scan system.
Installation
Guidance and manufacturer’s declaration - electromagnetic emissions
The S-scan system is intended for use in the electromagnetic environment specified below. The customer or
the user of the system should assure that it is used in such an environment.
Emission test Compliance Electromagnetic environment - Guidance
RF Emissions Group 2 The S-scan system must emit electromagnetic energy in order to
perform its intended function. Nearby electronic equipment may be
CISPR 11 affected. See note and warnings after the table.
RF Emissions Class A The S-scan system configuration must include a shielding booth with
minimum RF shielding effectiveness equal to that of the Modular
CISPR 11 shielding box.
Harmonic emissions Compliant
IEC 61000-3-2 Class A
Voltage N.A.
fluctuations/flicker
emissions
IEC 61000-3-3
Note
The EMISSIONS characteristics of this equipment make it suitable for
use in industrial areas and hospitals (CISPR 11 class A). If used in a
domestic environment, for which a CISPR rating of class B is normally
required), this equipment may not offer adequate protection for radio
communication services. The user may have to adopt measures to
mitigate such problems, such as the repositioning or reorientation of
the equipment.
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Caution
The use of this equipment when positioned adjacent to or on top of
other equipment should be avoided as this could cause a malfunction.
If however this situation cannot be avoided, it is important to monitor
the operation this device and the other equipment to check that they
all function correctly.
Caution
The use of cables and accessories other than those specified or
supplied by the manufacturer of the equipment may lead an increase
in electromagnetic emissions or a reduction in immunity to
electromagnetic disturbance and consequently a malfunction of the
equipment.
Caution
Portable RF communication equipment (including peripheral
equipment such as antenna cables and external antennas) must not be
used at a distance of less than 30 cm (12 inches) from any part of the
S-scan, including cables specified by the manufacturer. Failure to
observe this rule could cause a deterioration of the equipment’s
performance.
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Guidance and manufacturer’s declaration - electromagnetic immunity
Installation
Immunity Test IEC 60601 Compliance Electromagnetic environment - Guidance
Test level Level
Electrostatic r8 kV contact r8 kV contact Floors should be wood, concrete, ceramic tile or

discharge (ESD) covered with synthetic material. In any case,
IEC 61000-4-2 r15 kV air r15 kV air the minimum relative humidity shall be at least
45%.
for professional healthcare
environments and special The PC and the monitor are in compliance with
environments
the immunity levels of their applicable
international EMC standards. Please observe
the following warning: when the S-scan system
is in operation, never touch metallic parts of the
PC or monitor, and in particular connectors
located on the relative rear panels.
With regard to the system parts located inside

the shielding box (special environment), S-scan
satisfies the ESD requirements of Clause 8.1 of
IEC 60601-1-2.
Electrical fast r2 kV for power r2 kV for power Mains power quality should be that of a typical
transient/burst supply lines supply lines commercial or hospital environment.
IEC 61000-4-4
r1 kV for r1 kV for
for professional healthcare input/output lines input/output lines
environments and special
environments
Surge r1 kV differential r1 kV differential Mains power quality should be that of a typical

IEC 61000-4-5 mode mode commercial or hospital environment.
r2 kV common r2 kV common
mode mode
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350003100 Rev. 11 • 5 / 22
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Immunity Test IEC 60601 Compliance Electromagnetic environment - Guidance

Test level Level
Voltage dips 0% UT; 0.5 cycles 0% UT; 0.5 cycles Mains power quality should be that of a typical
IEC 61000-4-11 At 0°, 45°, 90°, At 0°, 45°, 90°, commercial or hospital environment.
135°, 180°, 225°, 135°, 180°, 225°, If the user of the S-scan system requires
270° and 315° 270° and 315° continued operation during power mains
interruptions, it is recommended that the
0% UT; 1 cycle 0% UT; 1 cycle S-scan system be powered from an
uninterruptible power supply.
and and
70% UT; 25/30 70% UT; 25/30

cycles cycles
Single phase: at Single phase: at

0° 0°
Power interruptions 0% UT; 250/300 0% UT; 250/300 Mains power quality should be that of a typical
IEC 61000-4-11 cycles cycles commercial or hospital environment.
If the user of the S-scan system requires
continued operation during mains power
interruptions, it is recommended that the
S-scan system be powered from an
uninterruptible power supply.
Power frequency 3 A/m 3 A/m Mains power quality should be that of a typical
(50/60 Hz) magnetic commercial or hospital environment.
field IEC 61000-4-8
for professional healthcare

environments
Power frequency See maximum peak-to-peak value Mains power quality should be that of a typical
(50/60 Hz) magnetic with magnetic field compensator, commercial or hospital environment.
field IEC 61000-4-8 given in the chapter “Technical
Description”, paragraph “Technical
for special environments Specifications”, section “Installation
area conditions”.
NOTE: UTis the AC mains voltage prior to application of the test level.
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Immunity IEC 60601 Compliance Electromagnetic environment - Guidance

Test Test level Level
Installation
Conducted RF 3 V 3V Portable and mobile RF communications equipment should not
IEC 61000-4-6 0.5 - 80 MHz 0.5 - 80 MHz be used in the vicinity of any part of the S-scan system,
including cables.
for professional 6 v in ISM 6 v in ISM
healthcare band band between Field strengths from fixed RF transmitters, as determined by an
environments and
special
between 0.15 MHz and electromagnetic site survey a, should be less than the
environments 0.15 MHz 80 MHz compliance level in each frequency range b.
and 80 MHz
80% AM at Interference may occur in the vicinity of equipment marked with
80% AM at 1 kHz the following symbol.
Radiated RF 1 kHz
IEC 61000-4-3
for professional 3 V/m

healthcare 3 V/m 80 MHz -
environments and
special
80 MHz - 2.7 GHz
environments 2.7 GHz
80% AM at
80% AM at 1 kHz
1 kHz
NOTE 1 At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption
and reflection from structures, objects and people.
a
Field strengths from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land
mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted theoretically
with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an electromagnetic site
survey should be considered. If the measured field strength in the location in which the S-scan system is used
exceeds the applicable RF compliance level above, the S-scan system should be observed to verify normal
operation. If abnormal performance is observed, additional measures may be necessary, such as reorienting or
relocating the S-scan system.
b
Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.
Warning
The S-scan system may be subject to electromagnetic interference by
electrical equipment positioned in the vicinity, even if this equipment
complies with the CISPR emission requirements.
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Recommended distances between radio (RF)
communication systems and S-Scan
We recommend that RF transmission systems are not used near the
magnetic resonance imaging equipment; RF systems may cause
disturbances that alter the image.
The operator can prevent disturbances caused by electromagnetic files by
maintaining a minimum distance between the MRI system and any RF
communication systems used (e.g. mobile phones, cell phones).
Disturbance can produce noise, artefacts and distorsions of the image that
are not attributable to a physiological cause and could lead to a false
diagnosis.
S-scan, in accordance with the definition of IEC 60601-1-2 ed. 4, is
suitable for installation in:
☛ professional healthcare environments, as regards the parts of the
system located outside the shielding box
☛ special environments, as regards the parts of the system located inside
the shielding box.
The operator must bear in mind that the intensity of the electromagnetic
fields generated by fixed transmitters (for example, radio base stations for
cell or cordless phones, amateur radio transmissions) cannot be predicted
on a theoretical basis. It therefore may necessary to measure the field
directly in the S-scan operating environment. If the intensity of the
electromagnetic field should exceed that specified in the immunity levels
reported in the tables above and anomalies are detected in the behaviour
of the scanner, it may be necessary to take additional measures such
changing the orientation or position of the S-scan.
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Magnetic Disturbance
☛ Never install the system where large ferrous masses (such as a column
in magnetic material) are placed at a distance of less than 3 m (10 feet)
from the magnet.
☛ Never install the system in the vicinity of lifts, underground trains,
trams or any other equipment that generates fluctuations of the magnetic
Installation
field.
The magnetic field fluctuation must be contained within the limits
expressed in the next chapter, paragraph “Technical specifications”,
sub-paragraph “Installation site characteristics”.
If necessary a fluctuation compensating device may be provided as an
option.
Warning
To avoid the appearance of artifacts on images, the S-scan system
must not be installed in areas subject to the presence of strong
magnetic disturbance, or in the vicinity of areas in which lifts, large
trucks or ambulances, trains, underground trains etc. operate.
RF Disturbances
☛ Never install the system in the vicinity of devices where normal
operation of the latter involves frequent activation/shutdown, or in areas
where anomalous voltage fluctuations occur.
☛ RF field intensity:up to - 30 dBµV/m. To define the maximum level of RF
disturbance compatible with the installation, this value must be added
with the RF attenuation value of the shielding structure. Noise inside the
room must remain below the calculated value, in the frequency range
from 10.22 MHz ± 210 kHz.
During examinations, all RF sources operating in this frequency range
must be switched off.
Warning
Electrical equipment, even if compliant with the CISPR emission
requirements, may generate RF interference which may cause
artifacts on the image displayed on the S-scan system
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☛ To assess susceptibility of the S-scan system to electromagnetic
disturbance deriving from peripheral equipment, the user interface
features a “Susceptibility test” protocol. See paragraph “Peripheral
equipment compatibility test”, chapters “Instructions for Safe Use” and
“System Management”.
☛ To assess susceptibility of peripheral equipment to electromagnetic
disturbance deriving from the S-scan system, the user interface features
a “Susceptibility test” protocol. See paragraph “Peripheral equipment
compatibility test”, chapters “Instructions for Safe Use” and “System
Management”.
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Power Requirements
☛ The S-scan system must be permanently connected to the electrical
mains supply by means of a UPS device (not supplied with the system).
☛ Power supply: 200-210/220-240 VAC, 50/60 Hz, 24 hours
☛ Power supply to monitor: 100-240 V
Installation
☛ PC power supply: 100/110/220/230/240±10% V
☛ Power absorption:
2100 VA during rapid heating of magnet.
2400 VA during acquisition
1200 VA during standby
400 VA when the system is off (temperature control only)
☛ Power consumed by the PC and monitor: 400 VA
☛ The electrical power supply must be fitted with a Residual Current
Circuit Breaker (RCCB), also if not dedicated. The RCCB is also known as
ELCB (Earth Leakage Circuit Breaker), RCD (Residual Circuit Breaker) or
GFI (Ground Fault Interrupter).
This device automatically interrupts an electrical circuit when an earth
leakage current is detected that exceeds the maximum set value.
☛ The system must be connected directly – or via a UPS device (not
supplied with the system) – to an approved 16 A automatic thermal
magnetic circuit breaker, which is to be connected to the RCCB described
above.
The automatic circuit breaker is a reconfigurable switch which is tripped
either by a long-lasting overcurrent, detected by a thermal cutout
mechanism, or a brief current surge, detected by a magnetic mechanism.
☛ The circuit breakers described above must be approved according to
current international, federal and/or local standards, and must be
installed in a wall-mounted sheltered box near the system (the following
figure shows an example of the sheltered -box position).
The electrical connection between the system and residual current circuit
breaker must be by means of a three-core power cable supplied by Esaote
S.p.A. The cable must be cut to the required length before connection to
the relative terminal.
☛ The system must be permanently connected to the electrical mains, in
accordance with the standard EN 60601-1 and subsequent amendments;
therefore the 3-core connection cable between the system and RCCB may
only be disconnected by the use of a tool (e.g. screwdriver).
☛ Earthing is required. The system must be earthed using an electric
cable with nominal diameter of at least 6 mm2 - in accordance with the
standard EN 60601-1 and subsequent amendments.
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fig. 4.1 - Example of a possible location for the External Power Switch
Indicator lights
☛ The system on/off switch is located on the front section of the S-scan
electronic box and is used to activate and deactivate the system in normal
conditions. When the system is on, a green indicator light illuminates on
the switch.
☛ When the switch is off, the system is deactivated with the exception of
the thermal control, which continues to operate to maintain the magnet at
a constant temperature of approx. 36 °C, provided that the system
remains connected to the power mains. A green led at the front of the
electronic box (next to the switch) indicates that the S-scan system is
powered.
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Safety Symbols
Part of the Unit is turned ON
Installation
Part of the Unit is turned OFF
Type B equipment
Non-ionising radiation
Alternated current (AC)
Earth
Protective earth
Neutral connection point
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WARNING: refer to enclosed documentation
WARNING: Irritant substances
Operating instructions: carefully read the User Manual
Thermal stability
To produce high quality images, the S-scan system permanent magnet
must be kept at a constant temperature. The system is equipped with a
thermostat control circuit to maintain the magnet at a constant
temperature, at a value slightly higher than that of the ambient
temperature: obviously, for the thermostat to function the system must
be connected to the power supply.
A green led at the front of the electronic box (next to the switch) indicates
that the S-scan system is powered.
To avoid disabling the thermal control circuit, do not switch off external
power unnecessarily.
If the electrical power supply must be disconnected due to an emergency
shutdown or for maintenance purposes, restore system power as soon as
possible: the system will automatically perform all the necessary system
checks. If S-scan remains disconnected from the power supply for a
prolonged interval, the user must wait for the magnet to heat completely
before the system is ready to operate. The waiting time depends on the
starting temperature, but in any event could take a number of hours.
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Environmental requirements
Temperature and humidity requirements

To function within its specifications, S-scan must be operated in the
ambient temperature range of 21 °C to 24 °C,), with fluctuation no
Installation
greater than ±3 °C per hour. The ambient relative humidity must be
within the range of 45% to 80%.
The installation area must be air conditioned to assure the stability of the
temperature and humidity specifications.
Caution
Never install S-scan in locations exposed to direct sunlight, air
draughts and temperature variations caused by other sources.
Other requirements
Caution
Do not install S-scan in locations where:
• the equipment may be exposed to steam, dripping water, or saline
atmospheres;
• the environment is extremely dusty
• it is subject to severe vibration or impact
• is it subject to inclines of more than 10 degrees
If S-scan is not used for prolonged intervals, cover with a waterproof
sheet.
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Patient routine monitoring requirements
To ensure audio and visual contact between the physician and the patient
during examinations, S-scan has been equipped with a Shielding Box
comprising a series of perforated semi-transparent metal panels. This
purpose of this component is to shield the internal volume from external
electromagnetic disturbances while maintaining audio contact between
the doctor and the patient and ensuring adequate ventilation. Visual
contact must be ensured by means of adequate lighting inside the
shielding box, also taking into account the lighting outside the box.
If S-scan is installed inside a traditional shielding booth the following
restrictions should be respected:
☛ the booth should be equipped with an open window space with a grille
to enable audio contact between the physician and the patient
☛ adequate lighting must be guaranteed inside the shielding booth, also
taking into account lighting of the room where the console is located, and
the position of the window must be in front of the S-scan installation to
ensure that the C-configuration of the magnet enables visual control of
the patient by the physician during the examination.
Installation procedure
Installation of the S-scan system must be carried out exclusively by
technical assistance personnel authorized by Esaote S.p.A., according to
the system installation procedure specified in the Service Manual.
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Controlled access area
The user must define a controlled access area around the S-scan system,
to ensure that the magnetic fringe field outside this area does not exceed
0.5 mT and that the level of electromagnetic interference complies with
Standard EN 60601-1-2 and subsequent amendments. See chapter 3,
“Instructions for Safe Use” in this document.
Installation
Use suitable warning/prohibition labels and symbols and define adequate
rules for access to the controlled access area by patients, operators,
personnel and others in general.
Restricted public access begins at the 0.5 mT line.
The maps of the magnetic fringe are provided in the chapter “Instructions
for safe use”, paragraph “MR personnel and patient exposure to the static
magnetic field”, in this manual.
Warning signs
The presence of the magnetic field and the related potential hazards must
be indicated by a pair of standard labels, as shown in the following figure,
on the door of the room where the unit is installed – as soon as the
magnet is positioned inside - and on the door of the shielding box if
present.
The 0.5 milliTesla line should also be outlined on the floor surrounding the
magnet. The material used to indicate the 0.5 mT line must be durable,
such as the yellow adhesive tape provided with the system.
fig. 4.2 - Warning signs
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WARNING SIGNS
Magnetic and radio frequency field
No active implants, e.g. pace-makers, neurostimulators, infusion pumps,

cochlear implants, defibrillators
No metal implants and/or other metal objects in the body
No ferromagnetic tools
No metal objects of any kind
No fire extinguishers with magnetizable metal housing
No ferromagnetic hospital equipment, e.g. wheelchairs, stretchers.
No mechanical watches, pocket calculators, etc.
No magnetic cards, magnetic tapes, etc.
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Environmental conditions for transport and storage
During transport and storage, the S-scan system must be kept in the
following conditions:
☛ temperature range must be between 0 and 50°qC
☛ Pressure range: from 500 to 1060 hPa
Installation
☛ Relative humidity: from 30 to 80% (condensate free)
☛ Exposure time: not exceeding 15 weeks
☛ Transportation angle: not exceeding 10 degrees.
Special storage and transport conditions

During transport and storage, the magnetic unit of the S-scan system
must be subject to special measures due to the magnetic fringe field. The
maximum distance from the 0.5 mT line to the perimeter of the magnetic
unit base is 150 cm.
☛ No one with electrically, magnetically or mechanically activated
implants, surgical clips, or other ferromagnetic implants shall approach
the magnetic unit or in particular should overstep the 0.5 mT line.
☛ Do not put ferromagnetic objects near the magnetic unit.
☛ Do not put cash machine cards or credit cards, mechanical
wrist-watches, floppy disks, magnetic tapes etc. near the magnetic unit.
☛ Keep the magnetic unit at least 1 m (3.28 feet) from large ferrous
masses.
☛ In the case of transporting/storing multiple magnetic units, maintain a
distance of 3 meters between the cavity centers.
☛ Handle the magnet with care and avoid collisions or sudden impact. The
magnet measures approximately one and half meters, with an accuracy of
approximately one tenth of a millimetre: It follows that any mechanical
stress, even if apparently insignificant, may compromise the accuracy of
the system.
☛ Handle the magnet:
• by means of a crane
• by means of a fork truck able to withstand a weight of 10 tons -
inserting the forks in the pallet at the rear side of the magnet.
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Packaging symbols
The various parts that make up the S-scan equipment are packed in four
separate boxes.
A label, such as that shown in fig. 4.2, is affixed to the magnet shipping
crate to warn of the presence of the magnetic field and the possible
related hazards.
The following symbols are present on the magnet crate and other system
packaging crates:
Do not tip crates
Do not stack crates
Temperature range must be between 0 and 50 °C
Never incline more than 10 degrees
Recyclable material
Fragile
High
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Non water-proof package
Installation
Magnet center of gravity
Use this side for lift-truck handling
Do not use lift trucks
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22 / 22 •• Chapter 4
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CHAPTER 5
Technical description
••••••
S-scan offers a host of advantages, such as:

☛ An open structure type magnet that provides a sufficient level of field
intensity and uniformity to enable the production of high quality
images with a reduced fringe field.
☛ The section of the magnetic unit is open, so that, with the exception of
the region examined, the patient is positioned virtually entirely
outside the gantry, thereby ensuring a comfortable ad acceptable
position, eliminating any risk of claustrophobia.
☛ A single coupling between the patient table and coil constitutes a
precise self-centering mechanism. Self-centering coils optimize
imaging and restrict involuntary limb movements.
☛ The S-scan user interface is simple and functionally comprehensive. For
routine examinations of limbs predefined imaging protocols are
available to guide the user in optimizing scanning parameters and reduce
operator training times to a minimum. The complete S-scan system
software provides all standard functions for image acquisition and
processing and is totally user-friendly.
System architecture
The S-scan system architecture is described below.
1 An electrical medical device, comprising the following parts:
• magnetic unit
• standard or compact patient table
• step for patient access
• receiving coils
• ergonomic cushions for patient positioning
• electronic box
• filter panel
• system power cables (between electrical mains and electronic box),
length 10 meters
• set of cables – electric power supply and signal – for connection of
electronic box – filter panel – magnetic unit. Cable length:
5 meters.
• optic fiber signal cables between electronic box and PC, (length
20 meters)
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2 Accessories:
• shielding box
• magnetic compensation kit
• E-MRI viewer for compatible DICOM® servers
3 Information Technology equipment:

• PC (commercial PC, including keyboard and mouse, power cable,
SDSP card)
• monitor (including power cable, and signal cable).
The magnet is an individual component, which has no electronics (as it

comprises a piece of magnetic material), but it is controlled by specific
electronics, and is part of the magnetic unit described in the sections
below.
The modular shielding box is a cage that can be installed in the room
without interacting in any way with the structure of the room itself, and
enables rapid and simple installation of the unit.
The electronic box must be fitted outside the shielding box at a maximum
distance of 4.5 m from the filter panel.
The magnetic unit must be installed inside the shielding box at a distance
of 2 m from the filter panel.
The operating console must be fitted outside the shielding box at a
maximum distance of 8 m from the filter panel.
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Operating console
The operating console is the instrument that enables the operator
(physician or technician) to use and dialog with the unit and enable
examination set-up. It comprises a PC, monitor, a keyboard and mouse
which can be positioned on the operator table - available in “comfort”
configuration - which is also equipped with a specific housing for the
computer. The operator seat completes the operating console.
The keyboard and mouse enable the user to execute commands and enter
information in the system via the main computer.
The user interface, and results of all processes performed by the user are
displayed on the monitor (e.g. selection menus, images acquired, error
messages, image database etc.).
To record images of patients, the commercial PC is supplied as standard
with a CD ROM or DVD drive.
fig. 5.1 - Operating console
Both the PC and monitor are powered directly from the mains.
The rear panel of the commercial PC is fitted with:
☛ a male connector (plug) which during installation is used for connection
of the cable supplying electrical power to the PC (maximum power
absorption 400 VA)
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Warning
The male connector (plug) positioned at the rear of the PC is used
exclusively for the PC power connection (maximum power absorption
400 VA).
Never disconnect this cable from the plug or connect to other
equipment.
☛ a female connector (socket) which during installation is used for

connection of the cable supplying power to the PC monitor (maximum
power absorption 400 VA)
Warning
The female connector (socket) positioned at the rear of the PC is used
exclusively to power the PC monitor (maximum power absorption
400 VA).
Never disconnect the monitor cable from the socket or connect to
other equipment.
Warning
Peripheral devices connected to S-scan must comply with:
or
If the devices comply with the safety standard EN 60950-1 they should
be installed away from the patient area, as foreseen by the safety
standard EN 60601-1-1 and subsequent amendments.
The peripheral devices connected to S-scan must also comply with
EN 60601-1-2 safety standard and subsequent amendments or the
electromagnetic compatibility provisions of 89/336/EEC Directive and
subsequent amendments.
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Warning
Do not touch the patient and any peripheral device connection at the
same time.
Doing so may cause an electric shock to the patient and/or operator.
Monitor specifications
The monitor supplied with the system has the following specifications:
☛ optimal resolution: 1920x1200 at 60 Hz
☛ supported resolutions: 1920x1080; 1600x1200; 1280x1024
☛ power supply requirements: AC 100-120 V / 200-240 V; 50/60 Hz;
integrated power supply
☛ power consumption: standby 0.3 W; 12-35 W (typical); 36-55 W (max)
The monitor also meets the minimum requirements specified below:
☛ LCD/TFT/LED panel, IPS technology, color, 24”
☛ color display: 16.7 million
☛ viewing angle: horizontal = 178°, vertical = 178°
☛ brightness: 300 cd/m2 (minimum)
☛ contrast: 1000:1
☛ connectors: Digital: 1 x DVI-D; Digital/Analog: 1 x DisplayPort; Analog:
1 x D-sub 15 pin
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System electronics
The electronic components are housed in the electronic box and in the
magnetic unit, as shown in the figure below:
fig. 5.2 - Details of electronics
Electrical power supply

It comprises:
1 a differential thermal-magnetic circuit breaker.
2 TRI, an isolation transformer to limit leakage current to earth in
accordance with standard EN 60601-1 and subsequent amendments,
relating to permanently installed medical systems
3 DISTR unit, a distribution box for power supplies of the various
modules, fitted with a network filter.
PC
It comprises:
1 a commercial PC, with PCI bus interface
2 SDSP card, which performs the following functions:
• control of ACM card
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• acquisition and processing of the MR signal and monitoring of data
from the ACM card
3 Nvidia GPU card, that enhance the calculating capacity and allow the
use of the SpeedUp 3D function.
Electronic box
It comprises:
1 the ACM card, which performs the functions described below.
• Digital synthesis:
a) generating the transmission RF pulse, with variable frequency,
amplitude, duration and phase;
b) selecting, from the DSP, 16 different transmission pulse
developments.
• acquisition:
a) transmitting the acquisition data to the DSP1;
b) analog piloting of the reception gains of the variable condensers
of the receiving coils;
c) selecting and monitoring the signals from the gradient amplifier
(GRA), magnetic compensation, temperature sensors, heaters,
variable condensers of the receiving coils and RFA module;
d) demodulation, in phase and in quadrature, of the MR signal.
• reception of MR signal, of the receiving coils, via four independent
channels
• direct digital conversion of the MR signal of each channel
• gain amplification of each channel
• coil recognition
• control of the 3.5” display on the CMR unit
• operation of standard patient table lock/unlock system
2 the TCM card, which performs the functions described below.
• compensation of magnetic disturbance
• management of signal from temperature sensors for thermal
control of magnetic unit
• power supply of the CMR module
• analysis of the fields generated by the gradients.
Gradient amplifier
The gradient amplifier supplies the required voltage and current values to
the gradient coils to generate a magnetic field of 20 mT/m.
This comprises the CGM board that manages gradient generation and
calibration:
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350003100 Rev. 11 • 7 / 20
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• transforming virtual gradients (selection, reading and phase) into
spatial gradients (x, y and z) and adding the homologous
component
• regulating eddy currents in channels x, y, z and B0;
• generating the three ramps of the spatial gradients, with correction
of single actuation delays
• regulating the offset of each channel to compensate the linear
gradients of the static magnetic field produced by the magnet;
• regulating the gain of the amplifier to avoid geometrical distortion;
• piloting the controllers of the gradient amplifiers;
• synchronizing the gradient amplifiers.
ALGRA power supply unit
The ALGRA power supply unit supplies electrical power to the gradient
amplifier.
RF amplifiers (RF1 and RF2)

The RF amplifiers can each supply the transmission coils with a maximum
power of 1500 W, to enable:
1 implementation of faster pulse sequences, reducing the duration of
the excitation pulse and thereby proportionally increasing the relative
intensity.
2 reduction of the distance between the RF shielding of the transmission
coil and receiving coil, thus simplifying gantry assembly.
Patient table lock/unlock power supply unit

This power supply unit provides the electrical power to the electromagnet
of the rotation lock/unlock system of the standard patient table.
Computer functions
The processes controlled by the computer are summarized below:
☛ management of user dialog (high level commands, image display);
☛ malfunction control (error messages);
☛ management of the dialog of all electronic components: each element
of the magnetic unit, thermal control and, if present, magnetic control
(low level commands);
☛ interception of diagnostics signals notified as error messages to the
user;
☛ acquisition and handling of MR signals to obtain 2D and 3D images for
diagnostic purposes (2DFFT and 3DFFT reconstruction);
☛ manipulation of MR images (LUT, zoom, rotations, ROI, distances etc.);
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☛ data base management (patients and images);
☛ management of communication with workstations, PACS and
DICOM3® printer
☛ diagnostics programs for service technicians
The computer controls:
☛ the gradient amplifier, piloting the waveform, duration and amplitude
☛ the digital synthesizer, waveform, frequency, phase and amplitude of
the transmission signal on output (also the input of the RF amplifier) and
local oscillator (used by the RF reception system to demodulate the
signals received)
☛ the RF reception system, controlling fine tuning of the receiving coils
(which depends on the size of the patient’s limb) and reception gain
During acquisition the computer performs a number of pre-processing
functions on incoming data, sending them to the hard disk for temporary
storage. On completion of acquisition, it reconstructs the images (using a
DSP card) and sends them to the disk (for archiving) and to the monitor.
As regards the thermal control, this maintains the magnet temperature at
the set operating value and must remain constantly active, even when the
computer is shut down. It is not controlled by the computer, but via the
temperature sensors located inside the magnet. The temperature reading
is used by the thermal control to change the temperature of heating
elements when necessary. The thermal control provides the computer
with the adjustment values so that it can verify that the system is
operating correctly.
In special ambient conditions, when the variations of the static magnetic
field are particularly intense and in the same direction as the magnetic
field generated by the S-scan magnet, a magnetic compensation module
must be installed. This comprises two magnetic sensors located inside the
room where the unit is installed, selecting the position where fluctuation
readings are most intense. The sensors are connected to the control
electronics inside the thermal control module, which controls a
compensation coil that generates a field of the same intensity by of the
opposite sign to the perturbing field, thereby minimizing undesired effects
on the image.
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fig. 5.3 - Functional diagram
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Magnetic unit
The magnetic unit comprises:
1 the magnet
2 a system of three orthogonal gradient coils controlled by the gradient
amplifier
3 the magnetic compensation coil, to compensate both the
homogeneous field B0 – generated by stray currents in the conductive
structure of the magnet – and external magnetic field interference
4 the RF transmission coil, controlled by the RF amplifier
5 the RF screen located between the RF coil and gradient coils, to reduce
RF noise from the gradient amplifier
6 the temperature sensors and heating elements of the thermal control
system, which are respectively the input and output of the control
module that maintains the magnet at the operating temperature
7 a set of resistors, used for the normalization of the resistor value of
the temperature sensor for thermal control (REGNTC)
8 RISC electronic unit, used for filtering the input signal of the heaters
9 the control panel, for real time positioning procedures
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Technical specifications
The following specifications are subject to modification without notice.
Imaging system
Anatomical regions: The regions compatible with examinations
using this system are: calf, knee, ankle, foot,
thigh, hand, wrist, forearm, elbow, arm,
shoulder, hip, lumbosacral, thoracic (under
license) and cervical column,
temporomandibular joint (under license),
head (under license, not for all countries)
Excited nuclei: lH
Acquisition and reconstruction methods:

- 2D multi-slice acquisition, with
reconstruction by transformed by Fourier 2D,
with zero-filling for partial acquisitions and
for rectangular FOV
- 2D multi-slice, half echo
- 2D multi-slice, half scan
- 2D multi-slice, turbo
3D acquisition, with reconstruction by
transformed by Fourier 3D (in isotropic 3D
the reconstructed volume can be stored both
on hard disk and optical disk for subsequent
multiplanar reslicing, in anisotropic 3D a
multi-slice is produced as in 2D);
- real time 2D as reference image for
positioning
- dynamic acquisition at pre-set time
intervals
Acquisition matrices: 2-D: from 128x128 to 512x512; the phase
encoding step is 8 and the frequency
encoding step is 32;
3D: from 192x128 to 256x256; slice
encoding from 24 to 256, step 8; the
encoding phase step is 8
Spatial resolution: up to 0.2 mm nominal
Field of View (FOV): from 100 mm to 400 mm step 10 mm, to
manage S/N ratio and image resolution
The usable area displayed corresponds to a
maximum FOV of 270 mm
Number of slices x echoes: from 1 to 128 (max. 2 echoes), in the case
of Turbo acquisitions (with multiple echoes)
the limit is adapted accordingly
(minimum 16)
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Slice selection method: selective gradient and RF pulse
Slice thickness: 2-D: from 2 mm to 10 mm, step 0.5 mm
3-D: from 0.6 mm to 10 mm, step 0.1 mm
Distance between slices: contiguous slices can be acquired
Slice orientation: transverse
sagittal
coronal
oblique
Packets: multiple parallel and non-parallel packets
TR independent of number of slices
Magnetic system
Magnet type: permanent, in NeFeB, “C” type proprietary
magnet circuit
Direction of field: vertical, between two faces of C
Static field intensity: 0.245 T ± 10 mT, f0: 10.432 MHz ±
422 kHz)
Thermal control: 5 independent channels for control of
magnet temperature at 35 °C
Stability of field: <30 Hz/10 minutes
Homogeneity: <± 3 ppm FWHM on 270 mm DSV
Shimming system: passive
Fringe field (5-Gauss line): contained within 1.8 m of center of magnet
Magnetic shielding: not necessary
Gantry opening: cavity height without covers: 37,3 cm
height of cavity from patient table surface,
without cushions: 33.9 cm
Dedicated gradient system

Coils: 3 gradient coils (X, Y, Z), one homogeneous
field coil (Bo)
Maximum intensity: ±20 mT/m
Slew rate: 56 mT/m/ms (the maximum variation 5%)
25 T/m/s (as defined by IEC 60601-2-33)
Linearity: ± 5% on 200 mm DSV; ± 12% on 230 mm
DSV
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350003100 Rev. 11 • 13 / 20
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Cooling system: both the coils and amplifier are air-cooled
Control system: digital based on DSP SHARC 21161
(600 MIPS, 600 MFLOPS, 128 KB)
4 independent channels (X - Y - Z - Bo)
18 bit DAC - refreshed every 7.2 µs
Ramp generation - pre-emphasis of induced
current compensation - adjustable delay
Calibration procedures: all calibrations of the gradient system are
managed by the console with various levels
of automation
Maximum value of the vector sum of the components of the field
generated by each of he three gradient
units:
E = 0.82 V/m, whose coordinates relative to
the isocenter of the magnet are x =
24.1 cm, y = 12.8 cm, z = 19.2 cm.
Magnetic compensation system (optional):
“open loop” control of variations in magnetic
field via external measurement (AC and DC
sensors), digital processing of signal in
separate channels (DC - 50/60 Hz - 16.6 Hz)
and correction actuation with Bo coil.
Light electronics based on DSP SHARC
21161
Radiofrequency transmission and acquisition system

Receiving coils: Shoulder Coil 1 (linear): 22.4 x 21.6 x 12.6
(ext.) 14.5 x 17.5 x 12.6 (int.) cm
Knee Coil 2 (DPA): 22.5 x 21.0 x 18.3 (ext.)
14.3 x 16.0 x 18.3 (int.) cm
Hand/Wrist Coil 3 (DPA): 17.8 x 17.5 x 20
(ext.) 11.9 x 7.2 x 20 (int.) cm
Ankle Coil 4 (DPA): 22.0 x 19.2 x 28.5 (ext.)
14.6 x 10.0 x 28.5 (int.) cm
Flexible Coil 6 (linear): 4.0 x 33.0x x 28.5 cm
(maximum ext.)
Shoulder Coil 7 (DPA): 21.5 30.0 x 21.8
(maximum ext.)
Optional receiving coils: Cervical column coil 9: 25.5 x 33.0x x
33.0 cm (maximum ext.)
Lumbosacral column Coil 10 (DPA): 4.5 x
32.2 x 28.4 cm (maximum ext.), extension in
cradle height with respect to base 5 cm,
large strap dimensions 89 x 18.5 cm, small
strap dimensions 69 x 18.5 cm
Cervical column Coil 14 (DPA): 29.4 x 32.2 x
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14 / 20 •• Chapter 5
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42.3 (maximum ext.), limb compartment:
max. height 22.1 cm, min. height 20.6 cm,
width 19 cm, length 13.1 cm
Coil 15 TMJ: max. height 23.7 cm, max
width 14.4 cm, thickness 2.8 cm
Coil 16 Head (Multichannel): height 26.7 x
length 25.5 x width 20.5 cm (maximum int.),
height 30.9 x length 29.0 x width 27.7 cm
(maximum ext.)
4-channel lumbosacral column Coil 17: 28 x
40.5 x 27 cm (internal), 28 x 48.8 x 30.5
(external)
4-channel lumbosacral column Coil 18: 28 x
47 x 2.8 cm (internal), 28 x 55.4 x 32.3
(external)
TMJ Coil 19: maximum height 23.1 cm,
maximum width 57.9, maximum length
32.2 cm.
Coil 20 Shoulder (Multichannel): height 23.0
x length 31.3 x width 20.5 cm (maximum
ext.)
Flexible Coil 11 (linear): 4.0 x 33.0 x 32.5 cm
(maximum ext.)
A suitable kit of cushions and accessories for the relative examinations is
supplied with the optional receiving coils.
Gantry: contains the gradient coils and the RF
transmission coil;
allows quick connection of the reception coil
and its automatic recognition.
Receiving chain: up to 8 independent channels depending on
hardware configuration
noise figure <1 dB
passband at 0.5 dB: 600 kHz (10.2MHz ±
300 kHz)
maximum output signal from
coil/preamplifier system: -3 dBm
gain of chain programmable in a range of
75 dB with two variable gain stages, each on
256 levels
A/D conversion and demodulation: conversion of RF signal to 10.25 MHz
40 MHz 14-bit sampling
digital in-phase and quadrature
demodulation
passband: gain 1 up to 0.43xfc, with fc from
156.25 to 4.882 kHz
stopband: from 0.5xfc
attenuation 90 dB
transfer to SDSP (image processing DSP) of
two pairs of raw data (real and imaginary
part)
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350003100 Rev. 11 • 15 / 20
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Synthesizer: digital, with frequency, amplitude and phase
modulation and resolution in frequency
9.3 µHz, amplitude 4096 levels, phase 1’19”:
stability: <1 ppm in the operating
temperature range
d8 x 10-8 over 15 minutes (maximum
variation of 0.75 degrees)
variable transmission gain: 16384 levels
Transmitter coil: linear double plane
input impedance 50 ohm
Transmission chain: 2 RF power amplifiers each up to 1500 W
pep
passband 10 to 10.6 MHz at 1 dBpp
B1RMS: 5.16 µT
Patient positioning
Standard patient table: fixed height, pivoting on a fixed
floor-mounted column
can be withdrawn from the magnet to
facilitate patient positioning
washable upholstery
manual positioning (rotation about fulcrum,
3 examination positions and 1 position
outside the magnet for patient positioning);
integrated in the overall design of the
apparatus, equipped with patient straps.
Compact patient table: fixed height, sliding on fixed floor-mounted
rails
can be withdrawn from the magnet to
facilitate patient positioning
washable upholstery
manual positioning (movement in/out of
gantry, 3 examination positions and 1
position outside the magnet for patient
positioning); integrated in the overall design
of the apparatus.
Keyboard and display on magnet: pushbuttons for real time management; TFT
5.7” display, 240x320, 64 grayscale levels for
the display of real-time images, to simplify
patient positioning possibility to select
high/low coil position (for coils with this
requirement).
Step: to facilitate patient access onto the table
Maximum patient weight: 200 kg
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16 / 20 •• Chapter 5
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Installation site characteristics
Type of installation: permanent
Overall dimensions with standard patient table:
20 m2 approx., minimum ceiling height 2.40 m
Overall dimensions with compact patient table:
9 m2 approx., minimum ceiling height 2.40 m
Flooring able to withstand a total weight of approx. 7000 Kg (including
patient and operator), in addition to the weight of the structure used for
RF shielding
Floor planarity: up to 5 mm in 3 m
Ambient operating conditions: temperature: 21 to 24 °C with variations of
<±3 °C/hour
relative humidity: 45 to 80% (without
condensation)
atmospheric pressure: 700 to 1060 hPa
Ambient conditions for storage: temperature: -20 to 60 °C
relative humidity: 15 to 85% (without
condensation)
atmospheric pressure: 500 to 1060 hPa
RF field intensity: up to - 30 dBµV/m
To define the maximum level of RF disturbance compatible with the
installation, this value must be added with the RF attenuation value of
the shielding structure expressed in dB
Vibration: d- 65 dBg from 0 to 100 Hz
attention interval with standard supports
from 12 to 20 Hz. For vibration in this
frequency range the specification is
d -75 dBg
Magnetic field fluctuations:
Maximum values without compensation:
DC: < 30 nT pk-pk
AC: 16.7 Hz < 6 nT pk-pk
50 to 60 Hz <20 nT pk-pk
With magnetic field compensator (optional):
DC: < 3000 nT pk-pk (single source)
AC: 16.7 Hz < 600 nT pk-pk (single source)
50 to 60 Hz < 1000 nT pk-pk (single source)
To define the maximum level of magnetic disturbance compatible with
the installation, the stated values for shielding structure attenuation
must be multiplied by the respective frequencies
If using the optional magnetic field compensator, the limits specified are
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350003100 Rev. 11 • 17 / 20
•
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•
valid in the specific conditions described in detail in the document “site
planning guide”. The same document specifies the values to be applied in
other cases
Power supply
Mains power supply: 200-210/220-240 VAC, 50/60 Hz, 24 hours
Power consumption: 2100 VA in rapid heating;
1100 VA in stand by
400 VA with unit switched off (thermal
control)
Current protection: thermal cutout 25 A primary, 20 A secondary
Earthing: via power cable with 6 mm2 section
Overall dimensions and weights

Magnet: H (vertical field direction Y) approx.
176.5 cm; W (horizontal field direction X)
approx. 100 cm; D (direction Z horizontal)
approx. 159 cm;
Weight approx. 6050 kg
Standard patient stable: approx. 150 kg
height of patient table minus cushions 87 cm
maximum length 288 cm
maximum width 93 cm
Compact patient stable: approx. 120 kg
height of patient table minus cushions 87 cm
maximum length 245 cm
table width 84.4 cm
maximum width 93.8 cm
Electronic box: 60 x 72 x 90 cm; 341 kg full
PC: 18 mm (width) x 45 mm (depth) x 48 mm
(height), 13 kg
PC packed: 30 mm (width) x 70 mm (depth) x 60 mm
(height), 18 kg
24’ TFT monitor: 55.68 x 37.78 - 52.8 x 22.76 cm; 10.6 kg
24’ TFT monitor packed: 65 x 50 x 32.5 cm; 14 kg
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18 / 20 •• Chapter 5
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Service equipment
System lifting equipment
Rf measurement kit, magnetic and vibrations
Remote assistance software (ARAS Brio)
Magnet shimming kit
Service manual
RF Attenuation meter
Accessories
Accessory cabinet: unit in non-magnetic material. Useful for
storing coils, phantoms, cushions,
documentation.
UPS
Viewer Lite
E-MRI Brio viewer for DICOMcompatible images£
Magnetic compensation sensor kit
Shielding box in Al: depending on the type of patient table
selected, we propose one of the following
shielding boxes:
- Opera/S-scan shielding box for its optimal
dimensions, equipped with a specific
templates kit for correct positioning during
installation of the magnet and standard
patient table and with provision for the floor
mounting of the relative table column.
approx. weight 1000 kg
- Compact S-scan shielding box for its
optimal dimensions, equipped with a specific
templates kit for correct positioning during
installation of the magnet and compact
patient table
approx. weight 700 kg
Both shielding boxes have the following
attenuation values:
RF 8 to 12 MHz 70 dB
magnetic field DC 1.0
magn.field AC 16.6 Hz 1.7
magn.field AC 50/60 Hz 3.0
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350003100 Rev. 11 • 19 / 20
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Warning
Use of parts or accessories other than those supplied by Esaote S.p.A.
may impair system safety.
Windows£‚ is a registered trademark of Microsoft Corporation

Pentium£is a registered trademark of Intel Corporation
DICOM£ is a registered trademark of National Electrical Manufacturers
Association
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20 / 20 •• Chapter 5
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CHAPTER 6
Patient table
••••••
The system has a choice of two patient table configurations:

☛ Standard patient table
☛ Compact patient table
the user must choose which type of patient table is required at the time of
ordering the system.
The patient table has been designed for maximum comfort during the
various types of examination.
The compact patient table, in addition to providing maximum patient
comfort during the various types of examination, has been designed to
allow the S-scan system to be installed in an area of just 9 m2.
The movements and standard accessories available with both patient
tables guarantee precise positioning for all types of examination possible
using the S-scan system.
Description of the standard patient table

The patient bed is moved manually into and out of the gantry, rotating
around its fulcrum at the end of the table (maximum rotation 55° outside
the gantry, 8.5° inside the gantry) to ensure correct positioning of the
anatomic region to be examined with respect to the magnet isocenter in
this direction.
The patient table has two wheels, of which the one of the side of the
operator is equipped with a brake, mounted under the right-hand cover of
the table.
On the patient table, on the side closest to the gantry a protection barrier
is fitted which covers the entire zone of panels containing the coil seats.
The patient table can be set in four different positions with respect to the
fulcrum, as shown in fig. 6.1.
The patient table is normally locked in the current position if the coil cable
is inserted in the connector on the upper section of the magnet.
The position of 90° counterclockwise with respect to the position in front
of the magnet is considered a reference position, and is marked A.
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•
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fig. 6.1 - Standard patient table positions
The possibile positions are:

☛ A = Table central
☛ B = Table inside
☛ C = Table outside
☛ D = Table in position for patient ascent/descent
To move the standard patient table manually:
Caution
☛ press the handle on the outer edge of the patient table

☛ keeping the handle pressed, move the patient table in the required
direction (into/out of the gantry) until the pin, fitted below the right-hand
cover of the patient table, is aligned with the relative hole on the floor.
☛ release the handle to lock the bed in the required position:
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2 / 16 •• Chapter 6
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To check correct centering of the anatomic region to be examined, after
making the manual manoeuvre described, perform a real-time sequence
by selecting, on the control panel, on of the following icons:
<Sagittal>
Patient table
<Coronal>
<Transverse>
The central section of the control panel displays the image in the area
examined in the selected position.
To interrupt the sequence in real time, select the <Abort> command.
The coil blocks are the rigid housings for coil insertion and are located
inside two different panels; one containing the coil seats for
examinatiopns of the limbs and joints (marked C, D, E in fig. 6.3) and
another, optional, containing the seat of the coil for examinations of the
spinal column (marked F in fig. 6.4).
With the exception of coil block F (optional), the coils can rotate in the
seat where they are inserted to obtain the correct examination position.
To secure the coil in the block, with the exception of coil F, simply turn the
lever at the base of the coil clockwise. Release in the same way (turn
counterclockwise).
To secure the coil in block F (optional), simply insert the Spine Coil
(optional) fully into its seat: mechanical connection is ensured by a
dedicated mechanism.
All coils contain a male connector that enables connection of the coil to the
magnetic unit (the female connector is located on the upper section of the
magnet).
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350003100 Rev. 11 • 3 / 16
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fig. 6.2 - Standard patient table
fig. 6.3 - Layout of coil blocks for examinations of the limbs and joints on the
standard patient table
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4 / 16 •• Chapter 6
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Patient table
fig. 6.4 - Position of coil block for examinations of the spinal column on the
standard patient table (optional)
Warning
Warning
Caution
positioned above the table throughout the movement of the table and
the examination. Limbs protruding from the sides of the table may be
trapped during movement of the table.
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350003100 Rev. 11 • 5 / 16
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Safety belts
The patient table is equipped with two safety belts padded with a soft
material.
The belts are adjustable in length and can slide along the entire length of
the patient table thanks to two guides fixed to the outer side of the table.
To enhance patient comfort, place a multipurpose cushion between the
open/close mechanism of the belt and the patient’s chest.
Limb protection
The standard patient table is equipped with a limb protection device,
made from plastic, which is positioned on the side of the patient table
nearest the gantry.
This protection has been introduced to prevent the limb not under
examination from protruding outside the patient table and consequently
the risk of it being trapped between the lower part of the gantry and the
patient table during movement of the table.
Description of the compact patient table

The patient table is moved manually in and out of the gantry, sliding on
two guide rails fixed to the floor, to ensure correct positioning of the
anatomic region to be examined with respect to the magnet isocenter.
The patient table has four wheels, of which the two on the side of the
operator are equipped with brake pedals, mounted under the right-hand
cover of the table.
On the guide rails, fixed to the floor, there are three recesses that help the
user identify the three examination positions of the patient table.
The patient table may assume four different positions, one to allow the
patient to get up or down from the table, and three positions allowing
examination of different anatomical regions and sides of the patient
(inside, central and outside).
The position centered in the magnet is considered as the reference
position.
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6 / 16 •• Chapter 6
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Patient table
fig. 6.5 - Compact patient table positions
The possibile positions are:

☛ A = Table central
☛ B = Table inside
☛ C = Table outside
☛ D = Table in position for patient ascent/descent
To move the compact patient table:
Caution
connector from the top of the magnet.
☛ lower the brake pedals on the two front wheels to unlock the table.
☛ using the dedicated handles, move the patient table in the desired
direction (in/out of the gantry), until the rear wheels engage the
appropriate positioning recess in the guide rails fixed to the floor, which
will depend on the anatomical region and the side of the patient to be
examined.
☛ lower the brake pedals on the two front wheels to lock the table in the
desired position.
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350003100 Rev. 11 • 7 / 16
•
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•
To check correct centering of the anatomic region to be examined, after
making the manual manoeuvre described, perform a real-time sequence
by selecting, on the control panel, on of the following icons:
<Sagittal>
<Coronal>
<Transverse>
The central section of the control panel displays the image in the area
examined in the selected position.
To interrupt the sequence in real time, select the <Abort> command
The coil blocks are the rigid housings for coil insertion and are located
inside two different panels; one containing the coil seats for
examinatiopns of the limbs and joints (marked C, D, E in fig. 6.3) and
another, optional, containing the seat of the coil for examinations of the
spinal column (marked F in fig. 6.4).
With the exception of coil block F (optional), the coils can rotate in the
seat where they are inserted to obtain the correct examination position.
To secure the coil in the block, with the exception of coil F (optional),
simply turn the lever at the base of the coil clockwise as far as it will go.
Release in the same way (turn counterclockwise).
To secure the coil in block F (optional), simply insert the Spine Coil
(optional) fully into its seat: mechanical connection is ensured by a
dedicated mechanism.
All coils contain a male connector that enables connection of the coil to the
magnetic unit (the female connector is located on the upper section of the
magnet).
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8 / 16 •• Chapter 6
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Patient table
fig. 6.6 - Compact patient table
fig. 6.7 - Layout of coil blocks for examinations of the limbs and joints on the
compact patient table
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350003100 Rev. 11 • 9 / 16
•
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fig. 6.8 - Position of coil block for examinations of the spinal column on the
compact patient table (optional)
Warning
Warning
Caution
positioned above the table throughout the movement of the table and
the examination. Limbs protruding from the sides of the table may be
trapped during movement of the table.
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10 / 16 •• Chapter 6
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Limb protection
A limb protection is incorporated in compact patient table on the side
nearest the gantry.
This protection prevents the limb not under examination from protruding
outside the patient table and consequently the risk of it being trapped
between the lower part of the gantry and the patient table during
Patient table
Back support
The compact patient table is equipped with a back support, to be used
with taller patients (over 1.70 m) to ensure correct positioning during
examinations of the foot/ankle and calf.
The back support has been designed to be placed on the patient table
surface, maintained in position by the weight of the patient.
The back support is fitted with two soft cushions, applied on the seat and
backrest respectively, to improve patient comfort.
The back support is fitted with a handle to enable transport.
fig. 6.9 - Back support
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350003100 Rev. 11 • 11 / 16
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Step for patient positioning on the table
The table is equipped with an access step to facilitate patient positioning.
The step has a maximum height of 23 cm and can withstand loads up to
200 kg.
fig. 6.10 - Step
Warning
The maximum load capacity of the step for patient positioning is
200 kg (approx. 440 lb). Never exceed this limit. Overloading may
cause mechanical failure of the step, with possible injury to the patient
or operator.
Do not stand on the step for prolonged periods.
Check that all four feet of the step are resting on the floor.
Tell patients about the step and how to use it correctly to get up and
down from the table.
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12 / 16 •• Chapter 6
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Instructions for the use of the patient’s table
Procedure to be followed before an examination:
1 Open the doors of the shielding box/cabin.
If using the compact patient table, go to point 2, otherwise go to
point 5.
Patient table
2 Raise the brake pedals on the two front wheels to unlock the table.
3 Using the handles provided, move the patient table out of the gantry
to the maximum travel limit.
4 Lower the brake pedals on the two front wheels to lock the table in the
correct position for patient access.
The procedure continues from point 6.
5 Press the handle on the edge of the patient table and, keeping it
pressed, move the patient table outside the gantry to the maximum
limit. The release the handle. Then release the handle to lock the
patient table in the correct position for patient access.
6 Depending on the anatomical region to be examined, insert, if not
already fitted, the panel containing the coil seats for examinations of
the limbs or joints of the panel with the seat for examinations of the
spinal column (optional) on the patient table.
7 Depending on the anatomical region to be examined, insert, if not
already present, the coil on the relative holder panel.
8 Help the patient to sit up on the table, to the left of the coil, and
instruct them on how to use the access step.
9 Help the patient lie down with the head facing the right or left
regardless of the anatomical region examined and relative side. Insert
the limb to be examined in the coil, or, if the spinal column (optional)
is to be examined, take great care to ensure that the section of the
spine to be examined is positioned above the spine coil used.
point 13.
11 Using the dedicated handles, move the patient table into the gantry to
center the coil relative to the magnet isocenter.
The coil is centered when the wheels engage the relative recess in the
guide rails fixed to the floor, depending on the anatomical region and
the side of the patient to be examined.
correct examination position.
The positioning procedure continues from point 14.
pressed, move the table manually into the gantry to center the coil
with respect to the magnet isocenter.
To center the coil, release the handle when the pin, mounted below the
right-hand cover of the patient table, is aligned with the relative hole
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350003100 Rev. 11 • 13 / 16
•
•
•
on the floor (central, innermost with respect to the gantry or
outermost with respect to the gantry depending on the anatomical
region to be examined and relative side)
14 Place any additional cushions deemed necessary to improve the
patient’s comfort.
15 Ensure that the area examined is centered with respect to the coil.
16 For all examinations, with the exception of the spinal column
(optional), block the coil by means of the special lever on the base so
that the coil opening is perpendicular to the gantry.
17 Insert the coil connection cable in the connector on the upper section
of the magnet.
18 Switch on the control panel from the user interface, using the control
switch (shown here on the left) on the Setup panel (see chapter
“Examination environment”, section “Setting up an examination for a
new patient ” in the User Interface Manual).
19 Close the doors of the shielding box/cabin.
Procedure to be followed after the examination:



2 Disconnect the coil connector from the upper section of the magnet.
3 Remove any cushions placed between the coil and anatomical region
examined, as well as those used for positioning.
point 7.
correct position for patient descent.
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14 / 16 •• Chapter 6
•
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7 Press the handle on the edge of the patient table, and keeping it
pressed down, move the table out of the gantry to its maximum travel
limit. Then release the handle to lock the table in the correct position
for patient descent.
8 If used, release the safety belts by means of the dedicated open/close
mechanism.
Patient table
9 Remove the patient’s limb from the coil.
10 Help the patient to sit up on the bed, with the legs off the table, near
the step.
11 Help the patient off the table, making use of the step.
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350003100 Rev. 11 • 15 / 16
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16 / 16 •• Chapter 6
•
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CHAPTER 7
Shielding and insulating parts
••••••
The S-scan M.R. unit can detect very-low-intensity RF waves emitted by

the spins contained in the sample under examination - such as a knee.
Since there are many signals of the same type and of greater intensity in
the air, it is necessary to shield both the anatomical region under
examination and the coil which receives the signals emitted by the
aforementioned spins. This is why the gantry must be properly shielded.
Therefore additional shielding of the patient’s limb is required. For this
purpose S-scan should be equipped either with a Shielding Box aimed to
contain all apparatus, except for the electronic box and operating console,
or with a traditional shielding cabin.
To ascertain whether the shielding method adopted is effective and
sufficient, a Scout sequence must be obtained.
Description of the shielding box

The Opera/S-scan shielding box (shown in fig. 7.1 and fig. 7.2) or
alternatively the compact S-scan shielding box (shown in fig. 7.3) is a
perforated metal enclosure designed to house the magnetic unit and the
patient table. No other additional shielding is generally needed.
The technical characteristics of the shielding box are specified in detail in
the user manual for this component, and a summarized in the chapter on
Technical Specifications in this document.
The weight of this component must be taken into account when evaluating
the weight of the system prior to installation, to verify suitability of the
site from a structural point of view.
•
•
• 1/6
•
•
•
fig. 7.1 - Opera/S-scan shielding box
•
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2/6 • Chapter 7
•
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fig. 7.2 - Dimensions of the Opera/S-scan shielding box
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350003100 Rev. 11 • 3/6
•
•
•
fig. 7.3 - Dimensions of the Compact S-scan shielding box
Precautions for using the shielding apparatus

Note some precautions to be taken during normal use of the Shielding
Box.
1 Check that the doors are fully open before the patient enters the
shielding box, especially if a stretcher or any mobile support device is
used.
2 Keep the floor area inside the shielding box clear at all times to ensure
free movement of the system (movement of the patient table).
3 Explain to the patient that the box will not prevent constant audio and
visual contact with the doctor during the examination.
4 Close the shielding box doors carefully after positioning the patient, to
ensure that the structure acts as an effective shield for the internal
volume.
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4/6 • Chapter 7
•
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•
5 Ensure that routine maintenance to the shielding box is performed at
the intervals stated in chapter 4 by the assistance personnel.
If the device is installed within a traditional shielding cabin, the user

should observe the following indications and the practical considerations
given in chapter 4 of this document.
1 Keep the floor area inside the shielding box clear at all times to ensure
free movement of the system (movement of the patient table).
2 Explain to the patient that audio and visual contact with the doctor will
be maintained throughout the examination
3 Close the shielding box doors carefully after positioning the patient, to
ensure that the structure acts as an effective shield for the internal
volume.
Caution
The interior of the shielding box or room can house the magnetic unit,
patient table, and an accessory cabinet (if required); any other object
and/or equipment must be kept outside this area to avoid interference
with or damage to the S-scan system.
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CHAPTER 8
Coils
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Solenoidal Coils
The S-scan MR equipment can detect very-low-intensity RF waves emitted
by the spins contained in the sample under examination. An RF coil
incorporated in the gantry is used to send an RF pulse to the sample. RF
receiving coils are mobile. Each of them has been optimized to examine a
specific anatomic area. These coils are receiving coils only (see functional
diagram in the figure below).
fig. 8.1 - Functional Diagram
Coil characteristics vary according to size and shape: Similarity between

coil and examined volume sizes is all important, as is the fact that the
region to be examined must be at the centre of the coil. Locking the limb
to be examined inside the coil is necessary to avoid any involuntary
movements, which may remarkably affect image quality.
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The coils are made of soft plastic so that the limb that is being examined
is not subject to any vascular and/or nervous compression. A series of soft
cushions of various shapes and sizes is supplied with the machine so that
the area that is being examined can be centred and blocked (see chapter
9).
Description of Shoulder Coil 1

This solenoid coil is designed to improve adaptation to the area examined.
This coil is recommended for medium and large-size shoulder
examinations but, thanks to the geometrical dimensions, can also be used
for large knee and thigh examinations in combination with the specific
cushions for correct positioning. The inner dimensions are 17.5 x12.6
x14.5cm (wxdxh).
The coil features a base element which engages in the housing located on
the patient table. Activation of the lever on the coil bases enables the coil
to be locked (clockwise lever rotation) and unlocked (counterclockwise
lever rotation) in the examination position.
The coil is equipped with a connecting cable, which if fitted to the
connector on the upper section of the magnet ensures electrical
connection and automatic coil model recognition.
fig. 8.2 - Shoulder Coil 1
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Description of Flexible Coils 6 and 11
These are solenoidal coils designed for hip examinations: these coils are
easily adaptable to the area examined enabling the user to easily position
the patient and obtain satisfactory image quality in terms of S/N ratio.
The flexible coil 6 may also be useful for shoulder and thigh studies,
whenever the patient positioning is not comfortable using a rigid coil, due
to painful traumas.
Coils
fig. 8.3 - Flexible coil 6
fig. 8.4 - Flexible coil 11
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The flexible coils are characterized by a central hole that allows the user to
correctly centre the joint in the coil.
The external surface of the coils is in soft PVC. The tuning circuit has been
enclosed in a plastic cover with no sharp edges.
The dimensions of the coil 6 are: 220 mm x 325 mm.
The dimensions of the coil 11 are: 450 mm x 333 mm.
Unlike all the other coils of the system, the flexible coils have no
mechanical mechanism for connection to the patient bed: this is due to
the special morphological adaptability of the coils.
To secure the coils to the patient and therefore ensure stable positioning
of the region of interest inside the field of view of the coil, the coils are
fitted with two belts.
The coils are equipped with a connecting cable, which if fitted to the
Since the coils are flexible, they can be bent over the patient's body to
carry out the examination: however avoid excessive bending which could
impair examination quality.
Warning
The flexible coil should be used with a curvature radius:
- for coil 6, between 110 mm (maximum) and 75 mm (minimum)
- for coil 11, between 200 mm (maximum) and 75 mm (minimum)
in order to avoid possible malfunctions and/or loss of Signal/Noise
ratio.
Use of the flexible coil outside this range will reduce the coils sensitivity
and decrease S/N (image quality).
Due to this fact, in some cases, the system may not be able to tune the
coil because of a variation in some of the coil parameters; in this case a
dialogue window will appear on the user interface to notify the user that it
is not possible to proceed with the examination.
Moreover, it is fundamental to take into account the existence of planes of
iso-sensitivity that are parallel to the coil plane: in fact the signal
decreases along the axis perpendicular to these planes.
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4 / 40 •• Chapter 8
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Use of the flexible coil outside this range will reduce the coil sensitivity and
decrease S/N ratio (image quality).
Due to this fact, in some cases, the system may not be able to tune the
coil because of a variation in some of the coil parameters; in this case a
dialogue window will appear on the user interface to notify the user that it
is not possible to proceed with the examination
Moreover, it is fundamental to take into account the existence of planes of
Coils
fig. 8.5 - Reference axis of the flexible coil 6
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fig. 8.6 - Reference axis of the flexible coil 11
Good image quality from the area placed in the coil hole can be obtained
up to a certain distance in the direction of the patient’s body - along the
axis perpendicular to the coil plane, which is very difficult to estimate for
all patients.
However, for the standard patient the value of this distance is:
☛ about 8 cm, for coil 6
☛ about 9 cm, for coil 11
Warning
By evaluating the Scout, the user must verify that the anatomic region
and/or pathology to be examined is at a distance less than:
- 8 cm, for coil 6
- 9 cm, for coil 11
from the area placed in the coil hole. Failure to do so will compromise
image quality.
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Description of Cervical Spine Coil 9
This is a linear surface coil designed for examinations of the cervical
section of the spinal column and more specifically to adapt to the cervical
vertebrae of the patient; the ergonomic design of the coil comprises a
solenoid made up of a lower fixed section and an upper removable section
to facilitate patient positioning and enhance comfort, while guaranteeing
an optimal Signal/Noise ratio. The dimensions of the patient table are:
255 mm x 270 mm x 330 mm (w x d x h)
Coils
fig. 8.7 - Cervical Coil
For correct use of the coil:

☛ Then close the two retainer hooks as shown in fig. 8.8
fig. 8.8 - Cervical Coil

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☛ detach the removable section (upper) of the solenoidal coil
☛ position the cervical section of the patient’s spinal column in the
opening of the lower section of the coil
☛ refit the removable section (top) of the solenoid onto the fixed lower
section of the coil, starting from the right-hand side of the patient. This
operation facilitates connection and avoids damage to the connectors
☛ Close the two retainer hooks, following the procedure described in
fig. 8.8 in reverse order.
Warning
When refitting the removable section (top) of the cervical coil, take
great care to avoid trapping the patient’s skin between the coil
connectors and/or the fixed and removable sections of the coil.
the patient’s throat and create difficulties with breathing.

The coil can be positioned at different angles with respect to the horizontal
plane, to enable examinations both with the neck in the normal position
and in hyperextension.
For this purpose, the coil is fitted with two levers: one named A, rotated
clockwise to incline the head support in four positions, and the other,
named B, again rotated clockwise to lock the coil in the required position.
The field of view of the coil is approx. 200mm along the column and
approx. 110mm from the left and right side of the patient.
There are six pairs of connectors inside the coil (three on each side).
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Description of TMJ Coil 15
This is a solenoidal coil designed for examinations of the
temporomandibular joint. this coil is easily adaptable to the area
examined enabling the user to easily position the patient and obtain
satisfactory image quality in terms of S/N ratio.
Coils
fig. 8.9 - TMJ coil
The coil in question is characterized by a central hole that allows the user
to correctly centre the joint in the coil.
The outer surface of the coil is covered by a plastic layer with no sharp
edges. The part contacting the patient is covered with soft neoprene.
The dimensions of the patient table are:
☛ maximum height 23.7 cm
☛ maximum width 14.4 cm
☛ thickness 2.8 cm.
Unlike all the other coils of the system, the TMJ coil has no mechanical
mechanism for connection to the patient bed: this is due to the special
morphological adaptability of the coil.
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To secure the coil to the patient and therefore ensure stable positioning of
the region of interest inside the field of view of the coil, the coil is fitted
with a 86.5 cm long belt.
The belt is attached to the coil with Velcro: this way, the coil and the belt
can be coupled matching the size of the patient since the coil grooves for
Velcro are larger than the belt. For small-sized patients the belt is to be
attached on the grooves on the opening side of the coil, whereas for
large-sized patients the belt is to be attached on the connector-side
groove. For standard-sized patients intermediate positions are to be used.
A soft padding sliding along the belt improves patient comfort during
examination. The padding is to be positioned between the coil and the
opening/closing mechanism if the left temporomandibular joint is being
examined and on the opposite side if the right temporomandibular joint is
being examined.
The coil is equipped with a dedicated wedge-shaped cushion that can be
removed (see previous picture). This cushion allows maximum adherence
of the coil to the anatomic region to be examined.
It is fundamental to take into account the existence of planes of
Good image quality from the area placed in the coil hole can be obtained
axis perpendicular to the coil plane, which is very difficult to estimate for
all patients.
However, for the standard patient the value of this distance is about 4 cm.
Warning
and/or pathology to be examined is at a distance less than 5 cm from
the area placed in the coil hole. Failure to do so will compromise image
quality.
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Dual Phased Array Coils
The Dual Phased Array coils are RF receiving coils and, unlike solenoidal
coils, they are made up of two different coils:
☛ a solenoidal coil that is sensitive to the RF field longitudinal polarization
☛ a second coil, orthogonal to the first one, sensitive to the vertical
polarization.
The orthogonal positioning of the two coils enables efficient detachment
Coils
this guaranteeing the maximum increase of the S/N ratio. The two coils
are assembled to enable use in the same way as with solenoidal coils.
fig. 8.10 - Functional Diagram
As the examined limb is the same, the DPA coils considerably improve the
signal to noise ratio, compared to the solenoidal coils. The user can
choose to obtain images with better resolution, without changing the
acquisition time, or to reduce the acquisition time, keeping the same
resolution.
Coil characteristics vary according to shape and size: Similarity between
coil and examined volume sizes is all important, as is the fact that the
region to be examined must be at the centre of the coil. Locking the limb
to be examined inside the coil is necessary to avoid any involuntary
movements, which may remarkably affect image quality.
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The coils are made of soft plastic so that the limb that is being examined
is not subject to any vascular and/or nervous compression. To centre and
block the area that is being examined in each coil it is sufficient to use the
series of soft rectangular cushions.
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Description of Knee Coil 2
This coil is intended for examining standard-size knees but, thanks to the
geometrical dimensions, can also be used for thigh, calf, elbow and
ankle-feet area examinations in case of standard-size patients and
forearm and arm examinations in case of large-size patients. It has a
roughly cylindrical shape and its internal dimensions are 160 x 183 x 143
cm (w x d x h).
Coils
fig. 8.11 - Knee Coil 2
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Description of Hand/Wrist Coil 3
This coil is intended for examining hands as well as wrists of standard
dimensions. It has a roughly cylindrical shape and its internal dimensions
are 119 x 200 x 72 mm (w x d x h).
fig. 8.12 - Hand/Wrist Coil 3
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Description of Foot/Ankle Coil 4
This coil is intended for examining the ankle-feet area in case of standard
and large-size patients but, thanks to the geometrical dimensions, can
also be used for elbow, forearm and arm examinations in case of
standard-size patients. It is roughly shoe-shaped and its internal
dimensions are 146 x 285 x 100 mm (w x d x h).
Coils
fig. 8.13 - Foot/Ankle Coil 4
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Description of Shoulder Coil 7
This DPA coil is designed for optimal adaptation to the shoulder, for large
and small patients. It is easily and comfortably position around the
anatomic region to be examined thanks to its special ergonomic design.
The internal dimensions are:
☛ 255 x 185 mm (w x h of large opening) and,
☛ 133 x 133 mm (w x h of small opening)
The coil is fitted with two bases (one for the “right shoulder configuration”
and the other for the “left shoulder configuration”) – both removable from
the actual coil – used to secure the coil in its seat on the patient bed.
Activation of the lever on the coil bases enables the coil to be locked
(clockwise lever rotation) and unlocked (counterclockwise lever rotation)
in the examination position.
Depending on the anatomical region to be examined – right or left

shoulder – the coil must be attached to the correct base, as described
below:
☛ to examine the right shoulder, attach the base marked with a yellow dot
to the coil, taking care to align the yellow dot of the base with the yellow
dot of the coil and inserting the tooth of the coil base in the groove with
Velcro.
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16 / 40 •• Chapter 8
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☛ to examine the left shoulder, attach the base marked with a red dot to
the coil, taking care to align the red dot of the base with the red dot of the
coil and inserting the tooth of the coil base in the groove with Velcro.
The configuration (right or left) is correct only when the tooth of the base
is perfectly inserted in the groove of the coil and the form of the base and
form of the coil coincide perfectly, as shown in the figure below.
Coils
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Description of DPA Lumbosacral column Coil 10
This is a DPA coil made up of a rigid section and a flexible section,
designed for examinations of the spinal column and more specifically to
adapt to the lumbosacral and thoracic vertebrae of the patient; the
morphological adaptation of the coil to the anatomic region to be
examined guarantees optimal Signal/Noise ratio.
The dimensions of the rigid section are: 320 mm x 280 mm x 45 mm (w x
d x h).
The dimensions of the large flexible section are: 888.34 mm x 185 mm (L
x D).
The dimensions of the extra large flexible section are: 1090 mm x
185 mm (L x D).
The flexible section can be supplied in two different forms, full or with
openings. The form has no effect on the quality of the image, patient
comfort or usability by the operator.
The coil can be positioned at two different heights with respect to the
patient bed, optimizing the Signal/Noise ratio for patients of different
sizes.
The first position envisages the insertion of the coil directly in its seat. The
second position – raised with respect to the first by 20 mm – envisages
the use of a frame to insert in the coil seat, on which the coil is then
placed.
fig. 8.16 - DPA lumbosacral column coil 10

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18 / 40 •• Chapter 8
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To connect the flexible section to the base, insert the male connectors on
the flexible section (fig. 8.17) into the female connectors on the base
(fig. 8.18) taking care that the two guides (fig. 8.19) are fitted below the
two hooks.
Then close the two retainer hooks as shown in fig. 8.21.
Coils
fig. 8.17 - Male connectors on flexible section
fig. 8.18 - Female connectors on base
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fig. 8.19 - Connector guide on flexible section
fig. 8.20 - Insertion of connector guide on flexible section
fig. 8.21 - Retainer hook closure
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Description of DPA Cervical Spine Coil 14
This is a DPA coil designed for examinations of the cervical section of the
spinal column and more specifically to adapt to the cervical vertebrae of
medium to large-sized patient; the ergonomic design of the coil comprises
a lower fixed section and an upper removable frame to facilitate patient
positioning and enhance comfort, while guaranteeing an optimal
Signal/Noise ratio.
The dimensions of the patient table are:
Coils
☛ maximum internal height 221 mm
☛ minimum internal height (i.e. tilted frame) 206 mm
☛ internal width 190 mm
☛ maximum length 423 mm
fig. 8.22 - Cervical coil 14 and dedicated cushion
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fig. 8.23 - Cervical coil 14 and dedicated cushion

☛ Open the two retainer hooks as shown in the figure below
fig. 8.24 - Open the retainer hooks of Cervical Coil 14
☛ Remove the upper frame of the coil

☛ Position the cervical section of the patient’s spinal column in the
opening of the lower section of the coil
☛ Refit the upper frame on the lower fixed section of the coil
☛ Close the two retainer hooks, following the procedure described in the
figure above in reverse order.
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Warning
the patient’s throat and create difficulties with breathing.
Coils
The upper frame and the lower fixed section of the coil are connected by
the connectors shown in the figure below.
fig. 8.25 - Upper frame-lower fixed section connectors

connection and automatic coil model recognition (coil 14).
The coil is equipped with a dedicated cushion (shown with the coil in the
figures above).
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Multichannel coils
Multichannel coils are RF reception coils comprising several different coils.
Coils 17 and 18, described in the sub-paragraph below, are 4-channel
coils made up of:
☛ two solenoidal coils that are sensitive to the RF field longitudinal
polarization
☛ two butterfly coils, orthogonal to the above, that are sensitive to the RF
field vertical polarization.
The four coils are assembled to ensure the same use as with linear coils.
The four channels are decoupled by a low input impedance preamplifier.
As the examined limb is the same, the 4-channel coils allow to increase
the field of view without losses in the S/N ratio. In particular 4-channel
coils allow an optimal signal homogeneity in the region of interest.
Coil 19, described in the following sub-paragraph, is a 2-channel coil.
Each channel is a loop shaped surface coil collecting signal from one side
of the patient head which lies in between them.
As a result, the images produced with this coil will show both the temporo
mandibular junctions.
The channels are decoupled with a capacitor and with
low-impedance-input preamplifiers.
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Coils
fig. 8.26 - Functional diagram of 4-channel coils (refer to fig. 8.8 for the
functional diagram of the 2-channel coil)
The characteristics of multichannel coils vary according to size and shape:

Similarity between coil and examined volume sizes is all important, as is
the fact that the region to be examined must be at the centre of the coil.
Locking the limb to be examined inside the coil is necessary to avoid any
involuntary movements, which may remarkably affect image quality.
Description of 4-channel coils 17 and 18 for lumbar spine

Four-channel coils have been designed for the examinations of the spinal
column and, more specifically, to adapt to the lumbosacral and thoracic
vertebrae of patients. The morphological adaptation of the coil to the
anatomic region to be examined guarantees optimal Signal/Noise ratio.
Coils are made up of a lower fixed section and of an upper removable
frame to facilitate patient positioning and enhance comfort.
Coils 17 and 18 have the same design but they are of different sizes.
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Coil 17 is intended for the examination of standard to small-sized
patients. The dimensions of coil 17 are:
☛ maximum internal width 405 mm
Coil 18 is intended for the examination of large-sized patients. The
dimensions of coil 18 are:
☛ maximum internal width 470 mm
fig. 8.27 - Four-channel lumbar coil
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26 / 40 •• Chapter 8
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Coils
fig. 8.28 - Four-channel lumbar coil: lower fixed section and upper removable
section
The upper removable section and the lower fixed section of the coil are
electrically connected by the connectors shown in the figure below.
The coils are equipped with a connecting cable, which if fitted to the
☛ Open the two retainer hooks as shown in the figure below
fig. 8.29 - Retainer hook opening
☛ Remove the upper part from the lower fixed section of the coil being
used
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☛ Position the lumbar section of the patient’s spinal column in the opening
of the lower section of the coil
☛ Refit the upper part from the lower fixed section of the coil being used
☛ Close the two retainer hooks, following the procedure described in the
figure above in reverse order.
Warning
When refitting the removable upper section of coils 17 and 18, take
the patient’s chest and/or abdomen creating difficulties with
breathing.
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Description of 2-channel TMJ coil 19
The 2-channels coil is designed to fulfill a bilateral examination of the
temporomandibular joint, thanks to two loops whose position is
adjustable to fit different head sizes maintaining close contact to the
anatomy and then an optimal Signal/Noise ratio.
In order to achieve a good comfort, the coil is shaped with a headrest
where a the cushion No. 13 has to be placed.
Coils
The coil is equipped with a multicoaxial connecting cable, which if fitted to
the connector on the upper section of the magnet ensures electrical
The dimensions of the coil are:
☛ maximum width 440 mm
☛ maximum height 229 mm.
fig. 8.30 - Bilateral TMJ coil 19
To place the two loops of the coil close to the temporomandibular joints,
left and right, press the button - shown in the next figure - and move the
loops in the patient direction. Each loop moves in a guide with fixed
position: release the button to let the loop inserts in the desidered
position.
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fig. 8.31 - Button to move the loop of the TMJ coil 19
To secure the patient to the coil and therefore ensure stable positioning of
the region of interest inside the field of view of the coil, the coil is fitted
with a 86.5 cm long belt.
The belt is engaged in the headrest of the coil and has to be placed around
the patient forehead and closed by the dedicated mechanism.
A soft padding sliding along the belt improves patient comfort during
examination.
It is fundamental to take into account the existence of planes of
iso-sensitivity that are parallel to the loops plane: in fact the signal
Good image quality from the area placed in the loop hole can be obtained
axis perpendicular to the loop plane, which is very difficult to estimate for
all patients.
However, for the standard patient the value of this distance is about 4 cm.
Warning
and/or pathology to be examined is at a distance less than 5 cm from
the area placed in each loop hole. Failure to do so will compromise
image quality.
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Description of 3-channels Shoulder Coil 20
This 3-channels coil is designed for optimal adaptation to the shoulder, for
large, medium and small patients. It is easily and comfortably position
around the anatomic region to be examined thanks to its special
ergonomic design.
The coil dimensions are:
Coils
The coil is fitted with one base (the same for the “right shoulder
configuration” and for the “left shoulder configuration”) – removable from
the coil – used to secure the coil in its seat on the patient bed.
Activation of the lever on the coil base enables the coil to be locked
(clockwise lever rotation) and unlocked (counterclockwise lever rotation)
in the examination position.
fig. 8.32 - 3-channels Shoulder Coil 20
Depending on the anatomical region to be examined – right or left

shoulder – the coil must be correctly attached to the base, as described
below:
☛ to examine the right shoulder, attach the coil (rotating it of 180° around
its vertical axis, with respect the left exam configuration) to the base as
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indicated in the next figure; let the coil slide on the base, until the tooth is
completely inserted into the groove. Close the retainer hook to secure the
coil to the base, avoiding undesired movements.
fig. 8.33 - 3-channels Shoulder Coil 20: right exam configuration
☛ to examine the left shoulder, attach the coil (rotating it of 180° around
its vertical axis, with respect the right exam configuration) to the base as
indicated in the next figure; let the coil slide on the base, until the tooth is
completely inserted into the groove. Close the retainer hook to secure the
coil to the base, avoiding undesired movements.
fig. 8.34 - 3-channels Shoulder Coil 20: left exam configuration
The configuration (right or left) is correct only when the coil is perfectly
inserted into the base and the form of the base and form of the coil
coincide perfectly.
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Coils
fig. 8.35 - Retainer hooks of 3-channels Shoulder Coil 20
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Description of Head Coil 16
This coil is designed for optimal adaptation to the head, for large, medium
and small patients. It is easily and comfortably position around the
anatomic region to be examined thanks to its special ergonomic
helmet-design.
The design offers a comfortable open view to reduce the claustrophobic
response.
The coil internal dimensions are:
☛ maximum height 267 mm
☛ maximum length 254.5 mm
The coil is fitted with one base (anchored to the panel for integration with
the patient table) removable from the coil – used to secure the coil in its
seat on the patient bed.
In order to achieve a good comfort, the base of the coil is shaped with a
headrest where the cushions No. 14 have to be placed.
fig. 8.36 - Head coil 16
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The base is equipped with a sliding mechanism (composed by two rails)
that makes easy and fast the positioning of the coil around the patient’s
head.
To connect the removable-helmet section to the base, insert the helmet
section in the coil housing (and consequently around the patient’s head),
letting it sliding gently in the dedicated rails until the final position has
been reached.
The helmet section is completely inserted in the final position when the
limit of the rail has been reached and, consequently, the mark present on
Coils
the helmet section is in physical correspondence of the mark present on
the rails.
To remove the helmet section from the base, move the dedicated
mechanism of locking/unlocking outwards and let the helmet section slide
on the rails in the opposite direction with respect the insertion.
Caution
When inserting the head coil in the coil housing (next step), have great
care to avoid to harm the patient - especially on the nose, ears and
head’s top - and to pull the patient’s hair: inserting the coil in the coil
housing implies inserting the coil around the patient’s head.
fig. 8.37 - Inserting the head coil 16 in its base
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Caution
Always remove the coil and the coil housing separately. Do not
transport the coil when inserted in the coil housing.
Risk of undesired detaching with consequent fall dawn and break of
coil or coil housing.
Precautions when using the coils
Warning
The receiving coils are shock sensitive. Be very careful that they are
not dropped or knocked against anything.
Take care when the coils are inserted into the gantry. If the base of the
coil is forced, the connector could be damaged.
Clean the receiving coils using a piece of gauze soaked in neutral
detergent. The detergent must evaporate completely before the coil is
used again.
The connector should never come into contact with the detergent.
Phantoms
The phantoms are artificial objects of known dimensions used for test runs
of the system.
Three homogeneous phantoms (two spherical and one bottle), a
geometric phantom and a phantom for the "ghosting" test are supplied
with the S-scan system.
All phantoms are filled with an aqueous solution of 5 mM of NiCl2 and 55
mM of NaCl.
The three uniform phantoms comprise:
☛ a cylindrical container (bottle) with a diameter of 74 mm, for use with
hand/wrist coil 3 and ankle coil 4 for system tuning, and for the quality
tests (Signal/Noise and Uniformity)
☛ a spherical container with a diameter of 140 mm, for use with knee coil
2, flexible coil 6 and shoulder coil 1 for system tuning, and for the quality
tests (Signal/Noise and Uniformity)
☛ a spherical container with a diameter of 86 mm, for use with knee coil 2
for system tuning.
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The geometrical phantom comprises a Plexiglas cylinder (height 50 mm
and internal diameter 100 mm) in which a number of geometrical
reference objects are placed in specific positions. This phantom is used for
system tuning and the evaluation of image properties.
The phantom for the “ghosting” test is used exclusively for this specific
purpose.
A large bottle, containing the aqueous solution described previously, is
supplied with the phantoms; this bottle is intended to be used exclusively
Coils
by technical assistance personnel authorized by Esaote S.p.A,. to fill the
phantoms when needed.
The tests using phantoms, performed by the doctor operator are
exclusively those described in the chapter “System Management”,
paragraphs “System Quality Test” and “Compatibility Test for auxiliary
equipment".
All other tests using phantoms on the system must be carried out
exclusively by technical assistance personnel authorized by Esaote S.p.A.,
according to the procedure specified in the Service Manual.
Warning
If a phantom leaks some solution or breaks, the following precautions
should be taken:
leaked solution
- use inert material (sand or earth for example) to absorb the material
cause an allergic reaction to the Nickel and in contact with the eyes
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fig. 8.38 - Uniform phantom (positioned in Shoulder coil 1)
fig. 8.39 - Geometric phantom (positioned in Knee coil 2)
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ACR phantom
For the purpose of verifying the parameters required for ACR site
accreditation (American College of Radiology), a protocol and a set of
measures to be applied to specific images have been made available to
the user as shown in the relevant section of the User Interface Manual.
Tests relating to such measures (with the exception of the S/N ratio)
require the use of the ACR phantom (shown in the figure below). The ACR
phantom is not supplied with the equipment, it is used by ACR personnel
Coils
during accreditation.
fig. 8.40 - ACR phantom (not included in the scope of supply) and relevant
support
Esaote's scope of supply includes the support (shown in the above figure)
for using the ACR phantom with the system coils.
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CHAPTER 9
Cushion Set
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S-scan is equipped with two cushion sets. One constitutes an integral part
of the device, the other is a set of optional cushions designed to increase
patient comfort during the examination procedure.
The optional cushions are used both to position the patient on the table
and to position the limb inside the coil that is being used for the
examination.
The cushions are made of a very soft, sponge-like material, which means
they can be fitted into narrow spaces between the limb and the coil
without causing any localized pressure that could interfere with the
well-being of the patient. These cushions, are in fact able to lock the limb
in the coil firmly and gently, minimizing the risk of movement of the limb
during the examination, which could cause artifacts on the images. The
Soft Cushion Set is an effective tool used to avoid any contact between the
limb and any part of the coil, in order to optimize the well-being of the
patient and the image quality.
Cushions for patient table

☛ Left-hand cushion
Description: this is a 1.5 cm thick cushion with horizontal and vertical
dimensions suitable for the patient table.
Intended use: all types of examination
fig. 9.1 - Left-hand cushion
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☛ Right-hand cushion
Description: this is a 1.5 cm thick cushion with horizontal and vertical
dimensions adaptable to the patient table.
Intended use: all types of examination
fig. 9.2 - Right-hand cushion
☛ Cushion for panel in all examinations of the spinal column.

Description: the vertical and horizontal dimensions of the cushion enable
adaptation – when combined with the right-hand cushion - to the patient
table and has a form designed to leave free access to the seat of the spinal
column coil.
Intended use: all types of examination of the spinal column
fig. 9.3 - Cushion for examinations of the spinal column.
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☛ Cushion for panel for examinations of the upper and lower limbs.
Description The vertical and horizontal dimensions of the cushion enable
adaptation – when combined with the right-hand cushion - to the patient
table and has a form designed to leave free access to the seats for
examinations of the upper and lower limbs.
Intended use: all types of examination of the upper and lower limbs
Cushion Set
fig. 9.4 - Cushion for examination of the upper and lower limbs.
☛ Bridge cushion No. 1 for examinations of the spinal column.

Description: the horizontal and vertical dimensions enable adaptation to
the coil for examinations of the spinal column, and has a form that enables
use in combination with the 10 DPA coil with a 20 mm frame to enhance
the patient’s comfort.
Intended use: for examinations of the lumbosacral section of the spinal
column.
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fig. 9.5 - Bridge cushion No. 1 for examinations of the lumbar column using
coil 10
☛ Bridge cushion No. 2 for examinations of the spinal column.

Description: the horizontal and vertical dimensions enable adaptation to
the coil for examinations of the spinal column, and has a form that enables
use in combination with the 10 DPA coil (without use of the 20 mm frame)
to enhance the patient’s comfort.
Intended use: for examinations of the lumbosacral section of the spinal
column.
coil 10
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☛ Bridge cushion No. 3
Description: cushion with horizontal and vertical dimensions that enable
adaptation to 4-channel coils 17, for examinations of the spinal column.
Intended use: to enhance the patient’s comfort in examinations of the
lumbar-sacral section of the spinal column using coil 17.
Cushion Set
coil 17
☛ Shoulder cushion.
Description The horizontal and vertical dimensions enable adaptation to
the coil for examinations of the shoulder, and has a form that enables use
in combination with the DPA coil 7 to enhance the patient’s comfort.
Intended Use: for shoulder examinations.
fig. 9.8 - Dedicated cushion for shoulder examinations
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Dedicated cushions
1 Cushions No. 1
Description: standard cushions, thickness 1.5 cm and 3 cm.
Intended use: to be used in all examinations to increase patient
comfort.
fig. 9.9 - Standard cushions
2 Cushion No. 2
Description: head support cushion.
Intended use: in all examinations with the exception of the ankle-foot
exam with the patient in a lateral position.
fig. 9.10 - Generic head support cushion
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3 Cushion No. 3
Description:cylindrical cushion for leg support.
Intended use: for positioning, in examinations of the lumbosacral,
dorsal and cervical sections of the spinal column, below the legs of the
patient lying down, to improve adherence of the anatomic region
examined to the spine coil and enhance the general comfort of the
Cushion Set
patient.
fig. 9.11 - Cylindrical cushion for leg support.
4 Cushion No. 4
Description: wedge cushion.
Intended use: to be positioned, in examinations of limbs and joints,
under the patient’s body, on the opposite side to the anatomic region
to be examined, to keep both sides – right and left – of the patient on
the same horizontal plane and enhance the general comfort of the
patient.
fig. 9.12 - Wedge cushion
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5 Cushion No. 5
Description: cradle shaped arm support cushion
Intended use: for elbow examinations with the knee coil;
recommended for use together with standard cushion No. 1 (thickness
3 cm), to be placed under the forearm and wrist examined to ensure
horizontal limb positioning.
For examinations of the shoulder using coil 7: position the arm (on the
relative side) on the cushion to enhance patient’s comfort.
fig. 9.13 - Arm cradle cushion
6 Cushion No. 6
Description: standard leg support cushion.
Intended use: in all types of examination in which the patient is lying
down. It must be positioned under the legs to improve the general
comfort of the patient.
fig. 9.14 - Standard leg support cushion
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7 Cushions No. 7
Description: leg support cushions
Intended use: in foot and ankle examinations with patient on his/her
side to support the weight of the leg examined and to maintain it at
the correct height in a horizontal position. These cushions can be used
to achieve the correct leg position.
Cushion Set
fig. 9.15 - Leg support cushions for ankle/foot examination
8 Cushions No. 8
Description: generic cradle cushions
Intended use: to be used in all examinations to improve patient
comfort.
fig. 9.16 - Standard cradle shaped cushions
9 Cushion No. 9
Description: patient support cushion for examinations of the hip and
the lumbar spine using coil 18.
Intended use: it must be positioned between the patient and the bed,
near the coil block, to make the patient comfortable in this position.
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In examination of the lumbar spine using coil 18, it must be positioned
on patient table cushion to bring the top of the table into alignment
with base of the coil.
fig. 9.17 - Patient support cushion for hip and lumbar spine examination
10 Cushion No. 10
Description: patient support cushion for temperomandibular joint
examinations.
Intended use: in temporomandibular joint examinations. This cushion
must be placed on the coil to ensure that it adheres to the anatomical
region examined, and to enhance patient comfort.
fig. 9.18 - Patient support cushion for TMJ examination
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11 Cushion No. 11
Description: patient support cushion for cervical examination with
coil 14 and bilateral temporomandibular examinations with coil 19.
Intended use: in cervical spine and bilateral temporomandibular
examinations. This cushion must be placed on the coils - the narrower
part on the headrest - to enhance patient comfort.
Cushion Set
fig. 9.19 - Patient support cushion for cervical (coil 14) and bilateral TMJ (coil 19)
examinations
12 Cushion No. 12
Description: cradle shaped cushions for head examination, thickness
1.3 and 1.5 cm.
Intended use: in head examinations. One of these cushions must be
placed - according to the patient’s dimensions - on the headrest of the
base of the head coil, to enhance patient comfort and correctly centre
the area to be examined.
fig. 9.20 - Cradle shaped cushions for head examination
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13 Cushion No. 13
Description: generic cushions for head examination, thickness 1 and
2 cm.
Intended use: in head examinations, to be placed in the holes of the
upper part of the head coil, in physical correspondence of the patient’s
temples, or between the patient’s jaws/cheeks and the internal
surface of the head coil, in order to avoid undesired movements of the
head during the exam.
fig. 9.21 - Generic cushions for head examination
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General use
These are some general considerations that apply to all examinations:
☛ The cushions are very flexible and therefore a sufficiently large cushion
should be used to guarantee absence of involuntary movements of the
limb.
Cushion Set
☛ The cushion shapes recommended in the patient positioning protocols
are those best suited to the examination in question; however the choice
of cushion also depends on the size of the limb under examination.
☛ Apart from any considerations of comfort, it is always better to avoid
any contact between the skin and the coil surface, which could lead to
points of excessive brightness in the images.
☛ The rectangular cushions can be folded to obtain different shapes and
sizes.
☛ The cushions deteriorate with use; check their condition periodically
and replace them if necessary, to ensure patient comfort and the correct
positioning of the examined region in the gantry. Cushions must be
disposed of in compliance with applicable national and/or local legislation.
For a detailed description of the cushions suited to each specific patient
position (i.e. for all types of examination), refer to chapters 12 to 21 in
this document.
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CHAPTER 10
Turning the system on and off
••••••
Turning on the system

To start up the system, proceed as follows:
1 press the On button on the front of the electronic box to start up
system electronics
2 press the button on the personal computer to start up
When the system is running, a green light illuminates on the switch of the
electronic box, while the green light next to the switch, if lit, indicates that
the system is powered.
The blue light next to the PC switch indicates that the computer is ON.
fig. 10.1 - ON / OFF switch
The system starts up automatically as soon as the switch is switched on.

This procedure normally takes about 2 minutes. The operating system
performs an auto check to verify the consistency of the file system during
which a series of system messages is displayed. In case of an emergency
stop, when the machine is restarted the operative system will
automatically run an error routine to recover any errors due to the
emergency stop. This procedure takes about 10 minutes.
After this operation, the user interface will automatically restart: the main
menu and the logo OPI - Operator Interface - will be displayed. From this
moment on, all of the functions of the system are available to the user.
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The equipment is provided with a software-controlled checking system
which periodically checks the unit components for correct operation; and
notifies the operator of any errors. Before starting work, make sure that
no error messages from the system have been displayed.
Turning off the system

To close the user interface, select the following from the main menu:
File o Exit.
To disconnect the user from the Windows£ system, for example for safety
reasons and to maintain the confidentiality of data in the system, select
Logoff in the Start menu (User logoff).
To shut down the system completely, proceed as follows:
1 close the user interface as described above (File o Exit)
2 from the Start menu of Windows£, select Close Session
3 wait for the computer to shut down, then turn off the S-scan main
switch on the front of the electronic box.
Note
Strictly observe the user interface closure and system shutdown
procedures. Failure to do so may cause damage to system files with
the consequent loss of data, images or programs.
Caution
At the end of the day, the system must always be shut down following
the procedure described above, to avoid premature wear of electrical
and electronic parts.
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Turning the system on and off
Emergency stop
In the event of an emergency it is possible to block the radio frequency
impulses and the generation of the magnetic field as described below:
1 via software, by clicking with the right mouse button in the Info Area
o Scanning of the user interface and selecting End o All in the menu
that appears: all scans queued will be interrupted.
2 Press the S-scan system ON button on the front of the electronic box
to start up system electronics
3 Turn off the wall-mounted main switch. In this case the equipment is
completely de-activated and therefore the thermal control is also
turned off; to re-activate the equipment it is necessary to turn on the
mains switch and the system switch and wait for the magnet to return
to its working temperature.
After performing one of the above procedures, the user should remove the
patient from potential influence of the magnetic field as described in the
procedure in the chapter “Positioning protocols”, paragraph “Removing
the patient in an emergency” in this document.
Note
If the emergency stop procedures requiring switching off the PC are
used, the file system may be damaged and data, images or programs
may be lost.
Warning
The S-scan magnet is a permanent magnet and its static magnetic field
cannot be de-activated in an emergency.
Never use resuscitation devices such as defibrillators, oxygen tanks,
etc., within the controlled access area.
Remove the patient from the influence of the magnet, following the
procedure described in the chapter “Positioning protocols” in this
document.
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CHAPTER 11
Positioning protocols
••••••
Size constraints of the S-scan system

When used properly for examinations within the scope of its intended use,
S-scan can be used safely and effectively for most patients. However, the
compact design of the equipment implies a number of dimensional
restrictions which reduce the number of types of examinations possible.
The size constraints of the S-scan system are as follows:
1 the vertical size of the gantry opening is 34 cm, which determines
the size limit for access to the center of the magnet. In particular
before examining the spinal column, the user should check that the
dimensions of the chest and abdomen are compatible with this size
fig. 11.1 - Vertical size of the gantry opening
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2 internal dimensions of the receiving coil. In fact, the region to be
examined should be compatible with the internal dimensions of the
coil. Refer to the Chapter “Coils” in this document for a description of
coil use, and the chapter “Technical description” for the coil
dimensions in this manual.
fig. 11.2 - Internal size of the coil (Knee Coil 2 is shown in the figure) limits the
girth of the anatomy that can be examined
3 the dimensions of the standard patient table are: 2880 x

650-930 x 870 mm (Length x Width x Height), which may
constitute a size constraint in the case of large patients. For this
reason it is essential that the user ensures that the patient’s head does
not protrude from the upper edge of the bed, before making any
movements of the table.
the dimensions of the compact patient table are: 2450 x
844-938 x 870 mm (Length x Width x Height), which may
constitute a size constraint in the case of large patients. For this
reason it is essential that the user ensures that the patient’s head does
not protrude from the upper edge of the bed, before making any
movements of the table.
4 the maximum size of the displayed image is a 270 x 270 mm
square because the homogeneity region of the magnet corresponds to
a 270 mm diameter sphere, centered on the isocenter of the magnet.
The maximum displayed image is a square circumscribed to the
maximum circumference of the sphere representing the homogeneity
region, as shown in the following figure, in which only half a sphere is
indicated for a clearer view.
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The maximum dimensions of the image displayed for the spinal
column are smaller, to the point of excluding from the image anatomic
regions of the human body that are not required for the diagnostic
assessment of the spinal column (see chapter “Image Quality in MR”
in the manual Image Quality and Sequences, paragraph “Image
Displayed”).
The field of view (FOV) in acquisition of the S-scan is adjustable from
100 x 100 mm2 to 400 x 400 mm2, to enable optimization of Signal to
Noise ratio and image resolution (refer to chapter on Image Quality in
MR in the Image and Sequence Quality manual).
fig. 11.3 - Homogeneity region (sphere centered in the magnet isocenter) and
maximum displayed image
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If the user chooses a FOV in acquisition larger than or equal to 270 x
270 mm2, the displayed image will nevertheless be 270 x 270 mm2
(except for the images of the spinal column, for which you should refer to
the Image and Sequence Quality manual), in order to minimize the
displayed area outside the homogeneity region, where artifacts can be
present due to distorted signals caused by inhomogeneity of the magnetic
field (refer to chapter on Image Quality in MR in the Image and Sequence
Quality manual).
If a FOV less than 270 x 270 mm2 is selected, the displayed image will be
the actual size at which it was acquired; this is not always true in the case
of the spinal column, in which case refer to the chapter “Image Quality in
MR” in the Image and Sequence Quality manual, paragraph “Image
Displayed”).
fig. 11.4 - Homogeneity region - Acquisition FOV and maximum displayed image
Due to the displayed image constraints, diffuse pathologies, such as large

tumors, may extend beyond the homogeneity region and therefore cannot
be examined entirely using the G-scan system.
In this case, O-scan Users are advised not to attempt evaluations or
diagnoses of such pathologies.
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Warning
Because of displayed image constraints, S-scan is not recommended
for use in evaluation of diffuse pathologies that may extend beyond
the maximum displayed image.
Users are advised to conclusively determine that tumors or other
diffuse pathologies are entirely within the maximum displayed image,
before attempting to assess or diagnose them.
It may be seriously difficult, or even impossible, to assess or diagnose
pathologies that extend beyond the maximum displayed image. The
size of the pathology may not be known and important diagnostic
structures may not be visible.
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Centering the Coil and the Anatomy to be Examined
The User must observe the following requirements for all S-scan
examinations:
1 The receiving coil must always be positioned in the center of the
magnet.
To ensure this for all the coils, except the Flexible Coil 6 and TMJ Coil
15, position and lock the coil in the coil seat located on the panel of
the patient’s table, then:
Standard patient table:
• move the patient table, pressing the handle on the outer edge of
the table until the pin mounted below the right-hand cover of the
table is aligned with one of the three holes present on the floor,
depending on the position of the coil used (see chapter 6 of this
document). Then release the handle.
Compact patient table:
• using the handles provided, move the patient table in the desired
direction towards the gantry until the wheels engage the
appropriate positioning recess in the guide rails fixed to the floor,
which will depend on the position of the coil being used (see
chapter 6 in this document).
When using Flexible Coil 6 and TMJ Coil 15: after fixing the coil around the
area being examined, the User must position the patient so that the
Flexible Coil 6 or TMJ Coil 15 is aligned with the required coil housing, and
then repeat the two steps described above.
2 The anatomical region examined must be positioned in the center of
the receiving coil with respect to the three spatial dimensions.
• To ensure this when using rigid coils, with the exception of spine
coils 9, 10, 14, 17 and 18 (optional), use standard cushions to
position and immobilize the anatomy being examined in the center
of the reception coil.
• In the case of spine coils 9, 10, 14, 17 and 18 (optional), this is
ensured by taking great care when positioning the section of spinal
column to be examined in the center of the coil, both in the
head-feet and right-left directions of the patient, and verifying the
position by executing a sequence in real time via the control panel.
• In the case of Flexible Coil 6 and TMJ Coil 15, this condition is
guaranteed by using the right or left holes of the coil, as described
for examinations of the hip, shoulder, thigh and temper-mandibular
joints in the chapters “Coils”, “Hip examinations.”, “Shoulder
Examinations”, “Thigh and Calf Area Examinations” and
“Examinations of the temperomandibular joint”.
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Warning
To avoid possible misinterpretation of images, it is the user’s
responsibility to verify that the anatomy to be examined is correctly
positioned in the center of homogeneity region of the magnet, by
using the Scout sequence and observing the initial scans.
For examinations of non-joint regions where well-defined anatomical

features may not be present, an MR marker may be applied directly to the
patient’s skin. The marker makes it easier to verify through the Scout
sequence evaluation that the anatomy to be examined is at the center of
the receiving coil.
Image Quality
To obtain optimal image quality, the user must comply with the following
indications:
1 always use the coil recommended for the anatomical region being
imaged;
2 when more than one coil size is available (for instance, in the case of
knee coils), select the smallest one compatible with the anatomy
under examination and the patient characteristics;
3 To prevent movement that could cause artifacts or blur the images,
secure the limb in place.
Caution
Do not proceed with an examination if interference is visible in the
Scout image, or if an error message indicates the presence of
interference. Check the doors of the shielding room for correct
operation and/or contact Esaote-authorized service personnel for
assistance.
Such interferences can impede image interpretation by degrading
quality and causing artifacts.
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Removing the patient in an emergency
If the patient needs to be removed quickly from the unit for emergency
treatment, proceed as follows.
1 Interrupt all the scans currently being executed/queued by clicking
with the right mouse button in the Info Area o Scanning of the user
interface and selecting End o All in the menu that appears.


4 Remove any cushions placed between the coil and anatomical region
examined, as well as those used for positioning.
point 8.
8 Press the handle on the patient table, and keeping it pressed move the
bed out of the gantry to its travel limit. Then release the handle to lock
the bed in the correct descent position.
9 If used, loosen the safety belts on the patient.
10 Remove the patient’s limb from the coil.
11 Help the patient to sit up on the bed, with the legs off the table, near
the step.
Only after carrying out these steps, will it be possible to move the patient
away from the influence of the magnetic field.
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CHAPTER 12
Knee examinations
••••••
Usable coils
As explained in detail in chapter 8 of this document, the coils that can be
used to examine the knee are:
☛ Knee Coil 2, for patients with standard-size knees.
☛ Shoulder Coil 1, for large-size patients.
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Warning
The user should take care to avoid compression of the postero-lateral
site of the external sciatic-popliteal nerve, especially the area
corresponding to the proximal tibial-fibular joint.
Sciatic-popliteal nerve compression may cause temporary or
permanent impairment of the leg.
To ensure correct use of these coils, refer to chapters 8 and 12 of this

document.
Patient Positioning Procedure

Knee Coil 2 is recommended when examining the knee in the case of
standard-size patients.
Shoulder Coil 1 is recommended when examining the knee in the case of
large size patients.
point 5.
correct position for patient access
pressed move the bed out of the gantry to its travel limit. Then release
the handle to lock the bed in the correct access position.
6 If not already inserted, fit the panel containing the seats for the coil
used for examinations of the limbs and joints. Then position the
specific cushion on the panel.
7a Insert the coil in the innermost seat with respect to the gantry if
examining the left-hand knee and the outermost seat if examining the
right-hand knee. Position the coil so that the connection cable faces
the external part of the gantry in the case of “right-hand knee”
configurations and towards the internal part of the gantry in the case
of “left-hand knee configurations.
7b Alternatively: insert the coil in the “central” seat and position it so that
the connection cable is facing the external part of the gantry.
8 Help the patient to sit up on the table, to the left of the coil, instructing
them on how to use the table access step.
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9 Let the patient lie down on the table with the head facing the left with
respect to the gantry, insert the limb in the coil; if required make small
adjustments moving the patient to reach the optimal position.
Knee examinations
Note
The fibro-cartilage plane must be positioned 1 cm (in the direction of
the head) from the center of the coil being used.
10 Place head support cushion No. 2 under the patient’s head.

11 Place other cushions as necessary to improve the patient’s comfort.
fig. 12.1 - Positioning the patient for examination of the knee with the standard
patient table
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fig. 12.2 - Positioning the patient for examination of the knee with the compact
patient table
12 Verify that the area under examination is centered with respect to the
coil. Move the lever on the coil base and lock the coil so that its
opening is parallel to the right-left direction of the bed (perpendicular
to gantry).
13 Insert and adequate number of standard cushions No. 1 (of different
thicknesses) between the coil and limb. This very important step
helps:
- to center the limb in the coil;
- to prevent involuntary movements of the patient
- to increase patient comfort;
- to avoid direct contact between the patient and the coil, which can
result in bright areas in the image that make diagnosis more difficult.
Warning
protruding from the sides of the table may be trapped during

point 17a or 17b according to the position of the coil.
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15aUsing the dedicated handles, move the patient table into the gantry to
The coil is centered, for examination of the left knee, when the wheels
Knee examinations
of the patient table engage the first positioning recess in the guide
rails, or for examination of the right knee, when they engage the third
recess in the guide rails.
15bIf the coil has been inserted in the central seat, it is centered when the
wheels of the patient table engage the second recess in the guide rails.
17aPress the handle on the edge of the patient table and, keeping it
pressed, move it manually into the gantry to center the coil with
respect to the magnet isocenter in this direction.
To center the coil, release the handle (and lock the table) when the
pin, mounted below the right-hand cover of the patient table, is
aligned with the innermost or outermost hole with respect to the
gantry – for right and left knee examinations respectively – on the
floor.
17bIf the coil is inserted in the central hole, to center it, release the handle
(thus locking the table) when the pin, mounted below the right-hand
cover of the table, is aligned with the central hole on the floor.
18 Connect the coil connection cable to the connector on the upper
section of the magnet.
19 Switch on the control panel, from the user interface, by selecting the
relative command (shown here on the left) on the tool bar.
20 Perform the sequence in real time, to verify correct positioning(see
chapters “User Interface and control panel” and “Examination
environment”); if the anatomic region concerned is not centered with
respect to the magnet isocenter, carefully check the position of the
region in the coil and the position of the bed in the direction in/out of
the gantry.
Then repeat the sequence in real time.
21 Close the shielding apparatus.
22 Acquire the Scout sequence (see chapter “Examination environment”
of the User Interface Manual).
Note
If no error message indicating the presence of interference and/or
noise upon acquisition is displayed and if the acquired scout images
are free of interference and/or noise, the examination can be
performed.
•
•
350003100 Rev. 11 • 5/6
•
•
•
On completion of the examination, proceed as follows:


3 Remove any cushions placed between the coil and area examined,
including those used for positioning.
point 7.
7 While holding pressed the handle on the edge of the patient table,
move the table out of the gantry to its maximum travel limit. Then
release the handle to lock the bed in the correct descent position.
8 Withdraw the patient’s limb from the coil
alternatively
release the coil by means of the release lever and remove the coil from
the limb of the patient.
9 Help the patient to sit up on the bed, with the legs off the table.
•
•
6/6 • Chapter 12
•
•
•
CHAPTER 13
Thigh and Calf Area Examinations
••••••
Usable coils
used to examine the calf and thigh areas are:
☛ Knee Coil 2, for standard and small-size patients
☛ Shoulder Coil 1, for medium-to-large and large-size patients
☛ flexible coil 6, for the calf examination whenever the patient positioning
is not comfortable using a rigid coil, due to acute and painful traumas
•
•
• 1 / 14
•
•
•
Warning
examination.
To ensure correct use of these coils, refer to chapters 8 and 12 of this

document.
•
•
2 / 14 •• Chapter 13
•
•
Warning
Users are advised to perform only targeted examinations of calf and
thigh with the S-scan system. An MR marker may be applied to
patient’s skin to delineate the area to be examined and verify correct
positioning.
The entire areas of the calf and thigh can not be examined in a single
acquisition because the anatomical structure of these areas may
extend beyond the S-scan homogeneity region.
Knee Coil 2 is recommended to study the thigh and calf when examining
standard and small-size patients.
Shoulder Coil 1 is recommended when studying the thigh or the calf on
large-size patients. In case of very large patients, Shoulder Coil 1 will not
accommodate the entire thigh, and therefore examination of entire thigh
is precluded.
Flexible Coil 6 is recommended for the calf examination whenever the
patient positioning is not comfortable using a rigid coil due to acute and
painful traumas or the knee in plaster.
When examining the proximal part of the thigh, avoid forcing this
anatomical area into the coil. Due to the anatomical conformation, it is
generally difficult to scan the proximal part of the thigh.
If using Knee Coil 2 or the Shoulder Coil 1:

point 5.
•
•
350003100 Rev. 11 • 3 / 14
•
•
•
examining the left-hand thigh (or calf) and the outermost seat if
examining the right-hand thigh (or calf). Position the coil so that the
connection cable faces the external part of the gantry in the case of
“right-hand thigh/calf” configurations and towards the internal part of
the gantry in the case of “left-hand thigh/calf” configurations.
8 Apply (optionally) a magnetic resonance marker on the area being
examined.
If you are performing an examination of the calf of a tall patient
using the compact patient table, go to point 9, otherwise go to
point 10
9 Position the back support on the patient table (see the paragraph “
Back support” in chapter 6), with the seat facing the coil.
The back support must be positioned at a suitable distance from the
coil based on the length of the limb examined, taking great care to
ensure that this support is not placed on or over the edge of the
patient table (narrow side).
point 12
11 Have the patient sit on the seat of the back support, making sure that
the patient’s back closely adheres to the backrest and introduce the
limb into the coil; if necessary, make small adjustments to position of
the patient while also moving the back support to achieve the optimal
position.
13 When examining the proximal part of the thigh, avoid forcing the area
concerned into the coil, causing physical discomfort to the patient. The
size and the anatomic conformation of the proximal part of the thigh
may preclude carrying out this examination.
•
•
4 / 14 •• Chapter 13
•
•
fig. 13.1 - Positioning the patient for examination of the thigh with the standard
patient table
fig. 13.2 - Positioning the patient for examination of the thigh with the compact
patient table
•
•
350003100 Rev. 11 • 5 / 14
•
•
•
fig. 13.3 - Positioning the patient for examination of the calf with the standard
patient table
fig. 13.4 - Positioning a medium height/short patient for examination of the calf
with the compact patient table
•
•
6 / 14 •• Chapter 13
•
•
fig. 13.5 - Positioning a tall patient for examination of the calf with the compact
patient table
to gantry).
17 Insert and adequate number of standard cushions No. 1 (of different
thicknesses) between the coil and limb. This very important step
helps:
Warning

•
•
350003100 Rev. 11 • 7 / 14
•
•
•
The coil is centered, for examination of the left thigh/calf, when the
wheels of the patient table engage the first positioning recess in the
guide rails, or for examination of the right thigh/calf, when they
engage the third recess in the guide rails.
gantry – for right and left thigh/calf examinations respectively – on
the floor.
21bIf the coil is inserted in the central hole, to center release the handle
24 Perform the sequence in real time, to verify correct positioning (see
chapter “Examination environment” of the user interface manual). As
the examination refers to an anatomical region that is difficult to
identify, use of an MR marker helps when checking centering.
If the anatomical region concerned is not centered with respect to the
magnet isocenter, carefully check the position of the region in the coil
and the position of the table with respect to the gantry.
Note
performed.
•
•
8 / 14 •• Chapter 13
•
•
See the end of the chapter for the procedure to follow on completion of the
examination.
If using the Flexible Coil:

point 5.
7 Apply (optionally) a magnetic resonance marker on the area being
examined.
8 Place the coil around the area to be examined as indicated in the note
below and close the belts around the patient’s thigh/calf by means the
dedicated open/close mechanism; take care that the coil adheres
tightly to the anatomical region examined.
The position of the open/close mechanism can be adjusted by moving
it along the longer belt, adapting the total belt length to the size of the
region of the patient.
Note
Depending on the area of the thigh/calf district to be examined, the
lateral part (internal or external) of the thigh/calf must be positioned at
the center of the hole of the flexible coil.
To examine the required area of the thigh/calf, the coil can be moved
along its vertical axis (i.e. in the head-feet direction of the patient). Do
not rotate it around the patient’s leg (i.e. do not move the coil along its
horizontal axis) as this will result in significant loss of acquisition
signal.
•
•
350003100 Rev. 11 • 9 / 14
•
•
•
9 If necessary, place a small standard cushion (No. 1) between the belt
open/close mechanism and the thigh/calf of the patient to enhance
comfort and avoid compression of the nerves or blood vessels: in this
case however, the cushion must not prevent close adherence of the
coil around the region of the patient.
point 11
10 Position the back support on the patient table (see the paragraph “
Back support” in chapter 6), with the seat facing the coil.
using the compact patient table, go to point 12a (or point 12b),
otherwise go to point 13a (or point 13b)
12aHelp the patient to sit down on the seat of the back support, taking
care that the patient’s back is positioned up against the back of the
support. Take great care to position the patient so that the coil is in
physical correspondence with the innermost coil seat if examining the
left thigh (or calf) and the outermost coil seat if examining the right
thigh (or calf).
12bOtherwise: Help the patient to sit down on the seat of the back
support, taking care that the patient’s back is positioned up against
the back of the support. Take great care to position the patient so that
the coil is in physical correspondence with the central coil seat.
13aLet the patient lie down on the table with the head facing the left with
respect to the gantry and take great care to position him/her so that
the coil is in physical correspondence with the innermost coil seat if
examining the left thigh (or calf) and the outermost coil seat if
examining the right thigh (or calf).
13bOtherwise: Let the patient lie down on the table and take great care
to position him/her so that the coil is in physical correspondence with
the central coil seat.
16 If necessary, make small adjustments to move the patient to the
optimal position.
•
•
10 / 14 •• Chapter 13
•
•
Warning

The coil is centered, for examination of the left thigh/calf, when the
guide rails, or for examination of the right thigh/calf, when they
To center the coil, release the handle (and thus lock the table) when
the pin, mounted below the right-hand cover of the patient table, is
gantry – for right and left thigh/calf examinations respectively – on
the floor.
20bIf the coil is inserted in the central hole, to center release the handle
•
•
350003100 Rev. 11 • 11 / 14
•
•
•
25 Acquire the Scout sequence to ensure correct centering of the area
being examined (see chapter “Examination environment” in the user
interface manual).
Note
performed.
•
•
12 / 14 •• Chapter 13
•
•


point 7.
alternatively
•
•
350003100 Rev. 11 • 13 / 14
•
•
•
•
•
14 / 14 •• Chapter 13
•
•
CHAPTER 14
Examination of the foot-ankle
region
••••••
Usable coils
As explained in detail in chapter 8 in this document, the coils that can be
used to examine the anatomical foot-ankle region are:
☛ Foot/Ankle Coil 4, in case of standard and large-size patients.
☛ Knee Coil 2, when examining the ankle on most women, children and
men with an average or small size foot.
•
•
• 1 / 10
•
•
•
Warning
examination.
Ankle examination: standard patient positioning procedure

Use of Foot/Ankle Coil 4 is recommended for examining the ankle/foot
region of most women, children and men with small to medium shoe size.
Use of Knee Coil 2 is recommended for examining the ankle/foot region of
standard or large patients.
As long as it is compatible with the size of the ankle-foot region being
examined, this coil is also recommended in the case of patients who are
unable to assume the standard lateral position.
The ankle examination procedure is described below. The same procedure
applies for examinations of other areas of the foot-ankle region.
If using Foot/Ankle Coil 4:

point 5.
examining the left foot/ankle and the outermost seat if examining the
right foot/ankle. Position the coil so that the connection cable faces the
external part of the gantry for right foot/ankle configuration and
towards the internal part of the gantry for left foot/ankle
configuration.
•
•
2 / 10 •• Chapter 14
•
•
Examination of the foot-ankle region
9 Let the patient lie on one side (left in the case of the right limb and
right vice versa), with the head facing the left with respect to the
gantry, and insert the limb in the coil and place his / her the foot in
vertical position. If necessary, make small adjustments moving the
patient to reach the optimize positioning.
Note
When examining the ankle, the malleolus must be positioned at the
center of Foot/Ankle Coil 4.

fig. 14.1 - Patient positioning for examinations of the ankle-foot region using
Ankle Coil 4 and the standard patient table
•
•
350003100 Rev. 11 • 3 / 10
•
•
•
fig. 14.2 - Patient positioning for examinations of the ankle-foot region using
Ankle Coil 4 and the compact patient table
to gantry).
13 Insert an adequate number of standard cushions of different
thicknesses (no. 1). This very important step helps:
The coil is centered, for examination of the left foot/ankle, when the
guide rails, or for examination of the right foot/ankle, when they
•
•
4 / 10 •• Chapter 14
•
•
gantry – for right and left foot/ankle examinations respectively – on
the floor.
Caution
protruding from the sides of the patient table may be trapped during
manual movement of the table.

chapter “Examination environment” in the User Interface Manual); if
the anatomic region concerned is not centered with respect to the
and the position of the bed with respect to the gantry.
Note
performed.
•
•
350003100 Rev. 11 • 5 / 10
•
•
•
The front part of the foot and Achilles’ tendon can also be examined by
positioning the foot differently and following the procedure described
above.
examination.
If using the Knee Coil 2:

point 5.
examining the left foot/ankle and the outermost seat if examining the
right foot/ankle. Position the coil so that the connection cable is facing
the external part of the gantry.
If you are performing an examination on a medium height/short
patient using the compact patient table, go to point 8
8 Place cushions No. 6, No. 4 and No. 9 on the patient table, to the left
of the coil, to create a comfortable position for the patient during the
examination.
If you are performing an examination on a tall patient using the
compact patient table, go to point 9, otherwise go to point 10
9 Position the back support on the patient table (see the paragraph
“Back support” in chapter 6), with the backrest facing the left of the
coil.
•
•
6 / 10 •• Chapter 14
•
•
If you are performing an examination on a tall patient using the
compact patient table, go to point 11, otherwise go to point 12
11 Have the patient sit on the seat of the back support, making sure that
the patient’s back closely adheres to the backrest, and introduce the
limb into the coil, with the foot making a 90 angle to the leg; if
necessary, make small adjustments to position of the patient while
also moving the back support to achieve the optimal position.
respect to the gantry, insert the limb in the coil with the foot in a
vertical position; if required make small adjustments moving the
patient to reach the optimal position.
Note
When examining the ankle, the malleolus must be positioned at the
center of Knee Coil 2.

14 Place cushion No. 6 or No. 3 under the knee: the ankle will move from
the vertical position so that it can correctly centered in the coil. Add
other cushions as necessary to improve the patient’s comfort.
fig. 14.3 - Patient positioning for examination of the ankle-foot region using Knee
Coil 2 and the standard patient table
•
•
350003100 Rev. 11 • 7 / 10
•
•
•
fig. 14.4 - Patient positioning for examination of the ankle-foot region using Knee
Coil 2 and the standard patient table
to gantry).
The coil is centered, for examination of the left foot/ankle, when the
guide rails, or for examination of the right foot/ankle, when they
•
•
8 / 10 •• Chapter 14
•
•
gantry – for right and left foot/ankle examinations respectively – on
the floor.
Caution

chapter “Examination environment” in the User Interface Manual); if
the anatomic region concerned is not centered with respect to the
and the position of the bed with respect to the gantry.
Note
noise during acquisition is displayed and if the acquired scout images
performed.
•
•
350003100 Rev. 11 • 9 / 10
•
•
•
The front part of the foot and Achilles’ tendon can also be examined by
positioning the foot differently and following the procedure described
above.


point 7.
alternatively
•
•
10 / 10 •• Chapter 14
•
•
CHAPTER 15
Hand-Wrist examinations
••••••
Usable coils
used to examine the hand-wrist region are:
☛ Hand/Wrist Coil 3, for examinations with the hand horizontal
☛ Foot/Ankle Coil 4, for examinations with the hand vertical
•
•
• 1/6
•
•
•
☛ Knee Coil 2, for examinations with the hand vertical

point 5.
7 Insert the coil in the innermost seat with respect to the gantry if
examining the left hand/wrist and the outermost seat if examining the
right hand/wrist. Position the coil so that the connection cable faces
the external part of the gantry for the left hand/wrist configuration and
towards the internal part of the gantry for the right hand/wrist
configuration.
8 Place cushion no. 9 over the coil seats not used for examinations.
10 Let the patient lie down on the table with the head facing the right with
respect to the gantry, and insert the limb in the coil; the forearm must
be laid straight in the coil, parallel to the body.
•
•
2/6 • Chapter 15
•
•
•
11aIf Hand/Wrist Coil No. 3 is used: have the patient position his/her hand
with the palm facing downwards (select the Horizontalposition on the
user interface).
11bIf Hand/Wrist Coil No. 4 or Knee Coil No. 2 is used: have the patient
position his/her hand with the palm vertical (select Vertical position on
the user interface) and insert standard cushions No. 1 and No. 8,
between the hand and the coil to keep the hand in a stable position.
Note
When examining the wrist, the radiocarpal joint plane must be
positioned at the center of the coil being used.

optimal position.
fig. 15.1 - Patient positioning for examination of the hand/wrist region using the
•
•
350003100 Rev. 11 • 3/6
•
•
•
fig. 15.2 - Patient positioning for examination of the hand/wrist region using the
compact patient table
to gantry).
Warning
protruding from the sides of the patient table may be trapped during
manual movement of the table.
•
•
4/6 • Chapter 15
•
•
•
17 If examining the left hand or wrist, take care to ensure that the hand
and entire arm not examined are correctly placed within the area of
the protection barrier, mounted on the patient table on the innermost
side of the gantry.
point 20.
The coil is centered, for examination of the left hand/wrist, when the
guide rails, or for examination of the right hand/wrist, when they
gantry – for right and left hand/wrist examinations respectively – on
the floor.
chapter “Examination environment” of the user interface manual).
Note
performed.
•
•
350003100 Rev. 11 • 5/6
•
•
•


point 7.
alternatively
•
•
6/6 • Chapter 15
•
•
•
CHAPTER 16
Elbow examinations
••••••
Usable coils
used to examine the elbow are:
☛ Knee coil 2 for large and medium-large patients
☛ Foot/Ankle coil 4 in the case of standard and small size patients
•
•
• 1/6
•
•
•
Warning
examination.

Knee coil 2 is recommended for examinations of the elbow on large and
medium-large patients.
Foot/Ankle coil 4 is recommended for examinations of the elbow on
standard and small patients.
point 5.
examining the left elbow and the outermost seat if examining the right
elbow. Position the coil so that the connection cable faces the external
part of the gantry in the case of “right elbow” configurations and
towards the internal part of the gantry in the case of “left elbow
configurations.
9 Have the patient lie down on the table with the head facing the right
with respect to the gantry, and insert the limb in the coil;
• if, in the user interface, Supine has been selected in the Patient
Position field, the forearm must be straight and parallel to the
patient’s body, with the palm of the hand facing downwards.
• If, in the user interface, Prone has been selected under the Patient
Position field, the forearm must be parallel to the patient’s body and
in supination, with the palm of the hand facing upwards.
•
•
2/6 • Chapter 16
•
•
•
Note
Elbow examinations
Position the humeroulnar or humeroradial plane at the centre of the
coil.

optimal position.
fig. 16.1 - Patient positioning for examination of the elbow using the standard
patient table
•
•
350003100 Rev. 11 • 3/6
•
•
•
fig. 16.2 - Patient positioning for examination of the elbow using the compact
patient table
to gantry).
Warning
•
•
4/6 • Chapter 16
•
•
•
15 If examining the left elbow, take care to ensure that the elbow and
entire arm not examined are correctly placed within the area of the
protection barrier, mounted on the patient table on the innermost side
of the gantry.
Elbow examinations
point 19.
17 Using the raised edge, move the patient table in the direction of the
gantry to center the coil relative to the magnet isocenter.
The coil is centered, for examination of the left elbow, when the
guide rails, or for examination of the right elbow, when they engage
the third recess in the guide rails.
To center the coil, release the handle (and thus lock the table) when
the pin, mounted below the right-hand cover of the patient table, is
gantry – for right and left elbow examinations respectively – on the
floor.
Note
performed.
•
•
350003100 Rev. 11 • 5/6
•
•
•


point 7.
alternatively
•
•
6/6 • Chapter 16
•
•
•
CHAPTER 17
Arm and forearm examinations
••••••
Usable coils
used to examine the arm/forearm are:
☛ Foot/Ankle coil 4 in the case of standard size patients
☛ Knee coil 2 in the case of standard and medium-large patients
•
•
• 1/8
•
•
•
Warning
examination.
Warning
Users are advised to perform only targeted examinations of arm and
forearm with the S-scan system. An MR marker may be applied to
patient’s skin to delineate the area to be examined and verify correct
positioning.
The entire arm and forearm sections cannot be examined in a single
acquisition because the anatomical structure of this area may extend
beyond the S-scan homogeneity region.
Foot/Ankle coil 4 is recommended for examination of the arm/forearm on

standard size patients.
Knee coil 2 is recommended for examinations of the arm/forearm on large
patients.
When examining the proximal part of the arm, do not force the area
concerned into the coil. The anatomical conformation of the proximal part
of the arm in fact makes it difficult to perform this examination.
point 5.
•
•
2/8 • Chapter 17
•
•
•
examining the right arm/forearm and the outermost seat if examining
the left arm/forearm. Position the coil so that the connection cable
faces the external part of the gantry in the case of “left arm/forearm”
of “right arm/forearm” configurations.
8 Place cushion No. Place cushion no. 9 over the coil seats not used in
the examination.
9 Apply (optionally) a magnetic resonance marker on the area to be
examined.
with respect to the gantry, and insert the limb in the coil;
• if, in the user interface, Supine has been selected in the Patient
Position field, the arm must be straight and parallel to the patient’s
body, with the palm of the hand facing downwards.
• if, in the user interface, Prone has been selected under the Patient
Position field, the arm must be parallel to the patient’s body, the
forearm in supination, with the palm of the hand facing upwards.
12 If examining the arm: when examining the proximal part, avoid
forcing the area concerned into the coil, causing physical discomfort
to the patient; the anatomical conformation of the proximal part of the
arm in fact makes it difficult to perform this examination.
optimal position.
•
•
350003100 Rev. 11 • 3/8
•
•
•
fig. 17.1 - Patient positioning for examination of the forearm using the standard
patient table
fig. 17.2 - Patient positioning for examination of the forearm using the compact
patient table
•
•
4/8 • Chapter 17
•
•
•
fig. 17.3 - Patient positioning for examination of the arm using the standard
patient table
fig. 17.4 - Patient positioning for examination of the arm using the compact
patient table
•
•
350003100 Rev. 11 • 5/8
•
•
•
to gantry).
Warning
18 If examining the left arm/forearm, take care to ensure that the

arm/forearm not examined is correctly placed within the area of the
of the gantry.
point 22.
The coil is centered, for examination of the right arm/forearm, when
the wheels of the patient table engage the first positioning recess in
the guide rails, or for examination of the left arm/forearm, when they
gantry – for right and left arm/forearm examinations respectively – on
the floor.
•
•
6/8 • Chapter 17
•
•
•
Note
performed.
•
•
350003100 Rev. 11 • 7/8
•
•
•


point 7.
alternatively
•
•
8/8 • Chapter 17
•
•
•
CHAPTER 18
Shoulder Examinations
••••••
Usable coils
used to examine the shoulder are:
☛ Shoulder coil 7, for small to large size patients
☛ 3-channel Shoulder coil 20, for small to large size patients
•
•
• 1 / 16
•
•
•
☛ Shoulder Coil 1, for large-size patients
☛ Flexible Coil 6, for the shoulder examination whenever the patient

positioning is not comfortable using a rigid coil, due to acute and painful
traumas
Warning
If the coil used is too small with respect to the limb size, it may exert
pressure on the nervous and/or vascular structures of the limb under
examination.
•
•
2 / 16 •• Chapter 18
•
•
Shoulder Coil 7 and the 3-channel Shoulder Coil 20 are recommended
when examining the shoulders of small and large patients. In this case
special attention must be paid to ensure correct coil configuration - right
or left - in relation to the district to be examined (see the chapter “Coils”
in this document).
Flexible Coil 6 is recommended for the shoulder examination whenever
the patient positioning is not comfortable using a rigid coil, due to acute
and painful traumas.
Shoulder Coil 1 is recommended when examining the shoulder of large
patients. L
If using the Shoulder Coil 7 or the 3-channel Shoulder Coil

20:
point 5.
the examination.
8a If using Coil 7: position both parts of the shoulder cushion on the
patient table. Depending on which side of the patient is to be
examined, the aperture of the right or left element should be aligned
with the coil seat.
8b When using Coil 20: insert the element of the Shoulder Cushion for the
side not under examination on the patient table and a cushion No. 8
on the coil base, as indicated in the figure below.
•
•
350003100 Rev. 11 • 3 / 16
•
•
•
fig. 18.1 - Cushion positioning for examination using Coil 20 (e.g. left shoulder)
9a When using Coil 7: depending on the anatomical region to be

examined - right or left shoulder - attach the coil to the appropriate
base, as described in the chapter “Coils”, paragraph “Description of
Shoulder Coil 7” in this manual.
9b When using Coil 20: depending on whether the right or left shoulder
is to be examined, attach the coil to the base correctly and lock it in
position as described in the chapter “Coils”, paragraph “Description of
Shoulder Coil 20” in this manual.
10aWhen using Coil 7: insert the coil in the innermost seat with respect
to the gantry if examining the right shoulder or the outermost seat if
examining the left shoulder. Position the coil so that the connection
cable faces the external part of the gantry in the case of “left shoulder”
of “right shoulder” configurations.
10bWhen using Coil 20: insert the coil in the innermost seat with respect
to the gantry if examining the right shoulder or the outermost seat if
examining the left shoulder. Position the coil so that the internal
surface of the coil faces the external part of the gantry for left shoulder
configurations and towards the internal part of the gantry for right
shoulder configurations.
•
•
4 / 16 •• Chapter 18
•
•
respect to the gantry, and insert the limb in the coil; them carefully
slide the arm into the coil opening (the patient should embrace the
coil).
optimal position.
Note
The glenohumeral joint must be positioned at the center of the
shoulder coil 1.
14 Position both the right and the left arms of the patient parallel to the
patient’s body.
fig. 18.2 - Patient positioning for examination of the left shoulder using shoulder
coil 7 and the standard patient table
•
•
350003100 Rev. 11 • 5 / 16
•
•
•
fig. 18.3 - Patient positioning for examination of the right shoulder using the
3-channel shoulder coil 20 and the standard patient table
fig. 18.4 - Patient positioning for examination of the left shoulder using shoulder
coil 7 and the compact patient table
•
•
6 / 16 •• Chapter 18
•
•
17 Make sure that the area under examination is centered with respect to
the coil. Move the lever on the coil base and lock the coil so that its
to gantry).
Warning

point 21.
The coil is centered, for examination of the right shoulder, when the
guide rails, or for examination of the left shoulder, when they engage
gantry – for left and right shoulder examinations respectively – on the
floor.
•
•
350003100 Rev. 11 • 7 / 16
•
•
•
Note
performed.
examination.
If using the Shoulder Coil 1:

point 5.
examining the right shoulder and the outermost seat if examining the
left shoulder. Position the coil so that the connection cable faces the
external part of the gantry in the case of “left shoulder” configurations
and towards the internal part of the gantry in the case of “right
shoulder” configurations.
the examination.
•
•
8 / 16 •• Chapter 18
•
•
Note
The glenohumeral joint must be positioned at the center of the
shoulder coil 1.
patient’s body.
fig. 18.5 - Patient positioning for examination of the shoulder using shoulder
coil 1 and the standard patient table
•
•
350003100 Rev. 11 • 9 / 16
•
•
•
fig. 18.6 - Patient positioning for examination of the shoulder using shoulder
coil 1 and the compact patient table
coil. Move the lever on the coil base and lock the coil as shown in the
images below.
fig. 18.7 - Correct positions of Shoulder Coil 1

•
•
10 / 16 •• Chapter 18
•
•
Warning
16 If examining the left shoulder, take care to ensure that the shoulder
not examined is correctly placed within the area of the protection
barrier, mounted on the patient table on the innermost side of the
gantry.
point 20.
floor.
•
•
350003100 Rev. 11 • 11 / 16
•
•
•
Note
performed.
examination.
If using Flexible Coil 6:

point 5.
7 Help the patient to sit up on the bed and assist with use of the step for
access to the patient table.
8 Place the coil around the shoulder as indicated in the following note
and close the belts around the patient’s chest by means of the
dedicated open/close mechanism; pass the longer belt under the
armpit of the patient side not examined. Take care to ensure that the
coil is positioned close to the region examined.
it along the longer belt, adapting the total belt length to the chest size.
•
•
12 / 16 •• Chapter 18
•
•
Note
The humeral head must be positioned at the center of the hole of the
Flexible Coil.
For particular types of shoulder examination, the flexible coil can be
moved along its vertical axis with respect to the position specified
above. Do not rotate it around the patient’s shoulder (i.e. do not move
the coil along its horizontal axis) as this will result in significant loss
of acquisition signal.

open/close mechanism and the chest of the patient to enhance
comfort and avoid compression of the nerves or blood vessels: in this
case however, the cushion must not prevent close adherence of the
coil around the region of the patient.
10 Have the patient lie down on the table and take great care to position
him/her so that the coil is in physical correspondence with the
innermost coil seat, if examining the right shoulder, or the outermost
coil seat if examining the left shoulder.
patient’s body.
optimal position.
Warning
15 If examining the left shoulder, take care to ensure that the shoulder
not examined is correctly placed within the area of the protection
barrier, mounted on the patient table on the innermost side of the
gantry.
point 19.
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350003100 Rev. 11 • 13 / 16
•
•
•
floor.
Note
performed.


•
•
14 / 16 •• Chapter 18
•
•
point 7.
alternatively
•
•
350003100 Rev. 11 • 15 / 16
•
•
•
•
•
16 / 16 •• Chapter 18
•
•
CHAPTER 19
Hip examinations
••••••
Usable coils
used to examine the hip are:
☛ Flexible Coil 6
☛ Flexible Coil 11
•
•
• 1 / 14
•
•
•
☛ 4-channel coil 17, for examinations of the hip in the case of standard
and small size patients
☛ 4-channel coil 18, for examinations of the hip in the case of large size
patients
Patient positioning procedure for examinations using coil 6 or

coil 11
Warning
Users are advised to perform only targeted examinations of hip with
the S-scan system.
An MR marker may be applied to patient’s skin to delineate the area to
be examined and verify correct positioning.
The entire areas of the hip can not be examined in a single acquisition
because the anatomical structure of this area may extend beyond the
S-scan homogeneity region.

point 5.
•
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2 / 14 •• Chapter 19
•
•
Hip examinations
examined.
8 Place the coil around the area to be examined as indicated in the note
below and close the belts around the patient’s hip by means the
dedicated open/close mechanism; take care that the coil adheres
tightly to the anatomical region examined.
it along the longer belt, adapting the total belt length to the patient’s
waistline.
Note
The greater trochanter must be positioned at the center of the aperture
of the flexible coil, allowing display up to the iliac fossa with good
image quality (if the distance between the greater trochanter and the
caput femoris is less than about 8 cm in case of Coil 6 or less than
about 8 cm in case of Coil 11).
For special types of hip examination, the flexible coil can be moved
along its vertical axis with respect to the position specified above. Do
not rotate it around the patient’s waist (i.e. do not move the coil along
its horizontal axis) as this will result in significant loss of acquisition
signal.

open/close mechanism and the patient’s waist to enhance comfort and
avoid compression of the nerves or blood vessels: in this case
however, the cushion must not prevent close adherence of the coil
around the region of the patient.
with respect to the gantry, taking great care to position him/her so
that the coil is in physical correspondence with the innermost coil seat
with respect to the gantry when examining the right hip, or the
outermost coil seat when examining the left hip.
12 Put the patient’s forearm (side under examination) on the abdomen
and his / her feet in intra-rotation.
optimal position.
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350003100 Rev. 11 • 3 / 14
•
•
•
fig. 19.1 - Patient positioning for examination of the left hip using the Coil 6 and
the standard patient table
•
•
4 / 14 •• Chapter 19
•
•
Hip examinations
fig. 19.2 - Patient positioning for examination of the left hip using the Coil 6 and
the compact patient table
Warning

point 19.
The coil is centered, for examination of the right hip, when the wheels
of the patient table engage the first positioning recess in the guide
rails, or for examination of the left hip, when they engage the third
recess in the guide rails.
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350003100 Rev. 11 • 5 / 14
•
•
•
gantry – for left and right hip examinations respectively – on the floor.
Note
performed.


•
•
6 / 14 •• Chapter 19
•
•
Hip examinations
3 Remove the coil from the patient and any cushions placed between the
coil and area examined, including those used for positioning.
point 7.
•
•
350003100 Rev. 11 • 7 / 14
•
•
•
Patient positioning procedure for examinations using coil 17 or 18
Warning
Users are advised to perform only targeted examinations of hip with
the S-scan system.
The entire areas of the hip can not be examined in a single acquisition
because the anatomical structure of this area may extend beyond the
S-scan homogeneity region.

point 5.
6 If not already installed on the patient table, fit the panel with the four
holes provided to accept the four feet of coil 17 or 18 used for
examinations of the spinal column.
7 Remove the upper section of the 4-channel coil used, by opening the
two retainer hooks as described in the chapter “Coils” in this manual.
8 Insert the fixed lower section of the coil in the dedicated panel
previously installed on the patient table, positioning it so that the
connection cable is facing the external part of the gantry.
9a If using coil 17: place the “bridge” cushion No 3 on the coil.
9b If using coil 18: use cushion No. 9 to align the height of the standard
cushion on the patient table with the height at the base of the coil.
examined.
•
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8 / 14 •• Chapter 19
•
•
with respect to the gantry, taking great care to position him/her so
that the great Infocenter is positioned at the center of the 4-channel
coil 17 or 18 on the table (centering of anatomical region examined
with respect to the coil).
Hip examinations
13 Reposition the removable upper section on the lower fixed section of
the 4-channel coil used.
14 Close the two retaining latches, following the procedure described in
the chapter “Coils” in this manual.
Warning
the patient’s chest and/or abdomen and create breathing difficulties.

optimal position.
16 Position the feet in intrarotation.
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•
350003100 Rev. 11 • 9 / 14
•
•
•
fig. 19.3 - Patient positioning for examination of the left hip using coil 17 and the
fig. 19.4 - Patient positioning for examination of the left hip using coil 18 and the
•
•
10 / 14 •• Chapter 19
•
•
Warning
Hip examinations

point 22.
center the coil relative to the magnet isocenter. The coil is centered
when:
a) for examination of the right hip, the indicator located on the right
cover of the patient table is aligned with the “Right Hip” icon on the
plate on the floor
b) for examination of the left hip, the indicator located on the right
cover of the patient table is aligned with the “Left Hip” icon on the
plate on the floor.
pressed, move it manually into the gantry to center the coil with respect
to the magnet isocenter in this direction. The coil is centered when:
a) for examination of the right hip, the indicator located on the right
cover of the patient table is aligned with the “Right Hip” icon on the
plate on the floor
b) for examination of the left hip, the indicator located on the right
cover of the patient table is aligned with the “Left Hip” icon on the
plate on the floor.
•
•
350003100 Rev. 11 • 11 / 14
•
•
•
Note
performed.



point 7.
alternatively
•
•
12 / 14 •• Chapter 19
•
•
Hip examinations
•
•
350003100 Rev. 11 • 13 / 14
•
•
•
•
•
14 / 14 •• Chapter 19
•
•
CHAPTER 20
Examination of the lumbar
column
••••••
Usable coils
used to examine the lumbar column are:
☛ DPA spinal column coil 10, for examination of lumbosacral region of the
spine (dimension of the flexible section to suit the dimensions of the
patient)
•
•
• 1 / 16
•
•
•
☛ 4-channel coil 17, for examination of the lumbar region of the spinal
column in the case of standard and small size patients
☛ 4-channel coil 18, for examination of the lumbosacral region of the

spinal column in the case of larger patients
•
•
2 / 16 •• Chapter 20
•
•
Examination of the lumbar column
Patient positioning procedure for examinations using coil 10
Warning
lumbosacral section of the spinal column with the S-scan system. An
MR marker may be applied to patient’s skin to delineate the area to be
examined and verify correct positioning.
The entire lumbosacral section of the spinal column cannot be
examined in a single acquisition because the anatomical structure of
this area may extend beyond the S-scan homogeneity region.

point 5.
6 If not already inserted, fit the panel containing the seat for the coil
used for examinations of the spinal column. Then position the specific
cushion on the panel.
7 For all patients, excluding large, insert the 20 mm frame above the coil
seat.
8 Insert the rigid section of the coil in the seat and position so that the
9 Engage the flexible coil section with the base on the opposite side to
the “magnet connection box”, inserting the make connector of the
flexible section in the female connector on the base.
10aIf using the 20 mm frame, place the “large bridge “ cushion on the coil
in the case of small-medium patients or the “small bridge” cushion in
the case of large patients.
10bIf not using the 20 mm frame, use cushions No. 9 to bring the top of
the coil base into alignment with the standard cushion placed on the
patient table.
examined.
•
•
350003100 Rev. 11 • 3 / 16
•
•
•
13 Have the patient lie down on the table with the head facing the gantry,
taking great care to position him/her so that the lumbosacral region
of the spine is in physical correspondence with the DPA spine coil 10
on the patient table (centering of anatomical region examined with
respect to the coil).
optimal position.
15 Engage the flexible coil section with the base on the side of the
“magnet connection box”, inserting the male connector of the flexible
section in the female connector on the base.
Refer to point 6 in this procedure for instructions regarding connection
of the flexible section to the respective base.
fig. 20.1 - Patient positioning for examination of the lumbosacral region of the
spine using the standard patient table
•
•
4 / 16 •• Chapter 20
•
•
spine using the compact patient table
Warning

point 21.
The coil is centered when the wheels of the patient table engage the
second recess in the guide rails.
•
•
350003100 Rev. 11 • 5 / 16
•
•
•
To center the coil, release the handle (thus locking the table) when the
pin, mounted below the right-hand cover of the table, is aligned with
the central hole on the floor.
22 Place cushion No. 6 or No. 3 under the patient’s legs to ensure the
lumbosacral section of the spine adheres closely to the coil.
magnet isocenter, carefully check the position of the region relative to
the coil and the position of the patient table with respect to the gantry.
Note
performed.


•
•
6 / 16 •• Chapter 20
•
•
point 7.
8 Detach the flexible coil section from the base, on the side of the
“magnet connection box”.
•
•
350003100 Rev. 11 • 7 / 16
•
•
•
Patient positioning procedure for examinations using coil 17 or 18
Warning

point 5.
6 If not already installed on the patient table, fit the panel with the four
holes provided to accept the four feet of coil 17 or 18 used for
examinations of the spinal column.
8 Insert the fixed lower section of the coil in the dedicated panel
previously installed on the patient table, positioning it so that the
9a If using coil 17: place the “bridge” cushion No 3 on the coil.
9b If using coil 18: use cushion No. 9 to align the height of the standard
cushion on the patient table with the height at the base of the coil.
examined.
12 Have the patient lie down on the table with the head facing to the right
of the gantry, taking great care to position him/her so that the
lumbosacral region of the spine is in physical correspondence with the
4-channel coil17 or 18 on the patient table (centering of anatomical
region examined with respect to the coil).
•
•
8 / 16 •• Chapter 20
•
•
optimal position.
14 Reposition the removable upper section on the lower fixed section of
the 4-channel coil used.
the chapter “Coils” in this manual.
Warning
the patient’s chest and/or abdomen and create breathing difficulties.

spine using the standard patient table and 4-channel coil 17 (use of the bridge
cushion)
•
•
350003100 Rev. 11 • 9 / 16
•
•
•
spine using the standard patient table and 4-channel coil 18
Warning

point 21.
•
•
10 / 16 •• Chapter 20
•
•
Note
performed.



•
•
350003100 Rev. 11 • 11 / 16
•
•
•
point 7.
•
•
12 / 16 •• Chapter 20
•
•
Prone patient positioning procedure
With the S-scan system, examination of the lumbosacral region of the
spinal column can also be performed with the patient in the prone
position.
This method can be used for patients who are unable to maintain a supine
position during the examination.
Warning
Note
The coil to be used for this type of examination is exclusively No. 10.

point 5.
•
•
350003100 Rev. 11 • 13 / 16
•
•
•
9 Use two cushions No. 9 - placing them between the coil (one to the
right and one to the left) and the patient table - to bring the standard
cushion on the table into alignment with the base of the coil.
examined.
11 Have the patient sit up on the table, to the left of the coil, instructing
12 Have the patient lie down on the table in the prone position, with the
head facing to the right of the gantry, while helping him/her to rotate
to his/her left into the final position.
13 Take great care to position him/her so that the lumbar region of the
spine is in physical correspondence with the coil on the patient table
(centering the anatomical region to be examined with respect to the
coil).
optimal position.
16 Place cushion No. 4 under the upper chest/shoulders of the patient.
fig. 20.5 - Prone patient positioning for examination of the lumbosacral region
of the spine using the standard patient table
•
•
14 / 16 •• Chapter 20
•
•
Warning

point 20.
•
•
350003100 Rev. 11 • 15 / 16
•
•
•
Note
performed.



point 7.
9 Help the patient to turn on to his/her left side and then sit up on the
patient table, with the legs over the edge of the table.
•
•
16 / 16 •• Chapter 20
•
•
CHAPTER 21
Examination of the thoracic spine
••••••
Usable coils
used to examine the thoracic spine are:
☛ 4-channel coil 17, for examination of the lumbar region of the spinal
column in the case of large patients.
☛ 4-channel coil 18, for examination of the thoracic region of the spinal
column in the case of large or standard size patients.
•
•
• 1 / 24
•
•
•
☛ DPA coil 10, for examination of thoracic region of the spine (dimension
of the flexible section to suit the dimensions of the patient)
☛ cervical coil 14, for examination of the cervical region, to determine an

anatomical landmark of the upper thoracic region of the spinal column in
the case of large and standard size patients.
•
•
2 / 24 •• Chapter 21
•
•
☛ cervical coil 9, for examination of the cervical region, to determine an
anatomical landmark of the upper thoracic region of the spinal column in
the case of small patients.
•
•
350003100 Rev. 11 • 3 / 24
•
•
•
Recommended patient positioning procedure
The thoracic region of the spinal column differs from the lumbar and
cervical regions of the spinal column in that it is generally larger than the
homogeneity region of the S-scan system.
The entire thoracic region of the spinal column can be examined executing
two or more examinations, depending on the patient size; in any case a
physical repositioning of the patient is required.
Due to the physical repositioning of the patient, it is not possible to merge
images coming from the different examinations executed, with stitching
software techniques.
It is the User’s responsibility to evaluate singularly the two or more
thoracic examinations performed and, in case, deduce conclusions about
the entire thoracic section.
For all of these reasons, users are advised to perform only targeted and
single examinations of thoracic region of the spinal column, evaluating
those anatomical areas that fall within in the homogeneity region of the
system.
The thoracic region of the spinal column and consequently its lower and
upper parts do not present anatomical landmarks easy to identify.
Because of this, examination of the thoracic region of the spinal column
must be preceded by a preliminary step to define the position of the
patient in terms of clear anatomical landmarks inside the imaging area,
and then inside the homogeneity region of the S-scan system.
This preliminary step consists of the execution of some sequences in the
thoracic-lumbar or thoracic-cervical region that allow the clear
identification on the MR images of the anatomical landmarks in these
areas, to be used as reference points for the actual examination of the
thoracic region.
The Users are advised to perform the examination of the thoracic region of
the spinal column having great care in the clear definition of the
anatomical landmarks, in order to avoid any problems about the correct
The use of external MR markers to be applied to patient’s skin to delineate
the area to be examined and verify correct positioning is strictly
recommended.
•
•
4 / 24 •• Chapter 21
•
•
Warning
Users are advised to perform only targeted examinations of thoracic
region of the spinal column with the S-scan system.
The entire thoracic region of the spinal column cannot be examined in
a single acquisition because the anatomical structure of this area may
extend beyond the S-scan homogeneity region.
Users are advised to perform the examination of the thoracic region of
the spinal column taking great care to clearly define the anatomical
landmarks, in order to avoid any possible problems about the correct
The entire thoracic region of the spinal column can be examined by
performing two or more examinations, but physical repositioning of
the patient is required.
Due to the physical repositioning of the patient, the two or more
examinations can not be merged with stitching software technique,
and have to be evaluated singularly.
It is the user’s responsibility to draw conclusions about the entire
thoracic region through evaluation of the single examinations
performed.
To summarize, examinations of the thoracic region of the spinal column

using the S-scan system require at least two different examinations:
☛ the first one, made in the lumbar or cervical section, is needed in order
to clearly identify an anatomical landmark (i.e. a vertebral body);
☛ the second one, made in the upper or lower thoracic section, consists in
the real diagnostic examination;
☛ the possible third one completes, if necessary, the whole thoracic region
(upper and lower).
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350003100 Rev. 11 • 5 / 24
•
•
•
Patient positioning procedure starting from lumbar spine
If using the compact patient table, go to point 2, otherwise go to point 5.
7 Only if using coil 10 (if using coil 17 or 18 go to the next step): if
necessary due to the dimensions of the patient, insert the 20 mm
frame above the coil.
8a If using the coil 17 or coil 18: remove the upper section of the
4-channel coil used, by opening the two retaining latches as described
in the chapter “Coils” in this manual.
8b If using the coil 10: engage the flexible coil section with the base on
the side of the “magnet connection box”, inserting the male connector
of the flexible section in the female connector on the base.
9a If using the coil 17 or coil 18: insert the lower section of the coil in the
seat on the integration panel, position it so that the connection cable
is facing the external part of the gantry.
9b If using the coil 10: insert the lower fixed section of the coil in the
housing on the integration panel, positioning it so that the connection
cable is facing the external part of the gantry.
10aIf using coils 18 or 10 without the 20 mm frame: use cushion No. 9 to
align the height of the standard cushion on the patient table with the
height at the base of the coil.
10bIf using coil 17: or 10 with the 20 mm frame: position the large
“bridge” cushion (No. 3 for coil 17, No. 1 for coil 10 and for standard
size patients, cushion No. 2 for coil 10 and large patients).
11 Apply an MR marker to the lumbar region of the spine to clearly
identify om MR images an anatomical landmark (e.g. a vertebral body,
preferably L1) where the lumbar region meets the thoracic. Secure
firmly the marker to the patient skin.
12 Place a second MR marker (securing it firmly) 20 centimeters from the
first one, towards the patient’s head.
•
•
6 / 24 •• Chapter 21
•
•
him/her so that the lumbar region of the spine is in physical
correspondence with the coil on the table (centering the anatomical
region to be examined with respect to the coil).
15aIf using coil 17 or coil 18: reposition the removable upper section on
the lower fixed section and close the two retaining latches, following
the procedure described in the chapter “Coils” in this manual.
15bIf using coil 10: attach the flexible coil section to the base on the side
of the “magnet connection box”, inserting the male connector of the
16 For greater comfort and more stable positioning, move the patient in
a series of small steps.
17 Position headrest cushion No. 2 under the patient’s head.
fig. 21.1 - Examination of the lumbar spine to clearly identify an anatomical

landmark, e.g. with standard patient table and coil 18
•
•
350003100 Rev. 11 • 7 / 24
•
•
•
fig. 21.2 - Examination of the lumbar spine to clearly identify an anatomical
Warning

point 22.
•
•
8 / 24 •• Chapter 21
•
•
chapter “Examination environment” of the user interface manual). If
the anatomical region concerned is not centered with respect to the
Note
performed.
28 Acquire the sequences necessary to clearly identify, by means the

magnetic resonance marker applied, an anatomical landmark where
the spinal column meets the thoracic spine.
Warning
The lumbar spine images acquired to identify the anatomical
landmark where the lumbar spine meets the thoracic spine are not
intended for diagnostic use but only as reference images to correctly
execute the thoracic spine examination.
The sequences included in the thoracic protocol are not optimized for
the lumbar section.
29 Have the patient move down the bed so that the magnetic resonance
marker placed in the area where the lumbar spine meets the thoracic
spine is in physical correspondence with the lower part of the coil.
30 Ask the patient to place his/her arms inside the coil.
31 Position cushion No. 6 or No. 3 under the patient’s legs to ensure the
thoracic region of the spine adheres closely to the coil.
•
•
350003100 Rev. 11 • 9 / 24
•
•
•
fig. 21.3 - Examination of the lower part of the thoracic spine, e.g. standard
patient table and coil 18
•
•
10 / 24 •• Chapter 21
•
•
32 Execute a sequence in real time to ensure correct positioning.
and the position of the bed along the in/out axis of the gantry. Then
repeat the sequence in real time.
33 Acquire the Scout sequence and the localizer sequences in the three
space directions (see chapter “Examination environment” of the User
Interface Manual) to verify the visibility and the expected positioning
on the MR images of the markers.
Note
performed.
34 Execute the examination of the upper part of the thoracic spine.
If it is necessary to examine also the lower part of the thoracic spine, at

the end of the examination of the upper part.
35 Remove any cushions used for patient positioning.
36 Have the patient move down the bed so that the magnetic resonance
marker placed in the area where the lumbar spine meets the thoracic
spine is in physical correspondence with the lower part of the coil.
thoracic region of the spine adheres closely to the coil.
•
•
350003100 Rev. 11 • 11 / 24
•
•
•
Note
noise upon acquisition is displayed, if the acquired scout and
localizers images are free of interference and/or noise, and if the
second marker is visible as expected, the examination can be
performed.
fig. 21.5 - Examination of the upper part of the thoracic spine, e.g. standard
•
•
12 / 24 •• Chapter 21
•
•
On completion of this first part of examination, proceed as follows:



point 7.
•
•
350003100 Rev. 11 • 13 / 24
•
•
•
8a If using coil 17 or 18: detach the flexible coil section from the base,
on the side of the “magnet connection box”.
8b If using coil 10: detach the flexible coil section from the base, on the
side of the “magnet connection box”.
•
•
14 / 24 •• Chapter 21
•
•
Patient positioning procedure starting from cervical spine
point 5.
7 Insert the cervical column coil in the seat and position so that the coil
head support is facing the right-hand side of the table (patient’s
head).
8 Open the two retaining latches as shown in the chapter “Coils” in this
manual
9 Detach the removable section (upper) of the solenoidal coil of the
cervical column coil.
10aIf using coil 9: place the relative cushion – supplied with the coil – on
the coil head support.
10bIf using coil 14: place the relative cushion – supplied with the coil –
on the housing of the coil head support.
11 Apply an MR marker to the cervical section of the spine to clearly
identify on MR images. an anatomical landmark (e.g. a vertebral body,
preferably C7 or T1) cervical spine meets the thoracic spine. Secure
firmly the marker to the patient skin.
12 Place a second magnetic resonance marker (securing it firmly) twenty
centimeters far - in the patient feet direction- from the first one.
him/her so that the cervical region of the spine is placed gently - with
the utmost care – in the coil opening (centering of anatomical region
examined with respect to the coil).
15 Return the removable section (upper) of the solenoid coil to the fixed
section of the cervical column coil.
fig. 8.6 in the chapter “Coils” in this manual.
•
•
350003100 Rev. 11 • 15 / 24
•
•
•
Warning

optimal position.
fig. 21.7 - Examination of the cervical spine to clearly identify an anatomical

Warning
19 Ensure that the right arm is correctly placed within the area of the
of the gantry.
point 23.
•
•
16 / 24 •• Chapter 21
•
•
Note
performed.
29 Acquire the sequences necessary to clearly identify, by means the

magnetic resonance marker applied, an anatomical landmark where
the cervical spine meets the thoracic spine.
•
•
350003100 Rev. 11 • 17 / 24
•
•
•
Warning
The cervical spine images acquired to identify the anatomical
landmark where the cervical spine meets the thoracic spine are not
intended for diagnostic use but only as reference images to correctly
execute examination of the thoracic spine.
The sequences included in the thoracic protocol are not optimized for
the cervical section.
On completion of this first part of examination, proceed as follows:



point 7.
8 Open the two retainer hooks as shown in Coils in this document
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18 / 24 •• Chapter 21
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10 Help the patient to sit up on the bed, clearing space around the coil in
use.
11 Remove the cervical coil in use.
12 Ask the patient to stay on the patient bed.
To examine the upper part of the thoracic spine:

1a If using coil 17 or coil 18: remove the upper section of the coil used
by opening the two retaining latches as described in the chapter
“Coils” in this manual.
1b If using the coil 10: engage the flexible coil section with the base on
the side of the “magnet connection box”, inserting the male connector
of the flexible section in the female connector on the base.
2a If using the coil 17 or coil 18: insert the lower section of the coil in the
seat on the integration panel, position it so that the connection cable
is facing the external part of the gantry.
2b If using the coil 10: insert the lower fixed section of the coil in the
housing on the integration panel, positioning it so that the connection
cable is facing the external part of the gantry.
3a If using coils 18 or 10 without the 20 mm frame: use cushion No. 9 to
align the height of the standard cushion on the patient table with the
height at the base of the coil.
3b If using coil 17 or 10 with the 20 mm frame: position the appropriate
“bridge” cushion (No. 3 for coil 17, No. 1 for coil 10 and for standard
size patients, No. 2 for coil 10 and large patients).
4 Have the patient lie on the table, making sure that the first MR maker
(which can be associated to a clear anatomical landmark,thanks to the
cervical examination performed) is in physical correspondence with
the upper part of the coil (and consequently the second marker is in
physical correspondence with the lower part of the coil).
5a If using coil 17 or coil 18: reposition the removable upper section on
the lower fixed section and close the two retaining latches, following
the procedure described in the chapter “Coils” in this manual.
5b If using coil 10: attach the flexible coil section to the base on the side
of the “magnet connection box”, inserting the male connector of the
7 For greater comfort and more stable positioning, move the patient in
a series of small steps.
9 Place other cushions as deemed necessary to improve the patient’s
comfort.
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Warning

point 13.
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20 / 24 •• Chapter 21
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•
15 Turn on the control panel from the user interface, by pressing the
relative command - shown here on the left - on the main tool bar.
16 Execute a sequence in real time to ensure correct positioning (see
chapter “Examination environment” in the user interface manual).
Note
performed.

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350003100 Rev. 11 • 21 / 24
•
•
•
If it is necessary to examine also the lower part of the thoracic spine, at
the end of the examination of the upper part:
21 Move the patient again in the direction of the head so that the second
MR marker on the patient (which can be associated with an anatomical
landmark as a result of the examination performed) is physically
aligned with the upper section of the coil.
thoracic section of the spine adheres closely to the coil.
Note
noise upon acquisition is displayed, if the acquired scout images are
free of interference and/or noise, and if the second marker is visible
as expected, the examination can be performed.
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22 / 24 •• Chapter 21
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350003100 Rev. 11 • 23 / 24
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At the end of the examination, proceed as follows:


If using the compact patient table, go to point 4, otherwise go to point 7.

8a If using coil 17 or 18: remove the upper section of the 4-channel coil
used, by opening the two retaining latches as described in the chapter
“Coils” in this manual.
8b If using coil 10: detach the flexible coil section from the base, on the
side of the “magnet connection box”.
9 Have the patient sit on the table with the legs over the side.
10 Help the patient to climb down from table, using the step provided for
the purpose.
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24 / 24 •• Chapter 21
•
•
CHAPTER 22
Examination of the cervical spine
••••••
Usable coils
used to examine the spinal column are:
☛ cervical coil 9, for examination of the cervical region of the spinal
column for standard and small size patients
☛ cervical coil 14, for examination of the cervical region of the spinal
column for large size patients.
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•
•
•
☛ DPA coil 10, for examination of the cervical region of the spinal column
for patients who cannot use coil 9 or 14, or - given that this coil also gives
the possibility to perform examinations on patients in the prone position -
those patients who cannot maintain a supine position during the
examination.
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2 / 12 •• Chapter 22
•
•
Warning
Users are advised to perform only targeted examinations of cervical
section of the spinal column with the S-scan system. An MR marker
may be applied to patient’s skin to delineate the area to be examined
and verify correct positioning.
The entire cervical section of the spinal column cannot be examined
If using cervical coil 9 or DPA cervical coil 14:

point 5.
7 Open the two retaining latches as shown in the chapter “Coils” in this
manual
9a If using coil 9: place the relative cushion – supplied with the coil – on
the coil head support.
9b If using coil 14: place the relative cushion – supplied with the coil – on
the housing of the coil head/neck support.
examined.
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350003100 Rev. 11 • 3 / 12
•
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•
him/her so that the cervical region of the spine is placed gently - with
the utmost care – in the coil opening (centering of anatomical region
examined with respect to the coil).
13 Return the removable section (upper) of the solenoid coil to the fixed
section of the cervical column coil.
fig. 8.6 in the chapter “Coils” in this manual.
Warning

optimal position.
fig. 22.1 - Patient positioning for examination of the cervical region of the spine
using the standard patient table
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4 / 12 •• Chapter 22
•
•
using the compact patient table
Warning
of the gantry.
point 21.
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350003100 Rev. 11 • 5 / 12
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•
•
Note
performed.



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6 / 12 •• Chapter 22
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•
point 7.
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350003100 Rev. 11 • 7 / 12
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Positioning procedure for examinations using coil 10
With the S-scan system, examination of the cervical region of the spinal
column using coil 10 can be performed with the patient in the supine and
the prone position.
Coil 10 can be used:
• in supine mode, for patients who are unable to use coil 9 or coil 14
• in prone mode, for patients who are unable to maintain a supine
position during the examination.
Warning
Users are advised to perform only targeted examinations of cervical
section of the spinal column with the S-scan system. An MR marker
may be applied to patient’s skin to delineate the area to be examined
and verify correct positioning.
The entire cervical section of the spinal column cannot be examined
Caution
The user is advised to provide the patient with ear plugs or ear
protectors.
In fact the 3D Hyce sequence (included in the Esaote protocol
dedicated to examinations of the cervical column), generates a noise
level which - while remaining within the limits set by International
Standards (see chapter “Instructions for safe use”, paragraph
“Excessive Noise”) - may cause discomfort for the patient.

point 5.
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8 / 12 •• Chapter 22
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•
9 Position a cushion No. 9 between the coil (to the left of the coil) and
the patient table, to bring the top of the standard cushion on the table
into alignment with the base of the coil.
examined.
11aIf the examination is performed with the patient in the supine position.
Have the patient lie down on the table in the prone position, with the
head facing right with respect to the gantry, while helping him/her to
turn to his/her left to reach the final position.
11bIf the examination is performed with the patient in the prone position.
Have the patient lie down on the table in the prone position, with the
head facing right with respect to the gantry, while helping him/her to
rotate to his/her left into the final position.
12 Take great care to position him/her so that the cervical region of the
spine is in physical correspondence with the coil on the patient table
(centering the anatomical region to be examined with respect to the
coil).
optimal position.
15 If the examination is performed with the patient in the prone position.
Place cushion No. 4 under the patient’s forehead.
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350003100 Rev. 11 • 9 / 12
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using coil 10 and the standard patient table
Warning

point 20.
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10 / 12 •• Chapter 22
•
•
Note
performed.



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350003100 Rev. 11 • 11 / 12
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point 7.
9 Help the patient to turn on to his/her left side and then sit up on the
patient table, with the legs over the edge of the table.
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12 / 12 •• Chapter 22
•
•
CHAPTER 23
Examination of the
temporomandibular joint
••••••
Usable coils
As explained in detail in the chapter “Coils” in this document, the coils
required for examination the temporomandibular joint are the following:
☛ TMJ Coil 19, for bilateral examination
☛ TMJ Coil 15, for unilateral examination
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Bilateral examination: patient positioning procedure
relative command on the main tool bar.
point 6.
3 Raise the brake pedal on the two front wheels to unlock the table.
8 Insert the TMJ coil 19 on the patient table; the coil headrest must face
the right side of the patient bed (patient’s head).
9 Position cushion No. 11 on the headrest of the coil.
10 Help the patient to sit up on the table, to the left of the coil seat panel,
and assist with using the step for access to the patient table.
11 Move the two loops of the coil - using the two dedicated keys as
indicated in the chapter “Coils” - to their maximum external position.
12 Have the patient lie on the table, taking care that the patient’s head is
placed on cushion No. 11 previously placed on the headrest of the coil.
13 Close the coil belt around the patient’s head by means of the
open/close mechanism.
optimal position.
16 Move the two loops of the coil - by using the two dedicated keys as
indicated in the chapter “Coils” - so that they are in contact with the
temporomandibular joints, left and right.
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2 / 10 •• Chapter 23
•
•
Examination of the
fig. 23.1 - Positioning the patient for bilateral TMJ examination with the standard
patient table
Warning
of the gantry.
point 21.
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350003100 Rev. 11 • 3 / 10
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•
•
22 Place cushion No. 6 or No. 3 under the patient’s legs.
Note
performed.



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4 / 10 •• Chapter 23
•
•
point 8.
Examination of the
8 Remove the coil belt from the patient’s head by opening the
9 Move the two loops of the coil - by using the two dedicated keys as
indicated in the chapter “Coils” - at their maximum external position.
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350003100 Rev. 11 • 5 / 10
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Unilateral examination: patient positioning procedure
relative command on the main tool bar.
point 6.
8 Position cushion No. 2 above the coil seat surface
9 Place head support cushion No. 2 in correspondence with the central
coil seat of the previously installed panel.
and assist with using the step for access to the patient table.
11 Check that the specific cushion for the TMJ coil No. 10 is positioned as
indicated in the chapter “Coils”, so as to ensure the coil closely adheres
to the region examined. If not present, position it.
12 Position the coil so that its opening corresponds to the
temporomandibular joint examined, with the connection cable facing
upwards. Close the coil belt around the head of the patient using the
open/close mechanism; ensure that the coil closely adheres to the
region examined.
The position of the cushion on the belt (right or left) can be modified
by simply removing the belt from the coil - by means of the Velcro
strips - and rotating it through 180°, so that the cushion is facing the
opposite side.
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6 / 10 •• Chapter 23
•
•
Examination of the
fig. 23.2 - Positioning the TMJ coil on the patient
13 Have the patient lie on the table, taking care that the head is facing
right with respect to the gantry and the nape of the neck is placed on
cushion No. 2 previously placed on the table.
optimal position.
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350003100 Rev. 11 • 7 / 10
•
•
•
fig. 23.3 - Patient positioning for TMJ examination with the standard patient
table
Warning
of the gantry.
point 19.
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8 / 10 •• Chapter 23
•
•
Examination of the
Note
performed.



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350003100 Rev. 11 • 9 / 10
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•
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point 8.
9 Remove the TMJ coil from the patient’s head by opening the relative
•
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10 / 10 •• Chapter 23
•
•
CHAPTER 24
Examination of the head
••••••
Note
The imaging of the head is a functionality not yet available in all
Countries. For further details, please contact your Esaote sales
representative.
Head indications for use

Due to the set of sequences available on the S-scan system (see
“G/S-scan Image Quality and Sequences” manual, chapter 3, sections
“Sequences”), the indications for use of the head imaging application only
refer to:
☛ screening
☛ trauma
☛ altered mental status
☛ dementia
☛ psychiatric disorder
☛ headaches
☛ demyelinating disease.
Warning
Because of the absence of particular sequences (e.g. DWI,
diffusion-weighted imaging), it may not be possible to assess some
head conditions (e.g. stroke, MRA, MRV, seizures and others) with the
S-scan system.
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•
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Usable coils
As explained in detail in chapter “Coils” in this document, the coil that can
be used to examine the head is:
☛ Head Coil 16
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2/6 • Chapter 24
•
•
•

1 To enable use of the control panel, turn it on via the user interface, by
selecting the relative command displayed alongside - on the main tool
bar.
If the compact patient table is being used, see point 3, otherwise
skip to point 6.
3 Lift the pedal brake on the two front wheels in order to release them.
4 Act on the handles in order to move the patient table out from the
gantry to the end limit.
5 Press the pedal brake on the two front wheels in order to lock the
patient table in the correct access position.
The positioning procedure goes on from point 7.
7 If not already inserted, fit the panel containing the coil housing
dedicated to the head examination. The coil headrest (present on the
coil housing) must face the right-hand side of the table (patient’s
head).
8 According to the patient’s head dimensions, place an adequate
amount of dedicated cushions No. 12 on the headrest present on the
coil housing.
9 Let the patient wear a MR compatible hair cap (not provided with the
system).
and assist with using the footboard for access to the patient table.
11 Help the patient to lie on the table, taking care that the head is placed
on the headrest, where cushions No. 12 have been previously placed
on. The patient’s shoulders should be placed close to the vertical edge
of the headrest.
12 Make small adjustments moving the patient to reach the optimize
positioning, if required.
Caution
When inserting the head coil in the coil housing (next step), have great
care to avoid to harm the patient - especially on the nose, ears and
head’s top - and to pull the patient’s hair: inserting the coil in the coil
housing implies inserting the coil around the patient’s head.
13 Insert the head coil in the coil housing (and consequently around the
patient’s head), let it slide gently in the dedicated rails until the final
position has been reached.
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350003100 Rev. 11 • 3/6
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•
The coil is completely inserted in the final position when the mark
present on the coil is in physical correspondence of the mark present
on the rail.
14 Depending on the head dimensions, gently insert two generic cushions
No. 13 (of adequate thickness) between the patient’s
jaws/cheeks/temples and the internal surface of the coil.
fig. 24.1 - Patient positioning for head examination with standard patient table
Caution
of the gantry.
skip to point 19.
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4/6 • Chapter 24
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•
17 Act on the handles and move the patient table inside the gantry in
order to centre the coils with respect to the magnet isocenter.

The coil is centred if the patient table wheels are aligned with the
second slot on the rails.
patient table in the correct examination position.
The positioning procedure goes on from point 20.
pressed, move it manually into the gantry to centre the coil with
To centre the coil, release the handle (thus locking the table) when the
21 Place other cushions as deemed necessary to improve the patient’s
comfort.
chapter “Examination environment” of the User Interface Manual).
If the anatomic region concerned is not centered with respect to the
magnet isocenter, carefully check the position of the anatomic region
with respect of the coil and the position of the patient table with
respect to the gantry.
Note
performed.

1 To enable use of the control panel, turn it on via the user interface, by
selecting the relative command displayed alongside - on the main tool
bar.
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350003100 Rev. 11 • 5/6
•
•
•
Caution - Compact patient table
Always disconnect the coil from the upper side of the magnet before
any new operation in order to avoid breaking the cable.
Caution - Standard patient table

skip to point 8.
6 Act on the handles in order to move the patient table out from the
gantry to the end limit.
patient table in the correct descent position.
The procedure goes on from point 9.
the handle to lock the bed in the correct descent position.
9 Move the dedicated mechanism of locking/unlocking outwards and
slide the coil out from the examination position, removing if from the
patient’s head.
10 Help the patient to sit up on the bed, with the legs off the patient table.
11 Help the patient off the table, making use of the footboard.
Caution
Always remove the coil and the coil housing separately. Do not
transport the coil when inserted in the coil housing.
Risk of undesired detaching with consequent fall dawn and break of
coil or coil housing.
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6/6 • Chapter 24
•
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•
CHAPTER 25
Control panel
••••••
Control panel
The control panel, comprised of a touch-screen display, is located on the
upper front section of the magnet, and enables:
☛ execution of the sequence in real time
☛ execution of the Scout and/or localizer sequence.
To select a command on the control panel, click on the required button;
each button is marked with a specific icon.
fig. 25.1 - Control panel
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•
•
•
Real time positioning
From the main menu on the control panel, select the command
PREVIEW, to access the area for real time positioning, which enables
acquisition of an image every 2 seconds (Scout Real Time).
The user can move the patient and simultaneously check the new position
on the control panel: this is a very useful function in that it helps the user
to correctly execute the Scout sequence at the first attempt.
To execute real time positioning, select one of the following commands:
☛ TRA
☛ SAG
☛ COR
The central image viewing box on the control panel displays the selected
position in relation to the anatomical region examined.
To interrupt the real time sequence, select STOP, to the left of the image
area; this command interrupts all sequences in progress (i.e. examination
sequences and Scout sequence).
If the real time sequence is activated via the control panel, it can only be
terminated by selecting the command STOP from the control panel and
not via the user interface.
The command CANCEL enables the user to return to the main menu of the
control panel.
Acquisition
From the main menu of the control panel, selection of the command
ACQUISITION accesses the area used for activation of the Scout sequence
- by means of the command SCOUT - or the Scout and Localizer sequence
- by means of the command LOCALIZER.
The command CANCEL enables the user to return to the main menu of the
control panel.
Turning the control panel on and off

To enable use of the control panel, turn it on via the user interface by
selecting the relative command (shown here on the left) on the main tool
bar.
The control panel remains on until a scan of any type (except for real time
sequences) is launched, after which it shuts down automatically.
Consequently the control panel must be switched on again each time it is
required after an acquisition.
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2/2 • Chapter 25
•
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APPENDIX A
General Principles of Magnetic
Resonance Imaging
••••••
The nuclear spin system

Many atomic nuclei show the property of spin (i.e. they spin about an axis)
and, as a consequence, possess a magnetic moment aligned along the
axis of the spin. The spin may either be a multiple of 1 or 1/2 and it is
usually indicated as I. The inherent angular moment is therefore
p = hI/2S
where h is Plank’s constant.

The magnetic moment, µ, is related to the angular momentum by the
equation
µ = Jp
where J is known as the gyromagnetic ratio and has a constant value that
depends on the particular nucleus.
The nuclei most commonly used in Nuclear Magnetic Resonance (NMR)
are those with I = 1/2 and, among these, hydrogen (proton) is the most
studied because of its inherent properties and its abundant presence in
the human body, which is mainly comprised of water (around 80%).
When a nuclear spin is placed in a magnetic field, it will attempt to line up
with the field. For a nucleus with I = 1/2 there are two stable states,
namely parallel and anti-parallel to the field. These types of alignment are
on different energy levels. The large number of spins present in a sample
will randomly distribute themselves between the two possible states, with
the majority of spin in the parallel direction, which requires less energy.
This is the quantity observed in NMR, It is called macroscopic
magnetization as in normally indicated as M0. M0 is proportional to the
applied field B0.
Although NMR phenomena should be described by quantum mechanics, in
the case of spins with I = 1/2, the principles of the classic model concur
exactly with those expected for the quantum mechanical model.
Therefore spin behavior in a magnetic field can be considered as similar to
that of a gyroscope or a spinning top.
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•
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•
•
•
When torsion is applied, such as when its axis is not aligned with the
magnetic field, a spinning top will tend to move through an angle
dependent on the torsion applied and assume a movement known as
precession. The same movement is obtained when the axis of the spinning
top is not aligned with the gravitational field, i.e. not vertical.
It is important to know how fast the protons precess. The precession
frequency is the rate of proton precession per unit second. It depends on
the magnetic field in which the protons are placed. The stronger the
magnetic field, the faster the precession rate and the higher the
precession frequency. In more formal terms, the rate of precession of a
classic spin, with angular momentum p and magnetic moment µ in a
magnetic field B0 is the Larmor frequency, f, but it is generally more
convenient to use the angular frequency of precession, Z, expressed in
radians per second.
Z0 = 2Sf = µB0p = JB0
Therefore,
Z0 = JB0 (Larmor equation)
where Z0 is the precession frequency in Hz or MHz, B0 is the strength of

the external magnetic field, which is given in Gauss (G) or Tesla (T) and,
as J is the ratio of the precession rate of the magnetic field, usually called
the gyromagnetic ratio. Different nuclei have different gyromagnetic
ratios: for example, for hydrogen J = (42.576 MHz/T)/2S.
•
•
2/6 • Appendix A
•
•
•
The role of RF pulse
To sum up, when a patient is placed inside a strong magnetic field, the
body protons tend to align themselves along the field axis, resulting in a
Resonance Imaging
magnetic moment (the so-called macroscopic magnetization) in the
direction of the external field. It would be ideal to measure this
magnetization, but this is not possible as it is in the same direction,
parallel to the external field. By sending a short burst of electromagnetic
waves, called radiofrequency (RF) pulse, to the patient, it is possible to
disturb the protons in order to change the direction of the magnetization.
Not all RF pulses disturb the alignment of protons. A pulse that can
exchange energy with the protons is required, i.e. one that has the same
frequency, the same angular velocity as the protons: the Larmor
Frequency. When the RF pulse and the protons have the same frequency,
protons may pick up some energy from the radio wave and show a
phenomenon known as resonance, analogous to the one observed in
acoustic experiments.
Another phenomenon also occurs. Due to the RF pulse, the protons no
longer point in random directions, and become “in phase”, i.e. they move
in synchrony, pointing in the same direction at the same time, so that
their magnetic vectors add up in this direction. The result is a magnetic
vector with a transverse component: this component is called transverse
magnetization. This moves in phase with preceding protons, inducing an
electrical current which is the actual MR signal. This can be picked up by
an antenna: the receiving coil.
Relaxation times
One of the problems is identifying the source of the signal in the human
body. To solve this problem, the rule mentioned above can be used as a
reference: Z0 = JB0. This rule means that the precession frequency is
directly proportional to the field intensity. The trick is then to take a
magnetic field, which has different strength at each point of the patient
cross-section, so that protons in different places precess at different
frequencies. As they precess at different frequencies, the MR signals from
different locations also have different frequencies: therefore frequency is
used to assign a signal to a certain location. The frequency encoding
described above is implemented by applying linear field gradients along
the three main orthogonal directions, as in a Cartesian coordinates
system. The most common technique is known as Spin warp technique,
where different points may precess in a direction with different
frequencies, while in the orthogonal directions a difference in the
precession phase can be detected. This is the reason why the first gradient
is usually called Readout Gradient while the orthogonal versions are called
Phase Encoding Gradients. In the case of data acquired using this
particular technique, the Fast Fourier Transform (2DFFT or 3DFFT) is used
to transform raw data into images.
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350003100 Rev. 11 • 3/6
•
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•
Moreover, as soon as the RF pulse is switched off, the whole system, which
was previously disturbed by the pulse, returns to the original quiet state,
so that the newly established transverse magnetization starts to
disappear (the process is known as transverse relaxation), while the
longitudinal magnetization increases back to its original dimension
(longitudinal relaxation). This process occurs because of the energy level
of the proton system: the protons that were raised to a higher energy
level by the RF pulse return to their lower energy level when the RF pulse
is switched off. This process is not immediate, but continuous: the protons
shift out of phase and thus transverse magnetization becomes smaller. In
the meantime, the energy picked up from the RF pulse is transmitted to
the surrounding protons, the so-called lattice. This is why longitudinal
relaxation is also known as spin-lattice relaxation.
The time it takes for the longitudinal magnetization to return to its original
value is called longitudinal relaxation time or more simply T1. It does not
give the exact duration of the relaxation process but is rather a constant
that describes how fast this process is.
Another interesting phenomenon is related to the inhomogeneity of the
magnetic field where the patient is positioned: the intensity is different at
different points of the field, thus giving rise to different precession
frequencies. Moreover, each proton is influenced by the small magnetic
fields from neighboring nuclei, also not distributed uniformly, again
causing different precession frequencies. Therefore, when the RF pulse is
switched off, the protons are no longer forced to move in synchrony and,
as they have different precession frequencies, they soon become out of
phase. In particular, in a short time interval, the protons will be 180o out
of phase, canceling out their magnetic moments in the respective plane.
This interval is a time constant known as the transversal relaxation time
or spin-spin relaxation (due to the spin-spin interaction): this interval is
also known more simply as T2.
T1 is longer than T2. In biological tissues, T1 varies between 300 and 2000
msec and T2 varies between 30 and 150 msec, depending on the type of
tissue examined. As it is difficult to precisely locate the end of the
longitudinal and transverse relaxation, T1 and T2 are not defined as the
times when relaxation is completed, but are defined respectively as the
time when approximately 63% of the original longitudinal magnetization
is reached (T1) and the time when transverse magnetization decreases to
37% of the original value (T2). These percentages are derived from
mathematic equations describing signal intensity (63% = 1-1/e;
37%=1/e).
By measuring the relaxation times, it is possible to obtain some degree of
tissue characterization. For example, liquids have a long T1 and a long T2
while, for fatty tissues, T1 and T2 are both short. Pathological tissues often
have a higher water content than the surrounding normal tissues.
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4/6 • Appendix A
•
•
•
T1 depends on tissue composition, structure and surroundings. Moreover,
given that precessing frequency depends on the intensity of the magnetic
field (Larmor equation) in the presence of a stronger magnetic field
protons precess faster. In this case it is more difficult for them to transmit
Resonance Imaging
energy to a lattice with slower fluctuating magnetic fields. This is why T1
is longer in a stronger magnetic field.
There are two causes of spin-spin relaxation: non-homogeneities of the
external magnetic field and the non-homogeneities of the local magnetic
fields within the tissues. If there are no significant differences in magnetic
field strength inside a tissue, the protons move in phase for a long time,
and therefore T2 is longer. On the contrary, larger differences in local
magnetic fields cause larger differences in precession frequencies, thus
protons shift out of phase faster and T2 is shorter.
From signal to image

When the proton system in a strong magnetic field is disturbed by an RF
pulse, the protons are in phase and transverse magnetization can be
detected. This can be seen as longitudinal macroscopic magnetization
tilted by 90° on the transverse plane. An RF pulse which tilts the
magnetization by 90° is called a 90° pulse. According to the strength and
the duration of the RF pulse, it is possible to obtain different tilt angles,
such as, for example, a 180° pulse.
Just after a 90° pulse, the transverse magnetization starts to decrease
because the protons are losing phase coherence, while the longitudinal
magnetization increases. Transverse and longitudinal magnetization
vectors add up to a sum vector. This sum vector performs a spiral motion
when it changes its direction from being in the transverse plane (no
longitudinal magnetization) to its final position (no transverse
magnetization). The resulting signal, that disappears with time, is called a
FID (free induction decay) signal.
Different tissues may have different relaxation times. Let us now see what
happens when tissues having different relaxation times are disturbed with
consecutive 90° pulses, i.e. a pulse sequence. If the time between two
consecutive pulses, which we shall call TR, is long enough, the different
tissues have regained all of their longitudinal magnetization, thus the
transverse magnetization after the following pulse will be the same for all
the tissues involved in the experiment. Vice versa, if the TR is short, as the
T1 of tissues is different, after a certain interval a tissue will have regained
more of its longitudinal magnetization than another one. If another 90°
pulse is sent at that moment, the transverse magnetization will be greater
in the first tissue with respect to the second, so the antenna will receive a
stronger signal from the first than from the second. The selection of a
sequence of pulses will determine which type of signal will be obtained
from a tissue. Therefore the pulse sequence for a specific study must be
selected and described with care.
•
•
350003100 Rev. 11 • 5/6
•
•
•
There are many image acquisition techniques for the evaluation of
relaxation times. The most common are known as Spin Eco, Inversion
Recovery and Fast Imaging.
Images obtained using the Spin Echo technique depend on both tissue
parameters (i.e. T1 and T2) and operating parameters (i.e. TR, TE), thus
modifying the contrast between different tissues when some of these
parameters are changed. This is important to highlight contrast
differences between normal and pathological regions.
Different types of image can be obtained in a single acquisition, by
combining a number of parameters. If, for example different TEs are used
during the same TR, it is possible to obtain a set of images weighted in T1
as well as in T2 or a combination of both. This technique is known as
Multiple Echo.
When the Inversion Recovery technique is used, the resulting images
mainly depend on T1. Therefore, structures presenting even small
differences in T1 may be characterized.
Fast sequences are now very popular because they enable quick
acquisition of images and a reduction in examination times. In particular,
they can be very useful in 3D imaging. There are different fast pulse
sequences, the differences between which are sometimes very modest.
Their structure as well as their names depend on the manufacturer’s
choice.
•
•
6/6 • Appendix A
•
•
•

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ACCIDENT REPORT FORM

Name of ESAOTE equipment/system..................................................

PRODUCT TRACEABILITY FORM

Name of ESAOTE equipment/system..................................................

Chapter 1 - Essential Prescribing Information

Chapter 2 - Manual Requirements

Chapter 3 - Instructions for Safe Use

Chapter 5 - Technical description

Chapter 6 - Patient table

Chapter 7 - Shielding and insulating parts

Chapter 10 - Turning the system on and off

Chapter 11 - Positioning protocols

Chapter 12 - Knee examinations

Chapter 13 - Thigh and Calf Area Examinations

Chapter 15 - Hand-Wrist examinations

Chapter 16 - Elbow examinations

Chapter 17 - Arm and forearm examinations

Chapter 18 - Shoulder Examinations

Chapter 19 - Hip examinations.

Chapter 20 - Examination of the spinal column

Chapter 23 - Examination of the temporomandibular

Chapter 24 - Examination of the head

Chapter 25 - Control panel

Appendix A - General Principles of Magnetic Resonance

Description of the system

General Warning and Precautions

MR Examinations of Infants and Pregnant Women

This user manual 350003100 Rev. 11 constitutes only a part of the

Safety Information: conventions

Personnel Qualifications and Training

Minimum physical requirements:

Instructions for Safe Use

Controlled access area

When the system is installed inside a shielded rectangular room - with RF

Instructions for Safe Use

Artifacts on images can be caused by loss in efficiency of the shielding

Instructions for Safe Use

Instructions for Safe Use

SPECIAL PRECAUTIONS: PREGNANT OR INFANT

SPECIAL PRECAUTIONS: HIGH RISK PATIENTS

Instructions for Safe Use

Emergency medical procedure

Monitoring the Patient during Examinations.

Instructions for Safe Use

Normal operating mode limits

Static Magnetic Field d2 T(*)

Gradient output for dedicated d3.3 V/m

Partial body SAR d6.4 W/kg

Head SAR d3.2 W/kg

The following values: a) nominal B0, b) maximum gradient of the static

Personnel and patient exposure to the acoustic noise

Special precautions against acoustic noise

Personnel and patient exposure to the static magnetic field

MR personnel and patient

Instructions for Safe Use

Fringe magnetic field

fig. 3.4 - Top view

Instructions for Safe Use

Instructions for Safe Use

Personnel and patient exposure to a time-varying magnetic field

Exposure of the operator falls below the action values of:

Exposure of the operator falls below the action values of: