ECHOCARDIOGRAPHY PROCEDURE REPORT TEMPLATES

TID 5200 Echocardiography Procedure Report

This template forms the top of a content tree that allows an ultrasound device to describe the results of an adult echocardiography imaging procedure. It is instantiated at the root node. It can also be included in other templates that need to incorporate echocardiography findings into another report as quoted evidence.

TID 5200 – Echocardiography Procedure ReportType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (125200, DCM, “Adult Echocardiography Procedure Report”) 1 M
2 > HAS CONCEPT MOD INCLUDE DTID (1204) Language of Content Item and Descendants 1 U
3 > HAS OBS CONTEXT INCLUDE DTID (1001) Observation Context 1 M
4 > CONTAINS CONTAINER DT (121064, DCM, “Current Procedure Descriptions”) 1 U
5 >> CONTAINS CODE DT (125203, DCM, “Acquisition Protocol”) 1-n M BCID (12001) Ultrasound Protocol Types
6 > CONTAINS INCLUDE DTID (5201) Echocardiography Patient Characteristics 1 U
7 > CONTAINS CONTAINER (111028, DCM, “Image Library”) 1 U
8 >> CONTAINS IMAGE No purpose of reference 1-n M
9 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-32600, SRT, “Left Ventricle”) $MeasType = DCID (12200) Echocardiography Left Ventricle
10 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-32500, SRT, “Right Ventricle”) $MeasType = DCID (12204) Echocardiography Right Ventricle
11 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-32300, SRT, “Left Atrium”) $MeasType = DCID (12205) Echocardiography Left Atrium
12 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-32200, SRT, “Right Atrium”) $MeasType = DCID (12206) Echocardiography Right Atrium
13 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-35400, SRT, “Aortic Valve”) $MeasType = DCID (12211) Echocardiography Aortic Valve
14 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-35300, SRT, “Mitral Valve”) $MeasType = DCID (12207) Echocardiography Mitral Valve
15 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-35200, SRT, “Pulmonic Valve”) $MeasType = DCID (12209) Echocardiography Pulmonic Valve
16 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-35100, SRT, “Tricuspid Valve”) $MeasType = DCID (12208) Echocardiography Tricuspid Valve
17 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-42000, SRT, “Aorta”) $MeasType= DCID (12212) Echocardiography Aorta
18 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-44000, SRT, “Pulmonary artery”) $MeasType DCID (12210) = Echocardiography Pulmonary Artery
19 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-48600, SRT, “Vena Cava” $MeasType = DCID (12215) Echocardiography Vena Cavae
20 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (T-48581, SRT, “Pulmonary Venous Structure” $MeasType = DCID (12214) Echocardiography Pulmonary Veins
21 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (P5-30031, SRT, “Cardiac Shunt Study”) $MeasType = DCID (12217) Echocardiography Cardiac Shunt
22 > CONTAINS INCLUDE DTID (5202) Echo Section 1 U $SectionSubject = EV (D4-30000, SRT, “Congenital Anomaly of Cardiovascular System”) $MeasType = DCID (12218) Echocardiography Congenital
23 > CONTAINS INCLUDE DTID (5204) Wall Motion Analysis 1-n U $Procedure = DT (P5-B3121, SRT, "Echocardiography for Determining Ventricular Contraction")

Content Item Descriptions

Row 23 The wall motion findings of stress stage. There may be multiple Template instances to report wall motion findings of multiple stages.

TID 5201 Echocardiography Patient Characteristics

Patient Characteristic concepts in this template, which may replicate attributes in the Patient Study Module, are included here as possible targets of by-reference relationships from other content items in the SR tree.

Note: Several of the concepts in this template duplicate concepts in TID 1007 “Subject Context, Patient”. The difference in use is that this template has those concepts as primary observations of the patient, while in TID 1007 the concepts are used to set (or reset) the context for other observations.

TID 5201Echocardiography Patient CharacteristicsType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121118, DCM, “Patient Characteristics”) 1 M
2 > CONTAINS NUM EV (121033, DCM, "Subject Age”) 1 U Units = DCID (7456) Units of Measure for Age
3 > CONTAINS CODE EV (121032, DCM, "Subject Sex”) 1 U DCID (7455) Sex
4 > CONTAINS NUM EV (8867-4, LN, “Heart Rate”) 1 U
5 > CONTAINS NUM EV (F-008EC, SRT, “Systolic Blood Pressure”) 1 U
6 > CONTAINS NUM EV (F-008ED, SRT, "Diastolic Blood Pressure") 1 U
7 > CONTAINS NUM EV (8277-6, LN, “Body Surface Area”) 1 M
8 >> INFERRED FROM CODE EV (8278-4, LN, "Body Surface Area Formula") 1 U BCID (3663) Body Surface Area Equations

TID 5202 Echo Section

This is a generic section heading Template for any of the anatomical headings. Measurements within a section heading appear as groups (by image mode, acquisition protocol, and/or protocol stage).

Parameter Name Parameter Usage
$SectionSubject The subject modifier of the section heading container
$MeasType The concept name of the measurement

TID 5202ECHO SECTIONType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, ”Findings”) 1 M
2 > HAS CONCEPT MOD CODE EV (G-C0E3, SRT, “Finding Site”) 1 M $SectionSubject
3 > CONTAINS CONTAINER DT (125007, DCM, “Measurement Group”) 1-n M
4 >> HAS CONCEPT MOD CODE EV (G-0373, SRT,”Image Mode” ) 1 U BCID (12224) Ultrasound Image Modes
5 >> HAS CONCEPT MOD CODE DT (125203,DCM,”Acquisition Protocol”) 1 U
6 >> HAS CONCEPT MOD TEXT DT (125203, DCM, “Acquisition Protocol”) 1 U
7 >> HAS ACQ CONTEXT CODE EV (LN, 18139-6, "Stage") 1 U BCID (12002) Ultrasound Protocol Stage Types
8 >> CONTAINS INCLUDE DTID (5203) Echo Measurement 1-n M $Measurement = $MeasType $Method=CID (12227) Echocardiography Measurement Method

Echo Section Descriptions

Rows 4, 5 Type of measurement group. May be grouped by image mode, or acquisition protocol, or some other user or manufacturer designated classification
Row 7 For measurements acquired in a staged protocol, all measurements in a measurement group are acquired at the identified stage.

TID 5203 Echo Measurement

Parameter Name Parameter Usage
$Measurement Coded term or Context Group for Concept Name of measurement
$Method Value for Measurement Method

TID 5203Echo Measurement Type: Extensible Order: Significant

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TID 5204 Wall Motion Analysis

The Wall Motion Analysis Template is used to document wall motion scoring for any imaging modality.

Parameter Name Parameter Usage
$Procedure The imaging procedure used for wall motion analysis.

TID 5204Wall Motion AnalysisType: Extensible Order: Significant

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Row 4 Image that graphically depicts the segments and their scores.
Row 5 Text narration accompanying this stage.
Row 6 The composite score computed from the average of the scored segments
Row 7 The type of scoring scheme used to score this exam.
Row 8 A container of all of the individual segment findings for this stage. The container shall be present if the observer makes an assessment, including the assessment of Not Visualized. It shall not be present if no evaluation was made.
Rows 11, 12 Scar/thinning (in Row 12) may accompany akinesis and dyskinesis (in Row 11).
Row 13 A numeric designation for the score. Score ranges vary, typically 0-4 or 0-5. Numeric scores may depend on wall motion findings as well as morphology findings. See the table below for conventional numeric assignment schemes. The UCUM annotation code enables specifying the numeric range, ("{L:N}", UCUM, "scale L:N"), where L and N are the lower and upper ends of the range.

Table 5204-1 Numeric Score Assignment for Segmental Findings

A description of the scoring schemes described in the table below is available in Recommendations for Quantitation of the Left Ventricle by Two-Dimensional Echocardiography , Journal of the American Society of Echocardiography, Vol 2, No 5 358-367, Oct 1989.

Conventional Numeric Assignment Wall Motion Finding or Morphology Finding
4 Point 5 Point 5 Point with Graded Hypokinesis
-1 (F-32050, SRT, ”Cardiac Wall Motion”) = (R-0030D SRT, “Hyperkinesis”) (F-32050, SRT, ”Cardiac Wall Motion”) = (R-0030D, SRT, “Hyperkinesis”) (F-32050, SRT, ”Cardiac Wall Motion”) = (R-0030D, SRT, “Hyperkinesis”)
0 (F-32050, SRT, ”Cardiac Wall Motion”) = (122288, DCM , “Not Visualized”) (F-32050, SRT, ”Cardiac Wall Motion”) = (122288, DCM , “Not Visualized”) (F-32050, SRT, ”Cardiac Wall Motion”) = (122288, DCM , “Not Visualized”)
1 (F-32050, SRT, ”Cardiac Wall Motion”) = (R-00344, SRT, “Normal Wall Motion”) (F-32050, SRT, ”Cardiac Wall Motion”) = (R-00344, SRT, “Normal Wall Motion”) (F-32050, SRT, ”Cardiac Wall Motion”) = (R-00344, SRT, “Normal Wall Motion”)
1.5 (F-32050, SRT, “Cardiac Wall Motion”) = (R-00327, SRT, “Mild Hypokinesis”)
2 (F-32050, SRT, “Cardiac Wall Motion”) = (R-4041B, SRT, “Hypokinesis”) (F-32050, SRT, “Cardiac Wall Motion”) = (R-4041B, SRT, “Hypokinesis”) (F-32050, SRT, “Cardiac Wall Motion”) = (R-0032F, SRT, “Moderate Hypokinesis”)
2.5 (F-32050, SRT, “Cardiac Wall Motion”) = (R-00370, SRT, “Severe Hypokinesis”)
3 (F-32050, SRT, “Cardiac Wall Motion”) = (F-30004, SRT, “Akinesis”) (F-32050, SRT, “Cardiac Wall Motion”) = (F-30004, SRT, “Akinesis”) (F-32050, SRT, “Cardiac Wall Motion”) = (F-30004, SRT, “Akinesis”)
4 (F-32050, SRT, “Cardiac Wall Motion”) = (F-32052, SRT, “Dyskinesis”) (F-32050, SRT, “Cardiac Wall Motion”) = (F-32052, SRT, “Dyskinesis”) (F-32050, SRT, “Cardiac Wall Motion”) = (F-32052, SRT, “Dyskinesis”)
5 (G-C504, SRT, "Associated Morphology") = (D3-10510, SRT, “Ventricular Aneurysm”) (G-C504, SRT, "Associated Morphology") = (D3-10510, SRT, “Ventricular Aneurysm”)

TID 5220 Pediatric, Fetal and Congenital Cardiac Ultrasound Reports

This template forms the top of a content tree that allows an ultrasound application to describe the results of a Cardiac Ultrasound imaging procedure. It is instantiated at the root node.

TID 5220Pediatric, Fetal and Congenital Cardiac Ultrasound ReportsType: Extensible

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Row 7 For Fetal Report, this row will be the patient history of the mother.
Row 8 For Fetal Report, this row will be the Patient Characteristics for the mother.
Row 10 For Fetal Report, this row will be the Summary Section for the mother.

TID 5221 Cardiac Ultrasound Pediatric Echo Measurement Section

TID 5221Cardiac Ultrasound Pediatric Echo Measurement SectionType: Extensible Order: Significant

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$SectionSubject The subject modifier of the section heading container
$MeasType The concept name of the measurement

TID 5222Pediatric, Fetal and Congenital Cardiac Ultrasound SectionType: Extensible Order: Significant

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$Measurement Coded term or Context Group for Concept Name of measurement
$Method Value for Measurement Method

TID 5223Pediatric, Fetal and Congenital Cardiac Ultrasound MeasurementType: Extensible Order: Significant

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Row 2 When this row is available, the row 1 is an index calculation of the object.

TID 5225 Cardiac Ultrasound Fetal Characteristics

Contains a list of Fetus Specific characteristics.

TID 5225Cardiac Ultrasound Fetal CharacteristicsType: Extensible Order: Significant

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Row 9 ID given to this Implant Component. Used to reference this specific Component within the Implantation Plan.
Row 10 See description of Component Type Code Sequence (0076,0034) Attribute in Template Assembly Module in PS 3.3
Row 11 Reference to the Template that describes that component. May be the same Implant Template as referenced in row 13. The target of the reference may not be needed or available during implantation. e.g. if the plan is opened in another hospital where those implant templates are not used.
Row 12 This Frame of Reference is the Frame of Reference of the Implant Component (Frame of Reference UID (0020,0052) Attribute in the Generic Implant Template Module in PS 3.3). This may help to find the right registration information (row 43).
Row 13 References the Original Template that was the basis for the Derived Template. May be the same Implant Template as referenced in row 11. The target of the reference may not be needed or available during implantation, e.g., if the plan is opened in another hospital where those implant templates are not used.
Row 14 If there is no Component Connection between sets of Implant Components, one Assembly must be used for each set.
Row 17 The ID of a planned Component that is defined in this document and which is part of this Relation.
Row 18 See description of Mating Feature Set ID (0068,63C0) Attribute in the Generic Implant Template Module in PS 3.3
Row 19 See description of Mating Feature ID (0068,63F0) Attribute in the Generic Implant Template Module in PS 3.3
Row 21 See description of Degree of Freedom ID (0068,6410) Attribute in the Generic Implant Template Module in PS 3.3
Row 22 – 27 Defines the range or exact value that was selected or calculated by the planning application.
Row 31 Defines the calibrated Horizontal Pixel Spacing that was used by the planning application, which may be different from the spacing encoded in the referenced Image SOP Instance.
Row 32 Defines the calibrated Vertical Pixel Spacing that was used by the planning application, which may be different from the spacing encoded in the referenced Image SOP Instance.
Row 33 Any patient data other than Image IEs used for the planning, e.g., Surface Segmentations.
Row 34 Fiducials selected by the user for registration of implant components referenced in the parent content item.
Row 35 User comment about the Fiducial. This may be the reason it was selected, the intended use, the anatomical or non-anatomical structure that the Fiducial represents, or any other intent.
Row 38 All kinds of information in PDF form that are created by a planning application may be referenced here, e.g., drawings.
Row 39 All kinds of images that are created by a planning application should be referenced here, e.g. images that show patient images overlaid with contour information of the Implant Component, or images that show how several implant components may be composed, or merged patient images.
Row 40 References registration objects that contain registration data that is relevant for this Implantation Plan, e.g., registration of Implant Components.
Row 41 Identifies one or more items within the sequence of referenced Frames of Reference (Registration Sequence (0070,0308) in the Spatial Registration Module or Deformable Registration Sequence (0064,0002) in the Deformable Spatial Registration Module in PS 3.3) that are relevant for this Implantation Plan. See Figure A-13.
Row 42 Any patient data created during the planning process that is not referenced in row 39 and 40, e.g., Surface Segmentation Instances created by the planning application.
Row 43 These Fiducials are derived from the Fiducials identified in Row 34.
Row 45 References to any relevant patient data containing IOD instances that were not used in planning or derived from it but belong to the patient model. Might be reports, images, surface segmentations, or other.

[pic]

Figure A-13: References to Registration Objects

TID 7001 Related Implantation Reports

This general template provides a means to reference related Implantation Plan SR Document instances that are not previous Reports. Other Implantations that are planned to be done during the same intervention should be referenced here.

TID 7001RELATED IMPLANTATION REPORTSType: Extensible Order: Significant

NL Rel with Parent VT Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (112365, DCM, ”Related Implantation Reports”) 1 M
2 > CONTAINS COMPOSITE 1-n M