IVUS REPORT TEMPLATES

The templates that comprise the IVUS Report within the Evidence Report IOD are interconnected as shown in Figure A-5.

[pic]

Figure A-5 IVUS Report Template Hierarchy

TID 3250 IVUS Report

The IVUS Report template is the root structure for the representation of IVUS measurements acquired during a catheterization procedure.

TID 3250 IVUS ReportType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (18752-6, LN, “Stress Testing Report”) 1 M
1
Row 17 The Procedure Time Base is the time from which elapsed times are measured. The Study Time (0008,0030) may include the patient prep period, while this Procedure Time Base is typically established when baseline data collection begins.

TID 3303 Stress Test Phase Data

The Stress Test Phase Data template provides a structure for measurements acquired during a single procedure phase.

TID 3303 Stress Test Phase DataType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1

TID 3304 Stress Test Measurement Group

Each instance of the Stress Test Measurement Group represents a group of data elements acquired at approximately the same instant, and conventionally rendered as row in a tabular presentation. It is typically generated during the Stress exam whenever a time interval elapses (for example, every minute of the phase), when a technician observes data worth capturing, or when measurements exceed a given range.

TID 3304 Stress Test Measurement Group Type: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1
Row 10 Included Template 3106 allows the recording of test medications other than the Pharmacological Stress Agent identified in Template x3301.
Rows 17, 18 ECG ST elevation/depression is measured in units of mV, but is conventionally reported in units of mm, based on strip recordings with scaling of 100 uV/mm. The display application should render these measurements in units meaningful to the user.
Row 19 Note that the MDC codes for “per lead” measurements specified in CID 3228 are base codes for post-coordination with lead identifiers conveyed in the Target Site modifier in TID 300. MDC also defines pre-coordinated codes that include both the measurement and the lead, which may be used in this row.
Row 20 Note that the MDC code for “QTc interval per lead” specified in CID 3227 is a base code for post-coordination with lead identifiers conveyed in the Target Site modifier in TID 300. MDC also defines pre-coordinated codes that include both the measurement and the lead, which may be used in this row. Note that TID 300 enables the encoding of a non-standard correction algorithm, either as a local code, or as a TEXT Method Citation (see TID 300 row 12).
Row 21 R-R interval used for QT correction algorithm
Row 22 Recommended range for ECG axis measurements is -90° to +270°

TID 3307 NM/PET Perfusion Measurement Group

TID 3307NM/PET Perfusion Measurement GroupType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER DT (121070, DCM, “Findings”) 1 M
1

TID 3311 Stress Test Summary

TID 3311Stress Test SummaryType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1

TID 3312 Physiological Summary

TID 3312Physiological SummaryType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1

TID 3313 Stress ECG Summary

TID 3313Stress ECG SummaryType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1
Row 12-13 This Concept and the associated Concept Modifier may be instantiated twice, once for resting state measurements, once for stress.

TID 3317 Stress Imaging Summary

TID 3317Stress Imaging SummaryType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1
Row 15 The LVEF code specified in this row is defined in LOINC with method “imaging”. LVEF measurement by ultrasound may also be encoded elsewhere in the Content Tree (e.g., in TID 3309 Stress Echo Measurement Group) with LOINC code 18043-0, which has method “ultrasound”. It is recommended that such findings from the per-phase measurements be summarized here with the generic “LVEF by Imaging” concept code.

TID 3318 Comparison to Prior Stress Exam

This template describes changes in findings from a prior stress exam. Comparison is to only one prior exam, even though the generic concept name for the template uses the plural “exams”.

TID 3318Comparison to Prior Stress ExamType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (111424, DCM, “Comparison to previous exams”) 1 M
1 CONTAINER EV (121076, DCM, "Conclusions") 1 MC IF Completion Flag (0040,A491) = COMPLETE
1 CONTAINER EV (122120, DCM, “Hemodynamics Report”) 1 M
2 > HAS OBS CONTEXT INCLUDE DTID (1002) Observer Context 1-n M
3 > INCLUDE DTID (3601) Procedure Context 1 M
4 > HAS OBS CONTEXT INCLUDE DTID (3602) Cardiovascular Patient Characteristics 1 M
5 > HAS ACQ CONTEXT INCLUDE DTID (3603) Procedure Environmental Characteristics 1 U
6 > CONTAINS INCLUDE DTID (3501) Hemodynamic Measurement Group 1-n M
7 > CONTAINS INCLUDE DTID (3570) "Summary, Hemodynamics" 1 U

TID 3501 Hemodynamics Measurement Group

The Hemodynamic Measurement Group template provides a structure for measurements acquired during a single procedure phase in a cardiac catheterization lab.

TID 3501 Hemodynamics Measurement GroupType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (121070, DCM, “Findings”) 1 M
2 > HAS ACQ CONTEXT CODE EV (G-72BB, SRT, “Catheterization Procedure Phase”) 1 M DCID (3651) Hemodynamic Measurement phase
3 > HAS ACQ CONTEXT INCLUDE DTID (3520) Hemodynamic Clinical Context 1 U
4 > HAS ACQ CONTEXT TEXT EV (121124, DCM, "Procedure Action ID") 1 U
5 > CONTAINS INCLUDE DTID (3510) Vital signs 1-n U
6 > CONTAINS INCLUDE DTID (3504) Arterial Pressure Measurement 1-n U
7 > CONTAINS INCLUDE DTID (3505) Atrial Pressure Measurement 1-n U
8 > CONTAINS INCLUDE DTID (3506) Venous Pressure Measurement 1-n U
9 > CONTAINS INCLUDE DTID (3507) Ventricular Pressure Measurement 1-n U
10 > CONTAINS INCLUDE DTID (3508) Gradient Measurement 1-n U
11 > CONTAINS INCLUDE DTID (3509) Blood Velocity Measurements 1-n U
12 > CONTAINS INCLUDE DTID (3515) Cardiac Output Measurement by Indicator Dilution 1-n U
13 > CONTAINS INCLUDE DTID (3516) Blood lab measurements 1-n U
14 > CONTAINS INCLUDE DTID (3560) Derived Hemodynamic Measurements 1-n U
15 > CONTAINS INCLUDE DTID (3714) ECG Lead Measurements 1-n U

Content Item Descriptions

Row 4 Procedure Action ID allows linkage between the hemodynamic measurements recorded in this Template and a procedure step or phase recorded in the Procedure Log, e.g., using TID 3100.

TID 3504 Arterial Pressure Measurement

The Arterial Pressure Measurement template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing systolic, diastolic, and mean measurements. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (finding site) value.

TID 3504Arterial Pressure MeasurementType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (P2-36102, SRT, “Arterial pressure measurements") 1 M
2 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 M $LocationName = EV (G-C0E3, SRT, “Finding Site”) $LocationValue = DCID (3606) Arterial source locations
3 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (8480-6, LN, “Intravascular arterial Systolic pressure”) $Units = DCID (3500) Pressure Units
4 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (8462-4, LN, “Intravascular arterial Diastolic pressure”) $Units = DCID (3500) Pressure Units
5 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (8478-0, LN, “Intravascular arterial mean pressure”) $Units = DCID (3500) Pressure Units
6 > CONTAINS INCLUDE DTID (3550) Pressure waveform measurements 1-n U

TID 3505 Atrial Pressure Measurement

The Atrial Pressure Measurement template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing a-wave, v-wave, and mean measurements. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (finding site) value.

TID 3505Atrial Pressure MeasurementType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122121, DCM, “Atrial pressure measurements") 1 M
2 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 M $LocationName = EV (G-C0E3, SRT, “Finding Site”) $LocationValue = DCID (3608) Atrial source locations
3 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (109016, DCM, “A-wave peak pressure”) $Units = DCID (3500) Pressure Units
4 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (109034, DCM, “V-wave peak pressure”) $Units = DCID (3500) Pressure Units
5 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (F 31150, SRT, “Mean blood pressure”) $Units = DCID (3500) Pressure Units
6 > CONTAINS INCLUDE DTID (3550) Pressure waveform measurements 1-n U

TID 3506 Venous Pressure Measurement

The Venous Pressure Measurement template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing a mean measurement. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (finding site) value.

TID 3506Venous Pressure Measurement Type: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (P2-36110, SRT, “Venous pressure measurements") 1 M
2 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 M $LocationName = EV (G-C0E3, SRT, “Finding Site”) $LocationValue = DCID (3607) Venous source locations
3 > CONTAINS INCLUDE DTID (300) Measurement 1 M $Measurement = EV (F 31150, SRT, “Mean blood pressure”) $Units = DCID (3500) Pressure Units
4 > CONTAINS INCLUDE DTID (3550) Pressure waveform measurements 1-n U

TID 3507 Ventricular Pressure Measurement

The Ventricular Pressure Measurement template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing systolic and end-diastolic measurements. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (finding site) value.

TID 3507Ventricular Pressure MeasurementType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122122, DCM, “Ventricular pressure measurements") 1 M
2 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 M $LocationName = EV (G-C0E3, SRT, “Finding Site”) $LocationValue = DCID (3609) Ventricular source locations
3 > CONTAINS INCLUDE DTID (300) Measurement 1 MC IFF $LocationValue selected in row 2 is (T-32600, SRT, “Left Ventricle”) or subsite thereof $Measurement = EV (F-03E0D, SRT, “Left Ventricular Systolic blood pressure”) $Units = DCID (3500) Pressure Units
4 > CONTAINS INCLUDE DTID (300) Measurement 1 MC IFF $LocationValue selected in row 2 is (T-32600, SRT, “Left Ventricle”) or subsite thereof $Measurement = EV (F-03E0E, SRT, “Left Ventricular End Diastolic pressure”) $Units = DCID (3500) Pressure Units
5 > CONTAINS INCLUDE DTID (300) Measurement 1 MC IFF $LocationValue selected in row 2 is (T-32500, SRT, “Right Ventricle”) or subsite thereof $Measurement = EV (F-03DFE, SRT, “Right Ventricular Systolic blood pressure”) $Units = DCID (3500) Pressure Units
6 > CONTAINS INCLUDE DTID (300) Measurement 1 MC IFF $LocationValue selected in row 2 is (T-32500, SRT, “Right Ventricle”) or subsite thereof $Measurement = EV (F-03E02, SRT, “Right Ventricular End Diastolic pressure”) $Units = DCID (3500) Pressure Units
7 > CONTAINS INCLUDE DTID (300) Measurement 1 MC IFF $LocationValue selected in row 2 is (T-32400, SRT, “Common Ventricle”) $Measurement = EV (122194, DCM, “Ventricular Systolic blood pressure”) $Units = DCID (3500) Pressure Units
8 > CONTAINS INCLUDE DTID (300) Measurement 1 MC IFF $LocationValue selected in row 2 is (T-32400, SRT, “Common Ventricle”) $Measurement = EV (122191, DCM, “Ventricular End Diastolic pressure”) $Units = DCID (3500) Pressure Units
9 > CONTAINS INCLUDE DTID (3550) Pressure waveform measurements 1-n U

TID 3508 Gradient Measurement

The Gradient Measurement template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing the gradient measurement. This implies that the name of the measurement is effectively post-coordinated from the measurement name, the Hemodynamic Measurement Group container (procedure phase) name, and the acquisition context (finding site) value.

TID 3508Gradient MeasurementType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122123, DCM, “Gradient assessment”) 1 M
2 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 MC XOR with Rows 3 & 4 IFF single location is appropriate $LocationName = EV (G-C0E3, SRT, “Finding Site”) $LocationValue = DCID (3610) Gradient Source Locations
3 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 MC XOR with Row 2 IFF a dual location is appropriate $LocationName = EV (121116, DCM, “Proximal Finding Site”) $LocationValue = DCID (3630) Cardiovascular Anatomic Locations
4 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 MC XOR with Row 2 IFF a dual location is appropriate $LocationName = EV (121117, DCM, “Distal Finding Site”) $LocationValue = DCID (3630) Cardiovascular Anatomic Locations
5 > CONTAINS INCLUDE DTID (300) Measurement 1-n M $Measurement = EV (F-023F7, ”Pressure Gradient”) $Units = DCID (3500) Pressure Units $Derivation = DCID (3627) Measurement Type
6 > CONTAINS INCLUDE DTID (3550) Pressure waveform measurements 1-n U

Content Item Descriptions

Row 5, which is used to encode the gradient measurements, uses Template 300 for the content item structure of the measurements. That template allows an INFERRED FROM relationship to other numeric measurements used in the computation or derivation of the current measurement. In the case of a gradient measurement, the pressure measurements at the distal and proximal locations may thus be explicitly conveyed.

TID 3509 Blood Velocity Measurement

The Blood Velocity Measurement template consists of a CONTAINER, with an acquisition context of the measurement anatomic site, and containing primary (not derived) velocity measurements, e.g., from a Doppler catheter. Derived velocity measurements may be recorded using TID 3560.

TID 3509Blood Velocity MeasurementType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122124, DCM, “Blood velocity measurements") 1 M
2 > INCLUDE DTID (3530) Hemodynamic Acquisition Context 1 M $LocationName = EV (G-C0E9, SRT, “Procedure site”) $LocationValue = BCID (3606) Arterial source locations
3 > CONTAINS INCLUDE DTID (300) Measurement 1-n M $Measurement = DCID (3612) Blood Velocity Measurements $Units = EV (mm/s, UCUM, "mm/s")
4 > CONTAINS INCLUDE DTID (3550) Pressure waveform measurements 1-n U

TID 3510 Vital Signs

The Vital Signs template consists of a CONTAINER containing the various vital signs measurements. These measurements may be acquired automatically from patient monitoring equipment, or may be entered based on manual measurements.

TID 3510Vital SignsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (8716-3, LN, “Vital Signs”) 1 M
2 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-008EC, SRT, "Systolic blood pressure") $Units = DCID (3500) $Method = BCID (3560) Blood Pressure Methods
3 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-008ED, SRT, "Diastolic blood pressure") $Units = DCID (3500)
4 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8867-4, LN, "Heart rate") $Units = EV ("{H.B.}/min", UCUM, "BPM")
5 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8310-5, LN, "Body temperature") $Units = EV (Cel, UCUM, “°C”)
6 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = DCID (3526) Blood gas saturation $Units = EV (%, UCUM, "%")
7 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV ( F-043E7, SRT, "Respiration rate") $Units = EV (/min, UCUM, "breaths/min")
8 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122195, DCM, "Pulse Strength") $Units = DT("{0:4}", UCUM, "range 0:4")
9 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-009EA, SRT, “Pain Score”) $Units = DT("{1:10}", UCUM, "range 1:10")
10 > CONTAINS CODE DT (8884-9, LN, "Cardiac Rhythm") 1 U BCID (3415) Cardiac Rhythms
11 > CONTAINS CODE DT (9304-7, LN, "Respiration Rhythm") 1 U BCID (3416) Respiration Rhythms

TID 3515 Cardiac Output Measurement by Indicator Dilution

The Cardiac Output Measurement by Indicator Dilution template consists of a CONTAINER containing the measurement and significant parameters of the technical method. If the measurement is based on a DICOM Hemodynamic Waveform SOP Instance, that object may also be referenced.

Note: Fick Cardiac Output is encoded in the Derived Hemodynamic Measurements Template 3560.

TID 3515Cardiac Output Measurement by Indicator DilutionType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (P2-34201, SRT, “Cardiac Output measurement”) 1 M
2 > CONTAINS INCLUDE TID (300) Measurement 1 M $Measurement = EV (8737-9, LN, “Cardiac Output by Indicator Dilution”) $Units = EV (l/min, UCUM, ”l/min”) $Method = DCID (3628) Cardiac Output Methods $WavePurpose = DT (121112, DCM, "Source of measurement”)
3 > HAS ACQ CONTEXT NUM EV (122319, DCM, “Catheter Size”) 1 MC IFF Row 2 indicates a thermal method UNITS = DCID (3510) Catheter Size Units
4 > HAS ACQ CONTEXT NUM EV (122320, DCM, “Injectate Temperature”) 1 MC IFF Row 2 indicates a thermal method UNITS = EV (Cel, UCUM, “°C”)
5 > HAS ACQ CONTEXT NUM EV (122321, DCM, “Injectate Volume”) 1 M UNITS = DT (ml, UCUM, “ml”)
6 > HAS ACQ CONTEXT NUM EV (122322, DCM, “Calibration Factor”) 1 M UNITS = DT (1, UCUM, “no units”)

TID 3516 Blood Lab Measurements

The Blood Lab Measurements template provides for the recording of measurements made on blood samples obtained during a catheterization procedure. The type and anatomic source of the blood is recorded as acquisition context. The results from the blood chemistry measurement system are quoted; the measurement names may be pre-coordinated with the type or source of the blood, or generic measurement names may be reported. In the latter case, the full measurement concept name may be effectively post-coordinated using the recorded acquisition context.

TID 3516Blood Lab MeasurementsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122125, DCM, ”Blood lab measurements”) 1 M
2 > HAS ACQ CONTEXT CODE EV (R-00254, SRT, "Specimen Type”) 1 M DCID (3520) Blood Source Type
3 > HAS ACQ CONTEXT CODE EV (G-C0E9, SRT, “Procedure site”) 1 M BCID (3630) Cardiovascular Anatomic Locations
4 > INCLUDE DTID (1000) Quotation 1 U
5 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (718-7, LN, “Hemoglobin”) $Units = DT (g/dl, UCUM, "g/dl")
6 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3524) Blood Gas Pressures $Units = DCID (3500)
7 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3525) Blood Gas Content $Units = DT (ml/dl, UCUM, "ml/dl")
8 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3528) Blood pH $Units = EV ([pH], UCUM, "pH")
9 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3526) Blood Gas Saturation $Units = EV (%, UCUM, "%")
10 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3527) Blood Base Excess $Units = DT (meq/dl, UCUM, "meq/dl")
11 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122183, DCM, "Blood temperature") $Units = EV (Cel, UCUM, “°C”)

TID 3520 Hemodynamic Clinical Context

The Clinical Context template allows the recording of information about the patient's clinical state that may affect interpretation of the hemodynamic measurements. This Template includes several coded conditions (e.g., complications, drugs, physiological challenges, etc.), each of which may have a Concept Modifier of “Relative Time”. This Modifier indicates the temporal relationship of the hemodynamic measurements to the conditions recorded in this template. E.g., the Content Item structure:

[CONTAINER] “Findings” HAS ACQ CONTEXT “Cath Procedure Phase” “Post-intervention phase” HAS ACQ CONTEXT [CONTAINER] “Clinical Context” CONTAINS [CODE] “Complication” “Arrhythmia” HAS CONCEPT MOD [CODE] “Relative Time” “After” CONTAINS [CONTAINER] “Arterial Measurements” …

conveys the semantics that this group of measurements for the post-intervention phase of a cath procedure was made after an occurrence of arrhythmia in the patient.

In the absence of a Relative Time modifier, the acquisition context is during the identified event or state.

TID 3520Hemodynamic Clinical ContextType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122127, DCM, "Clinical Context") 1 M
2 > CONTAINS CODE EV (109054, DCM, ”Patient State”) 1-n U BCID (3602) Hemodynamic Patient State
3 > CONTAINS TEXT EV (109054, DCM, ”Patient State”) 1 U
4 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (DD-60002, SRT, “Complication of Procedure”) $ConditionValue = DCID (3413) Adverse Outcomes
5 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (122086, DCM, "Contrast administered") $ConditionValue = BCID (12) Radiographic Contrast Agent
6 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (122083, DCM, "Drug administered") $ConditionValue = BCID (10) Interventional Drug
7 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (109059, DCM, ”Physiological challenges”) $ConditionValue = BCID (3271) Hemodynamic Physiological Challenges
8 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (122138, DCM, "Circulatory Support") $ConditionValue = DCID (3553) Circulatory Support
9 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (P2-2200A, SRT, "Ventilatory assistance") $ConditionValue = DCID (3554) Ventilation
10 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (P2-35000, SRT, "Cardiac Pacing") $ConditionValue = BCID (3555) Pacing
11 > CONTAINS INCLUDE DTID (3521) Relative Time 1-n U $ConditionName = EV (P0-0000, SRT, "Procedure") $ConditionValue = BCID (3405) Procedure Action Values

TID 3521 Relative Time

The Relative Time template is invoked by 3520 Hemodynamic Acquisition Context template. It specifies an applicable clinical context condition and the time of the current measurements relative to that condition.

TID 3521 Parameters

Parameter Name Parameter Usage
$ConditionName Coded term for Concept Name of condition
$ConditionValue Context Group for condition values

TID 3521Relative TimeType: Non-Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CODE $ConditionName 1 M $ConditionValue
2 > HAS CONCEPT MOD CODE EV (G-D709, SRT, "Relative time") 1 U BCID (3600) Relative times

TID 3530 Hemodynamic Acquisition Context

The Hemodynamic Acquisition Context template is invoked by the various hemodynamic measurement templates.

Parameter Name Parameter Usage
$LocationName Coded term for Concept Name of measurement location
$LocationValue Context Group for appropriate anatomic locations

TID 3530 Hemodynamic Acquisition Context Type: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 HAS CONCEPT MOD CODE $LocationName 1 M $LocationValue
2 > HAS CONCEPT MOD CODE EV (G-A1F8, SRT, “Topographical modifier”) 1 U BCID (3019) Cardiovascular anatomic location modifiers
3 HAS ACQ CONTEXT CODE EV (G-C036, SRT, “Measurement Method ") 1 U BCID (3241) Hemodynamic Measurement Technique
4 HAS ACQ CONTEXT WAVEFORM DT (121112, DCM, "Source of measurement”) 1 UC XOR Row 5
5 HAS ACQ CONTEXT TCOORD DT (121112, DCM, "Source of measurement”) 1 UC XOR Row 4
6 > SELECTED FROM WAVEFORM 1 M

TID 3550 Pressure Waveform Measurements

The Pressure Waveform Measurements template is invoked by the various hemodynamic measurement templates for recording general measurements made in conjunction with the specific required measurements for that anatomic location.

TID 3550Pressure Waveform MeasurementsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3611) Pressure Measurements $Units = DCID (3500)
2 CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3612) Blood Velocity Measurements $Units = EV (mm/s, UCUM, "mm/s")
3 CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3613) Hemodynamic Time Measurements $Units = DT (ms, UCUM, "ms")
4 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-32100, SRT, "Cardiac Output") $Units = EV (l/min, UCUM, "l/min")
5 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-32120, SRT, "Stroke Volume”) $Units = DT (ml, UCUM, "ml")
6 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (10230-1, LN, "LV Ejection Fraction") $Units = EV (%, UCUM, "%")
7 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8867-4, LN, "Heart rate") $Units = DT ("{H.B.}/min", UCUM, "BPM")
8 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV ( F-043E7, SRT, "Respiration rate") $Units = DT (“/min”, UCUM, "breaths/min")
9 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (109025, DCM, "Max dp/dt") $Units = DT (mm[Hg]/s, UCUM, "mmHg/s")
10 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (109026, DCM, "Max neg dp/dt") $Units = DT (mm[Hg]/s, UCUM, "mmHg/s")
11 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122190, DCM, "Max dp/dt/P") $Units = DT (s-1, UCUM, "/s")
12 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122192, DCM, "Indicator appearance time") $Units = DT (s, UCUM, "s")
13 CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122193, DCM, "Maximum pressure acceleration") $Units = DT (mm[Hg]/s2, UCUM, "mmHg/s/s")
14 CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3617) Valve Flows $Units = DT (ml/min, UCUM, "ml/min")

TID 3560 Derived Hemodynamic Measurements

The Derived Hemodynamic Measurements template consists of a CONTAINER containing measurements derived from one or more other measurements. These measurements are associated with a particular procedure phase, but not necessarily with a particular anatomic location.

TID 3560Derived Hemodynamic MeasurementsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122126, DCM, "Derived Hemodynamic Measurements") 1 U
2 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3614) Valve Areas, non-Mitral $Units = EV (cm2, UCUM, "cm2") $Equation = DT (122262, DCM, “Area = Flow / 44.5 * sqrt(Gradient[mmHg])”)
3 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-02320, SRT, "Mitral Valve Area”) $Units = EV (cm2, UCUM, "cm2") $Equation = DT (122263, DCM, “MVA= Flow / 38.0 * sqrt(Gradient[mmHg])”)
4 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3615) Valve Areas $ModType = EV (121425, DCM, “Index”) $ModValue = EV (8277-6, LN, “Body Surface Area”) $Units = DT (cm2/m2, UCUM, "cm2/m2")
5 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3616) Hemodynamic Period Measurements $Units = DT ("s/min", UCUM, "s/min")
6 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3617) Valve Flows $Units = DT (ml/s, UCUM, "ml/s")
7 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-32110, SRT, "Cardiac Index”) $Units = DT (l/min/m2, UCUM, "l/min/m2")
8 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3529) Arterial / Venous Content $Units = DT (ml/dl, UCUM, "ml/dl")
9 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3618) Hemodynamic Flows $Units = DT (l/min, UCUM, "l/min")
10 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8736-1, LN, "FICK Cardiac Output”) $Units = DT (l/min, UCUM, "l/min")
11 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8750-2, LN, "FICK Cardiac Index”) $Units = DT (l/min/m2, UCUM, "l/min/m2")
12 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122229, DCM, "Arteriovenous difference”) $Units = DT (ml/dl, UCUM, "ml/dl")
13 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = BCID (3620) Hemodynamic Ratios $Units = DT (1, UCUM, "ratio")
14 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122237, DCM, "Corrected Sinus Node Recovery Time”) $Units = DT (ms, UCUM, "ms")
15 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8861-7, LN, "Left Ventricular Stroke Work”) $Units = DT (gf.m, UCUM, "gf.m")
16 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8862-5, LN, "Right Ventricular Stroke Work”) $Units = DT (gf.m, UCUM, "gf.m")
17 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8863-3, LN, "Left Ventricular Stroke Work Index”) $Units = DT (gf.m/m2, UCUM, "gf.m/m2")
18 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (8864-1, LN, "Right Ventricular Stroke Work Index”) $Units = DT (gf.m/m2, UCUM, "gf.m/m2")
19 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122238, DCM, "Max volume normalized to 50mmHg pulse pressure”) $Units = DT (ml, UCUM, "ml")
20 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122239, DCM, "Oxygen Consumption”) $Units = DT (ml/min, UCUM, "ml/min") $Equation = BCID (3664) Oxygen Consumption Equations and Tables
21 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (19217-9, LN, "Oxygen partial pressure at 50% saturation (P50)") $Units = DCID (3500) $Equation = BCID (3666) P50 Equations
22 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (11556-8, LN, "Blood Oxygen partial pressure”) $Units = DCID (3500)
23 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3618) Hemodynamic Flows $ModType = EV (121425, DCM, “Index”) $ModValue = EV (8277-6, LN, “Body Surface Area”) $Units = DT (l/min/m2, UCUM, "l/min/m2")
24 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3619) Hemodynamic Resistance Measurements $Units = BCID (3502) Hemodynamic Resistance Units
25 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3619) Hemodynamic Resistance Measurements $ModType = EV (121425, DCM, “Index”) $ModValue = EV (8277-6, LN, “Body Surface Area”) $Units = BCID (3503) Indexed Hemodynamic Resistance Units
26 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122227, DCM, "Left to Right Flow”) $Units = DT (l/min, UCUM, "l/min")
27 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (122228, DCM, "Right to Left Flow”) $Units = DT (l/min, UCUM, "l/min")
28 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-32120, SRT, "Stroke Volume”) $Units = DT (ml, UCUM, "ml")
29 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-32120, SRT, "Stroke Volume”) $ModType = EV (121425, DCM, “Index”) $ModValue = EV (8277-6, LN, “Body Surface Area”) $Units = DT (ml,/m2 UCUM, "ml/m2")
30 > CONTAINS INCLUDE TID (300) Measurement 1 U $Measurement = EV (F-042BA, SRT, "Total blood volume”) $Units = DT (l, UCUM, "l")
31 > CONTAINS INCLUDE TID (300) Measurement 1-n U $Measurement = DCID (3667) Framingham Scores $Units = DT (%, UCUM, "%") $Equation = DCID (3668) Framingham Tables

TID 3570 Summary, Hemodynamics

This Template allows the recording of any significant numeric measurements or findings.

TID 3570Summary, HemodynamicsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121111, DCM, "Summary") 1 M
2 > CONTAINS TEXT EV (121111, DCM, "Summary") 1 U
3 > CONTAINS INCLUDE DTID (300) Measurement 1-n U
4 > CONTAINS CODE EV (121071, DCM, "Finding") 1-n U DCID (3640) Hypertension
5 >> INCLUDE DTID (1350) “Negation Modifier, Presence of Finding” 1 U
6 >> HAS PROPERTIES CODE EV (G-C197, SRT, "Severity") 1 U DCID (3716) Severity
7 > CONTAINS CODE DCID (3641) Hemodynamic Assessments 1-n U DCID (3642) Degree Findings
8 >> HAS PROPERTIES CODE EV (G-C0B2, SRT, “Condition”) 1 U EV (R-102B9, SRT, “Large v-wave”)
9 > CONTAINS CODE EV (121071, DCM, “Finding”) 1 U EV (R-102BA, SRT, “Diastolic pressure equalization”)

TID 3601 Procedure Context

The Procedure Context template describes acquisition context for measurements made or events recorded in a procedure.

TID 3601 Procedure ContextType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 HAS ACQ CONTEXT TEXT EV (121065, DCM, "Procedure Description") 1 U Defaults to Study Description (0008,1030) of the General Study Module
2 HAS ACQ CONTEXT CODE EV (G-C0E8, SRT, “Has Intent”) 1 U BCID (3629) Procedure Intent
3 HAS ACQ CONTEXT CODE EV (G-C09C, SRT, “Procedure Priority”) 1 U BCID (3414) Procedure Urgency
4 HAS OBS CONTEXT CODE EV (121023, DCM, ”Procedure Code”) 1-n U Defaults to Procedure Code Sequence (0008,1032) of General Study Module

TID 3602 Cardiovascular Patient Characteristics

This template describes the characteristics of the patient that are specific to the current clinical presentation (visit). 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 3602Cardiovascular Patient CharacteristicsType: Extensible Order: Significant

NL
Row 16 Breast size for interpretation of attenuation in nuclear medicine imaging

TID 3603 Procedure Environmental Characteristics

TID 3603Procedure Environmental CharacteristicsType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINER EV (122222, DCM, “Procedure Environmental Characteristics”) 1 M
2 > CONTAINS NUM EV (122223, DCM, “Room oxygen concentration”) 1 U UNITS = EV (%, UCUM, “%”)
3 > CONTAINS NUM EV (122224, DCM, “Room temperature”) 1 U UNITS = EV (Cel, UCUM, “ºC”)
4 > CONTAINS NUM EV (122225, DCM, “Room Barometric pressure”) 1 U UNITS = DT (mbar, UCUM, “millibar”)
ECG REPORT TEMPLATES

TID 3700 ECG Report

The ECG Report template is the root structure for the representation of analysis of an ECG waveform, potentially in comparison to a prior ECG waveform analysis. The analyzed waveform may or may not be stored as a DICOM SOP Instance.

TID 3700 ECG ReportType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 TEXT EV (122149, DCM, "Beat Number") 1 U Up to three numeric characters
2 CODE EV (G-C036, SRT, "Measurement Method") 1 U DCID (3676) Lead Measurement Technique
3 TCOORD EV (121112, DCM, "Source of measurement”) 1 U
4 > SELECTED FROM WAVEFORM 1 U

Content Item Descriptions

Row 1 Beat Number is specified as a numeric text string, and shall be treated as the ordinal of the beat (cardiac cycle) within the waveform acquisition for this lead that was analyzed for the measurements in this container (i.e., “1” for the first beat, “2” for the second, etc.). If absent, the measurements may have been made by a technique across multiple cycles as specified in Row 2 Measurement Method.

Rows 3 and 4 Source of measurement identify the specific channel and time period within a DICOM ECG Waveform SOP Instance that was analyzed for the measurements in this container.

TID 3717 ECG Qualitative Analysis

The ECG Qualitative Analysis template allows a free text qualitative interpretation of the analyzed ECG, as well as a structure for a coded analysis.

TID 3717 Qualitative Analysis, ECG Type: Extensible Order: Significant

NL
Row 5-6 Each primary ECG Finding of Row 3 may have multiple supporting coded findings in Row 5, with longer human-readable text strings if necessary in Row 6.

TID 3718 ECG Interpretive Statement (Retired)

This Template is retired. See PS3.16-2009.

TID 3719 Summary, ECG

TID 3719Summary, ECGType: Extensible Order: Significant

NL Relation with Parent Value Type Concept Name VM Req Type Condition Value Set Constraint
1 CONTAINS CONTAINER EV (121111, DCM, "Summary") 1 M
2 > CONTAINS TEXT EV (121111, DCM, "Summary") 1 U
3 > CONTAINS CODE DT(18810-2, LN, “ECG overall finding”) 1 U DCID (3677) Summary Codes ECG