When reading a trauma case for a pediatric head injury, Neuro staff recommends viewing and/or saving volume rendered images of the skull in order to not miss subtle skull fractures.
Typically, it’s not required to save the images to the patient’s study, but staff will occasionally instruct you to do so (particularly overnight on 1st call).
1. Find the best series for volume reconstruction. Typically, this is the thin bones or simply the bone reconstruction series.
2. Right Click on the image and select ‘Volume Rendering’.
3. Make sure iSite VR is clicked in top left corner
4. This is an optional step, but I suggest clicking these two menu buttons each time so that your toolbar and menu bar are always visible. (see below)
5. To subtract unwanted elements, click ‘Visualization’ on the top menu bar and then click ‘Make a segmentation’
There are multiple ways to subtract unwanted elements, but the easiest is to click the ‘Remove’ button and then click any element you want removed.
If you accidentally subtracted an element you need, press the ‘Undo’ button in the bottom left corner.
At this point, you should be able to rotate the skull freely by dragging the image with your mouse. For most studies, you can stop here.
To bring the skull back to default position, press Ctrl+Shift+G
1. Once you have your volume rendering and are happy with how it looks, you can save it to the chart by clicking the ‘Make a Movie’ button (under the Volume Segmentation section, as seen above)
2. We typically save 2 movies to the chart – one around the vertical axis, and one around the horizontal access. For the vertical axis, be sure to select the “Spin” preset and for the horizontal axis, be sure to select the ”Roll” preset.
3. Click ‘Save Movie’ to finish. It may take a moment, but the images should then be saved to the patient’s study for anyone to view. Once this is done for the Vertical and Horizontal axes, you should be finished!
4. If you need to delete the images, right click the series you created and select ‘Hide All Images’. Under reason, you can put “QC/Test Images”.