C.8.5.6 US Image Module
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#### C.8.5.6 US Image Module

Table C.8-18 specifies the Attributes that describe ultrasound images.

Table C.8-18. US Image Module Attributes

Attribute Name | Tag | Type | Attribute Description
--- | --- | --- | ---
Samples Per Pixel | (0028,0002) | 1 | Number of samples (planes) in this image. See Section C.8.5.6.1.12 for specialization
Photometric Interpretation | (0028,0004) | 1 | Specifies the intended interpretation of the pixel data. See Section C.8.5.6.1.2 for specialization.
Bits Allocated | (0028,0100) | 1 | Number of bits allocated for each pixel sample. See Section C.8.5.6.1.13 for specialization.
Bits Stored | (0028,0101) | 1 | Number of bits stored for each pixel sample. See Section C.8.5.6.1.14 for specialization.
High Bit | (0028,0102) | 1 | Most significant bit for pixel sample data. See Section C.8.5.6.1.15 for specialization.
Planar Configuration | (0028,0006) | 1C | Indicates whether the pixel data are sent color-by-plane or color-by-pixel. Required if Samples per Pixel (0028,0002) has a value greater than 1. See Section C.8.5.6.1.16 for specialization.
Pixel Representation | (0028,0103) | 1 | Data representation of pixel samples. See Section C.8.5.6.1.3 for specialization.
Frame Increment Pointer | (0028,0009) | 1C | Contains the Data Element Tag of the attribute that is used as the frame increment in Multi-frame pixel data (see Section C.7.6.6). Required if Number of Frames is sent. See Section C.8.5.6.1.4 for specialization.
Image Type | (0008,0008) | 2 | Image identification characteristics. See Section C.8.5.6.1.1 for specialization.
Lossy Image Compression | (0028,2110) | 1C | Specifies whether an Image has undergone lossy compression (at a point in its lifetime). Enumerated Values: 00 Image has NOT been subjected to lossy compression. 01 Image has been subjected to lossy compression. Once this value has been set to 01 it shall not be reset. See Section C.7.6.1.1.5 Required if Lossy Compression has been performed on the Image. May be present otherwise.
Number of Stages | (0008,2124) | 2C | Number of Stages in this protocol. Required if image was acquired in a Staged protocol.
Number of Views in Stage | (0008,212A) | 2C | Number of views in this Stage. Required if image was acquired in a Staged protocol.
R Wave Time Vector | (0018,6060) | 3 | The time offset(s) of the reported R Wave peaks, each relative to the time of the start of the acquisition of the first frame in msec. Multi-valued, with one value per reported R Wave.
Ultrasound Color Data Present | (0028,0014) | 3 | This element indicates if any ultrasound color data is present in an image. Enumerated Values: 00 Ultrasound color data not present in image 01 Ultrasound color data is present in image. See Section C.8.5.6.1.10
Stage Name | (0008,2120) | 3 | A Stage is a particular time slice of a protocol in which a set of images are collected. The names can be free form text. Recommended text for Stress Echo stage names: PRE-EXERCISE POST-EXERCISE PEAK-EXERCISE RECOVERY BASELINE LOW DOSE PEAK DOSE
Stage Code Sequence | (0040,000A) | 3 | Sequence of items describing the performed Ultrasound Protocol Stage(s). One or more Items are permitted in this Sequence.
>Include Table 8.8-1 “Code Sequence Macro Attributes” | Baseline CID 12002 “Ultrasound Protocol Stage Types”.
Stage Number | (0008,2122) | 3 | A number that identifies the Stage. Stage Number starts at one.
View Name | (0008,2127) | 3 | A View is a particular combination of the position and orientation when a set of images are acquired. Images are acquired at the same View in different Stages for the purpose of comparison.
View Number | (0008,2128) | 3 | A number that identifies the View. View Number starts at one.
Number of Event Timers | (0008,2129) | 3 | The number of event timers used at the time of acquisition of a Multi-frame image.
Event Elapsed Time(s) | (0008,2130) | 3 | An array of values associated with each event timer. Units in milliseconds.
Event Timer Name(s) | (0008,2132) | 3 | Name that identifies the event timer.
Include Table 10-7 “General Anatomy Optional Macro Attributes” | For intravascular ultrasound, Defined CID 3010 “Cardiovascular Anatomic Locations” and Defined CID 3015 “Coronary Arteries” are specified for the Anatomic Region Sequence and Defined CID 3019 “Cardiovascular Anatomic Location Modifiers” is specified for the Anatomic Region Modifier Sequence. No other Context IDs are specified.
Include Table 10-25 “Optional View and Slice Progression Direction Attributes” | See Section C.8.5.6.1.19 for Context Group IDs.
Acquisition DateTime | (0008,002A) | 1C | The date and time that the acquisition of data that resulted in this image started. Required if Modality (0008,0060) = IVUS May be present otherwise. ### Note The synchronization of this time with an external clock is specified in the Synchronization Module in Acquisition Time Synchronized (0018,1800).
Trigger Time | (0018,1060) | 3 | Time interval measured in msec from the start of the R-wave to the beginning of data taking
Nominal Interval | (0018,1062) | 3 | Average R-R interval used for these data, in msec
Beat Rejection Flag | (0018,1080) | 3 | Beat length sorting has been applied. Enumerated Values: Y yes N no
Low R-R Value | (0018,1081) | 3 | R-R interval low limit for beat rejection, in msec
High R-R Value | (0018,1082) | 3 | R-R interval high limit for beat rejection, in msec
Heart Rate | (0018,1088) | 3 | Beats per minute.
IVUS Acquisition | (0018,3100) | 1C | Defined Terms: MOTOR_PULLBACK MANUAL_PULLBACK SELECTIVE GATED_PULLBACK See Section C.8.5.6.1.21 Required if Modality (0008,0060) = IVUS
IVUS Pullback Rate | (0018,3101) | 1C | Required if IVUS Acquisition (0018,3100) value is MOTOR_PULLBACK. Specified in units of mm/sec. See Section C.8.5.6.1.22
IVUS Gated Rate | (0018,3102) | 1C | Required if IVUS Acquisition (0018,3100) value is GATED_PULLBACK. Specified in units of mm/beat. See Section C.8.5.6.1.23
IVUS Pullback Start Frame Number | (0018,3103) | 1C | Required if IVUS Acquisition (0018,3100) value is MOTOR_PULLBACK or GATED_PULLBACK. See Section C.8.5.6.1.24
IVUS Pullback Stop Frame Number | (0018,3104) | 1C | Required if IVUS Acquisition (0018,3100) value is MOTOR_PULLBACK or GATED_PULLBACK. See Section C.8.5.6.1.25
Lesion Number | (0018,3105) | 3 | Identifier(s) of the lesion(s) of interest imaged within the current SOP Instance. Each lesion shall have a unique numeric integer identifier within the study. See Section C.8.5.6.1.26.
Output Power | (0018,5000) | 3 | Manufacturer defined character string description of ultrasound output level(s) used in generating a given image. Data may be expressed in dB, %, W/cm2, etc.
Transducer Data | (0018,5010) | 3 | Manufacturer defined code or description of ultrasound transducer used.
Transducer Type | (0018,6031) | 3 | Defined Terms: SECTOR_PHASED SECTOR_MECH SECTOR_ANNULAR LINEAR CURVED LINEAR SINGLE CRYSTAL SPLIT XTAL CWD IV_PHASED IV_ROT XTAL IV_ROT MIRROR ENDOCAV_PA ENDOCAV_MECH ENDOCAV_CLA ENDOCAV_AA ENDOCAV_LINEAR VECTOR_PHASED
Focus Depth | (0018,5012) | 3 | The depth, from the transducer face, of the manufacturer defined beam focus used for the image, in cm.
Processing Function | (0018,5020) | 3 | Manufacturer defined description of processing of echo information. Data may include code or description of gain (initial, overall, TGC, dynamic range, etc.), preprocessing, postprocessing, Doppler processing parameters, e.g., cutoff filters, etc., as used in generating a given image.
Mechanical Index | (0018,5022) | 3 | See Section C.8.5.6.1.8 for Description.
Bone Thermal Index | (0018,5024) | 3 | See Section C.8.5.6.1.8 for Description.
Cranial Thermal Index | (0018,5026) | 3 | See Section C.8.5.6.1.8 for Description.
Soft Tissue Thermal Index | (0018,5027) | 3 | See Section C.8.5.6.1.8 for Description.
Soft Tissue-focus Thermal Index | (0018,5028) | 3 | See Section C.8.5.6.1.8 for Description.
Soft Tissue-surface Thermal Index | (0018,5029) | 3 | See Section C.8.5.6.1.8 for Description.
Depth of Scan Field | (0018,5050) | 3 | The depth, in mm, from the transducer face to the deepest point included in the displayed image- the field of view.
Overlay Subtype | (60xx,0045) | 3 | Defined Term that identifies the intended purpose of the ROI Overlay Type. See Section C.8.5.6.1.11 for specialization.

### Note

Referenced Overlay Sequence (0008,1130) and Referenced Curve Sequence (0008,1145) were previously included in this Module as optional Attributes but have been retired. See PS3.3-2004.

##### C.8.5.6.1 US Image Attribute Descriptions

###### C.8.5.6.1.1 Image Type

For US Images, Image Type (0008,0008) is specified to be Type 2.

Defined Terms for Value 3:

ABDOMINAL

BREAST

CHEST

ENDOCAVITARY

ENDORECTAL

ENDOVAGINAL

EPICARDIAL

FETAL HEART

GYNECOLOGY

INTRACARDIAC

INTRAOPERATIVE

INTRAVASCULAR

MUSCULOSKELETAL

NEONATAL HEAD

OBSTETRICAL

OPHTHALMIC

PEDIATRIC

PELVIC

RETROPERITONEAL

SCROTAL

SMALL PARTS

TEE

THYROID

TRANSCRANIAL

TTE

US BIOPSY

VASCULAR

Value 4 is constructed as a modality bit map to allow for a description of multi-modality displays. In using this bit map, the sum of the values of the various modalities will unambiguously determine the constituent modalities.

Bit Map Values for Value 4:

0001

  2D Imaging

0002

  M-Mode

0004

  CW Doppler

0008

  PW Doppler

0010

  Color Doppler

0020

  Color M-Mode

0040

  3D Rendering

0100

  Color Power Mode

0200

  Tissue Characterization

0400

  Spatially-related frames

### Note

1. All Values are hexadecimal encoded as a CS. See PS3.5.

2. For example, Color Flow with CW spectral Doppler would have a value 4 = 0015. Note that no assumption should be made in Color Doppler or Color M-Mode regarding underlying B or M-Mode, respectively.

3. See Section A.59.1 for the relationship between a 3D volume set and the 3D Rendering, 3D MPR View, and Spatially-related frames image types. In the case of "3D Rendering", Derivation Code Sequence (0008,9215) should be used to describe the specific type of 3D rendering (volume rendering, surface rendering, multiplanar reformatting, etc.).

###### C.8.5.6.1.2 Photometric Interpretation

Defined Terms:

MONOCHROME2

PALETTE COLOR

RGB

ARGB

  (retired)

YBR_FULL

YBR_FULL_422

YBR_PARTIAL_422

YBR_RCT

YBR_ICT

YBR_PARTIAL_420

### Note

It is recommended that future implementations should not use ARGB photometric interpretation.

See PS3.5 for restrictions imposed by compressed Transfer Syntaxes.

###### C.8.5.6.1.3 Pixel Representation

For US Images, Pixel Representation (0028,0103) is specified to use the following.

Enumerated Values:

0000H

  unsigned integer

###### C.8.5.6.1.4 Frame Increment Pointer

For US Multi-frame images, the Attribute Frame Increment Pointer (0028,0009) of the Multi-frame Module (see Section C.7.6.6) is specified by the following.

Defined Terms:

00181063

  sequencing by Frame Time (0018,1063)

00181065

  sequencing by Frame Time Vector (0018,1065)

###### C.8.5.6.1.5 (Retired)

###### C.8.5.6.1.6 (Retired)

###### C.8.5.6.1.7 (Retired)

###### C.8.5.6.1.8 Mechanical Index, Bone Thermal Index, Cranial Thermal Index, Soft Tissue Thermal Index

The thermal and/or mechanical indices, when made available by a manufacturer, are defined according to the Standard for Real-Time Display of Thermal and Mechanical Acoustic Output Indices on Diagnostic Ultrasound Equipment, a voluntary performance standard jointly published by AIUM and NEMA.

###### C.8.5.6.1.9 Image Transformation Matrix and Image Translation Vector

This section was defined in a previous version of the DICOM Standard. The Section is now retired. See PS3.3-2003.

###### C.8.5.6.1.10 Ultrasound Color Data Present

### Note

This data element can be used to indicate if an image contains any Ultrasound color data.

For example: Some Ultrasound images may have a Photometric Interpretation equal to RGB but the image will have no color information if R=G=B for all pixels.

For consistency within a particular implementation Monochrome Ultrasound images may be coded using a color photometric interpretation. In that case inclusion of this data element can significantly speed up processing. Since all components are known to be equal only one need be handled. The enhancements can be significant when compressed Transfer Syntaxes are used.

###### C.8.5.6.1.11 Overlay Subtype

Defined Terms:

ACTIVE 2D/BMODE IMAGE AREA

  identification of the active area of a 2D/B-mode image

###### C.8.5.6.1.12 Samples Per Pixel

For US Images, Samples Per Pixel (0028,0002) is specified to use the following values for specific Photometric Interpretations:

Table C.8-19. US Samples Per Pixel

Photometric Interpretation | Samples Per Pixel Value
--- | ---
MONOCHROME2 | 1
RGB | 3
YBR_FULL | 3
YBR_FULL_422 | 3
YBR_PARTIAL_422 | 3
YBR_RCT | 3
YBR_ICT | 3
YBR_PARTIAL_420 | 3
PALETTE COLOR | 1

###### C.8.5.6.1.13 Bits Allocated

For US Images, Bits Allocated (0028,0100) is specified to use the following values for specific Photometric Interpretations:

Table C.8-20. US Bits Allocated

Photometric Interpretation | Bits Allocated Value
--- | ---
MONOCHROME2 | 8
RGB | 8
YBR_FULL | 8
YBR_FULL_422 | 8
YBR_PARTIAL_422 | 8
YBR_RCT | 8
YBR_ICT | 8
YBR_PARTIAL_420 | 8
PALETTE COLOR | 8 - 8 bit palette, or 16 - 16 bit palette

###### C.8.5.6.1.14 Bits Stored

For US Images, Bits Stored (0028,0101) shall be equal to Bits Allocated (0028,0100).

###### C.8.5.6.1.15 High Bit

For US Images, High Bit (0028,0102) shall be one less than Bits Stored (0028,0101).

###### C.8.5.6.1.16 Planar Configuration

For US Images, Planar Configuration (0028,0006) is specified to use the following values for specific Photometric Interpretations:

Table C.8-23. US Planar Configuration

Photometric Interpretation | Planar Configuration Value
--- | ---
RGB | 0 - color-by-pixel, or 1 - color-by-plane
YBR_FULL | 1
YBR_FULL_422 | 0
YBR_PARTIAL_422 | 0
YBR_RCT | 0
YBR_ICT | 0
YBR_PARTIAL_420 | 0

###### C.8.5.6.1.19 View Code Sequence

The view of the patient anatomy may be described using coded terminology in the View Code Sequence (0054,0220). The view is typically specified by transducer position relative to the patient anatomy and/or transducer orientation,

The view may be described by a single Code Sequence Item, or by combination of post-coordinated Code Sequence Items. The principal coded item is specified in View Code Sequence, and modifier terms in the View Modifier Code Sequence (0054,0222). The Baseline CIDs for post-coordinated encoding of view are:

- CID 4 “Anatomic Region” (typically used for the primary coded item)

- CID 5 “Transducer Approach”

- CID 6 “Transducer Orientation”

- CID 7 “Ultrasound Beam Path”

Any of these Context Groups may be used in either the View Code Sequence or the View Modifier Code Sequence.

For cardiac imaging, a Baseline CID with pre-coordinated view codes is specified:

- CID 12226 “Echocardiography Image View”

### Note

Transducer Position Sequence (0008,2240) and Transducer Orientation Sequence (0008,2244), defined in this module in an earlier edition of the Standard (see PS3.3-2004), are retired.

###### C.8.5.6.1.20 (Retired)

###### C.8.5.6.1.21 IVUS Acquisition

Defined Terms:

MOTOR_PULLBACK

  The IVUS imaging catheter is positioned in the blood vessel under examination distal to the anatomical structures to be examined. Then the catheter is attached to a motorized mechanism capable of withdrawing the catheter through the vessel at a constant velocity specified by the attribute IVUS Pullback Rate (0018,3101) from the defined IVUS Pullback Start Frame Number (0018,3103) (see Section C.8.5.6.1.24) to the IVUS Pullback Stop Frame Number (0018,3104) (see Section C.8.5.6.1.25).

MANUAL_PULLBACK

  The IVUS imaging catheter is positioned in the blood vessel under examination distal to the anatomical structures to be examined. Then the catheter is manually withdrawn through the vessel region of interest.

SELECTIVE

  The IVUS imaging catheter is positioned in the blood vessel under examination near the anatomical structures to be examined. Then the catheter is manually withdrawn or advanced through the vessel region of interest.

GATED_PULLBACK

  The IVUS imaging catheter is positioned in the blood vessel under examination distal to the anatomical structures to be examined. Then the catheter is attached to a motorized mechanism capable of withdrawing the catheter through the vessel at a rate specified by the attribute IVUS Gated Rate (0018,3102), once per heart cycle, from the defined IVUS Pullback Start Frame Number (0018,3103) (see Section C.8.5.6.1.24) to the IVUS Pullback Stop Frame Number (0018,3104) (see Section C.8.5.6.1.25).

###### C.8.5.6.1.22 IVUS Pullback Rate

The attribute IVUS Pullback Rate (0018,3101) is required when IVUS Acquisition (0018,3100) is MOTOR_PULLBACK and it specifies the velocity of withdrawal of the IVUS imaging catheter in millimeters per second.

###### C.8.5.6.1.23 IVUS Gated Rate

The attribute IVUS Gated Rate (0018,3102) is required when IVUS Acquisition (0018,3100) is GATED_PULLBACK and it specifies the velocity of withdrawal of the IVUS imaging catheter in millimeters per beat.

###### C.8.5.6.1.24 IVUS Pullback Start Frame Number

The IVUS Pullback Start Frame Number (0018,3103) specifies the frame number of a IVUS multi-frame acquisition upon which motorized or gated pullback begins.

###### C.8.5.6.1.25 IVUS Pullback Stop Frame Number

The IVUS Pullback Stop Frame Number (0018,3104) specifies the frame number of a IVUS multi-frame acquisition upon which motorized or gated pullback ends.

###### C.8.5.6.1.26 Lesion Number

Attribute Lesion Number identifies the lesion(s) of interest imaged within the current SOP Instance. Each lesion shall have a unique numeric integer identifier within the study. If during a study the same lesion is imaged more than once, the same Lesion Number should be used for both SOP Instances.

### Note

1. Lesion Number is not a DICOM UID.

2. An IVUS pullback may contain multiple values in Lesion Number.

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