DICOM PS3.16 2021d - Content Mapping Resource

TID 5302 Post-coordinated Echo Measurement (Current)
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### TID 5302 Post-coordinated Echo Measurement

This template codes numeric echo measurements where most of the details about the nature of the measurement have been post-coordinated in modifiers and acquisition context. In contrast, see TID 5301 “Pre-coordinated Echo Measurement” .

This template is intended to be used for User-defined and Vendor-defined Echo Measurements.

Several modifier rows are conditional and are omitted when the modifier concept is not significant for the measurement encoded in the item. When these modifiers are included by the sender, it indicates that the modifier concept is significant and receivers will generally treat the measurements differently than similar measurements sent that omit that modifier.

### Note

The codes in the CIDs referenced below were sufficient to accurately encode all the best practice echo measurements recommended by the ASE. If, however, a new code is needed to record a specific User-defined or Vendor-defined measurement, most of the CIDs are extensible. It is not unreasonable to expect that measurements might be made at other Finding Sites than those listed in CID 12305 “Basic Echo Anatomic Sites” , or using Measurement Methods beyond those listed in CID 12227 “Echocardiography Measurement Method” .

The concept modifiers in the template below were sufficient to accurately encode all the best practice echo measurements recommended by the ASE. Although TID 5302 “Post-coordinated Echo Measurement” is extensible and adding new modifiers is not prohibited, the meaning and significance of such new modifiers will generally not be understood by receiving systems, delaying or preventing import of such measurements. Further, adding modifiers that replicate the meaning of an existing modifier is prohibited.

If such measurements cannot be encoded with the following structure, an implementation may choose to code the measurement in TID 5303 “Adhoc Measurement” , or to use TID 5200 “Echocardiography Procedure Report” instead of TID 5300 “Simplified Echo Procedure Report” .

Table TID 5302. Parameters

Parameter Name | Parameter Usage
--- | ---
$Measurement | Coded term or Context Group for Concept Name of measurement
$Preferred | Flag the preferred value by indicating the reason it was selected as preferred.

Type:

  Extensible

Order:

  Significant

Root:

  No

Table TID 5302. Post-coordinated Echo Measurement

| NL | Rel with Parent | VT | Concept Name | VM | Req Type | Condition | Value Set Constraint
--- | --- | --- | --- | --- | --- | --- | --- | ---
1 |  |  | NUM | $Measurement | 1 | M |  |
2 | > | HAS PROPERTIES | CODE | EV (121050, DCM, "Equivalent Meaning of Concept Name") | 1-n | U |  |
3 | > | HAS PROPERTIES | CODE | EV (121404, DCM, "Selection Status") | 1 | MC | IFF this measurement has been selected as the single preferred value for the measured concept. | $Preferred =MemberOf {DCID 12301 “Measurement Selection Reasons”}
4 | > | HAS CONCEPT MOD | CODE | EV (121401, DCM, "Derivation") | 1 | MC | IFF this measurement is not a sample. | EV (373098007, SCT, "Mean"))
5 | > |  | INCLUDE | DTID 320 “Image or Spatial Coordinates” | 1-n | U |  | $Purpose =EV (121112, DCM, "Source of measurement")
6 | > |  | INCLUDE | DTID 321 “Waveform or Temporal Coordinates” | 1-n | U |  | $Purpose = EV (121112, DCM, "Source of measurement")
7 | > | HAS CONCEPT MOD | CODE | EV (125306, DCM, "Measurement Type") | 1 | M |  | DCID 12303 “Echo Measurement Types”
8 | > | HAS CONCEPT MOD | CODE | EV (363698007, SCT, "Finding Site") | 1 | M |  | DCID 12305 “Basic Echo Anatomic Sites”
9 | > | HAS CONCEPT MOD | CODE | EV (125305, DCM, "Finding Observation Type") | 1 | M |  | DCID 12302 “Echo Finding Observation Types”
10 | > | HAS CONCEPT MOD | CODE | EV (125307, DCM, "Measured Property") | 1 | M |  | DCID 12304 “Echo Measured Properties”
11 | > | HAS CONCEPT MOD | CODE | EV (260674002, SCT, "Flow Direction") | 1 | MC | IFF Row 9 is (44324008, SCT, "Hemodynamic Measurements") and the Flow Direction is significant for this measurement. | DCID 12306 “Echo Flow Directions”
12 | > | HAS CONCEPT MOD | CODE | EV (370129005, SCT, "Measurement Method") | 1 | MC | IFF the Measurement Method is significant for this measurement. | DCID 12227 “Echocardiography Measurement Method”
13 | > | HAS ACQ CONTEXT | CODE | EV (399264008, SCT, "Image Mode") | 1 | MC | IFF the Image Mode is significant for this measurement. | DCID 12224 “Ultrasound Image Modes”
14 | > | HAS ACQ CONTEXT | CODE | EV (111031, DCM, "Image View") | 1 | MC | IFF the Image View is significant for this measurement. | DCID 12226 “Echocardiography Image View”
15 | > | HAS CONCEPT MOD | CODE | EV (272518008, SCT, "Cardiac Cycle Point") | 1 | MC | IFF the Cardiac Cycle Point is significant for this measurement. | DCID 12307 “Cardiac Phases and Time Points”
16 | > | HAS CONCEPT MOD | CODE | EV (272517003, SCT, "Respiratory Cycle Point") | 1 | MC | IFF the Respiratory Cycle Point is significant for this measurement. | DCID 12234 “Respiration State”
17 | > | HAS CONCEPT MOD | CODE | EV (125308, DCM, "Measurement Divisor") | 1 | MC | IFF the value of Row 7 is (125313, DCM, "Indexed") or (118586006, SCT, "Ratio") or (125314, DCM, "Fractional Change") |
18 | > | HAS PROPERTIES | TEXT | EV (125309, DCM, "Short Label") | 1 | U |  |

Content Item Descriptions

Row 1 | A fully pre-coordinated code that incorporates all the semantics of Rows 7-17 for this measurement. The code is intended to allow parsers to recognize post-coordinated measurements that have been previously encountered, thus facilitating incorporation of the measurement into databases, report templates, registries, etc. Typically these codes will be from a vendor or site specific coding scheme, e.g., 99ACME. Sending the same code consistently in different reports will depend on the recording system maintaining a stable list of these pre-coordinated codes. Such a list might be configured or internally generated and managed. This shall be populated by the recording system. If the recording system does not have a method to ensure that all occurrences of the same post-coordinated measurement use the same code, it shall use the code (125304, DCM, "Untrackable Measurement"). ### Note Two measurements with the same pre-coordinated code have, by definition, the same semantics (except for "Untrackable Measurements") Two measurements with the same constellation of modifier values have the same semantics but may have different pre-coordinated codes because they come from carts of different vendors who don't share the same code table come from carts of the same vendor, but the carts don't share the same code table come from the same cart, but it's code table has been modified come from the same cart, but it does not maintain a code table Two measurements with the same constellation of modifier values and different pre-coordinated codes have the same semantics and the receiver is entitled to treat them as the same (with respect to the scope of those modifiers) Recommended units for various Measured Properties (Row 10) can be found in the Units column of CID 12304 “Echo Measured Properties” . When the Measurement Type (Row 7) is (125313, DCM, "Indexed") , (118586006, SCT, "Ratio") or (125314, DCM, "Fractional Change") , the Units for Row 1 corresponds to the fully calculated $Measurement, incorporating both the numerator (Row 10) and the denominator (Row 17). E.g. a measure of Left Ventricular Outflow Tract Diameter / BSA would have units of (cm/m2, UCUM, "cm/m2") in Row 1, (125313, DCM, "Indexed") in Row 7, (81827009, SCT, "Diameter") in Row 10, and (8277-6, LN, "Body Surface Area") in Row 17.
Row 2 | One or more additional fully pre-coordinated codes which are semantically equivalent to the code in Row 1. This may be used to communicate known mappings, such as to national registry codes or other vendors' codes.
Row 3 | The reason that this value was selected as the preferred value for the measured concept. The parent template may allow TID 5301 “Pre-coordinated Echo Measurement” to be included multiple times with the same Measurement Concept Name, for example to allow multiple samples of the measurement. A given Measurement Concept Name might appear only once in the instance, in which case this this row may or may not be present. A given Measurement Concept Name may appear multiple times, however this row shall not be present for more than one value of a given measured concept. E.g. multiple measurements of (11706-9, LN, "Aortic Valve Peak Systolic Flow") may be present, but only one may be selected as preferred.
Row 4 | The method used to derive this measurement value from multiple samples of the Measurement Concept Name. If Row 3 is not present, then this measurement value is simply a single sample of the Measurement Concept Name. ### Note A measurement value that is a mean value of other samples and was also selected as the preferred value because it is the mean will have both Row 2 and Row 3 present. This row is not used to record whether the measurement value is a direct measurement vs a measurement calculated from an equation. Such information is recorded in Row 7.
Row 8 | The finding site reflects the anatomical location where the measurement is taken. CID 12305 “Basic Echo Anatomic Sites” contains the codes which proved to be sufficient for mapping the full set of ASE standard measurements. It is recommended to use these locations unless a more detailed location is truly necessary.
Row 9 | The finding observation type indicates the type of observation made at the finding site to produce the measurement. In many cases, for example Aortic Root Diameter, the structure of the finding site is being observed. In other cases, for example Mitral Valve Regurgitant Flow Peak Velocity, the finding site is the mitral valve, the hemodynamic flow (not the valve structure) is being observed, the measured property is the peak velocity, and the flow direction is retrograde.
Row 17 | The pre-coordinated code for the measurement that has been used as the denominator of this measurement. Only applies to measurements of type Indexed, Ratio or Fractional Change. The measurement referenced as the Measurement Divisor shall be present in the instance in which it is used. When Row 17 is present, any values in Rows 5-6, 8-16 shall reflect the numerator of the measurement rather than the Index, Ratio or Fractional Change as a whole. The rest of the rows, including the pre-coordinated measurement value, the pre-coordinated measurement code, the units and the short label, reflect the Index, Ratio or Fractional Change as a whole. E.g. in the case of an Indexed measurement, the value recorded in Row 1 has already been divided by the Index referenced in Row 17, and the Units in Row 1 match the indexed value, not the numerator Property described in Row 10. For a measurement of type Indexed, the numerator is divided by the Measurement Divisor. For a measurement of type Ratio, the numerator is divided by the Measurement Divisor and is unitless. For a measurement of type Fractional Change, the numerator is first subtracted from the Measurement Divisor and the result divided by the Measurement Divisor (i.e., (Divisor - Numerator) / Divisor ).
Row 18 | This may be used to label the measurement value when space is limited on the screen or report page. E.g. a Short Label of "LVIDD" might be provided for a measurement of the left ventricle internal diameter at end diastole. ### Note Short Labels are not standardized and may omit details of the measurement, thus it is not recommended to use them for purposes such as matching.

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DICOM PS3.16 2021d - Content Mapping Resource