DICOM PS3.17 2021e - Explanatory Information

SSSS Neurophysiology Waveforms

SSSS.1 Purpose of This Annex

This Annex describes the most common types, methods and use cases associated with the capture and usage of clinical neurophysiology waveforms.

SSSS.1.1 Electroencephalography

Electroencephalography(EEG) is a diagnostic technique recording the electrical activity of the brain. Usually the electrodes are placed on the scalp; special techniques use electrodes implanted extracranially as well, such as sphenoidal electrodes.

EEG is used to diagnose seizure disorders and epilepsy, to monitor EEG background activity in certain conditions such as encephalopathy, anesthesia and coma, and within polysomnography studies. In clinical practice, an EEG is typically recorded for 20-60 minutes. Long term monitoring (e.g., to monitor epilepsy) may last from one hours to several days. In both cases often video of the patient is recorded as well.

Within polysomnography recordings, the EEG is used to delineate wake and sleep stages and diagnosis of parasomnias and nocturnal epilepsy.

Electrical potentials are typically in the range of 1-500 µV.

SSSS.1.2 Electromyography

Electromyography (EMG) is a diagnostic technique recording the electrical activity of skeletal muscles. The electrical potential of the muscle cells changes on activation, due to a patient's movement or triggered by external stimulation. The data are used to detect neuromuscular abnormalities or to monitor muscular activity. In polysomnography, electromyography is used to measure muscle tension and movement.

Two different techniques are used.Surface EMG assesses muscle function by recording electrical potentials from muscle using macroelectrodes at the skin surface.Intramuscular EMG uses needle electrodes inserted through the skin into the muscle, often in combination with surface electrodes as reference.

Within Polysomnography only surface EMG is used.

Measured values are typically in the range of 50 µV - 30mV.

SSSS.1.3 Electrooculography

Electrooculography (EOG) is a diagnostic technique to record eye movement using electrodes placed on the skin surface around the eye. EOG is used in polysomnography studies to help define the sleep stage (such as in rapid eye movement sleep) and in EEG to help differentiate eye movement artifact from frontal EEG patterns.

Typically two electrodes are used to measure the eye movement. They are placed above or below the outer canthus of the eyes.

Measured values and sampling rates are approximately in the same range as EEG.

SSSS.1.4 Body Position

Continuous monitoring of the patient's position synchronously to the recording of neurophysiology data is an essential requirement especially in polysomnography.

Besides using synchronized video, body position can be monitored with various body position monitoring devices. Different techniques are used, e.g. simple mercury switches or acceleration sensors providing six data channels with angles and acceleration relatively to gravity.

Two types of data collection are common in polysomnography.

The first uses a single channel and records five discrete, defined values indicating the patient position: prone, lateral decubitus left, supine, lateral decubitus right, and upright.

The second used two channels to record two angles. The first channel records the patient's angle of rotation around the longitudinal axis (head-feet axis). An angle of zero indicates supine, and angle of 90° indicates left lateral decubitus, and angle of 180° indicates prone, and an angle of 270° indicates right lateral decubitus. The second channel records the angle of elevation of the patient against horizontal, which could change if the patient sits up in bed, if the head of the bed is elevated, or if the patient stands up. An angle of zero indicates the patient is lying flat, an angle of 90° indicates upright, and an angle of -90° indicates complete reverse Trendelenburg position with the head down and the legs pointed straight up.

Body Position Waveform Angle of Rotation Axes

Figure SSSS.1.4-1. Body Position Waveform Angle of Rotation Axes


Position Value

Channel I

Channel 2

Supine

0

0

Lateral decubitus left

90

0

Prone

180

0

Lateral decubitus right

270

0

Upright

0

90

Feet up

0

-90

The sampling rate varies but is relatively slow (60 Hz or less).

SSSS.1.5 Polysomnography

In sleep medicine, polysomnography (PSG) , also called a "sleep study", is a test to diagnose sleep disorders.Physiological parameters are recorded during sleep in order to identify the sleep stages, measure brain functioning, monitor respiratory control, and monitor patient movement and body position.

A polysomnography study consists of several measured quantities, the most important ones are:

  • brain activity (EEG)

  • eye movements (EOG)

  • activity of skeletal muscles (EMG)

Additionally some of the following parameters are recorded:

  • electrical activity of the heart (ECG)

  • changes in blood oxygen levels (pulse oximetry)

  • respiratory parameters like nasal and oral airflow via pressure transducers in front of nostrils and mouth or chest and abdominal expansion during breathing (via belts)

  • sound recordings to measure snoring

  • body position

Data acquisition is done via a multichannel recording unit which samples sensors attached to different parts of the patient's body. Study duration is typically up to 8 hours. Channelselection varies somewhat between labs. Recommended channels for PSG are defined by the American Academy of Sleep Medicine (Reference: Berry RB, Albertario CL, Harding SM, et al.; for the American Academy of Sleep Medicine. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. Version 2.5. Darien, IL: American Academy of Sleep Medicine; 2018).

In many cases a video is taken to show the person's movements during sleep.

SSSS.1.5.1 Mapping of Polysomnographic Data to DICOM

Neurophysiology time series SOP Classes relevant to sleep studies are:

Sleep Electroencephalogram Waveform Storage

The Sleep Electroencephalogram (EEG) Waveform Storage SOP Class is the specification of digitized electrical signals from the patient's encephalon collected on the skull surface, which has been acquired by an EEG modality or by an EEG acquisition function within a polysomnography modality.

Electromyogram Waveform Storage

The Electromyography (EMG) Waveform Storage SOP Class is the specification of digitized electrical signals evoked by the patient's muscle movements collected on the skin, which has been acquired by an EMG modality or by an EMG acquisition function within a neurophysiology recording device or a polysomnography modality.

Electrooculogram Waveform Storage

The Electrooculogram (EOG) Waveform Storage SOP Class is the specification of digitized electrical signals evoked by the patient's eye movements collected on the face, which has been acquired by an EOG modality or by an EOG acquisition function within a neurophysiology recording device or a polysomnography modality.

Non-neurophysiologic time series or video SOP Classes relevant to sleep studies, are:

General ECG Waveform Storage

The General Electrocardiogram (ECG) Storage SOP Class is used to store digitized electrical signals from the patient cardiac conduction system collected on the body surface, which has been acquired by an ECG modality or by an ECG acquisition function within an imaging modality or a recording device.

Basic Voice Audio Waveform Storage

The Basic Voice Audio Storage SOP Class is used to store digitized sound that has been acquired or created by an audio modality or by an audio acquisition function within an imaging modality or a recording device. A typical use is report dictation. In the context of Polysomnography this object could be used for snoring detection

Arterial Pulse Waveform Storage

The Arterial Pulse Waveform Storage SOP Class is used to store digitized electrical signals from the patient arterial system collected through pulse oximetry or other means by a Pulse modality or by a Pulse acquisition function within an imaging modality or a recording device. In the context of polysomnography this object could be used to record the oxygen saturation in blood.

Respiratory Waveform Storage and Multi-channel Respiratory Waveform Storage

The Respiratory Waveform Storage SOP Classes are used to store digitized electrical signals from the respiratory system, acquired by a Respiratory modality or by a Respiratory acquisition function within an imaging modality or a recording device. In the context of polysomnography this object could be used to record the patient's respiration.

Body Position Waveform Storage

The Body Position Waveform Storage SOP Class is the specification of digitized electrical signals, which have been acquired by adevice or sensor on the patient's body. Depending on the measurement method either the acquired sensor data or values derived from it are recorded.

Video Photographic Image Storage

Video Photographic Image Storage Storage SOP Class is used to store visible light multiframe photographic images. This SOP Class is used to store the video data acquired during Video-EEG or in polysomnography.

SSSS.1.6 Considerations On Storing Large Data Recordings

In principle, continuous recordings are stored within a single DICOM object, i.e., as a single file, as long as the limits resulting from DICOM data restrictions are not exceeded.

The length of Waveform Data (0054,1010), in which all of the data for a single channel is encoded, is limited to 4 GB of data by the 32 Bit unsigned integer used to store the length in bytes of the data element

For example, using 24 channels within one multiplex group, a sampling frequency of 256 Hz, and 16 Bit samples would allow amaximum recording time of more than 3 days.

Enhanced neurophysiology techniques like High Density EEG using 512 channels and a sampling frequencyof 5 kHz would reach this limit in less than 15 minutes, if all channels were stored within one multiplex group.

The file system or database, in which the DICOM data is stored, may place additional constraints on the total size of the DICOM object.

When such limits are reached, the recording has to be split into several objects with appropriate offsets and times. Synchronization has to be provided across such multiple objects.

To keep the data objects easy to handle, long duration recordings could be split in time slices of e.g., single days.

In addition, it may be desirable to use smaller objects to address reliability and random access concerns.

Such objects consisting of one recording being split to multiple parts shall belong to the same series.

SSSS.1.7 Example DICOM Routine Scalp EEG Waveform Object

Setup: 24 leads: 1 ECG, 23 EEG

Table SSSS.1.7-1 is a non-comprehensive sample representation of a 23-lead Routine EEG object.

Table SSSS.1.7-1. Sample representation of a 23-lead Routine EEG object

Nesting

Attribute

Tag

VR

VL (hex)

Value

SOP Class UID

(0008,0016)

UI

001C

1.2.840.10008.5.1.4.1.1.9.7.1

SOP Instance UID

(0008,0018)

UI

0036

1.3.6.1.4.1.23154.1.4.2881783832.12156.1533548323.951

Study Date

(0008,0020)

DA

0008

20000101

Content Date

(0008,0023)

DA

0008

20180806

Acquisition Date Time

(0008,002a)

DT

0016

20000101000000.000000

Study Time

(0008,0030)

TM

000e

000000.000000

Content Time

(0008,0033)

TM

0006

113843

Accession Number

(0008,0050)

SH

0008

76123455

Modality

(0008,0060)

CS

0004

EEG

Manufacturer

(0008,0070)

LO

0014

someManufacturerName

Referring Physician's Name

(0008,0090)

PN

0000

Patient's Name

(0010,0010)

PN

000c

PATIENT1^edf

Patient ID

(0010,0020)

LO

000a

ssspid0815

Patient's Birth Date

(0010,0030)

DA

0008

19670329

Patient's Sex

(0010,0040)

CS

0002

F

Synchronization Trigger

(0018,106a)

CS

000a

NO TRIGGER

Acquisition Time Synchronized

(0018,1800)

CS

0002

Y

Study Instance UID

(0020,000d)

UI

0036

1.3.6.1.4.1.23154.1.2.2881783832.12156.1533548324.952

Series Instance UID

(0020,000e)

UI

0036

1.3.6.1.4.1.23154.1.3.2881783832.12156.1533548324.953

Study ID

(0020,0010)

SH

0004

4711

Series Number

(0020,0011)

IS

0002

1

Instance Number

(0020,0013)

IS

0002

1

Synchronization Frame of Reference UID

(0020,0200)

UI

0036

1.3.6.1.4.1.23154.1.5.2881783832.12156.1533548324.954

Acquisition Context Sequence

(0040,0555)

SQ

ffffffff

%item

Value Type

(0040,A040)

CS

0004

CODE

Observation Start DateTime

(0040,A033)

DT

0016

20200101001500.000000

Observation DateTime

(0040,A032)

DT

0016

20200101001529.000000

Concept Name Code Sequence

(0040,A043)

SQ

ffffffff

%item

Code Value

(0008,0101)

SH

0006

130491

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0010

Stimulation Mode

%enditem

%endseq

Concept Code Sequence

(0040,A168)

SQ

ffffffff

%item

Code Value

(0008,0101)

SH

0008

2:53539

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

000e

Flash Stimulus

%enditem

%endseq

Content Item Modifier Sequence

(0040,0441)

SQ

ffffffff

%item

Value Type

(0040,A040)

CS

0008

NUMERIC

Concept Name Code Sequence

(0040,A043)

SQ

ffffffff

%item

Code Value

(0008,0101)

SH

0006

130492

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0018

Stimulus Sample Position

%enditem

%endseq

Numeric Value

(0040,A30A)

DS

0006

230400

%enditem

%item

Value Type

(0040,A040)

CS

0008

NUMERIC

Concept Name Code Sequence

(0040,A043)

SQ

ffffffff

%item

Code Value

(0008,0101)

SH

0006

130494

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

001a

Number of Stimulus Events

%enditem

%endseq

Numeric Value

(0040,A30A)

DS

0002

30

%enditem

%item

Value Type

(0040,A040)

CS

0008

NUMERIC

Concept Name Code Sequence

(0040,A043)

SQ

ffffffff

%item

Code Value

(0008,0101)

SH

0006

130495

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

001c

Frequency of Stimulus Events

%enditem

%endseq

Numeric Value

(0040,A30A)

DS

0002

1

Measurement Units Code Sequence

(0040,08EA)

SQ

ffffffff

%item

Code Value

(0008,0101)

SH

0002

Hz

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

0002

Hz

%enditem

%endseq

%enditem

%endseq

%endseq

Acquisition Context Description

(0040,0556)

ST

007e

Photometric Stimulation, 30 stimuli, first at sample position 230400, this is 15 minutes after start, one stimulus per second.

%endseq

Waveform Sequence

(5400,0100)

SQ

ffffffff

%item

Waveform Originality

(003a,0004)

CS

0008

ORIGINAL

Number of Waveform Channels

(003a,0005)

US

0002

0x0017

Number of Waveform Samples

(003a,0010)

UL

0004

0x001c1700

Sampling Frequency

(003a,001a)

DS

0004

256

Multiplex Group Label

(003a,0020)

SH

0004

EEG

Channel Definition Sequence

(003a,0200)

SQ

ffffffff

%item

Waveform Channel Number

(003a,0202)

IS

0002

1

Channel Label

(003a,0203)

SH

0002

O1

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1209

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

O1

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

Channel Impedance Sequence

(003A,0312)

SQ

ffffffff

%item

Impedance Value

(003A,0313)

DS

0008

67

Impedance Timepoint

(003A,0314)

DT

0016

19991231235835.000000

%enditem

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

2

Channel Label

(003a,0203)

SH

0002

P3

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1185

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

P3

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

3

Channel Label

(003a,0203)

SH

0002

C3

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1137

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

C3

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

4

Channel Label

(003a,0203)

SH

0002

F3

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1057

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

F3

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

5

Channel Label

(003a,0203)

SH

0004

FP1

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1041

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

Fp1

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

6

Channel Label

(003a,0203)

SH

0002

P7

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1257

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

P7

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

7

Channel Label

(003a,0203)

SH

0002

T7

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1249

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

T7

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

8

Channel Label

(003a,0203)

SH

0002

F7

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1073

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

F7

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

9

Channel Label

(003a,0203)

SH

0002

O2

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1214

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

O2

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

10

Channel Label

(003a,0203)

SH

0002

P4

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1190

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

P4

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

11

Channel Label

(003a,0203)

SH

0002

C4

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1142

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

C4

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

12

Channel Label

(003a,0203)

SH

0002

F4

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1062

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

F4

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

13

Channel Label

(003a,0203)

SH

0004

FP2

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1042

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

Fp2

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

14

Channel Label

(003a,0203)

SH

0002

P8

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1262

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

P8

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

15

Channel Label

(003a,0203)

SH

0002

T8

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1254

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

T8

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

16

Channel Label

(003a,0203)

SH

0002

F8

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1078

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

F8

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

17

Channel Label

(003a,0203)

SH

0002

FZ

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1008

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

Fz

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

18

Channel Label

(003a,0203)

SH

0002

CZ

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1016

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

Cz

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

19

Channel Label

(003a,0203)

SH

0002

PZ

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1024

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0002

Pz

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

20

Channel Label

(003a,0203)

SH

0004

SP2

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1314

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

Sp2

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002

0x0010

%enditem

%item

Waveform Channel Number

(003a,0202)

IS

0002

21

Channel Label

(003a,0203)

SH

0004

SP1

Channel Source Sequence

(003a,0208)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

7:1313

Coding Scheme Designator

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

Sp1

%enditem

%endseq

Channel Source Modifier Sequence

(003a,0209)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0006

109006

Coding Scheme Designator

(0008,0102)

SH

0004

DCM

Code Meaning

(0008,0104)

LO

0014

Differential signal

%enditem

%item

Code Value

(0008,0100)

SH

0006

7:1020

Coding Scheme

(0008,0102)

SH

0004

MDC

Code Meaning

(0008,0104)

LO

0004

CPz

%enditem

%endseq

Channel Sensitivity

(003a,0210)

DS

0008

0.100008

Channel Sensitivity Units Sequence

(003a,0211)

SQ

ffffffff

%item

Code Value

(0008,0100)

SH

0002

uV

Coding Scheme Designator

(0008,0102)

SH

0004

UCUM

Code Meaning

(0008,0104)

LO

000a

uV

%enditem

%endseq

Channel Sensitivity Correction Factor

(003a,0212)

DS

0002

1

Channel Baseline

(003a,0213)

DS

000a

0.0500038

Channel Sample Skew

(003a,0215)

DS

0002

0

Channel Offset

(003a,0218)

DS

0002

0

Waveform Bits Stored

(003a,021a)

US

0002