6440 QIMT E R02 - Esaote

Rev. 03

July 2018

MyLab

ADVANCED OPERATIONS

QIMT SECTION

350025000

MyLab - A D V A N C E D O P E R A T I O N S ii

I N D E X

QIM

T

Table of Contents1 QIMT Option ............................................................................... 1-1

General Information .................................................................................. 1-1QIMT Patient Data .................................................................................... 1-2Probes........................................................................................................... 1-2QIMT Activation........................................................................................ 1-2Image Acquisition....................................................................................... 1-3Controls in QIMT ...................................................................................... 1-4

QIMT in Freeze....................................................................................... 1-4Screen Layout .............................................................................................. 1-5

2 QIMT Automatic Measurements................................................ 2-1Measurements.............................................................................................. 2-1QIMT Measurement Setup ....................................................................... 2-2

3 QIMT Worksheet Organization.................................................. 3-1QIMT Measurements Folders .................................................................. 3-1QIMT Graphics Folders............................................................................ 3-1

A QIMT Bibliographic References................................................ A-1

B QIMT Reference Tables ............................................................ B-1Howard Tables ............................................................................................B-1

Black Population......................................................................................B-1White Population.....................................................................................B-2

Howard Extended Tables..........................................................................B-3Black Population......................................................................................B-3White Population.....................................................................................B-4

MESA Tables ..............................................................................................B-5Black Population......................................................................................B-5White Population.....................................................................................B-7Chinese Population .................................................................................B-9Hispanic Population..............................................................................B-11

CAPS Tables..............................................................................................B-13Artery Tables .............................................................................................B-14

MyLab - A D V A N C E D O P E R A T I O N S iii

I N D E X

MyLab - A D V A N C E D O P E R A T I O N S iv

Chapter

1Q

IMT

1. QIMT OptionGeneral InformationThe QIMT calculation automatically measures the thickness between theintima and the media on the image in real time using the radio frequencyreception signal.

The QIMT option requires a specific licence1 to be installed on the MyLab.

NOTE The QIMT licence requires the Vascular licence.

WARNING The QIMT algorithm works fine on normal patients of all ages. Theautomatic detection and real time feedback help to get the best possiblemeasurements. However, there might be cases in which the algorithmcould be unable to track the intima or the media thickness. For instance, itcould be sometimes difficult to distinguish an enlarged IMT from an initialplaque. In all these situations, it is recommended to check the results of theautomatic tracking and to discard them, if they are not satisfactory.

The QIMT calculation gives a rapid estimate of the thickness between intimaand adventitia. It is recommended to compare the estimates obtained with adirect measurement of the structure under examination.

1. Not available in the U.S.A. market.

MyLab - A D V A N C E D O P E R A T I O N S 1 - 1

Q I M T O P T I O N

QIMT Patient DataRefer to next chapters for further information on reference tables.

When QIMT licence is active, the Patient ID page in Vascular applicationallows to select the QIMT reference tables. These tables allow to compare theacquired intima-media thickness values to normal values related to age,gender and ethnic in accordance to published studies.

Table 1-1: QIMT parameters se le c table in the Vascular Patient ID page

NOTE In order to use the QIMT reference tables, MyLab requires to calculate thepatient age from the birth date.

ProbesThe following probes can be used in QIMT:

• L 4-15, L3-11, SL1543, SL3323, SL3332.

QIMT ActivationThe automatic QIMT calculation can be activated from the vascularapplication when one of the proper probes is active.

Procedure 1. In the Start Exam page, enter the patient’s data using the birth date to calculate the patient age.

2. Select the probe and the vascular application.

3. Select the reference table and ethnicity.

4. Tap the desired preset or press START EXAM to activate real time.

5. Optimize the B-Mode image.

NOTE The image has to be optimized in fundamental (FUNDAMENT button)before activating QIMT. The optimization should be repeated if it isactivated in TEI (TEI mode is not available in QIMT).

Field

QIMT TABLE Whether MESA, Howard, Howard Extended, CAPS and Artery tables.

QIMT ETHNICITY Whether black or white for Howard tables. Whether black, white, chinese or hispanic for MESA tables.


Q I M T O P T I O N

QIM

T

6. Tap QIMT in the touchscreen tools section.

NOTE The QIMT calculation cannot be activated when one of the followingmodes is active: 3D/4D, CnTI or VPan.

While in QIMT, the system keys and controls are available (B-MODE tab).

NOTE Some controls (for instance multi focus or MView) are not available inQIMT: the corresponding buttons are displayed in gray.

Image AcquisitionThe QIMT measurements should be performed on the far wall in theCommon Carotid Artery, 10mm far from the origin of the bulb.

The reference line must be positioned on the bulb origin. The line middleindicator must be positioned at the centre of the vessel. The arterial wallsegments should be assessed in the longitudinal way, strictly perpendicular tothe ultrasound beam, with both walls clearly visualized.

Use the controls available to optimize the image within the ROI.

NOTE Adjust the controls so that the structure under examination is well defined.

Adjust the image in order to increase the density of the lines: high densitymeans high quality in measuring the intima-media thickness. When the linesare stable and optimal, it is recommended to minimize the standard deviation.


Q I M T O P T I O N

Controls in QIMTIn QIMT the B-MODE tab displays the touchscreen with available systemkeys and controls for the image optimization.

The QIMT tab of the touchscreen displays the following controls:

DEPTHZOOM

DEPTH and ZOOM share the same knob; tap it to toggle between the twocontrols, rotate it to increase/decrease the value of the selected control(represented in blue).

DEPTH increases or decreases the scanning depth.

ZOOM enlarges the 2D area; the enlargement factor can be modified.

• If necessary, tap the key to activate the ZOOM control: theimage will be contoured by a yellow frame.

• Rotate the knob to change the zoom factor.

• Use the trackball to pan the image.

Tap ZOOM again to activate the full B-Mode format.

EXIT QIMT exits QIMT calculation. Alternatively you can tap QIMT in the touchscreentools section.

FREQUENCY affects the imaging frequency (PEN for optimal penetration, RES for optimalresolution, GEN for the best balance between resolution and penetration).

REF LINE sets the distance between the vertical line and the ROI.

QIMT in Freeze

The QIMT tab of the touchscreen displays the following controls available infreeze:

SEND TO L CAR REPSEND TO R CAR REP

adds the frozen measurements to the examination report. If severalmeasurements are sent to the report, the latest one overwrites the previousone.


Q I M T O P T I O N

QIM

T

Screen LayoutOnce the automatic QIMT calculation is activated, the system automaticallymoves to the standard B-Mode presentation.

WARNING Automatic measurement results are intended as a suggestion and shouldnot be considered sufficient to make a diagnosis.

On the B-Mode image, the ROI cursor (the area of interest) and a referenceline (on the left) are superimposed, as shown in the figure below.

Fig. 1-1: QIMT Screen Layout

The position of the ROI cursor and the line (which is bound to the cursor)can be changed with the trackball.

ACTION key allows the ROI dimensions to be changed. Change the size of thearea using the trackball.

The green line inside the ROI represents the intima and the orange linerepresents the adventitia. Points that are not detected are not displayed.

The yellow box beside the ROI cursor contains the standard deviationinformation. The box will blink at the detection of each cardiac cycle: thedisplayed standard deviation value is green when it is ≤ 21, orange otherwise.


Q I M T O P T I O N


Chapter

2Q

IMT

2. QIMT Automatic Measurements

This chapter describes which measurements are automatically calculated.

MeasurementsFig. 2-1: QIMT Automatic Measurement

On the measurement area of the screen (left side of the image) the firstcolumn (QIMT) gives the QIMT data and the second one (D) the vesseldimension.

Six (6) successive measurements, continuously updated, are shown togetherwith their average (AVG), standard deviation (SD) and the width (W) of theROI cursor.

IM AGE key saves the screen image with the related measurements.


Q I M T A U T O M A T I C M E A S U R E M E N T S

QIMT Measurement SetupOnce the QIMT licence is installed, the QIMT group is displayed in the“Application Measurements” folder of the Vascular application.

Table 2-1: QIMT Measurement group

Table Management The same menu allows to set which reference tables enable/disable forQIMT exams.

The listed tables are available in the Patient ID page when the correspondingbox (ENABLED column) is checked.

The table displayed with an orange background is the default table that isautomatically selected in the Vascular Patient ID page. To change the defaulttable follow the procedure listed below:

Procedure 1. Place the cursor on the corresponding row.

2. Press ENTER: the row will be highlighted.

3. Using the trackball, press the button SET AS DEFAULT .

Parameter Label

QIMT QIMT

QIMT standard deviation SD

Vessel diameter D

Standard deviation of vessel diameter

SD

ROI width W


Chapter

3Q

IMT

3. QIMT Worksheet Once QIMT measurements have been performed, the Vascular worksheetincludes dedicated folders containing the relevant QIMT measurements andgraphics.

QIMT Measurements FoldersThese folders are organized in left and right, selectable by the correspondingtoggle.

Each folder displays the following parameters:

• the QIMT value and its standard deviation,

• the vessel diameter and its standard deviation,

• the ROI width.

Once the reference table and the ethnicity parameters have been set in thePatient ID page, the worksheet also lists the following parameters:

• the maximum QIMT value and its ranking,

• the expected QIMT based on the set reference table andethnicity,

• the set reference table and ethnicity.

QIMT Graphics FoldersThis folder is available only when the reference table and ethnicity parametershave been set in the Patient ID page.


Q I M T W O R K S H E E T

Fig. 3-1: QIMT Graphics Folder

The left upper part indicates which table has been set.

The legenda, shown in the lower part of the screen, reports the correspondingmaximum QIMT with its ranking, the expected QIMT and the set ethnicity.


Appendix

AQ

IMT

A. QIMT Bibliographic References

• P.J. Touboul, M.G. Hennerici W. et al., “Mannheim CarotidIntima-Media Thickness Consensus (2004-2006)”,Cerebrovascular Deseases- Consensus paper, Oct. 2006.

• Pignoli P., Tremoli E., Poli A., Oreste P., Paoletti R., “IntimalPlus Medial Thickness of the Arterial Wall: A DirectMeasurement with Ultrasound Imaging”, in: Circulation(1986), 74: pp. 1399-1406.

• Mitchell JR., Schwartz CJ., “Relationship between arterialdisease in different sites. The study of the aorta, coronary,carotid and iliac arteries”, in: Br Med J. (1962), 1: pp. 1293-1301.

• Finn AV., Lolodgie FD., Virmani R., “Correlation betweencarotid intima/medial thickness and therosclerosis: A pointof view from pathology”, in: Arterioscler Thromb Vasc Biol.(2010), 30: pp. 177-181.

• Polak JF., Person SD., Wei GS., Godreau A., Jacobs DR.,Harrington A., Sidney S., O’Leary DH., “Segment-specificassociation of carotid intima-media thickness withcardiovascular risk factors. The Coronary Artery Riskdevelopment in Young Adult (CARDIA) Study”, in: Stroke(2010), 41: pp. 9-15.

• Schott LL., Wildman RP., Brockwell S., Simkin-SilvermanLR., Kuller LH., Sutton-Tyrrell K., “Segment-specific effectof cardiovascular risk factors on carotid intima-medialthickness in women at midlife”, in: Arterioscler Thromb VascBiol. (2004), 24: pp. 1951-1956.

• Burke GL, Evans GW., Riley W., Sharrett AR., Howard G.,Barnes RW., Rosamond W., Crow RS., Rautaharju PM., HeissG., “Arterial wall thickness is associated with prevalentcardiovascular disease in middle-aged adults. TheAtherosclerosis Risk in Communities (ARIC) Study”, in:Stroke (1995), 26: pp. 386-91.

MyLab - A D V A N C E D O P E R A T I O N S A - 1

Q I M T B I B L I O G R A P H I C R E F E R E N C E S

• Kablak-Ziembicka A., Tracz W., Przewlocki T., Pieniazek P.,Sokolowski A., Konieczynska M., “Association of increasedcarotid intima-media thickness with the extent of coronaryartery disease”, in: Heart (2004), 90: pp.1286-90.

• Davis PH., Dawson JD., Mahoney LT., Lauer RM.,“Increased carotid intimalmedial thickness and coronarycalcification are related in young and middle-aged adults. TheMuscatine study”, in: Circulation (1999), 100: pp. 838-42.

MyLab - A D V A N C E D O P E R A T I O N S A - 2

Appendix

BQ

IMT

B. QIMT Reference TablesHoward TablesNormal values in common carotid.

Black Population

Table B-1: Howard Tables - Black Populat ion - Female - Lef t Side

Table B-2: Howard Tables - Black Populat ion - Female - Right Side

Table B-3: Howard Tables - Black Populat ion - Male - Left Side

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.49 0.56 0.64

55 0.56 0.65 0.75

65 0.62 0.72 0.85

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.51 0.58 0.65

55 0.59 0.68 0.78

65 0.63 0.74 0.85

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.53 0.62 0.72

55 0.61 0.71 0.83

65 0.69 0.82 0.99

MyLab - A D V A N C E D O P E R A T I O N S B - 1

Q I M T R E F E R E N C E T A B L E S

Table B-4: Howard Tables - Black Populat ion - Male - Right Side

White Population

Table B-5: Howard Tables - White Populat ion - Female - Lef t Side

Table B-6: Howard Tables - White Populat ion - Female - Right Side

Table B-7: Howard Tables - White Populat ion - Male - Left Side

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.52 0.61 0.71

55 0.61 0.72 0.84

65 0.72 0.85 1.01

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.47 0.54 0.61

55 0.54 0.62 0.71

65 0.61 0.71 0.81

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.47 0.53 0.61

55 0.55 0.62 0.71

65 0.60 0.69 0.81

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.52 0.60 0.70

55 0.59 0.68 0.80

65 0.65 0.77 0.93



QIM

T

Table B-8: Howard Tables - White Populat ion - Male - Right Side

Reference G.Howard, AR.Sharrett, G.Heiss, GW.Evans, LE.Chambless, WA.Riley andGL.Burke “Carotid artery intimal-medial thickness distribution in generalpopulations as evaluated by B-mode ultrasound” In: ARIC InvestigatorsStroke, 1993;24;1297-1304 1993

Howard Extended TablesNormal values in common carotid.

Black Population

Table B-9: Howard Extended Tables - Black Populat ion - Female

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.50 0.57 0.66

55 0.57 0.66 0.77

65 0.65 0.76 0.90

Age (years)

(mm)

25 390

35 490

45 590

55 580

65 760

75 860



Table B-10: Howard Extended Tables - Black Populat ion - Male

White Population

Table B-11: Howard Extended Tables - White Populat ion - Female

Table B-12: Howard Extended Tables - White Populat ion - Male

Age (years)

(mm)

25 440

35 540

45 640

55 740

65 870

75 970

Age (years)

(mm)

25 350

35 450

45 550

55 640

65 730

75 830

Age (years)

(mm)

25 400

35 500

45 610

55 700

65 800

75 900



QIM

T

Reference G.Howard, AR.Sharrett, G.Heiss, GW.Evans, LE.Chambless, WA.Riley andGL.Burke “Carotid artery intimal-medial thickness distribution in generalpopulations as evaluated by B-mode ultrasound” In: ARIC InvestigatorsStroke, 1993;24;1297-1304 1993

MESA TablesNormal values in common carotid.

Black Population

Table B-13: MESA Tables - Black Populat ion - Female - Lef t Side

Table B-14: MESA Tables - Black Populat ion - Female - Right Side

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.54 0.63 0.73

54 0.54 0.63 0.73

55 0.59 0.67 0.80

64 0.59 0.67 0.80

65 0.63 0.76 0.90

74 0.63 0.76 0.90

75 0.68 0.78 0.91

84 0.68 0.78 0.91

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.55 0.64 0.74

54 0.55 0.64 0.74

55 0.60 0.71 0.81

64 0.60 0.71 0.81

65 0.65 0.76 0.92

74 0.65 0.76 0.92



Table B-15: MESA Tables - Black Populat ion - Male - Lef t Side

Table B-16: MESA Tables - Black Populat ion - Male - Right Side

75 0.71 0.83 0.96

84 0.71 0.83 0.96

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.56 0.69 0.81

54 0.56 0.69 0.81

55 0.63 0.75 0.92

64 0.63 0.75 0.92

65 0.69 0.82 0.99

74 0.69 0.82 0.99

75 0.72 0.85 1.02

84 0.72 0.85 1.02

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.58 0.67 0.89

54 0.58 0.67 0.89

55 0.61 0.74 1.05

64 0.61 0.74 1.05

65 0.71 0.85 1.11

74 0.71 0.85 1.11

75 0.74 0.85 1.13

84 0.74 0.96 1.13

Age (years)

25% (mm)

50%(mm)

75%(mm)



QIM

T

White Population

Table B-17: MESA Tables - White Populat ion - Female - Left Side

Table B-18: MESA Tables - White Populat ion - Female - Right Side

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.50 0.58 0.67

54 0.50 0.58 0.67

55 0.55 0.64 0.75

64 0.55 0.64 0.75

65 0.63 0.73 0.85

74 0.63 0.73 0.85

75 0.70 0.80 0.94

84 0.70 0.80 0.94

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.51 0.58 0.79

54 0.51 0.58 0.79

55 0.55 0.65 0.88

64 0.55 0.65 0.88

65 0.65 0.75 1.00

74 0.65 0.75 1.00

75 0.72 0.83 1.07

84 0.72 0.94



Table B-19: MESA Tables - White Populat ion - Male - Lef t Side

Table B-20: MESA Tables - White Populat ion - Male - Right Side

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.54 0.63 0.78

54 0.54 0.63 0.78

55 0.57 0.69 0.82

64 0.57 0.69 0.82

65 0.67 0.81 0.95

74 0.67 0.81 0.95

75 0.71 0.85 1.00

84 0.71 0.85 1.00

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.52 0.62 0.71

54 0.52 0.62 0.71

55 0.57 0.68 0.81

64 0.57 0.68 0.81

65 0.65 0.77 0.92

74 0.65 0.77 0.92

75 0.72 0.83 0.97

84 0.72 0.83 0.97



QIM

T

Chinese Population

Table B-21: MESA Tables - Chinese Populat ion - Female - Left Side

Table B-22: MESA Tables - Chinese Populat ion - Female - Right Side

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.49 0.58 0.67

54 0.49 0.58 0.67

55 0.52 0.63 0.72

64 0.52 0.63 0.72

65 0.58 0.71 0.87

74 0.58 0.71 0.87

75 0.64 0.76 0.94

84 0.64 0.76 0.94

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.55 0.60 0.70

54 0.55 0.60 0.70

55 0.54 0.63 0.77

64 0.54 0.63 0.77

65 0.59 0.71 0.84

74 0.59 0.71 0.84

75 0.67 0.77 0.96

84 0.67 0.77 0.96



Table B-23: MESA Tables - Chinese Populat ion - Male - Lef t Side

Table B-24: MESA Tables - Chinese Populat ion - Male - Right Side

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.55 0.63 0.73

54 0.55 0.63 0.73

55 0.57 0.70 0.84

64 0.57 0.70 0.84

65 0.62 0.72 0.86

74 0.62 0.72 0.86

75 0.69 0.84 0.97

84 0.69 0.84 0.97

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.54 0.64 0.73

54 0.54 0.64 0.73

55 0.56 0.70 0.83

64 0.56 0.70 0.83

65 0.62 0.73 0.92

74 0.62 0.73 0.92

75 0.66 0.79 0.98

84 0.66 0.79 1.07



QIM

T

Hispanic Population

Table B-25: MESA Tables - Hispanic Populat ion - Female - Left Side

Table B-26: MESA Tables - Hispanic Populat ion - Female - Right Side

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.51 0.58 0.68

54 0.51 0.58 0.68

55 0.58 0.68 0.79

64 0.58 0.68 0.79

65 0.62 0.72 0.86

74 0.62 0.72 0.86

75 0.68 0.77 0.91

84 0.68 0.77 0.91

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.51 0.58 0.67

54 0.51 0.58 0.67

55 0.57 0.69 0.77

64 0.57 0.69 0.777

65 0.65 0.76 0.87

74 0.65 0.76 0.87

75 0.63 0.78 0.92

84 0.63 0.78 0.92



Table B-27: MESA Tables - Hispanic Populat ion - Male - Left Side

Table B-28: MESA Tables - Hispanic Populat ion - Male - Right Side

Reference James H.Stein, Claudia E.Korcarz, R.Todd Hurst, Eva Lonn, ChristopherB.Kendall, Emile R.Mohler “ASE CONSENSUS STATEMENT: Use ofCarotid Ultrasound to Identify Subclinical Vascular Disease and EvaluateCardiovascular Disease Risk: A Consensus Statement from the AmericanSociety of Echocardiography”, American Society of Echocardiography, 2008

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.55 0.64 0.75

54 0.55 0.64 0.75

55 0.61 0.72 0.85

64 0.61 0.72 0.85

65 0.68 0.80 0.98

74 0.68 0.80 0.98

75 0.72 0.86 0.97

84 0.72 0.86 0.97

Age (years)

25% (mm)

50%(mm)

75%(mm)

45 0.53 0.62 0.73

54 0.53 0.62 0.73

55 0.60 0.67 0.82

64 0.60 0.67 0.82

65 0.65 0.78 0.90

74 0.65 0.78 0.90

75 0.71 0.81 0.92

84 0.71 0.81 0.92



QIM

T

CAPS TablesNormal values in common carotid.

White Population

Table B-29: CAPS Tables - White Populat ion - Female

Table B-30: CAPS Tables - White Populat ion - Male

Reference James H.Stein, Claudia E.Korcarz, R.Todd Hurst, Eva Lonn, ChristopherB.Kendall, Emile R.Mohler “ASE CONSENSUS STATEMENT: Use ofCarotid Ultrasound to Identify Subclinical Vascular Disease and EvaluateCardiovascular Disease Risk: A Consensus Statement from the AmericanSociety of Echocardiography”, American Society of Echocardiography, 2008

Age (years)

25% (mm)

50%(mm)

75%(mm)

25 0.524 0.567 0.612

35 0.575 0.615 0.66

45 0.619 0.665 0.713

55 0.665 0.719 0.776

65 0.718 0.778 0.852

75 0.771 0.837 0.921

85 0.807 0.880 0.935

Age (years)

25% (mm)

50%(mm)

75%(mm)

25 0.515 0.567 0.633

35 0.585 0.633 0.682

45 0.634 0.686 0.756

55 0.680 0.746 0.837

65 0.745 0.830 0.921

75 0.814 0.914 1.028

85 0.830 0.937 1.208



Artery TablesNormal values in common carotid.

Table B-31: Female Artery Table

Age (years)

25% (μm)

50%(μm)

75%(μm)

15 351 396 441

20 373 421 469

25 395 446 497

30 417 471 524

35 439 496 552

40 461 521 580

45 483 545 607

50 506 570 635

55 528 595 663

60 550 620 690

65 572 645 718

70 594 670 745

75 616 694 773

80 638 719 801

85 660 744 828



QIM

T

Table B-32: Male Artery Table

Reference L.Engelen, I.Ferreira, C.D.Stehouwer et al. “Reference Intervals forCommon Carotid Intima-Media Thickness Measured with Echotracking:Relation with Risk Factor”, European Heart J, 2012, Nov

Age (years)

25% (μm)

50%(μm)

75%(μm)

15 354 401 449

20 377 427 478

25 400 453 507

30 423 479 536

35 446 505 565

40 468 531 594

45 491 557 624

50 514 583 653

55 537 609 682

60 560 635 711

65 583 662 740

70 606 688 769

75 629 714 798

80 652 740 827

85 675 766 856




Documents

6440 QIMT E R02 - Esaote