Iu22 Reference Manual

U l t r a s o u n d S y s t e miU22

User Reference453561170891 Rev A

June 2004

Copyright © 2004 Koninklijke Philips Electronics N.V. All rights reserved Printed in USA

iU22 User Reference453561170891

2

Manufactured by Philips Ultrasound

22100 Bothell-Everett HighwayBothell, WA 98021-8431USATelephone +1 425-487-7000 or 800-426-2670Fax +1 425-485-6080www.medical.philips.com

European Union Representative

Philips Medical Systems Nederland B.V.Corporate Quality and Regulatory GroupVeenpluis 45684 PC BestThe NetherlandsTelephone +31 40 27 64432Fax +31 40 27 62499

CAUTIONUnited States federal law restricts this device to sale by or on the order of aphysician.

“Chroma”, “Cineloop”, “Color Power Angio”, “High Q”, “iU22“, SonoCT”, “Tissue Specific”, and “XRes” are trademarks of Koninklijke Philips Electronics N.V.

Non-Philips product names may be trademarks of their respective owners.

Philips Ultrasound products may be manufactured under or operate in accordance with one or more of the following United States patents and corresponding patents in other countries: U.S. Patent Numbers 4,868,476; 4,887,306; 5,050,610; 5,123,415; 5,152,292; 5,181,514; 5,197,477; 5,207,225; 5,215,094; 5,275,167; 5,287,753; 5,315,999; 5,381,795; 5,402,793; 5,456,257; 5,479,930; 5,482,045; 5,482,047; 5,555,887; 5,577,505; 5,603,323; 5,634,465; 5,706,819; 5,715,823; 5,718,229; 5,720,291; 5,735,281; 5,795,297; 5,833,613; 5,851,186; 5,860,924; 5,879,303; 5,891,035; 5,897,498; 5,908,389; 5,938,607; 5,951,478; 5,961,462; 6,043,590; 6,050,942; 6,126,599; 6,171,246; 6,210,328; 6,231,510; 6,251,074; 6,283,919; 6,299,579; 6,390,981; 6,450,958; 6,544,177; 6,629,927; 6,648,825; 6,663,569; D369,307; Re36,564. Other patent applications are pend-ing in various countries.

http://www.medical.philips.com

iU22 User Reference453561170891 3

Contents1 Read This First . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

User Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

User Information Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27

Your Compact Disc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28

Conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28

System Conventions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28

User Information Conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29

Upgrades and Updates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30

Customer Comments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30

Ordering Supplies and Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

Customer Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31

2 Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33

Electrical Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33

Mechanical Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .36

Equipment Protection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37

Biological Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40

ALARA Education Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41

Applying ALARA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42

Direct Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43

Indirect Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43

Receiver Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44

An Example of Applying ALARA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44

Additional Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45

Output Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45

Mechanical Index (MI) Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47

Contents


4

Thermal Index (TI) Displays. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47

Mechanical and Thermal Indices Display Precision and Accuracy . . . . . . . . .47

Control Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Controls Affecting the Indices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Output Power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

2D Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49

Color and Power Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50

M-Mode and Doppler Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51

Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51

Related Guidance Documents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52

Acoustic Output and Measurement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53

In Situ, Derated, and Water Value Intensities . . . . . . . . . . . . . . . . . . . . . . . . .53

Conclusions Regarding Tissue Models and Equipment Survey . . . . . . . . . . . .55

Acoustic Output Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56

Acoustic Measurement Precision and Uncertainty . . . . . . . . . . . . . . . . . . . . . . . .56

3 System Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59

System Capabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59

Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60

Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61

Image Capture and Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61

Patient Data Protection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61

System Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62

Imaging Feature Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62

Connectivity Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62

Clinical Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63

Calculations Package Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63

Voice Control Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64

Data Security Option . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64

Technical Administration Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64

Contents


System Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65

Video Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66

Control Module . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .66

Voice Control Headset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .68

VCR Microphone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .68

On/Standby Switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69

Data Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70

Peripherals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71

Transducer Receptacles and Cable Management . . . . . . . . . . . . . . . . . . . . . . . . .71

Physio (ECG) Receptacles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73

Rear Panel and Power Switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74

Wheel Brakes and Steering Lock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75

4 Preparing the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77

Connecting Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77

Connecting an External Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77

About External VCRs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79

Connecting an External VCR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79

Configuring Print Functions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80

Connecting an External Color Monitor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81

Connecting the Modem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82

Connecting to a Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82

Moving the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84

Preparing and Moving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84

Positioning in Confined Spaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87

Setting Up After Moving. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .87

Transporting the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90

Environmental Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91

Physical Dimensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91

Data Connections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92

Contents


6

Modality Interface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92

Electrical Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92

Pressure Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92

Humidity Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92

Temperature Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92

5 Using the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93

Turning the System On and Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93

Setting the System Time and Date. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .94

Using the Brake and Steering Lock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95

Adjusting the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96

Positioning the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96

Setting Default Monitor Brightness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97

Adjusting for Ambient Light . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97

System Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97

About the Control Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97

Positioning the Control Module. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98

About Touch Screen Buttons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99

About Touch Screen Rotary Displays . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .100

Adjusting the Touch Screen Brightness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102

Using the Keyboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103

About Status Icons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .104

Using Voice Control. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .105

About Voice Control Icons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106

Turning Headsets On and Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .107

Pairing Headsets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .108

Configuring Headsets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .109

About Training Voice Profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110

Creating and Training a Voice Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110

Deleting Voice Profiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .112

Contents


Doing Additional Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .112

Enabling Voice Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .112

About Background Noise. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113

Using Voice Commands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113

Using the Keyword Feature . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .114

Muting the Headset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

About Voice Annotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115

Using Voice Annotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116

Voice Control Commands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116

Voice Commands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117

Voice Annotation Commands . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .122

Logging On to the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143

Logging On . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143

Logging Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .144

Changing Your Password . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .144

Imaging Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .145

Using Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .146

Connecting Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .147

Selecting Transducers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .147

Using ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .148

Using the DVD Drive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .148

About Media Compatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .148

Installing a UDF Reader . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149

Loading and Ejecting a Disc. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149

Formatting a DVD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150

6 Customizing Your System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151

Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151

About Clinical Options and Tissue Specific Presets . . . . . . . . . . . . . . . . . . . . . .151

About Quick Save Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .152

Contents


8

Creating Quick Save Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .152

Modifying Quick Save Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153

Deleting Quick Save Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153

Copying Quick Save Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154

System Setups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155

Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .156

Installing Temporary Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .156

Purchasing Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157

7 Imaging Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 159

General Imaging Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159

About the Imaging Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159

Changing Display Element Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .160

Adjusting for Ambient Light . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161

Starting an Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161

Capturing Images and Loops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161

Navigating Thumbnails of Captured Images. . . . . . . . . . . . . . . . . . . . . . . . . . . . .162

Setting Cineloop Live Capture Type . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .162

Setting Mode Preferences . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .163

Printing an Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .163

2D Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164

Using 2D Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164

Using 2D Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164

Positioning the Focal Zone. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165

M-Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166

Using M-Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166

Using M-Mode Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166

About Sweep Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167

Changing the M-Mode Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167

Using M-Mode Zoom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .168

Contents


PW Doppler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .168

Using PW Doppler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .168

Using PW Doppler Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . .169

Positioning the Sample Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .169

High PRF Doppler Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .169

Setting Auto Invert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .170

Changing the Spectral Trace Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .170

CW Doppler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171

Using CW Doppler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171

Using CW Doppler Touch Screen Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . .171

Changing the Spectral Trace Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .172

Changing the Sweep Speed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .172

Duplex and Triplex. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173

Using Duplex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173

Using Triplex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173

Color Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174

Using Color Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174

Using Color Mode Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . .175

Comparing Images in Color Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175

Color Power Angio Imaging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175

Using Color Power Angio Imaging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176

Using Color Power Angio Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . .176

Comparing Images in Color Power Angio Mode . . . . . . . . . . . . . . . . . . . . . . . .176

3D Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .177

Using 3D/4D Acquisition Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . .177

About Acoustic Artifacts in 3D Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .178

About Freehand Technique . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179

About Freehand Geometry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180

Optimizing 3D Image Quality. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180

Contents


10

Acquiring a Freehand 3D Data Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181

Acquiring a Single-Sweep 3D Data Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181

Acquiring 4D. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .182

Setting the 4D Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .183

Defining a 3D Region of Interest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .183

3D Image Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .184

Using 3D Image Review Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . . .184

About Review Formats. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .184

Setting the Default 3D Review Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .185

Rotating 3D Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .186

Rotating Crosshairs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187

Magnifying a 3D Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187

Trimming Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187

Using 3D Cine . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .189

Using Pan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .189

Resizing a Volume View . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .190

Moving 3D Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .190

Resetting 3D Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .190

Saving and Recalling 3D Data Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .191

8 Imaging Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 193

Biopsy Guideline Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .193

Displaying the Biopsy Guideline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .193

Moving the Biopsy Depth Cursor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .194

Panoramic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .195

Panoramic Scanning Techniques. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .196

Panoramic Imaging Artifacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .196

Acquiring a Panoramic Data Set. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .197

Erasing and Retracing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .198

Using Panoramic Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .198

Contents


Panoramic Image Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .198

Performing Measurements on a Panoramic Image . . . . . . . . . . . . . . . . . . . . . . .199

Magnifying a Panoramic image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .199

Rebuilding a Panoramic image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .199

Rotating a Panoramic image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .200

Smoothing a Panoramic Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .200

Trimming a Panoramic image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .200

Printing and Storing Panoramic Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .201

Panoramic Cine Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .201

SonoCT Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .201

Using SonoCT Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .202

Contrast Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .203

About Acoustic Artifacts in Contrast Imaging. . . . . . . . . . . . . . . . . . . . . . . . . . .203

Using Contrast Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .204

Tissue Harmonic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .204

Using Tissue Harmonic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .205

iSCAN Intelligent Optimization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .205

About 2D iSCAN Intelligent Optimization . . . . . . . . . . . . . . . . . . . . . . . . . . . . .205

Using 2D iSCAN Intelligent Optimization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .206

About Doppler iSCAN Intelligent Optimization . . . . . . . . . . . . . . . . . . . . . . . . .206

Using Doppler iSCAN Intelligent Optimization . . . . . . . . . . . . . . . . . . . . . . . . .206

XRes Image Processing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .207

Using XRes Image Processing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .207

Dual Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .208

Using Dual Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .208

Cineloop Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .208

Using Cineloop Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .209

Using Cineloop Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .210

Editing a Cineloop Sequence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .210

Contents


12

Zoom Magnification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .211

Using Zoom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .211

Using HD Zoom. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .212

Physio (ECG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .212

Connecting Physio (ECG) Leads . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .212

Using ECG . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .214

Using ECG Touch Screen Controls. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .214

9 Annotation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 215

Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .215

Adding Labels Using Annotate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .215

Adding Labels Using the Keyboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .216

Adding an Image Title . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .216

Using Annotation Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . .216

Customizing Annotation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .217

Body Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .218

Displaying Body Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .218

Using Body Marker Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . .219

10 Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221

Measurement Setups and Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .221

Changing Measure Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .221

Using the Caliper Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . .222

Measurement Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .222

About Measurement Accuracy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .223

About Doppler Measurement Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .223

About Color and CPA Measurement Accuracy . . . . . . . . . . . . . . . . . . . . . . . . .223

About Display Size and Measurement Accuracy . . . . . . . . . . . . . . . . . . . . . . . . .223

About Caliper Placement and Measurement Accuracy. . . . . . . . . . . . . . . . . . . .224

About Speed of Sound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .224

About Doppler Alignment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .224

Contents


About Aliasing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .224

About Velocity Resolution in Doppler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .225

About Acquisition and Algorithmic Errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . .225

About Formulas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .225

Accuracy Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .226

Distance Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .228

Measuring 2D Depth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .228

Measuring 2D Distance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .229

Measuring Percent Diameter Reduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .229

About M-Mode Distance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .230

Measuring M-Mode Distance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .231

About Doppler Distance (Velocity) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .231

Measuring Doppler Distance (Velocity). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .232

Measuring a Curved Distance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .232

Measuring Time/Slope . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .233

Measuring Heart Rate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .233

Circumference and Area Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .234

Measuring 2D Circumference and Area (Ellipse) . . . . . . . . . . . . . . . . . . . . . . . .234

Converting Distance to Ellipse. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .235

Measuring 2D Circumference and Area (Continuous Trace). . . . . . . . . . . . . . .235

Percent Area Reduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .236

2D Volume Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .237

Measuring Volume (One Distance) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .237

Measuring Volume (Three Distance) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .237

Measuring Volume (One Distance and One Ellipse) . . . . . . . . . . . . . . . . . . . . . .238

3D Volume Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .239

Performing a 3D Volume Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .239

About the Stacked Contour Volume Measurement . . . . . . . . . . . . . . . . . . . . . .240

Performing a 3D Stacked Contour Measurement. . . . . . . . . . . . . . . . . . . . . . . .240

Contents


14

Doppler Trace Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .241

Manual Doppler Trace Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .241

High Q Automatic Doppler Measurements . . . . . . . . . . . . . . . . . . . . . . . . .241

Performing a Doppler Continuous Trace Measurement . . . . . . . . . . . . . . . . . .242

Performing a Doppler Trace-by-Points Measurement . . . . . . . . . . . . . . . . . . . .242

About High Q Automatic Doppler Measurement. . . . . . . . . . . . . . . . . . . . . . . .243

Turning On the High Q Mean Trace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .243

Displaying the Peak Trace and the High Q Measurement . . . . . . . . . . . . . . . . .244

Adjusting Markers for the High Q Measurement . . . . . . . . . . . . . . . . . . . . . . . .244

About the Volume Flow Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .245

Measuring Volume Flow . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .245

2D Hip Angle Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .246

Performing a Hip Angle Measurement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .247

11 Calculations (Calc) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 249

Calculations and Presets. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .249

About the Calc Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .249

Changing the Calculations Package . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .251

About Quick Save Presets and Calculations Packages . . . . . . . . . . . . . . . . . . . .252

About Calcs in Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .252

Labeling Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .252

Labeling Before Measuring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .253

Measuring Before Labeling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .253

Deleting Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .254

About the Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .254

Moving the Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .254

Creating a New Measurement Label . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .255

Patient Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .255

Displaying Patient Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .256

About Editing Patient Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .256

Contents


Editing Patient Reports. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .256

Entering Comments in Patient Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .257

Printing Patient Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .257

Structured Reporting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .257

Gynecology Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .258

Obtaining Gynecology Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .258

General Imaging Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .259

Abdominal Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .259

Small Parts Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .259

Cardiology (Adult Echo) Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .260

About the 2D/Color Adult Echo Calc List . . . . . . . . . . . . . . . . . . . . . . . . . . . . .260

Obtaining 2D/Color Adult Echo Measurements . . . . . . . . . . . . . . . . . . . . . . . . .260

About Simpson’s Rule Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .261

Obtaining Simpson’s Calculations Manually . . . . . . . . . . . . . . . . . . . . . . . . . . . . .261

Obtaining Simpson’s Calculations by Template . . . . . . . . . . . . . . . . . . . . . . . . . .262

About the M-Mode Adult Echo Calc List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .263

Obtaining M-Mode Adult Echo Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . .264

Using the M-mode All-Points Tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .264

About the Doppler Adult Echo Calc List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .265

Obtaining Doppler Adult Echo Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . .266

Using the Doppler RA Pressure Tool . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .266

Cross-Populating Cardiac Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267

Vascular Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267

Obtaining Vascular Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267

Obtaining the ICA/CCA Ratio in the Patient Report . . . . . . . . . . . . . . . . . . . . .268

Obstetrics (OB) Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .268

Selecting the Number of Fetuses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .269

General OB. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270

Advanced OB . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270

Contents


16

AFI/BPP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270

Using the Biophysical Profile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .271

Average Ultrasound Age (AUA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .271

Obtaining Gestational Age Based on LMP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .271

Established Due Date . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .272

Obtaining Gestational Age from the Established Due Date . . . . . . . . . . . . . . . .272

Obtaining GA, EDD(c), and LMP(c) from the DOC . . . . . . . . . . . . . . . . . . . . . .273

Gestational Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .273

Calculating Gestational Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .273

Automatic Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .274

Gestational Sac (GS). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .274

Fetal Heart Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .275

Calculating the Amniotic Fluid Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .275

About OB Measurement Ratios. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .276

About Estimated Fetal Weight (EFW) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .276

Selecting an Estimated Fetal Weight Equation . . . . . . . . . . . . . . . . . . . . . . . . . .277

About Fetal Heart. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .277

Analysis Configuration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .278

About Groups. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .279

About Build Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .280

Building a Calc List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .280

About Edit Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .281

Editing a Calc List . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .281

Selecting Fetal Tables and Equations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .281

About Custom Fetal Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .282

About Custom Fetal Age and Growth Tables. . . . . . . . . . . . . . . . . . . . . . . . . . .282

About Custom Age, Weight, and Growth Equations . . . . . . . . . . . . . . . . . . . . .283

About Prior Exams and Fetal Growth Graphs . . . . . . . . . . . . . . . . . . . . . . . . . .283

About Fetal Growth Graphs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .283

Contents


Viewing Fetal Growth Graphs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .284

Creating a New Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .285

Editing a Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .285

Deleting a Calc List or Group . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .286

Deleting a Measurement Label. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .286

Creating a New Equation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .287

12 Patient Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .289

Using Patient Data Entry Touch Screen Controls. . . . . . . . . . . . . . . . . . . . . . . . . . .289

Creating a New Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .289

Entering Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .290

Additional Exam Data. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .290

Editing Patient Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .290

Entering Study Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .291

Modality Worklist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .292

Selecting in the Worklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .293

Searching in the Worklist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .293

Working with Worklist Columns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .294

Pausing, Canceling, and Ending Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .294

About Pausing Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .294

Pausing an Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .295

Reactivating a Paused Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .295

Canceling an Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .295

Ending an Exam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .295

Customizing Patient Data Formats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .296

Changing Time and Date Formats . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .296

Changing the Name Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .296

Changing Units of Measure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .297

Contents


18

13 Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299

General Information on Review. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .299

Measurements in Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .299

3D in Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .299

Using Review Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .300

Starting Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .300

Selecting and Loading Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .302

Viewing Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .303

Navigating Thumbnails and Images. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .304

Image Layout. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .305

Playing Cineloop Sequences in Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .307

Patient Directory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .307

About Patient Directory Headers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .307

Finding Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .309

Sorting in the Patient Directory. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .309

Changing Column Width . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .309

Deleting Exams and Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .310

Deleting Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .310

Deleting Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .311

Sending Exams and Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .311

Sending Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .311

Sending Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .312

Exporting Images for PC Viewing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .313

Archiving Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .313

Formatting a DVD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .314

Loading Archived Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .315

Printing Exams and Images from Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .315

Contents


Customizing Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .316

Selecting the Default Layout . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .316

Selecting a Compression Factor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .316

14 Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .317

Transducer Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .317

Clinical Options and Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .317

Transducer Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .318

Acoustic Artifacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .319

Transducer Covers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .322

FDA Medical Alert, March 29, 1991, Allergic Reactions to Latex-Containing Medical Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .322

15 Biopsy Guides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .325

Attaching and Removing a Biopsy Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .325

Using the Biopsy Guideline Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .326

Verifying the Biopsy Guide Alignment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .327

Biopsy Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .332

Biopsy Guide Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .333

16 Disinfectants and Gels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .335

For More Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .335

Ordering Disinfectants and Gels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .335

Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .335

Latex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .336

FDA Medical Alert, March 29, 1991, Allergic Reactions to Latex-Containing Medical Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .336

Transmissible Spongiform Encephalopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . .338

Decontamination . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .338

Disinfecting Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .339

Sterilizing Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .342

Contents


20

Disinfecting Cables and Connectors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .345

Disinfecting System Surfaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .347

Disinfectants Compatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .348

Disinfectant Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .349

Choosing a Disinfectant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .350

Factors Affecting Disinfectant Efficiency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .351

Disinfectants Manufacturers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .351

Disinfectants Compatibility Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .351

Gels Compatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .356

17 Printing and Recording. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357

Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .357

Printing in Live Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .357

Printing Stored Images to a Local Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .357

Printing Stored Images to a DICOM Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . .358

Printing Exams to a DICOM Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .358

Printing Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .359

Changing Printer Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .359

Using Printing Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .359

Recording . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .360

Using the VCR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .360

Using Recording Touch Screen Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .361

18 Maintaining the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 363

Cleaning System Surfaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .363

Cleaning System Air Filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .364

Hard Drive Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .366

Transducer Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .366

Printer Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .367

VCR Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .367

Contents


Troubleshooting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .368

Error Messages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .369

For Assistance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .370

19 System Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .371

Managing Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .371

Copying Settings to a DVD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .371

Importing Settings from a DVD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .372

Deleting Quick Save Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .373

Configuring the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .374

About Standard Network Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .374

About the Connectivity Option. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .374

About Configuration Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .375

Changing Configuration Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .375

Deletion of Archived Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .377

Deleting Archived Exams with Connectivity . . . . . . . . . . . . . . . . . . . . . . . . .377

Deleting Archived Exams without Connectivity . . . . . . . . . . . . . . . . . . . . . .377

Configuring Deletion of Archived Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .377

Print and Capture Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .378

Changing Print and Capture Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .378

Printers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .379

Configuring Printers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .379

Adding Printers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .380

Servers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .381

Configuring Servers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .381

Selecting Servers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .381

Adding Servers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .382

Deleting Servers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .383

Worklist System Setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .383

Selecting a Worklist Server . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .383

Contents


22

Defining Worklist Query Criteria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .384

About PPS Servers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .385

Selecting the PPS Server. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .385

Setting Up Storage Commit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .385

Managing Data Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .386

Creating User Logons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .387

Deleting User Logons. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .387

Changing User Names and Passwords. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .388

Exporting User Logons. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .388

Importing User Logons. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .388

Enabling or Disabling Data Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .389

Setting the Auto Log Off Time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .389

About the Log File . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .390

Archiving and Clearing the Log File . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .390

Changing the System Administrator Password . . . . . . . . . . . . . . . . . . . . . . . . . .391

Technical Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .391

20 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 393

Measurement Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .393

Area, Circumference, and Volume. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .393

Pulsatility Index (PI), Resistive Index (RI), and Systole:Diastole (S/D) Ratio . . .393

Peak Gradient (PG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .393

Acceleration Time (AT) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .393

Infant Hip . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .393

Percent Diameter Reduction and Percent Area Reduction . . . . . . . . . . . . . . . .393

Velocity Time Integral (VTI). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .394

Acceleration Index (AI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .394

Internal Carotid Artery (ICA)/Common Carotid Artery (CCA) Ratio . . . . . . .394

Volume Flow. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .394

Contents


Obstetrical Calc Package . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .394

Amniotic Fluid Index (AFI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .394

Area Corrected Biparietal Diameter (BPDa) . . . . . . . . . . . . . . . . . . . . . . . . . . .394

Biophysical Profile. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .394

Fetal Ratios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .395

Cephalic Index (CI) (BPD/OFD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .395

FL/AC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .395

FL/BPD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .395

HC/AC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .395

Estimated Fetal Weight (EFW) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .395

Abdominal Circumference (AC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .395

Abdominal Circumference, Biparietal Diameter, and Femur Length (AC, BPD, FL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .395

Abdominal Circumference, Biparietal Diameter, Femur Length, Head Circumference (AC, BPD, FL, HC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .396

Abdominal Circumference and Femur Length (AC, FL) . . . . . . . . . . . . . . . .396

Abdominal Circumference, Femur Length, and Head Circumference (AC, FL, HC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .396

Fetal Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .396

Abdominal Circumference (AC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .396

Biparietal Diameter (BPD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .396

Biparietal Diameter Outer to Inner. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .397

Biparietal Diameter Outer to Outer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .397

Cerebellum (CER) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .397

Crown-Rump Length (CRL). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .397

Femur Length (FL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .397

Gestational Sac (GS). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .397

Head Circumference (HC). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .398

Head Circumference (HC measured and derived) . . . . . . . . . . . . . . . . . . . .398

Humerus (HUM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .398

Contents


24

Fetal Growth Graph Tables and Equations . . . . . . . . . . . . . . . . . . . . . . . . . . . . .398

Abdominal Circumference (AC) Growth Curve Equation . . . . . . . . . . . . . .398

AC Growth Curve Equation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .398

Biparietal Diameter (BPD) Growth Curve Equation. . . . . . . . . . . . . . . . . . .398

BPD (Outer-Inner) Growth Curve Equation . . . . . . . . . . . . . . . . . . . . . . . .399

Femur Length (FL) Growth Curve Equation . . . . . . . . . . . . . . . . . . . . . . . . .399

FL Growth Curve Equation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .399

Head Circumference (HC) Growth Curve Equation . . . . . . . . . . . . . . . . . .399

HC (derived) Growth Curve Equation . . . . . . . . . . . . . . . . . . . . . . . . . . . . .399

Occipito-Frontal Diameter (OFD) Growth Curve Equation . . . . . . . . . . . .399

Cephalic Index (CI) Growth Curve Equation . . . . . . . . . . . . . . . . . . . . . . . .399

Estimated Fetal Weight (EFW) Growth Curve Equation . . . . . . . . . . . . . . .399

HC:AC Growth Curve Equation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .400

Fetal Growth Percentiles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .400

Estimated Fetal Weight (EFW) Percentile . . . . . . . . . . . . . . . . . . . . . . . . . . .400

Philips Custom Percentile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .400

Adult Echo Calc Package . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .400

Body Surface Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .400

Cardiac Output Indexed by Body Surface Area . . . . . . . . . . . . . . . . . . . . . . . . .401

Cardiac Output (2-D and M-Mode). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .401

Cardiac Output (Doppler) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .401

Ejection Fraction (EF) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .401

Right Ventricular Systolic Pressure via Tricuspid Regurgitation . . . . . . . . . . . . .401

Maximum Pressure Gradient (Max PG) (Simplified Bernoulli) . . . . . . . . . . . . . .401

Mean Pressure Gradient (Mean PG) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .402

Qp/Qs Ratio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .402

E-to-A Ratio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .402

Fractional Shortening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .402

% Differences of LV Lengths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .402

Contents


IVS % . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .402

IVS/LVPW . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .402

LA/Ao Ratio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .403

LVPW % . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .403

Valve Area via the Continuity Equation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .403

Mitral Valve Area via Pressure Half-time. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .403

Mean Velocity (Vmean) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .403

Velocity Time Integral (VTI). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .403

Stroke Volumes (2-D) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .403

Stroke Volumes (Doppler). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .404

Volumes (Single-Plane Ellipsoid). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .404

Volumes (Cubed Method) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .404

Volumes (Single-Plane A2C, Single-Plane A4C, and Biplane Method of Disks) .404

Volumes (Teichholtz) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .404

21 Specifications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .405

Physical Dimensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .405

Gray Shades . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .405

Scan Lines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .405

Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .405

Input Signals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .405

Output Signals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .406

Data Connections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .406

Physio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .406

Peripherals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .406

Modality Interface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .406

Electrical Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .407

Languages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .407

Pressure Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .407

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Humidity Limits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .407

Temperature Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .408

Safety Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .408

22 Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 409

23 Index. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 463


1 Read This FirstThis section contains important information about the user documentation foryour system and about contacting Philips Ultrasound.

User Information This manual is part of your user information. The user information addresses thereader who is familiar with ultrasound techniques. Sonography training and clinicalprocedures are not included here.

User Information ComponentsThe user information provided with your system includes the following compo-nents:

• Compact Disc (CD) Includes all of the user information, except the OperatingNotes.

• Getting Started Introduces you to system features and concepts, and helpsyou set up your ultrasound system. This manual also includes procedures forbasic operation. For detailed operating instructions, refer to Help or the UserReference.

• Help Help is available on the system in some languages and the information inHelp is also included in User Reference on the CD. Help contains comprehen-sive instructions for using the system. Press Help on the system keyboard todisplay Help. It includes a glossary containing descriptions of all controls anddisplay elements.

• User Reference Contains all of the user information for the system, exceptthe Operating Notes and the Acoustic Output Tables. It includes a glossary con-taining descriptions of all controls and display elements. The User Reference isalso included on the CD.

• Quick Cards Two sets of Quick Cards are provided with the system, and arealso included on the CD. One set contains procedures, imaging tips, and infor-mation on system controls. The other set contains procedures for using voicecontrol and lists all commands used for voice control and voice annotation.

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• Acoustic Output Tables Included on the CD, it contains information aboutmechanical and thermal index precision and accuracy, the acoustic outputdefault tables, and the acoustic output tables.

• Medical Ultrasound Safety Included on the CD, it contains information onbioeffects and biophysics, prudent use, and implementing ALARA (as low asreasonably achievable).

• Operating Notes Contains information that clarifies certain systemresponses that might be misunderstood or cause user difficulty.

Your Compact DiscThe CD contains all of the user information, except the Operating Notes. Theinstructions for using the CD are included with the CD.

Please take the time to use the CD, complete the brief survey card included, andmail the survey card to us.

ConventionsThe system uses certain conventions throughout the interface to make it easy foryou to learn and use. The accompanying user information also uses typographicalconventions to assist you in finding and understanding information.

System ConventionsThese conventions are used in the system:

• Two unlabeled Select buttons are used with the trackball. Those controls,located on either side of the trackball, operate identically. Use either one toselect the object under the pointer.

• Tabs along the top of the monitor display let you choose additional sets ofsetup options. Tabs along the top of the touch screen let you choose addi-tional pages of controls.

• To enter text into a text field, click in the field and use the keyboard.

• To display a list, click the down arrow ( ). To scroll through a list, click thearrows at either end of the scroll bar or drag the scroll box up or down.

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• Controls on the control panel include buttons, knobs, knob-buttons, and slidecontrols. Press a button to activate or deactivate its function. Turn a knob tochange the selected setting. Press a knob-button to activate its function, orturn it to change the selected setting. Move a slide control to change its set-ting.

• Controls on the touch screen include buttons and knobs. To use a touchscreen button, simply touch it. To use a touch screen knob (located in thebottom row of the touch screen), adjust the corresponding knob below thetouch screen label. Many tabs on the touch screen contain two pages of con-trols. Touch Next and Previous to display these pages.

• Controls on the touch screen use several methods to indicate their status.Buttons that are either on or off turn green when on. Buttons that select asetting generally display the active setting either within the button or on themonitor display. An arrow in the lower right corner of a button indicates thatthe button displays or hides a group of related buttons. Where only one but-ton in a group can be selected at a time, the selected button is indicated by agreen outline or background. For more information, see "About Touch ScreenButtons" on page 99.

User Information ConventionsThe user information follows these conventions:

• All procedures are numbered, and all subprocedures are lettered. You mustcomplete steps in the sequence they are presented to ensure success.

• Bulleted lists indicate general information about a particular function or pro-cedure. They do not imply a sequential procedure.

• Control names and menu items or titles are spelled as they are on the system,and they appear in bold text. The only exceptions are the trackball and theSelect buttons adjacent to it, which are unlabeled.

• Symbols appear as they appear on the system.

• Click or select means to move the pointer to an object and press one of theunlabeled Select buttons located on either side of the trackball.

• Double-click means to quickly click twice to select an object or text.

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• Drag means to place the pointer over an object and then press and hold oneof the Select buttons while moving the trackball. Use this method to move anobject on the screen.

• Touch means to press a button on the touch screen, located above the controlpanel.

• The left side of the system is to your left as you stand in front of the system,facing the system. The front of the system is nearest you as you operate it.

• Transducers and pencil probes both are referred to as transducers, unless thedistinction is important to the meaning of the text.

Upgrades and UpdatesPhilips Ultrasound is committed to innovation and continued improvement.Upgrades may be announced that consist of hardware or software improvements.Updated user information will accompany those system upgrades.

Customer CommentsIf you have questions about the user information, or you discover an error in theuser information, please call Philips Ultrasound Customer Service at800-433-3246; or if you are outside the USA, call your local customer servicerepresentative. You can also send e-mail to Philips Ultrasound Technical Commu-nications at the following address:

[email protected]

mailto://[email protected]

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Ordering Supplies and AccessoriesYou can order transducer covers, biopsy guides, and other supplies and accesso-ries from CIVCO Medical Instruments:

CIVCO Medical Instruments102 First St. SouthKalona, IA 52247-9589

Telephone: 800-445-6741, Ext. 1 for Customer Service (USA)+1 319-656-4447 (International)

Fax: 877-329-2482 (USA), +1 319-656-4451 (International)

E-mail: [email protected]

Internet: www.civco.com

Customer ServiceCustomer service representatives are available worldwide to answer questionsand to provide maintenance and service. Please contact your local Philips Ultra-sound representative for assistance. You can also contact one of the followingoffices for referral to a customer service representative, or visit the Philips Ultra-sound Web site at www.medical.philips.com.

Corporate and North American Headquarters

P.O. Box 3003Bothell, WA 98041-3003USA

Telephone: 800-433-3246 or +1 425-487-7000Fax: +1 425-487-8188

Asia Pacific Headquarters

28/Floor, Hopewell Centre17 Kennedy Road, WanchaiHong Kong

Telephone: +852 2821 5888Fax: +852 2527 6727

http://www.medical.philips.com

mailto://[email protected]

http://www.civco.com

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European Headquarters (also serves Africa and the Middle East)

Roentgenstrasse 24, Gebaude SD-22335 HamburgGermany

Telephone: +49 40 5078 4532Fax: +49 40 5078 4546

Latin American Headquarters

1550 Sawgrass Corporate Parkway, Suite 300Sunrise, FL 33323USA

Telephone: +1 954-835-2600Fax: +1 954-835-2626


2 SafetyPlease read this information before using your ultrasound system. Itapplies to the ultrasound system, transducers, recording devices, and any optionalequipment.This section covers general safety information only. Safety informationthat applies only to a specific task is included in the procedure for that task.

This device is intended for use by, or by the order of, and under the supervisionof a licensed physician qualified to direct the use of the device.

A WARNING describes precautions necessary to prevent injury or loss of life.

A CAUTION describes precautions necessary to protect the equipment.

Electrical SafetyThis equipment has been verified by a recognized third-party testing agency as aClass I device with Type BF and Type CF isolated patient-applied parts. (The safetystandards met by this system are included in the system User Reference.) For max-imum safety observe these warnings:

WARNINGS• Shock hazards may exist if this system, including all externally mounted

recording and monitoring devices, is not properly grounded. Protectionagainst electrical shock is provided by grounding the chassis with a three-wirecable and plug. The system must be plugged into a grounded outlet. Thegrounding wire must not be removed or defeated.

• Do not remove the protective covers on the system; hazardous voltages arepresent inside. Cabinet panels must be in place while the system is in use. Allinternal adjustments and replacements must be made by a qualified PhilipsUltrasound field service engineer.

• Do not operate this system in the presence of flammable gases or anesthetics.Explosion can result.

• To avoid risk of electrical shock hazards, always inspect the transducer beforeuse: Check the face, housing, and cable before use. Do not use if the face iscracked, chipped, or torn, the housing is damaged, or the cable is abraded.

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WARNINGS• To avoid risk of electrical shock hazards, always turn off the system and dis-

connect it from the wall outlet prior to cleaning the system.

• All patient contact devices, such as transducers, pencil probes, and ECG leadsmust be removed from patient contact prior to application of a high voltagedefibrillation pulse.

• Connection of optional devices not supplied by Philips Ultrasound couldresult in electrical shock. When such optional devices are connected to yourultrasound system, ensure that the total system earth leakage current doesnot exceed 300 µA.

• To avoid risk of electrical shock, do not use any transducer that has beenimmersed beyond the specified cleaning or disinfection level. See the "Disin-fectants and Gels" section.

• To avoid risks of electrical shock and fire hazards, inspect the system powercord and plug on a regular basis. Ensure that they are not damaged in any way.

CAUTIONS• Although your system has been manufactured in compliance with existing

EMI/EMC requirements, use of this system in the presence of an electromag-netic field can cause momentary degradation of the ultrasound image. If thisoccurs often, review the environment in which the system is being used, toidentify possible sources of radiated emissions. These emissions could be fromother electrical devices used within the same room or an adjacent room.Communication devices such as cellular phones and pagers can cause theseemissions. The existence of radio, TV, or microwave transmission equipmentlocated nearby can cause emissions. In cases where EMI is causing distur-bances, it may be necessary to relocate your system.

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CAUTIONS• Electrostatic discharge (ESD), commonly referred to as a static shock, is a nat-

urally occurring phenomenon. ESD is most prevalent during conditions of lowhumidity, which can be caused by heating or air conditioning. During lowhumidity conditions, electrical charges naturally build up on individuals and cancreate static shocks. An ESD condition occurs when an individual with anelectrical energy build-up comes in contact with objects such as metal door-knobs, file cabinets, computer equipment, and even other individuals. Thestatic shock or ESD is a discharge of the electrical energy build-up from acharged individual to a lesser or non-charged individual or object. The level ofelectrical energy discharged from a system user or patient to the ultrasoundsystem can be significant enough to cause damage to the system or transduc-ers.

• The following precautions can help to reduce ESD: anti-static spray on car-pets; anti-static spray on linoleum; anti-static mats; or a ground wire connec-tion between the system and the patient table or bed.

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Mechanical Safety

WARNINGS• Be aware of the casters, especially when moving the system. The system could

cause injury to you or others if it rolls over feet or into shins. Exercise cautionwhen going up or down ramps.

• When attempting to overcome an obstacle, do not push the system fromeither side with excessive force, which could cause the system to tip over.

• Position external hardcopy devices away from the system. Ensure that theyare secure. Do not stack them on the system.

• When positioning the articulated monitor, move it carefully to avoid pinchinghands or extremities against other objects, such as a bed rail.

• Never park the system on an incline.

• The brakes are intended as a convenience. To increase cart security, use wheelchocks when the system is parked.

• If the system behaves abnormally after moving or transporting it, contact Phil-ips Ultrasound Customer Service immediately. System components can with-stand considerable shock, but excessive shock can cause a system failure.

• Before moving the system, ensure that the keyboard is retracted, the controlpanel is centered, and the monitor is locked (see "Positioning the ControlModule" on page 98 and "Preparing and Moving" on page 84). Whenextended, the keyboard might be damaged if it hits another object, and thevideo monitor could swing out during transport, causing injury or equipmentdamage.

CAUTIONS• Ensure that the cables for all patient-applied parts are secure before moving

the system. Use the cable management system to ensure that transducercables are protected from damage.

• Do not roll the system over transducer cables or power cables.

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Equipment ProtectionFollow these precautions to protect your system:

CAUTIONS• Excessive bending or twisting of cables on patient-applied parts may cause fail-

ure or intermittent operation of the system. Take care not to run over cableswith the system, which may damage them.

• Improper cleaning or sterilization of a patient-applied part may cause perma-nent damage. For cleaning and disinfection instructions, see the "Disinfectantsand Gels" section.

• Do not submerge the cables of patient-applied parts in solution. The cablesare not liquid-tight beyond the applied part/cable or cable/connector inter-faces.

• Do not use solvents such as thinner or benzine or abrasive cleaners on thesystem, transducers, or any hardcopy device.

• For optimal performance, your ultrasound system should be connected to acircuit dedicated solely for the ultrasound system.

• In general, only the area of the transducer acoustic window is watertight.Except where specified in specific transducer cleaning instructions, do notimmerse the remainder of a transducer in any liquid.

SymbolsThe International Electrotechnical Commission has established a set of symbolsfor medical electronic equipment that classify a connection or warn of potentialhazards. The classifications and symbols are shown below.

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The following symbols are also used on the system:

Isolated patient connection. (Type BF)

Isolated patient connection for applied parts in direct contact with major vessels. (Type CF)

Identifies ESD sensitivity of a connector that is not tested as specified in IEC 60601-1-2.

On the power switch, represents ON and OFF.

Identifies the On/Standby switch.

This symbol identifies a safety note. Ensure you understand the function of this control before using it. Refer to the appropriate section of the system documentation for an explanation of the control.

Identifies equipotential ground.

Indicates that this device is protected against the effects of vertically falling water. This degree of protection can apply to transducers.

Indicates that this device is protected against the effects of immersion. This degree of protection can apply to transducers.

This product consists of devices that may contain lead or mercury, which must be recycled or disposed of in accordance with local, state, or federal laws.

Do not throw away. Dispose of in accordance with local, state, or federal laws.

IPx1

IPx7

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The following symbols are used inside the system:

Connection for a pencil probe

Connection for a transducer

Connection for ECG

Print remote output

Input port for audio left/right, VHS/S-VHS, microphone, or DVD

Output port for audio left/right, VHS/S-VHS, video patient monitor, black-and-white printer, or interlaced RGB output port

VGA or parallel output port

USB input/output port

Ethernet connection

Identifies high-voltage components

Ground

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Biological SafetyThis section contains information about biological safety and a discussion of theprudent use of the system.

A list of precautions related to biological safety follows; observe these precau-tions when using the system. For more information refer to Medical UltrasoundSafety on your user information CD.

WARNINGS• Do not use the system if an error message appears on the video display indi-

cating that a hazardous condition exists. Note the error code, turn off powerto the system, and call your customer service representative.

• Do not use a system that exhibits erratic or inconsistent image updating. Dis-continuities in the scanning sequence are indicative of a hardware failure thatmust be corrected before use.

• Perform ultrasound procedures prudently. Use the ALARA (as low as reason-ably achievable) principle.

• Use only acoustic standoffs that have been approved by Philips Ultrasound.

• Verify the alignment of the biopsy guide before use. See the "Biopsy Guides"section in this manual.

• Verify the condition of the biopsy needle before use. Do not use a bent biopsyneedle.

• Transducer covers may contain natural rubber latex. Those covers may causeallergic reactions in some individuals. Refer to the FDA Medical Alert on LatexProducts, dated March 29, 1991, reprinted under "Transducer Covers" onpage 322 of this manual.

• In contrast studies using a high-MI acoustic field, capillary rupture, due tomicrobubble expansion within a capillary in an acoustic field, can causeextravasation.

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WARNINGS• Preventricular contractions can be caused by the oscillations of microbubbles

when a high-MI acoustic field is triggered in the heart at the end of systole. Ina very sick patient with certain risk factors, theoretically, this could lead toventricular fibrillation. References: 1. Skyba DM, Price RJ, Linka AZ, SkalakTC, Kaul S. Direct in vivo visualization of intravascular destruction of microbubblesby ultrasound and its local effects on tissue. Circulation 1998;98:290-293. 2. vanDer Wouw PA, Brauns AC, Bailey SE, Powers JE, Wilde AA. Premature ventric-ular contractions during triggered imaging with ultrasound contrast. J Am SocEchocardiogr 2000;13(4):288-94.

• If a sterile transducer cover becomes compromised during an intraoperativeapplication involving a patient with Creutzfeldt-Jakob disease, the transducercannot be sterilized with any sterilization method.

• If the system becomes contaminated internally with bodily fluids carryingpathogens, you must immediately notify your Philips Ultrasound service repre-sentative. The system’s internal components cannot be disinfected. In thiscase, the system must be disposed of as biohazardous material in accordancewith local or federal laws.

• The backlight lamps in the system displays contain mercury and must be recy-cled or disposed of according to local, state, or federal laws.

ALARA Education ProgramThe guiding principle for the use of diagnostic ultrasound is defined by the “as lowas reasonably achievable” (ALARA) principle. The decision as to what is reason-able has been left to the judgement and insight of qualified personnel. No set ofrules can be formulated that would be sufficiently complete to dictate the correctresponse to every circumstance. By keeping ultrasound exposure as low as possi-ble, while obtaining diagnostic images, users can minimize ultrasonic bioeffects.

Since the threshold for diagnostic ultrasound bioeffects is undetermined, it is thesonographer’s responsibility to control total energy transmitted into the patient.The sonographer must reconcile exposure time with diagnostic image quality. Toensure diagnostic image quality and limit exposure time, an ultrasound systemprovides controls that can be manipulated during the exam to optimize theresults of the exam.

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The ability of the user to abide by the ALARA principle is important. Advances indiagnostic ultrasound not only in the technology but in the applications of thattechnology, have resulted in the need for more and better information to guidethe user. The output display indices are designed to provide that important infor-mation.

There are a number of variables which affect the way in which the output displayindices can be used to implement the ALARA principle. These variables includeindice values, body size, location of the bone relative to the focal point, attenua-tion in the body, and ultrasound exposure time. Exposure time is an especiallyuseful variable, because it is controlled by the user. The ability to limit the indexvalues over time supports the ALARA principle.

Applying ALARA

The system imaging mode used depends upon the information needed. 2D andM-mode imaging provide anatomical information, while Doppler, Philips ColorPower Angio (CPA), and Color imaging provide information about blood flow. Ascanned mode, like 2D, CPA, or Color, disperses or scatters the ultrasonic energyover an area, while an unscanned mode, like M-Mode or Doppler, concentratesultrasonic energy. Understanding the nature of the imaging mode being usedallows the sonographer to apply the ALARA principle with informed judgement.Additionally, the transducer frequency, system setup values, scanning techniques,and operator experience allow the sonographer to meet the definition of theALARA principle.

The decision as to the amount of acoustic output is, in the final analysis, up to thesystem operator. This decision must be based on the following factors: type ofpatient, type of exam, patient history, ease or difficulty of obtaining diagnosticallyuseful information, and the potential localized heating of the patient due to trans-ducer surface temperatures. Prudent use of the system occurs when patientexposure is limited to the lowest index reading for the shortest amount of timenecessary to achieve acceptable diagnostic results.

Although a high index reading does not mean that a bioeffect is actually occurring,a high index reading should be taken seriously. Every effort should be made toreduce the possible effects of a high index reading. Limiting exposure time is aneffective way to accomplish this goal.

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There are several system controls that the operator can use to adjust the imagequality and limit the acoustic intensity. These controls are related to the tech-niques that an operator might use to implement ALARA. These controls can bedivided into three categories: direct, indirect, and receiver controls.

Direct Controls

Application selection and the Output Power control directly affect acousticintensity. There are different ranges of allowable intensity or output based onyour selection. Selecting the correct range of acoustic intensity for the applicationis one of the first things that occurs in any exam. For example, peripheral vascularintensity levels are not recommended for fetal exams. Some systems automati-cally select the proper range for a particular application, while others requiremanual selection. Ultimately, the user has the responsibility for proper clinical use.The ultrasound system provides both automatic (default) settings and manual(user-selectable) settings.

Output Power has direct impact on acoustic intensity. Once the application hasbeen established, the Output Power control can be used to increase ordecrease the intensity output. The Output Power control allows you to selectintensity levels less than the established maximum. Prudent use dictates that youselect the lowest output intensity that is consistent with good image quality.

Indirect Controls

The indirect controls are those that have an indirect effect on acoustic intensity.These controls affect imaging mode, pulse repetition frequency, focus depth, pulselength, and transducer selection.

The choice of imaging mode determines the nature of the ultrasound beam. 2D isa scanning mode, Doppler is a stationary or unscanned mode. A stationary ultra-sound beam concentrates energy in a single location. A moving or scanned ultra-sound beam disperses the energy over an area and the beam is concentrated onthe same area for a fraction of the time as that of an unscanned mode.

Pulse repetition frequency or rate refers to the number of ultrasound bursts ofenergy over a specific period of time. The higher the pulse repetition frequency,the more pulses of energy in a period of time. Several controls affect pulse repeti-tion frequency: focal depth, display depth, sample volume depth, flow optimiza-tion, scale, number of focal zones, and sector width controls.

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Focus of the ultrasound beam affects the image resolution. To maintain orincrease resolution at a different focus requires a variation in output over thefocal zone. This variation of output is a function of system optimization. Differentexams require different focal depths. Setting the focus at the proper depthimproves the resolution of the structure of interest.

Pulse length is the time during which the ultrasonic burst is turned on. The longerthe pulse, the greater the time-average intensity value. The greater the time-aver-age intensity, the greater the likelihood of temperature increase and cavitation.Pulse length or burst length or pulse duration is the output pulse duration inpulsed Doppler. Increasing the Doppler sample volume size increases the pulselength.

Transducer selection indirectly affects intensity. Tissue attenuation changes withfrequency. The higher the transducer operating frequency, the greater the attenu-ation of the ultrasonic energy. A higher transducer operating frequency requiresmore output intensity to scan at a deeper depth. To scan deeper at the same out-put intensity, a lower transducer frequency is required. Using more gain and out-put beyond a point, without corresponding increases in image quality, can meanthat a lower frequency transducer is needed.

Receiver Controls

Receiver controls are used by the operator to improve image quality. These con-trols have no effect on output. Receiver controls only affect how the ultrasoundecho is received. These controls include gain, TGC, dynamic range, and imageprocessing. The important thing to remember, relative to output, is that receivercontrols should be optimized before output is increased. For example: beforeincreasing output, optimize gain to improve image quality.

An Example of Applying ALARA

An ultrasound scan of a patient’s liver begins with selecting the appropriate trans-ducer frequency. After selecting the transducer and the application, which arebased on patient anatomy, adjustments to output power should be made toensure that the lowest possible setting is used to acquire an image. After theimage is acquired, adjusting the focus of the transducer, and then increasing thereceiver gain to produce a uniform representation of the tissue follows. If an ade-quate image can be obtained with the increase in gain, then a decrease in output

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should be made. Only after making these adjustments should you increase outputto the next level.

Having acquired the 2D display of the liver, Color can be used to localize bloodflow. As with the 2D image display, gain and image processing controls must beoptimized before increasing output.

Having localized the blood flow, use the Doppler controls to position the samplevolume over the vessel. Before increasing output, adjust velocity range or scaleand Doppler gain to obtain an optimal Doppler trace. Only if maximum Dopplergain does not create an acceptable image do you increase output.

In summary: select the correct transducer frequency and application for the job;start with a low output level; optimize the image using focus, receiver gain, andother imaging controls; if the image is not diagnostically useful at this point, thenincrease output.

Additional Considerations

Ensure that scanning time is kept to a minimum, and ensure that only medicallyrequired scanning is performed. Never compromise quality by rushing through anexam. A poor exam may require a follow-up, which ultimately increases exposuretime. Diagnostic ultrasound is an important tool in medicine, and, like any tool, itshould be used efficiently and effectively.

Output DisplayThe system output display comprises two basic indices: a mechanical index and athermal index. The thermal index further consists of the following indices: softtissue (TIS), bone (TIB), and cranial bone (TIC). One of these three thermal indi-ces will be displayed at all times. Which one depends upon the system preset oruser choice, depending upon the application at hand.

The mechanical index is continuously displayed over the range of 0.0 to 1.9, inincrements of 0.1.

The thermal index consists of the three indices, and only one of these is displayedat any one time. Each transducer application has a default selection that is appro-priate for that combination. The TIB, TIS, or TIC is continuously displayed overthe range of 0.0 to maximum output, based on the transducer and application, inincrements of 0.1.

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The application-specific nature of the default setting is also an important factor ofindex behavior. A default setting is a system control state which is preset by themanufacturer or the operator. The system has default index settings for the trans-ducer application. The default settings are invoked automatically by the ultrasoundsystem when power is turned on, new patient data is entered into the systemdata base, or a change in application takes place. Figure 2-1 illustrates the imple-mentation of the output display.

Figure 2-1 On-Screen TI and MI

The decision as to which of the three thermal indices to display should be basedon the following criteria:

• Appropriate index for the application: TIS is used for imaging soft tissue, TIBfor a focus at or near bone, and TIC for imaging through bone near the sur-face, as in a cranial exam.

• Mitigating factors that might create artificially high or low thermal index read-ings: location of fluid or bone, or blood flow. For example, is there a highlyattenuating tissue path so that the actual potential for local zone heating is lessthan the thermal index displays.

• Scanned modes versus unscanned modes of operation affect the thermalindex. For scanned modes, heating tends to be near the surface; forunscanned modes, the potential for heating tends to be deeper in the focalzone.

• Always limit ultrasound exposure time. Do not rush the exam. Ensure thatthe indices are kept to a minimum and that exposure time is limited withoutcompromising diagnostic sensitivity.

TI and MI values

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Mechanical Index (MI) Display

Mechanical bioeffects are threshold phenomena that occur when a certain level ofoutput is exceeded. The threshold level varies, however, with the type of tissue.The potential for mechanical bioeffects varies with peak pressure and ultrasoundfrequency. The MI accounts for these two factors. The higher the MI value, thegreater the likelihood of mechanical bioeffects occurring. There is no specific MIvalue that means that a mechanical effect is actually occurring. The MI should beused as a guide for implementing the ALARA principle.

Thermal Index (TI) Displays

The TI informs the user about the conditions that exist that might lead to anincrease in temperature at the surface of the body, within the body tissue, or atthe point of focus of the ultrasound beam on bone. That is, the TI informs theuser of the potential for temperature rise in body tissue. It is an estimate of tem-perature increase in body tissue with specific properties. The actual amount ofany temperature rise is influenced by factors such as tissue type, vascularity, modeof operation and others. The TI should be used as a guide for implementing theALARA principle.

The bone thermal index (TIB) informs the user about potential heating at or nearthe focus after the ultrasound beam has passed through soft tissue or fluid, forexample, at or near second or third trimester fetal bone.

The cranial bone thermal index (TIC) informs the user about the potential heatingof bone at or near the surface, for example, cranial bone.

The soft tissue thermal index (TIS) informs the user about the potential for heat-ing within soft homogeneous tissue.

You can display TIS, TIC, or TIB by touching TI. TIC is displayed when you selecta transcranial application.

Mechanical and Thermal Indices Display Precision and Accuracy

The MI and TI precision is 0.1 unit on the system.

The MI and TI display accuracy estimates for the system are given in Acoustic Out-put Tables, on the user information CD. These accuracy estimates are based onthe variability range of transducers and systems, inherent acoustic output model-ing errors and measurement variability, as discussed below.

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The displayed values should be interpreted as relative information to help the sys-tem operator achieve the ALARA principle through prudent use of the system.The values should not be interpreted as actual physical values in interrogated tis-sue or organs. The initial data that is used to support the output display is derivedfrom laboratory measurements based on the American Institute of Ultrasound inMedicine (AIUM) measurement standard. The measurements are then put intoalgorithms for calculating the displayed output values.

Many of the assumptions used in the process of measurement and calculation areconservative in nature. Over-estimation of actual in situ intensity exposure, forthe vast majority of tissue paths, is built into the measurement and calculationprocess. For example:

• The measured water tank values are derated using a conservative, industrystandard, attenuation coefficient of 0.3 dB/cm-MHz.

• Conservative values for tissue characteristics were selected for use in the TImodels. Conservative values for tissue or bone absorption rates, blood perfu-sion rates, blood heat capacity, and tissue thermal conductivity were selected.

• Steady State temperature rise is assumed in the industry standard TI models,and the assumption is made that the ultrasound transducer is held steady inone position long enough for steady state to be reached.

A number of factors are considered when estimating the accuracy of the displayedvalues: hardware variations, estimation algorithm accuracy, and measurementvariability. Variability among transducers and systems is a significant factor. Trans-ducer variability results from piezoelectric crystal efficiencies, process-relatedimpedance differences, and sensitive lens focusing parameter variations. Differ-ences in system pulser voltage control and efficiencies is also a contributor tovariability. There are inherent uncertainties in the algorithms used to estimateacoustic output values over the range of possible system operating conditions andpulser voltages. Inaccuracies in laboratory measurements are related to, amongothers, differences in hydrophone calibration and performance, positioning, align-ment, and digitization tolerances, and variability among test operators.

The conservative assumptions of the output estimation algorithms of linear prop-agation, at all depths, through a 0.3 dB/cm-MHz attenuative medium is not consid-ered in the accuracy estimate for the display. Neither linear propagation, noruniform attenuation at the 0.3 dB/cm-MHz rate, occur in water tank measure-ments or in most tissue paths in the body. In the body, different tissues and organs

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have dissimilar attenuation characteristics. In water, there is almost no attenua-tion. In the body, and in particular, in water tank measurements, non-linear propa-gation and saturation losses occur as pulser voltages increase.

Therefore, the display accuracy estimates are based on the variability range oftransducers and systems, inherent acoustic output modeling errors, and measure-ment variability. Display accuracy estimates are not based on errors in, or causedby measuring according to, the AIUM measurement standards, or the effects ofnon-linear loss on the measured values.

Control Effects

Controls Affecting the Indices

As various system controls are adjusted, the TI and MI values may change. Thiswill be most apparent as the Output Power control is adjusted; however, othersystem controls will affect the on-screen output values.

Output Power

Output Power controls the system acoustic output. Two real-time output valuesare on the screen: a TI and MI. They change as the system responds to OutputPower adjustments.

In combined modes, such as simultaneous Color, 2D and pulsed-wave Doppler,the individual modes each add to the total TI. One mode will be the dominantcontributor to this total. The displayed MI will be from the mode with the largestpeak pressure.

2D Controls

Sector Width

Narrowing the sector angle may increase frame rate. This action will increase theTI. Pulser voltage may be automatically adjusted down with software controls tokeep the TI below the system maximums. A decrease in pulser voltage willdecrease MI.

Zoom

Increasing the zoom magnification by pressing Zoom may increase frame rate.This action will increase the TI. The number of focal zones may also increase

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automatically to improve resolution. This action may change MI since the peakintensity can occur at a different depth.

Number of Focal Zones

More focal zones may change both the TI and MI by changing frame rate or focaldepth automatically. Lower frame rates decrease the TI. MI displayed will corre-spond to the zone with the largest peak intensity.

Focus

Changing the focal depth will change MI. Generally, higher MI values will occurwhen the focal depth is near the natural focus of the transducer.

Color and Power Controls

Flow Opt

Increasing the color sensitivity with the Flow Opt control may increase the TI.More time is spent scanning the color image. Color pulses are the dominant pulsetype in this mode.

Color Sector Width

Narrower color sector width will increase color frame rate and the TI willincrease. The system may automatically decrease pulser voltage to stay below thesystem maximum. A decrease in pulser voltage will decrease the MI. If pulsedDoppler is also enabled then pulsed Doppler will remain the dominant mode andthe TI change will be small.

Color Sector Depth

Deeper color sector depth may automatically decrease color frame rate or selecta new color focal zone or color pulse length. The TI will change due to the com-bination of these effects. Generally, the TI will decrease with increased color sec-tor depth. MI will correspond to the peak intensity of the dominant pulse typewhich is a color pulse. However, if pulsed Doppler is also enabled then pulsedDoppler will remain the dominant mode and the TI change will be small.

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Scale

Using the scale control to increase the color velocity range may increase the TI.The system may automatically adjust pulser voltage to stay below the system max-imums. A decrease in pulser voltage will also decrease MI.

Sector Width

A narrower 2D sector width in Color imaging will increase color frame rate. TheTI will increase. MI will not change. If pulsed Doppler is also enabled, then pulsedDoppler will remain the dominant mode and the TI change will be small.

M-Mode and Doppler Controls

Simultaneous and Update Methods

Use of combination modes affects both the TI and MI through the combination ofpulse types. During simultaneous mode, the TI is additive. During duplex, the TIwill display the dominant pulse type. The displayed MI will be from the mode withthe largest peak pressure.

Sample Volume Depth

When Doppler sample volume depth is increased the Doppler PRF may automat-ically decrease. An increase in PRF will increase the TI. The system may also auto-matically decrease the pulser voltage to remain below the system maximum. Adecrease in pulser voltage will decrease MI.

Other

2D, Color, M-Mode, CPA, PW, and CW

When a new imaging mode is selected, both the TI and MI may change to defaultsettings. Each mode has a corresponding pulse repetition frequency and maximumintensity point. In combined or simultaneous modes, the TI is the sum of the con-tribution from the modes enabled and MI is the MI for the focal zone and modewith the largest derated intensity. The system will return to the previouslyselected state if a mode is turned off and then reselected.

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Transducer

Each transducer type has unique specifications for contact area, beam shape, andcenter frequency. Defaults are initialized when you select a transducer. Factorydefaults vary with transducer, application, and selected mode. Defaults have beenchosen below the FDA limits for intended use.

Depth

An increase in 2D depth will automatically decrease the 2D frame rate. Thiswould decrease the TI. The system may also automatically choose a deeper 2Dfocal depth. A change of focal depth may change the MI. The MI displayed is thatof the zone with the largest peak intensity.

Application

Acoustic output defaults are set when you select an application. Factory defaultsvary with transducer, application, and mode. Defaults have been chosen below theFDA limits for intended use.

Related Guidance DocumentsFor more information about ultrasonic bioeffects and related topics the following:

1. AIUM Report, January 28, 1993, “Bioeffects and Safety of Diagnostic Ultra-sound”

2. Bioeffects Considerations for the Safety of Diagnostic Ultrasound, J UltrasoundMed., Sept. 1988: Vol. 7, No. 9 Supplement

3. Acoustic Output Measurement Standard for Diagnostic Ultrasound Equip-ment. (AIUM, NEMA. 1998)

4. Acoustic Output Labeling Standard for Diagnostic Ultrasound Equipment(AIUM, 1998)

5. Second Edition of the AIUM Output Display Standard Brochure, Dated March10, 1994. (A copy of this document is provided with each system.)

6. Information for Manufacturers Seeking Marketing Clearance of DiagnosticUltrasound Systems and Transducers. FDA. September 1997. FDA.

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7. Standard for Real-Time Display of Thermal and Mechanical Acoustic OutputIndices on Diagnostic Ultrasound Equipment. (Revision 1, AIUM, NEMA.1998)

8. WFUMB. Symposium on Safety of Ultrasound in Medicine: Conclusions andRecommendations on Thermal and Non-Thermal Mechanisms for BiologicalEffects of Ultrasound, Ultrasound in Medicine and Biology, 1998: Vol. 24, Supple-ment 1.

Acoustic Output and MeasurementSince the initial use of diagnostic ultrasound, the possible human biological effects(bioeffects) from ultrasound exposure have been studied by various scientific andmedical institutions. In October 1987, the American Institute of Ultrasound inMedicine (AIUM) ratified a report prepared by its Bioeffects Committee (Bioef-fects Considerations for the Safety of Diagnostic Ultrasound, J Ultrasound Med.,Sept. 1988: Vol. 7, No. 9 Supplement), sometimes referred to as the StoweReport, which reviewed available data on possible effects of ultrasound exposure.Another report “Bioeffects and Safety of Diagnostic Ultrasound,” dated January28, 1993, provides more current information.

The acoustic output for this system has been measured and calculated in accor-dance with the “Acoustic Output Measurement Standard for Diagnostic Ultra-sound Equipment” (AIUM, NEMA 1998), the “Standard for Real-Time Display ofThermal and Mechanical Acoustic Output Indices on Diagnostic UltrasoundEquipment” (Revision 1, AIUM, NEMA 1998), and the September, 1997 FDA doc-ument “Information for Manufacturers Seeking Marketing Clearance of DiagnosticUltrasound Systems and Transducers.”

In Situ, Derated, and Water Value Intensities

All intensity parameters are measured in water. Since water absorbs very littleacoustic energy, these water measurements represent a worst case value. Biolog-ical tissue does absorb acoustic energy. The true value of the intensity at anypoint depends on the amount and type of tissue and the frequency of the ultra-sound that passes through the tissue. The intensity value in the tissue, In Situ, hasbeen estimated by using the following formula:

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In Situ = Water [e-0.23alf]

Since the ultrasonic path during an examination is likely to pass through varyinglengths and types of tissue, it is difficult to estimate the true In Situ intensity. Anattenuation factor of 0.3 is used for general reporting purposes; therefore, the InSitu value which is commonly reported uses the formula:

In Situ derated = Water [e-0.069lf]

Since this value is not the true In Situ intensity, the term “derated” is used.

Mathematical derating of water based measurements using the 0.3 dB/cm-MHzcoefficient, may yield lower acoustic exposure values than would be measured in ahomogenous 0.3 dB/cm-MHz tissue. This is true because non-linearly propagatingacoustic energy waveforms experience more distortion, saturation, and absorp-tion in water than in tissue, where attenuation present all along the tissue pathwill dampen the buildup of non-linear effects.

Where: In Situ = In Situ Intensity Value

Water = Water Value Intensity

e = 2.7183

a = Attenuation Factor

Tissue = a(dB/cm-MHz)

AmnioticFluid

= 0.006

Brain = 0.53

Heart = 0.66

Kidney = 0.79

Liver = 0.43

Muscle = 0.55

l = Skin line to measurement depth (cm)

f = Center frequency of the transducer/system/mode combination (MHz)

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The maximum derated and the maximum water values do not always occur at thesame operating conditions; therefore, the reported maximum water and deratedvalues may not be related by the In Situ (derated) formula. For example: amulti-zone array transducer that has maximum water value intensities in its deep-est zone also has the smallest derating factor in that zone. The same transducermay have its largest derated intensity in one of its shallowest focal zones.

Conclusions Regarding Tissue Models and Equipment Survey

Tissue models are necessary to estimate attenuation and acoustic exposure levelsIn Situ from measurements of acoustic output made in water. Presently, availablemodels may be limited in their accuracy because of varying tissue paths duringdiagnostic ultrasound exposures and uncertainties in acoustical properties of softtissues. No single tissue model is adequate for predicting exposures in all situa-tions from measurements made in water, and continued improvement and verifi-cation of these models is necessary for making exposure assessments for specificapplications.

A homogeneous tissue model with an attenuation coefficient of 0.3 dB/cm-MHzthroughout the beam path is commonly used when estimating exposure levels.The model is conservative in that it overestimates the In Situ acoustic exposurewhen the path between the transducer and the site of interest is composedentirely of soft tissue, because the attenuation coefficient of soft tissue is generallyhigher than 0.3 dB/cm-MHz. When the path contains significant amounts of fluid,as in many first and second-trimester pregnancies scanned transabdominally, thismodel may underestimate the In Situ acoustical exposure. The amount of under-estimation depends on each specific situation. For example, when the beam pathis longer than 3 cm and the propagation medium is predominantly fluid (condi-tions that may exist during transabdominal OB scans), a more accurate value forthe derating term is 0.1 dB/cm-MHz.

Fixed-path tissue models, in which soft tissue thickness is held constant, some-times are used to estimate In Situ acoustical exposures when the beam path islonger than 3 cm and consists largely of fluid. When this model is used to esti-mate maximum exposure to the fetus during transabdominal scans, a value of 1dB/MHz may be used during all trimesters.

The maximum acoustic output levels of diagnostic ultrasound devices extend overa broad range of values:

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• A survey of 1990-equipment models yielded mechanical index (MI) valuesbetween 0.1 and 1 at their highest output settings. Maximum MI values ofapproximately 2 are known to occur for currently available equipment. Maxi-mum MI values are similar for real-time 2D, M-mode, pulsed Doppler, andColor flow imaging.

• Computed estimates of upper limits to temperature elevations during trans-abdominal scans were obtained in a survey of 1988 and 1990 pulsed Dopplerequipment. The vast majority of models yielded upper limits less than 1degree C and 4 degrees C for exposures of first-trimester fetal tissue and sec-ond-trimester fetal bone, respectively. The largest values obtained wereapproximately 1.5 degrees C for first-trimester fetal tissue and 7 degrees Cfor second-trimester fetal bone. Estimated maximum temperature elevationsgiven here are for a “fixed-path” tissue model and are for devices having ISPTA

values greater than 500 mW/cm2. The temperature elevations for fetal boneand tissue were computed based on calculation procedures given in Sections4.3.2.1-4.3.2.6 in Bioeffects and Safety of Diagnostic Ultrasound (AIUM, 1993).

Acoustic Output TablesAcoustic output tables are in Acoustic Output Tables, on your user information CD.

Acoustic Measurement Precision and UncertaintyAll table entries have been obtained at the same operating conditions that giverise to the maximum index value in the first column of the tables. Measurementprecision and uncertainty for power, pressure, intensity, and center frequency areshown inTable 2-1 and Table 2-2.

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Table 2-1 Acoustic Measurement Precision

NOTEPer Section 6.4 of the Output Display Standard, measurement precision on thefollowing quantities is determined by making repeated measurements and statingthe standard deviation as a percentage.

QuantityPrecision

(Percentage Standard Deviation)

Pr is the underated peak rarefactional pressure measured in MegaPascals.

Pr: 5.4%

Wo is the ultrasonic power in milliWatts.

6.2%

fc is the center frequency in MHz (NEMA UD-2 definition).

<1%

PII.3 is the derated spatial-peak pulse intensity integral in Joules/cm2.

PII.3: 3.2%

Table 2-2 Acoustic Measurement Uncertainty

Quantity

Measurement Uncertainty (percentage, 95% confidence

value)

Pr is the underated peak rarefactional pressure measured in MegaPascals.

Pr ± 11.3%

Wo is the ultrasonic power in milliWatts.

± 10%

fc is the center frequency in MHz (NEMA UD-2 definition).

± 4.7%

PII.3 is the derated spatial-peak pulse intensity integral in Joules/cm2.

PII.3: +18% to -23%

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3 System OverviewUse this section to acquaint yourself with the iU22 Ultrasound System and itscomponents.

System CapabilitiesThe iU22 Ultrasound System is a high-resolution system intended for generalimaging and shared services. The cart is ergonomically designed to be both highlymobile and adjustable for a range of users and operating conditions (Figure 3-1).You can use it for 2D, 3D, 4D, M-mode, Doppler, Color, and Philips Color PowerAngio (CPA) imaging. You can also perform duplex and triplex imaging. The sys-tem supports a wide range of transducers. The system provides measurementtools, calculations options, and DICOM network capabilities.

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Figure 3-1 iU22 Ultrasound System

MeasurementsThe system provides tools and controls for measuring distance, area, and volume.In calculations, the following application-specific tools are available:

• 2D Depth

• Distance

• Ellipse

• Convert to Ellipse

• Continuous Trace

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• Trace by Points

• Curved Distance

• Volume

• Hip Angle

• Volume Flow

• % Reduction

• Heart Rate

• Time/Slope

• Erase Caliper

• Backup

• End Measure

After you perform measurements, the system makes the pertinent calculationsand organizes the measurements, calculations, and patient information into apatient report. For information, see "Measurements" on page 221.

TransducersA range of transducers is available: curved, sector, linear, compact linear, and 3D.Specialty transducers are also available. Applications for specific transducers arelisted in "Clinical Options and Transducers" on page 317.

Image Capture and ReviewYou can capture and review single images and Philips Cineloop sequences. Imagesand Cineloop sequences can be stored on digital versatile discs (DVD RW) orsent over a network to an archive server or a printer.

Peripheral devices are available for recording images and exams. You can add aVCR to the system and connect a black-and-white page printer or a color pageprinter. You can also connect a report printer.

Patient Data ProtectionThe system provides a data security feature for protecting patient data and imagespreviously stored on the system. If data protection is implemented on your sys-

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tem, you can access patient data only after entering a password to log onto thesystem. The system automatically logs off a user when power is turned off. Thesystem stores a record of each user logon.

This data protection feature can be used to help meet the requirements of theU.S. Health Insurance Portability and Accountability Act (HIPAA), which becameeffective April 2003.

For more information on protecting patient data, see "Logging On to the System"on page 143.

System OptionsIn addition to the standard features available in the system, other features areavailable as purchasable options. The types of options available include clinicaloptions, protocols, imaging capabilities, and connectivity capabilities.

Imaging Feature OptionsOnce purchased, the imaging feature options listed here are available as sup-ported by the current transducer and application. The following imaging capabili-ties are available as purchasable options on your system:

• 2D iSCAN Intelligent Optimization

• 3D freehand

• 3D/4D (mechanical transducers)

• Doppler iSCAN Intelligent Optimization

• Panoramic Imaging

• Physio

• Philips SonoCT Real-time Compound Imaging

• Voice control

• Philips XRes Image Processing

Connectivity OptionThe following features are standard:

• Image and waveform export to removable media

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• Printing to DICOM printers

• Printing to local printers

• Printing report pages

In addition to those standard features, the Basic Connectivity purchasable optionincludes the following features:

• Image and waveform export to network storage servers

• DICOM worklist

• DICOM performed procedure step (PPS)

• DICOM storage commit (SC)

• DICOM structured reporting

Clinical OptionsClinical options are available on the system as separate purchasable options. Thefollowing clinical packages and their applications (for example, small parts superfi-cial) are associated with specific transducers:

• Abdomen

• Card Adult

• Contrast

• GYN

• Musculoskeletal

• OB

• Pediatric

• Small Parts

• Urology

• Vascular

Calculations Package Options• Abdominal

• Adult Echo

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• General

• GYN

• OB

• Small Parts

• Vascular

Voice Control OptionThe voice control option allows you to operate the system with voice commandstransmitted through a wireless headset You can also use voice control to add textannotation to images. The voice control option can recognize commands inEnglish, French, Italian, German, and Spanish.

Data Security OptionA data security option is available to help maintain the confidentiality of archivedpatient files. With this option, access to patient exam files is restricted to autho-rized personnel through password protection.

Technical Administration OptionThe system includes many diagnostic capabilities as standard features, such aserror handling and remote access for diagnosing the system. The technical admin-istration option adds the following capabilities:

• Advanced tests and other diagnostic tools

• Automatic monitoring and logging of system operating parameters and usage;warnings when operating limits are exceeded

• Enhanced capabilities for self diagnosis

• Enhanced error handling and notification

• Preventive maintenance logging and notification

• Reporting of system and component configuration

• Secure technical administration interface

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System ComponentsThe system is housed in an ergonomic cart. The cart is adjustable to accommo-date a wide range of operator heights and operating positions. Adjustable compo-nents can be locked in place so the cart can be safely moved. The majorcomponents include the monitor, control module, On/Standby switch, DVD RWdrive, peripheral bay, transducer receptacles, ECG/physio receptacles, foot pedals,and rear-panel power switch and audio/video receptacles (Figure 3-2).

Figure 3-2 System Components

Monitor

Power switch

ECG/physioreceptacles

Brake/steering lock foot pedals

Peripheral bayTransducerreceptacles

On/Standbyswitch

DVD RW drive

Controlmodule

Rear panel (Audio, video, and network receptacles)

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Video MonitorThe system video monitor consists of a 17-inch flat-panel display on an articulatedmounting arm. The monitor is adjustable to accommodate different operatingpositions and operator heights. The monitor can also be locked in position formoving the system (refer to "Moving the System" on page 84).

Control ModuleThe control module includes three main components: the control panel, thetouch screen, and the keyboard (Figure 3-3 and Figure 3-4). For more informationon the control module, refer to "System Controls" on page 97.

The control panel contains the main imaging controls. These controls include but-tons, knobs, TGC slide controls, and a trackball. The control module also allowsyou to select transducers, enter patient data, review and annotate images, per-form measurements and calculations, and change setups.

The touch screen, located above the control panel, displays controls that are spe-cific to the current operating mode. The type of controls on the touch screeninclude buttons and rotary displays.

You can adjust the position of the control module vertically and side-to-side. Youcan also swivel the control module.

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Figure 3-3 Control Module

Beneath the control panel is a retractable keyboard (Figure 3-4). The keyboard isused to enter patient data, comments, and text annotation on images. A lightabove the keyboard is switched on when the keyboard is pulled out.

Control panel

Trackball

Touch screen

TGC slide controls

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Figure 3-4 Keyboard

Voice Control HeadsetThe optional voice control feature allows you to operate the system when thecontrol module is out of reach or you need both hands for scanning. You can alsouse voice control to add text annotation to images. Voice control uses a wirelessheadset to send your voice commands to the system.

VCR MicrophoneThe VCR microphone allows you to record comments on a videotape(Figure 3-5).

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Figure 3-5 VCR Microphone

On/Standby SwitchThe On/Standby switch is to the left of the DVD RW drive on the front of thesystem, above the control module (Figure 3-6). When the system is in the standbystate, pushing this switch brings the system into a fully operational state. Pushingthis switch again returns the system to the standby state.

Figure 3-6 On/Standby Switch

VCR microphone

On/Standbyswitch

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Data Storage You can store exam data and images onto removable media using the DVD RWdrive, which is located above the control panel (Figure 3-7). The system harddrive is located inside the system.

Figure 3-7 DVD RW Drive

DVD RW drive

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PeripheralsThe peripheral bay at the back of the system provides space for two peripheraldevices. Those devices can be any combination of the following devices: ablack-and-white printer, a color printer, and a VCR (Figure 3-8). The devices canbe installed in the peripheral bay for access from either the right or left side of thesystem.

Figure 3-8 Peripheral Bay

Transducer Receptacles and Cable ManagementThe system includes three receptacles for array transducers and one receptaclefor a pencil probe (Figure 3-9). Two transducer holders are located on the controlpanel, and two more are on the side of the cart. The front handle is designed toprovide cable management.

Printer

VCR

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Figure 3-9 Transducer Receptacles, Holders, and Cable Management

Array-transducer and pencil-probe receptaclesTransducer holder

Front handle providescable management

Transducer holders

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Physio (ECG) ReceptaclesFor physio support, your system includes receptacles for both high-level andlow-level ECG signals. (The remaining physio receptacles on the system will beavailable in a future update.) The ECG receptacles are on the front panel of thesystem below the control module (Figure 3-10).

Figure 3-10 ECG and Physio Receptacles

Low-level ECG receptacle

High-level ECG receptacle

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Rear Panel and Power SwitchThe rear panel of the system contains the receptacles for the peripheral devices,network devices, and power cords. Also located on the rear panel is the powerswitch (Figure 3-11).

Figure 3-11 Rear Panel

Power switch

Audio, video, and network receptacles Pull door to open

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Wheel Brakes and Steering Lock The front wheels include brakes that you can engage to help keep the system inplace during use (Figure 3-12). When you release the brakes, you can engage asteering lock on the right rear wheel to aid in steering while moving the system.The brakes and steering lock are operated using the foot pedals at the lower frontof the cart.

Figure 3-12 Foot Pedals for Brake and Steering Lock

Foot pedals

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4 Preparing the SystemThe information and procedures in this section will help you prepare the iU22system for use. Preparations include connecting transducers and external devices,locking articulated components for moving, and ensuring that system operatingrequirements are met.

Connecting DevicesIn addition to the devices installed in the system cart, the iU22 system supportsexternal devices. These devices include printers, a VCR, and a color monitor.

CAUTIONS• Using accessories, transducers, peripherals, or cables not supplied with the

ultrasound system or recommended by Philips can affect the system in theform of increased emissions or decreased immunity to external EMI/EMCoccurrences.

• When using additional peripheral equipment powered from an electricalsource other than the ultrasound system, the combination is considered to bea medical system. It is your responsibility to comply with IEC 60601-1-1 andtest the system to those requirements. See “Electrical Safety” on page 21. Ifyou have questions, contact your Philips representative.

• Do not use nonmedical peripherals within six feet of a patient unless the non-medical peripherals receive power from an isolated power outlet on the Phil-ips ultrasound system, or from an isolation transformer that meets medicalsafety standards.

NOTEAny device that is not purchased from Philips and that is not installed by Philipspersonnel is not covered under a Philips service agreement or warranty, and itwill not be serviced by Philips.

Connecting an External Printer You can connect the following external printers to your system:

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• Sony UPD-23MD B/W Printer

• Sony UPD-895MD Color Printer

• Report printer

NOTEThe report printer must be connected to the USB port that is located on theback of the system behind the DVD drive.

For additional information, see "Printers" on page 379 and "Configuring PrintFunctions" on page 80.

➤ To connect an external printer

1. Turn off the system and unplug the power cord from the power source.

2. Connect a standard USB cable between the USB port on the printer and oneof the USB ports on the system (Figure 4-1).

3. Connect the printer’s power cord into the back of the printer, and plug theother end into an appropriate power source.

4. Turn on the printer, and then turn on the system.

Figure 4-1 Connecting an External Printer

USB ports

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About External VCRs You can connect the Mitsubishi HS-MD3000U (NTSC) or HS-MD3000E (PAL)VCR to your ultrasound system as an external device. If your system has an inter-nal VCR installed, an external VCR provides only playback on the system, andcannot support recording or control from the system.

The system supports VCR control through the system control module only if thisVCR is installed on the system using the Philips installation kit for that model. (Foravailability of this kit, contact your Philips representative.) If you connect this VCRwithout the installation kit or connect any other VCR, you must control it fromthe front panel controls on the VCR.

Connecting an External VCR

➤ To connect an external VCR

1. Turn off the system and unplug the power cord from the power source.

2. Connect an audio cable between AUDIO IN on the VCR and VCR AUDIOOUT on the system (Figure 4-2).

3. Connect an audio cable between AUDIO OUT on the VCR and VCRAUDIO IN on the system.

4. Connect an S-Video cable between S-VIDEO IN on the VCR and Y-C Outon the system. (This connector is available only if an internal VCR is notinstalled.)

5. Connect an S-Video cable between S-VIDEO OUT on the VCR and Y-C Inon the system.

6. Connect the 25-pin control cable from the system to RS-232C on the VCR.

7. Connect the VCR’s power cord into the back of the VCR, and plug the otherend into an appropriate power source.

8. Turn on the VCR, and then turn on the system.



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Figure 4-2 Connecting an External VCR

Configuring Print FunctionsIn the setups, you can associate a set of printers with each of the print controls.You cannot print to a printer unless it has been selected. A maximum of twoDICOM printers, two local printers, and one report printer can be selectedamong the three lists. Print can print to local and network printers; Alt Printcan print only to local printers. You can also change other printing parameters.

➤ To configure print functions

1. Press the Setups key.

2. In the setups, click Print/Network.

3. Click the Device Selection tab and Printer.

4. To configure a printer, select the printer name (not the check box) and clickEdit.

5. To specify which print controls will send images to the printer, select one orboth controls for Associate printer with.

6. To set the number of copies to be printed each time you use a print control,select the current setting and enter a number for Number of Copies.

VCR audio out

VCR audio in

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7. Make additional configuration changes, as needed. If necessary, to revert tothe default settings stored in the system, click Reset Defaults.

8. To apply and save your changes, click OK.

9. Click the Printer/Capture tab.

10. To change the area printed, make selections for Print and Alt Print forPrint Format.

11. To send report data to a computer or workstation, select To Report Serverfor Send Report. Otherwise, select To Report Printer.

12. To exit the setups, click Done.

Connecting an External Color MonitorYou can connect a compatible external color monitor to the VGA EXT videooutput port on the rear panel of the system (Figure 4-3). You can also connectexternal monitors to the S-VHS OUT receptacle. VGA EXT will provide thebest quality image. The power cord for the external monitor plugs directly into awall socket.

Figure 4-3 Connecting an External Color Monitor

VGA video output port



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Connecting the ModemThe system contains a modem that is used in remote diagnostics and for receivingsystem data. To use these features, the modem must be connected to a dedicatedtelephone line.

➤ To connect the internal modem to a telephone line

1. Turn off system power.

2. Connect one end of the provided modular phone cable to the wall phonejack.

3. Connect the other end of the cable to the modem receptacle on the rearpanel of the system (Figure 4-4).

Figure 4-4 Modem Receptacle

Connecting to a NetworkTo use connectivity features, the system must be connected to a network. Theethernet receptacle on the rear panel supports both 10-base-T and 100-base-T

Modem receptacle

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formats. The system is configured for network connectivity by a Philips field ser-vice engineer or your network administrator.

For information on changing the network configuration for the system, see the"System Administration" section.

➤ To connect the system to a network

1. Turn off system power.

2. Connect one end of the provided network connection cable to the wallreceptacle for your network.

3. Connect the other end of the cable to the rear panel of the system(Figure 4-5).

Figure 4-5 Network Receptacle

Network receptacle



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Moving the SystemObserve the following warnings and cautions before moving the system.

WARNINGS• Be aware of the casters, especially when moving the system. The system could

cause injury to you or others if it rolls over feet or into shins. Exercise cautionwhen going up or down ramps.

• When attempting to overcome an obstacle, do not push the system fromeither side with excessive force, which could cause the system to tip over.

• Position external hardcopy devices away from the system. Ensure that theyare secure. Do not stack them on the system.

• When positioning the articulated monitor, move it carefully to avoid pinchinghands or extremities against other objects, such as a bed rail.

• Never park the system on an incline.

• The brake is intended as a convenience. To increase cart security, use wheelchocks when the system is parked.

• Before moving the system, ensure that the keyboard is retracted, the controlpanel is centered, and the monitor is locked. When extended, the keyboardmight be damaged if it hits another object, and the video monitor could swingout during transport, causing injury or equipment damage.

CAUTIONS• Ensure that the cables for all patient-applied parts are secure before moving

the system. Use the cable management system to ensure that transducercables are protected from damage.

• Do not roll the system over transducer cables or power cables.

Preparing and Moving

➤ To prepare and move the system

1. Press On/Standby to put the system in standby.

2. When the system shuts down, set Power to off .

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3. Disconnect all external cables, including those to power, network, telephone,and external devices. Secure all cables, transducers, and accessories so thatthey do not interfere with the wheels.

4. Squeeze the release lever on the front handle and use the handles to move thecontrol module to its lowest position (Figure 4-6).

Figure 4-6 Control Module Locks

5. Turn the locking lever beneath the control module to the right (Figure 4-6).

6. Grip the module by the sides, and center the module so that it latches.

Release lever

Locking lever

(Turn to the right to lock)



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7. Lock the monitor arm by pressing the articulating portions of the armtogether (Figure 4-7).

8. Press the right foot pedal to release the wheel brake and engage the steeringlock on the rear wheel.

WARNINGDo not move the system when the locked wheels are pointing in the directionyou are moving the system. To avoid system instability while moving it, engage thesteering lock only after you have moved the system a short distance in theintended direction. This means that when you push the system by using the fronthandles, the wheels are locked under the system, not protruding out from underthe back of the system.

9. Move the cart using the front handles.

Figure 4-7 Monitor Arm Lock

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Positioning in Confined Spaces

➤ To position the system in confined spaces

1. Press the right foot pedal to its middle position to release the steering lockand the wheel brakes (Figure 4-8).

2. Move the system in any direction using the front handle or the positioninggrips on the rear of the system.

3. When the system is in position, press the left foot pedal down fully to set thewheel brakes.

Figure 4-8 Using the Brake and the Steering Lock

Setting Up After Moving

CAUTIONIf the system behaves abnormally after moving contact Philips Ultrasound Cus-tomer Service immediately. The components are installed securely and can with-stand considerable shock; however, excessive shock can cause a system failure.

Wheel brake

Steering lock



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➤ To set up the system after moving it

1. With the system in position and the brake set, connect the power, network,modem and other cables from the system to the appropriate wall receptacles.

2. Unlock the monitor by moving the release lever to the unlocked position(Figure 4-9), and then position the monitor.

Figure 4-9 Unlocking the Monitor

3. Unlock the control module by turning the locking lever below the module tothe left (Figure 4-10).

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Figure 4-10 Unlocking the Control Module

4. Squeeze the release lever on the front handle and position the control moduleto the desired position.

5. Set the power switch to on (Figure 4-11).

6. Press the On/Standby switch ( ) to switch the system on.

Locking lever

(Turn to the left to unlock)



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Figure 4-11 On/Standby Switch and Power Switch

Transporting the SystemTie points are built into the system for anchoring it during transport in a vehicle.The system can be safely transported in a van if it is properly strapped down usingthe tie points.

➤ To prepare the system for transport

1. Prepare the system as described in "Moving the System" on page 84.

2. Remove all transducers, cables, and accessories that are not attached to thesystem.

3. Using a lift gate or a secured ramp, load the system into the vehicle.

4. Once the system is in place, press the left foot pedal to engage the brakes.

5. Place wheel chocks on the wheels to prevent the system from rolling.

6. Attach tie-down straps to the tie points on the lower rear of the system andto the handles. Secure the straps to anchor points in the vehicle (Figure 4-12).

Power switch

On/Standby switch

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Figure 4-12 Tie Points on the System

Environmental RequirementsIf your system will be used in a variety of locations in your facility, ensure the fol-lowing operating requirements are met in each location.

Physical Dimensions

• Width: 57 cm (22.5 in)

• Height: 166.5 cm (65.5 in) with monitor fully raised139.7 cm (55 in) with monitor locked

• Depth: 113 cm (44.5 in)

• Weight: 145 to 161.4 kg (320 to 355 lbs), depending on the peripheral devicesinstalled

Tie points



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Data Connections

• Remote diagnostics (dedicated telephone line for modem)

• Ethernet network (10-base-T and 100-base-T)

• USB

Modality Interface

DICOM standard

Electrical Parameters

The system contains a universal power supply designed to work with these volt-ages: 100-120/220-240V~, 50/60 Hz, 1000VA. Power must be available through agrounded, hospital-grade outlet.

Pressure Limits

• Operating: 525 mm Hg to 795 mm Hg (700 hPa to 1,060 hPa)

• Storage: 375 mm Hg to 795 mm Hg (500 hPa to 1,060 hPa)

Humidity Limits

• Operating: 30% to 85%

• Storage: 15% to 95%

Temperature Limits

• Operating: 10°C to 40°C (50°F to 104°F)

• Storage: -34°C to 65°C (-29°F to 149°F)


5 Using the SystemThe procedures in this section will help you understand and use the features ofthe system. For a description of system components, see message URL http://www.medical.philips.com.

Turning the System On and OffThe system can be set to three different power modes: off, standby, and on.When set to off, the system consumes no power. In standby, some of the systemelectronics remain powered. This provides a quicker initialization cycle when youswitch from standby to on. To achieve a balance between convenience and energyefficiency, follow these recommendations.

• If the system will not be used overnight, switch the system to standby at theend of the day. Press the On/Standby switch above the control panel to gointo standby mode (Figure 5-1).

• If the system will not be used for longer than overnight, power the systemdown. Press the On/Standby switch above the control panel to put the systeminto standby mode and when the monitor goes off, set the power switch onthe back of the system to off .

• To power up the system, set the power switch on the back of the system toon and then press the On/Standby switch above the control panel.

NOTES• Never shut down the system while files are being transferred. File corruption

or loss may result.• Stop any VCR activity (such as playback or rewind) before switching the sys-

tem to standby or turning the system off.• Always use the procedures listed here for turning off the system, if possible.

Turning off the system in any other way will result in longer initialization timewhen the system is turned on again, and may cause other problems.

• If the system does not go into standby mode within one minute after youpress the On/Standby switch, set the power switch on the back of the systemto off , wait 1 minute, and then set the power switch to on . To restartthe system, press and release the On/Standby switch.

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Figure 5-1 On/Standby and Power Switches

Setting the System Time and DateThe system includes a clock/calendar function, which maintains accurate time anddate even when the system is turned off and disconnected from power. The sys-tem uses the clock/calendar function to display the time and date on the imagingdisplay, and to provide a time stamp on patient exams and captured images. Inaddition, the system date is used in date-dependent calculations, such as gesta-tional age. The system automatically adjusts the date for leap years.

NOTES• The system time and date cannot be set when an exam is active. It is recom-

mended that you check the system time and date periodically before an exam,and set the correct time and date, if necessary.

• If you change the system date while an exam is paused, existing date-depen-dent calcs results in the paused exam are not recalculated by the system atany time.

Power switch

On/Standby switch

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➤ To set the system time and date

1. Press the Setups key. By default, System Settings is selected, and theHeader tab is displayed.

2. In Set Time, double-click the hours or minutes in the Time box to select it,and then use the number keys to enter the correct setting. Repeat to set theother component of the time. Select AM or PM, if necessary.

3. In Set Date, double-click the year, month, or day in the Date box to selectit, and then use the number keys to enter the correct setting. Repeat to setthe other components of the date.

4. Click Done.

Using the Brake and Steering Lock All four wheels swivel to aid in maneuvering the system. You can engage a steeringlock to make steering easier when moving the cart. Brakes help keep the cart sta-tionary while in use.

Operate the brakes and the steering lock using the foot pedals at the lower frontof the cart (Figure 5-2). The pedals are linked to prevent the brakes and the steer-ing lock from being engaged at the same time.

WARNINGS• Never park the system on an incline.

• The brakes are intended as a convenience. To increase cart security, use wheelchocks when the system is parked.

➤ To use the steering lock and wheel brake

Do any of the following:

• To engage the steering lock and release the brakes, press the right pedal fully(Figure 5-2).

• To engage the brakes and release the steering lock, press the left pedal fully.

• To release both the steering lock and the brakes, press the higher pedal half-way down so that both pedals are even.

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Figure 5-2 Foot Pedals for Brake and Steering Lock

Adjusting the MonitorThe monitor is mounted on an articulated arm that permits it to be positionedvertically and in an arc from side to side. The monitor arm can also be locked formoving the system. You can adjust the brightness of the monitor image to com-pensate for ambient light. You can also change the default brightness setting forthe monitor

Positioning the Monitor You can adjust the position of the monitor to suit different operating positionsand operator heights. When it is released from its locked transport position, themonitor can be tilted up and down, swiveled left and right, and moved from sideto side. To adjust the monitor, simply grasp it by the sides and tilt, swivel, or moveit from side to side.

For information on locking and unlocking the monitor, refer to "Moving the Sys-tem" on page 84.

Wheel brake

Steering lock

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Setting Default Monitor BrightnessYou can change the default brightness of the monitor image in the setups. The sys-tem uses this default value to set monitor brightness each time the system isturned on.

➤ To set monitor brightness


2. With System Settings selected, click the Display tab.

3. Select a setting for Monitor Brightness from 1 (darkest) to 5 (lightest).

4. Click Done.

Adjusting for Ambient LightThe Monitor control on the 2D touch screen allows you to adjust monitorbrightness to compensate for changes in ambient light. Use this control to tempo-rarily change the monitor brightness. When you cycle power, the system resetsmonitor brightness to the default value (see "Setting Default Monitor Brightness"on page 97).

1. Touch Next on the 2D tab.

2. Turn Monitor to select a setting from 1 (darkest) to 5 (lightest).

System ControlsSystem controls are located on the control panel, the touch screen, and the key-board.

About the Control PanelThe control panel, located on the control module, contains the main imaging con-trols (Figure 5-3). These controls include knobs, buttons, TGC slide controls, anda trackball. Knobs that are indented on top act as both buttons and knobs. Forexample, when you press the M-Mode control, M-mode imaging begins; whenyou turn the M-Mode control, the 2D/M-mode gain changes; and in 3D imaging,when you turn the M-Mode control, the magnification changes.

A touch screen at the top of the control panel contains controls that assume dif-ferent functions, depending on the system operating mode.

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Figure 5-3 Control Panel

Positioning the Control ModuleYou can adjust the position of the control module vertically and side-to-side. Inaddition, you can also swivel the control module. For information on locking thecontrol module, see "Moving the System" on page 84.

➤ To position the control module


– To move the control module up or down, squeeze the release lever on thefront handle and use the handles to position the module.

Click a control to learn about its function

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Using the System

– To swivel the control module, release the module by turning the lockinglever to the left, then twist the module while gripping it by the sides.

– To move the control module side-to-side, release the module by turningthe locking lever to the left, then slide it while gripping it by the sides.

About Touch Screen ButtonsThe touch screen above the control panel provides controls that change functionaccording to the current mode or function. The touch screen can contain severaltypes of controls, depending on the function the control is to perform.

Use the information in Table 5-1 to learn about the touch screen controls.

Table 5-1 Using Touch Screen Controls

For this type of button Do this

Touch a tab to display a different set of buttons. Touching the tab in this example displays buttons associated with pulsed wave (PW) Doppler mode but does not switch to PW mode.

Touch Next or Previous to display the next or previous page of buttons associated with the current tab. For most tabs, there are two pages of buttons.

Touch to perform or update a function. Touching the button in this example sends an image to the printer associated with it.

Touch to turn a function on or off. The button is green when the function is on. In this example, SonoCT imaging is on.

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About Touch Screen Rotary Displays Rotary displays appear on the bottom row of the touch screen. Each rotary dis-play corresponds to a knob directly below it on the control panel (Figure 5-4).Like touch screen buttons, rotary displays assume different functions based on thecurrent imaging mode.

Turn the knob below a rotary display to change the value for that function. Formost functions, the value appears on the rotary display. In a few instances, how-ever, the value appears on the monitor display instead of on the rotary display.One example of this is the Gray Map rotary display.

Touch to display a row of buttons used to select a mode or setting. Touching the button in this example displays five related buttons, one of which is shown below. Touching it when the associated buttons are displayed hides those buttons.

Touch to select a mode or setting. This type of button is displayed only after you press the type of button shown above. Only one of the buttons in the row can be selected at one time. The button in this example is selected.

Touch to change the value displayed on the button. Repeatedly pressing this type of button cycles through the range of available values. Do not confuse these buttons with rotary displays, which also display a value. Rotary displays appear only in the bottom row of the touch screen, and although they look like buttons, they are intended only to show a value for a function.

Table 5-1 Using Touch Screen Controls

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Figure 5-4 Rotary Displays

Gray Map rotary display

Corresponding knob

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Adjusting the Touch Screen BrightnessThe touch screen brightness control is behind the touch screen at the top (seefigure). Use it to adjust the brightness of the touch screen display when you needto compensate for changes in ambient light.

Figure 5-5 Touch Screen Brightness Control

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Using the KeyboardBeneath the control panel is a retractable keyboard (Figure 5-6). You can use thekeyboard to enter patient data, exam comments, image annotation, and yourlogon password. The keyboard also includes function keys that access various fea-tures, such as setups and Help. To use the keyboard, simply pull it out. The key-board is illuminated when you pull it out fully. When you are finished, push it infully.

Figure 5-6 Keyboard

Pull out to use, push in to store

Click a function key to learn about its function

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About Status IconsThe icons in a row on the bottom of the display provide feature-status indicationsand control. Status indicators include color combinations; graphic overlays, suchas symbols and colored dots; lack of an overlay; and a non-displaying icon.

Table 5-2 Status Icon Descriptions

Icon Description

Indicates the status of the iSCAN Intelligent Optimization option:

No change (as shown): iSCAN optimization is available.Green (for 3 seconds): iSCAN is optimizing the image.

The iSCAN indicator is always present, even if iSCAN is not enabled in a Tissue Specific preset.

Indicates the status of deleted content:

No dot: InactiveGreen dot: ActiveRed dot: Failed

Click the icon to open the Delete Status dialog box. You can cancel any job listed.

Indicates the status of the DVD drive:

No dot: AvailableGreen dot: Writing dataYellow dot: Needs attentionRed dot: Failed

Click the icon to open the DVD Status dialog box. You can cancel, pause, or resume any data transfer job listed.

Indicates the status of a networked printer:

No dot: AvailableGreen dot: Active printingYellow dot: Pending, if portableRed dot: Failed

Click the icon to open the Printer Status dialog box. You can cancel, pause, or resume any print job listed.

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Using Voice ControlThe voice control option allows you to operate the system when the controlpanel is out of reach or you need both hands for scanning. You can also use voicecontrol to add text annotation to images. Voice control uses a wireless headset tosend your voice commands to the system. When this feature is active, you canstill use the controls on the control panel. The voice control option can recognizecommands in English, French, Italian, German, and Spanish.

Using voice control, you can operate the system controls that are most com-monly used during an exam. For knobs and some controls on the touch screen,you can direct the system to adjust the control up or down. You can include a rel-ative control setting, which specifies an increment or multiplier, depending on the

Indicates the status of network communication:

No dot: No activityGreen dot: Active communicationYellow dot: System or printer not on the networkRed dot: Failed

Click the icon to open the Network Status dialog box. You can cancel, pause, or resume any network job listed.

Indicates the basic feature status of the voice control option:

Large X: OffNo change (as shown): OnKey overlay: On, with the keyword feature onABC overlay: On, with the voice annotation feature on

Indicates the headset status of the voice control option:

Yellow on black: Not ready, not connected, out of rangeGray on black (as shown): Ready and listeningBlack on yellow: Did not recognize, did not executeBlack on green: Heard and executed

Indicates, when displayed, that the microphone is enabled. When the icon is not displayed, the microphone is disabled.

Table 5-2 Status Icon Descriptions

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command you use it with. For example, “2D gain up 5” corresponds to anincrease of 5 clicks of the 2D knob, while “Move color box up 5” moves the colorbox up 50 pixels (5 x 10, where 10 is the increment for this command).

When you first use voice control, try operating it without a profile. To do this,select Guest when enabling the feature. If you want to increase recognition accu-racy, create a profile and train it to recognize your speech.

You can set voice control to listen only to commands that start with a keyword.The keyword feature reduces the possibility of erroneous commands caused byconversation or noise. When the keyword feature in voice control is on, youmust start each full command with the word “Vox.” For example, “Vox color.” Ifyou have created a user profile, you can set the default state of the keyword fea-ture for your profile in the setups.

You can activate and deactivate voice control using one of the two voice controlicons on the display. These icons also indicate the status of voice control and thekeyword feature. For descriptions of these icons, see "About Voice ControlIcons" on page 106.

NOTEThe wireless headset emits radio waves in the ISM band at 2.4 GHz and complieswith FCC regulations. It is your responsibility to determine the suitability of thiswireless device in your environment.

About Voice Control IconsThe state of voice control is indicated on the display by two icons (Table 5-3). Thefirst icon shows whether voice control and the keyword feature are on or off. Thesecond icon shows whether or not the headset is connected. This icon also indi-cates when a command is recognized.

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Turning Headsets On and Off When a headset is on, the indicator on the headset flashes green once every twoseconds. To locate the controls on the headset, see the documentation providedwith the headset.

Table 5-3 Voice Control Icons

Icon Definition Function

First Icon

Voice control is not active. Activate voice control.

Voice control is active, and the keyword feature is off.

Deactivate voice control.

Voice control is active, and the keyword feature is on.


Voice control is active, and the voice annotation feature is on.


Second Icon

Voice control is not ready; headset is not connected.

Voice control is active and listening.

Voice control did not recognize a valid command and did nothing.

Voice control recognized and performed a command.

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➤ To turn a headset on and off

1. To turn a headset on, press and hold the Call Handling button on the headsetuntil you hear a low tone followed by a high tone.

2. To turn a headset off, press and hold the Call Handling button until you hear ahigh tone followed by a low tone.

Pairing HeadsetsThe system recognizes only headsets that have been paired to it in the setups. Youcan pair up to seven headsets to a system. Until you assign a name to a headset, itwill be identified on the Headset Config tab only by the model number, which isidentical for all headsets.

When using multiple headsets in one location, it is important to give each headseta unique name and to label each headset with its name. To locate the controls onthe headset, see the documentation provided with the headset.

NOTEWhen a new headset is paired to the system, it is necessary to pair the headsettwice. Pair the new headset. Click Unpair to unpair it, turn the headset off andon again into pair mode, then pair it a second time.

➤ To pair headsets with the system


2. Click Voice Control, and then click the Headset Config tab.

3. Wait until the message “Querying headsets” disappears from the bottom ofthe display, indicating that the system is finished querying headsets.

4. Ensure that the headset is off.

5. Press and hold the Call Handling button on the headset until the indicator firstblinks green and then blinks red and green. The headset is now in pair mode.

6. Click Refresh Current Status.

7. Select the headset in the list.

8. Click Pair.

9. At the prompt, type the passkey (0000) and click Next. If 0000 does notwork, use the passkey listed in the headset manual.

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Using the System

10. If the model number of the selected headset is listed under Name, give it aunique name: Click Change Name, type a name, and click OK.

11. Click Done.

12. Label the headset with the name you assigned to it in step 10.

Configuring HeadsetsOnce a headset has been paired to the system, you can configure the headset.Settings on the Headsets Config tab allow you to delete or rename a headsetand permit or prevent communications between a headset and the system. Tolocate the controls on the headset, see the documentation provided with theheadset.

➤ To configure headsets

1. Ensure the headset is on.


3. Click Voice Control, and then click the Headsets Config tab.

4. Observe the message at the bottom of the display and wait until the system isfinished querying headsets.

5. If your headset is not listed, first perform the procedure in "Pairing Headsets"on page 108.

6. Select a headset and do one of the following:

– To change the name of the headset, click Change Name, type a newname, and click OK.

– To delete the selected headset from the list, click Delete, and whenprompted, click OK to confirm the deletion.

– To prevent the selected headset from communicating with the system,click Unpair.

– To see any changes that are not reflected in the list, click Refresh Cur-rent Status.

7. Click Done.

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About Training Voice ProfilesTraining a voice profile involves reading text into the system using a voice controlheadset. The system lets you choose from among a number of books of text toread. Once you start the process, the system listens to your speech to associateeach written word with your pronunciation of it. As you read the text, the systemdisplays recognized text in green and unrecognized text in red.

If the system does not recognize one or more words, you can re-read some or allof the text on the page. When the system recognizes your reading of all text on apage, it displays the next page of text. It is not necessary that every word be rec-ognized by the system during training. If a few words are not recognized afterre-reading, you can skip to the next page by clicking Next.

If you need to stop the training before you are finished, you can click Suspend tosave your input, mark your place, and close the training window. When you openthe training window for your voice profile again, the system displays the text pageyou were working in when you suspended training.

Select a quiet location in which to train a voice profile. When reading duringtraining, speak in your normal tone of voice at your normal rate.

Creating and Training a Voice ProfileAlthough you can use voice control without creating a voice profile, your voicecommands are more accurately interpreted when you use a profile that you havetrained. Training a voice profile to a minimal level takes only about 2 minutes. Youcan further improve recognition accuracy by performing additional training (see"Doing Additional Training" on page 112).

NOTEWhen naming profiles, do not include single quotes or other special characters.

Before you begin creating and training a profile, read "About Training Voice Pro-files" on page 110.

➤ To create and train a voice profile

1. If the headset has been labeled, note the name or number on the label. Turnon the headset and put it on.


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3. Click Voice Control. On the Voice Profiles tab, click New Voice Profile.

4. Type a unique user name for your profile. Click Next.

5. Select the language you will be using for giving voice commands. Click Next.

6. Select the headset you are using from the list. Click Next.

7. If the headset has not been paired to your system, follow the prompts.

8. Acknowledge the communication between the system and the headset bypressing the Call Handling button on the headset.

9. Click Start and read the paragraph in the dialog box. When you are done,click Stop and then click Next.

10. To begin training voice control, click Training.

11. In the Training Topics dialog box, select a book you would like to read totrain voice control. Click OK.

12. Click Microphone and begin reading the text. Ignore text color for now andcontinue reading to the end of the displayed text. If all text is recognized, thenext page of text is displayed.

13. Any text not recognized is marked in red. When you have finished reading andthe text background changes to yellow, do one of the following:

– To reread the entire page, click Repeat and begin reading.

– To reread starting at the first unrecognized text, drag the text cursor tothe beginning of the first red text. Then click Microphone and read fromthat point to the end of the page.

14. If some text is still unrecognized after rereading it, click Next to display thenext page.

15. Read at least until the prompt indicates that you have reached minimal training(2 minutes or more). To improve recognition accuracy, read further.

16. If you need to stop the training temporarily before you are finished, click Sus-pend. When you resume training, the last uncompleted page will be displayed.

17. When you are finished reading, click Start Processing to apply the trainingto your profile. If Start Processing is not available, first click Microphone.

18. When processing is complete, click Done.

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Deleting Voice Profiles You can delete voice profiles that are no longer needed. If you are not satisfiedwith the training you have done so far, you can delete that voice profile and starttraining a new profile from the beginning.

➤ To delete voice profiles


2. Click Voice Control.

3. Select the profile that you want to delete, and then click Delete Voice Pro-file.

4. To delete other profiles, repeat step 3.

5. Click Done.

Doing Additional TrainingAfter you have trained a voice profile to the minimum level, you can do furthertraining at any time. Although additional training does improve recognition accu-racy, the longer you train, the smaller the degree of improvement becomes.

➤ To do additional training




4. On the Voice Profiles tab, select the profile you want to train.

5. Click Training.

6. Follow the prompts to do additional training, or refer to step 11 throughstep 18 in "To create and train a voice profile" on page 110.

Enabling Voice ControlBefore you can use voice control for the first time after powering up the system,you must enable it.

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➤ To enable voice control


2. Click the voice control icon . In some situations, you may need to press

Pointer first, to activate the pointer.

3. For User, select your profile or select Guest, and then click Next.

4. For Active Headsets, select your headset and click Next.

5. When your headset rings, press the Call Handling button to connect to thesystem.

About Background NoiseBackground noise in the exam room can interfere with your use of voice control.Fans, patient monitors, voice paging, and even Doppler audio on the system canlower the accuracy of voice recognition. If you are going to be using voice control,it is helpful to reduce or eliminate noise by turning off loud equipment and by lim-iting the volume level of Doppler audio.

Using Voice CommandsYou can use voice control regardless of whether you have created and trained avoice profile. It is recommended, however, that you create and train a voice pro-file before using voice control. Training voice control to recognize your speechsignificantly improves recognition accuracy.

For a list of voice commands, see iU22 Quick Cards.

➤ To control the system with voice commands

1. If you have not used voice control since the system was powered up, performthe procedure in "Enabling Voice Control" on page 112.

2. Do any of the following to use voice control:

– Say a command. Most controls can be activated by more than one com-mand. For example, to change the box size, you could say “Make” or“Make box” followed by “Wider” or “Taller” or “Larger,” and so on.

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– If voice control is set to use a keyword (indicated by ), start each full

command with the word “Vox.”

– To operate a button or key, say the name of the control. Some buttonshave two possible commands; for example, “Freeze” and “Unfreeze.”

– To operate a knob, say the name of the knob, followed by “Up” or“Down.” You can also say “Decrease” or “Increase,” followed by name ofthe knob. To state an increment of change, say a number (1-9). For exam-ple, to increase 2D gain, you can say “Increase 2D gain three” or “2Dgain” followed by “Up three.”

– To operate a control on the touch screen, say the name of the control.Controls on a touch screen page are available only when the tab for thatpage is displayed in the foreground and the control itself is not gray(unavailable based on the current mode).

– To display the next or previous touch screen, say “Next” or “Previous.”

– To display a touch screen tab that is currently in the background, say thetab name followed by “Tab.” For example, “Color tab.”

– To click or select an object on the screen, say “Select.”

– To repeat the last command, say “Repeat.”

– To turn the keyword feature on or off, say “Keyword on” or “Vox key-word off.”

– To turn on sleep mode, causing voice control to ignore commands, say“Go to sleep.” To make voice control listen again, say “Wake up.”

3. To disable voice control, click the voice control icon or .

Using the Keyword FeatureWhen the keyword feature is on, voice control performs only commands thatstart with the keyword “Vox.” Using this feature helps prevent erroneous com-mands. In the setups, you can select whether the keyword feature will be on oroff when you first activate voice control. Regardless of the default setting, you canturn the keyword feature on and off using a voice command.

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➤ To set the keyword default setting



3. On the Voice Profiles tab, select the profile you want to set up.

4. Select or deselect Use Keyword.

5. Click Done.

➤ To turn the keyword feature on and off

1. Ensure that voice control is active.

2. To turn the keyword feature on, say “Keyword on.”

3. To turn the keyword feature off, say “Vox keyword off.”

Muting the HeadsetWhen you want to talk with someone during an exam, it is a good idea to mutethe headset to avoid sending unintended commands. This is especially importantwhen the keyword feature is disabled. To locate the controls on the headset, seethe documentation provided with the headset.

➤ To mute the headset

Do one of the following:

• Say “Go to sleep” to mute the headset and say “Wake up” to unmute theheadset.

• Simultaneously press the volume buttons (+ and -) on the sides of the head-set. Each time you press these buttons together, the headset is either mutedor unmuted, depending on the current state.

About Voice AnnotationThe voice control feature lets you add annotation to the screen from a list ofterms. The list of terms that is displayed is dependent on which clinical option isselected.

These lists are included under "Voice Control Commands" on page 116 and in theiU22 Voice Control Quick Cards.

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The voice annotation feature is turned on and off with a voice command. “Eraseall text” and “Erase last word” are the only other voice commands available whenvoice annotation is on.

NOTETo simplify the annotation process, the keyword feature is not available whenvoice annotation is on.

Using Voice Annotation

➤ To use voice annotation

1. Say “Annotate on” or “Vox annotate on.”

2. Say the annotation term. For example, “Lateral.” Remember that the keywordfeature is not used in voice annotation.

3. To erase specific annotations, position the annotation cursor to the right ofthe term using the arrow keys, then press the Backspace key until it iserased. You can also say “Erase last word” to remove one word at a time.

4. To erase all annotations, say “Erase all text.”

5. To turn off voice annotation, say “Annotate off” or “Stop.“You can add “Stop”to the end of a command to save time.

Voice Control CommandsThe voice commands and annotations are listed in the following tables. Observethese conventions when speaking a command.

• Words in parentheses are required for a response.

• Words in brackets are optional.

• If words are separated by a vertical bar, an “or” condition exists. Use oneword or the other one.

• Commands are arranged in alphabetical order, based on the control name orspoken annotation.

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Voice Annotation Commands

The common annotations are used when you switch into annotation mode bysaying “Vox annotate.”

The common annotations can be combined with any Tissue Specific preset.

High Q [on | off]

invert



update

[angle] zero sixty [degrees]

Spoken Annotation, Common Displayed Annotation

annotate | annotate off | stop | stop annotate

anterior ANT

artery A

caudad CAUDAD

cephalad CEPHAD

coronal COR

decubitus DECUBITUS

distal DIST

dorsal DORSAL

erase all text

erase last word

inferior INF

CW Doppler Commands (Continued)

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lateral LAT

left LT

left lateral decubitus | LLD LLD

long | longitudinal LONG

lower LOWER

medial MED

middle | mid MID

oblique OBLQ

posterior POSTERIOR

prone PRONE

proximal PROX

right RT

right lateral decubitus | RLD RLD

sagittal | sag SAG

superficial SUPERFICIAL

superior SUPERIOR

supine SUPINE

transverse | trans TRANS

upper UPPER

upright UPRIGHT

vein V

ventral VENTRAL

Spoken Annotation, Common (Continued) Displayed Annotation

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Spoken Annotation, Abdominal Displayed Annotation

adnexa ADNX

aorta AO

appendix APPENDIX

bladder BLADDER

body BODY

bowel BOWEL

bypass BYPASS

celiac axis CELIAC AXIS

common bile duct | CBD CBD

cervix CVX

common hepatic duct CHD

cul de sac CUL DE SAC

duct DUCT

endometrium ENDO

fluid FLUID

fossa FOSSA

free fluid FREE FLUID

fundal FUNDAL

fundus FUND

gall bladder | GB GB

graft GRAFT

head HEAD

hepatic HEP

inferior mesenteric IM

inferior vena cava | IVC IVC

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junction JUNCTION

kidney KIDNEY

left hepatic vein LHV

liver LIVER

lobe LOBE

left portal vein LPV

left renal artery LRA

left renal vein LRV

mid hepatic vein MHV

midline MIDLINE

mid portal vein MPV

ovary OV

pancreas PANC

pancreatic PANCREATIC

pole POLE

post POST

post void residual | PVR PVR

pre PRE

prostate PROSTATE

pylorus PYLORUS

rectum RECTUM

reflux REFLUX

renal RENAL

right hepatic vein RHV

right portal vein RPV

right renal artery RRA

Spoken Annotation, Abdominal (Continued) Displayed Annotation

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right renal vein RRV

superior mesenteric SM

superior mesenteric artery SMA

spleen SPLEEN

splenic SPLENIC

stent STENT

surgery SURGERY

tail TAIL

tips TIPS

ureter URETER

urethra URETHRA

uterus UTERUS

vaginal cuff VAG CUFF

vagina VAG

val salva VAL SALVA

void VOID

volume VOL

wall WALL

Spoken Annotation, Vascular Displayed Annotation

anterior cerebral artery | ACA ACA

anterior communicator | Acomm | ACOA

ACoA

anterior tibial AT

aorta AO

Spoken Annotation, Abdominal (Continued) Displayed Annotation

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augmentation AUG

axillary AX

basilar BASILAR

bifurc | bifurcation BIFURC

brachial BRACH

bulb BULB

bypass BYPASS


cephalic CEPH

common carotid [artery] | CCA CCA

common femoral CF

compression COMP

dorsalis pedis DP

external carotid [artery] | ECA ECA

fossa FOSSA

gastrocnemius | gastroc GASTROC

graft GRAFT

greater saphenous GS

hepatic HEP

iliac IL



internal carotid [artery] | ICA ICA

junction JUNCTION



Spoken Annotation, Vascular (Continued) Displayed Annotation

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left renal vein LRV

lesser saphenous LS


mid portal vein MPV

middle cerebral artery | MCA MCA

peroneal PER

popliteal POP

post POST

posterior cerebral artery | PCA PCA

posterior communicator | Pcomm | PCOA

PCoA

posterior tibial PT

profundus PROF

radial RAD

renal RENAL





stent STENT

subclavian SUBCL

superficial femoral SF



surgery SURGERY


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term ICA | terminal ICA TICA

tips TIPS

ulnar UL

vert | vertebral VERT

Spoken Annotation, Urology Displayed Annotation

adnexa ADNX

apex APEX

apical APICAL

appendix APPENDIX

base BASE

bladder BLADDER

bowel BOWEL

cervix CVX


endometrium ENDO

fluid FLUID

fossa FOSSA


fundus FUND

junction JUNCTION

kidney KIDNEY

midline MIDLINE

ovary OV

pole POLE


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post POST

post void POST VOID


pre PRE

prostate PROSTATE

rectum RECTUM

reflux REFLUX

renal RENAL

surgery SURGERY

ureter URETER

urethra URETHRA

uterus UTERUS

vagina VAG


void VOID

volume VOL

wall WALL

Spoken Annotation, Small Parts Displayed Annotation

one o’clock 1:00

two o’clock 2:00

three o’clock 3:00

four o’clock 4:00

five o’clock 5:00

six o’clock 6:00

Spoken Annotation, Urology (Continued) Displayed Annotation

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seven o’clock 7:00

eight o’clock 8:00

nine o’clock 9:00

ten o’clock 10:00

eleven o’clock 11:00

twelve o’clock 12:00

anti radial A RAD

areolar AREOLAR

axilla AXILLA

axillary AX

body BODY

breast BREAST

duct DUCT

epididymus EPID

fluid FLUID


head HEAD

inner INNER

isthmus ISTHMUS

lymph node LYMPH NODE

lobe LOBE

midline MIDLINE

nerve NERVE

nipple NIPPLE

node NODE

outer OUTER

Spoken Annotation, Small Parts (Continued) Displayed Annotation

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pole POLE

radial RAD

tail TAIL

tendon TEND

testicle TESTICLE

testis TESTIS

thyroid THYROID

Spoken Annotation, Pediatrics Displayed Annotation

third ventricle 3rd VENT

fourth ventricle 4th VENT

abduct | abduction ABDUCT

acetabulum ACETABULUM

adnexa ADNX

aorta AO

appendix APPENDIX

aqueduct of Sylvius AQUEDUCT OF SYLVIUS

axial AX

bladder BLADDER

body BODY

bowel BOWEL

bypass BYPASS


common bile duct | CBD CBD

cerebellum CEREB

Spoken Annotation, Small Parts (Continued) Displayed Annotation

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cerebral cortex CEREBRAL COR

cervix CVX

common hepatic duct CHD

choroid plexus CHOROID PLEXUS

circle of Willis CIRC WILLIS

caudate nucleus CAUD NUC

corpus callosum CORP CALL

cavum septum pellucidum | CSP CSP


duct DUCT

endometrium ENDO

extend | extension EXTEND

femoral head FEM HEAD

flexor FLEX

fluid FLUID

fossa FOSSA


frontal FRONTAL

fundal FUNDAL

fundus FUND

gall bladder | GB GB

graft GRAFT

head HEAD

hemisphere HEMISPHERE

hepatic HEP

horn | horns HORN

Spoken Annotation, Pediatrics (Continued) Displayed Annotation

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junction JUNCTION

kidney KIDNEY


liver LIVER

lobe LOBE



left renal vein LRV

massa intermedia MASSA INTER


midline MIDLINE

mid portal vein MPV

occipital OCCIPITAL

ovary OV

pancreas PANC

pancreatic PANCREATIC

parietal PARIETAL

pole POLE

post POST

pre PRE

post void POST VOID


pylorus PYLORUS

reflux REFLUX


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renal RENAL





side up SIDE UP



spleen SPLEEN

splenic SPLENIC

stent STENT

surgery SURGERY

Sylvian fissure SYLV FISSURE

tail TAIL

thalamus THALAMUS

tips TIPS

ureter URETER

urethra URETHRA

uterus UTERUS


vagina VAG

ventricle VENT

void VOID


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Spoken Annotation, Obstetrics Displayed Annotation

three vessel cord 3V CORD

four chamber heart 4C HEART

abdominal circumference | AC AC

adnexa ADNX

aorta arch AO ARCH

aorta AO

arm ARM

arms ARMS

bladder BLADDER

bowel BOWEL

boy BOY

biparietal diameter | BPD BPD

c spine C-SPINE

cerebellum CEREB

cervix CVX

choroid plexus CHOROID PLEXUS

cord insertion CI

cisterna magna CM

crown rump length | CRL CRL

cavum septum pellucidum | CSP CSP


diaphragm DIAPHRAGM

ductal arch DUCTAL ARCH

endometrium ENDO

extremities EXTREMITIES

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extremity EXTREMITY

face FACE

feet FEET

femur FEMUR

fibula FIB

femur length FL

fluid FLUID

foot FOOT

fundus FUND

gestational sac GS

girl GIRL

hand HAND

hands HANDS

head circumference | HC HC

heart HRT

hepatic HEP

humerus HUM

inter atrium septum | IAS IAS

inter ventricular septum | IVS IVS

kidneys KIDNEYS

L-spine L-SPINE

left atrium | LA LT ATRIUM

leg LEG

legs LEGS

lip LIP

lips LIPS

Spoken Annotation, Obstetrics (Continued) Displayed Annotation

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lower quadrant LQ

lower uterine segment | LUS LUS

left ventricle | LV LV

left ventricular outflow tract | LVOT

LVOT

nose NOSE

nuchal NUCH

nuchal fold NUCH FOLD

orbits ORBITS

internal os OS

ovary OV

patent ductus arteriosus | PDA PDA

pelvis PELVIS

positive fetal heart motion +FHM

placenta PLAC

profile PROFILE

right atrium | RA RT ATRIUM

radius RADIUS

renal RENAL

right ventricle | RV RV

right ventricular outflow tract | RVOT

RVOT

sacral spine | s-spine S-SPINE

sacrum SACRUM

spine SPINE

stomach STOM


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t-spine T-SPINE

thoracic THORACIC

tibia | tib TIB

twin a TWIN A

twin b TWIN B

twin c TWIN C

ulna ULNA

umbilical cord UMB CORD

upper quadrant UQ

uterus UTERUS


ventricle VENT

yolk sac YS

Spoken Annotation, Cardiology Displayed Annotation

(apical) two chamber A2CH

(apical) four chamber A4CH

(apical) five chamber A5CH

aortic insufficiency | A I AI

apical long axis ALAX

aorta arch AO ARCH

aorta valve AOV

aorta AO

apex APEX

apical APICAL


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aortic regurgitation | A R AR

aortic stenosis | A S AS

ascending aorta ASC AO

descending aorta DESC AO

hepatic HEP

inter-atrium septum | I A S IAS

interventricular septum | I V S IVS

left atrium | L A LT ATRIUM

left ventricle | L V LV

left ventricular outflow tract | L V O T

LVOT

mitral inflow MITRAL INFLOW

mitral regurgitation | mitral regurg | M R

MR

mitral stenosis | M S MS

mitral valve MV

patent ductus arteriosus | P D A PDA

pulmonic insufficiency | P I PI

parasternal long axis PLAX

pulmonic regurgitation | P R PR

parasternal short axis PSAX

pulmonic valve PV

right atrium | R A RT ATRIUM

right ventricle | R V RV

right ventricular outflow tract | R V O T

RVOT

shunt SHUNT

Spoken Annotation, Cardiology (Continued) Displayed Annotation

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suprasternal SS

subcostal SUBCOSTAL

subcostal four chamber SUB4CH

subcostal short axis SUBSAX

tricuspid regurgitation TR

tricuspid valve TV

val salva VAL SALVA

Spoken Annotation, Musculoskeletal Displayed Annotation

abduct | abduction ABDUCT

achilles ACHL

biceps BICEPS

bursa BURSA

deltoid DELTOID

extensor | extend EXTEN

fascia FASCIA

flexor retinac | flexor retinaculum FLEX RET

flexor FLEX

hallucis brevis HAL BREV

hallucis longus HAL LONG

infra INFRA

infraspinatus | infraspinatis INFRASP IS

insertion INSERT

nerve NERVE

patella PATELLA

Spoken Annotation, Cardiology (Continued) Displayed Annotation

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patellar PATELLAR

plantaris PLANTARIS

radial RAD

retinaculum RETINACULUM

subscapularis SUBSCAP

supra SUPRA

supraspinatus SUPRASP

tendon TEND

teres | teres minor TERES M

tibial TIB

Spoken Annotation, Gynecology Displayed Annotation

adnexa ADNX

apical APICAL

appendix APPENDIX

bladder BLADDER

cervix CVX


endometrium ENDO

fluid FLUID

fossa FOSSA


fundus FUND

junction JUNCTION

kidney KIDNEY

Spoken Annotation, Musculoskeletal (Continued) Displayed Annotation

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Logging On to the SystemThe data security feature, if implemented on your system, limits access to previ-ously stored patient data and images. To gain access to such data, you must firstlog on to the system. When you are finished using the system, you can log offmanually or simply shut down the system, which logs you off automatically.

Logging On When data security is enabled, you must log on to the system before you will beable to view or load patient files.

➤ To log on to the system

1. Click the Log On icon at the bottom of the imaging display.

2. In the Logon dialog box, type your user name.

midline MIDLINE

ovary OV

pole POLE

post POST

pre PRE


reflux REFLUX

renal RENAL

surgery SURGERY

uterus UTERUS


vagina VAG

void VOID

Spoken Annotation, Gynecology (Continued) Displayed Annotation

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3. Press the Tab key and type your password. (If you forget your system pass-word, contact your system administrator.)

4. Select OK to log on to the system and start the valid access period.

Logging off of the system does not change the current patient, but it does denyfurther access to protected patient data.

Logging Off If you do not log off, the system will automatically log you off when you shutdown the system or after the system has been inactive for the length of timeshown in Auto Log Off on the User Settings tab of the Data Security set-ups. Only the system administrator can change the Auto Log Off setting.

➤ To log off of the system

1. Click the Log Off icon at the bottom of the imaging display.

2. In the LogOff dialog box, click Yes.

Changing Your PasswordIf the data security feature is implemented on your system, you must log on to thesystem to gain access to the patient data and images.

Once the system administrator has given you a password for the system, you canchange it as needed. A password must be 6 to 10 characters long and can containonly letters and numbers; punctuation marks and symbols are not allowed.

➤ To change your password


2. Click Data Security.

3. On the User Settings tab, click Change Password.

4. For Old Password, type your current password, and then press the Tab key.

5. For New Password, type the new password you want to use, and then pressthe Tab key.

6. For Confirm Password, type your new password again.

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7. Click OK.

8. To exit setups, click Done.

NOTEThe Auto Log Off time shown on the User Settings display indicates how longthe system can be inactive before you are logged off automatically. Only the sys-tem administrator can change this setting.

Imaging DisplayThe imaging display contains an ultrasound image, exam and image information,and indicators (Figure 5-7).

The image area is located approximately in the center of the monitor screen. Tothe right of the image itself are a depth scale and a curve representing the TGCsettings. To the right of the TGC curve is a list of values for the sliders. A gray-scale bar or color bar is displayed to the right of the TGC curve. In M-mode andDoppler, the sweeping display appears below the 2D image.

Patient and exam data are displayed in the area directly above the ultrasoundimage. The system does not display patient data in this area until you start anexam. This area also includes the current time and date, the institution name, theselected transducer and clinical option, the TI setting and the TI and MI values.

Image information is displayed to the left of the image. In modes such as duplex ortriplex, additional image information is also displayed. Those additional parametersets can be displayed below the initial set and to the right of the image.

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Figure 5-7 Elements of the Imaging Display

Using TransducersThe system includes three receptacles for array transducers and one receptaclefor a pulsed- or continuous-wave Doppler probe. All four receptacles can beoccupied at the same time, but only one transducer can be active at a time. Whena transducer is not in use, store it in one of the transducer holders on the controlmodule. Always use the cable management system to prevent cables from beingstepped on or run over by the cart wheels.

For information on transducer clinical options, maintenance, and artifacts, referto the "Transducers" section.

Image area Depth scale

2D imageparameters

TGC curve

Focal indicator

Patient and exam data

Grayscale or color bar

MI and TI values

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Connecting Transducers

➤ To connect a transducer

1. Set the transducer in one of the transducer holders on either side of the con-trol module.

2. Hang the transducer cable on the cable management bracket below the con-trol module.

3. Insert the transducer connector into one of the three receptacles on thefront of the system (Figure 5-8).

4. Turn the locking lever clockwise.

Figure 5-8 Inserting a Transducer Connector

Selecting TransducersWhen the system is turned on, the system defaults to the transducer connectedto the left-most connector. You can select among the three connected transduc-ers during system operation.

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➤ To select a transducer

1. Press Transducer.

2. On the Transducer touch screen, touch a transducer button to select atransducer.

3. Touch the clinical option and preset you want to use. The touch screen closeswhen you make your selection.

Using ECGThe system can display a trace on the image representing an ECG signal. ECGinput can be either a low-level signal (from leads connected to the patient) or ahigh-level signal (from a patient monitor). Separate receptacles are used to con-nect low-level ECG and high-level ECG signals to the system. Heart rate, derivedfrom the ECG signal, is displayed on the screen whenever ECG is connected anddisplayed.

For information on using ECG, see "Physio (ECG)" on page 212.

Using the DVD Drive The system includes a digital versatile disc (DVD) drive, located next to the On/Standby switch. You can use this drive to store and transfer patient files, includingfull exams, 3D data sets, and reports. In addition, you can save, restore, and dis-tribute setups data, including Quick Save presets and voice profiles.

For additional information on specific applications of the DVD drive, refer to "Sys-tem Administration" on page 371 and "Sending Exams and Images" on page 311.

About Media CompatibilityDVD and CD media are available in a number of types. Not all media types arefully compatible with the system DVD drive. You can use the following mediatypes with the system:

• DVD+RW (rewriteable, 4.7 GB capacity)

• DVD+R (write once, 4.7 GB capacity)

• CD-R (write once, 650 MB capacity)

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The system supports multi-session writing to both DVD+RW and CD-R media.This means that you can record information onto these discs in multiple sessions,provided each session is closed before a new session begins. The system automat-ically closes an open session when you end an exam and when you click Eject inthe Patient Directory.

If you always use Eject in the Patient Directory when ejecting discs, a CD-Rrecorded on the system will be compatible with most CD-ROM drives found onPCs. Likewise, a DVD+R recorded on the system will be compatible with mostDVD drives.

To use a compatible DVD on a PC, the PC must have the ability to read the UDFfile format used by the system to write to DVDs. This may require adding thiscapability to your PC.

Installing a UDF ReaderThe system uses the UDF file format to write to DVDs. PCs running the Win-dows XP operating system can read this file format directly. If your PC uses anyother operating system, a UDF reader must be installed on the PC. UDF readersare available for downloading from the Internet. Follow the installation instruc-tions for the UDF reader that you choose.

Loading and Ejecting a Disc

NOTEThe recommended method of opening the DVD tray is to click Eject in thePatient Directory display. This method ensures that discs recorded on the systemare compatible with the greatest number of DVD and CD-ROM drives. In addi-tion to creating compatibility issues, using the eject button on the front of thedrive can also result in lost exam data if a disc is removed while an exam is inprogress.

➤ To load and eject a DVD or CD

1. To open the tray, click Eject in the Patient Directory.

2. Place a disc into the tray. Ensure that the disc is seated properly in the recessin the tray.

3. To close the tray, click Eject again or gently push the tray in until it closes.

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Formatting a DVDFormatting an unformatted DVD prepares it to store data. Formatting a format-ted DVD that contains data erases all of the data on it. You can format a DVD inthe background while you continue to use the system. The system displays aprompt at the bottom of the screen to indicate when the formatting process isfinished.

➤ To format a DVD

1. Load a DVD into the drive.

2. In the Review Exam display or the Patient Directory, click Format. If theDVD is unformatted, the system displays an icon to indicate this.

3. In the Format DVD dialog box, click OK.


6 Customizing Your SystemYou can customize your system in several ways to make it more useful for you.You can create presets designed specifically for the exams you perform, you canchange system settings to reflect your needs, and you can add options to enhanceyour imaging abilities.

PresetsA preset is a group of settings that optimizes the system for a specific type ofexam. Presets establish many initial settings, such as gain value, color map, filter,and items on the Annotation and Measurement touch screens.

When you turn on your system, the default preset is active. Before you begin anexam, be sure that the appropriate preset is active.

You can choose from several default presets. You cannot delete these default pre-sets. However, they provide a starting point from which you can create your ownpresets. You can create and store up to 45 presets per transducer/applicationcombination, depending on the number of buttons available on the individualTransducer touch screens. If you need to create more than 45 presets pertransducer, you can save presets to a DVD and restore them when you need touse them.

NOTEPresets are available only if you purchased the corresponding application-packageoption.

About Clinical Options and Tissue Specific Presets Clinical options are broad areas of medical study. Within each clinical option,there are Philips Tissue Specific presets for specific areas of study. For example,within the Small Parts clinical option, the Tissue Specific presets are Thyroid, Tes-ticle, Breast, and Superficial. The Transducer touch screen lists the available clin-ical option/Tissue Specific preset combinations for the selected transducer.

You specify how the system will be set up for operation by selecting a clinicaloption/Tissue Specific preset. The more specific you are about your intended useof the system, the more you can benefit from Tissue Specific Imaging.

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About Quick Save PresetsQuick Save presets provide a quick way to set imaging parameters to the valuesyou prefer for a specific exam type. Using the Quick Save feature, you can definepresets for any combination of clinical option, preset, and transducer. A QuickSave preset stores the primary imaging mode and settings that are active whenyou create the Quick Save preset.

Once you create a Quick Save preset, it appears on the Transducer touchscreen when the associated transducer is selected. When you select the QuickSave preset, the system automatically invokes the settings in the preset. You canmodify or delete existing Quick Save presets, copy them onto a DVD, and loadthem into another iU22 system.

The number of Quick Save presets you can store for a transducer/applicationcombination is limited only by the number of buttons available on the corre-sponding Transducer touch screen. The number of buttons available, in turn, isdependent on which application is selected and how many Tissue Specific presetsthat application includes.

Creating Quick Save PresetsYou can create a new Quick Save preset that is based on an existing preset. Youcan do this even during an exam, while using the preset.

➤ To create Quick Save presets

1. Press Transducer.

2. On the touch screen, select the transducer and the preset on which you wantto base your Quick Save preset.

3. Adjust the system controls to create the settings for your preset. (You canselect an imaging mode, an image orientation, the number of focal zones, andso on.)

4. Press the Quick Save key.

5. For Quick Save Label, type the name of the new preset. (If you do notenter a name before saving a preset, the system will assign a name.)

6. For Calculation Package, select the desired calculations package.

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7. For Calc List, select the default calc list for the calculations package youselected.

8. For Annotation/Body Marks, select the annotations and body marks youwant as the default.

9. Click OK.

Modifying Quick Save PresetsYou can modify existing Quick Save presets and save your changes. You can dothis even during an exam, while using the preset.

➤ To modify Quick Save presets

1. If the preset you want to change is not currently active, press Transducer,select the transducer with which the preset is associated, and select the pre-set.

2. Adjust the system controls to create the settings for your modified preset.

3. Press the Quick Save key.

4. For Quick Save Label, type the name of the preset you are modifying.

5. Make changes to the remaining items, if desired, using the menus.

6. Click OK.

7. When the system warns you about overwriting the stored settings, click OK.

Deleting Quick Save PresetsYou can delete any Quick Save presets on the system except the active preset.

➤ To delete Quick Save presets

1. If a preset you want to delete is active, deactivate it by pressing Transducer,touching the associated transducer, and then touching a different preset.


3. In the setups, click Config & Test, and then click Manage Setups.

4. To delete specific presets, do the following:



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a. For Transducer, select the transducer with which the presets are associ-ated, or for multiple transducers, select All.

b. Select the presets you want to delete and click Delete Selected.

c. Click OK.

5. To delete all presets for a transducer, do the following:

a. For Transducer, select the transducer with which the presets are associ-ated.

b. Click Select Displayed, and click Delete Selected.

c. Click OK.

6. To delete all presets for all transducers, do the following:

a. For Transducer, select All.

b. Click Select Displayed, and click Delete Selected.

c. Click OK.

Copying Quick Save PresetsYou can copy Quick Save presets to a DVD. This function is useful for archivingpresets and for sharing presets among other iU22 systems.

NOTEWhen you load setups into the system from a DVD, the contents of the DVD aredisplayed, but you cannot select specific items to load. When you load setupsfrom a DVD, all setups are loaded. To load specific setups, create a DVD contain-ing only those items, and then load from that DVD.

➤ To copy Quick Save presets to a DVD

1. If a preset you want to copy is active, deactivate it by pressing Transducer,and then selecting the associated transducer and a different preset.



4. Select presets to copy by doing one of the following:

– To select all presets, click Select All.

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– To select specific quick save presets, select the transducer with which thepresets are associated, or for multiple transducers, select All, and thenselect the presets you want to copy.

5. Click Copy to DVD.

➤ To load Quick Save presets into the system from a DVD



3. Click Import from DVD.

4. Click OK.

System SetupsSetups are system parameters that you can change. By changing setups, you cancustomize the system to meet your operating preferences. Setups are organizedinto six standard categories: System Settings, Analysis Configuration,Annotation, Print/Network, Audio/Video, and Configuration/Test. Inaddition, two other categories appear only if the corresponding options areinstalled on the system. These optional categories are Voice Control and DataSecurity. Setups changes take effect immediately and remain in effect until youchange them again or load setups from a DVD.

For information on individual setup options, refer to the "Glossary" on page 409.

➤ To change setups


2. Click a setup category on the left side of the setups display.

3. Click a sub-category tab at the top of the setups display.

4. Enter text or make selections necessary to set up your system.

5. Click Done.



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OptionsIn addition to the standard features available in the system, other features areavailable as purchasable options. The types of options available include clinicaloptions, protocols, imaging capabilities, and connectivity capabilities.

For a list of options available for your system, see "System Options" on page 62.

Installing Temporary OptionsThe system lets you temporarily install up to five licensed options. You can thenevaluate these options for a fixed length of time, which is set by Philips. Beforeyou can install temporary options, you must request and receive an activation keyfor each option you want to install. The installation process requires restartingthe system, so be sure that the last exam has been closed before installingoptions.

➤ To install temporary options

1. Contact your Philips representative to obtain an activation key for eachlicensed option you want to evaluate.

2. Once you have received the activation keys, press End Exam to ensure thatthe last exam has been closed.


4. Click Config/Test.

5. Click Lic Options.

6. Click Enable Temp Lic Options.

7. For Key, type an activation key. Type each remaining key, one per line.

8. Click Submit.

9. Review the options installed, and then click OK.

10. Click Done.

11. In the System Restart dialog box, click OK to restart the system.

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Purchasing OptionsTo add licensed options to your system, you purchase them from your Philips rep-resentative. Once purchased, they are installed in your system by a Philips fieldservice engineer.



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7 Imaging ModesThe iU22 system offers a set of imaging modes to accommodate a variety of imag-ing applications. Some modes display a live grayscale image. Others are Dopplermodes to evaluate the amplitude or the direction of the blood flow and the spec-tral information. Special modes are also available for 3D imaging and Panoramicimaging.

NOTESome modes are available on your system only if the corresponding option hasbeen purchased and installed.

General Imaging InformationThis section includes information on beginning an exam, acquiring and printingimages, and changing imaging settings.

About the Imaging DisplayThe imaging display contains an ultrasound image, exam and image information,and indicators (Figure 7-1).

The image area is located approximately in the center of the imaging display. Tothe right of the image itself are a depth scale and a curve representing the TGCsettings. To the right of the TGC curve is a list of values for the slide controls. Agrayscale bar or color bar is displayed to the right of the TGC curve. In M-modeand Doppler, the sweeping display appears either below the 2D image or to theright of it, depending on the format you select.

Patient and exam data are displayed in the area directly above the ultrasoundimage. The system does not display patient data in this area until you start anexam. This area also includes the current time and date, the institution name, theselected transducer and clinical option, the thermal index (TI) setting and the TIand MI values.

Image information is displayed to the left of the image. In modes such as duplex ortriplex, additional image information is also displayed. Those additional parametersets can be displayed below the initial set and to the right of the image.

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Figure 7-1 Elements of the Imaging Display

Changing Display Element SettingsIn the setups, you can change the default settings for elements in the imaging dis-play. Display elements include image information, thumbnails, depth and TGC val-ues, the TGC curve, and tool tips. In addition, you can set the length of timebefore the system automatically freezes and turn that feature on or off.

➤ To change the default settings for the 2D display


2. Click System Settings.

3. Click the Display tab.

Image area Depth scale

TGC curve

Focal indicator

Patient and exam data

MI and TI values

Grayscale or color bar

2D imagepara-meter

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4. Make changes by clicking the desired settings for display elements.

5. Click Done.

Adjusting for Ambient LightThe Monitor control on the 2D touch screen allows you to adjust monitorbrightness to compensate for changes in ambient light. Use this control to tempo-rarily change the monitor brightness. When you cycle power, the system resetsmonitor brightness to the default value (see

➤ To compensate for changes in ambient light

1. Touch Next on the 2D tab.

2. Turn Monitor to select a setting from 1 (darkest) to 5 (lightest).

Starting an ExamBefore you begin an exam, press Patient Data and enter data for the patient.

To select a transducer, press Transducer.

To select a preset, touch the preset button on the Transducer touch screen.

Capturing Images and Loops You can capture and save a single frame or a Cineloop sequence. The capturedframe or Cineloop sequence is saved in the patient study, and a thumbnail of it isavailable in the live imaging display and the Review display. Images are automati-cally exported across the network either when you capture or print an image, orwhen you end an exam, depending on your selection for Send Images/Clips onthe Printer/Capture tab in the Print/Network setups.

During capture, the icon is displayed at the bottom of the display. When thecapture is complete, a thumbnail of the image is displayed.

➤ To capture a single image

Press Freeze and then press Print.

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➤ To capture a Cineloop sequence

Press Capture in live imaging or while reviewing a Cineloop sequence. Capturingduring live imaging saves prospective or retrospective frames, as specified in LiveCapture Type in the setups. Capturing while reviewing a Cineloop sequencesaves all retrospective frames in the Cineloop sequence.

NOTES• When an image is acquired, you will hear a beep to confirm that the loop or

image was saved in the patient's study. Do not press Review until you hearthe beep.

• If you press Capture in a non-simultaneous mode while a live M-mode orDoppler trace is active, you acquire a Cineloop sequence. If you press Cap-ture in a simultaneous mode, you acquire a single image.

Navigating Thumbnails of Captured ImagesIn live imaging, as you capture images, a set of thumbnail views appears on theright side of the display.

NOTEYou can turn the display of the thumbnail images on and off by using the Thumb-nails key.

➤ To navigate thumbnails of captured images

1. If the thumbnails of captured images are not visible, press the Setups key toturn the display of thumbnails on.

2. Do any of the following:

– Click or to move up or down through available thumbnails oneimage at a time.

– Click or to move up or down through available thumbnails onepage at a time.

Setting Cineloop Live Capture Type You can specify the type of capture for a Cineloop sequence. The options are"Prospective Capture" on page 445 or "Retrospective Capture" on page 449. You

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can also specify the length of capture in seconds (retrospective) or seconds orminutes (prospective).

➤ To specify the length and type of Cineloop capture


2. Click Print/Network.

3. Click the Printer/Capture tab.

4. To define the type of capture, select Prospective or Retrospective.

5. To define the length of the capture, select the desired value for the capturetype you selected.

6. Click Done.

Setting Mode PreferencesYou can change the default settings for imaging modes.

➤ To set mode preferences



3. Click the Mode Settings tab.

4. If you want the Color or Doppler scale to be inverted by default on steeringangle changes, select On for Auto Invert.

5. Select Full Screen, Dual, or Quad as the default format for 4D acquisition.

6. Select Full Screen, Quad, or Expand as the default format for 3D review.

7. Click Done.

Printing an ImageYou must assign Print on the control panel to a printer before you can use it. See"Configuring Print Functions" on page 80.

➤ To print an image


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• Press Print on the system control panel.

• Touch Print Screen or Alt Print on the touch screen.

• Press PRINT on a printer.

2D Mode2D mode is the most commonly used imaging mode. In 2D mode, the image isdisplayed in grayscale.

Whenever you press the 2D key, you exit the current mode and return to 2Dmode. The previous 2D settings are restored.

Using 2D Mode

NOTEWith sector transducers, such as the S4-1, the top of the image does not corre-spond to the skin line.

➤ To use 2D mode

1. Press 2D to start 2D imaging, if necessary. (The system starts up in 2D modeby default.)

2. Adjust the following controls to optimize the image:

– iSCAN

– 2D knob (turn to adjust 2D gain)

– Depth and Focus knobs

– TGC slide controls

3. Use additional controls on the touch screen, as needed.

4. To enter other imaging modes, press the button for an imaging mode.

5. To return to 2D-only imaging from any other imaging mode, press 2D.

Using 2D Touch Screen ControlsTo use a touch screen control or change its setting, touch it, or if it is in the bot-tom row, turn the knob directly below it.

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Click the name of a touch screen control in the following list to learn about itsfunction:

Positioning the Focal Zone Each type of transducer has a set of transmit focal zones that are fixed at specificdepths. These zones are translated by the system into a focal range. The indicatorto the right of the depth scale shows you where the focal range occurs for a giventransducer. Pressing Focus selects whether focal range or focal position isadjusted when you turn Focus. The icon changes to indicate the current function.In addition, the icon changes to indicate whether SonoCT imaging is on or off(Figure 7-2).

Figure 7-2 Focal Indicators

2D Opt

2D PRF

3D/4D

AGC

Alt Print

Angle A, B or C

Biopsy

Chroma Map

Compress

Dual

Dual 1 and Dual 2

Gray Map

Harmonics

Left/Right

Monitor

Output Power

Panoramic

Persistence

Print Screen

Res/Spd

Reset iSCAN

Sector Width

Set iSCAN

SonoCT

TI

Top/Bottom

Xres

Adjust focal range

Adjust focalposition

Adjust focal range

Adjustfocal

position

SonoCT imaging offSonoCT imaging on

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➤ To change the focal position and range

1. Press Focus, if needed, to activate the focal position adjustment, as indicatedby the green and white focal position graphic on the focal range graphic.

2. Turn Focus to position the indicator.

3. Press Focus to activate the focal range adjustment, as indicated by the blueand green focal range graphic.

4. Turn Focus to increase or decrease the focal range.

M-ModeIn M-mode, you can learn about the movement of an area of anatomy. First, youposition the M-line in the 2D image on the anatomy of interest. Then you can dis-play information about movement along that line in an M-mode trace. An M-modetrace can be helpful when you perform measurements, especially heart rate.

Using M-Mode

➤ To use M-mode

1. Press M-Mode to display the M-line on the 2D image.

2. Use the trackball to move the M-line to the anatomy of interest.

3. Turn 2D to change the initial gain for M-mode.

4. Press Update to display the M-mode trace.

5. To change the speed of the sweeping trace, touch Next and then turn Speedto select a setting.

6. To change the appearance of your image, use the controls on the touchscreen.

7. To review the M-mode trace, press Freeze, and use the trackball to scrollforward or backward.

8. To exit M-mode, press M-Mode or 2D.

Using M-Mode Touch Screen ControlsTo use a touch screen control or change its setting, touch it, or if it is in the bot-tom row, turn the knob directly below it.

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About Sweep SpeedDuring Doppler or M-mode imaging, you can change the speed of the sweepingdisplay by turning Speed, a rotary display. There are five sweep speeds: Min,Slow, Med, Fast, and Max. The sweep speed is displayed on the rotary display. Amedium sweep speed is suitable for normal use, but a fast sweep speed may beuseful to show the shape of some flow information. If, for example, a flow patternis to be analyzed carefully to calculate a mean pressure gradient, then it will bemuch easier to do this at a faster speed than at a slower speed.

There are three sizes of time markers in the sweeping displays. The largest timemarker denotes a time of 1 second, the smaller time marker denotes 0.2 second,and the smallest time marker denotes 0.1 second. The smallest time markerappears in the faster sweep speeds.

Changing the M-Mode FormatFive formats are available for displaying the M-mode trace.

➤ To change the M-mode format

1. With the M-mode trace displayed, touch Next to display the second page ofthe touch screen.

2. Touch Display Format to display the format buttons.

3. Touch the button that shows the format you want, or touch Full Screen todisplay the M-mode trace full screen without the 2D reference image.

2D Opt

2D PRF

3D/4D

AGC

Chroma

Chroma Map

Compress

Display Format

Gray Map

Harmonics

Left/Right

Monitor

Output Power

Persistence

Res/Spd

Sector Width

Speed

TI

Top/Bottom

Xres

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4. Touch Previous to return to the previous touch screen.

Using M-Mode ZoomWhen you are in M-mode, you can magnify a portion of the reference image byusing M-mode Zoom.

In M-mode Zoom, the M-mode trace represents only the information in thezoom box.

➤ To use M-mode Zoom

1. While in M-mode simultaneous or 2D with the M-line displayed, press Zoom.

2. Use the trackball to position the zoom box, and then press Zoom again.

3. Use the trackball to position the M-line in the zoomed image.

4. Press Update to display the M-mode trace.

5. To zoom out, press Zoom again.

PW DopplerPulsed-Wave (PW) Doppler is a Doppler mode that measures velocity in a PWsample volume and displays that information in a spectral trace with audio output.

Using PW Doppler

NOTEWhen in PW Doppler standby mode (Freeze), the ECG sweep speed cannot beadjusted. To adjust the ECG sweep speed, press Freeze (to unfreeze the display),and use Speed on the Physio touch screen.

➤ To use PW Doppler

1. In 2D mode, press PW.

2. Use the trackball to change the sample volume depth and position.

3. Turn SV Size to change the sample volume size.

4. To adjust the angle-to-flow correction, turn Angle Correct.

5. Press Update to display a PW spectral trace and the 2D reference image.

6. To adjust the volume of the Doppler audio, turn Volume.

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7. To switch between simultaneous and duplex, touch Simult.

8. To adjust the spectral display, press iSCAN, and turn PW, Baseline, andScale as needed.

9. To change sweep speed, touch Next and turn Speed.

10. To exit PW Doppler, press 2D, M-Mode, or PW.

Using PW Doppler Touch Screen ControlsTo use a touch screen control or change its setting, touch it, or if it is in the bot-tom row, turn the knob directly below it.


Positioning the Sample Volume

➤ To position the sample volume

1. Press Pointer, if necessary, until SV is displayed at the bottom of the imagingdisplay and the SV-line and sample volume are highlighted in green.

2. Use the trackball to position the sample volume.

High PRF Doppler ImagingHigh PRF is useful when normal pulsed-wave Doppler imaging cannot adequatelydisplay high-velocity or high-frequency signals. In high PRF, additional sample vol-umes are displayed as the depth of the sample volume of interest is increased. The

0°/60°

Angle Correct

Baseline

Chroma Map

Display Format

High PRF

High Q

Invert

Mean Trace

Output Power

PW Map

Scale

Simult

Speed

SV Size

TI

Wall Filter

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extra sample volumes provide points of reference that must be considered whenanalyzing the Doppler data.

When high PRF Doppler imaging is enabled, multiple sample volume cursors willappear on the 2D display as the PRF is increased by adjusting Scale. High PRF isavailable only on the S3-1, S4-1, C5-2, and C9-4 transducers.

➤ To enable high PRF Doppler imaging

Touch High PRF during pulsed-wave Doppler imaging to enable or disable highPRF Doppler imaging. The current state of this feature is displayed on the HighPRF touch screen control.

Setting Auto Invert You can use the Auto Invert feature to automatically invert the Doppler scalewhen you change the steering angle of a linear array transducer.

➤ To set the Auto Invert feature



3. Click the Mode Settings tab.

4. Select On for Auto Invert to automatically invert the Doppler scale, orselect Off to deactivate this feature.

5. Click Done.

Changing the Spectral Trace Format Five formats are available for displaying the Doppler spectral trace.

➤ To change the spectral trace format

1. Display the spectral trace.

2. If the PW tab on the touch screen is not selected, touch PW.

3. Touch Next.

4. Touch Display Format to display the format buttons.

5. Touch the button that shows the format you want, or touch Full Screen todisplay the spectral trace full screen without the 2D reference image.

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CW Doppler Continuous-wave (CW) Doppler uses continuously transmitted and receivedultrasound energy to generate a spectral display. Pulsed Doppler uses pulses ofsound waves to evaluate flow characteristics of direction and speed in a specificlocation. However, in pulsed Doppler, the time for echo information to return tothe transducer may be too great to accurately measure certain high velocities,resulting in false directional information known as aliasing.

As an alternative, CW Doppler allows accurate high-velocity determination.Though the sample rates for CW Doppler are greater than those available inpulsed Doppler, range information is unavailable. Accordingly, CW Doppler isappropriate when acquisition of high velocities is a more critical exam require-ment than capturing range information.

Only certain transducers provide CW capability. Pressing the CW control turnsCW Doppler on or off. CW is available only if the current transducer supportsCW operation.

Using CW Doppler

➤ To use CW Doppler

1. Select a transducer that supports CW acquisition.

2. Press CW to enter standby.

3. Use the trackball to adjust the D-line.

4. Press Update to start CW acquisition.

5. To end CW Doppler acquisition, press CW or any other mode button.

Using CW Doppler Touch Screen Controls To use a touch screen control or change its setting, touch it, or if it is in the bot-tom row, turn the knob directly below it.

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Changing the Spectral Trace Format Five formats are available for displaying the Doppler spectral trace.

➤ To change the spectral trace format


2. If the CW tab on the touch screen is not selected, touch CW.

3. Touch Next.

4. Touch Display Format.

5. Touch the button that shows the format you want, or touch Full Screen todisplay the spectral trace full screen without the 2D reference image.


Changing the Sweep Speed Five sweep speeds are available for displaying the Doppler spectral trace.

➤ To change the spectral trace sweep speed


2. If the CW tab on the touch screen is not selected, touch CW.

3. Touch Next.

4. Turn Speed to select a sweep speed.


0°/60°

Angle Correct

Baseline

Chroma Map

CW Map

Display Format

Invert

Output Power

Scale

Speed

TI

Wall Filter

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Duplex and Triplex Duplex and simultaneous update are available for 2D, and Doppler imaging. (InM-mode, the 2D image and the sweeping display are always simultaneous.) Triplex(also called triple mode) is the simultaneous update and display of 2D, Color orColor Power Angio imaging, and Doppler ultrasound information. Triplex can beused to decrease exam time and improve efficiency. Triplex is available with alltransducers.

Simultaneous and Triplex are available only with transducers that support PWDoppler.

Using Duplex Duplex enables you to display a live 2D image and a PW Doppler spectral trace,without simultaneous update.

➤ To use Duplex

1. In 2D mode, press PW.

2. Adjust the position and size of the sample volume depth and position.

3. Turn SV Size to change the sample volume size.

4. To adjust the angle-to-flow correction, turn Angle Correct.

5. Press Update to display a PW spectral trace and the 2D reference image.This is duplex.

6. To simultaneously update both the 2D image and the PW spectral trace,touch Simult.

NOTEIf you are in duplex and you press Color or CPA, you enter triplex.

Using Triplex Triplex enables you to display a live 2D image with a Color or Color Power Angioimage and a PW Doppler trace, with or without simultaneous update.

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➤ To use triplex

1. While in duplex PW Doppler, press Color or CPA. This is triplex.

2. Do one of the following:

– To exit triplex and remain in spectral Doppler, press Color or CPA.

– To exit spectral Doppler, press the button for any imaging mode.

Color Mode Color imaging uses Doppler principles to generate a Color image of the meanflow velocity, power, or velocity/variance. In Color mode, a color box is overlaidon the 2D image; its size and position can be adjusted within the 2D image. Thevelocity and direction of flow in the color box are represented with different col-ors for direction and different shades for velocity. The colors being used appear inthe color bar in the upper right corner of the imaging screen. The distribution ofcolors in the color bar is controlled by the color map you select. Six color mapsare available in Color imaging.

Turning on Color mode turns off M-mode, and turning on M-mode turns offColor.

Color imaging is available on all transducers, although not for all clinical options.

Using Color Mode

➤ To use Color mode

1. Press Color to start Color imaging.

2. Use the trackball to change the position of the Color box.

3. Press Select and use the trackball to change the size of the Color box.

4. To change the Color gain, turn Color.

5. To select a color map, turn Color Map.

6. To adjust the color image, turn Res Pen, Baseline, and Scale.

7. To exit Color imaging, press Color or the button for any other imagingmode.

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Imaging Modes

Using Color Mode Touch Screen Controls To use a touch screen control or change its setting, touch it, or if it is in the bot-tom row, turn the knob directly below it.


Comparing Images in Color ModeYou can use dual imaging in Color mode to compare two color images or to com-pare a color image and a flow-suppressed version of the same image.

➤ To compare images in Color mode

1. While viewing a live image in Color mode, touch Dual. Two images appear, animage that shows color flow and a flow-suppressed version of the same image.

2. To switch the color to the left image, touch Dual 1, to switch to the rightimage, touch Dual 2.

3. To exit dual imaging, touch Dual again.

Color Power Angio ImagingColor Power Angio (CPA) imaging uses Doppler principles to generate a CPAimage. In CPA, a color box is overlaid on the 2D image; its size and position canbe adjusted within the 2D image. The amplitude (intensity) of blood flow in theCPA box is represented with different hues. The colors being used appear in thecolor bar on the upper right corner of the imaging screen. The distribution of col-ors in the color bar is controlled by the color map you select. Six color maps areavailable in CPA imaging.

Baseline

Blend

Col Map

Dual

Dual 1 and Dual 2

Expanded Screen

Hide Color

Invert

Line Density

Output Power

Persistence

Res/Pen

Scale

Smooth

TI

Variance

Wall Filter

Write Priority

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Turning on CPA turns off M-mode, and turning on M-mode turns off CPA. CPA isavailable on all transducers, although not for all clinical options.

Using Color Power Angio Imaging

➤ To use CPA imaging

1. Press CPA to start CPA imaging.

2. Use the trackball to change the position of the CPA box.

3. Press Select and use the trackball to change the size of the CPA box.

4. To change the CPA gain, turn CPA.

5. To select a CPA map, turn CPA Map.

6. To adjust the CPA image, turn Res Pen and Scale.

7. To exit CPA imaging, press CPA or the button for any other imaging mode.

Using Color Power Angio Touch Screen Controls To use a touch screen control or change its setting, touch it, or if it is in the bot-tom row, turn the knob directly below it.


Comparing Images in Color Power Angio ModeYou can use dual imaging in Color Power Angio (CPA) mode to compare a CPAimage and a flow-suppressed version of the same image.

Blend

CPA Map

Dual

Dual 1 and Dual 2

Flow Opt

Hide Color

Line Density

Output Power

Persistence

Res/Pen

Scale

Smooth

TI

Wall Filter

Write Priority

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➤ To compare images in CPA mode

1. While you are viewing a live image in CPA mode, touch Dual. Two imagesappear.

2. Select Dual 2 and click CPA to turn it off. The display now includes an imagethat shows color flow and a flow-suppressed version of the same image.

3. To exit dual imaging, touch Dual again.

3D Acquisition Two options are available for acquiring a 3D data set on your system: Freehand3D and 4D imaging. Both options include support for setup, acquisition of images,and viewing and manipulation of 3D volume and 2D multiplanar reformatted(MPR) views.

The Freehand 3D option allows you to acquire an uncalibrated series of 2Dframes in Cine memory for 3D volume rendering. Freehand 3D is allowed only inradiology applications on non-motorized transducers. After acquisition, the sys-tem renders a 3D volume image from the 2D frames. You can use all conventionaltransducers for Freehand 3D imaging.

The 4D imaging option requires a 3D transducer. This option provides sin-gle-sweep 3D (single 3D volume) acquisition and continuous acquisition of multi-ple 3D volumes (4D).

The Freehand and 4D imaging options both include support for setup, acquisitionof images, and viewing and manipulation of 3D volume and "MPR views" onpage 440.

Once the images are acquired, you can adjust thresholds and image enhancementsettings, rotate 2D multiplanar images, rotate volume images, trim extraneousimage information, magnify images, and view Cine sequences.

Using 3D/4D Acquisition Touch Screen Controls To use a touch screen control or change its setting, touch it, or if it is in the bot-tom row, turn the knob directly below it.


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About Acoustic Artifacts in 3D ImagingResolution, attenuation, and propagation artifacts are all common to 3Dimaging. Careful scrutiny of the original 2D images is necessary to identify andpreclude these types of artifacts from the 3D volume image.

Gain, directional, and motion artifacts can present themselves in 3D imag-ing. Gain artifacts are mainly related to the use of excessive gain resulting in ran-dom color patterns in the 3D image that might be interpreted as diagnosticallysignificant. Directional artifacts are due to aliasing or directional confusion: Thevelocity range must be set properly, and the relationship between the transducerorientation and the flow vector must be understood. Patient motion can produceflash artifacts that are less obvious in 3D images than in 2D imaging.

Acquisition, rendering, and editing artifacts are specific to 3D volumeimages. Acquisition artifacts are related to patient motion, organ motion, or posi-tion-sensing errors. Rendering artifacts include elimination of structures by limit-

2D

2D Opt

2D PRF

3D

3D Image Controls

3D/4D

3D Opt

3D ROI

AGC

Angle

Back to Standby

Brightness

Cine/Pan

Cine Play

Cine Speed

Compress

Exit 3D

Frame

Geometry

Gray/Chroma

Gray Map

Harmonics

Hide Gray Bar

Lighting

Link

MPR X-Hair

Opacity M

Output Power

Persistence

Res/Spd

RESET

Reset Orientation

Rotate 1, 2, 3

Sector Width

SonoCT

START 3D

START 4D

Threshold

TI

Transparency

Trim Left, Right

Vol X-Hair

Xres

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ing the region of interest boundaries, thresholding that eliminates structures, andadjacent structure artifacts that add additional information or hide structures.Editing artifacts result from data deleted from a rendered image.

Limb deficit artifacts are specific to 3D volume images. In some studies, par-tially absent fetal limb bones have been demonstrated. One explanation for themissing limbs was shadowing caused by adjacent skeletal structures. Overcomingthe limb deficit artifact can be accomplished by changing the transducer positionand the acquisition plane.

Pseudoclefting and pseudonarrowing artifacts may be related to limb defi-cit artifacts. Some studies have also shown that artifacts may be present in 3Dimaging of the fetal face. Being aware of pseudoclefting of the fetal face and psue-donarrowing of the fetal spine can help the sonographer understand and identifythese artifacts. As with 2D imaging it is important to verify putative physicaldefects using additional images and other modalities.

Drop-out and shadowing are present in 3D imaging although more difficult torecognize due to different and unfamiliar displays. Acoustic shadowing and otherartifacts look very different when displayed in 3D volumes and may be more diffi-cult to recognize than on standard 2D imaging. These artifacts may produceapparent defects such as limb abnormalities or facial clefts where they are notpresent. Acquiring data from multiple orientations may avoid artifacts of this type.

Color and Color Power Angio artifacts relating to gain may also be confusingin rendered images.

Motion artifacts in 3D volumes can be caused by fetal movement, cardiacmotion, as well as movement of adjacent structures.

About Freehand TechniqueIn Freehand 3D imaging, the system uses the 2D images acquired and stored inCine memory to create a 3D image. Because the quality of the multiplanar andvolume images is dependent upon the quality of the 2D acquisition, special atten-tion should be paid to 2D imaging technique. Observe the Freehand 3D progressindicator (Figure 7-3). Your scan should fill the progress indicator at least to theminimum frame indicator. Ideally, the progress bar should fill the entire indicatorat about the same time your sweep is complete.

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Figure 7-3 Freehand 3D Progress Indicator

It may take several tries for you to match the frame rate of the system with thesweep speed of the transducer. You may need to adjust the frame rate, line den-sity, and focal zones to change the frame rate.

In Freehand 3D imaging, using a standard transducer, you drag (slide) or pivot(tilt) the transducer at the region of interest to acquire the images. If you drag thetransducer, hold the transducer with the same angular relationship to the skinthroughout the motion to keep the image planes parallel to each other. If you tiltthe transducer, pivot the transducer at an even rate, keeping the face of the trans-ducer in the same position on the skin. Move the transducer at a constant rate forequally-spaced images.

About Freehand GeometryIn freehand 3D imaging, you can use one of two types of motion to acquire a 3Dvolume. Most often, you pivot a curved or sector transducer in a fan-like motionor drag a linear array transducer. If you select a curved or sector transducer, thesystem sets Geometry to Fan. If you select a linear array transducer, the systemsets Geometry to Linear. You can change the Geometry setting in the 3DStandby touch screen.

Optimizing 3D Image Quality There are several features that aid in adjusting 3D acquisition for optimal imagequality. 3D Opt on the touch screen lets you quickly select acquisition settingsoptimized for penetration (Pen), resolution (Res) or general use (Gen). SonoCTimaging is another important tool for improving image quality in freehand 3Dacquisition. You can also use XRes either during acquisition or during review.

Minimum frameindicator

Freehand 3D

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Acquiring a Freehand 3D Data Set

WARNINGS• Spatial relationships are not accurate in uncalibrated 3D images.

• When reviewing 3D volumes acquired using freehand 3D imaging, always ver-ify that features in the 3D view also appear in the MPR view.

➤ To acquire a Freehand 3D image

1. Set up the system for the best image quality for the application.

2. Change the geometry setting, if necessary, by touching Geometry.

3. Preview the site to determine where to start and stop the sweep. Follow stan-dard AIUM protocols to ensure a standardized orientation of the 2D multipla-nar views.

4. Position the transducer at the starting point of the scanning region.

5. Touch 3D/4D. The 3D timing bar appears. The system is now in 3D standbymode.

6. Touch Start 3D and begin to pivot (curved or sector) or drag (linear array)the transducer in time with the timing bar.

7. To end acquisition before the timing bar is filled, touch Stop 3D. When the3D scanning is complete, the 3D Review display appears.

8. To start over and acquire another data set, touch Back to Standby and startagain at step 6.

Acquiring a Single-Sweep 3D Data SetSingle-sweep 3D acquisition can be used to capture a single 3D volume using a 3Dtransducer.

➤ To use single-sweep 3D imaging

1. Select a 3D transducer and set up the system for the best image quality forthe application.

2. Touch 3D/4D to enter 3D standby mode.

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3. Preview the site to determine where to start and stop the sweep. Follow stan-dard AIUM protocols to ensure a standardized orientation of the 2D multipla-nar views.

4. Position the 3D transducer over the scanning region.

5. Touch Start 3D to start the scan, and hold the transducer steady to minimizeartifacts. When the 3D scanning is complete, the 3D Review display appears.

Acquiring 4D4D imaging provides continuous acquisition of multiple 3D volumes using a 3Dtransducer. As in standard 3D imaging, the ROI box allows you to concentrate 3Dacquisition and processing on a specific region of interest.

➤ To use 4D imaging

1. Select a 3D transducer and set up the system for the best image quality forthe application.

2. Position the transducer over the anatomy of interest.

3. Touch 3D/4D to enter 3D standby mode.

4. Touch Angle/Tilt to adjust the angle (scan angle) or tilt function for the con-trol below, then turn the knob to adjust the setting.

5. Turn Res Speed to adjust image quality.

6. Touch Start 4D to start the scan, and hold the transducer steady to minimizeartifacts. The 4D image appears on the display.

7. To adjust the ROI box, move the trackball to modify size, press Select andposition the box, and press Select again and position the trim line.

8. To stop 4D acquisition and enter the 3D review stage, touch Stop 4D.

9. To start single-sweep 3D acquisition from this mode, touch Start 3D.

During 4D acquisition, you can use additional imaging controls by touching 3DImage Controls. You can also use active controls on the 2D and 3D touchscreens, as well as 2D (gain), TGC, and other controls on the control panel.

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Setting the 4D FormatThere are three image formats available in 4D acquisition; full screen, dual, andquad. In the setups, you can select the default format. Regardless of the default,you can change the format during 4D review using the format buttons on the 4DReview touch screen.

➤ To set the default 4D format


2. In the setups display, click System Settings, and then click Mode Settings.

3. For 4D Acquisition, select the desired setting.

4. Click Done.

➤ To set the format during 4D review

On the Realtime 3D Review touch screen, touch , , or .

Defining a 3D Region of Interest During 4D acquisition, the region of interest (ROI) graphic appears on the image.You can adjust the ROI using the trackball. The part of the ROI graphic assignedto the trackball is displayed in green (Figure 7-4).

Figure 7-4 3D Region of Interest Graphic

➤ To adjust the ROI

1. If the ROI graphic is not displayed during 4D acquisition, touch 3D ROI.

2. Use the trackball to position the ROI graphic.

3. Press Select and use the trackball to size the ROI graphic.

4. Press Select and use the trackball to position the ROI trim line, displayed inwhite.

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3D Image Review During 3D image review you can change the image display, rotation, magnification,threshold, image settings, and rendering mode. You can also return to the initial3D image. The 3D Review image display includes three multiplanar 2D images anda 3D volume image.

Using 3D Image Review Touch Screen Controls To change the setting of a touch screen control, touch it, or if it is in the bottomrow, turn the knob directly below it.


About Review FormatsThere are three review formats available: quad, full, and expanded. You select aformat by touching the appropriate control on the touch screen:

(full screen), (quad), or (expanded).

A view is a single image in any format. Full format displays any one of the viewsseparately on a larger scale (Figure 7-5). Quad format displays four views of simi-

3D

3D Image Controls

3D/4D

Back to Standby

Backup

Brightness

Caliper

Cine/Pan

Compress

Exit 3D

Frame

Gray/Chroma

Gray Map

Hide Gray Bar

Lighting

Link

Move 3D Info

MPR X-Hair

Opacity M

RESET

Reset Orientation

Resize

Rotate 1, 2, 3

Rotate MPR/X-Hairs

Save 3D Data

Smoothing

Smoothing/Lighting

Threshold

Transparency

Vol X-Hair

Volume

Xres

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lar size. Expanded format displays one view on a larger scale on the left side andthe three remaining views on the right side of the display.

Figure 7-5 3D Review Formats

The views are numbered, and the numbers remain unique to each view regardlessof the format used. When entering review, the acquisition view is the active view,indicated with a white border. Turn Frame to select a different view.

All formats allow for manipulation of the views for better clarity. There are fourviews numbered 1 through 4. View 1 is the acquisition view, a multiplanar refor-matted (MPR) view. Views 2 and 3 are also MPR views. View 4 is the 3D view,which is a reconstructed volume view, referred to as the volume view. The MPRviews are orthogonal, or perpendicular to each other.

Each view has a red, green, or blue border. In any view, the color of the crosshairsrepresents the plane of the view with the same color border.

Setting the Default 3D Review FormatThere are three image formats available in 3D review; full screen, quad, andexpanded. You can select the default format in the setups. That format is usedeach time you enter 3D review.

➤ To set the default 3D review format


2. In the setups display, click System Settings, and then click Mode Settings.

3. For 3D Review, select the desired setting.

4. Click Done.

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Rotating 3D Views The system default for rotation links the volume view and MPR views, so theyrotate together. When linked, the volume view updates to reflect rotation of theMPRs. The volume view can be unlinked from the MPR views by deselecting Linkon the touch screen, so that it rotates independently of the MPR views.The MPRviews are always linked to each other so they remain orthogonal. The volumeview will now rotate independent of the crosshairs. You can rotate a volume viewusing either the trackball or a Rotate control.

➤ To rotate the volume view using a Rotate control

1. To rotate the volume view separately from the MPR views, touch Link tounlink the views.

2. Turn Frame to move the frame box to frame 4, the volume view.

3. Turn the Rotate knobs to rotate the volume view. Each Rotate knob con-trols rotation in a different axis.

➤ To rotate the volume view using the trackball

1. Ensure that Cine/Pan is set to Cine.

2. Position the pointer in the volume view.

3. Press Select. The rotate cursor appears.

4. Use the trackball to rotate the volume view.

➤ To rotate the MPR views

1. To rotate the MPR views separately from the volume view, touch Link tounlink the views (Link is off).

2. Turn the Rotate knob that corresponds to the view you want to rotate. Forexample, in quad format, Rotate 1 corresponds to the transverse MPR viewin frame 1. The other MPR views update to remain orthogonal to each other.

➤ To return all views to their original orientation

Touch or click Reset Orientation. This also resets zoom magnification.

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Rotating Crosshairs In addition to rotating the volume view and MPR views, you can also rotate thecrosshairs in the MPR views.

➤ To rotate the crosshairs in the MPR views

Touch Rotate MPR/X-Hairs to switch rotation to crosshairs and turn Rotate1, Rotate 2, or Rotate 3 to rotate the crosshairs in the corresponding MPRview.

Magnifying a 3D Image You can magnify the MPR views, the volume view, or all four views together.

➤ To magnify views in 3D review


– To magnify only the MPR views, touch Link to unlink the views, turnFrame to select one of the MPR views.

– To magnify only the volume view, touch Link to unlink the views, turnFrame to select the volume view.

– To magnify the volume view and MPR views together, touch Link to linkthe views.

2. Turn Zoom to increase or decrease magnification.

➤ To return all views to their original zoom magnification

Touch or click Reset Orientation. This also resets rotation.

Trimming Views You can trim an MPR view by moving its border. Moving an MPR border also trimsaway all the data outside that border from the volume view. This provides a quickway to trim the volume. The trim is not permanent; it only hides the trimmedarea. You can move the border back toward its original position to display the ini-tial image.

You can also trim a volume view directly, using the sculpt tool ( ) locatedon the 3D Review display. The sculpt tool allows more precise removal of arbi-trary shaped sections of the volume data. The MPR views are not affected by the

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sculpt tool. You can undo the most recent sculpt operation on the volume viewwith the undo tool.

➤ To trim an MPR view

1. Move the cursor over the border of the MPR view until small circles appear.

2. Press Select. Use the trackball to move the border.

3. Press Select again to set the new border position. The volume view updatesand the views are centered automatically.

➤ To trim a volume view with the sculpt tool

1. Click .

2. Use the sculpt tool to outline the area to be trimmed from the view.

3. To remove the trim tool and cancel an uncompleted trim operation, touchQuit Trim.

4. As you near the beginning of the outline, press Select. The outline closes, andthe area inside the outline disappears. The trim does not show in the MPRviews.

➤ To trim a volume view with the eraser tool

1. Click .

2. Position the eraser tool on the area of the volume view that you want toerase, and then.

3. Press Select to turn on the eraser tool, and move the eraser tool to erase.


– To remove the trim tool and cancel an uncompleted trim operation, touchQuit Trim.

– To complete the erasure and turn off the eraser tool, press Select again.

➤ To undo a trim operation


– To undo the most recent trim, click .

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Imaging Modes

– To redo the most recent trim, click .

– To erase one step at a time when using the sculpt tool or the eraser tool,touch Backup, or hold it down to erase quickly.

– To undo all trim operations, touch or click RESET. This also resets rota-tion and all 2D review controls to their default settings.

Using 3D CineThe 3D Cine function allows you to change the depth of the MPR view in the vol-ume by moving the MPR image back and forward through the data. (3D Cine is aspatial review of the data, as compared with Cineloop Review, which is a temporalreview). Cine and Pan share a control on the touch screen; the active function isshown on the control.

➤ To use 3D Cine for MPR views

1. Touch Cine/Pan to select Cine.

2. In the active view, move the cursor away from borders and crosshairs.

3. Press Select. The Cine icon appears in the view.

4. Use the trackball to move the MPR image through the volume data.

5. Press Select again to turn off 3D Cine.

Using PanPan is used to drag or pan the MPR views. Pan and Cine share a control on thetouch screen; the active function is shown on the control.

➤ To pan the MPR views

1. Touch Cine/Pan to select Pan.

2. In the active view, move the cursor away from borders and crosshairs.

3. Press Select. The Pan icon appears .

4. Move the trackball to pan the image.

5. Press Select to turn off pan.

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Resizing a Volume ViewThe Resize control allows you to expand or contract the Z-scale of any uncali-brated (freehand) 3D volume. Because the scale of a freehand 3D image isunknown, it may be necessary to resize the image if the scale of the object doesnot appear to be correct.

➤ To resize an uncalibrated volume view

Turn Resize. As you turn Resize, the bar on the touch screen display for thecontrol changes to indicate the relative size of the volume view.

Moving 3D Information The 3D review display includes a list of control settings. The default position forthis information is on the right side of the display. You can move this informationto the other side of the display so that it appears in a print when you print thescreen.

➤ To move the 3D information on the display

Touch Move 3D Info. Each time you touch this control, the information movesfrom one side of the display to the other.

Resetting 3D Review There are two ways to reset the 3D review display. You can reset only the orien-tation of the views, or you can reset the orientation, all trim operations, and all3D review controls. Resetting restores view data, orientation, and controls todefault conditions.

➤ To reset the 3D review display


• To reset only the orientation of the views, touch or click Reset Orienta-tion.

• To reset the orientation, all trim operations, and all 3D review controls, clickRESET.

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Saving and Recalling 3D Data Sets The save function allows you to the save a complete 3D data set to the systemhard drive for review later. All functions of the review stage are available withrecalled 3D data sets, except saving a single image of the set to the hard drive.Once you have saved a 3D data set on the system hard drive, you can then archiveit to a DVD.

NOTEBecause no DICOM 3D format currently exists, you cannot save 3D data on anarchive server or restore 3D data from an archive server.

You recall a 3D data set from the hard drive or DVD just as you would recall anyother image. A 3D data set is marked with a cube icon displayed on the thumb-nail. When you recall a 3D data set, it is displayed in the 3D review display.

➤ To save a 3D data set

During review, touch Save 3D Data. The 3D data set is saved to the system harddrive.

➤ To recall a 3D data set

1. Press Review.

2. If there is no exam active, select the exam in the Patient Directory and clickDisplay Exams.

3. To recall the data set, double-click the view of the data set in the ReviewExam display.

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8 Imaging Features The iU22 system offers a range of imaging features that provide improved imagingand greater flexibility when you are imaging a patient.

Biopsy Guideline Display

WARNINGDo not attempt to use the biopsy guide until you have read the instructions forselecting the display, installing the sterile transducer cover, and verifying alignmentof the biopsy guide. These instructions are in the “Biopsy Guides” section of theiU22 User Reference.

The system generates a biopsy guideline through the displayed real-time ultra-sound image to indicate the anticipated path of the needle. You can use this guide-line to ensure that the needle or instrument is following the correct path.

When the biopsy display is active, a biopsy guideline is displayed on the left side ofthe screen during normal image presentation and on the right side when theimage presentation is reversed. Image presentation is defined by the location ofthe orientation marker.

When depth is changed, the biopsy display is redrawn to reflect the new relation-ships at the new depth setting.

Displaying the Biopsy Guideline The biopsy guideline can have a single, fixed path or multiple paths. The systemdetermines which guideline to display based on the type of biopsy guide availablefor the transducer you have selected.

➤ To turn the biopsy guideline on and off

1. Touch Next on the 2D touch screen, and then touch Biopsy. The biopsyguideline appears (Figure 8-1).

2. If you are using a biopsy guide with multiple needle paths, touch the control(for example, Angle A, Angle B) that corresponds to the path you will beusing.

3. To turn the biopsy guideline off, touch Biopsy again.

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➤ To display or hide the biopsy guideline on a frozen image

1. With a biopsy guideline displayed and the image frozen, touch Next on the2D touch screen.

2. Touch Hide Guideline. The biopsy guideline is hidden.

3. To display the biopsy guide, touch Hide Guideline again.

Figure 8-1 Biopsy Guideline

Moving the Biopsy Depth CursorA depth cursor appears on the biopsy guideline. The distance from the skin lineto the depth cursor appears at the bottom of the imaging screen.

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Imaging Features

➤ To move the biopsy depth cursor

Rotate the trackball to move the depth cursor along the guideline. The BiopsyDepth measurement value changes to reflect the distance between the biopsyguide reference point origin and the depth cursor.

Figure 8-2 Biopsy Depth

Panoramic ImagingPanoramic Imaging is an imaging process that produces a panoramic image usingcertain transducers. Panoramic Imaging broadens the scope of spatial relation-ships, thereby sequentially aligning individual images in their anatomical context.

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Panoramic Imaging has the ability to display an entire abnormality and show itsrelationship to adjacent structures on a single, static image.

Panoramic Imaging can be started from any live image format supported by thesystem, but it operates only in real-time 2D imaging. XRes image processing is notavailable in Panoramic standby or during acquisition. SonoCT Wide Screen imag-ing is not available in any stage of Panoramic Imaging. You can make measurementson the Panoramic image or on individual images in Cineloop review.

Panoramic Imaging is available with these transducers:

• C5-2

• C9-4

• C8-5

• L8-4

• L12-5

• L17-5

• 3D6-2

Panoramic Scanning Techniques

➤ To scan properly for Panoramic Imaging

1. Ensure that the system is imaging at a frame rate of at least 15 Hz.

2. Apply a sufficient amount of scanning gel (to prevent drag) to the entire areaof the body designated for Panoramic Imaging.

3. Perform a practice sweep to determine the desired scanning path.

4. Begin movement of the transducer smoothly and in a precise direction. If youfind that you are moving off plane or off of the desired path, you can stop for-ward motion and correct your orientation. Image registration stops if thetransducer is stationary. Continue movement at a slow and consistent speedalong the plane of interest.

Panoramic Imaging ArtifactsIn Panoramic Imaging, artifacts are most often caused by improper scanning tech-nique.

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Imaging Features

Seams or tearing artifacts can be caused by moving the transducer too fast ortwisting the transducer during imaging. Twisting the transducer can also result inoverlapping frames in the Panoramic image.

Blurring artifacts are often related to the angle of the transducer to the skin.Tilting the transducer can result in blurring artifacts and loss of proper curvaturein the image. When using a linear transducer, always keep the full length of thetransducer face in contact with the body surface and perpendicular to the skinline. Panoramic Imaging on a highly curved body surface can also result in blurring.Another source of blurring is transducer pressure. Excessive or uneven pressureapplied to the transducer results in tissue deformation and can produce blurringartifacts.

Acquiring a Panoramic Data SetDuring acquisition all controls and menu selections are disabled except these:Freeze, the TGC slide controls, 2D, Output Power, and End Exam. You canuse 2D to adjust gain as you scan across structures of different densities.

➤ To acquire a Panoramic data set

1. Touch Panoramic. The system enters the standby stage, and the capturearea box appears.

2. Optimize the image as desired setting the depth, gain, focus, and other imageparameters.

3. Touch Start or press Update to begin Panoramic acquisition.

4. Move the transducer at a consistent speed in a direction that extends the fieldof view (width of the image). The composite image begins to form. When theCineloop buffer is full, acquisition automatically stops.

– To stop the acquisition manually before the buffer is full, touch Stop orpress Freeze. Touch Stop or press Freeze a second time to clear thePanoramic image and return to standby.

– If needed, touch Exit Panoramic to exit Panoramic Imaging and returnto 2D live imaging or select another imaging mode.

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Erasing and RetracingIf you are unsatisfied with a small area of the image during acquisition, you canreverse the transducer movement to erase that portion and then reacquire theimage. Be careful to follow the exact original path when erasing to avoid creatinga seam at the point where retrace begins.

Using Panoramic Touch Screen ControlsTo change the setting of a touch screen control, touch it, or if it is in the bottomrow, turn the knob directly below it.


Panoramic Image ReviewAfter you acquire the Panoramic data set, the Panoramic image appears on theimaging screen. You can then manipulate the Panoramic image using the controlson the control panel and the touch screen.

2D

2D Opt

AGC

Alt Print

Auto Fit

Caliper

Chroma Map

Cine Play

Cine Review

Cine Speed

Compress

Exit Panoramic

Gray Map

Harmonics

Hide Ruler

Left/Right

Output Power

Pan Filter

Persistence

Print Screen

Rebuild

Rotate

SonoCT

Start

TI

Top/Bottom

Trim Image

Xres

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Performing Measurements on a Panoramic Image

WARNINGS• Do not use the skin line ruler for estimating depth on Panoramic images. Use

only the calibrated depth ruler for this purpose.

• Do not measure across Panoramic areas with no image data, such as the blackarea in a scan of the neck, leg, or other tightly curved anatomy.

On a Panoramic image, you can perform all 2D measurements except depth. Youcan delete measurements on a Panoramic image, but you cannot reactivate mea-surements.

You can make measurements on the Panoramic image or on individual images inCineloop review. If the object you are measuring is contained in an individualimage, make the measurements on the individual image instead of the Panoramicimage. This ensures that you will achieve optimal measurement accuracy.

Magnifying a Panoramic imageBy default, the system turns on Auto Fit to optimize the size of the Panoramicimage on the display. You can zoom up to 5 times the Auto Fit image size.

➤ To magnify a Panoramic image


• Turn Zoom to zoom in and out of the image.

• Move the trackball to pan the zoomed image.

• Turn Zoom counterclockwise to return the image to its original state.

Rebuilding a Panoramic imageRebuild is useful for restoring a trimmed Panoramic image to its original size ororientation. Touching Rebuild replicates the building process as it occurred whenthe Panoramic image was acquired. Touching Stop while the image is being rebuiltends the process, producing an incomplete Panoramic image. Rebuilding againproduces the same image that was generated during acquisition.

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➤ To rebuild a Panoramic image

1. Touch Rebuild to start rebuilding an image.

2. To cancel rebuilding while it is in process, touch Stop or press Freeze.

Rotating a Panoramic imageThe system adjusts the image size as needed to display the entire image duringrotation. However, if the image is zoomed larger than x1.0, portions of the imagecould move off the display during rotation.

➤ To rotate a Panoramic image

Turn Rotate in the direction you want to rotate the image.

Smoothing a Panoramic Image

➤ To smooth a Panoramic image

Turn Pan Filter to select a setting for the Panoramic temporal smoothing filter.

Trimming a Panoramic imageA Panoramic image can be trimmed from one or both of its edges. You canrestore a trimmed image either by rebuilding the image or by trimming it againand restoring the trimmed portions.

➤ To trim a Panoramic image

1. Touch Trim Image.

2. Use the trackball to move the trim cursor to the edge of the area you want totrim and press Select. The first trim cursor is anchored, and the second trimcursor is activated.

3. Position the second trim cursor to the other edge of the trim area, and pressSelect to anchor the cursor.

4. Press Select to switch between the trim cursors and adjust the trim areaagain, if needed.

5. Touch Trim Image to trim the areas outside the cursors.

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Imaging Features

6. To review the Panoramic image for acquisition consistency or to restore theimage to its original size, touch Rebuild or touch Trim again to move thetrim cursors back to the edges of the Panoramic image.

Printing and Storing Panoramic ImagesYou can print, store, review, and retrieve Panoramic images as you can with otherimages.

Panoramic Cine ReviewUsing Cine Review, you can view the individual images that make up the Pan-oramic image. In Cine Review, the display splits into two areas:

• The left side shows individual full-scale 2D images composing the Panoramicimage.

• The right side shows the Panoramic image. A frame or ROI shows the loca-tion of the individual full-scale 2D image within the Panoramic image. If thefield of view of the Panoramic image is wider than the display area, the edgesof the image are symmetrically clipped.

➤ To use Cine Review

1. Touch Cine Review.


– Use the trackball to move the capture area box to navigate through thedifferent linear 2D images composing the Panoramic image.

– Touch Cine Play to start play.

– Turn Cine Speed to increase or decrease the play speed. There are threespeeds available.

– Touch Cine Play again to pause play.

3. Touch Cine Review again to exit Cine Review.

SonoCT ImagingPhilips SonoCT Real-time Compound Imaging uses spatial compound imaging toreduce speckle, enhance contrast resolution, and improve contrast and definitionof tissues interfaces. You can use SonoCT imaging during live 2D acquisition,

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including harmonic imaging modes. SonoCT imaging is also available in non-simul-taneous PW Doppler, freehand 3D, and single sweep 3D. You can use SonoCTimaging with 4D imaging, but you cannot turn it on or off while in 4D imaging.While using SonoCT imaging, you can also display a wide-screen display createdfrom all of the ultrasound data acquired for compound imaging.

SonoCT imaging is available with these transducers:

• C5-2

• C9-4

• C8-4v

• C8-5

• C9-5ec

• L8-4

• L12-5

• L17-5

• 3D6-2

• 3D9-3v

Using SonoCT Imaging

WARNINGBecause SonoCT imaging creates a compound image from multiple transmitangles, it may change the appearance of acoustic shadowing. Consider this changein appearance when evaluating the composition of a cyst or tumor.

NOTESonoCT imaging cannot be turned on or off during 4D imaging. If you want to useSonoCT imaging in 4D imaging, turn it on before starting 4D. If 4D imaging isalready active when you decide to use SonoCT imaging, exit 4D, turn on SonoCTimaging, and start 4D again.

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Imaging Features

➤ To use SonoCT imaging

1. During live 2D image acquisition, non-simultaneous PW Doppler, or 3Dstandby, touch SonoCT to turn on SonoCT imaging.

2. Adjust Res Spd to optimize SonoCT imaging.

3. To display wide-screen imaging, touch Wide Screen.

4. Touch either Res Spd or Wide Screen again to turn off those features.

Contrast Imaging 2D Contrast imaging is used in conjunction with ultrasound contrast agents toenhance imaging of blood flow and microcirculation. When you select Contrastimaging mode, the system is optimized according to the transducer, application,contrast agent, and imaging scenario you select.

SonoCT imaging is available when Contrast imaging is active.

Two General Imaging Contrast presets are available; one for normal MechanicalIndex (MI), which is based on microbubble destruction (Contrast ADI) and onefor low MI for real-time imaging of microbubbles (Contrast General). Contrastimaging is supported for these transducers:

• C5-2

• C8-4v

• L8-4

• C9-5ec

• S4-1

About Acoustic Artifacts in Contrast ImagingArtifacts can be generated during Contrast imaging by the interaction of the con-trast agent, the ultrasound beam, and the anatomy.

Rib artifact appears as a dark, linear area in a lateral part of a sector image. Ribartifact occurs when a rib blocks scan lines, preventing microbubbles in the rib’sshadow from resonating. You can minimize or eliminate rib artifacts by reposition-ing the transducer in relation to the ribs.

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Shadowing or attenuation is a common artifact that appears as a dark area,generally in the mid to far field. Shadowing is caused by administering the contrastagent at a high rate or concentration. The resulting high concentration ofmicrobubbles in an area causes backscatter of the ultrasound energy, preventingsufficient energy from reaching the area behind the concentration. Shadowing isalleviated as the contrast agent becomes diluted. You can avoid shadowing byadministering the contrast agent at a lower rate and concentration.

Swirling occurs when the higher level of ultrasound energy in the near field dis-rupts or destroys the microbubbles in the contrast agent. Factors that contributeto swirling are high MI, low blood flow near the apex, and low concentration ofcontrast agent. Frame rate can also have an effect on swirling.

Using Contrast Imaging

➤ To use Contrast imaging

1. Select a transducer with a Tissue Specific preset for Contrast imaging, andthen select that preset.

2. Begin imaging. Adjust Output Power and TGC gain only as needed.

Tissue Harmonic ImagingTissue Harmonic Imaging (THI) uses the harmonic frequencies generated by tis-sue. The fundamental transmit frequency results in a harmonic frequency echo.The harmonic frequency received from the tissue is a multiple of the fundamentaltransmit frequency. The fundamental and any accompanying artifacts are missingfrom the harmonic frequency that the system receives. The artifact reduction, andthe concomitant reduction in haze and clutter, increases contrast resolution andimproves border delineation. THI is useful in difficult-to-image patients.

Tissue Harmonic Imaging can be used in conjunction with SonoCT imaging andXRes image processing.

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Imaging Features

Using Tissue Harmonic Imaging

➤ To use Tissue Harmonic Imaging

If Harmonics is not already active, touch Harmonics to start Tissue HarmonicImaging. THI is active when HGEN, HRES, or HPEN appears in the image infoarea on the left side of the display.

iSCAN Intelligent OptimizationiSCAN Intelligent Optimization is used to automatically optimize key imagingparameters during either 2D or Doppler acquisition. There are two options avail-able; 2D iSCAN Intelligent Optimization and Doppler iSCAN Intelligent Optimi-zation.

About 2D iSCAN Intelligent OptimizationPressing iSCAN during live 2D acquisition optimizes the system for imaging. Thesystem evaluates grayscale distribution to optimize TGC, compression (dynamicrange), and 2D gain for the image. The compression settings do not change;instead, the underlying dynamic range values used in each compression setting are

adjusted. The icon is displayed only when the selected transducer and TissueSpecific preset support iSCAN Intelligent Optimization. When you activateiSCAN, the icon changes to red for three seconds to indicate that the image hasbeen optimized.

When you press iSCAN, the current position of each TGC slide controlbecomes the zero position.

Touching Reset iSCAN restores the TGC and dynamic range settings in usebefore you activated iSCAN optimization. Touching Reset iSCAN also restores2D gain to the level set by the system when you selected the current transducerand application. iSCAN optimizes system settings based on the frame acquired atthe moment you press iSCAN. These settings remain unchanged until you pressiSCAN, touch Reset iSCAN, or change the affected controls manually.

If you are not satisfied with the brightness level set by iSCAN, you can change itby applying an offset value by using the rotary control below Set iSCAN on thesecond page of the 2D touch screen. This offset value will then be used to correctthe optimization process for the associated transducer each time you press

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iSCAN. You can save this offset value as part of a custom Tissue Specific presetby using the Quick Save key. iSCAN is not available for contrast applications orstored images, or during Panoramic Imaging, 3D imaging, or Cineloop Review.

Using 2D iSCAN Intelligent Optimization

➤ To use 2D iSCAN Intelligent Optimization

1. Select a transducer and a preset, and begin imaging the area of interest.

2. Adjust Output Power, Depth, and Focus as needed.

3. Press iSCAN.

4. To adjust the brightness level set by iSCAN, turn Set iSCAN. This settingwill be used each time you activate iSCAN with the current transducer.

5. If you want to return the system to the previous settings for 2D gain, TGC,and dynamic range, touch Next to display the second page of controls, andthen touch Reset iSCAN.

About Doppler iSCAN Intelligent OptimizationUsing iSCAN Doppler Intelligent Optimization can reduce exam time by eliminat-ing manual re-optimization for each new Doppler trace. An additional benefit maybe the resulting inter- and intra-operator consistency. This feature optimizes base-line and pulse repetition frequency during Doppler acquisition.

iSCAN Doppler optimization is supported for all general imaging applications. It isnot available for contrast and cardiology applications on shared services systems.iSCAN optimization is available in real-time 2D/PW Doppler acquisition. DoppleriSCAN optimization is not available for Cineloop Review or stored images.

Using Doppler iSCAN Intelligent Optimization

➤ To use Doppler iSCAN Intelligent Optimization

Press iSCAN during pulsed-wave Doppler imaging to optimize baseline and pulserepetition frequency for the Doppler display. You can change these settings byadjusting Baseline or Scale, respectively.

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XRes Image ProcessingThe XRes image processing feature is an adaptive, multi-resolution, algorithm thatenhances grayscale image quality by reducing speckle and noise, while maintainingimage resolution.

The feature is available for real-time 2D and dual 2D images and on rendered Pan-oramic and 3D images. XRes image processing is supported with SonoCTReal-time Compound Imaging, fundamental and harmonic imaging, and all otherstandard 2D features, including measurements, annotations, printing, and VCRcapabilities.

Using XRes Image ProcessingTouch XRes to turn XRes processing on and off. The feature remains on whenyou switch between imaging modes. In dual imaging, the feature can be on for oneimage, while it is off for the other image. When XRes image processing is on, indi-cators appear on the right side of the display, even if the image information isturned off (Figure 8-3).

Figure 8-3 XRes Indicators and Image Information

XRes imageinfo

XRes

indicator

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Dual ImagingUsing dual imaging, you can position two images side-by-side on the display.Touching Dual enables the dual image display. Before touching Dual, you can cap-ture an image for each of the dual images using Dual 1 and Dual 2. Once thedual image display is enabled, you can alternate image activity between the twoimages using Dual 1 and Dual 2. Dual imaging is available in all 2D live-imagingmodes, such as Color and CPA imaging. Dual images can be of different types; forexample one image can be 2D grayscale and the other 2D Color.

Dual imaging does not support making measurements across the two dual images.

Using Dual Imaging

➤ To use dual imaging

1. In 2D, Color, or CPA imaging, touch Dual. The image shifts to the left of thedisplay.

2. Touch Dual 2 to activate the second image.

3. Touch Dual 1 or Dual 2 to alternate the update between the two images.

4. Touch Dual to exit the dual display.

Cineloop ReviewCineloop image review is the storage and review of a sequence of images in sys-tem memory. Cineloop review is available by pressing Freeze. Moving the track-ball to the left or right moves through the Cineloop sequence. Images from aCineloop sequence can be measured and annotated. Cineloop sequences helpidentify timing information.

The Cineloop sequence can be played back to simulate real-time motion, or it canbe reviewed one image at a time. Each image is identified by a number displayedbelow the image. The image number relates the image to its position in theCineloop sequence relative to the first and last images of the Cineloop sequencedisplay. The trim cursors are used to temporarily edit the Cineloop sequence(Figure 8-4). Once enabled, the trackball moves the trim cursors and the Select

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Imaging Features

control selects between them. The right trim cursor corresponds to the mostrecent frame captured.

Pressing Capture allows you to store the contents of the Cineloop buffer to thesystem hard drive and the selected archive devices. At the completion of the loopcapture, the system displays the last frame of the Cineloop buffer. For more infor-mation about storing loops or images, see "Sending Exams and Images" onpage 311.

Figure 8-4 Cineloop Cursors and Image Number

Using Cineloop ReviewFreeze stops image acquisition and enables Cineloop operation. (In 3D imaging,Freeze stops the 3D scan process and opens the 3D Review display.)

➤ To use Cine Review

1. Obtain an image sequence and press Freeze.

2. Use the trackball to move through the Cineloop sequence frame-by-frame.(The frame counter changes as you move through the frames.)

3. Touch Cine Play to play the Cineloop sequence. (To stop playback, touchCine Play again or move the trackball.)

4. Touch Cine Speed to select a playback speed.

5. To save the Cineloop sequence on the system hard drive, press Capture.

Image numberLeft trim cursor

Image select cursor Right trim cursor

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Using Cineloop Touch Screen ControlsTo change the setting of a touch screen control, touch it, or if it is in the bottomrow, turn the knob directly below it.


Editing a Cineloop Sequence

➤ To edit a Cineloop sequence

1. Press Freeze to capture the sequence.

2. Touch Trim Left, or Trim Right, depending on which end you want to trim.

3. Use the trackball to position the trim cursor (Figure 8-5).


– If setting only one trim cursor, press Select to fix the cursor.

– If setting both cursors, press Select to fix the cursor, position the othercursor, touch the other trim control (Trim Left or Trim Right), andthen press Select again.

5. To save the trimmed sequence, press Capture.

Alt Print

Chroma Map

Dual

Dual 1 and Dual 2

Gray Map

Hide Guideline

Left/Right

Monitor

Print Screen

TI

Top/Bottom

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Figure 8-5 Cineloop Cursors and Image Number

Zoom MagnificationUsing zoom, you can magnify a region of interest in the 2D, Color, or CPA imagefor closer examination. Two types of zoom are available on the system: zoom andHD Zoom.

Zoom magnifies a region of interest in a live image or in a Cineloop frame orsequence. Zoom magnifies the region of interest up to eight times the normalsize. The zoomed image can be panned or moved around with the trackball. InM-mode imaging, you can set the region of interest in the 2D image, and concen-trate on the M-mode information defined by the M-line within the region of inter-est. M-mode information shallower or deeper than that defined by the region ofinterest is not displayed.

HD Zoom concentrates the system processing ability on a specific region of inter-est in the real-time image display. The result is a reduced field of view overall, butgreater detail and higher frame rate, which contribute to better image qualityover the region of interest.

Using Zoom Zoom is available during real-time acquisition, in freeze mode, and in CineloopReview.

Image numberLeft trim cursor

Image select cursor Right trim cursor

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➤ To use zoom

1. During 2D imaging, turn Zoom to activate zoom and to change the zoommagnification.

2. Use the trackball to pan the magnified image.

3. Turn Zoom to restore the image to its normal size.

Using HD Zoom HD zoom is available only during real-time acquisition.

➤ To use HD zoom

1. Press Zoom to activate HD Zoom. (In Color or CPA imaging, adjust the sizeand position of the color overlay before you press Zoom.)

2. Use the trackball to change the zoom box position.

3. Press Select and use the trackball to change the zoom box size.

4. Turn Zoom to change the zoom magnification.

5. Press Zoom. The image assumes normal size.

Physio (ECG)The system can display a trace on the image representing an ECG signal. ECGinput can be either a low-level signal (from leads connected to the patient) or ahigh-level signal (from a patient monitor). Separate receptacles are used to con-nect low-level ECG and high-level ECG signals to the system. Heart rate, derivedfrom the ECG signal, is displayed on the screen whenever ECG is connected anddisplayed.

The low-level ECG receptacle is a Lead II configuration. For best results, the useof pre-gelled ECG disposable electrodes is recommended. The use of reusableelectrodes is not recommended.

Connecting Physio (ECG) LeadsTo display ECG signals on the imaging display, you must connect the ECG cableand properly attach the ECG leads.

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Imaging Features

WARNINGDo not use ECG patient cables with detachable lead wires that have exposedmale pins. Electrocution can result if these pins are plugged into AC power.

➤ To connect ECG signals

Do one of the following (Figure 8-6):

• To connect a low-level ECG signal, orient the connector of the ECG leadswith the slot facing up and insert it into the low-level ECG receptacle.

• To connect a high-level ECG signal, insert the phone plug from the patientmonitor into the high-level receptacle.

Figure 8-6 Connecting ECG Signals

Low-level ECG

High-level ECG

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Using ECGBefore using ECG, you must attach the patient leads. See "Connecting Physio(ECG) Leads" on page 212.

➤ To use ECG

1. Press Physio to display the Physio tab on the touch screen, and then touchECG to turn on the ECG display.

2. To adjust the ECG display, touch the Physio tab and do any of the following:

– Turn Speed to select one of five sweep speeds for the ECG trace.

– Turn ECG Gain to adjust the gain of the ECG signal.

– Turn ECG Position to adjust the vertical position of the ECG on the dis-play.

3. Touch ECG again to turn off the ECG display.

4. Press Physio again to remove the Physio tab from the touch screen.

Using ECG Touch Screen ControlsTo use a touch screen control or change its setting, touch it, or if it is in the bot-tom row, turn the knob directly below it.

Click the name of a touch screen control in the following list to learn about itsfunction. These functions are available on the Physio touch screen:

Speed ECG Gain ECG Position


9 AnnotationYou can place text labels and arrows on an image to identify anatomical structuresand locations.You can also annotate an image with a body marker graphic thatindicates the part of the anatomy that you are scanning.

LabelsThe annotation feature allows you to add text to the display by typing or by usingthe controls on the Annotations touch screen. Labels are initially placed in thehome location, but you can move them anywhere in the image area. You can alsoadd an image display title, a specific type of annotation that appears in a fixed loca-tion near the top of the screen. A distinct set of labels is displayed for each com-bination of preset. You can modify each set of labels in setups to meet your needs.

The annotation feature is available in live-acquisition modes and in frozen modes.In Review, you can add annotations by using the Text Cursor key or the Anno-tate control. (Also, in Review, you can add body markers to clips but not toimages.)

Adding Labels Using Annotate

➤ To add labels using the Annotate control

1. Press Annotate.

2. Use the trackball to position the text cursor on the display, or touch Hometo return it to the home location.


– To add text, type the text that you want to appear on the display.

– To display predefined labels, touch a label control to display its text.

– To display an arrow, touch the Arrow control , position the arrowwith the trackball, and then click to fix the position.

– To erase the last word typed, touch Erase Last Word to erase wordsone at a time.

– To erase all text, press the Erase Text key or touch Erase All Text.

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– To erase all arrows, touch Erase Arrow.

– To move the text cursor to the home position, touch Home.

– To set a new home position, position the cursor and touch Set Home.

– To exit annotation mode, touch Close or press Annotate again.

Adding Labels Using the KeyboardYou can manually format the annotation labels you add using the keyboard. Usespaces before and after the words you type to center the text or improve theword wrap format.

➤ To add labels using only the keyboard

1. Press the Text Cursor key.

2. Use the trackball to position the text cursor on the display.

3. Type the text that you want to add.

4. To erase text, press the Backspace key.

5. When finished, press Select, or press the Text Cursor key again, to removethe text cursor.

6. To remove text, press the Erase Text key. You can also press Annotate andthen touch Erase Last Word or Erase All Text.

Adding an Image Title

➤ To add a title to the image display

1. Press the Title Cursor key.

2. Type the text that you want to add for the title.

3. To erase text, press the Backspace key.

4. When finished, press the Title Cursor key again to remove the title cursor.

Using Annotation Touch Screen ControlsTo use a touch screen control or change its setting, touch it.

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Customizing AnnotationSetups allow you to customize the Annotations touch screen. You can addexisting labels to the Annotations touch screen for each system preset, up to atotal of 29 labels per preset. You can also create your own labels and add them tothe Annotations touch screen.

➤ To customize labels


2. Click Annotate. The Annotate tab appears.

3. Click an application subtab (on the Annotate tab) and then select a presetfor Exam Type.


– To add existing labels to the next empty label buttons, select labels in the

list box and click . (To select a range of labels, drag the pointer overthe labels.)

– To add a label to a specific label button, select a label in the list box andclick an empty control in the touch screen area of the Annotate setupsdisplay. Add additional labels in the same way.

– To move a label, click the label in the touch screen area of the Annotatesetups display and then click an empty button to set the new location.

– To create a new label, click in the text box (above the list box) and typethe text. As you type, the text appears in the text box and in the ButtonPreview window as it will appear on the touch screen. Press the Enterkey to add the text to the list box.

– To see how a label will be displayed on the touch screen, click a label inthe list box. The label appears in the Button Preview window as it willappear on the touch screen.

Arrow

Erase All Text

Erase Arrow

Erase Last Word

Home

Set Home

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– To remove an unused label from the list box, select it and click Delete.

– To remove labels from the touch screen, select the labels in the list boxand click . (To select multiple labels, simply click the labels.)

5. To apply your changes for the current exam type (preset) to all exam types inthe current application, click Apply to All Exams, and click OK when thesystem prompts you to confirm the change. Changes to all exams are notsaved until you click Done.

6. To reset the annotations displayed on the touch screen to system defaults,click Reset Screen. Custom annotations you added to the list box are unaf-fected.

7. To reset the annotations displayed on the touch screen and in the list box tosystem defaults, click Reset Default.

8. Click Done to save your changes.

Body MarkersIn addition to adding text labels, you can add a body marker to the display. Withthe marker displayed, you can position a transducer scan plane indicator on thebody marker. The body markers available for the current preset are displayed onthe touch screen when you press Body Mark.

You cannot add body markers to images in Review, although you can add them toclips in Review.

Displaying Body Markers

NOTEDuring Review, the Body Markers touch screen is available only when FullScreen format is selected. You cannot add body markers to images in Review,although you can add them to clips in Review.

➤ To display body markers

1. Press Body Mark to display the Body Markers touch screen for the currenttransducer and preset.

2. Touch a button to put the corresponding body marker on the display in thehome location or to replace an existing body marker.

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3. Use the trackball to position the transducer scan plane indicator on the bodymarker. Turn Body Mark to change the orientation of the transducer indica-tor.

4. Do any of the following

– To move the marker, touch Move Body Mark, position the body markerusing the trackball, and touch Move Body Mark again.

– To remove a body marker, touch Erase Body Mark.

– To close the Body Markers touch screen, touch Close or press BodyMark again.

Using Body Marker Touch Screen ControlsTo use a touch screen control or change its setting, touch it.


Erase Body Mark

Move Body Mark

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10 MeasurementsThe measurement tools appear on the Caliper touch screen. Touching an activetool from the Caliper touch screen launches the tool. (The labels of inactivetools are gray.)

When you make measurements, the system calculates values from your measure-ments and includes them in the results. You can press Calc and assign a measure-ment value to a measurement label in the measurement list on the left side of thescreen. The patient report contains a list of measurements and calculations.

You can also erase the measurement calipers, back up a trace measurement, andend measurements. Erase Calipers, Backup, and End Measure on the Cali-per touch screen are used for these functions.

Ensure that you follow current medical practices when identifying specific mea-surement points on an image.

Measurement Setups and ControlsThe Measure setups in System Settings include Doppler results, units of mea-sure and precision for the distance, velocity, and volume measurements, and a set-ting for Dotted Lines between calipers.

The measurement controls include several touch screen controls on the Calipertouch screen, Freeze, the trackball, and two Select controls adjacent to thetrackball.

The Calc control displays the calc list across the top of the display and the activemeasurement list along the left side of the display. Calculations from the measure-ments appear at the bottom of the measurement list. Results from the currentmeasurements appear adjacent to the calculations.

Changing Measure Settings

➤ To change measure settings



3. Click the Measure tab.

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– Select an application from the menu under Doppler and select up toseven results to display.

– Select the desired units for distance, velocity, and volume measurements,and then select a precision setting for each measurement type.

– Select On or Off in Dotted Lines to display or remove dotted linesbetween the calipers.

5. Click Done.

Using the Caliper Touch Screen ControlsTo use a touch screen control or change its setting, touch it.


Measurement AccuracyYou can use the ultrasound system to make measurements and calculate resultsfrom ultrasound images. The measurements and calculations are then used withother clinical data to make a diagnosis.

% Area Reduction

% Diameter Reduction

1 Distance

2D Depth

3D Volume

4D imaging

Backup

Base Line

Caliper

Continuous Trace

Convert to Ellipse

Curved Distance

Diameter 1, 2

Dist+Ellip Volume

Distance

Done

Ellipse

End Measure

Erase Calipers

Heart Rate

Hip Angle

Inclination line

Percent Reduction

Roof Line

Stacked Contour

Trace by Points

Time/Slope

Volume

Volume Distance

Volume Distance 1, 2, 3

Volume Ellipse

Volume Flow

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Making a diagnosis based solely on measurements and calculations is not recom-mended. There are numerous factors to consider when using quantified data fromany ultrasound imaging system. A careful analysis of those factors indicates thatthe accuracy of each measurement and calculation is highly dependent on imagequality. Image quality in turn is highly dependent on system design, operator scan-ning technique, familiarity with system controls and, most important, patientechogenicity.

About Measurement AccuracyResolution is proportional to the transducer frequency. Penetration is inverselyproportional to the transducer frequency. Resolution is always best near the focalzone of the transducer where the ultrasound beam is narrowest. You set the focalpoint depth. Measurements are most accurate near the focal depth, and less accu-rate away from the focal point as the acoustic beam widens.

About Doppler Measurement AccuracyLower frequency transducers are capable of measuring higher velocity flows. Sam-ple volume size is limited laterally by the acoustic beam. Penetration is best withlow frequency transducers.

About Color and CPA Measurement AccuracyThe accuracy of a measurement made in Color imaging is subject to the same lim-itations as a similar type of measurement made on a gray-scale image. Do not useColor values for precise flow velocity quantification in any application. Color flowvalues are estimates of the mean velocity, and will not necessarily represent peakvelocities. The method of choice for quantifying flow for any application is spectralanalysis using pulsed or continuous-wave Doppler imaging.

About Display Size and Measurement AccuracyThe precision with which a caliper can be placed in an image can be improved bymaking sure that the area of interest fills as much of the screen as possible. In 2Dimaging, distance and area measurements are improved by minimizing the displaydepth and using the zoom function where possible. In M-mode and Doppler imag-ing, time measurements are improved by using the highest possible sweep speed.In Doppler imaging, velocity measurement accuracy is improved by using thesmallest possible vertical scale setting.

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About Caliper Placement and Measurement AccuracyWhen making a measurement, accurate placement of the calipers is essential. Toimprove caliper placement precision:

• Use the video controls and the imaging controls to adjust the display for max-imum sharpness

• Use leading (closest to the transducer) edges or borders for start and stoppoints of the measurement

• Maintain a consistent transducer orientation for each type of measurement.

About Speed of SoundUltrasound imaging and Doppler algorithms assume that the speed of sound isconstant at 1,540 m/s, but the speed of sound varies for different tissue types. Incardiovascular applications, where soft tissues, blood, and fatty layers are allinvolved, the error is random but is typically on the order of 2% to 5%. Ensurethat your tissue-equivalent phantom meets the following specification: speed ofsound = 1,540 m/s. If your tissue-equivalent phantom does not meet this specifi-cation, linear measurements derived using your tissue-equivalent phantom will beinaccurate.

About Doppler AlignmentDoppler velocity measurements are most accurate when the acoustic beam isaligned parallel with blood flow. Deviations from the parallel alignment of up to 20degrees for Doppler angles result in measurement errors of 6% or less. For largeralignment errors (Doppler angles exceeding 20 degrees), the measurement accu-racy falls off rapidly, and use of angle correction is recommended (vascular appli-cations only). The Doppler angle correction appears in the patient report withthe Doppler measurements.

About AliasingPulsed-wave Doppler uses signal sampling techniques to compute a velocity spec-trum. A theoretical limit exists for the maximum measurable velocity. When mea-suring high velocities, the sampling rate, which is determined largely by the samplevolume depth, may be insufficient; and velocity wraparound (aliasing) may occur. Apossible result could be that normal, high-velocity, laminar flows would be per-

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ceived as turbulence. Aliasing can be minimized, in some cases, by moving thebaseline, increasing the velocity scale, or using a lower frequency transducer. Incontinuous-wave Doppler, aliasing is virtually eliminated.

About Velocity Resolution in DopplerIn computing velocity spectra, the velocity field (the area where flow exists) isassumed to be stationary. In cardiovascular applications, velocity fields do notremain constant, owing to the pumping action of the heart. The dynamics ofblood flow places a practical upper limit on velocity resolution and spectral edgesharpness. The acoustic beam width determines the extent to which velocitiescan be differentiated in composite blood flow patterns.

About Acquisition and Algorithmic ErrorsIn general, there are two types of errors that can be introduced into a displayedmeasurement: acquisition and algorithmic.

Acquisition errors are introduced by ultrasound machine electronics, relating tothe front end signal acquisition, signal conversion, and the display of the image onthe screen. These machine errors are also introduced by generation of a pixelscale factor, application of that factor to the caliper positions on the screen, andthe subsequent measurement display. Calipers and readouts must be used againsta known phantom image displayed on the screen; it is impossible to state or test atolerance of a machine acquisition error by itself.

Algorithmic error is the error introduced by taking the basic measurements withacquisition errors as input to higher order calculations for display to the user. Thiserror is associated with floating point versus integer type math, and is also subjectto errors introduced by rounding versus truncating results for a given level of sig-nificant digit display of the values. The acquisition errors of the inputs are not car-ried forward into these higher calculations.

About FormulasSome formulas used in clinical applications are based on assumptions or approxi-mations, for example:

• Volume formulas may assume a specific three-dimensional shape.

• Pressure formulas use a simplified version of equations from fluid mechanics.

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All formulas used in the ultrasound system are based on extensive clinical refer-ences from medical literature. These references are described in your user infor-mation.

NOTEThe user is solely responsible for custom measurements and calculations.

Accuracy TablesThe measurements provided by the system do not define a specific physiologic oranatomic parameter. Rather, what is provided is a measurement of a physicalproperty such as distance or velocity for evaluation by the clinician.

For each of the measurements available on the system, the measurement accuracyand range over which that accuracy is valid is shown in the following tables. Mea-surement accuracy is also constrained by the caliper placement capability limit.Unless specified by a transducer or an application, all linear distance measure-ments have the following accuracy requirements.

The accuracy of area and circumference measurements and calculations is basedon user variability and ability to accurately trace the desired object.

Range and accuracy shown in the following tables are related as follows: Measure-ments made in the range listed are accurate to the percentage or units listed,whichever is greater.

Table 10-1 2D Measurement Accuracy and Range

Measurement Range Accuracy

Axial Distance 0.01–25 cm ± 1% or 1 mm

Lateral Distance 0.01–35 cm ± 2% or 2 mm

Diagonal Distance 0.01–25 cm ± 2% or 2 mm

Table 10-2 2D Hip Angle Measurement Accuracy

Measurement Accuracy

Alpha Angle ± 3 degrees

Beta Angle ± 3 degrees

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Table 10-3 M-Mode Measurement Accuracy and Range


Time 0.01–11.3 s ±2%

Distance 0.01–25 cm ±2% or 1 mm

Slope 0.01–999.99 cm/s ±0.1 cm/s2

Table 10-4 Doppler Measurement Accuracy and Range


Velocity PW: 0.1 cm/s–8.8 m/s

CW: 0.1 cm/s–30.8 m/s

±1% full scale

Time Difference 10 ms–12 s ±2 columns (1 column = 1 ms, 2 ms, 4 ms, 8 ms, or 16 ms, depending on speed)

Table 10-5 3D Measurement Accuracy and Range


Axial Distance 0.01–25 cm ±1% or 1 mm

Azimuthal Distance 0.01–33 cm ±2% or 2 mm

Elevation Distance 0.01–32 cm ±2% or 2 mm

Diagonal Distance (through volume)

0.01–40 cm ±3% or 3 mm

2D Area 0.01–1,000 cm2 ±5% or 0.4 cm2

2D Circumference 0.03–10,000 cm ±4% or 3 mm

Ellipsoid Volume 0.01–2,000 cc ±9% or ±0.7 cm3

Stacked Contour Volume 0.01–2,300 cc ±9% or ±0.7 cm3

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Distance MeasurementsTouching Distance displays a caliper. A caliper is a symbol used to measureobjects on an ultrasound image. You move the caliper with the trackball andanchor the caliper by pressing Select.

In the Measure setups, you can display or hide a dotted line between the cali-pers. The behavior and appearance of the caliper varies depending upon the imag-ing mode. In Doppler mode and M-mode, a vertical time line or a dashed verticalline are used to make some measurements.

NOTEIn Doppler mode, Distance is the measurement tool used to measure velocity.

Eight symbols identify the 2D distance calipers and the measurement values in theresults (Figure 10-1). As you make additional measurements, these symbols areused in the same order.

Figure 10-1 Measurement Caliper Symbols

Measuring 2D Depth

➤ To perform a 2D depth measurement

1. Obtain the desired 2D image.

2. Press Caliper.

3. Touch 2D Depth. A caliper appears on the 2D image.

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4. Use the trackball to position the caliper. The distance between the skin lineand the caliper appears in the results.

5. Touch End Measure.

Measuring 2D Distance

➤ To perform a 2D distance measurement

1. Obtain the desired image and press Freeze.

2. Press Caliper.

3. Touch Distance.

4. Use the trackball to position the caliper at the first point of the measurement.

5. Press Select to anchor the first caliper and display the second caliper.

6. Use the trackball to position the second caliper at the second point of themeasurement. The results update as the distance between the caliperschanges.

7. Press Select to alternate control between the two calipers.


Measuring Percent Diameter Reduction% Diam. Reduction, on the Caliper touch screen, is a complex distance mea-surement tool, because it requires more than one distance measurement toobtain a result. Percent diameter reduction is derived from a 2D diameter mea-surement of the original or unreduced vessel and a 2D diameter measurement ofthe stenotic or reduced-lumen diameter. Make the measurement on a cross-sec-tional 2D view of the vessel.

➤ To obtain the percent diameter reduction

1. Obtain a 2D image that displays a cross-sectional view of the vessel.

2. Press Freeze.

3. Press Caliper.

4. Touch Percent Reduction.

5. Touch % Diam. Reduction.

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6. Touch Diameter 1 (Initially, Diameter 1 is the selected by default.).

7. Move the first caliper to the outer vessel wall at the maximum diameter of thevessel under study and press Select. A second caliper appears.

8. Move the second caliper to the outer vessel wall opposite the location of thefirst caliper and press Select.

NOTEEach time you press Select, control switches between the two calipers. TouchingDiameter 2 ends the first diameter measurement and displays the first caliper ofthe second diameter measurement.

9. Touch Diameter 2.

10. Move the first caliper of the second diameter measurement to the inner ves-sel wall at the minimum diameter of the vessel under study and press Select.

11. Move the second caliper of the second diameter measurement to the innervessel wall opposite the location of the first caliper of the second diametermeasurement and press Select.

12. Touch Done to complete your measurements. The values for the maximumdiameter, the minimum diameter, and the diameter reduction are displayed inthe results.

About M-Mode DistanceIn M-mode, when you touch Distance a vertical time caliper and a horizontaldepth caliper appear. You use the trackball to position the vertical time caliperalong the time scale and the horizontal depth caliper at the desired depth withinthe M-mode display.

When you press Select, the vertical time caliper disappears, the horizontal depthcaliper is fixed, and a second horizontal depth caliper appears.The distancebetween the horizontal depth calipers is displayed in the results. The resultsupdate as you change the distance between the calipers. You can make up toseven distance measurements.

You can move the caliper to the 2D display to perform a 2D distance measure-ment any time before you anchor the M-mode time caliper.

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Measuring M-Mode Distance

➤ To perform an M-mode distance measurement

1. Obtain the desired M-mode display and press Freeze.

2. Press Caliper.

3. Touch Distance.

4. Use the trackball to position the vertical time caliper and the horizontal depthcaliper.

5. Press Select to display another horizontal depth caliper. (The vertical time cal-iper is removed.)

6. Use the trackball to position the horizontal depth caliper. The distancebetween the depth calipers appears in the results.

7. To make additional measurements, repeat step 5 and step 6.


About Doppler Distance (Velocity)In Doppler imaging, the behavior and appearance of the calipers depends uponwhether the Doppler display is sweeping or frozen. If the Doppler display issweeping, then a horizontal cursor appears across the width of the Doppler dis-play. There is no associated measurement value in the results. You can use thehorizontal cursor to determine the velocity or frequency of the Doppler wave-form along the velocity or frequency scale.

If the Doppler display is not sweeping, then a single velocity caliper appears in themiddle of the Doppler display. The results contain the velocity at the location ofthe caliper. Pressing Select displays a second velocity caliper and the calculationsof the Doppler results selected in Measure setups.

Starting velocity results, ending velocity results, and velocity difference results aredisplayed, if they are selected in Measure setups.

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Measuring Doppler Distance (Velocity)

➤ To perform a Doppler distance measurement on a sweeping display

1. Obtain the desired Doppler display (spectral waveform).

2. Press Caliper.

3. Touch Distance.

4. Use the trackball to position the horizontal cursor. There are no measure-ment values in the results; you can read the velocity or frequency value fromthe velocity or frequency scale.

➤ To perform a Doppler distance measurement on a frozen display

1. Obtain the desired Doppler display and press Freeze.

2. Press Caliper.

3. Touch Distance.

4. Use the trackball to position the caliper.

5. Press Select to anchor the caliper and display a second caliper. The velocity orfrequency values and calculations for your Doppler Results Display settingsfrom Measure setups appear in the results.

6. Use the trackball to position the second caliper.

7. Press Select to alternate control between the two calipers.


Measuring a Curved Distance Touching Curved Distance on the Caliper touch screen allows you to measurethe distance of an arc or curve on a 2D image. This measurement tool is similarto the continuous trace tool, but the trace cannot be closed and does not providean area calculation.

➤ To perform a curved distance measurement


2. Press Caliper.

3. Touch Curved Distance.

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4. Use the trackball to position the caliper at the first point of the measurementand press Select.

5. Use the trackball to guide the caliper along the arc. As you move the caliper,the shape is traced on the display.

NOTEBefore the trace is closed, you can touch Backup to back up and remove por-tions of the trace.


Measuring Time/Slope The Time/Slope tool can be used to measure time, slope, and velocity on anM-mode or Doppler display. You can make two time/slope measurements on adisplay. Results are displayed based on your selections in Measure setups.

➤ To perform an M-mode or Doppler time/slope measurement

1. Acquire the display that you want to measure and press Freeze.

2. Press Caliper.

3. Touch Time/Slope.

4. Move the caliper to the point at which you want to begin the slope measure-ment and press Select.

5. Use the trackball to move the caliper to the second point of the slope mea-surement and press Select. The measurements and calculations appear in theresults.


Measuring Heart Rate You can make a heart rate measurement from an M-mode or Doppler display. Toincrease the accuracy of the measurement, you can mark multiple heart cycles,which will produce an averaged result.

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➤ To perform a heart rate measurement on an M-mode or Dopplerdisplay

1. Acquire the display that you want to measure and press Freeze.

2. Press Caliper.

3. Touch Heart Rate.

4. Use the trackball to move the caliper to the point in the heart cycle at whichyou want to start the heart rate measurement and press Select.

5. Move the second caliper to an equivalent point in the next heart cycle andpress Select.

6. Continue to measure additional heart cycles. The heart rate, in bpm, appearsin the results.


Circumference and Area Measurements 2D circumference and area measurements are made using either the Ellipse orthe Continuous Trace tools. Two circumference and area measurements can beperformed on one image using the Ellipse tool. Four circumference and areameasurements can be performed on one image using the Continuous Tracetool.

Measuring 2D Circumference and Area (Ellipse)

➤ To perform an ellipse circumference and area 2D measurement

1. Obtain a 2D image and press Freeze.

2. Press Caliper.

3. Touch Ellipse.

4. Use the trackball to move the caliper to the perimeter of the shape to bemeasured and press Select.

5. Move the caliper to the second point of the shape and press Select. The posi-tion of the ellipse is fixed, and the expanse of the ellipse becomes adjustable.

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NOTEEach time you press Select, control switches between the calipers or expanse ofthe ellipse.

6. Use the trackball to match the ellipse to the outline of the shape.


Converting Distance to Ellipse You can convert a distance measurement to an ellipse circumference and areameasurement by touching Convert to Ellipse. Touching Convert to Ellipseplaces an ellipse over calipers of a distance measurement. A distance perpendicu-lar to the distance calipers, representing the other axis of the ellipse, is added tothe results.

➤ To convert a distance measurement to an ellipse measurement


2. Make a 2D distance measurement.

3. Touch Convert to Ellipse.

4. Perform an ellipse measurement.


Measuring 2D Circumference and Area (Continuous Trace)

➤ To trace a 2D circumference and area measurement


2. Press Caliper.

3. Touch Continuous Trace.

4. Use the trackball to move the caliper to the perimeter of the shape to bemeasured and press Select.

NOTEBefore the trace is closed, you can touch Backup to back up and remove por-tions of the trace.

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5. Use the trackball to guide the caliper around the perimeter of the shape. Asyou move the caliper, the shape is traced on the display.

6. When the caliper is near its origin, touch End Measure.

Percent Area ReductionThe percent area reduction is derived from 2D area measurements. A cross-sec-tional outline of the original or unreduced vessel is compared to a tracing of thestenotic or reduced lumen. From these measurements, the system calculates the2D areas and the percent of area reduction. In general, analysis of the Dopplerwaveform allows better quantitation of the hemodynamic significance of lumenreduction than does the percent area reduction.

➤ To obtain the percent area reduction

1. Obtain a 2D cross-sectional view of the vasculature under study.

2. Press Freeze.

3. Press Caliper.

4. Touch Percent Reduction.

5. Touch % Area Reduction.

6. Touch Ellipse (Initially, Ellipse is the selection by default.)

7. Use the trackball to move the caliper to the outer vessel wall at the maximumarea of the vessel under study and press Select.

8. Press Select and use the trackball as required to adjust the size and location ofthe ellipse to match the outer vessel wall.


10. Move the caliper to the inner vessel wall at the minimum diameter of the ves-sel under study and press Select.

11. Use the trackball to trace the reduced circumference of the vessel.

12. Touch Done to close the trace, and end the measurement. The values for themaximum area, the minimum area, and the percent area reduction are dis-played in the results.

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2D Volume MeasurementsVolume measurements are made using either the 1 Distance Volume, 3 Dis-tance Volume, or Distance + Ellip tools on the Caliper touch screen. Fourvolume measurements can be performed on one image using the 1 DistanceVolume tool; two volume measurements can be performed on one image usingthe 3 Distance Volume tool or the Distance + Ellip tool. Distance measure-ment results are displayed in centimeters (cm); volume calculation results are dis-played in centimeters cubed (cc or ml).

Because a volume is a 3-dimensional measurement, only the 1 Distance Volumemeasurement can be obtained from a single imaging orientation or plane. The sys-tem will calculate the volume using three equal distances.

If you choose the 3 Distance Volume or the Dist+Ellip Volume, then youmust perform one of the distance measurements for the 3 Distance Volume oreither the distance or ellipse measurement for the Dist+Ellip Volume on animage that is orthogonal to the other measurements.

Measuring Volume (One Distance)

➤ To obtain a volume calculation from one distance measurement


2. Press Caliper.

3. Touch Volume.

4. Touch 1 Distance Volume.

5. Touch Volume Distance.

6. Perform one distance measurement.

7. Touch Done. The distance measurement and volume calculation appear in theresults.

Measuring Volume (Three Distance)

➤ To obtain a volume calculation from three distance measurements


2. Press Caliper.

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3. Touch Volume.

4. Touch 3 Distance Volume.

5. The Volume Distance 1 tool is automatically enabled.

6. Perform the first distance measurement.

7. Touch Volume Distance 2 to end the first distance measurement and enablethe second distance measurement.

8. Perform the second distance measurement.

9. Change the imaging plane by 90 degrees to ensure an accurate volume calcula-tion.

10. Touch Volume Distance 3 to start the third distance measurement.

11. Perform the third distance measurement.

12. Touch Done. The distance measurements and volume calculation appear inthe results.

Measuring Volume (One Distance and One Ellipse)

➤ To obtain a volume calculation from distance and ellipsemeasurements


2. Press Caliper.

3. Touch Volume.

4. Touch Dist+Ellip Volume.

5. The Volume Distance tool is automatically enabled.

6. Perform a distance measurement.

7. Change the imaging plane by 90 degrees to ensure an accurate volume calcula-tion.

8. Touch Volume Ellipse and perform an ellipse measurement.

9. Touch Done. The distance measurements and volume calculation appear inthe results.

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3D Volume MeasurementsVolume measurements are made using either the 3D Volume method or theStacked Contour method. The 3D Volume method uses an ellipsoid volumemeasurement tool. The result is the volume of the ellipse determined by the 2Dellipse and the orthogonal distance measurements combined.

The Stacked Contour method allows you to perform a volume measurementon an irregular shape in a 3D volume data set. Both methods of measuring 3Dvolume are available in the Caliper touch screen during 3D review. 3D volumemeasurements are valid only for volume data acquired using 3D transducers.Because volume data acquired using Freehand 3D is not calibrated, 3D measure-ment tools are unavailable for freehand acquisition.

Performing a 3D Volume MeasurementIn 3D review, you can perform a volume measurement. The 3D Volume mea-surement tool is available from the Caliper touch screen, when the 3D quadview is displayed on the monitor display. At any time during the 3D volume mea-surement, you can touch Cancel to delete calipers, results, and display the Cali-per touch screen. You can also touch Erase Calipers to erase the calipers andthen touch 3D Volume to start the 3D volume measurement again.

➤ To perform a 3D volume measurement

1. Enter 3D review, and display a quad view of the image you want to measure.

2. Press Caliper.

3. Touch 3D Volume. The Ellipse tool is active by default in the bottom rightMPR view.

4. Move the caliper to the MPR view on which you want to perform an ellipsemeasurement.

5. Perform an ellipse measurement.

6. Touch Set Diameter to end the ellipse measurement and display diametergraphics orthogonal to the ellipse axes on the two remaining MPR views.

7. Use the trackball to adjust the diameter. (Moving the trackball up moves thediameter calipers further apart; moving the trackball down moves the diame-ter calipers closer together.)

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8. When the diameter measurement is complete, touch Done.

About the Stacked Contour Volume MeasurementThe Stacked Contour method allows you to perform a volume measurementon an irregular shape in a 3D volume data set. The stacked contour volume mea-surement tool is available from the Caliper touch screen, when the 3D quadview is displayed.

With the stacked contour measurement, you can perform a measurement on a3D volume image from which a volume calculation is made. You establish the endpoints of the measurement using the calipers displayed when you touch Set EndPoints (SEP). Between the calipers, you can select from 3 to 15 slices for inclu-sion in the stacked contour measurement. Using a continuous trace tool, youdraw contours on each slice. The volume calculation appears in the results afterthree contours have been completed, and the results update as you completemore contours.

The slice graphics are represented by white dotted lines between the SEP calipers.Once you complete a contour or continuous trace on a slice, a white dotted linedesignates the contour or the completed measurement. The actual measurementtrace is orange.

At any time during the 3D stacked contour measurement, you can touch Cancelto delete calipers, results, and display the Caliper touch screen. You can alsotouch Erase Calipers to erase the calipers and then touch Stacked Contourto start a new stacked contour measurement. Backup allows you to erase thelast few segments of the continuous trace. Previous Slice and Next Slice allowyou to select slices for measurement. You can select from 3 to 15 slices for thestacked contour measurement.

Performing a 3D Stacked Contour Measurement

➤ To perform a 3D stacked contour measurement

1. Enter 3D review, and display a quad view of the image you want to measure.

2. Press Caliper.

3. Touch Stacked Contour. The Set End Points (SEP) tool is active by defaultand the first caliper is displayed in the bottom right MPR view.

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4. Use the trackball to position the first SEP caliper in one of the MPR views toidentify the first end point of the object you are measuring.

5. Press Select to anchor the first SEP caliper and display the second SEP caliper.

6. Move the second SEP caliper to define the second end point of the shape (thedistance between the end points will be divided into slices or contours to cal-culate the volume).

7. Touch Set Contours to anchor the SEP calipers and display the slice graphicsand selector on the image containing the SEP calipers.

8. Use the slice selector to select the number of slices or contours to beincluded in the measurement. You can select from 3 to 15 contours or slicesto include in the measurement.

9. Touch Continuous Trace (CT). The first CT caliper appears in the MPRviews that are orthogonal to the SEP calipers.

10. Use the trackball to draw a contour on the slice.

11. Touch Next or Previous to select other slices for measurement. After youhave measured 3 contours, the volume calculation appears in the results.

12. Repeat step 9 through step 11 for each slice.

13. Touch Done to end the measurement.

Doppler Trace MeasurementsYou can perform manual Doppler trace measurements on a frozen Doppler dis-play. You can also obtain Doppler trace measurements automatically, using High QAutomatic Doppler measurements, on a real-time or on a frozen Doppler display.

Manual Doppler Trace Measurements

In a manual Doppler trace measurement, you manually trace the Doppler spec-trum, using either a continuous trace method or a trace-by-points method.

High Q Automatic Doppler Measurements

High Q Automatic Doppler measurement helps you save time during a patientexam. In live imaging, it automatically traces a waveform. Measurements are madeon the Doppler spectrum, displayed in the results, and updated every heart cycle.

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In a frozen Doppler spectrum, High Q Doppler automatically traces the Dopplerspectrum over one heart cycle. High Q then uses the trace to calculate and dis-play the results of selected Doppler measurements and calculations.

NOTES• High Q Automatic Doppler Measurement is an option on the system.• High Q Automatic Doppler Measurement is available only in PW Doppler.

Performing a Doppler Continuous Trace MeasurementOne continuous trace measurement can be made on one Doppler display. Theresults displayed for a Doppler area measurement depend upon your settings forDoppler Display Results in the Measure setups.

➤ To perform a continuous trace Doppler measurement

1. Obtain a Doppler display and press Freeze.

2. Press Caliper.


4. Move the caliper to the beginning of a heart cycle on the Doppler waveformand press Select.

5. Use the trackball to trace the Doppler waveform to the end of the heartcycle.

6. Touch End Measure to complete both ends of the trace to the baseline.

Performing a Doppler Trace-by-Points MeasurementThe Doppler trace-by-points method is similar to continuous trace, except it is anincremental method. The results displayed for a Doppler area measurementdepend upon the settings for Doppler Results in the Measure setups. Onetrace-by-points measurement can be made on one Doppler waveform.

➤ To perform a trace-by-points Doppler measurement

1. Obtain a Doppler display and press Freeze.

2. Press Caliper.

3. Touch Trace by Points.

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4. Use the trackball to move the caliper to the beginning of a heart cycle on theDoppler waveform.

5. Press Select to anchor the caliper and display another caliper.

6. Repeatedly move the caliper and press Select to set additional points alongthe Doppler waveform.

7. Press Select to set the final point at the end of the heart cycle.

8. Touch End Measure to complete both ends of the trace to the baseline.

About High Q Automatic Doppler MeasurementHigh Q Automatic Doppler measurements calculate, in real-time or freeze, up toseven Doppler results that you select in the Measure setups. You can also displaythe Doppler waveform peak trace and the mean trace in real-time, and adjustmarkers to define a portion of the Doppler waveform from which to calculate theDoppler results.

Changing the baseline, angle correction, sweep speed, invert, or display formatwill recalculate the High Q results.

For accurate results, optimize the Doppler display as follows:

• Center the sample volume cursor in the vessel.

• Avoid using High Q Doppler during simultaneous mode.

• Eliminate aliasing.

• Ensure the angle correction cursor is parallel to flow.

Turning On the High Q Mean Trace

➤ To turn on the mean trace

1. Obtain a Doppler trace.

2. On the PW touch screen, touch Next to display the High Q controls.

3. Touch Mean Trace. The mean trace appears in pink on the spectral Dopplertrace.

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4. Touch Direction to select Above, Below, or Both. (Trace direction estab-lishes which portions of the Doppler trace will be included in the mean andpeak trace.)

Displaying the Peak Trace and the High Q Measurement

➤ To perform a real-time High Q Automatic Doppler measurement

1. Verify that you have selected the Display Results you want in the Measuresetups.

2. Obtain an optimal Doppler waveform.

3. On the PW touch screen, touch Next to display the High Q controls.

4. Touch High Q. The peak trace appears automatically in blue, and the Dopplerresults appear in the results.

Adjusting Markers for the High Q Measurement

➤ To adjust markers for High Q Automatic Doppler measurement

1. Obtain an optimal Doppler waveform.

2. Press Freeze.

3. On the PW Frozen touch screen, touch Next to display the High Q con-trols.

4. Touch High Q. The markers appear on the Doppler display.

5. Touch Adjust Markers.

6. Use the trackball to move Marker 1 to the onset of systole of the first heartcycle.

7. Press Select to set the Marker 1 and activate Marker 2.

8. Use the trackball to move Marker 2. Ensure at least two systolic peaks areincluded between the markers.

9. The Doppler results appear in the results.

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About the Volume Flow MeasurementThe volume flow measurement has been used predominantly in the extremitiesfor vascular applications. General imaging applications have measured flow in theportal vein.

The volume flow measurement requires that you obtain a longitudinal view of thevasculature and measure its diameter. A Doppler waveform derived from thesame area is also required. The sample volume should be centered in and com-pletely insonate the vessel. The resulting Doppler waveform is then traced usingan automatic trace method that estimates the time-averaged mean, which is usedto calculate volume flow. The accuracy for this method of volume flow calculationis ±30%.

Measuring Volume Flow

➤ To measure volume flow

1. In duplex Doppler imaging, position the sample volume cursor within the areaof flow of a 2D longitudinal view of the vessel, and obtain an optimal Dopplerwaveform.

2. Press Freeze.

3. Press Caliper.

4. Touch Volume Flow. The system automatically does the following:

– Turns on the High Q mean trace

– Turns off the High Q peak trace

– Displays the Volume Flow touch screen

– Displays half of the diameter bar

5. Use the trackball to position half of the diameter bar along one side of thevessel wall.

6. Press Select to display the other half of the diameter bar. The distancebetween the two halves of the diameter bar appears in the results and isupdated as the diameter changes.

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7. Use the trackball to position the other half of the diameter bar along theopposite side of the vessel wall. The two halves of the diameter bar define thediameter of the vessel.

8. Press Select to alternate control of the two halves of the diameter bar andadjust the diameter bar as needed.

9. Touch Done to end the 2D diameter measurement. At this point, the diame-ter bar cannot be repositioned; a new 2D diameter measurement must bestarted to make an adjustment. (To start a new 2D measurement, touchDiameter.)

10. Touch Adjust Markers.

11. Use the trackball to position a marker at the beginning of the Doppler wave-form.

12. Press Select to fix the marker. The second marker appears to the right of thefirst marker.

13. Use the trackball to position the second marker at the end of the Dopplerwaveform. (You can include more than one Doppler waveform within theboundaries defined by the two markers, and the system will calculate the vol-ume flow as an average of the number of Doppler waveforms within the mark-ers.)

14. Touch Done. The diameter, 2D area, time-averaged mean, and the volumeflow appear in the results.

2D Hip Angle Measurement The development of the acetabular roof and subluxation of the femoral head canbe quantified by angular measurements. The baseline connects the osseous ace-tabular convexity to the point where the joint capsule and the perichondriumunite with the ilium. The inclination line connects the osseous acetabular convex-ity to the labrum acetabulare. The roof line connects the lower edge of the osilium to the osseous acetabular convexity.

Angle alpha (a) is defined by the roof line and baseline. Angle a characterizes theformation of the osseous acetabular convexity. Angle beta (b) is defined by theinclination line and the baseline. Angle b is a measure of the formation and size of

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the cartilaginous convexity. Refer to these sources for more information aboutthe hip angle measurement:

Graf, R. “Fundamentals of Sonographic Diagnosis of Infant Hip Dysplasia.” JournalPediatric Orthopedics, Vol. 4, No. 6: 735-740, 1984.

Graf, R. Guide to Sonography of the Infant Hip. Georg Thieme Verlag, Stuttgart andNew York, 1987.

Morin, C., Harcke, H., MacEwen, G. “The Infant Hip: Real-Time US Assessment ofAcetabular Development.” Radiology, 177: 673-677, December 1985.

Performing a Hip Angle Measurement

➤ To perform a hip angle measurement

1. Obtain a 2D image of the infant’s hip at the trochanter major.

2. Press Freeze.

3. Press Caliper.

4. Touch Hip Angle.

NOTEYou can perform the baseline, roof line and inclination line measurements in anyorder you prefer.

5. Touch Baseline.

6. Use the trackball to move the caliper to the osseous acetabular convexity andpress Select.

7. Move the caliper to the point where the joint capsule and the perichondriumunite with the iliac bone and press Select.

8. Touch Roof Line.

9. Move the caliper to the lower edge of the os ilium and press Select. The alpha(a) angle measurement appears in the results.

10. Move the caliper to the osseous acetabular convexity and press Select. Theroof line is locked, and a new caliper appears for the inclination line.

11. Touch Inclination Line.

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12. Move the caliper to the labrum acetabular and press Select. The beta (b) angleresults are displayed, and a new caliper appears. The results are updated asyou move the caliper.

13. Move the caliper to the osseous acetabular convexity and press Select. Themeasurement is complete.


11 Calculations (Calc)Calc is a system control that provides access to the groups, measurements, andcalculations that make up a calculations package. Calculations packages are systemoptions that are associated with transducers and presets.

A calculations package contains one or more calc lists that organize groups, mea-surements, and calculations into a coherent tool for diagnostic analysis.

In the setups is an analysis configuration capability that allows you to create yourown calc lists including groups, measurements, and calculations. In addition, themeasurements and calculations can be associated with system and custom tablesand equations.

The groups, measurements, and the calculations derived by the system are basedon medical references. The User Reference, on the user information CD, containsa list of those references.

Calculations and PresetsWhen you select a transducer, you also select a preset. The preset you select hasat least one corresponding calculations package associated with it. The calcula-tions packages include a range of measurements and calculations for medical spe-cialties such as obstetrics, small parts, vascular, and gynecology. There is also ageneral calculations package that can be assigned to a measurement you mightwant to include in a patient report.

About the Calc DisplayWhen you press Calc, a calc list for the selected calculations package appearsacross the top of the display, and a measurement list appears along the left side ofthe display (Figure 11-1). The calc list consists of tabs. When you click on a tab inthe calc list, a corresponding measurement list appears along the left side of thedisplay.

The measurement list includes a list of measurement labels and space for themeasurement values. When you make measurements, you can enter the valuesfor the labels in the list. Conversely, you can select a label, then make a measure-ment, and the value will be entered into the list when you complete the measure-ment. You can enter and store up to five values for each label. Once you exceed

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five values, the last value will be replaced by the newest value, a last-in, first-outscenario.

A group is several related measurements organized under one label. For example:+AFI is a group; when it is expanded, the related measurements are listed. In thecase of +AFI, clicking + expands the list, and values can be assigned to the differ-ent quadrants (LUQ, LLQ, RUQ, and RLQ) to calculate the amniotic fluidindex. Biophysical profile (BPP) is another example of a group. AFI/BPP is a tabin the Obstetrics calc list.

You can build and edit your own groups. Special, system-defined groups, known aslinked groups, contain default measurements and calculations that are consideredessential for specific imaging modes.

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Figure 11-1 Calc Display

Changing the Calculations PackageYou can change the active calculations package from the Change Calcs dialogbox. Changing the calculations package updates the calc list. Measurements andcalculations performed and entered using the previously active calc list are main-tained and still available by reselecting the calc list and measurement list.

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➤ To change the calculations package

1. Click the Change Calcs icon .

2. In the Change Calcs dialog box, select a calculations package from themenu.

3. Click OK.

About Quick Save Presets and Calculations PackagesWith the Quick Save feature, you can define custom presets for any combinationof transducer and preset. A Quick Save preset stores all primary modes andmode settings that are active when the preset is created. When creating a QuickSave preset, you can specify the default calculations package, annotation, and bodymark. You can create as many Quick Save presets for a transducer as will fit onboth pages of the corresponding Transducer touch screen.

Once you have selected settings for various system parameters and saved themusing Quick Save, the system will automatically invoke these settings when youselect your Quick Save preset. You can also save Quick Save presets on removablemedia and load them into other systems.

About Calcs in ReviewIn general, measurements and calculations work the same way in Review as inimaging. One difference is that, in review, you cannot save or store measurementsmade on a recalled exam. Also, regardless of whether you are working in the cur-rent exam or a recalled exam, High Q Automatic Doppler is not available inReview.

Labeling MeasurementsThere are two ways to assign a measurement value to a measurement label. Theeasiest method is to make measurements directly. Selecting a measurement labelautomatically selects the appropriate measurement tool and starts the measure-ment. When the measurement is complete, the measurement value is automati-cally assigned to the selected measurement label.

The other method of assigning measurement values lets you make measurementsusing a tool selected from the Calipers touch screen and then assign the mea-

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surement value to the label after the measurement has been made. Regardless ofwhich method you use to assign measurement values, the values and the derivedcalculations appear in the patient report.

Labeling Before Measuring

NOTEThe Doppler results specified in the setups correspond to the transducer andpreset selected in the Transducer touch screen, which corresponds to a calcula-tions package. If you select a different calculations package after selecting thetransducer and preset, you can get unexpected Doppler results from your mea-surements.

➤ To label the measurement before measuring

1. Obtain an image and press Freeze.

2. Press Calc.

3. In the calc list, click the tab of the measurement list you want to display.

4. Click a measurement label.

5. Make the measurement.

6. Touch End Measure to complete the measurement. The measurement valueappears below the measurement label.

Measuring Before Labeling

➤ To measure before labeling the measurement

1. Obtain an image and press Freeze.

2. Press Caliper.

3. Select a measurement tool from the touch screen.


5. Touch End Measure to complete the measurement.

6. Press Calc.

7. In the calc list, click the tab of measurement list you want to display.

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8. Click a measurement label. (Unavailable measurements will be gray.) The mea-surement value appears below the measurement label. (If the measurementlabel has more than one result assigned, the additional results will appear inthe patient report.)

Deleting MeasurementsDeleting a measurement value in the patient report also deletes it from the mea-surement list. After you delete the data in a cell and move the cursor to anothercell, updates to the dependent calculations occur, and the edited value is enclosedin brackets.

➤ To delete measurement values

1. Press Report to display the patient report.

2. On the patient report, click Edit Report.

3. On the editable report, use the keyboard to edit the measurement values.Changed values are enclosed in brackets.

4. When you are finished editing, click Close.

About the ResultsThe values from completed measurements (and some calculations derived fromthe measurements) appear in the results. The shapes of the calipers used to makemeasurements identify the measurements in the results. Abbreviations identifycalculations derived from your measurements. You can move the results on thedisplay by moving the pointer over the results.

Moving the Results

➤ To move the results

1. Perform a measurement.

2. Use the trackball to move the pointer into the results area and press Select.Ensure the pointer is not on a measurement value or calculation.

3. Use the trackball to move the results.

4. After you have positioned the results, press Select to anchor them.

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Creating a New Measurement LabelYou can create one new measurement label for each measurement list. Newlabels can accept only measurements made using tools on the Caliper touchscreen. You cannot make measurements directly from a new label (label beforemeasuring) as you can with other measurement labels. A new label appears in thepatient report only if it has one or more measurement values assigned to it. Anew label is a temporary label; it will not appear in the list once the exam is endedand you start a new patient exam.

The new label can contain up to 10 characters. Valid characters include letters,spaces, and numbers, but not symbols.

➤ To create a new measurement label

1. Press Calc.

2. In the calc list, click the tab of the measurement list you want to display.

3. Click NEW.

4. In the Add New Label dialog box, type a measurement label up to 10 char-acters long.

5. Click OK. Your new label appears in the measurement list.

Patient ReportsPressing Report displays the patient report. Patient data along the top of thepatient report is derived from the patient data you enter in the Patient Dataform. The date and name formats are determined by your selections in the set-ups. The measurement values will appear in the body of the patient report. Toedit a patient report, you must first click Edit Report to display an editable viewof the report. If you edit the report, clicking Close saves any changes you havemade to the patient report.

If an OB exam is active and the LMP or established due date have been deter-mined, clicking View Graph will display the graphs for the patient.

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Displaying Patient Reports

➤ To display the patient report

1. Ensure that you have entered patient data.

2. Perform at least one measurement for the patient.

3. Press Report.

About Editing Patient ReportsThe editable view of the patient report is also referred to as a worksheet. It con-tains all measurement labels and all calculations containing at least one value. Mul-tiple measurements appear in rows with up to five measurement values and anaverage value. The average value cannot be edited. Changes to the worksheet willupdate all dependent and related calculations in the patient report, graphs, andsetups.

Deleting a value or editing a cell of the editable report will remove the value anddisplay brackets in the edited cell.

In OB reports, authors available for measurement labels in the current study areavailable in a menu. Changing an author for a measurement label will only apply tothe active exam. If you change the author, the corresponding gestational age andrange will be recalculated and displayed. Estimated fetal weight (EFW) also con-tains an author menu from which you can select different authors for the estima-tion of fetal weight.

Editing Patient Reports

➤ To edit the patient report


2. On the patient report, click Edit Report. The editable view of the report(sometimes referred to as a worksheet) will open at the portion of the reportcorresponding to the displayed page of the patient report.

3. On the editable report, press Tab to navigate through the cells, or use thetrackball to move the pointer to a cell and click within the cell.

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4. Use the keyboard to edit the cell data. After you edit the data in a cell andmove the cursor to the next cell, updates to the dependent calculations occurand the edited value is enclosed in brackets.

5. When you are finished editing, click Close to save the edits in the report.

Entering Comments in Patient ReportsAt the end of each calculations package within a patient report, a comments fieldappears. Five lines of text can be displayed and a total of 22 lines of text can beentered as comments. You can scroll through the text using the scroll bar. Com-ments entered into the editable report appear in the patient report at the end ofthe calculations package.

➤ To enter comments into a report

1. On the patient report, click Edit Report.

2. Use the scroll bar to find the calculations package for which you want to entercomments.

3. Use the keyboard to enter the comments.

4. Click on Patient Report. Your comments appear in the patient report.

Printing Patient ReportsIf a printer is connected to the system, clicking Print Report sends the patientreport to the printer. Clicking Print Graphs sends the graphs to the printer.

➤ To print the patient report

• To print the patient report, touch Print Report.

• To print the graphs, touch Print Graphs. (You must use Print Graphs toprint the graphs; Print Report does not print the graphs.)

Structured ReportingStructured reporting allows you to send patient report data over a DICOM net-work to a structured report server.

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➤ To send a structured report


2. On the patient report, click Send Report.

Gynecology CalculationsThe Gynecology calculations package includes General GYN (Gynecology) andFertility calc lists.

General GYN includes measurement labels for the uterus, left and right ovaries,endometrial thickness, and cervical length. Uterine volume and right and left ova-rian volumes are the calculations derived from the measurement values enteredinto the General GYN measurement list.

Fertility includes measurement labels for the right and left ovarian follicles with10 measurement labels appearing for each in the Fertility measurement list.

Each measurement list includes a NEW measurement label for a custom mea-surement label and value.

Obtaining Gynecology MeasurementsThe volume calculations in General GYN are derived from the uterine and ova-rian measurements of length, width, and height of the anatomy. A result appearsbelow the measurement label. The volume calculations appear at the bottom ofthe measurement list. The measurement results and related calculations areentered into the patient report.

➤ To obtain gynecology calculations


2. Press Calc.

3. Click the tab in the calc list that you want.

4. In the measurement list, click + to expand the list. (If the measurement listexceeds the height of the allotted space, use the trackball to scroll up ordown.)

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5. Click a measurement label. (One of the planes of measurement must beorthogonal to the other two to obtain an accurate volume calculation.)

6. Click on an object to anchor the first caliper and display the next one.



General Imaging CalculationsThe General calculations package includes a calc list with a NEW measurementlabel for creating custom measurement label and measurement values.

Abdominal CalculationsThe Abdominal calculations package includes General, Arterial, Venous, andRenal calc lists.

• General includes a NEW measurement label for a custom measurement.

• Arterial includes measurement labels for the abdominal arteries.

• Venous includes measurement labels for the abdominal veins.

• Renal includes measurement labels for the right and left kidneys.

Small Parts CalculationsThe Small Parts calculations package consists of Thyroid, Testicle, and Breastcalc lists.

• Thyroid includes a NEW measurement label for your custom measure-ments.

• Testicle includes a NEW measurement label for your custom measure-ments.

• Breast includes measurement labels for lesion length, width, and height mea-surement values for the left and right breast. There are five sets available foreach side. There is also a NEW measurement label for your custom measure-ments.

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Cardiology (Adult Echo) CalculationsThe Adult Echo cardiology calculations package includes calc lists for each of thedifferent imaging modes: 2D/Color, M-mode, and Doppler. Refer to the User Ref-erence on the user information CD for a list of articles that support the adultecho calc lists.

About the 2D/Color Adult Echo Calc ListThe 2D/Color Adult Echo calc list includes an All Points tool and several addi-tional measurement labels.

2D/Color measurement labels include the following:

• All Points provides a series of left ventricular measurements that can betaken either individually or in series, following the prompts of the system.

• Ao/LA includes measurement labels for left ventricular outflow tract (LVOT)diameter, aortic root diameter, and left atrial (LA) diameter.

• Simpson's Rule provides measurements tools for the apical four-chamberand apical two-chamber views. From those measurements, an ejection frac-tion (EF) can be calculated.

The heart rate measurement is derived from the physio ECG trace data. A NEWmeasurement label is available for your custom measurements.

Obtaining 2D/Color Adult Echo Measurements

➤ To make 2D/color adult echo measurements

1. Obtain the desired 2D images and concurrent ECG trace and press Freeze.

2. Press Calc to display the Adult Echo calc lists.

3. Click the 2D/Color tab.


5. Select a measurement label.

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6. Press Select to anchor the first caliper and display the next one.



About Simpson’s Rule CalculationsSimpson’s Rule calculates the ejection fraction (EF) from the change in the leftventricular volume between diastole and systole. The left ventricular volumes arederived from traces of the endocardium obtained at end diastole and end systole.

In the System Settings setups, two methods are available for tracing a Simp-son's left ventricular volume: Manual and Adjustable Template. Select the oneof your choice.

The adjustable template automates the manual method by providing three anchorpoints from which you can make fine adjustments: the medial mitral annulus, thelateral mitral annulus, and the apex. Both methods allow the system to automati-cally trace and calculate the volume of 20 evenly-spaced discs from the apex tothe base of the left ventricle.

Obtaining Simpson’s Calculations Manually

➤ To obtain Simpson’s calculations using the manual method

1. Press Freeze.

2. Using Cine review, obtain the desired 2D images and concurrent ECG traces.

3. Scroll to the best systolic or diastolic image.


5. Click the 2D/Color tab if needed.

6. In the measurement list, click + to expand the Simpson’s list. (If the measure-ment list exceeds the height of the allotted space, use the trackball to scrollup or down.)

7. Under Simpson’s, select a measurement label corresponding to the selectedimage:

– A4Cd for a four-chamber view at end diastole

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– A4Cs for a four-chamber view at end systole

– A2Cd for a two-chamber view at end diastole

– A2Cs for a two-chamber view at end systole

It is important to complete all measurements.

8. Position the trace caliper, and then press Select.

9. Trace the left ventricular area, and then press Select.

10. Position the caliper at the annulus, and then press Select.

11. Position the caliper at the apex, and then press Select.


13. Obtain the next desired 2D image to continue the measurements.

14. Repeat step 7 through step 13 for each Simpson’s measurement label.

Obtaining Simpson’s Calculations by Template

➤ To obtain Simpson’s calculations using the adjustable template

1. Press Freeze.

2. Using Cine review, obtain the desired 2D images and concurrent ECG traces.

3. Scroll to the best systolic or diastolic image.


5. Click the 2D/Color tab if needed.

6. In the measurement list, click + to expand the Simpson’s list. (If the measure-ment list exceeds the height of the allotted space, use the trackball to scrollup or down.)

7. Under Simpson’s, select a measurement label corresponding to the selectedimage frame:

– A4Cd for a four-chamber view at end diastole

– A4Cs for a four-chamber view at end systole

– A2Cd for a two-chamber view at end diastole

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– A2Cs for a two-chamber view at end systole

It is important to complete all measurements.

8. Position the first caliper on the medial mitral annulus and press Select toanchor it and display the second caliper.

9. Position the second caliper on the lateral mitral annulus and press Select toanchor it and display the third caliper.

10. Position the third caliper on the apex and press Select to complete the bordertemplate placement.

11. Move the pointer to the edge of the template you want to adjust. The controlpoints in that region become active.

12. Press Select and drag the shape in the direction you want to adjust.


14. Obtain the next desired 2D image to continue the measurements.

15. Repeat step 7 through step 14 for each Simpson’s measurement label.

About the M-Mode Adult Echo Calc ListThe M-mode Adult Echo calc list includes an All Points tool and Ao/LA, MV,TV, PV, and HR.

• Ao/LA includes measurement labels for left ventricular outflow tract (LVOT)diameter, aortic root diameter, left atrial (LA) diameter

• MV (mitral valve) includes measurement labels for D-E excursion (Exc), E-Fslope, and E point septal separation (EPSS).

• TV (tricuspid valve) measurement labels include D-E Exc and E-F slope.

• PV (pulmonic valve) measurement labels include the late diastolic slope.

• HR (the heart rate measurement) is derived from measuring the heart rateon the M-mode trace.

A NEW measurement label is available for your custom measurements.

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Obtaining M-Mode Adult Echo Calculations

➤ To obtain M-mode adult echo calculations



3. Click the M-Mode tab.


5. Select a measurement label.

6. Move the first caliper to the appropriate point in the M-mode trace displayand press Select to anchor it and display the second caliper.

NOTEThe Ao/LA measurement LVOT Diam can be placed in either the M-modetrace display or on the image itself. All other measurements are available only inthe M-mode trace area.



Using the M-mode All-Points ToolThe All Points tool provides a programmed sequence of measurement points.When you select All Points and follow the prompts on the display, the systemautomatically calculates the ejection fraction (EF) using the Teichholz equation.

If you decide not to use All Points, and perform individual measurements, thenonly the calculations for the specific measurements you perform appear in theresults and the patient report.

➤ To obtain M-mode cardiac calculations using the All Points tool



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3. Click the M-Mode tab.

4. Click All Points. The M-mode time measurement caliper appears on theM-mode trace display.

5. Following the prompts, position the caliper on the M-mode display and pressSelect to define the measurement points as follows:

– Right ventricular inner dimension at end diastole

– Interventricular septum at end diastole

– Left ventricular inner dimension at end diastole

– Left ventricular posterior wall epicardium at end diastole

– Interventricular septum at end systole

– Left ventricular inner dimension at end systole

– Left ventricular posterior wall epicardium at end systole

NOTEThe individual measurements in the All Points sequence can be changed in thesetups.

About the Doppler Adult Echo Calc ListThe Doppler adult echo calc list includes protocols for the left ventricular outputtract (LVOT), mitral valve (MV), aortic valve (AV), tricuspid valve (TV), pul-monic valve (PV), and pulmonic veins (Pulm Veins).

• LVOT measurement labels include the left ventricular outflow tract diameter,maximum velocity (Vmax), and the velocity time integral (VTI).

• AV measurement labels include Vmax, VTI, AI End Diastolic Velocity, and AItime slope (pressure half time).

• MV measurement labels include the peak E and A velocities, VTI, Dec Slope,MV pressure half time, and isovolumtric relaxation time (IVRT).

• TV measurement labels include VTI, Vmax, and right atrium pressure.

• PV measurement labels include diameter, maximum velocity, and velocity timeintegral for the right ventricle output tract (RVOT), the maximum velocity andacceleration time for the pulmonic valve, and the end diastole velocity for thePI.

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• Pulm Veins measurement labels include the pulmonic diastole and systolevelocities, the A point reverse velocity and time slope.

The heart rate measurement is derived from the Physio data. A NEW measure-ment label is available for your custom measurements.

Obtaining Doppler Adult Echo Calculations

➤ To obtain Doppler adult echo calculations



3. Click the Doppler tab.


5. Click a measurement label.

6. Position the first caliper on the appropriate point in the Doppler trace displayand press Select to anchor it and display the next one.

NOTEThe RA Pressure tool uses a dialog box, instead of calipers, to set the value forthe right atrium pressure.



Using the Doppler RA Pressure ToolThe Doppler RA pressure tool sets the right atrium pressure manually. You canselect from one of the pre-set values or enter your own.

➤ To select the right atrium pressure

1. Acquire the Doppler display you want to measure and press Freeze.

2. Press Calc.

3. Select the RA Pressure measure label.

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4. On the RA Pressure dialog box, click the appropriate pressure value orselect Manual Entry and type in a value between 0 and 40.

5. Click OK.

Cross-Populating Cardiac MeasurementsCross-populated adult echo measurements are defined in the setups and appearin the results and reports associated with the exam. Cross-populated measure-ments can come either from a direct measurement or a derived measurement. Aderived measurement is populated from a tool result such as the VTI trace result.

➤ To cross populate a measurement

1. Obtain the Doppler or M-mode display and press Freeze.

2. Perform the desired measurement.


4. Click the M-Mode or Doppler tab.


6. Click a measurement label. The measurement is automatically inserted as themeasurement label result.

Vascular Calculations The Vascular calculations package includes Carotid, Venous, and Arterial calclists. The Doppler angle correction value appears in the patient report.

Obtaining Vascular Calculations

➤ To obtain vascular calculations


2. Press Calc.

3. In the calc list, click the tab that you want.

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4. Click + to expand the list. For example, clicking on +Right Carotid expandsthe measurement list, showing the measurement labels R Subclav through RVert.

5. Click the measurement label you want.

6. Perform the measurement.

7. Touch End Measure. The first measurement value appears in the list, all ofthe measurement and calculations appear in the results and the patient report.

Obtaining the ICA/CCA Ratio in the Patient ReportTo ensure an accurate ICA/CCA ratio appears in the patient report, the proximal,mid, and distal areas of the ICA and CCA must be examined and measured. Thehighest values identified from these three areas must then be identified andentered into the patient report to calculate the ICA/CCA ratio.

➤ To obtain the ICA/CCA ratio

1. Perform the ICA and CCA velocity measurements, and enter them into themeasurement list.

2. Identify the highest values for the ICA and CCA peak velocities.

3. Press Report.

4. Click Edit Report.

5. Scroll to the Vascular portion of the editable report.

6. Use the keyboard to enter the ICA and CCA peak velocity values identified instep 2.

7. Click Copy to Ratio.

8. Click View Report to see the ICA/CCA ratio in the patient report.

Obstetrics (OB) CalculationsThe OB calculations package includes General, Advanced, and AFI/BPP(Amniotic Fluid Index/Biophysical Profile) and Fetal Heart calc lists.

In the setups, using Analysis Configuration, you can create your own OB calc list.You can also create your own fetal measurements, fetal age and growth tables,fetal age, weight, and growth equations.

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You can evaluate fetal growth trending using the fetal growth graphs.

The system calculates the average ultrasound age (AUA) from your fetal measure-ments. The gestational age (GA) is also calculated based on the last menstrualperiod (LMP) or by the date of conception (DOC). The estimated date of deliverycan be calculated based on LMP, DOC, or AUA. You select the parameter thatwill be used to calculate GA.

Within the OB calc list an area-corrected biparietal diameter (BPDa) fetal agemeasurement and automatic calculation of head circumference from BPD andoccipito-frontal diameter (OFD) fetal measurements are included.

Selecting the number of fetuses, using the Multiple Gestations icon , pro-

vides all of the OB features for each of the fetuses you specify.

Selecting the Number of FetusesIn OB exams, you can account for multiple gestations by selecting the number offetuses seen. In the Multiple Gestations dialog box, you can select one to fivefetuses from a menu. The number of fetuses you select is included in the currentexam. You can then enter measurement values for each fetus. Measurement listsare identified for each fetus, and the measurements and calculations are organizedaccordingly.

➤ To select the number of fetuses in a multiple gestation

1. Click the Multiple Gestations icon .

2. On the Multiple Gestations dialog box, click the menu.

3. Select the number of fetuses for the exam.

4. Click OK. A menu for each fetus, Fetus A through E, corresponding to thenumber (1–5) selected in the Multiple Gestations dialog box appears in themeasurement list.

You can also select the number of fetuses for the current exam in the PatientData form.

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General OBGeneral OB includes measurement labels for gestational sac (GS), crown rumplength (CRL), biparietal diameter (BPD), occipito-frontal diameter (OFD), headcircumference (HC), abdominal circumference (AC), femur length (FL), post fossa,nuchal, and heart rate.

The gestational age and range are displayed for each of the measurement values, ifthe equation supports age and range. The average ultrasound age (AUA) is calcu-lated from BPD, HC, AC, FL, GS, and CRL.

The estimated fetal weight (EFW) is calculated and displayed when the measure-ments for the selected EFW equation selected in the setups have been completed.

The heart rate can be measured in M-mode and entered.

A NEW measurement label is available for your custom measurements.

The gestational age (GA) based on the last menstrual period (LMP) is also dis-played.

Advanced OBAdvanced OB includes measurement labels for humerus (HUM), radius (RAD),outer orbital diameter (OOD), cerebellum, cisterna magna (Cist Mag), nuchal fold(Nuch Fold), lateral ventricle (Lat Vent), and umbilical artery (Umb Art).

The gestational age and range are displayed for each of the measurement values, ifthe equation or table supports it. The average ultrasound age (AUA) is calculatedfrom HUM and cerebellum measurements. A NEW measurement label is avail-able for your custom measurements. The gestational age (GA) based on the lastmenstrual period (LMP) is also displayed.

AFI/BPPAFI/BPP includes measurement values for two groups: the amniotic fluid index(AFI) and the biophysical profile (BPP).

You enter distance measurements for the left upper quadrant (LUQ), left lowerquadrant (LLQ), the right upper quadrant (RUQ), and right lower quadrant(RLQ). The AFI is calculated and displayed in the results along with the averageultrasound age and the gestational age (GA) based on the last menstrual period(LMP).

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The biophysical profile allows you to evaluate fetus physical well-being by scoringthe gross fetal movement, fetal breathing, fetal tone, and amniotic fluid volume.

The parameters are listed as follows: breathing, movement, tone, and fluid vol-ume. If a multiple gestation has been selected, the biophysical profile will corre-spond to the active fetus in the current exam. The parameters for each fetus areidentified with the letters A through E.

Using the Biophysical Profile

➤ To use the biophysical profile

1. Click AFI/BPP in the OB calc list.

2. Click +BPP to expand the group.

3. Click the biophysical profile parameter that you want to score to switchbetween the following three scores: x, 0, and 2. When all of the parametersare assigned a score other than x, the score appears in the patient report.

Average Ultrasound Age (AUA)AUA is automatically calculated from the following system-defined fetal age mea-surements performed during the current exam: BPD, HC, AC, FL, GS, and CRL.Estimated fetal ages are available in the patient report for the number of fetusesspecified for a multiple gestation.

Obtaining Gestational Age Based on LMPYou can enter the date of the last menstrual period into the Patient Data form,or the LMP can be calculated from the dates you enter for the established duedate or the date of conception (DOC).

EDD (LMP) = LMP + 280 days

The LMP must be greater than or equal to the current date minus 295 days orless than or equal to the current date.

The GA based on LMP is calculated from the current system date minus the dateof LMP.

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➤ To obtain GA and EDD(c) from LMP

1. Press Patient Data.

2. Click Study Type to open the menu.

3. Click OB.

4. In the Study Info, click LMP.

5. Enter the LMP date in the displayed format.

6. Press the Enter key. GA and EDD(c) are calculated and displayed.

Established Due DateYou can enter an established due date in the Patient Data form. The establisheddue date replaces the estimated delivery date (EDD).

If you enter an established due date, the date you enter will be used for fetalgraphs or other calculations. The calculated EDD, identified as EDD(c), will not beused when you have entered an established due date.

Entering an established due date into the Study Info allows you to use anotherdate that has been accepted by the physician. This date may have been obtainedfrom an earlier ultrasound exam, an earlier determination based on the LMP, orsome other means.

Obtaining Gestational Age from the Established Due Date

➤ To obtain GA from the established due date



3. Click OB.

4. In the Study Info, enter the established due date in the displayed format.

5. Press the Enter key. GA is calculated and displayed. The established due dateyou entered is displayed for EDD.

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Obtaining GA, EDD(c), and LMP(c) from the DOCYou can enter a valid date of conception (DOC) in the Patient Data form. TheDOC will be used to calculate the estimated delivery date, EDD(c), the last men-strual period, LMP(c), and the gestational age (GA).

EDD (DOC) = Date of Conception - 14 days + 280 days

➤ To obtain GA, EDD(c), and LMP(c) from DOC



3. Click OB.

4. In the Study Info, click DOC.

5. Enter the DOC date in the displayed format.

6. Press the Enter key. GA, EDD(c), and LMP(c) are calculated and displayed.

Gestational AgeThe gestational age associated with a measurement value is derived from themost current ultrasound measurement. The average ultrasound age (AUA) dis-played in the patient report is based on the mean of the fetal measurements. Theaverage ultrasound age (AUA) and the estimated delivery date (EDD) based onthe average of all ultrasound ages obtained by measuring various fetal parametersare displayed in the patient report.

If you select two or more fetuses in the Multiple Gestations dialog box, indicat-ing multiple gestation, you can make and assign measurements for each fetus inthe study. Select a fetus from the menu near the top of the calc list before makingmeasurements for that fetus.

Calculating Gestational AgeYou can obtain a calculation of gestational age by performing the fetal measure-ments in General OB or Advanced OB. Each time you make a measurement,new values are displayed for gestational age (GA). (In the patient report, the fivemost recent measurements and their average are displayed.)

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➤ To calculate gestational age

1. Obtain the desired 2D image and press Freeze.

2. Press Calc and display the OB calc list.

3. Click General OB or Advanced OB.

4. Click the measurement label to begin the measurement.

5. Perform the measurement.

NOTEYou can also select a measurement tool, perform the measurement, and thenselect the measurement label.

6. Touch End Measure.The measurement value and gestational age appearbeneath the measurement label. The AUA and EDD(AUA) appear in thepatient report. The average of the measurements, the average GA, range, andauthor, where pertinent, also appear in the patient report.

Automatic CalculationsThe system will automatically calculate the head circumference from completebiparietal diameter (BPD) and occipito-frontal diameter (OFD) measurements. Itwill also calculate adjusted biparietal diameter (BPDa) from your BPD and OFDmeasurements.

The most recent BPD and OFD measurement values are used to calculate the HCvalue. Once you enter an HC measurement value, the system no longer calculatesthe HC value from the BPD and OFD measurement values. When the HC value iscalculated from BPD and OFD measurement values, the HC calculation in thepatient report will be identified with (c).

The most recent BPD and OFD measurements are used to calculate the BPDameasurement value that appears in the patient report.

Gestational Sac (GS)To complete an accurate gestational sac mean measurement, you must selectGestational Sac three separate times and complete the associated distancemeasurement three separate times. The patient report displays the three distancemeasurements and the average of those three measurements. The gestational ageand estimated delivery date (EDD) for those measurements are also displayed.

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Performing less than three separate distance measurements will result in a lessaccurate mean sac diameter.

Fetal Heart RateYou can obtain a fetal heart rate from an M-mode display.

➤ To obtain the fetal heart rate

1. Acquire an M-mode display of the fetal heart, and press Freeze.

2. Press Calc.

3. In the OB calc list, click General OB.

4. Click Heart Rate.

5. Select from 1 to 20 heart cycles over which the fetal heart rate will be calcu-lated.

6. Click on the start of the heart cycle.

7. Move the caliper to a corresponding point in a subsequent heart cycle andclick.

8. Continue to click on subsequent points to average the heart rate over severalcycles.

9. Touch End Measure. The heart rate value appears under the Heart Ratelabel and in the patient report.

Calculating the Amniotic Fluid Index The amniotic fluid index (AFI) is calculated from the sum of four distance mea-surements. The maternal abdomen is divided into four quadrants, and the verticaldistance of the largest pocket of fluid in each quadrant is measured. The measure-ments obtained from each quadrant are added together.

➤ To calculate amniotic fluid index

1. Obtain an image of a quadrant of the maternal abdomen, and press Freeze.

2. Press Calc.

3. In the OB calc list, click AFI/BPP.

4. Click +AFI to expand the group.

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5. Click a measurement label for one of the quadrants.

6. Click on the first point of the measurement.

7. Click on the second point of the measurement.

8. Touch End Measure to complete the measurement.

9. Press Freeze, and obtain an image of the next quadrant, and press Freezeagain.

10. Continue measuring in this manner until all four quadrants of the maternalabdomen have been measured. As the measurements are being made, the sumof the distances appears in the results and in the patient report.

About OB Measurement RatiosWhen the OB measurements have been made, the ratios are automatically calcu-lated. If more than one component measurement value is made, the averagedcomponent values are used to calculate the ratio. The display of the ratio value isnot dependent upon having a last menstrual period (LMP) age.

The BPD/OFD ratio is also called the cephalic index (CI).

Ratio range values not within the valid gestational age range will not be displayed.The ratio range values, dependent upon an LMP, is displayed in the patient report.

About Estimated Fetal Weight (EFW)You can display the EFW in grams or pounds and ounces. Grams is the defaultunit of display. The actual EFW value is compared to the expected normal EFWvalue to produce an EFW percentile value in the patient report. The EFW percen-tile value is of common use in determining intrauterine growth restriction(IUGR). Fetal weight is calculated from the following sets of OB measurements:

Ratio Gestational Age Ratio Range

BPD/OFD (CI) 14-40 weeks 70-86%

FL/BPD 23-40 weeks 71-87%

HC/AC 13-42 weeks 1.14-1.31

FL/AC 21-42 weeks 20-24%

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• AC

• AC, FL

• HC, AC, FL

• BPD, AC, FL

• BPD, HC, AC, FL

Fetal weight is automatically calculated and displayed in the patient report whenthe required measurements are performed.

Selecting an Estimated Fetal Weight Equation In the setups, you can select which EFW equation is used in calculations. Whenyou perform the measurements included in the EFW equation, the fetal weightcalculation appears in the patient report.

➤ To select an EFW equation (author)


2. Click Analysis Config.

3. Click the OB tab.

4. Click Author Editor.

5. In the EFW menu, select the author you want to use for the fetal weight cal-culations. The required measurements appear in the menu; for example,EFW-Hadlock (AC, FL).

6. Click the Percentile selection you want applied to the EFW: Philips Cus-tom or Hadlock.

7. Click Done.

When you perform the measurements included in the fetal weight equation selec-tion, the fetal weight calculation appears in the patient report.

About Fetal HeartFetal Heart includes measurement labels for distance measurements of the rightventricle, right atrium, right ventricular outflow tract (RVOT), left ventricle, leftatrium, left ventricular outflow tract (LVOT), aortic (AO) root diameter, pulmo-

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nary artery (PA), interventricular septum (IVS), thorax circumference and diame-ter. There are measurement labels for circumference measurements of the heartand thorax. The heart area is calculated and ratios of the left/right ventricles, left/right atria, aorta/pulmonic artery diameters appear in the results. The gestationalage (GA) based on the last menstrual period (LMP) also appears in the results.

Analysis ConfigurationAnalysis Config in the setups allows you to build, edit and delete calc lists,groups, measurements, and calculations. You can also edit, delete, and createtables and equations.

In the setups display, clicking on Analysis Config displays the available calcula-tions packages (Figure 11-2). The calculations packages are listed as tabs acrossthe top of the display. Clicking on a tab displays the calc lists available with thatcalculations package.

NOTEYou cannot open the Analysis Config setups when you have an in-processpatient exam open.

Each calculations package displays a master list of groups, measurements, and cal-culations. In Build mode you can use the arrows to move individual or groups ofmeasurements and calculations to and from the open list on the left, creating cus-tom measurement lists from the range of available selections in the master list.

In Edit mode you can create new calc lists, groups, measurements, and calcula-tions.

In OB Analysis Config, you can select between the Calc Editor and theAuthor Editor. The Calc Editor allows you to create and edit calc lists, group,measurement, and calculations labels. The Author Editor allows you to create,edit, and delete tables and equations to support groups, measurements, and cal-culations.

NOTEYou can use the Tab key to navigate through the Analysis Config display.

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Figure 11-2 Analysis Configuration Setups

About GroupsA group is a label that includes more than one measurement and zero to manycalculations. For example, AFI is a group consisting of LUQ, LLQ, RUQ, and RLQmeasurements. Groups can be system-defined or user-defined. A linked group is aspecial, system-defined group that contains default measurements and calculationsthat are essential for specific imaging modes. The measurements and calculationsof other groups consist of labels only. When you select an linked group, the spe-cial measurements and calculations are highlighted. Linked groups cannot bedeleted.

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About Build Mode While in Build mode, use the pointer to display a master calc list. The arrows areused to add or remove selected groups, measurements, and calculations labels toand from the open list on the left. The check boxes preceding the labels in theopen list are checked to indicate that the label will appear in the measurementslist. The unchecked boxes will appear only in reports.

Groups are predefined sets of measurement labels and calculation labels. Whenyou select and move a group between the master list and the open list, the entireset is added. You cannot remove an individual measurement from the open listthat was added as part of a group. You must remove the entire group. Calcula-tions, however, can be removed individually when they are added as part of agroup.

Building a Calc ListIf you are building an OB calc list, when your OB list is complete, you can clickAuthor Editor, and assign an editor to each measurement label, or create atable or equation for the measurements.

➤ To build a calc list



3. Click a calculations package tab, for example, OB.

4. Click the calculations package specialty that you want, for example, GeneralOB.

5. Click Build, if necessary. (Build is the default mode and may already beenabled.)

6. In the master list, click the group, measurement, or calculations labels youwant to include in the open list on the left.

7. Move the highlighted group, measurement, or calculations labels to the open

list on the left by clicking . (You can remove items from the open list by

using .)

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8. Repeat step 6 and step 7 until you have the groups, measurements and calcu-lations you want in your list on the left.

9. Click Done.

About Edit ModeWhile in Edit mode, you can click New to add labels for calc lists, groups, mea-surements, and calculations. When you select any of these items, an editing dialogbox appears for making modifications.

Editing a Calc ListWhile in Edit mode, use New to create new calc lists, groups, measurements, andcalculations labels.

➤ To edit a calc list



3. In the Analysis Config display, click Edit.

4. Click New to create a new calc list label, new group label, new measurementlabel, or new calculations label.

5. New labels appear in the master list as they are created.

6. Click Build.

7. Click the new calc list label.

8. Click a group, measurement, or calculation label to highlight it.

9. Click to add the label to the open list on the left. (You can remove the

labels in the open list by clicking them and then clicking .)

Selecting Fetal Tables and EquationsYou can select from several editors or investigators for some fetal tables, but forothers there are no tables available. You can create your own tables or equationsfor any OB measurement.

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➤ To select a fetal table





5. For the appropriate measurement, select a table (listed by author) from themenu available for that measurement.

6. Click Done.

About Custom Fetal MeasurementsYou can create your own fetal measurements for your local lab. This capabilityallows you to include measurements and calculations that may not be widelyaccepted or may be recently published and that therefore are not included in thesystem. You create custom measurements using Analysis Config in the setups.The corresponding fetal age, weight, growth tables, and equations can also be cre-ated.

Although you can associate a custom measurement with a fetal table, the ultra-sound age derived from the custom measurement is not included in the averageultrasound age (AUA) calculation.

About Custom Fetal Age and Growth TablesYou can define your own fetal age and growth tables for both the system defaultmeasurements and your own custom measurements.

You must supply the author name, the measurement the fetal age is based on,valid input range and standard deviation, output accuracy range, and output units(days or weeks and days).

The output units in which the growth tables are expressed is inferred from thetype of measurement (ratios do not have units, some have percentages, weight isin grams, etc.). For fetal growth graphs, you must also define the low and highranges as the 5th and 95th percentiles or plus or minus two standard deviations(SD).

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You can create the table, view and edit the table, and delete the table from thesystem. You can also delete lines from the table, correct single values, insert linesinto the table inadvertently skipped during original definition.

About Custom Age, Weight, and Growth EquationsYou can define your own fetal age, weight, and growth equations. All of the sys-tem default measurements are available for use in your custom equations. Theequations can be complex polynomial equations typical of fetal age, weight, andgrowth relationships. Multiple input parameters, constants, and mathematicalfunctions are allowed.

You must enter all information required for proper system use and reporting,including the author name, measurement label, valid input range, output rangeaccuracy, output age units.

The data that you enter for the equations should be checked for possible entryerrors and inconsistencies.

About Prior Exams and Fetal Growth GraphsPrior exam measurements can be displayed along with current exam measure-ments to show trends in fetal growth. For a multiple gestation, tabs correspondingto up to five fetuses are available. Across from the exam date for each prior examthe BPD, HC, AC, FL, EFW, CI, and HC/AC measurements for up to five priorexams can be entered.

The prior exam data is entered in two ways: manually from the keyboard or auto-matically from system memory. Manually entered prior exam data is editable untilyou use End Exam, Pause Exam, or Cancel Exam. Prior exam data will beavailable only if the exam has not been deleted from the system hard drive. Auto-matically entered prior exam data cannot be edited.

About Fetal Growth GraphsFetal growth graphs are available in the OB calculations package. The graphs pro-vide the capability to assess fetal growth relative to a normal growth graph. Thegrowth graph for a specific measurement label is displayed with the positive andnegative standard deviations or relevant percentiles. The ultrasound age derivedfrom your measurements is then plotted on the graph relative to the growthgraph. Prior study data can also be plotted relative to the standard growth graph.

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Depending on the graph, the vertical axis is marked off in centimeters for mea-surements, percent for ratios, or grams for fetal weight. The graph has age inweeks along the horizontal axis. The age reference used to plot points on thehorizontal axis is either the manually entered established due date or the agebased on the date of the last menstrual period (LMP) entered into the patientdata. If neither is available, then no points are plotted on the graph.

A multiple gestation evaluation provides one graph with up to five sets of data. Onthe graphs report, a symbol legend is available to identify the symbols used for thedifferent fetuses of the multiple gestation.

The default for the calculation from GA in Graphs will be LMP, unless only theestablished due date is defined in patient data entry. If LMP and the establisheddue date are unavailable, the graph will appear without GA symbols.

Prior exam dates will be listed on the graphs report. Up to five prior exam datescan be listed.

You can print the graphs by clicking Print Graphs.

Viewing Fetal Growth Graphs

➤ To view a patient’s OB graphs

1. During an OB exam, press Report.

2. On the patient report, click View Graph.

3. Perform the following to update the graph, as needed:

– Click the Graph menu to display a menu of measurement labels andselect the one you want. (The default author for this change is the one forthe active patient exam.)

NOTEYou can also use the Tab key to navigate through the Graph report in the follow-ing order: Graph, Author, and GA based on.

– Click the Author menu to display authors for the measurement labelappearing in the Graph report and select the author you want.

– Click LMP or EDD to select the one on which you want to base the ges-tational age (GA).

4. Click Close.

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Creating a New Table The setups provide the capability to create new tables for fetal age, fetal growth,and EFW growth.

NOTEYou are solely responsible for custom measurements and calculations and theaccuracy of elements entered into the tables.

➤ To create an OB table





5. Select the measurement label on which you want to base the fetal age. (ClickMore to add a label to the Fetal Age based on menu.

6. Select the measurement units (mm or cm) and the age units (days or weeksand days).

7. Enter the data into the table: measurement, age, low and high ranges, andstandard deviation (SD).

8. Click Insert Row or Delete Row as needed to insert or delete rows of datainto the table.

9. Click OK. The table is saved and can be selected for the measurement label,as required.

Editing a Table

➤ To edit a table




4. Click Edit Table.

5. Click Fetal Age based on and select a measurement label from the menu.

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6. Click Edit Name to edit the name of the author.

7. Click OK.

8. Edit the table as needed using the keyboard, Insert Row, and Delete Row.

9. Click OK.

Deleting a Calc List or GroupYou can delete user-defined groups, measurements, and calculations as well asnon-linked system-defined groups. All but one system- or user-defined calc listcan be deleted. If only one calc list is in the display, the editing dialog box does notinclude the Remove List button. System-defined measurements and calculationscannot be deleted, nor can linked groups.

➤ To delete a calc list or group



3. Click the calc list.

4. Click Edit.

5. Click the calc list or group you want to delete.

6. Click Remove List.

7. In the confirmation dialog box, click Yes.

Deleting a Measurement LabelYou can delete user-defined measurement labels. You cannot delete sys-tem-defined measurement labels.

➤ To delete a measurement label



3. Click the calc list you want to edit.

4. Click Edit.

5. Click the user-defined measurement label.

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6. Click Remove List.

7. In the Remove Measurement Label dialog box, click Yes.

Creating a New Equation

➤ To create a new equation





5. Click New Equation.

6. From the Fetal Age based on menu, select an item. (If you want to add alabel to the Fetal Age based on menu, click More and select the Type andLabel.)

7. Click Meas or Calc to determine which menu will be available in the Labelto Insert menu.

8. Move the cursor to Mean, SD, High, or Low fields.

9. Select a Label, and click Insert. The label appears in the field in which youplaced the cursor.

10. Click Advanced Functions as needed to create your new equation.

11. Click Number Pad to use the numbers and symbols to create your newequation.

12. Type your Input Range in the From and To fields.

13. Select the Input Units and Output Units.

14. Click OK.

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12 Patient ExamsBefore you begin acquiring images, you must create a patient exam or reactivate apaused patient exam. If you do not, you cannot capture, print, or save the imagesyou acquire. The way you create a patient exam depends on whether or not youare using the modality worklist feature.

Using Patient Data Entry Touch Screen ControlsTo change the setting of a touch screen control, touch it, or if it is in the bottomrow, turn the knob directly below it.


Creating a New Exam

WARNINGFailing to end the current exam before starting a new exam can result in databeing acquired and stored under the wrong patient name.

You start an exam by entering patient data into the system. There are two waysto enter patient data.

• If the worklist feature is not enabled or used on your system, you enterpatient data into the Patient Data form.

• If your system is connected to a DICOM network with the modality worklistfeature enabled, you can select an exam to load patient data instead of enter-ing that information manually. See "Selecting in the Worklist" on page 293.

The system uses a unique ID to identify each patient. You can enter an ID, or youcan have the system create one automatically. Stored images, fetal growth graphs,and reports are stored based on the patient ID.

An accession number is an optional entry assigned to each patient file by an insti-tution for internal information-management purposes.

Alt Print

Paused exam

Print Screen

Study Info

Worklist

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The exam date is set by the system when you first print or capture an image dur-ing the exam.

Entering Patient DataIf you are not using the worklist option, you start an exam by entering patientdata into the system.

NOTEYou can clear all patient data from the Patient Data form by clicking ClearPatient Data. Do not use this control unless you want to delete all of thepatient data you have entered into the form.

➤ To enter patient date manually (if you are not using the worklist)

1. Ensure that the previous exam ended by pressing End Exam or by clickingEnd Exam in the Patient Data form.

2. Press Patient Data on the control panel or press the Patient Data key.

3. On the Patient Data form, type the patient information. (Press the Tab keyto move the cursor from field to field.)

4. Click the Study Info tab.

5. For Study Type, select the study you will be performing.

6. Enter the pertinent study information for the patient.

7. When you are finished, click Close.

Additional Exam DataAfter you have started an exam by entering patient data, you can then enter addi-tional information for the exam. You can also edit the patient data you enteredpreviously.

Editing Patient DataYou can edit data for the current patient. Some data can be edited at any timeduring an exam. The following types of patient data can be edited only under cer-tain conditions:

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• Patient Name

• Patient ID

• Accession Number

• Birth Date

• Gender

If the system is connected to a network, you can edit these types until you cap-ture an image or print to any device except a local printer, or until prior examdata has been loaded into the system. If the system is not connected to a net-work, you can edit these types until prior exam data has been loaded into the sys-tem. You can edit all other patient data at any time during the exam.

➤ To edit patient data

1. Press the Patient Data key to display the Patient Data form.


– Double-click a word and type to replace it or press the Backspace key todelete it.

– Drag the pointer to select a series of words and type to replace them orpress the Backspace key to delete them.

– Click in the text, use the arrow keys to move the cursor, press the Back-space key to delete characters, and type to insert text.

3. Press Patient Data or click Close to save the patient data and to exit theform.

Entering Study Data

NOTEBefore entering patient data, verify that the date and time displayed on the systemare accurate. See "Setting the System Time and Date" on page 94.

➤ To enter study data

1. Click the Study Info tab in the Patient Data form.

2. Enter the patient’s height and weight in the units of measure shown on thedisplay. Press the Tab key after each entry. The patient’s body surface area iscalculated and displayed.

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3. Make a selection for Study Type.

4. For an OB exam, do one of the following for Gestational Age:

– Select LMP and type the date of last menstrual period. The system calcu-lates and displays the gestational age and the estimated date of delivery.

– Select EDD and type the estimated date of delivery. The system calculatesand displays the gestational age and a computed last menstrual period.

– Select Conception and type the date of conception. The system calcu-lates and displays the gestational age, estimated date of delivery, and acomputed last menstrual period.

5. If previous ultrasound OB exam data exist, click Prior Exam Data. ThePrior Exam Data form is displayed. If the form is empty, enter the priorexam data manually, using the keyboard.

WARNINGIf prior exams include study data for two or more fetuses, be aware that fetusesmay not be identified and designated consistently from one exam to another. Forexample, a fetus may be designated Fetus A in one exam and Fetus B in another.

6. Enter the information into the Prior Exam Data form. There are five examsavailable, and you should enter the data in chronological order, beginning withExam #1. For multiple fetuses, be sure to enter the data on the correct fetustab.

7. If you want to clear all prior exam data, click Clear Data. This clears all man-ually entered and automatically loaded data from the form.

8. When finished entering prior exam data, click OK to exit the Prior ExamData form.

9. When finished entering study data, click Close to exit the Patient Dataform.

Modality WorklistThe modality worklist feature provides a patient-management capability for thesystem within a network environment, using interconnected servers, printers, andultrasound systems.

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If your system is connected to a DICOM network with the modality worklist fea-ture enabled, you can load patient data and select a scheduled procedure insteadof entering this information manually. The worklist is updated automaticallyaccording to the Print/Network worklist setups. The system also updates theworklist when you click Update Worklist or Patient Search. The date andtime of the last update is shown directly below the list.

Selecting in the Worklist

➤ To select a patient in the worklist


2. On the Patient Data form, click the Worklist tab.

3. On the worklist, select the exam you want, and click Close.

4. The system loads the patient information, and you are ready to begin an examfor that patient.

Searching in the WorklistIf necessary, you can search for a specific exam by using Patient Search on thePatient Data form.

➤ To search for a patient file

1. Press Patient Data, then click the Worklist tab.


– To search for a patient in the worklist, choose a search parameter fromthe list on the Worklist tab, type the corresponding parameter, andselect the exam highlighted by a dashed box.

– To search for a patient not displayed in the worklist, click PatientSearch, type any of the patient data in the corresponding text fields, andclick Search.

3. To load data for this patient, click Close.

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Working with Worklist Columns

➤ To sort within columns and adjust column width in the worklist


2. On the Patient Data form, click the Worklist tab.

3. To change the order of the alphabetical sort, click a header in the list. A sym-bol in the header indicates the sort order, either normal (� ) or reverse (� ).

4. To change the width of a column, drag the border between it and the adjacentcolumn.

Pausing, Canceling, and Ending ExamsOnce the system has saved exam data for the current exam, you can pause, can-cel, or end the exam.

About Pausing ExamsIf an exam is interrupted, you can pause it. When you pause an exam, the systemtemporarily saves the patient data and suspends the exam for 24 hours. If you donot resume the exam within 24 hours, the system ends the exam without notify-ing you. Paused exams are listed in the Paused Exams tab in the Patient Dataform.

Pausing an exam allows you to perform other exams until you can reactivate thepaused exam.

You cannot pause an exam until you capture an image or print to any deviceexcept a local printer, or until prior exam data has been loaded into the system. Apaused exam cannot be deleted from the Patient Directory until you clickCancel Exam or press End Exam, or 24 hours have elapsed since it waspaused. There is no limit to the number of times you can pause and reactivate anexam.

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Pausing an Exam

➤ To pause an exam


2. Click Pause Exam.

Reactivating a Paused ExamYou can reactivate a paused exam within 24 hours of pausing it.

➤ To reactivate a paused exam


2. Click the Paused Exams tab.

3. Select the exam on the Paused Exams tab.

4. Click Close.

Canceling an ExamAfter the system has saved exam data for the current exam, you can cancel theexam. (The system saves exam data when you capture an image or print to anydevice except a local printer.) Canceling an exam clears all exam data (includingcaptured images) and prior exam data.

➤ To cancel an exam

1. Press Patient Data to display the Patient Data form.

2. Click Cancel Exam.

3. Click Done or enter patient data to begin a new exam.

Ending an ExamEach time you finish an exam, you must end the exam to save images, reports, andother exam data. You can end an exam in the current exam display or with thecurrent exam open in the Review display. You cannot end an exam while in thePatient Directory.

You will not be able to end the exam until the system has saved exam data for thecurrent exam. (The system saves exam data when you capture an image or print

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to any device except a local printer.) Ending an exam stores all exam data, clearsthe Patient Data form, and prepares for the next exam.

WARNINGFailing to end the current exam before starting a new exam can result in databeing acquired and stored under the wrong patient name.

➤ To end an exam

When the exam is complete, press End Exam.

Customizing Patient Data FormatsIn the setups, you can change the format used to enter and display the time, date,and patient name. Time formats are 12 hour and 24 hour. The date formats aremonth/day/year, day/month/year, and year/month/day. Name settings include first/last, last/first, and whether to display the middle initial. You can also change theunits of measure used to enter and display patient height and weight. Units ofmeasure for height are centimeters and feet/inches, and the units of measure forweight are kilograms/grams and pounds/ounces.

Changing Time and Date Formats

➤ To change the time and date formats



3. Click the Header tab.

4. For Format under Set Time, select a time format.

5. For Format under Set Date, select a date format.

6. Click Done.

Changing the Name Format

➤ To change the name format



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3. Click the Patient Data tab.

4. For Name Display, select a format, and then select or deselect DisplayMiddle Initial.

5. Click Done.

Changing Units of Measure

➤ To change the units of measure for height and weight



3. Click the Patient Data tab.

4. For Height, select a format.

5. For Weight, select a format.

6. Click Done.

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13 Review During or after an exam, you can use Review to examine and compare imagesacquired in the exam. You can also review multiple exams for one patient.

In Review, you can look at the images or Cineloop sequences that you stored. Youcan view, send, print, back up, and search your stored images. You can also per-form analysis on images in Review. Images that are in image memory can bestored on the ultrasound system hard drive, on a digital versatile disc (DVD), oron DICOM-compatible devices on a network. You can display images within anexam in several layouts, and you can display images from different exams.

General Information on ReviewIn Review mode, you can perform a variety of tasks, including making measure-ments, playing Cineloop sequences, and working with 3D images.

Measurements in ReviewDuring Review you can make measurements on images in the current exam. Animage must be full size before you can make measurements on it. Measurementcalipers are not available while playing a Cineloop sequence. Measurements madein Review on the current exam can be saved in the report. Measurements made inReview on prior exams cannot be saved. You can make as many measurements asneeded.

To display the measurement controls on the Review Exam touch screen, touchCaliper. To display the Review controls on the Review Exam touch screen,touch Image. You can also display the calc list by pressing Calcs.

You can clear all measurements from an image by touching Erase Calipers onthe Review Exam touch screen.

3D in ReviewWhen you double-click a 3D image or thumbnail in the Review Exam display,the image opens full size in the 3D application. You can then manipulate the 3Ddata set to view the volume image.

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Using Review Touch Screen ControlsTo use a touch screen control or change its setting, touch it, or if it is in the bot-tom row, turn the knob directly below it.


Starting ReviewPress Review to enter Review mode. The display that appears depends onwhether an exam is active on the system.

If an exam is in progress, pressing Review opens the Review Exam display(Figure 13-1).

Alt Print

Back

Caliper

Cine Play

Cine Speed

Current Exam

First Page

Image

2D

Last Page

Manual Cine

Page

Print Screen

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Figure 13-1 Review Exam Display

If no exam is in progress, pressing Review opens the Patient Directory display(Figure 13-2).

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Figure 13-2 Patient Directory Display

To to return to live imaging, press Review again.

Selecting and Loading ExamsIf an exam is currently in progress, pressing Review opens the Review Examdisplay with images loaded from the current exam. If no exam is in progress,pressing Review opens the Patient Directory display, which lists previous examson the selected drive.

To review previous exams, you first select them in the Patient Directory. You canselect and load multiple exams of the same patient for review. The Patient Direc-

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tory also provides features that allow you to back up and delete exams and con-vert images to different file formats.

➤ To select and load exams

1. Press Review.


– To review only the current exam, skip to step 3.

– To review the current exam and other exams for this patient, clickPatient Directory, click Current Exam, and select additional exams.

– If there is no exam currently in progress, select a source for Drive, andselect one or more exams for a patient in the Patient Directory.

– To select all exams on the current drive, click Select All.

3. Click Display Exams to load the selected exams for viewing.

Viewing Images The Review Exam display is used for viewing and comparing exam images in thelayout you select. Hard drive information and layout selection are available alongthe left side of the display. Thumbnail images for the current or selected examappear on the right side of the display. Items at the bottom of the display provideaccess to other review functions (Figure 13-3).

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Figure 13-3 Review Exam Display: Viewing Images

Navigating Thumbnails and ImagesIn Review, you can view small images, called thumbnails. Thumbnails are locatedon the right side of the Review Exam display.

NOTEWhen reviewing images of an exam loaded from the Patient Directory, thumbnailswill not be available in some circumstances. For example, exams copied fromDVD to the hard drive may not have thumbnails if the images they contain are nolonger in their native format.

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➤ To navigate thumbnails and images

1. For Layout, select the layout you want to use to display images.


– Click or to move up or down through available thumbnails oneimage at a time.

– Click or to move up or down through available thumbnails onepage at a time.

– Click or , or turn Page, to move backward or forwardthrough the available images, one page at a time.

– Touch First Page or Last Page to jump directly to the first or last pageof images.

– To view a thumbnail full screen, double-click it. (If the image represents a3D data set, it opens in 3D review mode.) Click Back to return to thereview screen.

Image LayoutIn the Layout menu, you can select the format, or layout, in which images are dis-played (Figure 13-4). The Review Exam display can display up to four images atone time. The available formats are 1:1, 2:1, and 4:1, which show 1, 2, and 4images, respectively.

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Figure 13-4 1:1 Layout in the Review Exam Display

NOTEAlthough the 1:1 layout displays a single image, it is not the same as a full-screendisplay. In full-screen review, full Cineloop functionality is available, and the thumb-nails and the drive and layout information are not displayed.

➤ To select an image layout

In the Layout menu on the left side of the Review Exam display, select one ofthe layouts.

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Playing Cineloop Sequences in ReviewIn Review, full playback functionality is available for Cineloop sequences only whenthe image is displayed full screen. You can, however, play a loop manually in 1:1 lay-out.

➤ To play Cineloop sequences

1. Double-click a Cineloop image to display it full screen.


– To play the loop manually, use the trackball to move through the frames.

– To play the loop automatically, touch Cine Play. To pause playback, touchCine Play again.

– To adjust playback speed, turn Cine Speed.

3. To return to the Review Exam display, touch Back.

Patient Directory The Patient Directory is a list of exams that are stored on the selected disk drive.Drives can include the system hard drive, a DVD, and network drives. The PatientDirectory includes options that allow you to search, view, transfer, and printexams. There is also an indicator that shows the disk space available.

If no current exam in progress when you start Review, no images appear in theReview Exam display. To select exams and viewing options, you must display thePatient Directory by clicking Patient Directory in the Review Exam display.

NOTEYou cannot end an exam while in the Patient Directory.

About Patient Directory HeadersIn the Patient Directory, exams are organized in a table containing 11 columns.Each column header describes the contents of the column using either text or anicon (Table 13-1).

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Table 13-1 Patient Directory Column Headers

Header Description

Indicates that a patient exam is locked to prevent deletion.

Patient Name

Patient name

Patient ID Patient identification number.

Exam Date/Time

Date and time of exam

Exam Exam type (application and preset)

Images The total number of images that are in the exam. (A Cineloop sequence or 3D data set is a single image.)

Status Current status of the exam: Active, Ended, Paused, or Voided. (This column is empty when a DVD is selected as the drive.)

(Print Status) A check mark in this column indicates the exam has been printed at least once to a printer. (This column is empty when a DVD is selected as the drive.)

(Archive Status) A check mark in this column indicates the exam has been archived. (This column is empty when a DVD is selected as the drive. The column is removed if the connectivity option is not installed or if the connectivity option is installed but no archive server is selected.)

(Commit Status) A check mark in this column indicates the exam has been committed. (This column is empty when a DVD is selected as the drive. The column is removed if the connectivity option is not installed or if the connectivity option is installed but no commit server is selected.)

(Export to DVD Status) A check mark in this column indicates that the exam has been exported to a DVD. (This column is empty when a DVD is selected as the drive.)

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Finding ExamsTo find an exam quickly, perform a search for it using the patient ID, patient name,or exam date. The system searches only the source selected in the Drive menu.You can enter a partial patient ID or patient name. To search by exam date, youcan enter a single date or two dates to specify a range to search. When a match isfound, it is highlighted with a dashed line.

➤ To search for a patient exam

1. In the Patient Directory, choose a search parameter from the list.

2. Click in the Find text box and type the information, or type as many charac-ters at the beginning of the information as you know.

3. To load data for this patient, select the highlighted exam and click DisplayExams.

Sorting in the Patient Directory You can sort the exams displayed in the Patient Directory by any of the exam datacategories. For example, you might find it useful to sort the list by name, by examdate, or by exam type. Categories are sorted alphabetically, numerically, or chro-nologically, depending on the content. In addition, categories can be in eitherascending or descending order, as indicated by the direction of the arrow in thetitle of the sorted category.

➤ To sort by categories in the Patient Directory

1. Display the Patient Directory.

2. To change the order of the alphabetic, numeric, or chronological sort, click aheader in the list. A symbol in the header indicates the sort order, either nor-mal (� ) or reverse (� ).

Changing Column WidthYou can change the width of each column in the Patient Directory to accommo-date the data contained in the columns.

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➤ To change column width in the Patient Directory

1. Display the Patient Directory.

2. To change the width of a column, drag the border between it and the adjacentcolumn.

Deleting Exams and ImagesThe Patient Directory allows you to delete exams stored on any drive listed inthe Drive menu. If you accidentally delete an exam, and the exam has beenarchived to a DVD, you can load the archived exam.

In the Review Exam display, you can delete stored images from an exam. This ispossible, however, only when Send Images/Clips in Print Network setups isset to At End of Exam. When an image is deleted, it remains temporarily in theReview Exam display with an X marked through it.

➤ To delete one or more images

1. Select the images you want delete by clicking their image numbers.

2. Select Delete Selected to mark the highlighted images for deletion. An Xappears through the images. After you end the exam, the marked images aredeleted and will not be exported.

NOTEIf you need to unmark images for deletion, follow the instructions displayed onthe X that is marked through them. You must do this before ending an exam,selecting a different exam, displaying the Patient Directory, or exiting Review. Youcan, however, undelete images in an exam that has been archived by loading theentire exam.

Deleting ExamsIn the Patient Directory, you can delete exams stored on any drive listed in theDrive menu.

➤ To delete exams

1. In the Patient Directory, select one or more exams. To select all exams, clickSelect All.

2. Click Delete Selected.

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3. In the Delete dialog box, click OK.

NOTEYou must wait for the system to complete the deletion before you can continue.Deleting several exams at once may cause an extended wait. To cancel a deletion,

click to open the Delete Status dialog box for making changes.

Deleting ImagesIn the Review Exam display, you can delete images in the currently loaded exam.

NOTEBefore attempting to delete stored images, ensure that Send Images/Clips inPrint Network setups is set to At End of Exam. If this is set to After EachPrint/Capture, you will not be able to delete stored images.

➤ To delete images

1. In the Review Exam display, select one or more images you want to deleteby clicking the number in the thumbnails.

2. Click Delete Selected. Deleted images are displayed with an X throughthem.

3. To undelete a deleted image, click the number in the thumbnail.

Sending Exams and ImagesIn Review, you can send specific images or entire exams to DICOM-compatibleprinters and servers on a network or to a DVD.

Sending Exams In the Patient Directory, you can send exams from the system to DICOM-com-patible printers and servers on a network. You can also send exams to the DVDdrive on the system. When you send exams to the DVD drive or to a server, theassociated images and reports are included. When you send exams to a printer,only the images are printed.

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NOTEIf the system loses power or is shut down from the rear power switch while aCineloop sequence is being stored to a DVD in the background, the current examis paused. Once the system is turned on again, resume the exam and complete it.Next, select all images and sequences except the one that was being stored whenthe system lost power, and then export them to a DVD manually. To verify the

status of a copy, click and check the Status column.

➤ To send exams


2. Click Send To.

3. In the Send To dialog box, select one or more destinations.

4. Click OK to send the selected exams.

Sending Images In the Review Exam display, you can send images from the system toDICOM-compatible printers and servers on a network. You can also send imagesto the DVD drive on the system.

NOTES• To transfer images from a DVD to the archive server, transfer the images from

the DVD to the system hard drive, and then transfer from the hard drive tothe archive server.

• In certain situations, the DVD indicator continues to flash after an unformat-ted disk is formatted and a study has been copied to it. To verify the status ofa copy job, click and check the Status column.

➤ To send images

1. In the Review Exam display, select one or more images.

2. Click Send To.

3. In the Send To dialog box, select one or more destinations.

4. Click OK to send the selected images.

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Exporting Images for PC ViewingThe Review Exam display allows you to export images in different formats sothey can be viewed on a personal computer. Single-frame images are exported inJPEG format, and Cineloop sequences are exported in AVI format.

The image export configuration is set in the Print/Network setups. Images canbe exported as compressed or uncompressed clips and images. Single images canbe exported as color or black and white. However, compressed and uncom-pressed clips can only be exported as color.

When images are exported in a compressed format, the system adds a label toeach image to indicate that the image has been compressed. The label “JPEG” isadded to the left of the image number on all images exported from the currentexam. The compression factor for exported images is selected in the setups.

➤ To export images for PC viewing

1. Select the images you want to export.

2. Click To DVD as JPG/AVI in the Review Exam display.

3. If the Format DVD dialog box is displayed, click OK, click Format in theReview Exam display, and follow the prompts. Then click To DVD as JPG/AVI again.

4. In the Copy To DVD dialog box, select or create a directory in which tostore the images on the DVD.

5. Click OK to start copying. When the images have been copied, a messageappears, indicating so.

Archiving ExamsFrom the Patient Directory, you can archive exams that are stored on the systemhard drive to either a DVD or an archive server on a network. A check mark in

the Archive Status column indicates that an exam has been sent to an archiveserver on a network. To see archive status and to archive exams, an archiveserver must be selected in the setups. After an exam is archived, it will be deletedfrom the system hard drive automatically, if Auto Delete is set to DeleteArchived/Committed Exams in the setups.

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After an exam is archived on an archive server and has been deleted from the sys-tem hard drive, you cannot directly access it from the system. To load and reviewan archived exam on the system, you must first copy the exam from the archiveserver to a DVD. See "Loading Archived Exams" on page 315.

➤ To archive exams

1. If you are archiving to a DVD, insert the formatted DVD into the drive.


3. Click Send To.

4. In the Send To dialog box, select DVD or an archive server.

5. Click OK to archive the selected images.

Formatting a DVDYou can format a DVD so that it can be reused. To write over obsolete data on aDVD, you must first format the disc.

➤ To format a DVD

1. Display the Patient Directory by pressing Review, and if necessary, clickingPatient Directory in the Review Exam display.

2. Click Eject in the Patient Directory display, insert the DVD into the DVDdrive, and click Eject again.

3. In the patient directory, select DVD for Drive.

4. Click Format.

5. In the Format DVD dialog box, click OK to erase and format the disc, orCancel to cancel the process.

6. When the dialog box indicates that formatting is complete, click OK.

7. You can now begin storing data to the DVD.

8. If you want to eject the DVD, click Eject in the Patient Directory display andremove the DVD.

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Loading Archived ExamsIf an exam has been archived, either to a DVD or an archive server, you can loadand review the archived exam on the system. If the exam was archived to anarchive server, you must first copy the exam from the archive server to a DVD.You can then select and load the exam from the DVD on the system.

➤ To load an archived exam on your system

1. If the exam was archived on an archive server, copy the exam from the serverto a DVD. This can be done only on the server or on a computer connectedto the server. Your system administrator can help you with this.

2. Display the Patient Directory by pressing Review, and if necessary, clickingPatient Directory in the Review Exam display.

3. Click Eject in the Patient Directory display, insert the DVD into the DVDdrive, and click Eject again.

4. In the patient directory, select DVD for Drive.

5. Select one or more exams for a patient in the patient directory, or clickSelect All to select all exams on the DVD.


– To copy the selected exams to the system hard drive, click Send To, andin the Send To dialog box, select Hard Drive and click OK. Now selectHard Drive for Drive, select the exams, and click Display Exams toload the selected exams for review.

– To review the exam directly from the DVD, click Display Exams to loadthe selected exams for review.

Printing Exams and Images from ReviewReview offers you a variety of options for printing exam images and reports. Thesystem supports printing to a local printer and to DICOM printers on a network.You can print entire exams or specific images to DICOM printers, provided theimages are not Cineloop sequences; you can send Cineloop sequences only to aDVD or an archive server.

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Customizing Review In the setups, you can select the default layout used in the Review Exam display,and you can select a compression factor to be used when exporting images.

WARNINGUsing the system setups or the Name/ID key to remove the patient name and IDfrom images increases the risk of misidentifying patient data on printed imagesand reports.

Selecting the Default Layout

➤ To select the default layout for the Review Exam display


2. Click System Settings, and then click the Display tab.

3. For Review Format, select the layout you want as the default.

4. Click Done to save your changes and exit the setups.

Selecting a Compression FactorImages can be exported as compressed or uncompressed clips and images. Singleimages can be exported as color or black and white. However, compressed anduncompressed clips can only be exported as color.

➤ To select compression factors for exported images


2. Click Print/Network, and then click the Printer/Capture tab.

3. For Compression, select a compression factor for both Clip (Cineloopsequences) and for Image.

4. If both Clip and Image options are set to Uncompressed, select Blackand White to export individual images without color data. Clips, however,are exported in color regardless of the setting.

5. Click Done to save your changes and exit the setups.


14 TransducersThe transducer that you select is the most important factor in image quality. Opti-mal imaging cannot be attained without the correct transducer. The system isoptimized for use based on your transducer selection.

The system limits patient contact temperature to 41 degrees Celsius, and acous-tic output values to their respective U.S. Food and Drug Administration limits. Apower-protection circuit protects against over-current conditions. If the powermonitor protection circuit senses an over-current condition, then the drive cur-rent to the transducer is shut off immediately, preventing overheating of thetransducer surface and limiting acoustic output. Validation of the power protec-tion circuit is performed under normal system operation.

CAUTIONMechanical transducers, such as the 3D6-2, should be operated only at normaloperating temperatures (50°F to 104°F or 0°C to 40°C). Operating a mechanicaltransducer at lower temperatures can damage it.

Transducer SelectionPressing Transducer displays the Transducer touch screen. From this touchscreen, you select a transducer and a preset. (The preset can be a Tissue Specificpreset or a Quick Save preset.) After you select the clinical option/preset, the sys-tem calibrates the transducer, enables the transducer for operation, and updatessystem status to reflect the transducer type and the preset you selected.

Clinical Options and TransducersThe clinical options, or applications, for each transducer for the system are listedhere (Table 14-1).

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Transducer MaintenanceTransducers require proper care, cleaning, and handling. Reasonable care includesinspection, cleaning, and disinfection or sterilization, as necessary.

Inspect the transducer cable, case, and lens before each use. Check for cracks orother damage that jeopardizes the integrity of the transducer. Report any damageto your Philips Ultrasound customer service representative, and discontinue useof the transducer.

CAUTIONSome ultrasound coupling gels, as well as some solutions for precleaning, disin-fecting, and sterilizing can damage a transducer. Before using a gel or solution on atransducer, see "Disinfectants and Gels" on page 335. You can also call PhilipsUltrasound Customer Service at 800-433-3246 (North America), or call yourlocal Philips Ultrasound representative (outside North America).

Table 14-1 Transducer Clinical Options

Transducer Clinical Options

C5-2 Abdomen, Contrast, GYN, OB, Pediatric, Urology

C8-4v Contrast, GYN, OB, Urology

C8-5 Pediatric, Vascular

C9-4 Abdomen, GYN, OB, Pediatric

C9-5ec GYN, OB, Urology, Contrast

L8-4 Musculoskeletal, Pediatric, Small Parts, Vascular, Contrast

L12-5 Musculoskeletal, OB, Pediatric, Small Parts, Vascular

L17-5 Musculoskeletal, Pediatric, Small Parts, Vascular

S3-1 Card Adult

S4-1 Abdomen, Contrast, OB, GYN

3D9-3v GYN, OB

3D6-2 OB

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Acoustic ArtifactsThe transducer adds its own signature to the echo information in the form ofbeam width effects, axial resolution limitations, and frequency characteristics. Thecontrol choices made by the sonographer that affect amplification, signal process-ing, and echo signal display can lead to significant differences in the displayedappearance of echo data. Following is a brief discussion of acoustic artifacts. Anunderstanding of the physical basis for the production of signals displayed onultrasound images is helpful in minimizing artifacts on images and interpreting theresults of studies.

An artifact is an echo displayed in a different position than its correspondingreflector in the body. Artifacts can also be caused by intervening tissue properties.Artifacts can originate from external noise, reverberations, multi-path reflections,or misadjusted equipment. They can also come from the ultrasonic beam geome-try and unusual changes in beam intensity. Artifacts and their manifestations arelisted below, and following are some definitions of various artifacts.

• Added objects displayed as speckle, section thickness, reverberation, mirrorimage, comet tail, or ring down

• Missing objects due to poor resolution

• Incorrect object brightness due to shadowing or enhancement

• Incorrect object location due to refraction, multi-path reflections, side lobes,grating lobes, speed error, or range ambiguity

• Incorrect object size due to poor resolution, refraction, or speed error

• Incorrect object shape due to poor resolution, refraction, or speed error

Acoustic saturation occurs when received signals reach a system’s high-ampli-tude limit. At that point the system becomes unable to distinguish or display signalintensities. At the point of saturation, increased input will not increase output.

Aliasing occurs when the detected Doppler frequency exceeds the Nyquistlimit. It is characterized on the spectral display by the Doppler peaks going off thedisplay, top or bottom, and then continuing on the other side of the baseline. Onthe Color display an immediate change in color from one Nyquist limit to theother is seen.

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Comet tail is a form of reverberation artifact produced when two or morestrong reflectors are close together and have a high propagation speed. In thiscase, sound does not travel directly to a reflector and back to the transducer; anda strong linear echo appears at the reflector and extends deeper than the reflec-tor.

Enhancement is an increased relative amplitude of echoes caused by an inter-vening structure of low attenuation.

Focal enhancement, also known as focal banding, is the increased intensity inthe focal region that appears as a brightening of the echoes on the display.

Mirror imaging artifact is most commonly seen around the diaphragm; this arti-fact results from sound reflecting off another reflector and back.

Mirroring is the appearance of artifacts on a spectral display when there isimproper separation of forward and reverse signal processing channels. Conse-quently, strong signals from one channel mirror into the other.

Multi-path positioning and refraction artifacts describe the situation in whichthe paths to and from a reflector are different. The longer the sound takes travel-ing to or from a reflector, the greater the axial error in reflector positioning(increased range). Refraction and multi-path positioning errors are normally rela-tively small and contribute to general degradation of the image rather than togross errors in object location.

Propagation speed errors occur when the assumed value for propagationspeed by the ultrasound system is incorrect. If the actual speed is greater thanthat assumed, the calculated distance to a reflector is too small, and the reflectorwill be displayed too far from the transducer. Speed error can cause a structure tobe displayed with incorrect size and shape.

Range ambiguity can occur when reflections are received after the next pulseis transmitted. In ultrasound imaging, it is assumed that for each pulse produced,all reflections are received before the next pulse is sent out. The ultrasound sys-tem calculates the distance to a reflector from the echo arrival time assuming thatall echoes were generated by the last emitted pulse. The maximum depth to beimaged unambiguously by the system determines its maximum pulse repetitionfrequency.

Reverberation is the continuing reception of a particular signal because ofreverberation rather than reflection from a particular acoustic interface. This phe-

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nomenon is analogous to the effect created by mirrors positioned on oppositewalls when an object, a head for instance, is placed between the mirrors. Theimage of the head is reflected back and forth infinitely between the two mirrors,creating the optical illusion of multiple heads. Reverberations are easily identifi-able, because they are equally spaced on the display screen.

Scattering is the diffuse, low-amplitude sound waves that occur when acousticenergy reflects off tissue interfaces smaller than a wavelength. In diagnostic ultra-sound, Doppler signals come primarily from acoustic energy back-scattered fromred blood cells.

Shadowing is the reduction in echo amplitude from reflectors that lie behind astrongly reflecting or attenuating structure. This phenomenon occurs when scan-ning a lesion or structure with an attenuation rate higher than that of the sur-rounding tissue. The lesion causes a decrease in beam intensity, which results indecreased echo signals from the structures beyond the lesion. Consequently, adark cloud behind the lesion image forms on the screen. This cloud, or shadow, isuseful as a diagnostic clue.

Side lobes (from single-element transducers) and grating lobes (from arraytransducers) cause objects that are not directly in front of the transducer to bedisplayed incorrectly in lateral position.

Speckle appears as tissue texture close to the transducer but does not corre-spond to scatterers in tissue. It is produced by ultrasound wave interference andresults in general image degradation.

Spectral broadening is a display phenomenon that occurs when the number ofenergy-bearing Fourier frequency components increases at any given point intime. As a consequence, the spectral display is broadened. Spectral broadeningcan indicate the disturbed flow caused by a lesion, and therefore it is importantdiagnostically. However, broadening can also result from interaction between flowand sample volume size, in which case it is an artifact.

Speed of sound artifacts occur if the sound propagation path to a reflector ispartially through bone, and the speed of sound is greater than in the average softtissue. Echo position registration artifacts will be produced. Reflectors appearcloser to the transducer than their actual distance because of this greater speedof sound, resulting in a shorter echo transit time than for paths not containingbone.

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Transducer CoversTransducer covers are recommended for clinical applications of an invasivenature, including intraoperative, transrectal, intravaginal, transesophageal, andbiopsy procedures. Philips Ultrasound recommends the use of qualified covers.See "Ordering Supplies and Accessories" on page 31 to order qualified covers.

For procedures on using transducer covers, refer to the instructions providedwith the covers.

WARNINGS• Some transducer covers contain natural rubber latex and talc, which can

cause allergic reactions in some individuals. Refer to the FDA Medical Alert,March 29, 1991, reprinted here.

• In neurosurgical applications, sterilized transducers should be used with ster-ile gel and a sterile pyrogen-free transducer cover.

• If the sterile transducer cover becomes compromised during an intraopera-tive application involving a patient with Creutzfeldt-Jakob disease, follow therecommendations described in “Transmissible Spongiform Encephalopathy” inthe Getting Started manual.

• Transducer covers are disposable and must not be reused.

• If an installed transducer cover is cut or contaminated prior to use, the probeshould be cleaned and disinfected, and a new sterile cover installed.

FDA Medical Alert, March 29, 1991, Allergic Reactions to Latex-Containing Medical Devices

Because of reports of severe allergic reactions to medical devices containing latex(natural rubber), the FDA is advising health care professionals to identify theirlatex sensitive patients and be prepared to treat allergic reactions promptly.Patient reactions to latex have ranged from contact urticaria to systemic anaphy-laxis. Latex is a component of many medical devices, including surgical and exami-nation gloves, catheters, intubation tubes, anesthesia masks, and dental dams.

Reports to the FDA of allergic reactions to latex-containing medical devices haveincreased lately. One brand of latex cuffed enema tips was recently recalled afterseveral patients died as a result of anaphylactoid reactions during barium enema

14


Transducers

procedures. More reports of latex sensitivity have also been found in the medicalliterature. Repeated exposure to latex both in medical devices and in other con-sumer products may be part of the reason that the prevalence of latex sensitivityappears to be increasing. For example, it has been reported that 6% to 7% of sur-gical personnel and 18% to 40% of spina bifida patients are latex sensitive.

Proteins in the latex itself appear to be the primary source of the allergic reac-tions. Although it is not now known how much protein is likely to cause severereactions, the FDA is working with manufacturers of latex-containing medicaldevices to make protein levels in their products as low as possible.

FDA’s recommendations to health professionals in regard to this problem are asfollows:

• When taking general histories of patients, include questions about latex sensi-tivity. For surgical and radiology patients, spina bifida patients and health careworkers, this recommendation is especially important. Questions about itch-ing, rash or wheezing after wearing latex gloves or inflating a toy balloon maybe useful. Patients with positive histories should have their charts flagged.

• If latex sensitivity is suspected, consider using devices made with alternativematerials, such as plastic. For example, a health professional could wear anon-latex glove over the latex glove if the patient is sensitive. If both thehealth professional and the patient are sensitive, a latex middle glove could beused. (Latex gloves labeled “Hypoallergenic” may not always prevent adversereactions.)

• Whenever latex-containing medical devices are used, especially when thelatex comes in contact with mucous membranes, be alert to the possibility ofan allergic reaction.

• If an allergic reaction does occur and latex is suspected, advise the patient of apossible latex sensitivity and consider an immunologic evaluation.

• Advise the patient to tell health professionals and emergency personnel aboutany known latex sensitivity before undergoing medical procedures. Consideradvising patients with severe latex sensitivity to wear a medical identificationbracelet.

The FDA is asking health professionals to report incidents of adverse reactions tolatex or other materials used in medical devices. (See the October 1990 FDADrug Bulletin.) To report an incident, call the FDA Problem Reporting Program,

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operated through the U.S. Pharmacopoeia toll-free number: 800-638-6725. (InMaryland, call collect 301-881-0256.)

For a single copy of a reference list on latex sensitivity, write to: LATEX, FDA,HFZ-220, Rockville, MD 20857.


15 Biopsy GuidesBiopsy guides are used to assist in the guidance of a biopsy tool. The system gen-erates a guideline that represents the anticipated path of the biopsy tool. The ech-oes of the anatomical target and the tool are displayed on the video display andassist in guiding the biopsy tool to the target.

Starter kits, which include the biopsy guide or biopsy guide bracket and proce-dure kits, are available from CIVCO Medical Instruments; see "Ordering Suppliesand Accessories" on page 31.

Attaching and Removing a Biopsy GuideDetailed information about attachment and removal of biopsy guides is providedwith the biopsy starter kits, guides, and brackets.

WARNINGS• Inspect all components and the transducer. Ensure that the biopsy guide you

are using is the correct one for the transducer, the system, and system soft-ware. Your Philips Ultrasound customer service representative can verify thisinformation for you.

• Use only Philips-approved biopsy guides, brackets, supplies, components, andaccessories. Other brands may not properly fit Philips Ultrasound transduc-ers. Improper installation may result in patient discomfort.

• Some biopsy guides must be installed over a sterile transducer cover. Refer tothe instructions provided with the biopsy guide.

• After each use, biopsy guides must be either sterilized or disposed of,depending upon the type. Refer to the instructions included with the biopsyguide.

• Most transducers can only be disinfected; they cannot be sterilized. Only thetransducer cover provides the sterile barrier.

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Using the Biopsy Guideline Display

WARNINGDo not attempt to use the biopsy guide until you have read the instructions forselecting the display, installing the sterile transducer cover, and verifying alignmentof the biopsy guide.

The system generates a biopsy guideline through the displayed real-time ultra-sound image to indicate the anticipated path of the needle. You can use this guide-line to ensure that the needle or instrument is following the correct path.

When the biopsy display is active, a biopsy guideline is displayed on the left side ofthe screen during normal image presentation and on the right side when theimage presentation is reversed. Image presentation is defined by the location ofthe orientation marker.

When depth is changed, the biopsy display is redrawn to reflect the new relation-ships at the new depth setting.

➤ To show or hide the biopsy guideline

1. Touch Next on the 2D touch screen, and then touch Biopsy. The biopsyguideline is displayed (Figure 15-1).

2. If you are using a biopsy guide with multiple needle paths, touch the control(for example, Angle A, Angle B, and so on) that corresponds to the pathyou will be using.

3. To hide the biopsy guide, touch Biopsy again.

➤ To move the biopsy depth cursor

Rotate the trackball to move the depth cursor along the guideline. The BiopsyDepth measurement value changes to reflect the distance between the biopsyguide reference point origin and the depth cursor.

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Biopsy Guides

Figure 15-1 Biopsy Guideline

Verifying the Biopsy Guide AlignmentPerform the alignment verification before each use of the biopsy guide. The pro-cedure verifies the system, transducer, and biopsy guide relationships.

Biopsy guideline

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WARNINGS• Alignment verification is necessary prior to performing procedures with the

biopsy guide.

• Do not use the biopsy guide if the needle is not following the intended path.

• The needle used for this alignment verification must not be used for the actualprocedure. Always use a new, sterile needle for each biopsy procedure.

• To assist in an accurate projection of the needle, use a straight, new needle foreach alignment procedure.

Do not use the biopsy guide if the needle is not following its indicated path. Con-tact a Philips Ultrasound customer service representative.

The following items are needed for the alignment verification:

• Transducer

• Biopsy guide or bracket (The bracket is not disposable. The type of bracketyou use depends upon the transducer you are using. For the correct bracket,contact CIVCO Medical Instruments; see "Ordering Supplies and Accesso-ries" on page 31.)

• Needle guide (Contact CIVCO for the needle guide that fits your biopsy guidebracket).

• Sterile procedure kit (disposable)

• New, straight, biopsy needle

• Beaker of water (or water bath)

➤ To verify alignment of the biopsy guide

1. Attach the biopsy guide. Although some transducers require the use of a sec-ond transducer cover for biopsy procedures, a second transducer cover isunnecessary for this alignment verification.

2. Connect the transducer to the system, and select the appropriate clinicaloption and preset.

3. Set the system depth for the procedure to be performed.

4. Display the biopsy guideline as described in "Using the Biopsy Guideline Dis-play" on page 326.

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Biopsy Guides

5. Without changing the position of the biopsy depth cursor, note the defaultdepth displayed at the bottom of the screen.

6. Immerse the transducer no more than 6 mm (0.25 in) into the water bath(Figure 15-2).

Figure 15-2 Immersing the transducer

7. Insert a straight, new needle into the biopsy guide.

8. Move the needle down into the water bath until its ultrasound image is visibleon the video display.

WARNINGIf the needle enters from the unexpected side of the display or cannot be seen,verify that the biopsy guide is correctly mounted on the transducer and that theorientation of the transducer is correct. If the needle is still not following theexpected path along the guideline, do not use the biopsy guide. Contact your Phil-ips Ultrasound customer service representative.

9. Verify that the needle, as seen on the video display, falls along the guidelinealong the entire depth of the guideline display. The biopsy guideline is onlyintended to provide an indication of the expected path of the needle. Actualposition must be verified by identifying the echoes from the needle.

Sterile transducer cover

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10. Remove the needle from the biopsy guide.

11. From the tip of the needle, measure a distance equal to the Biopsy Depthvalue noted in step 5. Mark this point on the needle.

12. Immerse the transducer no more than 6 mm (0.25 in) into the water bath.

13. Insert the needle into a guide channel that corresponds to the size of the nee-dle and the angle you selected. Continue sliding the needle in until the markon the needle aligns with the origin on the biopsy guide (Figure 15-3). (Theorigin is the point at which the needle enters the biopsy guide.)

14. Move the biopsy depth cursor to the tip of the needle, as seen on the display,and verify that the displayed depth is within 0.40 cm of the value noted instep 5.

15. Confirm that the needle is visible along its expected path. If so, then thebiopsy guide is properly aligned.

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Biopsy Guides

Figure 15-3 Biopsy Guide Depth and Distance Relationships Example:C9-5ec Transducer and Biopsy Guide

Location of depth cursor (The needle would intersect the

depth cursor at this point.)

Depth cursor Biopsy depth (13.7 cm)

Origin

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Biopsy Procedure

WARNINGS• Alignment verification should be performed at the selected depth prior to the

biopsy procedure to ensure that the biopsy guide and the needle have beeninstalled properly.

• Use a straight, new needle for each procedure.

• The biopsy guideline is intended only to provide an indication of the expectedpath of the needle. Actual position must be verified by identifying the echoesfrom the needle.

• If the needle is not following the expected path, discontinue the procedureand contact your Philips Ultrasound customer service representative.

• Thin needles can bend when entering tissue. Actual position must be verifiedby identifying the echoes from the needle.

• Reverberation or other tissue artifacts may produce false needle images,which can cause confusion in locating the actual needle image. Ensure the nee-dle path is along the guideline, and that you are not using a false needle imageto locate the needle.

• Philips Ultrasound does not recommend anatomical survey of the prostatewith the biopsy guide attached.

➤ To perform a biopsy procedure with the biopsy display

1. Install the transducer cover and the biopsy guide according to the instructionsprovided with the biopsy guide.

2. Set the system imaging controls for the biopsy procedure.

3. Touch Next on the 2D touch screen, and then touch Biopsy.

4. If you are using a biopsy guide with multiple needle paths, touch the controlthat corresponds to the path you will be using (Angle A, Angle B, and soon).

5. Orient the transducer to match image presentation. Use the 2D scan planeorientation marker.

6. If necessary, apply sterile acoustic coupling gel to the patient.

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Biopsy Guides

7. Begin scanning the patient. Position the transducer so that the puncture targetis intersected by the guideline displayed on the screen.


– For guides with a single angle, insert the needle into the needle guidegroove closest to the transducer.

– For guides with multiple angles, insert the needle into the needle guidegroove that corresponds to the angle you selected in step 4.

9. Perform the puncture by sliding the needle through the groove in the guideuntil the needle, as shown on the display, intercepts the target.

10. If you are using a biopsy guide bracket and procedure kit, you can remove thetransducer from the patient while the needle is still inserted in the patient:Separate the needle from the biopsy guide by pulling the tab up so that the pinsnaps out of the needle guide (Figure 15-4).

11. Remove the biopsy guide after use, as described in the instructions includedwith the biopsy guide or bracket.

Figure 15-4 Releasing the Needle Example

Biopsy Guide MaintenanceObserve the following warning and cautions when maintaining biopsy guides.

WARNINGThe procedure kit components are disposable and must not be reused.

Turn to unlock

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Refer to the instructions provided with the biopsy guide for procedures on clean-ing, disinfecting, and sterilizing the biopsy guide.


16 Disinfectants and GelsThis section contains information on cleaning, disinfecting, and sterilizing trans-ducers compatible with your system, as well as cleaning and disinfecting systemsurfaces. This section also lists the ultrasound gels that are safe to use with thetransducers compatible with your system.

These instructions are intended to assist in effective cleaning, disinfection, andsterilization. In addition, these instructions will help avoid damage—which couldvoid your warranty—during cleaning, disinfection, sterilization, and gel use.

For More InformationFor additional information on disinfectants and gels used with Philips Ultrasoundproducts, call Philips Ultrasound Customer Service at 800-433-3246 (NorthAmerica), or call your local Philips Ultrasound representative (outside NorthAmerica).

Ordering Disinfectants and GelsDisinfectants and gels are available from CIVCO Medical Instruments:

CIVCO Medical Instruments102 First St. SouthKalona, IA 52247-9589

SafetyPlease observe the following warnings and cautions when using disinfectants andgels. More specific warnings and cautions are included within the various proce-dures in this section and on the labels of the cleaning or disinfection solutions.

Telephone: 800-445-6741, Ext. 1 for Customer Service (USA)+1 319-656-4447 (International)

Fax: 877-329-2482 (USA)+1 319-656-4451 (International)

E-mail: [email protected]: www.civco.com

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WARNINGS• Disinfectants listed in “Disinfectants Compatibility” are recommended

because of their chemical compatibility with product materials, not their biolog-ical effectiveness. For the biological effectiveness of a disinfectant, refer to theguidelines and recommendations of the disinfectant manufacturer, Associationfor Practitioners in Infection Control, U.S. Food and Drug Administration, andU.S. Centers for Disease Control.

• The level of disinfection required for a device is dictated by the type of tissueit will contact during use. Ensure the disinfectant type is appropriate for thetype of transducer and the transducer application. For information, see thedisinfectant label instructions and the recommendations of the Association forPractitioners in Infection Control, U.S. Food and Drug Administration, andU.S. Centers for Disease Control.

• The use of sterile transducer covers and sterile coupling gel is recommendedfor clinical applications where introduction into a sterile site is possible. Donot apply the transducer cover and gel until you are ready to perform the pro-cedure. Repeated long-term exposure to coupling gel can damage transduc-ers.

• Use of a transducer cover is recommended but not required on transesoph-ageal and intracavity exams.

• In neurosurgical applications, sterilized transducers should be used with ster-ile gel and a sterile pyrogen-free transducer cover.

• Transducer covers can contain natural rubber latex, which may cause allergicreactions in some individuals. Refer to the following FDA Medical Alert onLatex Products.

Latex

FDA Medical Alert, March 29, 1991, Allergic Reactions to Latex-Containing Medical Devices

Because of reports of severe allergic reactions to medical devices containing latex(natural rubber), the FDA is advising health care professionals to identify theirlatex sensitive patients and be prepared to treat allergic reactions promptly.Patient reactions to latex have ranged from contact urticaria to systemic anaphy-

16



laxis. Latex is a component of many medical devices, including surgical and exami-nation gloves, catheters, intubation tubes, anesthesia masks, and dental dams.

Reports to the FDA of allergic reactions to latex-containing medical devices haveincreased lately. One brand of latex cuffed enema tips was recently recalled afterseveral patients died as a result of anaphylactoid reactions during barium enemaprocedures. More reports of latex sensitivity have also been found in the medicalliterature. Repeated exposure to latex both in medical devices and in other con-sumer products may be part of the reason that the prevalence of latex sensitivityappears to be increasing. For example, it has been reported that 6% to 7% of sur-gical personnel and 18% to 40% of spina bifida patients are latex sensitive.

Proteins in the latex itself appear to be the primary source of the allergic reac-tions. Although it is not now known how much protein is likely to cause severereactions, the FDA is working with manufacturers of latex-containing medicaldevices to make protein levels in their products as low as possible.

FDA’s recommendations to health professionals in regard to this problem are asfollows:

• When taking general histories of patients, include questions about latex sensi-tivity. For surgical and radiology patients, spina bifida patients and health careworkers, this recommendation is especially important. Questions about itch-ing, rash or wheezing after wearing latex gloves or inflating a toy balloon maybe useful. Patients with positive histories should have their charts flagged.

• If latex sensitivity is suspected, consider using devices made with alternativematerials, such as plastic. For example, a health professional could wear anon-latex glove over the latex glove if the patient is sensitive. If both thehealth professional and the patient are sensitive, a latex middle glove could beused. (Latex gloves labeled “Hypoallergenic” may not always prevent adversereactions.)

• Whenever latex-containing medical devices are used, especially when thelatex comes in contact with mucous membranes, be alert to the possibility ofan allergic reaction.

• If an allergic reaction does occur and latex is suspected, advise the patient of apossible latex sensitivity and consider an immunologic evaluation.

• Advise the patient to tell health professionals and emergency personnel aboutany known latex sensitivity before undergoing medical procedures. Consider



16

338

advising patients with severe latex sensitivity to wear a medical identificationbracelet.

The FDA is asking health professionals to report incidents of adverse reactions tolatex or other materials used in medical devices. (See the October 1990 FDADrug Bulletin.) To report an incident, call the FDA Problem Reporting Program,operated through the U.S. Pharmacopeia toll-free number: 800-638-6725. (InMaryland, call collect 301-881-0256.)

For a single copy of a reference list on latex sensitivity, write to: LATEX, FDA,HFZ-220, Rockville, MD 20857.

Transmissible Spongiform Encephalopathy

WARNINGIf the sterile transducer cover becomes compromised during an intraoperativeapplication involving a patient with Transmissible Spongiform Encephalopathy, suchas Creutzfeldt-Jakob disease, follow the guidelines for decontamination found inthis document from the World Health Organization: WHO/CDS/CSR/APH/2000.3, WHO Infection Control Guidelines for Transmissible Spongiform Encephalopa-thies. The transducers for your system cannot be decontaminated using a heatprocess. For such transducers, the WHO document recommends a thoroughcleaning of the transducer followed by a cold soak disinfection using a compatiblegluteraldehyde disinfectant solution.

DecontaminationDecontamination includes these steps:

1. Cleaning

2. Disinfection

3. Sterilization (if recommended)

The procedures in this section cover the above steps for the following items:

• Transducers

• Cables and connectors

• System surfaces

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NOTEBefore performing these procedures, see Table 16-2. From this table, you canchoose a chemically compatible disinfectant and find the figure that shows how farto immerse, or where to wipe, your device.

Disinfecting TransducersTo disinfect transducers, you can use either an immersion method or a wipemethod with a disinfectant recommended by Philips Ultrasound. Use the methodthat is biologically appropriate.

NOTETransducers can be disinfected using the wipe method only if the product labelingof the compatible disinfectant you are using indicates it can be used with a wipemethod.

WARNINGAlways use protective eyewear and gloves when cleaning and disinfecting anyequipment.

CAUTIONS• Transducers must be cleaned after each use. Cleaning the transducer is an

essential step prior to effective disinfection or sterilization. Be sure to followthe manufacturer’s instructions when using disinfectants.

• Do not allow sharp objects, such as scalpels or cauterizing knives, to touchtransducers or cables.

• When handling a transducer, do not bump the transducer on hard surfaces.

➤ To clean and disinfect transducers using an immersion method

1. Disconnect the transducer from the system.

2. Remove any transducer covers, biopsy guides, or tip guards.



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Cleaning

CAUTIONS• Do not use a surgeon’s brush when cleaning transducers. The use of even soft

brushes can damage the transducer.

• During cleaning, disinfection, and sterilization, orient the parts of the trans-ducer that must remain dry higher than the wetted parts until all parts aredry. This will help keep liquid from entering non-liquid-tight areas of the trans-ducer.

3. Use a soft cloth lightly dampened in a mild soap or compatible cleaning solu-tion, or an approved enzymatic cleaner, to remove any particulate matter orbody fluids that remain on the transducer or cable.

4. To remove remaining particulates, rinse with water up to the immersion point(Figure 16-1).

5. Wipe with a dry cloth; or wipe with a water-dampened cloth to remove soapresidue, then wipe with a dry cloth.

Disinfection

WARNINGS• Be sure to observe the expiration date of the sterilization solution.

• The level of disinfection required for a device is dictated by the type of tissueit will contact during use. Ensure the solution strength and duration of contactare appropriate for the intended clinical use of the transducer. For informa-tion, see the disinfectant label instructions and the recommendations of theAssociation for Practitioners in Infection Control, U.S. Food and Drug Admin-istration, and U.S. Centers for Disease Control.

16



CAUTIONS• Using non-recommended disinfectants, incorrect solution strengths, or

immersing a transducer deeper or for a longer contact time can damage ordiscolor the transducer and will void the transducer warranty.

• Do not immerse transducers longer than one hour, unless they are steriliz-able. Transducers may be damaged by longer immersion times.

• If you use an isopropyl alcohol solution for disinfection, ensure the solution isonly 70% alcohol or less. Solutions of more than 70% alcohol can cause prod-uct damage.

6. Mix the disinfection solution compatible with your transducer (seeTable 16-2) according to label instructions for solution strength. A disinfectanton Table 16-2 with the footnote “FDA 510(k) qualified” is recommended.

7. Immerse the transducer into the disinfectant as shown in the appropriate fig-ure for your transducer (Figure 16-1).

8. Follow the instructions on the disinfectant label for the duration of transducerimmersion. Do not immerse transducers longer than one hour, unless theyare sterilizable.

9. Using the instructions on the disinfectant label, rinse the transducer up to thepoint of immersion, then air dry or towel dry with a clean cloth.

10. Examine the transducer for damage, such as cracks, splitting, fluid leaks, orsharp edges or projections. If damage is evident, discontinue use of the trans-ducer and contact your Philips Ultrasound representative.



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Figure 16-1 Disinfecting Transducers (C8-5 Example)

Sterilizing TransducersThe transducers available for your system can be sterilized in an appropriate glut-araldehyde solution using a cold soak method. Sterilize transducers only as neces-sary for their clinical applications.

A 10-6 reduction in pathogens should be reached by following the sterilizationprocedures in this section and using Cidex solution.

Do not immerse above this point.

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WARNINGS• Always use protective eyewear and gloves when cleaning, disinfecting, or ster-

ilizing any equipment.

• In neurosurgical applications, sterilized transducers should be used with apyrogen-free transducer cover.

CAUTIONS• Transducers must be cleaned after each use. Cleaning the transducer is an

essential step prior to effective disinfection or sterilization. Be sure to followthe manufacturer’s instructions when using disinfectants.

• Sterilize transducers using only liquid solutions. Using autoclave, gas (EtO), orother methods not approved by Philips Ultrasound will damage your trans-ducer and void your warranty.

• Do not allow sharp objects, such as scalpels and cauterizing knives, to touchtransducers or cables.

• When handling a transducer, do not bump the transducer on hard surfaces.

➤ To clean and sterilize transducers

1. Disconnect the transducer from the system.

2. Remove any transducer covers or biopsy guides. Discard the covers.

Cleaning

CAUTIONS• Do not use a surgeon’s brush when cleaning transducers. The use of even soft

brushes can damage the transducer.

• During cleaning, disinfection, and sterilization, orient the transducer connec-tor higher than the wetted parts until all parts are dry. This will help keep liq-uid from entering non-liquid-tight areas of the connector.

3. Use a soft cloth lightly dampened in a mild soap or compatible cleaning solu-tion, or an approved enzymatic cleaner, to remove any particulate matter orbody fluids that remain on the transducer or cable.



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4. To remove remaining particulates, rinse with water up to the immersion point(Figure 16-2).

5. Wipe with a dry cloth; or wipe with a water-dampened cloth to remove soapresidue, then wipe with a dry cloth.

Sterilization

WARNINGBe sure to observe the expiration date of the sterilization solution.

CAUTIONEnsure the solution strength and duration of contact are appropriate for sterilization. Be sure to follow the manufacturer’s instructions.

6. Mix the sterilization solution compatible with your transducer (seeTable 16-2) according to label instructions for solution strength. A disinfectantin Table 16-2 with the footnote “FDA 510(k) qualified” is recommended.

7. Immerse the transducer in the sterilization solution as shown in Figure 16-2.

8. Follow the instructions on the sterilization label for the duration of trans-ducer immersion required for sterilization.

9. Remove the transducer from the sterilization solution after the recommendedsterilization time has elapsed.

10. Using the instructions on the sterilization label, rinse the transducer in sterilewater up to the point of immersion, then air dry or towel dry with a sterilecloth.

11. Examine the transducer for damage, such as cracks, splitting, fluid leaks, orsharp edges or projections. If damage is evident, discontinue use of the trans-ducer, and contact your Philips Ultrasound representative.

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Figure 16-2 Immersing Sterilizable Transducers (C8-5 Example)

Disinfecting Cables and ConnectorsThe cables and connectors of all transducers can be disinfected using a recom-mended wipe or spray disinfectant. To protect the electronics in the connector,Philips advises use of a Philips Connector Seal when you disinfect near the con-nector. Kits are available from CIVCO Medical Instruments (see "Ordering Disin-fectants and Gels" on page 335).


Do not immerse above this point.



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CAUTIONS• Attempting to disinfect a connector using a method other than the one

included here can damage the device and will void the warranty.

• Do not allow sharp objects, such as scalpels and cauterizing knives, to touchcables.

➤ To clean and disinfect cables and connectors

1. Disconnect the device from the system.

2. Orient the connector so that the cable exits up from the top.

CAUTIONS• Do not allow any type of fluid to enter the connector. Fluid in the connector

may void the transducer or device warranty.

• Do not use a brush on the connector label.

Cleaning

3. Use a soft cloth lightly dampened in a mild soap or detergent solution to cleanthe cable and the connector. A soft-bristled brush may be used to clean onlythe metal surfaces of the connector. Do not allow any type of fluid to enterthe connector through the electrical contacts.

Disinfection

WARNINGBe sure to observe the expiration date of the sterilization solution.

CAUTIONS• The use of 70% isopropyl alcohol (rubbing alcohol) is restricted. Wipe only

the distal tip of the transducer up to 1 inch (2.5 cm) from the strain relief/housing joint with an isopropyl alcohol solution. Do not wipe the strain relief/housing joint, the strain relief, or the cable with isopropyl alcohol. Isopropylalcohol can cause damage to these parts of the transducer. This damage is notcovered by the warranty or your service contract.

• Avoid disinfectant contact with the connector label.

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4. Mix the disinfection solution compatible with the cable (see Table 16-2)according to label instructions for solution strength. For the connector, use asolution compatible with system surfaces (see the list on page 347).

CAUTIONDo not spray disinfectant directly on the connector. Doing so may cause disinfec-tant to leak into the connector, damaging it and voiding the warranty.

5. Wipe the cable and connector with the disinfectant, following disinfectantlabel instructions for wipe durations, solution strengths, and duration of disin-fectant contact with the cable. Ensure that the solution strength and durationof contact are appropriate for the intended clinical use of the device. Ensurethat the disinfectant solution does not enter the device or connector or comeinto contact with the connector label.

6. Air dry or towel dry with a sterile cloth according to the instructions on thedisinfectant label.

7. Examine the device and cable for damage such as cracks, splitting, sharp edgesor projections. If damage is evident, discontinue use of the device and contactyour Philips Ultrasound representative.

Disinfecting System SurfacesThe exterior surfaces of the system can be disinfected using a recommended dis-infectant with a wipe method. The following products are approved for use on thesystem:

• Mild Soap Solution

• 70% Isopropyl alcohol (IPA)

• Sporicidin Spray

• Theracide Plus

• Sani-Cloth (all)

Use the following procedure to disinfect system surfaces.




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CAUTIONS• Use only recommended disinfectants on system surfaces. Immersion-type

disinfectants are not tested for use on system surfaces.

• If you use an isopropyl alcohol solution for disinfection, ensure the solution isonly 70% alcohol or less. Solutions of more than 70% alcohol can cause prod-uct damage.

➤ To clean and disinfect system surfaces

1. Turn off the system and disconnect the system power cord from the wall out-let.

Cleaning

2. Use a soft cloth lightly dampened in a mild soap or detergent solution to cleanexterior surfaces on the system.

Disinfection

3. Mix the disinfection solution compatible with your system (see the list onpage 347) according to label instructions for solution strength.

CAUTIONDo not spray disinfectant directly on system surfaces. Doing so may cause disin-fectant to leak into the system, damaging the system and voiding the warranty.

4. Wipe system surfaces with the disinfectant, following disinfectant labelinstructions for wipe durations, solution strengths, and disinfectant contactduration. Ensure the solution strength and duration of contact are appropriatefor the intended clinical application.

5. Air dry or towel dry with a sterile cloth according to the instructions on thedisinfectant label.

Disinfectants CompatibilityRefer to this information before performing disinfection and sterilization proce-dures. It discusses recommended disinfectants and choosing an appropriate disin-fectant for the required level of disinfection. It also includes a table (Table 16-2)listing the chemical compatibility of various disinfectants and cleaners with specific

16



transducers. In addition, the table refers to figures that show you how far toimmerse, or where to wipe, a specific device.

WARNINGS• Not all disinfectants are effective against all types of contamination. Ensure the

disinfectant type is appropriate for the type of transducer and that the solu-tion strength and time of contact are appropriate for the intended clinical use.

• The use of a transducer cover cleared by the FDA is recommended for allinvasive applications. Install a sterile transducer cover as described in theoperating instructions that accompany each transducer or the system userinformation.

• Disinfectants listed in this section are recommended because of their chemicalcompatibility with product materials, not their biological effectiveness. For thebiological effectiveness of a disinfectant, refer to the guidelines and recom-mendations of the disinfectant manufacturer, FDA, Association for Practitio-ners in Infection Control, U.S. Food and Drug Administration, and U.S.Centers for Disease Control.

• Be sure to observe the expiration date of the sterilization solution.

• Always use protective eyewear and gloves when cleaning and disinfecting anyequipment.

CAUTIONUsing a non-recommended disinfection solution, incorrect solution strength, orimmersing a transducer deeper or longer than recommended can damage thedevice and will void the warranty.

Disinfectant Types

WARNINGThe level of disinfection required for a device is dictated by the type of tissue itwill contact during use. Ensure the disinfectant type is appropriate for the type oftransducer and the transducer application. For more information, see the disinfec-tant label instructions and the recommendations of the Association for Practitio-ners in Infection Control, U.S. Food and Drug Administration, and U.S. Centersfor Disease Control.



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350

CAUTIONIf you use an isopropyl alcohol solution for disinfection, ensure the solution is only70% alcohol or less. Solutions of more than 70% alcohol can cause product dam-age.

Some disinfectants are recommended because of both their biological effective-ness (as qualified through the FDA 510(k) process) and their chemical compatibil-ity with Philips Ultrasound product materials. Other disinfectants arerecommended because of compatibility with Philips Ultrasound product materialsonly and not biological effectiveness.

Refer to "Choosing a Disinfectant" on page 350 and "Factors Affecting Disinfec-tant Efficiency" on page 351 for standard industry recommendations on disinfec-tion and information that can help you choose an appropriate disinfectant for therequired level of disinfection.

Choosing a DisinfectantTo choose an appropriate disinfectant, you first must determine the required levelof disinfection, based on the device classification (Table 16-1).

Use the following two Web sites to view lists of common active ingredients rec-ommended to achieve each level of disinfection:

• http://www.fda.gov/cdrh/ode/germlab.html

• http://www.cdc.gov/ncidod/hip/Sterile/sterile.htm

Also, low- and intermediate-level disinfectants marketed for use on medicalinstruments and based on quaternary ammonium compounds (QUATS) orsodium hypochlorite (NaOCl), equal to or less than 0.6%, are approved for use. In

Table 16-1 Levels of Disinfection Requirements

Classification Definition Level of Disinfection

Critical Device enters otherwise sterile tissue (intraoperative applications)

Sterilization

Semi-critical Device contacts mucous membranes (intracavity applications)

High (tuberculocidal)

Noncritical Device contacts intact skin Intermediate or low

16



addition, 70% isopropyl alcohol (IPA) and household bleach at a concentration of10% or less is also acceptable for use. All products must be used in a spray orwipe application.

Factors Affecting Disinfectant EfficiencyThe following factors will affect the efficiency of a disinfectant solution:

• Duration of exposure

• Concentration and potency of the disinfectant

• Quantity and location of the contamination

• Resistance of the contaminate

• Organic matter on the item to be disinfected

Disinfectants ManufacturersFor contact information on disinfectants and gels manufacturers, call Philips Ultra-sound Customer Service at 800-433-3246 (North America) or your local PhilipsUltrasound representative (outside North America).

Disinfectants Compatibility TableTable 16-2 lists the disinfectants compatible with the transducer available for yoursystem. If you need additional assistance, call Philips Ultrasound Customer Ser-vice at 800-433-3246 (North America) or your local Philips Ultrasound represen-tative (outside North America).



16

352

Tabl

e 16

-2 D

isin

fect

ants

Co

mpa

tibi

lity

So

luti

on

Countryof Origin

Qua

lifie

d U

seA

ctiv

e In

gred

ient

3D9-

3v

3D6-

2C

5-2

C8-

4vC

8-5

C9-

4C

9-5e

cL

8-4

L12

-5L

17-5

S3-

1S

4-1

70%

Isop

ropy

l A

lcoh

olA

llSp

ray/

Wip

eA

lcoh

olT

TT

TT

TT

TT

TT

T

Abc

oCid

eU

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Abc

oCid

e 28

USA

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Aid

alA

usSo

ak (

1)G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Aid

al P

lus

Aus

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Alk

aspr

ayF

Spra

y/W

ipe

Alc

ohol

, A

lkyl

amin

eT

TT

TT

TT

TT

TT

T

Am

phol

ysin

e Ba

siqu

eF

Spra

y/W

ipe

Bigu

anid

e/Q

uat.

Am

mon

iaT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CN

T,C

Bani

cide

USA

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Blea

ch 5

.25%

(10

%

Solu

tion)

USA

Spra

y/W

ipe

Sodi

um

Hyp

ochl

orite

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Cid

ex 1

USA

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Cid

ex 7

1U

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Cid

ex O

PA 1

USA

Soak

2O

rtho

-ph

thal

alde

hyde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

NT,

C

Cid

ex P

AE

14J

FSo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Cid

ex P

lus

1U

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Des

cont

on E

xtra

DSo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Dis

patc

hU

SASp

ray/

Wip

eSo

dium

H

ypoc

hlor

iteT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

C =

App

rove

d fo

r us

e on

the

cab

leN

= N

ot a

ppro

ved

for

use

T =

App

rove

d fo

r us

e on

the

tra

nsdu

cer

1 =

FD

A 5

10(k

) cl

eare

d2

= S

oak

or p

er p

rodu

ct in

stru

ctio

nsA

US

= A

ustr

alia

D =

Ger

man

yF

= F

ranc

eU

SA =

Uni

ted

Stat

es o

f A

mer

ica

16Disinfectants and Gels


Endo

FC

FSo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Endo

spor

ine

FSo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Enzo

lU

SAPr

e-cl

eane

rEn

zym

esT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Epiz

yme

Rap

idA

usPr

e-cl

eane

rEn

zym

esT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Gig

asep

t FF

DSo

ak 2

Succ

indi

alde

hyde

di

met

hoxy

te

trah

ydro

fura

n

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

NT,

C

Glu

taci

de P

lus

USA

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Inci

din

DSp

ray/

Wip

eA

lcoh

olT

TT

TT

TT

TT

TT

T

Inci

dur

Spra

yD

Spra

y/W

ipe

Alc

ohol

Qua

t, A

ldeh

yde

TT

TT

TT

TT

TT

TT

Inst

ruzy

me

FPr

e-cl

eane

rEn

zym

es, Q

uat.

Am

mon

ia,

Bigu

anid

e

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T.C

T,C

NT,

C

Kle

nzym

eU

SAPr

e-cl

eane

rEn

zym

esT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Koh

rsol

inD

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Kor

sole

x PA

EF

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Max

iCid

e Pl

usU

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Met

riC

ide

1U

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Met

riC

ide

28 1

USA

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Met

rici

de

Plus

30

1U

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Tabl

e 16

-2 D

isin

fect

ants

Co

mpa

tibi

lity

(Co

ntin

ued)

So

luti

on

Countryof Origin

Qua

lifie

d U

seA

ctiv

e In

gred

ient

3D9-

3v

3D6-

2C

5-2

C8-

4vC

8-5

C9-

4C

9-5e

cL

8-4

L12

-5L

17-5

S3-

1S

4-1

C =

App

rove

d fo

r us

e on

the

cab

leN

= N

ot a

ppro

ved

for

use

T =

App

rove

d fo

r us

e on

the

tra

nsdu

cer

1 =

FD

A 5

10(k

) cl

eare

d2

= S

oak

or p

er p

rodu

ct in

stru

ctio

nsA

US

= A

ustr

alia

D =

Ger

man

yF

= F

ranc

eU

SA =

Uni

ted

Stat

es o

f A

mer

ica



16

354

Met

riZ

yme

USA

Pre-

clea

ner

Enzy

mes

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Mild

Soa

p So

lutio

nA

llPr

e-cl

eane

rSu

rfac

tant

s /

Soap

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Milt

onA

usSp

ray/

Wip

eSo

dium

H

ypoc

hlor

iteT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Om

nici

de 1

4NS

USA

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Om

nici

de 2

8U

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Perf

ekta

n En

doD

Spra

y/W

ipe

Qua

t. A

mm

onia

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

NT,

C

Phag

ocid

e D

FSo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Phag

ozym

e N

DF

Pre-

clea

ner

Enzy

mes

, Q

uate

rnar

y A

mm

oniu

m

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

NT,

C

Pro-

Cid

eU

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Pro-

Cid

e 14

NS

1U

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Pro-

Cid

e 28

USA

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Pro-

Cid

e N

SU

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Pro-

Cid

e Pl

usU

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

PSS

Sele

ct 1

4 D

ayU

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

PSS

Sele

ct 2

8 D

ayU

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

PSS

Sele

ct P

lus

USA

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Riv

asco

pF

Spra

y/W

ipe

Qua

t. A

mm

onia

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

NT,

C

Tabl

e 16

-2 D

isin

fect

ants

Co

mpa

tibi

lity

(Co

ntin

ued)

So

luti

on

Countryof Origin

Qua

lifie

d U

seA

ctiv

e In

gred

ient

3D9-

3v

3D6-

2C

5-2

C8-

4vC

8-5

C9-

4C

9-5e

cL

8-4

L12

-5L

17-5

S3-

1S

4-1

C =

App

rove

d fo

r us

e on

the

cab

leN

= N

ot a

ppro

ved

for

use

T =

App

rove

d fo

r us

e on

the

tra

nsdu

cer

1 =

FD

A 5

10(k

) cl

eare

d2

= S

oak

or p

er p

rodu

ct in

stru

ctio

nsA

US

= A

ustr

alia

D =

Ger

man

yF

= F

ranc

eU

SA =

Uni

ted

Stat

es o

f A

mer

ica

16Disinfectants and Gels


Salv

anio

s pH

10

FSp

ray/

Wip

eQ

uat.

Am

mon

iaT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CN

T,C

Sani

-Clo

th (

all)

USA

Wip

eA

lcoh

ol, Q

uat.

Am

mon

iaT

TT

TT

TT

TT

TT

T

SDS

14 N

SU

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

SDS

28U

SASo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

Seku

cid

NF

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Seku

sept

Plu

sD

Soak

2G

luco

prot

amin

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

NT,

C

Ster

anio

s 2%

FSo

ak 2

Glu

tara

ldeh

yde

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

T,C

The

raci

de P

lus

USA

Spra

y/W

ipe

Alc

ohol

, Qua

t. A

mm

onia

TT

TT

TT

TT

TT

TT

T-Sp

ray

USA

Spra

y/W

ipe

Qua

t. A

mm

onia

T,C

NT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

T-Sp

ray

IIU

SASp

ray/

Wip

eQ

uat.

Am

mon

iaT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Vapo

sept

olF

Spra

y/W

ipe

Alc

ohol

, Bi

guan

ide

TT

TT

TT

TT

TT

TT

Vesp

ore

USA

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Wav

icid

e -0

1 1

USA

Soak

2G

luta

rald

ehyd

eT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

CT,

C

Tabl

e 16

-2 D

isin

fect

ants

Co

mpa

tibi

lity

(Co

ntin

ued)

So

luti

on

Countryof Origin

Qua

lifie

d U

seA

ctiv

e In

gred

ient

3D9-

3v

3D6-

2C

5-2

C8-

4vC

8-5

C9-

4C

9-5e

cL

8-4

L12

-5L

17-5

S3-

1S

4-1

C =

App

rove

d fo

r us

e on

the

cab

leN

= N

ot a

ppro

ved

for

use

T =

App

rove

d fo

r us

e on

the

tra

nsdu

cer

1 =

FD

A 5

10(k

) cl

eare

d2

= S

oak

or p

er p

rodu

ct in

stru

ctio

nsA

US

= A

ustr

alia

D =

Ger

man

yF

= F

ranc

eU

SA =

Uni

ted

Stat

es o

f A

mer

ica



16

356

Gels CompatibilityAlthough most gels will provide suitable acoustic coupling, some gels are incom-patible with certain transducer materials. Products that do not contain mineral oilare acceptable for use. Never use lotion based products.

WARNINGFor intraoperative applications, use only the Sterile Aquasonic or Sterile Ultra-phonic gel provided with the transducer cover.

CAUTIONS• Do not use gels that contain mineral oil or lotion. Such products may damage

the transducer and void the warranty.

• Gels listed in this section are recommended because of their chemical com-patibility with product materials.

Some recommended gels include:

• Aquasonic 100

• Aquasonic Clear

• Carbogel-ULT

• ECG Gel (Nicom)

• Nemidon Gel

• Scan

• Ultraphonic

For additional compatibility information, call Philips Ultrasound Customer Serviceat 800-433-3246 (North America) or your local Philips Ultrasound representative(outside North America).


17 Printing and RecordingYou can print to a local printer or to printers on a network. The system allowsyou to configure print controls and printers. With an optional VCR, you can alsorecord live imaging and play back the recording on the system or on anotherVCR.

PrintingYou can print single-frame images and reports to a local printer, usually inside thesystem, or to DICOM printers on a network. The printer can be a color printer,black-and-white printer, or a report printer.

Three print controls are available for printing images, Print, Alt Print, and PrintScreen. In the setups, you can assign Print and Alt Print to one or more print-ers in the setups. In addition, you can select whether these two print controlsprint the entire screen or just the image area. Report printing is also assigned toone or more printers.

Printing in Live ImagingYou can print live or frozen images during an exam.

➤ To print images

1. Acquire the desired image.


– Press Print on the system control panel.

– Touch Print Screen or Alt Print on the touch screen.

– Press PRINT on a printer.

Printing Stored Images to a Local PrinterFrom the Review Exam display, you can print stored single-frame images, one ata time, in full-screen format.

Printing and Recording


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➤ To print stored images to a local printer

1. Press Review, and if necessary, click Patient Directory.

2. Select an exam and click Display Exams.

3. In the Review Exam display, double-click an image to display it in full-screenformat.


– For an image from the current exam only, press Print to print it on a localprinter and save a copy of it on the hard drive under the current exam.

– For an image from any exam, touch Alt Print to print the image on alocal printer without saving a copy on the hard drive.

– To print an image from any exam to multiple printers, click Send To,select the devices you want to print to, and click OK.

5. To print additional images, repeat step 3 and step 4.

Printing Stored Images to a DICOM PrinterIn the Review Exam display, you can send single-frame images from the systemto DICOM-compatible printers and servers on a network.

➤ To print images


2. Select an exam and click Display Exams.

3. In the Review Exam display, select one or more images.

4. Click Send To.

5. In the Send To dialog box, select a DICOM printer.

6. Click OK to print the selected images.

Printing Exams to a DICOM PrinterFrom the Patient Directory, you can send exams to a DICOM-compatible printer.

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➤ To print exams to a DICOM printer


2. In the Patient Directory display, select the exams you want to print.

3. Click Send To.

4. In the Send To dialog box, select a DICOM printer.

5. Click OK to print the selected exams.

Printing ReportsPatient reports can be printed either directly from the report display or by send-ing the entire report to a report printer. To print reports, see "Printing PatientReports" on page 257.

Changing Printer SettingsIn the setups, you can associate a set of printers with each of the print controls.You cannot print to a printer unless it has been selected. A maximum of twoDICOM printers, two local printers, and one report printer can be selectedamong the three lists. Print can print to local and network printers; Alt Printcan print only to local printers. You can also change other printing parameters.

To change settings for printers and print controls, see "Configuring Print Func-tions" on page 80.

Using Printing Touch Screen ControlsTo use a touch screen control or change its setting, touch it, or if it is in the bot-tom row, turn the knob directly below it.


Alt Print

Print Screen



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RecordingYou can record live imaging to a local VCR and simultaneously record comments.The microphone must be turned on before you can record comments. The inter-nal VCR records and plays back standard S-VHS videocassettes. You can play backrecordings on the system or on other VCRs.

Using the VCR

NOTETurn off the VCR before suspending the system or turning the system off.

➤ To record and play back with the VCR

• To record or play a recording, press VCR on the system control panel anduse any of the following controls on either the VCR touch screen or theVCR:

– Play to play back the video at normal speed

– Stop to stop the playback

– Record to start recording

– Pause to temporarily stop tape movement

– Rewind to rewind the videotape

– Fast Forward to advance the videotape

– Eject to stop the current tape mode and eject the videocassette

• To search for a location on the tape, touch Search/Set Counter, type anumber in the format shown in the Search/Set Counter dialog box, andclick Search Tape.

• To set the playback counter, touch Search/Set Counter, type a number inthe format shown in the Search/Set Counter dialog box, and click SetCounter.

• To turn on or off the microphone, press the Mic key. The microphone is on

when appears in the icon list on the bottom of the display.

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Using Recording Touch Screen ControlsTo use a touch screen control or change its setting, touch it.


Eject

Fast Forward

Pause

Play

Record

Rewind

Stop



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18 Maintaining the SystemMaintenance should be performed regularly and as needed.

Cleaning System Surfaces

WARNINGBefore performing maintenance or cleaning, always press the On/Standby switchto put the system into standby mode, set the power switch to off , and thendisconnect the system from the wall outlet.

CAUTIONS• Do not use strong solvents, common cleaning products, or abrasive cleansers,

which will damage the system surfaces.

• Do not touch the displays with sharp objects or use paper towels to cleanthem, which may damage them.

Periodically, clean all exterior surfaces of the system using a soft cloth moistenedwith a mild detergent solution. For disinfection information, see the "Disinfectantsand Gels" section.

Remove dust from the monitor screen and touch screen with a soft, lint-freecloth. A micro-fiber cloth is recommended. Clean the monitor screen and touchscreen using a liquid screen cleaner specifically designed for LCDs. Spray the liquidonto the cleaning cloth or spray sparingly onto the displays. You can also usepre-moistened screen wipes. Dry the displays with a soft, lint-free cloth.

When cleaning the system control panel, monitor screen, touch screen, and key-board, take care not to get any solution inside the housings. Also take care not toscratch the face of the monitor while cleaning it.

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Cleaning System Air Filters

WARNINGS• Before performing maintenance or cleaning, always press the On/Standby

switch to put the system into standby mode, set the power switch to off ,and then disconnect the system from the wall outlet.

• When a certain internal temperature is reached, the system displays a warningmessage and then shuts off automatically 30 minutes later. Increased internaltemperature can be caused by dirty air filters. Failure to keep the air filtersclean can result in the system becoming unavailable during critical use.

CAUTIONTurn off power before you remove the air filters. Do not turn power on withoutair filters installed.

The system air filters should be inspected every week and cleaned as needed. Theair filters are located in a slot at the bottom left side of the system and on therear of the system. Spare air filters are included with the system. If you decide toclean the air filters with soap and water, you may want to use the spares while theother air filters dry. Additional air filters can be ordered from Philips UltrasoundCustomer Service.

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➤ To maintain the air filters

1. Remove the air filter cover on the lower left side of the system by pulling thebottom of the cover toward you (Figure 18-1).

Figure 18-1 Removing the Lower Left Air Filter

2. Inspect the filter, and if it is dirty, replace it with a spare.

3. Open the air filter door on the rear of the system and lift the filter out forinspection (Figure 18-2).



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Figure 18-2 Removing the Rear Air Filter

4. Inspect the filter, and if it is dirty, replace it with a spare.

5. Depending on the condition of the air filters, use either a vacuum cleaner orsoap and water to clean them.

Hard Drive MaintenanceSelecting and deleting several exams at once may cause an extended wait beforeyou can resume system operation. This generally happens only if the system harddrive contains a large number of exams, and it is most noticeable in the ReviewExam and Patient Data displays. It is recommended that hard drive mainte-nance be performed regularly and that no more than 5 to 10 exams be deleted ata time.

Transducer MaintenanceRefer to the "Disinfectants and Gels" section for all information regarding trans-ducer cleaning and disinfection and the use of acoustic coupling gels.

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Printer Maintenance

WARNINGPrior to performing any maintenance on a device, always disconnect it from thesource of power by either of the following: Disconnect the system from the walloutlet, if the device is internal to the system; or disconnect the device from thewall outlet, if it is external to the system.

CAUTIONS• Do not scratch the roller or allow dirt and dust to contact the roller of a

printer.

• Do not use strong solvents such as thinner or benzine, or abrasive cleaners,since these will damage a device cabinet.

Periodically clean the external surfaces of a device with a soft cloth. Difficult stainsmay be removed with a cloth lightly dampened with a mild detergent solution.

VCR Maintenance

WARNINGPrior to performing any maintenance on a device, always disconnect it from thesource of power by either of the following: Disconnect the system from the walloutlet, if the device is internal to the system; or disconnect the device from thewall outlet, if it is external to the system.



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CAUTIONS• Do not insert a videotape before the system has completed the initialization/

warm-up phase.

• Do not move the ultrasound system with the videotape cassette in the VCR.Damage to the VCR may result.

• Do not use commercial head-cleaning products on the VCR. These productsmay damage the recording heads. All maintenance should be performed by aPhilips Ultrasound field service engineer.

• Do not make adjustments to your VCR. Consult a Philips Ultrasound field ser-vice engineer for repair or maintenance of your VCR.

• Do not use strong solvents such as thinner or benzine, or abrasive cleaners,since these will damage a device cabinet.

Periodically clean the external surfaces of a device with a soft cloth. Difficult stainsmay be removed with a cloth lightly dampened with a mild detergent solution.

TroubleshootingIf you encounter difficulty in the operation of the system, use the informationhere to help correct the problem. If the problem is not covered here, contactyour Philips Ultrasound customer support representative.

The troubleshooting table contains a list of symptoms and the actions to take tocorrect the problems (Table 18-1).

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.

Error MessagesThe system displays error messages in response to operating or error conditionsdetected by the system. The error messages must be noted and reported to yourPhilips Ultrasound customer support representative. Do not use the system if anerror message is displayed.

Table 18-1 Troubleshooting

Symptom Corrective Action

The system does not power up. The monitor indicator light is off.

1. Verify the power connections.

2. Check the circuit breaker on the back of the system.

No image displays on the monitor. 1. After power up, the system takes about 20 seconds to initialize. During this time the monitor is blank.

2. After 20 seconds, adjust the monitor brightness and contrast controls.

3. Check the monitor cables and connections.

No audio comes from the system speakers.

Use the Volume control to ensure the speakers are not muted.

“The system failed to communicate...” error message is displayed during use of voice control.

1. Ensure headset is turned on.

2. Ensure headset is paired to system.

3. Refresh the Active Headsets list and select your headset again.

An error message indicates that the system is above normal operating temperature.

1. Click Continue. The system will power down automatically in 30 minutes.

2. With power off, check for obstructed air filters ("Cleaning System Air Filters" on page 364).



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For AssistanceIf you are unable to correct a problem, call your local Philips Ultrasound customersupport representative.


19 System Administration

NOTEThis information is intended primarily for system administrators who managemultiple iU22 Ultrasound Systems. System administration of data security is pro-tected by a password. This password is not the same as a user password, and isprovided only to registered system administrators.

The system includes several features that can help the system administrator man-age configuration files and the security of patient data. Additional managementfeatures are available as options:

• The DICOM services provided by the connectivity option automate certainmanagement functions, such as archiving images. The DICOM services includeDICOM modality worklist, performed procedure step, and storage commit.

• The technical administration option includes additional system utilities thatare intended for use by a system administrator.

Managing SettingsThe system allows settings to be copied to a DVD and imported from a DVD. Youcan use this feature to set up multiple iU22 Ultrasound Systems from a masterDVD, or quickly implement changes in settings to those systems.

Settings that can be transferred to and from a DVD include Quick Save presets,voice control profiles, and settings in these areas of the setups:

• System Settings

• Analysis Config

• Annotate

• Print/Network

• Audio/Video

Copying Settings to a DVDIf you want to back up or load only certain settings, select and copy only thosesettings to a DVD. When you import settings, all of the settings on the DVD willbe loaded into the system.

System Administration


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➤ To copy settings from the setups to DVD



3. Click the Manage Setups tab.

4. Insert a DVD into the DVD drive.

5. If you want to copy all settings in all categories, click Select All and continuewith step 9.

6. Select any setups categories of settings you want to copy.

7. To select Quick Save presets, do one of the following:

– To select all Quick Save presets, select All for Transducer and clickSelect Displayed.

– To select specific Quick Save presets, select a transducer and then selectthe Quick Save presets you want to copy. Repeat this step with othertransducers.

8. To select voice profiles, do one of the following:

– To select all voice profiles, click Select All.

– To select specific voice profiles, select the ones you want to copy.

9. Click Copy to DVD.

10. If a dialog box indicates that the DVD needs to be formatted, click OK in thedialog box, and then click Format and follow the prompts.

11. When a prompt indicates that the transfer is complete, click Eject in thePatient Directory, remove the DVD, and click Done.

Importing Settings from a DVDThe system allows you to import all of the settings on a DVD into your system.

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➤ To import settings from a DVD




4. Insert a DVD containing settings into the DVD drive.

5. Click Import from DVD.

6. To import the settings on the DVD, click OK.

7. When a prompt indicates that the transfer is complete, click Eject in thePatient Directory, remove the disc, and click Done.

Deleting Quick Save PresetsYou can delete any or all Quick Save presets that have been saved or importedinto the system.

➤ To delete Quick Save presets




4. To select Quick Save presets, do one of the following:

– To select all Quick Save presets, select All for Transducer and clickSelect Displayed.

– To select specific Quick Save presets, select a transducer and then selectthe Quick Save presets you want to copy. Repeat this step with othertransducers.

5. Click Delete Selected.



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6. When the Delete dialog box appears, click OK to delete the presets, or clickCancel to return to the setups.

7. When you are finished, click Done.

Configuring the System The ultrasound system is configured using the Print/Network setups. The con-figuration information for the system includes the IP address, port number, andother attributes required for transmitting images and other exam data across anetwork. To configure the system, information must be typed into the corre-sponding fields in the System setups display. The system must be configuredbefore you use either the standard network support or the capabilities availablethrough the connectivity option.

About Standard Network SupportThe system supports standard network functions, which include printing toDICOM printers, local printers, and report printers. This support also includesexporting images and other exam data to a DVD. Additional network capabilitiesare available in the connectivity option.

About the Connectivity OptionThe connectivity option permits network transfer of image and report informa-tion. Connectivity conforms to the Digital Imaging and Communications in Medi-cine (DICOM) standard, version 3.0. Centralized printers, print servers, networkfile servers, and review workstations that comply with the DICOM standard cantake advantage of connectivity.

With connectivity, you can store ultrasound images on DICOM-compatible fileservers or archive devices and review them using a workstation. You can alsoprint exams directly. Capabilities include support for DICOM services such asmodality worklist, performed procedure step, and storage commit. In addition,the connectivity option includes the structured reporting feature, which allowstransferring tagged report data to a PC, server, or other device.

The connectivity option is initially set up by your Philips Ultrasound field serviceengineer or the system administrator. The Print/Network setups are availablefrom the main setups display. After you select Print/Network, the options avail-

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able to you depend upon the configuration of your system: The connectivityoption requires additional levels of setup.

Once the ultrasound system is configured, it will remain that way through powercycles until you reconfigure it.

About Configuration InformationBefore you can use either the standard network support or the capabilities pro-vided by the connectivity option, the system must be configured to communicateon the network.The system configuration information must contain the correctAE title, port number, IP address, subnet mask, and subnet name for each deviceon the network, including the system itself.

If the connectivity option is installed on the system and you will be using aworklist server that searches using station name and system location, then thecorrect information must also be entered for those two fields.

Click the name of a data field in the following list to learn about its function:

Changing Configuration Settings

➤ To change the configuration settings for your system

1. Determine configuration information: AE title, port number, IP address, sub-net mask, and subnet name. If the connectivity option is installed and you willbe using a worklist server that searches using the station name and systemlocation, you will need that information also.



4. Click the Global Config tab (Figure 19-1).

AE (Application Entity) Title

Gateway

IP Address

Port Number

Station Name

Subnet Mask

System Location



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Figure 19-1 Global Configuration Setups

5. Select the device type you want to configure by doing one of the following:

– To edit the system information, click System.

– To edit information for a server or printer, click Devices.

6. To edit system information, use the keyboard to change information directly inthe fields under Ultrasound System Configuration. Ensure that youobserve the following conventions:

– The AE title, station name, and system location are case-sensitive. Forexample, Radiology and radiology are different names.

– The subnet mask and IP address, provided by the system administrator,must follow accepted rules of syntax, including the periods between bytes.

7. When finished, click Done to exit the setups and save your changes.

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Deletion of Archived ExamsThe way in which archived exams are deleted varies slightly between systems withthe connectivity option and systems without it.

Deleting Archived Exams with Connectivity

When a completed exam has been sent to the archive server, the server sendsconfirmation back to the system, indicating that the exam data has been stored.Once this confirmation has been received, the exam stored on the system cansafely be deleted. Deletion can be manual or automatic, depending on optionselected in Print/Network setups. For automatic deletion, you can choose tohave exams deleted immediately after confirmation or from 1 to 28 days afterconfirmation.

Deleting Archived Exams without Connectivity

When a completed exam has been printed, the exam stored on the system cansafely be deleted. Deletion can be manual or automatic, as described above.

Configuring Deletion of Archived Exams

➤ To define how archived or committed exam files are deleted



3. Click the Global Configuration tab, then click HD Maint.

4. Select an option by doing one of the following:

– To select manual deletion, click Manual Delete Only.

– To select automatic deletion, click Delete Archived/CommittedExams. For instant deletion upon commit confirmation, select Immedi-ately. For scheduled deletion, select a time interval.

– To return to the system default setting, click Reset Defaults.

5. Click Done.



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Print and Capture SettingsOn the Printer/Capture tab of the Print/Network setups, you can set upthese parameters:

• When capture begins in relation to pressing Capture

• The type of compression, if any, used to store captured images or clips

• Whether touching Alt Print saves the image to the system hard drive

• Printing format (full-screen or display-area) used for each print button

For systems with the connectivity option installed, these parameters are added:

• When captured images or clips are sent to the server

• When pending-exam data is sent to the server

Changing Print and Capture Settings

➤ To view or edit printer settings



3. Click the Printer/Capture tab. The current print and capture settings aredisplayed.

4. To change capture settings, do any of the following:

– To change image capture type, select Prospective or Retrospective andselect a capture length from the menu.

– To choose a compression type for storing captured images, select a com-pression quality setting (Lossy Low, Lossy Medium, or Lossy High) orselect Uncompressed to turn off compression.

5. To change print settings, do any of the following:

– To choose when captured images or clips are sent to the archive server,select After Each Printer/Capture or At End of Exam.

– To choose between full-screen or display-area capture formats, select asetting for Print and Alt Print.

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– To choose when the system archives data from an interrupted exam,select Automatically at Reconnect or Manually.

PrintersBefore a local or network printer can be used from the ultrasound system, itmust be configured and then added to the list of available printers on the Devicessubtab in setups. For each printer in that list, the system contains a file thatdescribes the capabilities of that printer. Those capabilities include such things asprinter type, film size, film format type, orientation, destination, and density.

Configuring PrintersIn the Print/Network setups, you can change the printer settings of any printerthat has been installed locally or on the network and added to the system.

➤ To change printer settings



3. Click the Device Selection tab, then click Printers. (On systems withoutthe connectivity option, this is the only choice displayed, so you do not needto click it.)

4. Select the printer you want to configure, then click Edit.

5. For Associate printer with, select one or both print control options.

6. For Image Print, select B/W or Color to choose formats for printingblack-and-white and color images.

7. If you want to return to the system default settings for the printer, clickReset Defaults.

8. For advanced printer setup options, click Advanced.

9. Make desired changes to printer settings and click OK when finished.

10. If the printer you configured is not selected, click its box to select it. If yourselection would exceed the maximum number of selected printers allowed,you must first deselect a printer.

11. Click Done.



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Adding PrintersOnce a DICOM printer has been installed on the network by your networkadministrator, you can add it to the list of printers available on your system. Youcan also install a local printer on your system and then add it to the list of avail-able printers.

NOTEBefore using the procedure below to add a local printer, connect the printer tothe ultrasound system according to the manufacturer’s instructions.

➤ To add a printer

1. If you will be adding a DICOM printer, obtain from your network administra-tor the printer type, device name, AE title, port number, and IP address of theprinter.



4. Click the Global Configuration tab, then click Devices.

5. Click New Device.

6. In the Add Device screen, select the device type for the DICOM or localprinter you are adding.

7. Do one of the following to specify the printer:

– To add a DICOM printer, for Printer Type, select the description for theprinter you are adding. For Device Name, type a name if none is dis-played. Then verify or type the AE title, port number, and IP address.

– To add a local printer, for Printer Type, select the description for theprinter you are adding. For Device Name, type a name if none is dis-played.

8. Click OK.

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ServersYou can view and change the settings of any server that has been installed on thenetwork.

If the connectivity option is installed, you can select servers to be used by yoursystem as commit, archive, and structured report servers. You can add or delete aDICOM archive server, DICOM commit server, DICOM performed-proce-dure-step server, DICOM worklist server, or DICOM structured report server.

You cannot add, edit, and delete servers during an active exam if items are activein the queue.

Configuring ServersIn the Print/Network setups, you can view and change the settings of any serverthat is available on the network. Changes to server settings should generally bemade only by or with the advice of the system administrator.

➤ To view and change server settings:




4. Select the server you want to configure. Settings are on the right side of thedisplay.

5. To change the settings for the selected server, click Edit.

6. In the Edit Device dialog box, change data for Device Name, AE Title,Port #, or IP Address as needed. To make changes, highlight text and typeto replace it.

7. Click OK.

Selecting Servers On systems with the connectivity option installed, you can select among availableservers to be used by your system as commit, archive, and structured reportservers. Available servers are those that have been installed on the network.



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Changes to server settings should generally be made only by or with the advice ofthe system administrator.

➤ To select a server



3. Click the Device Selection tab, then click Archive.

4. For Commit Server, select a server that will manage DICOM storage com-mit requests from the system and return commit confirmation back to thesystem.

5. For Target Archive Server, select a server that will be the default archiveserver.

6. For Structured Report Server, select a server that will receive structureddata from calculations reports.

7. Click Done.

Adding ServersIn the Global Configuration display, you can add a DICOM archive server,DICOM commit server, DICOM performed-procedure-step server, DICOMworklist server, or DICOM structured report server. You can also delete anyavailable server. Changes to server settings should generally be made only by orwith the advice of the system administrator.

➤ To add a server

1. Obtain from your network administrator the device type, device name, AEtitle, port number, and IP address of the server you are adding.




5. Click New Device.

6. In the Add Device display, select the device type for the DICOM server youare adding.

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7. Using the information from your network administrator, type the appropriatedata for Device Name, AE Title, Port #, and IP Address.

8. Click OK.

Deleting Servers

➤ To delete a server




4. In the list of devices, select the server you want to delete.

5. Click Delete.

6. In the Delete a Device Configuration dialog box, click Yes.

7. Click Done.

Worklist System SetupThe worklist feature can download a worklist for a scheduled procedure at a pre-determined time. The worklist feature is available only on systems with the con-nectivity option installed.

Changes in your work schedule or operating procedures may require changes tothe ultrasound system Worklist setups. Your objective for Worklist setups is tohave the system download the worklist at the time you want it, from the serverthat has the list you need.

Changes to worklist settings should generally be made only by or with the adviceof the system administrator.

Selecting a Worklist ServerChanges to worklist settings should generally be made only by or with the adviceof the system administrator.



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➤ To select a worklist server



3. Click the Device Selection tab, then click Worklist.

4. Select the desired server in the list under Worklist Server. Servers listedhere are set up by your system administrator as part of the local networkconfiguration.

NOTEThe Station Name and System Location data fields are set up to filter theworklist as specified by the system administrator and should not be changed with-out specific directions from the administrator. Those fields are determined whenthe system is set up for a site-specific configuration.

5. Click Done.

NOTESelecting None under Worklist Server will disable the worklist feature, and thesystem will operate as though it does not have this feature.

Defining Worklist Query CriteriaChanges to worklist settings should generally be made only by or with the adviceof the system administrator.

➤ To define the Worklist query criteria




4. Select the appropriate choice for Query Worklist Server:

– Only on user request sets the system to update the worklist each timeyou click Update Worklist on the Patient Data form.

– On End Exam sets the system to update each time you press EndExam.

– On Startup and every sets the system to update the worklist each timeit is turned on and thereafter at the interval you select from the list.

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NOTEThe optional filtering attributes for your system are set at installation. Only thesystem administrator should change them.

5. To add optional filtering attributes to the query, select Station Name, Sys-tem Location, and AE Title as required for your worklist server.

About PPS Servers For scheduled patient exams from a worklist, the modality performed procedurestep (PPS) feature provides for the transfer of exam information to a DICOM PPSserver. After an exam is completed, the PPS feature sends information to the PPSserver indicating that the exam was completed.

Your system administrator must install and configure the PPS server. The DeviceSelection setups for Worklist will then contain a PPS Server setup, whichmust be selected to allow use of the PPS feature with the worklist. The worklistfeature is available only on systems with the connectivity option installed.

Selecting the PPS Server

➤ To select the PPS server




4. For PPS Server, select the desired server.

5. Click Done.

Setting Up Storage Commit For scheduled patient exams from a worklist, the DICOM storage commit (SC)feature allows you to archive images to a network server and to receive aresponse from the server, indicating it has received the storage request and suc-cessfully stored the images. The system sends storage commit requests to the SCserver when all images from an exam have been sent to the target archive deviceand either a new exam has begun or Pause Exam on the Patient Data formhas been selected. You can observe the status of a storage commit request in the



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Patient Directory. If a check mark appears in the (Commit Status) column,the images were successfully stored on the network archive device.

Your system administrator must configure the system for an SC server. TheDevice Selection: Archive setups will then contain Commit Server and Tar-get Archive Server setups. Your system administrator selects which archivedevice will serve as the storage commit server.

➤ To setup the DICOM Storage Commit feature



3. Click the Device Selection tab, then click Archive/Network.

4. For Commit Server, select a server that will manage DICOM storage com-mit requests from the system and return commit confirmation back to thesystem.

5. Click Done.

Managing Data SecurityThe Health Insurance Portability and Accountability Act (HIPAA) was passed bythe U.S. Congress on August 2, 1996, and became effective April 2003. The pri-mary purpose of HIPAA is to provide improved portability of health benefits andbetter accountability in the area of health-care fraud. To help hospitals complywith HIPAA, this system protects the health-care information of individualsagainst access without consent or authorization.

The ultrasound system can be configured to protect patient data by requiringusers to log on by entering a personal password. Protected data is defined as previ-ously stored patient data and images. Users can access protected data whilelogged onto the system. Access to patient data is denied after the user logs off ofthe system, cycles system power, or does not use the system during the time-outperiod set by the system administrator. The current patient’s data is not pass-word-protected until images for the current patient are stored to the network.

The system automatically records all transactions related to patient data in a logfile on the system hard drive. It is the responsibility of the system administrator toarchive and clear the log file at regular intervals.

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The system administrator for the system can create, change, remove or importuser logons. In addition, the system administrator can enable or disable data secu-rity and set a time-out period for the access period.

Creating User LogonsWhen creating user names and passwords, you can use only letters and numbers;punctuation marks and symbols are not allowed.

➤ To create user logons



3. Click the Admin Settings tab.

4. For Password, type the system administrator password and then click Login.

5. Click Add User.

6. For User Name, type a unique user name of 6 to 10 characters (letters andnumbers only).

7. For Password, type a unique password of 6 to 10 characters (letters andnumbers only), and for Confirm Password, type the password again.

8. Click OK.

9. To create more user logons, repeat step 5 through step 8.

10. Click Done.

Deleting User LogonsTo restrict a user’s access to patient data or remove the logon of a user no longeremployed at your facility, you simply delete the logon for the user.

➤ To delete user logons







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5. In Registered Users, highlight the user name you want to remove.

6. Click Delete User.

7. In the Delete User dialog box, click Yes.

8. To delete more user logons, repeat step 5 through step 7.

9. Click Done.

Changing User Names and PasswordsTo change a user name or password, you must delete the existing logon for theuser and create a new one with the desired name and password.

Exporting User LogonsYou can export user logons to a DVD. Using this function, you can create a mas-ter list of all registered users. You can then distribute this list to multiple iU22Ultrasound Systems.

➤ To export user logons to a DVD





5. Insert a blank DVD into the DVD drive.

6. In Registered Users, select the user logons you want to export, and thenclick Export Users.

7. When the message Export to DVD Completed Successfully appearstemporarily, click Done.

Importing User LogonsYou can import user logons from a DVD. This function is useful if you have cre-ated a master list of all registered users and want to distribute the list to all iU22Ultrasound Systems in a hospital or clinic.

19



➤ To import user logons from DVD






6. In Registered Users, click Import Users.

7. When the message Import From DVD Completed Successfully is dis-played temporarily, click Done.

Enabling or Disabling Data Security

➤ To enable or disable data security






– To enable data security, select Registered Users Only.

– To disable data security, select Unrestricted.

6. Click Done.

Setting the Auto Log Off TimeThe system automatically logs off the current user after the system has been inac-tive (no controls used) for the length of time shown in Auto Log Off on theUser Settings tab of the Data Security setups. Five choices are available forthe Auto Log Off time, ranging from 5 minutes to 60 minutes.

➤ To set the Auto Log Off time





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5. In Auto Log Off, select a length of time.

6. Click Done.

About the Log FileTransactions related to patient data are automatically recorded in a log file on thesystem hard drive. Those transactions include logging onto or off of the systemand reading or making changes to removable media or any patient data (exceptdata from the current patient exam). The system records the time, date, and username for each transaction.

It is the responsibility of the system administrator to manage the log file. It is rec-ommended that the administrator archive and clear the log file at least every 30days. Clearing the log file creates a log entry of the transaction in the cleared logfile.

NOTEInformation that has been in the log file longer than 30 days will be overwritten asnew transactions occur.

The system allows guests to log on to the system without requiring a password.Guest access does not permit viewing removable media and patient data exceptfor clinical data from the current exam.

Archiving and Clearing the Log File

➤ To archive and clear the log file






6. In Activity Log, click Copy To DVD.

7. To clear the log, click Clear Log.

19



8. In the Clear Log Files dialog box, click Yes.

9. Click Done.

Changing the System Administrator Password

➤ To change the system administrator password





5. In Administrator Password, click Change Password.

6. For Old Password, type your current password, and then press the Tab key.

7. For New Password, type your new password, and then press the Tab key.

8. For Confirm Password, type your new password again.

9. Click OK.

10. Click Done.

Technical Administration The technical administration option provides software tools and services used torun tests, record system behavior, conduct analysis, and monitor the system. Thisoption is intended for use by a system administrator. All documentation for thisoption is in a Help file that is accessible from within technical administration.

➤ To log on to the technical administration option



3. Click the Tech Admin tab.

4. Type your username and password in the appropriate text boxes, and thenclick Login.

5. To view technical administration Help, click Help.



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20 References

Measurement Tools

Area, Circumference, and VolumeBeyer, W. H. Standard Mathematical Tables. 28th Edition. CRC Press, Boca Raton,Florida, 1987, p.126.

Pulsatility Index (PI), Resistive Index (RI), and Systole:Diastole (S/D) RatioZwiebel, W. J., ed. Introduction to Vascular Ultrasonography. Third Edition. W. B.Saunders Company, 1992.

Peak Gradient (PG)Powis, R., Schwartz, R. Practical Doppler Ultrasound for the Clinician. Williams &Wilkins, Baltimore, Maryland, 1991, p. 162.

Acceleration Time (AT)Starvos, A. T., et. al. “Segmental Stenosis of the Renal Artery Pattern Recognitionof Tardus and Parvus Abnormalities with Duplex Sonography.” Radiology, 184:487-492, 1992.

Taylor, K. W., Strandness, D. E. Duplex Doppler Ultrasound. Churchill-Livingstone,New York, 1990.

Infant HipGraf, R. “Fundamentals of Sonographic Diagnosis of Infant Hip Dysplasia.” Journalof Pediatric Orthopedics, Vol. 4, No. 6: 735-740, 1984.

Percent Diameter Reduction and Percent Area ReductionTaylor, K. W., Strandness, D. E. Duplex Doppler Ultrasound. Churchill-Livingstone,New York, 1990.

References


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394

Velocity Time Integral (VTI)Degroff, C. G. Doppler Echocardiography. Third Edition. Lippincott-Raven, Philadel-phia, 1999, p. 102-103.

Acceleration Index (AI)Strandness, D. E. Duplex Scanning in Vascular Disorders. Third Edition. Lippincott,Williams & Wilkins, 2002.

Internal Carotid Artery (ICA)/Common Carotid Artery (CCA) RatioStrandness, D. E. Duplex Scanning in Vascular Disorders. First Edition. Raven Press,New York, 1990.

Volume FlowGill, R. W. “Pulsed Doppler with B-Mode Imaging for Quantitative Blood FlowMeasurement.” Ultrasound in Medicine and Biology, Vol 5: 223-235, 1979.

Obstetrical Calc Package

Amniotic Fluid Index (AFI)Jeng, C. J., et al. “Amniotic Fluid Index Measurement with the Four-QuadrantTechnique during Pregnancy.” The Journal of Reproductive Medicine, Vol. 35, No. 7:674-677, July 1990.

Area Corrected Biparietal Diameter (BPDa)Doubilet, P., Greenes, R. “Improved Prediction of Gestational Age from FetalHead Measurements.” American Journal of Radiology, Vol. 142: 797-800, April 1984.

Biophysical Profile Fleischer, A.C., Manning, F. A., Jeanty, P., Romero, R. editors. Sonography in Obstet-rics and Gynecology Pinrciples and Practice. Sixth Edition. McGraw-Hill. 2001.

20


References

Fetal Ratios

Cephalic Index (CI) (BPD/OFD)

Hadlock, F., Deter, R., Carpenter, R., Park, D. “Estimating Fetal Age: Effect of HeadShape on BPD.” American Journal of Radiology, Vol. 137: 63-85, July 1981.

FL/AC

Hadlock, F., Deter, R., Harrist, R., Roecker, E., Park, P. A. “Date-Independent Pre-dictor of Intrauterine Growth Retardation: Femur Length/Abdominal Circumfer-ence Ratio.” American Journal of Radiology, Vol. 141: 979-984, November 1983.

FL/BPD

Hohler, C. W., Quetel, T. A. “Comparison of Ultrasound Femur Length and Bipa-rietal Diameter in Late Pregnancy.” American Journal of Obstetrics and Gynecology,Vol. 141, No. 7: 759-762, December 1981.

HC/AC

Campbell, S. “Ultrasound Measurement of the Fetal Head to Abdomen Circum-ference Ratio in the Assessment of Growth Retardation.” British Journal of Obstet-rics and Gynecology, Vol. 84: 165-174, March 1977.

Estimated Fetal Weight (EFW)

Abdominal Circumference (AC)

Campbell, S. Wilkin, D. “Ultrasonic Measurement of Fetal Abdomen Circumfer-ence in the Estimation of Fetal Weight.” British Journal of Obstetrics and Gynecology,Vol. 82, No. 9: 689-697, September 1975.

Abdominal Circumference, Biparietal Diameter, and Femur Length (AC, BPD, FL)

Hadlock, F., Harrist, R. B., Sharman, R. S., Deter R. L., Park, S. K. “Estimation ofFetal Weight with the Use of Head, Body, and Femur Measurements—A Prospec-tive Study.” American Journal of Obstetrics and Gynecology, Vol. 151, No. 3: 333-337,February 1, 1985.

References


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396

Abdominal Circumference, Biparietal Diameter, Femur Length, Head Circumference (AC, BPD, FL, HC)


Abdominal Circumference and Femur Length (AC, FL)


Abdominal Circumference, Femur Length, and Head Circumference (AC, FL, HC)


Fetal Age

Abdominal Circumference (AC)

Hadlock, F., Deter, R. L., Harrist, R. B., Park, S. K. “Estimating Fetal Age: Com-puter-Assisted Analysis of Multiple Fetal Growth Parameters.” Radiology, Vol. 152:497-501, 1984. (Biometric Age and Growth Equations)

Biparietal Diameter (BPD)


20


References

Biparietal Diameter Outer to Inner

Chitty, L. S., Altman, D. G. “New Charts for Ultrasound Dating of Pregnancy.”Ultrasound in Obstetrics and Gynecology, Vol. 10: 174-191, 1997.

Biparietal Diameter Outer to Outer


Cerebellum (CER)


Crown-Rump Length (CRL)

Hadlock, F., Shah, Y. P., Kanon, D. J., Math, B., Lindsey, J. V. “Fetal Crown-RumpLength: Re-Evaluation of Relation to Menstrual Age (5-18 weeks) with High-Reso-lution Real-Time Ultrasound.” Radiology, Vol. 182: 501-505, 1992.

Robinson, H. P., Fleming, J. E. E. “A Critical Evaluation of Sonar ‘Crown-RumpLength’ Measurements.” British Journal of Obstetrics and Gynecology, Vol. 82:702-710, September 1975.

Femur Length (FL)

Chitty, L. S., Altman, D. G., Henderson, A., Campbell, S. “Charts of Fetal Size.”British Journal of Obstetrics and Gynecology, Vol. 101: 132-135, February 1994.

Hadlock, F., Deter, R. L., Harrist, R. B., Park, S. K. “Estimating Fetal Age: Com-puter-Assisted Analysis of Multiple Fetal Growth Parameters.” Radiology, 152:497-501, 1984. (Biometric Age and Growth Equations)

Jeanty, P., Rodesch, F., Delbeke, D., Dumont, J. “Estimation of Gestational Agefrom Measurements of Fetal Long Bones.” Journal of Ultrasound in Medicine, Vol. 3:75-79, February 1984.

Gestational Sac (GS)

Nyberg, D. A., Hill, L. M., Bohm-Velez, M., Mendelson, E. B. “Transvaginal Ultra-sound.” Mosby Yearbook, 1992, p.76.

References


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398

Head Circumference (HC)

Hadlock, F., Deter, R. L., Harrist, R. B., Park, S. K. “Estimating Fetal Age: Com-puter-Assisted Analysis of Multiple Fetal Growth Parameters.” Radiology, 152:497-501, 1984. (Biometric Age and Growth Equations)

Head Circumference (HC measured and derived)


NOTEThe Chitty/Altman head circumference equation published in the referenced arti-cle contains an error, which has since been corrected by the authors. The cor-rected equation is used in the system.

Humerus (HUM)

Jeanty P., Rodesch F., Delbeke D., Dumont J. “Estimation of Gestational Age fromMeasurements of Fetal Long Bones.” Journal of Ultrasound in Medicine, Vol. 3:75-79, February 1984.

Fetal Growth Graph Tables and Equations

Abdominal Circumference (AC) Growth Curve Equation


AC Growth Curve Equation

Chitty, L. S., Altman, D. G., et. al. “Chart of Fetal Size: 3 Abdominal Measure-ment.” British Journal of Obstetrics and Gynecology, Vol. 101: 125-131, 1994. (Mea-sured and Derived.)

Biparietal Diameter (BPD) Growth Curve Equation


20


References

BPD (Outer-Inner) Growth Curve Equation

Chitty L. S., Altman D. G., et. al. “Charts of Fetal Size: 2 Head Measurements.”British Journal of Obstetrics & Gynecology, Vol. 101: 35-43, 1994. (Out-In andOut-Out)

Femur Length (FL) Growth Curve Equation


FL Growth Curve Equation

Chitty, L. S., Altman, D. G., et. al. “Charts of Fetal Size: 4 Femur Length.” BritishJournal of Obstetrics & Gynecology, Vol. 101:132-135, 1994.

Head Circumference (HC) Growth Curve Equation


HC (derived) Growth Curve Equation

Chitty L. S., Altman D. G., et. al. “Charts of Fetal Size: 2 Head Measurements.”British Journal of Obstetrics & Gynecology, Vol. 101: 35-43, 1994.

Occipito-Frontal Diameter (OFD) Growth Curve Equation


Cephalic Index (CI) Growth Curve Equation


Estimated Fetal Weight (EFW) Growth Curve Equation

Hadlock, F. P., Harrist, R. B., Martinez-Poyer, J. “In-utero Analysis of Fetal Growth:A Sonographic Weight Standard.” Radiology, Vol. 181: 129-133, 1991.

References


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400

HC:AC Growth Curve Equation

Campbell, S. “Ultrasound Measurement of the Fetal Head to Abdomen Circum-ference Ratio in the Assessment of Growth Retardation.” British Journal of Obstet-rics and Gynecology, Vol. 84: 165-174, March 1977.

Fetal Growth Percentiles

Estimated Fetal Weight (EFW) Percentile

Hadlock, F. P., Harrist, R. B., Martinez-Poyer, J. “In-utero Analysis of Fetal Growth:A Sonographic Weight Standard.” Radiology, Vol. 181: 129-133, 1991.

NOTEFor more information on the mathematical operations involved in the calculationsof the Z-score distribution for the Hadlock reference for estimated fetal weightpercentile, refer to the following: Abromowitz, M., Stegun, I., eds. Handbook ofMathematical Functions. Dover Publications, New York, p. 966-972, 1972.

Philips Custom Percentile

The Philips Custom percentile setting is a modification to the Hadlock, Harrist,and Martinez-Poyer equation for estimated fetal weight percentile. The PhilipsCustom percentile setting incorporates a broadening factor of 1.64 into the calcu-lation of the Z-score percentile. The broadening factor approximates the 10th to90th percentile.

Ln (weight) (g) = 0.578 + 0.332(MA) - 0.00354(MA2), 1 SD = 12.7 %

The Z-score is determined by using 0.127 * weight * 1.64.

The menstrual age (MA) range is 10 to 40 weeks.

Adult Echo Calc Package

Body Surface AreaDu Bois, D., Du Bois, E. F. “A Formula to Estimate the Approximate Surface Areaif Height and Weight be Known. 1916 [classic article]." Reprinted in Nutrition, Sep-tember-October 1989, 5(5): 303-11.

20


References

Cardiac Output Indexed by Body Surface AreaReynolds, T. The Echocardiographer’s Pocket Reference, Second Edition. ArizonaHeart Institute Foundation, Phoenix, 2000, p. 384.

Cardiac Output (2-D and M-Mode)Reynolds, T. The Echocardiographer’s Pocket Reference, Second Edition. ArizonaHeart Institute Foundation, Phoenix, 2000, p. 384.

Cardiac Output (Doppler)Calafiore, P., Stewart, W. J. "Doppler Echocardiographic Quantitation of Volumet-ric Flow Rate." Cardiology Clinics, May 1990, 8(2):191-202.

Reynolds, T. The Echocardiographer’s Pocket Reference, Second Edition. ArizonaHeart Institute Foundation, Phoenix, 2000, p. 384.

Ejection Fraction (EF)Reynolds, T. The Echocardiographer’s Pocket Reference, Second Edition. ArizonaHeart Institute Foundation, Phoenix, 2000, p. 415.

Right Ventricular Systolic Pressure via Tricuspid RegurgitationSilverman, N. H., Schmidt, K. G. "The Current Role of Doppler Echocardiographyin the Diagnosis of Heart Disease in Children." Cardiology Clinics, May 1989, 7(2):265-96.

Yock, P. G., Popp, R. L. "Noninvasive Estimation of Right Ventricular Systolic Pres-sure by Doppler Ultrasound in Patients with Tricuspid Regurgitation." Circulation,1984, 70(4): 657-662.

Maximum Pressure Gradient (Max PG) (Simplified Bernoulli)Silverman, N. H., Schmidt, K. G. "The Current Role of Doppler Echocardiographyin the Diagnosis of Heart Disease in Children." Cardiology Clinics, May 1989, 7(2):265-96.

References


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402

Mean Pressure Gradient (Mean PG)Reynolds, T. The Echocardiographer’s Pocket Reference, Second Edition. ArizonaHeart Institute Foundation, Phoenix, 2000, p. 382.

Qp/Qs RatioCloez, J. L., Schmidt, K. G., Birk, E., Silverman, N. H. "Determination of Pulmo-nary to Systemic Blood Flow Ratio in Children by a Simplified Doppler Echocar-diographic Method." Journal of American College of Cardiology, April 1988, 11(4):825-30.

E-to-A RatioReynolds, T. The Echocardiographer’s Pocket Reference, Second Edition. ArizonaHeart Institute Foundation, Phoenix, 2000, p. 403.

Fractional ShorteningReynolds, T. The Echocardiographer’s Pocket Reference, Second Edition. ArizonaHeart Institute Foundation, Phoenix, 2000, p. 415.

% Differences of LV LengthsSchiller, N. B., Shah, P. M., Crawford, M., DeMaria, A., Devereux, R., Feigenbaum,H., Gutgesell, H., Reichek, N., Sahn, D., Schnittger, I., Silverman, N. H., Tajik, A. J."Recommendations for Quantification of the LV by two-dimensional Echocardio-graphy." Journal of the American Society of Echocardiography, September-October1989, 2(5): 358-367.

IVS %Reynolds, T. The Echocardiographer’s Pocket Reference, Second Edition. ArizonaHeart Institute Foundation, Phoenix, 2000, p. 415.

IVS/LVPWReynolds, T. The Echocardiographer’s Pocket Reference, Second Edition. ArizonaHeart Institute Foundation, Phoenix, 2000, p. 414.

20


References

LA/Ao RatioReynolds, T. The Echocardiographer’s Pocket Reference, Second Edition. ArizonaHeart Institute Foundation, Phoenix, 2000, p. 414.

LVPW %Reynolds, T. The Echocardiographer’s Pocket Reference, Second Edition. ArizonaHeart Institute Foundation, Phoenix, 2000, p. 415.

Valve Area via the Continuity EquationOh, J. K., Seward, J., Tajik, A. J. The Echo Manual, Second Edition. Lippincott, Wil-liams and Wilkins, Philadelphia, 1999, p. 65.

Oh, J.K., et. al. "Prediction of the Severity of Aortic Stenosis by Doppler AorticValve Area Determination: Prospective Doppler-Catheterization Correlation in100 Patients." Journal of the American College of Cardiology, June 1988, 11(6):1227-34.

Mitral Valve Area via Pressure Half-timeOh, J. K., Seward, J., Tajik, A. J. The Echo Manual, Second Edition. Lippincott, Will-iams and Wilkins, Philadelphia, 1999, p. 68.

Mean Velocity (Vmean)Silverman, N. H., Schmidt, K. G. "The Current Role of Doppler Echocardiographyin the Diagnosis of Heart Disease in Children." Cardiology Clinics, May 1989, 7(2):265-96.

Velocity Time Integral (VTI)Silverman, N. H., Schmidt, K. G. "The Current Role of Doppler Echocardiographyin the Diagnosis of Heart Disease in Children." Cardiology Clinics, May 1989, 7(2):265-96.

Stroke Volumes (2-D)Oh, J. K., Seward, J., Tajik, A. J. The Echo Manual, Second Edition. Lippincott, Wil-liams and Wilkins, Philadelphia, 1999, p. 40.

References


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404

Stroke Volumes (Doppler)Oh, J. K., Seward, J., Tajik, A. J. The Echo Manual, Second Edition. Lippincott, Will-iams and Wilkins, Philadelphia, 1999, p. 59.

Volumes (Single-Plane Ellipsoid)Folland, E. D., et. al. "Assessment of Left Ventricular Ejection Fraction and Vol-umes by Real-Time, Two-Dimensional Echocardiography." Circulation, October1979, 60(4): 760-6.

Otto, C. Textbook of Clinical Echocardiography, Second Edition. WB Saunders, Phila-delphia, 2000.

Volumes (Cubed Method)Pombo, J. F., et. al. "Left Ventricular Volumes and Ejection Fraction by Echocardio-graphy." Circulation, 1971, 43: 480-90.


Volumes (Single-Plane A2C, Single-Plane A4C, and Biplane Method of Disks)Schiller, N. B., Shah, P. M., Crawford, M., DeMaria, A., Devereux, R., Feigenbaum,H., Gutgesell, H., Reichek, N., Sahn, D., Schnittger, I., Silverman, N. H., Tajik, A. J."Recommendations for Quantification of the LV by two-dimensional Echocardio-graphy." Journal of the American Society of Echocardiography, September-October1989, 2(5): 358-367.


Volumes (Teichholtz)Teichholz, L. E., et. al. "Problems in Echocardiographic Volume Determinations:Echocardiographic-Angiographic Correlations in the Presence or Absence ofAsynergy." American Journal of Cardiology, January 1976, 37: 7-11.


21 Specifications

Physical Dimensions• Width: 57 cm (22.5 in)

• Height: 166.5 cm (65.5 in) with monitor fully raised139.7 cm (55 in) with monitor locked

• Depth: 113 cm (44.5 in)

• Weight: 145 kg to 161.4 kg (320 to 355 lbs), depending on the peripheraldevices installed

Gray Shades255 in 2D, M-mode, and Doppler

Scan LinesUp to 1,024 scan lines, depending on transducer and mode

Monitor• 43-cm (17-inch) flat-panel monitor on a tilt/swivel arm

• Vertical adjustment range of 121.4 to148.1 cm (47.8 to 58.3 in) at the centerof the screen

• 128 hues of color available

Input Signals• Video: composite grayscale, composite color, S-Video

• VCR audio (left and right)

• Microphone for VCR voice recording

• VCR remote control

• External hardcopy device control

• Three transducer receptacles

Specifications


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406

• Pencil probe receptacle

• High- and low-level ECG

Output Signals• Video: composite color, S-Video

• VCR audio (left and right)

• External report printer USB serial data

Data Connections• Remote diagnostics (dedicated telephone line for modem)

• Ethernet network (10-base-T and 100-base-T)

Physio

Peripherals• Super VHS VCR

• B/W printer

• Color printer

• Report printer

Modality InterfaceDICOM standard

Table 21-1 Physio ECG Performance Characteristics

Lower Frequency Cut-off 0.70 Hz ± 10%

Upper Frequency Cut-off 17 Hz ± 10%

Nominal Input Amplitude ± 5 mV peak

Minimum QRS Wave Amplitude 0.05 mV

21


Specifications

Electrical ParametersThe system contains a universal power supply designed to work with these volt-ages: 100-120/220-240 V~, 50/60 Hz, 1,000 VA. Power must be available througha grounded, hospital-grade outlet.

Languages• Localized control panel, user interface, and documentation

– English

– French

– German

– Italian

– Spanish

• English control panel; localized keyboard and documentation

– Danish

– Swedish

• English control panel and localized documentation

– Portuguese

– Greek

– Russian

– Japanese

– Traditional and Simplified Chinese

Pressure Limits• Operating: 525 mmHg to 795 mmHg (700 hPa to 1,060 hPa)

• Storage: 375 mmHg to 795 mmHg (500 hPa to 1,060 hPa)

Humidity Limits• Operating: 30% to 85%

• Storage: 15% to 95%

Specifications


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408

Temperature Limits• Operating: 10°C to 40°C (50°F to 104°F)

• Storage: -34°C to 65°C (-29°F to 149°F)

Safety Requirements• Classification:

– Class I equipment with Type B, Type BF, and Type CF applied parts

– Ordinary Equipment

– Non-AP/APG

• Electromechanical safety standards met:

– CSA C22.2 No. 601.1, Canadian Standards Association, Medical ElectricalEquipment

– EN 60601-1, Second Edition, including Amendments 1 and 2, EuropeanNorm, Medical Electrical Equipment

– EN 60601-1-2, Second Edition, European Norm, Collateral Standard, Elec-tromagnetic Compatibility

– EN 60601-2-37, Particular Requirements for the Safety of the UltrasonicMedical Diagnostic and Monitoring Equipment

– UL 60601-1, Underwriters Laboratories, Medical Electrical Equipment

• Agency approvals:

– Canadian Standards Association (CSA)

– ISO 13485 Quality Assurance Standard

– CE marked to the European Community Medical Device Directive 93/42/EEC as a Class IIa device

Philips Ultrasound reserves the right to change specifications contained herein ordiscontinue manufacture at any time without prior notice. Current specificationsare supplied with each system purchased or are available from your Philips Ultra-sound representative.


22 GlossaryFor definitions of ultrasound terms, refer to the American Institute of Ultrasoundin Medicine, Recommended Ultrasound Terminology, Second Edition, 1997.

Symbols

% Area Reduction

A control on the Percent Reduction touch screen used to start a trace measurementas input for a percent area reduction calculation.

% Diameter Reduction

A control on the Percent Reduction touch screen used to start a distance measure-ment as input for a percent diameter reduction calculation.

* (Asterisk)

(1) In the Print/Network setups, an asterisk indicates a required field. A required fieldmust be filled in to ensure proper operation with the system. (2) In the Analysis Configsetups, an asterisk indicates that the label will appear in the patient report.

+FHM

Positive fetal heart motion

Numbers

0°/60°

A touch screen control used to select a Doppler angle correction value.

1 Distance

(1) A touch screen control used to start a one-distance volume calculation. (2) A volumecalculation method that uses one distance measurement to estimate the volume of anobject.

2D

(1) A control used to start 2D imaging, when it is pressed, and to adjust 2D gain, when itis turned. (2) A touch screen control used to display the 2D touch screen, from whichyou can adjust several 2D parameters.

2D/MM

A touch screen tab including controls for the 2D and M-mode displays.

Glossary


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410

2D Depth

A control on the Caliper touch screen used to measure the distance between the skinline and the location of the caliper on the image.

2D Opt

A touch screen control used to provide up to three settings that can be used to optimize2D imaging for resolution (Res), penetration (Pen), or general (Gen), which is a balancebetween resolution and penetration. (When Harmonic imaging is on, the optimizationsettings are HRes, HPen, and HGen.) To select a 2D optimization setting, touch 2DOpt on the 2D touch screen until the desired setting is displayed. The settings varydepending on the transducer and preset selected.

2D PRF

A touch screen control used to set the level of the pulse repetition frequency (PRF) ofthe 2D display. The PRF is the number of pulses emitted per second.

3 Distance Volume

A control on the Volume touch screen sub-window that starts a volume measurementmethod that uses three distance measurements.

3 Distances

A volume calculation method that uses three distance measurements to estimate the vol-ume of an object.

3D

A touch screen control used to enable 3D standby for Freehand 3D imaging. The Free-hand 3D option must be installed.

3D/4D

A touch screen control used to switch between 3D and 4D imaging. (Live or real-time3D are referred to as 4D, four-dimensional imaging.) The 4D Imaging option must beinstalled.

3D Box

A touch screen control used to display a 3D box around the volume view.

3D Image Controls

A Freehand 3D Review touch screen control used to display image processing controlsfor optimizing 3D imaging.

22


Glossary

3D Info

3D image information comprising the following: scan angle, tilt angle, header data, graymap number, Chroma map number, opacity map number, transparency percentage,brightness percentage, and lighting percentage. You can move the 3D Info with theMove 3D Info touch screen control.

3D Opt

A touch screen control used to provide up to three settings that can be used to optimize3D imaging for resolution (Res), penetration (Pen), or general (Gen), which is a balancebetween resolution and penetration. (When Harmonics is on, the optimization settingsare HRes, HPen, and HGen.) To select a 3D optimization setting, touch 3D Opt untilthe desired setting is displayed. The number of settings available and the default settingare both dependent on the transducer and Tissue Specific preset selected.

3D Review Format

In System Settings, a Mode Settings setup parameter used to set the format for 3Dreview. The settings are Full Screen, Quad, and Expand.

3D ROI

A touch screen control used during 4D acquisition to enable the trackball for the follow-ing functions, in this order: 3D ROI position, 3D ROI size, and 3D ROI trim line. Clickingchanges the 3D ROI trackball function.

3D Tilt

A touch screen knob, available during 4D standby and 4D acquisition, to change thesteering position in 1-degree increments from the centerline of the scan angle. When theTilt is set to the center point of the 3D volume, the value of the Tilt is 0 degrees. Whenthe Tilt is set to the left of the center point of the 3D volume, the value of the Tilt is anegative number. When the Tilt is set to the right of the center point of the 3D volume,the value of the Tilt is a positive number.

3D Volume

A control on the Caliper touch screen during 3D review that displays the 3D Volumesub-window, containing controls used to make a 3D volume measurement with an ellipsemethod.

3V Cord

Three-vessel cord

Glossary


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412

4D Acquisition Format

In System Settings, a Mode Settings setup parameter used to set the format for 3Dreview. The settings are Full Screen, Dual, and Quad.

4D imaging

(1) A touch screen control used to enter 4D standby. (2) An imaging mode that provideslive or continuous 3D imaging.

A

A2C

Apical two chamber

A4C

Apical four chamber

A5C

Apical five chamber

Abd

In the Annotate setups, a tab used to display the abdomen annotation setups touchscreen. You can assign existing annotations to the touch screen controls, and you cancreate your own annotations and add them to the touch screen.

Abdominal

A calculations package.

Activity Log

In Data Security setups, an Admin Settings setup parameter used to clear the accesslog or copy it to a DVD.

Add Device

A dialog box used in the Print/Network setups to configure a new device for operationwith the system.

Admin Settings

In Data Security setups, a tab used to display settings for patient data access, automaticlogoff, administrator password, activity log, and registered users.

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Administrative Password

In Data Security setups, an Admin Setting setup parameter used to change the sys-tem administrator password.

Adult Echo


AE (Application Entity) Title

(1) An arbitrary name, but a required field, for DICOM configuration. (2) In the Print/Network setups, a field in the Global Configuration setups into which you enter theAE Title.

AFI

Amniotic fluid index

AFI/BPP

Amniotic fluid index/biophysical profile are OB calc list groups.

AGC

Automatic Gain Control. A touch screen control used to automatically set the gain forthe image display.

All Points

In 2D/Color and M-mode cardiology calculations, a tool that, through displayed prompts,provides a sequence of measurement points.

Alt Print

A touch screen control used to print the full-screen or image display to a configured localprinter. The local printers and the type of image sent to the local printers are configuredin the setups. Touching Alt Print does not save the image to the system hard drive.

Analysis Config

Analysis Configuration. A selection in the setups used to display a group of setups forbuilding and editing calc lists, groups, measurements, and calculations. The OB calcula-tions package also allows author editing.

Angle

A touch screen knob that, during 4D standby and 4D acquisition, changes the steeringangle in 5-degree increments symmetrically about the centerline of the scan angle. This issimilar to steering the sector in 2D imaging.

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Angle A, B or C

Touch screen controls used to select the angle of the biopsy guideline.

Angle Correct

A touch screen control used to adjust the Doppler angle. During Doppler acquisition, theblood flow may not be directly toward or away from the transducer, resulting in an anglebetween the ultrasound beam and the blood flow. To ensure accurate display of bloodflow velocity, the angle between the ultrasound beam and blood flow is included in thecalculation that is used to derive the Doppler display scale for velocity.

Annotate

(1) A control used to display the Annotations touch screen. In the Annotate setups,you can assign existing annotations to the touch screen controls, and you can create yourown annotations and add them to the touch screen. (2) In the setups, a group of setupparameters used to select annotation for each application.

Ant

Anterior

Anterior-posterior diameter

An OB measurement of the thorax used in the fetal biometry to obtain an estimate ofultrasound age. Abbreviated as APD.

Ao

Aorta

AoV

Aortic valve

APD

Anterior posterior diameter

ARAD

Anti-radial

Archive

In the Print/Network setups, clicking Archive displays a list of archive servers fromwhich you can select three archive servers.

Arrow

A control on the Annotations touch screen that puts an arrow on the image display.

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Asc

Ascending

Association to Print/Alt Print/Report

In the Print/Network setups, you can select two DICOM printers, two local printers,and one local report printer from the association lists. Associating a printer with thePrint control, the Alt Print touch screen control, and the Print Report touch screencontrol allows you to print with those controls to the associated device.

Asterisk (*)

(1) In the Print/Network setups, an asterisk indicates a required field. A required fieldmust be filled in to ensure proper operation with the system. (2) In Analysis Config set-ups, an asterisk indicates that the label will appear in the patient report.

ATA

Anterior tibial artery

ATV

Anterior tibial vein

AUA

Average ultrasound age

Audio/Video

A setups selection used to display the Internal Microphone setup. You can setup themicrophone so that it is turned on at power up.

Aug

Augmentation

Author Editor

In Analysis Config setups, a selection used for displaying setups from which you can seethe authors of the tables and equations associated with fetal age, fetal weight, and fetalgrowth. You can also edit, create new, and delete equations and tables from this setupsdisplay.

Auto Fit

A touch screen control used in Panoramic Imaging to return an image to its original size.

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Auto Freeze

In System Settings, a Display setup parameter used to turn the auto freeze on or off.Turning auto freeze on, automatically invokes a freeze command, if a control is notmanipulated within the Wait time you specify. After auto freeze has been invoked, pressany control to restart imaging.

Auto Invert

In System Settings, a Mode Settings setup parameter used to turn the auto inversionof the Doppler and Color displays on or off.

Auto Log Off

In the Data Security setups, a User Settings parameter used to set the length of theperiod of inactivity before a user is automatically logged off the system.

Automatic DICOM Export

A component of the Basic Connectivity purchasable option that allows you to automati-cally export DICOM images upon capture.

B

Back

A control on the Review Exam touch screen and on the Review display that is used toreturn to the Review Exam display.

Back to Standby

A touch screen control used in Single-Sweep, Freehand 3D, or 4D Review to return to3D standby.

Backup

On the Calipers touch screen, used to back up a measurement trace.

Base Line

A control on the Hip Angle touch screen that displays calipers used to draw the base-line that connects the osseous acetabular convexity to the point where the joint capsuleand the perichondrium unite with the ilium.

Baseline

A touch screen control used to change the position of the zero baseline. The zero base-line represents zero velocity or frequency in the Doppler or Color display.

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Glossary

Basic Connectivity Option

A system option that provides the ability to export data to network servers, as well asproviding DICOM services such as worklist, performed procedure step, storage commit,and structured reporting.

Batch Mode

A print mode that sends all saved images when an “end exam” event occurs to the config-ured DICOM printers, a DVD, and other archive devices, instead of as in single-printmode, where the images are immediately sent.

Bifurc

Bifurcation

Biopsy

A touch screen control used to display a biopsy guideline through the real-time ultra-sound image to indicate the anticipated path of the needle. A depth cursor is displayed onthe guideline, which you adjust with the trackball. The depth of this cursor is indicated atthe bottom of the image display. If the selected transducer supports a biopsy guide withmore than one needle position, one or two biopsy angle buttons are available (Biopsy Aand Biopsy B). Biopsy is available only when you are in 2D mode using a noncardiacpreset and are using a transducer that supports biopsy.

Biopsy guideline

Displayed guideline within the 2D sector or linear image representing the path alongwhich a biopsy needle should pass.

Blend

A Color and CPA touch screen control used to smooth the transitions between thecolor pixels of the Color and CPA displays and the gray pixels of the 2D display. Theresult of this smoothing can be a decrease in edge and flash artifacts.

Body Mark

A control used to display the Body Markers touch screen, from which you position anddisplay anatomical icons on the image.

BP

Blood pressure

BPD

Bi-parietal diameter

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BPDa

Bi-parietal diameter, adjusted

BPH

Benign prostatic hyperplasia

BPP

Biophysical profile

Brightness

A touch screen control used in 3D review to change the brightness setting of the 3D dataset from 0 to 100. The brightness value appears in the 3D image information as a per-centage: Bright X%.

Build

In Analysis Config setups, a selection used for creating calc lists, groups, measure-ments, and calculations.

BW

Black and white

C

(c)

Appearing alongside a label, means the label was calculated from another parameter, forexample, EDD(c) calculated from an LMP date.

Calc

A system control that provides access to a calc list of the groups, measurements, and cal-culations that make up a calculations package.

Calc Editor

In Analysis Config setups, a selection used for creating calc lists, groups, measure-ments, and calculations. The Calc Editor is the same as the default mode in AnalysisConfig for all calculations packages except OB, which includes an Author Editormode.

Calc List

Pressing Calc displays a calc list. The calc list consists of tabs and icons. The tabs corre-spond to the calculations package associated with the active preset and transducer. Theicons are used to change the calc list, select a multiple gestation, and delete measure-

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Glossary

ments. Initially, the left-most tab in the calc list is selected and a related list of measure-ments is displayed along the left side of the display. Clicking a different tab in the calc listdisplays a different list of measurements. You can assign measurement values to the labelsin the measurement list for inclusion in the patient report.

Calculations Package

System option associated with transducers and presets, containing one or more calc liststhat organize groups, measurements, and calculations into a coherent tool for diagnosticanalysis.

Caliper

(1) A control used to display the Caliper touch screen, which contains measurementtools. (2) A control on the Review Exam touch screen used to display a touch screen ofmeasurement tools.

Cancel Exam

A control on the Patient Data form used to cancel an exam.

Capture

A control used to capture an image for review. You can capture and save a single frame ora Cineloop sequence. The captured frame or Cineloop sequence is saved in the patientstudy, and a thumbnail of it is available in the Review display. If Automatic DICOMExport is on, images are automatically exported across the network when you pressCapture.

Card

In the Annotate setups, a tab used to display the cardiology annotation setups. You canassign existing annotations to the touch screen controls, and you can create your ownannotations.

Caution

An icon displayed in a dialog box when there is an impending loss of data that must beacknowledged.

CBD

Common bile duct

CCA

Common carotid artery

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Cereb

Cerebellum

CF

Color flow

CFA

Common femoral artery

CFV

Common femoral vein

Change Calcs

A calc list icon used to change the calculations package.

Chroma

(1) A touch screen control that turns on or off the Chroma display. This control is avail-able only when a Chroma map is selected. (2) A display that assigns color values to thegray map to accentuate certain echo intensities or ranges of intensities.

Chroma Map

A touch screen knob used to assign a colorization map that replaces the grayscale map toimprove contrast resolution. Five Chroma maps are available. The Chroma map settingappears in the image info as Chroma X, where X is a number from 1 to 5.

CI

Cephalic Index. Cephalic Index is the BPD/OFD ratio.

Cine/Pan

A touch screen control used during 3D review to enable 3D Cine or 3D Pan. 3D Cine isavailable for MPR (multiplanar reformatted) views only. 3D Pan is available for MPR viewsand the volume view. When 3D Pan is active, a 3D Pan icon appears in the left corner ofthe active image view. Touch Reset to exit 3D Cine or 3D Pan.

Cine Play

A touch screen control used to play or pause the Cineloop review.

Cine Review

A touch screen control used to display the Cine Review touch screen controls and toexit Cineloop review.

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Cine Speed

A touch screen control used to adjust the speed of the Cineloop sequence.

Cist Mag

Cisterna magna

Clear Patient Data

A control on the Patient Data form used to clear all patient data from the form.

Col Map

Color Map. A touch screen control used to select and apply a color map to the Colordisplay. The color scale on the image display is a visual representation of the color map.The color scale includes the Nyquist limits, the color baseline, the color wall filter, and acolor-versus-echo write priority marker.

Color

(1) A control used to turn on the Color imaging and adjust Color gain. (2) A touchscreen tab containing controls for Color imaging.

Com

Comminuted

Commit Setups

In Print/Network setups, clicking Archive, displays a group of setups including commitserver and the target archive server.

Compress

A touch screen control used to select a compression curve for the image display. Ahigher compression curve softens the image; a lower compression curve produces ahigh-contrast image.

Compression

In Print/Network setups, a Printer/Capture setup parameter used to select the com-pression type for clips and images.

Config/Test

A group of setups that includes management of system settings and licensed options, sys-tem tests, and access to the Technical Administration option.

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Continuous Trace

A measurement tool on the Caliper touch screen used to measure 2D circumference ora Doppler spectral trace to obtain a 2D area or spectral area.

Contrast ADI

Contrast Agent Detection Imaging. A Tissue Specific preset available with general imagingapplications that uses a normal mechanical index (MI) to image the destruction ofmicrobubbles.

Contrast General

A Tissue Specific preset available with general imaging applications that uses a very lowmechanical index (MI) to image microbubbles in real time with minimal microbubbledestruction.

Convert to Ellipse

A measurement tool on the Caliper touch screen used to convert a 2D distance mea-surement into an elliptical circumference measurement from which an area calculation isderived.

Copy to DVD

In Config/Test setups, a touch screen control used to copy your System, AnalysisConfig, Annotate, and Print/Network settings, voice profiles, and Quick Save presetsto a properly formatted DVD.

Copy to Ratio

In the Vascular Calcs Edit Report display, a selection used to transfer manually adjustedCCA and ICA values into the calculated ratios. Adjusted values are indicated by squarebrackets.

CPA

Color Power Angio. (1) A control used to start CPA imaging, when it is pressed, and toadjust CPA gain, when it is turned. (2) A touch screen tab containing controls for CPAimaging.

CPA Map

A touch screen control used to select and apply a Color map to the Color Power Angiodisplay. The color scale on the image display is a visual representation of the Color map.

CRL

Crown rump length

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Glossary

Current Exam

A control on the Review Exam touch screen and on the Patient Data form that isused to display the stored images for the active exam.

Curved Distance

A measurement tool on the Caliper touch screen used to measure a curved distance onan image using a continuous-trace technique.

CW

Continuous Wave. A control used to turn on the CW Doppler sweeping display and dis-play the CW touch screen.

CW Map

A touch screen control used to select the grayscale map for the CW display. Five graymaps are available. The gray map setting appears in the image information as M X, whereX is a number from 1 to 5.

D

Data Security

A setups category that displays the User Settings screen, from which you can set theAuto Log Off and change your password. You can also click on the Admin Settings taband enter the administrator password to access Administrative setups.

Date Format

In System Settings, a Header setup parameter used to set the format of the systemdate. You select the format from a menu, then you enter the date in the format youselected. The date appears in the display header. It is also used in some calculations.

DCCA

Distal common carotid artery

Default Format: Review

In System Settings, a Display setup parameter used to select the review image format.The default value is 4:1. You can select 1:1, 2:1, or 4:1.

Define Query

A group of Worklist setups in the Print/Network setups, under the Device Selec-tion tab. You can set when the worklist server will be queried: on user request, at theend of an exam, on startup, and a selectable period of minutes. You can also select the

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attributes for the query: station name, system location, and application entity title areavailable.

Delete Status

This dialog box shows the status of exams deleted either manually or automatically fromReview or the Patient Directory. In this dialog box, deleted exams are listed in the Jobcolumn. You can cancel, select, or deselect all of the deleted exams using the selectionson the dialog box.

Depth

A control used to adjust the depth of the image display. The depth of ultrasonic echoesdisplayed in the sector image is based on the assumed constant velocity of ultrasound intissue, 1,540 m/s.

Depth Values

In System Settings, a Display setup parameter used to show or hide the depth values.

Desc

Descending

Device Name

(1) An arbitrary name that must be unique among the names of all device types config-ured in the setups and shown in the Device Configuration list. It is a required field forDICOM configuration. (2) In the Print/Network setups, a field in the Global Configu-ration setups for a device into which you enter the device name.

Device Selection

In Print/Network setups, a tab from which you select the printers and their associa-tions to Print and Alt Print, archive devices and their commit setup and structuredreport server setup, and the worklist server setup.

Devices

(1) A device includes DICOM archive servers, DICOM commit servers, DICOM PPSservers, DICOM worklist servers, DICOM report servers, DICOM structured reportservers, DICOM black-and-white printers, DICOM color printers, local black-and-whiteprinters, local color printers, and local report printers. (2) In the Print/Network set-ups, you configure devices by selecting Devices under the Global Config tab and eitherselecting the device from the Device Configuration list, editing the configuration, oradding a new device.

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Glossary

Diameter 1, 2

A control on the Percent Reduction touch screen that starts a distance measurementas part of a percent diameter reduction calculation.

DICA

Distal internal carotid artery

DICOM

Digital Imaging and Communications in Medicine. DICOM is a standard for networkcommunication.

Direction

A PW touch screen control used to select whether the High Q automatic Dopplerresults will be calculated from above the baseline, below the baseline, or from above andbelow the baseline.

Display

In System Settings, a tab used to display the Display setup parameters related to thetypes or manner in which certain display information appears: Image Info, Depth Val-ues, Thumbnails, Tool Tips, TGC, Auto Freeze, Review Format, SystemPower, Help Language and Monitor Brightness.

Display Format

A 2D/MM, CW, and PW touch screen control used to set the size of the sweeping dis-play. As the sweeping display increases in the size, the 2D image decreases in size. Alarger sweeping display can be helpful when performing measurements on the sweepingdisplay.

Display of Middle Initial

In System Settings, a Patient Data setup parameter used to either display the middleinitial of the patient or not.

Dist

Distal

Dist+Ellip Volume

A control on the Volume touch screen sub-window used to start a measurement thatcalculates volume from a distance and an ellipse measurement.

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Distance

A measurement tool on the Caliper touch screen used to measure the distancebetween objects on the image.

Distance and Ellipse

A volume measurement method that calculates volume from a distance and an ellipsemeasurement.

Done

(1) A touch screen control used to close a display and end a process. (2) A control on thecontrol panel used to close a display and end a process.

Doppler Results

In System Settings, a Measure setup parameter used to select up to eight Dopplerresults for display during Doppler imaging.

Doppler Trace Mode

A measurement and calculation method involving either an automated trace (High Q) ormanual trace of the Doppler spectrum.

Dotted Lines

In System Settings, a Measure setup parameter used to turn on or off the dotted linebetween the measurement calipers.

Dual

A touch screen control used to enable the display of two 2D images side by side. TheDual 1 and Dual 2 touch screen controls are then used to alternate acquisition betweenthe two images.

Dual 1 and Dual 2

Touch screen controls used to alternate acquisition between the two 2D images of a dualimage display. The Dual touch screen control enables dual 2D imaging.

DVD Status

A dialog box that shows the status, type, and destination of all DVD jobs. You can cancel,pause, resume, select or deselect all of the DVD jobs using the selections on the dialogbox.

DVT

Deep vein thrombosis

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Dynamic range

The range of signal amplitudes extending from the largest unsaturated signal to the small-est signal just discernible above system noise. Dynamic range is usually expressed in deci-bels (dB).

E

ECA

External carotid artery

ECG

Electrocardiography

ECG Gain

A touch screen control used to adjust the gain of the ECG display.

ECG Position

A touch screen control used to change the vertical position of the ECG trace on the dis-play.

EDC

Estimated Date of Confinement

EDD

Established due date, estimated delivery date

Edit Device

A dialog box in the Print/Network setups used to edit the configuration data for adevice.

Edit

In Analysis Config setups, a selection used for editing calc lists, groups, measurements,and calculations.

Edit Report

A selection on the patient report used to open the editable report for editing.

EF

Ejection fraction

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Eject

(1) A control on the VCR touch screen used to stop the current VCR mode and ejectthe videocassette. (2) A control in the Patient Directory display used to open and closethe drawer of the DVD RW drive.

Ellipse

A measurement tool on the Caliper touch screen used to measure the circumference ofobjects on a 2D image. An area calculation is derived from the measurement.

End Exam

A control and a selection on the Patient Data form used to end the current exam.

End Measure

On the Calipers touch screen, used to end a measurement and display results.

Epi

Epididymis

Erase All Text

A touch screen control used to erase all user-entered annotations.

Erase Arrow

A touch screen control used to erase the arrows on the display.

Erase Body Mark

A touch screen control used to erase the body mark from the display.

Erase Calipers

On the Calipers touch screen, used to erase the measurement calipers.

Erase Last Word

A touch screen control used to erase the last word entered onto the display.

Erase Text

A key used to erase all of the text annotation on the image display.

Eraser

An icon used during 3D Review to change the pointer to an eraser. The eraser is used toremove data from the volume view.

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Glossary

Exit 3D

A control on the 3D Review touch screen used to quit 3D review and return to 2Dimaging and display the 2D touch screen.

Exit Panoramic

A touch screen control used to exit Panoramic Imaging and return to 2D imaging.

Expanded Screen

A touch screen control used during 3D Review to display one of the image views inexpanded screen. In expanded screen, one of the four image views is larger and appearsto the left of the other three image views, which appear along the right side of the display.

F

Fast Forward

A control on the VCR touch screen used to advance the videotape.

FBM

Fetal breathing motion

First Page

A control on the Review Exam touch screen used to display the first page of images forthe selected exam.

FL

Femur length

Flex

Flexion

Flow Opt

Flow Optimization. A touch screen control used to optimize the Color and Power imagefor patient type. Also useful for Contrast imaging.

Focus

A control used set the focal range and locate the focal position. Focal zones are the areaswhere the image is most clearly focused. Using multiple focal zones decreases the framerate.

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Format

In the Review Exam display or the Patient Directory, used to format a DVD for copyingsystem settings or storing images or exams.

Frame

A touch screen knob in 3D Review used to highlight an image view. In quad screen, ithighlights one of the four image views; in expanded screen, it not only highlights theimage view, but moves the image views as the highlighted image is expanded; in fullscreen, it sequentially displays the image views.

Freehand 3D

An imaging mode in which a 3D image is created from the 2D images acquired and storedin Cine memory. In Freehand 3D, you acquire the 2D images by moving the transducer byhand instead of using a motorized or array transducer designed specifically for 3D acqui-sition.

Freeze

A control used to stop and start system image acquisition and update. Pressing Freezeresults in the system assuming Cineloop pause and assigning the trackball to manualCineloop review (frame-by-frame).

Full Screen

A touch screen control used during 3D Review to display one of the image views in fullscreen. In full screen, one of the four image views is displayed full screen.

G

Gateway

(1) A device or system that connects two networks together. (2) In the Print/Networksetups, a field in the Global Configuration setups into which you enter the gatewayaddress of the ultrasound system. This field requires a four-byte IP address with each byteseparated by a dot and in the range of 0-255.

GB

Gallbladder

GDA

Gastroduodenal artery

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Glossary

Geometry

A 3D touch screen control that switches between Fan and Linear settings. Fan geome-try is the default for a curved or sector transducer. Linear geometry is the default for alinear array transducer. Fan and linear geometries relate to the way in which the trans-ducer is swept across the anatomy to acquire the 2D images used for the 3D volumereconstruction.

Global Config

Global Configuration. A tab on the Print/Network setup display used to display theSystem, Devices, and HD Maint. (Hard Drive Maintenance) displays.

Gray/Chroma

A touch screen knob used during 3D review to apply the gray map or Chroma map set-ting to the 3D data set.

Gray Map

A touch screen knob used to select the grayscale map. Five gray maps are available.Thegray map setting appears in the image info as Map X, where X is a number from 1 to 5.

Group

In Analysis Config setups, a label that includes more than one measurement and zeroto many calculations. For example, AFI is a group consisting of LUQ, LLQ, RUQ, andRLQ measurements. Groups can be system-defined or user-defined.

GSV

Greater saphenous vein

GYN

(1) Gynecology. (2) A calculations package.

H

Harmonics

A touch screen control used to start and stop Tissue Harmonic Imaging (THI). WhenTHI is active, HGEN, HRES, or HPEN appears on the left side of the display.

HC

Head circumference

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HD Maint

Hard Drive Maintenance. A setting in Print/Network setups used to set up manualdeletions of exams or set a period of time after which exams will be deleted automati-cally.

HD Zoom

High Definition Zoom. Imaging feature that concentrates the system processing poweron a specific region of interest in the real-time display. The result is less field of view over-all, but greater detail and higher frame rate, which contributes to better image qualityover the region of interest. HD Zoom is available in 2D, M-mode, Color, and Powerimaging.

Header

In System Settings, a tab used to display setup parameters related to the header in theimage display: Institution Name, Time/Date, and Optional Header Info.

Headset Configuration

In Voice Control setups, a tab used to display instructions for headset configuration andcontrols necessary for headset configuration: Delete, Unpair, Pair, Change Name,and Refresh Current Status.

Heart Rate

(1) A control on the Caliper touch screen used to calculate the heart rate in beats perminute (bpm). (2) A General OB measurement label used to obtain the fetal heart rate.

Help

A key used to display the Help, which contains comprehensive instructions for using thesystem.

Help Language

In System Settings, a Display setup parameter used to select the language of the Help.

Hep

Hepatic

Hide Color

A touch screen control used during Color and CPA imaging to hide the Color and CPAimage data.

Hide Gray Bar

A touch screen control used during 4D acquisition and review to hide the gray bar.

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Hide Guideline

A control on the 2D Frozen touch screen used to hide the biopsy guideline on the fro-zen image.

Hide Ruler

A touch screen control used in Panoramic Imaging to remove the skin line ruler from thedisplay. The skin line ruler measures the distance that the transducer has traveled alongthe skin of the patient. The distance measurement tool can be used to measure thelength of the skin line ruler.

Hide Thumbnails

A key and a setup used to turn off the display of the thumbnail Review images.

High PRF

(1) A touch screen control used to enable high PRF Doppler acquisition and display. (2) ADoppler imaging technique. A pulse is transmitted before the echo from the previouspulse has been received by the transducer. Higher velocity signals can be displayed with-out aliasing. A disadvantage is the ambiguity in the spatial location of the sample volume.In high PRF, additional sample volumes are displayed as the depth of the sample volume ofinterest is increased. The extra sample volumes provide points of reference that must beconsidered when analyzing the Doppler data.

High Q

A touch screen control used to display the peak trace on the spectral waveform and dis-play the High Q automatic Doppler display measurement results.

High Q Automatic Doppler Analysis

Process of automatically detecting, computing, and displaying the calculation of specifiedDoppler parameters.

Hip Angle

On the Caliper touch screen, a measurement tool that provides hip angle calculationsused to evaluate infant hip dysplasia.

Home

A control on the Annotations touch screen used to move the text cursor to the defaultor home position on the image display.

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I

IAS

Interatrial septum

ICA

Internal carotid artery

IMA

Inferior mesenteric artery

Image

A control on the Review Exam touch screen used to display a touch screen of Reviewtools.

Image Info

(1) In System Settings, a Display setup parameter used to hide or show the imageinfo. (2) A key used to turn on or off the display of image information for the active imag-ing mode. Image information consists of display-related control settings.

Import from DVD

In Config/Test setups, a touch screen control used to import setups from a DVD to thesystem.

Import Setups

A dialog box used to select settings for import. You can import System, Analysis Con-fig, Annotate, and Print/Network settings, voice profiles and Quick Save presets froma DVD.

IMV

Inferior mesenteric vein

Inclination line

A control on the Hip Angle touch screen that displays calipers used to draw the inclina-tion line that connects the osseous acetabular convexity to the labrum acetabulare.

Inf

Inferior

Institution Name

In System Settings, a Header setup parameter used to enter the name of the hospital,clinic, or institution.

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Invert

A touch screen control used to invert the orientation of the Doppler image relative tothe baseline.

IP Address

(1) A four-byte IP address with each byte separated by a dot and in the range of 0-255. Arequired field for DICOM configuration of the ultrasound system or device. (2) In thePrint/Network setups, a field in the Global Config setups, into which you enter the IPaddress.

iSCAN Intelligent Optimization

A feature used during 2D imaging to optimize TGC, compression (dynamic range), and2D gain for the 2D image. In pulsed-wave Doppler imaging, iSCAN optimizes baselineand pulse repetition frequency for the Doppler display.

IVC

Inferior vena cava

IVS

Interventricular septum

J

K

L

LA

Left atrium

Last Page

A control on the Review Exam touch screen used to display the last page of images forthe selected exam.

Lat

Lateral

Layout

(1) A menu on the Review Exam display in which you can select the layout for the dis-played images. (2) An area in Print/Network setups in which you can select the docu-

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ment property Orientation for the associated local printers: Portrait or landscape arethe settings.

Left/Right

A touch screen control used to reverse the left/right orientation of the image. If you arein a noncardiac preset, a small open circle called a transducer orientation dot appears inthe upper left corner of a noninverted image. A transducer orientation dot appears onthe right of an inverted image. In a cardiac preset, the location of the transducer orienta-tion dot is reversed.

LHV

Left hepatic vein

Lighting

A touch screen knob on the 3D Image Controls touch screen that is used to changethe lighting setting of the 3D data set. The lighting value appears in the 3D image info as apercentage: Light X%, where X is a number from 0 to 100. Lighting shares a touchscreen knob with Smoothing. Use Smoothing/Lighting to switch between these twofunctions.

Line Density

A touch screen control used to vary the line density of the 2D display. Line density refersto the number of lines of ultrasound data that make up the image. Increasing line densitywill improve resolution and decrease frame rate. Up to three settings are available: Low,Medium, and High.

Link

A touch screen control used to link the rotation, zoom, and pan functions of the multi-planar reformatted (MPR) views and volume view. When Link is active, the volume vieworientation is tied to the orientation of the MPR views, and the volume view scale andposition are the same as the MPR views. When Link is not active, the volume view ori-entation, scale, and position can be adjusted independently.

Linked Group

In Analysis Config, a special, system-defined group that contains default measurementsand calculations that are essential for specific imaging modes. Linked groups cannot bedeleted.

Live Capture Type

In Print/Network setups, a Printer/Capture setup parameter used to select prospec-tive or retrospective capture and the capture length in seconds.

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LLQ

Left lower quadrant

LMP

Last menstrual period

LPV

Left portal vein

LRA

Left renal artery

LRV

Left renal vein

LSFJ

Left saphenous femoral junction

LSV

Lesser saphenous vein

LUQ

Left upper quadrant

LV

Left ventricle

LVID

Left ventricular inner dimension, left ventricular internal diameter

LVOT

Left ventricular outflow tract

LVPW

Left ventricular posterior wall

M

M-Mode

A control used to start M-mode acquisition and display. The “M” stands for motion. Themotion occurs over time, which is represented by a sweeping M-mode display.

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Manual Cine

A control on the Review Exam touch screen and on the Review display that allows youto use the trackball to control frame by frame review of a Cineloop sequence.

Master List

In Analysis Config setups, the master list is a calc list that displays the complete set ofgroups, measurements, and calculations available with a selected calculations package. InBuild mode you can use the arrows to move entire groups or individual measurementsand calculations to and from the open list on the left of the display, creating custom mea-surement and calculation lists from the selections in the master list.

MCA

Middle cerebral artery

MCCA

Middle common carotid artery

Mean Trace

A Doppler touch screen control used to turn the High Q mean trace on or off. Themean trace is displayed on the spectral waveform in pink. It is the instantaneous meanvalue calculated at each point along the spectral waveform.

Measure

In System Settings, a tab used to display the Measure setup parameters: Doppler,Measurement Units, and Dotted Lines.

Measurement tools

Located on the Caliper touch screen, used to make measurements, including distance,time, circumference, heart rate, slope, velocity, and 2D depth.

Measurement Units

In System Settings, a Measure setup parameter used to select the units and precisionof the distance, velocity, and volume measurements.

Med

Medial

MHV

Middle hepatic vein

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Glossary

MICA

Middle internal carotid artery

Microphone (Mic)

A key used to turn on and off the microphone.

Mid

Middle

Modality Worklist

In the Print/Network setups, under the Device Selection tab, a group of Worklistsetups used to select a worklist server, determine when to query the worklist server, andwhich query attributes to use.

Mode Settings

In System Settings, a tab used to display default format settings for the auto-inversionof Color and Doppler baseline and full-screen, dual, or quad 4D acquisition and 3Dreview.

Monitor

A 2D touch screen control used to adjust monitor brightness to compensate for changesin ambient light. Use this control to quickly make temporary adjustments to the monitorbrightness setting in the setups. Turn Monitor to select a setting from 1 (darkest) to 5(lightest).

Monitor Brightness

In System Settings, a Display setup parameter used to set the default monitor bright-ness setting. The settings vary from 1 (darkest) to 5 (lightest).

Move 3D Info

In 3D review, a touch screen control used to move the 3D image information from itsdefault location above the thumbnail area to the printable area of the screen. The 3Dimage information comprises the following: scan angle, tilt angle, header data, gray mapnumber, Chroma map number, opacity map number, transparency percentage, brightnesspercentage, and lighting percentage.

Move Body Mark

An Annotations touch screen control used to enable the trackball for body markmovement.

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MPA

Main pulmonary artery

MPR

Multiplanar reformatted, multiplanar reconstructed

MPR views

The three multiplanar reformatted (MPR) views displayed in 3D review.

MPR X-Hair

A touch screen control used to turn the crosshairs on and off in the multiplanar refor-matted (MPR) views. The crosshairs represent the intersection of the two planes orthog-onal to the view on which the crosshairs appear. The crosshairs are color-coded tocorrespond to the image view they represent. There are three settings: On, Partial, andOff.

MPV

Main pulmonary vein, middle portal vein

MSK

Musculoskeletal

Multiple Gestation

A calc list icon used to set the number of fetuses for the current exam.

MV

Mitral valve

N

Name/ID

A key used to hide the patient name and ID on the display.

Network Status

Dialog box that shows the status, type, and destination of all network jobs. (In this dialogbox, jobs can be either exams or images.) You can cancel, pause, resume, select or dese-lect all of the network jobs using the selections on the dialog box.

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Glossary

NEW

(1) A label used to create custom measurements. (2) In Analysis Config setups, a selec-tion used to create groups, measurements, and calculations.

New Equation

In Analysis Config setups, on the Author Editor display, a selection used to create anew equation for a calculation.

New Table

In Analysis Config setups, on the Author Editor display, a selection used to create anew table for a calculation.

Next

A touch screen control used to display another page of touch screen controls.

Nuch Fold

Nuchal fold

Nyquist Values

The values that appear at the ends of the Doppler, CPA, and Color scales.

O

OB

(1) Obstetrics. (2) A calculations package.

OFD

Occipital-frontal diameter

OOD

Outer orbital diameter

Opacity M

Opacity Map. A touch screen knob used in 3D review to apply one of five opacity mapsettings to the 3D data set.

Optional Header Info

In System Settings, a Header setup parameter used to select the display of patientbirth date, sonographer ID, or neither of those in the header area of the display.

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Output Power

A touch screen knob used to select the amount of ultrasound acoustic power producedby the transducer measured in Watts per square centimeter.

P

PA

Pulmonary artery

Page

A rotary display on the Review Exam touch screen used to quickly display pages ofstored images. Turn Page to move backward or forward through the available images,one page at a time.

Pan Filter

A touch screen control used to reduce image artifacts in Panoramic Imaging. A smooth-ing filter, it provides seven levels of image smoothing.

Panoramic

A touch screen control used to start Panoramic Imaging.

Password

In Data Security setups, a User Settings setup parameter used to set your password.

Patient Data

(1) A key on the keyboard or a control on the control panel used to display the PatientData form. (2) In System Settings, a tab used to display the Patient Data setupparameters: Patient Name and Patient Data Units.

Patient Data Access

In Data Security setups, an Admin Settings setup parameter used to select unre-stricted access or to restrict access to registered users only.

Patient Data Units

In System Settings, a Patient Data setup parameter used to select the height andweight units for the patient.

Patient Name

In System Settings, a Patient Data setup parameter used to determine the order inwhich the patient’s name appear and whether the middle initial is displayed.

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Glossary

Pause

A control on the VCR touch screen used to pause VCR playback.

Pause Exam

A control on the Patient Data form used to pause the current exam. If the exam is notresumed within 24 hours, the system ends the exam without notification.

Paused exam

An exam that you have paused. If the exam is not resumed within 24 hours, the systemends the exam without notification.

PCA

Posterior communicating artery

PCCA

Proximal common carotid artery

Per

Peripheral

Percent Reduction

A Caliper touch screen measurement tool used to select either percent diameter orpercent area reduction measurement tools.

Persistence

A CPA and Color touch screen knob used to select the level of smoothing or frameaveraging for the image display. Use Persistence to average consecutive frames to pro-vide a smoother appearance with less noise. Use lower persistence values for fast-movingorgans or tissues and higher persistence values for slower moving organs or tissues.

Physio

(1) A control used to turn on the ECG display. (2) A touch screen tab used to display atouch screen containing the ECG/Physio controls.

PICA

Proximal internal carotid artery

PLAX

Parasternal long axis

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Play

A control on the VCR touch screen used to start VCR playback.

Pointer

A control used to display a pointer. The pointer is used to select elements on the display.

Port Number

1) A number in the range of 0 to 65535, found in the DICOM Conformance Specificationfor the ultrasound system or device. A required field for DICOM configuration of theultrasound system or any device configured for DICOM operation. (2) In the Print/Net-work setups, a field in the Global Configuration setups into which you enter the portnumber.

PPS

Performed procedure step

PPS Server

Performed Procedure Step server. In Print/Network setups, on the Device Selectiontab, a Worklist setup listing the configured PPS servers.

Previous

A touch screen control used to display the default page of touch screen controls.

Previous Slice

A control on the Stacked Contour touch screen sub-window used to select the sliceto trace, moving forward through the slices.

Print/Network

Setups category used to configure your system for print and network operations.

Print

A control used to save an image of the full screen to the system hard drive and a copy tothe configured destination devices.

Print Format

In the Print/Network setups, a Printer/Capture setup parameter used to select thearea that will be printed, either the full screen or display area, when the Print or AltPrint functions are used.

Print Graphs

On the patient report, a selection used to print the patient’s graphs.

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Print Screen

A touch screen control used to save an image of the full screen to the system hard driveand a copy to the same destination devices as the Print control. Print Screen is avail-able only when the image is frozen.

Print Status

A dialog box that shows the status, type, and destination of all print jobs. You can cancel,pause, resume, select or deselect all of the print jobs using the selections on the dialogbox. The status of the current exam and configured printers is also shown.

Printer/Capture

In the Print/Network setups, a tab used to display the setup parameters used to set thelive capture time, print format, report destination, compression type, when and whereimages and clips will be sent, and when pending exam data will be sent.

Printer Type

In Print/Network setups, a menu from which you select the type of device that you areconfiguring for DICOM operation with the system.

Prospective Capture

In Print/Network setups, a Printer/Capture setting used to select the type of cap-ture. A prospective capture captures a specified acquired loop length. The other type ofcapture is a retrospective capture.

Prox

Proximal

Protocol

A control on the control panel, which is not currently used.

PSA

Prostate-specific antigen

PSAX

Parasternal short axis

PTA

Posterior tibial artery

PTV

Posterior tibial vein

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Pulse repetition frequency

PRF. The number of ultrasound pulses emitted per second. At 1,540 m/s, the pulse echotime is 13 microseconds. A typical PRF for real-time 2D imaging is 2-4000 pulses per sec-ond.

PV

Pulmonary vein

PW

Pulsed Wave. A control used to start and stop pulsed-wave Doppler imaging.

PW Map

Pulsed Wave map. A touch screen control used to select the gray map applied to the PWspectral display. Within each application, the PW gray maps are selected to optimize thedisplay of Doppler data.

PW Output Power

Pulsed Wave Output Power. A knob on the PW touch screen used to control the outputpower in PW mode.

Q

Quad Screen

A touch screen control used during 3D review to display the four image views in quadscreen.

Quick Save

A key used to save custom presets, which are used to set up the system for a specificarea of study, such as OB fetal echo or abdominal vascular.

Quick Save preset

Quick Save presets are controls that appear on the Transducer touch screen. For a spe-cific transducer/clinical option combination, you can set imaging controls and save thesesettings in a Quick Save preset. When you select the corresponding transducer, yourQuick Save presets appear on the Transducer touch screen along with the Tissue Spe-cific presets. Selecting any preset loads the control settings from the preset into the sys-tem.

Quit Trim

A touch screen control used to remove the Sculpt or Erase tools and cancel the trimoperation.

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R

RA

Right atrium

Rad

Radial

RA Pressure

The Doppler RA pressure tool sets the right atrium pressure manually. You can selectfrom one of the pre-set values or enter your own.

Rebuild

A touch screen control used during Panoramic Imaging review to rebuild and restore theimage display. It can be used to check the image for acquisition consistency.

Record

A control on the control panel used to record the image display to a VCR. PressingRecord when the VCR is not in record mode starts recording. Pressing Record subse-quently alternates between record pause mode and record mode. To stop recording,press VCR on the control panel to display the VCR touch screen, and then touch Stop.

Record

A control on the VCR touch screen used to record the image display to a VCR.

Redo

An icon on the display used during 3D review to redo up to eight freehand trim opera-tions.

Registered Users

In Data Security setups, an Admin Settings setup parameter used to register users,import users, export users, delete users, and add users for system access.

Ren

Renal

Report

A control used to display the patient report.

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Res/Pen

Resolution/Penetration. A touch screen knob on the Color and CPA touch screensused to vary the balance between image quality (resolution) and penetration. Up to threesettings are available; R1, RP, and P1. To select a resolution/penetration setting, turnRes/Pen clockwise to increase penetration and decrease resolution, or counterclock-wise to decrease penetration and increase resolution. The default setting and the numberof settings available are both dependent on the transducer and preset selected.

Res/Spd

Resolution/Speed. A touch screen knob that, during SonoCT imaging, provides betweenthree and five frame rate settings used to vary the balance between image quality (resolu-tion) and frame rate. The settings are R2, R1, RS, S1, and S2, which range from highimage quality (R2) to high frame rate (S2). To select a resolution/speed setting, turn Res/Spd clockwise to increase frame rate and decrease resolution, or counterclockwise todecrease frame rate and increase resolution. The default setting and the number of set-tings available are both dependent on the transducer and preset selected.

RESET

A control on the 3D Review touch screen and on the 3D review display used to undo allsculpting and linear trimming, and reset the image views to their default settings and orig-inal orientations.

Reset Defaults

A selection in the setups displays used to reset all of the setup parameters to theirdefault values.

Reset iSCAN

A touch screen control used to reset the image parameters to their original settings afteryou have used iSCAN optimization.

Reset Orientation

(1) A touch screen control used during 3D review to reset the orientation of the imageviews to their original orientations. (2) A selection on the 3D review display to reset theorientation of the 3D data set to the default state, corresponding to the presentationimmediately after acquisition.

Resize

A touch screen knob used during Freehand (non-calibrated) 3D review to change theZ-scale of the volume view. The range of the Resize knob is 0 to 100. Crosshair position

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Glossary

and adjustable trim planes maintain the same location in the acquired data set before andafter resizing.

Results

In calcs, the calculations appear in a results area. The results are moveable.

Retrospective Capture

In Print/Network setups, a Printer/Capture setting used to select the type of cap-ture. A retrospective capture captures a specified loop length that was acquired previ-ously. The other type of capture is a prospective capture.

Review

(1) A control on the control panel used to display the Review Exam display. (2) A touchscreen from which you control the review of the current patient’s images.

Review Format

In System Settings, a Display setup parameter used to select the number of reviewimages displayed: 1:1, 2:1, and 4:1.

Rewind

A control on the VCR touch screen used to rewind the videotape.

RHV

Right hepatic vein

RLQ

Right lower quadrant

ROI

Region of interest. A frame or box that appears on an image to show the portion of theimage that is magnified, acquired, or displayed.

Roof Line

A control on the Hip Angle touch screen that displays calipers used to draw the roofline that connects the lower edge of the os ilium to the osseous acetabular convexity.

Rotate

A Panoramic Review touch screen knob used to adjust the image size as needed todisplay the entire image. If the image is zoomed larger than x1.0, portions of the imagecould move off the display during rotation.

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Rotate 1, 2, 3

Knobs associated with the 3D Review touch screen used to rotate the correspondingMPR image view or the crosshairs on that view, depending on the setting of RotateMPR/X-Hairs. When these controls are turned slowly, a single step or click corre-sponds to a 1-degree rotation of the MPR image view. When these controls are turnedfaster, the degree of rotation per step is greater.

Rotate MPR/X-Hairs

A touch screen control used during 4D acquisition and review to switch the function ofthe Rotate 1, 2, 3 knobs between rotating the MPR images and rotating the crosshairs ineach image.

RPV

Right portal vein

RRA

Right renal artery

RRV

Right renal vein

RSFJ

Right saphenous femoral junction

RUQ

Right upper quadrant

RV

Right ventricle

RVD

Right ventricle diameter

RVID

Right ventricle inner dimension

RVOT

Right ventricular outflow tract

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S

Sag

Sagittal

Save 3D Data

A control on the 3D Review touch screen used to save the current 3D data set.

Scale

A control used to adjust the Color, CPA, or Doppler velocity scale. The velocity scale isthe vertical axis of the Doppler display; it is calibrated in cm/s or m/s. Increasing the scaleis one way to eliminate aliasing in the Doppler display.

Sector Width

A touch screen control used to adjust the width of the 2D sector. A narrower sectorwidth increases frame rate.

Select

Two unlabeled controls, one on either side of the trackball, that are used to selectobjects, activate controls, and make measurements. Use Select to click, double-click,select, drag, and trace objects. Both Select controls function identically.

Send Images/Clips

In Print/Network setups, a Printer/Capture setup parameter used to determinewhen the images and clips will be sent, either after each print or capture or at the end ofthe exam, and whether a copy will be sent to the DVD.

Send Pending Exam Data

In Print/Network setups, a Printer/Capture setup parameter used to determinewhen you want to send pending exam data, either automatically at reconnect or manually.

Send Report

(1) In Print/Network setups, a Printer/Capture setup parameter used to determinewhere a patient report will be sent: report printer or report server. (2) A selection onthe patient report used to send a report over a DICOM network to a structured reportserver.

Set Contours

A control on the Stacked Contour touch screen sub-window used to set the numberof slices or contours to be included in the stacked contour measurement.

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Set Date

In System Settings, a Header setup parameter used to select the date format and setthe date.

Set End Points

A control on the Stacked Contour touch screen sub-window used to set the endpoints of the stacked contour measurements.

Set Home

A control on the Annotations touch screen used to set a new default or home positionfor the annotation cursor.

Set iSCAN

A touch screen control used to adjust the brightness level set by iSCAN in 2D imaging.This setting will be used each time you activate iSCAN with the current transducer.

Set Time

In System Settings, a Header setup parameter used to select the time format and setthe time.

Setups

A key used to display the system setups. The setups are used to set several differenttypes of system parameters.

SFA

Saphenous femoral artery

SFJ

Saphenous femoral junction

SFV

Saphenous femoral vein

Simpson’s Rule

In 2D/Color cardiology calculations, a measurement tool that calculates the ejection frac-tion (EF) from the change in the left ventricular volume between diastole and systole.

Simult

Simultaneous. A PW touch screen control used to turn on simultaneous update of the2D and Doppler displays.

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Single Print Mode

A print mode used to immediately send images to the configured DICOM network print-ers, a DVD, and other network archive devices, instead of as in batch mode, whereimages are sent after the exam ends.

SMA

Superior mesenteric artery

Small Parts


Smooth

A touch screen control used to change the appearance of the flow data by using spatialfiltering. Use the Low settings for smaller vessels and the High setting for larger vessels.

Smoothing

A knob on the 3D Image Controls touch screen that is used to change the amount ofsmoothing applied to the surface of the object in the 3D volume. Smoothing shares atouch screen knob with Lighting. Use Smoothing/Lighting to switch between thesetwo functions.

Smoothing/Lighting

A control on the 3D Image Controls touch screen that is used to switch the functionof the touch screen knob below it between Smoothing and Lighting. The active func-tion appears on the touch screen label below Smoothing/Lighting.

SonoCT

A touch screen control used to turn on and off SonoCT Real-time Compound Imaging.

SonoCT Real-time Compound Imaging

SonoCT imaging is performed by rapidly acquiring a series of overlapping image framesfrom substantially differing spatial directions and combining these images to reducespeckle and improve contrast resolution.

Speed

A touch screen knob used to adjust the sweeping speed of the ECG, M-mode, or Dop-pler displays. There are five sweep speeds: Min, Slow, Med, Fast, and Max. The sweepspeed is displayed on the touch screen. A medium sweep speed is suitable for normaluse, but a fast sweep speed may be useful to show the shape of some flow information. If,for example, a flow pattern is to be analyzed carefully to calculate a mean pressure gradi-ent, then it will be much easier to do this at a faster speed than at a slower speed. There

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are three sizes of time markers in the sweeping displays. The largest time marker denotesa time of 1 second, the smaller time marker denotes 0.2 second, and the smallest timemarker denotes 0.1 second. The smallest time marker appears in the faster sweepspeeds.

SS

Suprasternal

Stacked Contour

(1) A measurement technique used to calculate the volume of an irregularly shaped 3Dvolume by tracing the contour of slices of the shape. (2) A control on the Caliper touchscreen used to start a stacked contour measurement during 3D review. This control dis-plays a sub-window of touch screen controls.

Start

A touch screen control used to start the construction of the Panoramic image display.

START 3D

A touch screen control used to start 3D acquisition.

START 4D

A touch screen control used to start 4D acquisition.

Station Name

(1) An arbitrary name, but a required field for DICOM configuration of the ultrasoundsystem. (2) In the Print/Network setups, a field in the Global Config setups, intowhich you enter the station name of the ultrasound system.

Steer

A touch screen control used to adjust the steering angle for a linear array transducer.

Stop

A control on the VCR touch screen used to stop playback and recording.

STOP 3D

A touch screen control used to stop 3D acquisition and start 3D review.

STOP 4D

A touch screen control used to stop 4D acquisition and start 4D review.

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Glossary

Structured report server

In Print/Network setups, clicking Archive displays a list of the configured structuredreport servers.

Study Info

A control on the Patient Data Entry touch screen used to display the Study Info tabof the Patient Data form, in which you can enter patient data for the selected exam.

SUB4C

Subcostal four chamber

Subnet Mask

(1) A four-byte IP address with each byte separated by a dot and in the range of 0 to 255.A required field for DICOM configuration of the ultrasound system. (2) In the Print/Network setups, a field in the Global Config setups into which you enter the subnetmask of the ultrasound system.

SubSAX

Subcostal short axis

Subscap

Subscapular

Sup

Superior

SV Size

Sample Volume size. A Doppler touch screen control used to adjust the sample volumesize. Sample volume size is represented by an adjustable cursor located along the D-lineat the sample volume depth, which is positioned on the 2D display using the trackball.

System Location

(1) An arbitrary name, but a required field for DICOM configuration of the ultrasoundsystem. (2) In the Print/Network setups, a field in the Global Config setups, intowhich you enter the ultrasound system location.

System Power

In System Settings, a Display setup parameter that sets the way in which the powerswitch functions: Full Power Down or Standby.

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System Settings

A setups category from which you set various system setup parameters.

T

TEE

Transesophageal echocardiography

Text Cursor

A key used to display the text cursor for annotating the image display.

TGC Curve/Values

In System Settings, the Display setup parameters used to turn on or off the TGCcurve and values. You can also set the curve and values to go off after 3 seconds.

TGC Slide Controls

A set of controls on the control panel used to adjust the TGC curve.

Threshold

A touch screen knob used during 3D review to remove low-level echoes from the 3Ddata set.

Thumbnails

(1) In review, miniature images. (2) In System Settings, a Display setup parameterused to show or hide the thumbnails in review. (3) In the Patient Directory, a controlused to open the DVD drive tray and automatically close the session on the DVD+R orCD-R, making the disc compatible with the greatest number of drives.

TI

Thermal Index. A touch screen control used to select the type of thermal index. Thermalindex is a displayed index that provides information about the conditions that exist thatmight lead to an increase in temperature at the surface of the body, within the body tis-sue, or at the point of focus of the ultrasound beam on bone. The settings are TIB, TIC,and TIS.

TIA

Transient ischemic attack

Time/Date

In System Settings, a Header setup parameter used to set the date and time and theirformats.

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Time/Slope

A measurement tool on the Caliper touch screen used for sweeping displays. It can beused to measure distance, time, and slope.

TIPSS

Transjugular intrahepatic portosystemic stent shunt

Tissue Specific preset

Tissue Specific presets are controls that appear on the Transducer touch screen. Youselect a Tissue Specific preset to specify imaging settings for a specific area of study, suchas OB fetal echo or abdominal vascular.

Title Cursor

A key used to display the title cursor on the image display.

Tool tips

(1) Brief descriptions of the function of icons and selections on the screen. (2) In Sys-tem Settings, a Display setup parameter used to show or hide the tool tips.

Top/Bottom

A touch screen control used to reverse the up/down orientation of the image, as indi-cated by a transducer orientation icon , which appears at the top of a noninvertedimage and at the bottom of an inverted image.

Touch screen

A system control module consisting of a matrix of related functions. When you touch thetouch screen, you initiate a function.

TR

Tricuspid regurgitation

Trace by Points

A measurement tool on the Caliper touch screen used to measure the circumference ofobjects on a 2D image or trace a spectral waveform to obtain a spectral area.

Trackball

A control used to move objects on the monitor. The trackball status is displayed in thetrackball arbitration list at the bottom of the screen, which indicates the functions linkedto the trackball.

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Training

In Voice Control setups, a control used to initiate the training process for voice con-trol. A dialog box with a list of training topics appears with instructions for use.

Trans

Transverse

Transducer

A control used to display the Transducer Select touch screen, from which you select atransducer and a clinical option/preset.

Transducer Select

A touch screen from which you select a transducer and a clinical option/preset.

Transparency

A touch screen control used during 3D review to change the transparency setting of the3D data set. The range of transparency settings is 0 to 100. The transparency settingappears in the image info as Trans X%, where X is a number from 0 to 100.

Trim Image

A touch screen control used in Panoramic Imaging to enable the trim functions. The Pan-oramic image can be trimmed from the left or right. You can touch Rebuild to returnthe image to its original size.

Trim Left, Right

A control on the 2D Frozen touch screen used to display trim cursors on the Cineloopindicator bar. You use the trim cursors to temporarily set new beginning and end pointsfor the Cineloop sequence. The trackball is used to move the trim cursors. PressingSelect anchors the active trim cursor and enables manual review.

Triplex

Triplex (also called triple mode) is the simultaneous update and display of 2D, Color orPower imaging, and Doppler ultrasound information. Triplex can be used to decreaseexam time and improve efficiency. Triplex is available with a select set of transducers.

TURP

Transurethral resection of the prostate

TV

Tricuspid valve

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Glossary

U

Undo

An icon on the display in 3D review, used to undo up to eight freehand trim operations.

Update

A control used to change the method by which the system updates the image display,alternating between duplex and simultaneous methods.

User Settings

In the setups, a tab used to display setup parameters related to Data Security: AutoLog Off and Password are available.

V

Variance

A touch screen control used to enable the variance display during Color imaging. Vari-ance is the difference in blood flow within a given number of samples; it indicates changein blood flow or possible turbulence due to an obstruction. Variance can be mapped to acolor, such as green, to identify it more clearly during an exam.

Vascular


VCR

(1) Videocassette recorder. (2) A control on the control panel used to display the VCRtouch screen.

View Graphs

In the editable report, a selection used to display the OB graphs.

Voice Control

In the setups, a display from which you set up your voice profiles and headset configura-tion.

Voice Profiles

In Voice Control setups, a tab that provides access to a list of voice profiles, training forvoice recognition, and selections for adding and deleting voice profiles.

Vol X-Hair

A touch screen control used to turn the crosshairs on and off in the volume view.

Glossary


22

460

Volume

(1) A control used to adjust the audio volume of the system speakers. (2) A touch screenknob, available during 4D review, when more than one complete volume has beenacquired. Turning the knob updates the volume display with the next volume in thesequence. (3) A control on the Caliper touch screen that displays the available volumemeasurements, which include 1 Distance, 3 Distance, and Distance Ellipse.

Volume Distance

A control on the Volume touch screen that starts a distance measurement as part of avolume measurement using a 1 Distance or Distance Ellipse method.

Volume Distance 1, 2, 3

Controls on the Volume touch screen that start distance measurements as part of a vol-ume measurement using a 3 Distance method.

Volume Ellipse

A control on the Volume touch screen that starts an ellipse measurement as part of avolume measurement using a Distance Ellipse method.

Volume Flow

A control on the Caliper touch screen used to launch the volume flow measurementtool.

VR

Volume rate

W

Wall Filter

A touch screen knob used to establish the wall filter setting during Doppler or Colorimaging. A wall filter removes low-frequency Doppler signals originating from slowlymoving reflectors, such as vessel walls.

Warning

An icon used when there is a possibility of a system malfunction that might prevent use ofthe ultrasound system.

WF

Wall filter

22


Glossary

Wide Screen

A touch screen control used during SonoCT compound imaging to display a wide-screendisplay created from all of the ultrasound data acquired for compound imaging

Worklist

A control on the Patient Data Entry touch screen used to display the Worklist tab inthe Patient Data form, in which you can load patient data and select a scheduled proce-dure

Write Priority

A Color and CPA touch screen control that establishes the threshold value at which the2D grayscale echo information is considered strong enough to indicate a solid structuresuch as a heart wall, rather than blood flow, even though that structure may be moving.

X

Xres

A touch screen control used to start XRes image processing.

XRes Image Processing

An adaptive algorithm that enhances grayscale image quality by reducing speckle andnoise, while maintaining image resolution.

Y

Z

Zoom

A control used with two types of image magnification: zoom and HD Zoom. Zoom mag-nifies existing display data from a region of a real-time image, Cineloop frame, orCineloop sequence up to eight times. The zoomed image can be panned with the track-ball. HD Zoom concentrates the system’s image processing on a region of a real-timeimage, resulting in greater detail and higher frame rate. An HD Zoom display cannot bepanned.

Glossary


22

462


Index

Numbers2D

about, 164circumference and area (continuous trace) measurements, 235circumference and area (ellipse) measurements, 234circumference and area measurements,

234depth measurements, 228distance measurements, 229hip angle measurements, 246, 247hip joint measurement accuracy, 226measurement accuracy and ranges, 226measurement accuracy, about, 222percent area reduction, obtaining, 236percent diameter reduction, obtaining,

229TI and MI values, 49touch screen controls, 164using, 164volume (one distance and one ellipse) measurements, 238volume (one distance) measurements,

237volume (three distance) measurements, 237volume flow measurements, 245volume measurements, 237

2D/Color All Points, 2602D/Color cardiac calculations, 2603D

acquiring a freehand data set, 181acquiring a single-sweep data set, 181acquisition, 177image review, 184

magnifying images, 187measurement accuracy, 227measuring volume, 239moving information, 190optimizing image quality, 180recalling data sets, 191resetting the review display, 190review format, 185rotating views, 186saving data sets, 191single-sweep, 181stacked contour measurements, 240storing data sets, 148touch screen controls, 177, 184volume measurements, 239

3D Cine, 1893D/4D touch screen controls, 1773D6-2 transducer, clinical options, 3183D9-3v transducer, clinical options, 3184D

acquiring, 182format, 183ROI, 183

AAbdomen clinical option, 318Accessories, 31Accuracy, measurement, 222

2D, 2232D hip joint, 2263D, 227caliper placement, 224Color, 223CPA, 223display size, 223Doppler, 223, 227

Index


464

M-mode, 227tables, 226

Acoustic artifacts, 178, 196, 203, 319Acoustic measurement

output and, 53precision and uncertainty, 56

Acoustic output tables, 28MI and TI accuracy estimates, 47

Acoustic saturation, 319Acquiring

3D data sets, 1774D, 182freehand 3D data sets, 181single-sweep 3D data sets, 181

Acquisition and algorithmic errors, 225Adult Echo calculations, 260Air filter, cleaning, 364ALARA

applying principle, 42education program, 41example, 44related guidance documents, 52

Alcohol solution, 341Algorithmic errors, 225Aliasing, 224, 319Alignment verification, biopsy guide, 327Alignment, Doppler, 224All Points

2D/Color, 260M-mode, 264

Allergic reactions to latex, 322, 336Ambient light, 102Ambient light, adjusting monitor for, 161Amniotic Fluid Index (AFI), 275Analysis Configuration

Build mode, 280Edit mode, 281groups, 279

Anatomical structures, annotating, 215

Annotationadding labels, 215customizing, 217touch screen controls, 216using labels, 215voice, 115

Applications, clinical options, 63, 156, 317Archive server, storing exams to, 313Archive status, 308, 313Archived exams

configuring deletion of, 377deleting, 377loading, 315

Archiving exams, 313Area measurements, 234Artifacts

3D imaging, 178acoustic, 319Contrast imaging, 203Panoramic Imaging, 196

Assistance, 31, 370Attaching ECG leads, 212Audio, troubleshooting, 369Auto Invert, setting, 170Auto Log Off time, 389Automatic deletion, 313AVI format, exporting to, 313Avoiding damage to transducers, 340, 343

BBackground noise and voice control, 113Backing up exams, 313Basic Connectivity features, 63Biological safety, 40Biopsy

guide alignment, 327guideline display, 326guides, 325maintaining guides, 333

Index


procedure, 332safety precautions, 40, 325

Biopsy guidelineabout, 193depth cursor, 194displaying, 193

Body markersdisplaying, 218moving, 219touch screen controls, 219

Brakes, 36, 75, 95Brightness

monitor, 97touch screen, 102

Build mode, 280Buttons

control panel, 29touch screen, 29, 99

CC5-2 transducer, clinical options, 318C8-4v transducer, clinical options, 318C8-5 transducer, clinical options, 318C9-4 transducer, clinical options, 318C9-5ec transducer, clinical options, 318Cable management, 71Cables

disinfecting, 345preparing to move the system, 85protecting from damage, 36, 37, 84, 346

Calculations, 249Analysis configuration, 280, 281options, 63

Caliper, placement and measurement accuracy, 224

Canceling an exam, 295Capabilities, system, 59Capillary rupture, 40Capture settings, 378

Capturing images, 61, 161Cardiology (Adult Echo) calculations

2D/Color, 260About, 260cross-populating, 267Doppler, 265, 266M-mode, 263, 264Simpson’s Rule, 261

Cardiology clinical options, 318Cart, 65Casters, 36, 84CD, user information, 27, 28Changing, 167

measurement units, 297name format, 296time and date formats, 296

Cine Review, Panoramic Imaging, 201Cineloop Review

about, 208editing sequences, 210touch screen controls, 210using, 209

Cineloop sequencescapture length setting, 162capture type setting, 162editing, 210exporting to AVI format, 313playing in image review, 307

Circumference measurements, 234CIVCO Medical Instruments, 31, 335Cleaning

air filter, 364cables and connectors, 346peripherals, 367system surfaces, 348, 363transducers, 340, 343, 366

Clinical options, 63, 156, 317Clinical options and Tissue Specific presets,

151Color bar, 145, 159

Index


466

Color modeabout, 174comparing images, 175measurement accuracy, 223touch screen controls, 175using, 174

Color Power Angioabout, 175comparing images, 176measurement accuracy, 223touch screen controls, 176using, 176

Column width, patient directory, 309Comet tail, 320Commands, voice control, 113, 116Comments

customer, 30patient report, 257

Commit server, selecting, 381Commit status, 308Compatibility

disinfectants, 348gels, 356

Compressed images, exporting, 313Compression factor, setting, 316Conception, 292Configuring

deletion of archived exams, 377print functions, 80printers, 379servers, 381system settings, 374voice control headset, 109

Connectingcolor monitor, 81devices, 77ECG signals, 212modem, 82network, 82physio leads, 212

printers, 77transducers, 147VCRs, 79

ConnectivityBasic Connectivity features, 63Basic Connectivity, about, 374changing configuration, 375configuration information, 375configuring printers, 379configuring, about, 374connecting to a network, 82deletion of archived exams, 377servers, about, 381standard network support, about, 374worklist setup, 383

Connectivity option, 62Connectors, disinfecting, 345Continuous trace, measuring 2D

circumference and area, 235Contrast clinical option, 318Contrast imaging

about, 203using, 204

Control module, 66Controls

buttons, 29control module, 66, 85, 98control panel, 29, 66, 97knob-buttons, 29knobs, 29on screen, 104slide controls, 29touch screen, 29, 66, 99, 289using, 97voice, 105

Controls affecting MI and TIdirect controls, 43indirect controls, 43receiver controls, 44

Index


Conventionssystem, 28user information, 29

CopyingQuick Save presets to a DVD, 154settings to DVDs, 372

Covers, transducer, 40, 41, 322, 336, 338CPA

about, 175comparing images, 176measurement accuracy, 223touch screen controls, 176using, 176

Creatingcustom fetal equations, 287custom fetal tables, 285Quick Save presets, 152voice profiles, 110

Creutzfeldt-Jakob disease, 338Critical device classification, 350Crosshairs, rotating, 187Cross-populating cardiac measurements,

267Curved distance, measuring, 232Custom equations, 287Custom tables, 285Customer

comments, 30service, 31

Customizingannotation, 217patient data format, 296presets, 151review, 316setups, 155system, 151

CW Dopplerabout, 171touch screen controls, 171using, 171

DData connections requirements, 92Data security

Auto Log Off, 145enabling or disabling, 389logging on, 143managing, 386option, 64passwords, 144

Data setsacquiring freehand 3D, 181acquiring Panoramic, 197acquiring single-sweep 3D, 181recalling 3D, 191saving 3D, 191

Data storage, 70, 148Date and time, setting, 94Date format, changing, 296Date, exam, 290Decontamination, 338Defibrillation, electrical safety, 34Delete Status icon, 104Delete, onscreen indicator, 104Deleting

archived exams, 377calc lists, 286exams, 310groups, 286images, 310, 311Quick Save presets, 153, 373servers, 383user logons, 387voice profiles, 112

Depthbiopsy, 195biopsy guide and distance relationships,

331measurements, 228moving biopsy cursor, 326

Index


468

scale, 145, 159value, hiding and showing, 160

Derated value intensities, 54Device class, 33Devices, connecting, 77DICOM

connectivity option and, 374printers, adding, 380sending report data, 257servers, adding, 382storage commit, 385

Disinfectants, 335choosing, 350compatibility, 348factors affecting efficiency, 351manufacturers, 351ordering, 335types, 349

Disinfectingcables and connectors, 345system surfaces, 347, 348transducers, 339, 342

Distance measurements2D, 2292D depth, 228about, 228curved, 232Doppler (velocity), 231heart rate, 233M-mode, 230, 231percent diameter reduction, 229time/slope, 233

Doppleralignment, 224continuous trace, 242heart rate measurements, 233High Q automatic measurements, 243mean trace, 243measurement accuracy, 223measurement accuracy and range, 227

measuring distance (velocity), 232time/slope measurements, 233trace, 241trace by points, 242velocity resolution in, 225

Doppler cardiac calculations, 265, 266Doppler RA pressure, 266Drive, DVD RW, 70Drive, DVD-RAM, 148Dual imaging


Duplex, 173DVD RW, 70, 148DVD status icon, 104DVDs

copying settings to, 372formatting, 314image capture and review, 61importing settings from, 373loading and ejecting, 149managing settings with, 371using, 149

EECG

attaching leads, 212connecting leads, 212monitoring signals, 212receptacles, 73, 212sweep speed, 168touch screen controls, 214using, 214

EDD, 292Edit mode, 281Editing Cineloop sequences, 210Editing patient data, 290Ejecting a DVD, 149Electrical parameters, 92, 407

Index


Electrical safety, 33Electrocardiography (ECG), 212Electromagnetism, 34Electrostatic discharge (ESD), 35Ellipse

circumference and area measurement,

234converting to, 235volume measurement, 238

Enabling voice control, 112Ending an exam, 295Enhancement artifacts, 320Entering patient data, 290Entering study data, 291Environmental requirements, 91Equipment protection, 37Eraser tool, 188Erasing

annotation, 215body markers, 219in Panoramic acquisition, 198to trim volume view, 188

Error messages, 40, 369Errors, acquisition and algorithmic, 225Estimated fetal weight, 276Estimated fetal weight equation, 277Estimated fetal weight references, 395Exam date, 290Exam List, 307Exam status, 308Exams

archiving, 313canceling, 295deleting, 310ending, 295finding, 309pausing, 294, 295printing to DICOM printer, 358reactivating paused, 295sending, 311

Explosion hazard, 33Export to DVD status, 308Exporting images for PC viewing, 313Exporting user logons, 388

FFalse needle image, 332Fetal equations, 281Fetal heart rate, 275Fetal tables, 281Fetal weight, estimated, 276Finding exams, 309Fire hazard, 34Focal banding, 320Focal enhancement, 320Focal zone, positioning, 165Foot pedals, brakes and steering lock, 75,

95Formats

changing name, 296changing time and date, 296customizing patient data, 296

Formatting a DVD, 150, 314Formulas, 225Freehand 3D

acquiring, 181geometry, 180technique, 179

Frequency, voice control headset, 106

GGateway, 375Gels, 335

compatibility, 356ordering, 335

Gestational age, 273, 292Gestational age references, 396Gestational sac, 274

Index


470

Glossary, 409Graphs

fetal growth, 283printing, 257prior exams, 283

Grating lobes, 321Grayscale bar, 145, 159Groups, Analysis Configuration, 279Guideline display, biopsy, 326Guides, biopsy, 325Gynecology calculations, 258Gynecology clinical option, 318

HHard drive, 70Hard drive maintenance, 366Harmonics, 205Hazards

explosion, 33fire, 34IEC symbols, 37shock, 33

HD Zoom, 212Headset, voice control

configuring, 109muting, 115option, 68transmit frequency, 106troubleshooting, 369turning on and off, 107

Heart rate measurements, 233Height, changing unit of measure, 297Help, 27Hiding the biopsy guideline, 193, 194, 326High PRF Doppler imaging, 169High Q automatic Doppler

adjusting markers, 244mean trace, 243

measurements, 243peak trace, 244

High-level ECG signals, connecting, 213Hip angle

about 2D, 246measuring, 247

HIPAA, 62, 386Humidity limits, 92, 407

IIcons, status, 104Icons, voice control, 106ID, patient, 289IEC symbols, 37Image information, 145, 159, 160Image layout

about, 305setting default, 316

Image review3D, 184formats, 184measurements, 299overview, 299playing Cineloop sequences, 307starting, 300touch screen controls, 300

Image updating, inconsistent, 40Images

acquiring freehand 3D, 181adding a title to the display, 216capturing, 161capturing and reviewing, 61comparing in Color mode, 175comparing in Color Power Angio, 176deleting, 310, 311erasing portions, 198exporting in JPEG format, 313exporting in PC formats, 313false needle, 332

Index


magnifying Panoramic, 199optimizing 3D quality, 180printing, 163, 311, 312printing to DICOM printer, 358printing to local printer, 357rebuilding Panoramic, 199retracing portions, 198rotating panoramic, 200sending, 311, 312smoothing panoramic, 200trimming Panoramic, 200troubleshooting the display of, 369using Panoramic Cine Review, 201XRes processing, 207

Imaging2D, 1643D, 1774D, 182Color, 174Color Power Angio, 175Contrast, 203display, 145, 159dual, 208duplex, 173freehand 3D, 180high PRF Doppler, 169iSCAN, 205M-mode, 166modes, 159options, 62Panoramic, 195pulsed-wave Doppler, 168SonoCT, 201Tissue Harmonic (THI), 204triplex, 173

Immersing sterilizable transducers, 345Immersion method, cleaning and

disinfecting transducers, 339

Importingsettings from DVDs, 373user logons, 388

In Situ value intensities, 53Indicators, on screen, 104Indices

artificially high or low readings, 46See also Mechanical Index (MI), Thermal Index (TI)

Input signals, 405Intensity parameters, 53Intraoperative applications, use of gels, 356IP address, 375iSCAN

2D, 205, 206Doppler, 206status icon, 104

Isolation transformers, 77

JJPEG

compression factor, 316exporting, 313

KKeyboard, 67, 103Keyword feature, voice control, 114Knob-buttons, 29Knobs, 29

LL12-5 transducer, clinical options, 318L17-5 transducer, clinical options, 318L8-4 transducer, clinical options, 318Labels

about, 215adding with Annotate control, 215adding with keyboard, 216

Index


472

creating new, 217customizing, 217deleting unused, 218moving, 217previewing, 217

Languages, 407Latex

allergic reactions, 322, 336transducer covers, 40, 322, 336

Layout, setting default, 316Leads

attaching ECG, 212connecting physio, 212

Leakage current, 34Limits, 92Linked groups, 279LMP, 292Loading

archived exams, 315DVDs, 149files from a DVD, 155

Log filesabout, 390archiving and clearing, 390

Logging on and off the system, 143Low-level ECG signals, connecting, 213

MMagnification, 211Magnifying 3D images, 187Maintaining

hard drive, 366system, 363transducers, 318

Manual Doppler trace, 241Manufacturers, disinfectant, 351Markers, adjusting for High Q

measurement, 244Mean trace, turning on, 243

Measurement controls, displaying during review, 299

Measurement tools, 60Measurement tools references, 393Measurements

2D accuracy, 2232D accuracy and range, 2262D hip joint accuracy, 2262D volume, 237about, 221accuracy of, 222acoustic, 53, 57biopsy depth, 195, 326, 330caliper placement and accuracy, 224changing settings, 221circumference and area, 234color and accuracy, 223CPA and accuracy, 223creating labels, 255cross-populating cardiac, 267custom, about, 282depth, 228display size and accuracy, 223distance, 228Doppler accuracy and range, 227Doppler continuous trace, 242Doppler mode and accuracy, 223Doppler RA pressure, 266Doppler trace, 241Doppler trace by points, 242heart rate, 233High Q automatic Doppler, 243M-mode accuracy and range, 227review, 299touch screen controls, 222types, 60

Index


Measuring2D circumference and area (continuous trace), 2352D circumference and area (ellipse), 2342D depth, 2282D distance, 2293D volume, 239continuous Doppler trace, 242curved distance, 232Doppler distance (velocity), 232Doppler trace by points, 242heart rates, 233hip angle, 247M-mode distance, 231obtaining the percent area reduction,

236obtaining the percent diameter reduction, 229time/slope, 233volume (one distance and one ellipse), 238volume (one distance), 237volume (three distance), 237volume flow, 245

Mechanical Index (MI), 45controls affecting, 49display, 47, 159display precision and accuracy, 47in contrast imaging, 203on-screen, 46, 145

Mechanical safety, 36Medical Ultrasound Safety, 28Messages, error, 40, 369MI. See Mechanical Index (MI)Microphone, VCR

location, 68status icon, 105turning on and off, 360using, 360

Mirror imaging artifact, 320Mirroring, 320M-mode

about, 166All Points, 264changing display format, 167distance measurements, 230heart rate measurements, 233measurement accuracy and range, 227time/slope measurements, 233touch screen controls, 166using zoom, 168

M-mode cardiac calculations, 263, 264Modality interface, 92, 406Modality performed procedure step

serversabout, 385selecting, 385

Modality worklistfeature, 292performed procedure step, 385query criteria, 384server selection, 383setup, 383storage commit, 385

Mode preferences, setting, 163Modem, connecting, 82Monitor

adjusting, 96ambient light, 97arm locks, 86brightness, 97brightness, default, 97cleaning, 363connecting, 81description, 66precautions when positioning, 36troubleshooting, 369

Moving 3D information, 190Moving body markers, 219

Index


474

Moving the biopsy depth cursor, 195, 326Moving the system

safety precautions, 36, 84setting up after, 87transporting the system, 90

MPR viewsCine, 189magnifying, 187panning, 189rotating, 186rotating crosshairs, 187trimming, 188

Multi-path positioning artifacts, 320Multiple-angle biopsy guides, 333Musculoskeletal clinical option, 318Muting voice control headset, 115

NName format, changing, 296Needle, biopsy

releasing, 332verifying guide alignment, 328

Networkconfiguration, 375connectivity option, 374data fields for connectivity, 375standard support, 374status icon, 105

Network connection, 82Network status, 105Neurosurgical applications, 336, 343Noncritical device classification, 350

OOB clinical option, 318OB ratios, 276OB references, 394Obstetrics calculations, 268

On/Standby switch, 38about, 69using, 93

Operating limits, 92Operating notes, 28Options

basic connectivity, 62calculations, 63clinical, 63, 317connectivity, 374data security, 64imaging, 62installing temporary, 156purchasing, 157system, 62technical administration, 391

Ordering supplies and accessories, 31, 335Output display, 45Output signals, 406Output tables, acoustic, 28, 47

PPairing headsets with the system, 108Pan Filter, 200Pan, using, 189Panoramic Imaging

acquiring a data set, 197artifacts, 196Cine Review, 201erasing, 198magnifying, 199measurement precautions, 199printing images, 201rebuilding an image, 199retracing, 198rotating an image, 200smoothing an image, 200storing images, 201techniques, scanning, 196

Index


touch screen controls, 198trimming an image, 200

Parameterselectrical, 92image area, 145, 159, 160intensity, 53

Passwordchanging system administrator, 391changing user, 144creating user, 387protection, 64system administrator, 371

Patient contact temperature, 317Patient data

customizing formats, 296editing, 290ending an exam properly, 295entering, 289entering manually, 290protecting, 61

Patient directoryabout, 307changing column width, 309display, 301headers, 307sorting, 309

Patient ID, 289Patient report data, sending, 257Patient reports

about, 255comments, 257displaying, 256editing, 256printing, 257

Paused exams, reactivating, 295Pausing exams, 295Peak trace, 244Pediatric clinical option, 318Percent area reduction, obtaining, 236Percent diameter reduction, obtaining, 229

Peripherals bay, 71Philips Ultrasound contact information, 31Physical dimensions, system, 91Physio

connecting leads, 212receptacles, 73

Playback, 360Port number, 375Power

cord, 74peripherals, 77protection circuit, 317switch, 74, 94troubleshooting, 369

PPS serversabout, 385selecting, 385

Preferences, setting mode, 163Presets, 151

clinical options, 151Contrast imaging, 203deleting Quick Save, 373Quick Save, 152Tissue Specific, 151

Pressure limits, 92, 407Preventricular contractions, 41Print status, 308Print Status icon, 104Printers

about, 379adding, 380associating with print controls, 80changing settings, 378configuring, 379configuring print functions, 80connecting external, 77DICOM, 358maintaining, 367parameters, 378peripheral bay location, 71

Index


476

Printingabout, 357DICOM printers, 358during imaging, 357exams and images in Review, 315graphs, 257image review, 315images, 163, 311, 312local printers, 357Panoramic images, 201reports, 257

Profiles, training voice, 110Propagation speed errors, 320Prospective capture, 162PW Doppler

about, 168changing display format, 170touch screen controls, 169

QQuick Cards, 27Quick Save presets

about, 152copying, 154creating, 152deleting, 153, 373loading from a DVD, 155modifying, 153

RRA pressure, 266Range ambiguity, 320Reactivating paused exams, 295Real-time 3D (4D)

acquiring, 182format, 183ROI, 183

Rear panel, 74

Rebuilding a Panoramic image, 199Receptacles

ECG, 73, 212network, 83physio (ECG), 73, 213transducer, 71, 146

Recording, 360Reference, User, 27References

measurement tools, 393OB, 394

Refraction artifacts, 320Releasing biopsy needles, 333Report data, sending, 257Reports

about, 255comments, 257displaying, 256editing, 256printing, 257

Requirementsenvironmental, 91levels of disinfection, 350

Resizing volume views, 190Retracing, 198Retrospective capture, 162Reverberation, 320Review

3D, 299customizing, 316measurements, 299overview, 299playing Cineloop sequences, 307printing from, 315starting, 300touch screen controls, 300

Review Exam display, 300, 303ROI, defining a 3D, 183Rotary displays, 100

Index


Rotating3D views, 186crosshairs, 187Panoramic images, 200

Rubber. See Latex

SS3-1 transducer, clinical options, 318S4-1 transducer, clinical options, 318Safety, 33

acoustic output and measurement, 53ALARA principle, 41biological, 40biopsy, 40, 325disinfectants, 335electrical, 33equipment protection, 37gels, 335guidance documents, 52mechanical, 36mechanical index. See Mechanical Index (MI)medical ultrasound, 28moving the system, 36, 84output display, 45symbols, 37thermal index. See Thermal Index (TI)

Safety requirements, 408Sample volume, positioning, 169Saturation, acoustic, 319Scattering, 321Sculpt tool, 188Searching for exams, 309Searching in the worklist, 293Security, data

Auto Log Off, 145enabling and disabling, 389logging on, 143managing, 386

option, 64passwords, 144patient data protection, 61

Select buttons, 28Selecting

exams, 302objects, 28patients in worklist, 293transducers, 147, 317

Sending exams, 311Sending images, 311, 312Sending images using E-mail, 313Sending report data, 257Servers

about, 381adding, 382changing settings, 381configuring, 381deleting, 383PPS, 385selecting, 381selecting PPS, 385selecting worklist, 383

Service, customer, 31Setting

Auto Invert, 170default 3D review formats, 185mode preferences, 163

Settingsconfiguration, 375managing, 371measurement, 221print and capture, 378printer, 379server, 381system setups, 155

Shadowing, 321Shock hazards

electrical, 33static, 35

Index


478

Showing the biopsy guideline, 193, 194, 326Signals, connecting ECG, 212Simpson, 2D, 261Single-angle biopsy guides, 333Single-sweep 3D acquisition, 181Skin line ruler, Panoramic images, 199Slide controls

control panel, 29Small parts clinical option, 318Smoothing Panoramic images, 200Solvents, 37, 363SonoCT imaging


Sortingpatient directory, 309worklist columns, 294

Specifications, 405Speckle, 321Spectral broadening, 321Spectral trace format, 170

changing in CW Doppler, 172Speed of sound, 224Speed of sound artifacts, 321Spongiform Encephalopathy, 338Stacked contour volume measurements,

240Starter kits, ordering biopsy-related, 325Starting an exam, 161States, system, 69Station name, 375Status, exam, 308Steering lock, 75, 95Sterilizing transducers, 342, 344Storage commit

selecting servers, 381setting up, 385

Storage limits, 92Storage, data, 70, 148

Stored imagesdeleting, 311printing to DICOM printer, 358printing to local printer, 357reviewing, 303

Storingexams, 311images, 312Panoramic images, 201

Structured report server, selecting, 381Structured reporting, 257Study data, entering, 291Subnet mask, 375Supplies, 31, 335Surfaces, disinfecting system, 347Sweep speed, 167

changing in CW Doppler, 172Symbols, 37System

cleaning, 348, 363components, 65configuring, 374controlling with voice commands, 113controls, using, 97conventions, 28error messages, 40, 369logging on and off, 143maintaining, 363moving, 84On/Standby switch, 38, 65, 69, 93options, 62overview, 59physical dimensions, 91positioning in confined spaces, 87protecting from damage, 37steering lock, 75symbols, 39transporting, 90troubleshooting, 368turning on and off, 93

Index


upgrades, 30using, 93

System administration, 371changing Worklist setups, 383configuring printers, 379configuring servers, 381configuring the system, 374managing data security, 386managing settings, 371technical administration option, 391

System location, 375

TTables, acoustic output, 28, 56Target archive server, selecting, 381Technical administration option, 64, 391Technical support, 370Temperature limits, environmental

system, 92, 408trandsucers, 317

Text entry, 28Text labels, 215TGC curve

hiding and showing, 160location, 159

TGC settings, on imaging display, 145Thermal Index (TI), 45

controls affecting, 49display precision and accuracy, 47displays, 47modes of operation, 46on-screen, 46, 145using appropriate for application, 46

Thermal Index (TI) display, 159Thumbnails

hiding and showing, 160opening full size images, 299

Thumbnailshiding and showing, 162TI. See Thermal Index (TI)

Time and date, setting, 94Time format, changing, 296Time markers in sweeping displays, 167Time/slope measurements, 233Tissue Harmonic Imaging (THI)


Tissue models, 55Tissue Specific presets, 151Titles, adding to image display, 216Tools, measurement, 60Touch screen

brightness, 102conventions, 29, 99description, 66

Touch screen controls2D mode, 1643D image review, 1843D/4D acquisition, 177annotation, 216body markers, 219caliper, 222Cineloop, 210Color mode, 175Color Power Angio mode, 176conventions, 99CW Doppler, 171ECG, 214measurement, 222M-mode, 166Panoramic Imaging, 198patient data entry, 289printing, 359PW Doppler, 169PW Doppler mode, 169recording, 361review, 300rotary displays, 100using, 99

Trace by points, Doppler, 242

Index


480

Trace, High Qmean, 243peak, 244

Trackball controls, 28Training voice profiles, 110Transducers, 339

about, 61, 317acoustic artifacts, 319affecting TI and MI values, 52avoiding damage to, 340, 343cleaning, 343, 348cleaning and disinfecting, 366connecting, 147covers, 322covers for, 40, 41, 336, 338disinfecting, 339, 342immersing sterilizable, 345inspecting for damage, 33, 325, 341, 344maintaining, 318receptacles, 71, 146selecting, 147, 317sterilizing, 342, 344using, 146using disinfectants and gels, 335verifying biopsy guide alignment, 329

Transformers, isolation, 77Transmissible Spongiform Encephalopathy,

338Transporting the system, 90

preparations, 84, 90safety precautions, 84setting up after, 87

Trash Can icon, 104Trimming

MPR views, 188Panoramic images, 200undoing, 188views, 188volume views with eraser tool, 188volume views with sculpt tool, 188

Triplex, 173Troubleshooting, 368

UU.S. Health Insurance Portability and

Accountability Act (HIPAA), 62Ultrasonic bioeffects, related

documentation, 52Units of measure, changing, 297Upgrades, system, 30Urology clinical option, 318User information

components, 27conventions, 29

User information CD, 27, 28User logons

creating, 387deleting, 387exporting, 388importing, 388

User names, creating, 387User Reference, 27User-defined equations, 287User-defined tables, 285

VVascular calculations, 267Vascular clinical option, 318VCR

connecting external, 79maintaining, 367microphone, 360microphone location, 68peripheral bay location, 71searching a tape, 360setting playback counter, 360using, 360

Index


VelocityDoppler distance measurements, 231resolution in Doppler, 225

Verifying biopsy guide alignment, 327Video monitor, 66Views

resizing volume, 190review formats, 184rotating 3D, 186rotating MPR, 186rotating volume, 186trimming, 187using Cineloop Review for MPR, 189

Voice annotation, 115Voice commands, 113, 116Voice control, 105

background noise, 113commands, using, 113enabling, 112headset, 68icons, 106keywords, 114status, 105status icons, 105training voice profiles, 110troubleshooting, 369voice annotation, 116, 122voice commands, 113, 116

Voice control headsetconfiguring, 109muting, 115option, 68pairing with the system, 108transmit frequency, 106troubleshooting, 369turning on and off, 107

Voice profiles, 110Voltage precautions, 37Volume control, troubleshooting, 369

Volume measurements2D, 2373D, 239flow, 245one distance, 237one distance and one ellipse, 238stacked contour, 240three distance, 237

Volume viewsmagnifying, 187resizing, 190rotating, 186trimming (erasing), 188trimming (sculpting), 188

Volume, voice control headset, 115Vox keyword, 114

WWater bath, verifying biopsy guide

alignment, 329Water value intensities, 55Web site, Philips Ultrasound, 31Weight, changing unit of measure, 297Wheel brakes, 36, 75, 95Worklist

column width, 294feature, 292performed procedure step, 385query criteria, 384searching, 293selecting patients, 293server selection, 383setup, 383sorting columns, 294storage commit, 385

XXRes image processing, 207

Index


482

ZZoom

3D, 187about, 211HD, 212M-mode, 168Panoramic Imaging, 199types, 211using, 211using HD, 212

Iu22 Reference Manual

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