H48691RU 4 VE6 EC300 BUM en-US
H48691RU 4 VE6 EC300 BUM en-US
H48691RU 4 VE6 EC300 BUM en-US
Revision 4
Software: EC300
Revision Date
Introduction
Address Tiefenbach 15
4871 Zipf
Austria
Telephone +43-7682-3800-0
Fax. +43-7682-3800-47
Internet http://www.gehealthcare.com
Diagnostic ultrasound
Dear Valuable Customer,
We herewith would like to inform you that the American Institute of Ultrasound in Medicine
(AIUM) advocates the responsible use of diagnostic ultrasound. The AIUM strongly
discourages the non-medical use of ultrasound for psychosocial or entertainment purposes.
The use of either two-dimensional (2D) or three-dimensional (3D) ultrasound to only view the
fetus, obtain a picture of the fetus or determine the fetal gender without a medical indication is
inappropriate and contrary to responsible medical practice.
Although the general use of ultrasound for medical diagnosis is considered safe, ultrasound
energy has the potential to produce biological effects. Ultrasound bioeffects may result from
scanning for a prolonged period, inappropriate use of color or pulsed Doppler ultrasound
without a medical indication, or excessive thermal or mechanical index settings (American
Institute of Ultrasound in Medicine: Keepsake Fetal Imaging; 2005).Thus ultrasound should be
used in a prudent manner to provide medical benefit to the patient.
• Read and understand all instructions in the Basic User Manual before attempting to use
the Voluson™ E6 BT15 .
• Keep this Basic User Manual with the product for future reference.
• Please note that the configuration of each system is based on the specific customer
order and may not contain all features listed in this Basic User Manual .
• The screen graphics and illustrations in this Basic User Manual are for illustrative
purposes only and may be different from what is displayed on the screen or device.
• Some features are only available on specific ultrasound consoles. Some scan modes are
only available for specific ultrasound probes.
• All references to standards / regulations and their revisions are valid for the time of
publication of this Basic User Manual .
Clinical applications
• Abdomen
• Gynecology
• Cardiology
• Transrectal
• Vascular
• Cephalic
• Pediatrics
• MSK
Patient population
• Location: worldwide
• Height: no limitations
Operator profile
• The operator must have read and understood the user manual.
Contraindications
The Voluson™ E6 BT15 system is not intended for:
• ophthalmic use or any use where the probe is directly applied to the eye.
• intra-operative use that is defined as introducing probe into a surgical incision or burr
hole.
Regulatory remarks
• This machine must be used in compliance with the law. Some jurisdictions restrict certain
uses such as gender determination, contrast imaging, IVF, PUBS or CVS, etc. Please
consider the local laws and regulations.
• The equipment conforms with regulations for electrical safety IEC 60601 and safety class
IIa according to the MDD 93/42/EEC regulation for use on human patients.
The manufacturer, assembler, importer or installer consider themselves responsible regarding
safety, reliability and performance of the equipment under the following conditions:
• Authorized personnel has performed installation and initial start-up of the system.
○ IEC 62359 Ultrasonics - Field characterization - Test methods for the determination
of thermal and mechanical indices related to medical diagnostic ultrasonic fields
○ WEEE (Waste Electrical and Electronic Equipment)
1.3 Contacting GE
For additional information or assistance, please contact your local distributor or the appropriate
support resource listed on the following pages:
INTERNET http://www.gehealthcare.com
http://www.gehealthcare.com/usen/ultrasound/products/
probe_care.html
Clinical For information in the United States, Canada, Mexico and parts of
Questions the Caribbean, call the Customer Answer Center
Phone: (1) 800-682-5327 or (1) 262-524-5698
In other locations, contact your local Applications, Sales or
Service Representative.
8 Tangihua Street
Auckland 1010
New Zealand
Tel: 0800 434 325
CANADA GE Healthcare
Ultrasound Service Engineering
9900 Innovation Drive
Wauwatosa, WI 53226
Phone: (1) 800 668-0732
Customer Answer Center Phone: (1) 262-524-5698
GREECE GE Healthcare
8-10 Sorou Str. Marousi
Athens 15125 Hellas
Phone: (+30) 210 8930600
Fax: (+30) 210 9625931
NETHERLAN GE Healthcare
DS De Wel 18 B, 3871 MV Hoevelaken
PO Box 22, 3870 CA Hoevelaken
Phone: (+31) 33 254 1290
Fax: (+31) 33 254 1292
NORTHERN GE Healthcare
IRELAND Victoria Business Park
9, Westbank Road, Belfast BT3 9JL
Phone: (+44) 28 90229900
REPUBLIC OF GE Healthcare
IRELAND Unit F4, Centrepoint Business Park
Oak Drive, Dublin 22
Phone: (+353) 1 4605500
RUSSIA GE Healthcare
Krasnopresnenskaya nab., 18, bld A, 10th floor
123317 Moscow, Russia
Phone: (+7) 4957 396931
Fax:(+7) 4957 396932
USA GE Healthcare
Ultrasound Service Engineering
9900 Innovation Drive
Wauwatosa, WI 53226
Phone: (1) 800-437-1171
Fax: (1) 414-721-3865
Safety
Warning
Indicates a hazard with a medium level of risk which, if not avoided, could result in death or
serious injury.
Caution
Indicates a hazard with a low level of risk which, if not avoided, could result in minor or
moderate injury.
Some symbols used with electrical medical equipment have been accepted as standard by
IEC. They serve for marking connections, accessories, and as warnings.
This symbol is followed by the manufacturing This symbol is followed by the name and
date of the device in the form YYYY-MM address of the manufacturer of the device.
CE Conformity mark according to Medical This product consists of devices that may
Device Directive 93/42/EEC contain mercury, which must be recycled or
0123: Identification number of the notified body disposed of in accordance with local, state, or
TÜV SÜD Product Service country laws. (Within this system, the backlight
lamps in the monitor display, contain mercury.)
Consult accompanying documents. This Green dot Indicates that the power cable is hospital
symbol advises the reader to consult the on power grade. Grounding reliability can only be
accompanying documents. cable plug achieved when the equipment is connected to
an equivalent receptacle marked “Hospital
only” or “Hospital grade”. Applicable depending
on local regulatory requirements.
This indicates the maximum rated power Caution, consult accompanying documents.
consumption of the system. This symbol advises the reader to consult the
accompanying documents for important safety-
related information such as warnings and pre-
cautions that cannot be presented on the
device itself.
These symbols indicate that at least one of the six hazardous substances of the China RoHS Labelling
Standard is above the RoHS limitation. The number inside the circle is referred to as the Environmental
Friendly Use Period (EFUP). It indicates the number of years that the product, under normal use, will remain
harmless to health of humans or the environment.
EFUP = 10 for Short Use Products
EFUP = 20 for Medium Use Products
Do not reuse! This symbol indicates that the This symbol indicates that in the United States
item/device is for single use only. of America, federal law restricts this device to
sale by or on the order of a physician.
The Common Mark of Products Circulation certifies that the products bearing this mark, passed all
conformity assessment (approval) procedures established by technical regulations of the Customs Union
and correspond to the requirements of all technical regulations of the Customs Union applied to these
products.
All labels looking similar to the label on the left Tipping danger. Do not lean on the system and
are a marker used during manufacturing and take special care when moving the system.
have no meaning relevant to the usage of the For transport (especially on inclines >5°)
device. always observe the instructions described in
'Moving the system' on page 2-10 .
Indicates the voltage range the device is built This indicates the electrical frequency that the
for. The device uses alternating current. device is built for. Please note that either the
first frequency OR the second frequency is
applicable – depending on your country’s
frequency.
Indicates the power connector for the auxiliary This indicates the approximate weight of the
outputs. system in kilograms.
Indicates a connector that allows for input only. Indicates a connector that allows for in- and
output.
Connect the monitor cable to this connector Connect the monitor cable to this connector
(One cable used for power, one cable used for (One cable used for power, one cable used for
signal). signal).
Push this button to eject a CD/DVD from the These symbols indicate that the DVD drive can
drive. read and write DVDs.
Use this button to change brightness and Use these buttons to navigate in the monitor
contrast of the monitor. menu.
The patient cable protects against the effects of the discharge of a cardiac defibrillator. Use the patient
cables as described in the chapter 'ECG Preamplifier' on page 12-12.
Manufactured for:
• TYPE
• REF
• SN
Warning
Only authorized personnel may perform modifications of the system.
Caution
The use of the equipment outside the described conditions or intended use, and disregarding
safety related information is considered abnormal use. The manufacturer is not liable for injury
or damage caused by abnormal use. Any abnormal use will void the warranty of the
equipment.
Caution
Only use equipment provided by the system manufacturer GE Healthcare Austria GmbH & Co
OG .
Caution
Some parts of the system or probes may have come into contact with latex. Accessories such
as probe sheaths may contain latex. There have been reports of severe allergic reactions to
medical devices containing latex (natural rubber). Operators are advised to identify latex-
sensitive patients and be prepared to treat allergic reactions promptly. Refer to FDA Medical
Alert MDA91-1.
Caution
Cleaning agents can lead to skin irritations. Ensure that no residue of the cleaning agent
remains on any part of the system after cleaning.
Caution
It is highly recommended to create a full backup of settings and patient data regularly.
The data from the backup always replaces the corresponding data on the Voluson™ E6
BT15 .
Caution
Do not touch the patient and the signal input/signal output (SIP/SOP) connectors
simultaneously.
Caution
Be careful when adjusting mechanical parts of the equipment.
• Do not put your hands or other body parts between movable parts of the equipment.
Caution
Position the Voluson™ E6 BT15 so that the AC Mains circuit breaker and the AC Mains plug
at the Mains wall-outlet is easily accessible at all times.
Caution
Disconnect mains from AC wall outlet to make device electroless.
Caution
Do not stare into the light beam of the LED.
Note GE Healthcare Austria GmbH & Co OG is not responsible for any damage caused by viruses,
malware and other harmful software.
General precautions
Observe the following precautions:
• The user is responsible for the safety of all persons in the vicinity of the ultrasound
system including the patient(s).
• The system is sensitive to shock and must be treated with care also if not in use.
• Do not twist, kink or pinch cables. Excessive bending or stress on cables may result in
damage to its insulating properties.
• Do not drop or subject the probe to any type of mechanical shock. Impact may
compromise probe operation, safety features or result in sharp edges that could damage
the protective sheath and/ or injure sensitive tissue. Any damage caused by improper
use will void the warranty.
• Installation and initial start-up of the system must be performed by authorized service
personnel.
• For safety reasons, avoid handling fluids in the vicinity of the system.
• Do not install software on the system that has not been released by GE, as this may lead
to erroneous data transfer and thereby decrease system performance.
• Everybody who connects additional equipment to the signal input portion or signal output
portion configures a medical system, and is therefore responsible that the system
complies with the requirements of the system standard IEC 60601. If in doubt, consult
the technical service department or your local representative.
Warning
Never use an adapter which does not ensure proper protective earth connection.
To avoid the risk of electric shock, this equipment must only be connected to a supply mains
with protective earth.
Never remove or disconnect the protective earth.
• Chapter 12
• Chapter 13
Caution
Do not operate the system in the vicinity of a heat source, of strong electric or magnetic fields
(close to a transformer), or near instruments generating high-frequency signals, such as HF
surgery. These can affect the ultrasound images adversely.
General precautions
Observe the following precautions:
• Do not use the equipment during transportation (e.g. ambulance cars, aircraft).
• Avoid operating the system in the vicinity of a heat source, of strong electric or magnetic
fields (close to a transformer), or near instruments generating high-frequency signals,
such as HF surgery. These can affect the ultrasound images adversely. For more
information see 'Safety conformance' on page 13-2.
• If the system has been moved from a cold (stock room, airfreight) to a warm
environment, wait for several hours before connecting to power (temperature balance
and passing of condensation humidity).
• Connect the equipment to an outlet on a circuit different from that to which the other
device(s) are connected.
• Lower the user interface to its minimal height and move it to center position.
• Always place the system on horizontal ground and engage the caster brakes.
• Move the system forward or backward when going up or down inclines. Do not move the
system sideways or diagonally.
Failure to follow these precautions could result in injury, uncontrolled motion and costly
damage.
For further information on user interface and monitor adjustment read 'User interface
adjustment ' on page 3-5 and 'Monitor adjustment' on page 3-11 .
• Ensure all peripheral devices (printer, ...) are firmly fixed within the system.
Caution
Always use a strap to lift the system.
• Two people are required when lifting more than 16 kg (35 lbs).
• Do not lift the system with the front handle of the user interface.
Caution
Patient data from different systems are only distinguished by the patient identification (ID) field!
Ensure that all patients receive a unique patient identification (ID). Digital patient data is only
identified by the patient ID. Once the patient ID has been assigned it cannot be changed. If the
ID is not unique, data may be overwritten or mixed.
Caution
Do not touch the patient and the signal input/signal output (SIP/SOP) connectors
simultaneously.
Image quality
Caution
The quality of the image used for diagnosis is essential:
• Changing the display settings can affect the image quality and compromise the
diagnostic quality. The user is responsible to use adequate display settings for achieving
appropriate image quality. If in doubt, only the image as displayed on the Voluson™
ultrasound system with default display settings is to be used for diagnostic purposes.
Caution
A lossy compression can reduce image quality which can lead to a false diagnosis!
Caution
Filters smoothen the final image (structures may be smeared out). For diagnostic purposes,
the Region of Interest must be checked without filter. A smoothed image might lead to false
diagnosis!
Caution
1
Features that facilitate measurements such as SonoAVC™follicle, VOCAL or SonoNT must
be used with extreme care. The measurement results are a suggestion of the system, if in
doubt verify with manual measurement methods.
The user is responsible for the diagnostic interpretation of the measurement results.
Caution
• Be aware that diagnostic conclusions must not be drawn from a specific mode, such as
Render Mode or XTD-Mode. Always check with other diagnostic procedures.
• The accuracy of measurements in specific modes such as Render Mode, XTD, MagiCut,
2
STIC or VOCAL is limited and can be lower than measurements in B-images.
• Do not diagnose based on 3D/4D Acquisition Mode. Always check and confirm
diagnostic findings in B-Mode.
Caution
The results achieved in Elastography Mode always depend on the accuracy of the procedure
performed. Any clinically relevant decisions need to be verified with other state of the art
methods.
Contrast media
Caution
• Cavitation may occur due to interactions between the ultrasonic waves and the contrast
medium. Always perform examination using the ALARA (As Low As Reasonably
Achievable) principle. The acoustic power can be adjusted by rotating the Transmit
Power button on the user interface.
• Stop the examination and perform appropriate treatment, if there is any abnormality with
the patient during use of the contrast medium.
In the United States contrast agent usage is restricted to usage on LVO (Left Ventricle
Outflow).
Remark • Handle the contrast medium as described in the operation manual supplied with the
contrast medium.
• Check the side effects of the contrast medium used with the manufacturer of the contrast
medium.
• GE Healthcare Austria GmbH & Co OG is not liable for any damage or injury resulting
from improper use of contrast media.
Probe orientation
Caution
Ensure that the actual probe position corresponds to the probe orientation configuration.
Special accuracy is required in Acquisition Mode 4D. Moving the probe can lead to errors in
displayed directions with respect to the displayed image.
• Before cleaning the console switch it off and disconnect from AC mains.
Cleaning
Caution
The following table provides cleaning instructions for the ultrasound device. It is the
responsibility of the user to decide which cleaning procedure is necessary to ensure a safe
working environment.
• Do not use high-proof alcohol (over 70% ) for cleaning the system.
• If you use a spray, apply it on a piece of cloth or tissue and then wipe the system. Do not
apply spray directly onto the system, to prevent liquids from entering.
Component Probe User Touch Monitor Housings Probes Air Filter Peripherals
holder Interface panel display (e.g.
* Printers...)
Sani-Cloth Active
Clean with a vacuum cleaner from the outside
Wipes X X X - X
(ready for use)
Descosept Pur
X X X - X
(ready for use)
Cleaning Agent
Descosept AF
X X X - X
(ready for use)
Cleanisept Wipes
X X X - X
(ready for use)
Ultrasol active
X X X - X
(1,0% solution)
Cleanisept Wipes
fort X X X - X
(ready for use)
Acryl-Des Wipes
X X X - X
(ready for use)
* Effective cleaning for parts with narrow gaps and holes (e.g. keyboard, trackball,...) is not
possible.
Disinfection
Effective Disinfection is always a balance between safe inactivation of infectious agents and
undesirable side effects.
Due to the generally uneven and irregular surface of Ultrasound consoles, a comprehensive
surface disinfection process cannot be recommended by the manufacturer.
Therefore the user has to determine the extent and frequency of disinfection for the system or
different parts of the equipment considering the specific environment of use.
When using the ultrasound system in areas of enhanced hygienic requirements, GE
recommends the use of a sterile system drape (e.g. CIVCO part number 610-025).
Info • Consider the exposure times and temperatures recommended by the manufacturer of
the cleaning agent.
• Residual cleaning agents can be removed by wiping them off with a damp, non-abrasive
cloth.
2.8 Maintenance
Warning
Caution
Periodic Maintenance Inspections
It has been determined by GE that your Voluson™ E6 BT15 system does not have any high
wear components, therefore no Periodic Maintenance Inspections are mandatory. However, to
maintain the safety and performance of the ultrasound system, a regular check by authorized
personnel remains recommended.
Remark Attempting do-it-yourself repairs invalidate warranty, and are an infringement to regulations
and are inadmissible acc. to IEC 60601-1.Only authorized personnel may perform service and
repairs. For expected lifetime of equipment and probes see Service Manual.
For probe specific information see: 'Cleaning and maintenance of probes' on page 5-5
Safety test
Recommended maintenance schedule: According to respective national regulations, and
according to the manufacturer recommendations for the medical-technical system.
Test Action
2.9 Disposal
Caution
Lithium battery included with this console. Do not puncture, mutilate or dispose of battery in
fire. Replace only with same type recommended by the manufacturer. Dispose of used battery
according to manufacturers' instructions and in accordance with your local regulations.
Caution
Dispose of the system according to manufacturers' instructions and in accordance with your
local regulations.
The separate collection symbol is affixed to a battery, or its packaging, to advise you that the
battery must be recycled or disposed of in accordance with local or country laws. The letters
below the separate collection symbol indicate whether certain elements (Pb=Lead,
Cd=Cadmium, Hg=Mercury) are contained in the battery. To minimize potential effects on the
environment and human health, it is important that all marked batteries that you remove from
the product are properly recycled or disposed. For information on how the battery may be
safely removed from the device, please consult the service manual or equipment instructions.
Information on the potential effects on the environment and human health of the substances
used in batteries is available at this url http://www.gehealthcare.com/euen/weee-recycling/
index.html
In spite of the relatively low risk of ultrasound scans compared to other imaging techniques,
the operator shall choose the exposure level with caution to minimize the risk of bioeffects.
“A fundamental approach to the safe use of diagnostic ultrasound is to use the lowest output
power and the shortest scan time consistent with acquiring the required diagnostic information.
This is the ALARA principle (i.e. As Low As Reasonably Achievable). It is acknowledged that
in some situations it is reasonable to use higher output or longer examination times than in
others: for example, the risks of missing a fetal anomaly must be weighed against the risk of
harm from potential bioeffects. Consequently, it is essential for operators of ultrasound
scanners to be properly trained and fully informed when making decisions of this nature.”
(Guidelines for the safe use of diagnostic ultrasound equipment, Safety Group of the British
Medical Ultrasound Society 2010)
Special care regarding ALARA should be taken with obstetric examinations as any potential
bioeffects are likely to be of greatest significance in the embryo or fetus.
It is strongly recommended to consider ALARA when undertaking ultrasound scans.
2.10.2 Bioeffects
Relevant parameters having physiological effects (For more information see 'Bioeffects' on
page 2-17. ) are regulated according to FDA and IEC guidelines and standards. These
parameters are
During obstetric examinations these displayed values shall be observed very critically,
because there may be conditions that are potentially hazardous even below the regulatory
limits.
Some guidelines recommend that embryonic and fetal in situ temperatures of 41˚C (4˚C above
normal temperature) should be limited in time by 5 min or less. Thus, for a reasonable safety
margin, TI values above 1 should be avoided. Additional factors, like fever of the mother, are
again reasons to keep the TI values as low as possible on the one hand, and go only as high
as necessary to achieve the desired clinical results ('Prudent Use – ALARA Principle' on page
2-17).
The mechanical index, which indicates the risk of cavitation, becomes important at the
interface between gas and soft tissue (nonfetal lung and bowel), but also with the use of gas
body contrast agents. Often an MI value of 0.4 or less is suggested for examinations of tissue
containing stabilized gas bodies. This value arises from operating experience and is not
confirmed.
Some examples where the MI and TI, respectively, are more or less important are shown in
the following table according to Particular requirements for the basic safety and essential
performance of ultrasonic medical diagnostic and monitoring equipment, IEC 60601-2-37.
Further information can be retrieved from Bioeffects & Safety of Diagnostic Ultrasound, AIUM,
1993 and Evaluation of Research Reports: Ultrasound Bioeffects Literature Reviews
(1992-2003).
Acoustic output reporting tables according to the below cited standards are provided in the
Advanced Acoustic Output References.
Particular requirements for the basic safety and essential performance of ultrasonic medical
diagnostic and monitoring equipment, IEC 60601-2-37.
Information for Manufacturers Seeking Marketing Clearance of Diagnostic Ultrasound Systems
and transducers, FDA Guidance.
Ultrasonics - Field characterization - Test methods for the determination of thermal and
mechanical indices related to medical diagnostic ultrasonic fields, IEC 62359.
The Voluson™ E6 BT15 is intended for use in electromagnetic environment specified below. The customer or the user of
the Voluson™ E6 BT15 should assure that it is used in such an environment.
RF emissions - CISPR 11 Group 1 The Voluson™ E6 BT15 uses RF energy only for its
internal function. Therefore, its RF emissions are very low
and are not likely to cause any interference in nearby
electronic equipment.
RF emissions - CISPR 11 Class A The Voluson™ E6 BT15 is suitable for use in all
establishments (i.e. hospitals, doctors practice etc.) other
Harmonic emissions IEC Class A than domestic. The Voluson™ E6 BT15 is intended for
61000-3-2 professional use only.
Voltage fluctuations/ flicker Complies
emissions IEC 61000-3-3
The Voluson™ E6 BT15 is intended for use in electromagnetic environment specified below. The customer or the user of
the Voluson™ E6 BT15 should assure that it is used in such an environment.
Electrical fast transient/burst ± 2kV for power supply lines ± 2kV for power supply lines Mains power quality should
IEC 61000-4-4 be that of a typical
±1kV for input/output lines ±1kV for input/output lines
commercial or hospital
environment.
Surge IEC 61000-4-5 ± 1kV differential mode ± 1kV differential mode Mains power quality should
be that of a typical
± 2kV common mode ± 2kV common mode
commercial or hospital
environment.
40% UT 40% UT
70% UT 70% UT
< 5% UT < 5% UT
for 5 s for 5 s
NOTE: UT is the a.c. mains voltage prior to application of the test level
The Voluson™ E6 BT15 is intended for use in electromagnetic environment specified below. The customer or the user of
the Voluson™ E6 BT15 should assure that it is used in such an environment.
Portable and mobile RF communications equipment should be used no closer to any part of the Voluson™ E6 BT15 ,
including cables, than the recommended separation distance calculated from the equation applicable to the frequency of
the transmitter.
800MHz to 2.5GHz
where P is the maximum output power rating of the transmitter in watts (W) according to the transmitter manufacturer
and d is the recommended separation distance in meters (m). Field strength from fixed RF transmitters, as determined
by an electromagnetic site survey, (a) should be less than the compliance level in each frequency range.(b) Interference
may occur in the vicinity of equipment marked with following symbol:
NOTE:
a) Field strength from fixed transmitters, such as base stations for radio (cellular/cordless) telephones and land mobile
radios, amateur radio, AM and FM radio broadcast cannot be predicted theoretically with accuracy. To access the
electromagnetic environment due to fixed RF transmitters, an electromagnetic site survey should be considered. If the
measured field strength in the location in which the Voluson™ E6 BT15 is used exceeds the applicable RF compliance
level above, the Voluson™ E6 BT15 should be observed to verify normal operation. If abnormal performance is
observed, additional measures may be necessary, such as reorienting or relocating the Voluson™ E6 BT15 .
b) Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m. The ultrasound image can be
influenced by electromagnetic radiation at levels as low as 200 mV/m depending on the specific ultrasound probe
connected. Influences may be visible in the operating frequencies of the probes in the range of 1 MHz to 30 MHz and to
a lesser extent in the range of 40 MHz to 60 MHz.
Recommended separation distances between portable and mobile RF communications equipment and the Voluson™
E6 BT15
The Voluson™ E6 BT15 is intended for use in an electromagnetic environment in which radiated RF disturbance are
controlled. The costumer or the user of the Voluson™ E6 BT15 can help prevent electromagnetic interference by
maintaining a minimum distance between portable and mobile RF communications as recommended below, according
to the maximum output power of the communications equipment.
Formula
100 12 12 23
For transmitters rated at a maximum output power not listed above, the recommended separation distance d in meters
(m) can be estimated using equation applicable to the frequency of transmitter, where P is the maximum output power
rating of the transmitter in watts (W) according to the transmitter manufacturer.
Note 1 At 80 MHz and 800 MHz, the separation distance for the higher frequency range applies.
Note 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects and people.
Physical and link layer interface: Ethernet IEEE 802.3 10BASE-T, 100BASE-TX
and 1000BASE-T
Physical and link layer interface: UMTS Terminal (Penta-Band HSPA+, Quad
(optional) Band EDGE, Quad Band GPRS)
Up to 21 Mbit/s downlink and 5,76 Mbit/s
uplink
• NetBIOS – Name, Datagram, Session services, Network file share MS network. Only
used as client.
3 DICOM is the registered trademark of the National Electrical Manufacturers Association for its standards publications
relating to digital communications of medical information.
• 53 – DNS Client
• 68 – DHCP Client
• 104 – DICOM
• Every Virus scanner is constantly active in the background. Due to the software-intensive
operating system of the Ultrasound scanner, all computing resources are required for
normal operation of this device. Anti-Virus software activities would have a negative
impact on the system performance.
Note A remote connection can affect the system's performance (e.g., in 3D/4D or Doppler mode).
Therefore, it is recommended to cease work on the system as soon as the field engineer
contacts the site and announces the remote connection.
Network Security:
The remote access features enables, after checkout has been performed, network services
like ftp or telnet on the ultrasound system. Therefore, it is advisable to restrict network access
to system for unauthorized personnel. It is strongly recommended to use a firewall to restrict
network access from and to an ultrasound system with the remote access feature installed.
Other precautions like a secure network segment are encouraged.
Note Software upgrade through the GE service platform may not be available in all markets.
Info Please contact a GE Healthcare Austria GmbH & Co OG service technician for further
assistance.
Caution
• High system temperature reached! Further use of the system is possible. If this message
persistently appears, please contact your service agent.
• High system temperature reached! If the system temperature stays high, the system will
shut down within 10 minutes.
Note If the system needs to shut down, an additional message will be displayed in the message
area of the monitor screen:
High system temperature - system shutdown within [ ] minutes!
System description
Overview - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-2
The system - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-3
The user interface - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-5
The monitor - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 3-11
3.1 Overview
The Voluson™ E6 BT15 is a professional, innovative, most versatile real-time scanning
system.
It opens new sonographic possibilities with the 3D/4D VOLUME scanning technique. The vast
array of probes makes it suitable for many clinical applications. The system is designed for
follow-up expansion.
The Voluson™ E6 BT15 is delivered with recommended basic settings for a variety of clinical
applications. Depending on the user's experience the default settings can be changed and
stored as new User Programs.
Diagnostic possibilities
The availability of image acquisition modes depends on the selected probe.
• 2D Mode
Operable probes
• Multi-element probes (linear array, curved array, phased array and pencil probes)
1. Monitor
2. USB ports
3. Speakers
4. DVD drive
5. Probe holder
6. User interface
7. Probe cable guide
8. Shelf for peripherals
9. Probe sockets
10. Foot rest
11. Casters
Applied parts
Applied parts of the Voluson™ E6 BT15 are the following parts/surfaces:
• The contact surface of the ultrasound probes to the patient (the transducer window for
transmitting ultrasound and the immediate surrounding housing material).
Info • The brake can be released for a maximum of 30 seconds. Then the brake hardware
needs a recovery time of about one minute.
• When the system is not supplied with power, the user interface is fixed and secured for
transport. Ensure to follow all safety precautions before moving the system. For more
information see 'Moving the system' on page 2-10.
Each mode menu is divided into Main and Sub menu and only shows buttons which are
available for the selected probe and image acquisition mode.
Info The touch panel can be blocked by direct sunlight, by objects or coupling gel. Clean the touch
panel regularly according to instructions. Avoid direct sunlight.
Hint If no ultrasound probe is selected, the Probe Select menu appears. Select a probe and then
select a mode.
Sample menu
Center Touch panel buttons according to the selected mode, preset and
ultrasound probe
This chapter lists available buttons on the user interface and touch panel.
3 Zoom Box on/off (push), Zoom Size (rotate), B-Image Depth (flip)
5 Display format
Basic functions
Standby Switches the system on and off. Located at the left part of the user interface.
End Stores patient and measurement data and clears all temporary data.
Bodymark Activates the annotation function in order to add body patterns to an image.
Pointer At the first push an arrow shaped cursor appears for menu and image
operations. At the second push the Indicator menu is opened.
Single Three different display formats are available to show one, two or four images
Dual on the monitor display.
Quad
UI Movement Locks and releases the horizontal movement of the user interface.
Specific functions
Depth Depth controls the distance over which the B-Mode images anatomy. To
visualize deeper structures, increase the depth. If there is a large part of the
display which is unused at the bottom, decrease the depth.
Gain Rotating a Mode key adjusts the gain. It increases or decreases the amount
of echo information displayed in an image. It may have the effect of
brightening or darkening the image if sufficient echo information is
generated.
auto Auto Optimize (Auto) lets you optimize the image based upon the actual B-
Mode image data. It functions as a pre-/post-processing picture analysis
system. Press Auto once to activate it (green) and once again to start/update
the optimization.
• In spectral Doppler images (PW, CW) the baseline and the PRF are
optimized. The spectrum is shifted into the middle, the PRF automatically
detects the highest flow velocities and adjusts according to it. To restore
the previous values, double click.
Zoom Three different zoom functions are available: Standard Zoom, High-definition
Zoom (HD Zoom) and Pan Zoom. Standard Zoom is available at any time by
simply rotating the Zoom button. Press the Zoom button to use HD or Pan
Zoom.
P1 - P6 Programmable buttons.
M Opens M-Mode.
PW Opens PW-Mode.
PD Opens PD-Mode.
LR Illuminated label indicating left/ right alignment. With this function the image
orientation on the screen in relation to the patient is alternated between left
and right without rotating the scan head itself. The orientation marker shows
the current orientation.
Prt Sc Print screen function copies the current screen to USB or HDD media.
Icon Description
Indicates that the button has to be pushed and rotated to activate the function.
Harm. Frequ. Multi Frequency mode lets you downshift to the probe's next lower frequency or
shift up to a higher frequency.
Foc. Zones Focal Zones increases the number of focal zones or moves the focal zone(s) so that
you can tighten up the beam for a specific area.
Dyn. Contr. Dynamic Contrast controls how echo intensities are converted to shades of gray,
thereby increasing the adjustable range of contrast.
Cine The Cine display (located at the lower right corner of the monitor display) indicates
which frame you are viewing of the whole loop (62:123), as well as the time at which
this frame occurs within the loop (1.6:3.2 s).
Quality The higher the color resolution, the lower the frame rate. Available settings: high,
norm and low.
WMF The Wall motion filter eliminates vessel wall motion noise that is low in velocity but
high in intensity. Use a wall filter that is high enough to remove motion artifacts, but
that is sensitive enough to display low velocity flows in small vessels. Available
settings: low1, low2, mid1, mid2, high1, high2 and max.
PRF The Pulse Repetition Frequency (PRF) has direct influence on the velocity range.
The higher the Pulse Repetition Frequency the lower the velocity range. As the
display scale increases, the maximum Doppler shift information that can be
displayed without aliasing also increases. Aliasing is where the blood velocity
exceeds the maximum measurable velocity, causing the displayed flow within the
vessel to portray flow in the wrong direction. The disadvantage of using a higher
PRF is a loss of sensitivity to low flow velocities.
Steer on/off You can slant the Color Flow linear image left or right to get more information
Steer Ang. without moving the probe. The angle steer function only applies to linear probes.
Display layout
Title bar
The title bar shows the corresponding logo of the device, patient and exam information, probe
and image information.
Trackball area
Trackball functions change according to the active mode. Active button assignment is shown
in green.
P-Button assignment
A P-Button is a programmable button which can be configured for individual tasks. The
corresponding symbol is displayed next to the button.
Icon window
Display of status icons and display functions of the right monitor area.
Icon Description
Icon Description
Miscellaneous Area
This area is used for different functionalities like on screen menus, listing of done
measurements, the graphical display of OB graphs with current measurement values and
others. After power down and reboot the last used page is displayed again.
Swiping
Swiping (Scrolling) of certain menus is possible with basic multi touch functionality using only
one finger. Only touch menus with tab structure have the Swiping function. The availability of
Swiping is indicated by menu tabs with underlines. If an underline exists swiping is possible.
Example:
"Main 3D" can be reached by swiping to the right. "Vol. Cine" can be reached by swiping to the
left.
The Measurement Result Window is opened by pressing the on screen button in the icon
area. If selected the Measurement Result Window is also open when a new exam is
started.
It is always available without any restriction, independent of exam application or
measurement application. All OB measurements and the calculated ratios can be
displayed.
The intended use of the Measurement Result Window is:
• to show done measurements of the current exam in a short form. The short form
reflects an extract of the measurement report.
• to show the corresponding graph with the current measurement and if configured with
measurements from previous exam(s), keyword "Trending".
Bootup Screen
The bootup Screen contains the user manual icon and the boot progress bar on the main
screen and a list of the US patents on the main and touch screen.
Getting started
Power on
Power off
Info Press the End Exam button before switching off the system. Otherwise current Patient Data as
well as all measurements in the Patient Report will be lost.
Shutdown dialogs
The shutdown dialogs can vary depending on the processes that may be active.
1. Normal shutdown options
• Shut down
• Restart
• Reset Monitor
4. If a process is running that cannot be stopped, the user will be informed that shutdown is
not possible.
Selecting a probe
1. Press the Probe button on the user interface.
2. The connected probes appear on the touch panel.
3. Touch the desired probe. The touch panel button turns green.
4. Select the User or the Factory tab.
5. Select a folder.
6. Select a preset.
7. The 2D Main Menu appears on the touch panel.
8. Perform the scan.
Info The Voluson™ E6 BT15 is delivered with recommended factory default presets. Individual
user presets can be stored.
Disconnecting a probe
1. Freeze the image by pressing Freeze.
Do not disconnect an active probe. Before disconnecting the probe, open the Probe
Selection menu and select a different probe.
2. Turn the probe lock-lever to horizontal position and remove the probe.
3D/4D scanning
1. Select a 3D/4D volume probe.
2. Optimize specific structures by using the available presets.
3. Adjust the size and position of the ROI Box (Region of Interest) by pressing Change (top
trackball key). Press Change again to set the size.
4. Adjust the volume acquisition by flipping the Vol.Angle switch up and down. The Volume
Angle is displayed on the lower section of the touch panel.
5. Start the volume acquisition by pressing Start (right trackball key) or Freeze.
P-buttons
The P1, P2, P3, P4, P5 and P6 buttons are assigned with default functions. The assigned
function is displayed at the lower, right-hand section of the monitor display.
Trackball
The trackball can be moved like a computer mouse. It is surrounded by the trackball buttons.
The function of each button depends on the activated and on the current image acquisition
mode. The assigned function is displayed at the lower, center section of the monitor display.
Saving a preset
1. Select a preset.
2. Make individual adjustments.
3. Press the Util. button on the user interface to open the Utilities menu.
4. Select the button Presets Administration.
• To overwrite the currently loaded user preset, select Save. A pop-up message
asking for confirmation appears.
Hint To quickly save your changes, use the shortcut Ctrl+S on the keyboard.
Info For more information see ' Presets ' on page 11-39.
Zoom
Three different zoom functions are available: Standard Zoom, High-definition Zoom (HD
Zoom) and Pan Zoom. Standard Zoom is available at any time by simply rotating the Zoom
button. To use HD or Pan Zoom follow the steps below:
1. Press Zoom to start the zoom function.
2. A reference image appears on the monitor screen.
3. Modify the size of the zoom window by rotating the Zoom button.
4. Press Zoom again to activate HD Zoom.
5. Rotate Zoom to enlarge the image.
6. Press the left trackball button to select Pan Zoom.
7. Press Zoom again to exit the zoom function.
Depth
Depth adjusts the field of view. It increases the field of view to look at larger or deeper
structures; it decreases the field of view to look at structures near the skin line. Depth can only
be adjusted in scan mode.
1. Flip the Depth switch down to increase the depth range.
2. Flip the Depth switch up to decrease the depth range.
Info Changing the depth may change the acoustic output indices. Observe the output display for
possible effects.
Focus
Focus adjusts the number of focal zones.
1. The number of focal zones is displayed at the lower section of the touch panel.
2. Rotate the knob adjacent to Foc.Zones to adjust the number of focal zones.
3. Flip the knob adjacent to Foc.Pos. to change the depth position of the focal zone(s).
Automatic optimization
The auto function optimizes the contrast resolution in the resulting image.
1. Press auto to activate the function.
2. Press auto again to update the optimization.
3. Double-click auto to end the optimization.
Cine
Cine images are constantly being stored by the system and are available for playback or
manual review via cine. Cine can be viewed as a continuous loop via Cine Loop or manually
frame by frame via the trackball.
Warning
Do not use damaged or defective probes. Injury to the operator or patient may occur if cracks,
cuts, sharp edges or exposed wiring exist. Cleaning and/ or gel solutions may leak into the
probe resulting in electrical shock. Discontinue use, immediately disconnect the ultrasound
probe and notify the GE Service representative.
Failure to follow these precautions can result in serious injury.
Warning
If a probe has dropped on the floor or on any other hard surface, immediately disconnect the
probe from the ultrasound system. Do not use the probe any more. There is a risk of electric
shock due to damaged electrical insulation.
Caution
In case HF surgical equipment is used in combination with a probe placed on the patient, the
following protective measures have to be taken to avoid the risk of burns to the patient:
• Keep a large distance between the HF surgical field and the applied probe
• Ensure that the neutral electrode of the HF surgical equipment is correctly positioned
Caution
Only use approved coupling gels and cleaning / disinfection agents, see Probe Care Card.
Caution
Do not immerse the probe into any liquid beyond the immersion level. Never immerse the
probe connector into any liquid.
Caution
After each use, inspect the probe’s lens, cable, and casing. Look for any damage that would
allow liquid to enter the probe. If any damage is found, the probe must not be placed into any
liquid (e.g. for disinfection) and must not be used until it has been inspected and repaired/
replaced by a GE Healthcare Austria GmbH & Co OG Service Representative.
Note Keep a log of all probe maintenance, along with a picture of any probe malfunction.
Caution
Adequate cleaning and disinfection is necessary to prevent disease transmission.
• High-level disinfection is recommended for surface probes and is required for endocavity
probes.
• In addition to cleaning and disinfection the use of sterile, legally marketed probe sheaths
for intracavitary procedures is mandatory.
• Do not use pre-lubricated condoms as a sheath. In some cases, they may damage the
probe. Lubricants in these condoms may not be compatible with probe construction.
• Probes must be cleaned and disinfected before they are replaced or disposed.
Caution
Creutzfeldt-Jakob disease
If a probe becomes contaminated with Creutzfeldt-Jakob disease, there is no adequate means
of disinfection.
Caution
Do not apply excessive force when inserting or manipulating endocavity probes.
Regularly inspect probes and biopsy equipment for sharp edges or rough surfaces that could
injure sensitive tissue.
Note If 3D/4D probes are operated in continuous 4D mode for an unusually extended period of time,
the surface temperature of the handle might get warm and exceed the limit according to
IEC60601-1. The temperature of the applied part will stay within the limits according to
IEC60601-2-37.
Caution
• Make contact with a metal surface of the console before connecting a probe to the
console.
○ a ground wire connection between the console and the patient table or bed
General information
Observe the following information:
• Sporadically, silicone grease can leak in small amounts from the probes’ cable bushing.
This leakage is not a failure or harmful to the human body. Silicone grease does not
contain any hazardous substances and is only used to seal the cable bushing. In case of
a leakage wipe the grease with a cloth.
• Thermal safety: Maintaining a safe thermal environment for the patient has been a
design priority at GE Healthcare Austria GmbH & Co OG . The operating temperature of
the applied part of the probe stays below 43˚C if used as intended.
• Probes may generate slight noise emissions when operated in volume mode.
• The high elasticity of the probe surface ensures an optimal coupling of the probe. This
elasticity can lead to small deformations of the applied part. The intended use of the
probe will be in no way affected by this deformation, and leads to no loss of the
ultrasound image quality.
• Approved coupling gels support optimal transmission of energy between the patient and
the probe.
When scanning in air (Ultrasound probe is not in contact with a human body or a phantom)
most of the ultrasound energy is reflected at the lens-air surface and bounces back and
forward between that interface and the transducer ceramics. Already the smallest deviation
from the ideal geometrical shape of the reflecting interfaces can cause irregularities in the
reverberation pattern across the transducer surface. However, when the probe is coupled to
the human skin or a phantom by using a sufficient amount of coupling gel most of the
ultrasound energy passes the lens-skin interface and these small geometrical deviations will
have a negligible effect on the ultrasound signal and image quality. Therefore variations of the
reverberation pattern along the transducer cannot be used for judging image and transducer
quality. The use of a tissue mimicking phantom is strongly recommended to assess image
quality.
Probes have been ergonomically designed to:
• The Probe Care Card is supplied with every probe and can also be downloaded from
http://www.gehealthcare.com/usen/ultrasound/products/probe_care.html
• The listed products have been validated for appropriate cleaning and disinfection of the
probes.
First steps:
1. Remove the probe sheath.
2. Disconnect the probe from the ultrasound console.
3. Remove all coupling gel and other visible substances from the probe by wiping with a
soft dry cloth. To remove material dried to the surface moisten the cloth with lukewarm
water.
4. After each use, inspect the lens, cable, and housing of the probe. Look for any damage
that would allow liquid to enter the probe. If the probe is damaged, do not place it into
any liquid (e.g. for disinfection) and do not use it until it has been inspected and repaired/
replaced by a GE Service Representative.
One of the recommended methods to disinfect the ultrasound probes is immersion
disinfection:
1. Place the probe into the solution of cleaning-disinfectant. Make sure not to immerse the
probe into the liquid beyond the immersion level given in the pictures below. Make sure
that the probe is covered with the cleaning-disinfectant up to the immersion level during
the complete disinfection time. For more information on the cleaning and disinfection
solution, please consult the instructions on the Probe Care Card and given by the
manufacturer of each listed product.
2. Scrub the probe as needed using a soft sponge, gauze, or cloth to remove all visible
residue from the probe surface. Prolonged soaking or scrubbing with a soft bristle brush
(such as a toothbrush) may be necessary if material has dried onto the probe surface.
3. Rinse the probe with enough clean, potable water to remove all disinfectant residues.
4. Use a soft cloth to clean the cable and the user section of the probe with the cleaning-
disinfectant liquid. Make sure that the surface of the probe and cable is wetted
thoroughly with the cleaning-disinfectant.
5. Allow probe to air dry completely.
6. Reconnect the probe to the ultrasound console and place the probe into its holder.
7. Inspect the probe prior to use for damage or degeneration to the housing, strain relief,
lens and seal. Do not use a damaged or defective probe until it has been inspected and
repaired/replaced by a GE Service Representative.
8. Put a new sterile, legally marketed probe sheath over the probe prior to next use.
Other appropriate disinfection methods for ultrasound probes, such as wipe disinfection, may
be applied as an alternative to disinfection by immersion, provided that the products listed in
the Probe Care Card are used.
Disinfect
- X X
endocavity probes
5.3 Probes
Intended use
Image Acquisition for diagnostic purposes including measurements on acquired image.
Extracting tissue samples with guided and freehand biopsy.
Contraindications
Probes are not intended for:
• ophthalmic use or any use causing the acoustic beam to pass through the eye
• intra-operative use that is defined as introducing probe into a surgical incision or burr
hole
Abdominal and linear probes are not intended for:
• endocavity use
Patient population
• Location: worldwide
5.3.2 Labeling
• Manufacturer
• GE part number
• Probe designation provided on the top of the connector housing, so it is easily read when
mounted on the system and is also automatically displayed on the screen when the
probe is selected.
Note Symbols used on the label: 'Description of symbols and labels' on page 2-2
1. Probe type
The manual refers to probes that can be connected to the device. It might be possible that
some probes, options or features are NOT available in some countries!
The below table shows which clinical application specific settings are provided for which
probe.
2D Probe
Fetal Cardio
Gynaecology
Small-Parts
Peripher V.
Cardiology
Abdominal
Obstetrics
Pediatrics
Cephalic
Breast
Rectal
MSK
11L-D - X - - - X - X - X - X
3Sp-D X - X X - - - - - X X -
4C-D X - X - - - - - X - - -
9L-D - X X - - - - X - X - X
C1-5-D X - X - - - - - X - - -
C4-8-D X - X - - - X - X X - -
IC5-9-D - - X - - - X - X - - -
ML6-15-D - X - - - X - X - X - X
P2D - - - X - - - X - - X -
P6D - - - X - - - X - - - -
S4-10-D - X - X - - - - - X - -
3D/4D Probe
Fetal Cardio
Gynaecology
Small-Parts
Peripher V.
Cardiology
Abdominal
Obstetrics
Pediatrics
Cephalic
Breast
Rectal
MSK
RAB2-5-D X - X - - - - - X - - -
RAB6-D X - X - - - X - X X - -
RIC5-9-D - - X - - - X - X - - -
RNA5-9-D X X X X - - - - - X - -
RSP6-16-D - X - - - X - X - X - X
5.3.4 Features
Symbol Description
SW Optional software feature
HW Optional hardware feature
X Available
- Not available
M
2D PW CW Color
AMMSW
Virtual convex
UpdateHW / SW
MHD-Flow™
HD-Flow™
Steerable
BetaView
Update
Duplex
Triplex
HPRF
norm
Wide
MTD
CFM
FFC
CRI
SRI
MC
CE
PD
TD
HI
M
11L-D x x x x x - x - - x - - - x x x - - - x x x -
3Sp-D x - x - x - x - - x x x x x x x x x x x x x x
4C-D x - x x x x - x - x x x x x x x x - - x x x x
9L-D x - x x x x x - - x - - - x x x - x x x x x -
C1-5-D x - x x x x - x - x x x x x x x x x - x x x x
C4-8-D x x x x x x - x - x x x x x x x x x - x x x x
IC5-9-D x - x x x x - x - x x x - x x x x - - x x x -
ML6-15-D x x x x x - x - - x - - - x x x - - - x x x -
P2D - - - - - - - - - - - - - - - - - x - - - - -
P6D - - - - - - - - - - - - - - - - - x - - - - -
RAB2-5-D x - x x x x - x x x x x x x x x x x - x x x x
RAB6-D x x x x x x - x x x x x x x x x x x - x x x x
RIC5-9-D x x x x x x - x x x x x x x x x x - - x x x x
RNA5-9-D x - x x x x - x x x x x x x x x x x x x x x x
RSP6-16-D x - x x x - x - x x - - - x x x - - - x x x -
S4-10-D x - x - x - x - - x x x x x x x x x x x x x x
ContrastSW
ContrastSW
HD-Flow™
HD-Flow™
ElastoSW
2D norm
ECGHW
VCI SW
Biopsy
VCISW
BFSW
BFSW
BFSW
norm
norm
CFM
CFM
XTD
PD
PD
TD
TD
TD
11L-D - - - - - - - - - - - - - - - - - - - x x - x x
3Sp-D - - - - - - - - - - - - - - - - - - - - - x - x
4C-D - - - - - - - - - - - - - - - - - - - x x x - x
9L-D - - - - - - - - - - - - - - - - - - - x x x - x
C1-5-D - - - - - - - - - - - - - - - - - - - x x x - x
C4-8-D - - - - - - - - - - - - - - - - - - - x x - - x
ContrastSW
ContrastSW
ContrastSW
HD-Flow™
HD-Flow™
ElastoSW
2D norm
ECGHW
VCI SW
Biopsy
VCISW
BFSW
BFSW
BFSW
norm
norm
CFM
CFM
XTD
PD
PD
TD
TD
TD
IC5-9-D - - - - - - - - - - - - - - - - - - - x x - x x
ML6-15-D - - - - - - - - - - - - - - - - - - - x x x x x
P2D - - - - - - - - - - - - - - - - - - - - - - - x
P6D - - - - - - - - - - - - - - - - - - - - - - - x
RAB2-5-D x x x x - x x x x x - x x x x x x x x x x x - x
RAB6-D x x x x - x x - x x - x - x x x x x x x x - - x
RIC5-9-D x x x x - x x x x x - x x x x x x x x x x x x x
RNA5-9-D x x x x - x x x x x - x x x x x x x x x x x - x
RSP6-16-D x x x x - x x - x x - x - x x x x - x x x - - x
S4-10-D - - - - - - - - - - - - - - - - - - - - - - - x
5.4 Biopsies
Caution
A biopsy must only be performed by physicians with adequate experience. Under all
circumstances the necessary safety precautions and sterility measures have to be respected.
Caution
All biopsy equipment depicted and described in this Basic User Manual has been validated for
use with the system and software. If biopsy equipment which is not listed in this Basic User
Manual is used, the user has the possibility to configure and store the predicted biopsy line. In
this case the user has to be aware that the biopsy equipment/probe/system/software
combination may not be validated and therefore responsibility for correct configuration and
usage lies with the user.
Caution
• Every time before using a biopsy guide ensure its correct position and optimal fit on the
probe.
• Before performing a biopsy ensure that the selected and displayed biopsy line
corresponds to the biopsy needle guide mounted to the ultrasound probe (left/right).
• The biopsy needle and the biopsy needle guide (and the bore inside) must be sterile.
Caution
For detailed information on a biopsy guide, please contact the manufacturer of the biopsy
guide.
Caution
Biopsy equipment is not sterile when delivered unless it is clearly labeled! If biopsy equipment
is not sterile it is mandatory to clean and sterilize it before usage. For additional details please
contact the legal manufacturer of the biopsy equipment.
Caution
Ensure the correct position and optimal fit every time before using a biopsy guide!
Caution
Caution
Before starting a biopsy procedure with a 3D/4D probe always perform a volume scan first.
This is important to ensure proper mechanical alignment and centering of the transducer
element before the biopsy is performed.
Caution
• The default biopsy lines provided with the system software, must be verified at least
once by the user. The procedure must be repeated if probes and/or biopsy guides are
exchanged.
• Before performing a biopsy, prepare a water bath of approx. 47°C and make sure that
the displayed biopsy line coincides with the needle track. Observe probe specific
information on the temperature of the water bath.
• The needle used for water bath alignment must not be used for a biopsy performed on a
patient.
• Depending on the needle stiffness/thickness and the elasticity and composition of the
different tissue-types in the path of the biopsy needle, the actual needle track can
deviate from the predicted biopsy line. The biopsy needle might bend and not follow a
straight line.
Freehand biopsy
Caution
When performing a freehand biopsy, i.e. without a biopsy guide, it is the user's responsibility to
use appropriate equipment. Ensure that the needle (especially the needle tip) is always visible
in the ultrasound image during the whole biopsy procedure.
Caution
Always only use basic modes when performing a freehand biopsy.
Note A water bath alignment verification is also necessary before performing freehand biopsy
procedures.
Caution
Cleaning and sterilization of reusable biopsy guides (for disposable biopsy guides, please refer
to enclosed manuals):
After each use, remove needle guide from transducer. Remove visible contaminants from
needle guide surface thoroughly, using a small, soft instrument brush. Take special care of all
narrow areas and tubes. Keep needle guide from drying out until complete cleaning can be
accomplished. After that, soak needle guide for minimum of five minutes in neutral pH, low
foamingenzymatic detergent.
While immersed, use instrument brush to remove trapped contaminants from surfaces, holes
and tubes. If visible contaminants cannot be easily removed, repeat soaking procedure for an
additional five minutes. Remove needle guide from cleaning solution and remove any
remaining residue with dry wipe. Follow cleaning solution manufacturer's instructions for use
and recommendations for concentration.
Autoclaving (moist heat) 121˚C for 20 minutes (3 Pre-Vacuum-cycles) or 134˚C for 5 minutes.
Recommended minimum sterilization level SAL 10-6.
All biopsy needle guides can easily be mounted to the transducer. Biopsy guides have a
special stop or handle to guarantee a good fix into the notch of transducers.
Note For some probes it is recommended to add some coupling gel to the biopsy notches on the
probe shaft, to ensure easy placement of the biopsy guide.
The cold-sterilized transducer can be kept sterile by placing a sterile sheath over the shaft
(sterile coupling gel between transducer and sheath).
Technical data:
The reusable biopsy needle guides are of stainless steel type 301, 303 and 304 (AISI No).
Sterilization for reusable biopsy needle guides:
Autoclaving (moist heat) 121˚C for 20 minutes (3 Pre-Vacuum-cycles) or 134˚C for 5 minutes.
Recommended minimum sterilization level SAL 10-6 .
Before starting a biopsy please make sure that in case you want to save a study, all relevant
patient information is entered.
Note Biopsy Line buttons are greyed, if needle path was not calibrated once (Biopsy Setup).
Biopsy kit name and the “Biopsy Line” buttons are dependent on the selected probe.
1. Water *
2. Biopsy-needle
1. Mount the desired biopsy guide to a probe and attach the needle.
2. Connect the probe and select it on the touch panel.
3. Press 2D on the user interface to activate B-Mode.
4. Place the probe into a water bath (about 47˚C, set OTI to “Normal”) and display the exact
position of the needle on the active B image.
5. Press Util. on the user interface.
6. Press System Setup on the touch panel.
7. Press Biopsy Setup on the touch panel.
8. The Biopsy Setup Menu is displayed on the touch panel.
Note A water bath alignment verification is also necessary before performing freehand biopsy
procedures.
1. Perform steps 1 to 8, see 'Preparation for biopsy line adjustment' on page 5-15.
2. Select a biopsy kit.
3. The biopsy line is shown on the monitor screen.
4. Adjust the biopsy line by using the Trackball (pos) and the left rotary button below the
touch panel (Line rotate).
5. Press Store to save the line.
6. Press Exit to close the Biopsy Setup.
1. Perform steps 1 to 8, see 'Preparation for biopsy line adjustment' on page 5-15.
2. Select a biopsy kit.
3. The biopsy line is shown on the monitor screen.
4. Adjust the biopsy line by using the Trackball (pos) and the left rotary button below the
touch panel (Line rotate).
5. Press Store to save the line.
6. Press Exit to close the Biopsy Setup.
Note Biopsy kits can be deleted (Delete Kit) or renamed (Rename Kit).
Biopsy lines can be deleted (Delete Line) or renamed (Rename Line).
• Gynecology
imaging < 1 mm (manufacturer) needle
• Gynecology
imaging mm > 1.2 mm
• Small-Parts
imaging < 1 mm (manufacturer) needle
• Obstetrics
Flow™, Power, Tissue,
PW and CW Doppler • Material: Stainless Steel
• Only the biopsy bracket
5.5.1.4 RAB6-D
• Abdomen • 3D/4D Real Time • Only CIVCO (manufacturer) needle guides may be
• Obstetrics
imaging used with this biopsy.
• Peripheral vascular
imaging < 1 mm (manufacturer) needle
4C-D Biopsy 4C
• Obstetrics • Wide field of view • Only CIVCO (manufacturer) needle guides may be
• Abdomen • Wide field of view • Only CIVCO (manufacturer) needle guides may be
• Gynecology
Flow™, Power, Tissue • Material: Plastic
and PW Doppler
• Multi-angle biopsy
• Broad bandwidth, Multi-
• Only the biopsy bracket is reusable.
frequency
• Small parts • Wide field of view • Only CIVCO (manufacturer) needle guides may be
• Peripheral vascular
(virtual convex) used with this biopsy.
• MSK
Power and PW Doppler
• Multi-angle biopsy
9L-D Biopsy 9L
• Small parts • Wide field of view • Only CIVCO (manufacturer) needle guides may be
• Obstetrics
(virtual convex) used with this biopsy.
•
Doppler
• Multi-angle biopsy
Pediatrics
• steerable CW Doppler
• Only the biopsy bracket is reusable.
• MSK
• For detailed information, please contact the
manufacturer.
• Small parts • Wide field of view • Only CIVCO (manufacturer) needle guides may be
• Peripheral vascular
(virtual convex) used with this biopsy.
•
Power and PW Doppler
• Multi-angle biopsy
MSK
• Broad Bandwidth, Multi
• Only the biopsy bracket is reusable.
• Breast Frequency
S4-10-D Biopsy
not available
• Small-Parts
frequency
• Obstetrics
Flow™, Power, Tissue, • Material: Plastic
•
PW Doppler
• Multi-angle biopsy
Pediatrics
• steerable CW Doppler
• Only the biopsy bracket is reusable.
• Cephalic
• For detailed information, please contact the
manufacturer.
5.5.6.1 P2D
P2D Biopsy
not available
• Peripheral Vascular
Doppler
• Cephalic
5.5.6.2 P6D
P6D Biopsy
not available
• Peripheral Vascular
Doppler
2D Mode
In 2D Mode the ultrasound image is derived from the tissue echoes that return to the scan head.
They are amplified, converted, and then mapped to an image processing curve that relates each
echo's intensity to a shade of gray. The greater the echo intensity, the brighter the shade of gray.
As each echo is received, it is arranged along a line within the ultrasound image display. The
location along the line that is displayed is related to the depth at which the echo occurs.
2D Mode is the system's basic mode. It can be combined with various other modes.
Screen formats
Available screen formats in standard and XL size are:
• Single
• Dual
• Quad
Orientation marker
Screen reference: 4
The orientation marker identifies the left/right orientation of the scan plane on screen in
relation to the left/right side of the scan head (ultrasound probe). The housing of a probe has a
mechanical scan plane indicator which corresponds to the orientation marker on screen.
Image info
Screen reference: 5
penet. Penetration
CE-penet. CE penetration
TGC curve
Screen reference: 6
The time gain compensation curve (TGC), located to the right of the image display, graphically
corresponds to the time gain compensation that is applied by the system. The TGC graphic on
the screen correlates to the TGC slider positions (projection to vertical US-line). For more
information see 'TGC Slider Menu' on page 7-2.
Ultrasound image
Screen reference: 7
6.2.1 B-Mode
Using B-Mode
1. Start a new exam and enter all relevant patient information.
2. Connect a probe to the system.
3. Select the probe and a preset.
4. The Main 2D menu appears on the touch panel.
5. Perform the scan.
6. Press Freeze.
Hint To change 2D Gain rotate the 2D button. To change the Frequency use the adjacent encoder
below the touch panel.
Note The availability of some functions or features depends on the probe and ultrasound system
used.
SRI Speckle Reduction Imaging ( SRI ) is an adaptive algorithm to reduce the unwanted
effects of speckle in the ultrasound image. Image speckle usually appears as a
grainy texture in otherwise uniform areas of tissue. Its appearance is related to
image system characteristics, rather than tissue characteristics, so that changes in
system settings, such as probe type, frequency, depth, and others, can change the
appearance of the speckle. Too much speckle can impair image quality and make it
difficult to see the desired detail in the image. Likewise, too much filtering of speckle
can mask or obscure desired image detail. Extra care must be taken to select the
optimal SRI level. SRI is available in B-Mode imaging and may be used with any
transducer or clinical application when image speckle appears to interfere with the
desired image detail.
XBeam CRI Cross Beam Compound Resolution Imaging (CrossXBeamCRI™) is the process of
combining three or more frames from different steering angles into a single frame.
CrossXBeamCRI™ is available on Convex and Linear probes.
CE Coded Excitation ( CE ) improves image resolution and penetration in the far field.
This allows to use a higher frequency on technically difficult-to-scan patients.
FFC Focus and Frequency Composite (FFC) technology utilizes two different transmit
frequencies and two different focal ranges in the 2D image. This function combines
a low frequency to increase the penetration and higher frequency to keep a high
resolution. It reduces speckle and artifacts in the 2D image to facilitate the
examination of difficult-to-scan patients.
2D+2D/SRI This function provides a comparison of images on the screen with and without SRI
activated. This button is not available with CRI.
Angle Image Angle selects a part of interest of the 2D image. The advantage of the
decreased field of view is an increased 2D frame rate due to the smaller sector
width.
ß-View The BetaView function allows the adjustment of the Volume O-Axis position of
Volume probes in 2D mode. The green line in the displayed symbol indicates the
position of the acoustic block. "+" and "-" define the corresponding sweep direction
on the touch panel. This function is probe dependent.
Dyn. Contr. Dynamic Contrast controls how echo intensities are converted to shades of gray,
thereby increasing the adjustable range of contrast.
Gray Map The Gray Map determines the displayed brightness of an echo in relationship to its
amplitude. Depending on individual requirements a “harder” or “softer” image can
be obtained with this function and can be adjusted in freeze and in scan mode
(post-processing).
Line Filter Line Filter smoothens the image in the direction parallel to the probe surface (or in a
curve).
Line Dens. Line Density optimizes B-Mode frame rate or spatial resolution for the best possible
image. It allows to make a trade-off between image resolution and frame rate.
Persist. Persistence is a frame averaging function that allows elimination of image speckle
from 2D images. With a higher persistence setting more frames are averaged.
Enhance Edge Enhance brings out subtle tissue differences and boundaries by enhancing
the gray scale differences corresponding to the edges of structures. A fine, sharper
impression of the image is produced.
Reject Rejection selects a level below which echoes will not be amplified (an echo must
have a certain minimum amplitude before it will be processed). It determines the
amplitude threshold above which ultrasound echoes are displayed on screen.
OTI Optimize Tissue Imaging (OTI) allows to fine tune the system for scanning different
kinds of tissue depending on the patients. Use the OTI control to adjust the
respective parameter. Four positions are possible: adipose, solid, cystic or normal
tissue.
SRI Speckle Reduction Imaging ( SRI ) is an adaptive algorithm to reduce the unwanted
effects of speckle in the ultrasound image. Image speckle usually appears as a
grainy texture in otherwise uniform areas of tissue. Its appearance is related to
image system characteristics, rather than tissue characteristics, so that changes in
system settings, such as probe type, frequency, depth, and others, can change the
appearance of the speckle. Too much speckle can impair image quality and make it
difficult to see the desired detail in the image. Likewise, too much filtering of speckle
can mask or obscure desired image detail. Extra care must be taken to select the
optimal SRI level. SRI is available in B-Mode imaging and may be used with any
transducer or clinical application when image speckle appears to interfere with the
desired image detail.
Cine Menu
For more information see 'Cine Mode' on page 7-13.
Color Flow Mode (CFM) is a Doppler Mode intended to add color coded qualitative information
concerning the relative velocity and direction of fluid motion within the B-Mode image.
Color Flow (CF) is useful to see flow in a broad area. Color Flow allows visualization of flow in
the CF ROI, whereas Doppler Mode provides spectral information in a smaller area.
Color Flow is also sometimes used as a stepping stone to Doppler. You use Color Flow to
locate flow and vessels prior to activating Doppler.
Tissue-Doppler (TD) imaging generates a Color image by using the Doppler principle. This
Color image is overlaid onto the 2D image. The Tissue image provides information about
tissue motion direction and velocity.
The Tissue-Doppler captures low flow but high amplitude signals associated with wall motion
and creates a color-coded tissue image.
Hint To change Color Gain rotate the C button. To change the Frequency use the adjacent encoder
below the touch panel. To change PRF or WMF use the adjacent encoder below the touch
panel.
Using TD Mode
1. Press 2D on the user interface to start B-Mode.
2. Press C on the user interface to start Color Flow Mode.
3. Press TD on the user interface to start TD Mode.
4. The Main TD menu appears on the touch panel.
5. Press the top trackball button (Change) and adjust size and position of the Color box
with the trackball.
6. Press Freeze.
Note The availability of some functions or features depends on the probe and ultrasound system
used.
Invert This function inverts the spectrum display in relation to the direction of flow.
The displayed spectrum is inverted around the baseline. The velocity or
frequency scale changes accordingly. Use Invert when necessary to change
the spectral display orientation. It is possible in both freeze and scan mode.
Threshold This function is only available in Read Mode. It eliminates small color noise or
motion artifact signals in the color image. It is similar to the Gain control in Scan
Mode.
Color Off This function is only available in Read Mode. It turns off color display.
Balance Balance establishes the amount of color displayed over bright echoes and
helps confine color within the vessel walls. Raising this balance displays color
on brighter structures. If you see color on vessel walls, the balance is probably
set too high. Additionally, wall motion ghosting can be suppressed with a low
balance setting.
WMF The Wall motion filter eliminates vessel wall motion noise that is low in velocity
but high in intensity. Use a wall filter that is high enough to remove motion
artifacts, but that is sensitive enough to display low velocity flows in small
vessels. Available settings: low1, low2, mid1, mid2, high1, high2 and max.
PRF The Pulse Repetition Frequency (PRF) has direct influence on the velocity
range. The higher the Pulse Repetition Frequency the lower the velocity range.
As the display scale increases, the maximum Doppler shift information that can
be displayed without aliasing also increases. Aliasing is where the blood
velocity exceeds the maximum measurable velocity, causing the displayed flow
within the vessel to portray flow in the wrong direction. The disadvantage of
using a higher PRF is a loss of sensitivity to low flow velocities.
Quality The higher the color resolution, the lower the frame rate. Available settings:
high, norm and low.
CFM Map This function allows selection of the color-coding for the blood flow display (similar
to the post-processing curves with gray scale 2D). It is useful especially with low
flow rates. It may be altered in Scan or Read Mode.
TD Map This function allows to select the color-coding for an optimization of the display of
motion (similar to the post-processing curves with gray scale 2D). It may be altered
in real time or Freeze mode, respectively.
Baseline Baseline can be used to prevent aliasing in one flow direction similar to the PW
Doppler baseline shift. Shifting the baseline enlarges the velocity range in one
direction. The zero line of the color bar is also shifted.
Frequ. Frequency
Flow Res. Flow Resolution controls the axial resolution of color in the display. It adjusts the
axial sample depth of color pixels.
L. Filter With Line Filter, the signals of neighboring pulses are less weighted for the image
which improves detail resolution and signal-to-noise ratio. Especially the lateral
resolution can be optimized with this correlation algorithm.
Ensemble This function controls the number of pulses for one displayed line. Since several
pulses are to be evaluated for displaying a result, the color display quality increases
with the number of evaluated pulses. With increasing Ensemble the frame rate
decreases.
Smooth / Fall Smoothing performs a temporal averaging which improves the appearance of the
color images. Different amounts of smoothing can be selected for rising velocity and
falling velocity. Filtering of the fall velocity leads to prolongation of the displayed
flow. Usage with quick pulses (short "color flashes") prolongates the flow for better
evaluation on the monitor.
Smooth / Rise Smoothing performs a temporal averaging which improves the appearance of the
color images. Different amounts of smoothing can be selected for rising velocity and
falling velocity. Filtering of the rise velocity leads to noise suppression. To be used
with small laminar flows. Avoid quick movements of the probe, because the flow is
"built up" slowly. When displaying pulses the Rise Filter must be set low.
Artefact Artefact suppression reduces movement artefacts in the image. For cardiac
examinations it is recommended to switch off the artefact suppression.
B-Mode Quality Improves the B-Mode quality through a better reverberation suppression but
contains a lower frame rate.
Cine Menu
For more information see 'Cine Mode' on page 7-13.
Power Doppler (PD) is a color flow mapping technique used to map the strength of the
Doppler signal coming from the flow rather than the frequency shift of the signal. Using this
technique, the ultrasound system plots color flow based on the number of reflectors that are
moving, regardless of their velocity. Power Doppler does not map velocity, therefore it is not
subject to aliasing.
High-Definition Flow (HD-Flow™) is a directional Power Doppler Mode incorporating the flow
direction into the displayed image. The focus of the settings for HD-Flow™ is on high spatial
resolution and low artefact visibility, allowing vessels to be seen with less blooming and finer
detail.
Using PD-Mode
1. Press 2D on the user interface to start B-Mode.
2. Press PD on the user interface to start Power Doppler Mode.
3. The Main PD menu appears on the touch panel.
4. Press Freeze.
Using HD-Flow™
1. Press 2D on the user interface to start B-Mode.
2. Press PD on the user interface to start Power Doppler Mode.
3. Press HD-Flow on the touch panel to start HD-Flow™.
4. The Main HD-Flow menu appears on the touch panel.
5. Press Freeze.
Hint To change 2D Gain rotate the 2D button. To change the Frequency use the adjacent encoder
below the touch panel.
Note The availability of some functions or features depends on the probe and ultrasound system
used.
Color Off This function is only available in Read Mode. It turns off color display.
Threshold This function assigns the gray scale level at which color information stops.
Quality The higher the color resolution, the lower the frame rate. Available settings: high,
norm and low.
WMF The Wall motion filter eliminates vessel wall motion noise that is low in velocity but
high in intensity. Use a wall filter that is high enough to remove motion artifacts, but
that is sensitive enough to display low velocity flows in small vessels. Available
settings: low1, low2, mid1, mid2, high1, high2 and max.
Balance Balance establishes the amount of color displayed over bright echoes and helps
confine color within the vessel walls. Raising this balance displays color on brighter
structures. If you see color on vessel walls, the balance is probably set too high.
Additionally, wall motion ghosting can be suppressed with a low balance setting.
PRF The Pulse Repetition Frequency (PRF) has direct influence on the velocity range.
The higher the Pulse Repetition Frequency the lower the velocity range. As the
display scale increases, the maximum Doppler shift information that can be
displayed without aliasing also increases. Aliasing is where the blood velocity
exceeds the maximum measurable velocity, causing the displayed flow within the
vessel to portray flow in the wrong direction. The disadvantage of using a higher
PRF is a loss of sensitivity to low flow velocities.
Invert This function inverts the spectrum display in relation to the direction of flow. The
displayed spectrum is inverted around the baseline. The velocity or frequency scale
changes accordingly. Use Invert when necessary to change the spectral display
orientation. It is possible in both freeze and scan mode.
Frequ. Frequency
Flow Res. Flow Resolution controls the axial resolution of color in the display. It adjusts the
axial sample depth of color pixels.
L. Filter With Line Filter, the signals of neighboring pulses are less weighted for the image
which improves detail resolution and signal-to-noise ratio. Especially the lateral
resolution can be optimized with this correlation algorithm.
Ensemble This function controls the number of pulses for one displayed line. Since several
pulses are to be evaluated for displaying a result, the color display quality increases
with the number of evaluated pulses. With increasing Ensemble the frame rate
decreases.
Smooth / Fall Smoothing performs a temporal averaging which improves the appearance of the
color images. Different amounts of smoothing can be selected for rising velocity and
falling velocity. Filtering of the fall velocity leads to prolongation of the displayed
flow. Usage with quick pulses (short "color flashes") prolongates the flow for better
evaluation on the monitor.
Smooth / Rise Smoothing performs a temporal averaging which improves the appearance of the
color images. Different amounts of smoothing can be selected for rising velocity and
falling velocity. Filtering of the rise velocity leads to noise suppression. To be used
with small laminar flows. Avoid quick movements of the probe, because the flow is
"built up" slowly. When displaying pulses the Rise Filter must be set low.
Balance Balance establishes the amount of color displayed over bright echoes and helps
confine color within the vessel walls. Raising this balance displays color on brighter
structures. If you see color on vessel walls, the balance is probably set too high.
Additionally, wall motion ghosting can be suppressed with a low balance setting.
Artefact Artefact suppression reduces movement artefacts in the image. For cardiac
examinations it is recommended to switch off the artefact suppression.
B-Mode Quality Improves the B-Mode quality through a better reverberation suppression but
contains a lower frame rate.
Info Also see 'B-Mode' on page 6-4 and 'Button description' on page 3-6.
Cine Menu
For more information see 'Cine Mode' on page 7-13.
PD Opens PD-Mode.
6.2.4 B-Flow
B-Flow helps to visualize complex hemodynamics and highlights moving structures or blood. It
is visually intuitive when viewing blood flow, for acute thrombosis, parenchymal flow and jets. It
is a realistic (intuitive) representation of flow information, allowing to view both high and low
velocity flow at the same time.
Using B-Flow
1. Press 2D on the user interface to start B-Mode.
2. Press BF on the user interface to start B-Flow Mode.
3. The Main B-Flow menu appears on the touch panel.
SRI Speckle Reduction Imaging ( SRI ) is an adaptive algorithm to reduce the unwanted
effects of speckle in the ultrasound image. Image speckle usually appears as a
grainy texture in otherwise uniform areas of tissue. Its appearance is related to
image system characteristics, rather than tissue characteristics, so that changes in
system settings, such as probe type, frequency, depth, and others, can change the
appearance of the speckle. Too much speckle can impair image quality and make it
difficult to see the desired detail in the image. Likewise, too much filtering of speckle
can mask or obscure desired image detail. Extra care must be taken to select the
optimal SRI level. SRI is available in B-Mode imaging and may be used with any
transducer or clinical application when image speckle appears to interfere with the
desired image detail.
Dyn. Contr. Dynamic Contrast controls how echo intensities are converted to shades of gray,
thereby increasing the adjustable range of contrast.
Gray Map The Gray Map determines the displayed brightness of an echo in relationship to its
amplitude. Depending on individual requirements a “harder” or “softer” image can
be obtained with this function and can be adjusted in freeze and in scan mode
(post-processing).
Persist. Persistence is a frame averaging function that allows elimination of image speckle
from 2D images. With a higher persistence setting more frames are averaged.
Enhance With the Enhance function the echo information is digitally processed such that
certain existing information becomes easily visible for the eye (e.g., adjacent media
layers). Due to the Enhance function a finer, sharper impression of the image is
produced.
SRI Speckle Reduction Imaging ( SRI ) is an adaptive algorithm to reduce the unwanted
effects of speckle in the ultrasound image. Image speckle usually appears as a
grainy texture in otherwise uniform areas of tissue. Its appearance is related to
image system characteristics, rather than tissue characteristics, so that changes in
system settings, such as probe type, frequency, depth, and others, can change the
appearance of the speckle. Too much speckle can impair image quality and make it
difficult to see the desired detail in the image. Likewise, too much filtering of speckle
can mask or obscure desired image detail. Extra care must be taken to select the
optimal SRI level. SRI is available in B-Mode imaging and may be used with any
transducer or clinical application when image speckle appears to interfere with the
desired image detail.
Line Dens. Line Density optimizes B-Mode frame rate or spatial resolution for the best possible
image. It allows to make a trade-off between image resolution and frame rate.
S/PRI Sensitivity Pulsed Repetition Index; a higher value improves the B-Flow image
Cine Menu
For more information see 'Cine Mode' on page 7-13.
6.2.5 M-Mode
M-Mode is intended to provide a display format and measurement capability that represents
tissue displacement (motion) occurring over time along a single vector.
M-Mode is used to determine patterns of motion for objects within the ultrasound beam. The
most common use is for viewing motion patterns of the heart.
Using M-Mode
1. Press 2D on the user interface to start B-Mode.
2. Press M on the user interface to start M-Mode.
3. The M Main menu appears on the touch panel.
4. Place the cursor line over the region of interest.
5. Press 2D/M run (right or left trackball button).
6. Press Freeze.
Hint To change M Gain rotate the M-button. To change the Frequency use the adjacent encoder
below the touch panel.
Info Also see 'Button description' on page 3-6. For the option AMM (Anatomical M-Mode) please
see 'Anatomical M-Mode (AMM)' on page 6-28.
Note The availability of some functions or features depends on the probe and ultrasound system
used.
Dyn. Contr. Dynamic Contrast controls how echo intensities are converted to shades of gray,
thereby increasing the adjustable range of contrast.
Harm. Frequ. Multi Frequency mode lets you downshift to the probe's next lower frequency or
shift up to a higher frequency.
Gray Map The Gray Map determines the displayed brightness of an echo in relationship to its
amplitude. Depending on individual requirements a “harder” or “softer” image can
be obtained with this function and can be adjusted in freeze and in scan mode
(post-processing).
M Opens M-Mode.
PW Doppler is typically used for displaying the speed, direction, and spectral content of blood
flow at information.
Using PW Doppler
1. Press 2D on the user interface to start B-Mode.
2. Optimize the B-Mode image.
3. Press PW on the user interface to start PW Doppler Mode.
4. The PW Main menu appears on the touch panel.
Info Also see 'B-Mode' on page 6-4 and 'Button description' on page 3-6.
PW Main Menu
Invert This function inverts the spectrum display in relation to the direction of flow. The
displayed spectrum is inverted around the baseline. The velocity or frequency scale
changes accordingly. Use Invert when necessary to change the spectral display
orientation. It is possible in both freeze and scan mode.
Angle Angle correction. The blood flow velocity calculation based on the incident angle of
the ultrasound onto the axis of the vessel can be determined this way.
PW Sub Menu
Gray Map The Gray Map determines the displayed brightness of an echo in relationship to its
amplitude. Depending on individual requirements a “harder” or “softer” image can
be obtained with this function and can be adjusted in freeze and in scan mode
(post-processing).
PW Opens PW-Mode.
CW Opens CW-Mode.
XTD-View provides the ability to construct and view a static 2D image which is wider than the
field of view of a given transducer. This feature allows for viewing and measurement of
anatomy that is larger than a regular screen.
XTD-View constructs an extended image from individual image frames as the operator slides
the transducer along the surface of the skin. The probe is oriented parallel to the direction of
motion throughout the scan. The quality of the result is user-dependent and requires some
additional skills and practice to develop proper technique and become fully proficient.
Examples include scanning of vascular structures and connective tissue in the arms and legs.
Note Read 'Operation safety' on page 2-11 before using this feature.
Using XTD-View
1. Press 2D on the user interface to start B-Mode.
2. Optimize the B-Mode image.
3. Press XTD-View on the user interface to start Extended View.
4. The Main XTD menu appears on the touch panel.
5. A blue box appears on the screen display.
Info Also see 'B-Mode' on page 6-4 and 'Button description' on page 3-6.
Main Menu
SRI Speckle Reduction Imaging ( SRI ) is an adaptive algorithm to reduce the unwanted
effects of speckle in the ultrasound image. Image speckle usually appears as a
grainy texture in otherwise uniform areas of tissue. Its appearance is related to
image system characteristics, rather than tissue characteristics, so that changes in
system settings, such as probe type, frequency, depth, and others, can change the
appearance of the speckle. Too much speckle can impair image quality and make it
difficult to see the desired detail in the image. Likewise, too much filtering of speckle
can mask or obscure desired image detail. Extra care must be taken to select the
optimal SRI level. SRI is available in B-Mode imaging and may be used with any
transducer or clinical application when image speckle appears to interfere with the
desired image detail.
Frqu. Frequency
Sub Menu
Gray Map The Gray Map determines the displayed brightness of an echo in relationship to its
amplitude. Depending on individual requirements a “harder” or “softer” image can
be obtained with this function and can be adjusted in freeze and in scan mode
(post-processing).
SRI Speckle Reduction Imaging ( SRI ) is an adaptive algorithm to reduce the unwanted
effects of speckle in the ultrasound image. Image speckle usually appears as a
grainy texture in otherwise uniform areas of tissue. Its appearance is related to
image system characteristics, rather than tissue characteristics, so that changes in
system settings, such as probe type, frequency, depth, and others, can change the
appearance of the speckle. Too much speckle can impair image quality and make it
difficult to see the desired detail in the image. Likewise, too much filtering of speckle
can mask or obscure desired image detail. Extra care must be taken to select the
optimal SRI level. SRI is available in B-Mode imaging and may be used with any
transducer or clinical application when image speckle appears to interfere with the
desired image detail.
OTI Optimize Tissue Imaging (OTI) allows to fine tune the system for scanning different
kinds of tissue depending on the patients. Use the OTI control to adjust the
respective parameter. Four positions are possible: adipose, solid, cystic or normal
tissue.
6.3.1 Elastography
Elastography shows the spatial distribution of tissue elasticity properties in a region of interest
by estimating the strain before and after tissue distortion caused by external or internal
forces.The strain estimation is filtered and scaled to provide a smooth presentation when
displayed.
Caution
The results achieved in Elastography Mode always depend on the accuracy of the procedure
performed. Any clinically relevant decisions need to be verified with other state of the art
methods.
Using Elastography
1. Press Elasto on the user interface.
2. Perform the scan. Proper manual compression/decompression is indicated by a fully
green quality bar.
3. Press Freeze.
SRI Speckle Reduction Imaging ( SRI ) is an adaptive algorithm to reduce the unwanted
effects of speckle in the ultrasound image. Image speckle usually appears as a
grainy texture in otherwise uniform areas of tissue. Its appearance is related to
image system characteristics, rather than tissue characteristics, so that changes in
system settings, such as probe type, frequency, depth, and others, can change the
appearance of the speckle. Too much speckle can impair image quality and make it
difficult to see the desired detail in the image. Likewise, too much filtering of speckle
can mask or obscure desired image detail. Extra care must be taken to select the
optimal SRI level. SRI is available in B-Mode imaging and may be used with any
transducer or clinical application when image speckle appears to interfere with the
desired image detail.
Frqu. Frequency
PRF The Pulse Repetition Frequency (PRF) has direct influence on the velocity range.
The higher the Pulse Repetition Frequency the lower the velocity range. As the
display scale increases, the maximum Doppler shift information that can be
displayed without aliasing also increases. Aliasing is where the blood velocity
exceeds the maximum measurable velocity, causing the displayed flow within the
vessel to portray flow in the wrong direction. The disadvantage of using a higher
PRF is a loss of sensitivity to low flow velocities.
Window Step Window step, Range: 1-max (max = 0.8* current Window Length) (Step size: 1)
Frame Reject Frame Reject, Range: 0-255 (step size: 5); Default: 40
Pixel Reject Pixel Reject, Range: 0-255 (Step size: 5); Default: 30
Line Dens. Line Density optimizes B-Mode frame rate or spatial resolution for the best possible
image. It allows to make a trade-off between image resolution and frame rate.
comparative tool that enables users to compare the strain of one tissue to the surrounding
tissue.
• To edit a ROI move the cursor over it until 2 yellow crosses appear along the circle.
See Figure 'Editing a ROI' on page 6-22. Change the size and position of the ROI
by using the trackball buttons Edit Size / Edit Pos . The diameter of the ROI is
displayed below the circle.
• To delete a ROI move the cursor over it and press Selected on the touch panel. To
delete all ROIs press All on the touch panel.
• To draw a ROI manually press Trace on the touch panel and draw a shape. The
position of this shape can be edited (Edit Pos). See Figure 'Hand-drawn ROI
(Trace)' on page 6-22.
11. The following plots can be displayed: Strain, Ratio or Strain & Ratio
• Press Strain & Ratio to see a combined view of the Strain and Ratio plot curves
(see Figure 'Touch panel: Elastography Analysis' on page 6-23).
• The ratio value indicates how many times the tissue of a ROI is harder or softer than the
tissue of the Reference ROI.
Touch panel
Strain & Ratio Dual plot image: upper image with strain data,
lower image with ratio data
Touch panel rotary and flip switch Start Frame Moves to the first frame of the loop
controls
End Frame Moves to the last frame of the loop
1 Reference ROI
2 Lesion
3 Harder compression
4 Lower compression
5 Strain plot
6 Ratio plot
7 Frame indicator lines: green lines indicate frames with color in the Elastography
image, red lines indicate invalid frames without color.
In both the Elastogram (top left) and the B-mode image (bottom left) a small ovoid shaped
dark lesion is visible. The region to the left and right of this lesion represents normal fatty
breast tissue. The reference ROI is placed in the fatty breast tissue (left yellow circle), the ROI
2 is placed in the lesion (right blue circle). In the strain plot (top right) the strain of the
reference is shown by the higher yellow line. Higher peaks of both lines are caused by harder
compression. The lower right plot depicts the strain ratio of both ROIs. The reference is set to
a straight yellow line with the value of 1, the strain ratio of the lesion is represented by the blue
plot. In the example, the ratio between breast tissue and the lesion is always close to 10.
Caution
• Cavitation may occur due to interactions between the ultrasonic waves and the contrast
medium. Always perform examination using the ALARA (As Low As Reasonably
Achievable) principle. The acoustic power can be adjusted by rotating the Transmit
Power button on the user interface.
• Stop the examination and perform appropriate treatment, if there is any abnormality with
the patient during use of the contrast medium.
In the United States contrast agent usage is restricted to usage on LVO (Left Ventricle
Outflow).
Remark • Handle the contrast medium as described in the operation manual supplied with the
contrast medium.
• Check the side effects of the contrast medium used with the manufacturer of the contrast
medium.
• GE Healthcare Austria GmbH & Co OG is not liable for any damage or injury resulting
from improper use of contrast media.
Main Menu
Enhance Max Sets the acoustic output to its maximum setting (100%), it does not take care about
any gain correction
CIS CIS (Contrast Imaging Simultaneous). Simultaneous display of the 2D image and
the Contrast Image in a dual format left/right.
SRI Speckle Reduction Imaging ( SRI ) is an adaptive algorithm to reduce the unwanted
effects of speckle in the ultrasound image. Image speckle usually appears as a
grainy texture in otherwise uniform areas of tissue. Its appearance is related to
image system characteristics, rather than tissue characteristics, so that changes in
system settings, such as probe type, frequency, depth, and others, can change the
appearance of the speckle. Too much speckle can impair image quality and make it
difficult to see the desired detail in the image. Likewise, too much filtering of speckle
can mask or obscure desired image detail. Extra care must be taken to select the
optimal SRI level. SRI is available in B-Mode imaging and may be used with any
transducer or clinical application when image speckle appears to interfere with the
desired image detail.
Contrast Clock You can use the Contrast Clock by activating it at the time of injection and
deactivating it at the end of the exam.
Sub Menu
Gray Map The Gray Map determines the displayed brightness of an echo in relationship to its
amplitude. Depending on individual requirements a “harder” or “softer” image can
be obtained with this function and can be adjusted in freeze and in scan mode
(post-processing).
Persist. Persistence is a frame averaging function that allows elimination of image speckle
from 2D images. With a higher persistence setting more frames are averaged.
Line Dens. Line Density optimizes B-Mode frame rate or spatial resolution for the best possible
image. It allows to make a trade-off between image resolution and frame rate.
SRI Speckle Reduction Imaging ( SRI ) is an adaptive algorithm to reduce the unwanted
effects of speckle in the ultrasound image. Image speckle usually appears as a
grainy texture in otherwise uniform areas of tissue. Its appearance is related to
image system characteristics, rather than tissue characteristics, so that changes in
system settings, such as probe type, frequency, depth, and others, can change the
appearance of the speckle. Too much speckle can impair image quality and make it
difficult to see the desired detail in the image. Likewise, too much filtering of speckle
can mask or obscure desired image detail. Extra care must be taken to select the
optimal SRI level. SRI is available in B-Mode imaging and may be used with any
transducer or clinical application when image speckle appears to interfere with the
desired image detail.
Enhance With the Enhance function the echo information is digitally processed such that
certain existing information becomes easily visible for the eye (e.g., adjacent media
layers). Due to the Enhance function a finer, sharper impression of the image is
produced.
S./PRI Sensitivity PRI is used to adjust the sensitivity of the Contrast Agent. By increasing
the sensitivity, you lower the frame rate; by decreasing the sensitivity, you raise the
frame rate.
Balance Balance establishes the amount of color displayed over bright echoes and helps
confine color within the vessel walls. Raising this balance displays color on brighter
structures. If you see color on vessel walls, the balance is probably set too high.
Additionally, wall motion ghosting can be suppressed with a low balance setting.
Time Delay Time Delay scans images at set intervals, delaying imaging according to the time
delay that you specify.
Dyn. Contr. Dynamic Contrast controls how echo intensities are converted to shades of gray,
thereby increasing the adjustable range of contrast.
Anatomical M-Mode gives you the ability to manipulate the cursor at different angles and
positions. The M-Mode display changes according to the position of the cursor.
CW Doppler imaging includes a spectral analysis which describes the Doppler shift signal from
the moving reflectors within the CW cursor line. The spectral display scrolls from left to right
and depicts the spectral distribution of the components of the Doppler shift frequency over
time. Frequency or velocity values appear on the vertical axis and time along the horizontal
axis. Component amplitudes appear as shades of gray. The brighter the shade, the higher the
amplitude.
Using CW-Doppler
1. Press 2D on the user interface to start B-Mode.
2. Press PW on the user interface to start PW-Mode.
3. Press CW on the touch panel to start CW-Doppler Mode.
Note The availability of some functions or features depends on the probe and ultrasound system
used.
Main Menu
Invert This function inverts the spectrum display in relation to the direction of flow. The
displayed spectrum is inverted around the baseline. The velocity or frequency scale
changes accordingly. Use Invert when necessary to change the spectral display
orientation. It is possible in both freeze and scan mode.
Angle Angle correction. The blood flow velocity calculation based on the incident angle of
the ultrasound onto the axis of the vessel can be determined this way.
Sub Menu
Gray Map The Gray Map determines the displayed brightness of an echo in relationship to its
amplitude. Depending on individual requirements a “harder” or “softer” image can
be obtained with this function and can be adjusted in freeze and in scan mode
(post-processing).
Scale Three different scale units (kHz, cm/s, m/s) are available.
CW Opens CW-Mode.
PW Opens PW-Mode.
Image management
The slider area itself allows direct operation of the sliders by touching in Run mode of all main
acquisition menus. In Freeze mode the sliders are disabled and grayed. Init sets all sliders to
the initial, middle position. TGC opens the TGC Slider Menu.
Hint A time-out for the Slider Menu window can be adjusted in the System Setup.
Controls
AO Acoustic Power adjusts the acoustic output of the transducer. It shall be set to the
minimum value which still allows well valuable information. Always keep the power
level and the exposure time AS LOW AS REASONABLY ACHIEVABLE.
Near Field The slider position corresponds to the TGC silder 1 and vice versa.
Far Field The slider position corresponds to the TGC silder 8 and vice versa.
The graphical TGC curve (line) is located on the right side of the image display in single format
and two/four independent curves are either on the left/right on the left/right image in dual/quad
format. They graphically correspond to the time gain compensation that is applied by the
system and correlate to the TGC slider positions projected to the vertical US-line of the US-
image. The TGC curve flips with the Up/Down invert key.
Controls
Scan Assistant Pause Pauses Scan Assistant during an exam. No selections are possible. Scan Assistant
Pause can also be activated by pressing F2.
Page 1,2,3 Selects the non visible group and/or check items if the number of the items exceeds
the Scan Assistant display area.
Keyboard Controls
Trackball Controls
Set (double click) Reloads the Image saved under the check item. If more than one image is
available, the last saved image is reloaded.
The touch panel serves as a means to display a predefined list of annotations, which can be
displayed on the screen with just one keystroke.
The touch panel has:
• different controls
• a default page on annotation mode activation (When a new exam is started always the
current exam application and the first page is set as default. During the exam always the
last used application and page are set.)
• two types of Auto text controls (single buttons with one text line and popup buttons with
max. 3 text lines)
• words set as default when a new exam is started or the possibility to enter free text.
Annotation Controls
Clear Text on selected Page A or B can be deleted. Only possible if the text menu is
present on the touch panel.
Exit Annotation off. Only possible if the text menu is present on touch panel.
AN keyboard Controls
F10 Text layer B is activated and additional annotation can be switched on if off.
F11 Home: text cursor can be positioned on current home position on the screen.
Fn + F11 Set Home: the current cursor position is stored under Home
Trackball Controls
Set To fix a text when there is active text. Switch highlight off if on.
Touch Panel
Layer A Text layer A is activated as active page and the layer is displayed on the screen.
Layer B Text layer B is activated as active page and the layer is displayed on the screen.
Hide Text The whole text is hidden on the screen but not deleted.
Auto Text keys Enter predefined annotations at the current text cursor position.
Del Text Clear text: the whole text on selected Layer A or B is deleted.
Return Return provides a line feed, moving the cursor to the next line as long as it is not
already on the last line. The cursor must be placed directly below the starting
position of the group.
Insert The Insert key functions as a toggle between overwrite/replace and insert mode.
Overwrite is the default mode. Insert mode is retained until the user changes it
including power down.
Home This key resets the cursor to its default position on the screen. (Home 1 defines a
global cursor position for all exams, Home 2 for each specific exam.)
Set Home A new home position can be set by pressing Fn + Home keys on the AN keyboard.
(Home 1: global position for all exams, Home 2: global position of the selected
application in the text menu.)
Hide Text The text layers perform a HIDE TEXT / SHOW TEXT functionality, thus allowing to
save/ print an image without annotations without having to actually clear the typed
text. If the Hide Text key is switched on the text of both layers is hidden (not
cleared).
7.3.2 Text
Editing text
Trackball and Set To select a word/text group the cursor must be placed upon the text group. If the
cursor is placed upon the text group, the font color changes to green indicating that
the text group can be selected. With Set the text will be selected.
In fixed mode the text cursor can be positioned over a word of an existing comment
and the word can be modified without pressing Set.
Keys to start text entering: all character keys, backspace, space, return
Grab with encoder control Encoder rotation highlights word by word on the screen. Highlighted words are
displayed with white background color.
Rotation clockwise: the next entered word is highlighted
Rotation counter clockwise: the previous entered word is highlighted
Grab with upper trackball button Word grabbing with this button is only possible if the text cursor is positioned over a
text group and text color has changed to green. If Grab Word is pressed, then the
word nearest to the text cursor is highlighted. If the button is pressed sequentially,
always the next entered word is highlighted.
New exam When a new exam is started all text annotations are deleted on Layer A and B.
Unfreeze When an image is unfrozen all text annotation is deleted on the active Layer A or B.
This depends on the presets in the system setup.
Means to delete text • Backspace (deletes character by character or whole words when they are
highlighted)
• Word Delete (The Word Delete key deletes the word the cursor is on.)
• Clear key (In annotation mode the Clear key deletes all text annotations on the
active text layer A or B.)
• Text Delete (All text entries are deleted on the active text layer A or B.)
Annotated text remains if the probe or setting is changed. End Patient/Exam deletes the text
annotation.
Fixed Mode: not flashing In this state the cursor itself can be positioned to select a new text position or a
current word or text group for editing. When text entering is started or an existing
text is selected, state 2 (Active Mode) is activated and the cursor starts flashing
Active Mode: flashing In this state the cursor and the text will be positioned together, the current green
text hangs on the cursor. With Set the text entry is fixed, the text color changes to
yellow and state 1 (Fixed Mode) is activated again.
Invisible Mode: hidden If the text cursor is moved out of the annotation area into the onscreen area it is
hidden and the system cursor appears in the onscreen area to operate/select the
screen controls.
If the system cursor is moved into the annotation area again the text cursor appears
on the position where the system cursor passed the annotation boundary and the
previous state 1 or 2 is selected again.
The text cursor is not visible on the screen when the system is not in annotation mode. The
character modes Insert and Overwrite have different cursor widths.
• If a blank is entered: automatically Word Wrapping is activated and the next word
separated by the blank is wrapped to the next line. When the bottom line is reached,
word wrapping is not possible, only Group move can take place.
7.3.2.3 Workflows
Annotations and indicator marks can be printed to film by using the usual print keys on the
front panel. Annotations and arrow marks present on the screen appear on images stored to
disk or sent to a DICOM device. The annotations cursor never appears on the saved / printed
images.
Annotation mode remains active after an image is printed or saved to disk.
Risk Mitigations
Annotations are always maintained correctly, also on all exported image types.
7.3.4 Indicators
• hand
Fixing an indicator
1. Switch on the indicator function. The last selected indicator appears in the middle of the
annotation area. Active indicators are green.
2. Change the type of indicator (if wanted).
3. Position the indicator with the trackball.
4. Rotate the indicator (if wanted) with the rotary encoder.
5. Store the indicator with the Set key (right or left trackball button). The indicator turns
white.
6. To set a new indicator repeat steps 1-5. When the trackball is moved the next indicator
appears.
7. To delete an indicator press Delete Last to delete the last fixed pointer or Delete All or
Clear to delete all fixed indicators.
7.3.5 Bodymark
For the documentation of the scan position on the patient, a selection of graphic body symbols
(bodymarks) is available. A short bright line indicates the scan position. This line can be
positioned freely on the bodymark symbol.
Press Bodymark to open the bodymark menu and select the desired bodymark. A default
bodymark is displayed automatically when Bodymark is activated.
Controls
Exam Application Tabs Switch between available exam application tabs. The selected exam application
opens the default bodymark menu. If no exam is started the last used bodymark
menu is opened.
Page x Switch between pages (only available when more than 1 bodymark page exists).
Off & Exit Deletes the inserted symbol and closes the menu.
Trackball
pos. Scan Moves the orientation marker inside the bodymark symbol.
Note The scan plane identification is shown in scan mode and freeze mode.
Note The main application (chosen in the “Probe Selection” menu) does not change! After touching
the Appl the touch panel changes to the “Application Select” menu. When a “main” application
in the “Probe Selection” menu is selected, the Bodymark application is set (changed) to this
application.
Screen Display
The probe mark has a green spot that indicates the orientation of the probe. The probe can be
rotated by using the Angle control.
The bodymark symbol appears in the left lower corner of the B-Image.
4 Graphic display of the default “Save Graphic display of the default “Save
length” programmed under P-button. length” programmed under P-button.
Cine-Split-Function for Dual- and Quad format: 'Cine-Split Function' on page 7-14
2D Auto Cine for Single-, Dual- and Quad format: '2D Auto Cine' on page 7-14
Remarks:
• The number of stored images depends on the number of scan lines, scan depth and
magnification. In freeze mode the length of the sequence is indicated on the status bar.
Display: Cine xxx
• Starting the Cine mode erases measuring marks and measuring displays.
• The Cine Function (operation and storage) is identical in 2D mode and CFM mode.
When in freeze mode a marker indicates the current image on the cine bar.
This marker can be moved using the trackball. The marker is green as long it is inside the
“save clip” section. Outside of the “save clip” section it turns red.
• Retrospective Cine: When the cine clip is saved in retrospective cine mode, all frames
that have been captured will be saved when the [Freeze] key or the [Px] key are
pressed. Then the cine clip will be saved. (time adjustable)
• Prospective Cine: When saving the cine clip in prospective cine mode, all frames will be
saved beginning at the moment of activating the cine (time adjustable).
After the cine has been stored it can be edited. Press the upper trackball key to enter the Edit
Clip mode.
The stored cine clip can be cropped by defining a start and a end image:
• To exit the Edit Clip mode press the upper trackball key.
After Freeze of a sequence in Multi-format 2D mode, two or four different images of the
sequence can be displayed simultaneously in Dual or Quad display mode.
Move the trackball horizontally to display the 2D images of the stored sequence or use the
flipswitch below the touch panel.
Using the [Format] keys you can change to the next (part of) frozen 2D image sequence to
play back the cine memory.
Remarks:
• In Dual image mode 2D cine each image takes half of the memory as in Single mode.
• In Quad image mode 2D cine each image takes only one quarter of the memory.
• The Cine-Split function (multiple format) is also possible with 2D Auto Cine: '2D Auto
Cine' on page 7-14
With the 2D Auto Cine function a defined sequence (start, end) of a 2D image can be
reviewed.
Px Clip Start/Stop Toggle between playback and stop of the selected clip
defined by start and end image. Button is disabled if no
save/send clip is available.
Orig. Clip Start/Stop Toggle between playback and stop of the original cine clip
3D and 4D Mode
Visualization - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-3
General advice to obtain good rendered 3D/4D images - - - - - - - - - - - - - - - - - - - 8-7
Initial Condition of different Probes - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-8
3D/4D Mode screen display - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-10
Volume Acquisition Modes - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-13
Volume Visualization Modes - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-18
Additional tools - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 8-37
This chapter describes how to use 3D and 4D Mode, also referred to as Volume Mode.
The Volume Mode allows for scanning a tissue volume and subsequent analysis of sections of the
volume in 3 dimensions. The liberal selection of sections within the volume and the simultaneous
real-time 4D display of three orthogonal planes and a rendered 3D image represents a new
dimension for e.g., the diagnosis of fetal abnormalities. The Volume Mode provides access to
sections unachievable by the 2D scan technique. A parallel interface provides the possibility to save
volume data on a hard disk drive for repeated analysis anytime.
1. Central 2D scan
2. Start 2D scan
3. Range of VOL sweep
The volume scan is automatically performed by an automatic sweep of the transducer array
inside the housing. The scanned volume is similar to a section of a torus.
VolPre mode
The VOL-Box frames the Region of Interest (ROI) on the actual 2D scan which will be stored
during the volume sweep. The range of the volume sweep is indicated by the Vol-Angle
Pictogram, which is displayed at the bottom right of the screen. This moving indicator gives
information about the position of the B image during the 3D volume scan. The sweep time
varies and depends on the VOL-Box size (depth range, angle) and the quality. The probe must
be held steady and in place during the 3D volume scan. The real time display of the swept B
frames allows continual observation of the scan quality. During the real time 4D scan it is not
necessary to hold the probe steady because of the continuous volume acquisition.
8.1 Visualization
The position of the volume body in relation to the display plane is determined by a relative
coordinate system. This is made up of three orthogonal axes. The common intersection of
these axes is the central dot. These axes are displayed within the display plane - exactly in the
X-, Y- and Z-directions and colored. Rotation around any of these axes and displacement of
the center of rotation make any imaginable plane within the volume body display-able. The
INIT position of the volume body in relation to the display plane is reset-able; it is the start
situation after completion of a volume scan.
The standard representation: 3 sectional planes The 3 orthogonal sectional planes are
simultaneously displayed on the screen. Each quarter of the monitor displays a sectional view
through the volume body as shown below.
Section/field A B C
By this definition the relation of the position of the 3 images A, B, C is also indicated (as made
clear by the direction of arrows). The presentation of 3 orthogonal sectional planes may lead to
non-conformance with the conventional customized orientation to the patient in 2D-
sonography. An identification system - the automatic display of the direction of section - will
clarify.
Please note:
Whenever a usual longitudinal section (of the patient) is selected for display field A, the usual
orientation for longitudinal and transverse sections is valid.
The display screen shows the sectional plane located within the volume, which has been
selected by rotating and shifting of the volume body in relation to the display plane.
While turning a rotary control, the corresponding axis is shown in the reference image as a line
(X- or Y-axis) or as a circle (Z-axis). Rotations around any one of the axes X, Y and Z can be
performed freely.
Hint • For faster rotation push on the rotary controls once (toggle function: slow rotation, fast
rotation) Press again to return to slower rotation.
• Do not rotate by large angles except when the orientation left/right or up/down is to be
changed. At 90˚ rotation around an axis, the sections A, B, C will change:
• Before performing a rotation, position the center of rotation in the area of the image that
you want to keep.
By rotation of the volume body in relation to the screen plane (as shown) the new sectional
planes are calculated in real time and displayed on screen.
1. Display plane
2. Volume Center plane
3. Resultant image of plane within volume
4. Displacement
Reference image: A
The sectional plane migrates from the
front to the rear through the volume
body.
Reference image: B
The sectional plane migrates from the
left to the right through the volume body.
Reference image: C
The sectional plane migrates from the
top to the bottom through the volume
body
Parallel movement of the reference image will display the new intersection lines with the non-
reference images. The sectional planes of the non-reference images are not altered.
Note The terms “front, left, top” etc., do not refer to the patient, but serve for explanation.
The center of rotation can be X/Y-positioned by the trackball. This causes also a parallel
displacement of those planes presented by the non-reference images. The intersection line of
the non-reference images with the reference image will undergo a parallel X or Y shift
accordingly.
Note • Positioning the center of rotation in the reference image marks that point which will not
get lost during the rotation.
• It is recommended to use the Parallel shift rotary control together with the reference
selection for the performance of parallel sections. In this mode only one image is
concerned by changes.
Note The center of rotation cannot leave the display field A, B or C. In case an intersection line
reaches the volume border, the line will stay there and the image (with further shift) will
continue to move in the shift direction. This is especially helpful when due to magnification the
display field is small compared with the area of the plane to be observed.
• Poor quality of the volume scan will lead to a poor quality 3D image.
• For a good 3D image quality, adjust high contrast in 2D mode of the interesting
structures before starting the volume scan.
• Only the ultrasound data within the ROI (render box) will be calculated and displayed.
• The correct placement of the ROI is essential for a good result, because the ROI
determines the view onto the interesting object.
• Surface Mode: note that the surface of interest has to be surrounded by hypo echoic
structures; otherwise the system is unable to define the surface. With the function
“THRESHOLD” echo structures adjacent to the surface can be "cut off" if their gray
values are much lower than the gray values of the surface structures.
• Minimum Mode: note that the interesting objects (vessels, cysts) should be surrounded
by hyper echoic structures. Avoid dark areas (shadows caused by attenuation, dark
tissue presentation) within the ROI, otherwise large parts of 3D images will be displayed
dark.
• Maximum Mode: avoid bright artefact echoes within the ROI, otherwise these artefacts
are displayed in the 3D images.
• X-Ray Mode: note that all gray values within the ROI are displayed. Therefore, in order
to enlarge the contrast of the structures within the ROI, the depth of the ROI should be
adjusted as low as allowable.
Color Mode
• Poor quality of the Color image in 2D mode will lead to poor image quality in 3D color
image.
• In Power-Doppler mode (control “PD”) a pure flow display without directional coding is
given.
• Use small VOL box and small sweep angle to reduce acquisition time.
• Smoothing Filter (Rise and Fall in 2D image) leads to smoother flow and a good color 3D
display of vessels (e.g., filtering of high pulsatile vessels). Disadvantage: The higher the
filter setting, the longer the acquisition time.
• Surface Mode: Displays the surface of the vessels (color signals) within the tissue
volume.
Note If the Mix control is adjusted to 100% color, the gray scale tissue information becomes
transparent.
• The probe has enhanced performance for more penetration and dynamic contrast at
usual temperatures.
• A - anterior (ventral)
• P - posterior (dorsal)
• Cr - cranial
• Ca - caudal
• R - right
• L - left
The sectional image A represents the 2D image visible in the Vol preparation area.
If the VOL-start image is a longitudinal section (Cr on the left of the screen below), the following Init positions are
obtained:
If the VOL-start image is a longitudinal section (Cr on the left of the screen below), the following Init positions are
obtained:
If the VOL-start image is a median-sagittal section (left side of the screen is posterior), the following Init positions are
obtained:
Volume Box
Screen reference: 1
The three dimensional Volume Box is displayed with help of two boxes, which are rectangular
to each other. All information inside the Box during the volume acquisition will be recorded and
stored in the volume memory.
VolAngle Indicator
Screen reference: 2
In 3D/4D pre mode the range of the volume sweep is indicated by the VolAngle Indicator,
which is displayed at the bottom right of the screen. This indicator shows the actual position of
2D system during a volume sweep, moving from start to end position of adjusted volume angle
filling the symbol. The filled color area shows the progress of the acquisition procedure.
Render Box
Screen reference: 3
The render box determines the ROI (content) of the volume data set to be rendered.
To obtain a good 3D picture, the following three points are very important (similar to a
photography):
This has to be adjusted with the render box. The render box determines the size of the volume
to be rendered. Therefore, objects that are not inside the box will not be included in the render
process and cut out (important for the surface mode to cut off objects, which obstruct the view
of the object). The positioning of the box inside the scanned volume is performed by trackball
and selection of a sectional plane A, B, C.
x,y,z axis
Screen reference: 4
The axis represent the relative coordinate system and mark the intersection lines of the slices.
Scale Marker
Screen reference: 7
The depth scale marker allows to determine the depth of the echoes or objects displayed in
the ultrasound image on sent or printed images.
Three depth scale markers are available:
Image info
Screen reference: 8
Mix70/30 Mix value between render main mode (70) and render
sub mode (30)
Only displayed in Visualization Mode Render & VCI.
Mix70/30 Mix value between render main mode (70) and render
sub mode (30)
Only displayed in Visualization Mode Render & VCI.
--- 2D ---
Program
12.50-3.40
25.0
Gn -3
C7/M7
P4/E2
SRI II 1
25.0
Gn 2.1
Frq mid
Qual norm
WMF low
PRF 1.8kHz
Caution
A lossy compression can reduce image quality which can lead to a false diagnosis!
Render S F S F S F - - - -
Multiplanar S F S F S F - - - -
OmniView S F - F - F - - - -
TUI S F S F S F - - - -
Niche - F - F - F - - - -
SonoVCAD™labor - F - F - F - - - -
SonoVCAD™heart - F - F - F - - - -
VCI - - - - - - S F - -
4D Biopsy - - - - - - - - S F
Real Time 4D mode is obtained through continuous volume acquisition and simultaneous
rendering. In Real Time 4D mode the volume acquisition box is at the same time the render
box. All information in the volume box is used for the render process. Therefore size and
position of the volume box is important for a good render result. After freezing, the image size
can be adjusted manually if desired, or play back the Volume Cine.
Visualization Modes
8.5.2 3D Static
Visualization Modes
STIC
Note STIC is an option.
Note Read 'Operation safety' on page 2-11 before using this feature.
With this acquisition method the fetal heart or vascularity can be visualized in 4D. It is not a
Real Time 4D technique, but a post processed 3D acquisition.
STICis designed for beating (fetal heart) as well as blood perfused organs. Only STIC can
synchronize structures that have a pulsation in Doppler mode or B-Flow but no visible
pulsation in B-mode.
Data is acquired for a predefined period of time (7.5 – 15 sec.). The acquired images are post
processed to calculate a 4D Volume Cine sequence representing one complete heart cycle.
In order to achieve a good result, try to adjust the size of the volume box and the sweep angle
to be as small as possible. The longer the acquisition time, the better the spatial resolution will
be. The user must be sure that there is minimal movement of the participating persons (e.g.,
mother and fetus), and that the probe is held absolutely still throughout the acquisition period.
Movement will cause a failure of the acquisition. If the user (trained operator) clearly
recognizes a disturbance during the acquisition period, the acquisition has to be canceled.
A good STIC data set shows a regular and synchronous beating of the fetal heart or of an
artery. Please make sure that the borders of the fetal heart or the artery are smooth and there
are no sudden discontinuities. Always adopt a critical attitude to images created in STIC mode.
One or more of the following artefacts in the data set indicate a disturbance during acquisition:
• Sudden discontinuities in the reference image B: These are due to motion of the mother,
the fetus or fetal arrhythmia during acquisition.
• Sudden discontinuities in the color display: Motion of the mother, the fetus or fetal
arrhythmia affects the color flow in the same way it affects the gray image.
• Fetal heart rate far too low or far too high: After acquisition the estimated fetal heart rate
is displayed. If the value does not correspond to the estimations based on other
diagnostic methods at all, the acquisition failed and has to be repeated.
• Asynchronous movement in different parts of the image: e.g., the left part of the image is
contracting and the right part is expanding at the same time.
• The color does not fit the structures displayed in gray mode: The color is displayed
above or below the actual vessel.
• Color “moves” through the image in a certain direction: This artefact is caused by a
failure in detecting the heart rate due to low acquisition frame rate. Use higher
acquisition frame rate for better result.
Note In all of the above cases the data set has to be discarded and the acquisition has to be
repeated.
When is it not allowed to perform the STIC fetal cardio acquisition?
• STIC
• STIC BF
• STIC CFM
• STIC PD
• STIC HDF
• STIC TD
These modes are displayed in the image info block together with information about the current
exam (STIC acquisition time, volume box angles, calculated heart rate,...). The two STIC sub
methods, STIC Cardio (STIC/Fetal Cardio) and STIC flow (STIC/Vessel), are not displayed on
the screen.
In STIC Color pre mode two different sets of color STIC settings (configurable in the system
setup) are available:
• 2D color settings
• STIC color settings (parameters from the current STIC user program)
Screen Layout
In STICpre / CFM STICpre mode all items are identical with 4D RT pre mode / 4D CFM RT pre
mode.
In STIC / CFM STIC data all items are identical with 4D RT mode / 4D CFM RT mode. The
caution icon and the calculated heart rate are displayed as well.
All hard key and trackball controls are the same as in 4D RT / 4D CFM RT mode. Therefore
only the STIC relevant controls are described here:
Quality Select the desired quality: max, high2, high1, mid2, mid1, low
Acqu. Time Only available in STIC. Acquisition time (7,5 sec, 10 sec, 12,5 sec, 15 sec) can be
set.
Exit/Stop Acquisition If more than 50% of the acquisition is done, use the acquired data or return to pre
mode
STIC Trigger The STIC Trigger setting defines on which data the STIC algorithm operates. In
Color STIC mode this can be either the grayscale 2D data or the Doppler data.
Grayscale data are used for the acquisition of the fetal heart, Doppler data are used
for the acquisition of vascular structures.
If the expected frame rate is too low (< 18 HZ) for a good STIC quality, a warning is displayed
in STIC mode. Nevertheless the acquisition can be started normally.
After the STIC acquisition is finished the calculation process starts to calculate the volume cine
sequence. If no result is found by the system, it switches back to STICpre mode. If a result is
detected by the system,the 4D Volume cine sequence is shown in run mode and the STIC
accept menu appears. As soon as the result is accepted the system releases the volume cine
mode. If the result is not accepted but canceled, the system switches back to STICpre mode.
Visualization Modes
8.5.4 VCI-A
Visualization Modes
8.5.5 4D Biopsy
Visualization Modes
8.6.1 Render
• 4D Real Time
• 3D Static
• STIC
Edit Light The Light source position can be changed with the trackball to any position or with
the preset buttons to dedicated positions. The current position is shown with help of
the Light Icon.
Fixed ROI The image data outside of the render box will be shown dimmed.
Zooming doesn't cut off parts of the image.
Init Set all translations and rotations back to the initial acquisition position.
Ref. Image Select the reference image to which all image dependent functions like parallel
shifts, rotations, etc. are applied.
3D Orient. Rotate the 3D image by tapping one of the two toggle buttons:
• 90° / 270°
• 0° / 180°
The selected orientation is shown in green.
Mix Render mix mode: toggles between the two selected render modes and Gray
Threshold low for 3D images.
Quality This control improves the resolution by reducing the frame rate. Respectively it
reduces the resolution by increasing the image frame rate.
3D Color Toggle between on and off to show or hide color data in slices. The button will be
grayed if no color data is available.
Info 2D Param. Displays extended image information in the top right corner.
3D Frame Toggle between on and off to show or hide the boarder of the rendered 3D image.
Volume Analysis Displays the Volume Analysis menu. (only available in freeze mode)
Using SonoRenderlive
1. Start the Render Visualization Mode.
2. Press the Sono RL touch panel control.
3. To adjust the distance between the render start position and the render object, rotate the
Sensit. control below the touch panel. A high value indicates a smaller distance.
Info In the case that Sono RL is not used, the Render Start line can also be modified manually.
Press the trackball button Curv to activate Curved Render Start and move the trackball to
modify the line.
Note SonoRenderlive is not available in STIC/eSTIC combination modes (i.e. STIC/eSTIC CFM,
STIC/eSTIC PD,...).
8.6.2 Multiplanar
• 4D Real Time
• 3D Static
• STIC
VCI Render Presets Change the preset of the selected render group.
Init Set all translations and rotations back to the initial acquisition position.
Ref. Image Select the reference image to which all image dependent functions like parallel
shifts, rotations, etc. are applied.
Quality This control improves the resolution by reducing the frame rate. Respectively it
reduces the resolution by increasing the image frame rate.
3D Color Toggle between on and off to show or hide color data in slices. The button will be
grayed if no color data is available.
Info 2D Param. Displays extended image information in the top right corner.
Volume Analysis Displays the Volume Analysis menu. (only available in freeze mode)
8.6.3 OmniView
rendering modes (70/30) plus a low setting of surface transparency (20-50) is used. The
resulting image shows the average (integrated) gray value of the tissue contained within the
narrow box. OmniView improves the contrast resolution and the signal / noise ratio and
therefore facilitates the detection of diffuse lesions in organs. The result is an image with no
speckle pattern and a highly improved tissue contrast.
Possible Acquisition Modes:
• 4D Real Time
• 3D Static
• STIC
Quality This control improves the resolution by reducing the frame rate. Respectively it
reduces the resolution by increasing the image frame rate.
VCI Render Presets Change the preset of the selected render group.
Clear All All existing lines are deleted and a new line entry is started.
Init Set all translations and rotations back to the initial acquisition position.
• Vertical: Up / Down
Mix Render mix mode: toggles between the two selected render modes and Gray
Threshold low for 3D images.
Info 2D Param. Displays extended image information in the top right corner.
Icon The icon shows the orientation of the OmniView slice in relation to the ref. slice.
Volume Analysis Displays the Volume Analysis menu. (only available in freeze mode)
• 4D Real Time
• 3D Static
• STIC
Quality This control improves the resolution by reducing the frame rate. Respectively it
reduces the resolution by increasing the image frame rate.
VCI Render Presets Change the preset of the selected render group.
Ref. Image Select the reference image to which all image dependent functions like parallel
shifts, rotations, etc. are applied.
Adjust Slices • Select a format pattern in which the slices are displayed.
• Change the amount of slices on the left and right of the center line.
Init Set all translations and rotations back to the initial acquisition position.
Info 2D Param. Displays extended image information in the top right corner.
Volume Analysis Displays the Volume Analysis menu. (only available in freeze mode)
8.6.5 SonoVCAD™heart
• 4D Real Time
• 3D Static
• VCI-OmniView
• STIC
Init Set all translations and rotations back to the initial acquisition position.
Ref. Image Select the reference image to which all image dependent functions like parallel
shifts, rotations, etc. are applied.
• Cardiac 4: Venous
Compare Image Open a sample image of the currently selected cardiac plane.
B-Mode Quality Improves the B-Mode quality through a better reverberation suppression but
contains a lower frame rate.
Info 2D Param. Displays extended image information in the top right corner.
8.6.6 Niche
Parts of the orthogonal sections A, B and C are compiled to a 3D-section aspect. The name
“Niche” has been chosen because the aspect shows a quasi spatial cut into the volume.
Possible Acquisition Modes:
• 4D Real Time
• 3D Static
• STIC
Niche Position Change the view direction for the niche mode.
Init Set all translations and rotations back to the initial acquisition position.
Ref. Image Select the reference image to which all image dependent functions like parallel
shifts, rotations, etc. are applied.
Info 2D Param. Displays extended image information in the top right corner.
Volume Analysis Displays the Volume Analysis menu. (only available in freeze mode)
8.6.7 SonoVCAD™labor
• 4D Real Time
• 3D Static
• STIC
2D: SRI Applies the filter to the sectional planes A, B, C and the VCI rendered slices.
-+ Tap the button on the left / right to decrease / increase the strength of the SRI
algorithm.
Init Set all translations and rotations back to the initial acquisition position.
Ref. Image Select the reference image to which all image dependent functions like parallel
shifts, rotations, etc. are applied.
Skull Contour Set the skull contour by tracing the position of the fetal head point by point.
Head Direction Set the head direction by drawing a line of two points along the maximum head
diameter. Then mark the most distant point of the head contour. The head direction
is automatically calculated as a line orthogonal to the max. diameter passing
through the distal point.
Midline Set the Midline by marking the position of the midline with a line of two points. The
measurement result is the calculated angle between the vertical axis and the
midline. As the rotation can be to the left or to the right it is necessary to start
measuring at the occiput to get accurate results
Progress. Distance Measure the progression of the fetal head. The measurement’s point of origin is
vertically locked to the pubis. Mark the distal point of the fetal head to measure the
distance between the pubis and the head in millimeters.
Progress. Angle Measure the progression of the fetal head angle. Starting from the center of the
pubis, set the end point that the dashed line is tangent to the fetal head. The
resulting measurement is the dihedral angle between the pubis and the defined line.
Show Select which measurements are displayed (indicated by the checkbox in the top left
corner of the respective button).
2D: SRI Applies the filter to the sectional planes A, B, C and the VCI rendered slices.
-+ Tap the button on the left / right to decrease / increase the strength of the SRI
algorithm.
Ref. Image Select the reference image to which all image dependent functions like parallel
shifts, rotations, etc. are applied.
Info 2D Param. Displays extended image information in the top right corner.
Volume Analysis Displays the Volume Analysis menu. (only available in freeze mode)
8.6.8 VCI-A
Quality This control improves the resolution by reducing the frame rate. Respectively it
reduces the resolution by increasing the image frame rate.
VCI Render Presets Change the preset of the selected render group.
Mix Render mix mode: toggles between the two selected render modes and Gray
Threshold low for 3D images.
Info 2D Param. Displays extended image information in the top right corner.
8.6.9 4D Biopsy
Quality This control improves the resolution by reducing the frame rate. Respectively it
reduces the resolution by increasing the image frame rate.
Init Set all translations and rotations back to the initial acquisition position.
Mirror View Changes the view direction of the render box (green line on the screen) to the
opposite side.
Mix Render mix mode: toggles between the two selected render modes and Gray
Threshold low for 3D images.
Info 2D Param. Displays extended image information in the top right corner.
Info The virtual light source of HDlive™ mode can be positioned by keeping the small center
trackball button pressed while moving the trackball.
Image rendering
The 3D Image Rendering is a calculation process to visualize certain 3D structures of a
scanned volume by means of a 2D image. The gray value for each pixel of the 2D image is
calculated from the voxels along the corresponding projection path (analyzing beam) through
the volume. The render (calculation) algorithm surface or transparent mode decides which 3D
structures are visualized.
Every operation/adjustment concerning the result of the rendering process can be followed in
real time. The fast hardware and intelligent software enables calculation in real time rendered
pictures. After an operation step the result is rendered with a lower resolution in order to speed
up the interactive feedback, and when no further operation takes place the result is rendered
in high resolution.
HDlive™
Note HDlive™ is an option.
Most current surface reconstructions use an illumination frontal to the rendered object. This
can cause the image to look flat. HDlive™ Rendering uses an illumination source that can be
positioned by the user around the rendered 3D object on a spherical surface. By highlighting
structures from the side, the three-dimensional impression is improved considerably.
the Mix control to use 50% of each mode. Rotate the Mix control to change the
percentage.
Figure 8-36 Gray & Inversion Render Mode: Main and Sub menu Figure 8-36 Gray & Inversion Render Mode: Main and Sub menu
Main Menu
Render group (A) Select one of the following render groups: Routine, HDlive™ , Surface, Tissue/
Bone, Heart, Biopsy
Presets (B) Select a render program.
Mix Render mix mode: toggles between the two selected render modes and Gray
Threshold low for 3D images.
Sub Menu
Render Mode 1 (basic) (E) Render Mode Group 1: Select the desired mode.
Render Mode 2 (mix) (F) Render Mode Group 2: Select the desired mode.
Save (G) Save the render programs with Save or Save as.
Surface Smooth The surface is displayed in a smoothed “texture” mode. The gray values of the
surface are identical with the gray values of the original scan.
Surface Texture A surface will be displayed in “texture” mode. The gray values of the surface are
identical with the gray values of the original scan.
Surface Enhanced Surface display is improved by homogeneous smoothing while retaining details in
the image.
Transp. Max The maximum gray values of the ROI are displayed.
Application: Representation of bony structures.
Transp. Min The minimum gray values of the ROI are displayed.
Application: Representation of vessels and hollow structures.
Transp X-Ray Representation of the average gray values within the ROI.
Application: Tissue block with tumor or similar.
Light A surface will be displayed in “light” mode. Structures close to the viewer are
displayed bright; structures more distant from the viewer are shaded.
The surface to be displayed has to be surrounded by hypo echoic structures (e.g.
liquids).
Gradient Light The surface will be displayed as if being illuminated from a spot light source.
The surface to be displayed has to be surrounded by hypo echoic structures (e.g.
liquids).
Mix Mode
Following combinations of gray modes can be mixed.
Gray2 (mix)
Gray1 (basic) HDlive™ Surface Gradient
Max Min X-Ray Light
Smooth Smooth Light
HDlive™ Surface x - - - - - -
Surface Smooth - - x x x x x
Surface Texture - x x x x x x
Surface Enhanced - x x x x x x
Max - x - x x - -
Min - x x - x - -
X-Ray - x x x - - -
Table 8-8 Gray render mixed modes
Main Menu
Render group Select one of the following render groups: Routine, HDlive™ , Color
Mix Render mix mode: toggles between the two selected render modes and Gray
Threshold low for 3D images.
Sub Menu
Surface
HDlive™ Surface Activates HDlive™ Surface.
Transp. Max The maximum gray values of the ROI are displayed.
Application: Representation of bony structures.
Light A surface will be displayed in “light” mode. Structures close to the viewer are
displayed bright; structures more distant from the viewer are shaded.
The surface to be displayed has to be surrounded by hypo echoic structures (e.g.
liquids).
Transp X-Ray Representation of the average gray values within the ROI.
Application: Tissue block with tumor or similar.
Mix Mode
Following combinations of color modes can be mixed.
Color 2
Color 1 HDlive™
Light Max Min
Gradient
HDlive™ Surface x - - -
Surface - x x x
Table 8-9 Color render mixed modes
Main Menu
Render group Select one of the following render groups: Routine, HDlive™ , GlassBody.
Mix Render mix mode: toggles between the two selected render modes and Gray
Threshold low for 3D images.
Sub Menu
Gray Render Select between HDlive™ Surface, Transp. Max., Surface and X-Ray.
Color render Select between HDlive™ Surface, Transp. Max. and Surface.
Mix Mode
Following combinations of render modes can be mixed.
Color
Gray
HDlive™ Surface Surface Max
HDlive™ Surface x - -
Surface - x x
Max - x x
X-Ray - x x
Table 8-10 Glassbody render mixed modes
Main Menu
Skin Represents the artificial surface of the structure shaped by the VOCAL trace.
Skin Color Color of the VOCAL structure representation valid for Skin and Wire Mesh display.
8.7.2 MagiCut
This software has the ability to electronically edit the images, and makes it possible to cut
away structures obstructing the view onto the ROI.
MagiCut Menu
Cut Mode • Trace Inside: content inside the trace will be cut
• Eraser Small: content along the entered trace (small width) will be cut
• Eraser Big: content along the entered trace (big width) will be cut
Using MagiCut
1. Select Trace Inside or Trace 1. Select Box Inside or Box Outside. 1. Select Eraser Small or Eraser Big.
Outside. 2. Use the rotation controls to rotate 2. Use the rotation controls to rotate
2. Use the rotation controls to rotate the rendered 3D image to a the rendered 3D image to a
the rendered 3D image to a position where 3D artifacts or position where 3D artifacts or
position where 3D artifacts or undesired information can be cut. undesired information can be cut.
undesired information can be cut. 3. Position the left upper point with 3. Position the first point and press
3. Enter the start point of the trace by the trackball and press Set. Set.
positioning the system cursor with 4. Move the point with the trackball in 4. Move the eraser over the part of
the trackball and press Set. a diagonal fashion to create a box. the image to be erased. The
4. Enter the trace with the trackball, The red trace of the box is entered trace is shown with a
the trace is shown with a red line. displayed immediately. black line in real time.
5. Enter the end point of the trace by 5. Enter the box by pressing Set. 5. Press the right or left trackball key
pressing Set.
• Cut depth Full: proceed with Set to finish the cut. The region
• Cut depth Full: proceed with step 6 underneath the eraser trace will be
cut from the 3D rendered image.
step 6
• Cut depth Defined: proceed
The system cursor appears again
• Cut depth Defined: proceed with step 7
to start a new cut action
with step 7 6. The cut action is performed. The
6. The trace closes from end to start system cursor appears again to
point and the cut action is start a new cut.
performed. The system cursor 7. Adjust the wanted depth with the
appears again to start a new cut. Depth-control. The result of the
7. Adjust the wanted depth with the adjustment is shown in real-time
Depth-control. The result of the on the 3D image.
adjustment is shown in real-time 8. Press Done to end the cut
on the 3D image. process.
8. Press Done to end the cut
process.
To get an overall 3D impression of the rendered object a certain number of calculated views
are displayed in a sequence. The rendered object rotates or moves in front of the observer.
Note Not all cine types are available in all visualization modes, see table below.
Render X X X - -
Multiplanar - - - X X
SonoAVC™ X - - - -
VOCAL X - - - -
Table 8-11 Cine type availability
3D Rot. Cine
3D rotation cine is the rotation of a volume around either X or Y axis.
Rotation Angle Defines the amount of rotation of the whole cine sequence.
Rot. Axis Defines the axis the image is rotated around to create the cine sequence.
1. Select a Rotation Angle or use the touch panel controls to adjust the Start Image angle
and End Image angle.
2. Select the Step Angle.
3. Select the Rot. Axis.
4. Touch the Calculate Cine Sequence button.
3D Transl. Cine
A render box is moved in a translational movement through a volume.
1. Use the touch panel controls to adjust the Start Image and End Image. When the first
image is selected (either Start Image or End Image) the lines denoting the images will be
linked, when you select the second image the lines will be unlinked.
2. Select the Step Size.
3. Touch the Calculate Cine Sequence button.
3D Slice Cine
2D images are moved in a translational movement through a volume.
Ref. Image Select the reference image to which all image dependent functions like parallel
shifts, rotations, etc. are applied.
Wide Range Set the Start Image and End Image as far away from each other as the size of the
render box allows.
1. Use the touch panel controls to adjust the Start Image and End Image. When the first
image is selected (either Start Image or End Image) the lines denoting the images will be
linked, when you select the second image the lines will be unlinked.
2. Select the Step Size.
3. Select the Ref. Image.
4. Select Wide Range to set the Start Image and End Image as far away from each other
as the size of the render box allows.
5. Touch the Calculate Cine Sequence button.
New Cine sequence Start a new cine sequence or change the cine type.
Note If selected in System Setup - User Settings, SRI affects slices and rendered image. Therefore,
it is also active in Full Screen mode.
In addition, if SRI is activated in 2D mode, it is automatically activated in 3D/4D VolPre mode
and automatically affects the image after/during acquisition.
Caution
Filters smoothen the final image (structures may be smeared out). For diagnostic purposes,
the Region of Interest must be checked without filter. A smoothed image might lead to false
diagnosis!
Activate SRI and change the level of smoothing in the sectional planes using the - + keys on
the touch panel. Use of SRI is indicated in the info block.
The 4D VolCine function allows the user to save and work with the acquired Volumes.
Depending on the memory and volume size up to volumes can be displayed. The advantage
of working with 4D VolCine is that during the acquisition the user can concentrate on the
acquisition itself. After acquisition the user has the possibility to review and work on the
acquired volumes.
Cine Edit P1-P6: P-Button which is configured for saving the selected clip defined by start and
end volume.
Start/Stop • P1 Clip Toggle between playback and stop of the selected clip defined by start
and end volume. Button is disabled if no save/send clip is available.
• Orig. Clip Toggle between playback and stop of the original cine clip
Note Disp. HR (Displayed Heart Rate) indicates the heart rate [B/min] calculated from the delta time
length per beat.
A yellow caution symbol will be displayed on the monitor, indicating that the displayed heart
rate is only an estimation. Do not diagnose based on this value.
Volume Analysis Displays the Volume Analysis menu. (only available in freeze mode)
8.7.6.1 VOCAL II
Note VOCAL II is an option.
Note Read 'Operation safety' on page 2-11 before using this feature.
VOCAL - Imaging program opens up completely new possibilities in cancer diagnosis, therapy
planning and follow-up therapy control. It offers different functions:
• Manual or Semi automatic Contour detection of structures (such as tumor lesion, cyst,
prostate, etc.) and subsequent volume calculation. The accuracy of the process can be
visually controlled by the examiner in multi-planar display.
• Construction of a virtual shell around the contour of the lesion. The wall thickness of the
shell can be defined. The shell can be imagined as a layer of tissue around the lesion,
where the tumor vascularization takes place.
Manual Trace This function allows you to manually outline any lesion by means of the trackball.
Alternatively, trace the object on the touch panel with your finger. The number of
manually generated contours depends on the selected rotation step.
Trace Finder This function allows you to outline any lesion by tracing the object on the touch
panel with your finger. The number of the semi automatic generated contours
depends on the selected rotation step.
Semi-auto Trace Finder Compared to Trace Finder, only 2 planes (one at the initial position, the other one at
90º rotation) have to be traced. The boundary of the ROI at all other rotation steps
is found by means of the contour detection algorithm via automatic interpolation. We
recommend to select 9˚ or 15˚ rotation step.
Sphere This computer assisted function is useful if you want to outline the surface of a
sphere. Using this function a sphere round the main contour axis is generated within
the two green arrows.
• Cystic: Typically for all fluid filled structures like gallbladder, urinary bladder,
cysts, etc.
• Hypo: Typically for hypo-echoic lesions, breast tumors, irregular shaped internal
structures not surrounded by fluid.
Rotation Steps Defines how many contours have to be generated. The decision, which rotation step
should be chosen depends on the shape of the ROI.
For example: An angle setting of 30˚ means that after the fist trace has been done,
the volume data set is rotated 30˚ and then the next trace has to be performed, and
so on. With rotation step 30˚, 6 traces have to be done (6˚ = 30, 9˚ = 20, 15˚ = 12
and 30˚ = 6 traces).
For symmetrical, roundish structures a 30˚ rotation step is fine for all generation
modes. For irregular shapes, select 15˚ for Manual Trace and Trace Finder, and 9˚
for Semi-auto Trace Finder.
Ref. Image Select the reference image to which all image dependent functions like parallel
shifts, rotations, etc. are applied.
• The accuracy of the VOCAL volume calculation is dependent on the accuracy of every
single VOCAL boundary.
• The resulting VOCAL trace must be reviewed and checked by comparing the actual US
image on the monitor to the boundaries displayed in each rotation slice.
• Only the US image on the monitor may be used for diagnostic purposes. The US Image
on the touch panel is considered a part of the user interface only. The image on the
touch panel is not in any way suited for diagnostic purposes.
Note • Semi-auto Trace Finder is faster than the Trace Finder method but less accurate. The
resulting VOCAL trace has to be reviewed with extreme care.
• If the Trace Finder modes do not lead to satisfying results, use Manual Trace to create
the VOCAL trace.
2D: SRI Applies the filter to the sectional planes A, B, C and the VCI rendered slices.
-+ Tap the button on the left / right to decrease / increase the strength of the SRI
algorithm.
Init Set all translations and rotations back to the initial acquisition position.
Threshold Volume Displays the calculated Threshold Volume (according to the monitor display).
Adjust the Threshold Volume by using the touch panel control. A small number cuts
off fewer signals than a higher number.
Ref. Image Select the reference image to which all image dependent functions like parallel
shifts, rotations, etc. are applied.
Info 2D Param. Displays extended image information in the top right corner.
Volume Analysis Displays the Volume Analysis menu. (only available in freeze mode)
SonoAVC™follicle
Note SonoAVC™follicle is an option.
This feature helps to detect low echogenic objects (eg. follicles) in an organ (eg. ovary) and
analyzes their shape and volume. From the calculated volume of the object an average
diameter will be calculated. All objects detected that way will be listed according to size.
The calculation results are displayed in the top left corner. The objects are listed according to
size. All different objects are color coded i.e. the color surrounding the number of the object
also denotes the object on the image. If the mouse cursor hovers over a specific item on the
list the respective object in the image is highlighted and vice versa. The color of the object is
bound to its position on the list.
SonoAVC™general
Note SonoAVC™general is an option.
In SonoAVC™general low echogenic objects in an organ (e.g. ovary) can be defined and
named by the user. User defined will show up in the patients report with the defined name.
3D Init Tilt Toggle between two predefined 3D positions and reset the rotations applied to the
3D image.
• Frontal (flat)
• Tilt (3Dview)
Init Set all translations and rotations back to the initial acquisition position.
Ref. Image Select the reference image to which all image dependent functions like parallel
shifts, rotations, etc. are applied.
Mix Render mix mode: toggles between the two selected render modes and Gray
Threshold low for 3D images.
3D Color Toggle between on and off to show or hide color data in slices. The button will be
grayed if no color data is available.
Info 2D Param. Displays extended image information in the top right corner.
Number Hide or show numbering next to the segmentations, according to the index.
3D Frame Toggle between on and off to show or hide the boarder of the rendered 3D image.
Volume Analysis Displays the Volume Analysis menu. (only available in freeze mode)
Gray 2D Menu
Tint 3D Menu
Save Saves the current tint map modified with HUE and Saturation under one of three
user buttons which can be selected in a pop-up window.
Start Default: 60
Slope Default: 30
2.1. In HDlive™ Mode HUE and Saturation can be modified by turning the rotary
controls below the touch panel. Press Save to store the modified Tint Map as
a user defined color.
2.2. If Depth Coloring is available, Color Transition can be modified by turning the
rotary controls below the touch panel.
3. Touch the Exit button to close the menu.
In order to simplify orientation in a 3D or 4D data set the user can activate the display of
directions like cranial, caudal, left, right, anterior, posterior at the border of the 3D or 4D data
set. The user has to select the position and the rotation of the probe in respect to the patient
(or in obstetrics in respect to the fetus) at the time of acquisition. Then the actual display of the
directions has to be activated manually. When the volume is rotated the orientations at the
border of the image are automatically adjusted accordingly. The display remains active until a
new acquisition is performed or until it is turned off by the user. If the display is activated and
the data set is saved, the probe orientation settings are stored in the data set. If the display is
turned off however, probe orientation settings are not stored.
Caution
Ensure that the actual probe position corresponds to the probe orientation configuration.
Special accuracy is required in Acquisition Mode 4D. Moving the probe can lead to errors in
displayed directions with respect to the displayed image.
Off Return to 3D/4D menu without applying changes. The orientation marks in 3D/4D
mode are hidden. Reset of probe orientation setting to default values. This key is
only available if probe orientation menu has been activated once.
Activate Activate new settings or changes. The 3D/4D Menu is active and orientation
markers are displayed in 3D/4D mode.
Body patterns 1. Front: The body pattern can be rotated in steps of 45˚.
2. Back: The body pattern can be rotated in steps of 45˚.
3. Top view: The body pattern cannot be rotated.
4. Bottom view: The body pattern cannot be rotated.
The lower right quadrant displays the body pattern and the probe marker, independent of the
selected visualization mode. Position of body pattern (body view and body rotation) and probe
marker are stored in the 3D/4D user program.
The green point on the probe marker indicates the rotation of the probe (like Voluson™ E6
BT15 -Logo on 2D image).
Note The Orientation marks appear on the Rotation Axis in the A-, B-, and C-Plane. They change
according to the rotation of the slices.
Following orientation markers are available:
A Anterior
P Posterior
L Left
R Right
Cr Cranial
Ca Caudal
There are also combinations thereof possible e.g.: AL, PRCa etc.
Note The orientation marks are visible if slices are present in T.U.I. mode (not in Render Full-
Screen). They are visible as long as they are not turned off, by touching Off in the Probe
Orientation Menu.
With the help of the “Edit light menu” the light source position can be changed with the
trackball or with the preset buttons. The current position is shown by the Light Icon. The preset
position can be changed by the user.
It is available only for the following 3D objects:
• 3D Rendered object if the 2nd render mode (mix mode) is “Gradient Light”, in run and
frozen mode
• VOCAL object
Save When Save is pressed, the popup window "Save preset under" appears. Select a
preset to save the current light position. The window closes.
Factory When the button Factory is pressed, then the factory setting of the current activated
preset button is restored.
Save Fac. Preset When the button Save Fac. Preset is pressed, the current light position is saved as
the new factory setting under the active (green) button. This button is only visible
when the master key is activated.
3D Brightn Light Brightness ranges from 0-100 (step size: 1) and is only available with HDlive™
Mix Render mix mode: toggles between the two selected render modes and Gray
Threshold low for 3D images.
Shadow Soft Shadow Softness ranges from 0-100 (step size: 5) and is only available with 3D
Rendered Images.
Fast access
A fast access/change of the light position is possible by using either the trackball or an
onscreen control.
Trackball With a 3D object on the screen, the "Light" function is available on the small right
down button. Press this button to activate it and to position the light source with the
trackball. To exit press the big key under the trackball.
On Screen Control With a 3D object with a light source on the screen, the function "Light" is available
with the "Lamp" icon. If the control is activated, the light source can be positioned
with the trackball.
Archive
The Voluson™ E6 BT15 provides an Image Management System that allows fast and
extremely easy image management. It allows users to view, print and transfer images stored in
the Voluson™ E6 BT15 . In addition, it allows users to send and receive DICOM images over
the DICOM Network.
Note The images are stored according to the patient’s ID. If there is no ID assigned to the current
images, enter an ID for proper storing.
The results of calculations are recorded in application dependent patient worksheets. By
pressing Report the worksheet page is switched on.
Note • To Backup or Export exams to DVD/CD+R(W) disk, please confirm that the DVD/CD
+R(W) storage medium used is clean and not scratched! When the hard disk (HDD) has
reached its maximum capacity a message will be displayed on the screen.
• It is recommended to copy data stored on a DVD every three years onto a new disc to
avoid data loss.
Exam started
First, press the Archive hardkey and then select the Archive button on the touch panel to open
the Archive.
• Use as current
• Reopen Exam
Image History and Exam Review (Reload) work without any change.
The Archive menu appears:
Menu controls
• DICOM Server
• Anonymized Archive
Search Starts the search process. Apply the search criteria and list only found exams/
patients/images. The search process can also be started with AN keyboard button
Return.
Show All Displays all patients.
AN keyboard: Left/right Displays next/previous page of the images in the thumbnail row.
Backuped? Flag that indicates whether a patient/exam has already been backuped. Shows also
whether a backuped patient/exam has changed since the last backup.
Double Click Image Open image in Exam Review Full Screen Mode
Trackball buttons.
Trackball buttons
Set (left key) 1x • highlight patient • highlight exam Select image (green border).
2x Opens PID menu to start a Opens Exam Review of the Opens image in Exam Review
new exam with the same selected exam Full Screen Mode.
patient data
If a current exam exists, a
dialog window appears.
Delete 1x Opens context menu. Opens context menu. Opens context menu.
2x - - -
Anonymize 1x Opens context menu. Opens context menu. Opens context menu.
2x - - -
Set (right key) 1x • highlight patient • highlight exam Select image (green border).
2x Opens PID menu to start a • No current exam: Opens Opens Exam Review and
new exam with the same Exam Review and reloads reloads images.
patient data the first image If a current exam exists, a
If a current exam exists, a • Current exam: open exam dialog window appears.
dialog window appears. - no action
Common controls
Exam Review Opens the „Exam Review Screen“. This button is only active if, an exam or an
Image is selected.
Image History Opens the „Image History Screen“ which allows to skim through all the pictures in
all exams of a single patient. This button is only active, if a patient or an exam or an
image is selected
Export Export dialog pops up. Export all data of the selected patients/exams or the
selected images .This button is only active, if patients or exams or images are
selected.
Import Import dialog pops up. This button is always active, independent of what is selected.
Print Prints all exams of the selected patient, all data of all selected exams or images.
This button is active, if patients, exams or images are selected
DICOM Send Sends all exams of the selected patient, all data of the selected exams or images.
This button is active, if patients, exams or images are selected
Use as Current Uses the currently selected patient as “Current Patient” and changes back to the
“Current Patient Screen”.
This button Is only active, if no exam is in progress and if a patient is selected.
Action is also performed if a patient is double-clicked.
Edit Data Opens Edit menu. This button Is only active, if a patient is selected.
Edit Data Opens Edit menu. It allows to edit edit the data of the currently selected patient.
This button Is only active, if an exam is selected.
Worksheet Opens the Worksheet. This button is only active, if an exam is selected.
Reopen Exam Reopens the selected exam. Only possible, if no current exam exists. Go to 2D
Write Mode with the selected exam active.
Details Opens Image Properties dialog. This button is only active, if an image is selected.
Deleting Patients/Exams/Images
If patients, exams or images are deleted, warning messages appear in a popup window when
locked exams are involved:
• Patient with all exams locked: "Your selection contains Exams that are locked and
cannot be deleted!"
• Patient with some exams locked: "Your selection contains Exams that are locked and
cannot be deleted! Do you want to delete the unlocked Exams?"
• Locked Exam(s) only: "Your selection contains Exams that are locked and cannot be
deleted!"
• locked and unlocked Exam(s): "Your selection contains Exams that are locked and
cannot be deleted! Do you want to delete the unlocked Exams?"
• Images of a locked exam: "The selected image(s) belongs to a locked Exam and cannot
be deleted!"
Press either "OK" or select between "Yes" (continue to delete) and "No" (close message
popup and cancel deleting) to continue.
9.1.1.3 Search
To search for a patient/exam/image, use the search area of the Archive Menu.
1. Apply your desired search criteria and select the source where you want to search.
Note When the source is the DICOM server, only reduced search possibilities are available.
(Searching with OR is not possible in Query/Retrieve Mode.)
Sorting exams
To sort exams, click onto the caption of the column. The list will be arranged according to the
selected caption.
9.1.1.4 Repro
Repro is the reload of work-settings of a stored picture. It is possible to recall the exact setting
(e.g. Geometry, Gain, Colormap, etc.) from a stored picture.
Choose a picture at the Exam Review, Patient Archive or from the Clipboard whose settings
Repro will recall. When using the repro function the same probe that was used when storing
the image has to be connected. When the probe is connected press OK, all probe settings will
be loaded automatically.
The repro can be loaded:
Common controls
Exam Review Opens the Exam Review Screen. This button is only active if, an Exam or an Image
is selected.
Image history Opens the Image History Screen. This button is only active, if a Patient or an Exam
or an Image is selected
DICOM Send Sends all Exams of the selected Sends all data of the selected Sends all selected images.
patient(s). exam(s).
Print Prints all Exams of the selected Prints all data of the selected Prints all selected images.
patient. exams.
Export Export dialog pops up. Exports Export dialog pops up. Exports Export dialog pops up. Exports
all data of all exams of the all data of all selected exams. all selected images.
selected patient.
Import Import dialog pops up. Import dialog pops up. Import dialog pops up.
Delete Deletes selected patient. Deletes selected exams. Deletes selected images.
Email Send
Send to • Patient
• Performing physician
• Referring physician
• Sonographer
All recipients with an included email address at the Patient ID menu are
preselected. If no email address is entered, an edit button appears. Selecting this
button opens the corresponding dialog.
• Send a Copy to me
The last selection shall be stored for the next Email Send.
Subject & Message A default subject and message (configured in the email system setup) can be
entered by clicking Default. Clear deletes the subject and the message input field.
Sending data
1. Select the data to send. The Email Send window appears.
2. Select the sending criteria (receiver, options,...) and type in a message if desired.
3. Press Send to send the data or Cancel to cancel the process.
9.2.2 Print
It is possible to print US data. Therefore select Print on the touch panel. The printing dialog
appears.
Note Although the menu looks the same as the menu in System Setup, this Printer Settings menu is
solely for print jobs initiated with the Px buttons or from Archive. If you want to edit printer
settings for print jobs initiated with the End Exam button, please refer to 'Button Configuration'
on page 11-29.
Instead of the button Properties the button DICOM Config appears when a DICOM printer is
used. Including Image Comments/Page Numbers or a Header is not possible for DICOM
printers.
When a USB printer device is used and no items are included, the image must be shown in
maximal size.
Printing data
1. Select the data to print and press Print. The printing dialog appears.
2. Define the desired printing properties and press Print again.
9.2.3 Export
This enables the export of images in BMP, JPG, TIFF; Cines in AVI, MOV or MPG; Images
and Cines can be exported in PC format (JPG & AVI) or MAC format (JPG & MOV) and
Volumes in VOL or RAW to a DVD/CD+(R)W, an mapped Network drive. To save all Patient
Data and images use either compressed or uncompressed 4DV.
After selecting the exam(s) to be exported using the trackball and the right trackball key Set,
click the Export button.
• If a 3D Volume image is selected, the complete data set can be exported in Volume file
format. The stored Volume files can be reviewed with the PC program “4D View”.
• Stored images in BMP, JPEG, TIFF can only be reviewed on an external PC.
• When exporting an AVI file, there is a 4th progress bar, regarding each single frame.
Therefore it is now possible to cancel an export any time.
Note It is possible to export an open, uncompressed 4dv archive to an export location without
importing the 4dv archive first into the local archive. A compressed 4dv archive cannot be
exported directly, it has to be imported into the local archive first.
Exporting data
1. Select the data for export and press Export. The export window appears.
2. Define the destination, the filename and select other desired properties (Save as type,
Create Patient / Exam Folders, Size, Quality, Avi-Codec, Include Report Data, Save Cine
SE / ES (start-end, end-start), Anonymize, PDF, TXT).
3. Press Save and then OK to export the data.
Note • The Anonymize function only works with US images. i.e.: It does not work with archive -
screenshots.
• Compare the estimated file size with the free space on disc before exporting. Do not
export unless the capacity of the storage volume is bigger than the estimated file size.
• If you want to additionally save the report data in a .txt or .pdf file, select Include Report
Data.
• All patient and exam data will be saved in an automatically created folder, when the
“Create Patient/Exam Folder” check box is selected. The folder will be named by the
patients ID.
• Apply JPG-compression with a quality setting less than 100% to an image only once.
• Images that were saved to Archive using lossy (less than 100%) JPG compression are
clearly marked with a yellow J (e.g., J80 = compression factor 80%)
• AVIs using MPEG4 compression cannot be played on a Windows PC without the right
codec installed. Please download the DivX codec from www.divx.com and install it on
your computer in order to view MPEG4-encoded AVIs!
Caution
A lossy compression can reduce image quality which can lead to a false diagnosis!
• Name (last/first/middle)
• DOB
2. Clinic Data
• Clinic name
• Sonographer
The Anonymize function is only available for following image types:
• avi
• mov
• jpeg
• bmp
• tif
It is not available for the following image types:
• 4DV
• vol
• raw
If some images cannot be made anonymous a warning appears.
9.2.4 Import
• 4DV-Files
Using Import
1. Press Import to start importing data.
2. Select
• selected patients
• selected exams
9.2.5 Delete
3. A dialog appears which asks for confirmation to delete the selected items.
Controls
9.2.6 Backup
Caution
It is highly recommended to create a full backup of settings and patient data regularly.
The data from the backup always replaces the corresponding data on the Voluson™ E6
BT15 .
9.3 Source
The selection for the Archive is stored at the internal hard drive.
This function allows to anonymize patients, exams and/or images in an own archive.
• Last name
• Middle name
• First name
• Date of birth/Age
• Sex
• Exam Comment
• Exam type
4. For going to the original image at the exam review, select an image and press the upper
trackball button. Then select Go to original image. The original image appears.
5. To edit enter an existing Patient ID. A dialog appears. All existing images are included
within the new Patient ID.
Controls
Generate Patient ID Generates by default a patient ID. It is also possible to create an own patient ID.
Patient ID If an existing patient ID is entered, a green checkmark appears and the button
Advanced Settings appears. It extends the Anonymize Dialog with existing exams. It
is possible to add the selected Patient/Exam/Image to an existing exam or create a
new exam.
Generate Patient ID automatically If checked, Generate Patient ID is grayed and a Patient ID prefix must be entered.
The selection Source = DICOM Server is available only when a Query/Retrieve Server was
configured and selected in the DICOM Configuration Dialog. When the DICOM Server is
selected, the archiving screen changes. It includes a 2nd patient ID, BSN or NHS.
If no previous query was performed, no stored data is available on this DICOM Server. All lists
(Patients, Exams, Images) are empty and the system automatically changes to the Exams &
Patients view. Also the buttons Query Exams and Retrieve Images are disabled.
17. Select a patient or exam and press Import to import the selected data into the local
archive. If the data is not imported, it is stored locally until a new exam is started. This
means that it is possible to switch back and forth between menus and modes, without
losing the query-data until a new exam is started. The locally stored temporary data is
also deleted upon reboot.
• Port 105 is used for retrieving the images. (This needs to be configured on the remote
DICOM server.)
• Only DICOM images that are marked as US (ultrasound) or “secondary capture” can be
retrieved. (No CT images for example.)
• Only data that was requested by the Voluson™ E6 BT15 system is accepted. It is not
possible to request from a third system data to be sent to the Voluson™ E6 BT15 .
• The port is only open during retrieve. During the retrieval the system is locked. It is not
possible to continue working while retrieving data from a remote server.
Note Not possible to use DICOM Storage Commit and Query Retrieve with the same DICOM
Server. It is usual to receive images and storage commits both on port number 104.
9.4 Patient ID
Press the Patient ID hard key to open the Patient Menu.
Controls
2nd Patient ID Entry field for a 2nd Patient ID: Only visible if activated in the system setup/
dependent on the system setup settings. The name can be BSN, NHS or 2nd
Patient ID.
First/Last/Middle Name, DOB, Patient data input fields. Following data can be entered:
Age, Sex
• ID number
• 2nd Patient ID
• First/Last/Middle Name
• Day of Birth (DOB): When the DOB is entered, the age is calculated
automatically.
• Sex
Opens a window to enter the email address and phone number of the patient, the
performing/referring physician or the sonographer.
Enter data ( Patient Name, Email Address, Phone Number, Send image via), Email
Options (Email send mode, Send as, Size, Quality, Cine SE/ES) and MMS Options
(MMS send mode). Press Set as default to save the settings as default, Cancel to
leave the menu or OK to apply the changes.
Search Opens the Search window. Uses the information from the Patient data input fields to
start a search of the patient database.
Exam Application (OB, GYN,...) Exam data input fields. Depending on the selected exam application following data
can be entered:
• Last Menstrual Period (LMP): The first day of the last period has to be entered.
(GA and EDD are calculated automatically.)
Note LMP dates are only displayed when the calculated EDD is not older than 43 weeks.
• Number of fetuses
• Scan Assistant
• Day of Cycles
• Day of Stimulation
• PSA
• Referring/Performing Physician
• Password: Only available if the Email send mode is "Password protected zip
archive".
• Send (Email, MMS, Email & MMS): Only available when "Use Email to MMS
Service" is enabled.
• Cine SE / ES (only for email): If checked, a cine from start to end and end to
start is sent.
Scan Assistant Select a Scan Assistant from the list available if desired.
Menu Controls
Archive Switch to the Archive. If an exam is started, the current patient/exam is displayed.
Exam Review Switch to the Exam Review. Only available when an exam is started.
Image History Switch to the Image History. Only available when an exam is started.
Exam Applications (OB, Gyn,...) Switch between the different PID menus.
Past Exam Displays the past exam dialog. Only available when the OB PID menu is selected.
Hide Pat. Info Hides the patient information in the Patient Header.
Clear Entries Deletes all input fields except the Patient ID.
End Closes the current exam. Only available when an exam is started.
Add Starts a new exam under the same patient. Patient ID and patient name remain the
same.
Continue Closes the PID menu. Only available when an exam is started.
Reopen Only available when an exam which can be reopened is selected. When an exam is
reopened, the system behaves as though the exam was never closed. It enables
the user to acquire new images/data and adds those to the existing exam.
Start Only available if no exam is started and the Patient ID field is not empty. Once this
button is pressed, the data in the current patient dialog is sent to the database and
a new exam is created. The current patient dialog is closed and the system goes to
2D run mode. A new exam can be started also when the Freeze HK is pressed.
Using Worklist
1. Press Worklist to enter the Worklist search dialog.
• Accession #
• Start Date
• End Date
• Procedure ID
• Station Name
• Station AE Title
3. Press Search to start the search on the currently active worklist server.
4. Use the Select button to close the Worklist dialog. All received Worklist entries are
inserted into the Patient ID menu.
5. Press Start Exam to close the Worklist dialog. An exam is started with all received
Worklist entries without showing in the Patient ID menu.
Press Past Exam to open the Past Exam dialog. This dialog is used to enter data from
previous ultrasound exams performed on other systems. Only available when OB is selected.
Controls
Past Exam Data shown from Shows data starting at this date.
Measurement Fields Enter measurement data from previous exams performed on different systems.
Save & Exit Return to the patient dialog and save data.
The procedure step dialog lists all procedure steps belonging to the selected procedure. If a
procedure with more than one procedure step is retrieved from the worklist, only one entry is
created. The number of steps is given in the S# column. If an entry from this list is selected
and the Select button is pressed, the “Procedure Step” dialog is displayed.
Controls
Complete Procedure Step Completes a step by sending a MPPS complete message. Only available when a
step is in progress.
Discontinue Procedure Step Cancels a step by sending a MPPS discontinue message. Only possible when a
step is in progress.
Select Procedure Step Select a Procedure step. Only available when no other step is in progress or
started. This button does not start the procedure immediately (Start Exam has to be
pressed). The Patient dialog returns.
Start Exam and Procedure Step Starts the procedure step. Only possible when no other step/exam is already in
progress.
Start Procedure Step Starts the procedure step immediately. Only possible when no other step is in
progress.
Return Returns to the Worklist dialog or the patient menu depending on where the
pricedure step dialog was started from.
9.5 Clipboard
The Clipboard displays stored US data of the current exam as preview images. Pressing one
of the P-buttons stores active image information and displays a preview on the clipboard. (This
implies that the respective button has been configured.)
Images of other patients will not be saved onto clipboard. If you reopen and continue an old
exam, then the images of this exam will be displayed on the clipboard. For more detail, an
image will be enlarged in a special preview window, which is activated by positioning the
mouse cursor over the respective image.
• 4x1
• 6x2
• 7x3
The 3 different Clipboard title bars (No Exam started, New Exam, Reloaded Exam) contain
information about the started exam type, the duration time of the current exam, the number of
thumbnails on the clipboard and the used capacity. No such information is provided without an
exam started.
The Clipboard is visible at every mode except System Setup, Measure Setup, PID and
Archive. Within Measure and Annotation Text the Clipboard can be shown depending on the
system setup.
Cine display Through Access Cine Turquoise bar with red marker.
Symbol
Delete Images marked for deletion have a red cross across the image.
Move Images marked to move have a red frame around the image.
Added to worksheet When an image is added to the worksheet with a Px-button the image has a green check
mark.
Tool tip While the cursor is positioned over a clipboard-image, the acquisition mode of this image
is shown.
Press the predefined Px-button (default: P1) on the user interface to save data onto the
clipboard.
Note Pressing the Px-button without having started an exam will show a dialog:
You have to start an exam first!
• Ok: Evokes the Current Patient Dialog to enter a patient. After entering the patient data
and returning to scan mode using the Start Exam button the image or cine will be stored
automatically.
• Cancel: Cancels the dialog and returns to scan mode. No patient has been entered and
pressing the Px-button will lead to the same dialog.
The clipboard is filled from left to right and from top to bottom. When one page is full, a new
page is created for the next images to come.
To change between pages:
1. Press Pointer on the user interface, if the cursor is inactive.
2. Click the triangle on the left or right of the displayed page-count.
• Copy to the end of the clipboard: saves an additional copy at the of the clipboard
• Copy after the reloaded Image: saves an additional copy after the reloaded image
Note Existing dataset information will not be lost. (independent of the setting “Copy after the
reloaded Image”)
• When a Volume Cine is saved as Singe Volume, the Volume Cine will not be overwritten.
The saved Single Volume will be saved to the end of the Clipboard.
• If a 2D cine is saved as (single) image, the 2D Cine will not be overwritten. The image
will be saved to the end of the clipboard.
• Save TUI one by one does not replace the reloaded volume but will be saved to the end
of the clipboard.
To switch fast between images, use either the keyboard Pg/Up, Pg/Dn buttons or the touch
panel control up/down.
Note The image(s) will be deleted after ending the exam. The export dialog will appear. For more
information see 'Export' on page 9-10.
Note If any blank slots are in between, the inserted image will be automatically placed behind the
last clipboard image.
Note The image(s) will be deleted after ending the exam. There will be no confirmation dialog.
Note Deletion using the trackball also works in the Exam Review.
The Exam History displays the image content from a former exam on the clipboard area. If the
exam history clipboard is switched off, the current exam content is displayed.
The exam history clipboard can be closed by pressing a Px button to save images. A Compare
window is only available when an exam history clipboard is open and can only be closed by
the user.
If no history exam exists, no exam history buttons are available. They become available as
soon as a new exam is started and an older exam exists.
Compare
The Compare function is used to show one image from an old exam on the screen together
with a current image. The Compare image can be resized and positioned freely (drag and
drop) during live scanning. It is shown on screen after it was selected from the exam history
with the system cursor (green frame) and by pressing the trackball button Compare.
The Compare window is switched off automatically when one of the following functions is
activated: End Exam, Util. PID, Probe, Report, Review, CALC, Caliper, Bodymark, Arrow. As
soon as the Compare View is switched off the Exam History window is enabled.
Measurements and calculations derived from ultrasound images are intended to supplement
other clinical procedures available to the attending physician. The accuracy of measurements
is not only determined by system accuracy, but also by the use of proper medical protocols by
the user.
Basically there are two measurement modes:
1. Generic measurements (general measurements not assigned to a specific clinical
application)
2. Calculation measurements (special measurements and calculations belonging to specific
clinical measurement applications)
Measurements can be performed in all modes and image formats. During a measurement the
measurement caliper can be active (green) or fixed (yellow). A dotted line is displayed to
indicate the path of the measurement (can be deactivated in the Measurement Setup).
A measurement is identified by the number assigned to it at the end of the measurement. The
same number is used to identify the measurements in the result window (max. 8).
Accuracy of Measurements
The possible accuracy of geometric, flow speed or other measurements with this ultrasound
system is a result of various parameters that shall be equally considered. The used images
shall be optimized and scaled to provide the best view of the examined structures. To ensure
this, the correct choice of the ultrasound probe and imaging mode for a certain clinical
application plays an essential role.
Despite the high theoretical accuracy of the scan geometry and the measuring system of the
Voluson™ ultrasound system, it is important to be aware of increased inaccuracies caused by
the ultrasound beam travelling through the inhomogeneous human tissue. Therefore
differences between operators shall be minimized by standardization of procedures.
For more information see Advanced Acoustic Output References.
For more information see 'Bioeffects and Safety of Ultrasound Scans' on page 2-17.
Sub categories Shows all available sub categories and the generic measurements depending on
the selected imaging mode.
Group Shows all available measurement groups depending on the selected sub category.
Measurement Shows all available measurements depending on the selected measurement group.
Delete Last/Cancel Deletes the last measurement or cancels the current not finished measurement.
Work Sheet Displays the current worksheet and the worksheet menu.
The Measurement Application Menu displays Measure Presets (1 Factory and 3 user-
definable presets) and Measure Applications.
With Result Size the font size of the results can be adjusted and Result Pos. enables
positioning the result window with the trackball (green border). Transp. enables adjusting the
transparency of the measure result background. With Off the transparency can be switched
off.
Basic operations
1. Basic operations done with the trackball
Available measurements:
• 2D Area Measurements
• 2D Volume Measurements
• 2D Angle Measurements
• 3D Volume Measurements
• Elastography Measurements
Dist. 2Point
To measure the distance between two points on a 2D image:
1. Select Dist 2Points. The measurement cursor appears.
2. Position the first point with the trackball an press Set. A second measurement cursor
appears.
3. Position the second point with the trackball and press Set to finish the measurement.
Note To readjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
Dist. 2Line
To measure the distance between two parallel lines on a 2D image:
Note To readjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
Length Point
This tool measures the length of a non-straight line defined by multiple points (start to end).
The "length" is displayed with a dotted line, start and end point are marked with a cross like in
normal distance measurement.
To measure the length point:
1. Select Length Point. The measurement cursor appears.
2. Position and enter point after point with the trackball and Set along the line.
3. To finish the length measurement enter the last point a second time by pressing Set.
Note To readjust the trace, press Undo before completing the measurement. The trace is cleared
step by step backwards.
Length Trace
This tool measures the length of a non-straight line distance along a trace drawn with the
measurement cursor. The "length" is displayed with a dotted line, start and end point are
marked with a cross like in normal distance measurement.
To measure the length trace:
1. Select Length Trace. The measurement cursor appears.
2. Position and enter the starting point with the trackball and Set.
3. Trace the length boundary with the trackball and fix the end point with Set.
Note To readjust the trace, press Undo before completing the measurement. The trace is cleared
step by step backwards.
Stenosis % Dist.
To measure the stenosis ratio between two distances:
1. Select Stenosis % Dist.. The measurement cursor appears.
2. Position the first line as described above with the trackball an press Set. A second
measurement cursor appears.
3. Position the second line as described above with the trackball and press Set to finish the
measurement.
Ratio D1 D2
To measure the ratio between two distances:
1. Measure the first distance as described above.
2. Measure the second distance as described above. The ratio is calculated automatically.
Ellipse
To measure the area of an ellipse:
1. Select Ellipse. The measurement cursor appears.
2. Position the first point of the long axis with the trackball and press Set.
3. Position the second point of the long axis and press Set.
4. Adjust the length of the short axis with the trackball and fix it with Set.
Note To re-adjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
Area Trace
This tool measures the area inside a traced boundary. The boundary is traced when the cursor
is moved over the boundary and displayed with a dotted line.
To measure the area trace:
1. Select Area Trace. The measurement cursor appears.
2. Position the starting point with the trackball and fix it with Set.
3. Trace the area boundary, which is displayed with a dotted line.
4. To finish the measurement press Set. The distance between the starting point and the
final cursor position is completed and the area is calculated and displayed.
Area Point
This tool measures the area inside a traced boundary. The boundary is entered with single
points with a linear interpolation in between. The boundary is displayed with a dotted line.
To measure the area point:
1. Select Area Point. The measurement cursor appears.
2. Position point after point with the trackball and enter each by pressing Set.
3. To finish the measurement enter the last point a second time with Set.
Note To readjust the trace, press Undo before completing the measurement. The trace is cleared
step by step backwards.
Area 2Dist.
To measure the area of an ellipse defined by two distances:
1. Select Area 2Dist. The measurement cursor appears.
2. Position the cursor on the perimeter of the shape to be measured and press Set. A
second cursor appears.
3. Move the second cursor along the longest distance of the object and press Set again.
4. Position the second cursor perpendicular to the first distance at the border of the object
to measure the second distance and press Set to finish.
Note To re-adjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
Stenosis % Area
To calculate the stenosis ratio between two areas:
Ratio A1/A2
To calculate the ratio between two areas:
1. Select Ratio A1/A2.
2. Measure the first and second area as described above. The ratio is calculated
automatically.
Ellipse
To measure the volume of an ellipse:
1. Select Ellipse. The measurement cursor appears.
2. Position the first point of the long axis of the ellipse with the trackball and fix it with Set.
3. Position the second point of the long axis of the ellipse with the trackball and press Set.
4. Adjust the length of the short axis with the trackball and fix it with Set. The volume (D1:
long axis, D2: short axis, MaxD: largest axis diameter, MInD: smalles axis diameter, C1:
Circumference, A1: Area, VOL1: Volume) is displayed.
Note To readjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
Ellipse 1Dist
To measure the volume of an ellipse with the help of a distance:
1. Select Ellipse 1Dist. The measurement cursor appears.
2. Position the starting point with the trackball and fix it with Set.
3. Position the second point with the trackball and fix it with Set. An ellipse defined by these
two points appears.
4. Adjust the width of the ellipse if necessary and press Set. the result is displayed.
5. In single image mode make the first measurement.
6. Press Freeze to return to scan mode and scan the second image. Press Freeze again
and a new cursor appears.
7. Perform the measurement of the distance.
Note To readjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
Multiplane
This measurement program allows volume determination of any organ, which was stored as a
volume scan. Several parallel planes are laid through the organ and the areas of these planes
are determined.
The application calculates the volume from the measured areas and the distance between
these areas. The larger the number of areas, the more exact the volume calculation result
becomes.
To use Multiplane:
1. Select the reference image in which the measurement is to be performed.
Note The first section should be set at the edge of the measured object.
4. Measure the area as described in Area Trace Measurement and press Set twice.
5. Repeat step 3 to continue measuring until the edge of the object is reached.
Note • The contour of the measured area is not erased when a new section is adjusted. From
the deviation in the new section it is possible to decide whether a new area should be
marked. As soon as a new contour is drawn, the old contour is erased.
• The different sections can be chosen freely, it is not necessary to follow a certain order.
1 Dist.
To measure a volume based on a single distance:
1. Select 1Dist. The measurement cursor appears.
2. Position the starting point of the line with the trackball and press Set.
3. Position the end point of the line with the trackball and Set. The volume is displayed.
Note To readjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
3 Dist.
To measure a volume based on three distances:
1. Select 3 Dist. The measurement cursor appears.
2. Position the first point of the first distance to measure and press Set.
3. Position the second point of the first distance to measure and press Set.
4. Repeat step 2 and 3 for the second and third distance to measure. As soon as the last
point is fixed with Set the measurement is finished.
Note To readjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
Angle 3Point
To measure the angle between two lines:
1. Select Angle 3Point. The measurement cursor appears.
2. Position the first point with the trackball and press Set.
3. Position the second point with the trackball and press Set. The line connecting the two
points is show.
4. Position the third point with the trackball and press Set. The second line is shown and
the angle measured.
Note To readjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
Angle2Line
To measure the angle of two lines crossing each other:
1. Select Angle 2Line. The measurement cursor appears.
2. Enter the first line by defining starting and end point of it.
3. Enter the second line by defining starting and end point of it. The angle is measured.
E. Ratio Ref/ROI 1
To measure the strain of the two ROIs "Ref" and "ROI 1" and to calculate the Ratio:
1. Select E. Ratio Ref/ROI 1. The measurement cursor appears.
2. Define the two circles, one after the other, as described above. The result is displayed.
Vessel Area
To measure the vessel area:
1. Select Vessel Area. The measurement cursor appears.
2. Position the starting point with the trackball and press Set.
3. Position the end point with the trackball and press Set again.
4. Adjust the width of the ellipse if necessary and press Set.
Note To readjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
Stenosis Area
To calculate the stenosis ratio between two areas:
1. Select Stenosis Area. The measurement cursor appears.
2. Position the first point of the long axis with the trackball and press Set.
3. Position the second point of the long axis and press Set.
4. Adjust the length of the short axis with the trackball and fix it with Set.
IMT
To measure the IMT:
1. Select IMT. The measurement cursor appears.
2. Position the starting point with the trackball and press Set.
3. Position the end point with the trackball and press Set. The result is displayed.
Vessel Diam.
To measure the vessel diameter:
1. Select Vessel Diam. The measurement cursor appears.
2. Position the starting point with the trackball and press Set.
3. Position the end point with the trackball and press Set again.
Note To readjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
Stenosis Diam.
To measure the diameter:
1. Select Stenosis Diam. The measurement cursor appears.
2. Position the starting and the end point of the line and press Set. The diameter is
displayed.
Flow Diam.
To measure the diameter:
1. Select Flow Diam. The measurement cursor appears.
2. Position the starting and the end point of the line and press Set. The diameter is
displayed.
Dist. 2Point
To measure the distance between two points on an M-Mode image:
1. Select Dist 2POint. The measurement cursor appears.
2. Position the first point with the trackball and fix it with Set. A second measurement cursor
appears. This one can only be moved vertically.
3. Position the second point with the trackball and fix it with Set to finish the measurement.
Note To re-adjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
Slope
To measure the slope:
1. Select Slope. The measurement cursor appears.
2. Position the first point with the trackball and fix it with Set. A second measurement cursor
appears.
3. Position the second point with the trackball and press Set to finish the measurement.
Note To readjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
Ratio D1/D2
To calculate the ratio between two distances:
1. Measure the first distance as described above.
2. Measure the second distance as described above. The ratio is displayed automatically.
Stenosis % Dist.
To calculate the stenosis ratio between two distances:
1. Select Stenosis % Dist.. The measurement cursor appears.
2. Position the first point with the trackball and fix it with Set. A second measurement cursor
appears. This one can only be moved vertically.
3. Position the second point with the trackball and fix it with Set to finish the measurement.
Time
To measure the time between two points on a TL (Time Line) image:
1. Select Time. The measurement cursor appears.
2. Position the first point with the trackball and fix it with Set. A second measurement cursor
appears. This one can only be moved horizontally.
3. Position the second point with the trackball and press Set to finish the measurement.
HR
The Heart Rate is calculated from the measured time and adjusted heart rate cycles. To
measure it:
1. Select HR. The measurement cursor appears.
2. Position the first point with the trackball and press Set. A second measurement cursor
appears. It can only be moved horizontally.
3. Position the second point with the trackball and fix it with Set to finish the measurement.
IMT
To measure the IMT:
1. Select IMT. The measurement cursor appears.
2. Position the starting point with the trackball and press Set.
3. Position the end point with the trackball and press Set. The result is displayed.
Vessel Diameter
To measure the vessel diameter:
1. Select Vessel Diam. The measurement cursor appears.
2. Position the starting point with the trackball and press Set.
3. Position the end point with the trackball and press Set again.
Note To readjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
Stenosis Diam.
To measure the diameter:
1. Select Stenosis Diam. The measurement cursor appears.
2. Position the starting and the end point of the line and press Set. The diameter is
displayed.
Basic Information
• To get the best resolution and accuracy from Doppler measurements, the Angle
correction cursor must be positioned parallel to the vessel axis (in the area of the
measuring volume).
• If more measurements are performed the current measurement will be placed in the
lower right corner. The previous measurements are displayed above (in successive
order, like a shift register).
• Except for Auto Trace measurements, all measurement results will be automatically
included in the corresponding Worksheet. To store Auto Trace measurement results,
press the right or left trackball key Set previously.
• Depending on the selected measurement package setting and the adjustment in the
Measure Setup:
○ RI and PI will be calculated using ED (End Diastole) or MD (Mid Diastole)
○ all previously set measuring marks are erased when starting a new scan (unfreeze
-> Run mode)
○ the Spectral Doppler envelope curve is performed with a continuous trace line or
by setting points
○ the Doppler measuring results (according to the “Auto/Manual Trace” setting) are
displayed after an Auto- or Manual Trace measurement (Setting will be ignored in
Cardiac calculations).
○ measurement items (e.g., BPD) will be shown with or without the Author’s Name.
○ the caliper (the last measuring mark of the current measurement) is fixed when
pressing the Freeze key, the Print A or Print B keys, Save key, etc., or not
Moreover, many display properties depend on the setting in the Measure Setup.
Vel.
To measure the velocity:
1. Select Vel.. The measurement cursor and a horizontal line "hanging" on the cursor
appear.
2. Position the velocity point and fix it with Set. The measurement is finished and Vel. is
switched off.
AutoTrace
To measure the AutoTrace:
1. Select Auto Trace to start the trace calculation. It traces the Doppler spectrum
automatically and displays the results.
2. Edit the trace if necessary (adjust sensitivity, trace mode, angle, starting/End point).
3. Accept the result (Peak Systolic/Diastolic Velocity, Min./End/Mean Diastolic Velocity,
Velocity Time Integral, TAmean) . The measurement is finished and Auto Trace is
switched off.
Manual Trace
To use this manual trace tool:
1. Select Manual Trace. The measurement cursor appears.
2. Position the starting point and fix it with Set.
3. Trace the envelope boundary and enter the end point to finish the measurement. The
values (Peak Systolic/Diastolic Velocity, Min./End/Mean Diastolic Velocity, Velocity Time
Integral, Heart Rate, Slope, Pressure Gradient Mean, Time, TAmean, PeakA) are
calculated and displayed.
Accel.
To measure the acceleration:
1. Select Accel. The measurement cursor appears.
2. Position the first point with the trackball and press Set. A second cursor appears.
3. Position the second point of the measurement and press Set.
Note To readjust the starting point, press Change before completing the measurement. It alternates
the control from one cursor to the other.
RI (Resistance Index)
To measure the RI:
1. Select RI. The measurement cursor appears.
2. Move the cursor to the peak systolic velocity and press Set. A second cursor appears.
3. Move the second cursor to the end diastolic velocity and press Set.
PI (Pulsatility Index)
To measure the PI:
1. Select PI. The measurement cursor appears.
2. Move the cursor to the start of the measurement and press Set.
3. Trace the curve.
4. Move the second cursor to the end of the measurement and press Set.
Time
To measure the time between two points on a TL (Time Line) image:
1. Select Time. The measurement cursor appears.
2. Position the first point with the trackball and fix it with Set. A second measurement cursor
appears. This one can only be moved horizontally.
3. Position the second point with the trackball and press Set to finish the measurement.
HR
The Heart Rate is calculated from the measured time and adjusted heart rate cycles. To
measure it:
1. Select HR. The measurement cursor appears.
2. Position the first point with the trackball and press Set. A second measurement cursor
appears. It can only be moved horizontally.
3. Position the second point with the trackball and fix it with Set to finish the measurement.
10.3 Calculations
The measurement packages allow measurements/calculations in 2D/3D Mode, M-Mode and
Doppler-Mode using most commonly used measure items (i.e. Fetal Biometry: BPD, HC, AC,
FL,...). These factory presets defined by the most commonly used items can be customized by
the user and adjusted in the system setup.
1. Press the Patient hard key on the control panel.
Note To cancel all calculations performed before and to start a new measurement, press the Patient
hard key and select End Exam or Clear Exam.
2. Select the proper exam and enter all patient information necessary for the selected exam
type.
3. Press Start Exam.
OB Calculations
2D/3D Mode: • Biometry (Fetal Biometry, Early Gestation, Lung, Long Bones, Fetal Cranium,
AFI, Uterus, Ovary, Umbilical Vein, Uterine, EFW, Fractional Limb Vol.,
Placenta, Cerebellar Vermis,)
• Z-Scores (Long Axis, Aortic Arch, Short Axis, Obl. Short Axis, 4 Chambers)
• Nuchal Translucency
• Intracranial Translucency
• Z-Score
Doppler Mode: • Biometry (Ductus Art., Ao, Left/right Carotid, Left/Right MCA, Umbilical Art.,
SMA, Left/Right Uterine Art., FHR, Celiac Art., Left/Right UMA, IVC)
• Fetal Echo (Mitral Vlave, Tricuspid Value, Aortic, Pulmonary, LPA, RPA, Ductus
Art., Cardiac Output, FHR, RVOT Rt TEI, LVOT Lt TEI, Ductus ven., Umbilical
Vein, Pulmonary Veins, PR Interval)
TR Calculations
2D/3D Mode: Thyroid, Testicle, Vessel, Dor. Pen.A., Breast Lesion #1-5
Cardio Calculations
2D/3D Mode: LV Simpson (Single & Bi-Plane), Volume A/L (Volume Area/Length), LV-Mass (Epi
& Endo Area, LV Length), LV (RVD, IVS, LVD, LVPW), LVOT Diameter, RVOT
Diameter, MV (Dist A, Dist B, Area), TV (Diameter), AV/LA (Aortic Valve & Left
Atrium Diameter), PV (Diameter)
Doppler Mode: MV, AV, LVOT, TV, PV, RVOT, Pulmonary Veins, PAP, HR
ABDO Calculations
2D/3D Mode: Liver, Gallbladder, Pancreas, Spleen, Kidney, Renal Artery, Aorta, Vessel, Port. V.,
Bladder
Gyn Calculations
2D/3D Mode: Uterus, Uterine, Ovary, Follicle, Fibroid, Pelvic Floor, Early Gestation
VASC Calculations
2D/3D Mode: Left/Right CCA (Common Carotid Artery), Left/Right ECA (External Carotid Artery),
Left/Right ICA (Internal Carotid Artery), Left/Right Bulb, Left/Right Vertebral Artery,
Left/Right Subclavian Artery, Vessel
M Mode: Left/Right CCA, Left/Right ECA, Left/Right ICA, Left/Right Bulb, Left/Right Vertebral
Artery, Left/Right Subclavian Artery, Vessel
Doppler Mode: Left/Right CCA, Left/Right ECA, Left/Right ICA, Left/Right Bulb, Left/Right Vertebral
Artery, Left/Right Subclavian Artery, Vessel
PED Calculations
CEPH Calculations
2D/3D Mode: Left/Right ACA (Anterior Cerebral Artery), Left/Right MCA (Middle Cerebral Artery),
Left/Right PCA (Posterior Cerebral Artery), Basilar Artery, A-Com A. (Anterior
Common Artery), Left/Right P-Com A. (Posterior Common Artery), Left/Right CCA
(Common Carotid Artery), Left/Right ICA (Internal Carotid Artery), Left/Right
Vertebral Artery, Vessel
M Mode: Left/Right ACA, Left/Right MCA, Left/Right PCA, Basilar Artery, A-Com A., Left/
Right P-Com A., Left/Right CCA, Left/Right ICA, Left/Right Vertebral Artery, Vessel
Doppler Mode: Left/Right ACA, Left/Right MCA, Left/Right PCA, Basilar Artery, A-Com A., Left/
Right P-Com A., Left/Right CCA, Left/Right ICA, Left/Right Vertebral Artery, Vessel
MSK Calculations
Some measurements are specific to the Voluson™ systems. Nevertheless they can be
adjusted and customized in the system setup.
Method 1
The three distance measurement requires three measurements (length, width, height) before
the age is displayed. The age is derived from the mean value of all three measurements.
The workflow is identical to the measurement "3 Dist".
Method 2
One distance measurement is required before the age is displayed. The age is derived from
the distance measurement.
To use this method:
1. Select GS. A cursor appears.
2. Measure the GS distance like a normal distance measurement. The result is displayed
immediately.
Note To readjust the starting point, press Change before completing the measurement.
Note If the current US image magnification is too low (the corresponding pixel size is bigger than
0.1mm), a magnification hint is displayed if activated in the system setup. When this hint
appears, increase the magnification and redo the measurement.
Note It is possible to select the calculation method by pressing Method: (i-i: inner-inner or i-m: inner-
middle).
IT (Intracranial Translucency)
SonoIT (Sonography based Intracranial Translucency) is a system supported
measurement for Intracranial Translucency. Starting from the routinely used
midsagittal view of the fetal face, obtained for assessment of the Nuchal
Translucency and nasal bone, the ultrasound system uses a semi-automated
mode to measure the anterior-posterior diameter of the fourth ventricle
recognizable as intracranial translucency.
The workflow is identical with SonoNT.
Figure: Fractional limb volume. Fractional Arm (AVol) and Thigh (TVol) volumes are based on
50% of the humeral (A) or femoral (B) diaphysis length. Mid-limb measurements eliminates the
need for tracing soft tissue borders near the ends of the bone shaft, where acoustic shadowing
is more likely to be encountered.
Method: The slice positions are determined depending on the reference distance line, the slice
number and the percentage of limb and displayed graphically on screen. The volume is
calculated after the area measurements are done on the slices.
Note To correct measurements select the slices one by one with Prev or Next.
10.3.1.4 SonoBiometry
SonoBiometry is an alternative to the common fetal biometry measurements. It provides
system suggested measurements for BPD, HC, AC and FL which need to be confirmed by the
user or can be changed manually.
To use :
1. Press Calc on the user interface.
2. Select the measurement package OB.
3. Select the desired measurement item (BPD, HC, AC or FL).
4. The calculation process starts. The result is displayed on the monitor screen. If the result
is not correct, proceed with manual correction by pressing Change or moving the
trackball cursor.
5. Press Set to accept the result and to finish the measurement.
• FMF Angle (Frontomaxillary Facial Angle): The FMF angle is measured between a line
along the upper surface of the palate and the upper corner of the anterior aspect of the
maxilla, extending to the external surface of the forehead, represented by the frontal
bones or an echogenic line under the skin below the metopic suture that remains open.
• MMF Angle (Mandibulomaxillary Facial Angle): The MMF angle is generated by using
the same first part and the same apex as for the FMF angle. The second part, however,
is drawn downwards and positioned so that the inner aspect of the line flushes with the
upper anterior corner of the mandible.
Note The Facial Angle measurements are not included in the presets but need to be added
manually to a measurement group.
Display of 2D Measurements
BPD: Type of Measurement GA: Gestational Age EDD: Estimated Date of Delivery
Note “GA=OOR” means that the “Gestational Age is Out Of Range” - no standard curve available
for current input.
Note EDD (Estimated Day of Delivery) is only displayed, if the selection of the field “Show EDD calc.
on screen” in the Measure Setup is “Yes”.
There are 3 possibilities to display 2D Measurement results:
1.
e.g. Mean: . SD
Note Selection of the field “Growth Dev. Display” in the Measure Setup is “SD”.
3.
Note Selection of the field “Growth Dev. Display” in the Measure Setup is “%”
Z-Scores
The Z-scores compare either GA, BPD or FL with any fetal echo parameter (i.e.: Aortic valve,
RV area, LV area). So in order to obtain Z-scores on your report, you either need to measure
BPD or FL, or have the GA calculated from your LMP; and measure any parameter from fetal
echo. To obtain Z-scores use measurements from the subcategory Z-scores.
Note As LV area and RV area are the biggest parameters, they are the parameters of your choice to
keep measurement inaccuracies at minimum level.
The Z-scores will be displayed on the worksheet.
Fetal echocardiac views from which the cardiac structures can be measured: (a) Long Axis
view of the left ventricle showing the aortic valve (1) and ascending aorta (2). (b) Aortic arch
view showing the aortic valve (1), ascending aorta (2), descending aorta (3) and inferior vena
cava (4). (c) Short axis view showing the pulmonary valve (1), main (2), right (3) and left (4)
pulmonary arteries. (d) Oblique short axis view, showing the pulmonary trunk and arterial duct
(5). (e) Four chamber view, showing the tricuspid valve (1), right ventricular end-diastolic
dimension (2), right ventricular inlet length (3), right ventricular area (dashed line) (4), mitral
valve (5), left ventricular end-diastolic dimension (6), left ventricular inlet length (7) and left
ventricular area (dotted line) (8). Ao, aorta; Desc Ao, descending aorta; IVC, inferior vena
cava; LA, left atrium; LPA, left pulmonary artery; LV, left ventricle; MPA main pulmonary
artery;RA right atrium; RPA, right pulmonary artery; RV right ventricle.
REFERENCE: Schneider C. et. al., “Development of Z-scores for fetal cardiac dimensions
from echocardio-graphy”, Ultrasound Obstet Gynecol. Vol. 26, 2005, pages 599-605.
Fomulas:
Z-scores = (ln(actual) - ln(predicted cardiac dimensions)) / Root MSE
ln (predicted cardiac dimensions) = m.ln(FL, GA or BPD) + c
FL...femur length; GA...gestational age in completed weeks; BPD...biparietal diameter;
m...multiplier; c...intercept
Note Some measurements and calculations may not be available in all countries.
10.4 Worksheet/Report
All calculation results are recorded in the application dependent patient worksheets. By
pressing Report on the control panel or touching Report in the Calculation menu, the
Worksheet of the selected Measurement Application is switched on. (Always starts with the
first page of worksheet.) According to the selected measurement application the worksheets
display the results of the calculations, graphs, growth percentile bars and application
dependent information available.
To close the worksheet press Exit on the touch panel.
Note It is now possible to switch between Gyn and OB worksheets (if both worksheets exists).
Note If a patient worksheet contains measurements that were performed in the XTD-View mode
('Extended View (XTD-View)' on page 6-17), a yellow caution symbol will be shown in the
worksheet header.
Editing a Worksheet/Report
Any stored measurements in a patient worksheet can be edited. Move the cursor to the
desired field, press Set and type in the changes. The edited values are marked with an
asterisk (* next to the changed value). Additionally some parameters or settings can be
changed by clicking into the specific field on the worklist page. For example: Method: average,
minimum, maximum, last or off.
Exam Comment
Touch Exam Comment to view the Exam Comment summary report, to enter a comment using
the keyboard, or to enter a previous defined comment by touching Comment A, Comment B or
Comment C on the touch panel.
If a comment exists already:
• type in the comment desired using the AN keyboard, or
Transferring a Worksheet
Press Transfer Data to transfer the patient worksheet data to the selected destination.
Note If a Structured Report Server exists, the data is transferred using DICOM Structured
Reporting, independent of whether there are other report servers (network, serial) available.
Note The Transfer Data key can only be selected if a “Service: REPORT” destination is specified in
the System Setup; To specify a DICOM Address: 'DICOM' on page 11-21
Note Receiving Report Data An example for software that can receive and store reports is the “PIA”
documentation system for medical diagnostics and digital image archiving from “ViewPoint”.
(www.viewpoint-online.com)
Printing a Report
1. Press Print Preview to see how the selected content will appear on the report. The
preview can be customized:
Info Compact A and Compact B are only available if the check box Use Compact Format is
checked in the Measure Setup.
1.3. Select the preview page to be displayed using the respective control below
the touch panel.
1.4. Enlarge or reduce the size of the preview by pressing Zoom In or Zoom Out if
desired.
1.5. Print the Report: Under Print Report(s) select if the Report should be printed
either for the selected measurement package or for all packages.
3. Select individual images by checking the icon next to an image or press Select all
images and then press Add to Worksheet.
Note IOTA LR2 Calculation may not be available in all countries (including USA, Japan).
The IOTA (International Ovarian Tumor Analysis) LR2 Worksheet contains an ovary
measurement tool for women with adnexal tumors that have been selected to undergo
surgery. The LR2 model is based on published literature and has been tested only on the
stated population. The literature states that the LR2 model can help to estimate the probability
of an adnexal mass of being malignant. The IOTA group has evaluated other ways including
an LR1 model in additional to the LR2 model.
Note IOTA states that use outside of the intended population can overestimate risk. Users are
expected to study the literature and reach their own professional conclusions regarding the
clinical utility of the tool. The model cannot replace training and experience in ultrasonography
and cannot compensate for poor quality ultrasound equipment.
The IOTA mathematical logistic regression model, LR2 is stated in literature as described in
the Advanced Reference Manual
Note For details see H48691UY EC300 Advanced Reference Manual – Chapter IOTA.
GE Healthcare is passing on this IOTA LR2 worksheet for your convenience based on
published literature of one group, but makes no representation of its effectiveness in your
practice. This calculation is not to be used as the primary driver in diagnostic decision making
on the probability of malignancy. It is secondary information for a physician to use based on
recent literature.
Workflow
1. Select IOTA LR2 Model on the Gynecology Worksheet touch panel.
2. Patient name and ID are entered by the system.
3. Fill in items 1 to 6. The Patient's age is entered by the system if available from the
Patient Information Dialog.
4. The IOTA LR2 model result is displayed.
Caution
The IOTA LR2 model should not be used without an independent clinical evaluation and is not
intended to be a screening test or to determine whether a patient should proceed to surgery.
Incorrect use of the IOTA LR2 model carries the risk of unnecessary testing, surgery, and/or
delayed diagnosis.
Utilities - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 11-2
System setup - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 11-9
11.1 Utilities
Use the Util. hard key to open the utility menu on the touchscreen.
When there is no probe connected, some functions are disabled:
• Histogram
• Guided Biopsy
Presets Administration Popup control: Save, Save as and Setup. Select the desired option.
• While you are scanning, notice the index numbers you are using and which
controls affect the readings.
• Try to keep the index numbers as low as you can, while maintaining diagnostic
information within the image. This is particularly important when scanning the
fetus.
For details review: 'Reporting Tables' on page 2-19 'Regulated Parameters' on page
2-18
Biopsy Kit Select a probe depending Biopsy Kit/Line.
UI Console: Button LED Change the brightness of the illumination of the hard key buttons.
UI Console: Floor LED Change the brightness of the illumination of the Floor LED.
Beeper: Volume Change the Beeper Volume of the system (i.e. the volume of the user interface
sounds)
• Save
• Save as
• Setup
Save
Note Save overwrites the current preset
Using Save:
1. Press the Util. hard key.
2. Press Presets Administration.
3. Choose Save or Save & Exit
4. The previous mode menu appears.
At the message area a 5 sec. message "Preset (xxx) successfully stored" is displayed.
Save can be equally replaced with the shortcut CTRL+S. When this shortcut is used, a
message box appears asking for confirmation to overwrite the preset. Confirm with OK or
Cancel. The shortcut cannot be used in Reload/Repro mode. In these modes Save
automatically switches to Save as.
Factory presets cannot be overwritten.
Save is available for 2D and 3D/4D modes. The Util. hard key is disabled in 3D/4Dpre mode.
Note Saving a preset in 3D/4D mode saves the visualization mode, its according acquisition and
render parameters and the link between those.
Save as
Using Save as:
1. Press the Util. hard key.
2. Press Presets Administration.
3. Choose Save as
4. A folder menu is displayed. The current selected folder and preset are preselected.
5. Select a folder to define a new position for the preset. If the folder is empty, a dialog
window for naming appears.
6. Choose Save&Exit
7. The previous mode menu appears.
In 3D/4D modes the Save as menu appears without User, Factory Tab and Folders. The Util.
hard key is disabled.
Note In 3D/4D modes Save as allows to change the name and position of an acquisition preset and
also saves the currently active render preset.
Setup
Using Setup:
1. Press the Util. hard key.
2. Press Presets Administration.
3. Choose Setup to enter the system setup page Presets.
11.1.3 Histogram
With this function the gray scale or color distribution within a marked Region of Interest (ROI)
will be graphically displayed. Three histograms may be shown on the screen simultaneously.
There are three possibilities to calculate the gray scale or color distribution.
2D Histogram
1. Store a 2D-, CFM- or PD - mode image.
2. Switch on Histogram by pressing Util. and then Histogram.
3. The touch panel changes to the Histogram menu.
4. Select the number of histogram: 1, 2 or 3.
5. Use the trackball to place the rectangle over the ROI.
6. The upper trackball key changes from position to size of the ROI and back.
7. Touch Calculate on the touch panel or press the right or left trackball key. The histogram
and corresponding number will be calculated and displayed.
Remark Measuring, text annotation, bodymarks entering as well as all post-processing settings are not
possible in Histogram mode.
3D Histogram
1. Store a 3D-, a 3D/PD- or a 3D/CFM - mode image.
2. Switch on Histogram by pressing Util. and then Histogram.
3. Select the number of histogram: 1, 2 or 3.
4. Use the trackball to place the ROI over one of the sectional planes.
5. The upper trackball key changes from position to size of the ROI and back.
6. Touch Calculate on the touch panel or press the right or left trackball key. The histogram
and corresponding number will be calculated and displayed.
Volume Histogram
Calculating a Volume Histogram is only possible in combination with the VOCAL™ - Imaging
program (Virtual Organ Computer-aided Analysis). For more information see ' VOCAL II ' on
page 8-47.
The Biopsy Kit button holds the name of the selected biopsy kit. The name of the biopsy kit is
also displayed on the Line Select button. A popup window appears displaying all available
biopsy kits of a probe.
The Biopsy Line buttons are only displayed when a biopsy kit is activated. They are on/off
buttons activating/deactivating biopsy lines.
Each line of the available biopsy kits is programmable and stored in the system.
• The biopsy lines must be programmed once by the service personnel or the user. The
procedure must be repeated if probes and/or biopsy guides are exchanged!
• Before performing a biopsy make sure that the displayed biopsy line coincides with the
needle track (check in a bowl filled with approx. 47˚C warm water). For further
instructions review: 'Biopsy line adjustment for single angle biopsy guide' on page 5-16
'Biopsy line adjustment for multi angle biopsy guide' on page 5-16
• Please read the “Instructions for safe Use” in 'Biopsy safety' on page 5-13
• For more information see 'Biopsy line adjustment for single angle biopsy guide' on page
5-16.
• For more information see 'Biopsy line adjustment for multi angle biopsy guide' on page 5-
16.
Lock Screen is a security function. It protects the system by password against unwanted
intruders. There are two ways to activate Lock Screen:
• All hardkeys are disabled except the trackball, left and right trackball buttons and the
power knob.
• Emergency button.
11.1.5.1 Password
The first time the System Login is enabled, a password has to be created. Therefore the
"Change Password" dialog appears.
1. Enter the current password.
2. Enter a new password.
3. Retype the new password.
4. To exit without saving changes press Exit, to save the changes and exit press
Save&Exit.
Note A valid password must be at least 6 characters long and has a maximum length of 80
characters. A password must contain at least 2 non-letter characters, 0...9 or ! @ # $% ^ * ().
If "Activate System Lock with Screen Saver" is selected in the System Setup, the system lock
screen is also activated as soon as the screen saver is started. During the System Lock no
buttons are visible on the touch screen. Only the short text message "System Locked" is
visible.
To log in enter your password into the blue box on the screen saver and click OK. Without the
correct password press Emergency.
Emergency Mode
When the Lock Screen is active, there are two possibilities to enter the system again: by typing
in the correct password or by pressing the Emergency button to enter Emergency Mode.
In Emergency Mode full ultrasound functionality is available but:
• search function and Worklist view are disabled in the patient archive.
Message dialogs appear in the restricted areas to inform about the restricted access and to
guide back to full functionality by entering the correct password.
If the emergency mode is active the button System Lock in the Utilities menu also becomes
active. To leave the emergency mode, press the System Lock button and the System Lock
Screen appears again.
Note During all system setting changes the touch screen remains black. Only the Exit button is
visible.
11.2.1 General
General includes:
• General Settings
• Details
• Annotation
• Clipboard
• Scan Assistant
Controls
Change Date & Time Date/time adjustment: A sub dialog appears in which date, time and time zone can
be adjusted. Ok saves the changes and closes the window.
NTP Time Server Settings: A checkbox is available to choose Synchronize with
NTP time server. There are entry fields for the NTP server as well as for update
intervals. The Update now button synchronizes with the NTP server.
Clinic Name Select the text box to enter a new clinic name. The clinic name will be copied into
the Hospital ID in the information header after closing with Save & Exit.
Screensaver Text Select the text box to enter an User Screensaver text. The text will be copied into
the Registry after closing with Save & Exit. The default entry is overwritten.
Language System: Select the desired language and press Save & Exit. The system reboots by
itself, which is necessary to change the current language. Only languages available
on the system are listed. If a new language is installed, it is automatically added to
the list.
EUM : Select the desired language for the EUM. This selection is not influenced by
the system language selection and vice versa.
• Show TX Power
• Screen Saver when checked it is also possible to select Activate System lock
with Screen Saver
Diverse On/off selection for:
• Auto Scan Stop: If the system is not active, it activates freeze mode after 5 min.
• 3D/4D Screen controls: Visibility of the screen controls is defined by the state of
the trackball.
• Beeper off: The acoustic signal for pressing a hard key is turned off.
• Show MI in orange > 1.0: The MI at the Info Header must be colored in orange
if the MI is greater than 1.0. At reload no colored MI is displayed.
Presentation Mode
The shortcut "Ctrl + Alt + I" starts and stops Presentation Mode. It supports only JPEG and
AVI files.
Image Duration Defines the time how long an image is displayed in Presentation Mode. (Range:
1-20 sec)
--> & <-- Copy pictures from the external register to the internal register and vice versa.
Burning to CD or DVD is not possible.
Select All All pictures or videos in the associated register are marked.
OK Closes the dialog and remembers changes of image duration. Changes are only
activated if Save & Exit is pressed in the system setup dialog.
Preview window If a picture/video is marked in the internal or external register it is shown in the
associate preview window. If more than one picture is marked, no preview is
available.
11.2.1.2 Details
Controls
• Use 2D Color for STIC: If checked (default), the system uses the 2D color
settings for STIC color. Otherwise the system uses the color settings from the
STIC user programs.
• Vascular Auto Frequency change: If checked (default), the system uses at the
vascular applications an algorithm for changing the frequency and the
depending PRF.
Overview Window Define Position and Size of the overview window or turn it off completely.
Zoom Key While in Zoom Pre Mode, select which Zoom Mode (Pan Zoom or HD Zoom) is
activated automatically, if the Zoom hardkey is pressed again.
OmniView "Show VCI-C Line when invoking OmniView" can be checked. When this box is
checked, a default horizontal straight line (VCI-C line) is included, otherwise not.
Dialog Color Level Select the desired color level of the user interface. Choose between Brightest,
Bright, Standard (Light Text), Standard (Dark Text), Dark (Default) and Darkest.
Export Brightness Increases the image brightness on export/transfer/video/print if checked.
Messagebox Show hidden messages: All hidden messages will be showed again.
Trackball Trackball speed: The trackball speed of listed functions can be changed and saved.
11.2.1.3 Annotation
Controls
Use Space key to switch "Abc" on When this check box is activated the image annotation Abc can be activated by
pressing the space bar on the keyboard.
Clear text on unfreeze If this check box has been selected all annotation will be cleared when you untoggle
the Freeze key.
Home position application specific If this check box is checked, a cursor home position can be stored for each package
when in image annotation mode.
Small List: use popup window Popup window to display the small list of words stored within a text button.
Show Annotation menu on screen Shows the Annotation Menu on the Screen Display.
Use timeout to switch "Abc" off Defines the timeout for annotation mode. After timeout system switches back to
scan mode.
Annotation Cursor position Defines the cursor position when annotation button Abc is pressed.
Annotation Presets
1. Select the button Annotation presets.
2. The annotation window is displayed.
3. Select the button Measurement package and select an application. If you don't want to
change the measurement package, select Return to go back to the previous annotation
window.
4. The annotation window is displayed again.
Entering a text 1. Select a text button and enter a text (maximum 24 characters).
2. Select the next text button.
3. When you have entered all desired texts, select Save.
4. There are 20 text buttons per page. To change between pages, select Prev
Page or Next Page.
Editing a text 1. Select the text button which should be edited. The existing text is highlighted.
2. To replace the whole text, simply start writing. The old text will be deleted.
3. To correct the text, place the cursor at the desired position and delete or insert
characters.
Editing a small list 1. Select the text button which should be edited.
2. In Small List select the text button which should be edited.
3. Edit the text and select Save.
Application Touch Application to change the Annotation application. The application select page
appears with the currently active application (yellow). It is only available when no
text key or small list key is activated.
Select the desired annotation application or press Return to go back without any
changes.
Text/Small List Text Each Text key can be programmed with a text line (up to 24 characters). If more
than one text line is entered, the Text key becomes a Small List Text key. Each
Small List Text key can be programmed with 2 or 3 text lines, each containing up to
24 characters. If only one small list word is entered, the key becomes a Text key.
Small List A new small list word can be entered or an existing word can be edited.
Return Go back to the main setup page without saving any changes.
11.2.1.4 Clipboard
Controls
Clipboard Reload Save Choose the desired option and Copy Position.
Controls
Calculate DOC by GA Select whether to automatically calculate the DOC (Date of Conception) when a GA
was entered in the current patient dialog.
Calculate Day of Cycle by LMP Select whether to automatically calculate the Day of Cycle when a LMP was
entered in the current patient dialog.
Capitalize Letters in patient names Write patient name in capital letters (information header, …) when typing the patient
name in the current patient dialog.
Hide Pat. Info: Name only If this box is checked, only the Patient Name is hidden. If this box is unchecked, all
patient data is hidden.
Worklist Auto-Query If this box is checked, the worklist is automatically queried with the entered Patient
ID or Patient Name and todays date when the Worklist button is pressed in the
Current Patient Screen. If this box is not checked, the worklist is only queried after
the Search button is pressed in the Worklist dialog. If no connection to a Worklist
server is available the former queried Worklist data (Show locally stored data) is
shown.
Auto Start Worklist If this box is checked, the worklist dialog is shown automatically after the PID Button
is pushed.
Title Bar Settings Define Font Size (small, medium, large), Font Brightness (100%, 90%, 80%) and
Display DOB / Age.
Archive: customize Exam columns Define the information displayed in Patients & Exams (last two columns) and Exams
Only (last Column). If Automatically list patients is checked, all available patients are
displayed when the Current Patient Search or the Archive dialog is opened.
2nd Patient ID Check Activate 2nd Patient ID if desired. If checked, the 2nd Patient ID is displayed
at Report, Structured Report, Worksheet, PID and on all exports and prints.
Delete PID Dropdown Delete List deletes all entries in the selected dropdown lists. Available checkboxes:
• Referring Physician
• Performing Physician
• Sonographer
• Exam Type
• Exam Comment
Controls
Add Opens the Add subwindow. Add items to existing lists or a new list. (Only available
if the maximum item number is not reached.)
Adding measurements is also possible.
Delete Opens the Delete subwindow. Deletes the selected Scan Assistant/group item/
check/item/measurement/annotation.
Reorder Opens the Reorder subwindow. Only available when an item is selected. Move
items up/down through the list.
Rename Opens the Rename subwindow. Enables renaming of an item. Measure items
cannot be renamed.
Load Factory Load the factory list for the selected application.
Insert Annotation Select when the check item annotation has to be inserted on screen: Freeze and/or
Abc activation.
11.2.2 Administration
Administration includes:
• Service
• System Info
• Option
11.2.2.1 Service
1. Position the cursor into the displayed “password window” and press Set.
2. Enter the password and click Accept to display the Service Tools window.
Controls
• 4D Shift Control: Sets the 4D shift control to visible. Shift control adjustment is
performed in 4D-real time mode. The determined shift control value is stored on
the probe device.
Service Tools Display Service Tool functions (System Serial Number, System Hour Meter, Auto
Tester,...)
Generate NLS keys Export the NLS setting of the ultrasound device.
Note For further details and explanations refer to the Service Manual of the system.
This tab gives information about the Software and Hardware System.
The button DVR Version gathers the DVR version and the button Patent Applications displays
all the patents and applications the Voluson™ E6 BT15 system is protected with.
11.2.2.3 Option
This page shows all available system options and their states.
Demo Key This field is used to enter and show the demo key (all options are available for a
certain period of time) from OKOS.
Permanent Key This field is used to enter and show encoding key for permanent available options.
• To Exit the System Setup without saving, click the Exit button.
1. Click Activate to unlock all the Options over a limited period of 3 months.
2. After activating, the 3 Month Demo field indicates the expiration date of the demo.
3. To Exit the System Setup click Save & Exit.
During Start-Up of the Voluson™ system a window appears that indicates the remaining
duration of the demo.
The 3 Month Demo option can only be activated once. The user can not repeat this activation.
To order a permanent option, or to get a Demo Key, please contact your local sales
representative.
11.2.3 Connectivity
• Peripherals
• Device Setup
• Button Configuration
• Drives
11.2.3.1 Peripherals
Controls
Add Printer A message box appears. If confirmed with Yes, a new printer can be installed.
Add network credentials To connect with a Network printer, Network credentials (e.g. Server name,...) have
to be added.
Printer Settings The drop-down list displays all printers available (no DICOM printers).
Report Printer Select which printer to use for printing reports from the drop down list.
Print Queue Select a printer from the pull down menu and press Clean Print Queue to delete all
jobs from the print queue of the selected printer. Check Select All Printers and press
Clean Print Queue to delete all jobs from all printers installed on the system.
Foot Switch Select the functionality of the Left / Middle / Right Foot Switch. Choose between
Update 2D, Freeze, P1, P2, P3, P4 and Vol. Start.
Depending on the Foot Switch, the Middle Option may not be available.
Ext. Monitor Output Connection of an additional external monitor. Choose between HDMI/DVI (FullHD)
and VGA/DVI - SXGA signal output on the rear panel according to the used monitor
type.
It is possible to switch between Fullscreen and Ultrasound area.
S-Video : Switch between PAL and NTSC. Only the ultrasound area can be
displayed.
It is possible to configure:
• DICOM
• Archive
• Network
11.2.3.2.1 DICOM
DICOM is the abbreviation of Digital Imaging and Communications in Medicine. This is the
industrial standard for communication of images and other information between medical
devices on the network. Using the DICOM option, you can send or print images after
connecting your ultrasound equipment and PACS.
This dialog section is used to set up details of all of your DICOM target nodes (image servers).
Once you have set up a DICOM node properly, data can simply be transmitted by selecting
the appropriate target node.
DICOM Configuration
Controls
AE Title Enter the AE (Application Entity) Title under which your DICOM application is known
to other DICOM applications (required). For setting the correct AE Title please
contact your DICOM network administrator.
Retry Count Seq. Retry count for sequential mode (only valid if Send sequ. is checked). If the end
number of Retry Count Seq. is reached and sending was not successful then the
“problem” data set is marked as “failed” in the spooler and the system continues
sending the next image data
Default Default values of Retry Count, Retry Count Seq., Retry Interval, Timeout (s) are set.
Test Connection If a destination from the Destination List is selected and the Test Connection button
is pressed, the connection to the selected destination is tested. If no destination is
selected the button is disabled.
Ping: Ping the selected destination and check the response. The result can be OK
or Failed
Verify: Send DICOM commands and check the response. The result can be OK or
Failed
If a serial report destination is selected, the Test Connection button changes to
Send Test Report and the Ping and Verify fields disappear. A test report is sent to
the serial port instead of testing the network connection.
Sound Notification Acoustic signal for a successful or unsuccessful transfer (sending Images,
Structured Report Transfer and Report).
Destination list Contains all available destinations and displays their Services, Alias, AE Title, IP
Address, Port and Color / Size. The checkboxes next to the destination, mark the
currently activated server. If more than one Service is added, then a selection of
one Service can be done with the checkbox.
To check the same Services is not possible for:
• MPPS
• STR. Report
• Query Retrieve
• Worklist
If more than one STORE, STORE3D or STORAGE COMMIT service is activated,
images are sent to all selected STORE or STORE3D destinations and committed
with the corresponding STORAGE COMMIT destinations.
Add Pressing the Add button opens the Device Setup dialog, where it is possible to add
DICOM destinations. For more information see 'Adding a Service' on page 11-23.
Edit Selecting a destination from the Destination List and pressing the Edit button opens
the Device Setup dialog, with the information on the selected destination.
The Edit button is disabled if no destination is selected.
Delete Selecting a destination from the Destination List and pressing Delete removes the
selected destination. The Delete button is disabled if no destination is selected
Save&Exit If the Save&Exit button is pressed, the DICOM Configuration dialog is closed and all
changes are saved.
Exit If the Exit button is pressed, the DICOM Configuration dialog is closed and all
changes are discarded.
Adding a Service
Select a Service and enter the destination settings (Alias, AE Title, IP Address and Port).
Services • STORE: Send screen images, 2D cine sequences and 3D/4D data to a DICOM
server (e.g., Viewpoint).
• STORE3D: Send 3D/4D data only (volumes and cine sequences) to a different
store server (e.g., PC with Software 4D View® installed) than screen images
and 2D cine sequences.
• QUERY RETRIEVE: Query images or other DICOM objects and Retrieve them
from a PACS or other DICOM Modality.
• REPORT: Send the Patient report data to a PC via network or serial port.
Alias Enter a name for the DICOM node to make it easier to handle various nodes. Use
any name, but do not insert space characters.
AE Title Enter the AE (Application Entity) Title under which your DICOM application is known
to other DICOM applications (required). For setting the correct AE Title please
contact your DICOM network administrator.
STORE / STORE3D
• If Send sequ. is not checked, up to 5 data sets can be transferred at the same
time. This means that transfer is faster. Images can arrive out of order in this
case. (Use for servers that have none of the limitations listed in the above
paragraph).
Storage Commit The Storage Commit drop down list contains all currently added Storage Commit
servers. The selected Storage Commit server is used for committing the images
sent to this store server.
4D View default Loads the default settings for 4D View®. The destination information must be
entered manually.
DICOM Station default Loads the default settings for DICOM Station. The destination information must be
entered manually.
Caution
A lossy compression can reduce image quality which can lead to a false diagnosis!
PRINT
Edit the Printer Setup as needed.
Note As soon as an MPPS server is created and selected, MPPS messages are created when an
exam is started or ended.
Storage Commit The Storage Commit drop down list contains all currently added Storage Commit
servers. The selected Storage Commit server is used for committing the images
sent to this store server.
Combine OB & GYN If the checkbox is enabled, the system sends the OB- and GYN - data into one file.
If not enabled the files will be sent individually.
Include Scan Assistant Data Select yes or no (default) from the drop down menu.
QUERY RETRIEVE
Select the Default Appl. from the drop down menu.
The drop down menu contains exam applications available in patient dialog (Abdomen, OB,
GYN, Cardio, Uro, Vascular, Neuro, Small Parts, Pediatric, Ortho). The selected exam
application is used for all exams that are imported into the local archive from a remote query/
retrieve server.
WORKLIST
Private Tags Determines whether the private tags defined for communication with the Viewpoint -
worklist are used when querying the worklist.
Modality Select either All or ULTRASOUND. No selection is also possible and defaults to
“all”.
Add local data • yes: Locally stored patient data and patient data from the worklist are merged.
(Fields that are available in the worklist are taken from the worklist, fields that
are only available in the data base are taken from the local data base.)
• no: Data only contained in the worklist is used to populate the patient data
fields. No locally stored data is used.
• ask: A dialog is shown whenever there is data from the worklist and from the
local database available. Depending on the selection in the dialog, either the
action described under yes or no is executed.
Note Private Tags only work if the other system also supports Private Tags.
REPORT
Select one of the following Transfer Modes.
• Network: Send the patient report to a PC report station via DICOM network.
• Serial: Send the patient report to a PC report station that is connected by serial port. The
optional “PRY USB-RS232 Connection kit” must be connected to the system.
When this Transfer Mode is selected, different fields are available: COM Port, Flow
control and Bits per second.
Note The bit rate (Bits per second) must be the same as on the receiving PC report station.
Transfer Sound
There are acoustic outputs for successful or failed transfers. The sounds are played when
Images, Structured Reports, Transfers and Reports are sent.
Note If more than 600 entries exist, a message appears asking to clear the DICOM Queue. If the
number of 1500 entries is exceeded, the DICOM transfer is stopped completely due to
overflow. Again a message appears informing that no more transfer is possible and that the
DICOM Queue has to be cleared.
Note If the transfer was successful, but a storage commitment request was not yet successful, the
images receive the status sent. As soon as the storage commitment was successful the
entries (both images and storage commit) are deleted from the list.
Controls
Hold Queue The system no longer tries to send data in the queue. As soon as Process Queue is
pressed, the system continues to send data.
Delete all Delete all exams, including items that are currently in wait status.
Show information This button is enabled if a failed DICOM transfer is selected in the Queue list.
With this function more information about the failed DICOM transfer can be
requested. A window pops up. If the Image is stored in the archive the additional
button Go to Archive is available. It opens the archive in Review Mode and the
failed image is shown.
11.2.3.2.2 Network
TCP/IP Configuration
Edit the TCP/IP Settings as needed.
Note It is not recommended to change configurations without being familiar with this task.
Edit the Network Adapter Settings as needed.
WLAN Configuration
Info The WLAN adjustments and hardware may differ in some countries. Please check the
requirements or talk to your local Online Center.
Note The WLAN Stick optionally provided by GE Healthcare Austria GmbH & Co OG does not
support WPA - Enterprise encryption!
Note In case you need further assistance, please contact a GE Healthcare Austria GmbH & Co OG
service technician.
Remark Error messages appear if no software is preloaded on the SysDVD, no WLAN adapter is
connected or the WLAN adapter is defect.
Network Profiles
Define and switch between different network settings for all your work environments to further
improve Voluson™ E6 BT15 ’s portability.
Use Network Profiles During the Boot-Process a window appears to select a Profile. If the Use Network
Profiles checkbox isn’t activated the system assumes the Standard - profile after the
Boot-Process.
Default Profile Shows all existing profiles. If a Default Profile is checked, the Network Profile
window appears during the Boot-Process for 10 sec in which the user can select
another Profile. After the 10 sec. the system automatically uses the Default Profile.
New Add a new Network Profile. A window opens in which a new Profile name can be
added.
If Current Settings is activated, all current settings are stored under a user definable
name.
The following settings are stored:
• Px Button configuration
• Hospital name
• Network-Drive mapping
• System’s AE title
If the lower ComboBox is activated, the user can select another available profile.
This Profile with all its settings is copied and stored under a user definable name.
Email Configuration
Enter your Identity, the SMTP Server Settings, a Default Subject / Message, Options and MMS
Options as needed. Adjust the Email To MMS Service Settings (Service, Phone Number
options, Options) if necessary.
Emails contain JPEGs for images and AVIs / MOVs / MPGs for cine sequences.
Modem Configuration
The button Modem Configuration is only visible when the optionally available "Cellular Modem"
is installed. It opens a dialog in which you can enter the APN (Access Point Name), User
name, Password, SIM Card PIN and check whether the Cellular Modem shall connect
automatically when the system is started.
At the Status bar a signal strength icon is displayed. Clicking on this icon opens a context
menu from which you can choose to
• If the SIM card PIN is wrong, a message appears informing about the wrong PIN and
asking to enter the correct one within the Modem Configuration. Confirm with OK.
• If the SIM card PIN is locked, an unlock dialog appears. Enter a PUK code to unlock the
SIM card and then a new PIN, which has to consist of min.4 and max. 8 numbers only.
Retype the new PIN code and then click OK to save the changes or Cancel to leave
without saving any changes.
• If the SIM card PIN cannot be set (e.g. due to a wrong PUK code or a SIM card
defect,...)another message appears informing about that.
Compression Rate
Ultrasound images are consuming a lot of the system’s memory resources. Therefore, the
JPEG - compression method can be applied to the images to reduce their size. When
selecting a JPEG - compression less than 100% a message appears.
Note Volume Wavelet Quality is only enabled if the volume compression is set to Wavelet Lossy.
If the volume contains color information, the color part of the volume is compressed with a
setting that is 5 points better than the selected setting, e.g. Setting Mid: color compression
High, grey compression Mid
If a volume is compressed using lossy wavelet compression, a yellow sign (Wxx; xx =
compression factor, e.g. W9) is added when reloading the image.
A lossy compression reduces image quality, which can lead to a false diagnosis!
• P1-P6
• Start Exam
• End Exam
11.2.3.3.1 P1 - P6 Keys
There are two different tabs available:
1. Overview: Select the basic actions to be performed when pressing a particular P - key.
2. Detailed Setup: Choose what exactly happens when a P - Key is pressed. (i.e.: If you
choose to save images in the Overview - tab, then the format of the images to save can
be selected in the Detailed Setup - tab.)
Overview
Save to Clipboard with Px Copy image data from the monitor to the clipboard.
Save to Worksheet with Px Save image data from the monitor to the worksheet.
Confirm Scan Assistant Item with Confirm a current selected check item.
Px
Export as JPEG / AVI with Px Allows to quickly export images and cine sequences from the US - Image area.
Use Px to send Email Send image data by email. If this box is checked, all other configuration possibilities
are deactivated. Settings becomes available for detailed Email configuration.
Use Px for Recorder Control Use it as Recorder control. If this box is checked, all other configuration possibilities
are deactivated.
DICOM Send data to a DICOM destination (1-3). The drop down list contains all available
DICOM Store destinations.
Print Print data on Printer 1-3. The drop down list contains all available printers (DICOM
and other printers).
Detailed Setup
2D Save Automatic:
• Saves data that is displayed on the screen.
• Saves Cine according to the Max. Cine Length setting in Write Mode.
Single: Always saves single 2D images independent of the selected mode.
Cine: Always saves 2D Cine.
• Saves Cine according to Max. Cine Length setting in Write- and Freeze - mode.
D/M Save Single: Saves single images containing both, current D/M data and current 2D data.
Cine: Saving 2 cines, one containing D/M data, the other containing 2D data.
3D Save Automatic:
• Saves 3D Volume that is displayed on the screen.
4D Save Automatic:
• Saves data that is displayed on the screen.
• Saves Cine according to the Max. Cine Length setting in Write Mode.
Single: Always saves a 3D Static data set independent of the selected mode.
Cine: Always saves 4D Cine.
• Saves Cine according to Max. Cine Length setting in Write- and Freeze - mode.
Request Comment If selected, a window pops up every time an image is saved / sent, asking for an
image comment.
Worksheet: All Pages If selected, the system prints, sends and/or saves all available Worksheet pages.
TUI: One-by-one If selected, the system prints TUI images one-by-one and an additional overview
image. This selection is also applied when data is saved to Archive, sent to a
DICOM Server or DICOM Printer or normal Windows Printer. It is not available for
the B/W video printer.
Use Report Printer for Reports Select to print reports using the report printer.
Max. Cine Length Select the desired Cine length settings for Save and Send. A pull down menu is
available but the length can also be adjusted with a direct input from the AN
keyboard (numbers 0-9).
Cine Capturing in "Run" mode Select either Retrospective or Prospective as Cine Capturing Mode.
Overview
Auto Start Acquisition If this radio button is on, the system automatically starts a new acquisition in 2D
Mode when Start Exam is pressed.
The following settings can be adjusted:
Probe/Program Menu If this radio button is on, the system automatically shows the Probe select menu
when Start Exam is pressed. The image on screen is cleared (no image visible).
Save to Clipboard Saves screenshot of Current Patient Dialog to Clipboard by pressing Start Exam.
Send to Destination 1-3 Sends a screenshot of the Current Patient Dialog to the selected destination by
pressing Start Exam.
Print to Printer 1-3 Prints a screenshot of the Current Patient Dialog on the selected printer by pressing
Start Exam.
Probe Activates the selected probe (if auto start is selected).
Application Activates the selected application (if auto start is selected). If Probe is selected as
last used, then also the application is switched to last used.
User Program Activates the selected user program (if auto start is selected). If Probe is selected
as last used, then also the User Program is switched to last used.
Overview
Move Clipboard Content to Internal Select to store the complete clipboard content in the internal archive when the End
Archive on End Exam Exam button is pressed.
Transfer Worksheet to Destination Select to automatically transfer the worksheet contents to a remote server when the
1-3 on End Exam End Exam button is pressed. Use the drop down menu listing all available
destinations to select the desired remote destination.
Show Exam End Dialog If this box is selected a dialog message is shown on screen when the End Exam
button is pressed.
Request Exam Comment on End If selected, a window pops up every time an exam is ended, asking for an exam
Exam comment.
Show New Patient Screen on End Select to automatically display the “Current Patient” screen after an exam was
Exam ended to start a new patient.
Auto start Acquisition (New Key) If this radio button is on, the system automatically starts a new acquisition with the
Auto Start Acquisition settings when End Exam is pressed.
No Action If this radio button is on, the system doesn’t do any action concerning Start Exam
procedure.
Send Clipboard Content to Select to send the complete clipboard content to a DICOM destination on End
Destination 1-3 on End Exam Exam.
The drop down list contains all available DICOM Store destinations.
Print Clipboard Content to Printer Select to print the complete clipboard content on the selected Printer on End Exam.
1-3 on End Exam The drop down list contains all available printers (DICOM and other printers).
Print Worksheet to Report Printer Select to automatically print the worksheet (if available) in the report printer.
on End Exam
Note If the Move Clipboard Content to Internal Archive on End Exam check box is not set, there is
no possibility to save the clipboard content.
11.2.3.4 Drives
This overview shows all connected USB-, Network- and CD/DVD - drives.
Controls
Rescan Drive Rescans the system to search for not recognized USB-Drives. A message dialog
appears guiding through the process and showing progress.
Erase CD/DVD Erase the inserted disc. A popup window appears asking for confirmation and the
desired Erase Mode(depending on the inserted medium).
Map Network Drive Press to connect a network drive. Enter the Network folder Name, User and
Password and choose whether to connect automatically.
11.2.3.5 Backup
The Backup function is the only tool to backup and reload the System Configuration and
Image Archive.
A backup can only be started without an exam or reloaded data set being open .
• DVD/CD+R(W)
• Any other drive connected to the system (e.g.; an external USB-hard disk)
Do not disconnect an external USB - device without stopping it. Disconnecting without
stopping can lead to data loss on the external device.
• Image settings
• Auto Text
Note In case software version and user program version are not identical, one of the following
messages will be displayed:
• When loading a Small Backup: "The current user programs are not compatible with this
software version".
• When loading parts of a Small Backup: "The current user programs are not compatible
with this software version. Do you want to load the complete set of user programs?"
This can be solved by loading the latest available backup (Small Backup) which is compatible
with the software version.
• Patient demographic and exam data (database containing the patient data and
measurements)
• Archive image data (NOT available when saving to the internal hard disk or DVD/CD)
• User Settings (databases and files containing gray curves and the user settings.)
• Image transfer settings (DICOM settings e.g., DICOM servers, AE Title, Station Name,
etc.)
• Voluson™ E6 BT15 settings (general settings such as language, time/date format and
the enabled options)
All settings and patient data created since last full system configuration backup are NOT
backed-up! It is highly recommended to create a full system configuration backup of settings
and patient data regularly.
5. Click Next and confirm with Yes to start the backup process.
6. After copying the data, confirm the next message with OK to reboot the system.
Remark • It is possible to store more than one backup on a destination. The backups reside in
subfolders of the main Fullbackup - folder found at the root of the drive (e.g., Z:
\Fullbackup). DO NOT modify this directory structure or any files within, otherwise the
backup data cannot be restored. .
• The Include Images” checkbox is only active, if destination Network Drive or Other drive
is selected.
• If the destination Other drive is selected, the available drives (e.g., external USB-memory
stick) can be chosen from the drop down list.
Note When the backup is saved to an external USB-device, the system has to be informed about
the removal of the hardware. For this purpose every last dialog of Full System Configuration
has a Stop USB Devices button.
There are circumstances where it is not possible to load (restore) all the data. The following
rules specify the restrictions:
1. Generally, only restoring data from an older to a newer software version is possible.
Loading a backup into a system that has a lower software version than the system the
backup was created on is prohibited.
2. Options can only be restored on the same Voluson™ E6 BT15 system within the same
major software version.
3. When loading a backup into a system with a software version that has a higher major
number (10.x.x -> 11.x.x), the following items will not be restored:
• User Settings
• Options
• State of the Service platform (new model type necessary for VOLC)
4. The user is only allowed to restore data to a different system if and only if the software
version on this system is the same as in the backup.
5. The user is only allowed to restore data onto the same system if and only if the software
version on this system is equal or higher than the version in the backup.
6. The user is not allowed to restore the following items to a different system:
• Options
• DICOM AE Title
The data from the backup always replaces the corresponding data on the Voluson™ E6 BT15
system.
5. Click Next again and confirm with Yes to start the restore process.
6. Confirm with Yes.
7. Confirm the next message box to reboot the system.
After copying the data, the system reboots.
4.2. Choose between Patient View and Exam View. Depending on which view you
choose you can select patients or exams to save in your backup. It is also
possible to choose a singular patient or a singular exam.
4.3. • To select or deselect a patient or an exam use the checkbox on the left
side of the screen.
• Use Select All or Deselect All below the information screen to select all
exams or patients or deselect them.
Note It is possible to use the Shift key on the keyboard to select more than one patient!
4.4. After selecting the patients or exams you desire confirm with Next.
8. If you have chosen CD/DVD as your saving destination, a dialogue will appear, asking
you to label your CD or DVD.
9. Confirm with OK.
10. Confirm with Yes and the saving procedure starts.
11. As soon as the saving procedure is finished confirm with OK. You will be returned to the
Image Archive tab.
• Use Select All or Deselect All below the information screen to select all exams or
patients or deselect them.
6. After selecting the patients or exams you desire confirm with Next.
7. Confirm with Yes and the loading procedure starts.
8. As soon as the loading procedure is finished confirm with OK. You will be returned to the
Image Archive tab.
Network Drive
1. Press Util to enter the System Setup.
2. Select Connectivity and then Drives.
3. Press Map Network Drive. A window appears.
4. Choose a network drive and enter either the network IP address or the host name and
folder to connect to.
5. Enter your user name as used to log onto the network destination and the password.
6. Check Automatic Reconnect to automatically reconnect to the network destination on
startup.
Note The image(s) will be deleted after ending the exam. The export dialog appears.
Worksheet/Report
All calculation results are recorded in the application dependent patient worksheets. By
pressing Report on the control panel or touching Report in the Calculation menu, the
Worksheet of the selected Measurement Application is switched on. (Always starts with the
first page of worksheet.) According to the selected measurement application the worksheets
display the results of the calculations, graphs, growth percentile bars and application
dependent information available.
Press Transfer Data to transfer a worksheet to the selected destination.
11.2.4 Presets
Monitor display
Setup
Preset folders and buttons can be moved, deleted, renamed and copied:
1. Select the Setup tab.
2. Select a probe from the drop down list.
The available folders and presets for 2D Mode will be displayed. Make sure that both a
preset folder and button is selected in order to display all available functions. If a volume
probe is selected, also the 3D/4D presets button will be available.
3. Modify folders or presets:
Move
• Select a folder or preset button. Keep the left or right trackball button (Set) pressed
to drag a folder or preset button from one position to another and release the Set
button.
Copy
• Select a folder or preset button. Press the left trackball button (Copy).
• Move the trackball to the desired position and press the left or right trackball button
(Paste).
• If the selected position is used for a different preset, a message window appears
asking if you really want to overwrite the preset or folder. Select No if you don´t
want to overwrite the preset or folder. If you want to overwrite it, you can either
overwrite the complete preset or only settings relevant for scan geometry.
Rename
• Select a folder or preset button. Press the right trackball button (Rename).
• Select a folder or preset button. Press the top trackball button (Cut).
• Move the trackball to the desired position and press the left or right trackball button
(Paste).
Delete
• A message window appears asking if you really want to delete the folder or preset
button.
4. Geometry change:
• Tick the box if the scan geometry should not be changed when changing from one
preset to another in run mode.
Info Select Copy Factory to User if you want to copy the factory settings to the user presets.
Global Parameters
Global parameters can be set for a specific application or for all applications. If parameters are
set, they are used regardless of the selected preset.
1. Select the Global Parameters tab.
2. Select a specific application or select General.
If General is selected, all applications will be affected.
3. Modify the desired parameters by selecting from the drop down lists.
If an option is active on the US-device, it is possible to program the 4D View® dongle to also
enable this option for 4D View®. Programming is done automatically when a dongle is
connected to the system.
The Dongle is valid for following options:
• SonoAVC™
• SRI II (CVIE)
• STIC-M
• HDlive™
• V-SRI
• HII
Conditions defined for the programming process:
• The dongle must be a valid 4D View® dongle. A common Service dongle cannot be
used.
• This programming possibility is only available if the option is active on the device.
11.2.6 Biopsy
11.2.7 Measure
Application Parameters
1. Select an Application and a Preset.
2. Edit the settings as you prefer.
On freeze 2D/3D start Automatically perform selected action when Freeze is pressed in 2D/3D Mode.
On freeze M start Automatically perform selected action when Freeze is pressed in M Mode.
On freeze D start Automatically perform selected action when Freeze is pressed in Doppler Mode.
Vol. Flow Method Use selected parameter for Volume Flow calculation.
Show Author’s Name at Measure Display the name of the author of an OB table beneath the measurement in the
Menu measurement menu.
Ratio orRatio / Graphs Select whether you want to calculate the selected parameters or not.
Calculate Z-Scores based on Select which values are used for calculating the Z-Scores in Application OB – Sub-
Application “Z-Scores”
Global Parameters
Edit the settings as you prefer.
Peripheral Devices
Note Always observe the instructions given in the manual of the peripheral/auxiliary device.
Basic Concept:
The Voluson™ E6 BT15 is equipped with an isolation transformer to provide the required
separation from AC mains for both the system and auxiliary devices. Two power cables for
connecting auxiliary devices are located in the shelves. An additional power cable is located
on the right side of the system and is accessible when the side cover is removed.
The Voluson™ E6 BT15 provides several inputs and outputs (I/O) such as Audio, Video,
Ethernet, USB, DICOM and Printer signals. Special care must be taken when connecting
auxiliary devices via these input and output (I/O) connections.
The IEC 60601 standard provides a guideline for safely interconnecting medical devices in
systems.
Everybody who connects additional equipment to the signal input portion or signal output
portion configures a medical system, and is therefore responsible that the system complies
with the requirements of the system standard IEC 60601. If in doubt, consult the technical
service department or your local representative.
1. The medical device may be connected to a single IEC XXX device (protection class I)
placed in a room which is not medically used.
2. If the device is to be connected in a medically-used room the following rule applies:
IEC XXX Stands for standards such as: IEC 60601 for medical devices IEC 60950 for
information technology equipment etc.
Caution
Possible loss of data during transfer via network from the ultrasound system.
Caution
Please observe that some printers may not be medical devices! If the Bluetooth Printer and /
or Line Printers are no medical devices, they have to be located outside of the patient
environment. Examples for typical patient environments can be found in standard IEC 60601
(see illustrations below).
Caution
• Auxiliary equipment with direct AC mains connection requires galvanic separation of the
signal and / or control leads.
• The sum of the power consumption of auxiliary equipment connected to these outlets
must not exceed 200VA.
• The leakage current of the entire system including any / all auxiliary equipment must not
exceed the limit values as per IEC 60601 resp. other valid national or international
standards. All equipment must comply with relevant UL, CSA and IEC requirements.
Caution
• There is an increased risk of electric shock due to increased leakage current when
peripherals such as a patient monitor, are connected to AC mains directly via a wall
outlet instead of utilizing the isolation transformer.
• There is an increased risk of electric shock due to increased leakage current when
connecting devices not explicitly recognized by the system manufacturer GE Healthcare
Austria GmbH & Co OG to the ultrasound system.
• Only use equipment provided by the system manufacturer GE Healthcare Austria GmbH
& Co OG .
• Color Printer
• DVD Recorder
• ECG Module
• Footswitch
• Isolation Transformer
• USB Stick
• WLAN Stick
• Cellular Modem
There are two connectors for auxiliary equipment in the shelves of the respective auxiliary
equipment.
The outlet voltage is set to 115V~ independent from the supply mains voltage.
For more information see 'External Inputs and Outputs' on page 13-36.
12.3.4 Monitor
For more information see ' User Connectivity (direct access)' on page 13-36.
To use this feature a standard SIM card is needed with the following requirements:
• data capable
• standard size
• PIN dis-/enabled
• prepaid or postpaid
2. Put in the SIM card as shown in the pictures below, fix it with the mounted clips and
return the upper cover.
12.4 DVD/USB/SW-DVR
Note The SW-DVR is an option.
It is possible to record US data on DVD, USB or SW-DVR. The created DVD includes an
automatically generated menu with chapters and can be played with a standard DVD-player.
The external USB-Port has to be activated in the System Setup to play and record from / to a
USB-device. Videos are created in .mp4 file format.
If both DVD and USB devices are available, always the last used media is used for new
recording.
DVD/DVR Menu
To open the DVD/DVR menu press DVD/DVR. A P-button can be configured in the System
Setup for Recorder Control.
Format Formats the DVD and then ejects it. All data is removed from the disc.
Finalize Starts the finalization process required for viewing the DVD on most DVD players.
FF Searches forward.
Messages
A progress bar and different messages can appear. Possible messages are:
• DVR: formatting
• disc full
DVR Icons
Depending on the DVR/USB mode different icons can be displayed:
The full info display contains the number of titles on the disc, the number of titles to finalize (if
available) and the remaining time to record.
Following media is supported:
1. Video:
• DVD + RW
• DVD - R
• DVD - RW
• DVD + R
2. USB:
• USB stick
Note If more than one USB media is connected, a dialog listing all available devices appears. The
desired record destination can be selected.
Data burning
1. Insert a CD or DVD.
2. Export files from the Archive or save a Backup and select the DVD/CD Drive as storage
device.
3. Click Save. The data burning process starts.
4. To eject the CD or DVD press F4 on the keyboard or Eject on the touch panel.
3. Select DVD and Format to prepare the inserted media for recording.
4. To start and pause recording press the programmed P-button or use the according DVR
Menu controls.
5. To finish recording open the DVR Menu and press Stop on the touch panel.
6. To eject the DVD press F4 on the keyboard or Eject on the touch panel.
Info Finalizing the inserted media is necessary to play the recorded video on a consumer DVD-
Player. It will automatically be started at: Shutdown, Eject and switch to USB record mode.
5. To finish recording open the DVR Menu and press Stop on the touch panel.
6. To eject the USB stick press F4 on the keyboard or Eject on the touch panel.
Note A minimum writing speed of 2 MByte / sec is required to ensure stable video recording on USB
devices. Lower writing speed can result in audio and / or video drop-outs.
The use of USB3.0 devices is recommended.
• Videos are recorded in MPEG2 standard: DVDs are playable on the following devices:
○ PC (MPEG driver required) with Windows Media Player
• For large backup data (Voluson format uncompressed, Full Back-Up) it is recommended
to use an external USB hard disk
• The ECG preamplifier is not intended for ECG diagnosis. It must not be used for an intra-
operative procedure of the heart.
• Only the patient cable supplied by GE Healthcare Austria GmbH & Co OG , and only
recommended electrodes must be used.
• Take care that neither bare parts of one of the three electrodes nor the patient comes
into contact with conductive parts (e.g., metal parts of the examination bed, trolley, or
similar).
• The ECG module consists of an ECG preamplifier (hardware part) and a patient
connection cable (NORAV, Code C3-C-E-ODU or LHI, Code LHGEAU-01).
• The 3 ECG electrodes form the applied part which are in electrical contact with the
patient, classified as CF applied part.
• The connector of the patient connection cable is on the front cover of the hardware
section, which is placed in a drive-slot in the front of the ultrasound machine.
• The ECG preamplifier is used for acquiring an ECG signal to be displayed with the
ultrasound image. The ECG preamplifier must not be used for ECG diagnostics. It is not
intended for use as a cardiac monitor.
• The simultaneous use of stimulation current devices can influence the ECG signal.
• If several instruments are simultaneously used on the patient, all instruments must be
connected to an appropriate potential equilibrium (avoidance of lead currents).
• When using a defibrillator while having the ECG connected, also always refer to the
defibrillator's user manual.
12.5.2 Handling
Press Util and the select ECG. The ECG menu appears on the touch panel.
• Position, speed and amplitude of the displayed ECG strip can be altered in the ECG
menu on the touch panel of the ultrasound machine.
• With the patient cable belonging to the ECG preamplifier only electrodes for push-button
connection can be used. Depending on requirements, commercially available extremity
clamp electrodes together with conductive gel or commercially available pre-jelled
adhesive electrodes can be used, preferably the latter should be used.
• With standard setting of the electrodes (red = right arm, yellow = left arm, black = left leg)
lead I is displayed. Other electrode arrangements may be necessary (lead II, III), if
amplitude supplied by lead I is too small.
1. Adjust the transmission gain of the ECG preamplifier signal (0, 1, 2, 3).
2. Select ECG velocity (0, 1, 2, 3).
3. Set the vertical position on the monitor.
4. Adjust ECG amplitude ( 0 to 100 in 10 steps).
5. Return to the main menu. The ECG function remains active.
6. Freeze the image. The most recent information is always on the right edge of the image.
When moving the trackball a indicator (small vertical line) is inserted on the ECG curve and
indicates the temporal position of the 2D image in relation to the recorded ECG line. In this
manner e.g., diastolic or systolic phase of the 2D mode image can be set (without ECG
trigger).
Remarks:
• On the screen the ECG curve starts running from left to right if scan mode is active.
• The most recent information is always on the right edge of the image.
• The green ECG line indicates to which image the trigger mark is related.
• The ECG preamplifier is an integral part of the ultrasound scanner unit. The system may
only be operated in places that go conform with the rules for medically used locations.
• The power cable of the ultrasound scanner system must not be connected to a damaged
socket. The socket must be equipped with a grounded conductor. If necessary a
potential equilibrium must be connected.
• Only the patient cable provided by GE Healthcare Austria GmbH & Co OG may be used.
Consequently, only push-button electrodes may be used.
• Take care that neither bare parts of one of the electrodes nor the patient can get in
contact with conductive parts (e.g., metal parts of the examination bed, trolley, or
similar).
• This device must not be used for an intra-operative procedure on the heart.
• If the use of a HF surgical unit with simultaneous connected ECG electrodes becomes
necessary, a maximum distance of ECG-electrodes from the surgical field and a correct
position and contact of the neutral electrode of the HF surgical unit must be observed
(avoidance of burning risk).
• Note that stimulation current devices can influence the ECG signal.
• If several instruments are simultaneously used on the patient, all these instruments must
be connected to an appropriate potential equilibrium (avoidance of lead currents).
• When used with the appropriate ECG cable, the ECG is protected against the effects of
cardiac defibrillator discharge.
• Conductive parts of electrodes and associated connectors for applied parts including the
neutral electrode should not contact other conductive parts and earth.
Note Follow the User Manual of the defibrillator. Do not touch the patient during defibrillation.
• Electrodes and the cables should be handled with the usual care. Refer to
manufacturer’s instructions in concerns of cleaning and maintenance.
• The ECG preamplifier does not require special maintenance but should be handled with
care.
• Do not perform any changes or repairs on the ECG preamplifier, the connecting cables
or the patient cable. A damaged patient cable must be replaced.
Conformance details
Safety classification: Class I, applied parts type BF acc. to IEC60601 incl. national deviations
Safety classification with ECG Class I, applied parts type CF acc. to IEC60601 incl. national deviations
Ambient temperature: • 18ºC to 30ºC resp. 64ºF to 86ºF (operation temp. of instrument)
Maximum operating altitude: 4000m; depending on the properties of the connected electronic devices the maximum
operating altitude is limited to the altitude stated in the corresponding user manual of
the connected electronic device
Pollution degree: 2
Overvoltage category: II
Light conditions Natural & artificial light source (Bright light could impact readability of screen)
Serial number
Position: Rear side of the system on the identification plate.
Rating plate
Examples:
Symbols
For more information see 'Description of symbols and labels' on page 2-2.
Mains outlets: • Accessories: all mains outlets are co-switched by the system mains switch via a
built-in isolation transformer
• Output power max: power of all connected accessories must not exceed 200VA.
Recording keys: Integrated for remote control of up to 4 Peripherals or DICOM devices, one dedicated
DVD recording key
Gel Holder: 2
Peripherals: On-board storage for peripherals: e.g. Black/white printer, color printer
Wheels: Wheel diameter 150 mm, integrated locking mechanism that provides rolling lock
13.2.4 Monitor
Flat panel monitor: 23” high-resolution LCD LED Display with DVI Interface
Brightness adjustable
• GYN
• Vascular
• Cardio
• Abdominal
• Small-Parts
• Transrectal
• Pediatrics
• MSK
• Cephalic
• Electronic Convex
• Electronic Linear
• Convex Array
• Linear Array
• PW Doppler Mode
• CW Doppler Mode
• XTD-Mode
• Elastography
• Dual (2D*+2D*)
• Quad (2D*+2D*+2D*+2D*)
• Sect. Planes: quad (A/B/C), dual (A/B, A/C, Ref/Any Plane), single (Ref)
• XL format
• MM/DD/YYYY
• DD/MM/YYYY
• YYYY/MM/DD
• 24 hours
• 12 hours
Probe Name
Frame Rate
Zoom Factor
• Receiver Frequency
• Acoustic Power
• Gain
• Dynamic Contrast
• Gray Map
• Edge Enhance
• Persistence
• SRI, CRI
M-Mode/AMM-Mode: • Gain
• Dynamic Contrast
• Edge Enhance
• Reject
• M-Cursor, AMM-Cursor
• Time Scale
• Gain
• Angle
• Spectrum Inversion
• Time Scale
• PRF
• HPRF
• Doppler Frequency
• Color Balance
• Quality
• PRF
• Color Map
• Spectrum Inversion
• Threshold
• Quality
• Mix
• Acquisition Mode
• Compression
• Orientation Markers
• SonoVCAD™
• Tx Frequency
• Transparency
• Elasto Map
• Persistance
• Line Density
• Velocity Range
TGC Curve
Recorder Status
Measurement Results
• Power output
ECG Line
GE Logo
• M (Conventional M)
• PW
• B-Flow
• Static 3D Mode:
○ B Mode only
○ B + Power Doppler Mode
○ B + CFM Doppler Mode
○ B + HD-Flow™ Mode
○ B + CRI
○ B + CRI + CFM
○ B + CRI + PD
○ B + CRI + HD-Flow™
○ Contrast (dependent on contrast option)
○ B-Flow (dependent on B-Flow option)
• Automatic Tissue Optimization
• XTD
• Pan Zoom
• Steering
• Virtual Convex
• Wide Angle
• Beta-View
• Inversion
• max 800 terms with 24 characters; 80 terms (four pages) for each package, 10
packages available
Volume Calculation II (VOCAL II) Can be used for 3D and with the additional Option Advanced
4D also for 4D
HDlive™ N/A
CW N/A
SonoAVC™ Can be used for 3D and with the additional Option Advanced
4D also for 4D
SonoVCAD™heart Can be used for 3D and with the additional Option Advanced
4D also for 4D
SonoVCAD™labor Can be used for 3D and with the additional Option Advanced
4D also for 4D
Languages: English, French, German, Spanish, Italian, Danish, Dutch, Finnish, Norwegian,
Swedish, Chinese, Japanese, Russian
Free programmable Scan including Add, Delete, Edit and Reorder of checklist items
assistant lists
Four programmable Px Save, DICOM Send, Print, Check, Cine length etc.
buttons for documentation
preferences
User presets:
Max. 8 user programmable preset folders per probe, each folder can contain max. 8
presets.
Max. 64 presets per probe.
M&A Setup including Add, Delete, Edit and Reorder of measure items
Package Setup including several parameters of Measurement, Doppler Trace and Calculation presets
Global Setup including several parameters of Measurement, Cursor and Result window presets
13.9.5 Pre-Processing
PW-Mode Gain
Dynamic Range
Acoustic Output
Transmission Frequency
PRF
Wall Motion Filter
Sample Volume Gate
Length, Depth, Pos
Velocity Scale
Sweep Speed
13.9.6 Post-Processing
B-Mode Read Zoom: 0.8x - 3.4x Zoom (with HD-Zoom functionality up to 22x Zoom )
2D Gain
Dyn. Contr.
Edge Enhancement
Gray Map
Colorized B
SRI II (Speckle Reduction Imaging)
BF Gray Map
Colorized BF
SRI II (Speckle Reduction Imaging)
Dyn. Contr.
Digital Beamformer
Gray 256
• Selectable CINE Sequence for CINE Review (by Start Frame and End Frame)
• typical: about 3min/4000 images (with curved array: 15cm depth, angle 81˚, 22
FPS)
Review: • Review of current Exam and archived data sets (Single Images and Cine Clips)
• Raw files: RAW (2D), VOL (Volume data), 4DV (RAW, VOL incl. Patient data)
Export Anonymous function: available for the following image types: AVI, MOV, BMP, TIFF, JPEG
Repro function Settings recall (e.g. Geometry, Gain, Colormap, etc.) from a stored or reloaded picture
• Image compare window on screen to compare images from previous exams with
current exam image
13.9.10 Connectivity
13.10.1 B-Mode
Tint maps: 9
13.10.2 M-Mode
• 26.44 / 13.22 / 8.81 / 6.61 / 4.40 / 2.94 cm/s in relation to system monitor
• Reject: 0 to 255
• Enhance: 0 to 5
• Gray maps: 18
• Tint maps: 9
Screen formats:(window • 2D+M and 2D+AMM: up/down (horizontal): three different sub formats 30/70, 50/50,
arrangement) 70/30%; left/right (vertical): 50/50%
13.10.3 M-CFM-Mode
• T (Turbulence)
• + 15 to -15dB (CW)
Spectrum Analyzer: FFT (Fast Fourier Transformation) max. 256 channels, 256 amplitude levels
PW sweep speeds: • Simplex (26,44 / 13.22 / 8.81 / 6.61 / 4.40 / 2.94 cm/s)
• Tint maps: 9
Screen formats: • 2D/D: up/down (horizontal): three different sub formats 30/70, 50/50, 70/30% left/
right (vertical): 50/50%
• Display modes:
○ V -T (velocity + turbulence)
○ V (velocity)
○ V-P (velocity + power)
○ T (turbulence)
○ P-T (power + turbulence)
Depth range: • axial: 0 to B scan range
Wall Motion Filter: 7 steps (low1, low2, mid1, mid2, high1, high2, max)
Frequency range: 1 to 18 MHz depending on the probe, adjustable in 3 steps (low, mid, high)
13.10.6 Power-Doppler
Wall motion Filter: 7 steps (low1, low2, mid1, mid2, high1, high2, max)
PD Ensemble: 7 to 31
Frequency range: 1 to 18 MHz depending on the probe, adjustable in 3 steps (low, mid, high)
Wall Motion Filter: 7 steps (low1, low2, mid1, mid2, high1, high2, max)
HD-Flow™ Ensemble: 7 to 31
Frequency Range: 1 to 18 MHz depending on the probe adjustable in three steps (low, mid, high)
• lateral: 0 to B-scan-range
Frequency range: 1 to 18 MHz depending on the probe, adjustable in 3 steps (low, mid, high)
• The required memory space depends on scan parameters (VOL-box size and
quality (low, mid1, mid2, high1, high2, max). typical: 0.8-5 MB
• The frame rate depends on scan parameters: VOL-Box size, quality and probe.
Display of sectional plane synchronous with control setting, arbitrary movement in volume, monitored position in
images: volume.
Gray maps: • Slices: 21 (18 basic curves and 3 User-defined (pre, post)
• 3D Image: one general map adjustable with Low Tones (-50 bis+50) & High Tones
(-50 to +50)
• 3D image: 9
13.10.10 BF (B-Flow)
Display modes: • BF
• Update: BF/PW
Tint maps: 9
Background: 0, 1, 2
Tint maps: 9
Background: 0, 1, 2
Screen formats: • Code PI: Single (B), Dual (B+B), Quad (B+B+B+B)
13.10.12 Elastography
Tx Frequency 3 (penet/norm/resol)
Elasto Maps 8
• Dual (2D/Elasto+2D/Elasto)
• Quad (2D/Elasto+2D/Elasto+2D/Elasto+2D/Elasto)
2D Mode and 3D: Distance: Distance (Point to Point), Distance (Line to Line), 2D Trace (Trace
Length&Point), Stenosis (% Dist), Ratio D1/D2
Area/ Ellipse, Trace (Line & Point), Area (2 Dist) Stenosis (% Area), Ratio
Circumference: A1/A2
PG PGmax, PGmean
13.11.2 Calculations
Abdomen: Liver, Gallbladder, Pancreas, Spleen, Left/Right Kidney, Left/Right Renal Artery, Aorta
(Proximal, Mid, Distal), Portal Vein, Vessel, Bladder Volume, Bladder
all included in Summary Reports
Small Parts: Default Left/Right Thyroid, Left/Right Testicle, Vessel, Left/Right Dorsal Penile Artery
all included in Summary Reports
Obstetrics: 2D: Fetal Biometry, Early Gestation, Fetal Long Bones, Fetal Cranium,
AFI, Uterus, Left/Right Ovary, Left/Right Uterine, Umbilical Vein, Fract
Limb Vol. , NT method: auto/manual, Placenta Volume
Doppler: Ductus Art., Ductus Ven.,Ao, Carotid, MCA, Celiac Artery, Superior
Mesenteric Artery, Umbilical Art., Umbilical Vein, Uterine Art., FHR
Gestational Age Calculation, Gestational Growth Calculation, Fetal Weight (FW) Estimation,
Fetal Trend Graph, Multi-Gestational Calculation & Fetal Compare, Calculation and Ratios,
Fetal Qualitative Description (Anatomical survey), Fetal Environmental Description
(Biophysical profile);
all included in Summary Reports
Obstetrics: Z-Scores Calculation of Z-Scores for: Long Axis, Aortic Arch, Short Axis, Obl. Short Axis, 4 Chamber;
all included in Summary Reports
Cardiology: 2D Mode: LV Simpson (Single & Bi-Plane), Volume (Area Length), LV-Mass (Epi
& Endo Area, LV Length), LV (RVD, IVS, LVD, LVPW), LVOT
Diameter, RVOT Diameter, MV (Dist A, Dist B, Area), TV (Diameter),
AV/LA (Aortic Valve/LeftAtrium), PV (Diameter)
M Mode: LV (IVS, LVD, LVPW, RVD), AV/LA (Ao Root Diam, LA Diam, AV
Cusp Sep., Ao Root Ampl.), MV (D-E, E-F Slope, A-C Interval, EPSS),
HR (Heart Rate), HR (HR, Atrial HR)
Transrectal: Prostate
all included in Summary Reports incl. PSAD, PPSA(1), PPSA(2) calculation
LEA: COM ILIAC A, EXT ILIAC A, INT ILIAC A, COM FEM A, DEEP FEM
A, SUP FEM A, POPL A, ANT TIB A, POST TIB A, PERON A, DORS
PED A, GRAFT, PROF A
LEV: IVC, COM ILIAC V, EXT ILIAC Vein, COM FEM, GSAPH V, FEM V,
DEEP FEM V, POPLIT V, L SAPH V, ANT TIB V, POST TIB V,
PERON V, PROF V
Gynecology: Uterus, Right/Left Ovary Right/Left Follicle, Fibroid, Endometrial thickness (Dist., Double
Dist), Cervix Length, Left/Right Ovarian Artery, Left/Right Uterine Artery, Vessels, Pelvic
Floor, FHR, IOTA LR2 Model (Ovary Measurement diagnostic’ tool)
all included in Summary Reports
Cephalic: Left/Right ACA (Anterior Cerebral Artery), Left/Right MCA (Middle Cerebral Artery), Left/
Right PCA (Posterior Cerebral Artery), Basilar Artery, A-Com. A (Anterior Com. Artery), P-
Com. A (Posterior Com. Artery), Left/Right CCA (Common Carotid Artery), Left/Right ICA
(Internal Carotid Artery), Left/Right Vertebral Artery, Vessels;
all included in Summary Reports
MSK: none
13.11.3 OB Tables
"Age" tables:
AD Persson
APAD Merz
APTD Hansmann
BOD Jeanty
BPD ASUM, Campbell, CFEF, Chitty (outer-outer) (outer-inner), Eik-Nes, Hadlock_82, Hadlock_84,
Hansmann, Hobbins, Jeanty, Johnsen, JSUM, Kurmanavicius, Kurtz, Leung, McLennan, Merz,
Nicolaides, OSAKA, Persson, Rempen, Sabbagha, Shinozuka, Siriraj, Tokyo, Verburg
CLAV Yarkoni
CRL ASUM, DAYA, Eik-Nes, Hadlock, Hansmann, JSUM, McLennan, Nelson, Persson , OSAKA,
Rempen, Robinson, Robinson_BMUS, Sahota, Shinozuka, Tokyo, Verburg
FIB Jeanty
FL ASUM, CFEF, Chitty, Eik-Nes, Hadlock_82, Hadlock_84, Hansmann, Hobbins, Hohler, Jeanty,
Johnsen, JSUM, Kurmanavicius, Leung, Persson, Merz, Nicolaides, O´Brien, OSAKA,
Shinozuka, Siriraj, Tokyo, WARDA
FTA Osaka
LV Tokyo
TTD Hansmann
"Growth" tables:
AD Persson
AFI Moore
APAD Merz
APTD Hansmann
AVOL Lee
APTDxTTD Shinozuka_SD
BOD Jeanty
BPD ASUM, Campbell, CFEF, Chitty, Eik-Nes, Hadlock, Hansmann, Jacot-Guillarmod, Jeanty,
JSUM, Kurmanavicius, Lai_Yeo, Lessoway, Leung, McLennan, Merz, Nicolaides, Persson,
OSAKA, Sabbagha, Shinozuka, Siriraj, Stork, Tokyo, Verburg, MEDVEDEV
CLAV Yarkoni
CM Nicolaides
CRL ASUM, Hadlock, Hansmann, JSUM, McLennan, OSAKA, Persson, Pexsters, Robinson,
Robinson1993, Shinozuka, Tokyo, MEDVEDEV
DV a/S JSUM
DV PI Baschat, JSUM
DV PLI: Baschat
DV PVIV Baschat
DV S/a Baschat
FL ASUM, CFEF, Chitty, Eik-Nes, Hadlock, Hansmann, Jacot-Guillarmod, Jeanty, Johnsen, JSUM,
Kurmanavicius, Lai_Yeo, Lessoway, Leung, Persson, Merz, Nicolaides, O´Brien, OSAKA,
Shinozuka, Siriraj, Stork, Tokyo, Verburg, WARDA, MEDVEDEV
FOOT Chitty
FTA Osaka
LV Tokyo
MCA CP Ebbing
MCA PV Mari
MV E/A HARADA
SAG. AP Malinger
SAG. CC Malinger
TC Chitkara
TTD Hansmann
TV E/A HARADA
TVol Lee
UtArt PI Merz
UtArtRI Merz
Vermis A Malinger
Vermis C Malinger
AC Campbell
AC, FL Hadlock 1
Avol Lee
Tvol Lee
Alexander, Ananth, Bourgogne, Brenner, CFEF, Doubilet, Eik-Nes, Hadlock, Hansmann, Hansmann (86), Hobbins/
Persutte, Johnsen, Jsum 2001, Kramer, Persson, Osaka, Shinozuka, Tokyo, Williams, Yarkoni
Fetal Ratios
CI (BPD/OFD) Hadlock
FL/AC Hadlock
FL/BPD Hohler
FL/HC Hadlock
HC/AC Campbell
Vp/Hem Nicolaides
LHR Peralta
LTR
CVR Peranteau
• Standard S-Video
• Resolution: SXGA
13.12.3 Peripherals
13.12.4 Drives
• 40x CD-ROM
• DVD+RW: 8x
• CD-R: 40x
• CD-RW: 32x
Symbols used:
CAUTION! Review user manual for proper operation! (Improper use may cause damage.)
ECG symbol
Glossary- Abbreviations
Abbreviation Designation
AC Abdominal Circumference
ACC Acceleration
AD Abdominal diameter
AV Aortic Valve
Abbreviation Designation
B-Flow B-Flow
Abbreviation Designation
Abbreviation Designation
CE Coded Excitation
CI Cephalic Index
CLAV Clavicle
CM Cisterna Magna
CO Cardiac Output
Abbreviation Designation
d Diastole (diastolic)
DEC Deceleration
DORS PED A lat. arteria dorsalis pedis = engl. Dorsal pedis artery
Abbreviation Designation
Dur Duration
Abbreviation Designation
EF Ejection Fraction
Abbreviation Designation
FL Femur Length
FS Fractional shortening
FW Fetal Weight
Abbreviation Designation
GA Gestational Age
GP Growth Percentile
GS Gestational Sac
Abbreviation Designation
HC Head Circumference
HEM Hemisphere
HI Harmonic Imaging
HR Heart Rate
HL Humerus Length
Abbreviation Designation
Abbreviation Designation
Abbreviation Designation
LV Length of Vertebra
LV Left Ventricle
Abbreviation Designation
MI Mechanical Index
MV Mitral Valve
Abbreviation Designation
NF Neck Fold
NT Nuchal Translucency
Abbreviation Designation
Abbreviation Designation
PD Power Doppler
PG Pressure Gradient
PI Pulsatility Index
PV Pulmonary Valve
Abbreviation Designation
Regurg Regurgitation
Abbreviation Designation
Renal renal
RI Resistivity Index
RT Real Time
Abbreviation Designation
s Systole (systolic)
SD Standard Deviation
SL Spine Length
Subclav subclavian
SV Stroke Volume
Abbreviation Designation
TD Tissue Doppler
TI Thermal Index
Abbreviation Designation
TV Tricuspid Valve
Abbreviation Designation
ULNAR Ulnar
Abbreviation Designation
Verteb Vertebral
Abbreviation Designation
Abbreviation Designation
YS Yolk Sac