Mindray Imagyn I9 Operator’s Manual

on the touch screen. See “1.2 Measurement Menu”

3. A performed application item/tool is marked with a

“√.”

(If one or some items in a submenu (extended menu) of a study are already performed, this study will be marked as measured.)

To Activate the Measurement Tool

The procedure is as follows:

Overview 1-5

1. Select the tool:

 Move the cursor onto the tool on the measurement menu and press <Set>.

 Or, touch the item on the touch screen or mapping menu to select the tool.

 Or, use the two-finger gesture for details.

2. Perform the measurement according to the actual situation.

3. After finishing the measurement, perform the necessary operations.

Select Measurement Method

Select directly from the touch screen.

Edit Caliper

Tap [Edit]. Select the measurement caliper. Move the pointer of the measurement caliper. The measurement is updated in the result window.

1.2.3 Mode Switching

Touch the mode tab to switch to other measurement menus available for other modes.

1-6 Overview

1.2.4 Measurement Library Switching

During application measurement, rotate the knob under [Library] on the touch screen to select from the available measurement libraries under the current probe of the current exam mode.

Available measurement libraries can be preset. See “2.4.2.2 Measurement Package Preset”

chapter for details.

1.3 Measurement, Calculation and Study

There are three kinds of measurement items.

Measurement

Results of measurements are directly obtained via the measurement tools, which are indicated by

“ ” in the preset screen ([Setup] -> [Measure]).

For example, “Distance” in the 2D general measurement or “HC” in the OB measurement.

On the touch screen, measurement tools are displayed using square button.

Calculation

Results of calculations are automatically derived by the system using other measured or calculated values as parameters, they are indicated by “ ” in the preset screen ([Setup] -> [Measure]).

For example, EFW (Estimated Fetal Weight) in the OB measurement.

If all measurements related to a calculation tool are completed, the system will automatically calculate the result. If some measurement tools are performed again, the system will automatically update the calculation result using the latest measurement results.

On the touch screen, calculation tools are displayed using square button.

Study

A group of measurements and/or calculations for a specific clinical application, which are indicated by “ ” in the preset screen ([Setup] -> [Measure]).

For example, AFI in the OB measurement.

Fold/unfold the study to hide/show the measurement or calculation items included.

On the touch screen, study items are displayed with an arrow indicating the tools to be selected.

1.4 Measurement Caliper

A measurement caliper is a graphic consisting of several points and a straight line or curve drawn on the ultrasound image.

Fixed/Active End

The ends of calipers can be active or fixed. The active end is called a Cursor.

Caliper Color

An active caliper appears green, while a fixed one appears white in the system default preset.

Overview 1-7

Caliper End Symbols

8 symbols are used as caliper ends, as shown in the figure below.

These symbols display in calipers as well as in the results window to identify different measurements.

NOTE: You can preset the cursor type in [Setup]->[System Preset]

→

[Application], see “2.2

Measurement Parameters Preset” for more information.

1.5 Results Window

The measurement window displays the conducted measurement’s result and the engaging measurement in real time.

1.5.1 Results Display

Select [Hide] on the touch screen and the latest results display in the results window in time sequence.

When viewing the results:

 If the results window is full, the oldest value will be replaced according to the “first in, first out” rule.

A maximum of 16 results can display in the results window and a maximum of two graphical results windows can display in the screen.

 To identify the measurement results, symbols or numbers are used in the numerical results window (B-histogram, B-profile) while “No:1” or “No:2” is used in the graphical results window.

The results can display as follows:

 No result displays when a measurement item/tool is activated but without the start point fixed.

 The result displays as digits when the value obtained is within the clinical range.

 The result displays as “?” when it is out of the ultrasonic range.

1.5.2 Moving the Results Window

To move the results window,

1. Place the cursor on the results window title and press <Set>.

2. Rotate the trackball to place the results window in the desired position.

3. Press <Set> to fix the results window.

1.5.3 Results Window Assignment

An application measurement result can be assigned to a general measurement item from the results window. The application item can be an existing item in the system or a new user-defined one.

Assigning an Existing Application Item

The procedure is as follows:

1. Move the cursor to a general measurement value in the results window. Press <Set> when the item is highlighted in green and the matching list appears as shown below.

1-8 Overview

Application items that meet the following requirements are displayed:

 Contained in the current application package.

 The item to be assigned and the assigner should use the same general measurement tool for the result.

Application items in the current measurements that use the “Distance” method are listed as shown above.

2. Select an application item from the list, then press <Set>.

3. The assigned value displays in the results window and is saved in the exam report.

Assigning a New Application Item

When no (desired) item displays in the matching list, you can create a new application item. The procedure is as follows:

1. Select [new] at the bottom of the matching list.

2. The following dialog box appears.

Type in the new name.

3. Click [OK] to assign the general result to the new item.

NOTE: Re-assignment for the assigned general result is not available.

Exiting Result Assignment

Press <Esc> on the keyboard, or select [Cancel] in the matching list to exit.

Auto-Spectrum Calculation Assignment

Like a general measurement result, you can assign the auto-spectrum calculation results to an application item, using the same steps as described above.

For details about auto-spectrum calculation, see “3.4.5 D Trace.”

NOTE: The application item to assign should be an item using D trace in the current application package.

Overview 1-9

1.6 Cross-window Measurement

For linear probing, cross-window measurement is available in dual-B mode when the left and right windows are imaging with the same probe, depth and invert mode.

Under Free Xros M mode (option), you can perform cross-window measurement of time and HR.

1.7 Report

The report records measurement results, which are automatically saved by the system after each measurement.

 Click [Report] on the touch screen to enter the report dialog box.

 The default report of the current exam appears.

 After viewing, press <Freeze> or <Esc>, or select [Report], [Cancel] or [OK] to exit the report page.

1.7.1 Viewing Reports

Items on the report page are described as follows:

 Each measurement contains the 3 or 6 latest values and a final value.

 The report only displays results of tools that are displayed in the report template by default and are completed, as shown in the figure above.

 Select [Previous] or [Next] to switch between pages if the report has more than one page.

1.7.2 Editing Reports

Available report editing operations are:

1-10 Overview

 Editing measurement data

 Entering ultrasound remarks

 Selecting images

 Adding anatomy images

 Save/load report

 Analyzing report data

Editing Measurement Data

CAUTION:

Input appropriate data when editing the measurement values, otherwise misdiagnosis may occur.

 The 3 or 6 measurement values in the text boxes are editable. Move the cursor to the text box and press <Set>.

 The modified value(s) is/are underlined.

 The final value displays in the [Value] column. Select an option ([Last], [Avg.], [Max.] or [Min.]) from [Method] to determine the method in which the final value is calculated.

 For result values used to calculate GA (Gestational Age) and SD (Standard Deviation), the formula used in this calculation can be selected from [Formula]. The GA and SD values update with the formula change.

NOTE: 1. Only measurement values are editable while calculation values are not.

2. After a measurement value is modified, the average value of the tool and the corresponding calculation value will be updated automatically.

Entering Ultrasound Remarks

In the [Comments] box, enter the corresponding information.

You can also save or load the comments.

 Save comment: enter information in the Comments box and then touch [Save Comment] on the touch screen to save current information in the report comment database.

 Load comment: touch [Load Comment] on the touch screen to open the dialogue box to check history saved comment information. You can select related information to add to current report comment or select the location of the comments.

Selecting Images

Images saved for the current exam can be added to the report.

1. Click [Add Picture] on the report page to bring up the following dialog box.

Overview 1-11

Left Column: Images saved for the current exam.

Right Column: Images selected to add to the report.

2. Select the image. a) Add/Remove the image by pressing:

[>]

[>>] to add the selected image in the left column to the right column. to add all the images in the left column to the right column.

[<]

[<<] to remove the selected image from the right column. to remove all images from the right column. b) Adjust the image arrangement.

Select an image in the right column and click [Move Up] or [Move Down] to adjust the sequence in which the images are arranged in the report.

3. Click [Exit] to confirm.

1-12 Overview

V-Mapping

The V-Mapping function is used to display various types of vascular anatomical graphics under the image scanning status. You can draw graphics, mark lesion position and types, and print graphics.

 Entering V-Mapping under report status

OB, EM OB, IVF, Stress Echo and LV analysis reports do not support this function.

1. Touch [V-Mapping] on the touch screen or click [V-Mapping] on the main screen. The dialog box appears.

Available items: the graphic saved in the current exam can be added to the report.

Selected items: the selected graphic will be added to the report.

2. Select the graphic

Adding/ Removing the image with:

Adding the selected graphic.

Adding all optional graphics to the selected items.

Removing the selected single graphic.

Removing all added graphics.

Adjusting the graphic’s sequence.

Select a graphic from the selected items. Click [Move Left] or [Move Right] to adjust the graphic sequence in the list.

The sequence of the graphic in the bottom column is that of the graphics in the report.

You may customize the anatomical graphic and import it to the report. Display effect of

480*640 works best.

3. Tap Right/Left or Prox/Mid/Dist/None. Select the measurement to be added to the anatomical curve (see the figure below).

Overview 1-13

4. When measuring the results of the anatomical curve, the measurements appear on the curve.

5. Select the painter color, and draw on the right anatomical area manually.

6. Click [Save] to add anatomical picture.

 Entering V-Mapping directly through the touch screen

It is only available under the vascular exam mode.

In both real-time and freeze modes, you can directly touch [V-Mapping] on the touch screen in

B/Color/Power imaging modes. In this case, the main screen remains the same as the imaging screen, and the touch screen enters the anatomical editing status. The operation of the touch screen is the same as that of the V-Mapping entered under report status.

Save/Load Report

After the report template is edited, the history report archived in the system will change at the same time. The user may print or export the current report to make a copy in advance.

 Save report

1. Under report status, touch [Save Report] on the touch screen or click [Save Report] on the main screen to bring up the following dialog box.

1-14 Overview

2. Select “Local” and click [Save] to save the information of the current report. You can click

[Load Report] to export or print the report.

Note: The function is disabled for anonymous patient.

 Export report

1. Under report status, touch [Save Report] on the touch screen or click [Save Report] on the main screen to bring up the above dialog box.

2. Select “Other Medium” and click [Save] to see the following dialogue box, you can export the report directly.

Reports can be exported as PDF documents, which can be viewed and edited on a PC.

3. Select the drive and directory.

4. Enter the filename for the report to export and select the file type.

5. Select the file type.

6. Click [OK] to confirm.

Create, delete or rename the directory by pressing:

[New]:

[Delete]:

[Rename]:

To create a new template.

To delete the selected directory. Make multiple selections using the

<Shift> and <Set> keys.

To rename a selected directory.

Overview 1-15

Analyzing Report Data

You can preset and edit anatomy information in the report.

1. Touch [Analyze] on the touch screen or click [Analyze] in the main screen.

2. Select or enter anatomy descriptions.

Tip: Descriptions of [Fetus Score] can only be selected from the drop-down list.

Use the [Previous]/[Next] buttons to switch between pages.

3. Click [Save] to confirm. Analysis information displays after the measurement values in the report.



See “1.7.6 Report Setting” chapter for details about analysis result print setting.

Signature

Fill in the signature after completing the report.

1. Tap [Signature] on the touch screen or click [Signature] on the main screen. Draw the signature information on the touch screen. Tap [OK] to save the information.

2. Print or preview the report to view the signature information.

1.7.3 Viewing History Reports

If more than one exam is performed for a patient, an [Exam] drop-down list appears in the top-right part on the report.

1. Select previous exams from the [Exam] drop-down list.

2. According to the exam mode, select a proper template from the [Report Type].

Make sure the template matches the exam mode, otherwise the measurement result will not display correctly. E.g. an abdomen measurement result will not display in an OB report template preset without any abdomen measurement items.

3. View the history report.

NOTE: 1. History reports can be viewed, but cannot be edited.

2. The patient's information can also be viewed in iStation, see “Patient Data

Management” in the Operator's Manual [Basic Volume] for details.

1.7.4 Printing Reports

Touch [Print] on the touch screen or click [Print] on the main screen to print the report.

Or touch [Preview] on the touch screen or click [Preview] on the main screen to preview. On the preview page, you can:

Print report:

Page up/down:

Click [Print].

Select [Prev. Page] or [Next Page] to view the previous or next page.

Zoom in/out: Select a zoom ratio from the drop-down list: whole page,

100%, page wide.

Exit the preview: Click [Close].

1.7.5 Fetal Growth Curve

If [Obstetric] in the [Patient Info] is selected in the report template (see “5.7.4 Fetal Growth Curve”), you can view the fetal growth curve by touching [Trend] on the touch screen. See “5.7.4 Fetal

Growth Curve” for details.

1-16 Overview

1.7.6 Report Settings

Click [Setting] in the bottom part of the Report screen to generally change the report display.

Type

Print information and layout

Description

Choose the item (s) to be displayed on the report: ultrasound image, anatomical graphic, analysis and comments.

Set the layout for ultrasound image and anatomical graphic for printing.

Ultrasound Image

Select the ultrasound image to be printed.

Then, set the image layout for printing.

If clicking “Ink-Saving Mode”, the ultrasound image is printed in white background.

Anatomical Graphic

Analyze

Comments

Select the anatomical graphic to be printed.

Then, set the graphic layout for printing.

Select to print the added analysis.

Select to print the comment column.

Measurement

Fetal Growth

Print colored

Show all measurement results

Show all fetus data in one report

Fetus compare

Fetal growth

After clicking it, WMS score mode of stress echo is displayed in color.

If not clicking it, WMS score mode is displayed in numeric.

Display all measurement results of each item for printing.

After clicking it, the report chooses and prints the multi-fetus data simultaneously.

Select the fetus comparison to be printed.

Select to print fetal growth result.

Then set the layout in the report.

Overview 1-17

Type

Method

Others

Fetal growth compare

2D/M/D Mode

Signature Count

Ink-Saving Mode

Simple Mode

Text Enhancement

Mode

Font Size

Print Font Size

Description

Select the result of fetal growth comparison to be printed.

Select the method in which the final value is calculated for 2D/M/D mode.

The sign “*” means methods for the same mode are not the same.

Select the signature number: 0, 1, 2.

If it is selected, the printing background color is white.

If it is deselected, the printing background color is black.

If it is selected, the report will be displayed in a compact layout.

If it is selected, characters on probe parameter area, patient information area and image parameter area will be printed in bold.

Set the font size for report viewing screen.

Set the font size for report preview screen and for printed report.

1-18 Overview

Measurement Preset

Before measuring, preset the following parameters:

 Measurement Parameters Preset

 Obstetric Preset

 General Measurement Preset

 Application Measurement Preset

 Report Preset

2.1 Basic Preset Procedures

The basic measurement preset procedures are as follows:

1. Press <F10 Setup> to enter the Preset:

2. Preset the measurement parameters.

Enter [Setup]

→

[System Preset]

→

[Application] to preset the measurement ruler, etc. See

“2.2 Measurement Parameters Preset” for details.

3. Preset the Obstetric formula.

Enter [Setup]

→

[System Preset]

→

[OB].

Preset the GA (Fetal Gestational Age), FG (Fetal Growth) and the Fetal Weight. See “2.3

Obstetric Preset” for details.

4. Measurement preset.

Enter [Setup]

→

[Measure]

→

[Caliper], [Measure] and [Report] to preset the measurement

menu and items. See “2.4 Measurement Preset” for details.

5. Exit the setup for the settings to take effect.

Select [OK] in the [Setup] menu to exit the setup.

NOTE: The settings are only brought into effect by clicking [OK] to exit the [Setup] menu.

2.2 Measurement Parameters Preset

Basic operation steps are as follows:

1. Press <F10 Setup> to display the [Setup] menu.

2. Select [Setup]

→

[System Preset]

→

[Application] to preset the following parameters:

 Measurement Ruler

 Left ventricular study

 PW Measure

 Follicle

 Text

 ICA/CCA && RAR

3. Click [OK] to confirm.

Measurement Preset 2-1

Measurement Ruler

You can preset:

Tools

Cursor Type

Cursor Size

Heartbeat

Cursor Line

Display

Ellipse

CrossLine

Display

Clear results while deleting caliper

Unit Setting

Descriptions

Type of cursor displayed on the measurement caliper and results window.

Value options:

 Number: the cursor always displays as “+” while different measurements are marked with numbers.

 Symbols: the cursor displays sequentially in 8 symbols to identify different measurements.

The size of the cursor. Value options: Large, Medium, Small.

The number of cardiac cycles in the heart rate calculation. (In heart rate measurement, the number of cardiac cycles should match the preset number.)

If deselected, the connecting line between the measuring ends will be hidden after measurement.

If deselected, the measuring axis within the ellipse area will be hidden after measurement.

Uncheck. The image is unfrozen or the image mode is changed after the measurement is completed. The measurement results are saved if the caliper is cleared.

Set the units of measurement items for the application selected from the drop-down list “App Region”. Click [Apply] to complete the settings.

Left Ventricle Function Study Tool Setting

Set the tools used in the Cube/Teichholz/Gibson study.

Follicle

Set the method for calculating the follicle. Value options:

Follicle 3 distances/2 distances/1 distance

2-2 Measurement Preset

PW Measure

PW measure velocity displays absolute value.

All measurement results in PW mode are absolute values based on the unit of velocity after checking this item.

ICA/CCA && RAR

Set the measurement properties of ICA, CCA, Renal A and Aorta.

Cardiac Value Range Display

Set whether to display value range of EMINCA Study for cardiac measurement results.

2.3 Obstetric Preset

Basic procedures:

1. Press <F10 Setup> to display the [Setup] menu.

2. Select [System]

→

[OB].

You can preset the Fetal Gestational Age (GA), Fetal Growth (FG) and Fetal Weight (EFW) formulae.

You can also create a new OB item and use an imported user-defined OB formulae.

See “2.3.2 Obstetric Preset Operations” for details.

3. After setting, click [OK] to exit the page.

2.3.1 Obstetric Formula

The obstetric formulae are used in the GA, EFW calculations and Fetal Growth Curve.

GA and FG Formulae

GA will be automatically calculated after the corresponding measurements are completed. The system will recalculate the GA after new measurements are completed.

Tip:

1. To preset the default formula, See “2.3.2.1 Basic Procedures” chapter.

2. For more information about the GA and Fetal Growth Curve, see “5 Obstetrics.”

3. You can add user-defined formulae for items (obstetric tools) that are not included

in the GA and FG table below. See “2.3.2.2 User-defined OB .”

The GA and FG formulae are shown in the table below:

Note: “/” means no formula provided for the item.

Tools GA FG

EFW/EFW2

Tokyo

Hadlock

Hansmann

Tokyo

Brenner

William

CFEF_2014

Persson

Measurement Preset 2-3

Tools

CRL

BPD

Hadlock

Tokyo

Jeanty

Kurtz

Hansmann

Merz

Rempen

ChittyOI

Osaka

China

Nicolaides

ASUM

CFEF

Verburg

Tokyo

Rempen

Hansmann

China

Hadlock

Tokyo

Jeanty

Nelson

Robinson

Rempen

Hansmann

China

ASUM

Daya

RobinsonBMUS

Daya

Verburg

Rempen

Tokyo

Hansmann

Hellman

Hadlock

Tokyo

Robinson

Rempen

Hansmann

ASUM

Medvedev

Hadlock

Tokyo

Jeanty

Kurtz

Sabbagha

Hansmann

Merz

Rempen

ChittyOI

Osaka

Nicolaides

ASUM

CFEF_2000/2006

INTERGROWTH-21 st

Medvedev

Verburg

2-4 Measurement Preset

Tools

Hadlock

Jeanty

Hansmann

Nicolaides

ASUM

CFEF

Chitty

Hadlock

Jeanty

Merz

Chitty

Nicolaides

ASUM

CFEF

Hansmann

Hadlock

Tokyo

Jeanty

Hohler

Merz

Hansmann

Warda

Chitty

Osaka

China

Nicolaides

ASUM

CFEF

Hadlock

Merz

Jeanty

Hansmann

Nicolaides

ASUM

CFEF_2000/2006

Chitty

INTERGROWTH-21 st

Medvedev

Verburg

Hadlock

Jeanty

Merz

Chitty

Nicolaides

ASUM

CFEF_2000/2006

Hansmann

INTERGROWTH-21 st

Medvedev

Verburg

Hadlock

Tokyo

Jeanty

Merz

Hansmann

O'Brien

Warda

Chitty

Osaka

Nicolaides

ASUM

CFEF_2000/2006

INTERGROWTH-21 st

Medvedev

Verburg

Measurement Preset 2-5

Tools

OFD

Hansmann

Nicolaides

ASUM

Jeanty

APAD

TAD

FTA

THD

HUM

CFEF

OSAKA

Hansmann

Jeanty

ASUM

Ulna Jeanty

Tibia Jeanty

RAD

FIB

CLAV

Jeanty

Yarkoni

TCD

Hill

Nicolaides

OOD Jeanty

Cist Magna /

Mean Sac Diam

MCA PI

Daya

Hellman

MCA RI

Umb A PI

Umb A RI

2-6 Measurement Preset

Merz

Jeanty

Medvedev

Merz

Jeanty

Merz

Jeanty

Yarkoni

Hill

Goldstein

Nicolaides

Verburg

Jeanty

Nicolaides

Hansmann

Merz

Nicolaides

ASUM

INTERGROWTH-21 st

Jeanty

Medvedev

Merz

CFEF

OSAKA

Hansmann

Jeanty

Merz

ASUM

Medvedev

Merz

Jeanty

Medvedev

JSUM

Tools

AFI

FL/HC

(Hadlock)

HC/AC

(Campbell)

AC(c)

Hadlock

Ut A PI

Ut A RI

Duct Veno PIV /

Duct Veno PVIV /

Duct Veno PLI /

Duct Veno S/a /

Foot Mercer

NBL /

Moore

Hadlock

Cambell

Chitty

Hadlock

Merz

Baschat

Mercer

Bunduki

Sonek

Fetal Weight Formulae

EFW is a calculation item. If all tools required for the EFW formula have been performed, EFW will be obtained automatically. The system will recalculate the EFW after new measurements are completed.

Tip: Formulae of EFW and EFW2 of GA/FG are different from those on the [Fetal Calc] page ([Setup]->[System Preset]->[OB] page).

 EFW formulae of GA/FG are used to perform the GA calculation or the Fetal Growth

Curve based on EFW.

 EFW formulae on the [Fetal Growth] page are used in the EFW calculation based on certain OB measurement results (e.g., AC).

The Fetal Weight formulae are shown in the following table:

Units

Formulae Descriptions

EFW Item

Hadlock

(AC, FL)

Hadlock

(AC, FL,

BPD)

EFW = 10 ^ (1.304 + (0.05281*AC) + (0.1938*FL) -

(0.004*AC*FL))

SD = 0.154*EFW SD Type = ±2SD

EFW = 10 ^ (1.335 - (0.0034*AC*FL) + (0.0316*BPD) +

(0.0457*AC) + (0.1623*FL))

SD = 0.146*EFW SD Type = ±2SD

Hadlock

(AC, FL, HC)

EFW = 10 ^ (1.326 - (0.00326*AC*FL) + (0.0107*HC) +

(0.0438*AC) + (0.158*FL))

SD = 0.148*EFW SD Type = ±2SD g g g g g g cm g cm g cm g

Measurement Preset 2-7

Units

Formulae Descriptions

EFW Item

Hadlock

(AC, FL, HC,

BPD)

EFW = 10 ^ (1.3596 - (0.00386*AC*FL) + (0.0064*HC) +

(0.00061*BPD*AC) + (0.0424*AC) + (0.174*FL))

SD = 0.146*EFW SD Type = ±2SD

Shepard

(AC, BPD)

EFW (Kg) = 10 ^ (-1.7492 + (0.166*BPD) + (0.046*AC) -

(2.646*AC*BPD/1000))

SD = 0.202*EFW SD Type = ±2SD g g kg g

Merz1 (AC,

BPD)

EFW = -3200.40479 + (157.07186*AC) + (15.90391*(BPD^2)) g

Merz2 (AC) EFW = 0.1*(AC^3) g

Hansmann

(BPD, THD)

Tokyo (BPD,

APTD, TTD,

FL)

EFW = (-1.05775*BPD) + (0.0930707*(BPD^2)) +

(0.649145*THD) - (0.020562*(THD^2)) + 0.515263

EFW = (1.07*(BPD^3)) + (3.42*APTD*TTD*FL) kg g

Osaka (FL,

BPD, FTA)

Campbell

(AC)

EFW = (1.25674*(BPD^3)) + (3.50665*FTA*FL) + 6.3

EFW (Kg) = EXP (-4.564+(0.282*AC) - (0.00331* (AC^2)))

Schild(HC,

AC, FL)

EFW = 5381.193 + 150.324

* HC + 2.069*FL^3 + 0.0232*AC^3

− 6235.478*log(HC)

Person(BPD,

FL, MAD)

EFW = (BPD*10)^0.972 * (MAD*10)^1.743 * (FL*10)^0.367 *

10^(-2.646) g kg g g cm g cm g cm cm cm cm cm cm cm cm

Weight Percentile for Age

The Clinical Percentile (CP) and Ultrasound Percentile (UP) is calculated and displayed in the report in the following format according to the formula selected for EFW calculation.

 CP (Calc Method) (Formula) ××.××%: Where Calc Method may be LMP, PRV, IVF, BBT,

DOC and EDD.

 UP (Calc Method) (Formula) ××.××%: Where Calc Method may be AUA, CUA.

 Clinical Percentile (CP)

Find the average value and calculate the threshold range in the formula (to calculate EFW) in the FG table according to the clinical GA (obtained in patient information such as LMP, IVF).

If the actual EFW value is in the following range, keep calculating. If not, the CP will not be displayed. average EFW x1.25 > EFW > average EFW x0.75

E.g. EFW-GP(LMP) is the EFW Clinical Percentile calculated from the LMP obtained from the patient information.

 Ultrasound Percentile (UP)

This has the same calculation method as CP except for using the ultrasound GA instead of clinical GA.

E.g. EFW-GP(AUA) and EFW-GP(CUA) is the EFW Clinical Percentile calculated from the

AUA and CUA respectively.

2-8 Measurement Preset

2.3.2 Obstetric Preset Operations

2.3.2.1 Basic Procedures

Basic procedures in the OB preset are as follows:

1. Enter the [Setup]

→

[System Preset]

→

[OB] page.

2. Set the default formula.

(1) On the [Fetal Gestational Age], [Fetal Growth] or [Fetal Weight] page, select an OB Item in the left column.

(2) Select a formula in the right column.

(3) Click [Default]. The default formula is marked with a

√.

On the [Fetal Gestational Age] page, select whether to display the SD or EDD in the obstetric result.

On the [Fetal Gestational Age] page, select whether to display the EFW derived GA in the report.

3. Set the fetal weight display. a) Enter the [Fetal Calc] page. b) Select the [Fetal Weight Unit].

Select Metric, English or English & Metric from the drop-down list. c) Select the formula for calculating the weight percentile.

Select the formula from the drop-down list of [EFW-GP].

4. Click [OK] to confirm.

Import/Export an OB Table or Formula

1. Select [Import] or [Export] on the Fetal Gestational Age or Fetal Growth page.

2. The system brings up the [Load Data] dialog box.

3. Select the drive and file path where the data is located.

4. Select the data file to load or export.

5. Click [OK] to confirm.

Tip: Only imported user-defined tables can be exported.

The imported user-defined table for FG and GA must be a *.csv file. The format of the *.csv file is described as follows:

 FG table

Table Type Author Name SD Type Meas. Value Unit SD Unit

Row Num.

No.

…

The author name

Row number

(N) of the table

GA value

…

Value of standard deviation

Min.

Minimum value

…

Unit of the measurement value

Meas. Value

Measurement value

…

Unit of the standard deviation

Max.

Maximum value

…

Measurement Preset 2-9

N … … … …

NOTE:

 Fill in the table according to the actual clinical values, except for those cells with bold text.

 Value of standard deviation:

Select from one of the following:

 None

 ±1SD

 ±2SD

 3%~97%

 5%~95%

 10%~90%

 Unit of the measurement value: according to the table to import, select from mm, cm, g, kg, cm² or mm².

 Row number (N) of the table: the maximum row number N in the column “No.”

 The third row is empty.

 GA value, Minimum value, Measurement value, Maximum value: enter the number of days without the unit.

 GA table

Table Type

Author Name SD Type

The author name Value of standard deviation

Meas. Value Unit

Unit of the standard deviation

Row Num.

No.

…

Row number (N) of the table

Meas. Value

Measurement value

…

SD(-)

Standard deviation (-)

…

GA value

…

SD(+)

Standard deviation (+)

…

NOTE:

 Fill in the table according to the actual clinical values, except for those cells with bold text.

 Value of standard deviation:

Select from one of the following:

 None

 ±1SD

 ±2SD

 3%~97%

 5%~95%

 10%~90%

 Unit of the measurement value: according to the table to import, select from mm, cm, g, kg, cm² or mm².

 Row number (N) of the table: the maximum row number N in the column “No.”

 The third row is empty.

 Measurement value, Standard deviation (-), GA value, Standard deviation (+): enter the number of days without the unit.

2-10 Measurement Preset

2.3.2.2 User-defined OB Items

NOTE: The calculation results of the user-defined OB formulae are used for reference rather than clinical diagnosis.

You can add user-defined formulae for items (obstetric tools) that are not included in the GA and

FG table in chapter “2.3.1 Obstetric Formula”.

1. Select [More OB Items] in the GA or FG tab sheet.

2. Select an item and click [OK].

The new item appears in the left column and the system asks if to add a formula.

3. Click [OK] to select the *.csv file (formula file) for the item. For user-defined formula, see

"Import/Export an OB Table or Formula" in chapter “2.3.2.1 Basic Procedures”.

Or add a formula for the new item by clicking [Import].

 Result Window

EDD display: the EDD is displayed in the result window after checking.

 GA Cycle For EDD

Normal Cycle ： GA is calculated according to 40 weeks after checking (EDD=LMP+287(40 weeks)).

French Cycle ： GA is calculated according to 41 weeks after checking (EDD=LMP+287(41 weeks)).

 Display EFW to estimate GA in the report

Estimate GA according to EFW data after checking.

2.4 Measurement Preset

Basic Procedures:

1. Press <F10 Setup> to display the [Setup] menu.

2. Select [Measure] in the [Setup] menu.

3. Preset the general measurement and application measurement.

For details, see “2.4.1 General Measurement Preset” and “2.4.2 Application Measurement

Preset.”

4. Click [OK] to confirm.

Note: In [Setup]  [Measure] screen, “exam mode XX” on the upper left side refers to the currently configured exam mode. The configured general/application menus are only related to the current exam mode.

2.4.1 General Measurement Preset

You can preset the General Measurement packages for 2D (B/Color/Power Mode), M Mode, or

Doppler (PW/CW) Mode respectively.

1. Select the [Caliper] on the [Measure] page, as shown in the figure below.

Measurement Preset 2-11

2. Select the [2D], [M] or [Doppler] tab to go to the corresponding preset menu.

[Available Items]: general measurement tools configured by the system in the current scanning mode which are available but not assigned yet.

[Selected Items]: displays the tools to be added to the menu.

3. Add/Remove the item.

Add/Remove the general measurement item using the following buttons:

[>] To add the selected tool from the [Available Items] to the [Selected Items].

[>>] To add all tools in the [Available Items] to the [Selected Items].

[<]

[<<]

To remove the selected tool from the [Selected Items] to the [Available

Items].

To remove all tools from the [Selected Items] to the [Available Items]. You do not need to select any items before removing.

4. Set the default item.

Select an item from the [Selected Items], then click [Default]. The item is marked with a

√.

The default item is activated automatically when entering this general measurement menu.

5. Adjust the item position.

Select an item from the right column and click [Up]/[Down] to adjust the sequence in which the items are arranged in the corresponding general measurement menu (touch screen display).

6. Modify the properties of a measurement item.

The following takes D trace as an example to show how to set the properties of a measurement tool.

(1) Enter the [Measure]

→

[Caliper]

→

[Doppler] page.

(2) Select [D Trace] from the [Selected Items] and click [Property] to bring up the following dialog box.

2-12 Measurement Preset

Descriptions of the attributes are shown in the following table.

Attributes

Item Name &

Result

Unit

CalcMethod

Descriptions

Results obtained from D trace are listed. The selected items will be displayed in the results window after measurement.

 If PV is selected, other results become deselected (except the temporary result “velocity”).

 Some results, such as PS and ED, can be derived via a simple method

(e.g., Velocity), but others, such as TAMAX, can only be derived via complicated methods such as Manual, Spline, Auto, etc.

 Only Vel. is available in [Method] if only PS or ED is selected.

 Methods for obtaining PS and TAMAX simultaneously (trace, spline and auto) should be chosen if both PS and TAMAX are selected

(TAMEAN should use auto method).

Select the measurement unit.

Click “Unit” column of each item to select.

Select the measurement method for the tool.

Click “CalcMethod” column of each item to select.

(3) Click [OK] to confirm the setting.

7. Select the measurement sequence.

 [Repeat]: after the current measurement is completed, the system automatically activates the current tool again.

 [Next]: after the current measurement is completed, the system automatically activates the next tool in the menu.

 [None]: after the current measurement is completed, the cursor can be moved over the whole screen. And the cursor will automatically return to the menu of the corresponding measurement.

8. Click [OK] to confirm.

Measurement Preset 2-13

2.4.2 Application Measurement Preset

2.4.2.1 Basic Procedures

1. Select [Measure] in the [Measure] page, as shown in the figure below.

2. Select the 2D, M or Doppler scanning mode.

3. Choose or edit the Measurement Package.

The default package for current exam mode appears in the [Measure Package].

 Enter or edit the package name directly in the [Measure Package] text box, then add items to edit the current package.

 Or click [Advanced] to add or select a package.

For details about creating, deleting and setting the default package, see “2.4.2.2 Measurement

Package Preset.”

4. Select an application region from the drop-down list under [Available Items].

5. Select [Measurement], [Calculate], [Study], [User Defined] or [All] from the drop-down list under [Available Items]. The corresponding items appear in the list.

For details about measurement, calculation and study, see “1.3 Measurement, Calculation and

Study.”

6. Preset the measurement menu.

For details on adding, creating and setting default items, see “2.4.2.3 Measurement Menu

Preset.”

For details on measurement tool property settings, see “2.4.1 General Measurement Preset.”

7. Select the measurement sequence.

 [Repeat]: after the current measurement is completed, the system automatically activates the current tool again.

 [Next]: after the current measurement is completed, the system automatically activates the next tool in the menu.

2-14 Measurement Preset

 [None]: after the current measurement is completed, the cursor can be moved over the whole screen. And the cursor will automatically return to the menu of the corresponding measurement.

8. Click [OK] to confirm.

2.4.2.2 Measurement Package Preset

During measurement, the preset package displays on the touch screen. Items in the package can be preset and may belong to different application regions.

You may configure more than one measurement package for current exam mode. Under actual measurement status, switch the measurement library if necessary (by rotating the knob under the

[Library] button on the touch screen or clicking the menu title.)

Click [Advanced] to enter the following page.

Here,

 [Available Items]: shows application packages configured in the system but not yet assigned to the current mode.

 [Selected Items]: shows application packages assigned to the current exam mode. If more than one package is assigned to the current exam mode, you can rotate the knob under the [Library] button on the touch screen or clicking menu title in the measuring status.

Package editing includes Creating Packages, Add/Remove Items, Deleting Measurement

Packages, Setting Default Packages, Adjusting Package Positions.

Creating Packages

1. Click [New].

2. Enter a name for the new package in the dialog box pop-up.

3. Click [OK] to confirm.

The new package displays in the [Selected Items] list.

Adding/Removing Packages

Add/remove the package by pressing:

[>]

To add the package selected from the [Available Items] to the [Selected

Items].

Measurement Preset 2-15

[>>] To add all packages in the [Available Items] to the [Selected Items].

[<]

To remove the package selected from the [Selected Items] to the [Available

Items].

[<<] To remove all packages in the [Selected Items] to the [Available Items].

Deleting Packages

1. Select a package from the [Available Items] list.

2. Click [Delete].

Tip: To delete an item from [Selected Items], you need to move it to the [Available Items] first.

Setting Default Packages

1. Select a package from the [Selected Items] list, then click [Default].

2. The default package is marked with a

√.

Tip: 1. The default package displays when entering the [Measure] page.

2. The measurement menu of the default package (corresponding to the exam mode) displays when entering the measuring status.

Adjusting Package Positions

Select a package from the [Selected Items] and click [Move Up]/[Move Down] to adjust the sequence that the packages in the menu are arranged in.

2.4.2.3 Measurement Menu Preset

The following operations are available.

 Adding/Removing Items

 Setting Default Items

 Adjusting Item Positions

 User-defined Measurement/ Calculation/ Study Items (see next section for details)

Adding/Removing Items

 Adding Items

You can add measurements, calculations or study items in the [Available Items] to the [Selected

Items] column, or to the study item in the [Selected Items] column (added items display as subitems in the study). The selected items display in the menu and on the touch screen.

Add/Remove the general measurement item using the following buttons:

[>] To add the selected tool from the [Available Items] to the [Selected Items].

[>>] To add all tools in the [Available Items] to the [Selected Items].

[<]

To remove the selected tool from the [Selected Items] to the [Available

Items].

2-16 Measurement Preset

[<<]

 Setting Default Items

You can set a measurement, calculation or study in the [Selected Items] as the default item. The default item will be activated automatically when entering the measurement menu containing it.

1. Select an item from the [Selected Items] list.

2. Click [Default]. The defaulted item is marked with a

√.

To deselect the default tool, select it and click [Default] or set another item as the default.

Tip:

To remove all tools from the [Selected Items] to the [Available Items]. You do not need to select any items before removing.

If a particular item is set as the default item, it automatically displays the submenu of the study when entering this measurement menu.

Adjusting Item Positions

You can adjust the position of the measurement, calculation or study in the [Selected Items] list.

1. Select an item from the [Selected Items].

2. Click [Move Up]/[Move Down].

The order in the list is also the item position in the menu.

2.4.2.4 User-defined Measurement/Calculation/Study

NOTE: Please ensure the correctness and validity of the defined formula, otherwise Mindray will not be liable for damage caused by improper definition of the formula.

User-defined Measurement

1. Enter the [Measure]

→

[Measure] page.

2. Click [New].

The “Measurement Custom Wizard” dialog box appears, as shown in the following figure.

3. Enter the Name in the “Measurement Custom Wizard” dialog box, then click [Next].

Measurement Preset 2-17

4. Select the [Tool Type], [App Region] and the Measurement Result.

Descriptions of the attributes in the dialog box are shown in the following table.

Attributes Descriptions

App Region Select the application region for the user-defined item.

Tool Type

General measurement tool type of the user-defined item. E.g. Select

Dist. if you want to add a new item to measure the distance.

Has Left-Right If selected, you can choose left or right side in the measurement menu.

Has Prox-Mid-

Dist

Measurement

Result

If selected, you can choose proximal, middle or distal in the measurement menu.

Choose the results to be displayed in the results window. The result name can be changed.

Move the cursor over an item and press <Set>, then enter the name in the text box.

Unit

Select the measurement unit.

Click “Unit” column of each item to select.

5. Click [Complete] to finish setting. The user-defined measurement item is listed in the “Selected

Items” menu and in the “User-defined” category of “Available Items.” An asterisk appears after the user-defined item for identification.

In the meantime, the user-defined measurement item will be added automatically to the “Selected

Items” in the Report template. If the item is completed in an exam, the results will be displayed in

the report. For detailed information about the Report template, see “2.4.3 Report Preset.”

2-18 Measurement Preset

User-defined Calculations

User-defined calculations are derived from arithmetic operations in which the parameters are measurement, calculation or study results obtained in measurement items which exist in the system or are user-defined.

1. Enter the [Measure]

→

[Measure] page.

2. Click [New].

3. Enter the Name in the “Measurement Custom Wizard” dialog box, choose [Add Calc.], then click [Next].

4. Select the [App Region] and edit the formula.

Descriptions of the attributes in the dialog box are shown in the following table.

Attributes

Formula

Verify

Application Region

Measurement Item

Calculator/Function

Descriptions

Displays the user-defined formula.

Used to verify if the formula is valid.

Select the application region for the user-defined item.

All available measurement items of the application region selected in the previous step.

You can select from measurement/calculation/study items in

2D/M/Doppler mode.

Used to enter numbers and functions in the formula. Unit

For example, to create a user-defined measurement item (HC/AC): a) Enter name for the item, such as “calculation 1.” b) In Region select “Obstetric,” then select the measurement tool sources “2D” and

“Measurement.” c) Find HC in the “Item Name” list, click to select it, then double-click HC in the Result

Name box on the right side. The index is added to the formula. d) In the Calculator, click “/” and it is added to the formula.

Measurement Preset 2-19

e) Find AC in the “Item Name” list, click to select it, then double-click AC in Result Name box on the right side. The index is added to the formula.

5. Verify the formula, select the unit of the result, then click [Complete]. The user-defined calculation item is listed in the “User-defined” category of “Available Items.”

In the meantime, the user-defined calculation item will be added automatically to the “Selected

Items” in the Report template. If the item is completed in an exam, the results will be displayed

in the report. For detailed information about the Report template, see “2.4.3 Report Preset.”

NOTE: 1. Trigonometric functions are in degrees, not radians.

2. PI is accurate to 15 digits.

User-defined Study Items

You can add or remove user-defined study items in the [Selected Items] column.

Enter the [Measure]

→

[Measure] page.

Click [Add Study] on the right.

Enter the study name in the dialog box that appears.

Click [OK] and the item will be added to the “Selected Items.”

Select a measurement/calculation item from the “Available Items” and click [>] to add the item to the user-defined study.

Repeat the last step to add more items if necessary.

Move the cursor to click on the study and click [Property] on the right to edit the sequence.

Edit User-defined Items

1. Select defined items in the “Available Items”.

2. Select the target item and click [Edit] on the right.

Remove User-defined Items

 Remove Measurement/Calculation

1. Select “User-defined” in the “Available Items”, and select the desired item.

2. Click [Delete] on the right.

 Remove Studies

Select a user-defined study, click [<].

NOTE: 1. Adding B-Hist or B-Profile to the study is not supported.

2. Click [Export Custom] in the measurement preset window to export the user-defined measurement.

2.4.3 Report Preset

NOTE: Deleting is not supported in IVF, IMT and EM reports.

Basic procedures:

1. Select [Report] on the [Measure] page.

2. Manage the report template. Available operations:

 Adding new Report Templates

 Deleting Report Templates

 Editing Report Templates

 Setting Default Report Templates

2-20 Measurement Preset

3. Continue setting other presets, or click [OK] in the [Setup] menu to bring the settings into effect.

2.4.3.1 Creating Report Templates

1. Enter the [Measure]

→

[Report] page.

2. Click [New] to bring up the following dialog box.

3. Select template: click the drop-down list under “Application Region” to select the template and click [OK] to confirm the template layout and exit the dialogue box.

4. Enter the name for the user-defined report template in the box after “Report Template Name”.

5. Click [Measurement] to select measurement results to be displayed in the report:

Select an application category from the drop-down list beside “Available Items”.

Select Measurement, Calculate, Study] or All from the drop-down list beside “Available

Items”. The corresponding items appear in the list.

Use the [>] or [>>] buttons to add items to the “Selected Item” list.

Only tools which appear in the right column and are completed in the ultrasound exam can be displayed in the report.

Note: in cardiac mode, if result items of only one formula are selected in

[Setup]  [Measurement]  [Property], only results of that one formula will be displayed after measurement. (For e.g., if only items suffixed with Teicholz are selected, not with

Gibson or Cube, then only results suffixed with Teicholz after measurement are displayed.)

See chapter “2.4.1 General Measurement Preset” for details.

Add the study.

Click [Add Study] and enter the study name in the dialog box which appears, then click

[OK].

The new added study appears in the “Selected Item” list.

Adjust the item position.

Select an item from the “Selected Item” list, click [Up]/[ Down] to adjust the position of the item in the list, as well as in the report template.

Measurement Preset 2-21

Click [OK] to save the settings and exit the dialogue box.

6. Set the module display in the report: click [Setting] to make a selection;

 Tick the small box in front of the module name to display the module in the report;

 After selecting the module, click [Up] or [Down] to change the module sequence.

 Click [OK] to save the setting and then exit.

7. Change the patient information layout in the report template:

 Change the template used in the report layout: click [New Layout] to select another template.

 Double click the information lines to be edited in “Report body”. The dialog box of font setting appears. Set the font size, font weight or hidden key words.

 Double click the blank of a module in “Report Body”. The dialog box of editing the content appears. Select the content to be displayed at current position.

 Press left <Set> key on the blank of a module in “Report Body”. Choose to add or delete the line, or add the table, etc.

8. Click [Save] to save the setting.

9. Click [Close] to quit the template.

Note: Watch the layout when setting the patient information layout of the report template. Do not set too many characters in one line; otherwise it may affect the display of the report.

2.4.3.2 Deleting Report Templates

1. Enter the [Measure]

→

[Report] page.

2. Select the template to be deleted from the list.

3. Click [Yes] to delete the selected template.

4. Click [Save] in the “Report” tab to confirm the settings.

2.4.3.3 Editing Report Templates

1. Enter the [Measure]

→

[Report] page.

2. Select the template to be modified from the list.

3. Select [Edit] to enter the [Measurement Report Preset] dialog box.

See section “2.4.3.1 Creating Report Templates” to edit the template.

4. Click [OK] in the “Report” tab to confirm the settings.

2.4.3.4 Setting Default Templates

1. Enter the [Measure]

→

[Report] page.

2. Select a report template from the list.

3. Click [Default].

4. Click [OK] to confirm.

2.5 Fast Measurement

Enter the [Setup]

→

[System Preset]

→

[[iConsole&Footswitch] or [Key Board] page and assign functions in the “Measurement” list on the right side to the keys. For details, see the Operator’s

Manual [Basic Volume].

2-22 Measurement Preset

General Measurement

General Measurement Tools:

 2D (B/Color/Power/DirPower) Mode

 M General Measurements

 Doppler (PW/CW) Mode

3.1 Basic General Measurement Procedures

1. Start the exam.

2. Select the imaging mode (B/M/Doppler), then scan the image.

3. Press <Caliper> to enter the 2D/M/Doppler general measurement menu.

4. Select an item from the general measurement menu (or the touch screen) to start the

measurement. See “1.2.2 Measurement Tool” chapter for details.

Or, enter the measurement tool by two-finger gesture chapter for details.

. See “1.2 Measurement Menu”

 You can use the trackball and <Set> key to perform general measurement on the main screen

(see 2D, M, Doppler general measurement for details);



Or, use the measurement tool on the touch screen under mapping mode, see “1.2

Measurement Menu” chapter for details.

Tip: 1.

The order of the measurement items can be preset. See “2.4.1 General

2. Set two line segments as described in “3.2.2 Distance.”

2. A measurement tool can be activated by clicking the item either in the measurement menu or on the touch screen. It is described as “Select/Click ... in the measurement menu” in the following procedures.

3. Under B+M or B+Doppler mode, touch mode tab on the touch screen to switch to the related measurement menu.

General Measurement 3-1

3.2 2D General Measurements

3.2.1 Depth

Function:

 Sectoral surface probe: the depth is the distance from the center of the sector to the cursor.

 Convex array or linear array probe: the depth is the distance from the transducer surface to the measuring cursor in the direction of the ultrasonic wave.

Tip: The real-time depth displays in the results window only before the <Set> key is pressed to fix the starting point. The history value of the depth is not displayed in the results window.

1. Select [Depth] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Use the trackball to move the cursor to the desired point.

3. Press <Set> to set the measurement point and the result displays in the results window.

3.2.2 Distance

Function: Measures the distance between two points on the image.

1. Select [Distance] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to the starting point with the trackball.

3. Press <Set> to set the starting point.

4. Move the cursor to the end point with the trackball. Then press <Clear> to cancel setting the starting point. Or press <Update> to switch between the fixed end and the active end of the caliper.

5. Press <Set> to set the end point and the result displays in the results window.

3.2.3 Distance P-L

Function: measures the distance between two parallel line segments.

1. Select [Distance P-L] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to the starting point with the trackball.

3. Press <Set> to set the starting point.

4. Move the cursor to the end point with the trackball. Then press <Clear> to cancel setting the starting point. Or press <Update> to switch between the fixed end and the active end of the caliper.

5. Press <Set> to set the end point and the result displays in the results window.

3.2.4 Angle

Function: measures the angle of two crossing planes on the image and the range is: 0°-180°.

1. Select [Angle] / [Angle 3P] in the measurement menu or the touch screen. The cursor appears on the screen.

The angle appears in the results window after setting the line segments.

3-2 General Measurement

3.2.5 Area & Circumference

Function: measures the area and circumference of a closed region on the image. Four measurement methods are available:

 Ellipse: fix an ellipse region by two equal-cut perpendicular axes.

 Trace: fix a closed region by free tracing.

 Spline: fix a spline curve by a series of points (12 points at most).

 Cross: fix a closed region with two axes perpendicular to each other. The starting point and the end point of the axes can both be fixed freely.

Tip: These four methods are also applicable to other measurement items and will not be repeated when mentioned below. The operations are as follows:

Ellipse

1. Select [Ellipse] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to an area of interest.

3. Press <Set> to set the starting point of the first axis of the ellipse.

4. Move the cursor to position the end point of the first axis of the ellipse. Then press <Update> to switch between the fixed end and the active end of the first axis. Or press <Clear> to cancel the start point of the first axis.

5. Press <Set> to set the end point of the first axis of the ellipse. The second axis appears on the screen.

6. Moving the trackball will increase or decrease the ellipse from the fixed axis. Move the trackball to trace the area of interest as closely as possible.

Or, press the <Update> or <Clear> key to return to the step before setting the first axis.

7. Press <Set> to anchor the ellipse region. The measurement result will be displayed in the results window.

Trace

1. Select [Trace] in the measurement menu or the touch screen. The cursor appears on the screen (and the touch screen).

2. Move the cursor to an area of interest.

3. Press <Set> to fix the starting point.

4. Move the cursor along the target to trace the outline of the target.

To modify the trace line, rotate the <Angle> knob:

Anticlockwise: to cancel a series of points.

Clockwise: to resume a series of points. You may also resume the points by rolling trackball back.

5. Press <Set> and the trace line will be closed with a straight line connecting the start and end points. The trace will also be closed when the cursor is very near to the starting point.

Spline

1. Select [Spline] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to an area of interest.

3. Press <Set> to set the first reference point of the spline.

4. Move the cursor along the area of interest and press <Set> to anchor the second reference point.

General Measurement 3-3

5. Roll the trackball and a spline defined by three points of the first and second reference points and the active cursor appears on the screen.

6. Move the cursor along the edge of the target and set more reference points (12 at most) to make the spline approach the target region as closely as possible.

To correct a previous point, press <Clear>.

7. Press <Set> twice to anchor the last reference point. The spline is fixed and the results display in the results window.

Cross

1. Select [Cross] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to an area of interest.

3. Press <Set> to fix the starting point of the first axis.

4. Use the trackball to position the end point of the first axis and then press <Set>. Then press <Update> to switch between the start point and the end point of the first axis. Or press <Clear> to cancel setting the starting point of the first axis.

5. Press <Set> to set the end point of the first axis. The second axis (perpendicular to the first axis) of the cross appears on the screen.

6. Move the trackball and press <Set> to fix the starting point of the second axis.

7. Move the cursor to the end point of the second axis. Then press <Update> to switch between the start point and the end point of the first axis. Or press <Clear> to cancel setting the starting point of the first axis.

8. Press <Set> to set the end point of the second axis and fix the region. The results appear in the result window.

3.2.6 Volume

Function: measures the volume of the target object.

Method:

 3 Dist.

For calculating the object's volume with 3 axes of two images scanned in the plane perpendicular to each other in B mode. The calculation formula is as follows:

V olume ( cm

)

฀

D 1 ( cm )

D 2 ( cm )

D 3 ( cm )

Where D1, D2 and D3 are the length of three axes of the target object.

 Ellipse

To calculate the object's volume by its horizontal section area. The calculation formula is as follows:

V olume ( cm

)

฀

× a ( cm )

× b

( cm )

Where a

is the length of the major axis of the ellipse while

b

the minor.

 Ellipse Dist.

To calculate the object's volume by its horizontal and vertical section area. The calculation formula is as follows:

V olume ( cm

)

฀

× a ( cm )

× b ( cm )

× m ( cm )

3-4 General Measurement

Here a, b and m indicate the length of the major, minor and the third axis of the ellipse respectively.

Operations:

Volume

1. Select [Volume] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Here D1, D2 and D3 are the lengths of three axes of the target object.

See “3.2.2 Distance” for detailed procedures.

Generally D1, D2 and D3 should belong to different scanning planes.

Volume (Ellipse)

1. Select [Volume (Ellipse)] in the measurement menu or the touch screen. The cursor appears on the screen.

2. The procedure is similar to that of Ellipse in the area measurement, see “3.2.5 Area” for

details.

Volume (Ellipse Dist.)

1. Select [Volume (E+ Dist.)] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Use the Ellipse method to measure the vertical section area.

The procedure is similar to that of Ellipse in the Area measurement, see “3.2.5 Area” for

details.

3. Unfreeze the image. Rescan the area of interest perpendicular to the previous image.

4. Measure the length of the third axis with the Distance measurement method, see “3.2.2

Distance” for detailed procedures.

3.2.7 Double Dist.

Function: measures the lengths of line segments A and B perpendicular to each other.

1. Select [Double Dist.] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to the measurement starting point.

3. Press <Set> to set the starting point of the first line segment.

5. Press <Set> to set the starting point of the first line segment. The second line segment perpendicular to the fixed line segment appears on the screen.

6. Move the cursor to the starting point of the second line segment.

7. Press <Set> to set the starting point of the second line segment. Or, press <Update> or

<Clear> to return to the last step.

8. Move the cursor to the end point of the second line segment. Then press <Update> to switch between the starting point and the end point of the second axis. Or press <Clear> to cancel setting the starting point of the second axis.

9. Press <Set> to confirm the end point of the second line segment.

General Measurement 3-5

3.2.8 Parallel

Function: measures the distance between every two line segments of five parallel line segments, namely, four distances in total.

1. Select [Parallel] in the measurement menu or the touch screen. Two lines perpendicular to each other appear on the screen. The intersection is the starting point of the line segment.

2. Rotate the <Angle> knob to change the angle of the lines and press <Set> to confirm.

3. Move the cursor to the starting point of the line segment.

4. Press <Set> to confirm the starting point and the first line.

5. Move the cursor and press <Set> to confirm the other four parallel lines when the last parallel line is set and the end point of the line that is perpendicular to the five parallel lines is confirmed. During the measurement, press <Set> twice to set the last parallel line and complete the measurement.

3.2.9 Curve Length

Function: measures the length of a curve on the image. Measurement methods available include

Trace and Spline.

Trace

1. Select [Trace Len] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to an area of interest.

3. Press <Set> to fix the starting point.

4. Move the cursor along the target to trace the outline of the target.

To modify the trace line, rotate the <Angle> knob:

Anticlockwise: to cancel a series of points.

Clockwise: to resume a series of points. You may also resume the points by rolling trackball back.

5. Press <Set> to anchor the end point of the trace line.

Spline

1. Select [Trace Len (Spline)] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to an area of interest.

3. Press <Set> to fix the starting point.

4. Move the trackball along the target and press <Set> to anchor the second, third, fourth, etc., points. A maximum of 12 points can be anchored.

To correct a previous point, press <Clear>.

5. Press <Set> twice to set the end point of the spline.

3.2.10 Ratio (D)

Function: measures the lengths of two line segments and then calculates their ratio.

1. Select [Ratio (D)] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Measure the length of the two line segments, see “3.2.2 Distance” for detailed procedures.

The results display in the results window after the measurement of the second line is completed.

3-6 General Measurement

3.2.11 Ratio (A)

Function: measures the area of two closed regions and then calculates their ratio. The methods are Ellipse, Trace, Cross and Spline.

1. Select [Ratio (A)] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Measure the area of the two closed regions; you may select different measurement methods

for each region. See “3.2.5 Area” for details.

Under STE and STQ imaging mode, in B+E dual display mode, click [Sync] on the touch screen to On. Measurements on either of the two windows will be displayed in the other window.

3.2.12 B-Profile

Function: measures the gray distribution of ultrasonic echo signals on a line.

Tip: The following operations are performed on Freeze images by default.

1. Select [B-Profile] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Set a line segment, see “3.2.2 Distance” for detailed procedures.

The result is shown in the figure below:

Where

No: The number of the graph. Value: 1 or 2.

The last two results will be displayed on the screen.

Gmax:

Gmin:

The maximum gray.

The minimum gray.

Gmean: The average gray.

Gsd: The variance of gray.

3.2.13 B-Hist

Function: measures and counts the gray distribution of ultrasonic echo signals within a closed region. The methods to set a closed region are Ellipse, Trace, Spline and Rect. (Rectangle).

Tip: The following operations are performed on Freeze images by default.

Rectangle

Rect. sets a rectangle with two points on the cross. The operations are:

1. Select [B-Hist (Rectangle)] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to the first vertex of the rectangle, press <Set>.

3. Move the cursor to the second vertex of the rectangle, press <Set>. The result is shown in the following figure:

General Measurement 3-7

Where

Horizontal axis: The gray of the image

The vertical axis: The gray distribution percentage.

No: The number of the graph. The last two results will be displayed on the screen.

N: The total pixel number in the area to be measured.

M: M =

∑

Di / N;

MAX: MAX = the pixel number in the maximum gray/N×100%

SD: Standard deviation. SD =

(∑

Di 2 /N-(

∑

Di/N) 2 ) 1/2

Di: the gray at each pixel point

∑

Di: the total grays of all pixels.

3.2.14 B-Ratio

Tip: 1. This measurement item is meant for a general estimation, not for accurate measurement.

2. B-Ratio should be performed on frozen images.

Function: measures gray statistics ratio of normal tissue to abnormal tissue.

1. Select [B Ratio] in the measurement menu or the touch screen. A circle appears on the screen.

2. Move the circle to the position to be measured, and rotate the <Angle> knob to adjust the size of the circle.

3. Press <Set> to fix the first circle, and the second circle appears.

4. Move the second circle to the position to be measured, and rotate the <Angle> knob to adjust the size of the circle.

5. Press <Set> to fix the second circle. The result displays in the results window.

3.2.15 Color Vel.

Tip: 1. This measurement item is meant for a general estimation, not for accurate measurement.

2. The following operations are performed on Freeze images by default.

Function: measures the velocity of blood flow on the Color Mode image.

3-8 General Measurement

1. Select [Color Vel.] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to the point to be measured for blood flow velocity.

3. Press <Set> to fix the point, a floating line is displayed in the direction parallel to the ultrasonic wave beam at that point.

The compensation angle is currently 0°. You can change the angle (0°-80°) by rotating the

<Angle> knob to align the floating line in the same direction as the blood flow at the point to be measured.

4. Press <Set> to set the direction of the blood flow. The result displays in the results window.

3.2.16 Volume Flow

Function: measures blood flow through a vascular cross section per unit time.

For details, see “3.4.7 Volume Flow.”

3.2.17 IMT

Tip: The IMT should be performed on frozen images.

IMT (Intima-Media Thickness) measures the distance between LI (Lumen-Intima) and MA (Media-

Adventia). For details, see “7.4.3 Study Tool Operations IMT.”

3.2.18 Strain

Function: Support making measurement and calculation of the strain in a region.

Tip: only elastography imaging supports this function. For details see [Basic Volume].

1. Under Strain Elasto mode, acquire the image and freeze. Select [Strain] in the measurement menu or the touch screen.

2. Adjust the circle size by rotating <Angle> after select [Strain (Circle)]. Set the shell thickness and select whether to turn on the shadow function.

 In B+E dual display mode, click [Sync] on the touch screen to On. Measurements on either of the two windows will be displayed in the other window.

 Rotate the knob under [Shell Thick] on the touch screen to set the mass shell size.

After the strain is measured, select the [Shell Thick] to be more than 0 mm. The system extends from lesion A automatically according to the shell thick value.

3. Perform measurements. You may select different measurement methods for each region. For

details, see “3.2.11 Ratio (A).”

Check the result window of the strain measurement after the measurement is completed. Tap [E

Export]. The data of the strain measurement is exported in batch.

3.2.19 Strain Ratio

Tip: The Strain Ratio should be performed on frozen images.

Function: measures the strain ratio in the image, strain ratio = strain (normal tissue)/strain (lesion).

Tip: only elastography imaging supports this function. For details see [Basic Volume].

In the image, the region selected from lesions is defined as A and the region selected from normal tissue is defined as B, where A' is the region extended from lesions and shell thick. refers to the thickness of the mass shell.

Tissue strain is related to forces on the probe and tissue depth. It is recommended to use regions of the same depth and same area for comparison.

1. Under Elasto mode, acquire the image and freeze. Select [Strain Ratio] in the measurement menu or the touch screen.

General Measurement 3-9

Adjust the circle size by rotating <Angle> after select [Strain Ratio (Circle)].

2. Set the shell thickness and select whether to turn on the shadow function.

 In B+E dual display mode, click [Sync] on the touch screen to On. Measurements on either of the two windows will be displayed in the other window.

 Rotate the knob under [Shell Thick] on the touch screen to set the mass shell size.

3. Perform measurements. You may select different measurement methods for each region. For

details, see “3.2.11 Ratio (A).”

4. After the strain ratio is measured, select the [Shell Thick] to be more than 0 mm. The system extends from lesion A automatically according to the shell thick value. The results window will display the results: B/A', B/Shell, A/Shell.

3.2.20 Strain.Hist

Tip: The Strain-Hist should be performed on frozen images.

Function: displays the strain ratio using the histogram, strain ratio = strain (normal tissue)/strain

(lesion).

1. Under Elasto mode, acquire the image and freeze. Select [Strain-Hist (Ellipse)] or [Strain-Hist

(Trace)] in the measurement menu or the touch screen.

2. Set the shell thickness and select whether to turn on the shadow function.

 In B+E dual display mode, change [Sync] on the touch screen to On. Measurements on either of the two windows will be displayed in the other window.

 Rotate the knob under [Shell Thick.] on the touch screen to set the mass shell size.

3. Perform measurements. You can select between ellipse or trace method. For details, see

“3.2.13 B-Hist.”

After the Strain-Hist is measured, select the [Shell Thick.] to be more than 0 mm. The histogram will display data for A as well as A'.Elas.

3.2.21 Elastography

Function: it supports the elasto measurement and the elasto calculation of the area.

1. In STE mode: a: capture the image b: freeze the image; c: enter the general measurement; d: select [Elasto Ellipse], [Elasto Trace] or [Elasto Circle] from the measurement menu.

Adjust the circle size by rotating <Angle> after select [Elasto Circle].

2. Perform elasto measurements, you can select between ellipse or trace method, for details,

please refer to “3.2.11 Ratio (A)”

3. Rotate [Shell Thickness] knob to set the size of the mass. The system expands inside or outside automatically in lesion A. The tissue of the lesion that is expanded appears in A’. The expansion thickness depends on the shell’s.

Due to the tumor infiltration to the peripheral organs, adjust the shell thickness according to the tumor expansion scope.

After the elasto measurement is completed ([Shell Thickness is enabled]), the results are displayed beneath the image.

3-10 General Measurement

Column A: results of lesion tissue

Shell

Column ：

Results of expansion area

Shell/A column: results of lesion tissue and expansion area

Column A’: results of lesion tissue after the expansion

Elasto metric

（ E/Cs/G ）

No: 1

E (kPa): A Shell Shell/A A’

Mean

Max

Mean:

Max:

Min

Min:

SD:

Check the result window of the elasto measurement after the measurement is completed. Tap [E

Export]. The data of the strain measurement is exported in batch.

3.2.22 Elas. Ratio

Function: obtain the elasto ratio. Elas. ratio ＝ elasto metric of the lesion tissue/elasto metric of the normal tissue

In the image, region selected from lesions is defined as A, and region selected from normal tissue is defined as B; while A’ is the lesion region that is extended outside, and shell thickness refers to the size of the mass shell.

1. In STE mode: a: capture the image; b: freeze the image; c: enter the general measurement; d: select [Elas. Ratio Ellipse], [Elas. Ratio Circle] or [Elas. Ratio Trace] from the measurement menu.

Adjust the circle size by rotating <Angle> after select [Elas. Ratio Circle].

2. Perform elasto ratio measurements, you can select between ellipse or trace method, for

details, please refer to “3.2.11 Ratio (A)”

Due to the tumor infiltration to the peripheral organs, adjust the shell thickness according to the tumor expansion scope.

After the elasto ratio measurement is completed ([Shell Thickness is enabled]), the results are displayed beneath the image.

A ： The tissue elasto of the lesion region;

A’ ： The tissue elasto of the lesion region after the expansion;

Shell ： The tissue elasto of inside the expansion;

Shell/A ： Tissue elasto ratio between the expansion region and the lesion region;

B ： The elasto of the normal tissue;

A/B ： Elasto ratio between the lesion region and the normal region;

A’/B ： Elasto ratio between the lesion region after the expansion and the normal region;

Shell/B ： Elasto ratio between the expansion region and the normal region;

General Measurement 3-11

Elasto metric type

（ E/Cs/G ）

Shell expand outside

Elasto metric ： E

A’

Shell

A/B

A’/B

Shell/A

Shell/B

Elasto metric ： E

A/B

A’/B

Shell/B

Shell expand inside

3.2.23 Elas. Hist

Function: it shows the elasto metrics which are drawn by the user in histograms.

1. In STE mode: a: capture the image; b: freeze the image; c: enter the general measurement; d: select [Elas. Hist Ellipse] or [Elas. Hist Trace] from the measurement menu. The measurement cursor appears on the screen.

2. Perform elasto histogram measurements, you can select between ellipse or trace method, for

details, please refer to “3.2.11 Ratio (A)”.

Due to the tumor infiltration to the peripheral organs, adjust the shell thickness according to the tumor expansion scope.

After the elasto histogram measurement is completed ([Shell Thickness is enabled]), the results are displayed beneath the image.

3-12 General Measurement

E/Cs/G (kPa) column ：

The tissue elasto of the lesion region

Shell column:

Elasto results of the tissue inside the expansion region

Y-axis: the occurrence frequency of one certain elasto metric, only the highest ratio of the occurrence frequency appears.

Mean

Max

Min

No: 1

Metric: E (kPa) Shell

Mean: 121.89 144.06

Max: 156.39 165.64

Min: 65.29 99.55

SD: 14.3 10.2

X-axis: elasto metric graphics (same with the color bar at the top left of the image)

3.2.24 Directional Ratio

This function applies for the directional ratio measurements. There is a difference in the elasto metrics if the transmission angle of the probe’ acoustic beam and the muscle fiber are different.

Function: it supports the elasto ratio measurement and the calculation on the target tissue of various planes. It is helpful to know the directional situation of target elasto tissue.

Directional ratio=Direc 1 metrics of the target tissue/Direc 2 metrics of the target tissue

1. In STE mode: a: capture the target tissue b: freeze the image; c: enter the general measurement; d: select [Directional Ratio]

→[

Direc1: (Ellipse/Trace)] (the measurements include the ellipse

method and trace method; refer to “3.2.13 B-Hist”).

e: measure the Direc 1 mean metrics on the target tissue.

2. a: Unfreeze the image. b: adjust the probe scanning direction. c: recapture the image, and the freeze the image. d: enter the general measurement. e: select [Directional Ratio]

→[

Direc2: (Ellipse/Trace)]. f: measure the Direc 2 mean metrics on the target tissue.

The results are displayed beneath the image after the elasto directional ratio is completed.

Elasto metric (E/CS/G): elasto metric types:

D1 Diam:

Direction 1: =Direction 1 mean metric of the target tissue;

General Measurement 3-13

D2 Diam:

Direction 2: =Direction 2 mean metric of the target tissue;

Direction 1/Direction 2: Direction 1 mean metric of the target tissue/Direction 2 mean metric of the target tissue;

Direction 2/Direction 1: Direction 2 mean metric of the target tissue/Direction 1 mean metric of the target tissue;

3.2.25 TSM

This function applies for the tissue stiffness measurement.

1. In STE mode: a. Capture the image. b. Freeze the image. c. Enter the general measurement. d. Select [TSM] from the measurement menu.

Adjust the circle size by rotating <Angle>.

2. Move the circle to the desired position, and press <Set> key to confirm the position.

The measurement results are displayed on the result window, including Depth, Diameter and

RLB index of the target tissue; Mean, Max, Min and SD value of the target tissue stiffness.

3.2.26 RAC

RAC (Relative Anisotropy Coefficient) is calculated though detecting Sagittal and Axial plane of the target tissue.

RAC = (Sagittal V mean

– Axial V mean

) / Sagittal V mean

Sagittal V mean:

The average value of strain is calculated on Sagittal plane of the target tissue.

Axial V mean:

The average value of strain is calculated on Axial plane of the target tissue.

Tip: Only [Elas. Metric] is Cs unit, RAC can be calculated.

1. In STE imaging mode, scan the image of Sagittal plane and freeze, enter caliper measure status and select RAC item in the measure menu, the average value of strain is calculated on

Sagittal plane of the target tissue.

2. Unfreeze the image. Move the probe, scan the image of Axial plane and freeze, enter caliper measure status and select RAC item in the measure menu, the average value of strain is calculated on Axial plane of the target tissue.

The result window displays:

Elas. Metric (Cs): the scale unit of Elas. Metric ；

Slag: The average value of strain is calculated on Sagittal plane of the target tissue.

XS: The average value of strain is calculated on Axial plane of the target tissue.

3.2.27 Smart Trace

Function: helps the operator to trace the contour of the target by automatically recognizing the margin of the target and measures the lengths of major axis and minor axis, area and circumference of the closed region.

Tip: Smart Trace should be performed on frozen images.

1. After the image is frozen, select [Smart Trace] in the measurement menu or the touch screen.

The cursor appears on the screen (and the touch screen).

2. Move the cursor to an area of interest.

3. Press <Set> to fix the starting point.

3-14 General Measurement

4. Move the cursor along the target to trace the outline of the target.

During tracing, you can roll the trackball backwards to delete latest tracing. Or, you can press

<Set> to fix the traced contour.

The faster the cursor moving speed, the bigger the cursor, and the lager the recognized area.

5. Press <Set> key twice and the trace line will be closed with a straight line connecting the start and end points. The trace will also be closed when the cursor is very near to the starting point.

3.2.28 Smart Caliper

Tip: This feature should be performed on frozen images.

Function: helps the operator to measure lengths of the major axis and the minor axis by automatically recognizing the lesions under breast or thyroid exam mode. Measurement calipers can be modified by the operator.

1. Select [Smart Caliper] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to the center of the target, and press <Set>. The major axis and the minor axis of the target are displayed on the screen.

If necessary, use the trackball to position the activated end point of the axis and then press

<Set>. Or

Press <Update> to switch the four end points of the two axes. Or

Long press <Clear> to cancel the caliper.

3. Press <Set> to fix the two axes. The results appear in the result window.

3.2.29 Color Pixel Percentage

Tip: 1. This feature should be performed on frozen images.

2. It is not suggested to perform CPP measurement on color mixing area.

Function: measures the pixel proportion of blood flow signal in the region of interest under Color or

Power mode.

The feature is not supported under TDI mode.

CPP(Ellipse)

1. Select [CPP(Ellipse)] in the measurement menu or the touch screen. The ellipse appears on the screen.

2. Rotate the knob under [CPP ROI] to adjust the ellipse of the ROI, and use the trackball to move the ellipse to the desired position.

If [Manual] is selected, you can draw the ellipse. For details on procedure of drawing ellipse,

see “3.2.5 Area”.

The ellipse should be in the color ROI.

3. Press <Set> key to fix the ellipse.

CPP(Rect)

1. Select [CPP(Rect)] in the measurement menu or the touch screen. The rectangle appears on the screen.

2. Rotate the knob under [CPP ROI] to adjust the ellipse of the ROI, and use the trackball to move the rectangle to the desired position.

General Measurement 3-15

If [Manual] is selected, you can draw the rectangle. For details on procedure of drawing

rectangle, see “3.2.13 B-Hist”.

The rectangle should be in the color ROI.

3. Press <Set> key to fix the rectangle.

CPP(Trace)

1. Select [CPP(Trace)] in the measurement menu or the touch screen.

2. See “Trace” in the “3.2.5 Area” for detailed procedures.

CPP(Recall)

Select [CPP(Recall)] in the measurement menu or the touch screen to repeat the last CPP measurement.

If CPP measurement has not been performed since the ultrasound system is powered on, the measurement result is based on the default size and position of an ellipse.

3.3 M General Measurements

3.3.1 Distance

Function: measures the distance between two points on the M Mode image.

1. Select [Distance] in the measurement menu or the touch screen. Two dotted lines perpendicular to each other appear on the screen.

2. Move the crossing point of the dotted lines to the measurement starting point and press <Set>.

3. Move the crossing point to the end point. The crossing point can then only be moved in a vertical direction. Then press <Update> to switch between the fixed end and active end of the caliper. Or press <Clear> to cancel setting the starting point.

4. Press <Set> to set the end point.

3.3.2 Time

Function: measures the time interval between two points on the M Mode image.

1. Select [Time] in the measurement menu or the touch screen. Two dotted lines perpendicular to each other appear on the screen.

2. Move the crossing point of the dotted lines to the measurement starting point and press <Set>.

3. Move the crossing point to the measurement end point. The crossing point can only be moved in a horizontal direction. Then press <Update> to switch between the fixed end and active end of the caliper. Or press <Clear> to cancel setting the starting point.

4. Press <Set> to set the end point.

3.3.3 Slope

Function: measures the distance and time between two points on the M Mode image and calculates the slope between the two points.

1. Select [Slope] in the measurement menu or the touch screen. Two dotted lines perpendicular to each other appear on the screen.

2. Move the crossing point of the dotted lines to the measurement starting point and press <Set>.

3. Move the crossing point to the measurement end point. The crossing point is connected to the starting point by a dashed line. Then

3-16 General Measurement

press <Update> to switch between the fixed end and active end of the caliper. Or press <Clear> to cancel setting the starting point.

4. Press <Set> to set the end point.

3.3.4 Velocity

Function: measures the distance and time between two points on the M Mode image and then calculates the average velocity between the two points.

1. Select [Velocity] in the measurement menu or the touch screen. Two dotted lines perpendicular to each other appear on the screen.

2. Move the crossing point of the dotted lines to the measurement starting point and press <Set>.

3. Move the crossing point to the end point. The crossing point can then only be moved in a vertical direction.

Then press <Update> to switch between the fixed end and active end of the caliper. Or press <Clear> to cancel setting the starting point.

4. Press <Set> to set the end point.

3.3.5 HR

Function: measures the time interval of n (n

≤8) cardiac cycles on the M Mode image and calculates the heart rate.

The number of cardiac cycles “n” can be preset in the [System Preset]

→

[Application] preset

dialog box. See “2.2 Measurement Parameters Preset” for details.

CAUTION:

During the measurement, the number of cardiac cycles between the measurement start and end points must be exactly the same as preset

([Setup]  [System Preset]  [Application]). Otherwise, misdiagnosis may occur.

1. Select [HR] in the measurement menu or the touch screen. Two dotted lines perpendicular to each other appear on the screen.

2. Select n cardiac cycles.

The HR result in the results window displays the measured heart rate value and the preset number of cardiac cycles, as shown in the figure below.

HR 76(2) Bpm

Number of

Cardiac Cycles

Heart Rate

3.3.6 HR (R-R)

Function: measures the time interval between the R peaks of n (n

≤8) cardiac cycles on the ECG image and calculates the heart rate.

The number of cardiac cycles “n” can be preset in the [System Preset]

→

[Application] preset

dialog box. See “2.2 Measurement Parameters Preset” for details.

General Measurement 3-17

CAUTION:

During the measurement, the number of cardiac cycles between the measurement start and end points must be exactly the same as preset

([Setup]  [System Preset]  [Application]). Otherwise, misdiagnosis may occur.

1. Select [HR (R-R)] in the measurement menu or the touch screen. Two dotted lines perpendicular to each other appear on the screen.

2. Move the cursor onto the starting R peak point and press <Set>.

3. Move the cursor onto the end R peak point and press <Set>.

3.4 Doppler General Measurements

3.4.1 Time

Function: measures the time interval between two points on the Doppler image.

The operations are similar to the Time measurement in M Mode. See “3.3.2 Time” for details.

3.4.2 HR

Function: measures the time interval between n (n

≤8) cardiac cycles on the Doppler Mode image and calculates the number of heart beats per minute (BPM).

The operations are similar to the Heart Rate measurement in M Mode. See “3.3.5 HR” for details.

3.4.3 D Vel.

Function: measures the velocity, pressure gradient and correction angle of a certain point on the

Doppler spectrum.

Tip: The real-time velocity displays in the results window only before the <Set> key is pressed to fix the starting point. The history value of the velocity is not displayed in the results window.

1. Select [D Vel.] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to the point to be measured for velocity.

3. Press <Set> and the result displays in the results window.

3.4.4 Acceleration

Function: measures the velocities of two points and their time interval on the Doppler image, and calculates the acceleration, pressure gradient, velocity difference and correction angle.

1. Select [Acceleration] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to the first point to be measured for velocity.

3. Press <Set> to fix the first point.

4. Move the cursor to the second point to be measured for velocity.

5. Press <Set> to fix the second point. The results display in the results window.

3.4.5 D Trace

Function: measures clinical indices using spectral Doppler tracing. Measurement methods available are Trace, Auto, Spline, Vel. (Velocity) and 2 PT (Two Points).

A sketch of a Doppler spectrum is shown below:

3-18 General Measurement

A heartbeat cycle

▼

PS a

Systolic cycle

▲

Diastolic cycle b

▲

Base line

NOTE: When doing D trace, please set systolic starting time as the starting point and diastolic ending time as end point. That is, by tracing the Doppler spectrum from systolic to diastolic to calculate indices.

 Operations:

1. Select [D Trace] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to the starting point to be measured and press the [Set] key to fix the point.

3. Move the cursor around the object.

Move the cursor right: draw a trace line overlapping the spectrum as much as possible.

Move the cursor left to correct the trace line already drawn.

4. Trace the end point to be measured and press <Set> to fix the point.

Result parameters

The results obtained from D trace are:

Parameters

Vel.

Peak Systolic Velocity

Descriptions

The highest velocity of the red blood cells crossing the sample volume.

End-Diastolic Velocity

Measures the blood velocity at the end of the cardiac cycle.

Min-Diastolic Velocity Minimum absolute Velocity in the diastolic cycle.

/ Flow velocity

Average velocity

PPG

Peak Pressure

Gradient

The average flow velocity in the whole traced Doppler spectrum.

 TAMAX (Time Averaged Maximum Velocity):

TAMAX( cm / s )

฀ ∫ Tb

( t ) dt

(

T b

−

T a

)

Where V(t) is the maximum velocity

 TAMEAN (Time Averaged Mean Velocity): Obtained by auto-spectrum calculation.

TAMEAN( cm / s )

฀ ∫ Tb

( t ) dt

(

T b

−

T a

)

Where V(t) is the mean velocity.

The corresponding pressure gradient of the peak systolic velocity. PPG (mmHg) = 4 × PS (m/s) 2

General Measurement 3-19

Parameters

Average

Pressure

Gradient

VTI

S/D

D/S

Velocity-Time Integral

Acceleration Time

Deceleration Time

Heart Rate

Pulsatility Index

Resistive Index

Peak Velocity

Descriptions

The average pressure gradient in the whole traced

Doppler spectrum.

 MPG: Maximum Pressure Gradient.

MPG ( mmHg )

∫

( )

2 dt

(

T b

−

T a

)

Where V(t) is the peak systolic velocity.

 MMPG: Mean velocity Mean Pressure Gradient.

(Obtained during auto-spectrum calculation.)

MMPG ( mmHg )

∫

( )

2 dt T b

−

T a

)

 Where V(t) is the mean systolic velocity.

Velocity-time integral. The integral of the product of

Doppler instantaneous velocity and the total time interval.

VTI

(

m

)

฀

∫

T b

V

T a

( )

dt

The time of the blood velocity accelerating from the end of diastole to the systolic peak. This is usually the time interval between the end of the first cardiac cycle and the peak of the next cardiac cycle. Choose the first peak when two peaks exist in the systolic cycle.

Deceleration Time.

Calculates the heart rate per minute by measuring the time interval of one cardiac cycle.

PS/ED.

S/D (No unit) = PS (m/s) / ED (m/s)

ED/PS.

D/S (No unit) = ED (m/s) / PS (m/s)

Pulsatility index.

PI (No unit) = |(PS (m/s) – ED (m/s)) / TAMAX (m/s)|

Resistance index. RI (No unit) = |(PS (m/s) – ED (m/s)) /

PS (m/s)|

The correction angle is the spectrum angle during measurement, which is a result obtained from a non D trace measurement tool and is usually displayed together with the spectral measurement results.

The peak velocity in systolic or diastolic cycles (with no difference), which is the highest velocity of the red blood cells that cross the sample volume. It can be used to examine the venous vessel.

3-20 General Measurement

Parameters Descriptions

NOTE:

1. In the formulae above, T means time, the unit is s; V means the velocity at each point during

T, the unit is cm/s; a is the traced starting point, while b is the traced end point.

2. The above parameters are all the information obtained in D trace, while in application the system only displays part of them according to the operation and preset.

Measurement Method

The measurement method varies according to the result selected.

 Velocity

Function: measures the velocity, pressure gradient and correction angle of a certain point on the Doppler spectrum.

The operations are similar to the Time measurement in M Mode. See “3.4.3 D Vel.” for details.

 2 PT

Function: measures the velocity, pressure gradient and correction angle between two points on the Doppler spectrum.

1. Select items using the [2 PT] method in the measurement menu, the cursor displays as a large “+.”

2. Move the cursor to the starting point to be measured and press <Set> to fix the point.

3. Move the cursor to the end point to be measured and press <Set> to fix the point.

 Spline

1. Select items using the [Spline] method from the measurement menu.

2. Move the cursor to the starting point to be measured and press <Set> to fix the point.

3. Move the cursor along the edge of the desired region. Continue to fix the second, third, etc., point (50 points at most) of the spectrum.

4. Press <Set> twice to anchor the last reference point. Or the measurement ends automatically when there are 50 reference points.

 Auto-Spectrum Calculation

You can also acquire the above results by auto calculation, which calculates the recent cardiac cycles.

 Click [Auto Calc.] in the PW image menu to activate it. The system traces automatically and displays the results in the top-right part of the screen.

 Touch “Auto Calc” tab on the touch screen, and click [Auto Calc. Param.] in the PW image menu. You can select the parameters to be calculated.

 Click [Auto Cardiac Cycle] in the PW image menu. You can select the cycle number to be calculated.

3.4.6 PS/ED

Function: measures the Peak Systolic (PS) velocity and End Diastolic (ED) velocity on the Doppler spectrum, and calculates their resistance index (RI), S/D and correction angle.

1. Select [PS/ED] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to the Systolic Peak and press <Set> to fix the point.

3. Move the cursor to the Diastolic End and press <Set> to fix the point.

General Measurement 3-21

3.4.7 Volume Flow

Function: measures blood flow through a vascular cross section per unit time.

1. Select [Volume Flow] in the touch screen. The submenu displays.

 Click [Vas. Area] to select the method for calculating the area: dist. or trace.

 Click [PW Scope] to select the scope to be traced.

2. Measure the vascular area.

3. Click [TAMEAN] or [TAMAX] to calculate the volume flow.

Item Description Methods or formulae

Vas. Area

Dist.

Trace

Obtain the area by measuring the vascular diameter.

Obtain the area using the trace method.

Vas. Area =

× Vas Diam (cm) 2 / 4

Area in 2D General Measurements

TAMEAN

TAMAX

Vol Flow(Area) -

TAMEAN

Vol Flow(Area) - TAMAX

Vol Flow(A) (ml/min) = |Vas TAMEAN (cm/s)|

× Vas. Area (cm 2 ) × 60 (s)

Vas. TAMEAN - Time Averaged Mean

Velocity, obtained from the Vas. Trace measurement.

Vol Flow(A) (ml/min) = |Vas TAMAX (cm/s)| ×

Vas Area (cm 2 ) × 60 (s)

Vas. TAMAX - Time Averaged Maximum

Velocity, obtained from the Vas. Trace measurement.

3.4.8 Velocity Ratio

Function: measure two D velocity values on one or two spectrums and calculate the ratio to analyze the flow information.

1. Select [Ratio (Vel)] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor and press <Set> to obtain two velocity values.

3. The system calculates the ratio automatically.

Where

Vel Ratio

(

Nounit

) ＝ Vel 1 (

cm

s

) / Vel 2 (

cm

s

)

3.4.9 VTI Ratio

Function: measure two VTI values on the spectrum and calculate the ratio.

1. Select [Ratio (VTI)] in the measurement menu or the touch screen. The cursor appears on the screen.

2. Move the cursor to obtain VTI1 and VTI2 values using the D trace method.

3. The system calculates the ratio automatically.

Where

VTI Ratio (

Nounit

) ＝ VTI 1 (

cm

) / VTI 2 (

cm

)

3-22 General Measurement

3.4.10 HR (R-R)

Function: measures the time interval between R peaks of n (n

≤8) cardiac cycles on the ECG image and calculates the number of heart beats per minute (BPM).

The operations are similar to the Heart Rate measurement in M Mode. See “3.3.5 HR” for details.

General Measurement 3-23

3.5 References

3Dist Volume: Emamian, S.A., et al., “Kidney Dimensions at Sonography: Correlation With

Age, Sex, and Habitus in 665 Adult Volunteers,” American Journal of

Radiology, January, 1993, 160:83-86.

HR (M general Dorland’s Illustrated Medical Dictionary, ed. 27, W. B. Sanders Co., measurement): Philadelphia,1988, p. 1425.

PG:

Acceleration:

PPG:

Powis, R., Schwartz, R. Practical Doppler Ultrasound for the Clinician.

Williams & Wilkins, Baltimore, Maryland, 1991, p. 162.

Starvos, A.T., et.al. “Segmental Stenosis of the Renal Artery Pattern

Recognition of Tardus and Parvus Abnormalities with Duplex Sonography.”

Radiology, 184:487-492, 1992.

Taylor,K.W., Strandness,D.E. Duplex Doppler Ultrasound. Churchill-

Livingstone, New York,1990.

Yoganathan, Ajit P., et al., “Review of Hydrodynamic Principles for the

Cardiologist: Applications to the Study of Blood Flow and Jets by Imaging

Techniques,” Journal of the American College of Cardiology, 1988, Vol. 12, pp. 1344-1353

MPG:

VTI:

RI:

PI:

S/D:

D/S:

Yoganathan, Ajit P., et al., “Review of Hydrodynamic Principles for the

Cardiologist: Applications to the Study of Blood Flow and Jets by Imaging

Techniques,” Journal of the American College of Cardiology, 1988, Vol. 12, pp. 1344-1353

Degroff, C. G. Doppler Echocardiography. Third Edition. Lippincott-Raven,

Philadelphia, 1999, p. 102-103

Burns, P.N., “The Physical Principles of Doppler and Spectral Analysis,” Journal of Clinical Ultrasound, November/December 1987, Vol. 15, No. 9, p. 586

Burns, Peter N., “The Physical Principles of Doppler and Spectral Analysis,”

Journal of Clinical Ultrasound, November/December 1987, Vol. 15, No. 9, p. 585

Ameriso S, et al., “Pulseless Transcranial Doppler Finding in Takayasu’s

Arteritis,” J Clin Ultrasound, September 1990; 18:592-6

Ameriso S, et al., “Pulseless Transcranial Doppler Finding in Takayasu’s

Arteritis,” J Clin Ultrasound, September 1990; 18:592-6

Burns, P.N., “The Physical Principles of Doppler and Spectral Analysis,”

Journal of Clinical Ultrasound, November/December 1987, 15(9):587.

Volume

Flow(Diam)-

TAMAX

Volume

Flow(Area)-

TAMAX

Burns, P.N., “The Physical Principles of Doppler and Spectral Analysis,”

Journal of Clinical Ultrasound, November/December 1987, 15(9):587.

3-24 General Measurement

Abdomen

4.1 Abdomen Exam Preparations

Make the following preparations before measuring:

1. Confirm that the current probe is appropriate.

2. Check that the current system date is correct.

3. Click [Info] on the touch screen and register the patient information in the [Patient Info]

→

[ABD] dialog box.

4. Switch to the correct exam mode.

4.2 Basic Abdomen Measurement Procedures

1. Click [Info] on the touch screen and register the patient information in the [Patient Info]

→

[ABD] dialog box.

2. Press <Measure> to enter the Application Measurements.

If the current menu is not the one containing the Abdomen Measurement tools, move the cursor to the menu title and select the package with the Abdomen Measurement tools.

3. Select the measurement tool in the menu (or the touch screen) to start the measurement.

See section “4.3 Abdomen Measurement Tools” and steps in “3 General Measurement” for

measurement methods.

4. Click [Report] on the touch screen to view the exam report. See “4.6 Abdomen Exam Report”

for details.

Abdomen 4-1

4.3 Abdomen Measurement Tools

NOTE: The measurement tools mentioned below are configured in the system. The application measurement packages provided in this system are generally different combinations of measurement tools.

Measurement, calculation and study measurement items in 2D and Doppler mode (no M mode measurement items) are listed below:

2D Abdomen Measurements

Types

Measurement

Tools

Liver L

Liver H

Renal L

Renal H

Renal W

Adrenal L

Adrenal H

Adrenal W

CBD

CHD

GB L

GB H

GB W

Liver W

Cortex

Portal V Diam

GB wall th.

Panc. duct

Panc. head

Descriptions

Liver Long

Diameter

Liver Anterior-

Posterior

Diameter

Liver Trans

Diameter

Renal Length

Renal Height

Renal Width

Renal Cortical

Thickness

Adrenal Length

Adrenal Height

Adrenal Width

Common bile duct

Portal Vein

Diameter

Common hepatic duct

Gallbladder

Length

Gallbladder

Height

Gall Bladder

Width

Gallbladder wall thickness

Pancreatic duct

Pancreatic head

Methods or formulae

Distance in 2D General Measurements

4-2 Abdomen

Types Tools

Panc. body

Panc. tail

Spleen L

Spleen W

Descriptions

Pancreatic body

Pancreatic tail

Spleen Length

Spleen Width

Methods or formulae

Skin-

L.Capsule

Dist.

Spleen H Spleen Height

Spleen Area /

Spleen V

Diam

Spleen A

Diam

Aorta AP

Aorta Trans

Aorta Bif.

Aorta

Aneurysm

Long

Aorta

Aneurysm AP

Spleen vein

Diam

Spleen artery

Diam

Abdominal

Aorta Anterior-

Posterior

Diameter

Abdominal

Aorta Trans

Diameter

Aorta

Bifurcation

The system automatic calculates Spleen Vol value.

Spleen Vol =

× Spleen L × Spleen W

× Spleen H

Area in 2D General Measurements

Abdominal

Aorta Aneurysm

Long Diameter

Abdominal

Aorta Aneurysm

Anterior-

Posterior

Diameter

Distance in 2D General Measurements

Aorta

Aneurysm

Trans

Iliac Diam.

Hepatic

Lesion1-3 ， d1-3

Hepatic

Cyst1-3 ， d1-

Renal Cyst1-

3 ， d1-3

Abdominal

Aorta Aneurysm

Trans Diameter

Iliac Diameter

Abdomen 4-3

Types Tools

Renal

Lesion1-3 ， d1-3

Descriptions

Pre-BL L

Pre-BL H

Pre-BL W

Post-BL L

PS Conflnc

Diam

Renal V Diam

SMV Diam

IMV Diam

Pre-void

Bladder Length

Pre-void

Bladder Height

Pre-void

Bladder Width

Post-void

Bladder Length

Post-BL H

Post-BL W

CHD

Portal V Diam

M Portal V

Diam

Splenic V

Diam

Post-void

Bladder Height

Post-void

Bladder Width

Common

Hepatic Duct

Shunt Diameter Shunt Diam

Cystic Duct

CBD

Panc duct

Panc neck

Pancreatic Duct

Pancreatic Neck

Appendix Appendix

Appendix Wall Appendix Wall

Pylorus

Pylorus Wall

Cystic Duct

Common Bile

Duct

Pylorus

Pylorus Wall

Portal Vein

Diameter

Main Portal Vein

Diameter

Splenic Vein

Diameter

Portal Splenic

Confluence

Diameter

Renal Vein

Diameter

Superior

Mesenteric Vein

Diameter

Inferior

Mesenteric Vein

Diameter

4-4 Abdomen

Methods or formulae

Types

Calculation

Study

Tools

Cortex(Renal

Transplant1-2)

Renal V

Diam(Renal

Transplant1-2)

Ureter

Diam(Renal

Transplant1-2)

Ureter

Hepatic

Lesion1~3

Elas.

Descriptions

Renal Cortical

Thickness

Renal Vein

Diameter

Ureter Diameter

LSM

Aorta

Aneurysm

Status

Smart HRI

Free Fluid

Aorta Stan D

Aorta Stan A

Renal Vol.

Pre-BL Vol.

Post-BL Vol.

Mictur. Vol.

Spleen

Methods or formulae

Hepatic

Lesion1~3

Elastography

Liver Stiffness

Measurement

Elastography in 2D General Measurements

Abdominal

Aorta Aneurysm

Status

Tick the shape of Abdominal Aorta Aneurysm.

Choose from: Fus (Fusiform); Sacc

(Saccular); Pseudo; N/A

See below

Free Fluid

Status

Aorta Stenosis

Diameter

Tick the organs or tissues containing free fluid.

Choose from: Hepat (Hepatic); Spln

(Splenic); Card (Cardiac); Pelv (Pelvis); N/A

Aorta Stenosis D (No unit) = (Normal Diam.

(cm) – Resid Diam. (cm)) / Normal Diam.

(cm) × 100%

Stenosis D (No unit) = | (D1-D2) / MAX

(D1, D2)|*100%

Where D1 and D2 refer to the measured

Aorta diameter, and MAX (D1, D2) represents the larger value of the two.

Aorta Stenosis

Area

Stenosis A (No unit) = | (A1-A2) / MAX (A1,

A2) |*100%

Where A1 and A2 refer to the measured

Aorta area, and MAX (A1, A2) represents the larger value of the two.

Renal Volume

See “Renal Vol.”

Pre-void

Bladder Volume

See “Pre-BL Vol.”

Post-void

Bladder Volume

See “Post-BL Vol.”

Micturated

Volume

See “Mictur. Vol.”

Spleen L 、 Spleen W 、 Spleen H 、 Spleen

Area

Abdomen 4-5

Types Tools

Aorta

Aneurysm

Descriptions Methods or formulae

Aorta Aneurysm H 、 Aorta Aneurysm W 、

Aorta Aneurysm L

Hepatic

Lesion1-3

Hepatic

Cyst1-3

Renal Cyst1-3 /

Renal

Lesion1-3

Kidney

Adrenal

Bladder

Hepatic

Lesion1~3

ElasRatio

Celiac Axis

SMA

Superior

Mesenteric

Artery

C Hepatic A

Proper

Hepatic A

Splenic A

GDA

IMA

Hepatic Lesion1-3 d1-3

Hepatic Cyst1-3 d1-3

Renal Cyst1-3 d1-3

Renal Lesion1-3 d1-3

See “Kidney”

See “Adrenal”

See “Bladder”

Elastography ratio in 2D General

Measurements

Common

Hepatic Artery

Proper Hepatic

Artery

Hepatic Artery

Splenic Artery

Gastroduodenal

Artery

Inferior

Mesenteric

Artery

Anterior-Posterior, Transverse

Same as the Distance measurement in 2D

General Measurements

Celiac Axis

Aneurysm

SMA

Aneurysm

C Hepatic A

Aneurysm

Proper

Hepatic A

Aneurysm

Hepatic A

Aneurysm

Superior

Mesenteric

Arterial

Aneurysm

Common

Hepatic Artery

Aneurysm

Proper Hepatic

Artery

Aneurysm

Hepatic Artery

Aneurysm

Long, Anterior-Posterior, Transverse

Same as the Distance measurement in 2D

General Measurements

4-6 Abdomen

Types Tools

Splenic A

Aneurysm

GDA

Aneurysm

IMA

Aneurysm

EVAR

Residual

Aneurysm

Sac(2D)

EVAR

Inflow(2D)

EVAR Graft

Body(2D)

EVAR

Limb(2D)

EVAR

Outflow(2D)

Aortic Bypass

Graft

Anast(2D)

Aortic Bypass

Graft

Graft(2D)

ABD Stenosis

1-4 2D

Descriptions

Splenic Arterial

Aneurysm

Gastroduodenal

Arterial

Aneurysm

Inferior

Mesenteric

Arterial

Aneurysm

Aortic

Endograft

Residual

Aneurysm Sac

Aortic

Endograft

Inflow

Aortic

Endograft Graft

Body

Aortic

Endograft Limb

Aortic

Endograft

Outflow

Methods or formulae

Anterior-Posterior, Transverse

Same as the Distance measurement in 2D

General Measurements

Aortic Bypass

Graft

Anastomosis

Aortic Bypass

Graft Graft

Abdominal

Arterial

Stenosis 1-4

 Anterior-Posterior, Transverse

Same as the Distance measurement in

2D General Measurements

 Stenosis

Stenosis Diameter (No unit) = | (Outer D-

Inner D) / MAX (Outer D, Inner D)|*100%

Where Outer D and Inner D refer to the measured vascular diameter, and MAX

(Outer D, Inner D) represents the larger value of the two.

Stenosis Area (No unit) = | (Outer A-

Inner A) / MAX (Outer A, Inner A) |*100%

Where Outer A and Inner A refer to the measured vascular area, and MAX

(Outer A, Inner A) represents the larger value of the two.

Abdomen 4-7

Types Tools

R Liver Lobe

L Liver Lobe

Descriptions

Right Liver

Lobe

Right Liver

Lobe

Gall Bladder GB

Kidney(Renal

Transplant1-

Adrenal(Renal

Transplant1-

Finding

1(Renal

Transplant1-

GB Finding 1-

Panc Finding

1-5

Gall Bladder

Finding 1-5

Pancreas

Finding 1-5

Methods or formulae

Height, Width, Length

Same as the Distance measurement in 2D

General Measurements d1-3

Same as the Distance measurement in 2D

General Measurements

IVC(2D)

Inferior Vena

Cava

 Anterior-Posterior, Transverse, Depth

Same as the Distance measurement in

2D General Measurements

 Checklist

Tick the status of Inferior Vena Cava.

Choose from: Cmp (Compression); Sp

(Spontenaity); Ph (phasicity); Aug

(Augmentation); Rflx (Reflux); N/A

Hepatic V(2D) Hepatic Vein

Lt Hepatic

V(2D)

M Hepatic

V(2D)

Rt Hepatic

V(2D)

Left Hepatic

Vein

Middle Hepatic

Vein

Right Hepatic

Anterior-Posterior, Transverse

Same as the Distance measurement in 2D

General Measurements

Renal A

Aneurysm

Renal Arterial

Aneurysm

Long, Anterior-Posterior, Transverse

Same as the Distance measurement in 2D

General Measurements

Doppler Abdomen Measurements

Types

Measurement

Tools

Ren. A Org.

Arcuate A

Segment A

Descriptions

Renal Artery Origin

Arcuate Artery

Segmental Artery

Methods or formulae

D trace in General D measurements

4-8 Abdomen

Types Tools

Interlobar A

Renal A

Descriptions

Interlobar Artery

Renal Artery

M Renal A

Aorta

Main Renal Artery

Aorta(Post)

Arterial Post Abdominal

Aorta

Celiac Axis /

Celiac Axis(Post) Arterial Post Celiac Axis

Methods or formulae

SMA

SMA(Post)

GDA

GDA(Post)

Superior Mesenteric

Artery

Arterial Post Superior

Mesenteric Artery

Gastroduodenal Artery

Arterial Post

Gastroduodenal Artery

IMA

IMA(Post)

Inferior Mesenteric

Artery

Arterial Post Inferior

Mesenteric Artery

C Hepatic A Common Hepatic Artery

C Hepatic A(Post) Common Hepatic Artery

D trace and PS/ED in General

D measurements

Proper Hepatic A Proper Hepatic Artery

Proper Hepatic

A(Post)

Arterial Post Proper

Hepatic Artery

Hepatic A

Hepatic A(Post)

Hepatic Artery

Arterial Post Hepatic

Artery

Splenic A

Splenic

Artery(Post)

EVAR Residual

Aneurysm Sac

EVAR Inflow

Splenic Artery

Arterial Post Splenic

Artery

Aortic Endograft

Residual Aneurysm Sac

Aortic Endograft Inflow

EVAR Graft Body

EVAR Limb

EVAR Outflow

Aortic Bypass

Graft Anast

Aortic Bypass

Graft Graft

Aortic Endograft Graft

Body

Aortic Endograft Limb

Aortic Endograft Outflow

Aortic Bypass Graft

Anastomosis

Aortic Bypass Graft Graft

D trace in General D measurements

Abdomen 4-9

Types

Portal V

M Portal V

Hepatic V

Lt Hepatic V

Rt Hepatic V

M Hepatic V

Splenic V

Renal V

Hepatic A

Anast(Liver

Transplant)

Hepatic V

Anast(Liver

Transplant)

Portal V

Anast(Liver

Transplant)

Artery

Anast(Renal

Transplant1-2)

Artery Anast

2(Renal

Transplant1-2)

Vein Anast(Renal

Transplant1-2)

Vein Anast

2(Renal

Transplant1-2)

Tools

IVC(Liver

Transplant)

Hep V Confl(Liver

Transplant)

Descriptions

Inferior Vena Cava

Hepatic Vein Confluence

Donor IVC(Liver

Transplant)

Renal A1

Renal A2

Hilum

TIPS

IVC

IVC Reflux

Inferior Vena Cava from the donor, not the recipient

Renal Artery A1

Renal Artery A2

Transjugular Intrahepatic

Portosystemic Shunt

Inferior Vena Cava

Reflux

Portal Vein

Main Portal Vein

Hepatic Vein

Left Hepatic Vein

Right Hepatic Vein

Middle Hepatic Vein

Splenic Vein

Renal Vein

Hepatic A Anastomosis

Hepatic V Anastomosis

Portal V Anastomosis

Artery Anastomosis

Artery Anastomosis 2

Vein Anastomosis

Vein Anastomosis 2

Methods or formulae

Time in M General

Measurements

D trace in General D measurements

4-10 Abdomen

Types

Calculation

Study

Tools

Renal A(Renal

Transplant1-2)

Renal A1(Renal

Transplant1-2)

Renal A2(Renal

Transplant1-2)

Descriptions

Renal Artery

Renal Artery A1

Renal Artery A2

Hilum(Renal

Transplant1=2)

Arcuate A(Renal

Transplant1-2)

Hilum

Interlobar A(Renal

Transplant1-2)

Interlobar Artery

Arcuate Artery

Segmental

A(Renal

Transplant1-2)

Renal Vein

1/2(Renal

Transplant1-2)

Segmental Artery

Renal Vein 1/2

SMV

IMV

RAR

SMA/Ao

CA/Ao

ABD Stenosis 1-4

Superior Mesenteric

Vein

Inferior Mesenteric

Artery

Ratio of Renal Artery

PS the Abdominal Aorta

Ratio of Superior

Mesenteric Artery PS and Abdominal Aorta

Ratio of Celiac Axis PS and Abdominal Aorta

Abdominal Arterial

Stenosis 1-4

Renal Transplant

1-2(Doppler)

Methods or formulae

RAR (no unit) = |Renal A PS

(cm/s)/Aorta PS (cm/s)|

SMA/Ao (no unit) = |SMA PS

(cm/s)/ Aorta PS (cm/s)|

CA/Ao (no unit) = |Celiac Axis

PS (cm/s)/ Aorta PS (cm/s)|

D trace in General D measurements

4.4 Abdomen Measurement Operations

Tip: 1.

See the table in “4 Abdomen Measurement Tools” above for measurement tools

and methods.

For the definitions of measurement, calculation and study, see “1.3 Measurement,

Calculation and Study”.

The order of the measurement items can be preset. See “2.4.2 Application

For details about report browsing, printing and exporting, etc., see “1.7 Report.”

Abdomen 4-11

4. A measurement tool can be activated by clicking the item in the measurement menu or on the touch screen. It is described as “Select/Click ... in the measurement menu” in the following procedures.

1. Select the item/tool in the measurement menu.

2. Perform the measurement referring to the methods in the table above.

 Auto HRI Measurement (Smart HRI)

Smart HRI is an auto measurement method for Hepatorenal Index (HRI). HRI is the brightness ratio of liver to right renal cortex. The procedure is as follows:

1. Scan the proper image.

2. Select the Smart HRI measurement item from the menu.

3. The system positions the ROI of Liver (marked by L) and the ROI of right renal (marked by

RC) automatically. The measurement results are displayed on the screen

If necessary, you can rotate the trackball to move the ROI or rotate the <Angle> knob to adjust the size of the ROI. Press <Update> to switch ROIs.

4. Press <Set> to confirm the measurement.

4.5 Calculation Tool Operations

Stenosis D

Function: measures the Normal Diam. and Resid. Diam., calculates the Stenosis D.

1. Select [Stenosis D] in the measurement menu or the touch screen.

2. Use the Distance measurement method in 2D General Measurements to measure the Normal

(D) and Resid (D).

The Stenosis D is calculated automatically.

Stenosis A

Function: measures the Normal Area and Resid. Area, calculates the Stenosis A.

1. Select [Stenosis A] in the measurement menu or the touch screen.

2. Use the Area measurement method in 2D General Measurements to measure the Normal(A) and Resid(A).

The Stenosis A is calculated automatically.

4.6 Abdomen Exam Report

During or after a measurement, Click [Report] on the touch screen to browse the report.

4-12 Abdomen

Obstetrics

Obstetric measurements are used to estimate the GA and EDD and calculate the growth indices, including the EFW. The growth estimate is determined by the growth curve and fetal biophysical profile.

5.1 Obstetric Exam Preparations

Make the following preparations before measuring:

1. Confirm that the current probe is appropriate.

2. Check that the current system date is correct.

3. Click [Info] on the touch screen and register the patient information in the [Patient Info]

→

[OB] dialog box.

For more details, see “Exam Preparation

→

Patient Information” in the Operator's Manual

[Basic Volume].

4. Switch to the correct exam mode.

CAUTION:

Ensure the system date is correct, otherwise the GA and EDD calculated will be wrong.

5.2 Basic Measurement Procedures

1. Click [Info] on the touch screen and register the patient information in the [Patient Info]

→

[OB] dialog box.

The clinical GA is calculated when the corresponding data is entered on this page. See “5.3.1

Clinical GA” for details.

2. Press <Measure> to enter the Application Measurements.

3. Select the measurement tool from the menu or the touch screen to start the measurement.

See the table in “5.4 Obstetric Measurement Tools” below for measurement tools.

See section “5.5 Obstetric Measurement Operations” and steps in “3 General Measurement”

for measurement methods.

4. Click [Report] on the touch screen to view the exam report. See “5.7 Obstetric Exam Report”

for details.

Obstetrics 5-1

5.3 GA

5.3.1 Clinical GA

The GA (Gestational Age) and EDD (Estimated Delivery Date) are calculated according to clinical parameters.

1. Click [Info] on the touch screen and register the patient information in the [Patient Info]

→

[OB] dialog box.

The system automatically calculates the GA and EDD after entering the relative information.

The calculation methods are listed as follows:

 LMP: enter the LMP, the system will calculate the GA and EDD.

 DOC: enter the DOC, the system will calculate the GA and EDD.

 IVF: after you enter IVF, the system will calculate the GA and EDD.

 PRV: enter the date and GA of the last exam, the system will calculate a new GA and

EDD.

 BBT: after you enter BBT, the system will calculate the GA and EDD.

 EDD: enter the EDD, the system will calculate the GA and LMP.

2. The clinical GA is shown at the top of the obstetric report.

Tip: The latest EDD and GA calculation is considered as the final value if more than one

EDD and GA calculations are valid.

5.3.2 Ultrasound GA

The ultrasound GA and ultrasound EDD are calculated according to the parameters obtained in the measurements.

 GA in OB Items

 AUA (Average Ultrasound Age)

 CUA (Composite Ultrasound Age)

GA in OB Items

The GA in the OB items is calculated from the related GA tables/formulae. It is independent from the clinical GA.

1. You can preset the GA formulae and whether to display the EDD or not in [System Preset]

→

[OB]. See “2.3 Obstetric Preset” for details.

2. The GA and other measurement values display in the results window after a measurement.

If the Diagnostic GA exceeds the threshold, an OOR (out of range) displays in the results window and this result is not recorded in the report.

3. The GA of an OB item displays to the right of the item measurements.

5-2 Obstetrics

4. For result values used to calculate GA (Gestational Age) and EDD (Estimated Date of

Delivery), the formula used in this calculation can be selected from [Formula].

AUA

AUA is the average of the valid GAs that are calculated according to the biparietal diameter (BPD), head circumference (HC), abdomen circumference (AC), femur length (FL), Gestational Sac (GS), crown rump length (CRL), etc.

1. All valid values of all the above items will be included in the AUA calculation in the system default method.

2. Click the checkboxes to the right of the related items to select whether to include the item in the AUA calculation or not. The AUA value varies according to the selection.

CUA

The CUA is calculated according to formulae based on certain measurement items (the items involved include the biparietal diameter (BPD), head circumference (HC), abdomen circumference

(AC) and femur length (FL)). To calculate the CUA, all the GA formulae of the parameters involved must be Hadlock, the unit of the parameters is cm and unit of CUA is week. The formulae are listed as follows:

1. CUA(BPD) = 9.54+1.482*BPD+0.1676*BPD 2

2. CUA(HC) = 8.96+0.540*HC+0.0003*HC 3

3. CUA(AC) = 8.14+0.753*AC+0.0036*AC 2

4. CUA(FL) = 10.35+2.460*FL+0.170*FL 2

5. CUA(BPD, HC) = 10.32+0.009*HC 2 +1.3200*BPD+0.00012*HC 3

6. CUA(BPD, AC) = 9.57+0.524*AC+0.1220*BPD 2

7. CUA(BPD, FL) = 10.50+0.197*BPD*FL+0.9500*FL+0.7300*BPD

8. CUA(HC, AC) = 10.31+0.012*HC 2 +0.3850*AC

9. CUA(HC, FL) = 11.19+0.070*HC*FL+0.2630*HC

10. CUA(AC, FL) =10.47+0.442*AC+0.3140*FL 2 - 0.0121*FL 3

11. CUA(BPD, HC, AC) = 10.58+0.005*HC2 +0.3635*AC+ 0.02864*BPD*AC

12. CUA(BPD, HC, FL) = 11.38+0.070*HC*FL+0.9800*BPD

13. CUA(BPD, AC, FL) = 10.61+0.175*BPD*FL+0.2970*AC+0.7100*FL

14. CUA(HC, AC, FL) = 10.33+0.031*HC*FL+0.3610*HC+0.0298*AC*FL

15. CUA(BPD, HC, AC, FL)=10.85+0.060*HC*FL+0.6700*BPD+0.1680*AC

The default method of calculating the CUA is to use the formula that involves more measurement items. You can also select the parameters by clicking the checkboxes to the right of the related items.

OB Growth Percentile

The obstetric growth percentile is used to estimate the fetal growth. It calculates the difference between the ultrasound measurement results and the measurement results corresponding to the clinical GA in the FG table. The percentile will not be calculated when there is no clinical GA, or no

FG table, or the SD Type of the FG table is set to “None.”

The premise is: data in the FG table are (approximately) normally distributed and support “lowerlimit < average value < upper-limit.”

Obstetrics 5-3

The system does not calculate the OB growth percentile if:

 An FG table is not normally distributed.

 There is no upper/lower deviation set in the FG table.

 The FG table has the upper/lower deviation set, but certain clinical GA values have no upper/lower deviation or the deviation value is not plus. The fetal growth curve is not affected.

E.g. Jeanty FG table of RAD.

The OB growth percentile is displayed in the results window, the measurement report, the exported

PDF report and the OB structured report, and it supports print viewing and printing.

5-4 Obstetrics

5.4 Obstetric Measurement Tools

The system supports the following 2D/M/Doppler obstetric measurements.

NOTE: 1. The measurement tools mentioned below are configured in the system. The application measurement packages provided in this system are generally different combinations of measurement tools. For more information about package preset,

see “2.4.2.2 Application Measurement Preset.”

2. The Smart NT must be used with convex-wide probe and good image quality. If an evident inaccurate recognition exists, confirm the target profile manually and adjust the result.

3. If the results of the calculation items of CI, FL/BPD, FL/AC, HC/AC and FL/HC exceed the clinical range, the result value displays as “value*.”

2D Obstetric Measurements

Types Tools

YS L

CRL

BPD

Measurement OFD

TAD

APAD

Descriptions Methods or formulae

Gestational Sac Diameter Distance in 2D General

Yolk Sac Length

Measurements

Crown Rump Length

Nuchal Translucency

Dist (same as Distance in

2D General

Measurements), Trace,

Spline

Distance in 2D General

Measurements (Support

Smart NT method if the

Smart NT function is configured)*

Biparietal Diameter

Occipital Frontal

Diameter

Femur Length

Head Circumference

Abdominal

Circumference

Distance in 2D General

Measurements (Support

Smart OB method if the

Smart OB function is configured)

The system automatic calculates GA value.

Circumference in 2D

General Measurements

(Support Smart OB method if the Smart OB function is configured)

Intracranial Translucency

Abdominal Transversal

Diameter

Anteroposterior

Abdominal Diameter

Distance in 2D General

Measurements

1 Head Circumference: in the HC measurement, if the measurement cursor of BPD appears on the screen, then the measurement starting point will be automatically positioned at the measurement cursor starting point of the last

BPD. If you use “Ellipse” to measure the HC, the measurement cursor of the last BPD will be the first axis of the ellipse in the default status.

Obstetrics 5-5

Types Tools

TCD

Cist Magna

LVW

OOD

NBL

IOD

HUM

Ulna

RAD

Tibia

FIB

CLAV

Vertebrae

Foot

Ear

APTD

TTD

FTA

THD

HrtC

Umb. VD

F-kidney L

F-kidney H

F-kidney W

Mat. Kidney

Lung

Stomach

YS H

YS W

5-6 Obstetrics

Descriptions

Cerebellum Diameter

Cist Magna

Lateral Ventricle Width

Hemisphere Width

Outer Orbital Diameter

Nasal Bone Length

Inter Orbital Diameter

Humerus Length

Ulna Length

Radius Length

Tibia Length

Fibula Length

Clavicle Length

Length of Vertebrae

Middle Phalanx Length

Methods or formulae

Foot Length

The GA is calculated automatically after foot measurements are completed.

Ear Length

Anteroposterior trunk diameter

Transverse trunk diameter

Fetal Trunk Crosssectional Area

Thoracic Diameter

Heart Circumference

Thoracic circumference

Umbilical Vein Diameter

Fetal kidney Length

Fetal kidney Height

Fetal kidney Width

Matrix Kidney Length

Lung Length

Stomach Length

Yolk Sac Height

Yolk Sac Width

Distance in 2D General

Measurements

Area in 2D General

Measurements

Distance in 2D General

Measurements

Area in 2D General

Measurements

Distance in 2D General

Measurements

Types

Sac Diam3

AF1

AF2

AF3

AF4

LVIDd

LVIDs

LV Diam.

LA Diam.

RVIDd

RVIDs

Measurement

RV Diam.

RA Diam.

Tools

Amniotic Sac L

Amniotic Sac H

Amniotic Sac W

Ovary Cyst L

Ovary Cyst H

Ovary Cyst W

UT AW

UT PW

Cervix L

Orbit

PL Thickness

Sac Diam1

Sac Diam2

Descriptions

Amniotic Sac Length

Amniotic Sac Height

Amniotic Sac Width

Ovary Cyst Length

Ovary Cyst Height

Ovary Cyst Width

UT Anterior wall thickness

UT Posterior wall thickness

Cervical Length

Amniotic Fluid

Nuchal Fold

Orbit

Placental Thickness

Gestational Sac Diameter

Amniotic Fluid 1

Amniotic Fluid 2

Amniotic Fluid 3

Amniotic Fluid 4

Left Ventricular Internal

Diameter at End-diastole

Left Ventricular Internal

Diameter at End-systole

Left Ventricular Diameter

Left Atrium Diameter

Right Ventricular Internal

Diameter at End-diastole

Right Ventricular Internal

Diameter at End-systole

Right Ventricular

Diameter

Right Atrium Diameter

Methods or formulae

Obstetrics 5-7

Types

IVSd

IVSs

IVS

LV Area

Tools

LA Area

RV Area

RA Area

Ao. Diam.

MPA Diam.

LVOT Diam.

RVOT Diam.

Facial Angle

Descriptions

Interventricular Septal

Thickness at Enddiastole

Interventricular Septal

Thickness at End-systole

Interventricular Septal

Thickness

Left Ventricular Area

Left Atrium Area

Right Ventricular Area

Right Atrium Area

Aorta Diameter

Main Pulmonary Artery

Diameter

Left Ventricular Outflow

Tract Diameter

Right Ventricular Outflow

Tract Diameter

Angle of the two lines: one from fetus nasal base to forehead and the other from nasal base to ear base.

Methods or formulae

Distance in 2D General

Measurements

Angle in 2D General

Measurements

HrtA Heart area

Area in 2D General

Measurements

MV Diam(Z-Score)

PV Diam(Z-Score)

Ao. Asc. Diam(Z-

Score)

Ao. Desc. Diam(Z-

Score)

Duct. Art. Diam(Z-

Score)

TV Diam(Z-Score)

LPA Diam(Z-Score)

RPA Diam(Z-Score)

Mitral Valve diameter

Pulmonary Valve

Diameter

Ascending Aorta

Diameter

Descending Aorta

Diameter

Ductus Arteriosus

Diameter

Tricuspid Valve Diameter

Left Pulmonary Artery

Diameter

Right Pulmonary Artery

Diameter

Aorta Valve Diameter AV Diam(Z-Score)

IVC Diam(Z-Score)

Inferior Vena Cava

Diameter

MPA Diam(Z-Score) /

Distance in 2D General

Measurements

5-8 Obstetrics

Types Tools

RV Diam(Z-Score)

LV Diam(Z-Score)

RV Area(Z-Score)

LV Area(Z-Score)

RVIDd(Z-Score) lVIDd(Z-Score)

UT L

UT H

UT W

Endo.

3rd Ventricle

NT Above Cord

NT Below Cord

Mandible

Prenasal th

Heart (AP)

Heart (T)

LV Width

LV Length

RV width

RV Length

RA width

LA width

LVWd

LVWs

RVWd

RVWs

CSP

Descriptions Methods or formulae

Uterine Length

Distance, Trace and Spline in 2D General

Measurements

Uterine Height

Uterine Width

Endometrium Thickness

Lateral Ventricle Anterior

Lateral Ventricle

Posterior

Prenasal thickness

Heart Anterior-Posterior

Heart Transverse

Left Ventricular Width

Left Ventricular Length

Right Ventricular Width

Right Ventricular Length

Right Atrium Width

Left Atrium Width

Left Ventricular Wall

Thickness at Enddiastole

Left Ventricular Wall

Thickness at End-systole

Right Ventricular Wall

Thickness at Enddiastole

Right Ventricular Wall

Thickness at End-systole

Cavum Septum

Pellucidum

Distance in 2D General

Measurements

Distance in 2D General

Measurements

Obstetrics 5-9

Types

Calculation

FMF

MMF

Tools

Lung CCAM L

Lung CCAM H

Lung CCAM W

Descriptions

Frontomaxillary facial angle

Mandibulomaxillary facial angle

Lung Congenital Cystic

Adenomatoid

Malformation Length

Lung Congenital Cystic

Adenomatoid

Malformation Height

Lung Congenital Cystic

Adenomatoid

Malformation Width

Abdominal Diameter

Methods or formulae

Angle in 2D General

Measurements

Distance in 2D General

Measurements

Lliac Wing Angle

FAGL

FAG

Fetal Adrenal Gland length

Fetal Adrenal Gland

Angle in 2D General

Measurements

Distance in 2D General

Measurements

Area in 2D General

Measurements

Intestinum Crassum /

Liver Length /

Rib Length

Shoulder Blade

AV Area

PV Area

Aorta Valve Area

Pulmonary Valve Area

AC (c)

Mean Sac Diam

AFI

EFW

EFW2

HC/AC

Distance in 2D General

Measurements

Area in 2D General

Measurements

Cross for area in 2D

General Measurements

AC(c ） = π (TAD+APAD)/ ２

Mean Gestational Sac

Diameter

The average value of three sac diameters

Measure the maximum AFs of the four amniotic fluid pockets of pregnant woman.

AFI = AF1+AF2+AF3+AF4

Estimated Fetal Weight 1 EFW is calculated by the default EFW formula, based on multiple measured

parameters. See “2.3.1

Estimated Fetal Weight 2

Obstetric Formula.” The

formula can be reselected in the OB report.

/ HC/AC

5-10 Obstetrics

Types

Study

FL/AC

FL/BPD

Tools

AXT

FL/HC

HC(c)

HrtC/TC

TCD/AC

LVW/HW

LVD/RVD

LAD/RAD

AoD/MPAD

LAD/AoD

UT Vol.

Uterus Body

UT-L/ CX-L

AFI

Uterus

M Obstetric Measurements

Types Tools

OB_FHR(M)

LVIDd

LVIDs

Measurement

RVIDd

RVIDs

IVSd

Descriptions

UT Volume

Methods or formulae

FL/AC×100

FL/BPD ×100%

APTD × TTD

BPD/OFD ×100%

FL/AC×100

HC(c) = 2.325×(BPD 2 +

OFD 2 ) 1/2

HrtC/TC

TCD/AC

LVW/HW × 100%

LV Diam/RV Diam

LA Diam/RA Diam

Ao Diam/MPA Diam

LA Diam/Ao Diam

See “UT Vol” in 8.4.2

See “Uterus Body” in 8.4.2

See “UT-L/ CX-L” in 8.4.2

Measures AF1, AF2, AF3,

AF4, calculates AFI

See “Uterus” in 8.4.3

Descriptions

Fetal Heart Rate

Methods or formulae

Heart Rate in M General

Measurements

Left ventricular shortaxis diameter at end diastole

Left ventricular shortaxis diameter at end systole

Right ventricular shortaxis diameter at end diastole

Right ventricular shortaxis diameter at end systole interventricular septal thickness at end diastole

Distance in 2D General

Measurements

Obstetrics 5-11

Types

IVSs

RVIDd(Z-Score)

LVIDd(Z-Score)

MVE

TVE

TAPSE

MAPSE

AVE

LV ICT

LV IRT

LV ET

RV ICT

RV IRT

RV ET

Calculation /

Study /

Tools Descriptions interventricular septal thickness at end systole

Mitral Valve Extent

Tricuspid Valve Extent

Tricuspid Annular

Plane Systolic

Excursion

Mitral Annular Plane

Systolic Excursion

Aorta Valve Extent

LV Isovolumil

Contraction Time

LV Isovolumic

Relaxation Time

LV Ejection Time

RV Isovolumil

Contraction Time

RV Isovolumic

Relaxation Time

RV Ejection Time

Doppler Obstetric Measurements

Types Tools

Umb A

Placenta A

MCA

Measurement Fetal Ao.

Desc. Aorta

Ut. A

Ovarian A

Descriptions

Umbilical Artery

Placenta Artery

Middle Cerebral Artery

Fetal Aorta

Descending Aorta

Uterine Artery

Ovarian Artery

Methods or formulae

Distance in M General

Measurements

Time in M General

Measurements

The system calculates TEI index automatically.

Methods or formulae

D trace in General D measurements

5-12 Obstetrics

Types

MV E

MV A

TV E

TV A

MV E’

MV A’

MV S’

TV E’

TV A’

TV S’

AV PV

AV VTI

PV VTI

Duct Art PV

Thoracic Aorta

Hepatic Vein

IVC

Tools

Duct. Veno

OB_FHR(Doppler) Fetal Heart Rate

Asc. Aorta

RVOT

LVOT

PV PV

Duct Art VTI

Umb V

Ovary /

Descriptions

Ductus Veno

Umbilical vein

Methods or formulae

D trace in General D measurements

Acquire Duct Veno D by 3-PT method to measure peak value of ventricular systole

(S), peak value of early diastole (D) and minimum value of atrial contraction (a).

HR in General D measurements

Ascending Aorta

Right Ventricle Outflow

Tract

Left Ventricle Outflow

Tract

Mitral Valve E-wave

Mitral Valve A-wave

Tricuspid Valve E-wave

Tricuspid Valve A-wave

Mitral Valve E’-wave

Mitral Valve A’-wave

Mitral Valve S’-wave

Tricuspid Valve E’-wave

Tricuspid Valve A’-wave

Tricuspid Valve S’-wave

Aorta Valve Peak velocity

Aorta Valve Flow velocity integral

Pulmonary Valve Peak velocity

Pulmonary Valve Flow velocity integral

Duct Art Peak velocity

Duct Art Flow velocity integral

Inferior Vena Cava

D Trace in General D measurements

D Vel. in Doppler General

Measurements

These measurement items should be performed on

Doppler mode

D Vel. in Doppler General

Measurements

These measurement items should be performed on TDI mode

D Trace in General D measurements

D Vel. in Doppler General

Measurements

D Trace in General D

Obstetrics 5-13

Types

Calculation

Study

Tools

Endometrium

Cervical Cancer

Fibroid

Duct Art

ICA

Celiac A

MV E/A

TV E/A

MV E/E’

TV E/E’

Descriptions

Ductus Arteriosus

Internal Carotid Artery

Celiac Artery

Methods or formulae measurements

Mitral Valve E-Vel./A-Vel.

Tricuspid Valve E-Vel./A-

Vel.

Mitral Valve E-Vel./E’-Vel.

Tricuspid Valve E-Vel./E’-

Vel.

MV E/A=|MV E Vel. (cm/s)

/MV A Vel. (cm/s)|

TV E/A=|TV E Vel(cm/s)/TV A

Vel(cm/s)|

MV E/E’=|MV E Vel.

(cm/s)/MV E’ Vel. (cm/s)|

TV E/E’=|TV E Vel(cm/s)/TV

E’ Vel(cm/s)|

5.5 Obstetric Measurement Operations

Operations of measurement, calculation and study are described using examples.

Tip: 1.

See the table in “5.4 Obstetric Measurement Tools” above for measurement tools

and methods.

For the definitions of measurement, calculation and study, see “1.3 Measurement,

The order of the measurement items can be preset. See “2.4.2 Application

See “Select Measurement Method” for details on how to select a method online.

5.5.1 Measurement Tool Operations

Take the HC measurement as an example.

1. Select the [HC] item/tool in the measurement menu or the touch screen.

2. Measure the area according to the Area method in 2D General Measurements.

The measurement results, GA calculation and OB growth percentile display in the results window.

You can preset whether to display the EDD or not in [System Preset]

→

[OB]

→

[Fetal

Gestational Age].

For more details about GA, see “5.3 GA.”

5-14 Obstetrics

 Auto OB Measurement (Smart OB)

There is an auto measurement method for commonly-used OB measurement items (BPD, HC, AC,

FL, HUM, OFD, NT and etc.). The procedure is as follows:

1. Scan the proper image.

2. Select the OB measurement item from the menu and select the [Auto] method.

3. The measurement caliper is drawn on the image automatically.

You can rotate the trackball to modify the caliper if the result of the auto measurement does not match the image exactly.

4. Press <Set> to confirm the measurement.

Or, press <Update>/<Clear> to modify the caliper for a more accurate result.

5.5.2 Calculation Tool Operations

Take the HC/AC measurement as an example.

1. Select the [HC/AC] item/tool in the measurement menu or the touch screen.

2. Measure the HC and AC according to the Area method in 2D General Measurements.

The second measurement is activated automatically when the first one is completed. The results display in the results window after measurement.

5.5.3 Study Tool Operations

The operation of the AFI measurement is as follows:

1. Select [AFI] in the measurement menu or the touch screen. Enter the submenu.

2. Measure the maximum AFs of the four amniotic fluid pockets of pregnant woman. The AFI is calculated automatically.

5.6 Multi-Fetus Exam

The system allows multi-fetus examination (4 at most).

NOTE: Ensure that the fetus displayed in the multi-fetus measurement menu is the one on which you intend to perform the measurements.

In a similar way to the OB measurement:

1. Set the number of fetuses in [Gestations] via [Info]

→

[OB].

If [Gestations] is set to be more than 1, the [Fetus] widget displays on the touch screen, as shown in the figure below.

Fetus

You can switch between [Fetus A], [Fetus B], [Fetus C] or [Fetus D] via rotating the knob under the [Fetus] item on the touch screen).

2. Carry out the measurement of the fetus respectively.

The measurement results in the results window are marked with fetus label A, B, C or D.

Obstetrics 5-15

3. In the Obstetric report, select [Fetus A], [Fetus B], [Fetus C] or [Fetus D] to switch between the results for different fetuses.

4. Touch [Fetus Compare] on the touch screen to see a visualized comparison result.

5. Touch [Tend] to enter the [OB Graph] dialog box, select [A], [B], [C] or [D] on the right to display the growth curves of the different fetuses.

 Data of Fetus: different symbols are used on the growth curves to identify measurement data of different fetuses.

 Historic/current data: symbol size is used to differentiate, with historic data appearing in smaller symbols.

Tip: you can select whether to print multi-fetus data in one report via [Report]->[Setting].

5-16 Obstetrics

5.7 Obstetric Exam Report

During or after a measurement, Click [Report] on the touch screen to browse the report.

See “5.6 Multi-Fetus Exam” for multi-fetus exam reports.

For details about report browsing, printing and exporting, etc., see “1.7 Report.”

5.7.1 Fetal Biophysical Profile

Fetal Biophysical Profile means to first obtain a few indices related to fetal growth through experiment or measurement and then evaluate the hazardous situation that the fetus is facing by grading these indices respectively.

1. Under OB report status, touch [Analyze] on the touch screen, the fetus Score is listed after the fetal analysis.

The scoring criteria the system provides are based on the Vintzileos formula, as shown in the table below.

Fetal growth index

Score 0 Score 2

FHR

FBM

<2, or Reactive

FHR

≥ 2 fetal movements

No FBM or duration

≤

≤15

30s bpm

Limbs stretch, no bend, fingers loose

No AF, or AF volume < 2 × 2 cm

Reactive FHR

≥ 15 bpm, duration

≥

15s,

≥ 2 times

≥ 3 times (continuous movement is deemed as

1 time)

FBM

≥ 1 times; duration

≥

30s

Limbs and spine stretch/bend

≥ 1 times

One or more AF volumes > 2 × 2 cm

Fetal scoring results criteria:

Observation

/ time

30 minutes

Remarks

The score(s) can be manually entered into the system.

Total scores

8-10

4-6

0-2

Growth condition

Normal, chronic asphyxia risk low

Chronic asphyxia risk suspicious

Chronic asphyxia risk high

2. The scores of each index as well as the total score will be appended to the report.

5.7.2 Comparison Bar

This function compares the clinical GA, the ultrasound GA obtained from OB measurements and the AUA (CUA).

1. Enter the patient's basic information and obstetric information in the [Patient Info]

→

[OB] dialog box.

2. Perform one or more GA related parameter tools.

3. Under report status, touch [Compare Bar] on the touch screen to bring up the following figure.

Obstetrics 5-17

 Select the [Print] checkbox to determine whether to include the bar in the printed report or not.

5.7.3 Z-Score

As the FL, BPD and GA are most relevant to the fetus cardiac structure and the Z-Score regression equation is related to the natural logarithm value of the FL, BPD and GA variables, the

Z-Score of cardiac structures can be obtained by looking at the Z-Score table, which is important in fetus cardiac growth evaluation and intrauterine interventional therapy.

In (predicted cardiac dimension) = m*In(FL, GA or BPD)+c

Z-Score = (In(actual)-In(predicted cardiac dimension))/root MSE

Where the unit of FL and BPD is cm, GA is week, m is multiplier, c is intercept and root MSE is root-mean-square error, which can be obtained from the table.

1. Enter the patient's basic information and obstetric information in the [Patient Info]

→

[OB] dialog box.

2. Measure the BPD and FL.

3. Select Z-Score parameters (with Z-Score tag in the name) from the measurement menu.

4. Open the report to check the Z-Score result.

Tip: the Z-Score study is effective for fetuses aged 15~40 weeks.

5.7.4 Fetal Growth Curve

The fetus growth curve compares the measured data of the fetus with the normal growth curve to judge whether the fetus is in normal growth state. The growth curve data is sourced from the Fetal

Growth Table.

1. Enter patient information and obstetric information in [Patient Info]

→

[OB] dialog box.

2. Perform one or more fetal growth parameter tools.

3. Touch [Trend] on the report touch screen to display the Obstetric Growth Curve dialog box.

The dialog box displays the growth curve and the position of the measurement value.

5-18 Obstetrics

 Two drop-down lists above the curve display the measurement item/tool and the formula of the curve, which can be changed.

 Different symbols are used on the growth curves to identify measurement data of different fetuses.

 Current and historic data of a fetus are displayed in the same symbols, with the historic data appearing in smaller symbols.

 Click the [Print] checkbox to determine whether to include the growth curve in the printed report or not.

 The green dotted line indicates the clinical GA on the X-axis.

 Select the number and layout of the curves from [Display Layout].

1*1: one curve displays in the screen.

2*1: two curves (up/down) display in the screen.

2*2: four curves display in the screen.

 Click [Previous]/[Next] to turn the growth curve pages.

4. Click [Save] to confirm the setting and exit the page.

Tip: If the patient ID is blank, the clinical GA is not calculated or the measurement value is not valid, the measurement values will not be displayed on the curve.

5.8 References

GS Rempen A., 1991

Arztliche Fragen. Biometrie in der Fruhgraviditat (i.Trimenon): 425-430.

Hansmann M., Hackelöer B.J., Staudach A.

Ultraschalldiagnostik in Geburtshilfe und Gynäkologie 1985

Hellman L.M., Kobayashi M., Fillisti L., et al. Growth and development of the human fetus prior to the 20th week of gestation. Am J Obstet Gynecol 1969;

103:784-800.

Studies on Fetal Growth and Functional Developments, Takashi Okai,

Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo

China

Written by Zhou Yiongchang & Guo Wanxue in Chapter 38 of “Ultrasound Medicine” (3rd edition) Science & Technology

Literature Press, 1997

Daya S., Wood S., Ward S., et al. Early pregnancy assessment with transvaginal ultrasound scanning Can Med Assoc J, 1991;144(4);441-446

Obstetrics 5-19

CRL

BPD

5-20 Obstetrics

Rempen A., 1991

Arztliche Fragen. Biometrie in der Fruhgraviditat (i.Trimenon): 425-430.

Hansmann M., Hackelöer B.J., Staudach A.

Ultraschalldiagnostik in Geburtshilfe und Gynäkologie 1985

Hadlock F.P., et al. Fetal Crown-Rump Length: Reevaluation of Relation to

Menstrual

Age (5-18 weeks) with High-Resolution Real-time US. Radiology 182:501-

505.

Jeanty P., Romero R. Obstetrical Sonography, p. 56. New York, McGraw-Hill,

1984.

Nelson L. Comparison of methods for determining crown-rump measurement by realtime ultrasound. J Clin Ultrasound February 1981;

9:67-70.

Robinson H.P., Fleming J.E. A critical evaluation of sonar crown rump length measurements. Br J Obstetric and Gynaecologic September 1975; 82:702-

710.

Fetal Growth Chart Using the Ultrasonotomographic Technique

Keiichi Kurachi, Mineo Aoki

Department of Obstetrics and Gynecology, Osaka University Medical School

Revision 3 (September 1983)

Studies on Fetal Growth and Functional Developments

Takashi Okai Department of Obstetrics and Gynecology, Faculty of

Medicine, University of Tokyo

Pam Loughna1, Lyn Chitty, Tony Evans, Trish Chudleigh. Fetal size and dating: charts recommended for clinical obstetric practice. British Medical

Ultrasound Society. ULTRASOUND August 2009 Volume 17 Number 3

China

Written by Zhou Yiongchang & Guo Wanxue in Chapter 38 of “Ultrasound Medicine” (3rd edition) Science & Technology

Literature Press, 1997

Ultrasonic fetal Measurement Standards for an Australian Population, compiled by Susan Campbell Westerway - Faculty of Health Sciences

University of Sydney http://www.asum.com.au/open.home.htm Date: December 2003

Merz E., Werner G. & Ilan E. T. “Ultrasound in Gynecology and Obstetrics”

Textbook and Atlas 312, 326-336. 1991 Georg Thieme Verlag, pp.326~327

Rempen A., 1991 Arztliche Fragen. Biometrie in der Fruhgraviditat

(i.Trimenon): 425-430.

Hansmann M., Hackelöer B.J., Staudach A. Ultraschalldiagnostik in

Geburtshilfe und Gynäkologie 1985

Jeanty P., Romero R. “Obstetrical Ultrasound.” McGraw-Hill Book Company,

1984, pp. 57-61.

Sabbagha R.E., Hughey M. Standardization of sonar cephalometry and gestational age. Obstetrics and Gynecology October 1978; 52:402-406.

Kurtz A.B., Wapner R.J., Kurtz R.J., et al. Analysis of bipariental diameter as an accurate indicator of gestational age. J Clin Ultrasound 1980;8:319-326.

Fetal Growth Chart Using the Ultrasonotomographic Technique, Keiichi

Kurachi, Mineo Aoki, Department of Obstetrics and Gynecology, Osaka

University Medical School Revision 3 (September 1983)

Studies on Fetal Growth and Functional Developments, Takashi Okai,

Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo

Chitty L.S., Altman D.G. British Journal of Obstetrics and Gynaecology

January 1994, Vol.101 P29-135.

China

Written by Zhou Yiongchang & Guo Wanxue in Chapter 38 of “Ultrasound Medicine” (3rd edition) Science & Technology

Literature Press, 1997

Altmann D.G.; Chitty L.S. New charts for ultrasound dating of pregnancy

Obstetrics and Gynecology Vol. 10: 174-191, 1997

Hadlock F.P., et al. Estimating Fetal Age: Computer-Assisted Analysis of

Multiple Fetal Growth Parameters. Radiology 1984:152: 497-501

Hansmann, Hackeloer, Staudach, Wittmann. Ultrasound Diagnosis in

Obstetrics and Gynecology. Springer-Verlag, New York, 1985

Jeanty P., Cousaert E., Hobbins J.C., Tack B., Bracken M., Cantraine F. A longitudinal Study of fetal head biometry. American Journal of Perinatology;

Volume1; Number 2; January 1984; pages 118-128

R. J. M. Snijders and K. H. Niicolaides. Fetal biometry at 14-40 weeks’ gestation. Ultrasound Obstet. Gynecol. 4 (1994) 34-48

Norio Shinozuka, Takashi Okai, Masahiko Mizuno. Issued by Shindan &

Tiryo Sya Tokyo University, School of Medicine, OB/GYN dept. How to interpret OB/GYN ultrasound measurement data. 80. Fetal Measurement

Obstetrics & Gynecology Chapter 56 Separate volume; 1989, Oct. 27th

Obstetrics 5-21

OFD

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Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynecology and Obstetrics Textbook and Atlas 312, 326-336.

Hansmann M., Hackelöer B.J., Staudach A.

Ultraschalldiagnostik in Geburtshilfe und Gynäkologie 1985

Jeanty P., Cousaert E., Hobbins J.C., Tack B., Bracken M., Cantraine F., “A longitudinal study of fetal head biometry” American Journal of Perinatology;

Volume 1; Number 2; January 1984

Ultrasonic fetal Measurement Standards for an Australian Population. compiled by Susan Campbell Westerway - Faculty of Health Sciences

University of Sydney http://www.asum.com.au/open.home.htm Date:

December 2003

Hansmann, Hackelöer, Staudach, (Wittmann). Ultrasound Diagnosis in

Obstetrics and Gynecology. Springer- Verlag, New York, 1986, p.433

R. J. M. Snijders and K. H. Niicolaides. Fetal biometry at 14-40 weeks’ gestation. Ultrasound Obstet. Gynecol. 4 (1994) 34-48

Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynecology and Obstetrics Textbook and Atlas 312, 326-336.

Jeanty P., Romero R. “Obstetrical Ultrasound.” McGraw-Hill Book Company,

1984.

Hadlock F.P., et al. Estimating Fetal Age: Computer-Assisted Analysis of

Multiple Fetal Growth Parameters. Radiology 1984; 152 (No. 2):499.

Hansmann M., Hackelöer B.J., Staudach A.

Ultraschalldiagnostik in Geburtshilfe und Gynäkologie 1985

Chitty L.S., Altman D.G.

British Journal of Obstetrics and Gynaecology January 1994, Vol.101

P29-135.

Chitty L.S., Altman D.G., Hendesson A., Campell S., Charts of fetal size: 2

Head measurements, Br J Obstetric Gynecology 1994, Vol 101, P 35-43.

Altmann D.G.; Chitty L.S. “New charts for ultrasound dating of pregnancy”

Ultrasound in Obstetrics and Gynecology Vol. 10: 174-191, 1997

Jeanty P., Cousaert E., Hobbins J.C., Tack B., Bracken M., Cantraine F., “A longitudinal study of fetal head biometry” American Journal of Perinatology;

Volume 1; Number 2; January 1984

Ultrasonic fetal Measurement Standards for an Australian Population. compiled by Susan Campbell Westerway - Faculty of Health Sciences

University of Sydney http://www.asum.com.au/open.home.htm Date:

December 2003

R. J. M. Snijders and K. H. Niicolaides. Fetal biometry at 14-40 weeks’ gestation. Ultrasound Obstet. Gynecol. 4 (1994) 34-48

Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynecology and Obstetrics Textbook and Atlas 312, Georg

Thieme Verlag, 326-336.

Hadlock F.P., et al. Estimating Fetal Age: Computer-Assisted Analysis of

Multiple Fetal Growth Parameters. Radiology 1984; 152 (No. 2):499.

Jeanty P., Romero R. A longitudinal study of fetal abdominal growth,

“Obstetrical Ultrasound.” MacGraw-Hill Book Company, 1984.

Chitty L.S., Altman D.G.

British Journal of Obstetrics and Gynaecology January 1994, Vol.101

P29-135.

Ultrasonic fetal Measurement Standards for an Australian Population. compiled by Susan Campbell Westerway - Faculty of Health Sciences

University of Sydney http://www.asum.com.au/open.home.htm Date:

December 2003

Crequat, J., Duyme, M., Brodaty, G. Biometry 2000. Fetal growth charts by the French College of fetal ultrasonography and the Inserm U 155.

Gynecol.Obstet Fertil., Vol. 28 No. 2, 2000, pages 435-455

Chitty L.S. Altman D.G. Hendesson A. Campell S. Charts of fetal size: 3.

Abdominal measurements. Br J Obstetric Gynaecology 1994, Vol 101, pages 35-43.

Chitty, L.S., Altman, D.G., Henderson, A., Campbell, S. Charts of fetal size:

3. Abdominal measurements Br.J.Obstet.Gynaecol. Vol. 101 No. 2, 1994, pages 125-131

Hansmann, Hackeloer, Staudach, Wittmann. Ultrasound Diagnosis in

Obstetrics and Gynecology Springer- Verlag, New York, 1986, p.431.

Jeanty P., Cousaert E., Cantraine F. Normal Growth of the Abdominal

Perimeter. American Journal of Perinatology; Volume 1 Number 2; January

1984; pages 129-135

R. J. M. Snijders and K. H. Niicolaides. Fetal biometry at 14-40 weeks’ gestation. Ultrasound Obstet. Gynecol. 4 (1994) 34-48

Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

Hansmann M., Hackelöer B.J., Staudach A.

Obstetrics 5-23

5-24 Obstetrics

Ultraschalldiagnostik in Geburtshilfe und Gynäkologie 1995

Hadlock F.P., et al. Estimating Fetal Age: Computer-Assisted Analysis of

Multiple Fetal Growth Parameters. Radiology 1984; 152 (No. 2):499.

Warda A. H., Deter R. L. & Rossavik, I. K., 1985.

Fetal femur length: a critical re-evaluation of the relationship to menstrual age. Obstetrics and Gynaecology, 66,69-75.

O'Brien G.D., Queenan J.T. (1981)

Growth of the ultrasound femur length during normal pregnancy,

American Journal of Obstetrics and Gynecology 141:833-837.

Jeanty P., Rodesch F., Delbeke D., Dumont J. Estimation of gestational age from measurements of fetal long bones. Journal of Ultrasound Medicine

February 1984; 3:75-79.

Hohler C., Quetel T. Fetal femur length: equations for computer calculation of gestational age from ultrasound measurements. American Journal of

Obstetrics and Gynecology June 15, 1982; 143 (No. 4):479-481.

Keiichi Kurachi, Mineo Aoki

Department of Obstetrics and Gynecology, Osaka University Medical

School

Revision 3 (September 1983)

Studies on Fetal Growth and Functional Developments

Takashi Okai Department of Obstetrics and Gynecology, Faculty of

Medicine, University of Tokyo

Chitty L.S., Altman D.G.

British Journal of Obstetrics and Gynaecology January 1994, Vol.101

P29-135.

Jeanty P., Cousaert E., Cantraine F., Hobbins J.C., Tack B., Struyven J. “A longitudinal Study of fetal limb growth” American Journal of Perinatology;

Volume 1; Number 2; January 1984;136-144

Jeanty P., Rodesch F., Delbeke D., Dumont J. “Estimation of Gestational

Age from

Measurements of Fetal Long Bones” Journal of Ultrasound Medicine, 3: 75-

79, February, 1984

China

Written by Zhou Yiongchang & Guo Wanxue in Chapter 38 of “Ultrasound

Medicine” (3rd edition) Science & Technology Literature Press, 1997

ASUM

Ultrasonic fetal Measurement Standards for an Australian Population, compiled by Susan Campbell Westerway - Faculty of Health Sciences

University of Sydney. http://www.asum.com.au/open/home.htm Date:

TAD

APAD

THD

FTA

HUM

CLAV

TCD

Ulna

December 2003

R. J. M. Snijders and K. H. Niicolaides; Fetal biometry at 14-40 weeks’ gestation Ultrasound Obstet. Gynecol. 4 (1994) 34-48

Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynecology and Obstetrics Textbook and Atlas 312, 326-336.

Hansmann M., Hackelöer B.J., Staudach A.

Ultraschalldiagnostik in Geburtshilfe und Gynäkologie 1985

Fetal Growth Chart Using the Ultrasonotomographic Technique

Keiichi Kurachi, Mineo Aoki

Department of Obstetrics and Gynecology, Osaka University Medical School

Revision 3 (September 1983)

Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

Jeanty P., Rodesch F., Delbeke D., Dumont J. Estimation of gestational age from measurements of fetal long bones. Journal of Ultrasound Medicine February

1984;

3:75-79.

Jeanty P., Cousaert E., Cantraine F., Hobbins J.C., Tack B., Struyven J. “A longitudinal Study of fetal limb growth” American Journal of Perinatology;

Volume 1; Number 2; January 1984;136-144

Ultrasonic fetal Measurement Standards for an Australian Population, compiled by Susan Campbell Westerway - Faculty of Health Sciences

University of Sydney. http://www.asum.com.au/open/home.htm Date:

December 2003

“Clavicular Measurement: A New Biometric Parameter for Fetal Evaluation.”

Journal of Ultrasound in Medicine 4:467-470, September 1985.

Goldstein I., et al. Cerebellar measurements with ultrasonography in the evaluation of fetal growth and development. Am J Obstet Gynecol 1987;

156:1065-1069.

Hill L.M., et al. Transverse cerebellar diameter in estimating gestational age in the large for gestational age fetus, Obstet Gynecol 1990; 75:981-985.

R. J. M. Snijders and K. H. Niicolaides; Fetal biometry at 14-40 weeks’ gestation Ultrasound Obstet. Gynecol. 4 (1994) 34-48

Hellman LM, Kobayashi M, Fillisti L, et al. Growth and development of the human fetus prior to the twentieth week of gestation. Am J Obstet

Gynecol,1969;103(6):789-800

Merz E., Werner G. & Ilan E. T., 1991

Obstetrics 5-25

Tibia

RAD

FIB

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

Jeanty P., Rodesch F., Delbeke D., Dumont J., “Estimation of Gestational

Age from Measurements of Fetal Long Bones.” J Ultrasound Med 3:75-79,

1984

Jeanty P., Cousaert E., Cantraine F., Hobbins J.C., Tack B., Struyven J. “A longitudinal Study of fetal limb growth” American Journal of Perinatology;

Volume 1; Number 2; January 1984;136-144

Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

Jeanty P., Rodesch F., Delbeke D., Dumont J., “Estimation of Gestational

Age from Measurements of Fetal Long Bones.” J Ultrasound Med 3:75-79,

1984

Jeanty P., Cousaert E., Cantraine F., Hobbins J.C., Tack B., Struyven J. “A longitudinal Study of fetal limb growth” American Journal of Perinatology;

Volume 1; Number 2; January 1984;136-144

Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynecology and Obstetrics Textbook and Atlas 312, 326-336.

Fetal Limb Bimetry (Letter), Radiology 147:602, 1983

Merz E., Werner G. & Ilan E. T., 1991

Ultrasound in Gynaecology and Obstetrics Textbook and Atlas 312, 326-336.

Fetal Limb Bimetry (Letter), Radiology 147:602, 1983

OOD

Ultrasound GA

Jeanty P., Cantraine R., Cousaert E., et al. The Binocular Distance: A New

Way to Estimate Fetal Age. J Ultrasound Med 1984; 3: 241-243.

Hadlock, Radiology, 1984 152:497-501

Cist Magna R. J. M. Snijders and K. H. Niicolaides. Fetal biometry at 14-40 weeks’ gestation. Ultrasound Obstet. Gynecol. 4 (1994) 34-48

FL/HC (Hadlock) Hadlock,F.P.,Harrist,R.B.,Shah,Y.,Park,S.K.,” The femur length/head circumference relation in obstetric sonography” J Ultrasound Med 1984, 3:

439-442 (Fetal Growth)

HC/AC(Campbell) Campbell S., “Ultrasound Measurement of Fetal Head and Abdomen

Circumference Ratio in the Assessment of Growth Retardation”.Obstetrics and Gynaecology, Vol 84, 165- 174, March 1977

5-26 Obstetrics

Estimated Fetal Weight (EFW)

Merz E., Werner G. & Ilan E. T., Ultrasound in Gynaecology and Obstetrics. Textbook and Atlas

1991 Georg Thieme Verlag, 308-338

Hansmann M., Hackel ö er B.J., Staudach A., Ultraschalldiagnostik in Geburtshilfe und Gyn ä kologie

1995

Campbell S., Wilkin D. “Ultrasonic Measurement of Fetal Abdomen Circumference in the Estimation of Fetal Weight.” Br J Obstetrics and Gynaecology September 1975; 82 (No. 9):689-697.

Hadlock F.P., Harrist R., et al. Estimation of fetal weight with the use of head, body, and femur measurements - a prospective study. American Journal of Obstetrics and Gynecology February 1,

1985; 151 (No. 3):333-337.

Shepard M., Richards V., Berkowitz R., Warsof S., Hobbins J. An Evaluation of Two Equations for

Predicting Fetal Weight by Ultrasound. American Journal of Obstetrics and Gynecology January

1982; 142 (No. 1): 47-54.

Fetal Growth Chart Using the Ultrasonotomographic Technique, Keiichi Kurachi, Mineo Aoki

Department of Obstetrics and Gynecology, Osaka University Medical School Revision 3

(September 1983)

Studies on Fetal Growth and Functional Developments, Takashi Okai Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo

Brenner W.E., Edelman D.A., Hendricks C.H. A standard of fetal growth for the United States of

America. VOL. 91, NO. 6, JUNE 1998

Hadlock F.P., Harrist R., Martinez-Poyer J. In utero analysis of fetal growth: A sonographic standard. Radiology 1991;181:129-133

Ronald Williams, Robert Creasy, George Cunningham, Warren Hawes, Rank Norris, Michiko

Tashiro. Fetal Growth and Perinatal Viability in California. Obstetric & Gynecology Vol. 59, NO. 5,

May 1982

Hansmann, Hackeloer, Staudach, Wittmann. Ultrasound Diagnosis in Obstetrics and Gynecology.

Springer-Verlag, New York, 1986

Shinozuka N., Okai T., Kohzuma S., Mukubo M., Shih C.T., Maeda T., et al. Formulas for Fetal

Weight Estimation by Ultrasound Measurements based on Neonatal Specific Gravities and

Volumes. American Journal of Obstetrics and Gynecology 157: 1140-1145; 1987

Hadlock FP, et al, “Sonographic Estimation of Fetal Weight”, Radiology 1984:150:535-540

Fetal Biophysical Profile

Manning FA. Dynamic ultrasound-based fetal assessment: the fetal biophysical profile score.

Women's Hospital, Department of Obstetrics and Gynecology, Winnipeg, Manitoba, Canada.

Dynamic ultrasound-based fetal Assessment: The Fetal Biophysical Profile Score, Clinical obstetrics and gynecology, Manning FA,38:26-44,1995a.

Obstetrics 5-27

Weight Percentile for Age

Hadlock F.P., Harrist R., Martinez-Poyer J. In utero analysis of fetal growth: A sonographic standard. Radiology 1991;181:129-133.

AFI

Thomas R., Moore M.D., Jonathan E., Cayle M.D. The amniotic fluid index in normal human pregnancy. American Journal of Obstetrics and Gynecology May 1990; 162: 1168-1173.

Z-Score

Schneider C. et. al., “Development of Z-scores for fetal cardiac dimensions from echocardiography”, Ultrasound Obstet Gynecol. Vol. 26, 2005: 599-605.

CI

Hadlock, F., Deter, R., Carpenter, R., Park, D. Estimating Fetal Age: effect of Head Shape on BPD.

American Journal of Roentgenology, 137: 83-85, July 1981

FL/AC

Hadlock F., Deter R., Harrist R., Roecker E., Park S. A Date-Independent Predictor of Intrauterine

Growth Retardation: Femur Length/Abdominal Circumference Ratio American Journal of

Roentgenology, 141:979-984, November 1983

FL/HC(Hadlock)

Hadlock,F.P., Harrist,R.B., Shah,Y., Park,S.K. The femur length/head circumference relation in obstetric sonography. J Ultrasound Med 1984, 3: 439-442 (Fetal Growth)

HC/AC(Campbell)

Campbell S. Ultrasound Measurement of Fetal Head and Abdomen Circumference Ratio in the

Assessment of Growth Retardation. Obstetrics and Gynaecology, Vol 84, 165- 174, March 1977

FL/BPD

Hohler C.W., Quetel, T:A: Comparison of Ultrasound Femur Length and Biparietal Diameter in Late pregnancy. American Journal of Obstetrics and Gynecology, volume 14, No. 7: 759-762, 1-Dec.-1981

Ut A RI/MCA RI

Kurmanavicius J., Florio I., Wisser J., Hebisch G., Zimmermann R., Muller R. et al. Reference resistance indices of the umbilical, fetal middle cerebral and uterine arteries at 24-42 weeks of gestation. Ultrasound Obstet. Gynecol. 1997;10:112-20.

Duct Veno

A. A. BASCHAT. Relationship between placental blood flow resistance and precordial venous

Doppler indices. Ultrasound Obstet Gynecol 2003; 22: 561–566

5-28 Obstetrics

IT

Bunduki V, Ruano R, Miguelez J, Yoshizaki CT, Kahhale S, Zugaib M. Fetal nasal bone length: reference range and clinical application in ultrasound screening for trisomy 21. Ultrasound Obstet

Gynecol 2003; 21: 156-160

Sonek JD, McKenna D, Webb D, Croom C, Nicolaides K. Nasal bone length throughout gestation: normal ranges based on 3537 fetal ultrasound measurements. Ultrasound Obstet Gynecol 2003;

21: 152-155

CFEF

L. J. SALOMON, M. DUYME, J. CREQUAT, G. BRODATY, C. TALMANT, N. FRIES and M.

ALTHUSER. French fetal biometry: reference equations and comparison with other charts.

Ultrasound Obstet Gynecol 2006; 28: 193–198

M Massoud

，

M Duyme

，

M Fontanges

，

D Combourieu. Chart for estimation of fetal weight 2014 by the FrenchCollege of Fetal Sonography (CFEF). J Gynecol Obstet Biol Reprod (Paris) (2015).

Verburg

B.O. VERBURG, E. A. P. STEEGERS, M. DE RIDDER, R. J.M. SNIJDERS, E. SMITH, A.

HOFMAN, H. A. MOLL, V. W. V. JADDOE and J. C. M. WITTEMAN. New charts for ultrasound dating of pregnancy and assessment of fetal growth: longitudinal data from a population-based cohort study. Ultrasound Obstet Gynecol 2008; 31: 388–396 Published online 17 March 2008 in

Wiley InterScience (www.interscience.wiley.com). DOI:10.1002/uog.5225

INTERGROWTH-21

Aris T Papageorghiou, Eric O Ohuma, Douglas G Altman, Tullia Todros, Leila Cheikh Ismail, Ann

Lambert, Yasmin A Jaffer, Enrico Bertino, Michael G Gravett, Manorama Purwar, J Alison Noble,

Ruyan Pang, Cesar G Victora, Fernando C Barros, Maria Carvalho, Laurent J Salomon, Zulfiqar A

Bhutta*, Stephen H Kennedy*, José Villar*. International standards for fetal growth based on serial ultrasound measurements: the Fetal Growth Longitudinal Study of the INTERGROWTH-21st

Project. The Lancet 2014; 384: 869-879

Obstetrics 5-29

Cardiology

6.1 Cardiac Exam Preparations

Make the following preparations before measuring:

1. Confirm that the current probe is appropriate.

2. Check that the current system date is correct.

3. Click [Info] on the touch screen and enter the patient information on the [Patient Info]

→

[CARD] page.

For more details, see “Exam Preparation

→

Patient Information” in the Operator's Manual

[Basic Volume].

4. Switch to the correct exam mode.

6.2 Basic Cardiac Measurement Procedures

1. Click [Info] on the touch screen and enter the patient information on the [Patient Info]

→

[CARD] page.

2. Press <Measure> to enter the Application Measurement.

3. Select the measurement tool from the menu or the touch screen to start the measurement.

See the table in “6.3 Cardiac Measurement Tools” for measurement tools.

See section “6.3 Cardiac Measurement Tools” and steps in “3 General Measurement” for

measurement methods.

4. Click [Report] on the touch screen to view the exam report. See “6.5 Cardiac Exam Report” for

details.

6.3 Cardiac Measurement Tools

The system supports the following cardiac measurements:

package preset, see “2.4.2.2 Application Measurement Preset.”

2. The heartbeat of the traced spectrum in VTI measurement should be equal to

that preset, otherwise the obtained HR (Heart Rate) will be incorrect. See “2.2

Measurement Parameters Preset” for the relevant preset.

3. Some application items in the measurement preset library (and matching list in the results assignment) are displayed different from those in the measurement menu and results window.

In the preset library (and matching list in the results assignment), the item is followed with the word indicating the mode or location.

Cardiology 6-1

6.3.1 2D Cardiac Measurements

Types

Measurement

Tools

LA Diam.

LA Major

LA Minor

RA Major

RA Minor

LV Major

LV Minor

LVLd apical

LVLs apical

RV Major

RV Minor

LA Area

RA Area

LV Area(d)

LV Area(s)

RV Area(d)

RV Area(s)

LVAd sax MV

LVAs sax MV

LVAd apical

Descriptions

Left Atrium Diameter

Left Atrium Major

Diameter

Left Atrium Minor

Diameter

Right Atrium Major

Diameter

Right Atrium Minor

Diameter

Left Ventricular Major

Diameter

Left Ventricular Minor

Diameter

Left Ventricular Long-axis

Length at End-diastole in apical view

Left Ventricular Long-axis

Length at End-systole in apical view

Right Ventricular Major

Diameter

Right Ventricular Minor

Diameter

Left Atrium Area

Right Atrium area

Left Ventricular area at end-diastole

Left Ventricular area at end-systole

Right Ventricular area at end-diastole

Right Ventricular area at end-systole

Left Ventricular Area at

Mitral Valve level at Enddiastole in Short-axis view

Left Ventricular Area at

Mitral Valve level at Endsystole in Short-axis view

Left Ventricular Long-axis

Area at End-diastole in apical view

Methods or formulae

Distance in 2D General

Measurements

Distance in 2D General

Measurements

Area in 2D General

Measurements

The system automatic calculates

FAC value.

FAC=((LV Area(d)- LV Area(s))/

LV Area(d))*100%

The system automatic calculates

RV FAC value.

RV FAC=((RV Area(d)- RV

Area(s))/ RV Area(d)

Area in 2D General

Measurements

） *100%

6-2 Cardiology

Types Tools

LVAs apical

LVAd sax Epi

Descriptions

Left Ventricular Long-axis

Area at end-systole in apical view

Left Ventricular Epicardial

Area at Papillary Muscle level at end-diastole in

Short-axis view

Methods or formulae

LVAd sax Endo

Left Ventricular

Endocardial Area at

Papillary Muscle level at end-diastole in Short-axis view

LVIDd

LVPWd

Left Ventricular Internal

Diameter at end-diastole The system automatic calculates

RWT value.

Left Ventricular Posterior wall thickness at endRWT=(LVPWd(cm)×2)/LVIDd(cm) diastole

LVIDs

RVDd

RVDs

LVPWs

Left Ventricular Internal

Diameter at end-systole

Right Ventricular Diameter at end-diastole

Right Ventricular Diameter at end-systole

Left Ventricular Posterior wall thickness at endsystole

RVAWd

RVAWs

Ao. ST Junct.

Right Ventricular Anterior wall thickness at enddiastole

Right Ventricular Anterior wall thickness at endsystole

IVSd

IVSs

Interventricular Septal

Thickness at end-diastole

Interventricular Septal

Thickness at end-systole

Aorta Diameter

Measurement

Ao. Diam.

Ao. Arch Diam. Aorta Arch Diameter

Ao. Asc. Diam. Ascending Aorta Diameter

Ao. Desc.

Diam.

Ao. Isthmus

Descending Aorta

Diameter

Aorta Isthmus Diameter

Aorta ST Junction

Diameter

Distance in 2D General

Measurements

Cardiology 6-3

Types

ACS

RVOT Diam.

MV Diam.

MVA

Tools

Ao. Sinus

Diam.

Duct. Art.

Diam.

Pre Ductal

Post Ductal

LVOT Diam.

AV Diam.

AVA

PV Diam.

LPA Diam.

RPA Diam.

MPA Diam.

MCS

MV EPSS

TV Diam.

TVA

IVC

Diam.(Insp.)

IVC

Diam.(Expir.)

SVC

Diam.(Insp.)

Measurement

SVC

Diam.(Expir.)

Descriptions

Aorta Sinus Diameter

Methods or formulae

Ductus Arteriosus

Diameter

Previous Ductal Diameter

Posterior Ductal Diameter

Aortic Valve Cusp

Separation

Left Ventricular Outflow

Tract Diameter

Aorta Valve Diameter

Distance in 2D General

Measurements

Aortic Valve Area

Area in 2D General

Measurements

Pulmonary Valve Diameter

Left Pulmonary Artery

Diameter

Right Pulmonary Artery

Diameter

Main Pulmonary Artery

Diameter

Distance in 2D General

Measurements

Right Ventricular Outflow

Tract Diameter

Mitral Valve diameter

Mitral Valve Area

Area in 2D General

Measurements

Mitral Valve Cusp

Separation

Distance between point E and Interventricular

Septum when mitral valve is fully open

Tricuspid Valve Diameter

Distance in 2D General

Measurements

Tricuspid Valve Area

Area in 2D General

Measurements

Inferior Vena Cava

Inspiration Diameter

Inferior Vena Cava

Expiration Diameter

Superior Vena Cava

Inspiration Diameter

Superior Vena Cava

Expiration Diameter

The system automatic calculates

IVC Depth(Expir), IVC

Depth(Insp), IVC Diam(Expir),

IVC Diam(Insp), SVC

Depth(Insp), SVC Diam(Insp),

SVC Depth(Expir), SVC

Diam(Expir), IVC-CI, IVC-DI,

SVC-CI, SVC-DI value. *1

6-4 Cardiology

Types

Calculation

Tools

LCA Diam

RCA Diam

VSD Diam.

ASD Diam.

PDA Diam.

PFO Diam.

PEd

PEs

Diastole

Systole

RA Vol(A4C)

AutoEF

RAP

LA/Ao.

Descriptions

Left Coronary Artery

Right Coronary Artery

Ventricular Septal Defect

Diameter

Atrial Septal Defect

Diameter

Methods or formulae

Patent Ductus Arteriosus

Diameter

Patent Oval Foramen

Diameter

Pericardial Effusion at diastole

Pericardial Effusion at systole

Distance in 2D General

Measurements

Heart Rate

Heart Rate in M General

Measurements

End-diastolic Left

Ventricular Measurement FoldLine in 2D mode

End-systolic Left

Ventricular Measurement

Right Atrium Volume (4chamber)

Automatic measuring of the diastolic and systolic sectional planes

See “Simpson” study

Right Atrium Pressure

Select from the pop-up dialog box or enter a value manually. See

RAP measurement in “RVSP”

Left Atrium Diameter/Aorta

Diameter

LA Diam. (cm)/Ao. Diam. (cm)

/ Study See below

*1 means:

IVC-CI = |IVC Diam(Expir) - IVC Diam(Insp)| / Max (IVC Diam(Expir), IVC Diam(Insp))

IVC-DI = |IVC Diam(Expir) - IVC Diam(Insp)| / Min (IVC Diam(Expir), IVC Diam(Insp))

SVC-CI = |SVC Diam(Expir) - SVC Diam(Insp)| / Max (SVC Diam(Expir), SVC Diam(Insp))

SVC-DI = |SVC Diam(Expir) - SVC Diam(Insp)| / Min (SVC Diam(Expir), SVC Diam(Insp))

Cardiology 6-5

6.3.2 M Cardiac Measurements

Types Tools

LA Diam.

LVIDd

LVPWd

LVIDs

RVDd

RVDs

LVPWs

RVAWd

Descriptions

Left Atrium Diameter

Methods or formulae

Distance in M General

Measurements

Left Ventricular Internal

Diameter at end-diastole The system automatic calculates

RWT value.

Left Ventricular Posterior wall thickness at endRWT=(LVPWd(cm)×2)/LVIDd(cm) diastole

Left Ventricular Internal

Diameter at end-systole

Right Ventricular Diameter at end-diastole

Right Ventricular Diameter at end-systole

Left Ventricular Posterior wall thickness at endsystole

Right Ventricular Anterior wall thickness at enddiastole

Measurement

RVAWs

IVSd

IVSs

Ao. Diam.

Right Ventricular Anterior wall thickness at endsystole

Interventricular Septal

Thickness at end-diastole

Interventricular Septal

Thickness at end-systole

Aorta Diameter

Ao. Arch

Diam.

Ao. Asc.

Diam.

Aorta Arch Diameter

Ascending Aorta Diameter

Ao. Desc.

Diam.

Descending Aorta Diameter

Ao. Isthmus Aorta Isthmus Diameter

Ao. ST

Junct.

Ao. Sinus

Diam.

Aorta ST Junction Diameter

Aorta Sinus Diameter

LVOT Diam.

ACS

Left Ventricular Outflow

Tract Diameter

Aortic Valve Cusp

Separation

Distance in M General

Measurements

6-6 Cardiology

Types Tools

LPA Diam.

RPA Diam.

MPA Diam.

RVOT Diam.

MV E Amp.

MV A Amp.

Descriptions

Left Pulmonary Artery

Diameter

Right Pulmonary Artery

Diameter

Main Pulmonary Artery

Diameter

Right Ventricular Outflow

Tract Diameter

Amplitude of the Mitral

Valve E wave

Amplitude of the Mitral

Valve A wave

Methods or formulae

MV E-F

Slope

MV D-E

Slope

Mitral Valve E-F slope

Mitral Valve D-E slope

Slope in M General

Measurements

MV D-E Amp

MCS

MV EPSS

PEd

PEs

LVPEP

LVET

RVPEP

RVET

Diastole

Systole

MAPSE

Amplitude of the Mitral

Valve DE wave

Mitral Valve Cusp

Separation

Distance between point E and the interventricular septum

Pericardial Effusion at diastole

Pericardial Effusion at systole

Distance in M General

Measurements

Left Ventricular pre-ejection period

Left Ventricular Ejection

Time

Right Ventricular Pre-

Ejection Period

Right Ventricular Ejection

Time

Time in M General Measurements

Heart Rate

Heart Rate in M General

Measurements

End-diastolic Left

Ventricular Measurement

End-systolic Left Ventricular

Measurement

Mitral Annular Plane

Systolic Excursion

Parallel method in M mode

Time in M General Measurements

Cardiology 6-7

Types Tools

TAPSE

MV ALL

Calculation LA/Ao.

Study See below

Descriptions

Tricuspid Annular Plane

Systolic Excursion

M wave measurement of mitral valve anterior leaflet

Left Atrium Diameter/Aorta

Diameter

Methods or formulae

Distance in M General

Measurements

See below

LA Diam. (cm)/Ao. Diam. (cm)

6.3.3 Doppler Cardiac Measurements

Types Tools

MV Vmax

MV E Vel.

MV A Vel.

MV E VTI

MV A VTI

MV VTI

MV AccT

Measurement

MV DecT

IVRT

IVCT

MV E Dur.

MV A Dur.

LVOT Vmax

LVOT VTI

LVOT AccT

AAo Vmax

Measurement

DAo Vmax

AV Vmax

AV VTI

Descriptions

Mitral Valve Maximum Velocity

Mitral Valve E-wave Velocity

Mitral Valve A-wave Velocity

Mitral Valve E-wave Velocity-

Time Integral

Mitral Valve A-wave Velocity-

Time Integral

Methods or formulae

D Vel. in Doppler General

Measurements

D Trace in Doppler General

Measurements

Mitral Valve Velocity-Time

Integral

Mitral Valve Acceleration Time

Mitral Valve Deceleration Time

Acceleration in Doppler

General Measurements

Mitral Valve Isovolumic

Relaxation Time

Mitral Valve Isovolumic

Contraction Time

Mitral Valve E-wave Duration

Mitral Valve A-wave Duration

Time in Doppler General

Measurements

Left Ventricular Outflow Tract

Maximum Velocity

Left Ventricular Outflow Tract

Velocity-Time Integral

Left Ventricular Outflow Tract

Acceleration Time

Ascending Aorta Maximum

Velocity

Descending Aorta Maximum

Velocity

Aorta Valve Maximum Velocity

Aorta Valve Velocity-Time

Integral

D Vel. in Doppler General

Measurements

D Trace in Doppler General measurements

Acceleration in Doppler

General Measurements

D Vel. in Doppler General

Measurements

D Trace in Doppler General measurements

6-8 Cardiology

Types Tools

LVPEP(Doppler)

LVET(Doppler)

AV AccT

AV DecT

RVET(Doppler)

RVPEP(Doppler)

TV Vmax

TV E Vel.

TV A Vel.

TV VTI

TV AccT

TV DecT

TV A Dur.

RVOT Vmax

RVOT VTI

PV Vmax

PV VTI

PV AccT

MPA Vmax

RPA Vmax

LPA Vmax

PVein S Vel.

PVein D Vel.

Descriptions

Left Ventricular Pre-Ejection

Period

Left Ventricular Ejection Time

Aorta Valve Acceleration Time

Aorta Valve Deceleration Time

Methods or formulae

Time in Doppler General

Measurements

Right Ventricular Ejection

Time

Right Ventricular Pre-Ejection

Period

Tricuspid Valve Maximum

Velocity

Tricuspid Valve E-wave Flow

Velocity

Tricuspid Valve A-wave Flow

Velocity

Tricuspid Valve Velocity-Time

Integral

Tricuspid Valve Acceleration

Time

Tricuspid Valve Deceleration

Time

Pulmonary Vein S-wave Flow

Velocity

Pulmonary Vein D-wave Flow

Velocity

Time in Doppler General

Measurements

D Vel. in Doppler General

Measurements

D Trace in Doppler General measurements

Acceleration in Doppler

General Measurements

Tricuspid Valve A-wave

Duration

Right Ventricular Outflow Tract

Maximum Velocity

Time in Doppler General

Measurements

D Vel. in Doppler General

Measurements

Right Ventricular Outflow Tract

Velocity-Time Integral

D Trace in Doppler General measurements

Pulmonary Valve Maximum

Velocity

Pulmonary Valve Velocity-

Time Integral

D Vel. in Doppler General

Measurements

D Trace in Doppler General measurements

Acceleration in Doppler

General Measurements

Pulmonary Valve Acceleration

Time

Main Pulmonary Artery

Maximum Velocity

Right Pulmonary Artery

Maximum Velocity

Left Pulmonary Artery

Maximum Velocity

D Vel. in Doppler General

Measurements

D Vel. in Doppler General

Measurements

Cardiology 6-9

Types Tools

PVein A Vel.

PVein A Dur.

PVein S VTI

PVein D VTI

PVein DecT

IVC Vel. (Insp.)

IVC Vel. (Expir.)

SVC Vel. (Insp.)

SVC Vel. (Expir.)

MR Vmax

MR VTI

MS Vmax dP/dt

AR Vmax

AR VTI

AR DecT

AR PHT

AR Ved

TR Vmax

TR VTI

PR Vmax

Descriptions

Pulmonary Vein A-wave Flow

Velocity

Pulmonary Vein A-wave

Duration

Pulmonary Vein S-wave

Velocity-time Integral

Pulmonary Vein D-wave

Velocity-time Integral

Pulmonary Vein Deceleration

Time

Inferior Vena Cava Inspiration

Maximum Velocity

Inferior Vena Cava Expiration

Maximum Velocity

Superior Vena Cava

Inspiration Maximum Velocity

Superior Vena Cava

Expiration Maximum Velocity

Mitral Valve Regurgitation

Maximum Velocity

Mitral Valve Regurgitation

Velocity-Time Integral

Mitral Valve Stenosis

Maximum Velocity

Rate of Pressure change

Aortic Valve Regurgitation

Maximum Velocity

Aortic Valve Regurgitation

Velocity-Time Integral

Aortic Valve Regurgitation

Deceleration Time

Aortic Valve Regurgitation

Pressure Half Time

Aortic Valve Regurgitation

Velocity at end-Diastole

Tricuspid Valve Regurgitation

Maximum Velocity

Tricuspid Valve Regurgitation

Velocity-Time Integral

Pulmonary Valve

Regurgitation Maximum

Velocity

Methods or formulae

Time in Doppler General

Measurements

D Trace in Doppler General measurements

Time in Doppler General

Measurements

D Vel. in Doppler General

Measurements

D Trace in Doppler General measurements

D Vel. in Doppler General

Measurements dP/dt Measurement

D Vel. in Doppler General

Measurements

D Trace in Doppler General measurements

Acceleration in Doppler

General Measurements

Doppler Measurement

D Vel. in Doppler General

Measurements

D Trace in Doppler General measurements

D Vel. in Doppler General

Measurements

6-10 Cardiology

Types

Calculation

Study

Tools

PR VTI

PR PHT

PR Ved

Descriptions

Pulmonary Valve

Regurgitation Velocity-Time

Integral

Pulmonary Valve

Regurgitation Pressure Half

Time

Pulmonary Valve

Regurgitation Velocity at end-

Diastole

VSD Vmax

ASD Vmax

PDA Vel(d)

PDA Vel(s)

Ventricular Septal Defect

Maximum Velocity

Atrial Septal Defect Maximum

Velocity

Patent Ductus Arteriosus

Velocity at End-diastole

Patent Ductus Arteriosus

Velocity at End-systole

Coarc. Pre-Duct. Coarctation of Pre-Ductus

Coarc. Post-Duct. Coarctation of Post-Ductus

AV/TV/MV/PV HR Heart Rate

RAP

Hepatic V S Vel.

Hepatic V D Vel.

Tau(BAI)

MV E/A

MVA(PHT)

TV E/A

TVA(PHT)

See below

Methods or formulae

D Trace in Doppler General measurements

Doppler Measurement

D Vel. in Doppler General

Measurements

Right Atrium Pressure

Mitral Valve E-Vel./A-Vel.

Mitral Valve Orifice Area

(PHT)

Tricuspid Valve E-Vel./A-Vel.

Tricuspid Valve Orifice Area

(PHT)

Select from the pop-up dialog box or enter a value manually. See RAP

measurement in “RVSP”

Hepatic Vein Systolic Peak

Velocity

Hepatic Vein Diastolic Peak

Velocity

Left Ventricular Diastolic Time

Constant

D Vel. in Doppler General

Measurements

Tau(BAI) Measurement

MV E Vel. (cm/s)/MV A Vel.

(cm/s)

MVA(PHT) (cm 2 ) = 220 /

MV PHT (ms)

TV E/A=TV E Vel(cm/s)/TV

A Vel(cm/s)

TVA(PHT)=220/TV

PHT(cm 2 )

6.3.4 TDI Cardiac Measurements

The following measurement items are performed in TDI mode.

Cardiology 6-11

Types

Measurement

Tools

Sa(medial)

MV Aa(lateral)

Descriptions

MV Aa(medial)

Mitral Valve medial Late diastolic motion

Mitral Valve medial Systolic motion

Mitral Valve lateral Late diastolic motion

MV Sa(lateral)

ARa(medial)

DRa(medial)

ARa(lateral)

DRa(lateral)

Mitral Valve lateral Systolic motion

Mitral Valve medial

Acceleration Rate

Mitral Valve medial

Deceleration Rate

Mitral Valve lateral

Acceleration Rate

Mitral Valve lateral

Deceleration Rate

Methods or formulae

D Vel. in Doppler General

Measurements

D Vel. in Doppler General

Measurements

Acceleration in Doppler General

Measurements

MV Ea(lateral)

Mitral Valve lateral Early diastolic motion

Ea(medial)

Calculation /

Study See below

Mitral Valve medial Early diastolic motion

Measure MV E Vel item to get

E/Ea result.

D Vel. in Doppler General

Measurements

Measure MV E Vel item to get

E/Ea result.

D Vel. in Doppler General

Measurements

*1 means:

E / Ea ( lateral )( Nounit ) ＝

MV E Vel

Ea ( lateral

(

)( cm cm

/ s ) s )

*2 means:

E / Ea ( medial

+ lateral )( Nounit ) ＝

MV E Vel ( cm

(

Ea ( medial )( cm / s )

/ s )

Ea ( lateral )( cm / s )

)

6.4 Cardiac Measurement Operations

Tip: 1.

See the table in “6.3 Cardiac Measurement Tools” above for measurement tools

and methods.

For the definitions of measurement, calculation and study, see “1.3 Measurement,

The order of the measurement items can be preset. See “2.4.2 Application

6-12 Cardiology

See table in “6.4.3.1 Left Ventricular Function”

4. A measurement tool can be activated by clicking the item in the measurement menuor on the touch screen. It is described as “Select/Click ... in the measurement menu” in the following procedures.

5. The measurements of some tools described in this chapter are to be performed in several imaging modes. Select the appropriate imaging mode before measurement.

6.4.1 Measurement Tool Operations

1. Select the item/tool in the measurement menu or the touch screen.

2. Perform the measurement referring to the methods in the table above.

MV ALL

Function: Measure M wave of mitral valve anterior leaflet.

 Measure items

Item Description

MV D Point End of systolic, immediately before the opening of the Mitral Valve.

MV E Point The anterior leaflet of the mitral valve opens, it peaks at E.

MV F Point Lowest point of the initial diastolic closing.

MV A Point

In atria systole, blood is propelled through the mitral orifice and the mitral leaflets reopen. The peak of this phase of mitral valve motion is indicated as A.

MV C Point Complete closure occurs after the onset of the ventricular systole.

 Measurement Result

Item

MV E Amp

MV D-E Amp

Description

Amplitude of the Mitral Valve E wave to C point

Method

Distance in M General

Measurements

Distance between the onset of the opening of the mitral valve at D and the maximum opening of the anterior mitral valve leaflet at E.

Distance in M General

Measurements

MV D-E

Slope

MV E-F

Slope

The rate of change that exists between two point (D,

E).

The rate of change that exists between two point (E,

F).

Slope in M General

Measurements

Slope in M General

Measurements

MV A Amp Amplitude of the Mitral Valve A wave to C point

Distance in M General

Measurements

MV A-C

Interval

The time interval between the A point and the C point.

Time in M General

Measurements

 Operation

Select the [MV ALL] in the measure menu.

Roll the trackball to move the cursor, press <Set> to fix points D, E, F, A and C in turn.

Corresponding character symbol will display at the right side of the point.

After D point and E point are fixed, MV D-E Amp and MV D-E Slope values are acquired.

MV E-F Slope value is acquired by fixing F point.

MV E Amp, MV A Amp and MV A-C Interval values are acquired by fixing A point and C point.

Cardiology 6-13

You can end measurement in advance by pressing <Set> twice on point E, F, A or C.

AutoEF

Function : Measure the systole and diastole planes automatically.

Tip: Only cardiac exam mode supports this function.

Recommend to connect ECG, capture the cine of standard A2C and A4C planes, and select cardiac cycles which have the clear plane of the cardiac muscle and less interference to perform AutoEF measure.

 Measure items

Item Description

LVLd (A2C) Left ventricular long-axis length at end diastole (A2C)

LVAd (A2C) Left ventricular long-axis area at end diastole (A2C)

LVLs (A2C) Left ventricular long-axis length at end systole (A2C)

LVAs (A2C) Left ventricular long-axis area at end systole (A2C)

LVLd (A4C) Left ventricular long-axis length at end diastole (A4C)

LVAd (A4C) Left ventricular long-axis area at end diastole (A4C)

LVLs (A4C) Left ventricular long-axis length at end systole (A4C)

LVAs (A4C) Left ventricular long-axis area at end systole (A4C)

 Measurement Result

Item

EDV (A2C/A4C/BP)

EDV Index

(A2C/A4C/BP)

ESV (A2C/A4C/BP)

Description

End-diastolic Left Ventricular Volume

End-diastolic Left Ventricular Volume Index

End-systolic Left Ventricular Volume

ESV Index

A2C/A4C/BP)

SV (A2C/A4C/BP)

SI (A2C/A4C/BP)

EF (A2C/A4C/BP)

CO (A2C/A4C/BP)

End-systolic Left Ventricular Volume Index

Stroke Volume

SV Index

Ejection Fraction

Cardiac Output

CI (A2C/A4C/BP) Cardiac output index

 Operation

1. Select the [AutoEF] in the measure menu.

2. In apical two-chamber view, measure the following parameters:

Left ventricular endocardium at end-diastolic, the EDV(A2C) is obtained automatically.

Left ventricular endocardium at end-systolic, the ESV(A2C) is obtained automatically.

3. In apical four-chamber view, measure the following parameters:

Left ventricular endocardium at end-diastolic, the EDV(A4C) is obtained automatically.

Left ventricular endocardium at end-systolic, the ESV(A4C) is obtained automatically.

6-14 Cardiology

4. If the height and weight have already been entered, the SV, EF, SI, EDV Index and ESV Index are calculated. ECG obtains the HR automatically. If ECG is not connected, it should start HR on the menu.

5. Use the soft menu to select the HR source: ECG or entered.

The CO and CI are calculated automatically using the entered height and weight values.

Tau(BAI)

Function : Measure the diastolic function of left ventricular.

Notes:

During the measurement, the range of the velocity axis in the spectrum window should be larger than the range of -1m/s to -3m/s.

1. Select [Tau(BAI)] in the measurement menu. The cursor appears on the screen.

2. Move the vertical dotted line by using the trackball to the starting point, which is the intersection of the horizontal dotted line of -3m/s and the descending portion of mitral valve regurgitation spectrum.

3. Press <Set> to set the starting point.

4. Move the vertical dotted line by using the trackball to the end point, which is the intersection of the horizontal dotted line of -1m/s and the descending portion of mitral valve regurgitation spectrum. Then press <Clear> to cancel setting the starting point. Or press <Update> to switch between the fixed end and the active end.

5. Press <Set> to set the end point and the result is displayed in the result window.

6.4.2 Calculation Tool Operations

1. Select the item/tool in the measurement menu or the touch screen.

2. The system calculates and displays the results after the measurement items have been completed.

6.4.3 Study Tool Operations

6.4.3.1 Left Ventricular Function

This group of studies estimates the Left Ventricular (LV) diastolic and systolic capabilities using a series of clinical indices measured on the B or M image. As well as calculating the left ventricular volume and end diastole and end systole, they may calculate the following indices (not all indices are calculated in every study, see the Study Results table for each study for reference).

Results

Descriptions

Stroke Volume

Cardiac Output CO(l/min) = SV(ml)×HR(bpm)/1000

Ejection Fraction EF(No unit) = SV(ml)/EDV(ml)

SV Index SI(No unit) = SV(ml)/ Body Surface Area (m 2 )

Cardiac output index

Fractional

Shortening

Formulae

SV(ml) = EDV(ml)-ESV(ml)

CI(No unit) = CO(l/min)/Body Surface Area (m 2 )

FS (No unit) = (LVIDd (cm) – LVIDs [cm]) / LVIDd (cm)

Cardiology 6-15

Results

MVCF

Descriptions

Mean Velocity of

Circumferential

Fiber Shortening

Formulae

MVCF = (LVIDd(cm) – LVIDs(cm)) / (LVIDd (cm) × ET (s))

NOTE: The HR value entered manually should be within the range 1~999.

S-P Ellipse

 Study Items

Tools

LVLd apical

LVAd apical

LVLs apical

LVAs apical

Descriptions

Left Ventricular Long-axis Length at Enddiastole in apical view

Left Ventricular Long-axis Area at Enddiastole in apical view

Left Ventricular Long-axis Length at Endsystole in apical view

Left Ventricular Long-axis Area at endsystole in apical view

Heart Rate

Operations

Distance in 2D General

Measurements

Area in 2D General

Measurements

Distance in 2D General

Measurements

Area in 2D General

Measurements

Obtained by ECG, HR(R-R) measurement or entered directly

 Study Results

Tools Descriptions

EDV(SP Ellipse)

End-diastolic Left

Ventricular Volume

Formulae

EDV(SP Ellipse) (

ml

)

฀

LVAd apical (

cm

)

LVLd apical (

cm

)

ESV(SP Ellipse)

End-systolic Left

Ventricular Volume

ESV(SP Ellipse) (

ml

)

฀

LVAs apical (

cm

)

LVLs apical (

cm

)

EDV Index(SP

Ellipse)

ESV Index(SP

Ellipse)

End-diastolic Left

Ventricular Volume

Index

End-systolic Left

Ventricular Volume

Index

EDV Index=EDV/BSA

ESV Index=ESV/BSA

SV(SP Ellipse) Stroke Volume

CO(SP Ellipse) Cardiac Output

EF(SP Ellipse) Ejection Fraction

SI(SP Ellipse) SV Index

CI(SP Ellipse) CO Index

 Operating Procedures

1. Select [S-P Ellipse] in the measurement menu or the touch screen.

2. In apical long-axis view at end-diastole, measure the following parameters:

6-16 Cardiology

LVLd apical

LVAd apical

The EDV value is then calculated.

3. In apical long-axis view at end-systole, measure the following parameters:

LVLs apical

LVAs apical

The ESV value is then calculated.

The system calculates the SV and EF.

If the height and weight have already been entered, the SI, EDV Index and ESV Index are calculated.

4. Use the menu to select the HR source: HR(R-R) measurement, ECG or entered.

The CO and CI are calculated automatically using the entered height and weight values.

B-P Ellipse

 Study Items

Tools

LVIDd

LVIDs

LVAd sax MV

LVAs sax MV

LVAd apical

LVAs apical

Descriptions

Left Ventricular Internal Diameter at Enddiastole

Left Ventricular Internal Diameter at End-systole

Left Ventricular Area at Mitral Valve level at Enddiastole in Short-axis view

Left Ventricular Area at Mitral Valve level at Endsystole in Short-axis view

Left Ventricular Long-axis Area at End-diastole in apical view

Left Ventricular Long-axis Area at end-systole in apical view

Operations

Distance in 2D General

Measurements

Area in 2D General

Measurements

HR Heart Rate

Obtained by ECG, HR(R-R) measurement or entered directly

 Study Results

Tools

EDV(BP Ellipse)

ESV(BP Ellipse)

EDV Index(BP

Ellipse)

Descriptions

End-diastolic Left

Ventricular Volume

End-systolic Left

Ventricular Volume

End-diastolic Left

Ventricular Volume Index

ESV Index(BP Ellipse)

SV(BP Ellipse)

End-systolic Left

Ventricular Volume Index

Stroke Volume

CO(BP Ellipse)

EF(BP Ellipse)

SI(BP Ellipse)

Cardiac Output

Ejection Fraction

SV Index

Formulae

EDV Index=EDV/BSA

ESV Index=ESV/BSA

See table in “6.4.3.1 Left Ventricular

Function”

Cardiology 6-17

Tools

CI(BP Ellipse)

Descriptions

CO Index

Formulae

*1 means:

EDV(BP Ellipse) ( ml ) ＝ 8

LVAd apical ( cm

)

LVAd sax MV ( cm

)

*2 means:

ESV(BP Ellipse) ( ml ) ＝ 8

 Operating Procedures

LVAs apical ( cm

)

LVAs sax MV ( cm

)

1. Select [B-P Ellipse] in the menu or the touch screen.

2. In left ventricular short-axis view, measure the following parameters:

LVIDd ( cm )

LVIDs ( cm )

At end diastole: LVIDd

At end systole: LVIDs

3. In short-axis view at mitral valve level, measure the following parameters:

At end diastole: LVAd sax MV

At end systole: LVAs sax MV

4. In apical long-axis view, measure the following parameters:

LVAd apical, the EDV is calculated

LVAs apical, the ESV is calculated

The system calculates the SV and EF after the LVAs apical has been measured.

If the height and weight have already been entered, the SI, EDV Index and ESV Index are calculated.

5. Use the menu to select the HR source: ECG, HR(R-R) measurement or entered.

The CO and CI are calculated automatically using the entered height and weight values.

Bullet

 Study Items

Tools Operations

LVLd apical

LVLs apical

LVAd sax MV

LVAs sax MV

Descriptions

Left Ventricular Long-axis Length at Enddiastole in apical view

Left Ventricular Long-axis Length at Endsystole in apical view

Left Ventricular Area at Mitral Valve level at

End-diastole in Short-axis view

Left Ventricular Area at Mitral Valve level at

End-systole in Short-axis view

Distance in 2D General

Measurements

Area in 2D General

Measurements

HR Heart Rate

Obtained by ECG, HR(R-R) measurement or entered directly

 Study Results

Tools

EDV(Bullet)

Descriptions

End-diastolic Left

Ventricular Volume

Formulae

EDV(ml) = 5/6×LVLd apical(cm)×LVAd sax

MV(cm 2 )

6-18 Cardiology

Tools

ESV(Bullet)

Descriptions

End-systolic Left

Ventricular Volume

EDV

Index(Bullet)

ESV Index(Bullet)

End-diastolic Left

Ventricular Volume

Index

End-systolic Left

Ventricular Volume

Index

SV(Bullet)

CO(Bullet)

Stroke Volume

Cardiac Output

Formulae

ESV(ml) = 5/6×LVLs apical(cm)×LVAs sax MV(cm

EDV Index=EDV/BSA

ESV Index=ESV/BSA

2 )

EF(Bullet)

SI(Bullet)

Ejection Fraction

SV Index

See table in “6.4.3.1 Left Ventricular Function”

CI(Bullet) CO Index

 Operating Procedures

1. Select [Bullet] in the measurement menu or the touch screen.

In apical long-axis view, measure the following parameters:

At end diastole: LVLd apical

At end systole: LVLs apical.

2. In short-axis view at mitral valve level, measure the following parameters:

At end diastole: LVAd sax MV, the EDV is calculated

At end systole: LVAs sax MV, the ESV is calculated

The system calculates the SV and EF. If the height and weight have already been entered, the

SI, EDV Index and ESV Index are calculated.

3. Use the menu to select the HR source: ECG, HR(R-R) measurement or entered.

The CO and CI are calculated automatically using the entered height and weight values.

Mod.Simpson

 Study Items

Tools

LVLd apical

LVLs apical

LVAd sax MV

LVAs sax MV

Descriptions

Left Ventricular Long-axis Length at End-diastole in apical view

Operations

Left Ventricular Long-axis Length at End-systole in apical view

Distance in 2D General

Measurements

Left Ventricular Area at Mitral Valve level at Enddiastole in Short-axis view

Left Ventricular Area at Mitral Valve level at Endsystole in Short-axis view

Area in 2D General

Measurements

LVAd sax PM

Left Ventricular Area at Papillary Muscle level at end-diastole in short axis view

LVAs sax PM

Left Ventricular Area at Papillary Muscle level at end-systole in short axis view

Cardiology 6-19

Tools

HR Heart Rate

Descriptions Operations

Obtained by ECG, HR(R-

R) measurement or entered directly

 Study Results

Tools Descriptions

EDV(Mod.Simpson) End-diastolic Left Ventricular Volume *1

ESV(Mod.Simpson) End-systolic Left Ventricular Volume *2

EDV

Index(Mod.Simpson)

End-diastolic Left Ventricular Volume

Index

ESV

Index(Mod.Simpson)

End-systolic Left Ventricular Volume

Index

Formulae

EDV Index=EDV/BSA

ESV Index=ESV/BSA

SV(Mod.Simpson) Stroke Volume

CO(Mod.Simpson) Cardiac Output

EF(Mod.Simpson) Ejection Fraction

SI(Mod.Simpson) SV Index

CI(Mod.Simpson) CO Index

See table in “6.4.3.1 Left

Ventricular Function”

*1 means:

EDV [ mL ]

LVLd apical [ cm ]





LVAd sax PM [

sax cm

MV [

]

+ cm

]

LVAd

sax

LVAd

MV [ cm

]

LVAd sax PM [ cm

]





*2 means:

ESV [ mL ]

LVLs apical [ cm ]





LVAs sax PM [ cm

2 ]

[ cm 2 ]

LVAs

sax

LVAs

MV [ cm 2 ]

LVAs sax PM [ cm 2 ]





 Operating Procedures

1. Select [Mod.Simpson] in the measurement menu or the touch screen.

2. In apical long-axis view, measure the following parameters:

At end diastole: LVLd apical

At end systole: LVLs apical

3. In short-axis view at mitral valve level, measure the following parameters:

At end diastole: LVAd sax MV

At end systole: LVAs sax MV

4. In short-axis view at papillary muscle level, measure the following parameters:

At end diastole: LVAd sax PM, the EDV is calculated

At end systole: LVAs sax PM, the ESV is calculated

The system calculates the SV and EF.

If the height and weight have already been entered, the SI, EDV Index and ESV Index are calculated.

5. Use the menu to select the HR source: ECG, HR(R-R) measurement or entered.

The CO and CI are calculated automatically using the entered height and weight values.

Simpson

You may select to measure single plane (A2C or A4C) only or both planes (A2C and A4C) to study.

6-20 Cardiology

 Study Items

Tools

A2Cd

A2Cs

A4Cd

A4Cs

 Study Results

Tools

Descriptions

Left ventricular long-axis length at end diastole in A2C view

Left ventricular long-axis length at end systole in A2C view

Left ventricular long-axis length at end diastole in A4C view

Left ventricular long-axis length at end systole in A4C view

Heart Rate

EDV(A2C/A4C)

EDV (BP)

ESV(A2C/A4C)

ESV (BP)

EDV Index

(A2C/A4C/BP)

ESV Index

(A2C/A4C/BP)

*1 means:

Operations

Simpson measurement

(Trace/Spline/Auto)

Obtained by ECG, HR(R-R) measurement or entered directly

Descriptions Formulae

End-diastolic Left

Ventricular Volume

(A2C/A4C)

EDV ( ml )

฀ π ×

LVLd apical ( cm )

20 i

20 ∑

1 r i

( cm )

LVLd apical: Left Ventricular Long-axis Length at End-diastole in apical view, i.e. the longaxis length obtained in measurement.

r

i : Radii obtained from diastolic measurement

End-diastolic Left

Ventricular Volume (BP)

End-systolic Left

Ventricular Volume

(A2C/A4C)

ESV ( ml )

฀ π ×

LVLs apical ( cm )

20 ∑ i

1 r i

( cm )

LVLs apical: Left Ventricular Long-axis Length at End-systole in apical view, i.e. the long-axis length obtained in measurement.

r

i : Radii obtained from systolic measurement

End-systolic Left

Ventricular Volume (BP)

End-diastolic Left

Ventricular Volume

Index (A2C/A4C/BP)

End-systolic Left

Ventricular Volume

Index (A2C/A4C/BP)

Stroke Volume

Cardiac Output

EDV Index=EDV/BSA

ESV Index=ESV/BSA

See table in “6.4.3.1 Left Ventricular Function”

Ejection Fraction

SV Index

CO Index

Cardiology 6-21

EDV ( ml ) ＝ π × MAX

{

LVLd

2 i

( cm ), LVLd

4 i

( cm )

}

∑

( r

2 i

( cm )

× r

4 i

( cm ) )

*2 means:

ESV ( ml ) ＝

π

× MAX

{

LVLs

2 i

( cm ), LVLs

4 i

( cm )

}

∑

( r

2 i

( cm )

× r

4 i

( cm ) )

Calculate the LV volume on the apical 2-chamber view image:

EDV 2 ( ml )

฀ π × LVLd

2 i

( cm )

× i

20 ∑

1 r

2 i

( cm )

ESV 2 ( ml ) ＝

π × LVLs

2 i

( cm )

20 ∑ i

1 r

2 i

( cm )

Calculate the LV volume on the apical 4-chamber view image:

EDV 4 ( ml ) ＝

π × LVLd

4 i

( cm )

× i

20 ∑

1 r

4 i

( cm )

ESV 4 ( ml )

＝ π × LVLs

4 i

( cm )

20 ∑ i

1 r

4 i

( cm )

Where

LVLd

2 i

– Left ventricular long-axis length at end diastole at apical two-chamber view, which is the long-axis length obtained by EDV(A2C) measurement

LVLd

4 i

– Left ventricular long-axis length at end diastole at apical four-chamber view, which is the long-axis length obtained by EDV(A4C) measurement

LVLs

2 i

– Left ventricular long-axis length at end systole at apical two-chamber view, which is the long-axis length obtained by ESV(A2C) measurement

LVLs

4 i

– Left ventricular long-axis length at end systole at apical four-chamber view, which is the long-axis length obtained by ESV(A4C) measurement r

2 i

– Radii obtained by EDV(A2C) or ESV(A2C) at apical two-chamber view r

4 i

– Radii obtained by EDV(A4C) or ESV(A4C) at apical four-chamber view

(1) Simpson single plane measurement (measure apical A2C or A4C only)

 Operating Procedures

1. Select [Simpson] in the measurement menu or the touch screen.

2. Measure the endocardium.

Measure the left ventricular endocardium at end-diastolic and set the long axis, the EDV is obtained.

Measure the left ventricular endocardium at end-systolic and set the long axis, the ESV is obtained.

The system calculates the SV and EF.

If the height and weight have already been entered, the SI, EDV Index and ESV Index are calculated.

3. Use the menu to select the HR source: ECG, HR(R-R) measurement or entered.

The CO and CI are calculated automatically using the entered height and weight values.

 Measurement Methods

The endocardium can be measured using trace, spline or auto, click items on the menu to select the method.

6-22 Cardiology

 Trace

Trace the endocardium along the edge of the target area using a method similar to the “Trace”

method in 2D Area measurements, then set the long axis.

 Spline

Set reference points (up to 12) along the edge of the endocardium using a method similar to

the “Spline” method in 2D Area measurements, then set the long axis.

 Auto

(1) Set points A and B using the trackball and <Set> key, where

 A: Left ventricular interventricular septal and mitral valve junction;

 B: Left ventricular wall and mitral valve junction;

(2) After setting A and B, the cursor will be automatically displayed at point D (where is considered as the apical part by system detecting). After point D is set, the long axis (line segment CD) and the line that traces the endocardium are displayed. Where

 C: Midpoint of A and B.

 D: Apical part of left ventricle.

You can:

 Adjust the long axis a) Rotate the trackball to position the cursor on the long axis (which turns yellow), then press <Set> b) Rotate the trackball and adjust point D (with point C unchanged) after the cursor changes to .

 Adjust the trace line a) Rotate the trackball to position the cursor on the trace line (which turns yellow), and then press <Set> b) Rotate the trackball and move the cursor along the endocardium edge to adjust the line after the cursor changes to .

(3) Press <Set> outside the line to confirm the adjustment.

(2) Simpson Bi-plane measurement

CAUTION:

When using Simpson to measure LV function, be sure to keep the apical four-chamber view and apical two-chamber view perpendicular. Otherwise the measurement result will be incorrect.

 Operating Procedures

1. Select [Simpson] in the measurement menu or the touch screen.

2. In apical two-chamber view, measure the following parameters:

Cardiology 6-23

Left ventricular endocardium at end-diastolic and set the long axis, the EDV(A2C) is obtained

Left ventricular endocardium at end-systolic and set the long axis, the ESV(A2C) is obtained

3. In apical four-chamber view, measure the following parameters:

Left ventricular endocardium at end-diastolic and set the long axis, the EDV(A4C) is obtained

Left ventricular endocardium at end-systolic and set the long axis, the ESV(A4C) is obtained

4. If the height and weight have already been entered, the SV, EF, SI, EDV Index and ESV Index are calculated.

5. Use the touch screen to select the HR source: ECG, HR(R-R) measurement or entered.

The CO and CI are calculated automatically using the entered height and weight values.

LV (2D)

 Study Items

Tools

Diastole

Systole

LVIDd

LVIDs

Descriptions

End-diastolic Left Ventricular

Measurement

End-systolic Left Ventricular

Measurement

Left Ventricular Internal Diameter at

End-diastole

Left Ventricular Internal Diameter at

End-systole

Operations

FoldLine in 2D mode

Parallel method in M mode

Distance in 2D/M General

Measurements

HR Heart Rate

 Study Results

Tools

IVSd

LVPWd

IVSs

LVPWs

EDV

ESV

EDV Index

ESV Index

MVCF

Descriptions

Interventricular Septal Thickness at Enddiastole

Left Ventricular Posterior Wall Thickness at End-diastole

Interventricular Septal Thickness at Endsystole

Left Ventricular Posterior Wall Thickness at End-systole

End-diastolic Left Ventricular Volume

End-systolic Left Ventricular Volume

End-diastolic Left Ventricular Volume

End-systolic Left Ventricular Volume

Stroke Volume

Cardiac Output

Ejection Fraction

Fractional Shortening

Mean Velocity of Circumferential Fiber

Shortening

Obtained by ECG, HR(R-R) measurement or entered directly

Formulae

Distance in 2D/M General

Measurements

EDV(ml)= LVIDd(cm)

ESV(ml)= LVIDs(cm)

EDV Index=EDV/BSA

ESV Index=ESV/BSA

See table in “6.4.3.1 Left

Ventricular Function”

6-24 Cardiology

Tools Descriptions Formulae

SV Index

CO Index

 Operating Procedures (taking the method using LVIDd, LVIDs, HR as an example)

1. Select [LV (2D)] in the measurement menu or the touch screen.

2. Measure LVIDd in 2D or M mode.

The LVIDd and EDV are obtained.

3. Measure the LVIDs in 2D or M mode.

The LVIDs and ESV are obtained.

The system calculates the SV, EF and FS.

4. Using the menu to select the HR source: ECG, HR(R-R) measurement or entered.

If the height and weight have already been entered, the SI, CO, CI, EDV Index and ESV Index are calculated.

The MVCF is calculated if the LVET is measured.

 In the [Setup]-[System Preset]-[Application] screen, you can set the method for the

Cube/Teichholz/HR study.

 Click [Property] in [Setup]->[Measure] to select formula for LV measurement by selecting result items: Cube, Teichholz or Gibson.

For example, select Diastole (2D) item and click [Property] as shown in the following figure. Check items with (Teich) symbol, then items will be calculated by Teichholz.(If all items are selected, then results of three methods are displayed.)

6.4.3.2 Left Ventricular Mass (LV Mass)

Estimates the Index of Left Ventricular Mass (LV Mass-I) by calculating the LV Mass.

LV MASS-I (No unit) = LV Mass (g) / Body Surface Area (m 2 )

LV Mass (Cube)

 Study Items

Tools

IVSd

LVIDd

LVPWd

Descriptions

Interventricular Septal Thickness at End-diastole

Left Ventricular Internal Diameter at End-diastole

Left Ventricular Posterior Wall Thickness at Enddiastole

Operations

Distance in 2D/M

General

Measurements

 Study Results

Tools

LV Mass (Cube)

Descriptions

Left Ventricular

Mass

Formulae

LV Mass (g) = 1.04 × ((LVPWd(cm) + IVSd(cm) +

LVIDd(cm)) 3 - LVIDd(cm) 3 ) - 13.6

LV MASS-I (Cube)

Index of Left

Ventricular Mass

See the LV Mass-I formula in “Left Ventricular Mass

(LV Mass)”

 Operating Procedures

1. Select [LV Mass (Cube)] in the measurement menu or the touch screen.

2. At end diastole, measure the following parameters:

IVSd

LVIDd

Cardiology 6-25

LVPWd

The LV Mass (Cube) is calculated.

If the height and weight have already been entered, the LV Mass-I(Cube) is calculated.

LV Mass (A-L)

 Study Items

Tools

LVAd sax Epi

LVAd sax Endo

LVLd apical

Descriptions

Left Ventricular Epicardial Area at Papillary

Muscle level at end-diastole in Short-axis view

Left Ventricular Endocardial Area at Papillary

Muscle level at end-diastole in Short-axis view

Left Ventricular Long-axis Length at Enddiastole in apical view

Operations

Area in 2D General

Measurements

Distance in 2D General

Measurements

 Study Results

Tools Descriptions

LV Mass (A-L) Left Ventricular Mass *1

LV MASS-I (A-L)

Index of Left

Ventricular Mass

Formulae

See the LV Mass-I formula in “Left Ventricular

Mass (LV Mass)”

*1 means:

LV Mass(g)

1.05

5/6

( LVAd sax Epi(cm

)

(LVLd apical(cm)

+ t(cm))

LVAd sax Endo (cm

)

LVL(cm))

Where t (cm)

(LVAd sax Epi(cm

) /

) (LVAd Sax Endo(cm

)

 Operating Procedures

1. Select [LV Mass (A-L)] in the measurement menu or the touch screen.

2. In long-axis view at end diastole, measure the LVLd apical.

3. In short-axis view at papillary muscle level at end diastole, measure the following parameters:

Endocardium area: LVAd sax Endo

Epicardium area: LVAd sax Epi

The LV Mass (A-L) is calculated.

If the height and weight have already been entered, the LV Mass-I(A-L) is calculated.

LV Mass (T-E)

 Study Items

Tools

LVAd sax Epi

LVAd sax Endo a

Descriptions

Left Ventricular Epicardial Area at Papillary

Muscle level at end-diastole in Short-axis view

Left Ventricular Endocardial Area at Papillary

Muscle level at end-diastole in Short-axis view

Semi-major axis from widest minor axis radius to apex

Operations

Area in 2D General

Measurements

Distance in 2D General

Measurements

6-26 Cardiology

Tools Descriptions Operations d

Truncated semi-major axis from widest minor axis radius to mitral annulus plane

 Study Results

Except for the values in the upper table, the following results can be obtained in this study:

Tools Descriptions

LV Mass (T-E) Left Ventricular Mass *1

LV MASS-I (T-E)

Index of Left

Ventricular Mass

Formulae

See the LV Mass-I formula in “Left Ventricular

Mass (LV Mass)”

*1 means:

LV Mass(g)

1.05

π ×

{ (b + t) 2 ×

[

2(a

+ t)

+ d -

3(a d 3

+ t) 2

] b 2 ×

(

+ d d 3

3a 2

)}

Where units of a, b, d, t are cm. a: Semi-major axis from widest minor axis radius to apex d: Truncated semi-major axis from widest minor axis radius to mitral annulus plane t: Thickness of the myocardium t (cm)

(LVAd sax Epi(cm

) /

) (LVAd Sax Endo(cm

) b: Short axis radius, usually measured where the radius is largest. b(cm)

(LVAd Sax Endo(cm

)

 Operating Procedures

1. Select [LV Mass(T-E)] in the measurement menu or the touch screen.

2. In short-axis view at papillary muscle level at end diastole, measure the following parameters:

Endocardium area: LVAd sax Endo

Epicardium area LVAd sax Epi

3. Measure a and d.

The LV Mass(T-E) is calculated.

If the height and weight have already been entered, the LV Mass-I(T-E) is calculated.

6.4.3.3 Mitral Valve Area (MVA)

The Mitral Valve Area (MVA) can be calculated using two methods: pressure half time (PHT) or velocity-time integral (VTI).

Tip: The MVA Calculation by PHT method should be performed in CW mode. See

MVA(PHT) in “6.3.3 Doppler Cardiac Measurement” for the formula for MVA calculated

using the PHT method.

MVA(VTI)

 Study Items

Tools

LVOT Diam.

LVOT VTI

Descriptions

Left Ventricular Outflow Tract

Diameter

Left Ventricular Outflow Tract

Velocity-Time Integral

Operations

Distance in 2D General Measurements

D trace in General D measurements

Cardiology 6-27

Tools Descriptions Operations

MV VTI Mitral Valve Velocity-Time Integral

 Study Results

Except for the values in the upper table, the following results can be obtained in this study:

Tools Descriptions

MVA(VTI) Mitral Valve Area

Formulae

MVA(VTI)(c m

)

π ×

LVOT VTI(cm)

LVOT Diam(cm 2 ) 2

MV VTI(cm)

 Operating Procedures

See the table above for methods and formulae for the measurement items.

6.4.3.4 AVA(VTI)

The Aortic Valve Area (AVA) can be calculated by velocity-time integral (VTI). The measurements should be performed on 2D and Doppler images

 Study Items

Tools Descriptions Operations

LVOT Diam.

LVOT VTI

Left Ventricular Outflow Tract

Diameter

Left Ventricular Outflow Tract

Velocity-Time Integral

Distance in 2D General

Measurements

D trace in General D measurements

AV VTI Aortic Valve Velocity-Time Integral

 Study Results

Except for the values in the upper table, the following results can be obtained in this study:

Tools Descriptions

AVA(VTI) Aortic Valve Area

Formulae

AVA(VTI)(c m

)

π ×

LVOT VTI(cm)

LVOT Diam(cm

)

AV VTI(cm)

 Operating Procedures

See the table above for methods and formulae for the measurement items.

6.4.3.5 LA Vol.

LA Vol. (Left Atrium Volume) used to estimate the size of the left atrium.

LA Vol.(A-L)

Estimates the Left Atrium Volume using area and length.

 Study Items

Tools Descriptions

LA apical Left Atrium Diameter

Operations

Distance in 2D General

Measurements

LAA(A2C)

LAA(A4C)

Left Atrium Area at apical 2-chamber view

Left Atrium Area at apical 4-chamber view

Area in 2D General Measurements

6-28 Cardiology

 Study Results

Except for the values in the upper table, the following results can be obtained in this study:

Tools

Description s

Formulae

Vol.(A

-L)

Left Atrium

Area

LA Vol(A L)(ml)

LAA(A4C)(c m 2 )

LAA(A2C)(c m

Vol.

Index

(A-L)

Left Atrium

Area

LA Vol. Index = LA Vol./BSA

 Operating Procedures

See the table above for methods and formulae for the measurement items.

2 ) LA apical(cm)

LA Vol. (Simp)

Estimates the left atrium volume using the Simpson method. Performed at apical two-chamber view and apical four-chamber view.

 Study Items and Results

Operations Tools

LA Vol.(A2C)

Descriptions

Left Atrium Volume at apical 2-chamber view

LA Vol.(A4C)

Left Atrium Volume at apical 4-chamber view

LA Vol. Index

(A2C/A4C)

Left Atrium Volume Index

 Operating Procedures

See “Simpson” for measurement procedures.

Same as the Simpson SP measurement

LA Vol. Index = LA Vol./BSA

6.4.3.6 LVIMP (LV Tei Index)

The LVIMP (Left Ventricular Index of Myocardial Performance) is used to analyze the integrative ventricular diastolic and systolic capabilities.

 Study Items

Tools Descriptions Operations

MV C-O Dur.

Mitral Valve Close-Open

Duration

Time in M/Doppler General Measurements

LVET Left Ventricular Ejection Time

 Study Results

Except for the values in the upper table, the following results can be obtained in this study:

Tools

LV Tei Index

Descriptions

Left Ventricular Index of

Myocardial Performance

LVIMP(Noun it)

Formulae

 Operating Procedures

See the table above for methods and formulae for the measurement items.

C O dur(s) LVET(s)

LVET(s)

Cardiology 6-29

6.4.3.7 RVSP

The RVSP measures the right ventricular systolic pressure.

 Study Items

Tools

TR Vmax

Descriptions

Tricuspid Valve Regurgitation

Maximum Velocity

Operations

D Vel. in Doppler General Measurements

RAP Right Atrium Pressure See below

 Study Results

Except for the values in the upper table, the following results can be obtained in this study:

Tools

TR PGmax

Descriptions

Tricuspid Valve

Regurgitation Pressure

Gradient

Formulae

TR PGmax (mmHg) = 4 × TR Vmax (m/s) 2

RVSP

Right Ventricular Systolic

Pressure

RVSP(mmHg)

RAP ( mmHg )

( TR V max( m / s )) 2

 Operating Procedures

1. Select [RVSP] in the measurement menu or the touch screen.

2. Measure the TR Vmax in Doppler mode.

The TR PGmax is calculated.

3. Select [RAP] in the [RVSP] sub-menu and select (or enter) the pressure in the dialog box which appears.

The range of input values is [0, 50.0 mmHg].

4. Click [OK] after selecting (or entering) the pressure. The RAP is obtained.

RVSP is calculated.

6.4.3.8 PAEDP

The PAEDP measures the pulmonary artery end diastolic pressure.

 Study Items

Tools

PR Ved

Descriptions

Pulmonary Valve

Regurgitation Velocity at end-

Diastole

Operations

D Vel. in Doppler General Measurements

RAP Right Atrium Pressure

See RAP measurement in “RVSP”

 Study Results

Except for the values in the upper table, the following results can be obtained in this study:

Tools Formulae

PR PGed

PAEDP

Descriptions

Pulmonary Valve

Regurgitation Pressure

Gradient at end-Diastole

Pulmonary Pressure at end-

Diastole

PAEDP(mmHg )

RAP ( mmHg )

( PR Ved ( m / s )) 2

6-30 Cardiology

 Operating Procedures

See the table above for methods and formulae for the measurement items.

6.4.3.9 RVIMP (RV Tei Index)

The measurement of RVIMP (Right Ventricular Index of Myocardial Performance) is similar to that of LVIMP.

 Study Items

Tools Descriptions Operations

TV C-O Dur. Tricuspid Valve Close-Open Duration

RVET Right Ventricular Ejection Time

Time in Doppler General

Measurements

 Study Results

Except for the values in the upper table, the following results can be obtained in this study:

Tools

RV Tei Index

Descriptions

Right Ventricular Index of

Myocardial Performance

RVIMP(Noun it)

Formulae

TV C

 Operating Procedures

See the table above for methods and formulae for the measurement items.

O dur(s) -

RVET(s)

6.4.3.10 Qp/Qs

Flow ratio of pulmonary circulation and systemic circulation.

 Study Items

Tools Descriptions

RVOT Diam. Right Ventricular Outflow Tract Diameter

Operations

LVOT Diam. Left Ventricular Outflow Tract Diameter

Distance in 2D General

Measurements

RVOT VTI

LVOT VTI

RVOT SV

Right Ventricular Outflow Tract Velocity-

Time Integral

Left Ventricular Outflow Tract Velocity-

Time Integral

D Trace in Doppler General

Measurements

 Study Results

Except for the values in the upper table, the following results can be obtained in this study:

Item Description

Right Ventricular Outflow Tract Stroke

Volume

Operations

RVOT CO

Right Ventricular Outflow Tract Cardiac

Output

RVOT SI

RVOT CI

RVOT Vmax

RVOT Vmean

Right Ventricular Outflow Tract SV Index

Right Ventricular Output Tract CO Index

Right Ventricular Outflow Tract Maximum

Velocity

Right Ventricular Outflow Tract Minimum

Average Velocity

Obtained from the RVOT VTI measurement

Cardiology 6-31

Item

RVOT PGmax

RVOT PGmean

LVOT SV

LVOT SI

LVOT CO

LVOT CI

LVOT Vmax

LVOT PGmax

LVOT Vmean

LVOT PGmean

Qp/Qs

Qp-Qs

Description

Right Ventricular Outflow Tract Maximum

Pressure Gradient

Right Ventricular Outflow Tract Average

Pressure Gradient

Left Ventricular Outflow Tract Stroke

Volume

Left Ventricular Outflow Tract SV Index

Left Ventricular Outflow Tract Cardiac

Output

Left Ventricular Output Tract CO Index

Left Ventricular Outflow Tract Maximum

Velocity

Left Ventricular Outflow Tract Maximum

Pressure Gradient

Left Ventricular Outflow Tract Average

Velocity

Left Ventricular Outflow Tract Minimum

Pressure Gradient

Flow ratio of Pulmonary circulation and

Systemic circulation

Flow difference of Pulmonary circulation and Systemic circulation

Operations

Obtained from the LVOT VTI measurement

See below

Where

Qp ( ml ) ＝ RVOT SV(ml)

=

( RVOT Diam(cm)/2 ) 2

×

RVOT VTI(cm)

Qs ( ml ) ＝ LVOT SV(ml)

=

( LVOT Diam(cm)/2 ) 2

×

LVOT VTI(cm)

Qp / Qs ( Nounit ) ＝

RVOT SV ( ml )

LVOT SV ( ml )

−

Qs ( Nounit )

＝

RVOT SV ( ml )

−

LVOT SV ( ml )

 Operating Procedures

See the table above for methods and formulae for the measurement items.

6.4.3.11 PISA

The PISA (Proximal Isovelocity Surface Area) is used in the quantitative analysis of the mitral valve regurgitation (PISA MR), aortic valve regurgitation (PISA AR), tricuspid valve regurgitation (PISA

TR) and pulmonary valve regurgitation (PISA PR) in color mode.

The PISA measurement procedure is as follows:

1. Start PISA and move the semicircular caliper by rotating the trackball.

2. Fix the center of the semicircular caliper by pressing <Set>.

3. Adjust the radius length orientation of the semicircular caliper by rotating the trackball.

4. Press <Set> to fix the caliper.

PISA MR

Mitral valve regurgitation (PISA MR) needs to be measured in Color and Doppler modes.

6-32 Cardiology

 Study Items

Tools

MR Rad

MR VTI

Descriptions

Mitral Valve Stenosis

Radius

Mitral Valve Regurgitation

Velocity-Time Integral

MR Als.Vel.

Mitral Valve Regurgitation

Aliasing Maximum Velocity

 Study Results

Tools

MR Vmax

Descriptions

Mitral Regurgitation

Maximum Velocity

Operations

PISA measurement

D Trace in Doppler General Measurements

You can choose to use the top aliasing velocity or bottom aliasing velocity, or enter the value directly.

Formulae

Obtained from the MR VTI measurement

MR Flow

Mitral Regurgitation

Flow

MR Flow(ml)

MR Rad(cm)

2 ×

MR Als.Vel(cm /s)

MR VTI(cm)

MRV max(cm/s)

MR Flow

Rate

Mitral Regurgitation

Flow Rate

MR Flow Rate(ml/s)

MR Rad(cm)

2 ×

MR Als.Vel(cm /s)

Fraction

Mitral Valve

Regurgitation

Fraction

MR Fraction (Nounit)

MR Flow(ml)

100 %

MV SV(ml)

MR EROA

Mitral Valve

Effective

Regurgitant Orifice

Area

MR EROA(cm)

2 =

MR Rad(cm)

2 ×

MR Als.Vel(cm /s)

MR Vmax(cm/s)

 Operating Procedures

1. Enter color mode and adjust the color map until the aliasing appears.

2. Select [PISA MR] in the measurement menu or the touch screen.

3. Measure MR Rad using the PISA caliper.

Input MR Als.Vel.

4. Measure the MR spectrum using D trace to obtain:

MR Vmax

MR VTI

The MR Flow, MR Flow Rate and MR EROA are calculated automatically.

If the MV SV is measured, the MR Fraction will be calculated automatically.

PISA AR

Aortic valve regurgitation (PISA AR) needs to be measured in Color and Doppler modes.

 Study Items

Tools Descriptions Operations

AR Rad. Aortic Valve Stenosis Radius PISA measurement

AR VTI

Aortic Valve Regurgitation

Velocity-Time Integral

D Trace in Doppler General Measurements

AR Als.Vel.

Aortic Valve Regurgitation

Aliasing Maximum Velocity

You can choose to use the top aliasing velocity or bottom aliasing velocity, or enter the value directly.

Cardiology 6-33

 Study Results

Tools

AR Vmax

Descriptions

Aortic Regurgitation

Maximum Velocity

Formulae

Obtained from the AR VTI measurement

AR Flow

Aortic Regurgitation

Flow

AR Flow(ml)

AR Rad(cm)

2 ×

AR Als.Vel(cm /s)

ARV max(cm/s)

AR VTI(cm

AR Flow

Rate

AR Fraction

Aortic Regurgitation

Flow Rate

Aortic Valve

Regurgitation

Fraction

AR Flow Rate(ml/s)

AR Rad(cm)

2 ×

AR Als.Vel(cm /s)

AR Fraction (Nounit)

AR Flow(ml)

AV SV(ml)

100 %

AR EROA

Aortic Valve

Effective

Regurgitant

Orifice Area

 Operating Procedures

Same as the PISA MR measurement.

AR EROA(cm)

2 =

AR Rad(cm)

2 ×

AR Als.Vel(cm /s)

AR Vmax(cm/s)

PISA TR

Tricuspid valve regurgitation (PISA TR) needs to be measured in Color and Doppler modes.

 Study Items

Tools

TR Rad.

TR VTI

TR Als.Vel.

Descriptions

Tricuspid Valve Stenosis

Radius

Tricuspid Valve

Regurgitation Velocity-Time

Integral

Tricuspid Valve

Regurgitation Aliasing

Maximum Velocity

 Study Results

Tools

TR Vmax

Descriptions

Tricuspid

Regurgitation

Maximum Velocity

Operations

PISA measurement

D Trace in Doppler General Measurements

You can choose to use the top aliasing velocity or bottom aliasing velocity, or enter the value directly.

Formulae

Obtained from TR VTI measurement

TR Flow

Tricuspid

Regurgitation Flow

TR Flow(ml)

TR Rad(cm)

2 ×

TR Als.Vel(cm /s)

TRV max(cm/s)

TR VTI(cm

TR Flow

Rate

TR Fraction

Tricuspid

Regurgitation

Flow Rate

Tricuspid Valve

Regurgitation

Fraction

TR Flow Rate(ml/s)

TR Rad(cm) 2 ×

TR Als.Vel(cm /s)

TR Fraction (Nounit)

TR Flow(ml)

TV SV(ml)

100 %

6-34 Cardiology

Tools Descriptions Formulae

TR EROA

Tricuspid Valve

Effective

Regurgitant

Orifice Area

 Operating Procedures

Same as the PISA MR measurement.

TR EROA(cm) 2 =

TR Rad(cm) 2 ×

TR Als.Vel(cm /s)

TR Vmax(cm/s)

PISA PR

Pulmonary valve regurgitation (PISA PR) needs to be measured in Color and Doppler modes.

 Study Items

Tools

PR Rad.

PR VTI

PR Als.Vel.

Descriptions

Pulmonary Valve Stenosis

Radius

Pulmonary Valve

Regurgitation Velocity-Time

Integral

Pulmonary Valve

Regurgitation Aliasing

Maximum Velocity

 Study Results

Tools

PR Vmax

Descriptions

Pulmonary

Regurgitation

Maximum Velocity

Operations

PISA measurement

D Trace in Doppler General Measurements

You can choose to use the top aliasing velocity or bottom aliasing velocity, or enter the value directly.

Formulae

Obtained from PR VTI measurement

PR Flow

Pulmonary

Regurgitation Flow

PR Flow(ml)

PR Rad(cm)

2 ×

PR Als.Vel(cm /s)

PRV max(cm/s)

PR VTI(cm)

PR Flow

Rate

PR Fraction

Pulmonary

Regurgitation Flow

Rate

Pulmonary Valve

Regurgitation

Fraction

PR Flow Rate(ml/s)

PR Rad(cm) 2 ×

PR Als.Vel(cm /s)

PR Fraction (Nounit)

PR Flow(ml)

100 %

PV SV(ml)

PR EROA

Pulmonary Valve

Effective

Regurgitant

Orifice Area

 Operating Procedures

Same as the PISA MR measurement.

PR EROA(cm)

2 =

PR Rad(cm)

2 ×

PR Als.Vel(cm /s)

PR Vmax(cm/s)

Cardiology 6-35

6.4.3.12 TDI

 Study Items

Tools Descriptions

MV Sa(medial) Mitral Valve medial Systolic motion

MV Ea(medial) Mitral Valve medial Early diastolic motion

MV Aa(medial) Mitral Valve medial Late diastolic motion

MV ARa(medial) Mitral Valve medial Acceleration Rate

MV DRa(medial) Mitral Valve medial Deceleration Rate

MV Sa(lateral) Mitral Valve lateral Systolic motion

MV Ea(lateral) Mitral Valve lateral Early diastolic motion

MV Aa(lateral) Mitral Valve lateral Late diastolic motion

MV ARa(lateral) Mitral Valve lateral Acceleration Rate

MV DRa(lateral) Mitral Valve lateral Deceleration Rate

 Study Results

Tools Descriptions

MV Ea/Aa(medial) MV medial E-Vel./A-Vel.

Operations

D Vel. in Doppler General

Measurements

Acceleration in Doppler General

Measurements

D Vel. in Doppler General

Measurements

Acceleration in Doppler General

Measurements

Formulae

Ea/Aa(medi al)(Nounit )

Ea(medial)

Aa(medial)

ATa(medial)

DTa(medial)

MV medial E-wave

Acceleration Time

MV medial E-wave

Deceleration Time

Obtained from the ARa(medial) measurement

Obtained from the DRa(medial) measurement

MV Ea/Aa(lateral) MV lateral E-Vel./A-Vel. Ea/Aa(late ral)(Nouni t)

Ea(lateral l)

Aa(lateral l)

MV E/Ea(medial)

MV E/Ea(lateral)

Used to estimate the diastolic function of left ventricular

Calculate after measuring MV E Vel and MV

Ea(medial):

MV E/Ea(media l)(Nounit)

MV E Vel

MV Ea(medial)

Calculate after measuring MV E Vel and MV

Ea(lateral):

MV E/Ea(later al)(Nounit )

MV E Vel

MV Ea(lateral )

E/Ea(medial+lateral)

Calculate after measuring MV E Vel, MV

Ea(medial) and MV Ea(lateral)

E / Ea ( medial

+ lateral )( Nounit ) ＝

(

MVEa ( medial )(

MV E Vel ( cm / cm / s ) s )

MVEa ( lateral )( cm / s )

)

ATa(lateral)

MV lateral E-wave

Acceleration Time

Obtained from the ARa(lateral) measurement

6-36 Cardiology

Tools Descriptions Formulae

DTa(lateral)

MV lateral E-wave

Deceleration Time

Obtained from the DRa(lateral) measurement

 Operating Procedures

See the table above for methods and formulae for the measurement items.

6.4.3.13 Z Score

Z Score indicates the standard deviation of the individually measured value against the mean value. Referenced pediatric cardiac value is corrected by the height, weight, and body surface. Z

Scores that is standardly transformed is used to evaluate the cardiac measurement values, to define the distribution of the measurement result of an individual pediatric among those of the healthy pediatrics.

The Z-Score study is effective for pediatrics aged under 18 years old.

Formula:

Z-Score = (measured actual value - population mean value)/population standard deviation

Operating procedures:

1. Input the DOB (age), weight, and height in the <Patient>  [CARD];

2. Select Z-Score related items in the measurement menu for performing measurement.

3. Check the Z-Score result in the <Report> page.

6.5 Cardiac Exam Report

During or after a measurement, click [Report] on the touch screen to browse the report.

For details about report browsing, printing and exporting, etc., see “1.7 Report.”

Cardiology 6-37

6.6 References

Body Surface Are (BSA):

 DuBois, D., DuBois, E.F., “A Formula to Estimate the Approximate Surface Area if Height and

Weight Be Known,” Nutrition, Sept-Oct 1989, Vol. 5, No. 5, pp. 303-313.

EDV(S-P Ellipse):

 Folland, E.D., et al., “Assessment of Left Ventricular Ejection Fraction and Volumes by

Real-Time, Two-Dimensional Echocardiography,” Circulation, October 1979, Vol. 60, No.4, pp. 760-766

ESV(S-P Ellipse):

 Folland, E.D., et al., “Assessment of Left Ventricular Ejection Fraction and Volumes by

Real-Time, Two-Dimensional Echocardiography,” Circulation, October 1979, Vol. 60, No.4, pp. 760-766.

Stroke Volume (SV):

 Gorge, G., et al., “High Resolution Two-dimensional Echocardiography Improves the

Quantification of Left Ventricular Function,” Journal of the American Society of

Echocardiography, 1992, 5: 125-34.

 Roelandt, Joseph, Practical Echocardiology, vol. 1 of Ultrasound in Medicine Series, ed. Denis

White, Research Studies Press, 1977, p. 124.

Ejection Fraction (EF):

 Pombo, J.F., “Left Ventricular Volumes and Ejection by Echocardiography,” Circulation, 1971,

Vol. 43, pp. 480-490.

Stroke Volume Index (SI):

 Gorge, G., et al., “High Resolution Two-dimensional Echocardiography Improves the

Quantification of Left Ventricular Function,” Journal of the American Society of

Echocardiography, 1992, 5: 125-34.

 Roelandt, Joseph, Practical Echocardiology, vol. 1 of Ultrasound in Medicine Series, ed. Denis

White, Research Studies Press, 1977, p. 124.

Cardiac Output (CO):

 Belenkie, Israel, et al., “Assessment of Left Ventricular Dimensions and Function by

Echocardiography,” American Journal of Cardiology, June 1973, Vol. 31

Cardiac output Index (CI):

 The Merck Manual of Diagnosis and Therapy, ed. 15, Robert Berkon, ed., Merck and Co.,

Rahway, NJ, 1987, p. 378.

 Schiller, N.B., et al., “Recommendations for Quantification of the LV by Two-Dimensional

Echocardiography,” J Am Soc Echo, Sept.-Oct., 1989, Vol. 2, No. 5,p. 364.

EDV(B-P Ellipse):

 Folland, E.D., et al., “Assessment of Left Ventricular Ejection Fraction and Volumes by

Real-Time, Two-Dimensional Echocardiography,” Circulation, October 1979, Vol. 60, No.4, pp. 760-766

ESV(B-P Ellipse):

 Folland, E.D., et al., “Assessment of Left Ventricular Ejection Fraction and Volumes by

Real-Time, Two-Dimensional Echocardiography,” Circulation, October 1979, Vol. 60, No.4, pp. 760-766

EDV (Bullet):

 Folland, E.D., et al., “Assessment of Left Ventricular Ejection Fraction and Volumes by

Real-Time, Two-Dimensional Echocardiography,” Circulation, October 1979, Vol. 60, No.4, pp. 760-766

ESV (Bullet):

6-38 Cardiology

 Folland, E.D., et al., “Assessment of Left Ventricular Ejection Fraction and Volumes by

Real-Time, Two-Dimensional Echocardiography,” Circulation, October 1979, Vol. 60, No.4, pp. 760-766

EDV (Simpson):

 Weyman, Arthur E., Cross-Sectional Echocardiography, Lea & Febiger, 1985, p. 295.Folland,

E.D., et al., “Assessment of Left Ventricular Ejection Fraction and Volumes by Real-Time,

Two-Dimensional Echocardiography,” Circulation, October 1979, Vol. 60, No.4, pp. 760-766

ESV (Simpson):

 Weyman, Arthur E., Cross-Sectional Echocardiography, Lea & Febiger, 1985, p. 295.Folland,

E.D., et al., “Assessment of Left Ventricular Ejection Fraction and Volumes by Real-Time,

Two-Dimensional Echocardiography,” Circulation, October 1979, Vol. 60, No.4, pp. 760-766

EDV (Simpson SP):

 Schiller, N.B., et al., “Recommendations for Quantification of the LV by Two-Dimensional

Echocardiography,” Journal of the American Society of Echocardiography, Sept-Oct 1989,

Vol.2, No. 5, p. 364

ESV (Simpson SP:

 Schiller, N.B., et al., “Recommendations for Quantification of the LV by Two-Dimensional

Echocardiography,” Journal of the American Society of Echocardiography, Sept-Oct 1989,

Vol.2, No. 5, p. 364

EDV (Simpson BP):

 Schiller, N.B., et al., “Recommendations for Quantification of the LV by Two-Dimensional

Echocardiography,” Journal of the American Society of Echocardiography, Sept-Oct 1989,

Vol.2, No. 5, p. 364

ESV (Simpson BP):

 Schiller, N.B., et al., “Recommendations for Quantification of the LV by Two-Dimensional

Echocardiography,” Journal of the American Society of Echocardiography, Sept-Oct 1989,

Vol.2, No. 5, p. 364

EDV (Cube):

 Dodge, H.T., Sandler, D.W., et al., “The Use of Biplane Angiography for the Measurement of

Left Ventricular Volume in Man,” American Heart Journal, 1960, Vol. 60, pp. 762-776.

 Belenkie, Israel, et al., “Assessment of Left Ventricular Dimensions and Function by

Echocardiography,” American Journal of Cardiology, June 1973, pg. 31.

ESV (Cube):

 Dodge, H.T., Sandler, D.W., et al., “The Use of Biplane Angiography for the Measurement of

Left Ventricular Volume in Man,” American Heart Journal, 1960, Vol. 60, pp. 762-776.

 Belenkie, Israel, et al., “Assessment of Left Ventricular Dimensions and Function by

Echocardiography,” American Journal of Cardiology, June 1973, pg. 31.

Fractional Shortening (FS):

 Belenkie, Israel, et al., “Assessment of Left Ventricular Dimensions and Function by

Echocardiography,” American Journal of Cardiology, June 1973, Vol. 31.

MVCF:

 Colan, S.D., Borow, K.M., Neumann, A., “Left Ventricular End-Systolic Wall Stress-Velocity of

Fiber Shortening Relation: A Load-Independent Index of Myocardial Contractility,” J Amer Coll

Cardiol, October, 1984, Vol. 4, No. 4,pp. 715-724.

 Snider, A.R., Serwer, G.A., Echocardiography in Pediatric Heart Disease, Year Book Medical

Publishers, Inc., Littleton, MA, 1990, p. 83.

Teichholz:

Cardiology 6-39

 Teichholz, L.E., et al., “Problems in Echocardiographic Volume Determinations:

Echocardiographic-Angiographic Correlations in the Presence or Absence of Asynergy,”

American Journal of Cardiology, January 1976, Vol. 37, pp. 7-11

LVMW:

 John H. Phillips, “Practical Quantitative Doppler Echocardiography”, CRC Press, 1991,

Page 96.

LV MASS-I:

 John H. Phillips, “Practical Quantitative Doppler Echocardiography”, CRC Press, 1991,

Page 96.

LA/Ao:

 Roelandt, Joseph, Practical Echocardiology, Ultrasound in Medicine Series, Vol. 1, Denis

White, ed., Research Studies Press, 1977, p. 270.

 Schiller, N.B., et al., “Recommendations for Quantification of the LV by Two-Dimensional

Echocardiography,” J Am Soc Echo, Sept-Oct, 1989, Vol. 2, No. 5,p. 364.

MV CA/CE:

 Maron, Barry J., et al., “Noninvasive Assessment of Left Ventricular Diastolic Function by

Pulsed Doppler Echocardiography in Patients with Hypertrophic

 Cardiomyopathy, J Am Coll Cardio, 1987, Vol. 10, pp. 733-742.

MV E/A:

 Maron, Barry J., et al., “Noninvasive Assessment of Left Ventricular Diastolic Function by

Pulsed Doppler Echocardiography in Patients with Hypertrophic Cardiomyopathy,” Journal of the American College of Cardiology, 1987, Vol. 10, pp. 733-742.

Pressure Half Time (PHT):

 Oh, J.K., Seward, J.B., Tajik, A.J. The Echo Manual. Boston: Little, Brown and Company, 1994, p.59-60

Mitral valve area:

 Goldberg, Barry B., Kurtz, Alfred B., Atlas of Ultrasound Measurements, Year Book Medical

Publishers, Inc., 1990, p. 65.

 Stamm, R. Brad, et al., “Quantification of Pressure Gradients Across Stenotic Valves by

Doppler Ultrasound,” J Am Coll Cardiol, 1983, Vol. 2, No. 4,pp. 707-718.

Right Ventricular Systolic Pressure:

 Stevenson, J.G., “Comparison of Several Noninvasive Methods for Estimation of Pulmonary

Artery Pressure,” Journal of the American Society of Echocardiography, June 1989, Vol. 2, pp.

157-171.

 Yock, Paul G. and Popp, Richard L., “Noninvasive Estimation of Right Ventricular Systolic

Pressure by Doppler Ultrasound in Patients with Tricuspid Regurgitation,” Circulation, 1984,

Vol. 70, No. 4, pp. 657-662.

E/Ea:

 Recommendations for the Evaluation of Left Ventricular Diastolic Function by

Echocardiography" 2009 Published by Elsevier Inc. on behalf of the American Society of

Echocardiography.

LVIDd/LVPWd

“ Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults:An

Update from the American Society of Echocardiography and the European Association of

Cardiovascular Imaging ” J Am Soc Echocardiogr 2015;28:1-39.

Cantinotti M;Scalese M;Murzi B;Assanta N;Spadoni I;Festa P;De Lucia V;Crocetti M;Marotta

M;Molinaro S;Lopez L;Iervasi G. Echocardiographic nomograms for ventricular, valvular and arterial dimensions in caucasian children with a special focus on neonates, infants and toddlers. J

Am Soc Echocardiogr 2014; 27: 179-191 (e2).

6-40 Cardiology

Cantinotti M, Scalese M, Murzi B, Assanta N, Spadoni I, et al. Echocardiographic Nomograms for

Chamber Diameters and Areas in Caucasian Children. J Am Soc Echocardiogr 2014; 27: 1279-

1292 (e2).

Tau(BAI)

Bai Xufang, Wen Chaoyang, “Current situation and prospects of left ventricular diastolic time contant (Tau) non-invasive measurement”, Chin J Med Imaging Technol, 2015, Vol 31, No 10

Z-Score

 Cantinotti M;Scalese M;Murzi B;Assanta N;Spadoni I;Festa P;De Lucia V;Crocetti M;Marotta

M;Molinaro S;Lopez L;Iervasi G. Echocardiographic nomograms for ventricular, valvular and arterial dimensions in caucasian children with a special focus on neonates, infants and toddlers. J Am Soc Echocardiogr 2014; 27: 179-191 (e2).

 Cantinotti M, Scalese M, Murzi B, Assanta N, Spadoni I, et al. Echocardiographic Nomograms for Chamber Diameters and Areas in Caucasian Children. J Am Soc Echocardiogr 2014; 27:

1279-1292 (e2).

Cardiology 6-41

Vascular

7.1 Vascular Exam Preparations

Make the following preparations before measuring:

1. Confirm that the current probe is appropriate.

2. Check that the current system date is correct.

3. Click [Info] on the touch screen and enter the patient information on the [Patient Info]

→

[VAS] page.

For more details, see “Exam Preparation

→

Patient Information” in the Operator's Manual

[Basic Volume].

4. Switch to the correct exam mode.

7.2 Basic Vascular Measurement Procedures

1. Click [Info] on the touch screen and enter the patient information on the [Patient Info]

→

[VAS] page.

2. Press <Measure> to enter the Application Measurement.

3. Select the measurement tool from the menu or the touch screen to start the measurement.

See the table in “7.3 Vascular Measurement Tools” below for measurement tools.

See section “7.4 Vascular Measurement Operations” and steps in “3 General Measurement”

for measurement methods.

4. Click [Report] on the touch screen to view the exam report. See “7.5 Vascular Exam Report”

for details.

Vascular 7-1

7.3 Vascular Measurement Tools

Vascular measurements are mainly used for carotid, cerebral, upper and lower extremity vessels.

The system supports the following 2D and Doppler vascular measurements.

NOTE: The measurement tools mentioned below are configured in the system. The application measurement packages provided in this system are generally different combinations of measurement tools.

2D Vascular Measurements

Types Tools

CCA IMT

Bulb IMT

ICA IMT

ECA IMT

Descriptions

Common Carotid

Artery IMT

Bulbillate IMT

Internal Carotid

Artery IMT

External Carotid

Artery IMT

Methods or formulae

ROI measurement in IMT

Axillary V AP Axillary Vein

Anterior-Posterior

Brachial V

Brachial Vein

Anterior-Posterior

Radial V AP Radial Vein

Anterior-Posterior

Measurement

Ulnar V AP Ulnar Vein

Anterior-Posterior

Cephalic V

Cephalic Vein

Anterior-Posterior

Basilic V AP Basilic Vein

Anterior-Posterior

C.Iliac V AP Common Iliac Vein

Anterior-Posterior

Ex.Iliac V AP External Iliac Vein

Anterior-Posterior

IIV AP Internal Iliac Vein

Anterior-Posterior

Distance in 2D General Measurements

CFV AP

Femoral V

DFV AP

Common Femoral

Vein Anterior-

Posterior

Femoral Vein

Anterior-Posterior

Deep Femoral

Vein Anterior-

Posterior

7-2 Vascular

Types Tools

Pop V AP

Descriptions

Popliteal Vein

Anterior-Posterior

P.Tib. V AP Posterior Tibial

Vein Anterior-

Posterior

Peroneal V

Peroneal Vein

Anterior-Posterior

Sural V AP Sural Vein

Anterior-Posterior

Soleal V AP Soleal Vein

Anterior-Posterior

A.Tib. V AP Anterior Tibial Vein

Anterior-Posterior

TP Trunk V

Saph V AP Great Saphenous

Vein Anterior-

Posterior

SSV AP

Tibial Peroneal

Trunk Vein

Anterior-Posterior

Small Saphenous

Vein Anterior-

Posterior

C.Iliac V

Trans

Ex.Iliac V

Trans

IIV Trans

CFV Trans

Common Iliac Vein

Trans

External Iliac Vein

Trans

Internal Iliac Vein

Trans

Common Femoral

Vein Trans

Femoral V

Trans

DFV Trans

Femoral Vein

Trans

Deep Femoral

Vein Trans

Pop V Trans Popliteal Vein

Trans

P.Tib. V

Trans

Posterior Tibial

Vein Trans

Peroneal V

Trans

Sural V

Trans

Soleal V

Trans

Peroneal Vein

Trans

Sural Vein Trans

Soleal Vein Trans

Methods or formulae

Vascular 7-3

Types

A.Tib. V

Trans

TP Trunk V

Trans

SF Junction

Tools

GSV Thigh

GSV Knee

GSV Calf AP Great Saphenous

Vein Calf Anterior-

Posterior

SP Junction

SSV Thigh

Extension

AP the Junction of

Small Saphenous

Vein and Popliteal

Vein Anterior-

Posterior

Small Saphenous

Vein Thigh

Extension Anterior-

Posterior

AASV AP

Great Saphenous

Vein Thigh

Anterior-Posterior

Great Saphenous

Vein Knee

Anterior-Posterior

PASV AP

Anterior Accessory

Saphenous Vein

Anterior-Posterior

Posterior

Accessory

Saphenous Vein

Anterior-Posterior

SFV

Descriptions

Anterior Tibial Vein

Trans

Tibial Peroneal

Trunk Vein Trans the Junction of

Great Saphenous

Vein and Femoral

Vein Anterior-

Posterior

Saph V

Trans

SSV Trans

SF Junction

Trans

GSV Thigh

Trans

Superficial

Femoral Vein

Great Saphenous

Vein Trans

Small Saphenous

Vein Trans the Junction of

Great Saphenous

Vein and Femoral

Vein Trans

Great Saphenous

Vein Thigh Trans

7-4 Vascular

Methods or formulae

Types Tools

GSV Knee

Trans

GSV Calf

Trans

SP Junction

Trans

Descriptions

Great Saphenous

Vein Knee Trans

Great Saphenous

Vein Calf Trans the Junction of

Small Saphenous

Vein and Popliteal

Vein Trans

SSV Thigh

Extension

Trans

Small Saphenous

Vein Thigh

Extension Trans

AASV Trans Anterior Accessory

Saphenous Vein

Trans

PASV Trans Posterior

Accessory

Saphenous Vein

Trans

Int Jug V AP Internal Jugular

Vein Anterior-

Posterior

Innom V AP Innominate Vein

Anterior-Posterior

Subclav V

Volar V AP

Subclavian Vein

Anterior-Posterior

Volar Vein

Anterior-Posterior

Axillary Vein Trans Axillary V

Trans

Brachial V

Trans

Brachial Vein

Trans

Radial Vein Trans Radial V

Trans

Ulnar V

Trans

Ulnar Vein Trans

Int Jug V

Trans

Innom V

Trans

Subclav V

Trans

Volar V

Trans

Internal Jugular

Vein Trans

Innominate Vein

Trans

Subclavian Vein

Trans

Volar Vein Trans

Methods or formulae

Vascular 7-5

Types

CA Junction

Tools

Upper Arm

Cephalic V

Cephalic-

Antecubital V

Descriptions

Cephalic Vein and

Axillary Vein

Junction Anterior-

Posterior

Upper Arm

Cephalic Vein

Anterior-Posterior

Cephalic

AnteCubital Vein

Anterior-Posterior

Forearm

Cephalic V

BA Junction

Upper Arm

Basilic V AP

Basilic-

Antecubital V

Forearm

Basilic V AP

Forearm Cephalic

Vein Anterior-

Posterior

Basilic Vein and

Axillary Vein

Junction Anterior-

Posterior

Upper Arm Basilic

Vein Anterior-

Posterior

Basilic AnteCubital

Vein Anterior-

Posterior

Forearm Basilic

Vein Anterior-

Posterior

Digital V AP Digital Vein

Anterior-Posterior

Median

Cubital V AP

Median Cubital V

Anterior-Posterior

Cephalic V

Trans

Basilic V

Trans

Cephalic Vein

Trans

Basilic Vein Trans

CA Junction

Trans

Cephalic Vein and

Axillary Vein

Junction Trans

Upper Arm

Cephalic V

Trans

Cephalic-

Antecubital V

Trans

Forearm

Cephalic V

Trans

Upper Arm

Cephalic Vein

Trans

Cephalic

AnteCubital Vein

Trans

Forearm Cephalic

Vein Trans

7-6 Vascular

Methods or formulae

Types Tools

BA Junction

Trans

Descriptions

Basilic Vein and

Axillary Vein

Junction Trans

Upper Arm Basilic

Vein Trans

Upper Arm

Basilic V

Trans

Basilic-

Antecubital V

Trans

Basilic AnteCubital

Vein Trans

Forearm

Basilic V

Trans

Digital V

Trans

Forearm Basilic

Vein Trans

Digital Vein Trans

Median

Cubital V

Trans

Median Cubital V

Trans

C.Iliac V

Status

Ex.Iliac V

Status

IIV Status

Common Iliac Vein

Status

External Iliac Vein

Status

Internal Iliac Vein

Status

CFV Status Common Femoral

Vein Status

Femoral V

Status

Femoral Vein

Status

DFV Status Deep Femoral

Vein Status

Pop V Status Popliteal Vein

Status

P.Tib. V

Status

Posterior Tibial

Vein Status

Peroneal V

Status

Sural V

Status

Soleal V

Status

A.Tib. V

Status

Peroneal Vein

Status

Sural Vein Status

Soleal Vein Status

TP Trunk V

Status

Saph V

Status

Anterior Tibial Vein

Status

Tibial Peroneal

Trunk Vein Status

Great Saphenous

Vein Status

Methods or formulae

Tick the status.

Choose from: Cmp (Compression); Sp

(Spontenaity); Ph (phasicity); Aug

(Augmentation); Rflx (Reflux); N/A

Vascular 7-7

Types Tools Descriptions

SSV Status Small Saphenous

Vein Status

SF Junction

Status the Junction of

Great Saphenous

Vein and Femoral

Vein Status

GSV Thigh

Status

GSV Knee

Status

GSV Calf

Status

SP Junction

Status

Great Saphenous

Vein Thigh Status

Great Saphenous

Vein Knee Status

Great Saphenous

Vein Calf Status the Junction of

Small Saphenous

Vein and Popliteal

Vein Status

SSV Thigh

Extension

Status

Small Saphenous

Vein Thigh

Extension Status

AASV Status Anterior Accessory

Saphenous Vein

Status

PASV Status Posterior

Accessory

Saphenous Vein

Status

Axillary V

Status

Axillary Vein

Status

Brachial V

Status

Radial V

Status

Brachial Vein

Status

Radial Vein Status

Ulnar Vein Status Ulnar V

Status

Int Jug V

Status

Innom V

Status

Subclav V

Status

Internal Jugular

Vein Status

Innominate Vein

Status

Subclavian Vein

Status

Volar Vein Status Volar V

Status

Cephalic V

Status

Basilic V

Status

Cephalic Vein

Status

Basilic Vein Status

7-8 Vascular

Methods or formulae

Types

Calculation

Study

Tools

CA Junction

Status

Descriptions

Cephalic Vein and

Axillary Vein

Junction Status

Upper Arm

Cephalic V

Status

Cephalic-

Antecubital V

Status

Upper Arm

Cephalic Vein

Status

Cephalic

AnteCubital Vein

Status

Forearm Cephalic

Vein Status

Forearm

Cephalic V

Status

BA Junction

Status

Upper Arm

Basilic V

Status

Basilic-

Antecubital V

Status

Basilic Vein and

Axillary Vein

Junction Status

Upper Arm Basilic

Vein Status

Basilic AnteCubital

Vein Status

Forearm

Basilic V

Status

Forearm Basilic

Vein Status

Digital Vein Status Digital V

Status

Median

Cubital V

Status

Median Cubital V

Status

Methods or formulae

Stenosis D Stenosis Diameter

Stenosis A Stenosis Area

Stenosis D (No unit) = (Normal Diam. (cm) –

Resid Diam. (cm)) / Normal Diam. (cm) ×

100%

Stenosis D (No unit) = | (D1-D2) / MAX

(D1, D2)|*100%

Where D1 and D2 refer to the measured vascular diameter, and MAX (D1, D2) represents the larger value of the two.

Stenosis A (No unit) = | (A1-A2) / MAX (A1,

A2) |*100%

Where A1 and A2 refer to the measured vascular area, and MAX (A1, A2) represents the larger value of the two.

IMT

CCA

Bulb

Intima-Media

Thickness

Common Carotid

Artery

Bulbillate

See below

 Anterior-Posterior, Transverse

Same as the Distance measurement in

2D General Measurements

Vascular 7-9

Types

Carotid

Bifurcation

ICA

Tools

ECA

Vert A

Subclav A

Innom A

Mammary A

Descriptions

Carotid Bifurcation

Internal Carotid

Artery

External Carotid

Artery

Vertebral Artery

Subclavian Artery

Brachiocephalic

Mammary A

Methods or formulae

 Stenosis

Stenosis Diameter (No unit) = | (Outer D-

Inner D) / MAX (Outer D, Inner D)|*100%

Where Outer D and Inner D refer to the measured vascular diameter, and MAX

(Outer D, Inner D) represents the larger value of the two.

Stenosis Area (No unit) = | (Outer A-

Inner A) / MAX (Outer A, Inner A) |*100%

Where Outer A and Inner A refer to the measured vascular area, and MAX

(Outer A, Inner A) represents the larger value of the two.

Innom A

Aneurysm

Mammary A

Aneurysm

Carotid Graft

1-3 Anast

Carotid Graft

1-3 Graft

Carotid Stent

1-3

Carotid

Stenosis 1-4

Axill A

Brachial A

Radial A

CCA

Aneurysm

Bulb

Aneurysm

Carotid

Bifurcation

Aneurysm

ICA

Aneurysm

ECA

Aneurysm

Vert A

Aneurysm

Subclav A

Aneurysm

Common Carotid

Arterial Aneurysm

Bulbillate

Aneurysm

Carotid Bifurcation

Aneurysm

Internal Carotid

Arterial Aneurysm

External Carotid

Arterial Aneurysm

Vertebral Arterial

Aneurysm

Subclavian Arterial

Aneurysm

Brachiocephalic

Aneurysm

Mammary Arterial

Aneurysm

Carotid Graft 1-3

Anastomosis

Carotid Graft 1-3

Graft

Axillary Artery

Brachial Artery

Radial Artery

Anterior-Posterior, Transverse, Long

Same as the Distance measurement in 2D

General Measurements

 Anterior-Posterior, Transverse

Same as the Distance measurement in

2D General Measurements

 Stenosis

Stenosis Diameter (No unit) = | (Outer D-

Inner D) / MAX (Outer D, Inner D)|*100%

7-10 Vascular

Types

UE A Stent

1-3

UE A

Stenosis 1-4

Tools

Ulnar A

Axill A

Aneurysm

Brachial A

Aneurysm

Radial A

Aneurysm

Ulnar A

Aneurysm

UE A Graft 1-

3 Native

Inflow

UE A Graft 1-

3 Anast

UE A Graft 1-

3 Graft

UE A Graft 1-

3 Native

Outflow

C.Iliac A

Ex.Iliac A

IIA

CFA

DFA

Descriptions

Ulnar Artery

Methods or formulae

Where Outer D and Inner D refer to the measured vascular diameter, and MAX

(Outer D, Inner D) represents the larger value of the two.

Stenosis Area (No unit) = | (Outer A-

Inner A) / MAX (Outer A, Inner A) |*100%

Where Outer A and Inner A refer to the measured vascular area, and MAX

(Outer A, Inner A) represents the larger value of the two.

Axillary Artery

Aneurysm

Brachial Artery

Aneurysm

Radial Artery

Aneurysm

Ulnar Artery

Aneurysm

Upper External

Arterial Graft 1-3

Native Inflow

Upper External

Arterial Graft 1-3

Anastomosis

Upper External

Arterial Graft 1-3

Graft

Upper External

Arterial Graft 1-3

Native Outflow

Anterior-Posterior, Transverse, Long

Same as the Distance measurement in 2D

General Measurements

Anterior-Posterior, Transverse

Same as the Distance measurement in 2D

General Measurements

Upper External

Arterial Stent 1-3

Upper External

Arterial Stenosis 1-

Common Iliac

Artery

External Iliac

Artery

Internal Iliac Artery

Common Femoral

Artery

Deep Femoral

Artery

Anterior-Posterior, Transverse, Long, Depth

Same as the Distance measurement in 2D

General Measurements

 Anterior-Posterior, Transverse

Same as the Distance measurement in

2D General Measurements

 Stenosis

Stenosis Diameter (No unit) = | (Outer D-

Inner D) / MAX (Outer D, Inner D)|*100%

Where Outer D and Inner D refer to the measured vascular diameter, and MAX

(Outer D, Inner D) represents the larger value of the two.

Stenosis Area (No unit) = | (Outer A-

Inner A) / MAX (Outer A, Inner A) |*100%

Where Outer A and Inner A refer to the

Vascular 7-11

Types Tools

SFA

Pop A

TP Trunk A

A.Tib A

Descriptions

Superficial

Femoral Artery

Popliteal Artery

Tibial Peroneal

Trunk Artery

Anterior Tibial

Artery

Peroneal A Peroneal Artery

P.Tib A

Dors.Ped. A

Posterior Tibial

Artery

Dorsalis Pedis

Artery

C.Iliac A

Aneurysm

Ex.Iliac A

Aneurysm

Common Iliac

Artery Aneurysm

External Iliac

Artery Aneurysm

IIA Aneurysm

Internal Iliac Artery

Aneurysm

CFA

Aneurysm

DFA

Aneurysm

SFA

Aneurysm

Pop A

Aneurysm

Common Femoral

Artery Aneurysm

Deep Femoral

Artery Aneurysm

Superficial

Femoral Artery

Aneurysm

Popliteal Artery

Aneurysm

TP Trunk A

Aneurysm

A.Tib. A

Aneurysm

Peroneal A

Aneurysm

P.Tib. A

Aneurysm

Dors.Ped. A

Aneurysm

LE A Graft 1-

3 Native

Inflow

LE A Graft 1-

3 Anast

Tibial Peroneal

Trunk Artery

Aneurysm

Anterior Tibial

Artery Aneurysm

Peroneal Artery

Aneurysm

Posterior Tibial

Artery Aneurysm

Dorsalis Pedis

Artery Aneurysm

Lower External

Arterial Graft 1-3

Native Inflow

Lower External

Arterial Graft 1-3

Anastomosis

Methods or formulae measured vascular area, and MAX

(Outer A, Inner A) represents the larger value of the two.

Anterior-Posterior, Transverse, Long

Same as the Distance measurement in 2D

General Measurements

Anterior-Posterior, Transverse

Same as the Distance measurement in 2D

General Measurements

7-12 Vascular

Types

1-6

Tools

LE A Graft 1-

3 Graft

LE A Graft 1-

3 Native

Outflow

LE A Stent 1-

LE A

Stenosis 1-4

LE A Finding

AVF-Inflow

Artery

AVF-Anast

AVF-Outflow

Vein Level 1-

AVF-

Stenosis 1-3

AVF-

Aneurysm 1-

AV Graft-

Inflow Artery

Descriptions

Lower External

Arterial Graft 1-3

Graft

Methods or formulae

Lower External

Arterial Graft 1-3

Native Outflow

Lower External

Arterial Stent 1-3

Lower External

Arterial Stenosis 1-

Anterior-Posterior, Transverse, Long, Depth

Same as the Distance measurement in 2D

General Measurements

 Anterior-Posterior, Transverse

Same as the Distance measurement in

2D General Measurements

 Stenosis

Stenosis Diameter (No unit) = | (Outer D-

Inner D) / MAX (Outer D, Inner D)|*100%

Where Outer D and Inner D refer to the measured vascular diameter, and MAX

(Outer D, Inner D) represents the larger value of the two.

Stenosis Area (No unit) = | (Outer A-

Inner A) / MAX (Outer A, Inner A) |*100%

Where Outer A and Inner A refer to the measured vascular area, and MAX

(Outer A, Inner A) represents the larger value of the two.

Lower External

Arterial Finding 1-6

Anterior-Posterior, Transverse, Long, Depth

Same as the Distance measurement in 2D

General Measurements

Arteriovenous

Fistula-Inflow

Artery

Arteriovenous

Fistula-

Anastomosis

Arteriovenous

Fistula-Outflow

Vein Level 1-6

Arteriovenous

Fistula-Stenosis 1-

Arteriovenous

Fistula-Aneurysm

1-3

Arteriovenous

Graft-Inflow Artery

Anterior-Posterior, Transverse, Depth

Same as the Distance measurement in 2D

General Measurements

Vascular 7-13

Types Tools

AV Graft-

Arterial

Anast

AV Graft-

Graft

AV Graft-

Venous

Anast

AV Graft-

Outflow Vein

Level 1-6

Descriptions

Arteriovenous

Graft-Arterial

Anastomosis

Arteriovenous

Graft-Graft

Arteriovenous

Graft-Venous

Anastomosis

Arteriovenous

Graft-Outflow Vein

Level 1-6

Methods or formulae

Stenosis A

Thigh Perf

Prox Calf

Perf

Stenosis (No unit)

= |(A1-A2)/ MAX(A1,A2)|*100%

Where A1 and A2 refer to the measured vascular area, and MAX (A1, A2) represents the larger value of the two.

You may select different method for the two area measurement.

Thigh Perforators  Anterior-Posterior, Transverse

Proximal Calf

Perforators

Mid Calf Perf Middle Calf

Perforators

Dist Calf Perf Distal Calf

Perforators

Same as the Distance measurement in

2D General Measurements

 Checklist

Tick the status.

Choose from: Cmp (Compression); Sp

(Spontenaity); Ph (phasicity); Aug

(Augmentation); Rflx (Reflux); N/A

7-14 Vascular

Doppler Vascular Measurements

Types

Measurement

CCA

Bulb

Tools

ICA

Carotid Bifurcation

ECA

Vert. A

Innom. A

Subclav. A

Mammary A

CCA Aneurysm

Bulb Aneurysm

Carotid Bifurcation

Aneurysm

ICA Aneurysm

ECA Aneurysm

Vert A Aneurysm

Subclav A Aneurysm

Innom A Aneurysm

Descriptions

Common Carotid Artery

Bulbillate

Internal Carotid Artery

External Carotid Artery

Vertebral Artery

Innominate Artery

Subclavian Artery

Methods or formulae

Common Carotid Arterial

Aneurysm

Bulbillate Aneurysm

Carotid Bifurcation

Aneurysm

Internal Carotid Arterial

Aneurysm

External Carotid Arterial

Aneurysm

Vertebral Arterial Aneurysm

D trace in General D measurements

Subclavian Arterial

Aneurysm

Innominate Artery

Aneurysm

Carotid Graft 1-3

Native Inflow

Carotid Graft 1-3

Anst Pre

Carotid Graft 1-3

Anst Max

Carotid Graft 1-3

Anst Post

Carotid Graft 1-3

Graft

Carotid Graft 1-3

Native Outflow

Carotid Stent 1-3

UE A Graft 1-3

Native Inflow

UE A Graft 1-3 Anast

Upper External Arterial

Graft 1-3 Native Inflow

Upper External Arterial

Graft 1-3 Anastomosis

Vascular 7-15

Types Tools

UE A Graft 1-3 Graft

UE A Graft 1-3

Native Outflow

UE A Stent 1-3

Descriptions

Upper External Arterial

Graft 1-3 Graft

Upper External Arterial

Graft 1-3 Native Outflow

Upper External Arterial

Stent 1-3

LE A Graft 1-3 Native

Inflow

Lower External Arterial

Graft 1-3 Native Inflow

LE A Graft 1-3 Anst

Pre

LE A Graft 1-3 Anst

Max

LE A Graft 1-3 Anst

Post

LE A Graft 1-3 Graft

Lower External Arterial

Graft 1-3 Anastomosis Pre

Lower External Arterial

Graft 1-3 Anastomosis Max

Lower External Arterial

Graft 1-3 Anastomosis

Post

Lower External Arterial

Graft 1-3 Graft

LE A Graft 1-3 Native

Outflow

Lower External Arterial

Graft 1-3 Native Outflow

LE A Stent 1-3

AVF-Inflow Artery

Lower External Arterial

Stent 1-3

Arteriovenous Fistula-

Inflow Artery

AVF-Anast

AVF-Outflow Vein

Level 1-6

AVF-Stenosis 1

-3

AV Graft-Inflow

Artery

AV Graft-Arterial

Anast

AV Graft-Graft

Arteriovenous Fistula-

Anastomosis

Arteriovenous Fistula-

Outflow Vein Level 1-6

Arteriovenous Fistula-

Stenosis 1-3

Arteriovenous Graft-Inflow

Artery

Arteriovenous Graft-

Arterial Anastomosis

Arteriovenous Graft-Graft

AV Graft-Venous

Anast

AV Graft-Outflow

Vein Level 1-6

SF Junction

GSV Thigh

Arteriovenous Graft-

Venous Anastomosis

Arteriovenous Graft-

Outflow Vein Level 1-6 the Junction of Great

Saphenous Vein and

Femoral Vein

Great Saphenous Vein

Thigh

Methods or formulae

7-16 Vascular

Types Tools

GSV Knee

GSV Calf

SP Junction

SSV Thigh

Extension

AASV

PASV

Mammary A

Aneurysm

Axill. A

Brachial A

Ulnar A

Radial A

Subclav. A

Axill. V

Cephalic V

Basilic V

Ulnar V

Radial V

C.Iliac A

Ex.Iliac A

CFA

SFA

Pop. A

Measurement

TP Trunk A

Peroneal A

P.Tib. A

A.Tib. A

Dors.Ped. A

C.Iliac V

Ex.Iliac V

Femoral V

Saph. V

Descriptions

Great Saphenous Vein

Knee

Great Saphenous Vein Calf the Junction of Small

Saphenous Vein and

Popliteal Vein

Small Saphenous Vein

Thigh Extension

Anterior Accessory

Saphenous Vein

Posterior Accessory

Saphenous Vein

Mammary Arterial

Aneurysm

Axillary Artery

Brachial Artery

Ulnar Artery

Radial Artery

Subclavian Artery

Axillary Vein

Cephalic Vein

Methods or formulae

D trace in General D measurements

Basilic Vein

Ulnar Vein

Radial Vein

Common Iliac Artery

External Iliac Artery

Common Femoral Artery

Superficial Femoral Artery

Popliteal Artery

Tibial Peroneal Trunk

Artery

Peroneal Artery

Posterior Tibial Artery

Anterior Tibial Artery

Dorsalis Pedis Artery

Common Iliac Vein

External Iliac Vein

Femoral Vein

Great Saphenous Vein

D trace in General D measurements

Vascular 7-17

Types Tools

Pop. V

TP Trunk V

Sural V

Soleal V

Peroneal V

P.Tib. V

A.Tib. V

ACA

A1 ACA

MCA

M1 MCA

M2 MCA

Measurement

PCA

P1 PCA

P2 PCA

AComA

Terminal ICA

PComA

Opthalmic A

ICA Siphon

Terminal Vert A

IIA

DFA

Ba V

Brachial V

IIV

Measurement CFV

SFV

DFV

SSV

C.Iliac V Reflux

Ex.Iliac V Reflux

Descriptions

Popliteal Vein

Tibial Peroneal Trunk Vein

Sural Vein

Soleal Vein

Peroneal Vein

Posterior Tibial Vein

Anterior Tibial Vein

Anterior Cerebral Artery

Anterior Cerebral Artery A1

Middle Cerebral Artery

Middle Cerebral Artery M1

Middle Cerebral Artery M2

Posterior Cerebral Artery

Ant.communicating br.

Terminal Internal Carotid

Artery

Post.communicating br.

Opthalmic Artery

Internal Carotid Artery

Siphon

Terminal Vertebral Artery

Basilar Artery

Internal Iliac Artery

Deep Femoral Artery

Basilar Vein

Brachial Vein

Internal Iliac Vein

Common Femoral Vein

Superficial Femoral Vein

Deep Femoral Vein

Small Saphenous Vein

Common Iliac Vein Reflux

External Iliac Vein Reflux

Methods or formulae

D trace in General D measurements

Time in General D measurements

7-18 Vascular

Types Tools

Femoral V Reflux

Saph. V Reflux

Pop. V Reflux

TP Trunk V Reflux

Sural V Reflux

Soleal V Reflux

Peroneal V Reflux

P.Tib. V Reflux

A.Tib. V Reflux

IIV Reflux

Descriptions

Femoral Vein Reflux

Great Saphenous Vein

Reflux

Popliteal Vein Reflux

Tibial Peroneal Trunk Vein

Reflux

Sural Vein Reflux

Soleal Vein Reflux

Peroneal Vein Reflux

Posterior Tibial Vein Reflux

Anterior Tibial Vein Reflux

Internal Iliac Vein Reflux

CFV Reflux

SFV Reflux

DFV Reflux

SSV Reflux

Common Femoral Vein

Reflux

Superficial Femoral Vein

Reflux

Deep Femoral Vein Reflux

Small Saphenous Vein

Reflux

SF Junction Reflux the Junction of Great

Saphenous Vein and

Femoral Vein Reflux Time

GSV Thigh Reflux

GSV Knee Reflux

Great Saphenous Vein

Thigh Reflux Time

Great Saphenous Vein

Knee Reflux Time

GSV Calf Reflux Great Saphenous Vein Calf

Reflux Time

SP Junction Reflux the Junction of Small

Saphenous Vein and

Popliteal Vein Reflux Time

SSV Thigh

Extension Reflux

AASV Reflux

PASV Reflux

ASP

BSP

Small Saphenous Vein

Thigh Extension Reflux

Time

Anterior Accessory

Saphenous Vein Reflux

Time

Posterior Accessory

Saphenous Vein Reflux

Time

Ankle Systolic Pressure

Brachial Systolic Pressure

Methods or formulae

Type in

Vascular 7-19

Types Tools

Calculation ICA/CCA(PS)

ABI

CCA(Sten)

Bulb(Sten)

Carotid

Bifurcation(Sten)

ICA(Sten)

Study

ECA(Sten)

Vert A(Sten)

Subclav A(Sten)

Innom A(Sten)

Mammary A(Sten)

Carotid Stenosis 1

-4

Axill A(Sten)

Brachial A(Sten)

Radial A(Sten)

Ulnar A(Sten)

UE A Stenosis 1

-4

C.Iliac A(Sten)

Ex.Iliac A(Sten)

IIA(Sten)

CFA(Sten)

DFA(Sten)

SFA(Sten)

Pop A(Sten)

TP Trunk A(Sten)

A.Tib A(Sten)

Peroneal A(Sten)

Descriptions

Ankle Brachial Index

Common Carotid Artery

Stenosis

Bulbillate Stenosis

Carotid Bifurcation

Stenosis

Internal Carotid Artery

Stenosis

External Carotid Artery

Stenosis

Vertebral Artery Stenosis

Subclavian Artery Stenosis

Innominate Artery Stenosis

Mammary A Stenosis

Methods or formulae

See below

Axillary Artery Stenosis

Brachial Artery Stenosis

Radial Artery Stenosis

Ulnar Artery Stenosis

Upper External Arterial

Stenosis 1-4

Common Iliac Artery

Stenosis

External Iliac Artery

Stenosis

Internal Iliac Artery

Stenosis

Common Femoral Artery

Stenosis

Deep Femoral Artery

Stenosis

Superficial Femoral Artery

Stenosis

Popliteal Artery Stenosis

Tibial Peroneal Trunk

Artery Stenosis

Anterior Tibial Artery

Stenosis

Peroneal Artery Stenosis

D trace in General D measurements

7-20 Vascular

Types Tools

P.Tib A(Sten)

Dors.Ped. A(Sten)

LE A Stenosis 1-4

Thigh Perf

Prox Calf Perf

Mid Calf Perf

Dist Calf Perf

Descriptions

Posterior Tibial Artery

Stenosis

Dorsalis Pedis Artery

Stenosis

Lower External Arterial

Stenosis 1-4

Thigh Perforators

Proximal Calf Perforators

Middle Calf Perforators

Distal Calf Perforators

Methods or formulae

 PV, Reflux

D trace and Time in

General D measurements

 Checklist

Tick the status.

Choose from: Cmp

(Compression); Sp

(Spontenaity); Ph

(phasicity); Aug

(Augmentation); Rflx

(Reflux); N/A

7.4 Vascular Measurement Operations

Tip: 1.

See the table in “7.3 Vascular Measurement Tools” above for measurement tools

and methods.

For the definitions of measurement, calculation and study, see “1.3 Measurement,

The order of the measurement items can be preset. See “2.4.2 Application

For details about report browsing, printing and exporting, etc., see “1.7 Report.”

5. The measurements of some tools described in this chapter are to be performed in several imaging modes. Select the appropriate imaging mode during measurement.

7.4.1 Measurement Tool Operations

1. Select the item/tool in the measurement menu.

2. Perform the measurement referring to the methods in the table above.

7.4.2 Calculation Tool Operations

Stenosis D

Function: measures the Normal Diam. and Resid. Diam., calculates the Stenosis D.

1. Select [Stenosis D] in the measurement menu or the touch screen.

2. Use the Distance measurement method in 2D General Measurements to measure the

Normal(D) and Resid(D).

Vascular 7-21

The Stenosis D is calculated automatically.

Stenosis A

Function: measures the Normal Area and Resid. Area, calculates the Stenosis A.

1. Select [Stenosis A] in the measurement menu or the touch screen.

2. Use the Area measurement method in 2D General Measurements to measure the Normal(A) and Resid(A).

The Stenosis A is calculated automatically.

ICA/CCA (PS)

Function: measures the flow velocity ratio between ICA and CCA to calculate the stenosis.

1. Select [ICA/CCA (PS)] in the measurement menu or the touch screen.

2. Measure the PS value of the ICA and CCA using the 2 PT method in D trace, and the system calculates the stenosis. Where, the ICA value adopts the maximum PS value of proximal, middle and distal and the CCA adopts the latest measured value after changing the

Prox./Mid./Dist. attribute (the default CCA adopts the distal PS value).

7.4.3 Study Tool Operations

IMT

NOTE: 1. The IMT function is unavailable on the product not configured with IMT.

2. The IMT measurement is available on frozen (or history) linear array images only.

Function: IMT (Intima-Media Thickness) measures the distance between LI (Lumen-Intima) and

MA (Media-Adventia).

The IMT values at 4 positions: CCA (Common Carotid Artery), ICA (Internal Carotid Artery), ECA

(External Carotid Artery) and Bulb (Bulbillate) need to be measured here.

1. Enter the IMT exam mode, scan and freeze the image (or review a historic image).

2. Select [IMT] in the measurement menu and enter the IMT measurement.

3. Select the side (Left/Right), angle and vessel wall (Near/Far).

4. Select an item such as [ICC, IMT], and the ROI box displays on the screen.

It appears as when Near is selected

Tip

It appears as when Far is selected

Make sure that you select the correct vessel wall (Near/Far) before the IMT measurement. Otherwise the intima may be recognized incorrectly due to different algorithms that are applied in near/far wall recognition.

5. Move the ROI box to the desired position, then press <Set>. Two auto trace lines appear in the box.

While the ROI box is green, you can:

 Adjust the size of the ROI box.

 Trace manually a) Move the cursor to a trace line. The trace line turns yellow. Press <Set>. b) Move the cursor along the interface of the vessel. Press <Set> to confirm the trace after re-adjusting.

 Erase the trace lines inside the box by pressing <Clear>. (Long press <Clear> to clear all measurement calipers on the screen.)

7-22 Vascular

6. Press <Set> outside the box to confirm the adjustment result after the manual trace is complete. The results are recorded in the IMT report.

The system calculates:

 IMT Max.

 IMT Min.

 IMT Mean

 IMT SD

 IMT ROI Length

 IMT Measure Length

 IMT Quality Index

The Quality Index indicates the reliability of one measurement. Manual trace or re-scan of an image with clear endocardium edges is recommended if the Quality Index value is small.

Tip: To achieve a good trace result, try to place the ROI box parallel with the vessel and adjust the box size to reduce unwanted interference.

For multiple measurements on the same side, vessel and angle, the system calculates the following parameters in the report:

 Average Mean IMT

 Average Max. IMT

 Standard deviation

It also provides the Composite Mean IMT, which is an overall mean value of all IMT mean values derived from the measured items.

ABI

Function: calculates the Ankle Brachial Index (ABI) by measuring the Ankle Systolic Pressure

(ASP) and the Brachial Systolic Pressure (BSP) on a Doppler image.

ABI = ASP/BSP

NOTE: needs to be measured on the left and right sides respectively.

Select [ABI] in the measurement menu.

1. Click [ASP] from the [ABI] menu and enter the value.

2. Click [BSP] from the [ABI] menu and enter the value.

The ABI is calculated by the system automatically.

7.5 Vascular Exam Report

During or after a measurement, click [Report] on the touch screen to browse the report.

An IMT report is applied to the record results in the IMT measurements, where selecting patient conditions (smoker/non-smoker, diabetic/not diabetic, etc.) and modifying the result data are available.

Vascular 7-23

7.6 References

Stenosis D: Honda, Nobuo, et al., “Echo-Doppler Velocimeter in the Diagnosis of

Hypertensive Patients: The Renal Artery Doppler Technique,” Ultrasound in

Medicine and Biology, 1986, Vol. 12(12), pp. 945-952.

Stenosis A: Jacobs, Norman M., et al., “Duplex Carotid Sonography: Criteria for Stenosis,

Accuracy, and Pitfalls,” Radiology, 1985, 154:385-391.

7-24 Vascular

Gynecology

8.1 Gynecology Exam Preparations

Make the following preparations before measuring:

1. Confirm that the current probe is appropriate.

2. Check that the current system date is correct.

3. Register the patient information in the [Patient Info]

→

[GYN] dialog box.

For more details, see “Exam Preparation

→

Patient Information” in the Operator's Manual

[Basic Volume].

4. Switch to the correct exam mode.

8.2 Basic Gynecology Measurement

Procedures

1. Register the patient information in the [Patient Info]

→

[GYN] dialog box.

2. Press <Measure> to enter the Application Measurement.

3. Select the measurement tool from the menu or the touch screen to start the measurement.

See the table in “8.3 Gynecology Measurement Tools” below for measurement tools.

See section “8.4 Gynecology Measurement Operations” and steps in “3 General

Measurement” for measurement methods.

4. Click [Report] on the touch screen to view the exam report. See “8.5 Gynecology Exam

Report” for details.

Gynecology 8-1

8.3 Gynecology Measurement Tools

The system supports the following gynecology measurements.

NOTE: The measurement tools mentioned below are configured in the system. The application measurement packages provided in this system are generally different combinations of measurement tools. For more information about package preset, see

See the table in “8.3 Gynecology Measurement Tools” above for measurement

Modes Types Tools

UT H

UT W

Descriptions

Uterine Height

Uterine Width

Methods or formulae

Same as the Distance measurement in 2D General

Measurements

UT L

Cervix L

Cervix H

Cervix W

Uterine Length

Uterine Cervix

Length

Uterine Cervix

Height

Uterine Cervix Width

Same as the Distance, Trace and Spline measurements in

2D General Measurements

Endo

Ovary L

Ovary H

Endometrium

Thickness

Ovary Length

Ovary Height

Ovary W Ovary Width

Follicle1~16 L Follicle 1~16 Length

Measurement

Follicle1~16

Fibroid1-3 d1-

GYN Lesion1-

3 d1-3

Ovarian

Cyst1-3 d1-3

Follicle 1~16 Width

Follicle1~16 Height

DWT

Intus. Depth

BSD (R)

Detrusor Wall

Thickness

Intussusceptions

Depth

Bladder Neck –

Symphysis

Distance (Rest)

Same as the Distance measurement in 2D General

Measurements

Same as the Parallel measurement in 2D General

Measurements

BSD (Va)

Bladder Neck –

Symphysis Distance

(Valsalva)

8-2 Gynecology

Modes Types Tools

Cx-SP Dist.

(R)

Cx-SP Dist.

(Va)

RA-SP Dist.

(R)

RA-SP Dist.

(Va)

Rectocele

Depth

Shuttle (R)

Shuttle (Va)

RVA (R)

RVA (Va)

UTA (R)

UTA (Va)

URA

PVA (R)

PVA (Va)

PUA (R)

PUA (Va)

ARA (R)

ARA (Va)

ARA (C)

Descriptions

Cervix - Symphysis

Publis Distance

(Rest)

Cervix - Symphysis

Publis Distance

(Valsalva)

Rectal Ampulla -

Symphysis Publis

Distance (Rest)

Rectal Ampulla -

Symphysis Publis

Distance (Valsalva)

Bladder Neck –

Symphyseal

Distance (Rest)

Bladder Neck –

Symphyseal

Distance (Valsalva)

Retrovesical Angle

(Rest)

Retrovesical Angle

(Valsalva )

Urethral Tilt Angle

(Rest)

Urethral Tilt Angle

(Valsalva)

Urethral Rotation

Angle

Pubovesical Angle

(Rest)

Pubovesical Angle

(Valsalva)

Pubourethral Angle

(Rest)

Pubourethral Angle

(Valsalva)

Anorectal Angle

(Rest)

Anorectal Angle

(Valsalva)

Anorectal Angle

(Contraction)

Methods or formulae

The system automatic calculates BSD, BPW-SP

Dist., Cx-SP Dist. and RA-SP

Dist. values.

See “Shuttle” study

Same as the Angle measurement in 2D General

Measurements

Gynecology 8-3

Modes Types

LH AP Diam

(R)

Tools

LH AP Diam

(Va)

LH AP Diam

(C)

LH Lateral

Diam (R)

LH Lateral

Diam (Va)

LH Lateral

Diam (C)

Descriptions

Levator Hiatal

Anteroposterior

Diameter (Rest)

Levator Hiatus

Anteroposterior

Diameter (Valsalva)

Levator Hiatus

Anteroposterior

Diameter

(Contraction)

Levator Hiatus

Lateral Diameter

(Rest)

Levator Hiatus

Lateral Diameter

(Valsalva)

Levator Hiatus

Lateral Diameter

(Contraction)

LA Thickness

(R)

LA Thickness

(Va)

Levator Ani

Thickness (Rest)

Levator Ani

Thickness (Valsalva)

LA Thickness

(C)

Levator Ani

Thickness

(Contraction)

LH Area (R) Levator Hiatus Area

(Rest)

LH Area (Va) Levator Hiatus Area

(Valsalva)

LH Area (C) Levator Hiatus Area

(Contraction)

LA Angle (R) Levator Ani Angle

(Rest)

LA Angle (Va) Levator Ani Angle

(Valsalva)

LA Angle (C) Levator Ani Angle

(Contraction)

LUG (R) Levator Urethra Gap

(Rest)

LUG (Va)

LUG (C)

Levator Urethra Gap

(Valsalva)

Levator Urethra Gap

(Contraction)

Methods or formulae

Same as the Distance measurement in 2D General

Measurements

Same as the Area measurement in 2D General

Measurements

Same as the Angle measurement in 2D General

Measurements

Same as the Distance measurement in 2D General

Measurements

8-4 Gynecology

Modes Types

Calculation

Study

BPW-SP Dist.

(S)

Tools

BPW-SP Dist.

(Va)

Descriptions

Bladder Post Wall -

Symphysis Publis

Distance (Stress)

Bladder Post Wall -

Symphysis Publis

Distance (Valsalva)

/ Lesion1-3

Elas.

Fibroid1-3

Elas.

Fibroid1-3

Strain

GYN

Lesion1~3

Strain

Ovary Vol.

Ovary Volume

UT Vol. UT Volume

Uterus Body /

UT-L/ CX-L /

Follicle 1-16 /

Fibroid1-3 d1-

GYN Lesion1-

3 d1-3

Ovarian

Cyst1-3 d1-3

Methods or formulae

Same as the Parallel measurement in 2D General

Measurements

Elastography in 2D General

Measurements

Same as the Strain measurement in 2D General

Measurements

See below

Mean DWT

IAS Damage

EAS Damage

Uterus

Mean Detrusor Wall

Thickness

Uterine Cervix /

Ovary

Follicle 1~16

Same as the Distance measurement in 2D General

Measurements

Mean DWT = (DWT1 +

DWT2 + DWT3) /3

Damage ratio= the length of sphincter muscle of anus damage / the length of sphincter muscle of anus

Length, height and width of uterus, endometrium thickness

Length, height and width of uterine cervix

Length, height and width of ovary

Length, height and width of follicle 1~16

Same as the Distance measurement in 2D General

Measurements

Gynecology 8-5

Modes

M /

Doppler /

Types

BL Height

BL Depth

Tools

GYN

Lesion1~3

StrRatio

Bladder Height

Bladder Depth

Uterine

Finding 1-6

Ovarian

Finding 1-6

Descriptions Methods or formulae

The system automatic calculates Residual Urine value.

Dietz formula ： Residual

Urine (ml) = BL Height (cm) *

BL Depth (cm) * 5.6, or

Haylen formula ： Residual

Urine (ml) = BL Height (cm) *

BL Depth (cm) * 5.9 – 14.6, or

Dicuio formula ： Residual

Urine (ml) = BL Height (cm) *

BL Depth (cm) * BL

Transverse Diameter (cm)*

0.52

Same as the Strain Ratio measurement in 2D General

Measurements

Same as the Distance measurement in 2D General

Measurements

Uterine Finding

Volume(cm^3

)=π/6

×Uterine

Finding D1(cm)×Uterine

Finding D2(cm)×Uterine

Finding D3(cm)

Same as the Distance measurement in 2D General

Measurements

Ovarian Finding

Volume(cm^3

)=π/6

×Ovarian

Finding D1(cm)×Ovarian

Finding D2(cm)×Ovarian

Finding D3(cm)

8.4 Gynecology Measurement Operations

Tip: 1.

tools and methods.

For the definitions of measurement, calculation and study, see “1.3 Measurement,

The order of the measurement items can be preset. See “2.4.2 Application

For details about report browsing, printing and exporting, etc., see “1.7 Report.”

8-6 Gynecology

8.4.1 Measurement Tool Operations

All items are measured using the Distance method except for UT L and Cervix L which support the

Distance, Trace and Spline methods.

Shuttle

The measurement of reference line distance: measure the distance from BN, front point, middle point, back point of pelvis floor to the reference line of the symphysis pubis.

1. Move the bigger cursor to a certain point.

2. Rotate <Angle> to adjust the orientation of the reference line.

3. Press <Set> to fix the reference line.

4. Press <Set> to fix BN position. Measure the distance from this point to the reference line (BN distance). Then, measure BPW-SP Dist., Cx-SP Dist. and RA-SP Dist..

Press <Clear> to remove the last measurement result. Double-click <Set> to complete the measurement in advance. Press <Update> to start a new measurement.

8.4.2 Calculation Tool Operations

Ovary Vol.

Function: measures the Ovary L, Ovary H and Ovary W, calculates the Ovary Vol.

NOTE: needs to be measured on the left and right sides respectively.

1. Select [Ovary Vol.] in the measurement menu or the touch screen.

2. Use the Distance method in 2D General Measurements to measure the Ovary L, Ovary H and

Ovary W. The Ovary Vol. is calculated automatically.

UT Vol

Function: measures the UT L, UT H and UT W, calculates the UT Vol.

1. Select [UT Vol.] in the measurement menu or the touch screen.

2. Use the Distance method in 2D General Measurements to measure the UT L, UT H and UT W.

The UT Vol. and Uterus Body are calculated automatically.

Uterus Body

Function: measures the UT L, UT H and UT W, calculates Uterus Body.

Uterus Body (cm) = UT L (cm) + UT H (cm) + UT W (cm)

1. Select [Uterus Body] in the measurement menu or the touch screen.

2. Use the Distance method in 2D General Measurements to measure the UT L, UT H and UT W.

The UT Vol. and Uterus Body are calculated automatically.

UT-L/ CX-L

Function: measures the UT L and Cervix L, calculates the ratio UT-L/CX-L.

UT-L/CX-L (No unit) = UT L (cm) / Cervix L (cm)

1. Select [UT-L/CX-L] in the measurement menu or the touch screen.

2. Use the Distance method in 2D General Measurements to measure the UT L and Cervix L.

The system calculates the UT-L/CX-L.

Gynecology 8-7

8.4.3 Study Tool Operations

Uterus

Function: measures the UT L, UT H, UT W and Endo, calculates the UT Vol., Uterine Body and

UT-L/CX-L.

1. Select [Uterus] in the measurement menu or the touch screen.

2. Use the Distance method in 2D General Measurements to measure the UT L, UT H, UT W and Endo.

The UT Vol. and Uterus Body are calculated automatically.

If the Uterus and Cervix L has been measured, the system also calculates the UT-L/CX-L.

Uterine Cervix

Function: measures the Cervix L, Cervix H and Cervix W, calculates the UT-L/CX-L.

1. Select [Uterine Cervix] in the measurement menu or the touch screen.

2. Use the Distance method in 2D General Measurements to measure the Cervix L, Cervix H and

Cervix W.

Ovary

Function: measures the Ovary L, Ovary H and Ovary W, calculates the Ovary Vol.

NOTE: needs to be measured on the left and right sides respectively.

1. Select [Ovary] in the measurement menu or the touch screen.

2. Use the Distance method in 2D General Measurements to measure the Ovary L, Ovary H and

Ovary W. The Ovary Vol. is calculated automatically.

Follicle

Function: measures the length, width and height of the follicle using the Distance method and calculates the length, width and height averages as well as the follicle volume.

Results Method

Average Diameter

Follicle Volume

2-distance

3-distance

1-distance

2-distance

3-distance

Formulae

Average Diam

฀

(

Length

Width

)

Average Diam

฀

(

Length

Width

Height

)

Vol

฀

(

Length

)

Vol

฀

(

Length

)

2 ×

Width

Vol

฀

6 length

Width

Height

Up to 16 follicles can be measured. Specify the follicle serial numbers before measuring a follicle.

NOTE: needs to be measured on the left and right sides respectively.

Take Follicle1 as an example. The measurements of other items are similar.

1. Select [Follicle1] in the measurement menu or the touch screen.

2. Use the Distance measurement method in 2D General Measurements to measure Follicle1 L,

Follicle1 W and Follicle1 H.

8-8 Gynecology

The system automatically calculates the average value of Follicle1 L, Follicle1 W and Follicle1

H as well as the volume of Follicle1.

The calculation methods of the follicle diameter and volume can be preset via [Setup]

→

[System Preset]

→

[Application].

8.5 Gynecology Exam Report

During or after a measurement, click [Report] on the touch screen to browse the gynecology/IVF/pelvic floor report.

8.6 References

Uterus

Body:

Feng Kui, Sun Yanling, Li Hezhou. Ultrasonic diagnosis of adenomyosis. Journal of Henan Medical University, 1995; 30 (2).

UT-L/ CX-L: Ji Jindi, et al. Ultrasonographic study of the intersex problems and the internal genitalia abnormalities. Journal of China medical ultrasound. 1996, Volume 12,

No8 P40.

Residual

Urine:

1. Dietz HP, et al. Determination of postvoid residual by translabial ultrasound. Int

Urogynecol J 2012; 23: 1749-1752.

2. Haylen BT. Verification of the accuracy and range of transvaginal ultrasound in measuring bladder volumes in women. Br J Urol 1989;64:350-352.

3. Cassadó, J., Espu?a-Pons, M., Díaz-Cuervo, H., Rebollo, P. and on behalf of the GISPEM Group (2015), How can we measure bladder volumes in women with advanced pelvic organ prolapse?. Ultrasound Obstet Gynecol, 46: 233–

238. doi:10.1002/uog.14678

1. 3-Dimensional transvaginal ultrasonography evaluation of femal pelvic floor Levator

Hiatus

Diam, Area, structure and function.

2. Dan V. Valsky, MD, Simcha Yagel, MD. Three-Dimensional Transperineal

Ultrasonography of the Pelvic Floor. J Ultrasound Med 2007; 26:1373–1387.

Thickness and LA

Angle

LUG

(Levator

Urethra

Gap)

1. H. P. DIETZ, A. ABBU and K. L. SHEK. The levator–urethra gap measurement: a more objectivemeans of determining levator avulsion? Ultrasound Obstet

Gynecol 2008; 32: 941–945.

Gynecology 8-9

Smart

Pelvic

1. Svabik K, Shek KL, Dietz HP. How much does the levator hiatus have to stretch during childbirth? BJOG 2009;116:1657–62

2. Abdool Z, Shek KL, Dietz HP. The effect of levator avulsion on hiatal dimensions and function. Am J Obstet Gynecol 2009;201(1). 89.e1–5.

3. Dietz, H., Hoyte, L., Steensma, A. (2008). Atlas of Pelvic Floor Ultrasound.

United Kingdom: Springer-Verlag London Ltd.

4. Dietz H, De Leon J, Shek K. Ballooning of the levator hiatus. Ultrasound Obstet

Gynecol 2008; 31: 676–680.

5. Eisenberg VH, Chantarasorn V, Shek KL, Dietz HP. Does levator ani injury affect cystocele type? Ultrasound Obstet Gynecol 2010; 36: 618–623.

6. Oerno A, Dietz H. Levator co-activation is a significant confounder of pelvic organ descent on Valsalva maneuver.Ultrasound Obstet Gynecol 2007; 30:

346–350.

7. Dietz H, Lanzarone V. Levator trauma after vaginal delivery.Obstet Gynecol

2005;106: 707–712.

8. Dietz HP, Abbu A, Shek KL. The levator–urethra gap measurement:a more objective means of determining levator avulsion? Ultrasound Obstet Gynecol

2008; 32: 941–945.

9. Dietz HP, Schierlitz L. Pelvic floor trauma in labour—myth or reality? Aust N Z

J Obstet Gynaecol 2005;45:3–11.

10. Dietz H, Abbu A, Shek K (2008) The levator urethral gap measurement: a more objective means of determining levator avulsion? Ultrasound Obstet Gynecol

32:941–945

11. Valsky DV, Yagel S. Three-dimensional transperineal ultrasonography of the pelvic floor: improving visualization for new clinical applications and better functional assessment. J Ultrasound Med 2007; 26: 1373–1387

12. Dietz HP. Pelvic floor ultrasound: a review. Am J Obstet Gynecol 2010; 202:

321–334

8-10 Gynecology

Urology

9.1 Urology Exam Preparations

Make the following preparations before performing a urology exam:

1. Confirm that the current probe is appropriate.

2. Check that the current system date is correct.

3. Click [Info] on the touch screen and register the patient information in the [Patient Info]

→

[URO] dialog box.

For more details, see “Exam Preparation

→

Patient Information” in the Operator's Manual

[Basic Volume].

4. Switch to the correct exam mode.

9.2 Basic Urology Measurement Procedures

1. Click [Info] on the touch screen and register the patient information in the [Patient Info]

→

[URO] dialog box.

2. Press <Measure> to enter the Application Measurements.

3. Select the measurement tool from the menu or the touch screen to start the measurement.

See the table in “9.3 Urology Measurement Tools” below for measurement tools.

See section “9.4 Urology Measurement Operations” and steps in “3 General Measurement” for

measurement methods.

4. Click [Report] on the touch screen to view the exam report. See “9.5 Urology Exam Report” for

details.

Urology 9-1

9.3 Urology Measurement Tools

See the table in “9.3 Urology Measurement Tools” above for measurement tools

The system supports the following measurements (no measurement tools in M mode).

Modes

Types Tools Descriptions

Methods or formulae

Renal L

Renal H

Renal W

Cortex

Renal Length

Renal Height

Renal Width

Renal Cortical

Thickness

Renal Cortical

Thickness

2D Measurement

Cortex(Renal

Transplant1-2)

Renal V

Diam(Renal

Transplant1-2)

Ureter Diam(Renal

Transplant1-2)

Adrenal L

Adrenal H

Adrenal W

Prostate L

Prostate H

Prostate W

Renal Vein Diameter

Ureter Diameter

Distance in 2D

General

Measurements

Seminal L

Seminal H

Seminal W

Testis L

Testis H

Testis W

Ureter Diam

Urethra

Pre-BL L

Pre-BL H

Adrenal Length

Adrenal Height

Adrenal Width

Prostate Length

Prostate Height

Prostate Width

Seminal Vesicle

Length

Seminal Vesicle

Height

Seminal Vesicle

Width

Testicular Length

Testicular Height

Testicular Width

Ureter Diameter

Pre-void Bladder

Length

Pre-void Bladder

Height

9-2 Urology

Modes

Types Tools

Pre-BL W

Post-BL L

Post-BL H

Descriptions

Pre-void Bladder

Width

Post-void Bladder

Length

Post-void Bladder

Height

Post-void Bladder

Width

Post-BL W

Measurement

Renal Cyst1-3 d1-

Renal Lesion1-3 d1-3

Prostate Mass1 d1-3

Prostate Mass2 d1-3

Prostate Mass3 d1-3

Testis Mass1 d1-3

Testis Mass2 d1-3

Testis Mass3 d1-3

Epididymis L

Epididymis W

Epididymis H

Scrotal Wall

Thickness

Renal Vol.

Prostate Vol.

Testicular Vol.

Calculation

Pre-BL Vol.

Study

Post-BL Vol.

Mictur. Vol.

Kidney

Adrenal

Prostate

Seminal Vesicle

Epididymis Length

Epididymis Width

Epididymis Height

Renal Volume

Prostate Volume

Testicular Volume

Pre-void Bladder

Volume

Post-void Bladder

Volume

Micturated Volume

Methods or formulae

Distance in 2D

General

Measurements

See below

Urology 9-3

Modes

Types Tools Descriptions

Testis

Bladder

Mass1-10

Prostate mass 1-3 /

Testis mass 1-3 /

/ Epididymis

Renal Cyst1-3 d1-

Renal Lesion1-3 d1-3

Kidney(Superior) /

Kidney(Mid) /

/ Kidney(Inferior)

Kidney(Renal

Transplant1-2)

Adrenal(Renal

Transplant1-2)

Finding 1-6(Renal

Transplant1-2)

Testicular A

Testicular V

Epididymis A

Epididymis V

Artery Anast(Renal

Transplant1-2)

Artery Anast

2(Renal

Transplant1-2)

Testicular Aorta

Testicular Vein

Epididymis Aorta

Epididymis Vein

Doppler Measurement

Renal A(Renal

Transplant1-2)

Renal A1(Renal

Transplant1-2)

Renal A2(Renal

Transplant1-2)

Hilum(Renal

Transplant1-2)

Interlobar A(Renal

Transplant1-2)

Arcuate A(Renal

Transplant1-2)

Methods or formulae

Distance in 2D

General

Measurements

Distance in 2D

General

Measurements

Distance in 2D

General

Measurements

D trace in General D measurements

9-4 Urology

Modes

Types

Study

Tools

Segmental

A(Renal

Transplant1-2)

Renal Vein 1-

2(Renal

Transplant1-2)

Vein Anast(Renal

Transplant1-2)

Vein Anast

2(Renal

Transplant1-2)

Renal Transplant

1-2 (Doppler)

Descriptions

Vein Anastomosis

Vein Anastomosis 2

Methods or formulae

D trace in General D measurements

9.4 Urology Measurement Operations

Tip: 1.

and methods.

For the definitions of measurement, calculation and study, see “1.3 Measurement,

The order of the measurement items can be preset. See “2.4.2 Application

For details about report browsing, printing and exporting, etc., see “1.7 Report.”

9.4.1 Measurement Tool Operations

All Urology measurement tool operations are the same as the Distance measurement of 2D

General Measurements.

The measurement procedures are as follows, taking the Prostate L measurement as an example:

1. Select [Prostate L] in the measurement menu or the touch screen.

2. Use the Distance tool in 2D General Measurements to measure the Prostate L.

9.4.2 Calculation Tool Operations

Renal Vol.

Function: measures the Renal L, Renal H and Renal W, calculates the Renal Vol.

NOTE: needs to be measured on the left and right sides respectively.

1. Select [Renal Vol] in the measurement menu or the touch screen.

2. Use the Distance measurement method in 2D General Measurements to measure the Renal

L, Renal H and Renal W. The Renal Vol. is calculated automatically.

Urology 9-5

Prostate Vol.

Function: measures the Prostate L, Prostate H and Prostate W, calculates the Prostate Vol. and

PPSA. If [Serum PSA] in [Patient Info]

→

[URO] has been entered, PSAD (Prostate Special

Antigen Density) will also be calculated.

PPSA (ng/ml) = PPSA Coefficient (ng/ml 2 ) × Prostate Vol (ml)

PSAD (ng/ml 2 ) = Serum PSA (ng/ml) / Prostate Vol. (ml)

Here, the PPSA Coefficient and Serum PSA are entered in the [Patient Info]

→

[URO] dialog box.

The default value of the PPSA Coefficient is 0.12.

1. Select [Prostate Vol.] in the measurement menu or the touch screen.

2. Use the Distance method in 2D General Measurements to measure the Prostate L, Prostate H and Prostate W.

The system calculates the Prostate Vol. and PPSA.

The PSAD displays in the report if the PSA value is entered.

Testiscular Vol.

Function: measures the Testis L, Testis H and Testis W, calculates the Testis Vol.

NOTE: needs to be measured on the left and right sides respectively.

1. Select [Testiscular Vol.] in the measurement menu or the touch screen.

2. Use the Distance measurement method in 2D General Measurements to measure the Testis L,

Testis H and Testis W. The Testis Vol. is calculated automatically.

Pre-BL Vol.

Function: measures the Pre-BL L, Pre-BL H and Pre-BL W, calculates the Pre-BL Vol.

1. Select [Pre-BL Vol] in the measurement menu or the touch screen.

2. Use the Distance method in 2D General Measurements to measure the Pre-BL L, Pre-BL H and Pre-BL W. The Pre-BL Vol. is calculated automatically. The Mictur.Vol is displayed in the report if the Post-BL Vol is measured.

Post-BL Vol.

Function: measures the Post-BL L, Post-BL H and Post-BL W, calculates the Post-BL Vol.

1. Select [Post-BL Vol] in the measurement menu or the touch screen.

2. Use the Distance method in 2D General Measurements to measure Post-BL L, Post-BL H and

Post-BL W. The Post-BL Vol is calculated automatically. The Mictur.Vol is displayed in the report if the Pre-BL Vol is measured.

Mictur. Vol.

Function: measures the Pre-BL Vol and Post-BL Vol, calculates the Mictur.Vol.

1. Select [Mictur.Vol] in the measurement menu or the touch screen.

2. Use the Distance method in 2D General Measurements to measure the Pre-BL L, Pre-BL H and Pre-BL W. The Pre-BL Vol. is calculated automatically and displayed in the report.

3. Use the Distance method in 2D General Measurements to measure Post-BL L, Post-BL H and

Post-BL W. The Post-BL Vol. and Mictur.Vol. are calculated automatically, the Post-BL Vol. is displayed in the report.

9-6 Urology

9.4.3 Study Tool Operations

Kidney

Function: measures the Renal L, Renal H and Renal W, calculates the Renal Vol.

NOTE: needs to be measured on the left and right sides respectively.

1. Select [Kidney] in the measurement menu or the touch screen.

2. Use the Distance measurement method in 2D General Measurements to measure the Renal

L, Renal H and Renal W. The Renal Vol. is calculated automatically.

3. Use the method of Distance measurement of 2D General Measurements to measure Cortex.

Adrenal

Function: measures Adrenal L, Adrenal H and Adrenal W.

NOTE: needs to be measured on the left and right sides respectively.

1. Select the [Adrenal] in the measurement menu or the touch screen.

2. Use the method of Distance measurement of 2D General Measurements to measure Adrenal

L, Adrenal H and Adrenal W.

Prostate

Function: measures the Prostate L, Prostate H and Prostate W, calculates the Prostate Vol. and

PPSA. If [Serum PSA] in [Patient Info]

→

[URO] has been entered, PSAD (Prostate Special

Antigen Density) will also be calculated.

PPSA (ng/ml) = PPSA Coefficient (ng/ml 2 ) × Prostate Vol (ml)

PSAD (ng/ml 2 ) = Serum PSA (ng/ml) / Prostate Vol. (ml)

Here, the PPSA Coefficient and Serum PSA are entered in the [Patient Info]

→

[URO] dialog box.

The default value of the PPSA Coefficient is 0.12.

1. Select the [Prostate] in the measurement menu or the touch screen.

2. Use the Distance method in 2D General Measurements to measure the Prostate L, Prostate H and Prostate W.

The system calculates the Prostate Vol. and PPSA.

The PSAD displays in the report if the PSA value is entered.

Seminal Vesicle

Function: measures the Seminal L, Seminal H and Seminal W.

NOTE: needs to be measured on the left and right sides respectively.

1. Select [Seminal Vesicle] in the measurement menu or the touch screen.

2. Use the Distance measurement method in 2D General Measurements to measure the Seminal

L, Seminal H and Seminal W.

Testis

Function: measures the Testis L, Testis H and Testis W, calculates the Testis Vol.

NOTE: needs to be measured on the left and right sides respectively.

1. Select [Testis] in the measurement menu or the touch screen.

2. Use the Distance measurement method in 2D General Measurements to measure the Testis L,

Testis H and Testis W. The Testis Vol. is calculated automatically.

Bladder

Function: measures the Pre-BL L, Pre-BL H, Pre-BL W, Post-BL L, Post-BL H and Post-BL W, calculates the Pre-BL Vol., Post-BL Vol and Mictur.Vol.

Urology 9-7

1. Select [Bladder] in the measurement menu or the touch screen.

2. Use the Distance method in 2D General Measurements to measure the Pre-BL L, Pre-BL H and Pre-BL W. The Pre-BL Vol. is calculated automatically.

3. Use the Distance method in 2D General Measurements to measure Post-BL L, Post-BL H and

Post-BL W. The Post-BL Vol. and Mictur.Vol. are calculated automatically.

Mass

Function: measures 3 distances in the mass.

Taking Mass1 as an example, the procedure is as follows:

1. Select [Mass1] in the measurement menu or the touch screen.

2. Use the Distance tool in the 2D General Measurement to measure Mass1 d1, Mass1 d2 and

Mass1 d3.

Epididymis

Function: measures the Epididymis L, Epididymis H and Epididymis W.

NOTE: needs to be measured on the left and right sides respectively.

1. Select [Epididymis] in the measurement menu or the touch screen.

2. Use the Distance measurement method in 2D General Measurements to measure Epididymis L,

Epididymis H and Epididymis W.

9.5 Urology Exam Report

During or after a measurement, click [Report] on the touch screen to browse the report.

9.6 References

PPSA:

PSAD:

Peter J. Littrup M.D., Fed LeE. M.D., Curtis Mettin. P.D. Prostate Cancer

Screening: Current Trends and Future Implications. CA-A CANCER JOURNAL

FOR CLINICIANS, Jul/Aug 1992, Vol.42, No.4.

MITCHELL C. BENSON, IHN SEONG, CARL A. OLSSON, J., McMahon, WILLIAM

H.COONER. The Use of Prostate Specific Antigen Density to Enhance the

Predictive Value of the Intermediate Levels of Serum Prostate Specific Antigen.

THE JOURNAL OF UROLOGY, 1992, Vol.147, p817-821

9-8 Urology

Small Parts

10.1 Small Parts Exam Preparations

Make the following preparations before measuring:

1. Confirm that the current probe is appropriate.

2. Check that the current system date is correct.

3. Click [Info] on the touch screen and register the patient information in the [Patient Info]

→

[SMP] dialog box.

For more details, see “Exam Preparation

→

Patient Information” in the Operator's Manual

[Basic Volume].

4. Switch to the correct exam mode.

10.2 Basic Small Parts Measurement

Procedures

1. Click [Info] on the touch screen and register the patient information in the [Patient Info]

→

[SMP] dialog box.

2. Press <Measure> to enter the Application Measurements.

3. Select the measurement tool in the menu or on the touch screen to start the measurement.

See the table in “10.3 Small Parts Measurement Tools” below for measurement tools.

See section “10.4 Small Parts Measurement Operations” and steps in “3 General

Measurement” for measurement methods.

4. Click [Report] on the touch screen to view the exam report. See “10.5 Small Parts Exam

Report” for details.

Small Parts 10-1

10.3 Small Parts Measurement Tools

The system supports the following small parts measurements.

See table “10.3 Small Parts Measurement Tools” above for measurement tools

Modes Types Tools Descriptions

Methods or formulae

Thyroid L

Thyroid H

Thyroid W

Isthmus H

Testis L

Thyroid Length

Thyroid Height

Thyroid Width

Isthmus height

Testicular Length

2D Measurement

Testis H

Testis W

Epididymis L

Epididymis W

Testicular Height

Testicular Width

Epididymis Length

Epididymis Width

Epididymis H Epididymis Height

Scrotal Wall Thickness /

Breast Mass1~10 L

Breast Mass1~10 W

Breast Mass1~10 H

Nip.-Mass 1~10 Dist.

Mass Length

Mass Width

Mass Height

Distance between nipple and mass

Skin-Mass 1~10 Dist.

Distance between skin and mass

Thyroid Mass 1-3 d1-3 Thyroid mass

Thyroid Nodule 1-3 d1-3 /

Thyroid Cyst 1-3 d1-3 /

Testicular Mass 1-3 d1-3 Testicular mass

THY Mass1~3 Strain Thyroid Mass Strain

THY Nodule1~3 Strain Thyroid Nodule Strain

Breast Mass1~10 Strain /

THY Mass1~3 Elas.

Thyroid Mass

Elastography

THY Nodule1~3 Elas.

Breast Mass1~10 Elas.

Thyroid Nodule

Elastography

Breast Mass

Elastography

Distance in 2D

General

Measurements

Strain in 2D

General

Measurements

Elastography in

2D General

Measurements

10-2 Small Parts

Modes Types

Calculation

Study

Thyroid Vol.

Testicular Vol.

Thyroid

Testis

Tools

Epididymis

Descriptions

Thyroid Volume

Testicular Volume

Breast Mass1~10

Thyroid Mass1~10

Testicular Mass1~10

THY Mass1~3 Strain

Ratio

THY Nodule1~3 Strain

Ratio

Breast Mass1~10 Strain

Ratio

THY Mass1~3 Elas.

Ratio

THY Nodule1~3 Elas.

Ratio

Breast Mass1~10 Elas.

Ratio

Thyroid(Superior)

Thyroid(Mid)

Thyroid(Inferior)

Parathyroid 1-2

Parotid

Lymph Node 1-6

Thyroid Mass Strain

Ratio

Thyroid Nodule Strain

Ratio

Thyroid Mass

Elastography Ratio

Thyroid Nodule

Elastography Ratio

Breast Mass

Elastography Ratio

Volume (3 Dist.) in 2D General

Measurements

Strain Ratio in

2D General

Measurements

Elastography

Ratio in 2D

General

Measurements

Distance in 2D

General

Measurements

Methods or formulae

Thyroid Vol.

(cm 3 ) = k ×

Thyroid L (cm) ×

Thyroid H (cm) ×

Thyroid W (cm)

Where k= 0.479 or 0.523

See Testicular

Vol. in chapter

“9.4.2

Calculation Tool

Operations”

Same formulae as in the Thyroid

Vol. calculation

See Testis in

See Epididymis

Small Parts 10-3

Modes

M /

Types Tools

Isthmus Finding 1-3

STA

Dopple r

ITA

Isthmus

Measurement

Parathyroid 1-2

Testicular A

Testicular V

Testis V(Valsalva)

Epididymis A

Calculation

Study

Epididymis V

Descriptions

Methods or formulae

Superior Thyroid

Artery

Inferior Thyroid Artery

Testicular Aorta

Testicular Vein

Epididymis Aorta

Epididymis Vein

D trace in

General D measurements

10.4 Small Parts Measurement Operations

Tip: 1.

and methods.

For the definitions of measurement, calculation and study, see “1.3

Measurement, Calculation and Study.”

The order of the measurement items can be preset. See “2.4.2 Application

See “10.3 Small Parts Measurement Tools” for calculation formulae.

10.4.1 Measurement Tool Operations

Take the measurement “Thyroid L” for example. The measurement procedure is as follows:

1. Select [Thyroid L] in the measurement menu or on the touch screen.

2. Use the Distance tool in 2D General Measurements to measure the Thyroid L. The value displays in the results window and exam report.

10.4.2 Calculation Tool Operations

Thyroid Vol.

Function: measures Thyroid L, Thyroid H and Thyroid W respectively, and calculates Thyroid Vol.

Tip: Needs to be measured on the left and right sides respectively.

1. Select [Thyroid Vol.] in the measurement menu or the touch screen.

10-4 Small Parts

2. Use the Distance tool in 2D General Measurements to measure the Thyroid L, Thyroid H and

Thyroid W.

Two Thyroid Vols are calculated automatically.

10.4.3 Study Tool Operations

Thyroid

Function: measures Thyroid L, Thyroid H and Thyroid W respectively, and calculates Thyroid Vol.

Tip: Needs to be measured on the left and right sides respectively.

1. Select [Thyroid] in the measurement menu or the touch screen

2. Use the Distance tool in 2D General Measurements to measure the Thyroid L, Thyroid H and

Thyroid W. The Thyroid Vol. is calculated automatically.

Mass

Function: measures the Mass L, Mass W and Mass H to calculate the Mass Volume, as well as measuring the Nip.-Mass Dist. and Skin-Mass Dist. Up to 10 masses can be measured.

Taking Mass1 as an example, the procedure is as follows:

1. Select [Mass1] in the measurement menu or the touch screen.

When measuring breast masses, rotate the knob under [Position] on the touch screen to record the mass position.

Rotate the knob under [Side: X] on the touch screen to record the mass side.

2. Use the Distance tool in the 2D General Measurement to measure Mass1 L, Mass1 W and

Mass1 H.

3. Use the Distance tool in the 2D General Measurement to measure the Nip.-Mass Dist. and

Skin-Mass Dist.

The measurements and the calculated Mass Volume are recorded in the report.

Testis

The same as “Testis” in “9 Urology.”

Epididymis

The same as “Epididymis” in “9 Urology.”

10.5 Small Parts Exam Report

During or after a measurement, click [Report] on the touch screen to browse the report.

For details about report browsing, printing and exporting, etc., see “1.7 Report.”

10.6 References

Thyroid Vol:

(k= 0.479)

Volumetrie der Schilddruesenlappn mittels Realtime-Sonographie; J Brunn,

U. Block, G. Ruf, et al.; Dtsch.med. Wschr.106 (1981), 1338-1340.)

Small Parts 10-5

Thyroid Vol:

(k=0.523)

Gomez J.M., Gomea N., et al. Determinants of thyroid volume as measured by ultrasonography in healthy adults randomly selected. Clin Endocrinol(Oxf),

2000;53:629-634)

10-6 Small Parts

Pediatrics

The HIP (Hip Joint Angle) measurement is used in pediatric Pediatrics. Such measurement provides early diagnosis for infant hip joint dislocation.

11.1 Pediatrics Exam Preparations

Make the following preparations before measuring:

1. Confirm that the current probe is appropriate.

2. Check that the current system date is correct.

3. Register the patient information in the [Patient Info]

→

[PED] dialog box.

For more details, see “Exam Preparation

→

Patient Information” in the Operator's Manual

[Basic Volume].

4. Switch to the correct exam mode.

11.2 Basic Pediatrics Measurement

Procedures

1. Register the patient information in the [Patient Info]

→

[PED] dialog box.

2. Press <Measure> to enter the Application Measurements.

3. Select the measurement tool in the menu or on the touch screen to start the measurement.

4. See the table in “11.3 Pediatrics Measurement Tools” below for measurement tools.

5. See section “11.4 HIP Measurement Operations” and steps in “3 General Measurement” for

measurement methods.

6. Click [Report] on the touch screen to view the exam report. See “11.5 Pediatrics Exam Report”

for details.

11.3 Pediatrics Measurement Tools

The measurement items, results and procedures are the same as “HIP.”

HIP

The HIP calculation assists in assessing the development of the infant hip. In this calculation, three straight lines are superimposed on the image and aligned with the anatomical features. The two angles are calculated and displayed.

The three lines are:

Pediatrics 11-1

 The baseline (BL), connecting the osseous acetabular convexity to the point where the joint capsule and the perichondrium unite with the ilium.

 The roof line (RL), connecting the lower edge of the ilium to the osseous acetabular convexity.

 The inclination line (IL), connecting the osseous acetabular convexity to the acetabular labrum.

The angles are:

 α: the angle between BL and RL.

 β: the angle between BL and IL

Dislocation type can be determined using the Graf method, as described in the following table.

I

Type

Ia

α

≥ 60 °

Bony roof

good

Superior bony rim

angular/slightly rounded

( “ blunt ” )

β

≤ 55 °

Cartilaginous roof

Age

(Weeks)

covers the femoral head any age

Ib

≥ 60° good angular/slightly rounded

(“blunt”)

55° covers the femoral head any age

II

IIa(+)

IIa(-)

D

IIa

IIb

IIc

[50°,60°)

[55°,60°)

[50°,55°)

[50°,60°)

[43 ° ,50 °

[43°,50°)

) adequate

(satisfactory) adequate

(satisfactory) deficient deficient severely deficient severely deficient rounded rounded rounded rounded rounded to flattened rounded to flattened any angle any angle any angle any angle

≤ 77 °

77° covers the femoral head covers the femoral head covers the femoral head covers the femoral head covers the femoral head

[0,6]

(6,12]

12 any age pressed shift any age

III IIIa

≤ 42 ° poor flattened no measure pressed upwardswithout structural alteration

(devoid of echoes) proximal perichondrium goes up to the contour of the iliac wall any age

11-2 Pediatrics

Type

IIIb

IV

α

≤ 42 °

Bony roof

poor poor

Superior bony rim

flattened flattened

β

Cartilaginous roof

Age

(Weeks)

no measure pressed upwards-with structural alteration (they are echogenic) proximal perichondrium goes up to the contour of the iliac wall any age no measure pressed downwards

(horizontal or mulded proximal perichondrium any age

HIP-Graf

d/D

Measures the distance between the baseline and bottom line of the osseous acetabular and the maximum width of the hip to estimate the hip osseous acetabular coverage.

1. Select [d/D] in the measurement menu or the touch screen.

2. Use the Distance tool in the 2D General Measurement to measure the maximum width of the hip (D), and the distance between the osseous acetabular roof and bottom (d). The system calculates the d/D.

11.4 HIP Measurement Operations

Tip: 1.

For the definitions of measurement, calculation and study, see “1.3 Measurement,