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M-Turbo

Ultrasound System
TM

User Guide

M-Turbo
Ultrasound System
TM

User Guide

SonoSite,Inc.
2191930thDriveSE
Bothell,WA98021
USA
T:18884829449or14259511200
F:14259511201
SonoSiteLtd
AlexanderHouse
40AWilburyWay
Hitchin
HertsSG40AP
UK
T:+441462444800
F:+441462444801

Caution:

Federal (United States) law restricts this device to sale by or on the order of a
physician.

M-Turbo, SiteLink, SonoCalc, SonoHD, SonoSite, and the SonoSite logo are registered trademarks or trademarks of SonoSite, Inc.
DICOM is the registered trademark of the National Electrical Manufacturers Association for its standards publications relating to digital
communications of medical information.
Non-SonoSite product names may be trademarks or registered trademarks of their respective owners.
The SonoSite product(s) referenced in this document may be covered by one or more of the following US patents: 5722412, 5817024,
5893363, 6135961, 6203498, 6364839, 6371918, 6383139, 6416475, 6447451, 6471651, 6569101, 6648826, 6575908, 6604630, 6817982,
6835177, 6962566, 7169108, D456509, D461895, D509900, D538432, D544962, D558351, D559390, and by the following counterpart
foreign patents: AU727381, AU730822, CA2373065, CN98106133.8, CN98108973.9, DE60021552.0, DE60029777.2, DE60034670.6,
DE69730563.5, DE6980539.6, DE69831698.3, FR0875203, FR0881492, FR0815793, FR1180970, FR1175713, GB0875203, GB0881492,
GB0815793, GB1180970, GB1180971, GB1175713, IT0881492, IT0815793, IT1175713, KR532359, KR528102, NZ542968,
RCD000897368-0001, SP0881492, SP0815793. Patents pending.

P0766202 10/2008
Copyright2008bySonoSite,Inc.
Allrightsreserved

ii

Contents
Introduction
Conventions, symbols, and terms ......................................................................... vii
Customer comments .................................................................................................. vii

Chapter 1: Getting Started


About the system .......................................................................................................... 1
Preparing the system ................................................................................................... 1
Installing or removing the battery ................................................................. 1
Using AC power and charging the battery ................................................. 2
Turning the system on or off ............................................................................ 3
Connecting transducers .................................................................................... 3
Inserting and removing USB storage devices ............................................ 4
System controls .............................................................................................................. 5
Screen layout .................................................................................................................. 7
General interaction ....................................................................................................... 8
Touchpad and cursor .......................................................................................... 8
On-screen options ............................................................................................... 8
Annotation and text ............................................................................................ 9
Preparing transducers ...............................................................................................10
Training videos .............................................................................................................11
Intended uses ...............................................................................................................11

Chapter 2: System Setup


Displaying the setup pages .....................................................................................15
Restoring default settings ........................................................................................15
A & B Key, Footswitch setup ....................................................................................15
Administration setup .................................................................................................15
Security settings .................................................................................................16
User setup .............................................................................................................16
Exporting or importing user accounts .......................................................17
Exporting and clearing the Event log .........................................................17
Logging in as user ..............................................................................................18
Choosing a secure password .........................................................................18
Annotations setup ......................................................................................................18
Audio, Battery setup ...................................................................................................19
Cardiac Calculations setup ......................................................................................19
Connectivity setup ......................................................................................................19
Date and Time setup ..................................................................................................20
Display Information setup ........................................................................................20
IMT Calculations setup ..............................................................................................20
Network Status setup .................................................................................................20

iii

OB Calculations setup ................................................................................................ 20


OB Custom Measurements setup .......................................................................... 21
OB Custom Tables setup ........................................................................................... 22
Presets setup ................................................................................................................. 22
System Information setup ........................................................................................ 23
USB Devices setup ...................................................................................................... 23
Limitations of JPEG format ............................................................................. 23

Chapter 3: Imaging
Imaging modes ............................................................................................................ 25
2D imaging ........................................................................................................... 25
M Mode imaging ................................................................................................ 26
CPD and color Doppler imaging ................................................................... 27
PW and CW Doppler imaging ........................................................................ 28
Adjusting depth and gain ........................................................................................ 30
Freezing, viewing frames, and zooming ............................................................. 30
Imaging modes and exams available by transducer ...................................... 31
Annotating images ..................................................................................................... 32
Patient information form .......................................................................................... 33
Images and clips .......................................................................................................... 35
Saving images and clips .................................................................................. 35
Reviewing patient exams ............................................................................... 36
Printing, exporting, and deleting images and clips ............................... 37
ECG Monitoring ............................................................................................................ 38

Chapter 4: Measurements and Calculations


Measurements .............................................................................................................. 41
Working with calipers ....................................................................................... 41
2D measurements .............................................................................................. 42
M Mode measurements ................................................................................... 43
Doppler measurements ................................................................................... 43
General calculations ................................................................................................... 45
Calculations menu ............................................................................................. 45
Performing and saving measurements
in calculations ...................................................................................................... 45
Displaying, repeating, and deleting
saved measurements in calculations .......................................................... 46
EMED calculations .............................................................................................. 46
Percent reduction calculations ...................................................................... 46
Volume calculations .......................................................................................... 48
Volume flow calculations ................................................................................ 48
Exam-based calculations .......................................................................................... 50
Cardiac calculations .......................................................................................... 50
Gynecology (Gyn) calculations ...................................................................... 58
IMT calculations .................................................................................................. 59
OB calculations ................................................................................................... 61

iv

Small Parts calculations ....................................................................................64


Transcranial Doppler and Orbital calculations ........................................65
Vascular calculations .........................................................................................67
Patient report ................................................................................................................68
Vascular and cardiac patient reports ...........................................................69
TCD patient report .............................................................................................69
OB patient report ...............................................................................................69
EMED worksheets ...............................................................................................70

Chapter 5: Troubleshooting and Maintenance


Troubleshooting ..........................................................................................................71
Software licensing .......................................................................................................71
Maintenance .................................................................................................................72
Cleaning and disinfecting the ultrasound system .................................73
Cleaning and disinfecting transducers .......................................................74
Cleaning and disinfecting the battery .......................................................75
Cleaning the footswitch ...................................................................................75
Cleaning and disinfecting ECG cables ........................................................76
Recommended disinfectants ..................................................................................77

Chapter 6: Safety
Ergonomic safety .........................................................................................................85
Position the system ...........................................................................................86
Position yourself .................................................................................................86
Take breaks, exercise, and vary activities ...................................................87
Electrical safety classification ..................................................................................87
Electrical safety .............................................................................................................88
Equipment safety ........................................................................................................90
Battery safety ................................................................................................................ 90
Clinical safety ................................................................................................................92
Hazardous materials ...................................................................................................93
Electromagnetic compatibility ...............................................................................93
Manufacturers declaration .............................................................................94
ALARA principle ...........................................................................................................97
Applying ALARA .................................................................................................98
Direct controls .....................................................................................................98
Indirect controls ..................................................................................................99
Receiver controls ................................................................................................99
Acoustic artifacts .........................................................................................................99
Guidelines for reducing MI and TI .........................................................................99
Output display ........................................................................................................... 102
MI and TI output display accuracy ............................................................ 103
Factors that contribute to display uncertainty ..................................... 103
Related guidance documents ..................................................................... 104
Transducer surface temperature rise ................................................................ 104
Acoustic output measurement ............................................................................ 105

In Situ, derated, and water value intensities ...........................................105


Tissue models and equipment survey ......................................................106
Acoustic output tables ............................................................................................107
Terms used in the acoustic output tables ...............................................132
Acoustic measurement precision and uncertainty ..............................133
Labeling symbols ......................................................................................................134

Chapter 7: References
Measurement accuracy ...........................................................................................139
Sources of measurement errors ...........................................................................140
Measurement publications and terminology .................................................141
Cardiac references ............................................................................................141
Obstetrical references .....................................................................................145
Gestational age tables ....................................................................................146
Growth analysis tables ...................................................................................148
Ratio calculations .............................................................................................149
General references ...........................................................................................149

Chapter 8: Specifications
Dimensions ..................................................................................................................153
System ..................................................................................................................153
Display ..................................................................................................................153
Supported transducers ...........................................................................................153
Imaging modes ..........................................................................................................153
Image and clip storage ............................................................................................153
Accessories ..................................................................................................................153
Peripherals ..........................................................................................................154
Temperature and humidity limits ........................................................................154
Operating ............................................................................................................154
Shipping and storage .....................................................................................154
Electrical .......................................................................................................................154
Battery ...........................................................................................................................154
Electromechanical safety standards ...................................................................154
EMC standards classification .................................................................................155
Airborne equipment standards ............................................................................155
DICOM standard ........................................................................................................155
HIPAA standard ..........................................................................................................155

Glossary
Terms .............................................................................................................................157
Abbreviations .............................................................................................................159

Index ...........................................................................................................................169

vi

Introduction

Theuserguideisforareaderfamiliarwith
ultrasoundtechniques.Itdoesnotprovide
traininginsonographyorclinicalpractices.
Beforeusingthesystem,youmusthave
ultrasoundtraining.
SeetheapplicableSonoSiteaccessoryuserguide
forinformationonusingaccessoriesand
peripherals.Seethemanufacturersinstructions
forspecificinformationaboutperipherals.

Customer comments
Questionsandcommentsareencouraged.
SonoSiteisinterestedinyourfeedbackregarding
thesystemandtheuserguide.Pleasecall
SonoSiteat8884829449intheUS.Outsidethe
US,callthenearestSonoSiterepresentative.You
canalsoemailSonoSite
at comments@sonosite.com.
Fortechnicalsupport,pleasecontactSonoSiteas
follows:
SonoSite Technical Support
Phone (US or
Canada):

877-657-8118

Phone (Outside
US and Canada):

Conventions, symbols, and


terms

425-951-1330
Or call your local
representative.

Fax:

425-951-6700

Theuserguidefollowstheseconventions:

E-mail:

service@sonosite.com

AWARNINGdescribesprecautionsnecessary
topreventinjuryorlossoflife.

Web site:

www.sonosite.com
Click Support & Service.

ACautiondescribesprecautionsnecessaryto
protecttheproducts.

Europe
Service
Center:

+44-(0)1462-444-800
uk.service@sonosite.com

Numberedstepsinproceduresmustbe
performedinorder.

Introduction

ThisMTurboUltrasoundSystemUserGuide
providesinformationonpreparingandusingthe
MTurboultrasoundsystemandoncleaning
anddisinfectingthesystemandtransducers.It
alsoprovidesreferencesforcalculations,system
specifications,andsafetyandacousticoutput
information.

Itemsinbulletedlistsdonotrequirea
sequence.
Singlestepproceduresbeginwith.
Symbolsandtermsusedonthesystemand
transducerareexplainedinChapter 1,Chapter 5,
Chapter 6,andGlossary.

vii

viii

Customer comments

Chapter 1: Getting Started


About the system

Alicensekeyisrequiredtoactivatethesoftware.
SeeSoftwarelicensingonpage 71.On
occasion,asoftwareupgrademayberequired.
SonoSiteprovidesaUSBdevicecontainingthe
software.OneUSBdevicecanbeusedtoupgrade
multiplesystems.

Getting Started

TheMTurboultrasoundsystemisaportable,
softwarecontrolleddeviceusingalldigital
architecture.Thesystemhasmultiple
configurationsandfeaturesetsusedtoacquire
anddisplayhighresolution,realtime
ultrasoundimages.Featuresavailableonyour
systemdependonsystemconfiguration,
transducer,andexamtype.

Figure 2 System Back Connectors:


(1) DC input connector, (2) I/O connector, (3) Battery,
and (4) ECG connector

To use the ultrasound system


1 Attachatransducer.
2 Turnthesystemon.(Forpowerswitch
location,seeSystemcontrolsonpage 5.)
3 PressthePATIENTkey,andcompletethe
patientinformationform.

4 Pressanimagingmodekey:2D,M MODE,
COLOR,orDOPPLER
4

Preparing the system

Installing or removing the battery


2

Figure 1 System Front Features:


(1) Control panel, (2) Handle, (3) Display, (4) USB
ports for storage, updates, importing, and exporting

WARNING:

To avoid injury to the operator and


to prevent damage to the
ultrasound system, inspect the
battery for leaks prior to installing.
To avoid data loss and to conduct a
safe system shutdown, always keep
a battery in the system.

Chapter 1: Getting Started

To install the battery


1 Disconnectthepowersupplyfromthe
ultrasoundsystem.
2 Removethesystemfromtheminidock(if
present)andturnitupsidedown.
3 Placethebatteryintothebattery
compartment,ataslightangle.SeeFigure 3.
4 Slidethebatteryforwarduntilitlocksinto
place.

Locking levers

5 Pushdownonthetwolockingleverstosecure
thebattery.

To remove the battery


1 Disconnectthepowersupplyfromthe
ultrasoundsystem.
2 Removethesystemfromtheminidock(if
present)andturnitupsidedown.
3 Pullupthetwolockinglevers.
4 Slidethebatteryback.
5 Liftthebatteryfromthecompartment.

Using AC power and charging the


battery
Thebatterychargeswhenthesystemis
connectedtotheACpowersupply.Afully
dischargedbatteryrechargesinlessthanfive
hours.
ThesystemcanrunonACpowerandchargethe
batteryifACpowerisconnectedtothesystem
directly,toaminidock,ortoadockingsystem.

Figure 3 Install the Battery

Preparing the system

Thesystemcanrunonbatterypowerforupto
twohours,dependingontheimagingmodeand
thedisplaybrightness.Whenrunningonbattery
power,thesystemmaynotrestartifthebatteryis
low.Tocontinue,connectthesystemtoAC
power.

Connecting transducers
The equipment shall be connected
to a center-tapped single phase
supply circuit when users in the
United States connect the
equipment to a 240V supply
system.

Caution:

Verify that the hospital supply


voltage corresponds to the power
supply voltage range. See
Electrical on page 154.

WARNING:

To avoid injury to the patient, do


not place the connector on the
patient. Operate the ultrasound
system in a docking system or on a
flat hard surface to allow air flow
past the connector.

Caution:

To avoid damaging the transducer


connector, do not allow foreign
material in the connector.

Getting Started

WARNING:

To operate the system using AC power


1 ConnecttheDCpowercablefromthepower
supplytotheconnectoronthesystem.See
Figure 2onpage 1.
2 ConnecttheACpowercordtothepower
supplyandtoahospitalgradeelectrical
outlet.

Turning the system on or off


Caution:

Do not use the system if an error


message appears on the display.
Note the error code and turn off the
system. Call SonoSite or your local
representative.

To turn the system on or off


Pressthepowerswitch.(SeeSystem

controlsonpage 5.)

To wake up the system


Toconservebatterylifewhilethesystemison,
thesystemgoesintosleepmodeifthelidisclosed
orifthesystemisuntouchedforapresettime.To
adjustthetimeforsleepdelay,seeAudio,
Batterysetuponpage 19.
Pressakey,touchthetouchpad,oropenthe

lid.
Figure 4 Connect the Transducer

Chapter 1: Getting Started

To connect a transducer
1 Removethesystemfromtheminidock(if
present),andturnitupsidedown.

WARNING:

To avoid damaging the USB storage


device and losing patient data from
it, observe the following:
Do not remove the USB storage
device or turn off the ultrasound
system while the system is
exporting.
Do not bump or otherwise apply
pressure to the USB storage
device while it is in a USB port on
the ultrasound system. The
connector could break.

Caution:

If the USB icon does not appear in


the system status area on-screen,
the USB storage device may be
defective or password-protected.
Turn the system off and replace the
device.

2 Pullthetransducerlatchup,androtateit
clockwise.
3 Alignthetransducerconnectorwiththe
connectoronthebottomofthesystem.
4 Insertthetransducerconnectorintothe
systemconnector.
5 Turnthelatchcounterclockwise.
6 Pressthelatchdown,securingthetransducer
connectortothesystem.

To remove a transducer
1 Pullthetransducerlatchup,androtateit
clockwise.
2 Pullthetransducerconnectorawayfromthe
system.

Inserting and removing USB storage


devices
Imagesandclipsaresavedtointernalstorageand
areorganizedinasortablepatientlist.Youcan
archivetheimagesandclipsfromtheultrasound
systemtoaPCusingaUSBstoragedeviceor
Ethernetconnection.Althoughtheimagesand
clipscannotbeviewedfromaUSBstoragedevice
ontheultrasoundsystem,youcanremovethe
deviceandviewthemonyourPC.
TherearetwoUSBportsonthesystem,andone
ontheminidock.ForadditionalUSBports,you
canconnectaUSBhubintoanyUSBport.
Note: Thesystemdoesnotsupportpassword
protectedUSBstoragedevices.Makesurethatthe
USBstoragedeviceyouusedoesnothavepassword
protectionenabled.

Preparing the system

To insert a USB storage device


InserttheUSBstoragedeviceintoanyUSB

portonthesystemorminidock.SeeFigure 1
onpage 1.
TheUSBstoragedeviceisreadywhenthe
USBiconappears.
Toviewinformationaboutthedevice,see
USBDevicessetuponpage 23.

To remove a USB storage device


RemovingtheUSBstoragedevicewhilethe
systemisexportingtoitmaycausetheexported
filestobecorruptedorincomplete.
1 WaitfivesecondsaftertheUSBanimation
stops.
2 RemovetheUSBstoragedevicefromtheport.

System controls
1

14

15
Getting Started

3
4
5

16
17
18
19

6
7

20

10

11

12 13

Power switch

Turns system on and off.

Alphanumeric keys

Use to enter text and numbers.

Annotation keys

See Alphanumeric keyboard on page 9.

ZOOM

Magnifies the image 100%.

DEPTH UP,
DEPTH DOWN

Decreases and increases imaging depth.

AUTO GAIN

Adjusts gain automatically.

Gain
Near

Adjusts the gain applied to the near field of the image.

Far

Adjusts the gain applied to the far field of the image.

Gain/
Cine Buffer

In live imaging, adjusts the overall gain applied to the entire image. On a
frozen image, moves the cine buffer.

Chapter 1: Getting Started

AC power indicator

A steady light indicates that AC power is connected. A flashing light


indicates that the system is asleep.

CALIPER
CALCS

Displays calipers on-screen for measuring.


Turns the calculations menu on and off.

10

Touchpad

Selects, adjusts, and moves items on-screen.

11

FREEZE

Stops live imaging and displays a frozen image.

12

SAVE

Saves an image to internal storage. If configured, also saves calculations to


the report. See Presets setup on page 22.

13

CLIP

Saves a clip to internal storage.

14

Control keys

Control on-screen options.

15

Forms
SETUP

Displays the system settings.

REPORT

Accesses the patient report and EMED worksheets.

REVIEW

Accesses the patient list, saved images, and archiving functions.

PATIENT

Accesses patient information.

16

EXAM

Opens exam menu.

17

A & B shortcut keys

Keys that you can program to perform common tasks.

18

SET

Sets a trace measurement.

SELECT

Used with the touchpad to select items on-screen. Also switches between
Color and Doppler options, calipers for measurement, pictograph-marker
position and angle, frozen images in duplex and dual screens, and arrow
position and orientation.

SAVE CALC

Saves calculations and their measurements to the patient report.

19

UPDATE

Toggles between dual and duplex screens and imaging modes in M Mode
and Doppler (for example, between D-line and Doppler spectral trace).

20

Imaging Modes
M MODE

Turns M Mode on, toggles between M-line and M Mode trace.

DOPPLER

Turns Doppler on, toggles between D-line and Doppler trace.

COLOR

Turns CPD/Color on and off.

2D

Turns 2D on.

System controls

Screen layout
9
1
2
3
4

10
Getting Started

11

7
8

Figure 1 Screen Layout


1

Mode Data Area

Current imaging mode information (for example, Gen, Res, THI, and PW).

Orientation Marker

Provides indication for image orientation. In dual and duplex images, the
orientation marker is green on the active screen.

Text

Text entered using keyboard.

Pictograph

Pictograph to indicate anatomy and transducer position. You can select


anatomy and screen location.

Calculations Menu

Contains available measurements.

Image

Ultrasound image.

Measurement and
Calculations Data Area

Current data on measurements and calculations.

On-screen Options

Options available in the current context.

Patient Header

Includes current patient name, ID number, institution, user, and date/time.

10

System Status

Information on system status (for example, exam type, transducer, AC


connected, battery charging, and USB).

11

Depth Marker

Marks in .5 cm, 1 cm, and 5 cm increments depending on depth.

Chapter 1: Getting Started

General interaction
Touchpad and cursor
Usethetouchpadtoadjustandmoveobjects
onscreen.Thetouchpadcontrolscaliper
position,CPDorColorboxpositionandsize,the
cursor,andmore.Thearrowkeyscontrolmuch
ofthesamefunctionalityasthetouchpad.
Thecursorappearsinthesetuppages,thepatient
informationform,andpatientreport.Youcontrol
thecursorthroughthetouchpad.Forexample,in
thepatientinformationform,placethecursor
overthelastnamefieldandpresstheSELECT
keytoactivatethatfield.Additionally,youcan
usethecursortoselectcheckboxesanditemsin
lists.

Cycle Movesthroughalistofsettings
continuously.Theuppercontrolkeycycles
upward.Thelowercontrolkeycyclesdownward.
Up-Down Movesthroughalistofsettings,
stoppingatthetoporbottom.Theuppercontrol
keymovesupward.Thelowercontrolkeymoves
downward.Bydefault,abeepsoundswhenyou
reacheitherendoftherange.(SeeAudio,Battery
setuponpage 19.)
On-Off Turnsafeatureonoroff.Youcanpress
eithercontrolkey.Informs,youcaninsteadselect
theoptionbyusingthetouchpadandthe
SELECTkey.
Action Performsanaction.Youcanpresseither
controlkey.Oryoucaninsteadselecttheoption
byusingthetouchpadandtheSELECTkey.

On-screen options
Theonscreenoptionsletyoumakeadjustments
andselectsettings.Theoptionsavailabledepend
oncontext.
Eachoptioniscontrolledbythepairofkeys
belowit.Dependingontheoption,thecontrol
keysfunctioninoneoffourways:

General interaction

Figure 5 On-screen options (2D imaging shown)

Annotation and text


Alphanumeric keyboard

10
2

Getting Started

1
11

3
4

TAB

Moves cursor among fields


in the forms, and tabs
between text position in
dual screens.

CAPS LOCK

Sets the keyboard to


capital letters.

SHIFT

Allows entry of capitalized


characters and
international characters.

TEXT

Turns the keyboard on and


off for text entry.

PICTO

Turns pictographs on and


off.

ARROW

Displays an arrow graphic


that can be moved and
rotated within the image
area.

SPACEBAR

Turns the keyboard on for


text entry. In text entry,
adds a space.

DELETE

Removes all text from the


screen during text entry
and when not measuring.

Arrow Keys

Move highlighted selection


in calculations menu, move
cursor one space when
entering text, move caliper
position, move cine buffer
forward and backward, and
move among pages in
image review and reports.

10

BACKSPACE

Removes the character left


of the cursor in text-entry
mode.

11

ENTER

Moves cursor among fields


in forms and saves
calculations to report.

Chapter 1: Getting Started

Symbols
Youcanentersymbolsandspecialcharactersin
selectfieldsandforms.Thesymbolsandspecial
charactersavailabledependoncontext.

Preparing transducers
WARNING:

Patient information form: Last,First,Middle,


PatientID,Accession,Indications,ProcedureID,
User,ReadingDr.,ReferringDr.,andInstitution
fields

Some transducer sheaths contain


natural rubber latex and talc, which
can cause allergic reactions in some
individuals. Refer to 21 CFR 801.437,
User labeling for devices that
contain natural rubber.
Some gels and sterilants can cause
an allergic reaction on some
individuals.

DICOM or SiteLink configuration page: Aliasand


AETitlefields
A & B Key, Footswitch setup page: Textfield
Text mode (imaging): Annotationfield

Figure 6 Symbols Dialog Box

To enter symbols or special characters

Caution:

To avoid damage to the transducer,


use only gels recommended by
SonoSite. Using gels other than the
one recommended by SonoSite can
damage the transducer and void
the warranty. If you have questions
about gel compatibility, contact
SonoSite or your local
representative.
SonoSite recommends that you
clean transducers after each use.
See Cleaning and disinfecting
transducers on page 74.

1 Selectthefield,andthenselectSymbols.
2 Selectthedesiredsymbolorcharacter.
Youcanalsopressthekeysonthekeyboard.
3 SelectOK.

Acousticcouplinggelmustbeusedduring
exams.Althoughmostgelsprovidesuitable
acousticcoupling,somegelsareincompatible
withsometransducermaterials.SonoSite
recommendsAquasonicgelandprovidesa
samplewiththesystem.
Forgeneraluse,applyaliberalamountofgel
betweenthetransducerandthebody.For
invasiveorsurgicaluse,applyatransducer
sheath.

10

Preparing transducers

4 SelecttheVideostab.
WARNING:

To apply a transducer sheath


SonoSiterecommendstheuseofmarketcleared,
transducersheathsforintracavitaryorsurgical
applications.Tolessentheriskofcontamination,
applythesheathonlywhenyouarereadyto
performtheprocedure.
1 Placegelinsidethesheath.
2 Insertthetransducerintothesheath.
3 Pullthesheathoverthetransducerandcable
untilthesheathisfullyextended.
4 Securethesheathusingthebandssupplied
withthesheath.
5 Checkforandeliminatebubblesbetweenthe
faceofthetransducerandthesheath.
Bubblesbetweenthefaceofthetransducer
andthesheathmayaffecttheultrasound
image.
6 Inspectthesheathtoensurethatthereareno
holesortears.

5 Ifthelistdoesnotappear,selectthecorrect
USBdevice:
a SelectSelect USB.
b IntheSelect USB device for media
playback dialog box,selecttheEducation
KeyUSBdevice(Trainingappearsunder
Type),andthenselectSelect.
Note: ImageGalleryisanunsupportedfeature.

To view a video
1 Displaythelistofvideos.
2 Selectthevideo.
3 SelectViewonscreen.
Thevideobeginsplaying.
4 Selectanyofthefollowing,asneeded:

Adjuststhevolume.Thehigherthe
number,thelouderthesound.Zerois
mute.

BackRewindsthevideo10seconds.
Pause Pausesthevideo.
PlayResumesplayingofapausedvideo.
ForwardAdvancesthevideo10seconds.

To exit a video
Selectoneofthefollowing:

Listtoreturntothevideolist.

Training videos
TheSonoSiteEducationKeytrainingvideos
areanoptionalfeature.

To display the list of videos


1 InserttheEducationKeyUSBdeviceintoa
USBportonthesystem.
2 PresstheREVIEWkey.
3 Ifthereisanactiveexam,selectListonscreen.

Donetoreturnto2Dimaging.

Intended uses
Thissystemtransmitsultrasoundenergyinto
variouspartsofthepatientsbodytoobtain
ultrasoundimages,asfollows.
Fortheintendedtransducerandimagingmodes
foreachexamtype,seeImagingmodesand
examsavailablebytransduceronpage 31.

Chapter 1: Getting Started

11

Getting Started

To prevent contamination, the use


of sterile transducer sheaths and
sterile coupling gel is
recommended for clinical
applications of an invasive or
surgical nature. Do not apply the
transducer sheath and gel until you
are ready to perform the procedure.

Abdominal Imaging Applications Youcanassess


theliver,kidneys,pancreas,spleen,gallbladder,
bileducts,transplantedorgans,abdominal
vessels,andsurroundinganatomicalstructures
forthepresenceorabsenceofpathology
transabdominally.
Cardiac Imaging Applications Youcanassessthe
heart,cardiacvalves,greatvessels,surrounding
anatomicalstructures,overallcardiac
performance,andheartsizeforthepresenceor
absenceofpathology.
Youcanobtainthepatientselectrocardiogram
(ECG).TheECGisusedfortimingofcardiac
events.
WARNING:

The ECG is not used to diagnose


cardiac arrhythmias and is not
designed for long term cardiac
rhythm monitoring.

Gynecology and Infertility Imaging Applications


Youcanassesstheuterus,ovaries,adnexa,and
surroundinganatomicalstructuresforthe
presenceorabsenceofpathology
transabdominallyortransvaginally.
Interventional Imaging Applications Youcanuse
thesystemforultrasoundguidanceinbiopsyand
drainageprocedures,vascularlineplacement,
peripheralnerveblocks,spinalnerveblocksand
taps,ovaharvesting,amniocentesisandother
obstetricalprocedures,andprovideassistance
duringabdominal,breast,andneurological
surgery.
Obstetrical Imaging Applications Youcanassess
thefetalanatomy,viability,estimatedfetal
weight,gestationalage,amnioticfluid,and
surroundinganatomicalstructuresforthe
presenceorabsenceofpathology
transabdominallyortransvaginally.CPDand
Colorimagingareintendedforhighrisk
pregnantwomen.Highriskpregnancy
indicationsinclude,butarenotlimitedto,

12

Intended uses

multiplepregnancy,fetalhydrops,placental
abnormalities,aswellasmaternalhypertension,
diabetes,andlupus.
WARNING:

To prevent injury or misdiagnosis,


do not use this system for
Percutaneous Umbilical Blood
Sampling (PUBS) or in vitro
Fertilization (IVF) The system has
not been validated to be proven
effective for these two uses.
CPD or Color images can be used as
an adjunctive method, not as a
screening tool, for the detection of
structural anomalies of the fetal
heart and as an adjunctive method,
not as a screening tool for the
diagnosis of Intrauterine Growth
Retardation (IUGR).

Pediatric and Neonatal Imaging Applications


Youcanassessthepediatricandneonatal
abdominal,pelvicandcardiacanatomy,pediatric
hips,neonatalhead,andsurroundinganatomical
structuresforthepresenceorabsenceof
pathology.
Superficial Imaging Applications Youcanassess
thebreast,thyroid,testicle,lymphnodes,
hernias,musculoskeletalstructures,softtissue
structures,ophthalmicstructures,and
surroundinganatomicalstructuresforthe
presenceorabsenceofpathology.Youcanusethe
systemforultrasoundguidanceinbiopsyand
drainageprocedures,vascularlineplacement,
peripheralnerveblocks,andspinalnerveblocks
andtaps.

WARNING:

Getting Started

To avoid injury to the patient, use


only an Orbital (Orb) or
Ophthalmic (Oph) exam type when
performing imaging through the
eye. The FDA has established lower
acoustic energy limits for
ophthalmic use. The system will
not exceed these limits only if the
Orb or Oph exam type is selected.

Transcranial Imaging Applications Youcan


assesstheanatomicalstructuresandvascular
anatomyofthebrainforpresenceorabsenceof
pathology.Youcanuseimagingtemporally,
transoccipitally,ortransorbitally.
WARNING:

To avoid injury to the patient, use


only an Orbital (Orb) or
Ophthalmic (Oph) exam type when
performing imaging through the
eye. The FDA has established lower
acoustic energy limits for
opthalmic use. The system will not
exceed these limits only if the Orb
or Oph exam type is selected.

Vascular Imaging Applications Youcanassessthe


carotidarteries,deepveins,andarteriesinthe
armsandlegs,superficialveinsinthearmsand
legs,greatvesselsintheabdomen,andvarious
smallvesselsfeedingorgansforthepresenceor
absenceofpathology.

Chapter 1: Getting Started

13

14

Intended uses

Chapter 2: System Setup


Thesystemsetuppagesletyoucustomizethe
systemandsetpreferences.

Displaying the setup pages


To display a setup page
1 PresstheSETUPkey.
2 SelectthesetuppageunderSetup Pages.
Toreturntoimagingfromasetuppage,select
Doneonscreen.

Footswitch (L),Footswitch (R) Thefunctionofthe


leftandrightfootswitches:Save Clip,Record,
Freeze,Save Image,orPrint.SeealsoToconnect
thefootswitch.

To connect the footswitch


TheSonoSitefootswitchallowshandsfree
operationwithacustomizabletwopedal
footswitch.Thefootswitchisanoptionalfeature.
WARNING:

To avoid contamination, do not use


the footswitch in a sterile
environment. The footswitch is not
sterilized.
Setup

Restoring default settings


1 Connectthecables:

To restore default settings for a setup page


Onthesetuppage,select Resetonscreen.

YadaptercabletotheECGconnectoron
theminidockordockingsystem

To restore all default settings

FootswitchcabletoYadaptercable

1 Turnthesystemoff.
2 ConnectthesystemtoACpower.(SeeTo
operatethesystemusingACpoweron
page 3.)
3 Simultaneouslypress1andthepowerkey.
Thesystembeepsseveraltimes.

A & B Key, Footswitch setup


OntheA&BKey,Footswitchsetuppage,youcan
programtheshortcutkeysandfootswitchto
performcommontasks.Selectfromthefollowing
lists:

2 OntheA&BKey,Footswitchsetuppage,
selectafunctionfortheleftandright
footswitches.

Administration setup
OntheAdministrationsetuppage,youcan
configurethesystemtorequireuserstologin
andenterpasswords.Requiredloginhelps
protectpatientdata.Youcanalsoaddanddelete
users,changepasswords,importandexportuser
accounts,andviewtheeventlog.

A Key, B Key Thefunctionoftheshortcutkeys.By


default,theAshortcutkeyissettoPrintandthe
BshortcutkeyissettoRecord.Theshortcutkeys
arebelowthealphanumerickeypad.

Chapter 2: System Setup

15

Security settings
WARNING:

Health care providers who maintain


or transmit health information are
required by the Health Insurance
Portability and Accountability Act
(HIPAA) of 1996 and the European
Union Data Protection Directive
(95/46/EC) to implement
appropriate procedures: to ensure
the integrity and confidentiality of
information; to protect against any
reasonably anticipated threats or
hazards to the security or integrity
of the information or unauthorized
uses or disclosures of the
information.

2 IntheUser Loginlist,selectOn.
Onrequiresausernameandpasswordat
startup.
Offallowsaccesstothesystemwithouta
usernameandpassword.

To change the administrator password or let


users change passwords
1 LoginasAdministrator.
2 UnderUser List,selectAdministrator.
3 Doanyofthefollowing:
Changetheadministratorpassword:
UnderUser Information,typethenew
passwordinthePasswordboxand
Confirmbox.(SeeChoosingasecure
passwordonpage 18.)

Securitysettingsonthesystemallowyoutomeet
theapplicablesecurityrequirementslistedinthe
HIPAAstandard.Usersareultimately
responsibleforensuringthesecurityand
protectionofallelectronicprotectedhealth
informationcollected,stored,reviewed,and
transmittedonthesystem.

4 SelectSave.

To log in as Administrator

To add a new user

1 OntheAdministrationsetuppage,type
AdministratorintheNamebox.

1 LoginasAdministrator.

2 Typetheadministratorpasswordinthe
Passwordbox.

3 UnderUser Information,fillintheName,
Password,andConfirmboxes.(SeeChoosing
asecurepasswordonpage 18.)

Ifyoudonthavetheadministratorpassword,
contactSonoSite.(SeeSonoSiteTechnical
Supportonpage vii.)
3 SelectLogin.

To log out as Administrator


Turnofforrestartthesystem.

To require user login


YoucansetthesystemtodisplaytheUserLogin
screenatstartup.
1 LoginasAdministrator.

16

Administration setup

Letuserschangetheirpasswords:Select
thePassword changescheckbox.

User setup

2 SelectNew.

4 (Optional)IntheUser box,typetheusers
initialstodisplaytheminthepatientheader
andtheUserfieldinthepatientinformation
form.
5 (Optional)SelecttheAdministration Access
checkboxtoallowaccesstoalladministration
privileges.
6 SelectSave.

To modify user information


1 LoginasAdministrator.

2 UnderUser List,selecttheuser.

2 LoginasAdministrator.

3 UnderUser Information,makechangesas
desired.

3 SelectImportonscreen.

4 SelectSave.
Anychangetotheusernamereplacesthe
previousname.

To delete a user
1 LoginasAdministrator.
2 UnderUser List,selecttheuser.
3 SelectDelete.
4 SelectYes.

To change a user password


2 IntheUser List,selecttheuser.

5 Restartthesystem.
Allusernamesandpasswordsonthesystem
arereplacedwiththeimporteddata.

Exporting and clearing the Event log


TheEventlogcollectserrorsandeventsandcan
beexportedtoaUSBstoragedeviceandreadon
aPC.

To display the Event log


1 LoginasAdministrator.
2 SelectLogonscreen.
TheEventlogappears.

3 TypethenewpasswordinthePasswordbox
andConfirmbox.

Toreturntothepreviousscreen,selectBack.

4 SelectSave.

To export the Event log

Exporting or importing user accounts


Theexportandimportcommandsletyou
configuremultiplesystemsandbackupuser
accountinformation.

To export user accounts


1 InsertaUSBstoragedevice.
2 LoginasAdministrator.
3 SelectExportonscreen.AlistofUSBdevices
appears.
4 SelecttheUSBstoragedevice,andselect
Export.
Allusernamesandpasswordsarecopiedto
theUSBstoragedevice.

Setup

1 LoginasAdministrator.

4 SelecttheUSBstoragedevice,andselect
Import.

TheEventlogandtheDICOMnetworkloghave
thesamefilename(log.txt).Exportingeitherone
toaUSBstoragedeviceoverwritesanyexisting
log.txtfile.
1 InsertaUSBstoragedevice.
2 SelectLogandthenselectExport onscreen.
AlistofUSBdevicesappears.
3 SelecttheUSBstoragedevice,andselect
Export.
TheEventlogisatextfilethatyoucanopenina
texteditingapplication(forexample,Microsoft
WordorNotepad).

To clear the Event log


1 DisplaytheEventlog.

To import user accounts

2 SelectClearonscreen.

1 InserttheUSBstoragedevicethatcontainsthe
accounts.

3 SelectYes.

Chapter 2: System Setup

17

Logging in as user
Ifuserloginisrequired,theUserLoginscreen
appearswhenyouturnonthesystem.(SeeTo
requireuserloginonpage 16.)

To log in as user
1 Turnonthesystem.
2 IntheUser Loginscreen,typeyournameand
password,andselectOK.

To log in as guest
Guestscanscanbutcantaccesssystemsetupand
patientinformation.
1 Turnonthesystem.
2 IntheUser Loginscreen,selectGuest.

To change your password


1 Turnonthesystem.
2 IntheUser Loginscreen,selectPassword.
3 Typeyouroldandnewpasswords,confirm
thenewpassword,andthenselectOK.

Choosing a secure password


Toensuresecurity,chooseapasswordthat
containsuppercasecharacters(AZ),lowercase
characters(az),andnumbers(09).Passwords
arecasesensitive.

Annotations setup
OntheAnnotationssetuppage,youcan
customizepredefinedlabelsandsetthe
preferenceformanagingtextwhenunfreezing
images.
Forinstructionstoannotateimages,see
Annotatingimagesonpage 32.

To predefine a label group


Youcanspecifywhichlabelsareavailableforan
examtypewhenannotatinganimage.(SeeTo
placetextonanimageonpage 32.)

18

Annotations setup

1 IntheExamlistontheAnnotationssetup
page,selecttheexamtypewhoselabelsyou
wanttospecify.
2 ForGroup,select A, B, or Cforthelabelgroup
youwantassociatedwiththatexam.
Thepresetlabelsappearfortheselectedgroup.
3 Doanyofthefollowing:
Addacustomlabeltothegroup:Typethe
labelintheTextbox,andselectAdd.
Renamealabel:Selectthelabel,typethe
newnameintheTextbox,andselect
Rename.
Movealabelwithinthegroup:Selectthe
label,andthenselecttheonscreenupor
downarrow.
Deletealabelfromagroup:Selectthe
label,andselectDelete.
Youcanusesymbolsinlabels.SeeSymbols
onpage 10.

To specify text retention when unfreezing


Youcanspecifywhichtexttokeepwhenyou
unfreezeanimageorchangetheimaginglayout.
IntheUnfreezelistontheAnnotationssetup

page,selectKeep All Text,Keep Home Text,or


Clear All Text.
ThedefaultsettingisKeep All Text.For
informationonsettingthehomeposition,see
Toresetthehomepositiononpage 33.

To export predefined label groups


1 InsertaUSBstoragedevice.
2 OntheAnnotationssetuppage,selectExport.
AlistofUSBdevicesappears.
3 SelecttheUSBstoragedevice,andselect
Export.
Acopyofallpredefinedlabelgroupsforall
examssavestotheUSBstoragedevice.

To import predefined label groups


1 InserttheUSBstoragedevicethatcontainsthe
labelgroups.
2 OntheAnnotationssetuppage,selectImport
onscreen.
3 SelecttheUSBstoragedevice,andthenselect
Import.
4 SelectDoneinthedialogboxthatappears.
Allpredefinedlabelgroupsforallexamsare
replacedwiththosefromtheUSBstorage
device.

Audio, Battery setup


Key clickSelectOnorOffforkeystoclickwhen
pressed.
Beep alert SelectOnorOffforthesystemtobeep
whensaving,warning,starting,orshutting
down.
Sleep delaySelectOff,or5or10minutesto
specifytheperiodofinactivitybeforethesystem
goesintosleepmode.
Power delaySelectOff,or15or30minutesto
specifytheperiodofinactivitybeforethesystem
automaticallyturnsoff.

Cardiac Calculations setup


OntheCardiacCalculationssetuppage,youcan
specifymeasurementnamesthatappearinthe
TissueDopplerImaging(TDI)calculationsmenu
andonthereportpage.
SeealsoCardiaccalculationsonpage 50.

To specify cardiac measurement names

OntheConnectivitysetuppage,youspecify
optionsforusingnonUSBdevicesandforalerts
wheninternalstorageisfull.Youalsoimport
wirelesscertificatesandspecifysettings
(includingTransferModeandLocation)for
SiteLinkandDICOM,whichareoptional
features.RefertotheSiteLinkandDICOM
documentation.

To configure the system for a printer


1 Setuptheprinterhardware.(Seeinstructions
includedwiththeprinterordockingsystem.)
2 InthePrinterlistontheConnectivitysetup
page,selecttheprinter.

To configure the system for a DVD recorder,


PC, or serial bar code scanner
1 OntheConnectivitysetuppage,dothe
following:
(DVDrecorder)IntheVideo Modelist,
selectthevideostandard:NTSCorPAL.
IntheSerial Portlist,selecttheperipheral.
Computer (PC) allowspatientreportdata
tobesentasASCIItextfromthesystemto
aPC.ThePCmusthavethirdparty
softwaretoacquire,view,orformatthe
dataintoareport.Checkthecompatibility
ofyoursoftwarewithSonoSiteTechnical
Support.(SeealsoTosendapatient
reporttoaPConpage 69.)
Note: Becausetheseperipheralsusethesame
RS232connectorontheminidock,youcan
connectonlyoneofthematatime.
2 Restartthesystem.
3 Attachaserialcable(RS232)fromtheserial
portontheminidockordockingsystemto
theperipheral.

UnderTDI WallsontheCardiacCalculations

setuppage,selectanameforeachwall.

Chapter 2: System Setup

19

Setup

OntheAudio,Batterysetuppage,youcanselect
optionsinthefollowinglists:

Connectivity setup

To receive storage alerts


OntheConnectivitysetuppage,select

Internal Storage Capacity Alert.


Thesystemdisplaysamessageifinternal
storageisnearcapacitywhenyouendan
exam.Thesystemthendeletesarchived
patientexamsifspecifiedinDICOM.

Date and Time setup


WARNING:

To obtain accurate obstetrics


calculations, an accurate date and
time are critical. Verify that the date
and time are accurate before each
use of the system. The system does
not automatically adjust for
daylight saving time changes.

To set the date and time


OntheDateandTimesetuppage,dothe

following:
IntheDate box,typethecurrentdate.
IntheTime box,typethecurrenttimein
24 hourformat(hoursandminutes).

Display Information setup


OntheDisplayInformationsetuppage,youcan
specifywhichdetailsappearonscreenduring
imaging.Youcanselectsettingsinthefollowing
sections:

IMT Calculations setup


OntheIMTCalculationssetuppage,youcan
customizetheIMTcalculationsmenu.Youcan
specifyuptoeightmeasurementnamesforboth
rightsideandleftsidecalculations.The
measurementnamesalsoappearinthepatient
report.
SeealsoIMTcalculationsonpage 59.

To customize the IMT calculations menu


OntheIMTCalculationssetuppage,dothe

following:
UnderIMT Calculations,select
measurementnamesfromthelists,or
selectNone.
Theselectednamesappearinthe
calculationsmenuandinthepatient
report.
Typethedesiredwidthinthe
Region width (mm)box.

Network Status setup


TheNetworkStatussetuppagedisplays
informationonsystemIPaddress,Location,
EthernetMACaddress,andthewireless
connectionifany.

OB Calculations setup

Patient HeaderInformationthatappearsinthe
patientheader.

OntheOBCalculationssetuppage,youselect
authorsforOBcalculationtables.Youcanalso
importorexportadditionalOBcalculationtables.

Mode DataImaginginformation.

SeealsoOBcalculationsonpage 61.

System StatusSystemstatusinformation.

20

Date and Time setup

To import OB calculationtables
Tablesthatyouimportareaddedtothosealready
onthesystem.
1 InserttheUSBstoragedevicethatcontainsthe
tables.
2 OntheOBCalculationssetuppage,select
Importonscreen.
3 SelecttheUSBstoragedevice,andthenselect
Import.
4 SelectOKinthedialogboxthatappears.
Thesystemrestarts.
Figure 1 OB Calculations Setup Page

1 OntheOBCalculationssetuppage,selectthe
desiredOBauthors(orselectNone)inthe
measurementlistsunderGestational Ageand
Growth Analysis.

OB Custom Measurements
setup
OntheOBCustomMeasurementssetuppage,
youcandefinemeasurementsthatappearinthe
OBcalculationsmenuandOBreport.OBCustom
Measurementsisanoptionalfeature.

Selectinganauthorplacestheassociated
measurementonthecalculationsmenu.

SeealsoOBcalculationsonpage 61.

2 (Optional)SelectMoretodisplaythelistof
userdefinedcustommeasurementsandto
associateacustomtableforthecustom
measurement.

To set up OB custom measurements

Thisoptionisavailableonlywhena
userdefinedcustomtablehasbeencreated
forthecustommeasurement.

To export OB calculation tables


1 InsertaUSBstoragedevice.
2 OntheOBCalculationssetuppage,select
Export.AlistofUSBdevicesappears.
3 SelecttheUSBstoragedevice,andselect
Export.
Alluserdefinedtablesandmeasurementsare
copiedtotheUSBstoragedevice.

Youcansaveuptofivecustommeasurements
thatappearintheOBcalculationsmenuandOB
report.
1 OntheOBCustomMeasurementssetuppage,
selectNew.
2 IntheNamebox,typeauniquename.
3 IntheTypelist,selectthedesired
measurementtype.
4 SelectSave.

To delete an OB custom measurement


IfyoudeleteanOBcustommeasurementduring
anexam,theexamends.
1 OntheOBCustomMeasurementssetuppage,
highlightthemeasurementintheCustom
Measurementslist.
2 SelectDelete Last.

Chapter 2: System Setup

21

Setup

To specify gestational age and growth


analysis

4 SelectNewonscreen.

3 SelectYes.
Theexamends,andanytablesandreport
dataassociatedwiththemeasurementare
removedfromthesystem.

5 IntheAuthorbox,typeauniquename.
6 Enterthedata.
7 SelectSaveonscreen.

OB Custom Tables setup


OntheOBCustomTablessetuppages,youcan
customizegrowthtablesthatappearinthe
calculationsmenuandpatientreport.
Gestational Age Table Measurements Thesystem
providesgestationalagemeasurementsby
selectedauthorsforCRL,GS,BPD,OFD,HC,AC,
FL,APTD,TTD,FTA,and5 additionalcustom
measurementlabels.
Growth Analysis Table MeasurementsThe
systemprovidesgrowthgraphsorcurvesfor
BPD,HC,AC,FL,EFW,andHC/AC.
WARNING:

Prior to use, verify that custom table


data entries are correct. The system
does not confirm the accuracy of
the custom table data entered by
the user.

To view OB tables
1 OntheOBCalculationsorOBCustom
Measurementssetuppage,selectTables
onscreen.
2 Selectthedesiredtableand
measurement/author.

To create a new OB custom table


YoucancreatetwocustomtablesforeachOB
measurement.
1 OntheOBCalculationsorOBCustom
Measurementssetuppage,selectTables
onscreen.
2 Selectthedesiredtable(GestationalAgeor
Growth Analysis).
3 IntheMeasurementlist,selectthe
measurementforthecustomtable.

22

OB Custom Tables setup

Todisplaythemeasurementforthecustomtable
inthecalculationsmenu,seeTospecify
gestationalageandgrowthanalysisonpage 21.

To edit or delete an OB custom table


1 OntheOBCalculationsorOBCustom
Measurementssetuppage,selectTables
onscreen.
2 SelecttheOBcustomtable.
3 Selectoneofthefollowingonscreen:
EditEnterdata,andthenselectSave
onscreen.
Deletetoremovethecustomtable.Select
Yes.

Presets setup
ThePresetssetuppagehassettingsforgeneral
preferences.Youcanselectfromthefollowing
lists:
Doppler ScaleSelectcm/sorkHz.
Duplex ThelayoutfordisplayingMModetrace
andDopplerspectraltrace:1/3 2D, 2/3 Trace;1/2
2D, 1/2 Trace;orFull 2D, Full Trace.
Live TraceSelectPeakorMean.
Thermal Index YoucanselectTIS,TIB,orTIC.The
defaultsettingisbasedonexamtype:OBisTIB,
TCDisTIC,andallothersareTIS.
Save KeyBehavioroftheSAVEkey.Image Only
savestheimagetointernalstorage.Image/Calcs
savestheimagetointernalstorageandsavesthe
currentcalculationtothepatientreport.
Dynamic RangeSettingsinclude-3,-2,-1,0,+1,
+2,or+3.Negativenumbersshowhigher

contrastimages,andpositivenumbersshow
lowercontrastimages.

compression.(SeealsoLimitationsofJPEG
format.)

UnitsUnitsforpatientheightandweightin
cardiacexams:in/ft/lbsorcm/m/kg.

Ahighcompressionhasasmallerfilesizebut
lessdetail.

LanguageThesystemlanguage.Changingthe
languagerequiresrestartingthesystem.

ForSiteLinkexporttype,theimageformat
affectsonlystillimages.ForDICOMexport
type,theimageformataffectsbothstill
imagesandclips.

Color SchemeThebackgroundcolorofthe
display.
Auto save Pat. FormAutomaticallysavesthe
patientinformationformasanimageinthe
patientsfile.

System Information setup

SeealsoToenteralicensekeyonpage 72.

USB Devices setup


OntheUSBDevicessetuppage,youcanview
informationaboutconnectedUSBdevices,
includingspaceavailability.Youcanalsospecify
afileformatforimagesandclipsinpatientexams
thatyouexporttoaUSBstoragedevice.(SeeTo
exportpatientexamstoaUSBstoragedeviceon
page 38.)

To specify a file format for exported images


1 OntheUSBDevicessetuppage,selectExport.
2 UnderUSB Export,selectanexporttype:
SiteLinkorganizesfilesinaSiteLinkstyle
folderstructure.ClipsexportinH.264
videosavedasMP4files.Toviewthem,
SonoSiterecommendsQuickTime7.0or
later.
DICOMcreatesfilesreadablebyaDICOM
reader.DICOMisanoptionalfeature.
3 Selectanimageformatforyourexporttype.
ForJPEGimageformat,alsoselectaJPEG

Toreturntothepreviousscreen,selectDevices.

Limitations of JPEG format


WhentransferringorexportingimagesinJPEG
format,thesystemuseslossycompression.Lossy
compressionmaycreateimagesthathaveless
absolutedetailthanBMPformatandthatdont
renderidenticallytotheoriginalimages.
Insomecircumstances,lossycompressedimages
maybeinappropriateforclinicaluse.For
example,ifyouuseimagesinSonoCalcIMT
software,youshouldtransferorexportthem
usingBMPformat.SonoCalcIMTsoftwareusesa
sophisticatedalgorithmtomeasureimages,and
lossycompressionmaycauseerrors.
Formoreinformationonusinglossycompressed
images,consulttheindustryliterature,including
thefollowingreferences:
PhysicsinMedicineandBiology,Quality
AssessmentofDSA,UltrasoundandCT
DigitalImagesCompressedwiththeJPEG
Protocol,DOkkalidesetal1994PhysMed
Biol3914071421doi:
10.1088/00319155/39/9/008
www.iop.org/EJ/abstract/00319155/39/9/008
CanadianAssociationofRadiologists,CAR
StandardsforIrreversibleCompressionin
DigitalDiagnosticImagingwithin
Radiology,Approved:June2008.
www.car.ca/Files/%5CLossy_Compression.
pdf

Chapter 2: System Setup

23

Setup

TheSystemInformationsetuppagedisplays
systemhardwareandsoftwareversions,and
licenseinformation.

4 ForSiteLinkexporttype,selectasortorder
underSort By.

24

USB Devices setup

Chapter 3: Imaging
Imaging modes
Thesystemhasahighperformancedisplayand
advancedimageoptimizationtechnologythat
significantlysimplifiesusercontrols.Imaging
modesavailabledependonthetransducerand
examtype.SeeImagingmodesandexams
availablebytransduceronpage 31.

2D options
In2Dimaging,youcanselectthefollowing
onscreenoptions.
Settings are as follows:
Res provides the best possible
resolution.
Gen provides a balance between
resolution and penetration.
Pen provides the best possible
penetration.
Some of the parameters optimized
to provide the best image include
focal zones, aperture size, frequency
(center and bandwidth), and
waveform. They cannot be adjusted
by the user.

Dynamic
Range

Adjusts the grayscale range: -3, -2,


-1, 0, +1, +2, +3.
The positive range increases the
number of grays displayed, and the
negative range decreases the
number of grays displayed.

Dual

Displays side-by-side 2D images.


Select Dual, and then press the
UPDATE key to display the second
screen and to toggle between the
screens. With both images frozen,
press the UPDATE key to toggle
between the images.
To return to full-screen 2D imaging,
select Dual or press the 2D key.

2D imaging
2Disthesystemsdefaultimagingmode.The
systemdisplaysechoesintwodimensionsby
assigningabrightnesslevelbasedontheecho
signalamplitude.Toachievethebestpossible
imagequality,properlyadjustthedisplay
brightness,gain,depthsettings,viewingangle,
andexamtype.Also,selectanoptimization
settingthatbestmatchesyourneeds.

To display the 2D image


1 Doanyofthefollowing:
Turnonthesystem.
Pressthe2Dkey.
2 Setoptionsasdesired.See2Doptions.

Chapter 3: Imaging

Imaging

Optimize

25

LVO On,
LVO Off

LVO On turns on Left Ventricular


Opacification. LVO Off turns off this
option.
Use LVO for cardiac exams in 2D
imaging mode when using an
imaging contrast agent. LVO lowers
the mechanical index (MI) of the
system to enhance visualization of
the contrast agent and endocardial
border.
This option depends on transducer
and exam type.

Orientation Select from four image orientations:


U/R (Up/Right), U/L (Up/Left), D/L
(Down/Left), D/R (Down/Right).
Brightness

Adjusts the display brightness.


Settings range from 1 to 10.
The display brightness affects
battery life. To conserve battery life,
adjust brightness to a lower setting.

Biopsy

Turns biopsy guidelines on and off.


This feature depends on transducer
type. See the SonoSite Biopsy user
guide.
Biopsy is not available when the
ECG cable is connected.

Guide

Turns the guideline on and off.


This feature depends on transducer
and exam type. See the user guide
for L25x transducer and needle
guide.

Sector

(Cardiac exam) Specifies the sector


width.
SonoMB On is available only for
Sector Full.

SonoMB
(MB)

MB On and MB Off turn SonoMB


multi-beam imaging technology on
and off. When SonoMB is on, MB
appears in the upper left-hand
screen.
SonoMB depends on transducer and
exam type.

ECG

Displays the ECG trace. See ECG


Monitoring on page 38.
This feature is optional and requires
a SonoSite ECG cable.

Clips

Displays the clips options. See To


capture and save a clip on page 35.
This feature is optional.

THI

Turns Tissue Harmonic Imaging on


and off.
When on, THI appears in the upper
left-hand screen. This feature is
optional and depends on transducer
and exam type.

Page x/x

Indicates which page of options is


displayed. Select to display the next
page.

M Mode imaging
Motionmode(M Mode)isanextensionof2D.It
providesatraceofthe2Dimagedisplayedover
time.Asinglebeamofultrasoundistransmitted,
andreflectedsignalsaredisplayedasdotsof
varyingintensities,whichcreatelinesacrossthe
screen.

To display the M-line


1 PresstheM MODEkey.
Note: IftheMlinedoesnotappear,makesurethat
theimageisntfrozen.
2 UsethetouchpadtopositiontheMlinewhere
desired.

26

Imaging modes

2 SelectCPDorColor.

3 Setoptionsasdesired.
Manyoptimizationanddepthoptions
availablein2Dimagingarealsoavailablein
M Modeimaging.See2Doptionson
page 25.

To display the M Mode trace


1 DisplaytheMline.
2 Adjustthedepthifnecessary.(SeeToadjust
depthonpage 30.)
3 PresstheM MODEkey.
Thetimescaleabovethetracehassmallmarks
at200msintervalsandlargemarksat
onesecondintervals.
4 Doanyofthefollowingasneeded:
Selectthesweepspeed
Fast).

(Slow, Med,or

PresstheUPDATEkeytotogglebetween
theMlineandMModetrace.

Thecurrentselectionalsoappearsinthe
upperlefthandscreen.
TheColorindicatorbarontheupperlefthand
screendisplaysvelocityincm/sinColor
imagingmodeonly.
3 Usingthetouchpad,positionorresizetheROI
boxasneeded.PresstheSELECTkeytotoggle
betweenpositionandsize.
WhileyoupositionorresizetheROIbox,a
greenoutlineshowsthechange.TheROIbox
indicatoronthelefthandscreenshowswhich
touchpadfunctionisactive.
4 Setoptionsasdesired.SeeCPDandColor
options.

CPD and Color options


InCPDorColorimaging,youcansetthe
followingonscreenoptions.
Toggle between CPD and Color.
The current selection appears in the
upper left-hand screen.

Tosetaduplexlayout,seePresetssetup
onpage 22.

Color
Suppress

Shows or hides color information.


You can select Show or Hide while
in live or frozen imaging. The
setting shown on-screen is the
current selection.

Flow
Sensitivity

The current setting appears


on-screen.
Low optimizes the system for low
flow states.
Med optimizes the system for
medium flow states.
High optimizes the system for
high flow states.

CPD and color Doppler imaging


ColorpowerDoppler(CPD)andcolorDoppler
(Color)areoptionalfeatures.
CPDisusedtovisualizethepresenceof
detectablebloodflow.Colorisusedtovisualize
thepresence,velocity,anddirectionofbloodflow
inawiderangeofflowstates.

To display the CPD or Color image


1 PresstheCOLORkey.
AROIboxappearsinthecenterofthe2D
image.

Chapter 3: Imaging

27

Imaging

Color, CPD

Ifusingaduplexlayout,presstheM MODE
keytotogglebetweenthefullscreen
Mlineandtheduplexlayout.

PRF Scale

Select the desired pulse repetition


frequency (PRF) setting by pressing
the control keys.
There is a wide range of PRF
settings for each Flow Sensitivity
setting (Low, Med, and High).
Available on select transducers.

Wall Filter

Settings include Low, Med, and


High.
Available on select transducers.

Steering

Variance

Invert

Select the steering angle setting of


the color ROI box (-15, 0, or +15). If
adding PW Doppler, see PW
Doppler options on page 29.
Available on select transducers.
Turns variance on and off.
Available only for cardiac exam.

Switches the displayed direction of


flow.
Available in Color imaging.

Sector

(Cardiac exam) Specifies the sector


width.

Page x/x

Indicates which page of options is


displayed. Select to display the next
page.

PW and CW Doppler imaging


Pulsedwave(PW)Dopplerandcontinuouswave
(CW)Dopplerimagingmodesareoptional
features.
PWDopplerisaDopplerrecordingofbloodflow
velocitiesinarangespecificareaalongthelength
ofthebeam.CWDopplerisaDopplerrecording
ofbloodflowvelocitiesalongthelengthofthe
beam.

YoucanusePW/CWDopplerandCPD/Color
simultaneously.IfCPD/Colorimagingison,the
colorROIboxistiedtotheDline.TheSELECTkey
cyclesamongcolorROIboxposition,colorROI
boxsize,theDline,and(inPWDoppler)angle
correction.Theactiveselectionisgreen.Also,the
indicatoronthelefthandscreenshowswhich
touchpadfunctionisactive.

To display the D-line


ThedefaultDopplerimagingmodeisPW
Doppler.Incardiacexams,youcanselecttheCW
Doppleronscreenoption.
1 PresstheDOPPLERkey.
Note: IftheDlinedoesnotappear,makesure
thatthesystemisinliveimaging.
2 Doanyofthefollowingasneeded:
Setoptions.SeePWDoppleroptionson
page 29.
Usingthetouchpad,positiontheDline
wheredesired.
(PWDoppler)Tocorrecttheangle
manually,presstheSELECTkeyandthen
usethetouchpadtoadjusttheanglein2
incrementsfrom74to+74.Pressthe
SELECTkeyagaintosetthedesiredangle.
TheSELECTkeytogglesbetweentheDline
andanglecorrection.

To display the spectral trace


1 DisplaytheDline.
2 PresstheDOPPLERkey.
Thetimescaleabovethetracehassmallmarks
at200msintervalsandlargemarksat
onesecondintervals.
3 Doanyofthefollowingasneeded:
Setoptions.SeeSpectraltraceoptions
onpage 29.
PresstheUPDATEkeytotogglebetween
theDlineandspectraltrace.

28

Imaging modes

Ifusingaduplexlayout,pressthe
DOPPLERkeytotogglebetweenthe
fullscreenDlineandtheduplexlayout.

0 has an angle correction of 0.


+15 has an angle correction of
+60.
You can manually correct the angle
after selecting a steering angle
setting. (See To display the D-line
on page 28.)
Available on select transducers.

Tosetaduplexlayout,seePresetssetup
onpage 22.

PW Doppler options
InPWDopplerimaging,youcansetthe
followingonscreenoptions.
PW, CW

Angle
Correction

Gate Size

Steering

Corrects the angle to 0, +60, or


-60.

Settings depend on transducer and


exam type.
In TCD or Orb exams, use the
touchpad to specify the Doppler
gate depth (the depth of the center
of the gate in the Doppler image).
The Doppler gate depth indicator is
on the lower right-hand screen.
Select TDI On to turn on tissue
Doppler imaging. When on, TDI
appears in the upper left-hand
screen. The default is TDI off.
Available only in cardiac exams.
Select the desired steering angle
setting. The PW Doppler angle
correction automatically changes
to the optimum setting.
-15 has an angle correction of
-60.

Page x/x

Indicates which page of options is


displayed. Select to display the next
page.

Spectral trace options


Inspectraltraceimaging,youcansetthe
followingonscreenoptions.
Scale

Select the desired scale (pulse


repetition frequency [PRF]) setting.
(To change the Doppler scale to
cm/s or kHz, see Presets setup on
page 22.)

Line

Sets the baseline position.


(On a frozen trace, the baseline can
be adjusted if Live Trace is off.)

Invert

Vertically flips the spectral trace.


(On a frozen trace, Invert is
available if Live Trace is off.)

Volume

Increases or decreases Doppler


speaker volume (0-10).

Wall Filter

Settings include Low, Med, High.

Sweep Speed Settings include Slow, Med, Fast.

Chapter 3: Imaging

29

Imaging

TDI On,
TDI Off

(Cardiac exam only) Toggle


between PW Doppler and CW
Doppler.
The current selection appears in the
upper left-hand screen.

Live Trace

Page x/x

Displays a live trace of the peak or


mean. (See Presets setup on
page 22 to specify peak or mean.)
Indicates which page of options is
displayed. Select to display the next
page.

Adjusting depth and gain


To adjust depth
Youcanadjustthedepthinallimagingmodes
butthetracemodes.Theverticaldepthscaleis
markedin0.5 cm,1 cm,and5 cmincrements,
dependingonthedepth.
Pressthefollowingkeys:

UPDEPTHkeytodecreasethedisplayed
depth.
DOWNDEPTHkeytoincreasethedisplayed
depth.
Asyouadjustthedepth,themaximumdepth
numberchangesinthelowerrightscreen.

To adjust gain automatically


PresstheAUTO GAINkey.Thegainadjusts

eachtimeyoupressthiskey.

To adjust gain manually


Turnagainknob:

box.InPWandCWDopplerimaging,the
theGAINknobaffectsDopplergain.
Nearandfarcorrespondtothetimegain
compensation(TGC)controlsonother
ultrasoundsystems.

Freezing, viewing frames, and


zooming
To freeze or unfreeze an image
PresstheFREEZEkey.

Onafrozenimage,thecineiconandframe
numberappearinthesystemstatusarea.

To move forward or backward in the cine


buffer
Freezetheimage,anddooneofthefollowing:

Turnthe

knob.

Usethetouchpad.Rightmovesforward,
andleftmovesbackward.
PresstheLEFTARROWandRIGHTARROW
keys.
Theframenumberchangesasyoumove
forwardorbackward.Thetotalnumberof
framesinthebufferappearsonscreeninthe
systemstatusarea.

To zoom in on an image

NEAR
adjuststhegainappliedtothe
nearfieldofthe2Dimage.

Youcanzoomin2DandColorimaging.Youcan
freezeorunfreezetheimageorchangethe
imagingmodeatanytimewhilezooming.

adjuststhegainappliedtothefar
FAR
fieldofthe2Dimage.

1 PresstheZOOMkey.AROIboxappears.

adjuststheoverallgainapplied
GAIN
totheentireimage.InCPDorColor
imaging,theGAINknobaffectsthecolor
gainappliedtotheregionofinterest(ROI)

3 PresstheZOOMkeyagain.

2 Usingthetouchpad,positiontheROIboxas
desired.

TheimageintheROIboxismagnifiedby
100%.
4 (Optional)Iftheimageisfrozen,usethe
touchpadorarrowkeystopantheimageup,

30

Adjusting depth and gain

down,left,andright.(Youcannotpanin
Dual.)

Imaging modes and exams available by


transducer

Toexitzoom,presstheZOOMkeyagain.

CPD3

Color3

PW Doppler4

CW Doppler

Abd

Neo

Nrv

Vas

OB

Gyn

Abd

Nrv

D2x

Crd

HFL38x

Bre

SmP

Vas

Thetransduceryouusedetermineswhichexam
typesareavailable.Inaddition,theexamtype
youselectdetermineswhichimagingmodesare
available.

Msk

IMT

Nrv

To change the exam type

Ven

Gyn

OB

WARNING:

To prevent misdiagnosis or harm to


the patient, understand your
systems capabilities prior to use.
The diagnostic capability differs for
each transducer, exam type, and
imaging mode. In addition,
transducers have been developed
to specific criteria depending on
their physical application. These
criteria include biocompatibility
requirements.
To avoid injury to the patient, use
only an Orbital (Orb) or Ophthalmic
(Oph) when performing imaging
through the eye. The FDA has
established lower acoustic energy
limits for ophthalmic use. The
system will not exceed these limits
only if the Orb or Oph exam type is
selected.

Dooneofthefollowing:

PresstheEXAMkey,andselectfromthe
menu.

C60x

ICTx

2D2
M Mode

Exam Type1

C11x

Imaging modes and exams


available by transducer

Imaging

Transducer

Imaging Mode

Onthepatientinformationform,select
fromtheTypelistunderExam.(See
Patientinformationformonpage 33.)

Chapter 3: Imaging

31

CW Doppler

CPD3

Color3

PW Doppler4

CW Doppler

Vas

Vas

Ven

Nrv

TEEx

Crd

Oph

Sup

Ven

Bre

SmP

Vas

IMT

1. Exam type abbreviations are as follows: Abd = Abdomen,


Bre = Breast, Crd = Cardiac, Gyn = Gynecology, IMT =
Intima Media Thickness, Msk = Muscle, Neo = Neonatal,
Nrv = Nerve, OB = Obstetrical, Oph = Ophthalmic, Orb =
Orbital, SmP = Small Parts, Sup = Superficial, TCD =
Transcranial Doppler, Vas = Vascular, Ven = Venous.
2. The optimization settings for 2D are Res, Gen, and Pen.
3. The optimization settings for CPD and Color are low,
medium, and high (flow sensitivity) with a range of PRF
settings for Color depending on the setting selected.
4. For the cardiac exam type, PW TDI is also available. See
PW Doppler options on page 29.

Nrv

Ven

Abd

Crd

Neo

Youcanannotateliveimagesaswellasfrozen
images.(Youcannotannotateasavedimage.)
Youcanplacetext(includingpredefinedlabels),
anarrow,orapictograph.Tosetpreferencesfor
annotations,seeAnnotationssetuponpage 18.

Abd

To place text on an image

OB

Crd

TCD

Orb

Msk

Usethetouchpadorarrowkeys.

Nrv

Sup

SelectHometomovethecursortothe
homeposition.

L38x

P10x

P21x

SLAx

32

Annotating images

2D2
M Mode

PW Doppler4

Exam Type1

Color3

Msk

Transducer

CPD3

L25x

2D2
M Mode

Exam Type1

Imaging Mode

Transducer

Imaging Mode

Annotating images

Youcanplacetextinthefollowingimaging
layouts:fullscreen2D,fullscreentrace,dual,or
duplex.Youcanplacetextmanuallyoradda
predefinedlabel.
1 PresstheTEXTkey.Agreencursorappears.
2 Movethecursorwheredesired:

Thedefaulthomepositiondependsonthe
imagingscreenlayout.Youcanresetthe
homeposition.SeeToresetthehome
positiononpage 33.
3 Usingthekeyboard,typetext.
Thearrowkeysmovethecursorleft,right,
up,anddown.
TheDELETEkeydeletesalltext.

4 PresstheARROWkeytosetthearrow.
Thearrowchangesfromgreentowhite.
Toremovethearrow,presstheARROWkeyand
thenselectHide.

To place a pictograph on an image


Thepictographsetavailabledependson
transducerandexamtype.
1 PressthePICTOkey.

The

Wordoptionremovesaword.

SelectSymbolstoenterspecialcharacters.
SeeSymbolsonpage 10.
4 (Optional)Toaddapredefinedlabel,select
Label,andthenselectthedesiredlabelgroup:
,
, or
.Selectthegroupagainfor
thedesiredlabel.
Thefirstnumbershowswhichlabelinthe
groupisselected.Thesecondnumberisthe
numberoflabelsavailable.
SeeAnnotationssetuponpage 18.

To reset the home position


1 PresstheTEXTkey.
2 Usingthetouchpadorarrowkeys,position
thecursorwheredesired.

Thefirstnumbershowswhichpictographin
thesetisselected.Thesecondnumberisthe
numberofpictographsavailable.
3 Usingthetouchpad,positionthepictograph
marker.
4 (Optional)Torotatethepictographmarker,
presstheSELECTkeyandthenusethe
touchpad.
5 Selectascreenlocationforthepictograph:U/L
(Up/Left),D/L(Down/Left),D/R
(Down/Right),U/R(Up/Right).
Inaduplexlayout,thepictographisrestricted
toupperleft.InDual,allfourpositionsare
available.
Toremovethepictograph,selectHide.

3 SelectHome/Set.

To place an arrow on an image

Patient information form

Youcanaddanarrowgraphictopointouta
specificpartoftheimage.

Thepatientinformationformletsyouenter
patientidentification,exam,andclinical
informationforthepatientexam.This
informationautomaticallyappearsinthepatient
report.

1 PresstheARROWkey

2 Ifyouneedtoadjustthearrowsorientation,
presstheSELECTkeyandthenusethe
touchpad.Whentheorientationiscorrect,
presstheSELECTkeyagain.
3 Usingthetouchpad,positionthearrowwhere
desired.

Whenyoucreateanewpatientinformationform,
allimages,clips,andotherdatayousaveduring
theexamarelinkedtothatpatient.(SeePatient
reportonpage 68.)

Chapter 3: Imaging

33

Imaging

Toturnofftextentry,presstheTEXTkey.

2 Select
x/xtodisplaythedesired
pictograph,andthenpresstheSELECTkey.

To create a new patient information form

IDPatientidentificationnumber

1 PressthePATIENTkey.

Accession Enternumber,ifapplicable.

2 Select

Date of birth

New/End.

Gender

3 Fillintheformfields.SeePatient
informationformfieldsonpage 34.

Indications Enterdesiredtext

4 SelectDone.

UserUserinitials

SeealsoToappendimagesandclipstoapatient
examonpage 37.

Procedure (button)AvailableiftheDICOM
Worklistfeatureislicensedandconfigured.
SeetheDICOMuserguide.

To edit a patient information form


Youcaneditpatientinformationiftheexamhas
notbeenarchivedorexportedandifthe
informationisnotfromaworklist.
SeealsoToeditpatientinformationfromthe
patientlistonpage 36.
1 PressthePATIENTkey.
2 Makechangesasdesired.
3 Selectoneofthefollowing:
Canceltoundochangesandreturnto
imaging.
Donetosavechangesandreturnto
imaging.

To end the exam


1 Makesurethatyouhavesavedimagesand
otherdatayouwanttokeep.(SeeSaving
imagesandclipsonpage 35.)
2 PressthePATIENTkey.
3 Select

New/End.

Anewpatientinformationformappears.

Patient information form fields


Thepatientinformationformfieldsavailable
dependonexamtype.Insomefieldsyoucan
selectSymbolstoentersymbolsandspecial
characters.SeeSymbolsonpage 10.
Patient
Last, First, Middle Patientname

34

Patient information form

SelectBacktosaveentriesandreturntothe
previousscreen.
Exam
Type Examtypesavailabledependon
transducer.SeeImagingmodesandexams
availablebytransduceronpage 31.
LMP Estab. DD(OBorGynexam)InanOB
exam,selectLMPorEstab. DDandthenenter
eitherthedateofthelastmenstrualperiodor
theestablishedduedate.InaGynexam,enter
thedateofthelastmenstrualperiod.TheLMP
datemustprecedethecurrentsystemdate.
Twins (OBexam)SelecttheTwinscheckboxto
displayTwin AandTwin Bmeasurementson
thecalculationsmenuandforaccesstoTwin
AandTwinBscreensforpreviousexamdata.
Previous Exams (button)(OBexam)Displays
fieldsforfivepreviousexams.Thedatefora
previousexammustprecedethecurrent
systemdate.Fortwins,selectTwin A/Bto
togglebetweenTwinAandTwinBscreens.(If
theTwin A/Boptiondoesnotappear,select
Back,andmakesurethattheTwinscheckbox
isselected.)
SelectBacktosavechangesandreturntothe
previousscreen.
BP(Cardiac,IMT,Orbital,Transcranial,or
Vascularexam)BloodPressure
HR (Cardiac,Orbital,Transcranial,orVascular
exam)HeartRate.Enterthebeatsperminute.

Savingtheheartrateusingameasurement
overwritesthisentry.
Height (Cardiacexam)Thepatientheightin
feetandinchesormetersandcentimeters.(To
changetheunits,seePresetssetupon
page 22.)
Weight (Cardiacexam)Thepatientweightin
poundsorkilos.(Tochangetheunits,see
Presetssetuponpage 22.)
BSA(Cardiacexam)BodySurfaceArea.
Automaticallycalculatedafteryouenter
heightandweight.

Bydefault,theSAVEkeysavesonlytheimage.As
ashortcutduringcalculations,theSAVEkeycan
saveboththeimagetointernalstorageandthe
calculationtothepatientreport.SeePresets
setuponpage 22.

To capture and save a clip


Clips,anoptionalfeature,letsyoucapture,
preview,andsaveclips.
1 SetClipsoptions.(SeeTosetClipsoptions
onpage 35.)
2 PresstheCLIPkey.

Ethnicity (IMTexam)Ethnicorigin

Oneofthefollowingoccurs:

Reading Dr.

IfPrev/Offisselected,theclipsaves
directlytointernalstorage.

Referring Dr.

Institution

Images and clips


Saving images and clips

Thepercentageiconinthesystemstatusarea
showsthepercentageofspaceusedininternal
storage.Toreceivealertswhenstorageisnear
capacity,seeToreceivestoragealertson
page 20.
Toaccesssavedimagesandclips,openthe
patientlist.SeeReviewingpatientexamson
page 36.

Aplaybackspeed

(1x, 1/2x, 1/4x)

Pausetointerruptplayback
Left: xorRight: xtoremoveframes
fromtheleftorrightsidesoftheclip
(wherexisthebeginningorending
framenumber)
Savetosavethecliptointernalstorage
Deletetodeletetheclip

To set Clips options


SettingClipsoptionsensuresthatclipsare
capturedtoyourspecifications.
1 In2Dimagingmode,selectClipsonscreen.
2 Setoptionsasdesired.

To save an image
PresstheSAVEkey.

Theimagesavestointernalstorage.

Chapter 3: Imaging

35

Imaging

Whenyousaveanimageorclip,itsavesto
internalstorage.Thesystembeepsafterwardif
BeepAlertison,andthepercentageiconflashes.
(SeeAudio,Batterysetuponpage 19.)Toaccess
savedimagesandclips,openthepatientlist.(See
Reviewingpatientexamsonpage 36.)

IfPrev/Onisselected,theclipplaysback
inpreviewmode.Youcanselectanyofthe
followingonscreen:

Clips options
Time, ECG

Time and ECG share the same


location on-screen.
With Time, capturing is based
on number of seconds. Select
the time duration.
With ECG, capturing is based
on the number of heart beats.
Select the number of beats.

Preview On,
Preview Off

PrevOn and PrevOff turn the


preview feature on and off.
With Prev/On, the captured
clip automatically plays
on-screen. The clip can be
trimmed, saved, or deleted.
With Prev/Off, the clip saves
to internal storage, and the
trim and delete options are
not available.

Prospective,
Retrospective

Pro and Retro determine how


clips are captured:
With Pro, a clip is captured
prospectively, after you press
the CLIP key.
With Retro, a clip is captured
retrospectively, from
pre-saved data before you
press the CLIP key.

Figure 1 Patient List

To display the patient list


1 PresstheREVIEWkey.
2 Ifthereisanactiveexam,selectListonscreen.

To sort the patient list


Afterthesystemstarts,thepatientlistisarranged
bydateandtime,withthemostrecentpatientfile
first.Youcanresortthepatientlistasneeded.
Selectthecolumnheadingthatyouwantto

sortby.Selectitagainifsortinginreverse
order.
Note: The

columnheadingisselectable.

To select patients in the patient list

Reviewing patient exams


Caution:

If the internal storage icon does not


appear in the system status area,
internal storage may be defective.
Contact SonoSite Technical
Support. (See SonoSite Technical
Support on page vii.)

Thepatientlistorganizessavedimagesandclips
inpatientexams.Youcandelete,view,print,or
archiveexams.YoucanalsocopythemtoaUSB
storagedevice.

Usingthetouchpad,selectthecheckboxfor

oneormorepatients.
Select Allselectsallpatients.
Todeselectpatients,selectcheckedboxesorClear
All.

To edit patient information from the patient


list
YoucaneditthepatientnameandIDfromthe
patientlistinsteadoffromthepatient
informationformiftheexamhasnotbeen
exportedorarchived.
1 Inthepatientlist,selectthepatient.

36

Images and clips

2 SelectEdit.
3 Fillintheformfields,andselectOK.

To append images and clips to a patient


exam
Althoughyoucannotaddimagesandclipstoa
patientexamthatisended,exported,orarchived,
youcanautomaticallystartanewpatientexam
thathasthesamepatientinformation.
Dependingonyourarchiver,thetwoexams
appearasonestudywhenexportedorarchived.
1 Selecttheexaminthepatientlist.
2 SelectAppendonscreen.
Anewpatientinformationformappears.The
formhasthesameinformationastheexam
youselected.

To review images and clips


Youcanreviewimagesandclipsinonlyone
patientexamatatime.
1 Inthepatientlist,highlightthepatientexam
whoseimagesandclipsyouwanttoreview.

3 Select
x/xtocycletotheimageorclipyou
wanttoreview.
4 (ClipOnly)SelectPlay.
Theclipplaysautomaticallyafterloading.
Theloadtimedependsoncliplength.
YoucanselectPausetofreezetheclipandcan
selectaplaybackspeed

1x, 1/2x, 1/4x.

5 Select
x/xtocycletothenextimageorclip
youwanttoview.
Toreturntothepatientlist,selectList.Toreturn
toimaging,selectDone.

WARNING:

To avoid damaging the USB


storage device and losing patient
data from it, observe the following:
Do not remove the USB storage
device or turn off the ultrasound
system while the system is
exporting.
Do not bump or otherwise apply
pressure to the USB storage
device while it is in a USB port on
the ultrasound system. The
connector could break.

To print an image
1 Verifythataprinterisselected.SeeTo
configurethesystemforaprinteron
page 19.
2 Dooneofthefollowing:
Inthepatientlist,reviewthepatients
images.SelectPrintwhentheimage
appears.

Imaging

2 SelectReviewonscreen.

Printing, exporting, and deleting images


and clips

Withtheimagedisplayed,presstheA
shortcutkey.
Bydefault,theAshortcutkeyprints.To
reprogramtheAandBshortcutkeys,see
Presetssetuponpage 22.

To print multiple images


1 Verifythataprinterisselected.SeeTo
configurethesystemforaprinteron
page 19.
2 Dooneofthefollowing:
Printallimagesformultiplepatients:
Selectoneormorepatientsinthepatient
list.Thenselect Print.
Printallimagesforonepatient:Highlight
thepatientinthepatientlist,andthen
selectPrint.

Chapter 3: Imaging

37

Eachimageappearsbrieflyonscreen
whileprinting.

To display information about a patient exam


1 Onthepatientlist,selecttheexam.

To export patient exams to a USB storage


device

2 Select Info.

AUSBstoragedeviceisfortemporarystorageof
imagesandclips.Patientexamsshouldbe
archivedregularly.Tospecifyfileformat,see
USBDevicessetuponpage 23.

ECG Monitoring

1 InserttheUSBstoragedevice.

ECGMonitoringisanoptionalfeatureand
requiresaSonoSiteECGcable.
WARNING:

2 Inthepatientlist,selectthepatientexamsyou
wanttoexport.
3 SelectExp. USB onscreen.AlistofUSB
devicesappears.

To avoid electrical interference with


aircraft systems, do not use the ECG
cable on aircraft. Such interference
may have safety consequences.

4 SelecttheUSBstoragedevice.Ifyouwantto
hidepatientinformation,deselectInclude
patient information on images and clips.
OnlyavailableUSBdevicesareselectable.
5 SelectExport.
Thefilesarefinishedexporting
approximatelyfivesecondsaftertheUSB
animationstops.RemovingtheUSBstorage
deviceorturningoffthesystemwhile
exportingmaycauseexportedfilestobe
corruptedorincomplete.Tostopinprogress
exporting,selectCancel Export.

To delete images and clips


1 Selectoneormorepatientsinthepatientlist.
2 SelectDeletetodeletetheselectedpatients.A
confirmationscreenappears.

To manually archive images and clips


YoucansendpatientexamstoaDICOMprinter
orarchiver,ortoaPCusingSiteLink.DICOM
andSiteLinkareoptionalfeatures.Formore
informationaboutarchiving,seetheSiteLinkand
DICOMdocumentation.
1 Selectoneormorepatientsinthepatientlist.
2 SelectArchive.

38

ECG Monitoring

To prevent misdiagnosis, do not use


the ECG trace to diagnose cardiac
rhythms. The SonoSite ECG option
is a non-diagnostic feature.

Caution:

Use only accessories recommended


by SonoSite with the system. Your
system can be damaged by
connecting an accessory not
recommended by SonoSite.

To monitor ECG
1 ConnecttheECGcabletotheECGconnector
ontheultrasoundsystem,minidock,or
dockingsystem.
ECGMonitoringturnsonautomatically.
Note: AnexternalECGmonitormaycausealag
inthetimingoftheECGtrace,correspondingwith
the2Dimage.Biopsyguidelinesarenotavailable
whenECGisconnected.
2 SelectECGonscreen.(ECGmaybeonanother
page.ItappearsonlyiftheECGcableis
connected.)
3 Selectoptionsasdesired.

ECG Monitoring options


Show/Hide

Turns on and off ECG trace.

Gain

Increases or decreases ECG gain.


Settings are 0-20.

Position

Sets the position of the ECG trace.

Sweep Speed Settings are Slow, Med, and Fast.

Displays Line and Save for clip


acquisition delay. (For instructions
to capture clips, see To capture and
save a clip on page 35.)

Line

The position of the delay line on the


ECG trace. The delay line indicates
where the clip acquisition is
triggered.

Save

Saves the current position of the


delay line on the ECG trace. (You
can change the position of the
delay line temporarily. Starting a
new patient information form or
cycling system power reverts the
delay line to the most recently
saved position.)
Select Delay to display these
options.

Imaging

Delay

Chapter 3: Imaging

39

40

ECG Monitoring

Chapter 4: Measurements and Calculations


Youcanmeasureforquickreference,oryoucan
measurewithinacalculation.Youcanperform
generalcalculationsaswellascalculations
specifictoanexamtype.
Measurementsareperformedonfrozenimages.
Forreferencesused,seeChapter 7,References.

Measurements
Youcanperformbasicmeasurementsinany
imagingmodeandcansavetheimagewiththe
measurementsdisplayed.(SeeTosavean
imageonpage 35.)ExceptfortheMModeHR
measurement,theresultsdonotautomatically
savetoacalculationandthepatientreport.Ifyou
prefer,youcanfirstbeginacalculationandthen
measure.SeePerformingandsaving
measurementsincalculationsonpage 45.
Someoptionsmaynotapplytoyoursystem.
Optionsavailabledependonyourconfiguration,
transducer,andexamtype.

To save a measurement to a calculation and


patient report
1 Withthemeasurementactive(green),press
theCALCSkey.
2 Fromthecalculationsmenu,selecta
measurementname.

3 Savethecalculation.(SeeTosavea
calculationonpage 45.)
Tostartacalculationbeforemeasuring,see
Performingandsavingmeasurementsin
calculationsonpage 45.

Whenmeasuring,youworkwithcalipers,often
inpairs.Resultsbasedonthecalipersposition
appearatthebottomofthescreen.Theresults
updateasyourepositionthecalipersbyusingthe
touchpad.Intracemeasurements,theresults
appearafteryoucompletethetrace.
Outsideacalculation,youcanaddcalipersby
pressingtheCALIPERkey.Youcanhavemultiple
setsofcalipersandcanswitchfromonesetto
another,repositioningthemasneeded.Eachset
showsthemeasurementresult.Theactive
calipersandmeasurementresultarehighlighted
green.Ameasurementiscompletewhenyou
finishmovingitscalipers.
Withinacalculation,calipersappearwhenyou
selectfromthecalculationsmenu.(SeeToselect
fromthecalculationsmenuonpage 45.)
Foranaccuratemeasurement,accurate
placementofcalipersisessential.

To switch the active calipers


Dooneofthefollowing:

Toswitchtheactivecaliperwithinaset,
presstheSELECTkey.
Toswitchtheactivesetwhenmeasuring
outsideacalculation,selectSwitch
onscreen.

To delete or edit a measurement


Withthemeasurementactive(highlighted),

dooneofthefollowing:
Todelete,selectDeleteonscreen.
Toedit,usethetouchpadtomovethe
calipers.
Note: Tracemeasurementscannotbeeditedonceset.

Chapter 4: Measurements and Calculations

41

Measurements

Onlymeasurementnamesavailableforthe
imagingmodeandexamtypeareselectable.

Working with calipers

To improve precision of caliper placement


Doanyofthefollowing:

Adjustthedisplayformaximum
sharpness.

Youcanperformacombinationofdistance,area,
circumference,andmanualtracemeasurements
atonetime.Thetotalnumberpossibledepends
ontheirorderandtype.

Useleadingedges(closesttothe
transducer)orbordersforstartingand
stoppingpoints.

To measure distance (2D)

Maintainaconsistenttransducer
orientationforeachtypeofmeasurement.

1 Onafrozen2Dimage,presstheCALIPERkey.

Makesurethattheareaofinterestfillsas
muchofthescreenaspossible.
(2D)Minimizethedepth,orzoom.

2D measurements
Thebasicmeasurementsthatyoucanperformin
2Dimagingareasfollows:
Distanceincm
Areaincm2
Circumferenceincm
Youcanalsomeasureareaorcircumferenceby
tracingmanually.

Youcanperformuptoeightdistance
measurementsona2Dimage.

Apairofcalipersappears,connectedbya
dottedline.
2 Usingthetouchpad,positionthefirstcaliper,
andthenpresstheSELECTkey.
Theothercaliperbecomesactive.
3 Usingthetouchpad,positiontheothercaliper.
Ifyoumovethecalipersclosetogether,they
shrinkandthedottedlinedisappears.
SeeTosaveameasurementtoacalculationand
patientreportonpage 41.

To measure area or circumference (2D)


1 Onafrozen2Dimage,presstheCALIPERkey.
2 SelectEllipseonscreen.
Note: Ifyouexceedtheallowednumberof
measurements,Ellipseisnotavailable.
3 Usethetouchpadtoadjustthesizeand
positionoftheellipse.TheSELECTkeytoggles
betweenpositionandsize.
SeeTosaveameasurementtoacalculationand
patientreportonpage 41.

To trace manually (2D)


1 Onafrozen2Dimage,presstheCALIPERkey.
2 SelectManualonscreen.
Figure 1 2D image with two distance and one
circumference measurement

Note: Ifyouexceedtheallowednumberof
measurements,Manualisnotavailable.
3 Usingthetouchpad,positionthecaliper
whereyouwanttobegin.

42

Measurements

4 PresstheSELECTkey.
5 Usingthetouchpad,completethetrace,and
presstheSETkey.
SeeTosaveameasurementtoacalculationand
patientreportonpage 41.

M Mode measurements
Thebasicmeasurementsthatyoucanperformin
M Modeimagingareasfollows:
Distanceincm/Timeinseconds

4 PresstheSELECTkey.
Asecondverticalcaliperappears.
5 Usingthetouchpad,positionthesecond
verticalcaliperatthepeakofthenext
heartbeat.
SeeTosaveameasurementtoacalculationand
patientreportonpage 41.Savingtheheartrate
measurementtothepatientreportoverwrites
anyheartrateenteredonthepatientinformation
form.

HeartRate(HR)inbeatsperminute(bpm)

SeealsoTomeasurefetalheartrate(MMode)
onpage 63.

Thetimescaleabovethetracehassmallmarksat
200 msintervalsandlargemarksatonesecond
intervals.

Doppler measurements

To measure distance (M Mode)


Youcanperformuptofourdistance
measurementsonanimage.
1 OnafrozenM Modetrace,presstheCALIPER
key.
Asinglecaliperappears.
2 Usingthetouchpad,positionthecaliper.
3 PresstheSELECTkeytodisplaythesecond
caliper.
4 Usingthetouchpad,positionthesecond
caliper.

Thebasicmeasurementsthatyoucanperformin
DopplerimagingareVelocity(cm/s),Pressure
Gradient,ElapsedTime,+/xRatio,Resistive
Index (RI),andAcceleration.Youcanalsotrace
manuallyorautomatically.
ForDopplermeasurements,theDopplerscale
mustbesettocm/s.SeePresetssetupon
page 22.

To measure Velocity (cm/s) and Pressure


Gradient (Doppler)
1 OnafrozenDopplerspectraltrace,pressthe
CALIPERkey.
Asinglecaliperappears.
2 Usingthetouchpad,positionthecalipertoa
peakvelocitywaveform.

To measure heart rate (M Mode)

Thismeasurementinvolvesasinglecaliperfrom
thebaseline.

1 OnafrozenM Modetrace,presstheCALIPER
key.
2 SelectHRonscreen.

SeeTosaveameasurementtoacalculationand
patientreportonpage 41.

Averticalcaliperappears.
3 Usingthetouchpad,positionthevertical
caliperatthepeakoftheheartbeat.

Chapter 4: Measurements and Calculations

43

Measurements

SeeTosaveameasurementtoacalculationand
patientreportonpage 41.

To measure Velocities, Elapsed Time, +/x


Ratio, Resistive Index (RI), and Acceleration
(Doppler)
1 OnafrozenDopplerspectraltrace,pressthe
CALIPERkey.
Asinglecaliperappears.
2 Usingthetouchpad,positionthecalipertoa
peaksystolicwaveform.
3 PresstheSELECTkey.
Asecondcaliperappears.

4 Usingthetouchpad,tracethewaveform.
Tomakeacorrection,selectUndoonscreen,
backtrackwiththetouchpad,orpressthe
BACKSPACEkey.
5 PresstheSETkey.
Themeasurementresultsappear.
SeeTosaveameasurementtoacalculationand
patientreportonpage 41.

To trace automatically (Doppler)

SeeTosaveameasurementtoacalculationand
patientreportonpage 41.

Aftertracingautomatically,confirmthatthe
systemgeneratedboundaryiscorrect.Ifyouare
notsatisfiedwiththetrace,obtainahighquality
Dopplerspectraltraceimage,ortracemanually.
(SeeTotracemanually(Doppler)onpage 44.)

To measure time duration (Doppler)

1 OnafrozenDopplerspectraltrace,pressthe
CALIPERkey.

1 OnaDopplerspectraltrace,presstheCALIPER
key.

2 SelectAutoonscreen.

4 Usingthetouchpad,positionthesecond
caliperattheenddiastoleonthewaveform.

2 PressTimeonscreen.
3 Averticalcaliperappears.
4 Usingthetouchpad,positionthecaliper
wheredesired,andpresstheSELECTkey.
5 Asecondcaliperappears.
6 Usingthetouchpad,positionthesecond
caliperwheredesired,andpresstheSELECT
key.

To trace manually (Doppler)


1 OnafrozenDopplerspectraltrace,pressthe
CALIPERkey.
2 SelectManualonscreen.
Asinglecaliperappears.
3 Usingthetouchpad,positionthecaliperatthe
beginningofthedesiredwaveform,andpress
theSELECTkey.
Ifcalipersarenotpositionedcorrectly,the
resultisinaccurate.

44

Measurements

Averticalcaliperappears.
3 Usingthetouchpad,positionthecaliperatthe
beginningofthewaveform.
Ifcalipersarenotpositionedcorrectly,the
calculationresultisinaccurate.
4 PresstheSELECTkey.
Asecondverticalcaliperappears.
5 Usingthetouchpad,positionthesecond
caliperattheendofthewaveform.
6 PresstheSETkey.
Themeasurementresultsappear.
SeeTosaveameasurementtoacalculationand
patientreportonpage 41.

Automatic trace results


Dependingontheexamtype,theresultsfrom
automatictracingincludethefollowing:
VelocityTimeIntegral(VTI)
PeakVelocity(Vmax)

MeanPressureGradient(PGmean)
MeanVelocityonPeakTrace(Vmean)

Menuitemsfollowedbyellipses(...)have
subentries.

PressureGradient(PGmax)

To select from the calculations menu

CardiacOutput(CO)

1 Onafrozenimage,presstheCALCSkey.

PeakSystolicVelocity(PSV)
TimeAverageMean(TAM)*
+/orSystolic/Diastolic(S/D)
PulsatilityIndex(PI)
EndDiastolicVelocity(EDV)
AccelerationTime(AT)
ResistiveIndex(RI)

Thecalculationsmenuappears.
2 Usingthetouchpadorarrowkeys,highlight
thedesiredmeasurementname.
Todisplayadditionalmeasurementnames,
highlightNext,Prev,orameasurementname
thathasellipses(...).ThenpresstheSELECT
key.
Onlymeasurementnamesavailableforthe
imagingmodeareselectable.

TimeAveragePeak(TAP)

3 PresstheSELECTkey.

GateDepth

Toclosethecalculationsmenu,presstheCALCS
keyonce(ifthemenuisactive)ortwice(ifthe
menuisinactive).

General calculations
Withincalculations,youcansavemeasurement
resultstothepatientreport.Youcandisplay,
repeat,anddeletemeasurementsfroma
calculation.Somemeasurementscanbedeleted
directlyfromthepatientreportpages.See
Patientreportonpage 68.
Calculationpackagesdependonexamtypeand
transducer.

Calculations menu

Inperformingameasurementwithina
calculation,youselectfromthecalculations
menu,positionthecalipersthatappear,andthen
savethecalculation.Unlikemeasurements
performedoutsideacalculation,thecalipers
appearbyselectingfromthecalculationsmenu,
notbypressingtheCALIPERkey.Thetypeof
calipersthatappeardependsonthe
measurement.

To save a calculation
Dooneofthefollowing:

Savethecalculationonly:Pressthe
SAVE CALCkey,orselectSaveonscreen.
Thecalculationsavestothepatientreport.
Tosavetheimagewiththemeasurements
displayed,seeTosaveanimageon
page 35.
Saveboththeimageandcalculation:Press
theSAVE keyiftheSAVEkeyfunctionality

Chapter 4: Measurements and Calculations

45

Measurements

Thecalculationsmenucontainsmeasurements
availablefortheimagingmodeandexamtype.
Afteryouperformandsaveameasurement,the
resultsavestothepatientreport.(SeePatient
reportonpage 68.)Also,acheckmarkappears
nexttothemeasurementnameinthecalculations
menu.Ifyouhighlightthecheckedmeasurement
name,theresultsappearbelowthemenu.Ifyou
repeatthemeasurement,theresultsbelowthe
menureflecteitherthelastmeasurementorthe
average,dependingonthemeasurement.

Performing and saving measurements


in calculations

issettoImage/Calcs.(SeePresetssetup
onpage 22.)
Thecalculationsavestothepatientreport,
andtheimagesavestointernalstorage
withthemeasurementsdisplayed.

Displaying, repeating, and deleting


saved measurements in calculations
To display a saved measurement
Dooneofthefollowing:

Highlightthemeasurementnameinthe
calculationsmenu.Theresultappears
belowthemenu.

Somemeasurementscanbedeleteddirectlyfrom
thepatientreportpages.SeePatientreporton
page 68.

EMED calculations
TheresultsfromEMEDcalculations
automaticallyappearintheEMEDworksheets.
AllEMEDcalculationsareavailableforeach
examtype.

To perform an EMED calculation:


1 PresstheCALCSkey.
2 SelectEMEDonscreen.
ThecalculationsmenubecomestheEMED
calculationsmenu.

Openthepatientreport.SeePatientreporton
page 68.

3 Selectthecalculationname.

To repeat a saved measurement

4 Performadistancemeasurement.

1 Highlightthemeasurementnameinthe
calculationsmenu.

5 Savethemeasurement.

2 PresstheSELECTkeyortheCALIPERkey.

Toreturntothecalculationsmenu,selectCalcs
onscreen.

3 Performthemeasurementagain.
Thenewresultsappearonscreeninthe
measurementandcalculationsdataarea.(See
Screenlayoutonpage 7.)Youcancompare
themtothesavedresultsbelowthemenu.
4 Tosavethenewmeasurement,pressthe
SAVE CALCkey.
Thenewmeasurementsavestothepatient
reportandoverwritesthepreviouslysaved
measurement.

To delete a saved measurement


1 Selectthemeasurementnamefromthe
calculationsmenu.
2 SelectDeleteonscreen.
Themeasurementlastsavedisdeletedfrom
thepatientreport.Ifitistheonly
measurement,thecheckmarkisdeletedfrom
thecalculationsmenu.

46

General calculations

Percent reduction calculations


WARNING:

To avoid incorrect calculations,


verify that the patient information,
date, and time settings are accurate.
To avoid misdiagnosis or harming
the patient outcome, start a new
patient information form before
starting a new patient exam and
performing calculations. Starting a
new patient information form clears
the previous patients data. The
previous patients data will be
combined with the current patient
if the form is not first cleared. See
To create a new patient
information form on page 34.

Transducer

Exam Types

b Usingthetouchpad,movethecaliperto
thetracestartingpoint,andpressthe
SELECTkey.

C11x

Abdomen

c Usingthetouchpad,tracethedesiredarea.

C60x

Abdomen

HFL38x

IMT, Small Parts, Vascular

L25x

Vascular, Muscle

L38x

IMT, Small Parts, Vascular

P10x

Abdomen

P21x

Abdomen

SLAx

Muscle, Vascular

Tomakeacorrection,selectUndo
onscreenorpresstheBACKSPACEkey.
d Completethetrace,andpresstheSETkey.
e Savethecalculation.SeeTosavea
calculationonpage 45.
Thepercentareareductionresultappears
onscreeninthemeasurementandcalculation
dataareaandinthepatientreport.

To calculate percent diameter reduction


1 Onafrozen2Dimage,presstheCALCSkey.
2 DothefollowingforD1andthenforD2:
a Fromthecalculationsmenu,selectthe
measurementnameunderDia Red.
b Positionthecalipers.(SeeWorkingwith
calipersonpage 41.)
c Savethecalculation.SeeTosavea
calculationonpage 45.
Thepercentdiameterreductionresultappearsin
themeasurementandcalculationdataareaand
inthepatientreport.

Figure 2 Percent area reduction calculation of right


carotid bulb
Measurements

To calculate percent area reduction


Thepercentareareductioncalculationinvolves
twomanualtracemeasurements.
1 Onafrozen2Dimage,presstheCALCSkey.
2 DothefollowingforA1andthenforA2:
a Fromthecalculationsmenu,selectthe
measurementnameunderArea Red.

Chapter 4: Measurements and Calculations

47

Volume calculations
WARNING:

To avoid incorrect calculations,


verify that the patient information,
date, and time settings are
accurate.
To avoid misdiagnosis or harming
the patient outcome, start a new
patient information form before
starting a new patient exam and
performing calculations. Starting a
new patient information form
clears the previous patients data.
The previous patients data will be
combined with the current patient
if the form is not first cleared. See
To create a new patient
information form on page 34.

Transducer

Exam Types

C11x

Abdomen, Nerve

C60x

Abdomen, Gyn, Nerve

HFL38x

Breast, Nerve, Small Parts,


Vascular

ICTx

Gyn

L25x

Muscle, Nerve, Vascular,


Superficial,

L38x

Breast, Nerve, Small Parts,


Vascular

P10x

Abdomen, Neonatal

P21x

Abdomen

SLAx

Muscle, Nerve, Superficial,


Vascular

48

General calculations

To calculate volume
Thevolumecalculationinvolvesthree2D
distancemeasurements:D1,D2,andD3.Afterall
measurementsaresaved,theresultappears
onscreenandinthepatientreport.
Dothefollowingforeachimageyouneedto

measure:
a Onthefrozen2Dimage,presstheCALCS
key.
b Dothefollowingforeachmeasurement
youneedtotake:
i

Fromthecalculationsmenu,selectthe
measurementnameunderVolume.(If
VolumeisnotavailableinaGynexam,
selectGynandthenselectVolume.)

ii Positionthecalipers.(SeeWorking
withcalipersonpage 41.)
iii Savethemeasurement.SeeTosavea
calculationonpage 45.

Volume flow calculations


WARNING:

To avoid incorrect calculations,


verify that the patient information,
date, and time settings are accurate.
To avoid misdiagnosis or harming
the patient outcome, start a new
patient information form before
starting a new patient exam and
performing calculations. Starting a
new patient information form clears
the previous patients data. The
previous patients data will be
combined with the current patient
if the form is not first cleared. See
To create a new patient
information form on page 34.

Transducer

Exam Types

C11x

Abdomen

C60x

Abdomen

HFL38x

Vascular

L25x

Vascular

L38x

Vascular

P10x

Abdomen

P21x

Abdomen

SLAx

Vascular

Difficultyensuringuniforminsonationof
thevessel.
Thesystemislimitedtothefollowing
samplevolumesizes:
C11xtransducer:1,2,3GateSize(mm)
C60xandP10xtransducers:2,3,5,7,
10,12GateSize(mm)
HFL38x,L25x,L38x,andSLAx
transducers:1,3,5,7,10,12GateSize
(mm)
P21xtransducer:2,3,5,7,11.5,14Gate
Size(mm)
Precisioninplacingthecaliper
Accuracyinanglecorrection

Thefollowingtableshowsthemeasurements
requiredtocompletethevolumeflow
calculation.Fordefinitionsofacronyms,see
Glossaryonpage 157.
Volume Flow Calculations
Menu
Heading
Vol Flow

Measurement
(Imaging
Mode)

Calculation
Result

D (2D)
TAM (Doppler)

VF (Volume
Flow l/min)

Theconsiderationsanddegreeofaccuracyfor
volumeflowmeasurementsandcalculationsare
discussedinthefollowingreference:
Allan,PaulL.etal.ClinicalDopplerUltrasound,
4thEd.,HarcourtPublishersLimited,(2000)
3638.

To calculate volume flow


1 Performthe2Dmeasurement:
a Onafrozenfullscreen2Dimageorduplex
image,presstheCALCSkey.
b Fromthecalculationsmenu,selectD
(distance)underVol Flow.
c Positionthecalipers.(SeeWorkingwith
calipersonpage 41.)

Considerthefollowingfactorswhenperforming
volumeflowmeasurements:

d Savethecalculation.SeeTosavea
calculationonpage 45.

Usersshouldfollowcurrentmedicalpractice
forvolumeflowcalculationapplications.
Theaccuracyofthevolumeflowcalculation
largelydependsontheuser.
Thefactorsidentifiedintheliteraturethat
affecttheaccuracyareasfollows:

2 PerformtheDopplermeasurement:
a OnafrozenDopplerspectraltrace,press
theCALCSkey.
b Fromthecalculationsmenu,selectTAM
underVol Flow.
Averticalcaliperappears.

Usingthediametermethodfor2Darea

Chapter 4: Measurements and Calculations

49

Measurements

Botha2DandaDopplermeasurementare
requiredforthevolumeflowcalculation.The
Dopplersamplevolumeshouldcompletely
insonatethevessel.

c Usingthetouchpad,positionthevertical
caliperatthebeginningofthewaveform.
Ifcalipersarenotpositionedcorrectly,the
calculationresultisinaccurate.
d PresstheSELECTkeytodisplayasecond
verticalcaliper.
e Usingthetouchpad,positionthesecond
verticalcaliperattheendofthewaveform.
f

PresstheSETkeytocompletethetraceand
todisplaytheresults.

g Savethecalculation.SeeTosavea
calculationonpage 45.
Todisplaythevolumeflowcalculation,see
Patientreportonpage 68.

Exam-based calculations
Inadditiontothegeneralcalculations,thereare
calculationsspecifictotheCardiac,Gynecology
(Gyn),IMT,OB,Orbital,SmallParts,Transcranial
Doppler(TCD),andVascularexamtypes.

Transducer

Exam Type

D2x

Cardiac

P10x

Cardiac

P21x

Cardiac

TEEx

Cardiac

Thefollowingtableshowsthemeasurements
requiredtocompletedifferentcardiac
calculations.Fordefinitionsofacronyms,see
Glossaryonpage 157.
Cardiac Calculations
Menu
Heading

To avoid incorrect calculations,


verify that the patient information,
date, and time settings are accurate.
To avoid misdiagnosis or harming
the patient outcome, start a new
patient information form before
starting a new patient exam and
performing calculations. Starting a
new patient information form clears
the previous patients data. The
previous patients data will be
combined with the current patient
if the form is not first cleared. See
To create a new patient
information form on page 34.

50

Exam-based calculations

Calculation
Results
CO
EF
SV
LVESV
LVEDV
IVSFT
LVPWFT
LVDFS
CI
SI

LVLVd

RVW (2D)
RVD (2D)
IVS (2D)
LVD (2D)
LVPW (2D)

LVs

RVW (2D)
RVD (2D)
IVS (2D)
LVD (2D)
LVPW (2D)
HRa needed for
CO & CI

Ao/LA

Ao (2D or
M Mode)

Ao
LA/Ao

AAo (2D)

AAo

LA (2D or
M Mode)

LA
LA/Ao

LVOT D (2D)

LVOT D
LVOT area

Cardiac calculations
WARNING:

Cardiac
Measurements
(Imaging Mode)

Cardiac
Measurements
(Imaging Mode)

Cardiac
Measurements
(Imaging Mode)

Calculation
Results

Menu
Heading

ACS (M Mode)

ACS

PISA

LVET (M Mode)

LVET

EF:Slope
(M Mode)

EF SLOPE

Ann D (2D)
Radius (Color)
MR/VTI (Doppler)
MV/VTI (Doppler)

EPSS (M Mode)

EPSS

PISA Area
ERO
MV Rate
Regurgitant
Volume
Regurgitant
Fraction

LVLVd

RVW (M Mode)
RVD (M Mode)
IVS (M Mode)
LVD (M Mode)
LVPW (M Mode)

Qp/Qs

LVs

RVW (M Mode)
RVD (M Mode)
IVS (M Mode)
LVD (M Mode)
LVPW (M Mode)

CO
EF
SV
LVESV
LVEDV
IVSFT
LVPWFT
LVDFS
CI
SI
LV Mass

LVOT D (2D)
RVOT D (2D)
LVOT VTI
(Doppler)
RVOT VTI
(Doppler)

D
VTI
VMax
PGmax
Vmean
PGmean
SV
Qp/Qs

TDI

(Wall) e and a
(Doppler)
(Wall) e and a
(Doppler)
(Wall) e and a
(Doppler)
(Wall) e and a
(Doppler)
(Wall) e and a
(Doppler)

E(MV)/e ratio

Menu
Heading

MV

HRa

Area

AV (2D)

AV Area

MV (2D)

MV Area

LV Vol
(EF)

A4Cd (2D)
A4Cs (2D)
A2Cd (2D)
A2Cs (2D)

LV Vol
LV Area
EF
CO
SV
CI
SI
Biplane

LV mass

Epi (2D)
Endo (2D)
Apical (2D)

LV Mass
Epi Area
Endo Area
D Apical

Measurements

HR

Calculation
Results

Chapter 4: Measurements and Calculations

51

Menu
Heading

Cardiac
Measurements
(Imaging Mode)

Calculation
Results

Menu
Heading

Cardiac
Measurements
(Imaging Mode)

P. Vein

A (Doppler)

VMax

AV

Vmax (Doppler)

Adur (Doppler)

time

Vmax
PGmax

S (Doppler)

VMax
S/D ratio

VTI (Doppler)

VTI
Vmax
PGmax
Vmean
PGmean

VTI or Vmax from


LVOT (Doppler)
VTI or Vmax from
AV (Doppler)

AVA

D (Doppler)
MV

E (Doppler)
A (Doppler)

Adur (Doppler)

time

PHT (Doppler)

PHT
MVA
Decel time

VTI (Doppler)

MVMR

E
E PG
A
A PG
E:A

VTI
Vmax
PGmax
Vmean
PGmean

IVRT (Doppler)

time

dP:dTb (CW
Doppler)

dP:dT

Ao/LA

LVOT D (2D)

AV

VTI (Doppler)

Ao/LA

LVOT D (2D)

AV

VTI (Doppler)

Ao/LA

LVOT D (2D)

HR

HRa

LVOT

Vmax (Doppler)

Vmax
PGmax

VTI (Doppler)

VTI
Vmax
PGmax
Vmean
PGmean

PHT (slope)
(Doppler)

AI PHT
AI slope

AVAI

52

Exam-based calculations

Calculation
Results

SV

CO

To measure LVd and LVs

Menu
Heading

Cardiac
Measurements
(Imaging Mode)

TV

TRmax (Doppler)

Vmax
PGmax

E (Doppler)
A (Doppler)

E
E PG
A
A PG
E:A

PHT (Doppler)

VTI (Doppler)

PV

Calculation
Results

PHT
MVA
Decel time
VTI
Vmax
PGmax
Vmean
PGmean

1 Onafrozen2DimageorM Modetrace,press
theCALCSkey.
2 Fromthecalculationsmenu,selectthe
measurementname.
3 Positiontheactive(green)caliperatthe
startingpoint.(SeeWorkingwithcalipers
onpage 41.)
4 PresstheSELECTkey,andpositionthesecond
caliper.
5 PresstheSELECTkey.
Anothercaliperappears,andthecalculations
menuhighlightsthenextmeasurementname.
6 Positionthecaliper,andpresstheSELECTkey.
Repeatforeachmeasurementnameinthe
calculationgroup.
EachtimeyoupresstheSELECTkey,another
caliperappears,andthecalculationsmenu
highlightsthenextmeasurementname.

RA pressurec

RVSP

7 Savethecalculation.(SeeTosavea
calculationonpage 45.)

Vmax (Doppler)

Vmax
PGmax

To measure Ao, LA, AAo, or LVOT D

VTI (Doppler)
AT (Doppler)

a. You can enter the HR measurement three ways: Patient


information form, Doppler measurement (See To
calculate Heart Rate (HR) on page 57), or M Mode
measurement (See To measure heart rate (M Mode) on
page 43).
b. Performed at 100 cm/s and 300 cm/s.
c. Specified on the cardiac patient report. See To delete a
vascular or cardiac measurement on page 69.

2 Fromthecalculationsmenu,selectthe
measurementname.
3 Positionthecalipers.(SeeWorkingwith
calipersonpage 41.)
Measurements

VTI
Vmax
PGmax
Vmean
PGmean
AT

1 Onafrozen2DimageorM Modetrace,press
theCALCSkey.

4 Savethecalculation.(SeeTosavea
calculationonpage 45.)

To calculate LV Volume (Simpsons Rule)


1 Onafrozen2Dimage,presstheCALCSkey.
2 Dothefollowingforeachmeasurement:
a Fromthecalculationsmenu,selectthe
desiredviewandphase.
b Positionthecaliperatthemitralannulus,
andpresstheSELECTkeytostartthetrace.

Chapter 4: Measurements and Calculations

53

c Usingthetouchpad,tracetheleft
ventricular(LV)cavity.
Tomakeacorrection,selectUndoonscreen
orpresstheBACKSPACEkey.

6 Savethecalculation.

d Completethetrace,andpresstheSETkey.

To measure peak velocity

e Savethecalculation.(SeeTosavea
calculationonpage 45.)

Foreachcardiacmeasurement,thesystemsaves
uptofiveindividualmeasurementsand
calculatestheiraverage.Ifyoutakemorethan
fivemeasurements,themostrecentmeasurement
replacesthefifthone.Ifyoudeleteasaved
measurementfromthepatientreport,thenext
measurementtakenreplacesthedeletedonein
thepatientreport.Themostrecentlysaved
measurementappearsatthebottomofthe
calculationsmenu.

To calculate MV or AV area
1 Onafrozen2Dimage,presstheCALCSkey.
2 Inthecalculationsmenu,locateArea,and
thenselectMVorAV.
3 Positionthecaliperwhereyouwanttobegin
thetrace,andpresstheSELECTkey.
4 Usingthetouchpad,tracethedesiredarea.
Tomakeacorrection,selectUndoonscreenor
presstheBACKSPACEkey.
5 Completethetrace,andpresstheSETkey.
6 Savethecalculation.(SeeTosavea
calculationonpage 45.)

To calculate LV Mass
1 Onafrozen2Dimage,presstheCALCSkey.
2 Inthecalculationsmenu,locateLV Mass.
3 DothefollowingforEPIandthenforEndo:
a Selectthemeasurementnamefromthe
calculationsmenu.
b Positionthecaliperwhereyouwantto
beginthetrace,andpresstheSELECTkey.
c Usingthetouchpad,tracethedesiredarea.
Tomakeacorrection,selectUndo
onscreenorpresstheBACKSPACEkey.
d Completethetrace,andpresstheSETkey.
e Savethecalculation.(SeeTosavea
calculationonpage 45.).
4 SelectApical fromthecalculationsmenu.

54

5 Positioningthecalipers,measurethe
ventricularlength.(SeeWorkingwith
calipersonpage 41.)

Exam-based calculations

1 OnafrozenDopplerspectraltrace,pressthe
CALCSkey.
2 Fromthecalculationsmenu,selectMV,TV,or
TDI,orP. Vein.
3 Dothefollowingforeachmeasurementyou
wanttotake:
a Selectthemeasurementnamefromthe
calculationsmenu.
b Positionthecalipers.(SeeWorkingwith
calipersonpage 41.)
c Savethecalculation.(SeeTosavea
calculationonpage 45.)

To calculate Velocity Time Integral (VTI)


Note: Thiscalculationcomputesotherresultsin
additiontoVTI.SeethetableCardiacCalculations
onpage 50.
1 OnafrozenDopplerspectraltrace,pressthe
CALCSkey.
2 Fromthecalculationsmenu,selectVTI under
MV,AV,TV,PV,orLVOT.
3 Positionthecaliperatthestartofthe
waveform,andpresstheSELECTkeytostart
thetrace.

4 Usingthetouchpad,tracethewaveform.
Tomakeacorrection,selectUndoonscreen,
backtrackwiththetouchpad,orpressthe
BACKSPACEkey.
5 PresstheSETkeytocompletethetrace.
6 Savethecalculation.(SeeTosavea
calculationonpage 45.)
Forinformationontheautomatictracetool,see
Totraceautomatically(Doppler)onpage 44.

To calculate Right Ventricular Systolic


Pressure (RVSP)
1 OnafrozenDopplerspectraltrace,pressthe
CALCSkey.
2 Fromthecalculationsmenu,selectTVand
thenselectTRmax.
3 Positionthecaliper.(SeeWorkingwith
calipersonpage 41.)
4 Savethecalculation.(SeeTosavea
calculationonpage 45.)
5 ToadjusttheRApressure,seeTodeletea
vascularorcardiacmeasurementonpage 69.
ChangingtheRApressurefromthedefault5
affectstheRVSPcalculationinthepatient
report.

To calculate Pressure Half Time (PHT) in MV,


AI, or TV

2 Fromthecalculationsmenu,selectMV, AV,or
TV,andthenselectPHT.
3 Positionthefirstcaliperatthepeak,andpress
theSELECTkey.
Asecondcaliperappears.
4 Positionthesecondcaliper:
InMV,positionthecaliperalongtheEF
slope.

5 Savethecalculation.(SeeTosavea
calculationonpage 45.)

To calculate Proximal Isovelocity Surface


Area (PISA)
ThePISAcalculationrequiresameasurementin
2D,ameasurementinColor,andtwo
measurementsinDopplerspectraltrace.Afterall
measurementsaresaved,theresultappearsin
thepatientreport.
1 MeasurefromAnnD(2D):
a Onafrozen2Dimage,presstheCALCSkey.
b Fromthecalculationsmenu,locatePISA,
andthenselectAnn D.
c Positionthecalipers.(SeeWorkingwith
calipersonpage 41.)
d Savethecalculation.(SeeTosavea
calculationonpage 45.)
2 MeasurefromRadius(Color):
a OnafrozenColorimage,presstheCALCS
key.
b Fromthecalculationsmenu,selectRadius.
c Positionthecalipers.
d Savethecalculation.
3 OnafrozenDopplerspectraltrace,pressthe
CALCSkey.
4 DothefollowingtomeasurefromMRVTI
andagaintomeasurefromMVVTI(Doppler):
a Fromthecalculationsmenu,selectPISA
andthenselectMR VTI orMV VTI.
b Positionthecaliperatthestartofthe
waveform,andpresstheSELECTkeyto
startthetrace.
c Usingthetouchpad,tracethewaveform.

Chapter 4: Measurements and Calculations

55

Measurements

1 OnafrozenDopplerspectraltrace,pressthe
CALCSkey.

InAV,positionthecaliperattheend
diastole.

Tomakeacorrection,selectUndo
onscreen,backtrackwiththetouchpad,or
presstheBACKSPACEkey.
d PresstheSETkeytocompletethetrace.
e Savethecalculation.

4 PresstheSELECTkey.
Asecondhorizontaldottedlinewithanactive
caliperappearsat300cm/s.
5 Positionthesecondcaliperalongthe
waveformat300cm/s.

Forinformationontheautomatictracetool,see
Totraceautomatically(Doppler)onpage 44.

6 Savethecalculation.(SeeTosavea
calculationonpage 45.)

To calculate Isovolumic Relaxation Time


(IVRT)

To calculate Aortic Valve Area (AVA)

1 OnafrozenDopplerspectraltrace,pressthe
CALCSkey.
2 Fromthecalculationsmenu,selectMVand
thenselectIVRT.
Averticalcaliperappears.
3 Usingthetouchpad,positionthecaliperatthe
aorticvalveclosure.
4 PresstheSELECTkey.
Asecondverticalcaliperappears.
5 Usingthetouchpad,positionthesecond
caliperatonsetofmitralinflow.
6 Savethecalculation.(SeeTosavea
calculationonpage 45.)

TheAVAcalculationrequiresameasurementin
2DandtwomeasurementsinDoppler.Afterthe
measurementsaresaved,theresultappearsin
thepatientreport.
1 MeasurefromLVOT(2D):
a Onafrozen2Dimage,presstheCALCSkey.
b Fromthecalculationsmenu,selectLVOT D.
c Positionthecalipers.(SeeWorkingwith
calipersonpage 41.)
d Savethecalculation.(SeeTosavea
calculationonpage 45.)
2 MeasurefromLVOT,andthenmeasurefrom
AV(Doppler):

To calculate Delta Pressure: Delta Time


(dP:dT)

ForVmax,seeTomeasurepeakvelocity
onpage 54.Fromthecalculationsmenu,
selectAV,selectsamplesite,andthen
selectVmax.

ToperformthedP:dTmeasurements,theCW
Dopplerscalemustincludevelocitiesof300 cm/s
orgreateronthenegativesideofthebaseline.
(SeeSpectraltraceoptionsonpage 29.)

ForVTI,seeTocalculateVelocityTime
Integral(VTI)onpage 54.Fromthe
calculationsmenu,selectAV,selectsample
site,andthenselectVTI.

1 OnafrozenCWDopplerspectraltrace,press
theCALCSkey.
2 Fromthecalculationsmenu,selectMV,and
thenselectdP:dT.
Ahorizontaldottedlinewithanactivecaliper
appearsat100cm/s.
3 Positionthefirstcaliperalongthewaveform
at100cm/s.

56

Exam-based calculations

To calculate Qp/Qs
TheQp/Qscalculationrequirestwo
measurementsin2Dandtwomeasurementsin
Doppler.Afterthemeasurementsaresaved,the
resultappearsinthepatientreport.
1 Onafrozen2Dimage,presstheCALCSkey.
2 DothefollowingtomeasurefromLVOTD
andagaintomeasurefromRVOT D:

a Fromthecalculationsmenu,locateQp/Qs
andthenselectLVOT D or RVOT D.

c Positionthecalipers.(SeeWorkingwith
calipersonpage 41.)

b Positionthecalipers.(SeeWorkingwith
calipersonpage 41.)

d Savethecalculation.(SeeTosavea
calculationonpage 45.)

c Savethecalculation.(SeeTosavea
calculationonpage 45.)
3 OnafrozenDopplerspectraltrace,pressthe
CALCSkey.
4 DothefollowingtomeasurefromLVOTVTI
andagaintomeasurefromRVOTVTI:
a Fromthecalculationsmenu,selectQp/Qs
andthenselectLVOT VTI or RVOT VTI.
b PresstheSELECTkeytostartthetrace.
c Usingthetouchpad,tracethewaveform.
Tomakeacorrection,selectUndo
onscreen,backtrackwiththetouchpad,or
presstheBACKSPACEkey.
d PresstheSETkeytocompletethetrace.
e Savethecalculation.(SeeTosavea
calculationonpage 45.)
Forinformationontheautomatictracetool,see
Totraceautomatically(Doppler)onpage 44.

To calculate Stroke Volume (SV) or Stroke


Index (SI)

1 (SIOnly)FillintheHeightandWeightfields
onthepatientinformationform.TheBSAis
calculatedautomatically.(SeeTocreatea
newpatientinformationformonpage 34.)
2 MeasurefromLVOT(2D):
a Onafrozen2Dimage,presstheCALCSkey.
b Fromthecalculationsmenu,selectLVOT D.

Forinformationontheautomatictracetool,see
Totraceautomatically(Doppler)onpage 44.

To calculate Heart Rate (HR)


HeartRateisavailableinallcardiacpackages.
TheHeartRateisnotcalculatedusingtheECG
trace.
Savingtheheartratetothepatientreport
overwritesanyheartrateenteredonthepatient
informationform.
1 OnafrozenDopplerspectraltrace,pressthe
CALCSkey.
2 Fromthecalculationsmenu,selectHR.
Averticalcaliperappears.
3 Usingthetouchpad,positionthefirstvertical
caliperatthepeakoftheheartbeat.
4 PresstheSELECTkey.
Asecondverticalcaliperappears.Theactive
caliperishighlightedgreen.
5 Usingthetouchpad,positionthesecond
verticalcaliperatthepeakofthenext
heartbeat.
6 Savethecalculation.(SeeTosavea
calculationonpage 45.)

To calculate Cardiac Output (CO) or Cardiac


Index (CI)
TheCOandCIcalculationsrequireStroke
VolumeandHeartRatecalculations.CIalso
requiresBodySurfaceArea(BSA).Afterthe
measurementsaresaved,theresultappearsin
thepatientreport.

Chapter 4: Measurements and Calculations

57

Measurements

TheSVandSIcalculationsrequirea
measurementin2Dandameasurementin
Doppler.SIalsorequiresBodySurfaceArea
(BSA).Afterthemeasurementsaresaved,the
resultappearsinthepatientreport.

3 Measurefromaorta(Doppler).SeeTo
calculateVelocityTimeIntegral(VTI)on
page 54.Fromthecalculationsmenu,select
AVandthenselectVTI.

1 (CIOnly)FillintheHeightandWeightfields
onthepatientinformationform.TheBSAis
calculatedautomatically.(SeeTocreatea
newpatientinformationformonpage 34.)

WARNING:

2 CalculateSV.SeeTocalculateStrokeVolume
(SV)orStrokeIndex(SI)onpage 57.

To avoid misdiagnosis or harming


the patient outcome, start a new
patient information form before
starting a new patient exam and
performing calculations. Starting a
new patient information form
clears the previous patients data.
The previous patients data will be
combined with the current patient
if the form is not first cleared. See
To create a new patient
information form on page 34.

3 CalculateHR.SeeTocalculateHeartRate
(HR)onpage 57.

To measure a Tissue Doppler Imaging (TDI)


waveform
1 EnsurethatTDIison.(SeePWDoppler
optionsonpage 29.)
2 OnafrozenDopplerspectraltrace,pressthe
CALCSkey.
3 Fromthecalculationsmenu,selectTDI,and
thendothefollowingforeachmeasurement
youwanttotake:
a Fromthecalculationsmenu,selectthe
measurementname.
b Positionthecalipers.(SeeWorkingwith
calipersonpage 41.)
c Savethecalculation.(SeeTosavea
calculationonpage 45.)

To avoid incorrect calculations,


verify that the patient information,
date, and time settings are
accurate.

Transducer

Exam Type

C60x

Gyn

ICTx

Gyn

To measure uterus or ovary


1 Onafrozen2Dimage,presstheCALCSkey.

Gynecology (Gyn) calculations


Gynecology(Gyn)calculationsincludeUterus,
Ovary,Follicle,andVolume.Forinstructionsto
calculatevolume,seeVolumecalculationson
page 48.

2 Fromthecalculationsmenu,selectGyn.
3 Dothefollowingforeachmeasurementyou
wanttotake:
a Selectthemeasurementnamefromthe
calculationsmenu.
b Positionthecalipers.(SeeWorkingwith
calipersonpage 41.)
c Savethecalculation.(SeeTosavea
calculationonpage 45.)

58

Exam-based calculations

To measure follicles

To avoid incorrect calculations,


verify that the patient information,
date, and time settings are
accurate.

Youcansaveuptosixfollicularmeasurements,
onedistancemeasurementforeachofuptosix
follicles.
1 Onafrozen2Dimage,presstheCALCSkey.

To avoid misdiagnosis or harming


the patient outcome, start a new
patient information form before
starting a new patient exam and
performing calculations. Starting a
new patient information form
clears the previous patients data.
The previous patients data will be
combined with the current patient
if the form is not first cleared. See
To create a new patient
information form on page 34.

2 Fromthecalculationsmenu,selectFollicle.
3 Dothefollowingforeachfollicleyouwantto
measure:
a Fromthecalculationsmenu,selectthe
measurementnameunderRight FolorLeft
Fol.
b Positionthecalipers.(SeeWorkingwith
calipersonpage 41.)
c Savethecalculation.(SeeTosavea
calculationonpage 45.)

IMT calculations
WARNING:

To ensure high quality images, all


patient images must be obtained
by qualified and trained individuals.
To avoid patient injury, IMT results
should not be used as a sole
diagnostic tool. All IMT results
should be interpreted in
conjunction with other clinical
information or risk factors.

Transducer

Exam Type

L38x

IMT

HFL38x

IMT

Thefollowingtableshowsavailable
measurementsforIMTcalculations.TheIMT
measurementnamesarespecifiedontheIMT
setuppage.SeeIMTCalculationssetupon
page 20.

Measurements

To avoid measurement errors, all


measurements must be of the
common carotid artery (CCA). This
tool is not intended for measuring
the bulb or the internal carotid
artery (ICA).

Chapter 4: Measurements and Calculations

59

IMT tool options


IMT Calculations (2D)
Menu Heading

Available Measurements

Right-IMT
Left-IMT

Ant N (Anterior Near Wall)


Ant F (Anterior Far Wall)
Lat N (Lateral Near Wall)
Lat F (Lateral Far Wall)
Post N (Posterior Near Wall)
Post F (Posterior Far Wall)
IMT 1
IMT 2
IMT 3
IMT 4
IMT 5
IMT 6
IMT 7
IMT 8

Plaque

Plaq 1
Plaq 2

WhenusingtheIMTtool,youcanselectthe
followingoptionsonscreen.
Option

Description

Hide

Use to check results. Hides the


measurement results and trace
line. Select Show to redisplay
them.

Move

Repositions the tool horizontally


by several pixels. The upper key
moves the tool right, and the
lower key moves the tool left.

Width

Adjusts the tool width by 1 mm.


The upper key increases the
width, and the lower key
decreases the width.

Edit

Displays Smooth, Adven, and


Lumen.

Smooth

Adjusts the IMT line smoothing.


Select Edit to display this option.

Adven

Adjusts the adventitia-media


line. The upper key moves the
line upward. The lower key
moves the line downward.
Select Edit to display this option.

Lumen

Adjusts the lumen-intima line.


The upper key moves the line
upward. The lower key moves the
line downward.
Each of the two IMT lines can be
adjusted independently.
Select Edit to display this option.

To calculate IMT automatically


1 Onafrozen2Dimage,presstheCALCSkey.
2 Fromthecalculationsmenu,selectthe
measurement.
3 Usingthetouchpadorarrowkeys,position
theIMTtoolovertheareaofinterestuntilthe
measurementresultsappear.
4 Adjustthetool,andeditasneeded.SeeIMT
tooloptionsonpage 60.
5 Savethecalculation.(SeeTosavea
calculationonpage 45.)

60

Exam-based calculations

To trace IMT manually


InmanuallytracingIMT,theuserdefinesthe
location.
1 Onafrozen2Dimage,presstheCALCSkey
2 Fromthecalculationsmenu,selecta
measurementname.
3 SelectEditonscreen,andthenselectManual,
andthenselectSketch.
Asinglecaliperappears,andTraceappears
nexttothemeasurement.
4 Dothefollowingforthedesired
adventitiamediaboundaryandthenforthe
lumenintimaboundary:
a Positionthecaliperatthebeginningofthe
boundary,andpresstheSELECTkey.
b Usingthetouchpad,markpointsby
movingthecalipertothenextdesired
pointandpressingtheSELECTkey.
Tomakeacorrection,selectUndo
onscreenorpresstheBACKSPACEkeyto
deletethelastsegment.
c PresstheSETkeytocompletethetraceline.
5 Savethecalculation.(SeeTosavea
calculationonpage 45.)

To sketch IMT
TheIMTsketchmeasurementinvolvestwo
userdefinedsketchlinesthatyoucanadjust
manually.

2 Fromthecalculationsmenu,selecta
measurementname.
3 SelectEditonscreen,andthenselectManual.

b Usingthetouchpad,markpointsby
movingthecalipertothenextdesired
pointandpressingtheSELECTkey.
Tomakeacorrection,selectUndo
onscreenorpresstheBACKSPACEkeyto
deletethelastsegment.
c PresstheSETkeytocompletethetraceline.
d Ifnecessary,adjustoreditthe
measurement.SeeIMTtooloptionson
page 60.
e Savethecalculation.(SeeTosavea
calculationonpage 45.)

OB calculations
EFWiscalculatedonlyafterappropriate
measurementsarecompleted.Ifanyoneofthese
parametersresultsinanEDDgreaterthanwhat
theOBcalculationtablesprovide,theEFWisnot
displayed.
WARNING:

Make sure that you have selected


the OB exam type and the OB
author for the OB calculation table
you intend to use. See Results from
System-Defined OB Measurements
and Table Authors on page 62.
To avoid incorrect obstetrics
calculations, verify with a local
clock and calendar that the systems
date and time settings are correct
before each use of the system. The
system does not automatically
adjust for daylight savings time
changes.

Asinglecaliperappearsonscreen,andSketch
appearsnexttothemeasurement.
4 Dothefollowingforthedesired
adventitiamediaboundaryandthenforthe
lumenintimaboundary:

Chapter 4: Measurements and Calculations

61

Measurements

1 Onafrozen2Dimage,presstheCALCSkey

a Positionthecaliperatthebeginningofthe
boundaryandpresstheSELECTkey.

To avoid misdiagnosis or harming


the patient outcome, start a new
patient information form before
starting a new patient exam and
performing calculations. Starting a
new patient information form
clears the previous patients data.
The previous patients data will be
combined with the current patient
if the form is not first cleared. See
To create a new patient
information form on page 34.
Prior to use, verify that OB custom
table data entries are correct. The
system does not confirm the
accuracy of the custom table data
entered by the user.
Transducer

Exam Type

C60x

OB

ICTx

OB

P21x

OB

Ifyouchangethecalculationauthorduringthe
exam,thecommonmeasurementsareretained.
Thefollowingtableshowsthesystemdefined
measurementsavailableforOBcalculationsby
author.Fordefinitionoftheacronyms,see
Glossaryonpage 157.Toselectauthors,see
OBCalculationssetuponpage 20.

Results from System-Defined OB Measurements


and Table Authors
Calculation
Result

Gestational OB
Measurements

Table
Authors

Gestational
Agea

YS

GS

Hansmann,
Nyberg,
Tokyo U.

CRL

Hadlock,
Hansmann,
Osaka,
Tokyo U.

BPD

Chitty,
Hadlock,
Hansmann,
Osaka,
Tokyo U.

OFD

Hansmann

HC

Chitty,
Hadlock,
Hansmann

TTD

Hansmann,
Tokyo U.b

APTD

Tokyo U.b

AC

Hadlock,
Hansmann,
Tokyo U.

FTA

Osaka

FL

Chitty,
Hadlock,
Hansmann,
Osaka,
Tokyo U.

CX L

SeealsoOBCustomMeasurementssetupon
page 21andOBCustomTablessetupon
page 22.

62

Exam-based calculations

Calculation
Result

Gestational OB
Measurements

Table
Authors

Estimated Fetal
Weight (EFW)c

HC, AC, FL

Hadlock 1

BPD, AC, FL

Hadlock 2

AC, FL

Hadlock 3

BPD, TTD

Hansmann

BPD, FTA, FL

Osaka U.

BPD, AC

Shepard

BPD, TTD, APTD, FL

Tokyo U.

HC/AC

Campbell

FL/AC

Hadlock

FL/BPD

Hohler

FL/HC

Hadlock

page, determines the measurements you must perform to


obtain an EFW calculation. (See OB Calculations setup on
page 20.)
Individual selections for Hadlocks EFW equations 1, 2, and 3
are not determined by the user. The selected equation is
determined by the measurements that have been saved to
the patient report with priority given to the order listed
above.
d. The Growth Analysis tables are used by the Report Graphs
feature. Three growth curves are drawn using the table data
for the selected growth parameter and published author.
Growth tables are only available with a user-entered LMP or
Estab. DD.

To measure gestational growth (2D)


Ratios

Amniotic Fluid
Index

Q ,Q ,Q ,Q

Jeng

Growth Analysis
Tablesd

BPD

Chitty,
Hadlock,
Jeanty

Chitty,
Hadlock,
Jeanty

AC

Chitty,
Hadlock,
Jeanty

FL

Chitty,
Hadlock,
Jeanty

EFW

Hadlock,
Jeanty

HC/AC

Campbell

a. The Gestational Age is automatically calculated and displayed


next to the OB measurement you selected. The average of the
results is the AUA.
b. For Tokyo U., APTD and TTD are used only to calculate EFW. No
age or growth tables are associated with these
measurements.
c. The Estimated Fetal Weight calculation uses an equation that
consists of one or more fetal biometry measurements. The
author for the OB tables, which you choose on a system setup

1 Inthepatientinformationform,selectOB
examtype,andselectLMPorEstab.DD.Select
Twinsifappropriate.
2 Onafrozen2Dimage,presstheCALCSkey.
3 Dothefollowingforeachmeasurementyou
wanttotake:
a Fromthecalculationsmenu,selectthe
measurementname.Fortwins,select
Twin AorTwin B,andthenselectthe
measurementname.
Thecalipertoolmaychangedependingon
themeasurementselected,buttheposition
remainsconstant.
b Positionthecalipers.(SeeWorkingwith
calipersonpage 41.)
c Savethecalculation.(SeeTosavea
calculationonpage 45.)

To measure fetal heart rate (M Mode)


1 OnafrozenM Modetrace,presstheCALCS
key.
2 SelectFHRfromthecalculationsmenu.
Averticalcaliperappears.

Chapter 4: Measurements and Calculations

63

Measurements

HC

Foreach2DOBmeasurement(exceptAFI),the
systemsavesuptothreeindividual
measurementsandtheiraverage.Ifyoutake
morethanthreemeasurements,theearliest
measurementisdeleted.

CerebralArtery)orUmbA(Umbilical
Artery).

3 Usingthetouchpad,positionthevertical
caliperatthepeakoftheheartbeat.

b Positionthecalipers:

4 PresstheSELECTkey.

ForS/D, RI,positionthefirstcaliperat
thepeaksystolicwaveform.Pressthe
SELECTkey,andpositionthesecond
caliperattheenddiastoleonthe
waveform.

Asecondverticalcaliperappears.
5 Usingthetouchpad,positionthesecond
verticalcaliperatthepeakofthenext
heartbeat.
6 Savethecalculation.(SeeTosavea
calculationonpage 45.)

ForS/D, RI, PI,positionthecaliperat


thebeginningofthedesiredwaveform,
andpresstheSELECTkey.Usethe
touchpadtomanuallytracethedesired
area.PresstheSETkey.
Ifcalipersarenotpositionedcorrectly,
thecalculationresultisinaccurate.

OB Doppler Calculations
Menu
Heading

OB
Calculation

MCA (Middle
Cerebral
Artery)

S/D, RI

SD
RI

S/D, RI, PI*

SD
RI
PI

S/D, RI

SD
RI

S/D, RI, PI*

SD
RI
PI

Umb A
(Umbilical
Artery)

Results

c Savethecalculation.(SeeTosavea
calculationonpage 45.)
Onlyonecalculation(S/D, RIorS/D, RI, PI)
canbesaved.

Small Parts calculations


SmallPartscalculationsincludevolume,hip
angle,andd:Dratio.Forinstructionstocalculate
volume,seeVolumecalculationsonpage 48.
Transducer

Exam Type

HFL38x

Small Parts

L38x

Small Parts

*Calculation requires a trace measurement.

To calculate MCA or Umba (Doppler)


Note: ThesystemdoesnotprovideanMCA/UmbA
ratiofromthePI(PulsatilityIndex).

To calculate hip angle

1 Select OBexamtype,andselectLMPor
Estab.DDinthepatientinformationform.

2 Fromthecalculationsmenu,selectRightor
Left.

2 OnafrozenDopplerspectraltrace,pressthe
CALCSkey.

3 SelectBaselineunderHip Angle.

3 Dothefollowingforeachmeasurementyou
needtotake:
a Fromthecalculationsmenu,selectthe
measurementnameunderMCA(Middle

64

Exam-based calculations

1 Onafrozen2Dimage,presstheCALCSkey.

Abaselineappearsonscreen.
4 Positionthebaseline,andpresstheSETkey.
(SeeWorkingwithcalipersonpage 41.)
LineA(alphaline)appearsonscreen,and
Line Aisselectedinthecalculationsmenu.

5 PositionLineA,andsavethemeasurement.
(SeeTosaveacalculationonpage 45.)
LineB(betaline)appearsonscreen,andLine
Bisselectedinthecalculationsmenu.

Transcranial Doppler and Orbital


calculations
WARNING:

6 PositionLineB,andsavethemeasurement.

To calculate d:D ratio

To avoid injury to the patient, use


only an Orbital (Orb) exam type
when performing imaging through
the eye.
Verify that the patient information,
date, and time settings are
accurate.

1 Onafrozen2Dimage,presstheCALCSkey.
2 Fromthecalculationsmenu,selectRightor
Left.

To avoid carrying over


measurements from the previous
patient, start a new patient
information form for each new
patient before you perform
calculations on the new patient.
See To create a new patient
information form on page 34.

3 Underd:D Ratio,selectFem Hd(femoral


head).
4 Usingthetouchpad,positionandresizethe
circle.TheSELECTkeytogglesbetween
positionandsize.
5 PresstheSETkey.
Thebaselineautomaticallyappearswiththe
leftcaliperactive.
6 Positionthecaliper.(SeeWorkingwith
calipersonpage 41.)
7 Savethemeasurement.(SeeTosavea
calculationonpage 45.)

Transducer

Exam Types

P21x

Transcranial (TCD), Orbital


(Orb)

Thefollowingtableshowsthemeasurements
requiredtocompleteTranscranialDoppler(TCD)
andOrbital(Orb)calculations.Fordefinitionsof
acronyms,seeGlossaryonpage 157.

Measurements

Chapter 4: Measurements and Calculations

65

Transcranial and Orbital Calculations


Transcranial and Orbital Calculations
Menu Heading
TT
MCA

TCD and Orb


Measurements

Dist
Mid
Prox
Bifur*
ACA
ACoA*
TICA

TT

PCAp1
PCAp2
PCoA

TO

OA
Siphon

SM

ECICA

Menu Heading

TCD and Orb


Measurements

FM

VA

Results
TAP
PSV
EDV
PI
RI
S/D
Gate Size

TAP
PSV
EDV
PI
RI
S/D
Gate Size
TAP
PSV
EDV
PI
RI
S/D
Gate Size

FM
BA

AL

Prox
Mid
Dist

ECVA

Results
TAP
PSV
EDV
PI
RI
S/D
Gate Size
TAP
PSV
EDV
PI
RI
S/D
Gate Size

*Available but not required

WARNING:

To avoid injury to the patient, use


only an Orbital (Orb) or
Ophthalmic (Oph) when
performing imaging through the
eye. The FDA has established
lower acoustic energy limits for
opthalmic use. The system will not
exceed these limits only if the
Orbital or Ophthalmic exam type
is selected.

To perform a Transcranial Doppler or Orbital


calculation
1 Selectthecorrectexamtype:
Orbital (Orb)tomeasureOpthalmicArtery
andSiphon
Transcranial (TCD)forothermeasurements
SeeTochangetheexamtypeonpage 31.

66

Exam-based calculations

2 OnafrozenDopplerspectraltrace,pressthe
CALCSkey.
3 Fromthecalculationsmenu,selectLeftor
Right.

Vascular calculations
WARNING:

4 Dothefollowingforeachmeasurementyou
wanttotake:
a Fromthecalculationsmenu,selectthe
measurement.(Youmayneedtoselect
NextorPrevtolocatethemeasurement.)
b Dooneofthefollowing:
Foramanualtracemeasurement,usethe
touchpadtopositionthecaliper.Pressthe
SELECTkey.Usethetouchpadtotracethe
waveform.

To avoid incorrect calculations,


verify that the patient information,
date, and time settings are
accurate.

Ifyouneedtomakeacorrection,select
UndoonscreenorpresstheBACKSPACE
key.
Foranautotracemeasurement,select
Autoonscreen,andusethetouchpadto
positionthefirstcaliperatthebeginning
ofthewaveform.PresstheSELECTkey,and
positionthesecondcaliperattheendof
thewaveform.
Confirmthatthesystemgenerated
boundaryiscorrect.Ifyouarenotsatisfied
withthetrace,obtainahigherquality
Dopplerspectraltraceimage,ortrace
manually.
c PresstheSETkey.

Transducer

Exam Type

C11x

Vascular

HFL38x

Vascular

L25x

Vascular

L38x

Vascular

SLAx

Vascular

Thevascularmeasurementsthatyoucansaveto
thepatientreportarelistedinthefollowingtable.
Fordefinitionsofacronyms,seeGlossaryon
page 157

Chapter 4: Measurements and Calculations

67

Measurements

d Savethecalculation.(SeeTosavea
calculationonpage 45.)

To avoid misdiagnosis or harming


the patient outcome, start a new
patient information form before
starting a new patient exam and
performing calculations. Starting a
new patient information form
clears the previous patients data.
The previous patients data will be
combined with the current patient
if the form is not first cleared. See
To create a new patient
information form on page 34.

3 Dothefollowingforeachmeasurementyou
wanttotake:

Vascular Calculations

a Fromthecalculationsmenu,selectthe
measurementname.

Menu
Heading

Vascular
Measurement

Calculation
Results

CCA

Prox

s (systolic),
d (diastolic)

Mid

s (systolic),
d (diastolic)

Dist

s (systolic),
d (diastolic)

d Usingthetouchpad,positionthesecond
caliperattheenddiastoleonthe
waveform.

Bulb

s (systolic),
d (diastolic)

e Savethecalculation.(SeeTosavea
calculationonpage 45.)

Prox

s (systolic),
d (diastolic)

ICA

ECA

Mid

s (systolic),
d (diastolic)

Dist

s (systolic),
d (diastolic)

Prox

s (systolic),
d (diastolic)

Mid

s (systolic),
d (diastolic)

Dist

s (systolic),
d (diastolic)

VArty

s (systolic),
d (diastolic)

b Usingthetouchpad,positionthecaliperat
thepeaksystolicwaveform.
c PresstheSELECTkey.
Asecondcaliperappears.

Patient report
Thepatientreportcontainscalculationresults
andpatientinformation.ForCardiac,OB,
Transcranial,andVascularexams,thepatient
reporthasadditionaldetailsandfeatures.
Youcandisplaythepatientreportatanytime
duringtheexam.
Thevalueforacalculationappearsonlyifthe
calculationisperformed.Thepoundsymbol(###)
indicatesavaluethatisoutofrange(forexample,
toolargeorsmall).Calculationvaluesthatareout
ofrangearenotincludedinderivedcalculations
(forexample,mean).

To display a patient report


1 PresstheREPORTkey.

To perform a Vascular calculation


Afteryouperformvascularmeasurements,
valuesintheICA/CCAratiosareselectableonthe
vascularpageofthepatientreport.
1 OnafrozenDopplerspectraltrace,pressthe
CALCSkey.
2 Fromthecalculationsmenu,selectLeftor
Right.

68

Patient report

2 Doanyofthefollowing:
Todisplayadditionalpages,select
onscreen.

1/x

(Cardiac,Vascular,orTCD)SelectDetails
orSummaryonscreen.Themeanofthe
detailentriesisusedinthesummary.
3 (Optional)PresstheSAVEkeytosavethe
currentpageofthepatientreport.

Toexitthepatientreportandreturntoimaging,
selectDone.

To send a patient report to a PC


YoucansendapatientreporttoaPCasatextfile.
1 Ensurecorrectconfiguration.SeeTo
configurethesystemforaDVDrecorder,PC,
orserialbarcodescanneronpage 19.
Makesuretousetheconnectioncable
suppliedbySonoSite.Otherconnectioncables
maycauseaudiointerference,includingan
inaudibleDopplersignal.
2 SelectSend Rep.onscreen.

To delete a row of TCD measurements


1 OntheDetailspageoftheTCDpatientreport,
selecttherowsTAPmeasurementusingthe
touchpad.(Theselectedmeasurementis
green.)
2 SelectDeleteonscreen.
Deletedmeasurementsarenotincludedinthe
summaryinformation.

OB patient report
TheOBpatientreportpageshaveaspacefor
signingprintedreports.

To display the OB Twins patient report

Vascular and cardiac patient reports


To delete a vascular or cardiac measurement
1 OntheDetailspageofthepatientreport,
selectthemeasurementbyusingthe
touchpad.(Theselectedmeasurementis
green.)
2 SelectDeleteonscreen.
Deletingsomemeasurementsalsodeletes
relatedmeasurements.Deleted
measurementsarenotincludedinthe
summaryinformation.

(Vascular) To modify the ICA/CCA ratio


IntheRatiolistinthevascularpatientreport,

selectmeasurementsfortheICA/CCAratio
forboththerightandleftsides.

OntheOBpatientreport,selectoneofthe

followingonscreen:
Twin A/Bforindividualtwinpatient
reports
Compareforbothtwinsinonepatient
report

To delete an OB measurement
1 OntheOBpatientreport,selecttheOB
measurementbyusingthetouchpad.
Theselectedmeasurementisgreen.
2 SelectDeleteonscreen.
Todeleteallmeasurements,selectthe
measurementlabelandpresstheSELECTkey
andthenselectDeleteonscreen.
Measurements

(Cardiac) To adjust the RA pressure


OntheSummarypageofthecardiacpatient

report,selectfromtheRAlist.
ChangingtheRApressurefromthedefault5
affectstheRVSPcalculationresult.

TCD patient report


ThemaximumvaluesfortheTAPcalculation
appearonthesummarypage.

Chapter 4: Measurements and Calculations

69

measurement/authororselect
onscreen.

1/x

Fortwins,bothmeasurementsetsareplotted
onthesamegraph.
3 (Optional)PresstheSAVEkeytosavethe
currentgraphpage.
4 Selectoneofthefollowingonscreen:
Reporttoreturntothepreviouspatient
reportpage
Donetoreturntoliveimaging.
Figure 3 OB Anatomy Checklist Page

EMED worksheets

To fill out the OB anatomy checklist

EMEDworksheetscontainresultsfromEMED
calculationsandcheckliststhatyoucancomplete.

Youcandocumentreviewedanatomy.
OntheAnatomy ChecklistpageintheOB

patientreport,selectthecheckboxes.
PresstheTABkeytomovebetweenfieldsand
theSPACEBARtoselectanddeselectitemsin
thechecklist.

To complete the OB biophysical profile


Onpage2oftheOBpatientreport,select

valuesunderBPP.
Thetotaliscalculatedwhenvaluesare
selected.NST(nonstresstest)isoptional.

To display OB graphs
YoucandisplayOBgraphsiftheLMPorEstab.
DDfieldsarecompleteinthepatientinformation
form.
1 OntheOBpatientreport,selectGraphs
onscreen.
2 IntheGraphslist,selectthedesired
measurement/author.
Thegraphfortheselectedmeasurement
appears.Youcanselectanother

70

Patient report

To display an EMED worksheet


Thisfeatureisoptional.
1 Afterorduringtheexam,presstheREPORT
key.
2 SelectEMEDonscreen.
3 SelecttheworksheetfromtheWorksheetlist
orbyselecting

x/xonscreen.

Chapter 5: Troubleshooting and Maintenance


Thischaptercontainsinformationtohelpcorrect
problemswithsystemoperation,toentera
softwarelicense,andtotakepropercareofthe
system,transducer,andaccessories.

EnsurethattheDVDrecorderisturnedonand
setupproperly.SeetheapplicableSonoSite
accessoryuserguideandthemanufacturers
instructions.
Externalmonitordoesnotwork.

Troubleshooting
Ifyouencounterdifficultywiththesystem,use
thefollowinglisttohelptroubleshootthe
problem.Iftheproblempersists,contactSonoSite
TechnicalSupport.(SeeSonoSiteTechnical
Supportonpage vii.)
System does not turn on.Checkallpower
connections.
RemovetheDCinputconnectorandbattery,wait
10seconds,andthenreinstallthem.
Ensurethatthebatteryischarged.
System image quality is poor.Adjustthedisplay
toimproveviewingangle.
Adjustthebrightness.
Adjustthegain.
No CPD image.Adjustthegain.
No Color image.AdjustthegainorthePRFscale.
NoOBmeasurementselections.
SelecttheOBexamtype.
Print does not work.Selecttheprinteronthe
Connectivitysetuppage.SeeToconfigurethe
systemforaprinteronpage 19.
Checktheprinterconnections.

DVD recorder does not record.ChecktheDVD


recorderconnections.

Checkthemonitortoensurethatitisturnedon
andsetupproperly.Seethemonitor
manufacturersinstructions,ifnecessary.
System does not recognize the transducer.
Disconnectandreconnectthetransducer.
A maintenance icon
appears on the system
screen.Systemmaintenancemayberequired.
RecordthenumberinparenthesesontheC:line
andcontactSonoSiteoryourSonoSite
representative.

Software licensing
SonoSitesoftwareiscontrolledbyalicensekey.
Afteryouinstallnewsoftware,thesystem
promptsyouforalicensekey.Youmustobtain
onekeyforeachsystemortransducerthatuses
thesoftware.
Thesoftwarewilloperateforashorttime(the
graceperiod)withoutalicensekey.Duringthe
graceperiod,allsystemfunctionsareavailable.
Afterthegraceperiod,thesystemisnotusable
untilyouenteravalidlicensekey.Graceperiod
timeisnotusedwhilethesystemisofforasleep.
Graceperiodtimeremainingappearsonthe
licenseupdatescreen.
Caution:

Troubleshooting

Ensurethattheprinteristurnedonandsetup
properly.Seetheprintermanufacturers
instructions,ifnecessary.

Checkthemonitorconnections.

After the grace period expires, all


system functions except licensing
are unavailable until a valid license
key is entered.

Chapter 5: Troubleshooting and Maintenance

71

Toobtainalicensekeyforyoursoftware,contact
SonoSiteTechnicalSupport.(SeeSonoSite
TechnicalSupportonpage vii.)Youneedto
providethefollowinginformation.(SeeSystem
Informationsetuponpage 23.)
System Software

Transducer Software

Name of person
installing the
upgrade

Name of person installing


the upgrade

Serial number (on


bottom of system)

Transducer serial number

ARM version

Transducer part number


(REF)
or model number (for
example, C60x)

PCBA serial
number

To enter a license key


1 Turnonthesystem.
Thelicenseupdatescreenappears.
2 EnterthelicensekeyintheEnter license
numberfield.
3 SelectDoneonscreen.
Ifyouenteredavalidlicensekeybutthe
licenseupdatescreenappears,verifythatyou
enteredthelicensekeycorrectly.Ifthelicense
updatescreenstillappears,contactSonoSite
TechnicalSupport.(SeeSonoSiteTechnical
Supportonpage vii.)

Maintenance
Usetherecommendationsinthissectionwhen
cleaningordisinfectingyourultrasoundsystem,
transducer,andaccessories.Usethecleaning

Maintenance

Noperiodicorpreventivemaintenanceis
requiredforthesystem,transducer,or
accessoriesotherthancleaninganddisinfecting
thetransduceraftereveryuse.(SeeCleaning
anddisinfectingtransducersonpage 74.)There
arenointernalcomponentsthatrequireperiodic
testingorcalibration.Allmaintenance
requirementsaredescribedinthischapterandin
theultrasoundsystemservicemanual.
Performingmaintenanceproceduresnot
describedintheuserguideorservicemanual
mayvoidtheproductwarranty.
ContactSonoSiteTechnicalSupportforany
maintenancequestions.(SeeSonoSiteTechnical
Supportonpage vii.)

Transducer bundle version

Afteryouobtainalicensekey,youmustenterit
intothesystem.

72

recommendationsintheperipheral
manufacturersinstructionswhencleaningor
disinfectingyourperipherals.

WARNING:

Disinfectants and cleaning methods


listed are recommended by
SonoSite for compatibility with
product materials, not for biological
effectiveness. Refer to the
disinfectant label instructions for
guidance on disinfection efficacy
and appropriate clinical uses.
The level of disinfection required for
a device is dictated by the type of
tissue it contacts during use. To
avoid infection, ensure that the
disinfectant type and the solution
strength and duration are
appropriate for the equipment. For
information, see the disinfectant
label instructions and the
recommendations of the
Association for Professionals in
Infection Control and Epidemiology
(APIC) and the FDA.

WARNING:

Caution:

To prevent contamination, the use


of sterile transducer sheaths and
sterile coupling gel is
recommended for clinical
applications of an invasive or
surgical nature. Do not apply the
transducer sheath and gel until you
are ready to perform the procedure.

Some transducer sheaths contain


natural rubber latex and talc, which
can cause allergic reactions in some
individuals. Refer to 21 CFR 801.437,
User labeling for devices that
contain natural rubber.

Cleaning and disinfecting the


ultrasound system
Theexteriorsurfaceoftheultrasoundsystemand
theaccessoriescanbecleanedanddisinfected
usingarecommendedcleanerordisinfectant.See
Recommendeddisinfectantsonpage 77.

WARNING:

To avoid electrical shock, before


cleaning, disconnect the system
from the power supply or remove
from the mini-dock or docking
system.
To avoid infection always use
protective eyewear and gloves
when performing cleaning and
disinfecting procedures.

Do not spray cleaners or


disinfectant directly on the system
surfaces. Doing so may cause
solution to leak into the system,
damaging the system and voiding
the warranty.
Do not use strong solvents such as
thinner or benzene, or abrasive
cleansers, since these will damage
the exterior surfaces.
Use only recommended cleaners or
disinfectants on system surfaces.
Immersion-type disinfectants are
not approved for use on system
surfaces.
When you clean the system, ensure
that the solution does not get
inside the system controls or the
battery compartment.
Do not scratch the LCD screen.

To clean the LCD screen


Dampenaclean,nonabrasive,cottoncloth

withanethanolicbasedcleaner,andwipethe
screenclean.
Applythecleanertotheclothratherthanthe
surfaceofthescreen.

To clean and disinfect system surfaces


1 Turnoffthesystem.
2 Disconnectthesystemfromthepowersupply,
orremoveitfromtheminidockordocking
system.
3 Cleantheexteriorsurfacesusingasoftcloth
lightlydampenedinamildsoapordetergent
cleaningsolutiontoremoveanyparticulate
matterorbodyfluids.
Applythesolutiontotheclothratherthanthe
surface.
4 Mixthedisinfectantsolutioncompatiblewith
thesystem,followingdisinfectantlabel

Chapter 5: Troubleshooting and Maintenance

73

Troubleshooting

To avoid infection, ensure that the


solution expiration date has not
passed.

Caution:

instructionsforsolutionstrengthsand
disinfectantcontactduration.
5 Wipesurfaceswiththedisinfectantsolution.
6 Airdryortoweldrywithacleancloth.

Cleaning and disinfecting transducers


Todisinfectthetransduceranditscable,usethe
immersionmethodorthewipemethod.
Immersibletransducerscanbedisinfectedonlyif
theproductlabelingindicatestheycanbeused
withanimmersionmethod.
SeeTable 1,DisinfectantCompatibilitywith
SystemandTransducersonpage 77.
WARNING:

To avoid electrical shock, before


cleaning, disconnect the transducer
from the system.
To avoid injury, always use
protective eyewear and gloves
when performing cleaning and
disinfecting procedures.
To avoid infection, ensure that the
solution expiration date has not
passed.

Using a non-recommended
cleaning or disinfection solution,
incorrect solution strength, or
immersing a transducer deeper or
for a longer period of time than
recommended can damage or
discolor the transducer and void the
transducer warranty.
Do not allow cleaning solution or
disinfectant into the transducer
connector.
Do not allow disinfectant to contact
metal surfaces. Use a soft cloth
lightly dampened in a mild soap or
compatible cleaning solution to
remove any disinfectant that
remains on metal surfaces.
Attempting to disinfect a
transducer or transducer cable
using a method other than the one
included here can damage the
transducer and void the warranty.

To clean and disinfect a transducer (wipe


method)
1 Disconnectthetransducerfromthesystem.

Caution:

Transducers must be cleaned after


every use. Cleaning transducers is
necessary prior to effective
disinfection. Ensure that you follow
the manufacturer's instructions
when using disinfectants.
Do not use a surgeon's brush when
cleaning transducers. Even the use
of soft brushes can damage a
transducer. Use a soft cloth.

2 Removeanytransducersheath.
3 Cleanthesurfaceusingasoftclothlightly
dampenedinamildsoapordetergent
cleaningsolutiontoremoveanyparticulate
matterorbodyfluids.
Applythesolutiontotheclothratherthanthe
surface.
4 Rinsewithwaterorwipewith
waterdampenedcloth;thenwipewithadry
cloth.
5 Mixthedisinfectantsolutioncompatiblewith
thetransducer,followingdisinfectantlabel
instructionsforsolutionstrengthsand
disinfectantcontactduration.
6 Wipesurfaceswiththedisinfectantsolution.

74

Maintenance

7 Airdry.
8 Examinethetransducerandcablefordamage
suchascracks,splitting,orfluidleaks.

Cleaning and disinfecting the battery


Caution:

Ifdamageisevident,discontinueuseofthe
transducer,andcontactSonoSiteoryourlocal
representative.

To clean and disinfect a transducer


(immersion method)
1 Disconnectthetransducerfromthesystem.
2 Removeanytransducersheath.
3 Cleanthesurfaceusingasoftclothlightly
dampenedinamildsoaporcompatible
cleaningsolutiontoremoveanyparticulate
matterorbodyfluids.
Applythesolutiontotheclothratherthanthe
surface.
4 Rinsewithwaterorwipewith
waterdampenedcloth,andthenwipewitha
drycloth.
5 Mixthedisinfectantsolutioncompatiblewith
thetransducer,followingdisinfectantlabel
instructionsforsolutionstrengthsand
disinfectantcontactduration.
6 Immersethetransducerintothedisinfection
solutionnotmorethan1218 inches
(3146 cm)fromthepointwherethecable
enterstheconnector.
Followtheinstructionsonthedisinfectant
labelforthedurationofthetransducer
immersion.

8 Examinethetransducerandcablefordamage
suchascracks,splitting,orfluidleaks.

To clean and disinfect a battery (wipe


method)
1 Removethebatteryfromthesystem.
2 Cleanthesurfaceusingasoftclothlightly
dampenedinamildsoapordetergent
cleaningsolution.
Applythesolutiontotheclothratherthanthe
surface.
3 Wipethesurfaceswiththedisinfection
solution.SaniClothHB,SaniClothWipes,or
70%isopropylalcoholisrecommended.
4 Airdr.

Cleaning the footswitch


Caution:

To avoid damaging the footswitch,


do not sterilize. It is not intended for
use in a sterile environment.

To clean the footswitch


1 Dampenanonabrasiveclothwithoneofthe
followingproducts:
Isopropylalcohol
Soapandwater
Cidex
SodiumHypochlorite5.25%(Bleach)
diluted10:1
Troubleshooting

7 Usingtheinstructionsonthedisinfectant
label,rinsetothepointoftheprevious
immersion,andthenairdryortoweldrywith
acleancloth.

To avoid damaging the battery, do


not allow cleaning solution or
disinfectant to come in contact
with the battery terminals.

2 Wringoutclothuntilslightlywetandthen
gentlyrubsoiledareauntilclean.

Ifdamageisevident,discontinueuseofthe
transducer,andcontactSonoSiteoryourlocal
representative.

Chapter 5: Troubleshooting and Maintenance

75

Cleaning and disinfecting ECG cables


Caution:

To avoid damaging the ECG cable,


do not sterilize.

To clean and disinfect the ECG cable (wipe


method)
1 Removethecablefromthesystem.
2 Cleanthesurfaceusingasoftclothlightly
dampenedinamildsoapordetergent
cleaningsolution.
Applythesolutiontotheclothratherthanthe
surface.
3 Wipethesurfaceswithanyofthefollowing
products:
Bleach(sodiumhypochlorite)
Cidexdisinfectants
Greensoap
4 Airdryortoweldrywithacleancloth.

76

Maintenance

Recommended disinfectants
Table 1 does not have the following regulatory information for disinfectants:
EPA Registration
FDA 510(k) clearance (liquid sterilant, high level disinfectant)
CE approval
Before using a disinfectant, confirm that its regulatory status is appropriate for your jurisdiction and use. Verify
expiration dates on chemicals.
When disposing of chemicals, follow manufacturer recommendations and EPA regulations.
Seewww.sonosite.comforupdatedcleaninganddisinfectantinformation.

Table 1: Disinfectant Compatibility with System and Transducers

Chapter 5: Troubleshooting and Maintenance

Disinfection and
Cleaning Solutions

Country
of Origin

Type

Active Ingredient

C60x
ICTx
L38x
P10x
P21x
SLAx

AbcoCide 14

USA

Liquid

Gluteraldehyde

Accel Plus

CAN

Wipe

Accel TB

CAN

Accel Wipes

C11x/
L25x

System
Surfaces

Hydrogen Peroxide

Wipe

Hydrogen Peroxide

CAN

Wipe

Hydrogen Peroxide

Aidal Plus

AUS

Liquid

Gluteraldehyde

Alkacide

FRA

Liquid

Gluteraldehyde

Alkazyme

FRA

Liquid

Quat. Ammonia

Anioxyde 1000

FRA

Liquid

Peracetic Acid

Aquatabs (1000)

IRL

Tablet

Sodium
Dichloroisocyanurate

77

HFL38x

D2x

Troubleshooting

78

Table 1: Disinfectant Compatibility with System and Transducers (continued)


C60x
ICTx
L38x
P10x
P21x
SLAx

D2x

HFL38x

C11x/
L25x

System
Surfaces

Disinfection and
Cleaning Solutions

Country
of Origin

Type

Active Ingredient

Aquatabs (2000)

IRL

Tablet

Sodium
Dichloroisocyanurate

Aquatabs (5000)

IRL

Tablet

Sodium
Dichloroisocyanurate

Ascend

USA

Liquid

Quat Ammonia

Asepti-HB

USA

Liquid

Quat Ammonia

Asepti-Steryl

USA

Spray

Ethanol

Asepti-Wipes

USA

Wipe

Propanol (Isopropyl
Alcohol

Bacillocid rasant

DEU

Liquid

Glut./Quat. Ammonia

Bacoban

DEU

Liquid

Ethanol Isopropanol

Bacoban WB

DEU

Liquid

Benzalkoniumchloride
Diethylenglycol

Banicide

USA

Liquid

Gluteraldehyde

Betadine

USA

Liquid

Providone-Iodine

Bleach

USA

Liquid

NaCl Hypochlorite

Cavicide

USA

Liquid

Isopropyl

Caviwipes

USA

Wipes

Isopropanol

Chlor-Clean

GBR

Liquid

Sodium
Dichloroisocyanurate

Table 1: Disinfectant Compatibility with System and Transducers (continued)


C60x
ICTx
L38x
P10x
P21x
SLAx

D2x

HFL38x

C11x/
L25x

System
Surfaces

Chapter 5: Troubleshooting and Maintenance

Disinfection and
Cleaning Solutions

Country
of Origin

Type

Active Ingredient

Cidalkan

FRA

Liquid

Alkylamine, isopropanol

Cidalkan Lingettes

FRA

Wipes

Ethyl Alcohol

Cidex

USA

Liquid

Gluteraldehyde

Cidex OPA

USA

Liquid

Ortho-phthaldehyde

Cidex Plus

USA

Liquid

Gluteraldehyde

Cleanisept

DEU

Wipes

Quat. Ammonia

Clorox Wipes

USA

Wipes

Isopropanol

Control III

USA

Liquid

Quat. Ammonia

Coverage Spray

USA

Spray

Quat. Ammonia

Denatured Alcohol USA

Liquid

Ethanol

DentaSept

FRA

Liquid

Quat. Ammonia

DisCide Ultra
Disinfecting
Towelettes

USA

Wipes

Isopropyl Alcohol

DisCide Wipes

USA

Wipes

Isopropyl Alcohol

DisOPA

JPN

Liquid

Ortho-phthaldehyde

Dispatch

USA

Spray

NaCl Hypochlorite

Dynacide PA

FRA

Liquid

Peracetic Acid

79
Troubleshooting

80

Table 1: Disinfectant Compatibility with System and Transducers (continued)

Disinfection and
Cleaning Solutions

Country
of Origin

Type

Active Ingredient

C60x
ICTx
L38x
P10x
P21x
SLAx

End-Bac II

USA

Liquid

Quat. Ammonia

Endozime AW Plus

FRA

Liquid

Propanol

Envirocide

USA

Liquid

Isopropyl

Enzol

USA

Cleaner

Ethylene Glycol

Expose

USA

Liquid

Isopropyl

Gigasept AF

DEU

Liquid

Quat. Ammonia

Gigasept FF

DEU

Liquid

Bersteinsaure

Gluteraldehyde SDS USA

Liquid

Gluteraldehyde

Hexanios

FRA

Liquid

Polyhexanide/Quat.
Ammonia

Hi Tor Plus

USA

Liquid

Chloride

Hibiclens

USA

Cleaner

Chlorhexidine

Hydrogen Peroxide USA

Liquid

Hydrogen Peroxide

Isopropanol Alcohol ALL

Liquid

Alcohol

Kodan Tcher

DEU

Liquid

Propanol

Kohrsolin ff

DEU

Liquid

Gluteraldehyde

Korsolex basic

DEU

Liquid

Gluteraldehyde

Lem-O-Quat

USA

Liquid

Alkyl/Chloride

D2x

HFL38x

C11x/
L25x

System
Surfaces

Table 1: Disinfectant Compatibility with System and Transducers (continued)

81

Country
of Origin

Type

Active Ingredient

LpHse

USA

Liquid

O-phenylphenol

Lysol

USA

Spray

Ethanol

Lysol IC

USA

Liquid

O-phenylphenol

Madacide 1

USA

Liquid

Isopropanol

Matar

USA

Liquid

O-phenylphenol

MetriCide 14

USA

Liquid

Gluteraldehyde

MetriCide 28

USA

Liquid

Gluteraldehyde

MetriZyme

USA

Cleaner

Propylene Glycol

Mikrobak forte

DEU

Liquid

Ammonium Chloride

Mikrozid Wipes

DEU

Wipe

Ethanol/Propanol

Nuclean

FRA

Spray

Alcohol/Biguanide

Precise

USA

Spray

O-phenylphenol

Ruthless

USA

Spray

Quat. Ammonia

Sagrosept Wipe

DEU

Wipe

Propanol

Salvanios pH 7

FRA

Liquid

Quat. Ammonia

Sani-Cloth HB

USA

Wipe

Quat. Ammonia

Sani-Cloth Plus

USA

Wipe

Quat. Ammonia

Sekusept

DEU

Liquid

Gluteraldehyde

Troubleshooting

Chapter 5: Troubleshooting and Maintenance

Disinfection and
Cleaning Solutions

C60x
ICTx
L38x
P10x
P21x
SLAx

D2x

HFL38x

C11x/
L25x

System
Surfaces

82

Table 1: Disinfectant Compatibility with System and Transducers (continued)


C60x
ICTx
L38x
P10x
P21x
SLAx

D2x

HFL38x

C11x/
L25x

System
Surfaces

Disinfection and
Cleaning Solutions

Country
of Origin

Type

Active Ingredient

Sklar

USA

Liquid

Isopropanol

Sporicidin

USA

Liquid

Phenol

Sporicidin Wipes

USA

Wipe

Phenol

Staphene

USA

Spray

Ethanol

Steranios

FRA

Liquid

Gluteraldehyde

Super Sani-Cloth

USA

Wipe

Isopropyl Alcohol

T-Spray

USA

Spray

Quat. Ammonia

T-Spray II

USA

Spray

Alkyl/Chloride

TASK 105

USA

Spray

Quat. Ammonia

TBQ

USA

Liquid

Alkyl

Theracide Plus
Wipes

USA

Wipe

Quat. Ammonia

Tor

USA

Liquid

Quat. Ammonia

Transeptic

USA

Cleaner

Alcohol

Tristel

GBR

Liquid

Chlorine Dioxide

Tristel Duo

GBR

Tristel Solo

GBR

Foam

Hexamethylenebiguanide

Tristel Wipes

GBR

Wipe

Chlorine Dioxide

Table 1: Disinfectant Compatibility with System and Transducers (continued)


C60x
ICTx
L38x
P10x
P21x
SLAx

D2x

HFL38x

C11x/
L25x

System
Surfaces

Chapter 5: Troubleshooting and Maintenance

Disinfection and
Cleaning Solutions

Country
of Origin

Type

Active Ingredient

Vesphene II

USA

Liquid

Sodium/
o-Phenylphenate

Virex II 256

USA

Liquid

Ammonium Chloride

Virex TB

USA

Liquid

Quat. Ammonia

Virox 5

CAN

Wipe

Hydrogen Peroxide

Virufen

FRA

Liquid

Alkyl Ammonium Chloride

Wavicide -01

USA

Liquid

Gluteraldehyde

Wavicide -06

USA

Liquid

Gluteraldehyde

Wet Wipe
Disinfection

DNK

Wipe

Guanidinium-chloride

Wex-Cide

USA

Liquid

O-phenylphenol

A = Acceptable
N = No (Do not use)
U = Untested (Do not use)

83
Troubleshooting

84

Chapter 6: Safety

Ergonomic safety
Thesehealthyscanningguidelinesareintendedtoassistyouinthecomfortandeffectiveuse
ofyourultrasoundsystem.
WARNING:

To prevent musculoskeletal disorders, follow the guidelines in this section.


Use of an ultrasound system may be linked to musculoskeletal disorders (MSDs)a,b,c.
Use of an ultrasound system is defined as the physical interaction between the
operator, the ultrasound system, and the transducer.
When using an ultrasound system, as with many similar physical activities, you may
experience occasional discomfort in your hands, fingers, arms, shoulders, eyes, back,
or other parts of your body. However, if you experience symptoms such as constant
or recurring discomfort, pain, throbbing, aching, tingling, numbness, burning
sensation, or stiffness, do not ignore these warning signs. Promptly see a qualified
health professional. Symptoms such as these can be linked with MSDs. MSDs can be
painful and may result in potentially disabling injuries to the nerves, muscles,
tendons, or other parts of the body. Examples of MSDs include carpal tunnel
syndrome and tendonitis.
While researchers are not able to definitively answer many questions about MSDs,
there is a general agreement that certain factors are associated with their
occurrence including preexisting medical and physical conditions, overall health,
equipment and body position while doing work, frequency of work, duration of
work, and other physical activities that may facilitate the onset of MSDsd. This
chapter provides guidelines that may help you work more comfortably and may
reduce your risk of MSDse,f.

a.Magnavita, N., L. Bevilacqua, P. Mirk, A. Fileni, and N. Castellino. Work-related Musculoskeletal Complaints
in Sonologists. Occupational Environmental Medicine. 41:11 (1999), 981-988.
b.Craig, M. Sonography: An Occupational Hazard? Journal of Diagnostic Medical Sonography. 3 (1985),
121-125.
c.Smith, C.S., G.W. Wolf, G. Y. Xie, and M. D. Smith. Musculoskeletal Pain in Cardiac Ultrasonographers:
Results of a Random Survey. Journal of American Society of Echocardiography. (May1997), 357-362.
d.Wihlidal, L.M. and S. Kumar. An Injury Profile of Practicing Diagnostic Medical Sonographers in Alberta.
International Journal of Industrial Ergonomics. 19 (1997), 205-216.

Chapter 6: Safety

85

Safety

Thischaptercontainsinformationrequiredbyregulatoryagencies,includinginformation
abouttheALARA(aslowasreasonablyachievable)principle,theoutputdisplaystandard,
acousticpowerandintensitytables,andothersafetyinformation.Theinformationappliesto
theultrasoundsystem,transducer,accessories,andperipherals.

e.Habes, D.J. and S. Baron. Health Hazard Report 99-0093-2749. University of Medicine and Dentistry of New
Jersey. (1999).
f.Vanderpool, H.E., E.A. Friis, B.S. Smith, and K.L. Harms. Prevalence of Carpal Tunnel Syndrome and Other
Work-related Musculoskeletal Problems in Cardiac Sonographers. Journal of Medicine. 35:6 (1993), 605-610.

Position the system


Promote comfortable shoulder, arm, and hand postures
Useastandtosupporttheweightoftheultrasoundsystem.

Minimize eye and neck strain


Ifpossible,positionthesystemwithinreach.
Adjusttheangleofthesystemanddisplaytominimizeglare.
Ifusingastand,adjustitsheightsothatthedisplayisatorslightlybeloweyelevel.

Position yourself
Support your back during an exam
Useachairthatsupportsyourlowerback,thatadjuststoyourworksurfaceheight,that
promotesanaturalbodyposture,andthatallowsquickheightadjustments.
Alwayssitorstandupright.Avoidbendingorstooping.

Minimize reaching and twisting


Useabedthatisheightadjustable.
Positionthepatientasclosetoyouaspossible.
Faceforward.Avoidtwistingyourheadorbody.
Moveyourentirebodyfronttoback,andpositionyourscanningarmnexttoorslightlyin
frontofyou.
Standfordifficultexamstominimizereaching.
Positiontheultrasoundsystemordisplaydirectlyinfrontofyou.
Provideanauxiliarymonitorforpatientviewing.

Promote comfortable shoulder and arm postures


Keepyourelbowclosetoyourside.
Relaxyourshouldersinalevelposition.
Supportyourarmusingasupportcushionorpillow,orrestitonthebed.

86

Promote comfortable hand, wrist, and finger postures


Holdthetransducerlightlyinyourfingers.
Safety

Minimizethepressureappliedonthepatient.
Keepyourwristinastraightposition.

Take breaks, exercise, and vary activities


Minimizingscanningtimeandtakingbreakscaneffectivelyallowyourbodytorecoverfrom
physicalactivityandhelpyouavoidMSDs.Someultrasoundtasksmayrequirelongeror
morefrequentbreaks.However,simplychangingtaskscanhelpsomemusclegroupsrelax
whileothersremainorbecomeactive.
Workefficientlybyusingthesoftwareandhardwarefeaturescorrectly.
Keepmoving.Avoidsustainingthesameposturebyvaryingyourhead,neck,body,arm,
andlegpositions.
Dotargetedexercises.Targetedexercisescanstrengthenmusclegroups,whichmayhelpyou
avoidMSDs.Contactaqualifiedhealthprofessionaltodeterminestretchesandexercises
thatarerightforyou.

Electrical safety classification


Class I equipment

Ultrasound system powered from power supply or part


of the Mobile Docking System

Internally powered equipment

Ultrasound system not connected to the power supply


(battery only)

Type BF applied parts

Ultrasound transducers

Type CF applied parts

ECG module/ECG leads

IPX-7 (watertight equipment)

Ultrasound transducers

IPX-8 (watertight equipment)

Footswitch

Non AP/APG

Ultrasound system power supply, docking system, and


peripherals. Equipment is not suitable for use in the
presence of flammable anaesthetics.

Chapter 6: Safety

87

Electrical safety
ThissystemmeetsEN606011,ClassI/internallypoweredequipmentrequirementsandType
BFisolatedpatientappliedpartssafetyrequirements.
Thissystemcomplieswiththeapplicablemedicalequipmentrequirementspublishedinthe
CanadianStandardsAssociation(CSA),EuropeanNormHarmonizedStandards,and
UnderwritersLaboratories(UL)safetystandards.SeeChapter 8,Specifications.
Formaximumsafetyobservethefollowingwarningsandcautions.
WARNING:

To avoid discomfort or minor risk of patient injury, keep hot surfaces away from the
patient.
Under certain circumstances, the transducer connector and back of the display
enclosure can reach temperatures that exceed EN60601-1 limits for patient contact,
therefore only the operator shall handle the system. This does not include the
transducer face.
To avoid discomfort or minor risk of operator injury when handling the transducer
connector, the system should not be operated for more than 60 minutes
continuously in a live-scan mode (as opposed to freeze or sleep modes).
To avoid the risk of electrical shock or injury, do not open the system enclosures. All
internal adjustments and replacements, except battery replacement, must be made
by a qualified technician.
To avoid the risk of injury, do not operate the system in the presence of flammable
gasses or anesthetics. Explosion can result.
To avoid the risk of electrical shock, use only properly grounded equipment. Shock
hazards exist if the power supply is not properly grounded. Grounding reliability can
only be achieved when equipment is connected to a receptacle marked Hospital
Only or Hospital Grade or the equivalent. The grounding wire must not be
removed or defeated.
To avoid the risk of electrical shock, when using the system in an environment where
the integrity of the protective earth conductor arrangement is in doubt, operate the
system on battery power only without using the power supply.
To avoid the risk of electrical shock, do not connect the systems power supply or a
docking system to an MPSO or extension cord.
To avoid the risk of electrical shock, before using the transducer, inspect the
transducer face, housing, and cable. Do not use the transducer if the transducer or
cable is damaged.
To avoid the risk of electrical shock, always disconnect the power supply from the
system before cleaning the system.

88

WARNING:

Safety

To avoid the risk of electrical shock, do not use any transducer that has been
immersed beyond the specified cleaning or disinfection level. See Chapter 5,
Troubleshooting and Maintenance.
To avoid the risk of electrical shock to the patient, do not simultaneously touch the
patient and the ungrounded signal input/output connectors on the back of the
ultrasound system.
To avoid the risk of electrical shock and fire hazard, inspect the power supply, AC
power cords, cables, and plugs on a regular basis. Ensure that they are not damaged.
To avoid the risk of electrical shock and fire hazard, the power cord set that connects
the power supply of the ultrasound system or MDS to mains power must only be
used with the power supply or docking system, and cannot be used to connect
other devices to mains power.
To avoid the risk of electrical shock, use only accessories and peripherals
recommended by SonoSite, including the power supply. Connection of accessories
and peripherals not recommended by SonoSite could result in electrical shock.
Contact SonoSite or your local representative for a list of accessories and peripherals
available from or recommend by SonoSite.
To avoid the risk of electrical shock, use commercial grade peripherals
recommended by SonoSite on battery power only. Do not connect these products
to AC mains power when using the system to scan or diagnose a patient/subject.
Contact SonoSite or your local representative for a list of the commercial grade
peripherals available from or recommended by SonoSite.
To avoid the risk of electrical shock to the patient/subject, do not touch the system
battery contacts while simultaneously touching a patient/subject.
To prevent injury to the operator/bystander, the transducer must be removed from
patient contact before the application of a high-voltage defibrillation pulse.
To avoid possible electrical shock or electromagnetic interference, verify proper
operation and compliance with relevant safety standards for all equipment before
clinical use. Connecting additional equipment to the ultrasound system constitutes
configuring a medical system. SonoSite recommends verifying that the system, all
combinations of equipment, and accessories connected to the ultrasound system
comply with JACHO installation requirements and/or safety standards such as
AAMI-ES1, NFPA 99 OR IEC Standard 60601-1-1 and electromagnetic compatibility
standard IEC 60601-1-2 (Electromagnetic compatibility), and are certified according
to IEC Standard 60950 (Information Technology Equipment (ITE)).

Caution:

Do not use the system if an error message appears on the image display: note the
error code; call SonoSite or your local representative; turn off the system by pressing
and holding the power key until the system powers down.
To avoid increasing the system and transducer connector temperature, do not block
the airflow to the ventilation holes on the side of the system.

Chapter 6: Safety

89

Equipment safety
Toprotectyourultrasoundsystem,transducer,andaccessories,followtheseprecautions.
Caution:

Excessive bending or twisting of cables can cause a failure or intermittent operation.


Improper cleaning or disinfecting of any part of the system can cause permanent
damage. For cleaning and disinfecting instructions, see Chapter 5, Troubleshooting
and Maintenance.
Do not submerge the transducer connector in solution. The cable is not liquid-tight
beyond the transducer connector/cable interface.
Do not use solvents such as thinner or benzene, or abrasive cleaners on any part of
the system.
Remove the battery from the system if the system is not likely to be used for some
time.
Do not spill liquid on the system.

Battery safety
Topreventthebatteryfrombursting,igniting,oremittingfumesandcausingpersonalinjury
orequipmentdamage,observethefollowingprecautions.
WARNING:

The battery has a safety device. Do not disassemble or alter the battery.
Charge the batteries only when the ambient temperature is between 0 and 40C
(32 and 104F).
Do not short-circuit the battery by directly connecting the positive and negative
terminals with metal objects.
Do not touch battery contacts.
Do not heat the battery or discard it in a fire.
Do not expose the battery to temperatures over 60C (140F). Keep it away from fire
and other heat sources.
Do not charge the battery near a heat source, such as a fire or heater.
Do not leave the battery in direct sunlight.
Do not pierce the battery with a sharp object, hit it, or step on it.
Do not use a damaged battery.
Do not solder a battery.
The polarity of the battery terminals are fixed and cannot be switched or reversed.
Do not force the battery into the system.

90

Do not connect the battery to an electrical power outlet.


WARNING:

If the battery leaks or emits an odor, remove it from all possible flammable sources.

Caution:

To avoid the battery bursting, igniting, or emitting fumes from the battery and
causing equipment damage, observe the following precautions:
Do not immerse the battery in water or allow it to get wet.
Do not put the battery into a microwave oven or pressurized container.
If the battery emits an odor or heat, is deformed or discolored, or in any way appears
abnormal during use, recharging or storage, immediately remove it and stop using
it. If you have any questions about the battery, consult SonoSite or your local
representative.
Store the battery between -20C (-4F) and 60C (140F).
Use only SonoSite batteries.
Do not use or charge the battery with non-SonoSite equipment. Only charge the
battery with the system.

Chapter 6: Safety

91

Safety

Do not continue recharging the battery if it does not recharge after two successive
six hour charging cycles.

Clinical safety
WARNING:

Non-medical (commercial) grade peripheral monitors have not been verified or


validated by SonoSite as being suitable for diagnosis.
To avoid the risk of a burn hazard, do not use the transducer with high frequency
surgical equipment. Such a hazard may occur in the event of a defect in the high
frequency surgical neutral electrode connection.
Do not use the system if it exhibits erratic or inconsistent behavior. Discontinuities in
the scanning sequence are indicative of a hardware failure that must be corrected
before use.
Some transducer sheaths contain natural rubber latex and talc, which can cause
allergic reactions in some individuals. Refer to 21 CFR 801.437, User labeling for
devices that contain natural rubber.
Perform ultrasound procedures prudently. Use the ALARA (as low as reasonably
achievable) principle and follow the prudent use information concerning MI and TI.
SonoSite does not currently recommend a specific brand of acoustic standoff. If an
acoustic standoff is used, it must have a minimum attentuation of .3dB/cm/MHz.
Some SonoSite transducers are approved for intraoperative applications if a
market-cleared sheath is used.
To avoid injury or reduce the risk of infection to the patient, observe the following:
Follow Universal Precautions when inserting and maintaining a medical device
for interventional and intraoperative procedures.
Appropriate training in interventional and intraoperative procedures as dictated
by current relevant medical practices as well as in proper operation of the
ultrasound system and transducer is required. During vascular access, the
potential exists for serious complications including without limitation the
following: pneumothorax, arterial puncture, guidewire misplacement, and risks
normally associated with local or general anesthesia, surgery, and post-operative
recovery.
To avoid device damage or patient injury, do not use the P10x, P17x, or P21x needle
guide bracket on patients with pacemakers or medical electronic implants. The
needle guide bracket for the P10x, P17x, and P21x transducers contains a magnet
that is used to ensure the bracket is correctly oriented on the transducer. The
magnetic field in direct proximity to the pacemaker or medical electronic implant
may have an adverse effect.

92

Hazardous materials
The liquid crystal display (LCD) contains mercury. Dispose of the LCD properly in
accordance with local regulations.

Safety

WARNING:

Electromagnetic compatibility
Theultrasoundsystemhasbeentestedandfoundtocomplywiththeelectromagnetic
compatibility(EMC)limitsformedicaldevicestoIEC6060112:2001.Theselimitsaredesigned
toprovidereasonableprotectionagainstharmfulinterferenceinatypicalmedicalinstallation.
Caution:

Medical electrical equipment requires special precautions regarding EMC and must
be installed and operated according to these instructions. It is possible that high
levels of radiated or conducted radio-frequency electromagnetic interference (EMI)
from portable and mobile RF communications equipment or other strong or nearby
radio-frequency sources, could result in performance disruption of the ultrasound
system. Evidence of disruption may include image degradation or distortion, erratic
readings, equipment ceasing to operate, or other incorrect functioning. If this occurs,
survey the site to determine the source of disruption, and take the following actions
to eliminate the source(s).

Turn equipment in the vicinity off and on to isolate disruptive equipment.


Relocate or re-orient interfering equipment.
Increase distance between interfering equipment and your ultrasound system.
Manage use of frequencies close to ultrasound system frequencies.
Remove devices that are highly susceptible to EMI.
Lower power from internal sources within facility control (such as paging
systems).
Label devices susceptible to EMI.
Educate clinical staff to recognize potential EMI-related problems.
Eliminate or reduce EMI with technical solutions (such as shielding).
Restrict use of personal communicators (cell phones, computers) in areas with
devices susceptible to EMI.
Share relevant EMI information with others, particularly when evaluating new
equipment purchases which may generate EMI.
Purchase medical devices that comply with IEC 60601-1-2 EMC Standards.

Chapter 6: Safety

93

Caution:

To avoid the risk of increased electromagnetic emissions or decreased immunity, use


only accessories and peripherals recommended by SonoSite. Connection of
accessories and peripherals not recommended by SonoSite could result in
malfunctioning of your ultrasound system or other medical electrical devices in the
area. Contact SonoSite or your local representative for a list of accessories and
peripherals available from or recommended by SonoSite. See the SonoSite
accessories user guide.
Electrostatic discharge (ESD), or static shock, is a naturally occurring phenomenon.
ESD is common in conditions of low humidity, which can be caused by heating or air
conditioning. Static shock is a discharge of the electrical energy from a charged
body to a lesser or non-charged body. The degree of discharge can be significant
enough to cause damage to a transducer or an ultrasound system. The following
precautions can help reduce ESD: anti-static spray on carpets, anti-static spray on
linoleum, and anti-static mats.

Manufacturers declaration
Table 1andTable 2documenttheintendeduseenvironmentandEMCcompliancelevelsofthe
system.Formaximumperformance,ensurethatthesystemisusedintheenvironments
describedinthistable.
Thesystemisintendedforuseintheelectromagneticenvironmentspecifiedbelow.
Table 1: Manufacturers Declaration - Electromagnetic Emissions
Emissions Test

Compliance

Electromagnetic Environment

RF emissions

Group 1

The SonoSite ultrasound system uses RF energy only


for its internal function. Therefore, its RF emissions
are very low and are not likely to cause any
interference in nearby electronic equipment.

Class A

The SonoSite ultrasound system is suitable for use in


all establishments other than domestic and those
directly connected to the public low-voltage power
supply network which supplies buildings used for
domestic purposes.

ClSPR 11

RF emissions
ClSPR 11

Harmonic emissions

Class A

IEC 61000-3-2
Voltage fluctuations/
flicker emissions
IEC 61000-3-3

94

Complies

Thesystemisintendedforuseintheelectromagneticenvironmentspecifiedbelow.
Table 2: Manufacturers Declaration - Electromagnetic Immunity
IEC 60601 Test Level

Compliance Level

Electrostatic
Discharge (ESD)

2.0KV, 4.0KV, 6.0KV


contact

2.0KV, 4.0KV, 6.0KV


contact

IEC 61000-4-2

2.0KV, 4.0KV, 8.0KV air

2.0KV, 4.0KV, 8.0KV


air

Electrical fast

2KV on the mains

2KV on the mains

Transient burst

1KV on signal lines

1KV on signal lines

0.5KV, 1.0KV, 2.0KV on


AC power lines to
ground

0.5KV, 1.0KV, 2.0KV


on AC power lines
to ground

0.5KV, 1.0KV on AC
power lines to lines

0.5KV, 1.0KV on AC
power lines to
lines

Voltage dips,
short
interruptions
and voltage
variations on
power supply
input lines

>5% UT

>5% UT

(>95% dip in UT ) for


0.5 cycle

(>95% dip in UT )
for 0.5 cycle

40% UT

40% UT

(60% dip in UT ) for 5


cycles

(60% dip in UT ) for


5 cycles

IEC 61000-4-11

70% UT

70% UT

(30% dip in UT ) for 25


cycles

(30% dip in UT ) for


25 cycles

>5% UT

>5% UT

(>95% dip in UT ) for 5s

(>95% dip in UT )
for 5s

IEC 61000-4-4
Surge
IEC 61000-4-5

Safety

Immunity Test

Electromagnetic
Environment
Floors should be wood,
concrete or ceramic tile. If
floors are covered with
synthetic material, the relative
humidity should be at least
30%.
Mains power quality should
be that of a typical
commercial or hospital
environment.
Mains power quality should
be that of a typical
commercial or hospital
environment.

Mains power quality should


be that of a typical
commercial or hospital
environment. If the user of the
SonoSite ultrasound system
requires continued operation
during power mains
interruptions, it is
recommended that the
SonoSite ultrasound system
be powered from an
uninterruptible power supply
or a battery.

Chapter 6: Safety

95

Table 2: Manufacturers Declaration - Electromagnetic Immunity (Continued)


Electromagnetic
Environment

Immunity Test

IEC 60601 Test Level

Compliance Level

Power
Frequency
Magnetic Field

3 A/m

3 A/m

If image distortion occurs, it


may be necessary to position
the SonoSite ultrasound
system further from sources of
power frequency magnetic
fields or to install magnetic
shielding. The power
frequency magnetic field
should be measured in the
Intended installation location
to assure that it is sufficiently
low.

Conducted RF

3 Vrms

3 Vrms

IEC 61000-4-6

150 kHz to 80 MHz

Portable and mobile RF


communications equipment
should be used no closer to
any part of the SonoSite
ultrasound system including
cables, than the
recommended separation
distance calculated from the
equation applicable to the
frequency of the transmitter.

IEC 61000-4-8

Recommended Separation
Distance
d = 1.2 P
Radiated RF

3 Vim

IEC 61000-4-3

80 MHz to 2.5 GHz

3 V/m

d = 1.2 P
80 MHz to 800 MHz
d = 2.3 P
800 MHz to 2,5 GHz
Where P is the maximum
output power rating of the
transmitter in watts (W)
according to the transmitter
manufacturer and d is the
recommended separation
distance in meters (m).

96

Table 2: Manufacturers Declaration - Electromagnetic Immunity (Continued)

Radiated RF
IEC 61000-4-3
(continued)

IEC 60601 Test Level

Compliance Level

Electromagnetic
Environment

Safety

Immunity Test

Field strengths from fixed RF


transmitters, as determined by
an electromagnetic Site
surveya, should be less than
the compliance level in each
frequency rangeb.
Interference may occur in the
vicinity of equipment marked
with the following symbol:

(IEC 60417 No. 417-IEC-5140:


Source of non-ionizing
radiation)
Note: UT is the AC mains voltage prior to application of the test level.
At 80 MHz and 800 MHz, the higher frequency range applies.
These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects and people.
a.Field strengths from fixed transmitters such as base stations for radio (cellular/cordless) telephones and
land mobile radios, amateur radio, AM and FM radio broadcast and TV broadcast cannot be predicted
theoretically with accuracy. To assess the electromagnetic environment due to fixed RF transmitters, an
electromagnetic site survey should be considered. If the measured field strength in the location in which
the SonoSite ultrasound system is used exceeds the applicable RF compliance level above, the SonoSite
ultrasound system should be observed to verify normal operation. If abnormal performance is observed,
additional measures may be necessary, such as re-orienting or relocating the SonoSite ultrasound system.
b.Over the frequency range 150 kHz to 80 MHz, field strengths should be less than 3 V/m.

ALARA principle
ALARAistheguidingprinciplefortheuseofdiagnosticultrasound.Sonographersandother
qualifiedultrasoundusers,usinggoodjudgmentandinsight,determinetheexposurethatis
aslowasreasonablyachievable.Therearenosetrulestodeterminethecorrectexposurefor
everysituation.Thequalifiedultrasounduserdeterminesthemostappropriatewaytokeep
exposurelowandbioeffectstoaminimum,whileobtainingadiagnosticexamination.
Athoroughknowledgeoftheimagingmodes,transducercapability,systemsetupand
scanningtechniqueisnecessary.Theimagingmodedeterminesthenatureoftheultrasound
beam.Astationarybeamresultsinamoreconcentratedexposurethanascannedbeam,which
spreadsthatexposureoverthatarea.Thetransducercapabilitydependsuponthefrequency,

Chapter 6: Safety

97

penetration,resolution,andfieldofview.Thedefaultsystempresetsareresetatthestartof
eachnewpatient.Itisthescanningtechniqueofthequalifiedultrasounduseralongwith
patientvariabilitythatdeterminesthesystemsettingsthroughouttheexam.
ThevariableswhichaffectthewaythequalifiedultrasounduserimplementstheALARA
principleinclude:patientbodysize,locationofthebonerelativetothefocalpoint,attenuation
inthebody,andultrasoundexposuretime.Exposuretimeisanespeciallyusefulvariable,
becausethequalifiedultrasoundusercancontrolit.Theabilitytolimittheexposureovertime
supportstheALARAprinciple.

Applying ALARA
Thesystemimagingmodeselectedbythequalifiedultrasounduserisdeterminedbythe
diagnosticinformationrequired.2Dimagingprovidesanatomicalinformation;CPDimaging
providesinformationabouttheenergyoramplitudestrengthoftheDopplersignalovertime
atagivenanatomicallocationandisusedfordetectingthepresenceofbloodflow;Color
imagingprovidesinformationabouttheenergyoramplitudestrengthoftheDopplersignal
overtimeatagivenanatomicallocationandisusedfordetectingthepresence,velocity,and
directionofbloodflow;TissueHarmonicImaginguseshigherreceivedfrequenciestoreduce
clutter,artifact,andimproveresolutiononthe2Dimage.Understandingthenatureofthe
imagingmodeusedallowsthequalifiedultrasoundusertoapplytheALARAprinciple.
Prudentuseofultrasoundrequiresthatpatientexposuretoultrasoundbelimitedtothelowest
ultrasoundoutputfortheshortesttimenecessarytoachieveacceptablediagnosticresults.
Decisionsthatsupportprudentusearebasedonthetypeofpatient,examtype,patienthistory,
easeordifficultyofobtainingdiagnosticallyusefulinformation,andpotentiallocalized
heatingofthepatientduetotransducersurfacetemperature.
Thesystemhasbeendesignedtoensurethattemperatureatthefaceofthetransducerwillnot
exceedthelimitsestablishedinSection42ofEN60601237:Particularrequirementforthe
safetyofultrasoundmedicaldiagnosticandmonitoringequipment.SeeTransducersurface
temperatureriseonpage 104.Intheeventofadevicemalfunction,thereareredundant
controlsthatlimittransducerpower.Thisisaccomplishedbyanelectricaldesignthatlimits
bothpowersupplycurrentandvoltagetothetransducer.
Thesonographerusesthesystemcontrolstoadjustimagequalityandlimitultrasoundoutput.
Thesystemcontrolsaredividedintothreecategoriesrelativetooutput:controlsthatdirectly
affectoutput,controlsthatindirectlyaffectoutput,andreceivercontrols.

Direct controls
Thesystemdoesnotexceedaspatialpeaktemporalaverageintensity(ISPTA)of720 mW/cm2
forallimagingmodes.(ForeithertheOphthalmicorOrbitalexam,theacousticoutputis
limitedtothefollowingvalues:ISPTAdoesnotexceed50 mW/cm2;TIdoesnotexceed1.0,and
MIdoesnotexceed0.23.)Themechanicalindex(MI)andthermalindex(TI)mayexceedvalues
greaterthan1.0onsometransducersinsomeimagingmodes.OnemaymonitortheMIandTI
valuesandadjustthecontrolstoreducethesevalues.SeeGuidelinesforreducingMIandTI

98

Indirect controls
Thecontrolsthatindirectlyaffectoutputarecontrolsaffectingimagingmode,freeze,and
depth.Theimagingmodedeterminesthenatureoftheultrasoundbeam.Tissueattenuationis
directlyrelatedtotransducerfrequency.ThehigherthePRF(pulserepetitionfrequency),the
moreoutputpulsesoccuroveraperiodoftime.

Receiver controls
Thereceivercontrolsarethegaincontrols.Receivercontrolsdonotaffectoutput.Theyshould
beused,ifpossible,toimproveimagequalitybeforeusingcontrolsthatdirectlyorindirectly
affectoutput.

Acoustic artifacts
Anacousticartifactisinformation,presentorabsentinanimage,thatdoesnotproperly
indicatethestructureorflowbeingimaged.Therearehelpfulartifactsthataidindiagnosisand
thosethathinderproperinterpretation.Examplesofartifactsinclude:
Shadowing
Throughtransmission
Aliasing
Reverberations
Comettails
Formoreinformationondetectingandinterpretingacousticartifacts,seethefollowing
reference:
Kremkau,FrederickW.DiagnosticUltrasound:PrinciplesandInstruments.7thed.,W.B.
SaundersCompany,(Oct.17,2005).

Guidelines for reducing MI and TI


ThefollowingaregeneralguidelinesforreducingMIorTI.Ifmultipleparametersaregiven,
thebestresultsmaybeachievedbyminimizingtheseparameterssimultaneously.Insome
modeschangingtheseparametersdoesnotaffectMIorTI.Changestootherparametersmay
alsoresultinMIandTIreductions.PleasenotetheMIandTIvaluesontherightsideofthe
screen.

Chapter 6: Safety

99

Safety

onpage 99.Additionally,onemeansformeetingtheALARAprincipleistosettheMIorTI
valuestoalowindexvalueandthenmodifyingthisleveluntilasatisfactoryimageorDoppler
modeisobtained.FormoreinformationonMIandTI,seeBSEN60601237:2001:AnnexHH.

Table 3: MI
Transducer

Depth

C11x

C60x

HFL38x

ICTx

L25x

L38x

P10x

P21x

SLAx

TEEx

Decrease or lower setting of parameter to reduce MI.


Increase or raise setting of parameter to reduce MI.

Table 4: TI (TIS, TIC, TIB)


Color Power Doppler Settings
Transducer

Box
Width

Box
Height

C11x
C60x

HFL38x

ICTx
L25x

PRF

Depth

(Depth)

(PRF)

(Depth)

P21x

100

Optimize

Exam Gyn

(PRF)
(PRF)

L38x
P10x

PW Settings

Box
Depth

(Depth)

(PRF)
(PRF)

Table 4: TI (TIS, TIC, TIB)

Transducer

PW Settings

Box
Width

Box
Height

Box
Depth

PRF

Depth

Optimize

SLAx

(PRF)

TEEx

(PRF)

Decrease or lower setting of parameter to reduce MI.


Increase or raise setting of parameter to reduce MI.

Chapter 6: Safety

101

Safety

Color Power Doppler Settings

Output display
ThesystemmeetstheAIUMoutputdisplaystandardforMIandTI(seelastreferencein
Relatedguidancedocumentsbelow).Table 5indicatesforeachtransducerandoperating
modewheneithertheTIorMIisgreaterthanorequaltoavalueof1.0,thusrequiringdisplay.
Note: TheD2xtransducerhasastaticcontinuouswave(CW)output.Thisoutputisfixed.Therefore,
TIandMIvaluescannotbechangedbyanysystemcontrolsavailabletotheuser.
Table 5: TI or MI 1.0
CPD/
Color

PW
Doppler

CW
Doppler

MI

No

No

No

TIC,TIB, or TIS

No

Yes

Yes

MI

Yes

No

No

TIC, TIB, or TIS

No

No

Yes

MI

No

TIC,TIB, or TIS

Yes

MI

No

Yes

Yes

TIC, TIB, or TIS

No

Yes

Yes

MI

No

No

No

TIC, TIB, or TIS

No

No

Yes

MI

No

Yes

No

TIC,TIB, or TIS

No

No

Yes

MI

No

Yes

Yes

TIC, TIB, or TIS

No

Yes

Yes

MI

No

Yes

Yes

No

TIC, TIB, or TIS

Yes

Yes

Yes

Yes

MI

Yes

Yes

Yes

No

TIC, TIB, or TIS

Yes

Yes

Yes

Yes

MI

No

No

No

TIC, TIB, or TIS

No

No

Yes

Index

C11x/8-5

C60x/5-2

D2x/2

HFL38x/13-6

ICTx/8-5

L25x/13-6

L38x/10-5

P10x/8-4

P21x/5-1

SLAx/13-6

102

2D/
M Mode

Transducer Model

Table 5: TI or MI 1.0 (Continued)


CPD/
Color

PW
Doppler

CW
Doppler

MI

No

No

No

No

TIC, TIB, or TIS

No

No

Yes

Yes

Index

TEEx/8-3

EvenwhenMIislessthan1.0,thesystemprovidesacontinuousrealtimedisplayofMIinall
imagingmodes,inincrementsof0.1.
ThesystemmeetstheoutputdisplaystandardforTIandprovidesacontinuousrealtime
displayofTIinallimagingmodes,inincrementsof0.1.
TheTIconsistsofthreeuserselectableindices,andonlyoneoftheseisdisplayedatanyone
time.InordertodisplayTIproperlyandmeettheALARAprinciple,theuserselectsan
appropriateTIbasedonthespecificexambeingperformed.SonoSiteprovidesacopyofAIUM
MedicalUltrasoundSafety,whichcontainsguidanceondeterminingwhichTIisappropriate(See
Relatedguidancedocumentsonpage 104).

MI and TI output display accuracy


TheaccuracyresultfortheMIisstatedstatistically.With95%confidence,95%ofthemeasured
MIvalueswillbewithin+18%to25%ofthedisplayedMIvalue,or+0.2ofthedisplayedvalue,
whichevervalueislarger.
TheaccuracyresultfortheTIisstatedstatistically.With95%confidence,95%ofthemeasured
TIvalueswillbewithin+21%to40%ofthedisplayedTIvalue,or+0.2ofthedisplayedvalue,
whichevervalueislarger.Thevaluesequateto+1dBto3dB.
Adisplayedvalueof0.0forMIorTImeansthatthecalculatedestimatefortheindexislessthan
0.05.

Factors that contribute to display uncertainty


Thenetuncertaintyofthedisplayedindicesisderivedbycombiningthequantifieduncertainty
fromthreesources:measurementuncertainty,systemandtransducervariability,and
engineeringassumptionsandapproximationsmadewhencalculatingthedisplayvalues.
Measurementerrorsoftheacousticparameterswhentakingthereferencedataarethemajor
sourceoferrorthatcontributestothedisplayuncertainty.Themeasurementerrorisdescribed
inAcousticmeasurementprecisionanduncertaintyonpage 133.
ThedisplayedMIandTIvaluesarebasedoncalculationsthatuseasetofacousticoutput
measurementsthatweremadeusingasinglereferenceultrasoundsystemwithasingle
referencetransducerthatisrepresentativeofthepopulationoftransducersofthattype.The
referencesystemandtransducerarechosenfromasamplepopulationofsystemsand
transducerstakenfromearlyproductionunits,andtheyareselectedbasedonhavingan
acousticoutputthatisrepresentativeofthenominalexpectedacousticoutputforall
transducer/systemcombinationsthatmightoccur.Ofcourseeverytransducer/system

Chapter 6: Safety

103

Safety

2D/
M Mode

Transducer Model

combinationhasitsownuniquecharacteristicacousticoutput,andwillnotmatchthenominal
outputonwhichthedisplayestimatesarebased.Thisvariabilitybetweensystemsand
transducersintroducesanerrorintodisplayedvalue.Bydoingacousticoutputsampling
testingduringproduction,theamountoferrorintroducedbythevariabilityisbounded.The
samplingtestingensuresthattheacousticoutputoftransducersandsystemsbeing
manufacturedstayswithinaspecifiedrangeofthenominalacousticoutput.
Anothersourceoferrorarisesfromtheassumptionsandapproximationsthataremadewhen
derivingtheestimatesforthedisplayindices.Chiefamongtheseassumptionsisthatthe
acousticoutput,andthusthederiveddisplayindices,arelinearlycorrelatedwiththetransmit
drivevoltageofthetransducer.Generally,thisassumptionisverygood,butitisnotexact,and
thussomeerrorinthedisplaycanbeattributedtotheassumptionofvoltagelinearity.

Related guidance documents


InformationforManufacturersSeekingMarketingClearanceofDiagnosticUltrasound
SystemsandTransducers,FDA,1997.
MedicalUltrasoundSafety,AmericanInstituteofUltrasoundinMedicine(AIUM),1994.(A
copyisincludedwitheachsystem.)
AcousticOutputMeasurementStandardforDiagnosticUltrasoundEquipment,NEMA
UD22004.
AcousticOutputMeasurementandLabelingStandardforDiagnosticUltrasoundEquipment,
AmericanInstituteofUltrasoundinMedicine,1993.
StandardforRealTimeDisplayofThermalandMechanicalAcousticOutputIndiceson
DiagnosticUltrasoundEquipment,NEMAUD32004.
GuidanceontheinterpretationofTIandMItobeusedtoinformtheoperator,AnnexHH,BS
EN60601237reprintedatP05699.

Transducer surface temperature rise


Table 6andTable 7listthemeasuredsurfacetemperaturerisefromambient(23C3C)of
transducersusedontheultrasoundsystem.Thetemperaturesweremeasuredinaccordance
withEN60601237section42withcontrolsandsettingspositionedtogivemaximum
temperatures
Table 6: Transducer Surface Temperature Rise, External Use (C)

104

Test

C11x

C60x

D2

HFL38x

L25x

L38x

P10x

P21x

Still air

17.6

16.2

8.3

15.5

16.1

16.3

15.6

16.8

Simulated
Use

9.1

8.8

1.9

7.9

8.5

9.6

9.8

9.0

Table 7: Transducer Surface Temperature Rise, Internal Use (C )


ICTx

SLAx

TEEx

Still air

9.2

9.5

9.3

Simulated
Use

5.2

4.8

5.8

Safety

Test

Acoustic output measurement


Sincetheinitialuseofdiagnosticultrasound,thepossiblehumanbiologicaleffects(bioeffects)
fromultrasoundexposurehavebeenstudiedbyvariousscientificandmedicalinstitutions.In
October1987,theAmericanInstituteofUltrasoundinMedicine(AIUM)ratifiedareportfrom
itsBioeffectsCommittee(BioeffectsConsiderationsfortheSafetyofDiagnosticUltrasound,J
UltrasoundMed.,Sept.1988:Vol.7,No.9Supplement).Thereport,sometimesreferredtoas
theStoweReport,reviewedavailabledataonpossibleeffectsofultrasoundexposure.Another
report,BioeffectsandSafetyofDiagnosticUltrasound,datedJanuary28,1993,provides
morecurrentinformation.
Theacousticoutputforthisultrasoundsystemhasbeenmeasuredandcalculatedin
accordancewithAcousticOutputMeasurementStandardforDiagnosticUltrasound
Equipment(NEMAUD22004),andStandardforRealTimeDisplayofThermaland
MechanicalAcousticOutputIndicesonDiagnosticUltrasoundEquipment(NEMA
UDe32004).

In Situ, derated, and water value intensities


Allintensityparametersaremeasuredinwater.Sincewaterdoesnotabsorbacousticenergy,
thesewatermeasurementsrepresentaworstcasevalue.Biologicaltissuedoesabsorbacoustic
energy.Thetruevalueoftheintensityatanypointdependsontheamount,typeoftissue,and
thefrequencyoftheultrasoundpassingthroughthetissue.Theintensityvalueinthetissue,
In Situ,hasbeenestimatedbyusingthefollowingformula:
In Situ=Water[e(0.23alf)]
where:
In Situ=In Situintensityvalue
Water=Waterintensityvalue
e=2.7183
a=attenuationfactor(dB/cm MHz)

Chapter 6: Safety

105

Attenuationfactor(a)forvarioustissuetypesaregivenbelow:
brain=0.53
heart=0.66
kidney=0.79
liver=0.43
muscle=0.55
l=skinlinetomeasurementdepthincm
f=centerfrequencyofthetransducer/system/modecombinationinMHz
Sincetheultrasonicpathduringtheexamislikelytopassthroughvaryinglengthsandtypes
oftissue,itisdifficulttoestimatethetrueIn Situintensity.Anattenuationfactorof0.3isused
forgeneralreportingpurposes;therefore,theIn Situvaluecommonlyreportedusesthe
formula:
In Situ(derated)=Water[e(0.069lf)]
SincethisvalueisnotthetrueIn Situintensity,thetermderatedisusedtoqualify it.
Themaximumderatedandthemaximumwatervaluesdonotalwaysoccuratthesame
operatingconditions;therefore,thereportedmaximumwaterandderatedvaluesmaynotbe
relatedbytheIn Situ(derated)formula.Forexample:amultizonearraytransducerthathas
maximumwatervalueintensitiesinitsdeepestzone,butalsohasthesmallestderatingfactor
inthatzone.Thesametransducermayhaveitslargestderatedintensityinoneofitsshallowest
focalzones.

Tissue models and equipment survey


TissuemodelsarenecessarytoestimateattenuationandacousticexposurelevelsIn Situfrom
measurementsofacousticoutputmadeinwater.Currently,availablemodelsmaybelimitedin
theiraccuracybecauseofvaryingtissuepathsduringdiagnosticultrasoundexposuresand
uncertaintiesintheacousticpropertiesofsofttissues.Nosingletissuemodelisadequatefor
predictingexposuresinallsituationsfrommeasurementsmadeinwater,andcontinued
improvementandverificationofthesemodelsisnecessaryformakingexposureassessments
forspecificexamtypes.
Ahomogeneoustissuemodelwithattenuationcoefficientof0.3 dB/cm MHzthroughoutthe
beampathiscommonlyusedwhenestimatingexposurelevels.Themodelisconservativein
thatitoverestimatestheIn Situacousticexposurewhenthepathbetweenthetransducerand
siteofinterestiscomposedentirelyofsofttissue.Whenthepathcontainssignificantamounts
offluid,asinmanyfirstandsecondtrimesterpregnanciesscannedtransabdominally,this
modelmayunderestimatetheIn Situacousticexposure.Theamountofunderestimation
dependsuponeachspecificsituation.

106

Existingtissuemodelsthatarebasedonlinearpropagationmayunderestimateacoustic
exposureswhensignificantsaturationduetononlineardistortionofbeamsinwaterispresent
duringtheoutputmeasurement.
Themaximumacousticoutputlevelsofdiagnosticultrasounddevicesextendoverabroad
rangeofvalues:
Asurveyof1990equipmentmodelsyieldedMIvaluesbetween0.1 and1.0attheirhighest
outputsettings.MaximumMIvaluesofapproximately2.0areknowntooccurforcurrently
availableequipment.MaximumMIvaluesaresimilarforrealtime2DandM Modeimaging.
Computedestimatesofupperlimitstotemperatureelevationsduringtransabdominalscans
wereobtainedinasurveyof1988and1990pulsedDopplerequipment.Thevastmajorityof
modelsyieldedupperlimitslessthan1and4C(1.8and7.2F)forexposuresof
firsttrimesterfetaltissueandsecondtrimesterfetalbone,respectively.Thelargestvalues
obtainedwereapproximately1.5C(2.7F)forfirsttrimesterfetaltissueand7C(12.6F)for
secondtrimesterfetalbone.Estimatedmaximumtemperatureelevationsgivenherearefor
afixedpathtissuemodelandarefordeviceshavingISPTAvaluesgreaterthan500 mW/
cm2.Thetemperatureelevationsforfetalboneandtissuewerecomputedbasedon
calculationproceduresgiveninSections4.3.2.14.3.2.6inBioeffectsandSafetyofDiagnostic
Ultrasound(AIUM,1993).

Acoustic output tables


Table 8throughTable 31indicatetheacousticoutputforthesystemandtransducer
combinationswithaTIorMIequaltoorgreaterthanone.Thesetablesareorganizedby
transducermodelandimagingmode.Foradefinitionoftermsusedinthetables,seeTerms
usedintheacousticoutputtablesonpage 132.

Chapter 6: Safety

107

Safety

Fixedpathtissuemodels,inwhichsofttissuethicknessisheldconstant,sometimesareusedto
estimateIn Situacousticexposureswhenthebeampathislongerthan3 cmandconsistslargely
offluid.Whenthismodelisusedtoestimatemaximumexposuretothefetusduring
transabdominalscans,avalueof1 dB/cm MHzmaybeusedduringalltrimesters.

Table 8: Transducer Model: C11x/8-5

Operating Mode: CPD/Color


TIS

Index Label

M.I.

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Dim of Aaprt
PD
PRF
pr@PIImax

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

deq@Pllmax
Focal Length
IPA.3@MImax

Operating
Control
Conditions

(MPa)

(a)
#

TIB
Non-scan

TIC

1.2

40.50

#
#
#

4.38
0.36
0.5

#
#
#

(cm)

FLx (cm)

1.56

FLy (cm)

2.5

(W/cm2)

Control 1: Mode
Control 2: Exam Type
Control 3: PRF
Control 4: Optimization/Depth
Control 5: Color Box
Position/ Size

#
CPD
Vas
2841
Med/2.0
Top/
Short

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

108

Table 9: Transducer Model: C11x/8-5

Operating Mode: PW Doppler


TIS

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

(a)
#

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Dim of Aaprt
PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax
Operating
Control
Conditions

M.I.

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

Non-scan

TIC

1.8

1.7

26.29

24.65

1.1

0.236
#

#
#
#

4.36
0.28
0.5

4.36
0.2
0.5

#
#
#

(cm)

0.226

FLx (cm)

0.77

FLy (cm)

2.5

(W/cm2)

Control 1: Exam Type


Control 2: Sample Volume
Control 3: PRF
Control 4: Sample Volume Position

#
Any
2 mm
3906
Zone 1

Any
3 mm
3906
Zone 0

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

Chapter 6: Safety

109

Safety

Index Label

TIB

Table 10: Transducer Model: C60x/5-2

Operating Mode: 2D
TIS

Index Label

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

1.0
1.69

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Non-scan

TIC

(b)

4.7

2.84

#
#
#

#
#
#

deq@Pllmax

X (cm)
Y (cm)
(sec) 0.579
(Hz) 5440
(MPa) 2.679
(cm)

Focal Length

FLx (cm)

FLy (cm)

Dim of Aaprt
PD
PRF
pr@PIImax

IPA.3@MImax
Control 1: Exam Type
Operating
Control
Conditions

M.I.

TIB

Control 2: Optimization
Control 3: Depth
Control 4: THI
Control 5: MB (Multi Beam)

(W/cm2) 197.7
Abd/
OB
Any
11/
13 cm
On
On

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

110

Table 11: Transducer Model: C60x/5-2

Operating Mode: M Mode


TIS

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

1.0
1.62

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Non-scan

TIC

(a)

(b)

4.7

#
2.85

#
#
#

#
#
#

#
#
#

deq@Pllmax

X (cm)
Y (cm)
(sec) 0.577
(Hz) 800
(MPa) 2.576
(cm)

Focal Length

FLx (cm)

FLy (cm)

Dim of Aaprt
PD
PRF
pr@PIImax

IPA.3@MImax
Operating
Control
Conditions

M.I.

Control 1: Exam Type


Control 2: Optimization
Control 3: Depth
Control 4: MB (Multi Beam)

(W/cm2) 184.3
Any
Pen
7.8 cm
Off or
On

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

Chapter 6: Safety

111

Safety

Index Label

TIB

Table 12: Transducer Model: C60x/5-2

Operating Mode: PW Doppler


TIS

Index Label

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

(a)
#

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Dim of Aaprt
PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax
Operating
Control
Conditions

M.I.

TIB

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

Non-scan

TIC

3.1

(b)

85.64

1.255

0.51
#

#
#
#

2.233
0.6552
1.3

#
#
#

#
#
#

(cm)

0.415

FLx (cm)

FLy (cm)

(W/cm )

Control 1: Exam Type


Control 2: PRF
Control 3: Sample Volume
Control 4: Sample Volume Position

#
Abd
Any
12 mm
Zone 1

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

112

Table 13: Transducer Model: D2x/2

Operating Mode: CW Doppler


TIS

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

(a)
#

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Dim of Aaprt
PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax
Operating
Control
Conditions

M.I.

Control 1: Exam Type


Control 2: Depth
Control 3: Zone

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

Non-scan

TIC

2.6

(b)

90.52

1.1

0.66
#

#
#
#

2.00
0.8
0.4

#
#
#

#
#
#

(cm)

0.54

FLx (cm)

FLy (cm)

(W/cm2)

#
Crd
Fixed
Fixed

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

Chapter 6: Safety

113

Safety

Index Label

TIB

Table 14: Transducer Model: HFL38x/13-6

Operating Mode: CPD/Color


TIS

Index Label

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

1.1
2.556

Non-scan
Aaprt1

Aaprt>1

1.0

(b)

53.49

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

TIC

Nonscan

Scan

W0

Dim of Aaprt

Operating
Control
Conditions

M.I.

TIB

1.2

5.328

5.324
0.44
0.4

#
#
#

0.525
2597
3.187

(cm)

FLx (cm)

1.32

FLy (cm)

2.5

(W/cm2)

Control 1: Mode
Control 2: Exam Type
Control 3: Optimization/Depth/PRF

Control 4: Color Box Position/Size

325.5
Color
Any
Low/3.3 cm/
393
Any

Color
Any
Med/
2.7 cm/
1938
Top/
Short

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

114

Table 15: Transducer Model: HFL38x/13-6

Operating Mode: PW Doppler


TIS

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

(MPa)

Aaprt1

Aaprt>1

1.2

46.55

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

Non-scan

TIC

2.2

(b)

46.55

1.1

0.9

0.33
5.32

5.33
1.04
0.4

5.33
1.04
0.4

#
#
#

1.29
1008
2.404

(cm)

0.46

FLx (cm)

3.72

FLy (cm)

2.5

(W/cm2)

Control 1: Exam Type


Operating
Control
Conditions

1.0
2.37

Non-scan
Scan

W0

Dim of Aaprt

Other Information

M.I.

Control 2: Sample Volume


Control 3: PRF
Control 4: Sample Volume Position

323.35
Bre/Vas
SmP/IMT
1 mm
1008
Zone 2

Vas/Ven/
IMT
12 mm
10417
Zone 7

Vas/Ven/
IMT
12 mm
10417
Zone 7

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

Chapter 6: Safety

115

Safety

Index Label

TIB

Table 16: Transducer Model: ICTx/8-5

Operating Mode: PW Doppler


TIS

Index Label

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

(a)
#

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Dim of Aaprt
PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax
Operating
Control
Conditions

M.I.

TIB

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

Non-scan

TIC

1.2

(a)

16.348

1.6

0.192
#

#
#
#

4.36
0.6
0.5

#
#
#

#
#
#

(cm)

0.187

FLx (cm)

FLy (cm)

(W/cm2)

Control 1: Exam Type


Control 2: Sample Volume
Control 3: PRF
Control 4: Sample Volume Position

#
Any
3 mm
Any
Zone 1

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

116

Table 17: Transducer Model L25x/13-6

Operating Mode: PW Doppler


TIS

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

(MPa)

Aaprt1

Aaprt>1

(a)

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

Non-scan

TIC

1.6

(b)

14.02

0.6

0.155
#

#
#
#

6.00
0.16
0.3

#
#
#

#
#
#

(cm)

0.1549

FLx (cm)

FLy (cm)

(W/cm2)

Control 1: Exam Type


Operating
Control
Conditions

(a)
#

Non-scan
Scan

W0

Dim of Aaprt

Other Information

M.I.

Control 2: Sample Volume


Control 3: PRF
Control 4: Sample Volume Position

#
Vas/Nrv/
Ven
12 mm
20833
Zone 0

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

Chapter 6: Safety

117

Safety

Index Label

TIB

Table 18: Transducer Model: L38x/10-5

Operating Mode: CPD/Color


TIS

Index Label

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

1.3
2.89

Non-scan
Scan

Aaprt1 Aaprt>1

1.0

64.88

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Dim of Aaprt
PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax
Operating
Control
Conditions

M.I.

TIB

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

Non-scan

TIC

(b)

1.1

4.91

4.91
0.54
0.4

#
#
#

0.529
9547
3.48

(cm)

FLx (cm)

1.5

FLy (cm)

2.5

(W/cm2)

Control 1: Mode
Control 2: Exam Type
Control 3: PRF
Control 4: Optimization/Depth
Control 5: Color Box Position/Size

439.3
Color
Any
331
Any/3.1
Any

CPD
Bre
2137
Med/3.1
Def/
Def/Def

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

118

Table 19: Transducer Model: L38x/10-5

Operating Mode: PW Doppler


TIS

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

1.04
2.345

Non-scan
Scan

Aaprt1

Aaprt>1

2.0

84.94

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Dim of Aaprt
PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax
Operating
Control
Conditions

M.I.

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

Non-scan

TIC

2.6

(b)

84.94

1.3

0.8

0.4685
5.01

5.05
1.80
0.4

5.05
1.80
0.4

#
#
#

1.29
1008
2.693

(cm)

0.2533

FLx (cm)

5.54

FLy (cm)

2.5

(W/cm2)

Control 1: Exam Type


Control 2: Sample Volume
Control 3: PRF
Control 4: Sample Volume Position

284.5
Any
1 mm
1008
Zone 0
(top)

Vas
12 mm
Any

Vas
12 mm
Any

Zone 7

Zone 7

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

Chapter 6: Safety

119

Safety

Index Label

TIB

Table 20: Transducer Model: P10x/8-4

Operating Mode: 2D Mode


TIS

Index Label

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

(a)
#

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Dim of Aaprt
PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax
Operating
Control
Conditions

M.I.

TIB

Control 1: Exam Type


Control 2: Optimization
Control 3: Depth
Control 4: MB/SonoHD

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

Non-scan

TIC

1.0

35.24

#
#
#

4.84
0.416
0.7

#
#
#

(cm)

FLx (cm)

1.67

FLy (cm)

5.0

(W/cm2)

#
Neo
Gen
2.0
Off/Off

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

120

Table 21: Transducer Model: P10x/8-4

Operating Mode: Color


TIS

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

1.0
2.02

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Dim of Aaprt
PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax

Operating
Control
Conditions

M.I.

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

TIC

1.3

41.38

2.4

3.90

#
#
#

3.91
0.608
0.7

0.70
2772
2.80

(cm)

FLx (cm)

2.48

FLy (cm)

5.0

(W/cm2)

Control 1: Mode
Control 2: Exam Type
Control 3: Optimization/Depth/PRF

Control 4: Color Box Pos/Size

Non-scan

252
Color
Neo
Low/
3.7/
772
Any/
Tall

Color
Abd
Med/
2.0/
2315
Short/
Narrow

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

Chapter 6: Safety

121

Safety

Index Label

TIB

Table 22: Transducer Model: P10x/8-4

Operating Mode: PW Doppler


TIS

Index Label

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

1.0
2.03

Non-scan
Scan

Aaprt1

Aaprt>1

1.2

36.25

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Non-scan

TIC

2.0

1.8

34.4

31.5

0.8

2.1

0.32
3.87

6.86
0.992
0.7

3.84
0.416
0.7

3.86
.224
0.7

deq@Pllmax

X (cm)
Y (cm)
(sec) 1.28
(Hz) 1563
(MPa) 2.70
(cm)

Focal Length

FLx (cm)

6.74

0.92

FLy (cm)

5.0

5.0

Dim of Aaprt
PD
PRF
pr@PIImax

IPA.3@MImax
Operating
Control
Conditions

M.I.

TIB

(W/cm2)

Control 1: Exam Type


Control 2: Sample Volume
Control 3: PRF/TDI
Control 4: Sample Volume Position

0.25

233
Crd
1 mm
1563/
Off
Zone 3

Crd
7 mm
Any/
On
Zone 6

Neo
12 mm
15625/
Off
Zone 2

Crd
1 mm
5208/
Off
Zone 1

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

122

Table 23: Transducer Model: P10x/8-4

Operating Mode: CW Doppler


TIS

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

(a)
#

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Dim of Aaprt
PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax
Operating
Control
Conditions

M.I.

Control 1: Exam Type


Control 2: Depth
Control 3: Zone

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

Non-scan

TIC

2.1

2.0

40.72

30.00

0.7

0.36
#

#
#
#

4.00
0.320
0.7

4.00
0.16
0.7

#
#
#

(cm)

0.27

FLx (cm)

0.92

FLy (cm)

5.0

(W/cm2)

#
Card
Any

Card
Any

Zone 3

Zone 0

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

Chapter 6: Safety

123

Safety

Index Label

TIB

Table 24: Transducer Model: P21x/5-1

Operating Mode: 2D
TIS

Index Label

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

1.4
1.92

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Non-scan

TIC

2.3

171.53

5.1

1.93

#
#
#

1.94
1.9
1.3

deq@Pllmax

X (cm)
Y (cm)
(sec) 0.842
(Hz) 4000
(MPa) 2.53
(cm)

Focal Length

FLx (cm)

18.46

FLy (cm)

5.5

Dim of Aaprt
PD
PRF
pr@PIImax

IPA.3@MImax
Operating
Control
Conditions

M.I.

TIB

Control 1: Exam Type


Control 2: Optimization
Control 3: Depth
Control 4: THI
Control 5: Sector Width

(W/cm2) 355.1
Card
Res
4.7/7.5
cm
On
Narrow

Card
Pen
27 cm
Off
Narrow

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

124

Table 25: Transducer Model: P21x/5-1

Operating Mode: M Mode


TIS

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

1.5
2.10

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm) 3.645
(cm)

deq(zsp)
fc

(MHz)

1.93

Non-scan

TIC

1.4

1.1

40.08

29.71

4.9
0.343

#
#
#

1.93
1.835
1.3

1.94
1.9
1.3

deq@Pllmax

X (cm)
Y (cm)
(sec) 0.904
(Hz) 800
(MPa) 2.679
(cm)

Focal Length

FLx (cm)

18.46

FLy (cm)

5.5

Dim of Aaprt
PD
PRF
pr@PIImax

IPA.3@MImax
Control 1: Exam Type
Operating
Control
Conditions

M.I.

Control 2: Optimization
Control 3: Depth
Control 4: THI
Control 5: MB
(Multibeam)

0.341

(W/cm2) 237.4
Abd/
OB
Any
7.5 cm
On

Gen/Res
10/13 cm
On

On

On or Off

Abd/OB

Abd/OB
/Card
Pen
27 cm
Off
On or
Off

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

Chapter 6: Safety

125

Safety

Index Label

TIB

Table 26: Transducer Model: P21x/5-1

Operating Mode: CPD/Color


TIS

Index Label

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

(MPa)

Aaprt1 Aaprt>1

1.3

136.91

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Non-scan

TIC

2.4

137.5

4.5

2.15

2.16
0.918
1.3

2.16
0.918
1.3

deq@Pllmax

X (cm)
Y (cm)
(sec) 1.20
(Hz) 1063
(MPa) 2.574
(cm)

Focal Length

FLx (cm)

3.68

3.68

FLy (cm)

5.5

5.5

PD
PRF
pr@PIImax

IPA.3@MImax

(W/cm2) 330.4

Control 1: Mode
Control 2: Exam Type
Operating
Control
Conditions

1.5
2.19

Non-scan
Scan

W0

Dim of Aaprt

Other Information

M.I.

TIB

Control 3: PRF/Depth
Control 4: Color Optimization
Control 5: THI
Control 6: Color Box Size

Color
Abd/
OB
300/10
Any
On
Any

CPD

Color

OB

Abd

850/7.5
Med
Off
Short and
Narrow

751/7.5
Med
Off
Short and
Narrow

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

126

Table 27: Transducer Model: P21x/5-1

Operating Mode: PW Doppler


TIS

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

Non-scan
Scan

Aaprt1

Aaprt>1

1.3

W0

1.2
(MPa) 1.844
(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

120.13

z1

(cm)

3.1

zbp

(cm)

2.66

zsp

(cm) 3.718
(cm)

deq(zsp)
fc

(MHz)

2.16

Non-scan

TIC

4.0

2.7

95.55

95.55

0.6
0.49

2.22
1.9
1.3

2.23
0.459
1.3

2.23
0.459
1.3

deq@Pllmax

X (cm)
Y (cm)
(sec) 1.21
(Hz) 1562.5
(MPa) 2.432
(cm)

Focal Length

FLx (cm)

13.84

1.55

FLy (cm)

5.5

5.5

Dim of Aaprt
PD
PRF
pr@PIImax

IPA.3@MImax
Operating
Control
Conditions

M.I.

0.49

(W/cm2) 187.5

Control 1: Exam Type


Control 2: Sample Volume
Control 3: PRF
Control 4: Sample Volume Position

Card
1mm
1563
Zone 1

Card
3mm
3906
Zone 4

TCD
14mm
12500
Zone 0

TCD
14mm
12500
Zone 0

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

Chapter 6: Safety

127

Safety

Index Label

TIB

Table 28: Transducer Model: P21x/5-1

Operating Mode: CW Doppler


TIS

Index Label

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

(a)
#

Non-scan
Scan

Aaprt1

Aaprt>1

1.0

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

102.54

z1

(cm)

1.386

zbp

(cm)

1.71

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Dim of Aaprt
PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax
Operating
Control
Conditions

M.I.

TIB

Control 1: Exam Type


Control 2: Zone

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

Non-scan

TIC

3.4

2.9

88.30

101.73

1.255

0.49
#

2.00
0.786
1.3

2.00
0.655
1.3

2.00
0.459
1.3

#
#
#

(cm)

0.45

FLx (cm)

13.84

1.55

FLy (cm)

5.5

5.5

(W/cm2)

#
Card

Card

Card

Zone 4

Zone 1

Zone 0

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

128

Table 29: Transducer Model: SLAx/13-6

Operating Mode: PW Doppler

Index Label

M.I.

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Aaprt>1

(a)

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

PD
PRF
pr@PIImax

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

deq@Pllmax
Focal Length
IPA.3@MImax

Non-scan

TIC

1.2

(b)

8.75

0.65

0.13
#

#
#
#

6.00
0.24
0.3

#
#
#

#
#
#

(cm)

0.13

FLx (cm)

FLy (cm)

(W/cm )

Control 1: Exam Type


Operating
Control
Conditions

(a)
#

Aaprt1

W0

Dim of Aaprt

Other Information

(MPa)

TIB

Non-scan
Scan

Safety

TIS

Control 2: Sample Volume


Control 3: PRF
Control 4: Sample Vol. Position

#
Vas, Nrv,
Ven
5 mm
20833
Zone 2

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

Chapter 6: Safety

129

Table 30: Transducer Model: TEEx/8-3

Operating Mode: PW Doppler


TIS

Index Label

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

(a)
#

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Dim of Aaprt
PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax
Operating
Control
Conditions

M.I.

TIB

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

Non-scan

TIC

1.7

(b)

29.29

0.6

0.34
#

#
#
#

3.84
0.261
0.9

#
#
#

#
#
#

(cm)

0.34

FLx (cm)

FLy (cm)

(W/cm2)

Control 1: Exam Type


Control 2: Sample Volume
Control 3: PRF
Control 4: Sample Volume Position

#
Crd
1 mm
2604
Zone 1

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

130

Table 31: Transducer Model: TEEx/8-3

Operating Mode: CW Doppler


TIS

Associated Acoustic
Parameter

Global Maximum Index Value


pr.3

Other Information

(MPa)

(a)
#

Non-scan
Scan

Aaprt1

Aaprt>1

(a)

W0

(mW)

min of [W.3(z1),ITA.3(z1)]

(mW)

z1

(cm)

zbp

(cm)

zsp

(cm)

deq(zsp)

(cm)

fc

(MHz)

Dim of Aaprt
PD
PRF
pr@PIImax
deq@Pllmax
Focal Length
IPA.3@MImax
Operating
Control
Conditions

M.I.

Control 1: Exam Type


Control 2: Depth
Control 3: Zone

X (cm)
Y (cm)
(sec)
(Hz)
(MPa)

Non-scan

TIC

1.2

(b)

27.23

1.1

0.39
#

#
#
#

4.00
0.435
0.9

#
#
#

#
#
#

(cm)

0.34

FLx (cm)

FLy (cm)

(W/cm2)

#
Crd
Any
Zone 3

(a) This index is not required for this operating mode; value is <1.
(b) This transducer is not intended for transcranial or neonatal cephalic uses.
#No data are reported for this operating condition since the global maximum index value is not reported for
the reason listed. (Reference Global Maximum Index Value line.)
Data are not applicable for this transducer/mode.

Chapter 6: Safety

131

Safety

Index Label

TIB

Terms used in the acoustic output tables


Table 32: Acoustic Output Terms and Definitions

132

Term

Definition

ISPTA.3

Derated spatial peak, temporal average intensity in units of milliwatts/cm2.

TI type

Applicable thermal index for the transducer, imaging mode, and exam type.

TI value

Thermal index value for the transducer, imaging mode, and exam type.

MI

Mechanical index.

Ipa.3@MImax

Derated pulse average intensity at the maximum MI in units of W/cm2.

TIS

(Soft tissue thermal index) is a thermal index related to soft tissues. TIS scan is
the soft tissue thermal index in an auto-scanning mode. TIS non-scan is the
soft tissue thermal index in the non-autoscanning mode.

TIB

(Bone thermal index) is a thermal index for applications in which the


ultrasound beam passes through soft tissue and a focal region is in the
immediate vicinity of bone. TIB non-scan is the bone thermal index in the
non-autoscanning mode.

TIC

(Cranial bone thermal index) is the thermal index for applications in which
the ultrasound beam passes through bone near the beam entrance into the
body.

Aaprt

Area of the active aperture measured in cm2.

Pr.3

Derated peak rarefactional pressure associated with the transmit pattern


giving rise to the value reported under MI (Megapascals).

Wo

Ultrasonic power, except for TISscan, in which case it is the ultrasonic power
passing through a one centimeter window in units of milliwatts.

W.3(z1)

Derated ultrasonic power at axial distance z1 in units of milliwatts.

ISPTA.3(z1)

Derated spatial-peak temporal-average intensity at axial distance z1


(milliwatts per square centimeter).

z1

Axial distance corresponding to the location of maximum [min(W.3(z), ITA.3(z)


x 1 cm2)], where z > zbp in centimeters.

zbp

1.69

zsp

For MI, the axial distance at which pr.3 is measured. For TIB, the axial distance
at which TIB is a global maximum (for example, zsp = zb.3) in centimeters.

( A a p r t ) in centimeters.

Table 32: Acoustic Output Terms and Definitions (Continued)


Definition

deq(z)

Equivalent beam diameter as a function of axial distance z, and is equal to

Safety

Term

( 4 ( ) ) ( ( Wo ) ( I TA ( z ) ) ) , where ITA(z) is the temporal-average intensity as a

function of z in centimeters.
fc

Center frequency in MHz.

Dim. of Aaprt

Active aperture dimensions for the azimuthal (x) and elevational (y) planes in
centimeters.

PD

Pulse duration (microseconds) associated with the transmit pattern giving


rise to the reported value of MI.

PRF

Pulse repetition frequency associated with the transmit pattern giving rise to
the reported value of MI in Hertz.

pr@PIImax

Peak rarefactional pressure at the point where the free-field, spatial-peak


pulse intensity integral is a maximum in Megapascals.

deq@PIImax

Equivalent beam diameter at the point where the free-field, spatial-peak


pulse intensity integral is a maximum in centimeters.

FL

Focal length, or azimuthal (x) and elevational (y) lengths, if different


measured in centimeters.

Acoustic measurement precision and uncertainty


Alltableentrieshavebeenobtainedatthesameoperatingconditionsthatgiverisetothe
maximumindexvalueinthefirstcolumnofthetable.Measurementprecisionanduncertainty
forpower,pressure,intensity,andotherquantitiesthatareusedtoderivethevaluesinthe
acousticoutputtableareshowninthetablebelow.InaccordancewithSection 6.4oftheOutput
DisplayStandard,thefollowingmeasurementprecisionanduncertaintyvaluesare
determinedbymakingrepeatmeasurementsandstatingthestandarddeviationasa
percentage.

Chapter 6: Safety

133

Table 33: Acoustic Measurement Precision and Uncertainty


Precision
(% of standard deviation)

Uncertainty
(95% confidence)

Pr

1.9%

+11.2%

Pr.3

1.9%

+12.2%

Wo

3.4%

+10%

fc

0.1%

+4.7%

PII

3.2%

+12.5 to -16.8%

PII.3

3.2%

+13.47 to -17.5%

Quantity

Labeling symbols
Thefollowingsymbolsareusedontheproducts,packaging,andcontainers.
Table 34: Labeling Symbols
Symbol

Definition
Alternating Current (AC)
Class 1 device indicating manufacturers declaration of conformance with
Annex VII of 93/42/EEC
Class 1 device requiring verification by the Notified Body of sterilization or
measurement features, or to a Class IIa, IIb, or III device requiring verification or
auditing by the Notified Body to applicable Annex(es) of 93/42/EEC
Attention, see the user guide

Device complies with relevant Australian regulations for electronic devices.

LOT

Batch code, date code, or lot code type of control number


Biological risk

134

Table 34: Labeling Symbols (Continued)


Symbol

Definition

Canadian Standards Association. The C and US indicators next to this mark


signify that the product has been evaluated to the applicable CSA and ANSI/UL
Standards, for use in Canada and the US, respectively.

REF

Catalog number
Collect separately from other household waste (see European Commission
Directive 93/86/EEC). Refer to local regulations for disposal.

STERILE EO

Contents sterilized using ethylene oxide process.


Corrugated recycle

Dangerous voltage

Date of manufacture

Direct Current (DC)


Do not get wet.

Do not stack over 2 high.

Do not stack over 5 high.

Chapter 6: Safety

135

Safety

Device complies with relevant Brazilian regulations for electro-medical devices.

Table 34: Labeling Symbols (Continued)


Symbol

Definition
Do not stack over 10 high.

Electrostatic sensitive devices

Device complies with relevant FCC regulations for electronic devices.


Fragile

GEL STERILE R

Gel sterilized by radiation.


Hot
Indoor use only

Device emits a static (DC) magnetic field.

Non-ionizing radiation

Paper recycle

SN

Serial number type of control number


Storage temperature conditions

Submersible. Protected against the effects of temporary immersion.


Water-Tight Equipment. Protected against the effects of extended immersion.

136

Table 34: Labeling Symbols (Continued)


Symbol

Definition
Safety

Handle transducer with care.

Follow manufacturers instructions for disinfecting time.

Disinfect transducer.

Type BF patient applied part


(B = body, F = floating applied part)
Defibrillator proof type CF patient applied part
Underwriters Laboratories labeling

Pollution Control Logo. (Applies to all parts/products listed in the China RoHS
disclosure table. May not appear on the exterior of some parts/products
because of space limitations.)
China Compulsory Certificate mark (CCC Mark). A compulsory safety mark for
compliance to Chinese national standards for many products sold in the
Peoples Republic of China.
Contains mercury. (Applies to the LCD and may apply to other components in
the ultrasound system.)
WARNING:
Connect Only
Accessories and
Peripherals
Recommended by
SonoSite

WARNING: Connect Only


Accessories and Peripherals
Recommended by SonoSite

Chapter 6: Safety

137

138

Chapter 7: References

The2Dlineardistancemeasurementresultsare
displayedincentimeterswithoneplacepastthe
decimalpoint,ifthemeasurementistenor
greater;twoplacespastthedecimalpoint,ifthe
measurementislessthanten.
Thelineardistancemeasurementcomponents
havetheaccuracyandrangeshowninthe
followingtables.

Range (cm)

Test Methodb

Accuracy
By

System
Tolerancea

Axial
Distance

< 2% plus
1% of full
scale

Acquisition Phantom

0-26 cm

Lateral
Distance

< 2% plus
1% of full
scale

Acquisition Phantom

0-35 cm

Diagonal
Distance

< 2% plus
1% of full
scale

Acquisition Phantom

0-44 cm

Areac

Acquisition Phantom
< 4% plus
(2% of full
scale/smallest
dimension) *
100 plus 0.5%

0.01-720
cm2

Circumferenced

Acquisition Phantom
< 3% plus
(1.4% of full
scale/
smallest
dimension) *
100 plus 0.5%

0.01-96
cm

a. Full scale for distance implies the maximum depth of the


image.
b. An RMI 413a model phantom with 0.7 dB/cm MHz attenuation
was used.
c. The area accuracy is defined using the following equation:
% tolerance = ((1 + lateral error) * (1 + axial error) 1) * 100 +
0.5%.
d. The circumference accuracy is defined as the greater of the
lateral or axial accuracy and by the following equation:
% tolerance = ( 2 (maximum of 2 errors) * 100) + 0.5%.

Chapter 7: References

139

References

Themeasurementsprovidedbythesystemdo
notdefineaspecificphysiologicaloranatomical
parameter.Rather,themeasurementsareofa
physicalpropertysuchasdistanceforevaluation
bytheclinician.Theaccuracyvaluesrequirethat
youcanplacethecalipersoveronepixel.The
valuesdonotincludeacousticanomaliesofthe
body.

Table 1: 2D Measurement Accuracy and Range


2D Measure
Accuracy
and Range

Measurement accuracy

Heart Rate

< +/2%
plus
1% of
full
scalec

Acquisition Phantomd

0-26 cm

0.01-10
sec

Acquisition Phantomd 5-923


< +/bpm
2%
plus
(Full
Scalec *
Heart
Rate/1
00) %

a. Full scale for distance implies the maximum depth of the


image.
b. An RMI 413a model phantom with 0.7 dB/cm MHz
attenuation was used.
c. Full scale for time implies the total time displayed on the
scrolling graphic image.
d. SonoSite special test equipment was used.

Doppler Mode
Measurement
Accuracy and Range

< +/- 2%
plus 1% of
full scaleb

Acquisition

Phantom

0.01
cm/sec550 cm/s
ec

Frequency
cursor

< +/- 2%
plus 1% of
full scaleb

Acquisition

Phantom

0.01kHz20.8 kHz

Time

< +/- 2%
plus 1% of
full scalec

Acquisition

Phantom

0.01-10
sec

Range

Velocity
cursor

System
Tolerance

Range

Test Method

Acquisition Phantomb

Test
Methoda

Time

< +/2%
plus
1% of
full
scalea

Table 3: PW Doppler Mode Measurement and


Calculation Accuracy and Range

Accuracy By

Distance

Accuracy By

System Tolerance

M Mode Measurement
Accuracy and Range

Table 2: M Mode Measurement and


Calculation Accuracy and Range

a. SonoSite special test equipment was used.


b. Full scale for frequency or velocity implies the total frequency
or velocity magnitude, displayed on the scrolling graphic
image.
c. Full scale for time implies the total time displayed on the
scrolling graphic image.

Sources of measurement
errors
Ingeneral,twotypesoferrorscanbeintroduced
intothemeasurement:
Acquisition Error Includeserrorsintroducedby
theultrasoundsystemelectronicsrelatingto
signalacquisition,signalconversion,andsignal
processingfordisplay.Additionally,
computationalanddisplayerrorsareintroduced
bythegenerationofthepixelscalefactor,
applicationofthatfactortothecaliperpositions
onthescreen,andthemeasurementdisplay.
Algorithmic Error Theerrorintroducedby
measurements,whichareinputtohigherorder
calculations.Thiserrorisassociatedwith

140

Sources of measurement errors

floatingpointversusintegertypemath,whichis
subjecttoerrorsintroducedbyroundingversus
truncatingresultsfordisplayofagivenlevelof
significantdigitinthecalculation.

Measurement publications
and terminology

Body Surface Area (BSA) in m2


Grossman,W.CardiacCatheterizationand
Angiography.Philadelphia:LeaandFebiger,
(1980),90.
BSA=0.007184*Weight0.425*Height0.725
Weight=kilograms
Height=centimeters

Cardiac Index (CI) in l/min/m2

Terminologyandmeasurementscomplywith
AIUMpublishedstandards.

Oh,J.K.,J.B.Seward,A.J.Tajik.TheEchoManual.
2ndEdition,Boston:Little,BrownandCompany,
(1999),59.

Cardiac references

CI=CO/BSA

Acceleration (ACC) in cm/s2


Zwiebel,W.J.IntroductiontoVascular
Ultrasonography.4thed.,W.B.Saunders
Company,(2000),52.
ACC=abs(deltavelocity/deltatime)

Acceleration Time (AT) in msec


Oh,J.K.,J.B.Seward,A.J.Tajik.TheEchoManual.
2nded.,Lippincott,Williams,andWilkins,
(1999),219.

where:

CO=CardiacOutput
BSA=BodySurfaceArea

Cardiac Output (CO) in l/min


Oh,J.K.,J.B.Seward,A.J.TajikTheEchoManual.
2nded.,Lippincott,Williams,andWilkins,
(1999),59.
CO=(SV*HR)/1000
where:

CO=CardiacOutput
SV=StrokeVolume
HR=HeartRate

Aortic Valve Area (AVA) by Continuity


Equation in cm2

Cross Sectional Area (CSA) in cm2

Reynolds,Terry.TheEchocardiographersPocket
Reference.2nded.,SchoolofCardiacUltrasound,
ArizonaHeartInstitute,(2000),393,442.

Reynolds,Terry.TheEchocardiographersPocket
Reference.2nded.,SchoolofCardiacUltrasound,
ArizonaHeartInstitute,(2000),383.

A2=A1*V1/V2

CSA=0.785*D2

where:

A2=Aovalvearea

where:

A1=LVOTarea;V1=LVOTvelocity;
V2=Aovalvevelocity

Deceleration Time in msec

D=diameteroftheanatomyof
interest

LVOT=LeftVentricularOutflow
Tract
AVA(PVLVOT/PVAO)*CSALVOT

Reynolds,Terry.TheEchocardiographersPocket
Reference.2nded.,SchoolofCardiacUltrasound,
ArizonaHeartInstitute,(2000),453.

AVA(VTILVOT/VTIAO)*CSALVOT

|timeatimeb|

Chapter 7: References

141

References

Thefollowingsectionslistthepublicationsand
terminologyusedforeachcalculationresult.

Delta Pressure: Delta Time (dP:dT) in


mmHg/s
Otto,C.M.TextbookofClinicalEchocardiography.
2nded.,W.B.SaundersCompany,(2000),117,
118.
32 mmHg/timeintervalinseconds

E:A Ratio in cm/sec


E:A=velocityE/velocityA

E/Ea Ratio
Reynolds,Terry.TheEchocardiographersPocket
Reference.2nded.,SchoolofCardiacUltrasound,
ArizonaHeartInstitute,(2000),225.
EVelocity/Eavelocity
where:

Reynolds,Terry.TheEchocardiographersPocket
Reference.2nded.,SchoolofCardiacUltrasound,
ArizonaHeartInstitute,(2000),455.
ERO=6.28(r2)*Va/MRVel
r=radius
Va=aliasingvelocity

Ejection Fraction (EF), percent


Oh,J.K.,J.B.Seward,A.J.Tajik.TheEchoManual.
2nded.,Lippincott,Williams,andWilkins,
(1999),40.
EF=((LVEDVLVESV)/LVEDV)*100%
where:

142

ET=timebetweenvelocitycursorsin
milliseconds

Heart Rate (HR) in bpm


HR=3digitvalueinputbyuserormeasuredon
M ModeandDopplerimageinoneheartcycle

Interventricular Septum (IVS) Fractional


Thickening, percent
Laurenceau,J.L.,M.C.Malergue.TheEssentialsof
Echocardiography.LeHague:MartinusNijhoff,
(1981),71.
IVSFT=((IVSSIVSD)/IVSD)*100%
where:

Evelocity=MitralValveEvelocity
Ea=annularEvelocity,alsoknown
as:Eprime

Effective Regurgitant Orifice (ERO) in mm2

where:

Elapsed Time (ET) in msec

EF=EjectionFraction
LVEDV=LeftVentricularEnd
DiastolicVolume
LVESV=LeftVentricularEnd
SystolicVolume

Measurement publications and terminology

IVSS=InterventricularSeptal
ThicknessatSystole
IVSD=InterventricularSeptal
ThicknessatDiastole

Isovolumic Relaxation Time (IVRT) in msec


Reynolds,Terry.TheEchocardiographersPocket
Reference.SchoolofCardiacUltrasound,Arizona
HeartInstitute,(1993),146.
|timeatimeb|

Left Atrium/Aorta (LA/Ao)


Feigenbaum,H.Echocardiography.Philadelphia:
LeaandFebiger,(1994),206,Figure449.

Left Ventricular End Volumes (Teichholz) in


ml
Teichholz,L.E.,T.Kreulen,M.V.Herman,et.al.
Problemsinechocardiographicvolume
determinations:echocardiographicangiographic
correlationsinthepresenceorabsenceof
asynergy.AmericanJournalofCardiology,(1976),
37:7.
LVESV=(7.0*LVDS3)/(2.4+LVDS)
where:

LVESV=LeftVentricularEnd
SystolicVolume

LVDS=LeftVentricularDimension
atSystole
LVEDV=(7.0*LVDD3)/(2.4+LVDD)
where:

LVEDV=LeftVentricularEnd
DiastolicVolume
LVDD=LeftVentricularDimension
atDiastole

Oh,J.K.,J.B.Seward,A.J.Tajik.TheEchoManual.
2ndEdition,Boston:Little,BrownandCompany,
(1999),39.

Schiller,N.B.,P.M.Shah,M.Crawford,et.al.
RecommendationsforQuantitationoftheLeft
VentriclebyTwoDimensional
Echocardiography.JournalofAmericanSocietyof
Echocardiography.SeptemberOctober1989,2:362.

V = ---
4

LVID=InternalDimension
PWT=PosteriorWallThickness
IVST=InterventricularSeptal
Thickness
1.04=Specificgravityofthe
myocardium
0.8=Correctionfactor

Left Ventricular Volume: Biplane Method in


ml
Schiller,N.B.,P.M.Shah,M.Crawford,et.al.
RecommendationsforQuantitationoftheLeft
VentriclebyTwoDimensional
Echocardiography.JournalofAmericanSocietyof
Echocardiography.SeptemberOctober1989,2:362.

V = ---
4

ai bi --n-
L

i=1

where:

V=Volumeinml
a=Diameter
b=Diameter
n=Numberofsegments(n=20)
L=Length
i=Segment

ai

2 L

-- n

i=1

where:

LVMass=1.04[(LVID+PWT+IVST)3LVID3]*
0.8+0.6
where:

References

Left Ventricular Mass in gm

Left Ventricular Volume: Single Plane


Method in ml

V=Volume
a=Diameter
n=Numberofsegments(n=20)
L=Length
i=Segment

Left Ventricular Dimension (LVD) Fractional


Shortening, percent
Oh,J.K.,J.B.Seward,A.J.Tajik.TheEchoManual.
Boston:Little,BrownandCompany,(1994),
4344.
LVDFS=((LVDDLVDS)/LVDD)*100%
where:

LVDD=LeftVentricleDimensionat
Diastole
LVDS=LeftVentricleDimensionat
Systole

Left Ventricular Posterior Wall Fractional


Thickening (LVPWFT), percent
Laurenceau,J.L.,M.C.Malergue.TheEssentialsof
Echocardiography.LeHague:MartinusNijhoff,
(1981),71.
LVPWFT=((LVPWSLVPWD)/LVPWD)*100%
where:

LVPWS=LeftVentricularPosterior
WallThicknessatSystole
LVPWD=LeftVentricularPosterior
WallThicknessatDiastole

Mean Velocity (Vmean) in cm/s


Vmean=meanvelocity

Chapter 7: References

143

Mitral Valve Area (MVA) in cm2

Pressure Half Time (PHT) in msec

Reynolds,Terry.TheEchocardiographersPocket
Reference.2nded.,SchoolofCardiacUltrasound,
ArizonaHeartInstitute,(2000),391,452.

Reynolds,Terry.TheEchocardiographersPocket
Reference.2nded.,SchoolofCardiacUltrasound,
ArizonaHeartInstitute,(2000),391.

MVA=220/PHT

PHT=DT*0.29

where:
PHT=pressurehalftime
Note: 220isanempiricalderivedconstantandmay
notaccuratelypredictmitralvalveareainmitral
prostheticheartvalves.Themitralvalvearea
continuityequationmaybeutilizedinmitral
prostheticheartvalvestopredicteffectiveorificearea.

where:

MV Flow Rate in cc/sec


Reynolds,Terry.TheEchocardiographersPocket
Reference.2nded.,SchoolofCardiacUltrasound,
ArizonaHeartInstitute,(2000),396.
Flow=6.28(r2)*Va
where:

r=radius
Va=aliasingVelocity

Pressure Gradient (PGr) in mmHG


Oh,J.K.,J.B.Seward,A.J.Tajik.TheEchoManual.
2nded.,Lippincott,Williams,andWilkins,
(1999),64.
PGr=4*(Velocity)2
PeakEPressureGradient(E PG)

DT=decelerationtime

Proximal Isovelocity Surface Area (PISA) in


cm2
Oh,J.K.,J.B.Seward,A.J.Tajik.TheEchoManual.
2nded.,Boston:Little,BrownandCompany,
(1999),125.
PISA=2 r2
where:

2 =6.28
r=aliasingradius

Qp/Qs
Reynolds,Terry.TheEchocardiographersPocket
Reference.2nded.,SchoolofCardiacUltrasound,
ArizonaHeartInstitute,(2000),400.
Qp/Qs=SVQpsite/SVQssite
SVsiteswillvarydependinguponthelocationof
theshunt.

Regurgitant Fraction (RF) in percent

E PG=4*PE2

Oh,J.K.,J.B.Seward,A.J.Tajik.TheEchoManual.
Boston:Little,BrownandCompany,(1999),125.

PeakAPressureGradient(A PG)

RF=RV/MVSV

A PG=4*PA2

where:

PeakPressureGradient(PGmax)

RV=RegurgitantVolume
MVSV=MitralStrokeVolume

PGmax=4*PV2

Regurgitant Volume (RV) in cc

MeanPressureGradient(PGmean)

Reynolds,Terry.TheEchocardiographersPocket
Reference.SchoolofCardiacUltrasound,Arizona
HeartInstitute,(2000),396,455.

PGmean=Averageofpressure
gradients/Durationofflow

144

Measurement publications and terminology

RV=ERO*MRVTI

Right Ventricular Systolic Pressure (RVSP) in


mmHg
Reynolds,Terry.TheEchocardiographersPocket
Reference.SchoolofCardiacUltrasound,Arizona
HeartInstitute,(1993),152.
RVSP=4*(VmaxTR)2+RAP
where:

Stroke Volume (SV) 2D and M Mode in ml


Oh,J.K.,J.B.Seward,A.J.Tajik.TheEchoManual.
2nded.,Boston:Little,BrownandCompany,
(1994),44.
SV=(LVEDVLVESV)
where:

RAP=RightAtrialPressure

Reynolds,Terry.TheEchocardiographersPocket
Reference.2nded.,SchoolofCardiacUltrasound,
ArizonaHeartInstitute,(2000),217.

Velocity Time Integral (VTI) in cm

Svelocity/Dvelocity

Reynolds,Terry.TheEchocardiographersPocket
Reference.2nded.,SchoolofCardiacUltrasound,
ArizonaHeartInstitute,(2000),383.

where:

VTI=sumofabs(velocities[n])

Svelocity=PulmonaryveinSwave
Dvelocity=PulmonaryveinDwave

Stroke Index (SI) in cc/m2


MosbysMedical,Nursing,&AlliedHealth
Dictionary,4thed.,(1994),1492.
SI=SV/BSA
where:

AutoTracedistance(cm)blood
travelswitheachejectionperiod.
Velocitiesareabsolutevalues.

Obstetrical references
Amniotic Fluid Index (AFI)

SV=StrokeVolume
BSA=BodySurfaceArea

Stroke Volume (SV) Doppler in ml


Oh,J.K.,J.B.Seward,A.J.Tajik.TheEchoManual.
2nded.,Lippincott,Williams,andWilkins,
(1999),40,59,62.
SV=(CSA*VTI)
where

where:

CSA=CrossSectionalAreaofthe
orifice(LVOTarea)
VTI=VelocityTimeIntegralofthe
aorticvalve

Jeng,C.J.,etal.AmnioticFluidIndex
MeasurementwiththeFourQuadrantTechnique
DuringPregnancy.TheJournalofReproductive
Medicine,35:7(July1990),674677.

Average Ultrasound Age (AUA)


ThesystemprovidesanAUAderivedfromthe
componentmeasurementsfromthe
measurementtables.

Estimated Date of Delivery (EDD) by Average


Ultrasound Age (AUA)
Resultsaredisplayedasmonth/day/year.

Tricuspid Valve Area (TVA)

EDD=systemdate+(280daysAUAindays)

Reynolds,Terry.TheEchocardiographersPocket
Reference.2nded.,SchoolofCardiacUltrasound,
ArizonaHeartInstitute,(2000),55,391,452.

Estimated Date of Delivery (EDD) by Last


Menstrual Period (LMP)

TVA=220/PHT

Thedateenteredintothepatientinformationfor
LMPmustprecedethecurrentdate.
Resultsaredisplayedasmonth/day/year.

Chapter 7: References

145

References

S/D

SV=StrokeVolume
LVEDV=EndDiastolicVolume
LVEDSV=EndSystolicVolume

EDD=LMPdate+280days

Estimated Fetal Weight (EFW)


Hadlock,F.,etal.EstimationofFetalWeight
withtheUseofHead,Body,andFemur
Measurements,AProspectiveStudy.American
JournalofObstetricsandGynecology,151:3
(February1,1985),333337.
Hansmann,M.,etal.UltrasoundDiagnosisin
ObstetricsandGynecology.NewYork:
SpringerVerlag,(1986),154.
OsakaUniversity.UltrasoundinObstetricsand
Gynecology.(July 20,1990),103105.
ShepardM.J.,V.A.Richards,R.L.Berkowitz,et
al.AnEvaluationofTwoEquationsfor
PredictingFetalWeightbyUltrasound.
AmericanJournalofObstetricsandGynecology,142:1
(January1,1982),4754.
UniversityofTokyo,Shinozuka,N.FJSUM,etal.
StandardValuesofUltrasonographicFetal
Biometry.JapaneseJournalofMedicalUltrasonics,
23:12(1996),880,Equation1.

Gestational Age (GA) by Last Menstrual


Period (LMP)
ThegestationalagederivedfromtheLMPdate
enteredonthepatientinformationform.
Resultsaredisplayedinweeksanddays,andis
calculatedasfollows:
GA(LMP)=SystemdateLMPdate

Gestational Age (GA) by Last Menstrual


Period (LMPd) Derived from Established Due
Date (Estab. DD)
SameasGAbyEstab. DD.
Thegestationalagederivedfromthesystem
derivedLMPusingtheEstablishedDueDate
enteredonthepatientinformationform.
Resultsaredisplayedinweeksanddays,andis
calculatedasfollows:
GA(LMPd)=SystemDateLMPd

146

Measurement publications and terminology

Last Menstrual Period Derived (LMPd) by


Established Due Date (Estab. DD)
Resultsaredisplayedasmonth/day/year.
LMPd(Estab. DD)=Estab. DD280days

Gestational age tables


Abdominal Circumference (AC)
Hadlock,F.,etal.EstimatingFetalAge:
ComputerAssistedAnalysisofMultipleFetal
GrowthParameters.Radiology,152:(1984),
497501.
Hansmann,M.,etal.UltrasoundDiagnosisin
ObstetricsandGynecology.NewYork:
SpringerVerlag,(1986),431.
UniversityofTokyo,Shinozuka,N.FJSUM,etal.
StandardValuesofUltrasonographicFetal
Biometry.JapaneseJournalofMedicalUltrasonics,
23:12(1996),885.
WARNING:

The gestational age calculated by


your SonoSite system does not
match the age in the
aforementioned reference at the
20.0 cm and 30.0 cm abdominal
circumference (AC) measurements.
The implemented algorithm
extrapolates the gestational age
from the slope of the curve of all
table measurements, rather than
decreasing the gestational age for a
larger AC measurement indicated in
the referenced table. This results in
the gestational age always
increasing with an increase in AC.

Anteroposterior Trunk Diameter (APTD)


UniversityofTokyo,Shinozuka,N.FJSUM,etal.
StandardValuesofUltrasonographicFetal
Biometry.JapaneseJournalofMedicalUltrasonics,
23:12(1996),885.

Biparietal Diameter (BPD)


Chitty,L.S.andD.G.Altman.Newchartsfor
ultrasounddatingofpregnancy.Ultrasoundin
ObstetricsandGynecology10:(1997),174179,
Table3.

Hansmann,M.,etal.UltrasoundDiagnosisin
ObstetricsandGynecology.NewYork:
SpringerVerlag,(1986),440.
OsakaUniversity.UltrasoundinObstetricsand
Gynecology.(July 20,1990),98.

Hansmann,M.,etal.UltrasoundDiagnosisin
ObstetricsandGynecology.NewYork:
SpringerVerlag,(1986),431.
OsakaUniversity.UltrasoundinObstetricsand
Gynecology.(July 20,1990),101102.
UniversityofTokyo,Shinozuka,N.FJSUM,etal.
StandardValuesofUltrasonographicFetal
Biometry.JapaneseJournalofMedicalUltrasonics,
23:12(1996),886.

Fetal Trunk Cross-Sectional Area (FTA)

UniversityofTokyo,Shinozuka,N.FJSUM,etal.
StandardValuesofUltrasonographicFetal
Biometry.JapaneseJournalofMedicalUltrasonics,
23:12(1996),885.

OsakaUniversity.UltrasoundinObstetricsand
Gynecology.(July 20,1990),99100.

Crown Rump Length (CRL)

Hansmann,M.,etal.UltrasoundDiagnosisin
ObstetricsandGynecology.NewYork:
SpringerVerlag,(1986).

Hadlock,F.,etal.FetalCrownRumpLength:
ReevaluationofRelationtoMenstrualAge(518
weeks)withHighResolution,RealTime
Ultrasound.Radiology,182:(February1992),
501505.
Hansmann,M.,etal.UltrasoundDiagnosisin
ObstetricsandGynecology.NewYork:
SpringerVerlag,(1986),439.
OsakaUniversity.UltrasoundinObstetricsand
Gynecology.(July20,1990),20and96.
TokyoUniversity.GestationalWeeksand
ComputationMethods.UltrasoundImaging
Diagnostics,12:1(19821),2425,Table3.

Femur Length (FL)


Chitty,L.S.andD.G.Altman.Newchartsfor
ultrasounddatingofpregnancy.Ultrasoundin
ObstetricsandGynecology10:(1997),174179,
Table8,186.

Gestational Sac (GS)

Nyberg,D.A.,etal.TransvaginalUltrasound.
MosbyYearbook,(1992),76.
Gestationalsacmeasurementsprovideafetal
agebasedonthemeanofone,two,orthree
distancemeasurements;however,Nybergs
gestationalageequationrequiresallthree
distancemeasurementsforanaccurate
estimate.
TokyoUniversity.GestationalWeeksand
ComputationMethods.UltrasoundImaging
Diagnostics,12:1(19821).

Head Circumference (HC)


Chitty,L.S.andD.G.Altman.Newchartsfor
ultrasounddatingofpregnancy.Ultrasoundin
ObstetricsandGynecology10:(1997),174191,
Table5,182.

Chapter 7: References

147

References

Hadlock,F.,etal.EstimatingFetalAge:
ComputerAssistedAnalysisofMultipleFetal
GrowthParameters.Radiology,152:(1984),
497501.

Hadlock,F.,etal.EstimatingFetalAge:
ComputerAssistedAnalysisofMultipleFetal
GrowthParameters.Radiology,152:(1984),
497501.

Hadlock,F.,etal.EstimatingFetalAge:
ComputerAssistedAnalysisofMultipleFetal
GrowthParameters.Radiology,152:(1984),
497501.
Hansmann,M.,etal.UltrasoundDiagnosisin
ObstetricsandGynecology.NewYork:
SpringerVerlag,(1986),431.

Occipito-Frontal Diameter (OFD)


Hansmann,M.,etal.UltrasoundDiagnosisin
ObstetricsandGynecology.NewYork:
SpringerVerlag,(1986),431.

Transverse Trunk Diameter (TTD)


Hansmann,M.,etal.UltrasoundDiagnosisin
ObstetricsandGynecology.NewYork:
SpringerVerlag,(1986),431.
UniversityofTokyo,Shinozuka,N.FJSUM,etal.
StandardValuesofUltrasonographicFetal
Biometry.JapaneseJournalofMedicalUltrasonics,
23:12(1996),885.

Growth analysis tables


Abdominal Circumference (AC)
Chitty,LynS.etal.ChartsofFetalSize:3.
AbdominalMeasurements.BritishJournalof
ObstetricsandGynaecology101:(February1994),
131,Appendix:ACDerived.
Hadlock,F.,etal.EstimatingFetalAge:
ComputerAssistedAnalysisofMultipleFetal
GrowthParameters.Radiology,152:(1984),
497501.
JeantyP.,E.Cousaert,andF.Cantraine.Normal
GrowthoftheAbdominalPerimeter.American
JournalofPerinatology,1:(January1984),129135.
(AlsopublishedinHansmann,Hackeloer,
Staudach,Wittman.UltrasoundDiagnosisin
ObstetricsandGynecology.SpringerVerlag,
NewYork,(1986),179,Table7.13.)

148

Measurement publications and terminology

Biparietal Diameter (BPD)


Chitty,LynS.etal.ChartsofFetalSize:2.Head
Measurements.BritishJournalofObstetricsand
Gynaecology101:(January1994),43,Appendix:
BPDOuterInner.
Hadlock,F.,etal.EstimatingFetalAge:
ComputerAssistedAnalysisofMultipleFetal
GrowthParameters.Radiology,152:(1984),
497501.
JeantyP.,E.Cousaert,andF.Cantraine.A
LongitudinalStudyofFetalLimbGrowth.
AmericanJournalofPerinatology,1:(January1984),
136144,Table5.
(AlsopublishedinHansmann,Hackeloer,
Staudach,Wittman.UltrasoundDiagnosisin
ObstetricsandGynecology.SpringerVerlag,
NewYork,(1986),176,Table7.8.)

Estimated Fetal Weight (EFW)


HadlockF.,etal.InUteroAnalysisofFetal
Growth:ASonographicWeightStandard.
Radiology,181:(1991),129133.
Jeanty,Philippe,F.Cantraine,R.Romero,E.
Cousaert,andJ.Hobbins.ALongitudinalStudy
ofFetalWeightGrowth.JournalofUltrasoundin
Medicine,3:(July1984),321328,Table1.
(AlsopublishedinHansmann,Hackeloer,
Staudach,andWittman.UltrasoundDiagnosis
inObstetricsandGynecology.SpringerVerlag,
NewYork,(1986),186,Table7.20.)

Femur Length (FL)


Chitty,LynS.etal.ChartsofFetalSize:4.Femur
Length.BritishJournalofObstetricsand
Gynaecology101:(February1994),135.
Hadlock,F.,etal.EstimatingFetalAge:
ComputerAssistedAnalysisofMultipleFetal
GrowthParameters.Radiology,152:(1984),
497501.

JeantyP,E.Cousaert,andF.Cantraine.A
LongitudinalStudyofFetalLimbGrowth.
AmericanJournalofPerinatology,1:(January1984),
136144,Table5.
(AlsopublishedinHansmann,Hackeloer,
Staudach,Wittman.UltrasoundDiagnosisin
ObstetricsandGynecology.SpringerVerlag,
NewYork,(1986),182,Table7.17.)

Chitty,LynS.,etal.ChartsofFetalSize:2.Head
Measurements.BritishJournalofObstetricsand
Gynaecology101:(January1994),43,Appendix:
HCDerived.
Hadlock,F.,etal.EstimatingFetalAge:
ComputerAssistedAnalysisofMultipleFetal
GrowthParameters.Radiology,152:(1984),
497501.
JeantyP,E.Cousaert,andF.Cantraine.A
longitudinalstudyofFetalHeadBiometry.
AmericanJofPerinatology,1:(January1984),
118128,Table3.
(AlsopublishedinHansmann,Hackeloer,
Staudach,Wittman.UltrasoundDiagnosisin
ObstetricsandGynecology.SpringerVerlag,
NewYork,(1986),176,Table7.8.)

Head Circumference (HC)/Abdominal


Circumference (AC)
CampbellS.,ThomsAlison.Ultrasound
MeasurementsoftheFetalHeadtoAbdomen
CircumferenceRatiointheAssessmentof
GrowthRetardation,BritishJournalofObstetrics
andGynaecology,84:(March1977),165174.

FL/BPD Ratio
Hohler,C.W.,andT.A.Quetel.Comparisonof
UltrasoundFemurLengthandBiparietal
DiameterinLatePregnancy,AmericanJournalof
ObstetricsandGynecology,141:7(Dec.11981),
759762.

FL/HC Ratio
HadlockF.P.,R.B.Harrist,Y.Shah,andS.K.Park.
TheFemurLength/HeadCircumference
RelationinObstetricSonography.Journalof
UltrasoundinMedicine,3:(October1984),439442.

HC/AC Ratio
CampbellS.,ThomsAlison.Ultrasound
MeasurementsoftheFetalHeadtoAbdomen
CircumferenceRatiointheAssessmentof
GrowthRetardation,BritishJournalofObstetrics
andGynaecology,84:(March1977),165174.

General references
+/x or S/D Ratio
+/x=abs(VelocityA/VelocityB)
where

A=velocitycursor+
B=velocitycursorx

Acceleration Index (ACC)


Zwiebel,W.J.IntroductiontoVascular
Ultrasonography,4thed.,W.B.Saunders
Company,(2000),52.

Ratio calculations

ACC=abs(deltavelocity/deltatime)

FL/AC Ratio

Elapsed Time (ET)

HadlockF.P.,R.L.Deter,R.B.Harrist,E.Roecker,
andS.K.Park.ADateIndependentPredictorof
IntrauterineGrowthRetardation:Femur

ET=timebetweenvelocitycursorsin
milliseconds

Chapter 7: References

149

References

Head Circumference (HC)

Length/AbdominalCircumferenceRatio,
AmericanJournalofRoentgenology,141:(November
1983),979984.

Hip Angle/d:D Ratio

Percent Diameter Reduction

Graf,R.FundamentalsofSonographic
DiagnosisofInfantHipDysplasia.Journalof
PediatricOrthopedics,Vol.4,No.6:735740,1984.

Handa,Nobuoetal.,EchoDopplerVelocimeter
intheDiagnosisofHypertensivePatients:The
RenalArteryDopplerTechnique,Ultrasoundin
MedicineandBiology,12:12(1986),945952.

Morin,C.,Harcke,H.,MacEwen,G.TheInfant
Hip:RealTimeUSAssessmentofAcetabular
Development.Radiology177:673677,December
1985.

%DiameterReduction=(1D2(cm)/D1(cm))*
100
where:

Intima Media Thickness (IMT)


HowardG,SharrettAR,HeissG,EvansGW,
ChamblessLE,RileyWA,etal.CarotidArtery
IntimaMedialThicknessDistributioninGeneral
PopulationsAsEvaluatedbyBMode
Ultrasound.ARICInvestigators.
AtherosclerosisRiskinCommunities.Stroke.
(1993),24:12971304.

D1=originaldiameterofthevessel
incm
D2=reduceddiameterofthevessel
incm

Pressure Gradient (PGr) in mmHG


Oh,J.K.,J.B.Seward,A.J.Tajik.TheEchoManual.
2nded.,Lippincott,Williams,andWilkins,
(1999),64.

OLeary,DanielH.,MDandPolak,Joseph,F.,
MD,etal.UseofSonographytoEvaluate
CarotidAtherosclerosisintheElderly.The
CardiovascularHealthStudy.Stroke.(September
1991),22,11551163.

4*(Velocity)2

Redberg,RitaF.,MDandVogel,RobertA.,MD,
etal.Taskforce#3WhatistheSpectrumof
CurrentandEmergingTechniquesforthe
NoninvasiveMeasurementofAtherosclerosis?
JournaloftheAmericanCollegeofCardiology.(June
4,2003),41:11,18861898.

A PG=4*PA2

Percent Area Reduction


TaylorK.J.W.,P.N.Burns,P.Breslau.Clinical
ApplicationsofDopplerUltrasound,RavenPress,
N.Y.,(1988),130136.
ZwiebelW.J.,J.A.Zagzebski,A.B.Crummy,etal.
CorrelationofpeakDopplerfrequencywith
lumennarrowingincarotidstenosis.Stroke,3:
(1982),386391.
%AreaReduction=(1A2(cm2)/A1(cm2))*100
where:

150

A1=originalareaofthevesselin
squarecm
A2=reducedareaofthevesselin
squarecm

Measurement publications and terminology

PeakEPressureGradient(E PG)
E PG=4*PE2
PeakAPressureGradient(A PG)

PeakPressureGradient(PGmax)
PGmax=4*PV2
MeanPressureGradient(PGmean)
PGmean=4*Vmax2

Pulsatility Index (PI)


Kurtz,A.B.,W.D.Middleton.Ultrasoundthe
Requisites.MosbyYearBook,Inc.,(1996),469.
PI=(PSVEDV)/V
where

PSV=peaksystolicvelocity
EDV=enddiastolicvelocity
V=meanflowvelocitythroughout
theentirecardiaccycle

Resistive Index (RI)


Kurtz,A.B.,W.D.Middleton.Ultrasoundthe
Requisites.MosbyYearBook,Inc.,(1996),467.

RI=abs((VelocityAVelocityB)/VelocityA)in
measurements
where

A=velocitycursor+
B=velocitycursorx

Time Averaged Mean (TAM) in cm/s


TAM=mean(meanTrace)
References

Volume (Vol)
Beyer,W.H.StandardMathematicalTables,28thed.,
CRCPress,BocaRaton,FL,(1987),131.

Volume Flow (VF) in l/m


Allan,PaulL.etal.ClinicalDopplerUltrasound,
4thed.,HarcourtPublishersLimited.(2000),
3638.
VF=CSA*TAM* .06

Chapter 7: References

151

152

Measurement publications and terminology

Chapter 8: Specifications
Thischaptercontainssystemandaccessory
specificationsandstandards.Thespecifications
forrecommendedperipheralsareinthe
manufacturersinstructions.

Dimensions
System

Imaging modes
2D(256grayshades)
ColorpowerDoppler(CPD)(256colors)
ColorDoppler(Color)(256colors)
M Mode
Pulsedwave(PW)Doppler
Continuouswave(CW)Doppler

Width:10.8in.(27.43cm)

TissueDopplerImaging(TDI)

Height:3.1in.(7.87cm)

TissueHarmonicImaging(THI)

Weight:8.5lbs.(3.9kg)withtheC60xtransducer
andbatteryinstalled

Image and clip storage

Display
Length:8.4in.(21.34cm)

Internalstorage:Thenumberofimagesandclips
youcansavedependsonimagingmodeandfile
format.

Height:6.3in.(16cm)
Diagonal:10.4in.(26.4cm)

Accessories

Supported transducers

Thefollowingitemsareeitherincludedwithor
availableforuseontheultrasoundsystem:

C11x/85MHz(6ft/1.8m)

Battery

C60x/52MHz(5.5ft/1.7m)

BiopsyGuide

D2x/2MHz(5.5ft/1.7m)

Carrycase

HFL38x/136MHz(5.6ft/1.7m)

ECGcable(6ft/1.8m)

ICTx/85MHz(5.5ft/1.7m)

Educationkeys

L25x/136MHz(7.5ft/2.3m)

Externaldisplay

L38x/105MHz(5.5ft/1.7m)

Footswitch

P10x/84MHz(6ft/1.8m)

MiniDock

P21x/51MHz(6ft/1.8m)

MobileDockingSystemMSeries(MDSm)

SLAx/136MHz(7.5ft/2.3m)

MobileDockingSystemLiteII(MDSLiteII)

TEEx/83MHz(7.2ft./2.2m)

NeedleGuide

Chapter 8: Specifications

153

Specifications

Length:11.8in.(29.97cm)

Powersupply
SiteLinkImageManager
SonoCalcIMT
SystemACpowercord(10ft/3.1m)
TripleTransducerConnect

Peripherals
Seethemanufacturersspecificationsforthe
followingperipherals.

Shipping and storage


System and transducer
3565C(31149F),1595%R.H.
500to1060hPa(0.5to1.05ATM)

Battery
2060C(4140F),1595%R.H.(Forstorage
longerthan30days,storeatorbelowroom
temperature.)
500to1060hPa(0.5to1.05ATM)

Medical grade
Barcodescanner,serial
Barcodescanner,USB
Blackandwhiteprinter
Recommendedsourcesforprinterpaper:
ContactSonyat8006867669or
www.sony.com/professionaltoordersupplies
ortofindthelocaldistributor.

Electrical
PowerSupplyInput:100240VAC,50/60Hz,2.0
AMax@100VAC
PowerSupplyOutput#1:15VDC,5.0AMax
PowerSupplyOutput#2:12VDC,2.3AMax

Colorprinter

Battery

DVDrecorder

Thebatterycomprisessixlithiumioncellsplus
electronics,atemperaturesensor,andbattery
contacts.

Non-medical grade
Kensingtonsecuritycable
USBstoragedevice

Runtimeisuptotwo hours,dependingon
imagingmodeanddisplaybrightness.

Temperature and humidity


limits

Electromechanical safety
standards

Note: Thetemperature,pressure,andhumiditylimits
applyonlytotheultrasoundsystem,transducers,and
battery.

EN606011:1997,EuropeanNorm,Medical
ElectricalEquipmentPart 1.General
RequirementsforSafety.

Operating
System, battery, and transducer
1040C(50104F),1595%R.H.
700to1060hPa(0.7to1.05ATM)

154

Temperature and humidity limits

EN6060111:2001,EuropeanNorm,Medical
ElectricalEquipmentPart1.General
RequirementsforSafetySection11.Collateral
Standard.SafetyRequirementsforMedical
ElectricalSystems.

EN60601237:2001+AmendmentA1:2005,
EuropeanNorm,Particularrequirementsforthe
safetyofultrasonicmedicaldiagnosticand
monitoringequipment.
CAN/CSAC22.2,No.601.1M90,Canadian
StandardsAssociation,MedicalElectrical
EquipmentPart1.GeneralRequirementsfor
Safety(includingCSA601.1Supplement1:1994
andCSA601.1Amendment2:1998).
CEI/IEC61157:1992,International
ElectrotechnicalCommission,Requirementsfor
theDeclarationoftheAcousticOutputof
MedicalDiagnosticUltrasonicEquipment.

EMC standards classification


EN6060112:2007,EuropeanNorm,Medical
ElectricalEquipment.GeneralRequirementsfor
SafetyCollateralStandard.Electromagnetic
Compatibility.RequirementsandTests.

RTCA/DO160E:2004,RadioTechnical
CommissionforAeronautics,Environmental
ConditionsandTestProceduresforAirborne
Equipment,Section 21.0EmissionofRadio
FrequencyEnergy,Category B.

DICOM standard
NEMAPS 3.15:2000,DigitalImagingand
CommunicationsinMedicine(DICOM)Part15:
SecurityProfiles.

HIPAA standard
TheHealthInsuranceandPortabilityand
AccountabilityAct,Pub.L.No.104191(1996).
45CFR160,GeneralAdministrative
Requirements.
45CFR164,SecurityandPrivacy.

CISPR11:2004,InternationalElectrotechnical
Commission,InternationalSpecialCommitteeon
RadioInterference.Industrial,Scientific,and
Medical(ISM)RadioFrequencyEquipment
ElectromagneticDisturbance
CharacteristicsLimitsandMethodsof
Measurement.
TheClassificationfortheultrasoundsystem,
dockingsystem,accessories,andperipherals
whenconfiguredtogetheris:Group1,ClassA.

Chapter 8: Specifications

155

Specifications

UL606011(1stEdition),Underwriters
Laboratories,MedicalElectrical
EquipmentPart 1:GeneralRequirementsfor
Safety.

Airborne equipment
standards

156

HIPAA standard

Glossary
Terms
Forultrasoundtermsnotincludedinthisglossary,refertoRecommendedUltrasound
Terminology,SecondEdition,publishedin1997bytheAmericanInstituteofUltrasoundin
Medicine(AIUM).
The guiding principle of ultrasound use, which states that you should
keep patient exposure to ultrasound energy as low as reasonably
achievable for diagnostic results.

curved array
transducer

Identified by the letter C (curved or curvilinear) and a number (60). The


number corresponds to the radius of curvature of the array expressed
in millimeters. The transducer elements are electrically configured to
control the characteristics and direction of the acoustic beam. For
example, C15, C60e.

depth

Refers to the depth of the display. A constant speed of sound of


1538.5 meters/second is assumed in the calculation of echo position in
the image.

in situ

In the natural or original position.

LCD

liquid crystal display

linear array
transducer

Identified by the letter L (linear) and a number (38). The number


corresponds to the radius of width of the array expressed in
millimeters. The transducer elements are electrically configured to
control the characteristics and direction of the acoustic beam. For
example, L38.

mechanical index
(MI)

An indication of the likelihood of mechanical bioeffects occurring: the


higher the MI, the greater the likelihood of mechanical bioeffects. See
Chapter 6, Safety, for a more complete description of MI.

MI/TI

See mechanical index (MI) and thermal index (TI).

NTSC

National Television Standards Committee. A video format setting. See


also PAL.

PAL

Phase Alternating Line. A video format setting. See also NTSC.

phased array

A transducer designed primarily for cardiac scanning. Forms a sector


image by electronically steering the beam direction and focus.

Glossary

Glossary

as low as reasonably
achievable (ALARA)

157

158

skinline

A depth on the display that corresponds to the skin/transducer


interface.

SonoHD

A subset of the 2D imaging mode in which the 2D image is enhanced


by reducing speckle noise artifact at tissue margins and improving
contrast resolution by reducing artifacts and improving visualization of
texture patterns within the image.

SonoMB

A subset of the 2D imaging mode in which the 2D image is enhanced


by looking at a target from multiple angles and then merging or
averaging the scanned data together to improve overall image quality
and, in parallel, reducing noise and artifacts.

Tissue Doppler
Imaging (TDI)

A pulsed wave Doppler technique used to detect myocardial motion.

thermal index (TI)

The ratio of total acoustic power to the acoustic power required to raise
tissue temperature by 1C under defined assumptions. See Chapter 6,
Safety, for a more complete description of TI.

TIB (bone thermal


index)

A thermal index for applications in which the ultrasound beam passes


through soft tissue and a focal region is in the immediate vicinity of
bone.

TIC (cranial bone


thermal index)

A thermal index for applications in which the ultrasound beam passes


through bone near the beam entrance into the body.

TIS (soft tissue


thermal index)

A thermal index related to soft tissues.

Tissue Harmonic
Imaging

Transmits at one frequency and receives at a higher harmonic


frequency to reduce noise and clutter and improve resolution.

transducer

A device that transforms one form of energy into another form of


energy. Ultrasound transducers contain piezoelectric elements, which
when excited electrically, emit acoustic energy. When the acoustic
energy is transmitted into the body, it travels until it encounters an
interface, or change in tissue properties. At the interface, an echo is
formed that returns to the transducer, where this acoustic energy is
transformed into electrical energy, processed, and displayed as
anatomical information.

variance

Displays a variation in Color Doppler flow imaging within a given


sample. Variance is mapped to the color green and is used to detect
turbulence.

Abbreviations
Abbreviations in User Interface
Definition

+/

+ Caliper/ Caliper Ratio

A Wave Peak Velocity

A PG

A Wave Peak Pressure Gradient

A2Cd

Apical 2 Chamber diastolic

A2Cs

Apical 2 Chamber systolic

A4Cd

Apical 4 Chamber diastolic

A4Cs

Apical 4 Chamber systolic

AAA

Abdominal Aortic Aneurysm

AAo

Ascending Aorta

Abd

Abdomen

abs

Absolute value

AC

Abdominal Circumference

ACA

Anterior Cerebral Artery

ACC

Acceleration Index

ACoA

Anterior Communicating Artery

ACS

Aortic Valve Cusp Separation

Adur

A wave duration

AFI

Amniotic Fluid Index

AI

Aortic Insufficiency

AI PHT

Aortic Insufficiency Pressure Half Time

AL

Atlas Loop

Ann D

Annulus Diameter

ANT F

Anterior Far

ANT N

Anterior Near

Glossary

Abbreviation

Glossary

159

Abbreviations in User Interface (Continued)

160

Abbreviation

Definition

Ao

Aorta

AoD

Aortic Root Diameter

Apical

Apical View

APTD

Anteroposterior Trunk Diameter

AT

Acceleration (Deceleration) Time

AUA

Average Ultrasound Age


Calculated by averaging the individual ultrasound ages for the fetal
biometry measurements performed during the exam. The
measurements used to determine the AUA are based on the selected
OB calculation authors.

AV

Aortic Valve

AV Area

Aortic Valve Area

AVA

Aortic Valve Area

BA

Basilar Artery

Bifur

Bifurcation

BP

Blood Pressure

BPD

Biparietal Diameter

BPM

Beats per Minute

Bre

Breast

BSA

Body Surface Area

CCA

Common Carotid Artery

CI

Cardiac Index

CO

Cardiac Output

CPD

Color Power Doppler

Crd

Cardiac

CRL

Crown Rump Length

CW

Continuous Wave Doppler

Abbreviations in User Interface (Continued)


Definition

Cx L

Cervix Length

Diameter

D Apical

Distance Apical

DCCA

Distal Common Carotid Artery

DECA

Distal External Carotid Artery

DICA

Distal Internal Carotid Artery

Dist

Distal

dP:dT

Delta Pressure: Delta Time

E Wave Peak Velocity

E PG

E Wave Peak Pressure Gradient

E:A

E:A Ratio

E/e

E velocity = Mitral Valve E velocity divided by the annular e velocity

ECA

External Carotid Artery

ECG

Electrocardiogram

ECICA

Extracranial Internal Carotid Artery

ECVA

Extracranial Vertebral Artery

EDD

Estimated Date of Delivery

EDD by AUA

Estimated Date of Delivery by Average Ultrasound Age


The estimated date of delivery calculated from the measurements
performed during the exam.

EDD by LMP

Estimated Date of Delivery by Last Menstrual Period


The due date calculated from the user-entered LMP.

EDV

End Diastolic Velocity

EF

Ejection Fraction

EF:SLOPE

E-F Slope

Glossary

Abbreviation

Glossary

161

Abbreviations in User Interface (Continued)

162

Abbreviation

Definition

EFW

Estimated Fetal Weight


Calculated from the measurements performed during the exam. The
measurements used to determine EFW are defined by the currently
selected EFW calculation author.

Endo

Endocardial

Epi

Epicardial

EPSS

E Point Septal Separation

Estab. DD

Established Due Date


A user-entered due date based on previous exam data or other
available information. The LMP is derived from the Established Due
Date and is listed in the patient report as LMPd.

ET

Elapsed Time

FH

Femoral Head

FHR

Fetal Heart Rate

FL

Femur Length

FM (Right and Left)

Foramen Magnum (same as SO)

FTA

Fetal Trunk Area

GA

Gestational Age

GA by LMP

Gestational Age by Last Menstrual Period


The fetal age calculated using the date of the Last Menstrual Period
(LMP).

GA by LMPd

Gestational Age by derived Last Menstrual Period


The fetal age calculated using the Last Menstrual Period (LMPd)
derived from the Estab. DD.

Gate

Depth of Doppler Gate

GS

Gestational Sac

Gyn

Gynecology

HC

Head Circumference

HR

Heart Rate

Abbreviations in User Interface (Continued)


Definition

ICA

Internal Carotid Artery

IMT

Intima Media Thickness

IVRT

Iso Volumic Relaxation Time

IVS

Interventricular Septum

IVSd

Interventricular Septum Diastolic

IVSFT

Interventricular Septum Fractional Thickening

IVSs

Interventricular Septum Systolic

LA

Left Atrium

LA/Ao

Left Atrium/Aorta Ratio

LAT F

Lateral Far

LAT N

Lateral Near

LMP

Last Menstrual Period

LMP

Last Menstrual Period


The first day of the last menstrual period. Used to calculate gestational
age and EDD.

LMPd

derived Last Menstrual Period


Calculated from the user-entered Estab. DD.

LV

Left Ventricular

LV Area

Left Ventricular Area

LV mass

Left Ventricular mass

LV Volume

Left Ventricular Volume

LVd

Left Ventricular diastolic

LVD

Left Ventricular Dimension

LVDd

Left Ventricular Dimension Diastolic

LVDFS

Left Ventricular Dimension Fractional Shortening

LVDs

Left Ventricular Dimension Systolic

Glossary

163

Glossary

Abbreviation

Abbreviations in User Interface (Continued)

164

Abbreviation

Definition

LVEDV

Left Ventricular End Diastolic Volume

LVESV

Left Ventricular End Systolic Volume

LVET

Left Ventricular Ejection Time

LVO

Left Ventricular Opacification

LVOT

Left Ventricular Outflow Tract

LVOT Area

Left Ventricular Outflow Tract Area

LVOT D

Left Ventricular Outflow Tract Diameter

LVOT VTI

Left Ventricular Outflow Tract Velocity Time Integral

LVPW

Left Ventricular Posterior Wall

LVPWd

Left Ventricular Posterior Wall Diastolic

LVPWFT

Left Ventricular Posterior Wall Fractional Thickening

LVPWs

Left Ventricular Posterior Wall Systolic

LVs

Left Ventricular systolic

MB

SonoMB

MCA

Middle Cerebral Artery

MCCA

Mid Common Carotid Artery

MECA

Mid External Carotid Artery

MI

Mechanical Index

MICA

Mid Internal Carotid Artery

Mid

Middle

MM

M Mode

MR PISA

Mitral Regurgitation Proximal Iso Velocity Surface Area

MR/VTI

Mitral Regurgitation/Velocity Time Integral

Msk

Muscle

MV

Mitral Valve

Abbreviations in User Interface (Continued)


Definition

MV Area

Mitral Valve Area

MV Regurgitant
Fraction

Mitral Valve Regurgitant Fraction

MV Regurgitant Volume

Mitral Valve Regurgitant Volume

MV/VTI

Mitral Valve/Velocity Time Integral

MVA

Mitral Valve Area

MV ERO

Mitral Valve Effective Regurgitant Orifice

MV PISA Area

Mitral Valve Proximal Iso Velocity Surface Area

MV Rate

Mitral Valve Rate

Neo

Neonatal

Nrv

Nerve

NST

Non-stress test

NTSC

National Television Standards Committee

OA

Ophthalmic Artery

OB

Obstetrical

OFD

Occipital Frontal Diameter

Oph

Ophthalmic

Orb

Orbital

PAL

Phase Alternating Line

PCAp

Posterior Cerebral Artery Peak

PCCA

Proximal Common Carotid Artery

PCoA

Posterior Communicating Artery

PECA

Proximal External Carotid Artery

PGmax

Maximum Pressure Gradient

PGmean

Mean Pressure Gradient

PGr

Pressure Gradient

Glossary

Abbreviation

Glossary

165

Abbreviations in User Interface (Continued)

166

Abbreviation

Definition

PHT

Pressure Half Time

PI

Pulsatility Index

PICA

Proximal Internal Carotid Artery

PISA

Proximal Isovelocity Surface Area

Plaq

Plaque

POST F

Posterior Far

POST N

Posterior Near

PRF

Pulse Repetition Frequency

Prox

Proximal

PSV

Peak Systolic Velocity

PV

Pulmonic Valve

P. Vein

Pulmonary Vein

PW

Pulsed Wave Doppler

Qp/Qs

Pulmonary blood flow divided by systemic blood flow

RA

Right Atrial (pressure)

RI

Resistive Index

RVD

Right Ventricular Dimension

RVDd

Right Ventricular Dimension Diastolic

RVDs

Right Ventricular Dimension Systolic

RVOT D

Right Ventricular Outflow Tract Diameter

RVOT VTI

Right Ventricular Outflow Tract Velocity Time Integral

RVSP

Right Ventricular Systolic Pressure

RVW

Right Ventricular Free Wall

RVWd

Right Ventricular Free Wall Diastolic

RVWs

Right Ventricular Free Wall Systolic

Abbreviations in User Interface (Continued)


Definition

SonoHD

S/D

Systolic/Diastolic Ratio

SI

Stroke Index

Siphon

Siphon (internal carotid artery)

SM

Submandibular

SmP

Small Parts

SO

Suboccipital

Sup

Superficial

SV

Stroke Volume

TAM

Time Average Mean

TAP

Time Average Peak

TCD

Transcranial Doppler

TDI

Tissue Doppler Imaging

THI

Tissue Harmonic Imaging

TI

Thermal Index

TICA

Terminal Internal Carotid Artery

TO

Transorbital

TRmax

Tricuspid Regurgitation (peak velocity)

TT

Transtemporal

TTD

Transverse Trunk Diameter

TV

Tricuspid Valve

TVA

Tricuspid Valve Area

UA

Ultrasound Age
Calculated on the mean measurements taken for a particular fetal
biometry.

Umb A

Umbilical Artery

Glossary

Abbreviation

Glossary

167

Abbreviations in User Interface (Continued)

168

Abbreviation

Definition

VA

Vertebral Artery

VArty

Vertebral Artery

Vas

Vascular

Ven

Venous

VF

Volume Flow

Vmax

Peak Velocity

Vmean

Mean Velocity

Vol

Volume

VTI

Velocity Time Integral

YS

Yolk Sac

Index
Symbols
+/x measurement 44

Numerics
2D imaging 25
2D options 25

B
bar code scanner 19
baseline 29
battery
clean 75
safety 90

C
cables
clean and disinfect ECG 76
connect power 3
calculations
cardiac. See cardiac calculations
delete measurement 46
general 45
gynecology (Gyn) 58
IMT 59
menu 7, 45
OB 61
percent area 47
percent diameter 47
percent reduction 46
perform measurement 45
performing 45
repeat measurement 46
save 45
small parts 64
specialized 50
vascular 67
view measurement 46
volume 48
volume flow 48, 49
calipers 41
cardiac calculations
AAo 53
Ao 53
AVA 56
CI 57
CO 57
dP:dT 56
HR 57
IVRT 52
LA 53
LV volume (Simpsons Rule) 53

Index

A & B shortcut keys 15


abbreviations 159
abdominal, intended uses 12
AC power indicator 6
acceleration (ACC) index 44
accessories list 153
acoustic measurement precision 133
acoustic output
measurement 105
tables 107, 132
acquisition error 140
add new user 16
Administrator 16
age, gestational 62
airborne equipment standards 155
ALARA principle 97, 98, 157
alphanumeric keys 5
angle correction 28, 29
annotations
keys 5
place 32
predefine label groups 18
setup 18
aorta (Ao) 53
aortic valve area (AVA) 56
arrow graphic 33
ascending aorta (AAo) 53
audio 19

setup 19
specifications 154
beeps 19
biological safety 92
biopsy 26
bodymarker. See pictographs
brightness 26

Index

169

LVd 53
LVOT D 53
LVs 53
MV/AV area 54
overview 50
PHT 55
PISA 51
RVSP 55
setup 19
SV 57
TDI 58
VTI 54
cardiac index (CI) 57
cardiac output (CO) 57
cardiac references 141
cardiac, intended uses 12
cautions, definition vii
cine buffer 5, 30
clean
battery 75
ECG cable 76
footswitch 75
LCD screen 73
system 73
transducers 74
clip acquisition delay 39
clips
See also images and clips
options 26, 35
color Doppler (Color) imaging 27
color power Doppler (CPD) imaging 27
color scheme, background 23
color suppress 27
Color. See color Doppler (Color) imaging
connectivity setup, wireless certificates 19
continuous wave (CW) Doppler imaging 28, 29
controls
direct 98
indirect 99
receiver 99
CPD. See color power Doppler (CPD) imaging
customer assistance vii
CW Doppler. See continuous wave (CW) Doppler
imaging

D
date 20
default settings 15
delta pressure:delta time (dP:dT) 56

170

Index

depth
adjust 30
definition 157
keys 5
marker 7
DICOM standard 155
disinfect
battery 75
ECG cable 76
system 73
transducers 74
disinfectants, compatibility 77
display setup 20
distance measurements
2D 42
M mode 43
D-line 28
Doppler
Doppler gate depth 29
measurements 43
scale setup 22
dual images 25
duplex 22
DVD recorder 19, 71
Dynamic Range 22

E
ECG
Monitoring 26, 38
elapsed time (ET) measurement 44
electrical
safety 88
specifications 154
electromagnetic compatibility 93
electromechanical safety standards 154
EMC classification standards 155
EMED worksheets 70
equipment safety 90
error message 89
errors
acquisition 140
algorithmic 140
measurement 140
estimated date of delivery (EDD) 145
estimated fetal weight (EFW) 146
Event log 17
exam
change type 31
end 34

type and transducer 31


export and import
OB calculation tables 21
predefined label groups 18
user accounts 17

F
far 5
fetal heart rate (FHR) 63
flow sensitivity 27
focal zones, optimize 25
footswitch setup 15
forms 6
freeze 30

G
gain
adjust 30
ECG 39
knob 5
gate size 29
gestational age
setup 21
tables, references 146
gestational growth, measure 63
grace period 71
grayscale 25
growth analysis
setup 21
tables, references 148
guidance documents, related 104
guideline 26
gynecology, intended uses 12

heart rate 34
heart rate (HR) 43, 57, 63
HIPAA standard 155
home position 33
humidity limits 154

I
image quality, poor 71
images and clips
archive 38
delete 38

K
keys 5
knobs 5

L
labeling symbols 134
language 23
layout 22
LCD screen
clean 73
output 103
left atrium (LA) 53
left ventricular diastolic (LVd) 53
left ventricular outflow tract diameter (LVOT D) 53
left ventricular systolic (LVs) 53
left ventricular volume (LV volume) 53
license key 71
live trace 22, 30
login
Administrator 16
user 16
LVO (Left Ventricular Opacification) 26

Index

171

Index

export to USB 38
review 37
imaging modes
list of 153
transducer 31
import. See export and import
IMT. See Intima Media Thickness (IMT)
in situ, definition 157
infertility, intended uses 12
intended uses 1113
intensity
derated 105
in situ 105
water-value 105
interventional, intended uses 12
Intima Media Thickness (IMT)
calculations 20, 59
sketch 61
trace 61
intraoperative, intended uses 12
invert
Color 28
spectral trace 29
iso volumic relaxation time (IVRT) 52

M
M Mode imaging 26
maintenance 72
measurements
+/x Ratio, Doppler 44
See also calculations
2D 42
about 41
Acceleration, Doppler 44
accuracy 41, 139
area, 2D 42
automatic trace, Doppler 44
circumference, 2D 42
delete 41
distance, 2D 42
distance, M Mode 43
Doppler 43
edit 41
Elapsed Time, Doppler 44
errors 140
fetal heart rate 63
heart rate 43, 63
M Mode 43
manual trace 42, 44
Pressure Gradient, Doppler 43
publications 141
Resistive Index, Doppler 44
save to calculation and report 41
terminology 141
vascular 67
Velocities, Doppler 44
mechanical index (MI) 103, 157
mitral valve/aortic valve (MV/AV) 54
M-line 26
mode data 7, 20
modes, keys 6

N
near 5
network 20
NTSC
definition 157
option 19

O
OB
calculations 20, 61
custom measurements setup 21

172

Index

custom tables setup 22


graphs 70
intended uses 12
references 145
tables setup 22
on-screen controls 6
optimize 25
orientation
marker 7
option 26
output display 103

P
PAL
definition 157
option 19
password 16, 17, 18
patient header 7, 20
patient information form 33, 36, 37
patient list 36
patient report
about 68
cardiac 69
general 68
OB 69
save measurement to 41
vascular 69
PC 19
pediatric, intended uses 12
percent reduction calculation 46
peripherals 154
pictographs
PICTO key 7
placing 33
power delay 19
power key 5
precision, acoustic measurement 133
preferences 22
presets 22
pressure half time (PHT) 55
pressure limits 154
PRF 28, 29
print 37
printer
problem 71
setup 19
probe. See transducer
proximal isovelocity surface area (PISA) 51
pulsed wave (PW) Doppler imaging 28

PW Doppler. See pulsed wave (PW) Doppler imaging

R
recording problem 71
references
cardiac 141
general 149
gestational age tables 146
growth analysis tables 148
obstetrical 145
ratio calculations 149
report, patient 68
resistive index (RI) measurement 44
right ventricular systolic pressure (RVSP) 55

T
Technical Support vii
temperature limits 154
text 32
text description 7
thermal index (TI) 22, 103, 158
THI 26
time setup 20
tissue Doppler imaging (TDI) 29, 58
tissue models 106
touchpad 6, 8
transcranial, intended uses 13
transducer
clean and disinfect 74
curved array 157
definition 158
disinfect 74
exam type 31
general use 10
imaging modes 31
invasive or surgical use 10
linear array 157
preparation 10
problems 71
specifications 153
troubleshoot 71

Index

safety
battery 90
biological 92
electrical 88
electromagnetic compatibility 93
equipment 90
save
calculations 45
image 6
measurements 41
SAVE key 22
scale 29
scanhead. See transducer
screen layout 7
security 15, 16
serial port 19
setup pages 15
shipping specifications 154
shortcut keys 15
Simpsons Rule 53
skin line, definition 158
sleep delay 19
small parts calculations 64
software license 71
SonoHD 158
SonoMB 26, 158
specifications 153
spectral trace 28
standards
airborne equipment 155
DICOM 155
electromechanical 154

EMC classification 155


HIPAA 155
steering
CPD 28
Doppler 29
storage specifications
equipment 154
images 153
stroke volume (SV) 57
superficial, intended uses 12
sweep speed
Doppler 29
ECG 39
M Mode 27
symbols, labeling 134
system
clean and disinfect 73
controls 5
software 1
status 7, 20
wake up 3

Index

173

U
ultrasound terminology 157
unfreeze text 18
USB storage device, export to 38
user account 17
user guide, conventions used vii
user setup 16
uses, intended 1113

V
variance 28
vascular
calculations 67
intended uses 13
velocity measurement 44
velocity time integral (VTI) 54
volume
calculation 48
Doppler, adjust 29
volume flow 48

W
wall filter 28, 29
warnings, definition vii
worksheets, EMED 70

Z
zoom 30

174

Index

P07662-02

*P07662-02*