HD11 Reference Manual

HD11 Ultrasound System
User Reference
4535 611 65311 Rev A
February 2005
Copyright 2005 Koninklijke Philips Electronics N.V.
All rights reserved
Printed in USA
Manufactured by Philips Ultrasound

22100 Bothell-Everett Highway
Bothell, WA 98021-8431
USA
Telephone: +1 425-487-7000 or 800-426-2670
Fax: +1 425-485-6080
www.medical.philips.com
CE marking is for Council Directive 93/42/EEC.

This product complies with the Medical Device Directive.
European Union Representative
Philips Medical Systems Nederland B.V.
Corporate Quality and Regulatory Group
Veenpluis 4
5684 PC Best
The Netherlands
Telephone: +31 40 27 64432
Fax: +31 40 27 62499
CAUTION
United States federal law restricts this device to sale by or on the order of a
physician.
This document and the information contained in it is proprietary and confidential information of Philips Medical Systems
("Philips") and may not be reproduced, copied in whole or in part, adapted, modified, disclosed to others, or disseminated
without the prior written permission of the Philips Legal Department. This document is intended to be used by customers
and is licensed to them as part of their Philips equipment purchase. Use of this document by unauthorized persons is strictly
prohibited.
Philips provides this document without warranty of any kind, implied or expressed, including, but not limited to, the implied
warranties of merchantability and fitness for a particular purpose.
Philips has taken care to ensure the accuracy of this document. However, Philips assumes no liability for errors or omissions
and reserves the right to make changes without further notice to any products herein to improve reliability, function, or
design. Philips may make improvements or changes in the products or programs described in this document at any time.
This product may contain remanufactured parts equivalent to new in performance, or parts that have had incidental use.
Color Power Angio, Cineloop, EnVisor, Hif Q, OmniPlane, SonoCT, and XRES are trademarks of Koninklijke Philips Electronics N.V.
Non-Philips product names may be trademarks of their respective owners.
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Contents
1 Read This First . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
Intended Audience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
About Your User Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
About Your Compact Disc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
Conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
Upgrades and Updates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Customer Comments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Ordering Supplies and Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
Customer Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
2 Using Help . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Opening Help. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Help Viewer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
Resizing Help Panes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31
Finding Help Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31
Searching for Help Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32
Using Favorites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
Printing Help Topics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34
3 HD11 System Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37
System Capabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .37
System Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
Clinical Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
Imaging and Connectivity Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40
System Layout and Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
On/Off Button . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42
Control Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42
Video Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43
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CD and MOD Drives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44

Transducer Connector Panel and Cable Management . . . . . . . . . . . . . . . . . . . . .44
Physio (ECG) Panel. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46
Peripheral Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46
Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
4 Preparing Your System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 51
Turning the System On and Off. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
Setting the System Time and Date. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Positioning the Control Panel and Monitor. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Using the Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53
Using the Control Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .54
Connecting Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
Connecting Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
Connecting a Modem . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58
Connecting to a Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
Moving the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60
Precautions for Moving the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .61
Using the Removable Media Drives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .62
Loading and Ejecting CDs and MODs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
Viewing a CD or an MOD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
Formatting an MOD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64
Erasing a Disk . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .64
Recalibrating an Image in VCR Playback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .65
5 DICOM Networking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 67
DICOM Setup. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67
Entering System DICOM Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .68
Changing or Setting the PC Name . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70
Assigning DICOM Servers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71
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Automatic DICOM Export . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72

Managing Networked Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73
Setting Up Automatic DICOM Export and Export Options. . . . . . . . . . . . . . . . .74
Changing the Image Format for DICOM Export. . . . . . . . . . . . . . . . . . . . . . . . . .76
Configuring Your Viewer Based on Study Description. . . . . . . . . . . . . . . . . . . . .79
Troubleshooting Automatic DICOM Export . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
Setting Up Automatic Study Deletion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80
Rescuing Stranded Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81
Automatic DICOM Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82
Setting Up Automatic DICOM Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83
Troubleshooting Automatic DICOM Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
Configuring a New DICOM Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .84
About Intelliprint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86
Changing DICOM Printer Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86
Canceling DICOM Jobs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88
Modality Worklist. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89
About the Patient Selection Window . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .89
Using Modality Worklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90
Setting Up Modality Worklist . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91
Changing Modality Worklist Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92
Importing and Exporting in DICOM Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .93
6 Customizing Your System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95
Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95
About Exam Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
Selecting a Preset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
Creating a Preset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97
Modifying a Preset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97
Deleting a Preset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98
Using Preset Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98
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Removing the Preset Name from the Display . . . . . . . . . . . . . . . . . . . . . . . . . . . .98

Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99
Installing Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .101
Assigning Option Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102
System Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102
Changing System Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .105
Adjusting the Monitor Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106
Selecting the Type of Dual Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106
About Security Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .107
Changing the Background Color . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .108
Changing the Image Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .108
Activating Body Markers During Dual Imaging and Freeze . . . . . . . . . . . . . . . . .109
Mode Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .109
Changing the M-mode Format and the Doppler Settings . . . . . . . . . . . . . . . . . .110
Turning Adaptive Doppler On or Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .111
Controlling Spectral and M-mode Trace Scrolling . . . . . . . . . . . . . . . . . . . . . . .111
Changing the Spectral Trace Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .112
Changing the Autotrace Evaluation Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . . .112
Changing the Default Tissue Doppler Setting . . . . . . . . . . . . . . . . . . . . . . . . . . .113
Controlling Cursor Tracking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .114
Turning the M-mode Reference Line On or Off . . . . . . . . . . . . . . . . . . . . . . . . .114
Label Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115
Measurements and Analysis Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115
Specifying the Measurement Circumference Method . . . . . . . . . . . . . . . . . . . . .115
Defaulting to Doppler Auto Trace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .116
Specifying the Measurement Caliper Connection . . . . . . . . . . . . . . . . . . . . . . . .116
Choosing Quick Calcs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117
Changing High Q Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117
Changing the Position of the Measurements Results Box. . . . . . . . . . . . . . . . . .118
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Customizing the Measurements and Calculations Menus . . . . . . . . . . . . . . . . . .119

Analysis and Reports Application Package/Group List . . . . . . . . . . . . . . . . . . . .120
Obstetrics Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121
Creating a User-Defined Calculation by Using a Formula . . . . . . . . . . . . . . . . .121
Creating a User-Defined Calculation by Using a Table . . . . . . . . . . . . . . . . . . . .122
Editing a User-Defined Calculation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123
Deleting a User-Defined Calculation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124
Selecting Fetal Growth Graphs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125
Setting Fetal Weight Options. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .125
Acquisition Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .126
Specifying Acquisition Preferences. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .126
Setting the Duration of a Loop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .127
Specifying the Disk Full Strategy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .128
3D/4D Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .128
Optical Disk, CD, and Peripherals Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .129
About Backup and Restore Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .130
Backing Up Presets and Settings to a CD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .131
Restoring Presets and Settings from a CD . . . . . . . . . . . . . . . . . . . . . . . . . . . . .132
Assigning Record Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .133
Setting the VCR Record Time Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .133
About the Foot Switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .134
Configuring the Foot Switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .134
Installing Peripheral Software Drivers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .135
Setting the VCR Display for Record Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . .136
Using the VCR Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .136
Language Input Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .137
Changing the Input Language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .137
Selecting the Name Representation for the Top Border . . . . . . . . . . . . . . . . . .138
Entering Japanese Characters in the Patient Identification Window . . . . . . . . .138
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Displaying the Input Method Editor Status Window. . . . . . . . . . . . . . . . . . . . . .139

Physio (ECG) and Stress Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .139
Connecting the ECG Cable and Attaching the ECG Leads. . . . . . . . . . . . . . . . .140
Using Physio Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141
Changing Physio Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141
Triggering . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .142
Setting the Trigger Type in Doppler Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . .142
Changing Triggering Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143
Using Triggering Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143
7 Performing a Basic Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
8 Imaging Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
General Imaging Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149
Beginning an Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150
Acquiring an Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151
Printing in Live Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151
Resizing and Repositioning an Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .152
Moving a Reference Line . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .152
2D Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153
Using 2D Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153
Fusion Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154
Fusion Icons . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154
Using 2D Soft Keys. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155
M-mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .156
M-mode Zoom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .156
Using M-mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157
Using M-mode Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157
About the M-mode Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .158
About M-mode Trace Scrolling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .158
About Color M-mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159
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Using Color M-mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159

PW Doppler Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .160
Using Doppler Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .160
Using PW Doppler Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161
Repositioning the PW Sample Volume Gate . . . . . . . . . . . . . . . . . . . . . . . . . . . .162
Changing Doppler Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .163
Turning Intelligent Doppler On or Off . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .163
About High Pulse Repetition Frequency Doppler Mode . . . . . . . . . . . . . . . . . .163
About Nonimaging Doppler. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164
Optimizing Doppler Trace Settings with Doppler iSCAN Intelligent Optimization
164
About Duplex and Triplex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165
Using Duplex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165
Using Triplex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166
Using Duplex Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166
Using Triplex Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167
CW Doppler Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167
Using CW Doppler Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167
About Spectral Trace Scrolling . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .168
About the Spectral Trace Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .169
Tissue Doppler Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .169
Using Tissue Doppler Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .170
Color Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .170
Using Color Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171
Resizing and Repositioning an Angio, a Color, an ROI, or a Zoom Box . . . . . .171
Using Color Suppress. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .172
About Color Compare. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .172
Using Color Compare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .172
Using Color Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173
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Color Power Angio (CPA) Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173

Using Color Power Angio Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174
Using Color Power Angio Suppress . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174
Using Color Power Angio Compare . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175
Using Color Power Angio (CPA) Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . .175
3D/4D Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176
About 3D Volume Data Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176
About Acoustic Artifacts in 3D Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .177
About 3D Freehand and Motorized Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . .178
Activating 3D/4D Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179
About Working in 3D Preview Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180
Acquiring a Freehand 3D Data Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180
Acquiring a Motorized 3D Data Set . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181
Using 3D Preview and Acquisition Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . .182
3D Image Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .183
Using 3D Render Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .183
About the 3D Render Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .184
About 3D/4D Display Layouts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .185
Editing the ROI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187
Making Measurements on 2D MPR Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188
Using Slice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188
Changing the Orientation of the Volume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188
Changing the View Direction of the Rendered 3D Image . . . . . . . . . . . . . . . . .189
Swiveling a 3D Volume. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .190
Using Swivel Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .192
About Editing 3D Volumes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .192
Zooming and Magnifying Images in 3D/4D . . . . . . . . . . . . . . . . . . . . . . . . . . . . .194
Using Render Controls Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .195
Using Image Controls Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .195
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About 3D/4D Render Mode Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .196

About 3D/4D Vision Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .197
Changing the Vision Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .198
Modifying a Render Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .198
4D Imaging Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .199
Using 4D Soft Keys. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .200
Acquiring 4D Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .200
Reviewing 4D and Fetal STIC Images. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .201
Saving 4D and Fetal STIC Loops, Images, and Volumes . . . . . . . . . . . . . . . . . . .202
Using Volume Cine Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .202
Fetal STIC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .203
Using Fetal STIC Soft Keys. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .204
About the Fetal Heart Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .205
9 Imaging Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .207
Biopsy Guides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .207
Turning the Biopsy Guide On . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .208
About the Biopsy Guide Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .209
Contrast Harmonic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .210
Using Contrast Harmonic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .210
Using Contrast Harmonic Imaging Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . .211
Adjusting Settings for Contrast Harmonic Imaging . . . . . . . . . . . . . . . . . . . . . . .212
About Contrast Harmonic Imaging Principles . . . . . . . . . . . . . . . . . . . . . . . . . . .214
About Acoustic Artifacts in Contrast Imaging. . . . . . . . . . . . . . . . . . . . . . . . . . .215
Dual Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .215
About Single Buffer and Two Buffer Modes . . . . . . . . . . . . . . . . . . . . . . . . . . . .216
About The Active Buffer Indicators. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .217
Using Two Buffer and Two Buffer Dual Imaging . . . . . . . . . . . . . . . . . . . . . . . . .218
Using Single Buffer Dual Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .218
Using Quick Review in Dual Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .219
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iSCAN Intelligent Optimization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .220

About 2D iSCAN Intelligent Optimization . . . . . . . . . . . . . . . . . . . . . . . . . . . . .220
Using 2D iSCAN Intelligent Optimization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .221
Adjusting the Default 2D iSCAN Gain . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .221
Panoramic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .222
About the Accuracy of Panoramic Images. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .222
Acquiring a Panoramic Data Set. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .223
Using Panoramic Preview and Acquisition Soft Keys . . . . . . . . . . . . . . . . . . . . .224
Exiting Panoramic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .224
Panoramic Image Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .224
Using Panoramic Render Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .224
Moving a Panoramic Image Around the Display . . . . . . . . . . . . . . . . . . . . . . . . .225
Magnifying Panoramic Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .226
Performing Measurements on a Panoramic Image . . . . . . . . . . . . . . . . . . . . . . .226
Placing a Title Above a Panoramic Image. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .227
Placing a Label on a Panoramic Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .228
Saving Panoramic Images and Data Sets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .228
Quick Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .229
Using Quick Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .229
Using Quick Review Soft Keys. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .230
Playing Back a Quick Review Loop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .230
SonoCT Real-time Compound Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .231
About SonoCT Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .231
Using SonoCT Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .232
Tissue Harmonic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .232
Using Tissue Harmonic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .233
Trapezoidal Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .233
Using Trapezoidal Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .234
XRES Adaptive Image Processing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .234
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Zoom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .235
Using Zoom During Live Imaging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .235
Magnifying Live and Frozen Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .236
Using Color or Color Power Angio Zoom. . . . . . . . . . . . . . . . . . . . . . . . . . . . .236
Using M-mode Zoom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .237
10 Imaging Tips . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .239
Imaging Tips for 2D Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .239
I need to increase the penetration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .239
I need to improve the resolution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .240
I want the image to be less soft, hazy, or gray. . . . . . . . . . . . . . . . . . . . . . . . . . .240
I want the image to be less contrasty or grainy. . . . . . . . . . . . . . . . . . . . . . . . . .241
I need to be able to see the soft tissue.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .241
I want the fluid-filled structures to have fewer echoes. . . . . . . . . . . . . . . . . . . .242
Imaging Tips for M-mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .242
I want to reduce noise in the M-mode trace. . . . . . . . . . . . . . . . . . . . . . . . . . . .242
I want to increase the size of the M-mode trace. . . . . . . . . . . . . . . . . . . . . . . . .243
Imaging Tips for PW Doppler Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .243
I want the Doppler to be more sensitive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .243
I need to be able to see a Doppler signal that is audible, but not visible. . . . . .244
I need to unwrap an aliased spectrum. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .244
I want to reduce artifacts and noise in the spectrum.. . . . . . . . . . . . . . . . . . . . .244
I want the 2D reference image to be updated. . . . . . . . . . . . . . . . . . . . . . . . . . .245
I want to display low-velocity signals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .245
Imaging Tips for CW Doppler Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .245
I want the Doppler to be more sensitive. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .246
I need to be able to see a Doppler signal that is audible, but not visible. . . . . .246
I want to reduce artifacts and noise in the spectrum.. . . . . . . . . . . . . . . . . . . . .247
I want the 2D reference image to be updated. . . . . . . . . . . . . . . . . . . . . . . . . . .247
I want to display low-velocity signals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .247
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Imaging Tips for Color Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .248

I want the color to be more sensitive.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .248
I want the color to have less noise, flashing, or fewer artifacts. . . . . . . . . . . . . .248
I want the color to be less speckled or fragmented.. . . . . . . . . . . . . . . . . . . . . .249
I need to improve the color filling.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .249
I want to unwrap aliased signals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .250
I need to increase the frame rate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .250
Imaging Tips for Color Power Angio Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .251
I want the angio to be more sensitive.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .251
I want the angio to have less noise, flashing, or fewer artifacts. . . . . . . . . . . . . .251
I need to improve the angio filling.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .252
I need to improve the angio resolution. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .253
I need to increase the frame rate. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .253
11 Stress Echocardiography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
Stress Echo Setup . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .256
Modifying a Stress Echo Preset . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .257
About Stress Echo Protocols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .257
About Stress Echo Acquisition Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .258
About ECG Artifacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .258
Minimizing ECG Artifacts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .259
Using a VCR During a Stress Echo Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .260
Using the Timer During a Stress Echo Study. . . . . . . . . . . . . . . . . . . . . . . . . . . .260
Stress Echo Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .261
Performing a Stress Echo Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .261
Using Stress Echo Soft Keys. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .262
About the View Icon and the Stage-View Label . . . . . . . . . . . . . . . . . . . . . . . . .262
Acquiring Loops for a Single-Cycle or a Quad-Cycle Acquisition Stage. . . . . . .263
Acquiring Loops for a Multi-Cycle Acquisition Stage . . . . . . . . . . . . . . . . . . . . .264
Acquiring Images Outside of a Stress Echo Protocol . . . . . . . . . . . . . . . . . . . . .264
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Using the ROI Box in Stress Echo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .265

Moving the 2D Reference Line in Stress Echo . . . . . . . . . . . . . . . . . . . . . . . . . .265
Stopping and Resuming a Stress Echo Study . . . . . . . . . . . . . . . . . . . . . . . . . . . .266
Stress Echo Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267
Selecting the Preferred Stress Echo Loop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267
Relabeling Views . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .268
Viewing All the Stress Echo Loops for a View . . . . . . . . . . . . . . . . . . . . . . . . . .268
Playing Back Stress Echo Loops . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .269
Performing Wall Motion Scoring . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .269
12 Annotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .271
Labels . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .271
Placing a Label on the Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .271
Typing a Label on the Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .272
Modifying a Label . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .272
Placing Arrows and Drawings on the Display . . . . . . . . . . . . . . . . . . . . . . . . . . .273
Moving or Deleting Annotations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .273
Using Annotation Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .274
Body Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .275
Placing a Body Marker on the Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .275
Moving a Body Marker or the Transducer Icon . . . . . . . . . . . . . . . . . . . . . . . . .276
Rotating or Specifying the Shape of the Transducer Icon . . . . . . . . . . . . . . . . . .277
Using Body Marker Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .277
Using Body Markers and Dual Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .278
13 Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .279
Analysis Setup and Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .280
Configuring the Analysis Menu. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .280
About the Accuracy of Measurements and Calculations . . . . . . . . . . . . . . . . . . . . .281
About the Sources of Measurement Error . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .281
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About Measurement Primitives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .283

About Volume Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .284
About PISA Measurements and Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .286
About Pulsatility Index and Resistivity Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .287
Doppler Trace Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .288
About Doppler Auto Trace . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .289
Using Doppler Auto Trace. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .289
Using Doppler Auto Trace Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .291
Using Multi-Cycle Doppler Auto Trace. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .291
Performing a Manual Doppler Trace Measurement . . . . . . . . . . . . . . . . . . . . . .292
Using High Q Doppler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .293
14 Measurements and Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 295
Working with Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .295
About Calipers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .296
Approving Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .296
Displaying Measurement Values . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .297
Reactivating a Measurement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .297
Deleting a Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .298
Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .298
Performing Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .299
Unlabeled Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .299
Performing a 1-Point Depth or Velocity Measurement . . . . . . . . . . . . . . . . . . .299
Performing a 2-Point Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .300
Performing an Ellipse Measurement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .301
Performing a Trace Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .302
Performing a Method of Discs Measurement or SPE Volume . . . . . . . . . . . . . .303
Quick Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .304
Labeled Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .311
Performing a Labeled Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .311
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Performing a Protocol Measurement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .312

Entering a Measurement Value Manually . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .312
Using Labeled Measurement Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .312
Assigning a Measurement Value . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .313
Performing a Hip Angle Measurement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .313
Performing an IMT Trace Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .315
Performing an IMT Linear Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .315
Labeled Measurements by Exam Type. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .316
Cardiac Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .316
Cardiac Triggered Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .325
Vascular Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .326
TCD Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .326
Carotid Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .330
UE Artery Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .336
UE Vein Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .340
LE Artery Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .341
LE Vein Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .347
IMT Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .348
General Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .348
Abdominal Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .349
Prostate Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .352
Thyroid Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .354
Breast Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .356
Testicular Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .357
Superficial Measurements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .359
Pediatric Hip Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .361
Obstetric Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .362
Gynecology Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .365
Musculoskeletal Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .368
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Labeled Calculations by Exam Type. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .368

General Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .369
Prostate Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .371
Thyroid Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .374
Breast Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .375
Testicular Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .376
Superficial Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .378
Hip Angle Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .380
Cardiac Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .380
Obstetric Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .386
Gynecology Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .389
Vascular Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .391
15 Patient Studies, Image Review, and Reports . . . . . . . . . . . . . . . . . . . . . . 399
Patient Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .399
Creating Patient Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .399
Creating a Patient Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .399
Editing Patient Demographic Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .400
Saving a Patient Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .400
Closing a Patient Study. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .401
Managing Patient Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .401
Restarting a Patient Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .401
Searching for a Patient Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .402
Searching for a Patient Folder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .403
Deleting a Patient Folder . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .404
Deleting a Patient Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .404
Viewing a Previous Study for the Current Patient . . . . . . . . . . . . . . . . . . . . . . .405
Image Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .405
Working in Image Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .406
About Single Images, Thumbnails, and Full-Screen Images . . . . . . . . . . . . . . . . .406
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Deleting an Image in Image Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .407

Adding a Caption or a Flag to an Image. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .407
Viewing 3D or Panoramic Images in Image Review. . . . . . . . . . . . . . . . . . . . . . .407
Printing Images in Image Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .408
About Reactivating Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .409
Reactivating an Image in Image Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .410
Using the Select Key in Image Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .410
Specifying the Image Selection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .411
Specifying the Image Display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .411
Playing Back Loops in Image Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .412
Controlling the Playback of Loops in Image Review . . . . . . . . . . . . . . . . . . . . . .412
Viewing a Full-Screen Frame or Playing Back a Loop in Image Review . . . . . . .413
Playing Back More Than One Image in Image Review. . . . . . . . . . . . . . . . . . . . .414
Playing Back Images That You Select . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .414
Playing Back a Series of Sequential Images. . . . . . . . . . . . . . . . . . . . . . . . . . . . . .415
Comparing Images from Two Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .415
Editing the Endpoints of a Loop . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .416
Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .416
Report Work Area. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .417
Finalizing a Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .418
Viewing Report Versions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .418
Printing a Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .419
Saving a Report as a Series of Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .419
Adding an Image to a Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .419
Manipulating Measurements in a Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .420
Adding Patient Information to a Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .421
Adding Interpretations to a Cardiac or a Vascular Report. . . . . . . . . . . . . . . . .421
Adding Visualizations and Observations to an Obstetric Report . . . . . . . . . . . .422
Adding Visualizations and Observations to a Gynecologic Report. . . . . . . . . . .423
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Adding Comments to a Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .425

Generating Obstetric Trending Graphs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .425
Formulas Used in Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .426
Importing and Exporting. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .427
Importing a Patient Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .428
Exporting the Current Patient Study in DICOM Format . . . . . . . . . . . . . . . . . .429
Exporting Patient Studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .430
About the Icons in the Search for Study Window . . . . . . . . . . . . . . . . . . . . . . .431
Setting the Brightness for an Automatic Export . . . . . . . . . . . . . . . . . . . . . . . . .432
Exporting an Image in PC Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .434
Exporting Images in PC Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .435
Exporting a Report in PC Format . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .435
Exporting Images and Reports from Patient Studies in PC Format . . . . . . . . . .436
Exporting Data to a Third-Party Application. . . . . . . . . . . . . . . . . . . . . . . . . . . .437
16 Clinical References for Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439
Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .439
A . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .440
B . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .444
C . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .445
D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .446
E . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .447
F . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .453
G . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .455
H . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .475
I . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .476
L . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .476
M . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .479
O . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .482
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P . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .483
R . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .485
S . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .485
T . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .487
U . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .488
V . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .488
W . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .489
17 Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .491
18 Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .533
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1 Read This First

This section contains important information about the user information for your
system and about contacting Philips Ultrasound.
Intended Audience
Before you use your user information, you need to be familiar with ultrasound
techniques. Sonography training and clinical procedures are not included here.
This information is intended for sonographers, physicians, and biomedical engineers who operate and maintain the ultrasound system.
About Your User Information

The user information provided with your system includes the following components:
Compact Disc (CD): Includes all of the user information.
Getting Started: Introduces you to system features and concepts, and helps
you set up your ultrasound system. This manual also includes procedures for
basic operation. For detailed operating instructions, refer to Help or the User
Reference.
Help: Help is available on the system in some languages and the information
in Help is also included in User Reference on the CD. Help contains comprehensive instructions for using the system. Press Help on the system keyboard
to display Help. It includes a glossary containing descriptions of all controls
and display elements.
User Reference: A printed version of the Help that is localized to specific

markets.
Quick Guide: Contains procedures, imaging tips, and information on system

controls.
Acoustic Output Tables: Included on the CD, it contains information about

mechanical and thermal index precision and accuracy, the acoustic output
default tables, and the acoustic output tables.
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Read This First
Medical Ultrasound Safety: Included on the CD, it contains information on

bioeffects and biophysics, prudent use, and implementing ALARA (as low as
reasonably achievable).
About Your Compact Disc

The CD contains all of the user information, except the Operating Notes. The
instructions for using the CD are included with the CD.
Conventions
The system uses certain conventions throughout the interface to make it easy for
you to learn and use. The accompanying user information also uses typographical
conventions to assist you in finding and understanding information.
User Information Conventions

The user information follows these conventions:
Hypertext links appear in blue.
All procedures are numbered, and all subprocedures are lettered. You must
complete steps in the sequence they are presented to ensure success.
Bulleted lists indicate general information about a particular function or procedure. They do not imply a sequential procedure.
Control names and menu items or titles are spelled as they are on the system,
and they appear in bold text.
Symbols appear as they appear on the system.
The left side of the system is to your left as you stand in front of the system,
facing the system. The front of the system is nearest you as you operate it.
Transducers and pencil probes both are referred to as transducers, unless the
distinction is important to the meaning of the text.
Information that is essential for the safe and effective use of the ultrasound system
appears throughout this manual as follows:
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Read This First
NOTE
Notes bring your attention to important information that will help you operate
the ultrasound system more effectively.
CAUTION
Cautions highlight ways that you could damage your ultrasound system and consequently void your warranty or service contract.
WARNING
Warnings highlight information vital to the safety of you, the operator, and the
patient.
Upgrades and Updates

Philips Ultrasound is committed to innovation and continued improvement.
When upgrades that consist of hardware or software improvements are released,
updated user information sets will accompany those system upgrades.
Customer Comments
If you have questions about the user information set, or to report an error in the
user information set
For U.S. customers, call Philips Ultrasound Customer Service at

800-433-3246
For customers outside the USA, call your local customer service representative or contact one of the offices under "Customer Service" on page 26.
You can also send e-mail to Philips Ultrasound Technical Communications at the
following address:
bothell.techpubs@philips.com
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Read This First
Ordering Supplies and Accessories

You can order transducer covers, biopsy guides, and other supplies and accessories from CIVCO Medical Instruments:
CIVCO Medical Instruments
102 First St. South
Kalona, IA 52247-9589
Telephone: 800-445-6741, Ext. 1 for Customer Service (USA)
+1 319-656-4447 (International)
Fax:
877-329-2482 (USA)
+1 319-656-4451 (International)
E-mail:
info@civcomedical.com
Internet:
civco.com
Customer Service
Customer service representatives are available worldwide to answer questions
and to provide maintenance and service. Please contact your local Philips Ultrasound representative for assistance. You can also contact one of the following
offices for referral to a customer service representative, or visit the Philips Ultrasound Web site:
www.medical.philips.com
Corporate and North American Headquarters
22100 Bothell-Everett Highway
Bothell, WA 98021-8431
USA
Telephone: 800-433-3246 or +1 425-487-7000
Fax: +1 425-487-8188
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Read This First
Asia Pacific Headquarters

28/Floor, Hopewell Centre
17 Kennedy Road, Wanchai
Hong Kong
Telephone: +852 2821 5888
Fax: +852 2527 6727
European Headquarters (also serves Africa and the Middle East)
Roentgenstrasse 24, Gebaude S
D-22335 Hamburg
Germany
Telephone: +31 40 27 62092
Fax: +49 40 5078 4546
Latin American Headquarters
1550 Sawgrass Corporate Parkway, Suite 300
Sunrise, FL 33323
USA
Telephone: +1 954-835-2600
Fax: +1 954-835-2626
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Using Help
2 Using Help
The HD11 Help window displays four tabs along the top of the left pane to help
you navigate to specific topics:
Click the
tab to view the contents of the Help.
Click the
tab to search for topics by keyword.
Click the
tab to search the entire Help.
Click the
tab to display topics you have bookmarked.
There are two navigational icons on the toolbar. You can click them to navigate
through Help topics.
Back displays the last topic you viewed.

Forward displays the next topic in a previously displayed sequence of
topics.
Some words and phrases appear in blue text. If you click these words, additional
information appears, in the form of a pop-up window or a related topic. To make
the pop-up window disappear, click anywhere outside the pop-up. To return to
the original topic, click
Back.
Opening Help
To open Help, press the Help key.
To close Help, press the Help key.
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Using Help
Help Viewer
Toolbar
Navigation pane
Topic pane
On the left side of the viewer is the navigation pane. It contains four navigational
tabs: Contents, Index, Search, and Favorites.
On the right side of the viewer is the topic pane. It displays the selected topic.
Above the navigation and topic panes is the toolbar.
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Using Help
Resizing Help Panes
To temporarily resize the navigation or topic pane, point to the divider between
the two panes. When the pointer changes to a double-headed arrow, drag the
divider right or left. The panes return to original size when you end an exam or
cycle system power.
Finding Help Topics

In the navigation pane, do one of the following:
To browse through the table of contents, click the Contents tab. The table of
contents is an expandable list of topics; click the book icons to expand or collapse the list. Click the entry to display the topic.
To see a list of index entries, click the Index tab, and then type a word, or
scroll through the list. Topics are often indexed under more than one index
entry. Click the entry and then Display to display the topic.
To locate every occurrence of a word or phrase in Help, click the Search tab,
and then type the word or phrase. Click List Topics and then click the entry
and Display to display the topic.
To link from one topic to a related topic, click the blue underlined words or
phrases at the end of the topic.
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Using Help
Searching for Help Topics

The Search tab allows both basic and advanced text searches. Advanced searching allows you to search using Boolean and nested expressions. Searches are not
case-sensitive, so you can type your search in upper case or lower case. You can
search for any combination of letters and numbers. Punctuation marks and symbols are ignored during a search.
The AND, OR, NOT, and NEAR operators enable you to precisely define your
search by creating a relationship between search terms. To search for both terms
in the same topic, use AND. To search for either term, use OR. To search for the
first term but not the second term, use NOT. To search for two terms close
together in the same topic, use NEAR. Use parentheses to nest expressions
within a query. The expressions in parentheses are evaluated before the rest of
the query. For example, interval AND ((absolute OR relative) NEAR time) finds
topics containing the word interval along with the words absolute or relative close to the word time.
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Using Help
To search in Help
1. Click the Search tab.

2. Type the word, phrase, or characters you
want to find.
6a
3. Click List Topics.
4. Select a topic to view.
5. Click Display to view the selected topic.

6. To refine your search, do any of the following:
To do an advanced search, type a

word, select a Boolean operator from the
menu, and then type another word.
To search only the topics displayed

from a previous search, select Search
previous results.
To search for words similar to your

search text as well as exact matches,
select Match similar words.
6b
To exclude topic content and search

only topic titles, select Search titles only.
6c
6d
Using Favorites
On the Favorites tab, you can build a list of topics that you use frequently. This
list allows quick access to your favorite topics without having to search for them.
The topics you add to the list are saved automatically and remain in the list until
you delete them.
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Using Help
To use the Favorites list
1. Click the Favorites tab.

2. To add a topic, display the topic
in the topic pane and click Add.
3. To display a topic in the Favorites
list, select the topic and click Display.
4. To remove a topic from the Favorites list, select the topic and click
Remove.
4
3
2
Printing Help Topics

To print the displayed Help topic
Press the Record key you assigned to your printer.
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Using Help
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Using Help
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3 HD11 System Overview

Use this section to acquaint yourself with the HD11 ultrasound system and its
components.
System Capabilities
The HD11 system is a powerful ultrasound imaging and image review tool.
This section includes the following:
NOTE
"What You Can Do with the HD11 System" on page 37
"Image Acquisition Modes" on page 38
"Image Formats" on page 38
Some of the following features are options and are not available on all HD11 systems.
What You Can Do with the HD11 System

Use the HD11 system to perform the following tasks:
Image in a variety of modes, including 3D/4D mode and Panoramic Imaging.
Store, manage, and review images.
Perform measurements and calculations by using the comprehensive analysis

package.
Create, edit, and add images to reports.
Send images and patient information over a network.
Print images to one of the printers.
Export data in PC formats to removable media.
Export DICOM data to removable media (requires the DICOM Media

option).
Obtain the days worklists (requires the DICOM Networking option).
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HD11 System Overview
Archive data to removable media (if your system does not have a DICOM
option).
Send images and patient information over a network to a DICOM picture

archiving and communication system (PACS).
Image Acquisition Modes

The HD11 system supports the following image acquisition modes:
2D
3D
4D
Color Doppler
Color Power Angio (CPA) Imaging
Contrast
CW Doppler
MMode
PW Doppler
Stress Echocardiography
TDI
You can also perform duplex and triplex imaging.
Image Formats
All HD11 systems can export images in one of two ways:
PC Format
PC format allows you to view images on any PC. The different types of images
are exported as follows when you export them in PC format:
38
Still images are exported as .BMP files
Loops are exported as .AVI files
Report pages are exported as .HTML files
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NOTE
Images that you export using PC format cannot be imported back into the HD11
system. Therefore, do not use this format to back up your studies.
Export or Export DICOM formats

These two formats allow exported images to be imported into the HD11 system.
If your system has an MOD drive, the Export DICOM option is available
and the studies are exported in DICOM format. Images can be imported
back into the HD11 system, and you can also view them using any DICOM
viewer.
If your system does not have an MOD drive, the Export option is available. When you select this option, the images in the study are exported in
a proprietary backup format. You can import the images back into the
HD11 system, but you cannot view them on a PC or on a DICOM viewer.
System Options
In addition to the standard features available in the system, other features are
available as purchasable options. The types of options available include clinical,
imaging, and connectivity options.
"Clinical Options" on page 39
"Imaging and Connectivity Options" on page 40
Clinical Options
Each HD11 system includes one of the four standard clinical software applications. You must purchase the clinical application package for each exam type that
you want to perform.
Optionally, you can purchase the Shared Service Clinical package which combines
all of the applications and presets listed in the following sections and includes
physio (ECG), exam-specific calculations and analysis, reports, and biopsy capabilities.
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Cardiac
Provides adult and pediatric presets. Also includes physio (ECG), and cardiac calculations and analysis.
General Imaging
Provides adult and pediatric presets for abdominal (including renal), small parts,
musculoskeletal, and prostate exams. This application also includes biopsy capabilities, and exam-specific calculations and analysis.
OB/GYN
Provides presets for obstetrical, gynecological, endovaginal, and fetal echo. This
option also includes biopsy capabilities, OB/GYN calculations and analysis, and
OB trending.
Vascular
Provides presets for carotid, transcranial Doppler (TCD), and bilateral lower and
upper extremities. Also includes physio (ECG), and vascular calculations and analysis.
Imaging and Connectivity Options

The imaging options listed here are available as supported by the current transducer and application. The following are available as purchasable options on your
system:
NOTE
40
"Stress Echocardiography" on page 255
"DICOM Networking" on page 67
"Fetal STIC" on page 203
"Contrast Harmonic Imaging" on page 210
Fetal STIC requires the installation of 4D hardware. The 4D package is not a software-configurable optionit is a hardware option that requires the purchase and
installation of the motor controller board. The Fetal Heart software option functions if you have installed the basic 4D option. Contact your Philips representative
for more information.
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System Layout and Controls

The HD11 system is housed in an ergonomic cart. The cart is adjustable to
accommodate a wide range of operating positions. You can lock adjustable components to safely move the system.
The major components include the monitor, control panel, removable media
drives, transducer connector panel, physio panel, and wheel controls (Figure 3-1).
Figure 3-1 HD11 System
Monitor
Transducer holders
Soft key panel

Control panel
Printer
CD Drive
Transducer
connector panel
Physio Panel
MOD Drive
Storage bin
Wheels
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On/Off Button
The On/Off button is located in the upper right corner of the soft key panel
(Figure 3-2).
The indicator above the On/Off button is lit when the system is on.
Figure 3-2 On/Off Button
On/Off button
Control Panel
The control panel includes two main components: the soft key panel, and the
main control panel (Figure 3-3). For more information about the control panel
keys and controls, see the "Glossary" on page 491.
Soft Key Panel

The soft key panel is the angled panel located below the monitor. It contains buttons and soft key controls. The functions of the soft keys change depending on
the mode, the application, the preset, and the transducer. The function of each
soft key is described above the soft key on the bottom of the display. Press the
control under each soft key label to adjust its setting.
Main Control Panel

The main control panel (Figure 3-3) is the horizontal surface that contains the
keys and buttons that you press, knobs that you turn and push, and slide controls
that you move left and right or up and down. The main control panel includes the
keyboard to type information into fields and to type labels, titles, and Quick Text
labels onto the display.
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Figure 3-3 HD11 System Control Panel
Video Monitor
The HD11 system includes a color video monitor. You can adjust the monitors
brightness and contrast to best suit your environment. You can also raise, lower,
and swivel the control panel and monitor to make using the HD11 system as
comfortable as possible.
If you need to transport the HD11 system in a vehicle, you must first remove the
monitor from the system. For instructions on removing the monitor, see the
HD11 Getting Started.
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CD and MOD Drives

You can store exam data, images, and system settings onto removable media by
using the CD drive or the optional magneto-optical disk (MOD) drive. The system hard drive is located inside the system.
CD Drive
Each HD11 system includes a CD drive that supports CD-R (Recordable) and
CD-RW (Rewritable) discs, on which you can:
Store images and reports.
Back up presets, system settings, and OB trending data.
if the system does not also have an MOD drive, you can export studies to a CD,
but the image files cannot be viewed on DICOM viewers. The studies that you
export from the HD11 system can only be viewed when you import them back
into the HD11 system.
MOD Drive
If you purchased the DICOM Media option, your HD11 system also includes an
MOD drive. The MOD is reusable media that you can use to manually transfer
studies to a picture archiving and communication system (PACs) (if your network
is down). On an MOD disk, you can save studies, images, and reports in DICOM
format.
Transducer Connector Panel and Cable Management

The HD11 system can contain up to five transducer connectors. The number of
connectors on your system corresponds to the number of transducers you purchased. If you do not purchase five transducers, the unused connectors will be
inactive.
The HD11 system supports the following types of transducer connectors:
44
Cartridge
Explora
Nonimaging (Doppler Pencil)
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NOTE
The T6H OmniPlane III transducer requires an adapter to connect to the HD11
system.
The transducer connector panel is located on the front of the system
(Figure 3-4), and the transducer holders are located on each side of the control
panel. The holders for transmission gel are located behind each set of transducer
holders.
Use the hooks to manage the transducer cables. One large hook is centrally
located on the front of the system, and the other hooks are located under each
transducer holder.
Figure 3-4 Transducer Connectors
Cartridge-style
Explora-style
Nonimaging-style
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Physio (ECG) Panel

The physio panel is located on the front left side of the system, below the CD
drive (Figure 3-5).
Figure 3-5 Physio Panel
Peripheral Devices
The following peripheral devices are available for use with your HD11 system.
Storage
Multi-session CD drive (standard on all HD11 systems)
1.3-GB MOD drive (optional, included with the DICOM Media option)
Printers
The HD11 system supports the following types of printers:
USB printers, including plain-paper
Video printers
VCR
Mitsubishi HS-MD3000U (NTSC)
Mitsubishi HS-MD3000E (PAL)
Foot Switch
The foot switch is an option that you can purchase separately. It is also included in
the Stress Echo option.
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Transducers
The HD11 ultrasound system supports a wide variety of transducers. The following tables list the transducers by type:
"Curved Array Transducers" on page 47
"Sector Array Transducers" on page 48
"Linear Array Transducers" on page 49
"Doppler Pencil Transducers" on page 49
"3D/4D Transducers" on page 50

Table 3-1 Curved Array Transducers
Name/
Connector
C5-2
Applications
Frequency
Biopsy
Capable?
Harmonic
s Capable?
Abdominal, OB/GYN
2.05.0 MHz
Yes
Yes
Endovaginal, OB/GYN
4.08.0 MHz
Yes
No
Abdominal, Neonatal
head, OB/GYN,
Pediatric
5.08.0 MHz
Yes
No
4.09.0 MHz
Yes
No
Explora
Abdominal, OB/GYN,
Pediatric
C9-5ec
Endocavity
5.09.0 MHz
Yes
No
Cartridge
C8-4v
Cartridge
C8-5
Explora
C9-4
Explora
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Table 3-2 Sector Array Transducers

Name/
Connecto
r
PA 4-2a
Cartridge
S3-1
Explora
S4-2
Cartridge
S8-3
Explora
S12-4
Explora
Applications
Biopsy
Capable?
Frequency
Harmonics
Capable?
Abdominal, Cardiac,
OB/GYN, TCD
2.04.0 MHz
Yes
Yes
Abdominal, Cardiac,
TCD
1 3.0 MHz
No
Yes
Abdominal, Cardiac,
TCD, OB/GYN
2.04.0 MHz
Yes
Yes
Cardiac, Neonatal head, 3.08.0 MHz

OB/GYN, Pediatric
abdominal
No
No
Pediatric cardiac,
Pediatric abdominal,
Intraoperative,
Neonatal head
No
No
4.012.0 MHz
a. Indicates that this transducer is not sold with the system, but is supported.
Table 3-3 TEE Transducers

Name
S7-2omni
Applications
Frequency
Biopsy
Capable?
Harmonics
Capable?
No
Yes
Explora
Transesophageal (Adult and 2.07.0 MHz

Pediatric cardiac)
S7-3t
mini-Multi

Pediatric cardiac)
No
No

Pediatric cardiac)
No
Yes
Explora
T6Ha,b
SONOS
a. Indicates that this transducer is not sold with the system, but is supported.
b. Requires an adapter for use on the HD11 system.
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Table 3-4 Linear Array Transducers

Name
L8-4
Explora
L12-3
Cartridge
L12-5
Explora
L15-7io
Explora
Applications
Frequency
Biopsy Harmonics
Capable? Capable?
Abdominal, Musculoskeletal,
Pediatric Hips, Small Parts,
Vascular
4.08.0 MHz
Yes
Yes
Abdominal, Musculoskeletal,
Pediatric Hips, Small Parts,
Vascular
3.012.0 MHz
Yes
Yes
Abdominal, Pediatric Hips,

Small Parts, Vascular
5.012.0 MHz
Yes
No
Cardiac, Intraoperative,
Musculoskeletal, Vascular
7.015.0 MHz
No
No
Table 3-5 Doppler Pencil Transducers

Name
D2cwc
Applications
Frequency
Biopsy
Capable?
Harmonics
Capable?
Cardiac
2.0 MHz
No
No
Transcranial Doppler
2.0 MHz
No
No
Cardiac, Vascular
5.0 MHz
No
No
Pencil
D2tcd
Pencil
D5cwc
Pencil
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Table 3-6 3D/4D Transducers

Name
3D 6-2
Applications
Frequency
Biopsy
Capable?
Harmonics
Capable?
Abdominal, OB/GYN, Pediatric 2.06.0 MHz Yes
Yes
Abdominal, OB/GYN, Pediatric 4.08.0 MHz Yes
Yes
Endovaginal, OB/GYN
Yes
Explora
3D 8-4
Explora
3D 9-3v
3.09.0 MHz Yes
Explora
For information on caring for your transducers, see the HD11 Getting Started.
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4 Preparing Your System

Use this section to learn how to prepare your HD11 system for use. Preparations
include:
"Turning the System On and Off" on page 51
"Setting the System Time and Date" on page 52
"Positioning the Control Panel and Monitor" on page 52
"Connecting Devices" on page 56
"Moving the System" on page 60
"Using the Removable Media Drives" on page 62
"Recalibrating an Image in VCR Playback" on page 65
Turning the System On and Off

The On/Off button is located on the upper right section of the soft key panel.
When the system is on, the light above the On/Off button is lit.
To turn the system on or off
Press the On/Off button.
NOTE
When the system is off, press the On/Off button to turn it on.
When the system is on, press the button to start the shutdown process and
to turn off the system completely.
Do not hold the On/Off button down. Press it only once.
CAUTION
Do not unplug the system from the wall outlet until the system is completely off.
If you unplug your system before the shutdown message appears, you will have to
wait longer than usual to use your system the next time you turn it on. You may
also corrupt files, which can result in the loss of patient data or an inoperative
system.
If the system does not turn off after 90 seconds, press and hold the On/Off button for 5 seconds to force the system to turn off.
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Preparing Your System
NOTES
Pressing and holding the power button to force the system to shut down can
cause the same problems as prematurely unplugging the system. Wait the full
90 seconds before assuming that the system has failed to shut down normally.
The fan comes on periodically to regulate the temperature within the system,
even when the system is turned off.
To break the connection from the main power supply, remove the ultrasound
system plug from the wall outlet.
Setting the System Time and Date

To set the system time and date
1. Press Setup.
2. In the Setup window, click the System tab.
3. Select Date/Time to open the Date and Time Properties window.
4. Click the Time Zone tab and select the time zone for your area.
5. Click the Date/Time tab and do the following:
a. In the Date field, select todays date.
b. In the Time field, enter the current time.
6. Click OK to save the date and time settings.
Positioning the Control Panel and Monitor

There are two ways you can adjust the monitor:
Adjust the display settings each time the ambient light changes. For instructions, see "System Settings" on page 102.
Position the monitor and control panel for comfortable use.
To raise, lower, and rotate the system control panel and monitor
1. To unlock the system control panel, do either of the following:
52
Grasp the adjustment handle under the system control panel and pull it
toward you.
Squeeze either button in the center of the system handle.
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2. Raise or lower the control panel, or rotate the control panel left or right as
needed.
3. Release the handle or buttons to lock the system control panel in place.
Using the Soft Keys

The soft keys are the keys above the system control panel and below the monitor.
The functions of the soft keys change depending on the mode, the application, the
preset, and the transducer. The function of each soft key is shown above the soft
key on the bottom of the display.
To use a soft key
Press the up arrow or the down arrow on the soft key to choose or change the
selection that corresponds to the text label on the display.
To locate a soft key
Press Next to see if it appears in the next level of soft keys.
Press Select to change the function that is highlighted in the Select menu. In
some modes, the soft keys change depending on the active function of the
trackball.
Soft Key Levels

Some applications and features have more than one level of soft keys. You can
determine how many soft key levels are available and which level is active by looking at the soft key level indicator, a vertical set of small circles centered on the
bottom of the display. The number of circles indicates the number of available soft
key levels, up to three. When only one soft key level is available, no indicator
appears.
The solid circle indicates the active soft key level. The top circle indicates the primary soft key level, and the bottom indicates the last soft key level. Press Next
on the soft key panel to cycle through the soft key levels; as you press Next the
solid circle changes to indicate the active soft key level.
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The following illustration shows the soft key level indicator, which is showing that
the first of two available soft key levels is active:
In 3D/4D and Fetal STIC Imaging, some soft keys have their own additional sublevel of soft keys. For more information, see "Using 3D Render Soft Keys" on
page 183.
Using the Control Panel

Using the Select and Enter Keys
The main control panel also includes the trackball, Enter key, and the Select key
that work together like a computer mouse. Moving the trackball is like moving the
mouse. Pressing the Enter key is like pressing the left mouse button. Pressing the
Select key is like pressing the right mouse button.
Clicking an Item on the Display or Choosing an Option

To click an item on the display or to choose an option, use the trackball to move
the cursor over the item or the option, and press the Enter key.
Changing the Active Function of the Trackball

In many circumstances, you can use the trackball for more than one function. The
possible functions of the trackball for the current mode, transducer, and preset
are listed in the Select menu on the bottom right corner of the display. The
active trackball function is highlighted. To change the active trackball function,
press the Select key.
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Using the Control Panel Backlight

You can control the backlight level on the control panel by pressing the Ctrl key
and B key (Ctrl+B) together. Continue pressing Ctrl+B to cycle through the
settings (Low, Medium, and High).
For information on using the Setup window to change the control panel backlight settings, see "System Settings" on page 102.
Using Keyboard Shortcuts

You can gain quick access to several HD11 system features by using keyboard
shortcuts.
Table 4-1 Shortcut

Ctrl+B
Table 4-2 Feature

Keyboard backlight setting
Ctrl+J
Job Manager
Ctrl+Q
Autotrace Evaluation setting
Using the World Keys

The World keys are labeled with a globe. They appear on either side of the spacebar. Use a World key to type the characters that appear on the right side of
some keys on the keyboard.
To type a character that appears on the bottom right corner of a
keyboard key
Press the World key and the keyboard key simultaneously.
To type a character that appears on the top right corner of a keyboard
key
Press the World key, the Shift key, and the keyboard key simultaneously.
Typing Special Characters

To make an apostrophe ('), a quotation mark (), an accent (`), a tilde
(~), or a caret (^) appear when you are using the keyboard
Type the character and then press the spacebar.
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Connecting Devices
In addition to the devices installed in the system cart, the HD11 system supports
external peripheral devices, as listed in "Peripheral Devices" on page 46.
For instructions on connecting a printer, a VCR, or a foot switch, see the HD11
Getting Started.
This section provides instructions for:
"Connecting Transducers" on page 56
"Connecting a Modem" on page 58
"Connecting to a Network" on page 59
Connecting Transducers
This section provides the following instructions for connecting and removing each
type of transducer style to and from the HD11 system (cartridge, Explora, and
nonimaging). It also includes information and instructions for connecting and
removing the T6H OmniPlane III transducer and its adapter.
"Connecting and Removing Cartridge-Style, Explora-Style, and Nonimaging

Transducers" on page 56
"Connecting an OmniPlane III Transducer" on page 57
"Connecting the T6H Transducer" on page 57
Connecting and Removing Cartridge-Style, Explora-Style, and

Nonimaging Transducers
To connect a transducer
1. Place the transducer in one of the transducer holders on either side of the
control panel.
2. Do one of the following, depending on the connector style:
56
For a cartridge-style or nonimaging-style connector, align the connector

and plug it in.
For an Explora-style connector, turn the latch to the unlocked position

and plug the transducer into the slot. Be sure the transducer is firmly
seated in the connector. To lock, turn the transducer latch to the locked
position.
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To remove a transducer
Do one of the following, depending on the connector style:
For a cartridge-style connector, press the Release button on the connector

and pull the connector toward you.
For a nonimaging-style connector, pull the connector toward you.
For an Explora-style connector, turn the latch to the unlocked position and
pull the connector toward you.
Connecting an OmniPlane III Transducer

Before you connect the OmniPlane III TEE transducer, be sure the tip and shaft
are straight. When you connect the transducer, it automatically recalibrates itself
to the 0 (horizontal plane) position. As with any array movement, the motor
makes a humming sound while recalibrating.
NOTE
With TEE transducers, if the Calibration failed message appears, try unlocking
the transducer connector, straightening the tip and shaft, and then locking the
connector.
Connecting the T6H Transducer

The T6H OmniPlane III transducer requires an adapter for use with the HD11
system.
To connect the T6H OmniPlane III transducer to the OmniPlane
Adapter and to the system
1. Plug the adapter into the HD11 system transducer connector with the latch
side facing out.
2. Turn the latch on the adapter to lock the adapter to the system.
3. Plug the T6H OmniPlane III transducer into the adapter.
4. Turn the latch 90 degrees clockwise to lock the transducer into the adapter.
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NOTE
With TEE transducers, if the Calibration failed message appears, try unlocking
the transducer connector, straightening the tip and shaft, and then locking the
connector.
To remove the T6H OmniPlane III transducer from the OmniPlane

Adapter
Turn the latch to the unlocked position (90 degrees counterclockwise) and pull
the connector toward you.
To remove the adapter from the system
Turn the adapter latch to its unlocked position and pull it toward you.
Connecting a Modem
The system includes a modem that is used in remote diagnostics and for receiving
system data. To use these features, the modem must be connected to a dedicated
telephone line and the system must be turned on.
To connect a telephone line to the internal modem
1. Connect one end of the provided modular phone cable to the wall phone
jack.
2. Connect the other end of the cable to the telephone jack on the rear panel of
the system (Figure 4-1).
WARNING
If you have a modem, make sure it is not connected to a telephone line while you
are imaging a patient.
NOTE
58
To facilitate remote diagnosis, remove all connected transducers.
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Figure 4-1 Location of Analog Telephone Jack
Analog telephone jack
Connecting to a Network
To use connectivity features, the system must be connected to a network. The
Ethernet connector on the rear panel supports both 10Base-T and 100Base-T
formats. The system is configured for network connectivity by a Philips field service engineer or your network administrator.
CAUTION
Make sure that the system network parameters are properly configured before
you connect the network cable. Incorrect network configuration can interfere
with the correct operation of your system when the network cable is connected.
To connect the system to a network
1. Connect one end of the provided network connection cable to the wall
receptacle for your network.
2. Connect the other end of the cable to the network connector on rear panel
of the system (Figure 4-2).
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Figure 4-2 Network Connection
Network
connector
Moving the System

The weight of the system depends on the peripherals installed, but generally
includes the monitor and the power module. The typical weight is approximately
100 kg (220 lb) without peripherals.
WARNING
This weight dictates discretion when moving the system. The ability to move the
machine is, however, directly related to an individuals size and strength. Seek
assistance to move the system when necessary.
This system is equipped with a front handle and brakes on the front wheels. The
front wheels on the HD11 system have controls that you can engage and disengage independently. Each front wheel has three levers: one red, one green, and
one gray . The back wheels do not have controls.
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Figure 4-3 Wheel Controls
Steer
lock
Wheel lock and

steer lock release
Wheel lock
To lock the front wheels for moving the system in a straight line
Press the green lever.
To move the system
Always use the handle at the front of the cart to move the system from one location to another.
To apply the brakes to each wheel
Press the red lever.
To release the wheel locks or the steer locks
Press the gray lever.
WARNING
Do not use the wheel controls to hold the system on an incline greater than
5 degrees.
Precautions for Moving the System
Turn off the system and unplug it from the power source.
Always use the front handle to push the system. Do not push the system from
the side or the back. Do not use the handle to lift the system.
Be sure the system control panel and monitor are locked. Rotate the control
panel left and right; it will lock automatically.
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Disconnect and remove external devices and all loose equipment from the
top of the ultrasound system.
Make sure the strap that holds the system peripherals on top of the system
cart is securely tightened.
Do not move the system over uneven elevator entrances by lifting up on the
machine.
Use two people to transport the ultrasound system when you are moving it
up and down ramps longer than 6 m (20 ft) or steeper than 5 degrees.
(Wheelchair ramps are usually less than 5 degrees.)
The system has been tested for stability by using the IEC 60601-1 test protocol.
This protocol calls for the device to not tip over when moved over a 10-degree
incline in any direction. It is, however, possible to exceed this amount of incline
when the system is moved over a roadside curb or some other small but steep
incline. Use care when moving the system.
WARNING
Avoid ramps that are steeper than 10 degrees to eliminate the potential danger of
the system tipping over.
Using the Removable Media Drives

This section provides instructions for using CDs and MODs. It includes the following instructions:
62
"Loading and Ejecting CDs and MODs" on page 63
"Viewing a CD or an MOD" on page 63
"Formatting an MOD" on page 64
"Erasing a Disk" on page 64
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Loading and Ejecting CDs and MODs

This section provides instructions for loading and ejecting a CD and an MOD.
To load and eject a CD
1. To open the tray, press the Eject button located below the CD drive.
2.
Place a disc into the tray. Ensure that the disc is seated properly in the recess
in the tray.
3. To close the tray, press the Eject button again.

To load and eject an MOD
1. To load the MOD, insert the MOD into MOD drive.
2. To eject the MOD, press the small button located on the MOD drive.
Viewing a CD or an MOD
This section provides instructions for viewing the contents of a CD and an MOD.
Viewing the contents is called browsing.
To browse the contents of a CD
1. Press Setup.
2. In the Setup window, click the CD tab.
3. Click Browse CD to open the Browse CD window.
4. To close the Browse CD window when done, click Close.
5. To close the Setup window, click Close.
To browse the contents of an MOD
1. Press Setup.
2. In the Setup window, click the Optical Disk tab.
3. Click Browse Disk to open the Browse Disk window.
4. To close the Browse CD window when done, click Close.
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Formatting an MOD
Formatting an unformatted MOD prepares it to store data. Formatting a formatted disk that contains data erases all of the data on it. You can format a disk in the
background while you continue to use the system. The system displays a message
at the bottom of the display to indicate when the formatting process is finished.
NOTE
You only need to format MODs for use. The system automatically formats a CD
when you store images to it.
To format an MOD
1. Insert the MOD into the MOD drive.
2. Press Setup.
4. Click Format Disk.
5. Change other settings as necessary.
6. To format the disk, click Start.
Erasing a Disk
Erasing a CD-RW or MOD deletes all of the files and data currently stored on the
disk.
CAUTION
You cannot restore data after is it erased from a disk.

To erase the contents of a CD
NOTE
You cannot erase a CD-R; you can only erase a CD-RW.

1. Press Setup.
2. In the Setup window, click the CD tab.
3. Click Erase CD to open the Erase CD window.
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4. To erase the contents of the CD, click OK.

5. To close the Erase CD window, click Close.
To erase the contents of an MOD
1. Press Setup.
3. Click Erase Disk to open the Erase CD window.
4. To erase the contents of the MOD, click OK.
5. To close the Erase Disk window, click Close.
Recalibrating an Image in VCR Playback

You can calibrate a paused VCR image so you can perform measurements on it.
The system allows five types of calibration on paused VCR frames:
2D
M-mode
Doppler Velocity
Doppler Frequency
Physio
When the you press Caliper or Trace while a paused VCR image is displayed,
the system prompts you to choose the type of calibration. The system then provides a series of prompts to walk you through the calibration process.
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DICOM Networking
5 DICOM Networking
DICOM is a format for transferring patient studies over the information management system. These studies are accessed by physicians at remote viewing stations.
It is also a format for receiving work order requests at your HD11 system.
The HD11 system offers the following DICOM options:
With the DICOM Networking option, you can:
Export images and studies over a network to a DICOM PACS server or to

a DICOM printer. See "Setting Up Automatic DICOM Export and Export
Options" on page 74 and "Setting Up Automatic DICOM Printing" on
page 83.
Use Modality Worklist (MWL) and Modality Performed Procedure Step

(MPPS). See "Setting Up Modality Worklist" on page 91.
With the DICOM Media option, you can export to an MOD, a CD-R, or a
CD-RW in DICOM format. See the HD11 Getting Started.
To learn how to enter DICOM settings for your system and assign DICOM servers, see "DICOM Setup" on page 67.
DICOM Setup
Before you use DICOM Networking features, you must enter DICOM settings
for your system and assign DICOM servers.
CAUTION
If you want to change DICOM settings not covered here, see your network
administrator. Do not make any changes to network settings without consulting
with your network administrator.
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DICOM Networking
DICOM Setup Workflow

The following workflow describes the sequence of steps you need to follow for a
successful DICOM connection.
Step 1: Enter HD11 System DICOM Settings
"Entering System DICOM Settings" on page 68
Step 2: Enter Server Information and Assign Servers to Roles
"Assigning DICOM Servers" on page 71
Step 3: Set Up Automatic Export, Printing, and Study Deletion
"Automatic DICOM Export" on page 72
"Automatic DICOM Printing" on page 82
"Setting Up Automatic Study Deletion" on page 80
"Setting Up Modality Worklist" on page 91
Entering System DICOM Settings

You must enter DICOM settings for your HD11 system before you connect your
system to the network. If you have questions, see your network administrator.
NOTE
You cannot make DICOM system name or port changes if you have a study open
or if any DICOM jobs are pending. You need to close the open study and delete
pending DICOM jobs (Print, Store, or MPPS) first. A message is displayed if you
have pending jobs. See "Canceling DICOM Jobs" on page 88.
To enter DICOM settings for your HD11 system

1. Do not connect the LAN cable to the system. If it is already connected, disconnect it.
2. Press Setup.
3. Click the System tab.
4. On the System tab, click DICOM.
5. In the DICOM Setup window, click the This System tab.
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DICOM Networking
6. On the This System tab, in the System Name area, enter the AE Title
for your system specified by your network administrator. See "Changing or
Setting the PC Name" on page 70.
NOTES
NOTE
The AE Title for each device on the network must be unique.

AE Titles are case sensitive (that is, PACS1 is different from Pacs1).
In many institutions, the AE Title is derived from the PC Name, which must
be unique across the institutions network.
7.
In the System port number area, enter the port number specified by your
network administrator. You can use the up arrow or down arrow to change
the number, or you can type it in.
The default port number, 104, is assigned to ultrasound systems at most institutions.
8. In the Network settings area, click the Network settings button.
9. In the Internet Protocols (TCP/IP) Properties window, enter the IP
Address, Subnet Mask, and any other network parameters specified by
your network administrator.
10. Click OK.
11. Click OK.
12. Click Close.
13. Connect the LAN cable to the system. After about 10 to 20 seconds, the
Status should change to Connected.
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DICOM Networking
Changing or Setting the PC Name

The system administrator may want to change the factory-configured PC name
on the HD11 system.
To change the PC Name in DICOM setup
1. Press Setup.
4. In the DICOM Setup window, click the This System tab.
5. On the This System tab, in the System Name area, click Change next to
the PC Name field.
6. Enter the new computer name in the field provided.
7. Click OK.
8. Click OK to confirm the name change.
9. Click OK to exit the message box.
10. Click OK.
11. Click Close.
12. Shut down the system and restart it.
NOTE
70
After you change the PC Name, the system disables all DICOM options until
you restart the system. After you restart the system, all installed DICOM options
will be available again.
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DICOM Networking
Assigning DICOM Servers

You must assign DICOM servers before you connect your system to the network.
If you have questions, see your network administrator.
To assign DICOM servers
1. Press Setup.
4. In the DICOM Setup window, click the Servers & Roles tab.
5. On the Servers and Roles window, in the Servers area, click New.
6. Assign a name to the sever and enter it in the Name field.
NOTE
This name will be used in all dialog boxes and error messages that relate to this
server. It does not have to be the same as the AE Title.
7. Enter the AE Title and Host/IP Address specified by your network administrator in the respective AE Title and Host/IP Address fields.
8. In the Servers area, click Done.
9. To test the server connection, click Ping.
In a few seconds, you should see the message [Server Name] is correctly
configured as a DICOM server and is up and running.
10. In the Roles area, click Modify.
11. For each DICOM role, select the appropriate server from the list. You can
assign DICOM servers to the following roles:
Storage SCPThe server assigned to this role receives and stores

images acquired from the system.
Storage Commit SCPThe server assigned to this role takes ownership of the study.
Black-and-White (B&W) Printer SCPThe server assigned to this

role is a black-and-white printer.
Color Printer SCPThe server assigned to this role is a color printer.

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DICOM Networking
MWL SCP(Modality Worklist) The server assigned to this role provides information about scheduled patients to the HD11 system.
MPPS SCP(Modality Performed Procedure Step) The server assigned

to this role receives information about studies that are started and completed on the HD11 system.
12. Click Advanced to the right of the menu for each role to configure additional settings, if applicable.
13. In the Roles area, click Done.
14. Click OK.
15. Click Close.
16. Make a preset backup disk. All DICOM settings will be saved with the System settings, except changes made under Network Settings. See "Backing
Up Presets and Settings to a CD" on page 131.
NOTES
You cannot make DICOM setup changes if you have a study open or if any
DICOM jobs are pending. You need to close the open study and delete pending DICOM jobs (Print, Store, or MPPS) first. A message is displayed if you
have pending DICOM jobs. See "Canceling DICOM Jobs" on page 88.
One server may perform more than one role. Storage and Storage Commit
roles are often done by one server.
Automatic DICOM Export

You can set up automatic DICOM export so that images are automatically
exported over a network when you press Acquire or when you save or close a
study.
You can set up automatic DICOM study deletion so that a study is automatically
deleted as soon as all of its images are exported over a network. See "Setting Up
Automatic Study Deletion" on page 80.
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DICOM Networking
NOTES
If you have configured a Storage Commit server, automatic study deletion

occurs after the images are exported to the PACS and after the Storage Commit server has accepted ownership of the images (which typically means a
backup has been made). For example, a Storage Commit server might be configured to accept ownership only after the nightly backup, in which case the
study will remain on the system until the next day, after the backup is complete.
The ability to export to a DICOM PACS server or to a DICOM printer is a
feature of the DICOM Networking option.
Before you can make any DICOM setup changes, you need to close any open
study and delete any pending DICOM jobs (Print, Store, or MPPS). A message
is displayed if you have pending jobs. See "Canceling DICOM Jobs" on page 88.
Managing Networked Studies

Several DICOM settings enable you to manage the studies on the system hard
drive, as well as how and when the images in those studies are sent to the PACS
server.
Hard Drive Management Guidelines

To temporarily disable network export of studies and images
Disable the DICOM Networking option on the Options tab in the Setup window. See "Installing Options" on page 101.
To make images available on the DICOM viewer as soon as the study is
completed
Select the Send as you go AutoSend option. See "Setting Up Automatic DICOM
Export and Export Options" on page 74.
To review images before exporting them over the network
Select the Batch mode AutoSend option. See "Setting Up Automatic DICOM
Export and Export Options" on page 74.
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To remove studies from the HD11 system as soon as they are accepted
by the PACS
Select the Immediately Auto Delete option. "Setting Up Automatic Study
Deletion" on page 80.
Setting Up Automatic DICOM Export and Export Options

Before you use automatic DICOM export, you must assign and select a valid Storage SCP server. That is where the images are saved. You can also select a Storage
Commit SCP server.
If you have any questions about servers, ask your network administrator.
To set up automatic DICOM export
1. Press Setup.
4. On the DICOM Setup window, click the Servers & Roles tab.
5. On the Servers and Roles window, in the Roles area, click Modify.
6. Select the appropriate server from the Storage SCP list.
7. Select the appropriate server from the Storage Commit SCP list, if necessary.
NOTE
Many sites do not have a Storage SCP server. If you inadvertently assign a server
that does not support the Storage Commitment role to the role of Storage Commitment SCP, an error will occur. Check with your network administrator to verify the site supports Storage Commitment.
8. Click the Advanced button to the right of Storage SCP.
9. On the Network Export Preferences window, click the Auto Store tab.
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10. In the Auto Store Mode box, select the appropriate option:
Manual export onlyYou must export over the network manually. See
"Exporting Patient Studies" on page 430.
Batch modeAll images are automatically exported over the network

when you save or close the study.
Send as you goEach image is automatically exported over the network

when you press Acquire.
11. To set Auto Store options to prevent large or incompatible files from being
exported to the Storage SCP, in the Auto Store Options box, select the
appropriate options:
NOTE
Send all 2D cine loopsAn acquired 2D loop will be exported to the

Storage SCP.
Send all 3D/4D still frames acquired without volume data sets
A 3D/4D image acquired without volume data will be exported to the
Storage SCP.
Send all 3D swivel loops and 4D Volume replay loops acquired

without volume data setsA 3D/4D loop acquired without volume
data will be exported to the Storage SCP.
Send all 3D/4D volume data set informationAn acquired 3D/4D

image with volume data will be exported to the Storage SCP.
3D/4D images and loops can be exported only in RGB Uncompressed ELE format, regardless of which export format you have selected on the Image Format
DICOM setup tab. (See "Changing the Image Format for DICOM Export" on
page 76.) If your DICOM viewer or PACS does not accept the RGB Uncompressed ELE format, clear all the options in the Auto Store Options box.
12. On the Image Format tab, click Display Compensation.
13. In the Display Compensation window, select the appropriate option:
No display compensationfor viewing the image at the same brightness as on the HD11 monitor.
Optimized for CRTfor viewing on an remote viewing station with a

CRT monitor.
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Optimized for LCDfor viewing on an remote viewing station with a

LCD flat panel monitor.
Tailor to your individual preferencemove the slider to the appropriate number. For information on how to determine the compensation
number, see "Determining the Display Compensation Number" on
page 433.
14. Click OK.

15. Click Done.
16. Click OK.
17. Click Close.
NOTES
The ability to export to a DICOM PACS server or to a DICOM printer is a

feature of the DICOM Networking option.
Before you turn off your system at the end of each day, check the DICOM Job
Manager window to make sure that the queue is empty to ensure that all
studies have been sent to the PACS server. You can quickly access the Job
Manager window by pressing Ctrl+J (not available in Review mode).
Changing the Image Format for DICOM Export

You can select the image format for studies that are exported to a PACS (Storage
SCP).
To change the image format
1. Press Setup.
5. On the Servers & Roles tab, in the Roles area, click Modify.
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7. In the Network export preferences window, click the Image Format
tab.
8. Select one of the following options:
Palette Color with RLE (lossless) compression
Palette Color Uncompressed ILE (Implicit VR, Little Endian)
Palette Color, Uncompressed ELE (Explicit VR, Little Endian)
RGB with RLE (lossless) compression
RGB, Uncompressed ILE (Implicit VR, Little Endian)
RGB, Uncompressed ELE (Explicit VR, Little Endian)
YBR, JPEG Compressed

If YBR, JPEG Compressed is selected, click Still frames or Loops
and drag the slider to adjust the image quality balance.
NOTES
Not all viewers support all DICOM formats. You should test your selected
format by viewing a study on the PACS viewer.
3D/4D images and loops can be exported only in RGB Uncompressed ELE
format, regardless of which export format you select. If your DICOM viewer
or PACS does not accept the RGB Uncompressed ELE format, clear all the
options in the Auto Store Options box when setting up automatic DICOM
export. See "Setting Up Automatic DICOM Export and Export Options" on
page 74.
9. Click Loop Timing to set the timing of loop frames for DICOM viewers:
Select Frame Time Vector for viewers that allow frames in a loop to
have different time durations.
Select Average Frame Time for viewers that require all frames in a
loop to have the same time duration.
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10. Click Study Description to determine how to populate the Study

Description field on the Patient Identification window:
Select MWL Information to use the patient data from the Modality
Worklist. This is the default setting if you have Modality Worklist.
Select Use Entered Text to customize the Study Description field

options. This is the default setting if you do not have Modality Worklist.
11. Click Display Compensation to set the brightness of exported images on

remote viewing stations:
Optimized for CRTfor viewing on a remote viewing station with a

CRT monitor.
Optimized for LCDfor viewing on a remote viewing station with a

Tailor to you individual preferencemove the slider to the appropriate number. For information on how to determine the compensation
page 433.
12. Click OK.

13. Click Done.
14. Click Close.
NOTES
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YBR, JPEG Compressed format offers the most flexibility and image compression. It is useful if you are capturing loops. However, not all DICOM viewers can read this format.
RGB, Uncompressed (ILE) is supported on many DICOM devices, but this
format offers no compression and therefore stores the largest files.
Color Palette provides the best viewing flexibility. Use RGB if Color Palette
is not supported by your viewer.
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Configuring Your Viewer Based on Study Description

Some DICOM viewers use the Study Description field in a patient study to
determine their viewer settings. As a result, all studies with a certain value in the
Study Description field are automatically viewed with the same viewer configuration.
See "Changing the Image Format for DICOM Export" on page 76 to learn how to
set the Study Description field value.
Troubleshooting Automatic DICOM Export

If you set up Automatic DICOM Export and the images do not store or export,
try the following:
Make sure you configured a Storage SCP server. See "Assigning DICOM Servers" on page 71.
Make sure you did not select Manual export only as the Auto Store setting. See "Setting Up Automatic DICOM Export and Export Options" on
page 74.
If you selected Batch mode as the Auto Store setting, close the study. See
"Setting Up Automatic DICOM Export and Export Options" on page 74.
If
is displayed in the Search for Study window, the export failed.
Try to export the study manually. See "Exporting the Current Patient Study in
DICOM Format" on page 429.
If you want to check the progress of the export, return to live imaging and
press Ctrl+J. Your job will appear in the Job Manager window.
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Setting Up Automatic Study Deletion

You can set up automatic DICOM study deletion so that a study is automatically
deleted as soon as all of its images are exported over a network. If you assigned
Storage Commit server, a study is not deleted until after all its images have been
exported to the PACS and the Storage Commit server has taken ownership of
the images.
To turn automatic DICOM study deletion on or off
1. Press Setup.
7. On the Network Export Preferences window, click the Auto Delete tab.
8. On the Auto Delete tab, select the appropriate option.
No Auto DeletionStudies are not deleted from your system after all
of their images are exported over the network. When space is limited on
your system, the oldest studies are automatically deleted, or you are
prompted to delete studies (according to the Disk Full Strategy). See
"Specifying the Disk Full Strategy" on page 128.
Immediate Auto DeleteA study is automatically deleted when all of

its images are exported over the network. If you have just a storage SCP
defined, then the study is deleted as soon as all the images have been successfully sent to the Storage SCP. If you also have a Storage Commit SCP
defined, then studies are not deleted until the Storage SCP (PACS) server
has informed the HD11 system that every image in the study has been
successfully stored to its archive and that the Storage Commit server has
taken ownership of the images. The Storage Commit server might not
accept ownership of the images until the nightly backup has completed.
9. Click OK.
10. Click Done.
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11. Click OK.

12. Click Close.
NOTES
If you have any questions about servers, see your network administrator.
DICOM export is a component of the DICOM Networking option.
Rescuing Stranded Studies

If the networked server goes offline, the HD11 system will retry to export a
study. If the server is offline for a long time, however, the study may not be
exported successfully to the PACS server.
At the end of each day, check the Job Manager (Ctrl+J) for unsuccessful exports
that are indicated by
or
Try to resend each job from the Job Manager. If that fails, delete the jobs from the
Job Manager and manually export each study from Image Review.
NOTE
You can configure the number of export retries and the retry interval. See
"Assigning DICOM Servers" on page 71.
To resend a job
1. Press Ctrl+J to open the Job Manager from the live display.
2. Look for jobs with a status of Error in the Status column.
3. Select a job with an status of Error.
4. Click Retry Job.
5. If the job retry fails, click Delete Job to delete the job from the Job Manager.
6. Click Close.
If the attempt to resend the job fails, manually export the job from Image Review.
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To manually export a job

1. Press Review.
2. Click the Search for Study button.
3. Click the Search button.
4. Look for studies in the search results box with either
MRN column.
or
next to the
5. Use the trackball to position the cursor over a study, and press Select.
6. Select Export DICOM from the shortcut menu.
7. Select the DICOM PACS from the Export to Device list.
8. Click Start Export.
9. Click Close.
10. Press Review.
Automatic DICOM Printing

You can set up automatic DICOM printing so that images are automatically sent
to a DICOM printer when you press Acquire or when you save or close a study.
NOTES
82
By default, a page is not printed until six images are sent to the DICOM
printer. To print a different number of images on a page, see "Changing
DICOM Printer Settings" on page 86.
The ability to print to a networked DICOM printer is a feature of the DICOM
Networking option.
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Setting Up Automatic DICOM Printing

To set up automatic DICOM printing
1. Press Setup.
6. Do one of the following:
To specify a black-and-white printer, select the appropriate server from

the B&W Printer SCP list.
To specify a color printer, select the appropriate server from the Color
Printer SCP list.
7. To change the automatic DICOM printing setting, click the Advanced button
to the right of B&W Printer SCP or Color Printer SCP.
8. On the Printer Configuration window, click the Auto-Print tab.
9. Select the appropriate option:
Manual print onlyYou must print manually. See "Exporting Patient

Studies" on page 430.
Batch modeStill images in the study are automatically printed when

you save or close the study.
Send as you goWhen a frozen image is acquired, it is automatically

queued for printing. When a page is full or the study is closed, the page is
immediately sent to the printer.
10. Click OK.

11. Click Done.
12. Click Close.
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NOTES

Networking option.
Troubleshooting Automatic DICOM Printing

If you set up automatic DICOM printing and the images do not print, check the
following:
Make sure you configured a B&W Printer SCP or Color Printer SCP server.
See "Assigning DICOM Servers" on page 71.
Make sure you did not select Manual print only as the Auto-Print setting.
See "Setting Up Automatic DICOM Printing" on page 83.
If you selected Batch mode as the Auto-Print setting, close the study. See
"Setting Up Automatic DICOM Printing" on page 83.
Check the DICOM Job Manager window (Ctrl+J). Make sure that there are
no jobs with a status of Error, which indicates that a print job failed. If the
print failed, delete it and try to print the study manually. See "Importing and
Exporting in DICOM Format" on page 93. You can also try to ping the server
to see if there is a network problem. See "Assigning DICOM Servers" on
page 71.
Configuring a New DICOM Printer

To configure a new DICOM printer
1. Press Setup.
3. Click DICOM.
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To specify a black-and-white printer, select the appropriate server from

the B&W Printer SCP list.
To specify a color printer, select the appropriate server from the Color
Printer SCP list.
7. To change the automatic DICOM printing setting, click the Advanced button
to the right of B&W Printer SCP or Color Printer SCP.
8. On the Printer Configuration window, click the Advanced tab.
9. On the Advanced tab, for immediate printer use, select the Derive number of pixels from Film Size and Resolution check box.
10. Click OK.
11. Click OK.
12. Click Close.
To obtain the specific settings for your DICOM printer, you can contact your Philips Service Representative. Or you can export and view the printer configuration
Excel spreadsheet that is stored on the HD11 system hard drive to obtain the
correct pixel and resolution settings for your DICOM printer.
To export the DICOM printer spreadsheet
1. Press Setup.
3. Click DICOM.
4. On the DICOM Setup window, click the Diagnostics tab.
5. On the Diagnostics tab, click Logging.
6. On the DICOM Diagnostics window, click Copy log files.
7. Under Select log files to copy, select PrintCatalog.xls.
8. Under Copy to, select CD.
9. Click OK.
10. Click OK.
11. Click Close.
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About Intelliprint
Intelliprint is an HD11 feature that automatically routes images to the appropriate
printer when you have both a color and a black-and-white printer configured.
When both printers are configured, Intelliprint automatically routes
black-and-white images to the black-and-white printer and color images to the
color printer.
If you have only a black-and-white printer configured, all imagescolor and
black-and-whitewill be sent to it for printing.
When color images are sent to a black-and-white printer, either the printer or
the HD11 system converts the color to black-and-white, depending upon your
printer server connection. These conversions will not look the same, and you
may prefer one conversion over the other.
If you have only a black-and-white printer, test color prints on it to see which conversion you prefer. Configure it first as a black-and-white printer on the DICOM
Servers and Roles tab and do a test print. Then configure it as a color printer
on the Servers and Roles tab and do another test print. Compare the results
and configure the printer according to the printouts you prefer.
NOTE
If you configure a black-and-white printer as a color printer, the print job may end
up with an error status if the printer cannot make the color conversion. Check
the test print. Then delete any error jobs and reconfigure the printer as a
black-and-white printer.
Changing DICOM Printer Settings

You can change many DICOM printer settings in the B&W Printer Configuration window and in the Color Printer Configuration window.
Information about each setting appears in the Description area. The DICOM
information about each setting appears below the Description area.
Some menus include Printer-specific so that you can enter a value used specifically for your printer. If you select Printer-specific, you can type a value in the
field to the right of the menu.
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To change the DICOM printer settings

1. Press Setup.
6. Click the Advanced button to the right of B&W Printer SCP or Color
Printer SCP.
7. On the Printer Configuration window, click the Basic or the Advanced
tab.
8. On the Basic or Advanced tab, make any necessary changes to the printer
settings.
NOTE
On the Advanced tab, in the Pixel section, you may need to set the number of
pixels and resolution in order to lay out the print page properly for your DICOM
printer. Your Philips service representative can provide the pixel and resolution
settings for your DICOM printer model. See "Configuring a New DICOM
Printer" on page 84.
9. Click OK.
10. Click Done.
11. Click Close.
NOTES
The ability to print to a DICOM printer is a feature of the DICOM Networking option.
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Canceling DICOM Jobs

To cancel DICOM jobs (Print, Store, MPPS)
Press Ctrl+J.
Press Setup, click the System tab, click DICOM, click the Diagnostics
tab, and then click Jobs.
2. On the Job Manager window, use the trackball and the Enter key to highlight the job you want to delete.
3. Click Delete Job.
NOTE
You cannot use the Delete Job button to delete jobs that are in progress. See
"Canceling All DICOM Jobs" on page 88 to cancel in-progress jobs.
4. Click Close.
5. Click OK.
6. Click Close.
Canceling All DICOM Jobs

To cancel all DICOM jobs, including in-progress jobs
1. In live imaging, press Ctrl+J.
2. On the Job Manager window, click Delete all jobs.
3. Click Close.
NOTE
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You cannot cancel a job that is in progress while a study is open. You must close
any open studies before canceling all jobs.
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Modality Worklist
If your system is connected to the hospital information system (HIS), the Patient
Selection window displays a list of scheduled patients, called the Modality
Worklist. You select a patient from the list, and the Patient Identification window opens, populated with the patient's demographic information.
If you temporarily disconnect your system from the HIS, you can still use Modality
Worklist. The most recent information from the HIS is stored on your system
and is updated when you reconnect to the HIS.
If you specify a server for Modality Performed Procedure Step (MPPS), your system notifies the HIS when a patient study is started and when it is complete. The
list of scheduled patients and patient billing information can then be updated.
NOTES
Before you use Modality Worklist, you must specify the Modality Worklist
server. See "Setting Up Modality Worklist" on page 91.
Modality Worklist is a component of the DICOM Networking option.
About the Patient Selection Window

If your system is connected to the HIS, you can see and select from a list of scheduled patients in the Patient Selection window.
The Patient Selection window opens when you press Patient. The main areas
of the window are:
Patient selection filterEnables you to customize which patient names appear
in the Modality Worklist by setting filter criteria. If the Find field is clear, all
patients on the Modality Worklist are displayed. The In Column field selections are saved when you exit the Patient Selection window. All filter settings
are saved when you select Save Filter.
Modality Worklist(Bottom left corner) A list of scheduled patients. You can
sort the list by clicking the column headings. You can also change column width by
dragging column separators to the left or right. To select a patient to start a study,
highlight the patients name and click OK, or double-click the patients name.
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NOTE
The Scheduled Time and Status columns are minimized by default. If your institution uses these fields, drag the column separators to resize them.
Patient information(Top right corner) Displays demographic information for
the highlighted patient in the Modality Worklist on the left.
Patient searching tipsProvides alternatives if you cannot find a patient on
the Modality Worklist. Clear filter removes filter criteria in the Patient selection filter area so that you can see all patients on the Modality Worklist or create a new filter. Refresh Now updates the Modality Worklist from the server.
Manual Entry opens the Patient Identification window so you can enter the
patient information manually. More Info tells you when the next update from the
server is scheduled.
Using Modality Worklist

To use Modality Worklist
1. Press Patient to open the Patient Selection window.
The Modality Worklist displays scheduled patients.
2. On the Patient Selection window, click a column header to sort the Modality Worklist by last name, exam time, or another category.
3.
Search for the patient, if necessary.
Enter one or more letters or numbers in the Find field and select a column from the In Column menu. As you type, the list changes to show
only the patients that match your criteria.
To find a subset of the results, type a value for a different column in the
And field and select the column from the In Column menu.
Click Save Filter to store the current filter settings as the default.
Click Clear filter to start a new search.
90
Select the patient. Click the name of the patient and click OK or double-click the highlighted patient name. The Patient Identification window opens and is populated with the patient's demographic information.
You can edit and save.
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If the patient's name does not appear in the Patient Selection window,
click Manual Entry. A blank Patient Identification window opens.
NOTES
If you click Manual Entry, the HIS will not be updated when the exam is complete, and the patients billing information will need to be updated manually.
The In Column field selections are saved when you close the Patient
Selection window.
Before you use Modality Worklist, you must specify the Modality Worklist
server. See "Setting Up Modality Worklist" on page 91.
Setting Up Modality Worklist

If you set up Modality Worklist, a list of scheduled patients appears when you
press Patient. If you select a Modality Performed Procedure Step (MPPS) server,
the list of scheduled patients may be updated when you complete a study.
To set up Modality Worklist
1. Press Setup.
6. Select the Modality Worklist server from the MWL SCP menu.
7. Select the Modality Performed Procedure Step (MPPS) server from the
MPPS SCP menu, if necessary.
8. Click Advanced to customize the Modality Worklist entries.
9. Click Done.
10. Click OK.
11. Click Close.
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NOTES
Changing Modality Worklist Settings

You can specify which scheduled patients appear in the Modality Worklist. You
can either choose from several default queries, or you can define your own query.
You can also specify how often your system retrieves patient information from the
hospital information system (HIS).
To change Modality Worklist settings
1. Press Setup.
6. Click the Advanced button to the right of MWL SCP.
7. On the Set Modality Worklist Query window, click the query you want.
To modify a query, click the Change button to its right.
To restore the queries to their original settings, click Set Factory

Defaults.
8. Click the up arrow or the down arrow in the MWL Polling Frequency area
or type the number to specify how often your system should retrieve information from the HIS.
9. Click OK.
10. Click Done.
11. Click OK.
12. Click Close.
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NOTES
Importing and Exporting in DICOM Format

You can export a patient study in DICOM format to an optical disk, to a CD-R or
CD-RW, or over a network.
You can import one or more studies that were created on an HD11 system and
saved in DICOM format from an optical disk or a CD-R or CD-RW.
For information about importing and exporting studies in DICOM format, see the
following topics:
"Importing a Patient Study" on page 428
"Exporting the Current Patient Study in DICOM Format" on page 429
"Exporting Patient Studies" on page 430
NOTES
You can also import one or more studies that were created on a Philips EnVisor system and saved in DICOM format to a CD-R or CD-RW.
Exporting a study over a network is a component of the DICOM Networking
option.
If you have the DICOM Media option, you can export studies in DICOM format. Those studies can be viewed on any DICOM viewer. If you do not have
the DICOM Media option, exported studies can only be viewed on HD11 systems.
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Customizing Your System
6 Customizing Your System

You can customize your system in the following ways to make it more useful for
you:
NOTE
Create presets designed specifically for the exams you perform.
Add options to enhance your imaging abilities.
Change system settings to reflect your needs.
Back up and restore system settings and presets.
Change the language input settings.
Change Physio and Triggering settings.
No matter how you customize your system, be sure to back up your presets, settings, and patient information regularly.
Presets
A preset is a group of settings that optimizes the system for a specific type of
exam. Presets establish many initial settings, such as gain value, color map, filter,
and items on the Label menu.
When you turn on your system, the most recently used preset is active. Before
you begin an exam, be sure that the appropriate preset is active.
You can choose from several default presets. You cannot delete these default presets. However, they provide a starting point from which you can create your own
presets. You can create up to 20 presets for each of the 9 exam types. If you need
to create more than 180 presets, you can save presets to a CD and restore them
when you need to use them.
NOTE
Presets are only available if you purchased the corresponding application package
option.
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About Exam Types

Related presets are organized in categories called exam types. Presets are only
available if you purchased the corresponding application package option.
Exam Type
Application Package Option
Abdominal
General Imaging
Abdominal Vascular
Vascular
Cardiac
Cardiac
Cardiac Vascular
Cardiac
Musculoskeletal
General Imaging
OB/GYN
OB/GYN
Pediatric
General Imaging
Small Parts
General Imaging
Vascular
Vascular
On the preset menu, the active exam type is displayed at the top of the menu.
The presets that belong to that exam type are listed underneath.
Selecting a Preset
Before you begin an exam, check to see if the correct preset is active. If it is not,
you need to select the appropriate preset from its related exam type.
To select a preset
1. Press Preset.
A menu appears with the current exam type at the top and all of the presets
for that exam type listed. Presets that you created appear above default presets.
2. If you want to select a preset of a different exam type, click the exam type at
the top of the menu and then click the appropriate exam type.
3. Use the trackball to highlight the preset you want and press Enter or Select.
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Creating a Preset
You can create a new preset based on a default preset or on a preset that you
created previously.
To create a preset
1. Select a preset that you want to use as a starting point for your preset.
2. Modify any settings that you want to change for your preset.
3. Press Preset.
4. Press Save Preset.
5. Click Create New.
6. Type the name of the preset you want to create.
7. Click Save.
The Preset application is turned off and the new preset is active.
NOTE
You can also create a new preset in the Setup window.
Modifying a Preset
You can make changes to any preset that you created. You cannot modify default
presets.
To modify a preset that you created
1. Activate the preset.
2. Modify any settings that you want to change.
3. Press Preset.
5. Click Modify Current.
6. Click OK.
The Preset application is turned off and the modified preset is active.
NOTE
You can also change a preset in the Setup window.

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Deleting a Preset
You can delete any preset that you created. You cannot, however, delete default
presets.
To delete a preset
1. Press Preset.
2. Use the trackball to highlight the preset you want to delete.
3. Press Delete Preset.
4. Click OK.
The Preset application is turned off. If you deleted the active preset, then the Preset menu stays open and the first preset in the current exam type is activated. You
can see the preset name update in the side border.
Using Preset Soft Keys

To change any of the soft key settings
Press the key below the soft key label.
See the Glossary to learn about the function of each soft key.
Delete Preset
Display Name
Save Preset
Removing the Preset Name from the Display

By default, the name of the preset appears on the display. You can hide the name
and display it again later.
To hide or display the name of the preset
1. Press Preset.
2. Press Display Name.
3. Press Preset.
The Display Name control is automatically turned back on when you select a
different preset.
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Options
The following table lists each option you must purchase separately. The left column lists the option as it appears on the Options tab in the Setup window. The
right column lists the corresponding option package or packages that you can
purchase to obtain that option.
Option
Option Package
Resident Self-Test
Panoramic
Panoramic Imaging
Stress
Stress
XRes
Advanced Clinical Performance

XRES
DICOM Networking
DICOM Networking
Color for 4D Imaging
4D Imaging
3D Fetal Echo STIC
3D Fetal Echo STIC
Contrast
Contrast
SonoCT
Advanced Clinical Performance
Vascular
Vascular Software Application

Shared Services Clinical Option
OB/GYN
OB/GYN Software Application

Shared Services Clinical
Application
General Imaging
General Imaging Application

Application
Cardiac
Cardiac Software Application

Application
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You must install a software option before using it for the first time.
Application Package Options

Each HD11 system includes one of the following four standard clinical software
applications. You must purchase the clinical application package for each exam
type that you want to perform.
CardiacIncludes adult and pediatric presets. Also includes physio (ECG), and
cardiac calculations and analysis.
General ImagingIncludes abdominal (including renal), musculoskeletal, small
parts, prostate, and pediatric presets.
OB/GYNIncludes obstetric, gynecological, endovaginal, and fetal echo presets.
Also includes biopsy capabilities, OB/GYN calculations and analysis, and OB
trending.
VascularIncludes presets for carotid, transcranial Doppler (TCD), and bilateral lower and upper extremities. Also includes physio (ECG), and vascular calculations and analysis.
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Installing Options
When you receive your system, the options you purchased are installed and
enabled.You can install new options and remove or disable options.
To install, remove, or disable an option
1. Press Setup.
2. Click the Options tab.
3. Click the Options button.
4. In the Options window, do one of the following:
To install an option with an access code, select an option, click Install,

and type the access number.
To permanently remove an option, click Remove. A password is required

to prevent accidental deletion of an option. Note the confirmation number.
To temporarily disable an option, deselect the appropriate check box. To

re-enable an option, select the appropriate check box.
5. Click Apply.
6. Click OK.
7. Click Close.
Information in the Status column in the Options window indicates the status of
each application as follows:
Not installedAn option that is not yet installed
PermanentAn installed option
Expires on [date]A temporary option that expires on the specified date
ExpiredAn expired temporary option
RemovedA permanently deleted option
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Assigning Option Keys

Before you use the Contrast Harmonic Imaging or Stress Echochardiography
options that you have purchased separately, you must assign an option key to the
application.
The option keys are labeled Option 1 and Option 2. To use the application,
press the option key assigned to the application.
To assign an option key to Contrast Harmonic Imaging or Stress
Echocardiography
1. Press Setup.
2. Click the Options tab.
3. On the Options tab, click Keyboard.
4. To assign an option key to an application, select the application from the
appropriate menu.
5. Click OK.
6. Click Close.
System Settings
On the System tab in the Setup window, you can change settings that affect the
configuration of your system and that are not typically changed while scanning.
You can save settings to a preset unless they are system-wide settings.
System-wide Settings
You can change the following system-wide settings, but you cannot save them to a
preset:
Border and Prompts
Determines the information that appears on the top of your display and the language name representation. Also allows you to disable or enable system prompts.
Date/Time
Sets the correct time and date.
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Locale
Changes settings, such as language or currency, for your location.
DICOM
Changes DICOM settings. See "DICOM Networking" on page 67 to learn more
about changing these settings.
Monitor Adjust
Adjusts the contrast and brightness for the current lighting conditions. See
"Adjusting the Monitor Display" on page 106.
Dual
Allows you to choose between Single Buffer and Two Buffer dual imaging. See
"Activating Body Markers During Dual Imaging and Freeze" on page 109.
Security
Allows the system administrator to manage security settings, such as system timeouts and password requirements.
Name Format
Controls the format for displaying the patient name on the top border of the display and in the patient report.
Backlight Level
Controls the brightness of the backlighting on the control panel and keyboard.
Settings are High, Medium, and Low.
TEE Temperature Units
Controls whether the TEE temperature is displayed in Celsius or Fahrenheit.
Activate body marker during freeze and dual
Controls whether or not a body marker automatically appears on the display during Dual Imaging and Freeze.
Height/Weight Units
Controls whether the height and weight units are displayed in Metric or English.
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Settings That Can Be Saved to a Preset

You can change the following settings and save them to a preset:
LGC Profile Display
Controls whether or not a horizontal line, the LGC profile, appears on upper
right corner of the display to indicate the LGC setting:
OnThe LGC profile always appears on the display.
OffThe LGC profile does not appear on the display.
AutoThe LGC profile appears on the display briefly while you are adjusting the
LGC setting.
TGC Profile Display
Controls whether or not a vertical line, the TGC profile, appears on the upper
right corner of the display to indicate the TGC setting:
OnThe TGC profile always appears on the display.
OffThe TGC profile does not appear on the display.
AutoThe TGC profile appears on the display briefly while you are adjusting the
TGC setting.
Thermal Index
Controls the way the output power is measured and displayed:
NormalThe most appropriate index based on the preset, transducer, and
other factors
TIS (thermal index: soft tissue)Temperature rise in soft tissue
TIB (thermal index: bone)Temperature rise in deep bone
TIC (thermal index: cranial)Temperature rise at the surface
Depth Marking
Controls whether and where the depth markings appear:
OffNo depth markings appear.
VerticalDepth markings appear on the right side of the display.
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BothDepth markings appear to the left and the right of the image.
LeftDepth markings appear to the left of the image.
RightDepth markings appear to the right of the image.
Background Color
Controls whether the display background is set to Black or Gray.
Image Size
Controls the size of the image displayed on the display. Choices are Large and
Medium.
Related Topics
Changing System Settings

NOTE
You cannot save system-wide settings to a preset.
To change system settings

1. Press Setup.
3. On the System tab, do one of the following:
Click a button in the System Settings area, take the appropriate action
in the dialog box that appears, and then click OK.
Click a radio button or check box to choose the setting you want.
4. If the setting you change can be saved to a preset, you are prompted to modify
the current preset or create a new one.
To apply the changes you made to the current state of the system and save
them to a preset, click Save. If the current preset is a default preset, you
are prompted to create a new preset.
To apply the changes you made to the current state of the system, but not
to the current preset, click Apply.
5. Click Close.
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Adjusting the Monitor Display

Every time the ambient light changes, adjust the contrast and brightness of the
monitor display.
To adjust the monitor contrast and the brightness
1. Press Setup.
3. Click Monitor Adjust.
4. Follow the instructions on the display.
To adjust the monitor brightness, press the + key or the key below the
symbol on the front of the monitor.
To adjust the monitor contrast, press the + key or the key below the
symbol on the front of the monitor.
Selecting the Type of Dual Imaging

The Dual Imaging setting is a system-wide setting. The most recently used setting
is selected when you turn on your system.
To select Single Buffer dual or Two Buffer dual imaging
1. Press Setup.
3. On the System tab, click Dual.
4. Select Single Buffer or Two Buffer.
5. Click OK.
6. Click Close.
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About Security Settings

You can configure a variety of security settings on the HD11 system to protect
patient information from unauthorized access. You access the security settings
from the System tab in the Setup window.
NOTES
The default administrator password is the systems serial number, which can
be found through the Options tab in the Setup window. See "Options" on
page 99. Use this password to access the security settings on the system.
Passwords are case sensitive. Note whether the keyboard Caps Lock is on
or off when you create a new administrator or user password.
You can configure the following security settings:

Password Protected Operations
Controls whether or not the user is required to enter a case-sensitive password
before being able to complete the action. When a user is logged on, they have
access until they log off or are automatically logged off by the system. The user
only needs to log in once, not each time a password-protected operation is used.
The user can also login or logout by clicking the Login/Logout button on the
Image Review toolbar.
Password required to search for existing studiesThe user is required to
enter a password in order to have access to the Search for Studies and the
Search for Patient Folder window in Image Review.
Password required to enter a new patientThe user is required to enter a
password in order to have access to the Patient Identification window.
Password required to access the Modality WorklistThe user is required
to enter a password in order to have access to the Modality Worklist.
Set User PasswordEnables the system administrator to create the user password that is required for the selected password protected operations. Only one
user password can be created, which all users will share.
Automatic Logoff
Controls whether or not the user will be logged off the system if the system sits
idle for a specified period of time.
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Automatically log off if idle for <specified> minutes (1-120)Logs off the
user if the system is idle for the specified number of minutes. The administrator
can set the time-out from between one and 120 minutes.
Automatically close in-progress study on automatic logoffAvailable if
the automatic logoff option is selected. Closes the in-progress study when the
user is automatically logged off. The closed study will then be exported according
to the selected Auto Store option in DICOM setup. If this option is not selected
when the system automatically logs off a user, the system is locked from all access
until the user password is entered or the system is powered down. See "Setting
Up Automatic DICOM Export and Export Options" on page 74.
Set Administrator Password
Enables you to change the administrator password. If the administrator password
is lost, contact your field service representative to obtain a temporary password
to reset the password back to the serial number.
Changing the Background Color

You can change the background color, that is, the color outside of the image.
To change the background color
1. Press Setup.
3. On the System tab, select the appropriate Background color option:
Black or Gray.
4. Click Apply or Save.
5. Click Close.
Changing the Image Size

You can specify the size of the image. Your choices are Medium and Large.
To change the image size
1. Press Setup.
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3. On the System tab, select the Large or the Medium option to specify the
2D image size.
5. Click Close.
Activating Body Markers During Dual Imaging and Freeze

You can choose to have a body marker automatically appear on the display during
dual imaging and Freeze (when you press the Left key, the Right key, or Freeze).
To activate body markers during dual imaging and Freeze
1. Press Setup.
3. On the System tab, select Activate body marker during freeze and
dual.
5. Click Close.
NOTE
When you activate body markers during dual imaging and Freeze, the following
occur:
When you press Freeze, you must press Marker before using the trackball to
scroll through the frames.
When you press the Left key or the Right key, a body marker appears on
both images.
Mode Settings
The Mode tab in the Setup window enables you to customize display layouts (formats) for M-mode and Spectral. It also enables you to change the settings for
Doppler and trace modes.
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Changing the M-mode Format and the Doppler Settings

To change the M-mode format and the Doppler settings
1. Press Setup.
2. Click the Mode tab.
3. On the Mode tab, select an M-mode format option:
Small over large
Side by side
Full screen
4. Select a Doppler Spectral format option:
Small over large
Large over small
Side by side
Full screen
5. Select a Doppler scale units option:
kHz
cm/s
m/s
6. For PW Doppler mode, select an Optimum cursor angle option:
NOTE
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50
55
60
65
If you select m/s or cm/s, the spectrum is measured as a velocity. If you select
kHz, the spectrum is measured as a frequency.
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7. Select an AutoTrace Evaluation option:
Above
Below
8. Select Scrolling Trace On or Off.

9. Select Adaptive Doppler On or Off.
11. Click Close.
Turning Adaptive Doppler On or Off

Adaptive Doppler reduces the background noise in the spectral trace and in the
audio. Adaptive Doppler is turned on by default on the HD11 system.
To turn Adaptive Doppler on or off
1. Press Setup.
3. On the Mode tab, do one of the following:
To turn Adaptive Doppler on, select the Adaptive Doppler check box.
To turn Adaptive Doppler off, deselect the Adaptive Doppler check

box.

5. Click Close.
Controlling Spectral and M-mode Trace Scrolling

You can control whether the spectral or M-mode trace is scrolling or nonscrolling.
To control spectral trace scrolling
1. Press Setup.
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For a scrolling trace, select the Scrolling Trace check box.
For a nonscrolling trace, deselect the Scrolling Trace check box.
4. Click OK.
Changing the Spectral Trace Format

You can specify the format of the Doppler display, which is how the spectral trace
and the 2D reference image appear on the display.
To change the spectral trace format
1. Press Setup.
3. On the Mode tab, select a Spectral format:
Small over large
Large over small
Side by side
Full screen

5. Click Close.
Changing the Autotrace Evaluation Setting

You can specify how much of the waveform is evaluated and used by Doppler
Auto Trace and High Q Doppler Analysis. The Autotrace Evaluation setting
takes effect when you unfreeze a waveform. You can change the Autotrace
Evaluation setting in the Setup window or while imaging.
Specifying the Autotrace Evaluation Setting in the Setup Window

To specify the Autotrace Evaluation setting in the Setup window
1. Press Setup.
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3. On the Mode tab, do one of the following to select the appropriate

Autotrace Evaluation option:
AboveInformation above the baseline
BelowInformation below the baseline
BothInformation above and below the baseline (non-cardiac presets

only)

5. Click Close.
Changing the Autotrace Evaluation Setting While Imaging

To change the Autotrace Evaluation setting while Imaging
Press Ctrl+Q to cycle through the Autotrace Evaluation settings.
Changing the Default Tissue Doppler Setting

The Default Tissue Doppler setting determines the type of Tissue Doppler
imaging selected when you press the TDI key.
To change the Default Tissue Doppler setting
1. Press Setup.
3. On the Mode tab, select a Default Tissue Doppler setting:
Color
PW
PW and Color

5. Click Close.
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Controlling Cursor Tracking

You can control whether or not the Color box or CPA box moves with the cursor.
To turn Color and CPA cursor tracking on or off
1. Press Setup.
To turn cursor tracking on, select the Color/CPA/Cursor Tracking
check box.
To turn cursor tracking off, deselect the Color/CPA/Cursor Tracking

check box.

5. Click Close.
Turning the M-mode Reference Line On or Off

You can choose to display or hide the M-mode reference line.
To turn the M-mode reference line on or off
1. Press Setup.
2. Click the Measurements tab.
3. On the Measurements tab, do one of the following:
To turn the M-mode reference line on, select the M-mode Ref Line
check box.
To turn the M-mode reference line of, deselect the M-mode Ref Line
check box.

5. Click Close.
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Label Settings
The Label tab in the Setup window allows you to customize the labels that
appear on the label menu when you are annotating an image. On the Label tab,
you can add and delete labels, as well as rearrange the sequence of labels in the
label menu for a given preset.
NOTE
You cannot use parentheses in a label.
Editing the Label Menu

To edit the label menu
1. Press Setup.
2. Click the Label tab.
3. On the Label tab, use the trackball to position the cursor on the list of labels.
4. Type a new label or delete or edit an existing label.
6. Click Close.
Measurements and Analysis Settings

The Measurements tab in the Setup window enables you to customize a variety
of measurement settings, including general measurement settings and settings
specific to 2D mode, M-mode, and Doppler modes.
The Analysis tab in the Setup window enables you to configure the measurement and calculation menus for different analysis packages and groups.
Specifying the Measurement Circumference Method

You can specify the measurement circumference method for labeled measurements as either Manual Trace or Ellipse.
To specify the measurement circumference method
1. Press Setup.
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3. On the Measurements tab, select an option under Circumference

Method:
Manual Trace
Ellipse

5. Click Close.
Defaulting to Doppler Auto Trace

If you want your system to automatically trace a Doppler spectrum the first time
you press Trace in PW Doppler, select the Default to Doppler Auto Trace
setting.
To default to Doppler Auto Trace
1. Press Setup.
3. On the Measurements tab, select the Default to Doppler Auto Trace
check box.
5. Click Close.
Specifying the Measurement Caliper Connection

You can select the type of line that connects measurement calipers. The setting
applies to measurements in live imaging as well as measurements in Image Review.
To specify the measurement caliper connection
1. Press Setup.
3. On the Measurements tab, select a type of caliper connection under the
Caliper Connection box:
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None
Dotted Line
Solid Line
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5. Click Close.
Choosing Quick Calcs

You can specify which Quick Calcs appear in the results box for the current preset.
To select which Quick Calcs appear in the results box
1. Press Setup.
3. On the Measurements tab, click 2D, M-mode, or Doppler to configure
the Quick Calcs that appear when you are in that mode.
4. Select the check boxes for the Quick Calcs that you want to see in the results
box for the current preset when you are in the specified mode.
5. Click Apply.
6. Click OK.
8. Click Close.
Changing High Q Settings

For High Q Doppler, you can specify the number of cycles used for the averaged
measurements. You can also specify whether you want to display the peak trace,
the mean trace, or both.
To change High Q settings
1. Press Setup.
3. To change the Number of Cycles Averaged, click the up arrow or the
down arrow or type the number in the box.
4. To specify which trace or traces are displayed, select the check box for Display Peak Trace, Display Mean Trace, or both.
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6. Click Close.
NOTES
ECG input is required for High Q Doppler (cardiac only).

The High Q feature is only available in PW Doppler mode.
Only those waveforms (peak trace or mean trace) that you selected on the
Measurements tab are displayed in High Q Doppler and when you press
Freeze.
If you selected neither Peak Trace nor Mean Trace on the Measurements tab, press Freeze and then the Waveform soft key to view both
waveforms.
Changing the Position of the Measurements Results Box

You can specify which corner of the display you want the measurements results
box to appear.
To change the position of the measurements results box
1. Press Setup.
3. On the Measurements tab, select an option from the Results Box Position list:
Upper Lt
Upper Rt
Lower Rt
Lower Lt

5. Click Close.
NOTE
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You can also change the position of the measurements results box while imaging.
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Customizing the Measurements and Calculations Menus

You can select which labeled measurements and calculations appear in the Measurements and the Calculations menu for each application package and group.
To customize the Measurements and Calculations menus
1. Press Setup.
2. Click the Analysis tab.
3. In the top left corner of the Analysis tab, select the application package and
group whose menu items you want to change.
4. In the bottom right corner of the Analysis tab, click View.
5. In the Available box, select an imaging mode to filter the Measurements
and Calculations lists in the Available list.
6. Add or remove measurements and calculations:
To add measurements and calculations, select items in the Available box

and click the left arrow button.
To remove measurements and calculations, select items in the In Menu

box and click the right arrow button.
To remove all items from the list, click the double-right arrow button.
7. To resequence the menu items, select the calculation or measurement you

want to move, hold the Enter key, and use the trackball to drag it to its new
position on the list.
8. To reset the menu to the default list, click Default.
9. If you are in a Cardiac package/group, to configure protocol measurements:
a. Click Protocol.
b. Select the appropriate measurements in the Protocol Measurement
Sequence Configuration window.
c. Click OK.
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10. If you are in an OB/GYN package/group, to configure average ultrasound age

measurements:
a. Click AUA.
b. Select the appropriate measurements in the AUA Component Configuration window.
c. Click OK.
11. Click Apply or click Save to save your changes to a preset.
12. Click Close.
Analysis and Reports Application Package/Group List

The following table lists the analysis packages and groups from which you can
choose when customizing the Measurements and Calculations menus and when
changing the Reports work area:
Cardiac/Adult
General/Prostate
Cardiac/Pediatric
General/Thyroid
Cardiac/Fetal Heart
General/Breast
Vascular/TCD
General/Testicular
Vascular/Carotid
General/Superficial
Vascular/UE Artery
General/Pediatric Hips
Vascular/UE Vein
OB/1st Trimester
Vascular/LE Artery
OB/2nd-3rd Trimester
Vascular/LE Vein
Gynecology
General/Abdomen
Musculoskeletal
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Obstetrics Settings
In the Setup window, the Obstetrics tab enables you to add user-defined calculations and configure fetal weight tables.
Creating a User-Defined Calculation by Using a Formula

You can create a calculation by using a formula. You can add the calculations that
you create to the Calculations menu for OB/GYN.
NOTES
You must define a gestational age (GA) calculation so that the answer is displayed in weeks. You must define a GA range calculation so that the answer is
displayed in days.
You cannot define range calculations for fetal weights or for ratios.
To create a user-defined equation by using a formula

1. Press Setup.
2. Click the Obstetrics tab.
3. On the Obstetrics tab, under Calculation Type, select the type of calculation you want to create:
Gestational Age
Fetal Growth
Fetal Weight
Ratio
4. Click the New Equation button.

5. In the Equation Editor window, type the name of the calculation in the
Equation Name field.
6. Click an option button under Formula to specify whether the formula is a
Value (weeks) or a Range (days).
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7. Generate the formula:

a. Click the keypad to place numbers and mathematical operators in the formula. Or type the formula on the system keyboard.
b. Select inputs to the formula from the Biometry menu.
c. Click Edit Input Limits to edit input limits for the formula.
8. Click OK.
10. Click Close.
Creating a User-Defined Calculation by Using a Table

When you are in an OB/GYN package/group, you can create an calculation by
using a table. You can add the calculations that you create to the Calculations
menu for OB/GYN package/group. You can use the table to calculate fetal growth.
To create a user-defined calculation by using a table
1. Press Setup.
3. On the Obstetrics tab, under Calculation Type, select the type of calculation you want to create:
Gestational Age
Fetal Growth
4. Click New Table.

5. On the Table Editor window, type the name of the calculation in the Table
Name field.
6. Select the biometry from the Biometry menu.
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7. Indicate how the age should be displayed by selecting the appropriate option
under Display Age:
Weeks
Weeks and Days
Days
8. Type values in the Measurement, GA, and Range columns.
To type a value, click a table cell and then type the value.
To move between table cells, press Tab or the arrow keys.
To remove all of the values in the table, click Clear Table.
To add a row above the current row, click Insert Row.
To delete the current row, click Delete Row.
9. Click OK.
11. Click Close.
Editing a User-Defined Calculation

After you create a calculation by using a formula or a table, you can modify the
calculation.
To edit a user-defined calculation
1. Press Setup.
3. On the Obstetrics tab, under Calculation Type, select the type of calculation you want to edit:
Gestational Age
Fetal Growth
Fetal Weight
Ratio
4. Click Edit Equation or Edit Table.

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5. In the Table Editor or Equation Editor window, select the calculation you
want to edit from the Equation Name or the Table Name menu.
6. Make any necessary changes to the calculation.
7. Click OK.
9. Click Close.
Deleting a User-Defined Calculation

You can delete a user-defined calculation that you created by using a formula or a
table.
To delete a user-defined calculation
1. Press Setup.
3. On the Obstetrics tab, under Calculation Type, select the type of calculation you want to delete:
4. Click Delete Equation or Delete Table.
5. In the Table Editor or Equation Editor window, select the calculation you
want to delete from the Equation Name or the Table Name menu.
6. Click Delete Calculation or Delete Table.
7. To confirm, click OK.
8. Click OK.
10. Click Close.
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Selecting Fetal Growth Graphs

You can select the fetal growth graph used for each biometry.
To select a fetal growth graph
1. Press Setup.
3. On the Obstetrics tab, under Fetal Growth Graphs, select a graph for
each biometry.
5. Click Close.
Setting Fetal Weight Options

You can set the fetal weight to be calculated in metric or English units.
To set the fetal weight options
1. Press Setup.
3. On the Obstetrics tab, under Fetal Weight Options:
Specify the weight units (grams or lbs/oz) under Units.
Select the Fetal Weight Percentiles check box if you want fetal weight
percentiles to appear in the report.

5. Click Close.
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Acquisition Settings
In the Setup window, the Acquisition tab allows you to control several settings
related to image acquisition.
Loop DurationEnables you to specify whether loops will be acquired by
Time (seconds, maximum of 30) or Beats (cardiac cycles, maximum of 10).
Acquire BorderEnables you to specify whether or not the system will capture the blue borders when an image is captured.
Switch to Review after acquire completesEnables you to specify whether
or not the system will transition either to live imaging or Image Review mode
after an image is captured.
Beep after acquire completesEnables you to specify whether or not the
system will play an audio tone whenever the system has successfully acquired a
loop or frame.
Display Warning MessageEnables you to specify whether or not the system
will display a warning message when you press Acquire and you have not yet
entered patient information for the active study.
Disk Full StrategyEnables you to specify the strategy the system uses when
the disk is almost full.
Specifying Acquisition Preferences

You can control some aspects of image acquisition.
To specify acquisition preferences
1. Press Setup.
2. Click the Acquisition tab.
3. On the Acquisition tab, do any combination of the following:
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If you want the blue border around the image to be saved when you press
Acquire, select the Acquire Border check box.
If you want to switch to Image Review after you press Acquire, select the
Switch to Review after acquire completes check box.
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If you want to hear a beep after an image is acquired, select the Beep
after acquire completes check box.
If you want to see a warning message if the patients last name isnt
entered when you press Acquire, select the Display warning message
when Acquire control is pressed if patient last name is not
entered check box.

5. Click Close.
To learn about the Disk Full Strategy, see "Specifying the Disk Full Strategy" on
page 128.
Setting the Duration of a Loop

You can specify the duration (in seconds or number of heartbeats) of an acquired
loop.
To specify the length of a loop
1. Press Setup.
3. On the Acquisition tab, under Loop Duration, do one of the following:
To define the length of the loop in seconds, select Time.
To define the length of the loop in number of heartbeats, select Beats.
To change the number of Seconds or Heartbeats, click the up arrow or

the down arrow or type the number in the field.

5. Click Close.
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Specifying the Disk Full Strategy

You can specify the strategy the system uses when the disk is almost full. You have
two choices:
The oldest studies are automatically deleted when the disk is almost full.
When you press Patient, you are automatically prompted to specify which
studies to delete if the disk is almost full.
To specify the disk full strategy

1. Press Setup.
3. On the Acquisition tab, click Disk Full Strategy.
4. Select the disk full strategy:
Automatically delete the oldest studies
Prompt the user to manually delete studies
5. Click OK.
7. Click Close.
3D/4D Settings
In the Setup window, the 3D/4D tab enables you to display or hide the distance
ruler and the axis icon. You can control navigational crosshairs on the rendered
3D image and MPR images in 3D Render and 4D acquisition.
Changing the 3D/4D Settings

To change the 3D/4D settings
1. Press Setup.
2. Click the 3D/4D tab.
3. To display the distance ruler instead of white selection brackets on each corner, select the Show Distance Ruler check box.
4. To display the axis icon, select the Show Axis Icon check box.
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5. To change the rendered 3D image crosshair setting, choose an option under

Volume Graphics:
Off
On
Crosshair
6. To change the MPR crosshair setting, choose an option under MPR Graphics:
Off
Partial
Crosshair

8. Click Close.
Optical Disk, CD, and Peripherals Settings

The Optical Disk tab in the Setup window enables you to view a list of the files
on the MOD (browse the disk), as well as erase or format the disk.
The CD tab enables you to view a list of the files on the CD and erase all the files
from the CD (CD-RW only). You can also backup or restore your system settings
to a CD-R or a CD-RW.
The Peripherals tab enables you to:
Specify which peripherals are attached to the system and specify the Record
keys (Rec 1, Rec 2, Rec 3) that control them.
Install peripheral software drivers.
Set the VCR tape time.
Set display settings for record mode.
Assign the foot switch pedals to the Record (Rec 1, Rec 2, Rec 3) keys and
the Freeze key.
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About Backup and Restore Options

It is very important to back up the information on your system in case your system's memory fails for any reason.
Backing Up Presets and System Settings

You need to back up the presets that you create. If you do not and your system's
memory fails, you will need to re-create all of the presets you created. If you need
to create more presets than you can store on your system, you can save the presets to a disk and restore them when you need to use them.
Every time you back up presets, your system settings, user-defined calculations,
printer and VCR settings, and options settings are automatically backed up. You
can restore one or more of these at any time.
To learn how to back up presets and settings, see "Backing Up Presets and Settings to a CD" on page 131.
Backing Up Patient Studies

The data in your system's memory is temporary storage. You need to save any
important patient data and images to an MO Disk, a CD-R or a CD-RW, or over
a network. If your system's memory fails and you did not back up the patient folders, all patient information and images will be lost.
To learn how to back up patient studies, see "Exporting Patient Studies" on
page 430.
NOTES
130
The ability to export data over a network is a component of the DICOM Networking option.
An optical disk drive is included with the DICOM Media option.
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Backing Up Presets and Settings to a CD

You should regularly back up your presets and settings. If your system's memory
fails for any reason and you did not save your presets and settings to a disk, you
will lose all of this information.
You can create up to 20 presets for each exam type. If you need to create more
presets, you can save presets to a CD-R or a CD-RW and restore them when you
need to use them.
To back up presets, system settings, printer and VCR settings, or
options settings
1. Insert a CD-R or CD-RW into the CD drive.
CAUTION
System settings, printer and VCR settings, and options that are already on the CD
will be overwritten. If you try to save a preset with the same name as a preset
already on the CD, you have to choose whether or not to overwrite the preset.
2. Press Setup.
3. Click the CD tab.
4. On the CD tab, click Backup.
5. In the Backup Settings window, do one of the following:
NOTE
Select the check boxes for the presets you want to save
Select the Select All check box
System settings, printer and VCR settings, options, and security settings are automatically saved.
6. Click Start.
7. Click Close.
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Restoring Presets and Settings from a CD

To restore presets, system settings, VCR and printer settings, options,
or security settings from a CD
1. Insert into the CD drive the CD-R or CD-RW that contains the presets or
settings you want to restore.
2. Press Setup.
3. Click the CD tab.
4. On the CD tab, click Restore.
5. In the Restore Settings window, do one of the following:
Select the check boxes for the presets you want to restore
Select the Select all check box
6. In the Restore Settings window, click the check boxes for the settings you
want to restore:
NOTE
System settings
Printer and VCR settings
Options
Security settings
When you restore options, the system must have the same serial number as the
system from which the backup was made.
7. Click Start.
NOTE
The display is blank for a moment while the system restores the presets or settings.
8. Click Close.
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Assigning Record Keys

You must assign a Record key to each VCR, printer, and serial output cable that is
connected to your system. The Record keys, which appear on the system control
panel, are labeled Rec1, Rec2, and Rec3.
To assign a Record key to a peripheral or to a serial output cable
1. Press Setup.
2. Click the Peripherals tab.
3. On the Peripherals tab, select from the menu the device that you want associated with each Record key.
5. Click Close.
NOTE
Your Philips representative types a value for the Tape Time setting when installing peripherals. This setting determines the time displayed on the display when a
videotape is inserted into the VCR. You can change this setting when you assign a
Record key to a peripheral.
Setting the VCR Record Time Display

You can set how the VCR tape time is displayed on your system: flashing, highlighted, or normal.
To set how the VCR tape time is displayed
1. Press the Setup key.
3. In the Peripherals window, select the Record Display:
Highlightshows the tape time in reverse video
Flashshows the tape time flashing
No Highlightshows the tape time unhighlighted.
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About the Foot Switch

The HD11 system foot switch has three pedals. Each pedal corresponds to a key
on the system control panel. The foot switch pedals have different functions in different modes. The following table summarizes the foot switch functions:
Mode
Left Pedal
Middle Pedal
Right Pedal
2D
Rec1
Freeze
Rec2
3D
Rec1
Freeze
Acquire
Panoramic Imaging
Rec1
None
Acquire
None
Review
Acquire
You can change the configuration of the foot switch for 2D Mode. See "Configuring the Foot Switch" on page 134.
NOTES
The foot switch is an option that you can purchase separately. It is also
included in the Stress Echo option.
For the foot switch to function as described in the preceding table, the Stress
Echo soft keys must be visible. To display the Stress Echo soft keys, press the
Stress Echo option key.
WARNING
The foot switch supplied with the ultrasound system meets only drip-proof construction requirements and cannot be used in the operating room.
Configuring the Foot Switch

You can use the foot switch during 2D imaging, 3D imaging, Panoramic imaging,
and Stress imaging. You can change the default configuration for 2D imaging but
not for the others.
To configure the foot switch
1. Press Setup.
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3. On the Peripherals tab, in the Footswitch section, select a control panel

key from the Left, Middle, or Right drop-down menu. The options are:
Rec1
Rec2
Rec3
Freeze

5. Click Close.
WARNING
The foot switch supplied with the ultrasound system meets only drip-proof construction requirements and may not be used in the operating room.
Installing Peripheral Software Drivers

To install the software drivers for system peripherals
1. Press Setup.
3. On the Peripherals tab, click Install Software Drivers.
Select the peripheral types in the Installation Groups Options box.
Click Select All to select all the options in the Installation Groups
Options box.
5. Click OK.
The drivers are installed and the Peripherals tab is displayed.
6. Click Close.
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Setting the VCR Display for Record Mode

You can set how the VCR tape time is displayed on your system: flashing, inverse
video, or normal.
To set how the VCR tape time is displayed
1. Press the Setup key.
3. In the Peripherals window, select the timer display.
4. Click OK.
5. Click Close.
Using the VCR Soft Keys

To change any of the soft key settings, press the soft key below the soft key label.
Click the name of a soft key in the following list to learn about its function:
External Video
Use the External Video soft key to display VCR images from any VCR other
than the Panasonic MD-835.
FF/RW
Use the FF/RW soft key to rewind or fast forward through the videotape. Press
the up arrow to fast forward. Press the down arrow to rewind.
Jog
Use the Jog soft key to move forward or backward through the recording frame
by frame.
Play or Pause
Use the Play soft key to play back what you recorded.
Use the Pause soft key to pause the playback.
Search
Use the Search soft key to play the recording forward or backward at a high
speed.
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Stop
Use the Stop soft key to halt the playback of the tape.
Tape Find
Use the Tape Find soft key to advance or rewind the videotape to a specified
point. Press the Tape Find soft key while the search is in progress to cancel.
Language Input Settings

You can enter patient information and annotation labels using any of your systems
input languages. In addition, on Japanese systems, you can use up to three name
representation methods to enter information in the Patient Identification window:
Roman
Ideographic
Phonetic
All representations of the patient information appear in the patients report.

NOTE
To learn how to select input languages for your system, contact your Philips representative.
Changing the Input Language

You can enter patient information and annotation labels using any of your systems
input languages.
To change the current input language
Press Alt+Shift to cycle through the available input languages.
NOTE
To learn how to select input languages for your system, contact your Philips representative.
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Selecting the Name Representation for the Top Border

On Japanese systems, you can specify the name representation for the information that appears in the top border of the display.
To specify the name representation for the top border
1. Press Setup.
3. On the System tab, click Borders and Prompts.
4. In the Borders and Prompts window, click a Name Representation
option button:
Roman
Ideographic
Phonetic
5. Click OK.
7. Click Close.
Entering Japanese Characters in the Patient Identification

Window
On Japanese systems, option buttons appear in the Patient Identification window that allow you to enter patient information using up to three name representation methods:
Roman
Ideographic
Phonetic
To enter characters in the Patient Identification window

1. Enter the patient information normally. See "Creating a Patient Study" on
page 399.
2. Click the Ideographic or Phonetic option button.
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3. Enter patient information by using the selected name representation method.

All representations appear in the report.
NOTES
On a Japanese system, you must enter information by using the Roman

method first.
On a Chinese or Russian system, name representation buttons do not appear,
but you can enter non-Roman characters in the Patient Identification window.
Displaying the Input Method Editor Status Window

If the selected input language uses an input method editor (IME), the IME status
window appears by default in Image Review and in the report. It does not appear
by default in live imaging.
To display or hide the IME status window
Press the World key twice.
Physio (ECG) and Stress Settings

In the Setup window, the Physio tab enables you to choose whether the ECG
physio input, the auxiliary physio input, or the ECG and the auxiliary physio inputs
appear on the display. You can also control the R-wave source and the R-wave
beep when you use a 12-lead ECG, display the auxiliary physio input.
The Stress tab in the Setup window enables you to activate stress protocols
and to configure stress protocols and save them as presets. See "Stress Echocardiography" on page 255 for more details
To perform a Stress Echocardiography study, you must display an ECG or an auxiliary physio input on the display. See "Changing Physio Settings" on page 141.
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Connecting the ECG Cable and Attaching the ECG Leads

For the ECG physio inputs to appear on the display, you must connect the ECG
cable and properly attach the ECG leads.
WARNING
Do not use ECG patient cables with detachable lead wires that have exposed
male pins. Electrocution can result if these pins are plugged into AC power.
To connect the ECG cable and to attach the ECG leads
1. Plug the ECG cable into the port on the physio panel, which is under the CD
drive and above the MOD drive.
2. Attach the ECG leads to the patient as shown in the following illustration:
A = Right arm
B = Left leg
C = Left arm
NOTE
Although the lead placement does not match the anatomical labels on the leads,
you need to attach the electrodes as shown to receive a good ECG signal.
3. Make sure the ECG signal appears properly on the display. If it does not, check
the cable connections and the placement of the electrodes and leads.
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Using Physio Soft Keys

To display the Physio soft keys
Press Setup.
The Physio soft keys appear on the display, under the Setup window.
Beats
Display Dialog
ECG Gain or Aux Gain
ECG Invert or Aux Invert
ECG Position or Aux

Position
Select ECG or Select Aux
Sweep
Changing Physio Settings

You can choose whether the ECG physio input, the auxiliary physio input, or the
ECG and the auxiliary physio inputs appear on the display. You can also control
the R-wave source and the R-wave beep.
To change physio settings
1. Press Setup.
2. Click the Physio tab.
3. On the Physio tab, select either Display ECG or Display Aux, or both, to
specify which input or inputs appear on the display.
4. Select the appropriate R-Wave Source and R-Wave Beep options.
6. Click Close.
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Triggering
Triggering allows you to control how often and when an image is updated in live
2D mode or in Doppler mode.
2D image triggering can be set up to occur at specific time intervals or after a
specified time period has elapsed since the occurrence of an ECG R-Wave peak.
Doppler image triggering is automatically set by the system, depending upon
whether or not an R-Wave is detected.
When a triggered acquisition is in progress, the triggering icon appears to the
right of the transducer depth on the display.
NOTE
Triggering is not available in Stress Echocardiography.
Setting the Trigger Type in Doppler Modes

In Doppler modes, the system selects the Trigger mode based on whether an
R-wave is detected or not. If it is detected, Trigger mode is set to ECG; otherwise
it is set to Timer.
Setting the Trigger Type in 2D Mode

To set the Trigger in 2D mode
Press Trigger to set the type of 2D image triggering:
142
OffTriggering is turned off and images are displayed in real time.
ECGThe live image is updated after a specified number of heart beats.
Timer The live image is updated after a specified number of milliseconds.
Loop/ECGThe acquired loop, rather than the live image, is triggered. The
system will acquire a frame for every nth heart beat, as specified in the setting.
Loop/TimerThe acquired loop, rather than the live image, is triggered.

The system will acquire frames that occur between the specified number of
milliseconds.
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NOTE
If a stress protocol is activated, Triggering is disabled no matter what state Trigger is set to. When the stress protocol is deactivated, Triggering is re-enabled in
whatever state it was in before the protocol, unless stress is deactivated by a
change in presets in which case triggering will be in whatever state the preset designates.
Changing Triggering Settings

To change triggering settings
1. Press Setup.
2. Press Next to display the Triggering soft keys.
NOTE
Triggering soft keys are displayed on the primary level if Contrast Harmonic Imaging is turned on, and the Physio soft keys are moved to the secondary level.
3. Press Trigger to turn triggering on or off and to specify the triggering mode.
4. Use the triggering soft keys to specify the triggering frequency and the ECG
sweep speed.
5. Press Setup.
NOTE
When Trigger is set to Loop/ECG or Loop/Timer, you can press Acquire to

stop the loop acquisition manually.
Using Triggering Soft Keys

To display the Triggering soft keys
1. Press Setup.
2. Press Next.
The Triggering soft keys appear on the display, under the Setup window.
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Beats
Sweep
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Delay
Update
7 Performing a Basic Exam

This section provides a brief guide to performing a basic ultrasound exam on the
HD11 system. You can learn more about specific imaging modes and features in
the appropriate Help sections.
To perform an exam
1. Enter or select patient information:
a. Press Patient.
If the Patient Selection window opens, select the patient from the Modality Worklist. See "Using Modality Worklist" on page 90 for more information.
If the Patient Identification window opens, click New.
b. Type the patient information in the Patient Identification window.
c. To add other patient information relevant to the exam type, click the
Additional tab.
d. Click OK.
2. Choose a preset:
a. Press Preset.
b. Use the trackball to highlight the preset you want. If you need to see a list
of exam types, highlight the exam type at the top of the menu and press
Enter.
c. Press Enter.
3. Select a transducer. Press Probe until the transducer you want to use is displayed on the right side of the display. The active transducer is listed under the
preset name.
4. (Cardiac) Adjust the physio settings:
a. Press Setup.
b. Click the Physio tab.
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Performing a Basic Exam
c. On the Physio tab, select either Display ECG or Display Aux, or both,
to specify which input or inputs appear on the display.
d. Select the appropriate options to turn the R-wave source on or off and to
turn the R-wave beep on or off.
e. Click Apply or Save.
f. Click Close.
5. Optimize the image:
a. Press iSCAN to automatically optimize the TGC, 2D Gain, and Compress settings.
b. Adjust other settings as required:
TGC slide controls
LGC slide controls
Gain
Depth
Focus
Zoom
Fusion
Tissue Harmonic fusion setting (THI)
6. Acquire an image. Do one of the following:
Press Acquire to obtain a loop.
Press Freeze, and then press Acquire to obtain a still image.
Press Rec 1, Rec 2, or Rec 3 to send the image to a printer or the VCR.
7. Annotate the image:

a. Press Text.
b. Use the trackball to position the cursor on the image.
c. Type the label on the image.
d. Use the trackball to position the cursor at a new location on the image to
add another label. Then type the label on the image.
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e. Press Text to exit.

8. Take measurements:
a. Press Caliper.
b. Use the trackball to position the caliper on the image.
c. Press Select or Caliper to freeze the first caliper and bring up a second
one.
d. Position the second caliper on the image.
e. Press Enter to freeze the second caliper.
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8 Imaging Modes
The HD11 ultrasound system offers several imaging modes to accommodate a
variety of imaging requirements. The following topics are covered in this section.
"General Imaging Information" on page 149
"2D Mode" on page 153
"M-mode" on page 156
"PW Doppler Mode" on page 160
"CW Doppler Mode" on page 167
"Tissue Doppler Mode" on page 169
"Color Mode" on page 170
"Color Power Angio (CPA) Mode" on page 173
"3D/4D Mode" on page 176
"4D Imaging Mode" on page 199
"Fetal STIC" on page 203
General Imaging Information

This section includes the following information:
"Beginning an Exam" on page 150
"Acquiring an Image" on page 151
"Printing in Live Imaging" on page 151
"Resizing and Repositioning an Image" on page 152
"Moving a Reference Line" on page 152
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Imaging Modes
Beginning an Exam
Before you begin acquiring images, you must create a patient study. If you do not,
you cannot acquire images.
To begin an exam
1. Enter or select patient information:
a. Press Patient.
If the Patient Selection window opens, select the patient from the Modality Worklist. See "Using Modality Worklist" on page 90 for more information.
If the Patient Identification window opens, click New.
b. Type the patient information in the Patient Identification window.

c. To add other patient information relevant to the exam type, click the
Additional tab.
d. Click OK.
2. Choose a preset:
a. Press Preset.
b. Use the trackball to highlight the preset you want. If you need to see a list
of exam types, highlight the exam type at the top of the menu and press
Enter.
c. Press Enter.
3. Select a transducer. Press Probe until the transducer you want to use is displayed on the right side of the display. The active transducer is listed under the
preset name.
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Imaging Modes
Acquiring an Image
You can acquire a single frame or an image loop. The loop or frame is saved in the
patient study. If Automatic DICOM Export is on, images are automatically
exported across the network when you press Acquire. See "Automatic DICOM
Export" on page 72.
To acquire an image
Press the Freeze and then press Acquire.
To acquire a loop
Press Acquire in live imaging.
NOTES
When it is possible to acquire an image, the acquisition icon (a small, open

box) appears on the bottom right corner of the display to the right of the
transducer frequency and depth.
When an image is acquired, the system beeps to confirm that the loop or
frame was saved in the patient's study, if you have selected Beep after
acquire completes in your Acquisition preferences. Do not press Review
until you hear the beep. See "Specifying Acquisition Preferences" on page 126.
If you press Acquire while a live M-mode or Doppler trace is displayed, you
acquire an image, not a loop.
Automatic DICOM Export is a component of the DICOM Networking
option.
Printing in Live Imaging

You must assign a Record key to a printer or a VCR before you can use it. See
"Assigning Record Keys" on page 133.
To print an image
Press the Record key assigned to the printer you want to use.
During printing, a printer icon appears and the soft keys disappear. You cannot
start printing again until the printer icon is removed from the display.
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Imaging Modes
NOTES
To learn how to print images to a DICOM printer when you press Acquire,
see "Setting Up Automatic DICOM Printing" on page 83.
Networking option.
You cannot assign a Record key to a DICOM printer.
Pressing the Record key assigned to a VCR begins a VCR recording.
Resizing and Repositioning an Image

You can resize an image. If an image is not full size, you can change its position.
Resizing an Image
To resize an image
1. Press Select until Size is highlighted on the Select menu.
2. Use the trackball to change the size of the image.
Repositioning an Image
To reposition an image
1. Press Select until Position is highlighted on the Select menu.
2. Use the trackball to reposition the image.
NOTE
Position only appears on the Select menu if the image is not full size. You cannot reposition a full-size image.
Moving a Reference Line

A 2D reference line appears in cardiac presets, an M-mode reference line appears
in M-mode, and a Doppler reference line appears in Doppler mode.
To move the reference line
1. Press Select until Line is highlighted on the Select menu.
2. Use the trackball to move the reference line.
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Imaging Modes
NOTE
The CW Doppler transmit and receive focus is indicated by a small focus diamond
on the CW reference line. Use the trackball to move the CW Doppler transmit
and receive focus and the reference line as one unit.
2D Mode
In 2D mode, the image is displayed in grayscale.
You can use the 2D control as an exit key from any other mode. When you
press 2D, you exit the current mode and return to 2D mode with the previous
2D settings restored. The 2D control is unique in this exit behavior.
Using 2D Mode
To use 2D mode
1. Press 2D.
2. Adjust the following controls to optimize the image:
2D GAIN
Depth and Focus
LGC and TGC
3. To change the appearance of your image, use the soft keys.

4. To change the fusion setting, press Fusion.
5. To change the size of the image, press Select to highlight Size on the Select
menu. Then use the trackball to resize the image.
6. If you are using a linear transducer, turn the Angle knob to steer the 2D
image.
7. To exit 2D mode, press a key for any other imaging mode.
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Imaging Modes
Fusion Settings
Fusion settings control the transmit and receive frequencies for the transducer.
Each fusion setting is optimized for one or more of the following:
Penetration (P)
General (G)
Resolution (R)
Fusion settings apply to:
2D mode
Tissue Harmonic Imaging
Contrast Harmonic Imaging
The number of available fusion settings depends on the transducer and mode you
are using. In 2D mode, you can choose from a maximum of five fusion settings. In
Tissue Harmonic imaging and in Contrast Harmonic Imaging fewer settings may
be available.
Fusion Icons
A fusion icon appears on the lower left corner of the display. This icon summarizes information about the fusion setting.
The following table shows representative icons used for each imaging mode:
Mode
2D mode
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Icon
Description
The transducer is transmitting and receiving
over a range of 1.6 to 4.3 MHz. The dark
portion near the G indicates that the Fusion
setting is optimized for General.
Imaging Modes
Tissue Harmonic
Imaging
The transducer is transmitting at 1.9 MHz and

is receiving at 3.8 MHz. The circle around the
R indicates that the Fusion setting is optimized
for Resolution.
is receiving at 4.2 MHz. The circles around the
G and the R indicate that the Fusion setting is
optimized for General and Resolution.
This icon is used for enhanced Pulse Inversion.
Contrast Harmonic
Imaging

P indicates that the Fusion setting is optimized
for Penetration.
P indicates that the Fusion setting is optimized
for Penetration. This icon is used for enhanced
Pulse Inversion.
NOTE
The transmit and receive frequencies depend on the current preset and transducer.
Using 2D Soft Keys

Soft key availability is transducer and preset dependent.
Biopsy
Chroma
Compress
Edit End
Edit Start
Focal Zones
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Imaging Modes
L/R Invert
Map
Persist
Replay
Smooth
SonoCT
Trap
U/D Invert
XRes
M-mode
In M-mode, you can learn about the movement of an area of anatomy. It involves
two steps:
Position the M-mode reference line in the 2D image on the anatomy of interest.
The system displays information about movement along that line in an

M-mode trace.
An M-mode trace can be helpful when you perform measurements, especially

heart rate.
You can also work in Color mode when in M-mode.
M-mode Zoom
When you are in M-mode and Zoom at the same time, only the part of the
M-mode line that falls within the Zoom box is used to supply data for the
M-mode trace. The area of the anatomy displayed in the 2D image aligns with the
area of the anatomy captured in the M-mode trace. Both the 2D image and the
M-mode trace are zoomed.
You cannot use Magnify while an M-mode trace is displayed. If Magnify is on with a
2D image, it is temporarily turned off while an M-mode trace is displayed. Magnify
is turned back on after M-mode is turned off.
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Imaging Modes
Using M-mode
To use M-mode
If you are in a non-cardiac preset, press Mmode to enter M-mode Preview. An M-mode reference line appears on the 2D image. Use the trackball to move the M-mode reference line to the anatomy of interest. Press
Mmode.
If you are in a cardiac preset, use the trackball to move the 2D reference
line to the anatomy of interest. Press Mmode.
The M-mode trace appears with the 2D reference image.

NOTE
If Magnify was applied to the 2D image, it is automatically turned off while the
M-mode trace is displayed.
2. To change the travel speed of the scrolling trace, press Sweep.
3. To change the appearance of your M-mode trace, use the soft keys.
The soft keys available to you depend on the term that is highlighted on the
Select menu.
M-mode soft keys are available when Line is highlighted.
2D soft keys are available when Size or Position is highlighted.
4. To review the M-mode trace, press Freeze, and use the trackball to scroll
forward or backward.
5. To exit M-mode, press Mmode or 2D.
Using M-mode Soft Keys

Soft key availability is transducer, preset, and mode dependent.
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B/W Suppress
XRes
Sweep
Filter
Chroma
Compress
Map
Frequency
L/R Invert
Persist
Map Invert
Packet
SonoCT
Priority
Smooth
About the M-mode Format

You can specify the format of the M-mode display, which is how the M-mode trace
and the 2D reference image appear on the display. You have the following three
options:
Small over largeThe small 2D reference image appears above the large
M-mode trace.
Side by sideThe M-mode trace and the 2D reference image appear next
to each other.
Full screenA full-screen M-mode trace appears. A very small reference

image appears in the corner.
About M-mode Trace Scrolling

You can control whether the M-mode trace is scrolling or nonscrolling.
158
Scrolling traceWhile the trace is live, it moves from right to left, with
new data appearing at the right margin.
Nonscrolling traceAn erase bar slides from left to right across the trace,
with new data appearing just to the left of the erase bar.
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About Color M-mode

You are in Color M-mode when you are in Color mode and M-mode at the same
time.
In Color M-mode, a color box appears on the 2D reference image, and information about color flow along the entire M-mode reference line appears in the
M-mode trace.
The position of the color box in the 2D reference image does not affect the color
information displayed in the M-mode trace.
Using Color M-mode

To use Color M-mode
If you are in a non-cardiac preset, press Mmode to enter M-mode Preview. An M-mode reference line appears on the 2D image. Use the trackball to move the M-mode reference line to the anatomy of interest.
If you are in a cardiac preset, use the trackball to move the 2D reference
line to the anatomy of interest.
2. Press Color.
3. Press Mmode.
NOTE
If you want, you can press Mmode before pressing Color.

4. To change the travel speed of the scrolling trace, press Sweep.
5. To change the appearance of your M-mode trace, use the soft keys.
The soft keys available to you depend on the term that is highlighted on the
Select menu.
M-mode soft keys are available when Line is highlighted.
Color Mode soft keys are available when Size or Position is highlighted.
6. To review the M-mode trace, press Freeze, and use the trackball to scroll
forward or backward.
7. To exit Color M-mode, press Mmode or 2D.
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PW Doppler Mode
Pulsed-Wave (PW) Doppler mode measures velocity in a PW sample volume gate
and displays that information in a spectral trace with audio output.
PW Doppler mode is available only with transducers that support PW Doppler.
Using Doppler Soft Keys

The following sections list the soft keys available in different Doppler modes.
Doppler Preview Soft Keys (PW, TDI)

The following soft keys may appear in PW Doppler mode or in Tissue Doppler
Preview mode, depending upon the selected transducer, preset, or specific function when Gate is selected on the Select menu (as the trackball function).
Audio
Gate
Spectral Doppler Soft Keys (PW, CW, TDI)

The following soft keys may appear in Doppler in live spectral mode, depending
upon the selected transducer, preset, or specific function when Gate or Line is
selected on the Select menu (as the trackball function). When Size or Position
is selected on the Select menu, the soft keys relate to 2D, Color, or CPA modes
and are described in their respective sections.
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2D Hold
Chroma
Compress
Delay
Duplex
Filter
Frequency
Gate
Reject
Smooth
Spectral Invert
Steer
Sweep
Triplex
Update
Doppler Freeze Soft Keys (PW, CW, TDI)

The following soft keys may appear in Doppler freeze mode, depending upon the
selected transducer, preset, or specific function when Trace is selected on the
Select menu (as the trackball function). When Image is selected in the Select
menu, the soft keys relate to 2D, Color, or CPA modes and are described in their
respective sections.
Chroma
Compress
Reject
Waveform
Map
Using PW Doppler Mode

To use PW Doppler mode
1. Press PW.
A PW cursor line and an angle-to-flow arrow appear on the 2D image. The
PW sample volume gate lies on the PW cursor line. This is PW Doppler Preview.
2. Use the trackball to place the PW sample volume gate in the vessel.
3. To adjust the width of the PW sample volume gate, press Gate.
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4. Press PW, Enter, or the Update key.

A PW spectral trace appears with a 2D reference image. This is PW Spectral
Doppler.
5. To adjust the volume of the Doppler audio, turn the Volume knob.
6. To adjust the angle-to-flow arrow, turn the Angle knob.
NOTE
Pressing the Angle knob selects 60, -60, or 0 degrees for the angle-to-flow
arrow.
7. To adjust the spectrum, use the Color/Doppler Gain knob and the Scale
and Baseline controls.
8. To optimize the spectral trace, use the soft keys and the iSCAN control.
If you are in Color PW Doppler mode or Color Power Angio PW Doppler mode,
the soft keys available to you depend on the item that is highlighted on the Select
menu.
PW Doppler soft keys appear when Gate is highlighted.
2D, Color Mode, or Color Power Angio (CPA) soft keys appear when
Size or Position is highlighted.
9. To control whether the 2D reference image or the PW spectral trace is live,

press Enter or the Update key.
10. To scroll the spectral trace, press Freeze and use the trackball to scroll forward or backward.
11. To exit PW Doppler, press PW or 2D.
NOTE
If you press the Update key when you are in 2D mode, the system enters PW
Spectral Doppler.
Repositioning the PW Sample Volume Gate

To reposition the PW sample volume gate
1. Press Select until Gate is highlighted on the Select menu.
2. Use the trackball to reposition the PW sample volume gate.
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Changing Doppler Settings

You can change the following Doppler settings:
Optimum cursor angle
Doppler scale units
Spectral format
Autotrace Evaluation
Scrolling Trace
Adaptive Doppler
Turning Intelligent Doppler On or Off

When Intelligent Doppler is on, turning the Angle knob moves the PW cursor
line whenever the angle-to-flow arrow is moved to maintain an optimum cursor
angle between the angle-to-flow arrow and the direction of PW cursor line. You
select the optimum cursor angle on the System Setup window.
To turn on Intelligent Doppler
1. If PW Doppler is off, press PW.
2. Press Steer.
3. Select the Auto setting.
Intelligent Doppler is only available in PW Doppler with linear transducers.
About High Pulse Repetition Frequency Doppler Mode

High Pulse Repetition Frequency (HPRF) Doppler mode is a system-mediated
Doppler mode, based on PW Doppler.
Pulse repetition frequency (PRF) and the transducer frequency determine the
maximum velocity that can be measured using PW Doppler mode. These relationships come into play especially when attempting to record and to measure
increased velocities that might occur in the case of an obstructive lesion such as a
valvular or subvalvular stenosis. Above the Nyquist limit aliasing occurs.
Aliasing is an ambiguous display of velocities, which have exceeded the Nyquist
Limit. Forward velocities may be displayed below the zero line, or vice versa.
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HPRF extends the ability of the system to accurately measure high velocity at a
given depth by establishing additional gates with echoes that coincide with the
selected gate echoes. The additional gates are shown on the display as smaller
sample volume gates along the Doppler line.
About Nonimaging Doppler

Tips for using nonimaging transducers with Doppler:
If you are using a nonimaging transducer that supports only CW Doppler, the
system is automatically in CW Spectral Doppler mode.
If you are using a nonimaging transducer that supports only PW Doppler, the
system is automatically in PW Spectral Doppler mode.
When you are using a nonimaging transducer that supports CW Doppler and
PW Doppler, press CW or PW to switch between CW Doppler mode and
PW Doppler mode.
When you use a nonimaging transducer, no reference image appears.
The Update key is inactive when you are using a nonimaging transducer.
PW Gate depth and size are available.
Optimizing Doppler Trace Settings with Doppler iSCAN

Intelligent Optimization
Doppler iSCAN Intelligent Optimization automatically optimizes key imaging settings during Doppler Trace acquisition.
Doppler iSCAN optimization allows you automatically optimize the Doppler
Trace settings by pushing one button. Instead of manually adjusting the Doppler
velocity scale and baseline settings, which may need several adjustments, you can
press iSCAN once.
Doppler iSCAN optimization is available only when the system is in PW or CW
Doppler mode and the spectral trace is live.
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Using Doppler iSCAN Optimization

To use Doppler iSCAN optimization
Press iSCAN.
After the iSCAN button is pressed, a progress notification message appears on
the display. While Doppler iSCAN is in progress, the system freezes the area of
the display. When the optimal settings are determined, the progress notification
message is removed, and the trace area returns to a live state.
About Duplex and Triplex

Duplex enables you to simultaneously display a live 2D image and a PW spectral
trace.
Triplex enables you to simultaneously display a live 2D image with color or CPA
and a PW Doppler trace.
Tips for Using Duplex and Triplex
Duplex and Triplex are only available with transducers that support PW Doppler mode.
Triplex is not available with cardiac presets.
Duplex is only available with cardiac presets when PW Tissue Doppler is on.
Being in Duplex and Triplex limits the Doppler pulse repetition frequency
(PRF), which limits the maximum velocity of blood flow that can be measured
without aliasing. When you are in Duplex or Triplex, the displayed velocity
scale may automatically be reduced.
Using Duplex
To use Duplex
1. While in PW Doppler mode, press the Duplex soft key.
To exit Duplex and remain in spectral Doppler, press the Duplex soft key
again.
To exit spectral Doppler, press any 2D in PW.

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NOTE
If the system is in Duplex and you press Color or Angio, the system enters Triplex.
Using Triplex
To use Triplex
1. While in PW Doppler mode, press Color or Angio.
2. Press the Triplex soft key.
To exit Triplex and remain in spectral Doppler, press the Triplex soft key
again.
To exit spectral Doppler, press 2D or PW.
NOTE
If the system is in Triplex mode and you press Color or Angio, you enter Duplex
mode.
Using Duplex Soft Keys

The soft keys available to you depend on the term that is highlighted on the bottom right corner of the display.
In Duplex, PW Doppler soft keys appear when Gate is highlighted on the Select
menu.
Chroma
Compress
Focal Zone
L/R Invert
Map
Persist
Smooth
SonoCT
U/D Invert
XRes
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Using Triplex Soft Keys

The soft keys available to you depend on the term that is highlighted on the bottom right corner of the display.
In Triplex:
PW Doppler soft keys appear when Gate is highlighted on the Select menu.
Color Mode or Color Power Angio soft keys appear when Size or Position
is highlighted on the Select menu.

B/W Suppress
Density
Filter
Frequency
Map
Map Invert
Packet
Persist
Priority
Smooth
XRes
CW Doppler Mode
Continuous-Wave (CW) Doppler mode measures velocity along a Doppler line
and displays that information in a spectral trace with audio output.
CW Doppler mode is available only with transducers that support CW Doppler.
Using CW Doppler Mode

To use CW Doppler mode
If you are in a non-cardiac preset, press CW. A CW reference line

appears on the 2D image. This is CW Doppler Preview.
If you are in a cardiac preset, you do not need to press CW. A 2D reference line appears on the 2D image.
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2. Use the trackball to move the focus diamond on the reference line to the
anatomy of interest.
3. Press CW. From CW Doppler Preview, you can alternatively press Enter,
CW, or the Update key.
A CW spectral trace appears with a 2D reference image. This is CW Spectral
Doppler.
If you are in Color CW Doppler mode or Color Power Angio CW Doppler
mode, the soft keys available to you depend on the term that is highlighted on
the bottom right corner of the display.
CW Doppler soft keys appear when Line is highlighted.
2D, Color Mode, or Color Power Angio (CPA) soft keys appear when
Size or Position is highlighted on the Select menu.
5. To scroll the spectral trace:

a. Press Freeze and use the trackball to scroll forward or backward.
b. Press Select until Trace is highlighted on the Select menu.
6. To specify whether the 2D reference image or the CW spectral trace is live,
press Enter or the Update key. The soft keys affect the element that is live.
7. To exit CW Doppler mode, press 2D or CW.
NOTE
If you press Update when the system is in 2D mode, the system enters PW
Spectral Doppler mode.
About Spectral Trace Scrolling

You can control whether the spectral trace is scrolling or nonscrolling on the
Setup Mode window.
168
Scrolling traceWhile the trace is live, it moves from right to left, with
new data appearing at the right margin.
Nonscrolling traceAn erase bar slides from left to right across the trace,
with new data appearing just to the left of the erase bar.
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About the Spectral Trace Format

You can specify the format of the Doppler display on the Setup Mode window.
This specifies how the spectral trace and the 2D reference image appear on the
display. You have four options:
Small over largeThe small 2D reference image appears above the large
Doppler trace.
Large over smallThe large 2D reference image appears above the small
Doppler trace.
Side by sideThe Doppler trace and the reference image appear next to
each other.
Full screenA full-screen Doppler trace appears. A very small reference

image appears in the corner.
Tissue Doppler Mode

Tissue Doppler optimizes settings to measure the movement of tissue by using
color or pulsed-wave Doppler. Tissue Doppler imaging is available only with:
Adult cardiac presets
Sector transducers in those presets.
You can choose one of the following types of Tissue Doppler imaging to be the
default:
Color Tissue Doppler
PW Tissue Doppler
Color PW Tissue Doppler
The default Tissue Doppler setting determines the type of Tissue Doppler imaging selected when you press the TDI key.
You can also activate Color M-mode Tissue Doppler
To activate Color M-mode Tissue Doppler
1. Turn on Color Tissue Doppler.
2. Turn on M-mode.
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Using Tissue Doppler Imaging

To use Tissue Doppler imaging
1. Press TDI.
Depending on the default Tissue Doppler imaging setting, you are in one of
the following modes:
NOTE
Color Tissue Doppler mode
Color PW Tissue Doppler mode
PW Tissue Doppler mode
To enter Color M-mode Tissue Doppler mode, you must press Mmode. You
cannot enter Color M-mode Tissue Doppler mode by default.
2. You can switch from one type of Tissue Doppler imaging to another:
To switch between Color Tissue Doppler and Color PW Tissue Doppler,

press PW.
To switch between Color Tissue Doppler from Color M-mode Tissue

Doppler, press Mmode.
To switch between PW Tissue Doppler and Color PW Tissue Doppler,

press Color.
3. Press 2D or TDI to exit Tissue Doppler imaging mode.
Color Mode
In Color mode, a color box appears on the image. The velocity and direction of
flow in the color box are represented with different colors for direction and different shades for velocity. The colors being used appear in the color bar in the
upper right corner of the display.
Turning on Color mode turns off Color Power Angio (CPA) mode, but does not
turn off M-mode, PW Doppler mode, or CW Doppler mode.
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Using Color Mode

To use Color mode
1. In 2D mode, optimize the image.
2. Resize and reposition the 2D image by using the trackball.
3. Press Color.
4. Resize and reposition the color box by using the trackball.
5. Adjust the Baseline, Color Gain, and Scale if necessary.
6. Change the appearance of your image by using the soft keys.
7. If you are using a linear transducer, use the Angle knob to steer the color
box.
8. To exit Color mode, press Color or 2D.
Resizing and Repositioning an Angio, a Color, an ROI, or a

Zoom Box
To resize a box
1. Press Select until Size is highlighted on the Select menu.
2. Change the size of the box by using the trackball.
To reposition a box
1. Press Select until Position is highlighted on the Select menu.
2. Reposition the box by using the trackball.
NOTE
If you change the size or position of an angio or a color box, the 2D image will, if
necessary, move or become larger to accommodate it.
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Using Color Suppress

Color Suppress temporarily removes color data from a frozen color image without exiting Color mode.
To use Color Suppress
1. While in Color mode, press Freeze to freeze the image.
2. Press Color.
Color data is removed from the image.
3. Press Color again to bring color data back to the frozen image.
4. Press Freeze to return to live imaging.
About Color Compare

Color Compare shows two versions of the same live image, side-by-side on the
display. The right-hand image displays color; the left-hand image has color suppressed.
Color Compare is similar to and uses the same controls as Dual Imaging.
Color Compare is available in live imaging in the following modes:
Color
Color Power Angio imaging
Tissue Doppler Imaging
Using Color Compare

To use Color Compare
1. While you are viewing a live image in Color mode, press Dual.
2. If you are using Two Buffer, press the key for the displayed buffer.
Two images appear: an image that shows color flow on the right and a
color-suppressed version of the same image on the left.
3. To transition to standard "Dual Imaging" on page 215, press Dual again.
5. To exit Color Compare, press 2D.
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Using Color Soft Keys

B/W Suppress
Density
Filter
Frequency
Map
Map Invert
Packet
Persist
Priority
Smooth
XRes
Color Frozen Soft Keys

Chroma
Edit End
Edit Start
Map
Map Invert
Replay
XRes
Color Power Angio (CPA) Mode

In Color Power Angio mode, an angio box appears on the image. The amplitude
(intensity) of flow in the angio box is represented with different hues. The colors
being used appear in the color bar on the upper right corner of the display.
Turning on Color Power Angio mode turns off Color mode and M-mode, but
does not turn off PW Doppler mode or CW Doppler mode.
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Using Color Power Angio Mode

To use Color Power Angio mode
1. In 2D mode, optimize the image.
2. Resize and reposition the 2D image by using the trackball.
3. Press CPA to enter Color Power Angio mode.
4. Resize and reposition the angio box by using the trackball.
5. Adjust the Baseline, CPA Gain, and Scale if necessary.
7. If you are using a linear transducer, use the Angle knob to steer the angio
box.
8. To exit Color Power Angio mode, press CPA or 2D.
Using Color Power Angio Suppress

Color Power Angio Suppress temporarily removes angio data from a frozen angio
image without exiting Color Power Angio mode.
To use Color Power Angio Suppress
1. While in Color Power Angio mode, press Freeze to freeze the image.
2. Press CPA to remove Angio data from the image.
3. Press CPA again to bring angio data back to the frozen image.
4. To return to live imaging, press Freeze.
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Using Color Power Angio Compare

Color Power Angio Compare shows angio flow on the right-hand image and a
flow-suppressed version of the same image on the left.
To use Color Power Angio Compare
1. While you are viewing a live image in Color Power Angio mode, press Dual.
Two images appear: an image that shows angio flow on the right and a
flow-suppressed version of the same image on the left.
3. To transition to Dual Imaging, press Dual again.
5. To exit Color Power Angio Compare, press 2D.
Using Color Power Angio (CPA) Soft Keys

B/W Suppress
Density
Filter
Frequency
Map
Priority
Packet
Persist
Smooth
XRes
Color Power Angio (CPA) Frozen Soft Keys

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Chroma
XRes
Edit Start
Map
Edit End
Replay
3D/4D Mode
The HD11 3D/4D application supports both freehand and motorized image
acquisition, and it has a special feature to capture fetal heart images (Fetal STIC).
3D/4D Acquisition and Transducers

Freehand acquisition is supported on all hand-held imaging transducers. TEE
transducers are not supported.
Motorized acquisition requires transducers that support motorized 3D acquisition. These transducers support the following modes of operation:
3D mode, also called single sweep, in which a single volume is acquired
4D mode, also called Live 3D mode, in which a stream of volumes are

acquired and rendered live
Fetal STIC mode, in which multiple fetal heart cycles are acquired in a single
sweep of a motorized transducer.
3D/4D and Other Modes and Features
3D acquisitions can be made in grayscale, Color, and Color Power Angio

(CPA) modes.
4D mode is restricted to grayscale imaging.
Both 3D and 4D can be combined with Zoom.
About 3D Volume Data Sets

In 3D/4D acquisitions, you acquire a series of 2D images, form which one or
more volumes, or 3D data sets, are constructed. The system processes this 3D
data set and produces multiplanar reformatted image (MPR) views and the rendered 3D image.
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The rendered 3D image presents information with depth as well as height and
width, enabling you to visualize the region of interest in 3D. You can review and
edit the 3D volume data.
Managing 3D Data Sets

You can save the MPR and the 3D image with or without its associated data set. If
you are exporting studies to a PACS, you might not want to send the data set
because the files are large and may not be compatible with your DICOM viewer.
To learn how to set up your system to handle 3D data exporting, see "Setting Up
Automatic DICOM Export and Export Options" on page 74.
About Acoustic Artifacts in 3D Imaging

Resolution, attenuation, and propagation artifacts are all common to 3D
imaging. Careful scrutiny of the original 2D image planes is necessary to identify
and preclude these types of artifacts from the 3D volume image.
Color gain, directional, and motion artifacts can present themselves in 3D
imaging. Color and Color Power Angio gain artifacts are mainly related to the use
of excessive gain resulting in random color patterns in the 3D image that might be
interpreted as diagnostically significant. Directional artifacts are due to aliasing or
directional confusion: The velocity range must be set properly, and the relationship between the transducer orientation and the flow vector must be understood.
Motion artifacts in 3D volumes can be caused by fetal movement, cardiac motion,
and the movement of adjacent structures. Patient motion can produce flash artifacts that are less obvious in 3D imaging than in 2D imaging.
Acquisition, rendering, and editing artifacts are specific to 3D volume
images. Acquisition artifacts are related to patient motion, organ motion, or position-sensing errors. Rendering artifacts include elimination of structures by limiting the region-of-interest (ROI) boundaries, thresholding that eliminates
structures, and adjacent structure artifacts that add additional information or hide
structures. Editing artifacts result from data deleted from a rendered image.
Limb deficit artifacts are specific to 3D volume images. In some studies, partially absent fetal limb bones have been demonstrated. One explanation for the
missing limbs was shadowing caused by adjacent skeletal structures. Overcoming
the limb deficit artifact can be accomplished by changing the transducer position
and the acquisition plane.
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Pseudoclefting and pseudonarrowing artifacts may be related to limb deficit artifacts. Some studies have also shown that artifacts may be present in 3D
imaging of the fetal face. Being aware of pseudoclefting of the fetal face and psuedonarrowing of the fetal spine can help the sonographer understand and identify
these artifacts. As with 2D imaging, it is important to verify putative physical
defects by using additional images and other modalities.
Drop out and shadowing are present in 3D imaging although more difficult to
recognize due to different and unfamiliar displays. Acoustic shadowing and other
artifacts look very different when displayed in 3D volumes and may be more difficult to recognize than on standard 2D imaging. These artifacts may produce
apparent defects such as limb abnormalities or facial clefts where they are not
present. Acquiring data from multiple orientations may avoid artifacts of this type.
About 3D Freehand and Motorized Imaging

Single sweep 3D volumes can be acquired for grayscale, color, and CPA images by
using standard imaging (freehand) transducers or transducers that support
motorized 3D imaging. TEE transducers are not supported.
Standard imaging transducers require you to move the transducer by using

either a fanned or linear movement. This is called freehand acquisition.
Transducers that support motorized 3D acquisition require you to hold the

transducer in a fixed location during acquisition. This is called motorized acquisition.
Freehand Imaging Technique

Because the quality of the MPR and volume images is dependent upon the quality
of the 2D acquisition, special attention should be paid to 2D imaging technique.
It may take several tries for you to match the frame rate of the system with the
sweep speed of the transducer. You may need to adjust the frame rate, line density, and focal zones to synchronize the acquisition with the sweep speed.
In freehand 3D imaging, you can use one of two types of motion to acquire a 3D
volume. You can pivot (tilt) a transducer in a fan-like motion or drag (slide) a
transducer over the region of interest.
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Consider the following tips:
If you drag the transducer, hold the transducer perpendicular to the skin
throughout the motion to keep the image planes parallel to each other, and
drag the transducer from left to right.
If you tilt the transducer, pivot the transducer at an even rate, keeping the face
of the transducer in the same position on the skin.
Move the transducer at a constant rate for equally spaced images.
The freehand motion must be perpendicular to the transducers image.
About Freehand Imaging and Geometry

If you select a curved or sector transducer, the system sets Geometry to Fan.
If you select a linear array transducer, the system sets Geometry to Linear.
You can change the Geometry setting by pressing the Geometry soft key.
Activating 3D/4D Mode

To activate 3D/4D mode
1. Press 3D/4D.
2. If the 4D or 4D and the Fetal STIC options are installed, press 3D/4D Mode
soft key to cycle through the volume acquisition modes.
3D/4D Control Functionality

The 3D/4D control works differently depending upon which mode is active and
which transducer is selected when you activate 3D/4D mode.
When in 2D grayscale, pressing 3D/4D enters 3D/4D in the same acquisition

mode in which you last used 3D/4D.
When the 3D Color option is installed, in Color mode or CPA mode with an
motorized transducer selected, pressing 3D/4D enters 3D mode with Color
and CPA modes retained. However, if 3D/4D was last used in STIC Acquisition mode, STIC is selected with color retained if it was on and with CPA
turned off if it was on. For all other modes and transducers, the system enters
3D Grayscale mode.
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NOTE
When the 3D Color option is installed, in 3D Grayscale, Color, or CPA Preview modes with a motorized transducer selected, pressing Color enters and
exits 3D Color Preview mode; pressing CPA enters and exits 3D CPA Preview mode.
In any 3D/4D submode, pressing 3D/4D exits 3D and returns to the originating mode (2D, Color, or CPA).
The 3D/4D application is available only with standard imaging transducers and
transducers that support motorized 3D acquisition. If you switch to a nonimaging
or a TEE transducer during 3D/4D imaging, the system exits 3D/4D mode.
About Working in 3D Preview Modes

When you first enter 3D mode, 4D mode, or Fetal STIC mode, you are in Preview mode.
Preview mode allows you to make the following adjustments before acquiring the
3D, 4D, or 3D fetal heart images:
NOTE
Position and size the preview ROI.
Adjust the Elevation angle by using the Angle soft key.
Adjust the Resolution by using the Resolution soft key (not in Fetal STIC).
Adjust 2D image controls.
When volume acquisition starts, Persistence, SonoCT, and XRes are turned
off.
Acquiring a Freehand 3D Data Set

To acquire a freehand 3D data set with an imaging transducer
1. Optimize the 2D image in a 2D imaging mode.
2. Press 3D/4D to enter 3D Preview.
3. Adjust the size and position of the Preview ROI with the Select key and the
trackball.
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4. To make additional grayscale image optimizations, press Next to see next

level of soft keys.
5. Press Geometry to specify the scanning method.
6. Begin moving the transducer at a constant speed. Be sure to scan with the
method specified by the Geometry soft key.
7. Press Acquire.
8. Acquisition automatically stops when the maximum number of frames are
acquired.
9. To end the acquisition before the maximum number of frames are acquired,
do one of the following:
Press Back to Preview to return to 3D Preview and discard the acquired

frames.
Press Acquire or Freeze to end the acquisition and enter 3D Render to

view the acquired volume.
CAUTION
Confirm any diagnosis made with 3D/4D imaging with 2D imaging.
Acquiring a Motorized 3D Data Set

Requires a transducer that supports motorized 3D imaging (3D6-2, 3D8-4,
3D9-3v).
To acquire a motorized 3D data set
1. Optimize the 2D image in a 2D imaging mode.
3. Adjust the size and position of the Preview ROI with the Select key and the
trackball.
4. To make additional grayscale image optimizations, press Next to see the next
level of soft keys.
5. To set the scanning resolution or elevation angle, press Resolution or
Angle.
6. Hold the transducer steady over the area you want to image.
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7. Press Acquire.
Acquisition automatically stops when the appropriate number of frames are
acquired.
8. To end the acquisition early, press Back to Preview.
CAUTION
Using 3D Preview and Acquisition Soft Keys

3D Preview Soft Keys

3D/4D Mode
Angle
Compress
Geometry
Map
Persist
Resolution
Smooth
Length
3D Color and CPA Preview Soft Keys

3D/4D Mode
Angle
Smooth
Filter
Geometry
Map
Map Invert
Packet
Resolution
3D Acquisition Soft Key

Back to Preview
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3D Image Review
This section includes information on working with MPR and rendered 3D images
in 3D Render.
About 3D Render
After the 3D data set has been acquired, the 3D volume is generated and the system enters 3D Render. The rendered 3D image and the three MPR images appear
on the display in Quad format.
The three MPR images represent:
The acquisition, or the front view (A)
90 degrees to the acquisition, or the right view (B)
90 degrees to both views, or the top view (C)
You can perform manipulations on images when in 3D Render. You can perform
some manipulations on the rendered 3D image and the MPR images, such as orientation and cross-hair placement; you can perform others only on the rendered
3D image, such as editing the volume.
To return to 3D Preview
Press Freeze.
Using 3D Render Soft Keys

In 3D/4D and Fetal STIC Imaging, some soft keys have their own additional sublevel of soft keys (Render Controls, Image Controls, Swivel, and Sculpt/
Erase). The symbols, >>, on the soft key label indicates that a sublevel will
become available when the soft key is pressed. Sublevel soft key labels are green.
To exit the soft key sublevel, press Next.
The following illustration shows soft key labels that indicate an available sublevel:
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The following illustration shows an active soft key sublevel. On the display, the
soft key labels and level indicator appear in green.

Acquire 3D Data
Accept ROI
Edit ROI
Format
Image Controls
Render Controls
Reset
Rotate
Sculpt/Erase
Swivel
View
Resize
About the 3D Render Display

The following features appear on the 3D Render display.
Selection BracketThe four corner brackets that appear at the corners of the
active view. Move the selection bracket to the view you want to manipulate by
using the Enter, Left, or Right keys.
Distance RulerA ruler that appears at the lateral edge of the active view if the
view for motorized acquisitions. If the image is for a freehand acquisition, the
ruler is not displayed. You can enable or disable the ruler on the 3D/4D tab in the
Setup window.
CrosshairsEach view contains crosshairs to help orient the image or indicate
an important spot. The crosshairs represent the three axes. The x-axis is red, the
y-axis is yellow, and the z-axis is blue. You can adjust the volume and MPR
crosshair settings in the Setup window. When Edit ROI is off and an MPR view
is active, the XYZ rotation knobs rotate around the crosshair point. See "3D/4D
Settings" on page 128.
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ViewShows the MPR or rendered 3D image. The MPR views show slices
through the volume. The Volume view shows a rendered 3D image.
View DirectionThe direction from which the rendered 3D image is being
viewed. The choices are Front, Back, Top, Bottom, Left, and Right.
Axis IconThe icon that appears on the bottom left of each 3D image. It illustrates the orientation of the image in relation to the x-axis, the y-axis, and the
z-axis of the volume as originally acquired. As you rotate, orbit, or otherwise
manipulate the MPRs or volume view, the Axis Icon spins to reflect the changing
orientation. As an axis moves toward you, its letter changes to uppercase. If an
axis points towards you, its letter is uppercase. If an axis points away from you, its
letter is lowercase.
Screen FormatThe layout of the images on the screen, in this case Quad format. Other layouts available with the Format soft key are: Full, Dual, and
Expanded.
Select MenuThe Select menu options change in 3D Render depending upon
certain conditions. When Edit ROI is on, the options are Size, Pan, and Slice.
When Edit ROI is off and an MPR view is active, the options are Pan, X-Hair, and
Slice. When Edit ROI is off and the rendered 3D image is active, the options are
Pan, Orbit, and Rotate.
About 3D/4D Display Layouts

You can select from the following screen formats, or layouts, in 3D Render, 4D
acquisition, and Volume Cine. A view is a single image in any format.
QuadDisplays four images of similar size. The bottom right image is the
rendered 3D image. The other three images are the MPR images.
FullDisplays one image (MPR or rendered volume).
DualDisplays two images of similar size side by side. An MPR image is on

the left and the rendered 3D image is on the right.
ExpandedDisplays one view on a larger scale on the left side and the three
remaining views on the right side of the display.
The default format in 3D Render and Fetal STIC is Quad. The default format in
4D acquisition is Dual.
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Changing the Format

To change the screen format in 3D Render, 4D acquisition, and Volume
Cine
Press Format to cycle between Quad, Full, Dual, and Expanded screen formats.
The first press of Format brings up Full format. In OB presets and the cardiac
fetal heart preset, it also activates the Volume view. For all other presets, the view
that was active remains active in Full format. Subsequent presses of Format cycle
through the other options.
Changing the Active Image

In Quad, Dual, and Expanded formats, one image is active at a time. The active
image has selection brackets or the ruler.
In Full format, the displayed image is active.
To change the active image in 3D Render, 4D acquisition, and Volume
Cine
To move the selection bracket from image to image in Quad and Expanded formats or to display a different image in Full format, press Enter or the Left and
Right keys.
To move the selection bracket from image to image in Dual format, press Enter.
To make the left or right volume active in Dual format, press Left or Right.
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Editing the ROI

When you enter 3D Render and 4D acquisition, the Edit ROI feature is on, which
allows you to modify the ROI. You can resize the ROI box and pan (change the
position of) and magnify the image. You can also rotate the volume within the
ROI. When you enter Volume Cine from a Fetal STIC acquisition, the Edit ROI
feature is off.
To adjust the ROI or pan the image within the ROI
1. Press Edit ROI to turn it on if it is not already on.
2. Move the trackball to resize the ROI.
The trackball is assigned to ROI Size by default.
3. Press Select to switch the trackball function to Pan.
4. Move the trackball to pan the image.
5. Turn the Zoom knob to magnify the image in the ROI box.
6. Turn the X, Y, and Z knobs to rotate the volume.
7. To return to the volume to its acquisition state, press Reset.
8. To save the ROI and turn the Edit ROI feature off, press Accept ROI.
NOTES
If you press Reset while the Edit ROI feature is on, the ROI is returned to
its acquisition state, even if you have previously edited the ROI. If you press
Reset while Edit ROI is off, the 3D volume position, orientation, and zoom is
returned to the last Accept ROI state.
When the Edit ROI feature is off and you turn it back on, the Zoom, Pan,
Size, and orientation settings are returned to the last Accept ROI state.
After the ROI is accepted, volume manipulations apply to the ROI intersected
with the volume. Zooming, panning and rotations apply to both the ROI and
the volume.
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Making Measurements on 2D MPR Images

You can make distance and circumference area measurements on MPR images
from motorized acquisitions. You cannot make measurements on rendered 3D
images or on MPR images from freehand acquisitions.
Using Slice
Use Slice, an option on the Select menu when an MPR view is active, to look at
various planes in the MPR views. Slice is also available on the Select menu when
the volume view is active and Edit ROI is on.
To look at planes of the MPR views
1. Press Enter until the MPR view you want is active.
2. Press Select until Slice is highlighted on the Select menu.
3. Use the trackball to scroll through the MPR image.
In Quad and Expanded formats, when Edit ROI is off, the crosshair moves in the
non-active MPR views to show, in profile, which plane the active view is showing.
When Edit ROI is on, the MPR images move while the crosshairs remain fixed.
Changing the Orientation of the Volume

You can change the orientation of the 3D volume by rotating and orbiting it. All of
the views, the MPRs, and the rendered 3D images are affected by theses operations. The MPRs change because the plane where each MPR intersects the volume
moves to a new orientation. The rendered 3D image changes because it shows
the volume looked at from a different angle.
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The X, Y, and Z knobs change the orientation of the 3D volume in small

increments on a specific, controlled rotation axis (X, Y, or Z). The X, Y, and Z
knobs work when any view is active.
The Rotate option on the Select menu spins the image about the axis of the
volume view.
The Orbit option on the Select menu spins the image about any axis perpendicular to the axis of the volume view.
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To rotate a 3D volume
1. Turn the X, Y, and Z knobs to rotate the 3D volume and MPRs on each plane.
2. Press Enter until the rendered 3D image is active.
3. Press Select until Rotate is highlighted on the Select menu.
4. Move the trackball to rotate the volume.
To orbit a 3D volume
1. Press Enter until the rendered 3D image is active.
2. Press Select until Orbit is highlighted on the Select menu.
3. Spin the image by using the trackball.
NOTES
When you rotate the volume with the Rotate option on the Select menu in
combination with orbiting the volume, you have the same control over the
volume as you do when you use the X, Y, and Z knobs in combination.
The orientation changes are reset with every new acquisition.
Changing the View Direction of the Rendered 3D Image

You can change the view direction of the rendered 3D image, the direction from
which you are viewing it. There are six view directions to choose from: Front,
Back, Right, Left, Top, or Bottom.
To change the view direction of the rendered 3D image
1. Press Enter until the volume view is active.
2. Press Next to view the next level of soft keys.
3. Press View until you have the view direction you want.
The Rotate soft key changes the orientation of the rendered 3D image in the following increments: 0, 180, 90, and 270 degrees).
To rotate a rendered 3D image with the Rotate soft key
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3. Press Rotate until you have the rotation you want.

NOTES
The View and Rotate soft key change only the volume view. The X, Y, Z knobs
affect both the MPRs views and the volume view.
The View and Rotate soft key settings are presettable.
Swiveling a 3D Volume
Swivel rotates the 3D volume by showing a sequence of rendered 3D images. It
is available in 3D Render or Volume Cine. Swivel can rotate about the vertical or
horizontal axes. Its motion can be back and forth or one way.
The Swivel feature has its own soft key sublevel that is activated when you press
Swivel.
To swivel a 3D volume
2. Press Swivel.
3. Adjust the Left-Right or Up-Down step size to 1, 3, or 6 degrees
Left-Right swivels around the vertical axis.
Up-Down swivels around the horizontal axis.
A larger step size minimizes the time to calculate the rendered 3D images
and to give rapid motion to the swiveling loop.
A smaller step size gives slower motion to the swiveling loop.
4. Adjust the Min Angle setting to the lower end or the range of angle over
which you want to swivel.
The system displays the volume is rotated by the setting you selected.
5. Adjust the Max Angle setting to the upper end of the range over which you
want to swivel.
The system displays the volume is rotated by the setting you selected.
6. Press Play or Freeze to start swiveling.
A progress bar indicates how soon swivel will play at full speed.
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7. Press the play direction soft key to toggle between one-way play and back-and
forth.
8. After the swivel is playing at full speed, press Speed to adjust the speed.
9. To increase or decrease the range of angles over which the volume is swiveling, use the Min Angle and Max Angle keys.
10. To stop swiveling without exiting Swivel, press Stop or Freeze.
11. While stopped, up can do any of the following:
NOTE
Resume playing with Resume or Freeze.
Adjust the MinAngle and MaxAngle
Adjust the step size
Switch between vertical and horizontal
Change the volume orientation
Change the zoom
If yo use Reset to undo any changes, you can Resume swiveling, taking advantage
of the images calculated before you paused.
12. To exit, press Next.
Saving Cine Loops, Still 3D Images, and 3D Volumes in Swivel

To save a 3D cine loop or still image in Swivel
Press Acquire.
NOTE
If the image is still, then it is stored as a still image.
If the image is swiveling, then it is stored as a Cine loop.
When storing a Dineloop, the box in the lower right corner goes blank until the
acquisition is complete. If you start pushing buttons before the box Comes back,
only a partial loop is stored.
To save a 3D volume (image and data set) in Swivel

Press Acquire 3D Data.
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Using Swivel Soft Keys

To use any of the Swivel sublevel of soft keys
To exit the Swivel soft key sublevel
Press Next.
Acquire 3D Data
Stop/Play/Resume
Speed
Reset
Step Size
Min Angle
Max Angle
Play Direction
About Editing 3D Volumes

You can remove extraneous information from the 3D Volume when in 3D Render
or Volume Cine. Pressing Sculpt/Erase enables this feature.
The Sculpt function allows you to use the trackball to cut away areas of the
volume by encircling them with a freehand motion.
The Erase function activates an eraser that you control with the trackball.
Information is deleted from the volume as you move the eraser across the
volume.
The Sculpt/Erase feature has its own soft key sublevel that is activated when you
press Sculpt/Erase.
Editing 3D Volumes with Sculpt/Erase

The Sculpt/Erase feature does not affect MPR images, just the rendered 3D image.
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To edit a 3D volume
2. Rotate the volume to display the extraneous material so that you know you
are only removing unwanted material from the volume. See "Changing the
Orientation of the Volume" on page 188.
3. Press Sculpt/Erase.
4. Use the trackball to position the cursor over the area in which you want to
draw.
5. Press Enter to turn on the drawing capability.
The Sculpt cursor on the screen is green, indicating that it is active.
6. Move the trackball to draw around the portion you want to remove.
7. Press Enter to end the drawing.
The contents of the shape you drew are deleted from the 3D volume.
8. To correct a drawing mistake, press Undo and try again.
9. Press Select to activate Erase on the Select menu.
10. Use the trackball to position the cursor over the area you want to erase.
11. Press Enter to activate the eraser.
The Erase cursor is green, indicating that it is active.
12. Move the trackball to erase the information from the 3D volume.
The information is erased as you move the eraser with the trackball.
13. Press Enter to turn off the eraser.
14. Press Next.
Using Sculpt/Erase Soft Keys

To use any of the Sculpt/Erase sublevel of soft keys
To exit the Sculpt/Erase soft key sublevel
Press Next.
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Redo
Reset
Undo
Zooming and Magnifying Images in 3D/4D

You can use both zoom features, Zoom and Magnify, with 3D and 4D images. You
can magnify in 3D Preview, but it has no effect on the subsequent volume acquisition.
Acoustic Zoom with 3D/4D Images

You can Zoom a 2D image before entering 3D or 4D imaging.
If you want 3D/4D imaging of acoustically zoomed anatomy
1. In 2D, enter acoustic zoom.
3. Select the volume acquisition mode: 3D, 4D, or Fetal STIC.
4. Resize and position the 3D Preview ROI.
5. Start the volume acquisition.
Magnifying a Rendered 3D Image

After 3D acquisition, during 4D acquisition, and in Volume Cine, you can magnify
the rendered image. Magnify is applied to all displayed views and is maintained
across format changes. You can also magnify in Sculpt/Erase and Swivel (stopped)
modes.
To magnify a rendered 3D image
Turn the Zoom knob.
The amount of magnification is displayed in the right border.
NOTE
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Using Render Controls Soft Keys

Render Controls soft keys are used to modify the individual settings for a Vision
setting. They are available from any 3D/4D submode that displays a volume:
3D Render
4D Acquisition
Volume Cine
To activate the 3D Render Controls

Press Render Controls.
These controls are activated as a soft key sublevel and are displayed in green text
on the display.
To exit the Render Controls soft key sublevel
Press Next.
Brightness
Transparency
Smooth
Threshold
Opacity
Using Image Controls Soft Keys

Image Controls soft keys are used to change the Vision setting and color mode, as
well as modify map and chroma values. They are available from any 3D/4D submode that displays a volume:
3D Render
4D Acquisition
Volume Cine
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To activate the Image Controls

Press Image Controls.
These controls are activated as a soft key sublevel and are displayed in green text
on the display.
To exit the Image Controls soft key sublevel
Press Next.
Adjusta
MPR Chromab
Priority
Render Mode
Reset
Vision
Vol Chroma
Vol Map
a. Displayed only in Render mode Color/Gray.

b. Displayed only in Render mode Grayscale.
About 3D/4D Render Mode Options

The Render Mode soft key is available only in 3D Color mode and 3D CPA
mode. It is accessible when Image Controls are enabled from within 3D Render
and Volume Cine.
The Render Mode determines which information to display in the volume and
MPR views.
Grayscale shows only grayscale anatomy with no color.
Color shows only color anatomy with no grayscale.
Color/Gray shows both grayscale and color anatomy.
Within each Render Mode, several Vision settings are available.
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Changing the Render Mode

To change the Render Mode
1. From within 3D Render, press Image Controls.
2. Press Render Mode to select the Render Mode you want.
3. Press Next to exit Image Controls and return to 3D Render.
About 3D/4D Vision Settings

A Vision setting is a set of predefined values for the Render Mode. Vision settings
control the aesthetics, or look, of the data set.
The available Vision settings depend upon the selected Render Mode. You can
change the default Vision settings and save them as a preset.
The Vision soft key is accessible when Image Controls are enabled from within:
3D Render
4D Acquisition
Volume Cine
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Vision Definitions
The following table lists the Vision settings available for each Render Mode.
Render Mode
Grayscale
Vision Setting
Surface
Skeletal
Color or Color/Gray with

Color Velocity
Surface
Color or Color/Gray with

CPA
Surface
Translucent
Glass Body
Changing the Vision Setting

To change the Vision setting
1. Press Image Controls.
2. Press Vision to select the Vision setting you want.
3. Press Next to exit the Image Controls soft keys.
Modifying a Render Control

You can change the render controls of a Vision setting and save the changes in a
preset. Click a setting to learn more about it.
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Threshold
Brightness
Transparency
Opacity
Smooth
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To Modify Vision Settings

NOTE
In Color/Gray rendering, you must use the Adjust key to select the Grayscale or
Color Vision.
1. Press Image Controls.
2. Press Vision to select the Vision setting you want to change.
3. Press Next to access the primary level of soft keys.
4. Press Render Controls to access the Vision Settings.
5. Change the Vision settings by using the soft keys.
6. Press Next to return to the primary level of soft keys.
7. To restore the original Vision settings, press Reset.
You can save the new Vision settings as a preset. See "Creating a Preset" on
page 97.
4D Imaging Mode
In 4D imaging mode, also called Live 3D, the system acquires a stream of grayscale
volumes and renders them live. 4D requires a transducer that supports motorized acquisition of 3D images.
In 4D Preview, you can optimize the image with 3D Preview controls.
During 4D acquisition, you can manipulate the volume with 3D Render controls.
And you can freeze and unfreeze the acquisition to enter and exit Volume Cine
replay mode, where you can play and edit the volume.
NOTE
The 3D/4D option is not available with nonimaging or TEE transducers. If you
switch to a nonimaging or TEE transducer while imaging, 3D/4D mode closes.
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Using 4D Soft Keys

4D Preview Soft Keys

The soft keys in the following list are available in 4D Preview mode and in 3D Preview mode:
3D/4D Mode
Angle
Compress
Geometry
Map
Persist
Resolution
Smooth
4D Acquisition Soft Keys

The soft keys in the following list are available during 4D image acquisition:
Angle
Back to Preview
Edit ROI
Format
Image Controls
Render Controls
Reset
Resolution
Rotate
View
Vision
Acquiring 4D Images
4D mode requires a transducer that supports motorized acquisition of images.
To acquire 4D images
1. Optimize the 2D image in a 2D mode.
2. Position the transducer over the anatomy of interest.
3. Press 3D/4D.
4. Press 3D Mode until 4D is selected.
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5. Adjust the size and position of the preview ROI with the Select key and the
trackball.
6. Press Next to see the next level of soft keys to make additional grayscale
image optimizations.
7. Press Resolution or Angle to set the scanning resolution or angle.
NOTE
You may not need to adjust the Resolution or Angle settings, depending upon
the selected preset.
8. Hold the transducer steady over the area you want to image.
9. Press Acquire to begin acquiring the data set.
10. Modify the angle, resolution, ROI, Image Controls, and Render Controls settings as needed during the live acquisition.
11. Press Freeze to end the acquisition.
When acquisition has ended, the system enters Volume Cine so you can review
the images.
CAUTION
Reviewing 4D and Fetal STIC Images

You review 4D images and 3D Fetal STIC images in Volume Cine mode. You can
scroll, edit, and play volumes in a loop.
NOTE
When 3D Fetal STIC image acquisition is complete, the system automatically

enters playback mode, with the cine loop playing at 100% speed.
To review 4D images in Volume Cine Mode

1. Press Freeze during 4D image acquisition.
2. Move the trackball to scroll through the cine loop frames.
3. Press Replay to play the volume cine loop.
4. Press Replay again to increase or decrease playback speed or to stop playback.
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5. To modify the start and end points of the loop, use Edit Start and Edit End.
6. Press Freeze to return to 4D imaging.
To review 3D Fetal STIC images in Volume Cine
1. When acquisition is complete, press Replay to increase or decrease playback
speed or to stop playback.
2. Move the trackball to scroll through the cine loop frames if playback is
stopped.
3. To modify the start and end points of the loop, use Edit Start and Edit End.
4. Press Freeze to return to Fetal STIC imaging.
Saving 4D and Fetal STIC Loops, Images, and Volumes

To save a 4D or a Fetal STIC cine loop or a still image in Volume Cine
Press Acquire.
If the image is frozen, then it is stored as a still image.
If the loop is playing, then it is stored as a Cine loop.
To save a 4D or a Fetal STIC volume (image and data set) in Volume

Cine
Press Acquire 3D Data.
Using Volume Cine Soft Keys

The soft keys in the following list are available in 4D and Fetal STIC after you
press Freeze.
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Accept ROI
Acquire 3D Data
Edit End
Edit ROI
Edit Start
Format
Image Controls
Render Controls
Replay
Reset
Sculpt/Erase
Swivel
View
Fetal STIC
3D Fetal STIC is a special 3D acquisition mode. It acquires multiple fetal heart
cycles in a single sweep of a motorized transducer. Then it creates a volume
cineloop of the fetal heart through a single composite heart cycle. If the data is
sufficient, it also calculates the fetal heart rate.
Acquiring Fetal STIC Images

To acquire fetal STIC images
1. In 2D mode, place the transducer in the center of the anatomy.
2. Locate the fetal heart in the 2D image.
3. Zoom to include just the fetal heart in the image window.
The system sets the elevation angle based on the lateral angle of the image
window.
4. Optimize the fetal heart image.
NOTE
There is no Smoothing control in Fetal STIC mode.

5. Press 3D/4D.
6. Press 3D Mode until Fetal STIC is selected.
7. Press Acquire and hold the transducer still until acquisition stops.
During the acquisition phase the system displays 2D images in real time.
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8. If the calculated fetal heart rate is determined to be reasonable, click Yes to

accept it.
To reject the calculated rate and return to Preview mode, click No.
9. If the fetus or transducer moves during the acquisition, press Back to Preview and begin the procedure again.
After the acquisition, the system renders the 3D images and plays the volume
cineloop. See "Reviewing 4D and Fetal STIC Images" on page 201.
Using Fetal STIC Soft Keys

Fetal STIC Preview Soft Keys

3D/4D Mode
Acquire Time
Compress
Map
Persist
Smooth
Color Fetal STIC Preview Soft Keys

3D/4D Mode
Acquire Time
Density
Filter
Map
Map Invert
Packet
Fetal STIC Acquisition Soft Key

Back to Preview
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About the Fetal Heart Rate

The HD11 system calculates the fetal heart rate after acquisition is complete. You
are prompted to accept the calculated rate. Verify that the calculated fetal heart
rate is reasonable. If you reject the calculated rate, the system returns to preview
mode. If you accept the calculated heart rate, the volumes are displayed. The fetal
heart rate is displayed on the right border of the display.
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Imaging Modes
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The HD11 system offers the following range of imaging features that provide
improved imaging and greater flexibility when you are imaging a patient:
"Biopsy Guides" on page 207
"Contrast Harmonic Imaging" on page 210
"Dual Imaging" on page 215
"iSCAN Intelligent Optimization" on page 220
"Panoramic Imaging" on page 222
"Quick Review" on page 229
"SonoCT Real-time Compound Imaging" on page 231
"Tissue Harmonic Imaging" on page 232
"Trapezoidal Imaging" on page 233
"XRES Adaptive Image Processing" on page 234
"Zoom" on page 235
Biopsy Guides
The Biopsy Guide feature helps you position transducers with biopsy needle guide
attachments. The Biopsy Guide displays guide lines on the image that show the
anticipated path of the needle. You can use these guide lines to ensure that the
needle or instrument is following the correct path.
NOTE
The biopsy guide for the L12-5 50 has infinite angle capability and can be installed
on either side of the transducer; it does not constrain the biopsy needle to a particular path. Because the needle path is not predictable, neither the Biopsy soft
key nor biopsy graphics appear on the display when you are using the L12-5 50. A
biopsy with this transducer is a manual action. For information about the
L12-5 50 biopsy guide, see the HD11 Getting Started.
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WARNINGS
Do not attempt to use the biopsy guide until you have read the instructions
for selecting the display, installing the sterile transducer cover, and verifying
alignment of the biopsy guide. See the HD11 Getting Started.
Biopsy guidelines are intended as guides only. Never use biopsy guidelines as
an absolute reference.
Biopsy guidelines do not take into account the possible bending of the needle.
The crossover depth is only an estimate. Never use the crossover depth
exclusively to identify the needle position on the biopsy guide. Never use the
crossover depth as a replacement for using the depth marker or for performing measurements.
Some biopsy guides can inadvertently be installed backward. When you turn
Biopsy Guide on for the first time during an exam, a warning appears on the display if the selected transducer supports one of these biopsy guides.
Turning the Biopsy Guide On

Before you can access the Biopsy Guide, the system must
Be in 2D mode only (for example, all Flow, Mmode, and Doppler modes are
off)
Be in a non-cardiac preset
Have a transducer that supports biopsy selected
Have Zoom turned off
Have the General Imaging or the OB/GYN application package installed
To turn Biopsy Guide on

1. Press Next to access the next level of 2D soft keys.
2. Press Biopsy to turn it on.
3. Press Biopsy again to select either the Gun or Needle setting.
4. If the selected transducer supports a biopsy guide with more than one needle
position, the Biopsy soft key displays the current crossover depth. Press
Biopsy to select the correct crossover depth.
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NOTES
If the selected transducer supports a biopsy guide that can inadvertently be

installed backward, a warning appears on the display.
The biopsy guide for the L12-5 50 has infinite angle capability. When you are
using the L12-5 50 transducer, neither the Biopsy soft key nor biopsy graphics appear on the display. For information about the L12-5 50 biopsy guide,
see the HD11 Getting Started.
About the Biopsy Guide Display

The following elements are displayed on the display when Biopsy Guide is turned
on:
The biopsy guide lines
The needle length crosshair
About the Biopsy Guide Lines

When Biopsy Guide is turned on, one or two dotted lines are displayed on the
image.
One line represents gun graphicsthis line indicates the most probable needle path.
Two lines represent needle graphicsthese lines make up a cone shape and
indicate the probable limits on the needle path.
When depth is changed, the biopsy display is redrawn to reflect the new relationships at the new depth setting.
Moving the Needle Length Crosshair

When Biopsy Guide is turned on, a thick blue crosshair, the needle length
crosshair, can be controlled by the trackball. It is initially hidden from view, however. You should use the trackball to make the crosshair visible on the display and
to position it at the presumed final location of the needle point.
The needle length, the distance from the top of the needle guide to the crosshair,
appears in the upper right corner of the display.
You can move the needle length crosshair to any position along the needle path by
using the trackball.
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To display and move the biopsy needle length crosshair

1. Press Select until Needle is highlighted on the Select menu.
2. Scroll the trackball downward to move the crosshair onto the display and to
move it along the anticipated needled path.

Contrast Harmonic Imaging is a type of harmonic imaging that is optimized for
imaging with contrast agents. You can use Contrast Harmonic Imaging with any
imaging mode and preset.
Contrast Harmonic Imaging is an option and is only available with harmonics-capable transducers, for example, C5-2 and S3-1.
In Contrast Harmonic Imaging, you need to adjust settings to improve your ability
to see the contrast agent while minimizing the destruction of the contrast agent.
See "Adjusting Settings for Contrast Harmonic Imaging" on page 212.
Before you use Contrast Harmonic Imaging soft keys, you need to assign one of
the Option keys to Contrast Harmonic Imaging. See "Assigning Option Keys" on
page 102.
Using Contrast Harmonic Imaging

NOTE
Before you can use the Contrast Harmonic Imaging option, it must be installed
and you must set up a Contrast Option key to use it. See "Installing Options" on
page 101 and "Assigning Option Keys" on page 102.
To use Contrast Harmonic Imaging

1. Press Contrast Option to turn on Contrast Harmonic Imaging. A Contrast
icon appears on the lower left corner of the display
2. Adjust the necessary settings to minimize the destruction of the contrast

agent and to improve your ability to see the contrast agent. See "Adjusting
Settings for Contrast Harmonic Imaging" on page 212.
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3. Press the Contrast Option key to cycle through and select a Contrast
fusion recipe.
4. To display the Contrast Timer, press Contrast Timer. Press Contrast
Timer again to start the timer. Press it again to stop it.
5. Press Next to cycle through the three levels of soft keys and make the appropriate setting adjustments.
6. Press FusionTHI to exit Contrast Harmonic Imaging.
NOTES
Contrast Harmonic Imaging is an option and is only available with harmonics-capable transducers: PA4-2, s4, C5-2, and s3-1.
The Contrast Option key is available only in Contrast mode. When Contrast
Harmonic Imaging is enabled, pressing Contrast Option cycles through the
Contrast fusion recipes.
Pressing Contrast Option will not turn off Contrast Harmonic Imaging. You
can turn it off only by pressing Fusion.
Using Contrast Harmonic Imaging Soft Keys

When Contrast Harmonic Imaging is turned on, Contrast-specific soft keys are
active. There are two more levels of soft keys available during Contrast Harmonic
Imaging.
To cycle through the Contrast Harmonic Imaging soft key sets
Press Next.
Contrast Timer
Flash
Power
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Adjusting Settings for Contrast Harmonic Imaging

You can prolong the life of the contrast agent and improve your ability to see the
contrast agent by adjusting certain system settings.
Every contrast agent is unique. Therefore, after you determine the proper settings for each contrast agent that you use, be sure to save those settings to a preset.
Improving Ability to See the Contrast Agent

Studies have shown that minimizing the exposure of contrast microbubbles to
ultrasound increases both the duration and the intensity of the contrast agent.
The following sections provide information for improving your ability to see the
contrast agent.
Adjusting the Gain
Receive gains that are set so that a little signal is present help maximize the ability
to see the contrast agent.
To adjust the Gain
Turn the Gain knob.
Moving the Transmit Focus Deeper
Making the mechanical index (MI) more uniform prevents contrast microbubbles
from being selectively destroyed in one section of the image. Changing the transmit focus affects both the maximum MI, which appears on the right side of the display, and the image depth at which this maximum occurs. Generally, to make the
MI more uniform, you move the transmit focus deeper. At times, too much
microbubble destruction will occur in the near field, particularly with cardiac
imaging. This will show up as swirling in the apex in cardiac images from the apical window. To minimize this effect, lower the Mechanical Index. If the swirling
persists, moving the transmit focus to mid cavity will help.
To move the transmit focus deeper
Press the down arrow on the Focus key.
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Decreasing the Dynamic Range

Dynamic range, or compression, determines the amount of acoustic dynamic
range that appears on the display. As the dynamic range setting is lowered, smaller
changes appear larger, making them better for visualizing the contrast agent.
When you are using a contrast agent, decrease the dynamic range to minimize
this effect.
To decrease the dynamic range
Press Compress.
Using the Appropriate Postprocessing Map
The postprocessing map determines the video intensity that is displayed for a
given acoustic intensity. Postprocessing maps A and E are recommended for imaging contrast agents. However, for purely qualitative studies and for offline analysis
of video intensity, use the linear postprocessing map A.
To specify a postprocessing map
Press Map.
Minimizing Ultrasonic Exposure

The following sections provide information for minimizing ultrasonic exposure.
Decreasing the Transmit Power If You Are Not Using Triggering
An effective way to prolong the life of the contrast agent is to lower the transmit
power. One indication of transmit power is the mechanical index (MI), which
appears in the border on the right side of the display.
Although higher transmit power causes shorter contrast effect, the higher power
generates greater nonlinearities, which results in a stronger harmonic signal.
Using a lower frame rate allows the destroyed microbubbles to replenish before
the next frame. Therefore, Philips recommends using a higher power setting
when using triggering.
To change the transmit power, do one of the following
Turn the Power knob.
When Contrast Harmonic Imaging soft keys are displayed, press the Power
soft key.
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NOTE
The power limits of the HD11 ultrasound system adhere to all FDA guidelines
concerning patient and operator safety. For more safety information, see the
HD11 Getting Started.
Using Triggering
Changing the triggering settings allows you to control how often and when the
image is updated so that you can reduce the destruction of the contrast agent.
You can trigger off of the patients ECG or you can use a timer. When you are
using triggering, increase the transmit power.
To use triggering
1. Press Setup.
2. Use the Trigger soft key to specify the triggering source.
If you need temporal resolution (for endocardial border definition, for example), Philips does not recommend the use of triggering.
About Contrast Harmonic Imaging Principles

The principle of Contrast Harmonic Imaging is based on the fact that microbubbles (which have diameters between 1 and 8 micrometers) resonate when excited
by ultrasonic energy in the diagnostic frequency range (1 to 10 MHz). Resonating
microbubbles undergo large changes in their diameters as they contract and
expand in the ultrasonic field. If the alternate expansion and contraction phases
do not produce equal changes in bubble size, a nonlinear response occurs. The
resulting nonlinear response of the contrast agent then contains harmonics of the
transmitted (fundamental) frequency.
Tissue produces harmonics as well, but of much lower intensity. Therefore, when
you use contrast agents with Contrast Harmonic Imaging, the system displays the
energy at the second harmonic rather than the fundamental frequency, resulting in
considerably more backscatter in the microbubbles than the tissue. The use of
harmonic imaging for imaging contrast agents has been shown to increase the sensitivity and the duration of the contrast agent.
You can adjust settings to prolong the life of the contrast agent and to improve
your ability to see the contrast agent.
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About Acoustic Artifacts in Contrast Imaging

Artifacts can be generated during Contrast imaging by the interaction of the contrast agent, the ultrasound beam, and the anatomy.
A rib artifact appears as a dark, linear area in a lateral part of a sector image. Rib
artifacts occur when a rib blocks scan lines, preventing microbubbles in the ribs
shadow from resonating. You can minimize or eliminate rib artifacts by repositioning the transducer in relation to the ribs.
Shadowing or attenuation is a common artifact that appears as a dark area, generally in the mid field to far field. Shadowing is caused by administering the contrast
agent at a high rate or concentration. The resulting high concentration of
microbubbles in an area causes backscatter of the ultrasound energy, preventing
sufficient energy from reaching the area behind the concentration. Shadowing is
alleviated as the contrast agent becomes diluted. You can avoid shadowing by
administering the contrast agent at a lower rate and concentration.
Swirling occurs when the higher level of ultrasound energy in the near field disrupts or destroys the microbubbles in the contrast agent. Factors that contribute
to swirling are high MI, low blood flow near the apex, and low concentration of
contrast agent. Frame rate can also have an effect on swirling.
Dual Imaging
Dual Imaging allows you to display two images side by side. One image can be live
while the other is held inactive. Or both images can be frozen.
Only one image can be active on the display at a time. If one image is live, it is by
default the active image, and the other image is held inactive.
If you press Freeze, both images are frozen. Either of them can be the active one.
You can scroll through the frames of the active image by using Quick Review.
Dual Imaging is available in:
"2D Mode" on page 153
"Tissue Harmonic Imaging" on page 232
"Color Mode" on page 170
"Color Power Angio (CPA) Mode" on page 173

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About Single Buffer and Two Buffer Modes

The HD11 system has two buffer settings that affect full-screen and Dual modes.
A buffer is temporary memory where image frames are accumulated for Quick
Review. You select the buffer mode of operation with the Dual button on the System Setup window, but the buffer mode affects both Dual and full-screen operation.
Single Buffer Mode
When Single Buffer mode is active with a full-screen display, all of the systems
Quick Review memory is organized into a single buffer.
When Single Buffer mode is active and Dual is turned on (with the Dual, Left, or
Right) controls, the single buffer is split in two.
The older half of the single buffer is flushed and becomes the new active Dual
buffer, associated with the active Dual side. You select the active buffer or side
with the Left and Right keys. The active buffer or side is the one where new
frames are accumulated when Freeze is off or the one the at is scrollable when
Freeze is on.
The most recent half of the single buffer, accumulated just before Dual is turned
on, is retained at the initial contents of the inactive Dual buffer. The most recent
frame, before Dual is turned on, is initially displayed as the held image on the inactive side.
When Dual turns off, both buffers are flushed and combined back into a single
buffer, accumulating new, live frames. When Single Buffer mode is active and Dual
turns off, Freeze is forced off.
Two Buffer Mode

In Two Buffer mode, the quick review memory is organized into two separate
buffers.
When Two Buffer mode is active with a full-screen display, the transducer dot
indicates whether the Right buffer or the Left buffer is active. Un Two Buffer
full-screen mode, the Left and Right keys switch the active buffer, but do not turn
on Dual mode.
When Two Buffer mode is active and Dual turns on, through the Dual control, the
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played on the right. the buffer that was active in full-screen mode remains the
active on when Dual turns on. The Left and Right keys switch the active buffer.
When Dual turns off, both buffers are retained exactly as they were in Dual
mode, with the active buffer remaining active and displayed full-screen. The inactive buffer is hidden but saved.
About The Active Buffer Indicators

In Single Buffer mode, the active image displays an open circle, the transducer orientation dot, on the upper left of an uninverted image.
In Single Buffer Dual display, the active image displays the transducer dot with an
open circle, while the inactive image displays a solid circle.
In Two Buffer full-screen display, the transducer dot becomes a two-toned oval:
When the right half of the oval is brighter, the displayed frame is stored in the
right buffer.
When the left half of the oval is brighter, the displayed frame is stored in the
left buffer.
In Two Buffer Dual Display, the active image is marked with a bright oval and the
inactive image is marked with a dim oval:
NOTES
You can use a different preset or transducer to image each side in Dual or for
each buffer in Two Buffer mode.
To acquire Dual images into Cine Review, press Freeze and then Acquire.
To take measurements across Dual images, both images must have been
obtained from the same transducer at the same the depth setting with Zoom
off.
When you acquire Dual images into Cine Review with Color on one side and
CPA n the other, only the active images flow data is displayed in review.
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Using Two Buffer and Two Buffer Dual Imaging

In Two Buffer Dual Imaging, while you are viewing a full-screen image, you can
change the active image by pressing its corresponding buffer key (Left or Right).
To view images side-by-side in Two Buffer Dual Imaging
1. Activate Dual Imaging by doing one of the following:
Press Dual.
If you are in Color Mode or Color Power Angio, press Dual twice. Pressing it once activates Color Compare or Color Power Angio Compare.
2. To activate the inactive image, press its key (Left or Right).

3. To turn on Color mode or Color Power Angio for the active image, press
Color or CPA.
4. To use Color Suppress or Color Power Angio Suppress on the active image,
press Freeze and then Color or CPA.
5. To magnify the active image, turn the Zoom knob.
6. To view a full-screen image, press Dual or 2D to exit Dual Imaging. The
image that was active in Dual Imaging is displayed.
NOTE
When the images are frozen and you switch between full-screen and Dual Imaging, the frame selected by Quick Review scrolling stays the same for the active
buffer, the Color Suppress or Color Power Angio Suppress state does not change,
and the magnification stays the same.
Using Single Buffer Dual Imaging

To use Single Buffer Dual Imaging
1. Press Dual to activate Dual Imaging.
2. Change which image is active by doing one of the following:
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Press Left or Right.
If you are in Color Mode or Color Power Angio, press Left or Right
twice. Pressing the key once activates Color Compare or Color Power
Angio Compare.
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3. To turn on Color mode or Color Power Angio for the active image, press
Color or CPA.
4. To use Color Suppress or Color Power Angio Suppress on the active image,
press Freeze and then Color or CPA.
5. To magnify the active image, turn the Zoom knob.
6. Press Dual or 2D to exit Dual Imaging. The image that was active in Dual
Imaging is displayed.
Using Quick Review in Dual Imaging

In Dual Imaging, you can freeze both images and use Quick Review on the active
image.
To use Quick Review while you are in Dual Imaging
1. Press Freeze.
Both images are frozen. The active image is labeled with the Quick Review
icon.
2. To scroll through the active image frame by frame, move the trackball.
3. To change which image is active, press Left or Right.
4. To unfreeze the active image, press the Freeze again.
NOTE
In Two Buffer, when the images are frozen, and you switch between full-screen
imaging and Dual Imaging, the frame selected by Quick Review scrolling stays the
same for the active image.
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iSCAN Intelligent Optimization

iSCAN Intelligent Optimization automatically optimizes key imaging settings during either 2D or Doppler Trace acquisition. 2D iSCAN optimization adjusts the
TGC, 2D Gain, and Compress settings for the current image. Doppler iSCAN
optimization adjusts the baseline and scale.
When 2D iSCAN optimization is on, the following iSCAN icon appears on the
display:
You must be in 2D mode to turn 2D iSCAN optimization on or off. 2D iSCAN

optimization remains on if you switch to another mode.
The iSCAN Gain soft key allows you to adjust the default 2D iSCAN optimization gain.
2D iSCAN optimization is available with all transducers and in all non-cardiac presets. 2D iSCAN optimization is not available with nonimaging transducers.
About 2D iSCAN Intelligent Optimization

Pressing iSCAN during live 2D acquisition optimizes the system for imaging. The
image will freeze for a very short period of time while the system evaluates grayscale distribution to optimize TGC, Gain, and Compress settings for the image.
2D iSCAN Tips
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You can adjust the TGC, Gain, and Compress settings after turning 2D iSCAN
optimization on. They are treated as adjustments to the iSCAN optimization
settings, not to your original settings.
When 2D iSCAN optimization is on, pressing and holding iSCAN will turn it
off.
When you turn 2D iSCAN optimization off, the pre-iSCAN optimization 2D

Gain and Compress values are restored and the TCC locations determine the
TGC curve.
2D iSCAN is turned off automatically when any preset is activated or there is

a transducer change.
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Using 2D iSCAN Intelligent Optimization

To use iSCAN optimization
1. In 2D mode, press iSCAN to optimize the image.
The iSCAN icon appears on the display.
2. To reoptimize the image, press iSCAN again.
3. To turn 2D iSCAN optimization off, press and hold iSCAN until the iSCAN
icon no longer appears on the display.
The original gain and compression settings are restored.
When you turn 2D iSCAN optimization on, if the transducer does not make
complete contact with the skin, you must narrow the image width and press
iSCAN again to reoptimize the image. See "Resizing and Repositioning an Image"
on page 152.
Adjusting the Default 2D iSCAN Gain

You can adjust the default brightness of images generated with 2D iSCAN optimization with the iSCAN Gain soft key in the Setup window.
To adjust the default 2D iSCAN optimization gain
1. Press Setup.
2. Press Next.
The iSCAN Gain soft key appears below the Setup window.
3. Press iSCAN Gain to increase or decrease the default iSCAN gain.
4. Press Setup to exit Setup.
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Panoramic Imaging
In Panoramic Imaging, you acquire a series of images in 2D mode. These images
are called the panoramic data set. This data set is compiled to show a larger area
of anatomy.
As you scan, the image frames are held in memory and are then electronically
stitched together for display. The panoramic image is static and appears in grayscale.
To use Panoramic Imaging, you must first acquire the panoramic data set in Panoramic Preview. You can then review and edit the panoramic image in Panoramic
Render.
Panoramic Imaging does not support up/down inverted images. Up/down inverted
images appear uninverted in Panoramic Imaging.
About the Accuracy of Panoramic Images

If the skin is moved significantly or the tissue is compressed to various degrees by
the transducer during the acquisition of a panoramic data set, resulting artifacts
can affect the quality and reliability of the rendered panoramic image.
A panoramic image acquired along a radius smaller than 30 cm (such as a neck
transverse or an arm or a leg transverse) may not correspond to the real anatomy. Therefore, do not use such an image to make a measurement or a diagnosis
based on anatomic geometry.
WARNING
If you determine by the previous criteria or by your own clinical training or experience that a panoramic image is poorly reconstructed, do not use the image to
make dimensional measurements. If for any reason such an image is used to make
a measurement, do not use the measurement to make diagnostic decisions.
If you have any doubt about image-related artifacts or the accuracy of the panoramic image, reacquire the panoramic data set.
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Acquiring a Panoramic Data Set

When you use Panoramic Imaging, you must first acquire a series of 2D images,
called the panoramic data set.
To acquire a panoramic data set
1. Press Pano to enter Panoramic Preview.
2. To optimize your image, use system controls and soft keys.
3. Press Scan Direction to specify the scanning direction.
4. Begin moving the transducer at a constant speed across the area of interest.
NOTE
Avoid rocking and tilting the transducer. Do not move the transducer backward.
5. Press Acquire to acquire the panoramic data set. Continue moving the transducer during acquisition.
6. To complete the acquisition, press Acquire again.
NOTE
Imaging automatically stops when the maximum number of frames is acquired.

7. If you decide not to complete the acquisition, press Cancel Acquire.
When the acquisition is complete, the panoramic image is displayed so you can
review or edit it.
NOTES
When you enter Panoramic Preview, SonoCT Real-time Compound Imaging

and XRES Adaptive Image Processing are turned off and persistence is set to
0. The result is a coarser image than you had when Panoramic imaging was
turned off.
When you return to 2D imaging from Panoramic Imaging, your previous 2D
image settings are restored.
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Using Panoramic Preview and Acquisition Soft Keys

2D soft keys are available during Panoramic Imaging, depending upon the chosen
preset and transducer. In addition, the following soft keys are available during Panoramic Imaging.
Panoramic Preview Soft Key

Scan Direction
Panoramic Acquisition Soft Key

Cancel Acquire
Exiting Panoramic Imaging

To exit Panoramic Imaging
Press Pano or 2D.
Panoramic Image Review

After you acquire the panoramic data set, the system enters Panoramic Render.
The panoramic image appears on the display. You can manipulate it by using the
system control panel and soft keys.
Using Panoramic Render Soft Keys

The following soft keys are available when you are reviewing panoramic images in
Panoramic Render mode.
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Archive
Re-Acquire
Reset
Save to CD
NOTE
To display or hide the cursor in Panoramic Render mode, press Enter. When the
cursor is hidden, the trackball function is assigned to the highlighted function on
the Select menu.
Moving a Panoramic Image Around the Display

To reposition the panoramic image
1. If the cursor appears on the display, press Enter to remove it.
2. If Zoom appears on the Select menu, press Zoom.
Pan and Rotate appear on the Select menu.
3. Press Select until Pan is highlighted in the bottom right corner of the display.
4. Move the trackball to reposition the panoramic image.
Rotating a Panoramic Image

To rotate the panoramic image
1. If the cursor appears on the display, press Enter to remove the cursor from
the display.
2. If Zoom appears on the Select menu, press Zoom.
Pan and Rotate appear on the Select menu.
3. Press Select until Rotate is highlighted.
4. Move the trackball to rotate the image.
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Changing the Point of Rotation

To change the point of rotation
1. Press Enter until the cursor appears on the display.
2. Use the trackball to move the cursor to the point you want the panoramic
image to rotate around.
3. Press Enter again to set the new point of rotation.
Related Topics
Magnifying Panoramic Images

There are two methods for magnifying a panoramic image, using the Depth key
or the Zoom knob.
To magnify a panoramic image by using the Depth key
Press Depth to increase or decrease magnification.
To magnify a panoramic image by using the Zoom knob
1. If the cursor appears on the display, press Enter to remove it.
2. If Pan and Rotate appear on the Select menu, press Zoom.
Zoom is highlighted on the Select menu.
3. Move the trackball up or to the left to increase magnification. Move it down
or to the right to decrease magnification.
Performing Measurements on a Panoramic Image

You can perform only 2-point measurements on a panoramic image.
You can delete measurements on a panoramic image, but you cannot reactivate
measurements.
Whenever possible, perform measurements on a single acquired image frame.
NOTE
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The calipers and other measurement displays look different from when Panoramic
Imaging is off. Measurement functionality is identical, however, whether Panoramic
Imaging is on or off.
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You can perform a 2-point (linear) measurement to measure the length of a structure or a length of time. As you perform unlabeled measurements, the results of
the measurements and of the Quick Calcs appear in the results box on the display.
To perform a 2-point measurement on a panoramic image
1. Press Caliper.
2. Use the trackball to position the caliper that appears on the image and press
Enter or Caliper.
A second caliper appears on the display, Endpt 2 is highlighted on the Select
menu, and the length appears in the results box in blue.
3. Use the trackball to position the second caliper.
To approve the measurement, press Enter.
To approve the measurement and start a new measurement, press Caliper.
When complete, the measurement changes to green.
Placing a Title Above a Panoramic Image

You can place a title above a panoramic image before you save the panoramic data
set. It appears on the upper left corner of the display.
To place a title above a panoramic image
1. Press Text.
2. Press the Title soft key.
If no title currently exists, a cursor appears on the upper left corner of the
display. Type a title for the panoramic image.
If a title already exists, the title is selected so that you can edit it.
To delete the title, press Clear.
4. When you are finished, press Text again.
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Placing a Label on a Panoramic Image

You can type a label anywhere on a panoramic image.
To place a label on a panoramic image
1. Press Text.
2. Use the trackball to move the I cursor to the location where you want to
type a label.
3. Type the label.
4. You can move, edit, or delete the label:
To move a label, use the trackball to move the cursor over the label, press
Enter, and use the trackball to move the label. Press Enter again to reposition the label.
To edit a label, use the trackball to move the cursor over the label until
the cursor starts to blink. Use the Backspace key to remove characters.
Then type new characters.
To delete a label, use the trackball to move the cursor over the label.
Press Clear. If you press Clear without moving the cursor over a label, all
labels are deleted.
5. When you are finished, press Text again.
Saving Panoramic Images and Data Sets

You can save panoramic images and data sets in DICOM format. Or you can save
only panoramic images in PC format to a CD.
To save panoramic images and data sets in DICOM format
1. In Panoramic Render mode, press Archive.
2. Select the appropriate option to save the data set or the still image.
3. Click Save.
The image title is saved with the data set. The title, labels, and measurements are
saved with the still image.
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Saving Panoramic Images to CD

To save panoramic images to CD
1. In Panoramic Render mode, press Save to CD.
2. Type the name for the image in the File Name field.
3. Click Save.
Quick Review
Quick Review allows you to interrupt live imaging and scroll through a loop, scroll
through a trace, or cause a loop to play back.
If you are in 2D mode, Color Power Angio mode, or Color mode, you can
either scroll through the loop frame by frame or cause the loop to play back
repeatedly.
If you are in CW Spectral Doppler mode, PW Spectral Doppler mode, or

M-mode Trace, you can scroll through either the image loop or the trace.
When you return to live imaging, the Quick Review images are erased from
memory.
Using Quick Review

To use Quick Review
1. While in live imaging, press Freeze.
The image freezes on the current frame. Any measurements are removed
from the image.
2. If you are in CW Spectral Doppler mode, PW Spectral Doppler mode, or
M-mode Trace, do one of the following:
To scroll through the image loop, press Select until Image is highlighted on
the Select menu.
To scroll through the trace, press Select until Trace is highlighted on the
Select menu.
3. Move the trackball to the right or the left to scroll forward or backward
frame by frame.
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4. To save the frame to the patient study, press Acquire.

5. Press Freeze again to return to live imaging.
Using Quick Review Soft Keys

In Quick Review, three related soft keys become active. Other soft keys appear as
well, depending on the mode you are in. If you are in M-mode, PW Doppler
mode, or CW Doppler mode, the soft keys apply to the image when Image is
highlighted on the Select menu. The soft keys apply to the trace or the spectrum
when Trace is highlighted.
Edit End
Edit Start
Replay
Playing Back a Quick Review Loop

You can play back a Quick Review loop if you are in 2D mode, Color Power
Angio mode, or Color mode.
To play back a Quick Review loop
1. While in live imaging, press Freeze.
The image freezes on the current frame.
2. Press Replay to play back the loop.
3. To increase or decrease the playback speed, press top or the bottom of the
Replay soft key.
The loop speed appears on the soft key label, written as a percentage of actual
speed. The loop speed and the location of the frame appear on the bottom
right corner of the display.
4. To adjust the endpoints of the loop, use the Edit Start and Edit End soft
keys.
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5. To save the loop to the patient study, press Acquire.

NOTE
Only the portion of the loop between the start and the end markers is saved to
the study.
6. To scroll through the loop, press Select and use the trackball.
7. Press Freeze to return to live imaging.
SonoCT Real-time Compound Imaging

SonoCT Real-time Compound Imaging provides the following benefits:
Reduces speckle and improves image smoothness
Enhances contrast resolution
Improves contrast and definition of tissues interfaces.
SonoCT imaging takes successive frames at different steering angles and blends
them together.
You can use SonoCT imaging during:
Live 2D acquisition, including harmonic imaging modes
Freehand 3D and motorized 3D imaging (not available in 4D)
SonoCT imaging is available only for linear and curved linear transducers.
SonoCT imaging works well in conjunction with XRES Image Processing.
About SonoCT Imaging

SonoCT imaging acquires frames at different steering angles and averages the pixels of each frame together, blending holes and filling seams. A maximum of 11
angles are available, depending upon the selected transducer.
When SonoCT imaging is on, the following icon appears on the display, above the
Select menu:
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SonoCT Imaging Modes

SonoCT imaging has the following modes:
Survey mode limits the number of angles to three and is typically used when
positioning the transducer to an optimal scanning location.
Target mode begins the full SonoCT imaging frame processing, with the number of frames determined by the transducer.
NOTES
In 3D imaging, only Survey mode is available.

If Trapezoidal Imaging is on, turning SonoCT imaging on will turn Trapezoidal
Imaging off.
Using SonoCT Imaging

To use SonoCT imaging
1. Press the SonoCT soft key to enter Survey mode.
appears on the side border.
2. Position the transducer over the area of interest.
3. Press the SonoCT soft key to enter Target mode.
4. Press the SonoCT soft key again to turn it off.

Tissue Harmonic Imaging (THI) is a 2D mode in which the transducer receives at
twice the transmit frequency. THI reduces artifacts, haze, and clutter from the
image. It also increases contrast resolution and border delineation. It can be helpful when imaging areas that are filled with fluid, such as the gallbladder or heart
chambers and is useful in difficult-to-image patients, as well.
THI can be used in conjunction with "SonoCT Real-time Compound Imaging" on
page 231 and "XRES Adaptive Image Processing" on page 234.
NOTE
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In THI, the frame rate is generally limited to 30 Hz for the black-and-white image.
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Using Tissue Harmonic Imaging

To use Tissue Harmonic Imaging
1. Press THI to turn on Tissue Harmonic Imaging. An icon like the one that follows appears on the lower left corner of the display:
2. Adjust the 2D Gain and the TGC controls.

4. To change the fusion recipe, press THI until you find the recipe you want.
5. Press Fusion to exit Tissue Harmonic Imaging.
NOTE
Tissue Harmonic Imaging is only available with harmonics-capable transducers.
Trapezoidal Imaging
Trapezoidal Imaging adds an additional imaging area by changing a linear transducer's rectangular image to a trapezoidal shape. The extended field of view is
often useful in vascular and small parts presets.
The linear portion of the image becomes slightly narrower when Trapezoidal
Imaging is on. The amount of narrowing varies with transducer and imaging depth;
deeper imaging depths cause more narrowing of the linear portion of the image.
You can use Trapezoidal Imaging when:
General Imaging or Vascular application is installed.
A linear transducer is selected.
Biopsy and Zoom are both off.
SonoCT imaging is not available in Trapezoidal Imaging.
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Using Trapezoidal Imaging

To use Trapezoidal Imaging
1. Press Next to access the next level of soft keys.
2. Press Trap to turn Trapezoidal Imaging on or off.
If you turn Trapezoidal Imaging on when you are in 2D mode, it remains on if you
switch to another mode.
NOTE
When you turn on Trapezoidal Imaging, SonoCT imaging is turned off. The result
is a coarser image than you had when Trapezoidal Imaging was turned off.
XRES Adaptive Image Processing

The XRES Adaptive Image Processing feature enhances images without altering
the image resolution. XRES processing provides the following benefits:
Improves contrast resolution
Reduces artifacts
Improves visibility of tissue texture patterns
Improves border definition and continuity
Works well in conjunction with SonoCT imaging.
XRES is not available with M-mode or PW trace.

In 4D and Panoramic Imaging, XRES is available only on rendered images.
XRES processing affects only the black-and-white portion of the 2D or 3D
images; it does not affect flow data or traces.
When XRES processing is on, the XRES icon appears on the side border of the
display.
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Using XRES processing

To turn XRES processing on and off
Press XRES.
When XRES processing is on, the following icon appears on the display, above the
Select menu:
Zoom
The HD11 system has two zoom features:
Zoom enables you to enlarge an isolated area of the original image. It offers
improved image resolution because it recalibrates the image data in order to
enlarge it. Zoom can be performed only on live images.
Magnify enables you to incrementally enlarge the entire image, regardless of

the area of interest. It offers lower image quality but faster results than Zoom
because it does not reprocess the acoustic data. Magnify can be performed on
live and frozen images.
Both Zoom and Magnify are controlled with the Zoom knob.
Push Zoom to enable Zoom.
Turn Zoom to enable Magnify.
The Zoom and Magnify features function differently depending upon the selected
mode.
Using Zoom During Live Imaging

To use Zoom during live imaging
1. Press the Zoom knob. A zoom box appears on the image.
2. Use the trackball to change the size and position of the zoom box so that the
zoom box contains the area that you want to enlarge.
3. Press Zoom again to enlarge the selected area.
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4. To change the size or position of the zoomed portion of the image, press
Select while the image is live until Size or Position is highlighted on the
Select menu. Use the trackball to resize or reposition the image.
5. Press Zoom or 2D to exit Zoom.
Magnifying Live and Frozen Images

You can magnify live and frozen images in grayscale or in a flow mode.
To magnify a live image
Do one of the following:
Turn Zoom clockwise to increase magnification.
Turn Zoom counterclockwise to decrease magnification.
To magnify a frozen image

1. Press Freeze.
2. Turn Zoom clockwise to increase magnification. Turn it counterclockwise to
decrease magnification.
3. To pan around the entire image, press Select until Pan is highlighted on the
Select menu. Use the trackball to pan the image.
4. To acquire the portion of the image visible on the display, press Acquire.
NOTE
You cannot magnify images when an M-mode trace is displayed. However, you can
apply Zoom to both the 2D image and the M-mode trace together.
Using Color or Color Power Angio Zoom

Color Zoom shows color flow in zoomed image. Color Power Angio (CPA)
Zoom shows angio flow in a zoomed image.
To use Color or CPA zoom
1. Press Color or CPA to turn Color or CPA on.
2. To change the size and position of the color or angio box, use the trackball.
3. Press Zoom. A zoom box appears on the image.
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4. Use the trackball to change the size and position of the zoom box so that it
contains the area that you want to magnify.
NOTE
As you resize and reposition the zoom box, the color or angio box moves around
the image to remain centered inside the zoom box.
5. Press Zoom again. The zoomed area appears.
6. To change the size and position of the color or angio box, use the trackball.
NOTE
The size of the color or angio box is limited to the size of the zoomed image.
7. To change the size and position of the zoom box:
a. Press Color or CPA to turn Color or CPA off and assign the trackball to
the zoom box.
b. Use the trackball to change the size and position of the zoom box.
c. Press Color or CPA to turn Color or CPA back on.
8. Press Zoom to exit zoom.
Using M-mode Zoom

When you are in M-mode, you can zoom a portion of the reference image by
entering M-mode Zoom. In M-mode Zoom, the M-mode trace represents only
the information in the zoom box.
You can also magnify the M-mode image by turning the Zoom knob.
To use M-mode Zoom
1. Press Mmode.
2. Use the trackball to move the M-mode reference line to the anatomy of interest.
3. Press Mmode again.
The M-mode trace appears with the reference image.
NOTE
If you are in a cardiac preset, the M-mode trace appears the first time you press
Mmode.
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4. Press Zoom. A zoom box appears on the image.

5. Use the trackball to change the size and position of the zoom box so that it
contains the area that you want to enlarge.
6. Press Zoom again. The enlarged image appears on the display.
7. Exit Zoom and M-mode.
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To exit M-mode and remain in Zoom, press Mmode.
To exit Zoom and remain in M-mode, press Zoom.
To exit M-mode Zoom, press 2D or Mmode and Zoom.
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10
10 Imaging Tips
Imaging tips help you improve the appearance of your image or solve problems
you encounter while imaging. Imaging tips are available for several imaging modes.
"Imaging Tips for 2D Mode" on page 239
"Imaging Tips for M-mode" on page 242
"Imaging Tips for PW Doppler Mode" on page 243
"Imaging Tips for CW Doppler Mode" on page 245
"Imaging Tips for Color Mode" on page 248
"Imaging Tips for Color Power Angio Mode" on page 251
Imaging Tips for 2D Mode

Click the statement that best describes your goal:
"I need to increase the penetration." on page 239
"I need to improve the resolution." on page 240
"I want the image to be less soft, hazy, or gray." on page 240
"I want the image to be less contrasty or grainy." on page 241
"I need to be able to see the soft tissue." on page 241
"I want the fluid-filled structures to have fewer echoes." on page 242
I need to increase the penetration.

Possible Actions:
Press Fusion to try the P (Penetration) setting.
Lower the position of the focal zones by pressing Focus.
Increase the gain by turning 2D Gain clockwise.
Move the bottommost TGC slide controls to the right.
Increase the power by turning Power clockwise.

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Imaging Tips
NOTE
After adjusting any control, always check the position of the transducer.
I need to improve the resolution.

Possible Actions:
NOTE
Press Fusion to try the R (Resolution) setting.
Press Focus to move the focal zone to the area of interest.
If you are using a linear or a curved linear array transducer, press Focal
Zones to increase the number of focal zones.
If you are using a linear transducer, turn Angle to achieve the optimal angle
for the 2D structure.
Adjust the compression by pressing Compress.
Use the trackball to decrease the image width.
Increase the persistence by pressing Persist.
After adjusting any control or soft key, always check the position of the transducer.
I want the image to be less soft, hazy, or gray.

Possible Actions:
240
Decrease the gain by turning 2D Gain counterclockwise.
Move the TGC slide controls to the left.
Change the grayscale contrast by pressing Map.
Decrease the compression by pressing Compress.
Decrease the Smooth setting by pressing Smooth.
Sharpen the image by decreasing the persistence by pressing Persist.
If you are using a transducer that supports harmonics, press THI to turn on
Tissue Harmonic Imaging.
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NOTE
10
I want the image to be less contrasty or grainy.

Possible Actions:
NOTE
Change the grayscale postprocessing map to a softer, less contrasty map by

pressing Map.
Increase compression by pressing Compress.
Increase the Smooth setting by pressing Smooth.
Press Fusion to select the R setting.
I need to be able to see the soft tissue.

Possible Actions:
NOTE
Reposition the transducer.
Increase the gain by turning 2D Gain clockwise.
Move the TGC slide controls to the right.
Adjust the compression by pressing Compress.
Press Fusion to try a different fusion setting.
Adjust the Smooth setting by pressing Smooth.
Press Chroma to improve the contrast resolution.
Increase the power by turning Power clockwise.
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Imaging Tips
I want the fluid-filled structures to have fewer echoes.

Possible Actions:
NOTE
Decrease the gain by turning 2D Gain counterclockwise.
Move the TGC slide controls to the left.
If you are using a transducer that supports harmonics, press THI to turn on
Tissue Harmonic Imaging.
Choose a more contrasty postprocessing map by pressing Map.
Decrease the Smooth setting by pressing Smooth.
Imaging Tips for M-mode

"I want to reduce noise in the M-mode trace." on page 242
"I want to increase the size of the M-mode trace." on page 243
I want to reduce noise in the M-mode trace.

Possible Actions:
NOTE
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Decrease the gain by turning Doppler Gain counterclockwise.
Select a map with more contrast by pressing Map.
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I want to increase the size of the M-mode trace.

Possible Actions:
NOTE
Change the M-mode format to Small over large or Full screen.
Press Resize 2D Image, if necessary, and press Zoom to make the M-mode
image and trace larger.
After adjusting any soft key, always check the position of the transducer.
Imaging Tips for PW Doppler Mode

"I want the Doppler to be more sensitive." on page 243
"I need to be able to see a Doppler signal that is audible, but not visible." on
page 244
"I need to unwrap an aliased spectrum." on page 244
"I want to reduce artifacts and noise in the spectrum." on page 244
"I want the 2D reference image to be updated." on page 245
"I want to display low-velocity signals." on page 245
I want the Doppler to be more sensitive.

Possible Actions:
NOTE
Increase the gain by turning Doppler Gain clockwise; increase the compression by pressing Compress; and decrease the Reject setting by pressing
Reject to increase the amount of Doppler information displayed.
Turn on Adaptive Doppler. Press Setup, click the Mode tab, and select the
Adaptive Doppler check box.
Increase the size of the PW sample volume gate by pressing Gate.
Decrease the scale by pressing Scale.
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Imaging Tips
I need to be able to see a Doppler signal that is audible, but

not visible.
Possible Actions:
NOTE
Adjust the scale by pressing Scale.
Increase the gain by turning Doppler Gain clockwise.
Increase the compression by pressing Compress, and decrease the Reject

setting by pressing Reject to increase the range of echoes displayed.
Decrease the Filter setting by pressing Filter.
If you are using a linear transducer, press Steer to adjust the cursor steer.
I need to unwrap an aliased spectrum.

Possible Actions:
NOTE
Press Baseline to unwrap the signal.
Increase the scale by pressing Scale to increase the range of displayed velocities and to decrease the size of the waveform.
After adjusting any control, always check the position of the transducer.
I want to reduce artifacts and noise in the spectrum.

Possible Actions:
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Increase the Filter setting by pressing Filter.
Increase the Reject setting by pressing Reject.
Decrease the power by turning Power counterclockwise.
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NOTE
10
I want the 2D reference image to be updated.

Possible Actions:
NOTE
Make sure that the Delay or the Update soft key is not set to 2D Hold On.
Change the Update interval at which your 2D image is updated by pressing

the Update soft key.
Increase the ECG Gain setting. Press Setup. The ECG Gain soft key setting
is displayed. Press ECG Gain to adjust the setting in cardiac presets.
Incardiac presets, press Enter or Update to manually update the 2D image.

Press Enter or Update again to make the spectral trace live again.
Check the ECG leads for proper placement.
I want to display low-velocity signals.

Possible Actions:
NOTE
Imaging Tips for CW Doppler Mode

"I want the Doppler to be more sensitive." on page 246
"I need to be able to see a Doppler signal that is audible, but not visible." on
page 246
"I want to reduce artifacts and noise in the spectrum." on page 247
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Imaging Tips
"I want the 2D reference image to be updated." on page 247
"I want to display low-velocity signals." on page 247
I want the Doppler to be more sensitive.

Possible Actions:
NOTE
Increase the gain by turning Doppler Gain clockwise; increase the compression by pressing Compress; and decrease the Reject setting by pressing
Reject to increase the amount of Doppler information displayed.
Turn on Adaptive Doppler. Press Setup, click the Mode tab, and select the
Adaptive Doppler check box.
If you are using a linear transducer, adjust the Steer setting to achieve the
optimal angle of flow.
Use the trackball to move the focus diamond on the CW reference line over
the area where the greatest sensitivity is needed.
I need to be able to see a Doppler signal that is audible, but

not visible.
Possible Actions:
NOTE
246
Adjust the scale by pressing Scale.
Increase the gain by turning Doppler Gain clockwise.
Increase the compression by pressing Compress and decrease the Reject

setting by pressing Reject to increase the range of echoes displayed.
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10
I want to reduce artifacts and noise in the spectrum.

Possible Actions:
NOTE
Increase the Reject setting by pressing Reject.
Decrease the power by turning Power counterclockwise.
I want the 2D reference image to be updated.

Possible Actions:
NOTE
Make sure that the Delay or Update soft key is not set to 2D Hold On.
Change the Update interval at which your 2D image is updated by pressing

the Update soft key.
Increase the ECG Gain setting. Press Setup. The ECG Gain soft key setting
is displayed. Press ECG Gain to adjust the setting.
Press Enter or Trace to manually update the 2D image. Press Enter or

Trace again to make the spectral trace live again.
Check the ECG leads for proper placement.
I want to display low-velocity signals.

Possible Actions:
NOTE
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Imaging Tips
Imaging Tips for Color Mode

"I want the color to be more sensitive." on page 248
"I want the color to have less noise, flashing, or fewer artifacts." on page 248
"I want the color to be less speckled or fragmented." on page 249
"I need to improve the color filling." on page 249
"I want to unwrap aliased signals." on page 250
"I need to increase the frame rate." on page 250
I want the color to be more sensitive.

Possible Actions:
NOTE
Increase the gain by turning Color Gain clockwise.
Use the Focus key to place the focal zone at the area of interest.
Change the Doppler frequency by pressing Frequency.
Decrease the density by pressing Density.
I want the color to have less noise, flashing, or fewer artifacts.

Possible Actions:
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Decrease the gain by turning Color Gain counterclockwise.
Increase the scale by pressing Scale.
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10
Resize the color box to make it narrower, to remove the source of artifacts.
NOTES
In cardiac imaging, mechanical heart valves occasionally cause unavoidable
flashing artifacts. Artifacts can also be caused by external sources such as
lighting, other equipment, or telecommunications devices.
I want the color to be less speckled or fragmented.

Possible Actions:
NOTE
For slow-moving blood or structures, increase the persistence by pressing

Persist.
Decrease the Density setting by pressing Density.
I need to improve the color filling.

Possible Actions:
Use the Focus key to place the focal zone at or just below the area of interest.
Increase the packet size by pressing Packet.

Persist.
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Imaging Tips
NOTE
If you are using a linear transducer, turn Angle to adjust the color box to
achieve the optimal angle for the 2D structure.
Select a lower frequency by pressing Frequency, if available.
I want to unwrap aliased signals.

Possible Actions:
NOTE
Unwrap aliased signals by pressing Baseline.
Select the lowest frequency by pressing Frequency, if available. Otherwise,

use a lower frequency transducer.
I need to increase the frame rate.

Possible Actions:
250
Resize the color box to make it smaller.
If the scale setting is very low, increase the scale by pressing Scale.
If you are using a sector or curved linear array transducer, turn on B/W Suppress by pressing B/W Suppress.
If you are using a linear transducer, resize the 2D image before pressing Color
to turn on Color Mode.
Decrease the packet size by pressing Packet.
Decrease the imaging depth by pressing Depth.
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NOTE
10
Imaging Tips for Color Power Angio Mode

"I want the angio to be more sensitive." on page 251
"I want the angio to have less noise, flashing, or fewer artifacts." on page 251
"I need to improve the angio filling." on page 252
"I need to improve the angio resolution." on page 253
"I need to increase the frame rate." on page 253
I want the angio to be more sensitive.

Possible Actions:
NOTE
Increase the gain by turning CPA Gain clockwise.
Use the Focus key to place the focal zone at the area of interest.
Change the Doppler frequency by pressing Frequency.
I want the angio to have less noise, flashing, or fewer artifacts.

Possible Actions:
Decrease the gain by turning CPA Gain counterclockwise.

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Imaging Tips
Resize the angio box to make it narrower, to remove the source of artifacts.
NOTES
In cardiac imaging, mechanical heart valves occasionally cause unavoidable
flashing artifacts. Artifacts can also be caused by external sources such as
lighting, other equipment, or telecommunications devices.
I need to improve the angio filling.

Possible Actions:
NOTE
252
Increase the gain by turning CPA Gain clockwise.
Use the Focus key to place the focal zone at or just below the area of interest.

Persist.
If you are using a linear transducer, turn Angle to adjust the angio box to
achieve the optimal angle for the 2D structure.
If you are using a multifrequency transducer, press Frequency to select a

lower frequency.
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10
I need to improve the angio resolution.

Possible Actions:
NOTE
Press Focus to place the focal zone at the area of interest.
For small vessels, decrease the Smooth setting by pressing Smooth.
Increase the Density setting by pressing Density.
If you are using a multifrequency transducer, press Frequency to select a

higher frequency.
I need to increase the frame rate.

Possible Actions:
NOTE
Resize the angio box to make it smaller.
If the scale setting is very low, increase the scale by pressing Scale.
If you are using a sector or curved linear array transducer, turn on B/W Suppress by pressing B/W Suppress.
If you are using a linear transducer, resize the 2D image before pressing CPA
to turn on CPA Mode.
Decrease the packet size by pressing Packet.
Decrease the imaging depth by pressing Depth.
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10
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11 Stress Echocardiography
On the HD11 system, a Stress Echo study consists of two to eight stages and can
acquire loops for up to eight anatomical views.
Before You Perform Your First Stress Echo Study

Before you perform the first Stress Echo study, Stress Echo must be installed on
your system. See "Installing Options" on page 101.
Also, you need to assign one of the option keys to Stress Echo. See "Assigning
Option Keys" on page 102.
Gain Save
During the first stage of a Stress Echo protocol, you can adjust the system settings, the ROI setting, and imaging controls, such as Depth, 2D Gain, and TGC.
Because of a feature called Gain Save, the settings for each view are saved and
then are restored when you acquire the same view in the other stages.
NOTE
If you stop and resume a Stress Echo study, Gain Save no longer applies.
ECG in Stress Echo

In Stress Echo, the acquisition of loops is triggered by the R-wave. Therefore, to
perform a Stress Echo study, an ECG trace with R-waves must appear on the display. If no R-wave is detected,
displayed, and a 1-second Stress Echo loop
is acquired:
The ECG is captured and displayed with loops that you acquire in Stress Echo.
NOTES
Stress Echo is an option.

The foot switch option is included in the Stress Echo option.
When you export a Stress Echo study, only the preferred loops are exported.
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Stress Echo Setup

Before you begin a Stress Echo study, you can create Stress Echo presets based on
default Stress Echo protocols. During a Stress Echo study, you can modify the
Stress Echo preset you are using by adding views or stages.
Creating a Stress Echo Preset

To create a Stress Echo preset
1. Select a cardiac preset as a starting point for your Stress Echo preset. See
"Selecting a Preset" on page 96.
2. Press Setup.
3. Click the Stress tab.
4. On the Stress tab, make changes that you want for your preset:
256
Load DefaultsChoose one of three default protocols or create your

own. See "About Stress Echo Protocols" on page 257.
Default Acquisition TypeSpecify whether the stages are single-cycle

or quad-cycle acquisition stages. See "About Stress Echo Acquisition
Methods" on page 258.
Stage NameAdd stages or edit stage names.
Start ViewSelect a new starting view for any stage. The view order
appears below the Load Defaults button.
MultiSpecify the multi-cycle stage. See "About Stress Echo Acquisition

Methods" on page 258.
VCRSpecify which stages are VCR stages. See "Using a VCR During a
Stress Echo Study" on page 260.
TimerSpecify the timer stage. See "Using the Timer During a Stress
Echo Study" on page 260.
Edit ViewsAdd views or edit view names.
Clear AllDelete all of the settings.
R-Wave DelaySpecify the time lapse between the R-wave and the
acquisition of the first frame. A positive number results in acquisition after
the R-wave; a negative number results in acquisition before the R-wave.
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5. Click Apply.
6. Click Close.
7. Press Preset.
9. Click Create New.
10. Type the name of the preset you want to create.
11. Click Save.
Modifying a Stress Echo Preset

You can modify the current Stress Echo preset at any time.
To modify the current Stress Echo preset
1. Press Setup.
2. Click the Stress tab.
3. On the Stress tab, make changes to the preset.
You can define additional views or delete views for a protocol before you
acquire the first loop of a study.
You can create additional stages anytime.
You can delete a stage if you have not yet acquired a loop for that stage.

5. Click Close.
About Stress Echo Protocols

You can use one of the three Philips Stress Echo protocols to perform a Stress
Echo study, or you can base your own preset on one of the protocols.
Protocol
Name
Exercise
2-Stage
Stages
Timer
VCR
First
View
Acquisition
Type
Rest
Off
Off
LAX
Quad-cycle
ImPost
On
On
AP4
Multi-cycle
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Exercise
3-Stage
Rest
Off
Off
LAX
Quad-cycle
Peak
On
On
AP4
Multi-cycle
Post
Off
Off
LAX
Quad-cycle
Pharmacol Base
ogical
Low
4-Stage
Peak
Off
Off
LAX
Quad-cycle
Off
Off
LAX
Quad-cycle
On
On
LAX
Quad-cycle
Post
Off
Off
LAX
Quad-cycle
About Stress Echo Acquisition Methods

For each Stress Echo stage, you can choose from the following three acquisition
methods:
NOTE
Single-cycleWhen you press Acquire, one loop is acquired and saved to

the study.
Quad-cycleWhen you press Acquire, four consecutive loops (one per

heart cycle) are acquired and saved to the study.
Multi-cycleWhen you press Acquire, up to 200 loops (one per heart

cycle) are continuously acquired and saved to the study, allowing you to continuously acquire loops for all views in a particular stage. Press Enter to proceed from one view to the next. After you have imaged all of the views, press
Acquire to end the acquisition. Press End Acquire when you are finished
with the multi-cycle acquisition to enter Image Review.
Only one multi-cycle stage is allowed in each protocol.
About ECG Artifacts

Although artifacts can occur during traditional echocardiography exams while
patients are lying at rest, exercise-induced Stress Echo exams are more likely to
produce ECG artifacts due to increased muscle movement and respiration rates.
The type of Stress Echo exam you perform influences the probability of ECG artifact occurrences, as described in the following table:
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Respiration
Artifacts
Muscle Motion
Artifacts
Recommended
Type of ECG
Traditional
Echocardiography
No
No
3-lead
Stress Echo
(Pharmacological)
Yes
No
12-lead
Stress Echo (Exercise)
Yes
Yes
12-lead
Examination Type
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The presence of ECG artifacts can cause the following problems:
The heart rate display may be inaccurate if an artifact is detected as a heart

beat.
A premature trigger for image acquisition may occur due to an ECG artifact.
Philips highly recommends that you videotape Stress Echo studies to avoid losing
image data due to ECG artifacts.
Minimizing ECG Artifacts

The following options may reduce the incidence of ECG artifacts and triggering
problems during Stress Echo studies:
NOTE
The best way to monitor ECG artifacts is to activate the audible R-wave beep.
This audio signal helps you distinguish between true arrhythmias and premature triggering caused by ECG artifacts.
To minimize motion and respiration artifacts, use a 12-lead cardiograph.

Adjust the ECG Gain so that the QRS pulses are detected and an accurate
heart rate appears on the ultrasound system.
To learn how to change the ECG Gain, see "Using Physio Soft Keys" on page 141.
Some 12-lead cardiographs provide a square-wave pulse output signal that can
be input into the ultrasound systems ECG auxiliary channel on the physio
panel. This output signal helps minimize ECG artifacts. If a square-wave pulse
from another machine is used, you may have to increase the ECG Gain.
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Using a VCR During a Stress Echo Study

The VCR begins recording when you do one of the following:
You press the Record key that is assigned to the VCR.
You press Acquire to acquire the first view of a VCR stage.
The VCR stops recording when one of the following occurs:
One loop has been acquired for a single-cycle VCR stage.
Four loops have been acquired for a quad-cycle VCR stage.
You press End Acquire during a multi-cycle VCR stage.
Two hundred loops have been acquired for a multi-cycle VCR stage.
You press the VCR Stop soft key.
You press the Record key assigned to the VCR to pause recording.
Using the Timer During a Stress Echo Study

The timer indicates the time that has elapsed since the timer started. The timer
starts under the following circumstances:
The timer automatically starts when you begin acquiring loops in a stage that
you defined as a timer stage.
You can start the timer at any point by pressing Timer. If the timer is already
running, pressing Timer hides the timer. Elapsed time is maintained while the
timer is hidden.
The timer stops automatically at the end of the stage. You cannot manually turn
off the timer.
NOTE
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If an ImPost stage is defined to be a timer stage, be sure to account for the time
lapse between the moment exercise ends and acquisition begins.
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Stress Echo Acquisition

A Stress Echo protocol leads you through the acquisition and acceptance of loops
for each view for each stage of the protocol. The number of loops acquired for
each stage depends on the acquisition method you choose for the stage.
To display the Stress Echo soft keys at any time
Press the Stress Echo option key.
Performing a Stress Echo Study

The following overview describes how to perform a Stress Echo study.
To perform a Stress Echo study
1. Connect the ECG cable and attach the ECG leads. See "Connecting the ECG
Cable and Attaching the ECG Leads" on page 140.
2. Assign an option key to Stress Echo if you have not done so already. See
"Assigning Option Keys" on page 102.
3. Create a Stress Echo preset, or select a Stress Echo preset that you created
previously. See "Creating a Preset" on page 97 or "Creating a Stress Echo Preset" on page 256.
4. Create a new patient study. See "Creating a Patient Study" on page 399.
5. Press the Stress Echo option key.
6. A view icon and a stage-view label appear on the display. See "About the View
Icon and the Stage-View Label" on page 262.
7. Acquire loops for single-cycle or quad-cycle acquisition stages. See "Acquiring
Loops for a Single-Cycle or a Quad-Cycle Acquisition Stage" on page 263.
8. Select the preferred loop for each view in Image Review. See "Selecting the
Preferred Stress Echo Loop" on page 267.
9. Acquire loops for the multi-cycle acquisition stage (if the protocol includes
one). See "Acquiring Loops for a Multi-Cycle Acquisition Stage" on page 264.
10. Select the preferred loop for each view in Image Review. See "Selecting the
Preferred Stress Echo Loop" on page 267.
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NOTE
To perform a Stress Echo study, an ECG trace must appear on the display. If no
R-wave is detected,
is displayed, and a 1-second Stress Echo loop is
acquired.
Using Stress Echo Soft Keys

To display the Stress Echo soft keys at any time
Press the Stress Echo option key.
Refer to the Glossary to learn about the function of each soft key.
End Acquire
Hide/Show ROI
Pause/Unpause Protocol
Stage
Timer
View
About the View Icon and the Stage-View Label

When you are acquiring loops in a Stress Echo study, a view icon and a stage-view
indicator appear on the display to help you monitor loop acquisition.
View Icon
A rectangle appears on the upper right corner of the display that indicates how
many views have been acquired for the current stage. The rectangle contains four
or eight squares, one for each possible view.
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Blank squareThe view has not yet been acquired, or the loop has been
deleted.
Check markThe view has been acquired.
XNo view needs to be acquired. For instance, if a stage has five views,
three of the eight squares will contain an X.
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Stage-View Label
The stage-view label lists the name of the current stage and view.
Acquiring Loops for a Single-Cycle or a Quad-Cycle

Acquisition Stage
To acquire loops for a single-cycle or a quad-cycle acquisition stage
1. Press Acquire to begin acquiring loops for the first view of the first stage.
For a single-cycle acquisition stage, one loop is acquired and is displayed

for your review in Image Review.
For a quad-cycle acquisition stage, four loops (one per heart cycle) are
acquired and are displayed for your review in Image Review.
The first loop you acquire for each view is by default the preferred loop.
2. To change the preferred loop, select the check box in the bottom left corner
of the loop.
To accept the loop or the loops and proceed to the next view, press
Review or 2D.
To reject the loop or loops and reacquire the view, press Acquire.
4. After you acquire all of the views for a stage, do one of the following:
To accept the loop or loops and proceed to the next stage, press Review
or 2D.
To reject the loop or loops and reacquire any views, press Acquire.
5. To add a stage or view, press Setup. See "Modifying a Stress Echo Preset" on
page 257.
NOTE
Although you automatically advance to the next view or stage, you can use the
View or Stage soft keys to specify which view or stage you want to acquire.
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Acquiring Loops for a Multi-Cycle Acquisition Stage

To acquire loops for a multi-cycle acquisition stage
1. Press Acquire.
Up to 200 consecutive loops (one per heart cycle) can be acquired. A memory gauge appears on the top left corner of the display, showing how many
loops of the possible 200 have been acquired.
To begin acquiring loops for the second view, press Enter.
To begin acquiring loops for a different view, press View.
NOTE
If you do not press Enter or View, all loops will be labeled with the same view.
You can relabel these loops after the multi-cycle acquisition ends.
3. Press Acquire to pause acquisition. Press Acquire again to resume.
4. Complete the exam.
a. Press Acquire to pause the acquisition.
b. Press End Acquire to view the loops in Image Review.
Acquiring Images Outside of a Stress Echo Protocol

You can temporarily leave the Stress Echo protocol so that you can acquire loops
or frames, such as images in Color mode or PW Doppler mode, outside of the
Stress Echo protocol.
To acquire images outside of the stress echo protocol
1. Press Pause Protocol.
2. Acquire images in any mode.
3. Return to the Stress Echo protocol.
a. Press 2D.
b. Press the Stress Echo option key to display the Stress Echo soft keys.
4. Press Unpause Protocol.
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Using the ROI Box in Stress Echo

When you are in a Stress Echo protocol, a region of interest (ROI) box appears
on the image. The area in the ROI box is the portion of the image that is acquired.
To reposition the ROI box
1. Press Select until ROI is highlighted on the Select menu.
2. Move the ROI box with the trackball.
To remove the ROI box from the display
Press Hide ROI.
To display the ROI box
Press Show ROI.
Moving the 2D Reference Line in Stress Echo

When you are in a Stress Echo protocol and an ROI box appears on the image,
the reference line may obscure the acquired image.
To move the reference line in Stress Echo
1. Press the Stress Echo option key to display the Stress Echo soft keys.
2. Press Hide ROI.
3. Press Select until Line is highlighted on the Select menu.
4. Move the reference line with the trackball.
6. Press Show ROI.
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Stopping and Resuming a Stress Echo Study

You can stop a partially completed Stress Echo study to perform another study
and then resume the prior Stress Echo study without having to reacquire resting
images. The study can only be resumed on the same day you started the study.
You must also be using the same system and preset.
Stopping a Stress Echo Study

To stop a partially completed Stress Echo study
1. Complete the current stage.
2. Click
Resuming a Stress Echo Study

To resume a Stress Echo study
1. Make sure you are in the same preset you used before you stopped the study.
2. Press Review.
3. Click
4. Highlight the study you want to resume with the trackball.

5. Click Open Study to open the report.
6. Press Review to view the images you acquired before you stopped the study.
7. Press 2D to resume acquiring images.
8. Click OK to confirm that you want to resume the study.
The view icon and the stage-view label appear on the display.
10. Press Stage to change the stage, if necessary.
11. Continue acquiring images.
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Stress Echo Review

After you acquire all of the loops for a view, you view the loops in Image Review.
The loops are labeled with the following:
Name of the stage
Name of the view
Time (if the timer was on)
Heart rate
Specifying the Type of Stress Echo Review Display

In Thumbnails, you can view all of the images in the order they were acquired, all
of the images of the same view, or all of the images in a stage.
To specify the type of display
Use the trackball to select Display Stages, Display Views, or Show
Sequence from the Stress Display menu.
Adding Information About Stress Echo Stages in the Report Work Area
You can enter information about stress echo stages on the Information tab in
the report work area if at least one image has been acquired during the study.
Selecting the Preferred Stress Echo Loop

After you acquire Stress Echo loops, they appear in Image Review, which is where
you select the preferred loop.
The default preferred loop is indicated with a check mark in the lower left corner
of the image.
To choose another loop to be the preferred loop
Select the check box in the lower left corner of that image.
All of the loops are still saved except those you marked for deletion. You can
change the preferred loop at a later time.
The preferred loop is the loop that you see when you are in the View Stages
Stress Display in Thumbnails.
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NOTE
When you export a Stress Echo study, only the preferred loops are exported.
Relabeling Views
You can change the name of the view associated with a loop by using the Select
key or the Enter key.
To relabel a Stress Echo view while in Stress Echo review using the
Select key
1. Use the trackball to move the cursor over the loop.
2. Press Select.
3. Highlight Relabel Views with the trackball.
4. Highlight the correct view name with the trackball.
5. Press Enter.
To relabel a Stress Echo view while in Stress Echo review using the
Enter key
1. Use the trackball to move the cursor over the view name in the upper left
corner of the loop.
2. Press Enter.
3. Highlight the correct view name with the trackball.
4. Press Enter.
Viewing All the Stress Echo Loops for a View

If you acquire more than one loop for a view, only the preferred loop is visible in
Thumbnails when you are in the Show Stages Stress Display.
To view all of the loops you acquired for that view
Click
on the lower left corner of the preferred image.
All of the loops you acquired for that view are displayed.
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Playing Back Stress Echo Loops

To play back one Stress Echo loop in Thumbnails
1. Use the trackball to move the cursor over the image.
Press Enter twice.
Press Enter and click Play.
To play back all of the Stress Echo loops for a stage or a view
1. In Thumbnails, select Display Stages or Display Views from the Stress
Display menu.
2. Use the trackball to move the cursor over the first image, and do one of the
following:
Press Enter twice.
Press Enter and click Play.
For more information about playing back loops, see "Playing Back More Than One
Image in Image Review" on page 414.
Performing Wall Motion Scoring

After a Stress Echo study, you can perform wall motion scoring for each wall segment. Graphics showing the wall scores automatically appear in the report.
NOTE
To enter scores for wall segments, you must be in Image Review, and you must be
in a cardiac preset.
To perform wall motion scoring

1. In Thumbnails, view the stage you want to score.
2. Click
3. Use the slider at the top of the window to indicate which stage you are scoring.
4. Click the view icons to see the wall segments from different perspectives.
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If all wall segments are normal, click All Normal.
Use the trackball to move the cursor over the wall segment, press Select,
highlight the wall score for the segment, and press Enter.
6. Repeat step 2 through step 5 for each stage. Click Carry Over to apply the
scores from the previous stage to the current stage.
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Annotation
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12 Annotation
You can annotate an image with labels and arrows. You can also add body marker
graphics that indicate the parts of the anatomy you are scanning.
Labels
You can place a label anywhere on the display so that you can comment on the
image. You can also add an arrow to indicate which part of the image the label
applies to.
Using Quick Text

The quickest way to place a label on the display is to position the cursor on the
screen with the four keyboard arrow keys and then start typing. If you do not
position the cursor, the Quick Text label will appear at the home position.
To learn how to move or delete a Quick Text label, see "Moving or Deleting
Annotations" on page 273.
Placing a Label on the Display

You can place system-defined labels on the display by pressing the Label key or the
Text key.
Using the Label Key to Place a Label

To place a system-defined label on the display by using the Label key
1. Press Label.
2. Use the trackball to select the label you want on the Label menu.
Use the trackball to drag the label onto the display and to position it on
the display. Press Enter to anchor the label.
Press Enter to place the label on the display at the current location of the
cursor.
4. Press Label to exit the Label menu.

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Annotation
Using the Text Key to Place a Label

To place a system-defined label on the display by using the Text key:
1. Press Text.
2. Use the trackball to position the cursor where you want the label to appear.
3. Press Select to highlight Label on the Select menu.
4. Move the trackball up and down to scroll through the menu selections on the
display.
5. Press Enter to anchor the label you want on the display.
6. Press Text to exit.
Typing a Label on the Display

To type your own label on the display by using the Text key
1. Press Text.
2. Use the trackball to position the cursor where you want the label.
3. Type the label.
Modifying a Label
To modify a label on the display
1. Press Text.
2. Move the cursor over the label.
3. Add or remove text from the label by using the keyboard and the soft keys.
NOTE
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You can also press the Tab key on the keyboard to move word by word through
the labels on the display.
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Placing Arrows and Drawings on the Display

You can add arrows and freehand drawings to images.
To place an arrow on the display
1. Press Pointer.
2. Position the arrow by using the trackball.
3. Press Enter to anchor the arrow.
Creating Freehand Drawings on the Display

To add a freehand drawing to an image
1. Press Pointer.
2. Position the cursor where you want to start the drawing.
3. Press Select to highlight Draw on the Select menu.
4. Move the trackball to create the drawing.
5. Press Pointer to exit.
Rotating an Arrow
To rotate an arrow
1. Press Text.
2. Use the trackball to position the cursor over the arrow.
3. Turn the Angle knob to rotate the arrow.
Moving or Deleting Annotations

You can move or delete labels, arrows, and drawings.
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Annotation
Moving Annotations
To move a label, an arrow, or a drawing
1. Press Text.
2. Position the cursor over the label, arrow, or drawing you want to move by
using the trackball.
The selected item is highlighted.
3. Press Enter.
4. Position the label, arrow, or drawing in its new location by using the trackball.
5. Press Enter to anchor the label, arrow, or drawing.
Deleting Annotations
To delete a label, an arrow, or a drawing
1. Press Text.
2. Use the trackball to select the label, arrow, or drawing.
3. Press Clear.
NOTE
If you do not select an annotation before pressing Clear, all annotations on the
display are deleted.
Using Annotation Soft Keys

Refer to the Glossary to learn about the function of each soft key.
Arrow
Home
Long/Trans
Set Home
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Lt/Mid/Rt
Annotation
12
Body Markers
You can place a body marker graphic on the display to indicate the part of the
anatomy that you are scanning. When you place the body marker, a transducer
icon also appears. You can manipulate it to show the position and orientation of
the transducer.
Exiting Body Markers

To exit Body Markers and remove the body marker and the transducer
icon from the display
Press the Erase Marker soft key.
To exit Body Markers and leave the body marker and the transducer
icon on the display
Press the Marker key or the key for another mode or application.
Placing a Body Marker on the Display

To place a body marker and a transducer icon on the display
Press the Marker key.
Choosing a Body Marker

You can use three different methods to specify which body marker appears on the
display.
To specify which body marker appears on the display, using the Body
Marker soft key
1. Press Marker.
2. Press the soft key to the left of the View All soft key repeatedly until the set
of body markers that you want appears.
NOTE
Body marker sets are organized by exam type.

3. Press the soft key on the far left until the body marker that you want appears.
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Annotation
To specify which body marker appears on the display, using a dialog box
1. Press Marker.
2. Press View All.
3. In the Body Markers window, click the tab for the exam type.
4. Use the trackball to move the cursor over the body marker you want.
5. Press Enter.
To specify which body marker appears on the display, using the Select
menu and the trackball
1. Press Marker.
2. Press Select until Scroll is highlighted on the Select menu.
3. Scroll through the body markers in the current body marker set by using the
trackball.
4. To change the body marker set, press Enter.
5. Press Marker to exit.
Moving a Body Marker or the Transducer Icon

You can move a body marker or the transducer icon.
Moving a Body Marker

To move a body marker
1. Press Select until Icon is highlighted on the Select menu.
2. Use the trackball to move the body marker.
3. Press Enter to anchor the body marker.
4. Press Marker to exit.
Moving the Transducer Icon

To move the transducer icon
1. Press Select until Probe is highlighted on the Select menu.
2. Use the trackball to move the transducer icon.
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3. Press Marker or any imaging mode or application key to anchor the transducer icon and exit Body Markers.
NOTE
If you change modes, the body marker will remain in the same relative position.
Returning a Body Marker to the Default Position

To return a body marker to the default position on the display
2. Press Default Position.
Rotating or Specifying the Shape of the Transducer Icon

You can rotate the transducer icon and change its shape.
Rotating the Transducer Icon

To rotate the transducer icon
Press Rotate Probe.
Turn the Angle knob to rotate the icon.
Specifying the Shape of the Transducer Icon

To specify the shape of the transducer icon
2. Press Probe Size until the shape that you want is displayed.
Using Body Marker Soft Keys

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Annotation
Body Marker
Body Marker Set
Default Position
Erase Marker
Left
Probe Size
Right
Rotate Probe
View All
Using Body Markers and Dual Imaging

To use body markers and Dual Imaging at the same time
Press the Left key or the Right key while a body marker is displayed.
If you are in Dual Imaging, press Marker.
The body marker appears on both images.

2. Press the Left soft key to manipulate the body marker on the left-hand image.
Press the Right soft key to manipulate a body marker on the right-hand
image.
3. To freeze the active image, press Freeze.
You can manipulate the body marker on the frozen image.
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Analysis
13
13 Analysis
Analysis of 2D images, M-mode traces, and Doppler spectral traces is made by
measuring displayed image features. You can then display the measurements, use
them in calculation, or store them in a database for reporting.
The following features enable you to analyze images.
Unlabeled Measurements
Unlabeled measurements are measurements that are not associated with an anatomical label. Each measurement graphic can report one primitive, or a set of
measurement primitives obtained. Unlabeled measurements of the same primitive
are not averaged.
Unlabeled measurements are displayed in the results box.
Quick Calculations
Quick calculations are computed based on one unlabeled measurement primitive
and are displayed in the results box with their unlabeled primitives. Quick calculations are nonspecific, have no anatomic labeling, and are not averaged.
Labeled Measurements and Calculations

A labeled measurement consists of one measurement primitive that is specific to
an anatomical structure. A labeled measurement can be an input to one or many
calculations. When you perform multiple instances of the same labeled measurement in a study, it is considered a collection. The collection is given one value that
is used as the input to a calculation. Labeled measurements are organized in package/group divisions.
High Q Automatic Doppler Analysis and Automatic Doppler Trace

High Q Doppler is an automatic quantification on a live spectral image, and Automatic Doppler Trace is an automatic quantification on a frozen spectral image.
Both functions analyze the Doppler spectrum and return quantitative information
on the speed and time duration of the spectrum at various event points. Both
High Q Doppler and Automatic Doppler Trace can perform this analysis over a
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Analysis
single heart cycle, or over multiple heart cycles. High Q and Automatic Doppler
Trace are only available in PW spectral mode.
NOTE
When you export a study to an optical disk or over a network, measurements

and calculations appear on exported images but the calculation data is not saved
with your study.
Analysis Setup and Controls

Analysis options are organized according to application packages and groups. See
"Analysis and Reports Application Package/Group List" on page 120.
Some of the settings you can configure in the Setup window are:
Default to Doppler Auto Trace
Measurement caliper connection
How Quick Calcs appear
For more information, see "Customizing Your System" on page 95.
Configuring the Analysis Menu

The Analysis menu is configured in the Setup window. Analysis configuration is
system-wide and is not associated with any preset.
You can configure the following:
Measurements and Calculations Menus
User-Defined Calculation by using a table
User-defined equation by using a formula
Fetal growth graphs
Fetal Weight options
High Q settings
For more information, see "Customizing Your System" on page 95.

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About the Accuracy of Measurements and Calculations

You can use the HD11 system to provide measurements and calculations derived
from ultrasound images. The quantified image data is then used in conjunction
with other clinical data to make a diagnosis.
Philips does not recommend making a diagnosis based solely on measurement
data. There are numerous factors to consider when using quantified data from any
ultrasound imaging system. A careful analysis of those factors indicates that the
accuracy of each measurement and subsequent calculation is highly dependent on
image quality. Image quality in turn is highly dependent on system design, operator
scanning technique, familiarity with system controls and, most importantly, patient
echogenicity.
About the Sources of Measurement Error

Measurement errors can be caused by several factors, including:
"Doppler Alignment" on page 281
"Formulas" on page 282
"Height, Weight, and Age Demographics" on page 282
"Operator Variability" on page 282
"Screen Pixel Resolution" on page 282
"Speed of Sound" on page 282
"Sphygmomanometer Error" on page 283
"Sweep Speed" on page 283
Doppler Alignment
Doppler velocity measurements are most accurate when the direction of blood
flow is aligned with the acoustic beam axis. Errors due to misalignment are typically about 5%.
For best accuracy, aim the transducer so that the acoustic beam axis is aligned as
closely as possible with blood flow. With linear transducers, when alignment is
not possible, use the Angle knob to compensate.
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Analysis
Formulas
Some formulas used in clinical calculations are based on assumptions or approximations. For example, volume formulas may assume a particular three-dimensional shape. Circumference measurements approximate the actual shape by using
a polygon made up of many short line segments.
Be sure you understand how the formulas you are using are calculated.
Height, Weight, and Age Demographics

Height and weight values are manually entered to estimate body surface area for
cardiac calculations. Height and weight values can be estimated incorrectly. Moreover, adult weight values can vary over the course of the day. Entering an incorrect age can also result in errors.
Operator Variability
A skilled sonographer can reduce the largest potential component of measurement variabilitynamely, operator variability. With training and experience, a
sonographer learns how to acquire the best view and image quality for each type
of measurement. Identification of anatomical structures and correct, consistent
cursor placement are needed.
Screen Pixel Resolution

The ultrasound screen is composed of an array of (roughly) square picture elements known as pixels. The measurement pixel resolution error is assumed to be
1 pixel. The pixel error is significant for small dimensions. Using Zoom minimizes pixel resolution error, which is 0.23% (or better) of the full-scale screen.
Speed of Sound
Ultrasound imaging algorithms assume that the speed of sound in tissues is 1,540
m/s. However, the speed of sound varies for different tissues. Within soft tissues,
the error is typically within 2% of the speed of sound, but may be as high as 5%,
particularly if fatty tissue is present in the measurement area.
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Sphygmomanometer Error
Some pressure calculations require manual entry of blood pressure. The system
assumes that the pressures you enter are perfect. However, sphygmomanometer
errors are typically 5 to 10 mm Hg.
Sweep Speed
Time measurement errors are larger when slower display sweep speeds are used.
About Measurement Primitives

The HD11 system uses the following primary measurements, called primitives, to
produce other measurements and calculations.
Depth
In 2D mode, when you press the Caliper key, a free crosshair appears on the
image, and the system reports the depth at that point in the image. The depth is
displayed in centimeters as a measurement primitive in the results box. The depth
is calculated from the apex (for sector transducers) or from the scanning edge of
the footprint (for linear transducers) to the center of the free crosshair. A vertical
tick mark appears at the origin point of the depth measurement, and there is no
line connecting this point with the free crosshair.
Frequency
The frequency measurement is calibrated using a frequency source traceable to
the National Institute of Science and Technology (NIST). The accuracy of this calibration is considerably greater than 99%. There is no need to recalibrate this
measurement given the high level of initial accuracy and the knowledge that drift
due to equipment age or thermal issues should not be a routine concern.
Length
The system assumes that the speed of sound is 1,540 m/s and that this speed is
homogeneous in all tissues. Several books on ultrasound cite differences in the
speed of sound based on the type of tissue. One source says that sound speeds
can range from 1,500 to 1600 m/s. These differences would produce an inaccuracy of up to 4%.
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The length measurements on the system are verified using an American Institute
of Ultrasound in Medicine (AIUM) standard phantom. The calibrations are performed using depth settings that give the greatest resolution for the phantom
length being measured. The accuracy of this calibration should be within 5%.
Time
Time measurements can be used for calculations performed in the following
areas: physio channels, M-mode, and Doppler mode. The time calibration is performed using a time-interval signal generator with a calibration traceable to
National Institute of Science and Technology (NIST). The calibration of the display
is not expected to drift. Calibration of the time axis should be done by measuring
1-second pulses at the different sweep speeds. The accuracy of these measurements should be within 5%, independent of the sweep speed.
These specifications are based on data taken with optimum control settings.
Accuracy specifications can be obtained at other control settings by repeating the
calibration at the settings you want. The depth and sweep speed settings have the
greatest impact on measurement accuracy. The accuracy of a 1-cm length and a
3-cm2 area measurement on a 24-cm depth display is different from the accuracy
of the same measurements performed on a 4-cm depth display. Measurements
taken at a sweep speed of 100 mm/s are more accurate than those taken at 25
mm/s.
About Volume Calculations

The following sections describe the methods used to calculate cardiac, three-distance, and one-distance volumes.
Cardiac Volumes
You can calculate cardiac volumes in two ways:
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Method of Discs (MOD): single-plane method and biplane method
Area-length method (Non-MOD)
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Method of Discs
The method of discs (MOD) single-plane volume calculation uses one orthogonal
plane for area (the apical four-chamber view or the apical two-chamber view) and
a long-axis length. The area traces are divided into 20 elliptical disc segments. The
MOD biplane volume calculation uses two orthogonal-plane area traces (the
two-chamber apical view and the four-chamber apical view) and a long-axis length
(the longer of the two long axes). The area traces are divided into 20 elliptical disc
segments.
Area-Length Method
The non-MOD single-plane ellipse, biplane ellipse, and Bullet volume calculations
use the area-length method, which uses apical measurements. When a two-chamber or a four-chamber measurement is made, the area values are copied into the
equivalent generic apical measurement, using the meta-measurement feature.
However, generic apical measurements are not copied back into either the
two-chamber view or the four-chamber view measurements.
Three-Distance Volumes
For radiology and other applications, volumes of solids are calculated using the
following formula:
One-Distance Volumes
Follicular volumes are one-distance volumes. They are calculated using the following formula:
0.523 x D x D x D
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where D = follicular distance
About PISA Measurements and Calculations

The following PISA (proximal isovelocity surface area) calculations are used when
you are in PW Doppler mode or CW Doppler mode and in a cardiac preset:
MR PISA
MR flow rate
MR ERO
MR volume
MR RF
Before you obtain the preceding calculations, you need to perform the following
measurements:
NOTE
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MR PISA radius (measured on a full-screen 2D image or a 2D reference

image)
MR max vel
MR VTI
MR alias vel
MV E point
MV diam 1
MV diam 2
To perform an MR alias vel, shift the baseline down until aliasing occurs. Then
match the color of the isovelocity hemisphere to the color bar and the pulse repetition frequency (PRF) to the scale. The PRF is the alias velocity.
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About Pulsatility Index and Resistivity Index

Doppler Trace uses the end-diastolic velocity (D)not the minimum velocity, as
recommended in some medical sourcesto calculate pulsatility index (PI) and
resistivity index (RI).
End-Diastolic Velocity vs. Minimum Velocity
You can manually position the S, D, and S1 bars. If you manually move the D bar
to select the minimum velocity in the situation shown in the previous figure, PI
and RI are calculated according to PI and RI formulas, which use the minimum
velocity. However, Acceleration Time (AT), Acceleration Slope (AS), Diastolic/
Systolic (D/S) ratio, and Systolic/Diastolic (S/D) ratio are now inaccurately
reported, because these formulas require use of the end-diastolic rather than the
minimum diastolic velocity.
If you want to use the minimum velocity method, you should use your best diagnostic judgment in making and using PI and RI calculations that come from Doppler Auto Trace.
You can also use manual Doppler trace to produce PI and RI calculations.
References
Roger C. Sanders, ed. Clinical Sonography - A Practical Guide, 2nd ed. Little Brown
and Company, 1991.
Nanda, Navin D. Doppler Echocardiography, 2nd ed. Lea and Febiger, Philadelphia
1993, p. 29.
Sahn, D., DeMaria, A., Kisslo, J., Weyman, A., The Committee on MMode Standardization of the American Society of Echocardiography. Recommendations
Regarding Quantitation in MMode Echocardiography: Results of a Survey of
Echocardiographic Measurements. Circulation, Vol. 58, No. 6: 10721083, 1978.
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Feigenbaum, Harvey. Echocardiography, 4th ed. Lea and Febiger, Philadelphia 1986,
115122.
Emamian, S.A., et al. Kidney Dimensions at Sonography: Correlation With Age,
Sex, and Habitus in 665 Adult Volunteers. American Journal of Radiology, 160:83
86, January 1993.
Doppler Trace Analysis

You can use three types of Doppler trace:
Doppler Auto Trace
Manual Doppler trace
High Q Doppler
Doppler Auto Trace and Manual Doppler Trace

Doppler Auto Trace automatically traces a frozen Doppler spectrum over one
heart cycle and uses the trace to calculate and display the results of key Doppler
measurements and calculations. Doppler Auto Trace allows you to save time during a patient exam.
In a manual Doppler trace, you manually trace the Doppler spectrum.
In Doppler Auto Trace in non-cardiac presets, the system displays measurement
bars on the trace that represent three points on the spectrum:
Systolic (S)
Diastolic (D)
Next systolic (S1)
In cardiac presets, a begin and an end bar appear on the spectrum at the beginning
and end of an R-wave.
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High Q Doppler
High Q Doppler automatically traces a waveform in live imaging. Measurements
are made on the Doppler spectrum, are displayed in the results box, and are
updated every heart cycle. You can specify the number of cycles used for the averaged measurement values.
NOTES
ECG input is required for cardiac Doppler Auto Trace and High Q Doppler.
Doppler Auto Trace and High Q Doppler are only available in PW Doppler
mode.
About Doppler Auto Trace

Doppler Auto Trace is intended for use on spectral waveforms that are fully displayed above and below the baseline; for example, in studies of arterial grafts,
carotid arteries, umbilical arteries, renal arteries, and transcranial arteries.
When initiated on a frozen Doppler spectrum, Doppler Auto Trace automatically
detects the strongest Doppler complex in which the first and succeeding systolic
points (S and S1) are similar.
In non-cardiac presets, the system marks the first systolic, the end-diastolic,
and the succeeding systolic points with S, D, and S1 measurement bars.
In cardiac presets, the system displays a begin bar and an end bar at the beginning and end of an R-wave.
In non-cardiac presets, you can use your judgment to manually position the S, D,
and S1 points. If you move the S bar to another complex, the measurements are
averaged over multiple waveforms.
Using Doppler Auto Trace

If you want your system to automatically trace a Doppler spectrum the first time
you press Trace, select the Default to Doppler Auto Trace check box on the
Measurements Setup tab.
To learn how to use multi-cycle Doppler Auto Trace, see "Using Multi-Cycle
Doppler Auto Trace" on page 291.
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To use Doppler Auto Trace

1. In PW Spectral Doppler, press Freeze.
If the Default to Doppler Auto Trace check box is selected, press

Trace once.
If the Default to Doppler Auto Trace check box is not selected, press
Trace twice.
The spectrum is automatically traced, and several calculations appear in the

results box. In non-cardiac presets, S, D, and S1 measurement bars appear on
the spectral trace. In cardiac presets, bars appear on the spectral trace that
mark the beginning and end of an R-wave.
3. To adjust points, press Select.
4. To show or hide the waveform, press Waveform.
5. To reposition the measurement bars if you are in a non-cardiac preset, use the
soft keys or press Select until the name of the bar is highlighted on the
Select menu. Use the trackball to move the measurement bar.
To approve the measurement and exit, press Enter.
To erase measurements from the results box, press Clear.
The measurement changes to white to indicate that it is complete.
Changing the Autotrace Evaluation Setting

You can specify how much of the waveform is evaluated and used by Doppler
Auto Trace and High Q (above the baseline, below the baseline, or both). The
autotrace evaluation setting takes effect when you unfreeze a waveform.
To change the Autotrace Evaluation setting while imaging
Press Ctrl+Q.
NOTES
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Doppler Auto Trace and High Q Doppler are only available in PW Doppler.
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Using Doppler Auto Trace Soft Keys

Doppler Auto Trace soft keys are only available in non-cardiac single cycle presets.
Box Position
Calcs Results
D Time
D Velocity
S Time
S Velocity
S1 Time
S1 Velocity
Waveform
The High Q settings determine whether the peak trace, the mean trace, or both
are displayed. Without the High Q feature, both traces are displayed.
Using Multi-Cycle Doppler Auto Trace

If you are using Doppler Auto Trace, you can select more than one waveform.
Measurements are averaged over the selected waveforms.
To use multi-cycle Doppler Auto Trace
1. Press Trace.
Measurement bars that are appropriate for the current preset appear on the
display and Off is highlighted on the Select menu. The measurement values
appear in the results box.
NOTE
You cannot use the trackball to adjust measurements.

2. To activate the measurement, press Select.
Depending on the preset, S or Begin is highlighted on the Select menu.
3. Position the S bar or Begin bar at the beginning of the first cycle by using the
trackball.
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4. Press Select.
Depending on the preset, S1 or End is highlighted on the Select menu.
5. Move the S1 or end bar to include the number of cycles you want included in
the averaged measurements.
The number of cycles averaged and the averaged measurements appear in the
results box.
NOTE
In non-cardiac presets, Begin and End measurement bars appear and End is
highlighted on the Select menu.
6. Press Enter to approve the measurement.
NOTES
Doppler Auto Trace and High Q Doppler are only available in PW Doppler
mode.
Performing a Manual Doppler Trace Measurement

To perform a manual Doppler trace measurement
1. In PW Spectral Doppler mode, press Freeze.
If the Default to Doppler Auto Trace check box is selected, press

Trace twice.
If the Default to Doppler Auto Trace check box is not selected, press
Trace once.
3. Press Select.
4. Move the trackball to trace the waveform.
5. To erase the trace one dot at a time, press Clear.
6. To approve the measurement and exit, press Enter.
7. If you are in a non-cardiac preset, you are prompted to position the end diastolic point.
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Using High Q Doppler

High Q Doppler automatically traces a waveform in live imaging.
To use High Q, in live spectral Doppler mode
Press Trace.
The number of heart cycles used for the measurements and the averaged measurements appear in the results box. The measurements are updated every heart
cycle.
You can specify the number of cycles used for the averaged measurements. You
can also specify whether you want to display the peak trace, the mean trace, or
both. See "Changing High Q Settings" on page 117.
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14 Measurements and Calculations

This section includes the following:
"Working with Measurements" on page 295
"Calculations" on page 298
"Unlabeled Measurements" on page 299
"Quick Calculations" on page 304
"Labeled Measurements" on page 311
Working with Measurements

The information and procedures in this section will help you work with measurements on the HD11 system. The measurements available at any one time depend
on the system configuration and mode.
NOTE
"About Calipers" on page 296
"Approving Measurements" on page 296
"Displaying Measurement Values" on page 297
"Reactivating a Measurement" on page 297
"Deleting a Measurement" on page 298
"Labeled Measurements" on page 311
"Performing a Labeled Measurement" on page 311
"Performing a Protocol Measurement" on page 312
"Using Labeled Measurement Soft Keys" on page 312
"Assigning a Measurement Value" on page 313
"Performing a Hip Angle Measurement" on page 313
When you export a study to an optical disk or over a network, measurements

and calculations appear on exported images but the calculation data is not saved
with your study.
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About Calipers
HD11 supports up to eight sets of distinct calipers that are used as the pointing
device when performing measurements. You control the calipers with the trackball.
The caliper sets are:
Calipers have four states denoted by four distinct colors.
Color
State
White
The measurement is complete.
Yellow
The measurement is highlighted.
Orange
The measurement can be reactivated at this point.
Blue
The measurement is active.
The measurement calipers will shrink and grow dynamically to accommodate

measurements of both small and large structures. As you move the caliper farther
away from the anchor point, both the anchor and the caliper grow in size. As you
move the caliper closer to the anchor point, they both shrink.
When you press Caliper or Trace, a large free caliper appears in the middle of
the image. You can move this caliper within the image by using the trackball.
Each measurement and its corresponding value in the results box are labeled with
the same type of caliper so that you know which value is associated with each
measurement.
Approving Measurements
To approve a measurement, do any of the following
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After you perform a measurement, press Calc to approve and to save the
measurement and initiate another.
Press Enter to approve and save the measurement and exit analysis.
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Enter any of the following modes to automatically approve the currently active
measurement:
Print
Acquire
Freeze
Analysis menu
Displaying Measurement Values

Results of measurements that you perform appear in the results box on the display. Use the Box Position soft key to position the results box in any corner of
the display.
You can also specify the display mode for the results box with the Calcs Results
soft key. The options are:
NOTE
All MeasAll measurements are displayed along with any associated calculations.
Last MeasOnly the last or highlighted measurement is displayed along with

any associated calculations.
HiddenThe results box is not displayed.
TCG measurement graphics are not displayed when the results box is on the right
side of the display.
Reactivating a Measurement
You can reactivate an existing measurement if you want to move the endpoints.
When you reactivate a measurement, the system saves the first measurement
value and calculates the new one. Both values are displayed in the report.
To reactivate a measurement
1. Press Caliper or Trace.
2. Use the trackball to move the crosshair over an endpoint until the measurement changes to orange to indicate that it is active.
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3. Press Enter.
The measurement changes to blue to indicate that it is active again.
4. Use the trackball to move the endpoint.
5. To approve the measurement, press Enter.
Deleting a Measurement
You can delete a single measurement or you can erase all measurements.
To delete a single measurement
1. Press Caliper or Trace to reactivate the completed measurement.
2. Use the trackball to move the crosshair over the measurement until the measurement changes to orange or yellow to indicate that it is active.
3. Press Clear to erase the measurement graphic.
NOTE
You can also erase individual measurements by performing more than eight measurements on the image. Each measurement that you perform erases the measurement graphic in the order in which it is performed to accommodate for new
measurements.
To delete all measurements

When there is no active free crosshair, press Clear to erase all measurements.
NOTE
Pressing Clear erases the measurement graphics but does not remove the associated values from the report.
Calculations
You can perform many calculations in each preset. You can change the calculations
available in the Analysis menu, and you can create your own calculations for OB/
GYN presets.
The calculations available depend on the system configuration and mode.
Measurements that you perform, and any resulting calculations, appear in the
results box in the corner of the display as specified.
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Performing Calculations
To perform a calculation
1. Press Calc.
2. Use the trackball to highlight the calculation you want to perform and press
Enter or Select.
A list of the measurements and calculations that you need to perform for the
selected calculation appears.
3. Select and perform each of the measurements or calculations on the list. You
can perform them in any order.
NOTE
You can access the entire list of calculations for all installed packages by selecting
Main Menu on the Calculations menu.
Unlabeled Measurements
You can perform five types of unlabeled measurements:
1-point velocity or 1-point depth
2-point
Ellipse
Method of discs (MOD)
Trace
Results of unlabeled measurements that you perform appear in the results box.
Results of unlabeled measurements are not saved in the report.
Quick Calcs are common calculations that are computed automatically as unlabeled measurements are made. Quick Calc results appear in the results box.
Performing a 1-Point Depth or Velocity Measurement

When you are in 2D, PW Doppler, or CW Doppler mode and initiate a measurement, a 1-point depth measurement or a 1-point velocity measurement automatically appears in the results box.
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As you perform unlabeled measurements, the results of the measurements and of

the associated Quick Calcs appear in the results box on the display.
To perform a 1-point depth or velocity measurement
1. Press Freeze.
2. Press Caliper.
A caliper appears on the image and the measurement value appears in blue in
the results box.
3. Use the trackball to position the caliper.
4. Press Enter to approve the measurement.
NOTE
When you unfreeze an image, measurements disappear from the image.
Performing a 2-Point Measurement

You can perform a 2-point (linear) measurement to measure the length of a structure or a length of time. As you perform unlabeled measurements, the results of
the measurements and of the Quick Calcs appear in the results box on the display.
To perform a 2-point measurement
1. Press Freeze.
2. Press Caliper.
3. Use the trackball to position the caliper that appears on the image and press
Select or Caliper.
A second caliper appears on the display, Endpt 2 is highlighted on the Select
menu, and the length appears in the results box in blue.
To approve the measurement, press Enter.
To reactivate the first caliper, press Select.

When complete, the measurement changes to white.
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Performing an Ellipse Measurement

You can perform an ellipse measurement on a 2D image to measure a volume. As
you perform unlabeled measurements, the results of the measurements and of
the associated Quick Calcs appear in the results box on the display.
To perform an ellipse measurement on a 2D image
1. Press Freeze.
2. Press Trace.
An ellipse appears on the display, Endpt 2 is highlighted on the Select menu,
and the active measurement appears in blue in the results box.
3. Use the trackball to position the second endpoint.
4. Press Select until AXIS is highlighted on the Select menu.
5. Move the trackball to adjust the width of the ellipse, and then press Select.
The previously anchored endpoint is active and Endpt 1 is highlighted on the
Select menu.
6. To reposition an endpoint or to change the width of the ellipse, press Select
repeatedly until the part of the measurement you want to change is highlighted on the Select menu. Move the trackball to make the change.
To approve the measurement and initiate another measurement, press

Trace.
To approve the measurement and exit analysis, press Enter.
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Performing a Trace Measurement

You can perform a trace measurement to measure the area or circumference of
an irregularly shaped area. As you perform unlabeled measurements, the results
of the measurements and of the associated Quick Calcs appear in the results box.
To perform a manual trace measurement
1. Press Freeze.
2. Press Trace two times.
A caliper appears on the display, Endpt is highlighted on the Select menu,
and the active measurement values appear in blue in the results box.
3. Position the endpoint with the trackball and press Select.
The active caliper appears on the display and Manual is highlighted on the
Select menu.
4. Move the trackball.
The values in the results box are updated as you move the trackball.
To approve the measurement and perform another measurement, press

Trace.
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Performing a Method of Discs Measurement or SPE Volume

You can perform a method of discs (MOD) measurement to measure the volume
of an irregularly shaped area. As you perform unlabeled measurements, the
results of the measurements and of the associated Quick Calcs appear in the
results box.
To perform a method of discs measurement
1. Press Freeze.
2. Press Trace two times.
A caliper appears on the display, Endpt is highlighted on the Select menu,
3. Move the trackball to position the endpoint.
4. To initiate the trace, press Select and move the trackball.
A caliper appears on the display, Manual is highlighted on the Select menu,
6. To complete the trace, press Select.
A short axis appears across the trace and Endpt 2 is highlighted on the
Select menu.
7. Move the trackball to move the endpoint.
Chords appear on the MOD volume trace graphic.
8. Press Select.
The previously anchored endpoint is active and you can control it with the
trackball. The measurement values appear in the results box.
To approve the measurement and perform another measurement, press

Trace.
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Quick Calculations
Quick Calcs are common calculations that are computed automatically as unlabeled measurements are made. Quick Calc results appear in the results box.
The following tables list all Quick Calculations in the order in which they are displayed in the results box:
"2D Quick Calculations" on page 305
"M-mode Quick Calculations" on page 305
"Physio Quick Calculations" on page 306
"Cardiac Doppler Quick Calculations" on page 306
"Doppler Quick Calculations" on page 308
See "Clinical References for Calculations" on page 439 for details on the formula
used, inherent approximations and assumptions, and clinical references.
See "Choosing Quick Calcs" on page 117 for information about selecting which
Quick Calcs are displayed.
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2D Quick Calculations
Associated
Quick
Calculation
Measurement
Type
Units
1-Pointa
DEPTH
cm
2-Point
DIST
cm
AREA
cm2
AREA
cm2
CIRC
cm
AREA
cm2
CIRC
cm
DIST
cm
SPE-VOL
cm3
MOD-VOL
cm3
Trace
Volume
a. This measurement cannot be configured using the

Measurement tab in the Setup window.
M-mode Quick Calculations

Measurement
Type
2-Point
Associated
Quick
Calculation
Units
DIST
cm
TIME
sec
SLP
cm/s
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Physio Quick Calculations

Measurement
Type
2-Pointa
Associated
Quick
Calculation
TIME
Units
sec
a. This measurement cannot be configured through the

Cardiac Doppler Quick Calculations

Measurement
Type
1-Pointa
2-Point
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Associated
Quick
Calculation
Units
VEL
cm/s
PG
mm Hg
FREQ
kHz
MAX
cm/s
MAX
kHz
TIME
sec
SLP
cm/s2
MAX PG
mm Hg
P1/2T
msec
Measurement
Type
Trace
Automatic Trace/
High Qb
Associated
Quick
Calculation
14
Units
TIME
sec
MAX
cm/s
MAX
kHz
Mean VEL
cm/s
VTI
cm
MAX PG
mm Hg
MEAN PG
mm Hg
TIME
sec
MAX
cm/s
MAX
kHz
MEAN VEL
cm/s
VTI
cm
MAX PG
mm Hg
MEAN PG
mm Hg
a. You cannot configure this measurement using the

b. This measurement is not available in CW Doppler
mode.
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Doppler Quick Calculations

Associated
Quick
Calculation
Measurement
Type
1-Pointa
2-Point
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Units
VEL
cm/s
PG
mm Hg
FREQ
kHz
cm/s
cm/s
kHz
kHz
TIME
sec
S/D Ratio
unitless
D/S Ratio
unitless
RI
unitless
Associated
Quick
Calculation
Measurement
Type
Manual Trace
14
Units
cm/s
cm/s
kHz
kHz
MEAN VEL
cm/s
VTI
cm
S/D RATIO
unitless
D/S RATIO
unitless
RI
unitless
PI
unitless
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Associated
Quick
Calculation
Measurement
Type
Automatic Trace/
High Qb
Units
cm/s
cm/s
kHz
kHz
MEAN VEL
cm/s
AT
sec
AS
cm/s2
TAVM
cm/s
S/D RATIO
unitless
D/S RATIO
unitless
RI
unitless
PI
unitless
a. This measurement cannot be configured using the

b. This measurement is not available in CW Doppler
mode.
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Labeled Measurements
You select labeled measurements from the Analysis menu by pressing Calc. You
can perform several labeled measurements in each preset.
The measurements available depend on the system configuration and mode.
Results of measurements that you perform appear in the results box on the display. Results of labeled measurements appear in the report.
Performing a Labeled Measurement

As you perform labeled measurements, the results of the measurements appear in
the results box on the display, and the results are saved in the report.
To perform a labeled measurement
1. Press Calc.
A menu appears listing the labeled measurements and calculations that are
configured on your system.
2. Use the trackball to highlight the measurement you want to perform and
press Enter or Select.
A crosshair appears on the image.
3. Perform the measurement.
NOTE
You can enter the measurement value manually by pressing the Keyboard Entry
soft key.
4. To approve the measurement, press Enter.
NOTE
You can access the entire list of measurements for all installed packages by selecting Main Menu on the Measurements menu.
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Performing a Protocol Measurement

When you perform one of the measurements in a set of protocol measurements
and press Enter, the next measurement in the protocol sequence is initiated. If
you do not want to perform the next measurement, press Clear.
Entering a Measurement Value Manually

You can enter a measurement value manually in live imaging and Report view.
To enter a measurement value manually in live imaging
See "Performing a Labeled Measurement" on page 311.
To enter a measurement manually in Report view
1. Press Report.
2. Press Calc.
3. Select the Measurement Mode from the list.
4. Select the measurements.
5. Double-click the measurement or click Keyboard.
6. In the Keyboard Entry window, type the value and click OK.
7. Press Calc.
The measurement appears in the measurements list.
Using Labeled Measurement Soft Keys

To change any of the soft key settings,
Assign Value
Box Position
Calcs Results
Explain Text
Fetus A, B, C, D
Keyboard Entry
Right, Left, Mid/Main
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Assigning a Measurement Value

You can assign a value from an unlabeled or a labeled measurement value to a
labeled measurement of the same type. You can assign multiple values at a time.
To assign a value to a measurement
1. Perform an unlabeled or a labeled measurement that produces a measurement graphic.
2. Press Calc.
The Analysis menu appears.
3. Select the measurement you want to assign the previous measurement value
to.
4. Press the Assign Value soft key.
The value from the previous measurement is assigned to the selected labeled
measurement.
Performing a Hip Angle Measurement

When performing a hip angle measurement, perform all segments of the measurement either from left to right or from right to left.
The first point of each line, depicted by a caliper, represents the source of the
line. The second point, depicted by the arrow, represents the end of the line.
When the hip angle measurement is complete, the arrows on each line should
point in the same direction.
The first line you create is the baseline reference line.
The second line is the alpha reference line.
The third line is the beta reference line.
To readjust an endpoint
Press Select to select the endpoint and use the trackball.
To perform a hip angle measurement
1. Press Calc.
The Analysis menu appears.
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2. Use the soft key to specify the right or left hip.

3. Press Enter to select the hip angle measurement.
Hip angle Alpha and Beta measurements appear in blue in the results box and
Endpt 1 is highlighted on the Select menu.
4. Place the first caliper on the hip and press Select.
A caliper appears on the display and Endpt 2 is highlighted on the Select
menu.
5. Place the second caliper on the distal end of the femur toward the knee and
press Caliper.
menu.
6. Place the third caliper above the baseline and press Select.
menu.
7. Place the fourth caliper below the baseline to create the alpha angle.
NOTE
The two lines must intersect.

8. Press Caliper.
A caliper appears on the display.
9.
Press Select to highlight Endpt 5 on the Select menu.
10. Place the fifth caliper below the baseline and press Select.
A caliper appears on the display and Endpt 6 is highlighted in the Select
menu.
11. Place the sixth caliper above the baseline to create the beta angle.
NOTE
The two lines must intersect.

12. Press Enter to complete the measurement.
The Hip Angle-Alpha and Hip Angle-Beta measurements appear in the
results box.
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Performing an IMT Trace Measurement

To perform an IMT trace measurement
1. Press Calc.
2. Select an IMT measurement from the Measurements menu.
A caliper is displayed.
4. Press Select or Trace.
The caliper is anchored and another caliper is displayed.
5. Use the trackball to trace the wall.
6. Press Trace or Enter.
A third caliper is displayed.
8. Press Select or Trace.
9. Use the trackball to trace the second wall.
10. Press Enter.
Performing an IMT Linear Measurement

To perform an IMT linear measurement
1. Press Calc.
2. Select an IMT measurement from the measurements menu.
A caliper is displayed.
4. Press Caliper.
6. Press Enter.
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Labeled Measurements by Exam Type

This section lists all labeled measurements by exam type:
"Cardiac Measurements" on page 316
"Vascular Measurements" on page 326
"General Measurements" on page 348
"Obstetric Measurements" on page 362
"Gynecology Measurements" on page 365
"Musculoskeletal Measurements" on page 368
Information about each measurement, such as units, measurement type, and

meaning, is included in the tables in each section.
Instructions for performing the measurements are not included in the tables. To
learn how to perform labeled measurements, see "Performing a Labeled Measurement" on page 311.
To view a list of all available calculations
Press Calc and select Main Menu.
Cardiac Measurements
The following tables list all cardiac measurements and demographics:
316
"Cardiac Demographics" on page 317
"2D/Physio Cardiac Measurements" on page 317
"LVAd sax epi, LVAd sax PM, and LVLd apical" on page 319
"Doppler Cardiac Demographics" on page 320
"Doppler/Physio Cardiac Measurements" on page 320
"M-mode/Physio Cardiac Measurements" on page 323
"M-mode Protocol Measurements" on page 324
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Cardiac Demographics
Demographic
Meaning
Type of Data
Patient ID
Patient identification
text
Institution Name
Institution name
text
Ht
Patient Height
real number
Wt
Patient Weight
real number
BSA
Body Surface Area

calculation
real number
DOB
Date of Birth
date
Age
Patient Age
real and units
Sex
Sex of patient
integer
2D/Physio Cardiac Measurements
Label
Unit
s
Type
Meaning
Asc Ao
cm
Length
Ascending aorta dimension
Duct Art
cm
Length
Ductus arteriosis dimension
EDA
cm2
Area
End diastolic area
EDV (MOD-sp2)
cm3
Volume
Volume (single-plane, 2-chamber MOD)
EDV (MOD-sp4)
cm3
Volume
ESA
cm2
Area
End systolic area
ESV (MOD-sp2)
cm3
Volume
ESV (MOD-sp4)
cm3
Volume
IVSd
cm
Length
Interventricular septal dimension at end diastole
IVSs
cm
Length
Interventricular septal dimension at end systole
LA
cm
Length
Left atrial dimension

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Label
Unit
s
Type
Meaning
Left diam
cm
Length
Flow diameter on left side of heart
LVAd ap2
cm2
Area
Left ventricular long-axis area at end diastole,

apical two-chamber
LVAd ap4
cm2
Area
Left ventricular long-axis area at end diastole,

apical four-chamber
LVAd apical
cm
Length
LVAd sax epi
cm2
Area
Left ventricular area at end diastole, apical

Left ventricular short-axis area at epicardium at
end diastole
LDAd sax MV
cm2
Area
Left ventricular short-axis area at mitral valve

level at end diastole
LVAd sax PM
cm2
Area
Left ventricular short-axis area at papillary muscle

level at end diastole
LVAs ap2
cm2
Area
Left ventricular area at end diastole, apical
LVAs ap4
cm2
Area
Left ventricular long-axis area at end systole,

apical four-chamber
LVAs apical
cm2
Area
Left ventricular area at end systole, apical
LVAs sax MV
cm2
Area
Left ventricular short-axis area at mitral valve

level at end systole
LVAs sax PM
cm2
Area
Left ventricular short-axis area at papillary muscle

level at end systole
LVIDd
cm
Length
Left ventricular internal diameter at end diastole
LVIDs
cm
Length
Left ventricular internal diameter at end systole
LVLd apical
cm2
Length
Left ventricular length at end diastole, apical
LVLs apical
cm
Length
Left ventricular length at end systole, apical
LVOT diam
cm
Length
Left ventricular outflow tract diameter
LVPWd
cm
Length
Left ventricular posterior wall dimension at end

diastole
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Label
Unit
s
Type
14
Meaning
LVPWs
cm
Length

systole
MR PISA radius
cm
Length
Alias radius of the proximal convergence zone of

the mitral valve regurgitation
MV Diam 1
cm
Length
Mitral valve diameter 1
MV Diam 2
cm
Length
Mitral valve diameter 2
Right diam
cm
Length
Flow diameter on right side of heart
RVAWd
cm
Length
Right ventricular wall dimension at end diastole
RVDd
cm
Length
Right ventricular internal diameter at end diastole
LVAd sax epi, LVAd sax PM, and LVLd apical
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Doppler Cardiac Demographics

Label
Units
RA press
mm Hg
Meaning
Estimated right atrial pressure
Doppler/Physio Cardiac Measurements

Label
Units
Type
Meaning
AI max PG
mm H
g
Pressure gradient
Aortic insufficiency maximum

pressure gradient
AI max vel
cm/s
Maximum velocity
Maximum velocity of aortic

insufficiency
Annular Vel
cm/s
Maximum velocity
Annular velocity
Ao dec slope
cm/s2
Acceleration
Aortic insufficiency deceleration

slope
Ao dec timea
sec
Time
Measure the aortic deceleration

time
Ao max PG
mm H
g
Pressure gradient
Aortic flow maximum pressure

gradient
Ao mean PG
mm H
g
Pressure gradient
Aortic flow mean pressure gradient
Ao V2 max
cm/s
Maximum velocity
Maximum velocity for continuity

formula
Ao V2 VTI
cm
Velocity time
integral
Velocity time integral 2 for

continuity formula
Aortic R-R
sec
Time
R-R interval measured when

making measurements on the
aortic valve
Duct Art Flow
cm/s
Velocity
Ductus arteriosis flow velocity
IVR Time
sec
Time
Isovolumic relaxation time
Left max vel
cm/s
Maximum velocity
Maximum flow volume on left side

of heart
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Type
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Label
Units
Meaning
LV mean PG
mm H
g
Pressure gradient
Left ventricular mean pressure

gradient
LV V1 max
cm/s
Maximum velocity
Maximum velocity for continuity

formula at 2D diam
LV V1 VTI
cm
Velocity time
integral
Velocity time integral 1 for

continuity at 2D diam
LVOT diam
cm
Length, height
Left ventricular outflow tract

diameter
LVOT maxV
cm/s
Keyboard entry
Velocity of the left ventricular

outflow tract
MR alias vel
cm/s
Maximum velocity
Aliasing velocity of the proximal

convergence zone of the mitral
valve regurgitation
MR max PG
mm H
g
Pressure gradient
Mitral regurgitation maximum

pressure gradient
MR max vel
cm/s
Maximum velocity
Maximum velocity of mitral

regurgitation
MR mean PG
mm H
g
Pressure gradient
Mitral regurgitation mean pressure

gradient
MR mean vel
cm/s
Mean velocity
Mean velocity of the mitral valve

regurgitant flow
MR VTI
cm
Velocity time
integral
Velocity time integral of the mitral

valve regurgitant flow
MV A point
cm/s
Maximum velocity
Mitral valve A-point maximum

velocity
MV dec slope
cm/s2
Acceleration
Mitral valve deceleration slope
MV dec timea
sec
Time
MV E point
cm/s
Maximum velocity
Mitral valve E-point maximum

velocity
MV Max PG
mm H
g
Pressure gradient
Maximum pressure gradient of the

flow distal to the mitral valve
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Label
Units
MV Mean PG
mm H
g
Pressure gradient
Mean pressure gradient of the flow

distal to the mitral valve
MV P1/2t max v
cm/s
Maximum velocity
Mitral valve maximum velocity for

P1/2t
MV V2 Max
cm/s
Velocity
Maximum velocity of the flow distal

to the mitral valve
MV V2 VTI
cm
Velocity time
integral
Velocity time integral based on flow

Myocardial Vel
cm/s
Maximum velocity
Myocardial velocity
PA acc time
sec
Time
Measure the pulmonic acceleration

time
PA dec slope
cm/s2
Acceleration
Pulmonic deceleration slope
PA dec timea
sec
Time
Measure the pulmonic deceleration

time
PA max PG
mm H
g
Pressure gradient
Pulmonary artery maximum

pressure gradient
PA mean PG
mm H
g
Pressure gradient
Mean pressure gradient of the flow

PA V2 max
cm/s
Maximum velocity
Maximum velocity measured distal

to the pulmonary artery with CW
Doppler
PI max PG
mm H
g
Pressure gradient
Pulmonic insufficiency maximum

pressure gradient
PI max vel
cm/s
Maximum velocity
Maximum velocity of pulmonic

insufficiency
Pul V A wave max
cm/s
Maximum velocity
A-wave maximum velocity of the

pulmonic valve
Pul V D
cm/s
Minimum velocity
Diastolic velocity of the pulmonic

valve
Pul V S
cm/s
Maximum velocity
Systolic velocity of the pulmonic

valve
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Type
Meaning
Label
Units
Type
14
Meaning
Right max vel
cm/s
Maximum velocity
Maximum flow volume on right

side of heart
RVOT maxV
cm/s
Maximum velocity
Velocity of the right ventricular

outflow tract
TR Max PG
mm H
g
Maximum pressure
gradient

tricuspid regurgitation
TR max vel
cm/s
Maximum velocity
Maximum velocity of the tricuspid

valve regurgitation
TV max PG
mm H
g
Pressure gradient

fow distal to the tricuspid valve
TV mean V
cm/s
Pressure gradient
Mean velocity of the flow distal to

the tricuspid valve
a. These measurements are not included on the Analysis menu and cannot be performed individually. Non-performable measurements are usually associated with a meta-measurement.
M-mode/Physio Cardiac Measurements
Label
Unit
s
Type
Meaning
ACS
cm
Height
Aortic cusp separation
Ao root diam
cm
Height
Aortic root diameter
Aortic R-R
sec
Time
R-R interval measured when making

measurements on the aortic valve
EPSS
cm
Height
E-point septal separation
IVSd
cm
Height
Interventricular septal dimension at end diastole
IVSs
cm
Height
Interventricular septal dimension at end systole
LA dimension
cm
Height
Left atrial dimension
LVIDd
cm
Height
Left ventricular internal diameter at end diastole
LVIDs
cm
Height
Left ventricular internal diameter at end systole
LVPWd
cm
Height

diastole
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Label
Unit
s
Type
Meaning
LVPWs
cm
Height

systole
MM R-R int
sec
Time
M-mode or 2D R-R interval
MV E-F slope
cm/s MM slope Mitral valve E-F slope
MV excursion
cm
Height
Mitral valve excursion
Q-to-PV close
sec
Time
Q-wave to pulmonic valve closing
Q-to-TV open
sec
Time
Q-wave to tricuspid valve opening
RVAWd
cm
Height
Right ventricular wall dimension at end diastole
RVDd
cm
Height
Right ventricular internal diameter at end diastole
M-mode Protocol Measurements

M-mode also supports the following protocol measurements. These are measurements that are made one after the other, usually occurring in a single slice of the
anatomy.
NOTE
324
Whenever a gap is created (by turning off one of the following measurements), a
free crosshair appears for the next measurement in the protocol list.
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Cardiac Triggered Measurements

A number of triggered measurements are supported in the cardiac package.
When these measurements are performed, a set of associated measurement values are automatically performed by the system. The associated measurements do
not need to be added to the Analysis menu in order to be performed.
The following table lists the triggered measurements with their corresponding
measurements:
Triggered Measurement
ESV(MOD-sp2)
Associated Measurements
LVAs ap2
LVAs apical
LVLs apical
EDV(MOD-sp2)
LVAd ap2
LVAd apical
LVLd apical
ESV(MOD-sp4)
LVAs ap4
LVAs apical
LVLs apical
EDV(MOD-sp4)
LVAd ap4
LVAd apical
LVLd apical
Ao V2 VTI
Ao V2 max
Ao max PG
Ao mean PG
MV V2 VTI
MV V2 max
MV max PG
MV mean PG
LV V1 VTI
LV V1 max
LV mean PG
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MR max
MR max PG
PI max vel
PI max PG
AI max vel
Ao V2 max
AI max PG
MV V2 max
PA V2 max
MV max PG
TR max vel
TR max PG
PA mean PG
PA V2 max
Ao max PG
PA max PG
PA max PG
Ao dec slope
Ao dec time
MV dec slope
MV dec time
PA dec slope
PA dec time
Vascular Measurements
This section lists the following vascular measurements:
"TCD Measurements" on page 326
"Carotid Measurements" on page 330
"UE Artery Measurements" on page 336
"UE Vein Measurements" on page 340
"LE Artery Measurements" on page 341
"LE Vein Measurements" on page 347
"IMT Measurement" on page 348
TCD Measurements
This section lists the following TCD vascular measurements:
326
"% Stenosis Measurements" on page 327
"3-Axis Volume Measurements" on page 327
"A/B Velocity Ratio Measurements" on page 327
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"Flow Volume Measurements" on page 328
"Resistivity and Pulsatility Index Measurements" on page 328
14
% Stenosis Measurements
Unit
Label
s
Type
Meaning
Area 1 cm2
Area
True or residual area
Area 2 cm2
Area
Diam
1
cm
Length True or residual diameter
Diam
2
cm
3-Axis Volume Measurements
Label
Unit
s
Type
Meaning
Distance 1 cm
Length Height, length, or width
Distance 2 cm
Distance 3 cm
A/B Velocity Ratio Measurements
Label
Velocity
A
Unit
s
Type
Meaning
cm/s Velocit
y
Generic velocity
Velocity B cm/s Velocit

y
Generic velocity
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Flow Volume Measurements
Label
Unit
s
Type
Flow Diam
cm
Distance
Flow TAVM
cm/s Mean velocity
Meaning
Flow volumes diameter
Mean velocity for flow
volume
Resistivity and Pulsatility Index Measurements

The following table lists TCD vessels. When you select any of the following vessels from the analysis menu, the system automatically initiates a 2-point Doppler
measurement.
Table 14-1 TCD Vessels
Label
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TAVP
ACA
Dist Basilar
MCA (M1)
Mid Basilar
PCA (P1)
PCA (P2)
Prox Basilar
Prox ECA
Prox ICA
Vertebral
14
The following table lists the Resistivity and Pulsatility Index Measurements.
Table 14-2 Resistivity and Pulsatility Index Measurements
Label
Unit
s
Type
SV
cm/s Velocity
DV
cm/s Velocity
TAVP (PI)
cm/s Velocity
ACA DVa
cm/s Velocity
ACA SVa
cm/s Velocity
ACA TAVP (PI)a
cm/s Velocity
Dist Basilar DVa
cm/s Velocity
Dist Basilar SVa
cm/s Velocity
Dist Basilar TAVP (PI)a
cm/s Velocity
MCA (M1) DVa
cm/s Velocity
MCA (M1) SVa
cm/s Velocity
MCA (M1) TAVP (PI)a
cm/s Velocity
Mid Basilar DVa
cm/s Velocity
Mid Basilar SVa
cm/s Velocity
Mid Basilar TAVP (PI)a
cm/s Velocity
PCA (M1) DVa
cm/s Velocity
PCA (M1) SVa
cm/s Velocity
PCA (M1) TAVP (PI)a
cm/s Velocity
PCA (M2) DVa
cm/s Velocity
PCA (M2) SVa
cm/s Velocity
PCA (M2) TAVP (PI)a
cm/s Velocity
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Table 14-2 Resistivity and Pulsatility Index Measurements

Prox Basilar DVa
cm/s Velocity
Prox Basilar SVa
cm/s Velocity
Prox Basilar TAVP (PI)a
cm/s Velocity
a. You cannot add these measurements to the Analysis menu. You can only add the name of the
vessel.
Carotid Measurements
This section lists the following carotid measurements:
"Carotid % Stenosis Measurements" on page 330
"Carotid 3-Axis Volume Measurements" on page 331
"Carotid A/B Velocity Ratio Measurements" on page 331
"Carotid Flow Volume Measurements" on page 331
"Carotid Intima Media Thickness (IMT) Measurements" on page 332
"Carotid ICA/CCA Ratio Measurements" on page 333
"Carotid Resistivity Index and Pulsatility Index Measurements" on page 333
Carotid % Stenosis Measurements

Unit
Label
s
Type
330
Meaning
Area 1 cm2
Area
Area 2 cm2
Area
Diam
1
cm
Diam
2
cm
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Carotid 3-Axis Volume Measurements

Unit
s
Type
Label
Meaning
Distance 1 cm
Distance 2 cm
Distance 3 cm
Carotid A/B Velocity Ratio Measurements
Label
Velocity
A
Unit
s
Type
Meaning
cm/s Velocit
y
Generic velocity

y
Generic velocity
Carotid Flow Volume Measurements
Label
Unit
s
Type
Flow Diam
cm
Distance
Flow
TAVMFlow
TAVM
cm/s Mean velocity
Meaning
volume
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Carotid Intima Media Thickness (IMT) Measurements
Label
NOTE
332
Unit
s
Type
Dist CCA IMT
cm
Length
Dist ICA IMT
cm
Length
Mid CCA IMT
cm
Length
Mid ICA IMT
cm
Length
Prox CCA IMT
cm
Length
Prox ICA IMT
cm
Length
The IMT measurements appear on the report under the IMT heading. Therefore,
IMT does not appear in each IMT measurement in the report.
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Carotid ICA/CCA Ratio Measurements

Label
Unit
s
Type
Meaning
CCA DV (ratio)
cm/s Velocity
Common carotid artery

diastolic velocity for the
ICA/CCA ratio
CCA SV (ratio)
cm/s Velocity
Common carotid artery

systolic velocity for the
ICA/CCA ratio
ICA DV (ratio)
cm/s Velocity
Internal carotid artery

diastolic velocity for the
ICA/CCA ratio
ICA SV (ratio)
cm/s Velocity
Internal carotid artery

systolic velocity for the
ICA/CCA ratio
Carotid Resistivity Index and Pulsatility Index Measurements

The following table lists carotid vessels. When you select any of the following vessels from the Analysis menu, the system automatically initiates a 2-point Doppler
measurement.
Table 14-3 Carotid Vessels
Label
TAVP
Bulb
Dist CCA
Dist ECA
Mid CCA
Mid ECA
Mid ICA
Prox CCA
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Table 14-3 Carotid Vessels (Continued)

Label
TAVP
Prox ECA
Prox ICA
Vertebral
Where:
Label
334
Unit
s
Type
DV
cm/s Velocity
SV
cm/s Velocity
TAVP (PI)
cm/s Velocity
Bulb DVa
cm/s Velocity
Bulb SVa
cm/s Velocity
Bulb TAVP (PI)a
cm/s Velocity
Dist CCA DVa
cm/s Velocity
Dist CCA SVa
cm/s Velocity
Dist CCA TAVP (PI)a
cm/s Velocity
Dist ECA DVa
cm/s Velocity
Dist ECA SVa
cm/s Velocity
Dist ECA TAVP (PI)a
cm/s Velocity
Dist ICA DVa
cm/s Velocity
Dist ICA SVa
cm/s Velocity
Dist ICA TAVP (PI)a
cm/s Velocity
Mid CCA DVa
cm/s Velocity
Mid CCA SVa
cm/s Velocity
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Label
Unit
s
14
Type
Mid CCA TAVP (PI)a
cm/s Velocity
Mid ECA DVa
cm/s Velocity
Mid ECA SVa
cm/s Velocity
Mid ECA TAVP (PI)a
cm/s Velocity
Mid ICA DVa
cm/s Velocity
Mid ICA SVa
cm/s Velocity
Mid ICA TAVP (PI)a
cm/s Velocity
Prox CCA DVa
cm/s Velocity
Prox CCA SVa
cm/s Velocity
Prox CCA TAVP (PI)a
cm/s Velocity
Prox ECA DVa
cm/s Velocity
Prox ECA SVa
cm/s Velocity
Prox ECA TAVP (PI)a
cm/s Velocity
Prox ICA DVa
cm/s Velocity
Prox ICA SVa
cm/s Velocity
Prox ICA TAVP (PI)a
cm/s Velocity
Vertebral DVa
cm/s Velocity
Vertebral SVa
cm/s Velocity
Vertebral TAVP (PI)a
cm/s Velocity
a. You cannot add these measurements to the Analysis menu. You can only add the name of the vessel.
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UE Artery Measurements
This section lists the following UE artery measurements:
"UE Artery % Stenosis Measurements" on page 336
"UE Artery 3-Axis Volume Measurements" on page 336
"UE Artery A/B Velocity Ratio Measurements" on page 337
"UE Artery Flow Volume Measurements" on page 337
UE Artery % Stenosis Measurements
Label
Unit
s
Type
Meaning
Area 1 cm2
Area
Area 2 cm2
Area
Diam
1
cm
Diam
2
cm
UE Artery 3-Axis Volume Measurements
Label
336
Unit
s
Type
Meaning
Distance 1 cm
Distance 2 cm
Distance 3 cm
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UE Artery A/B Velocity Ratio Measurements
Label
Velocity
A
Unit
s
Type
Meaning
cm/s Velocit
y
Generic velocity

y
Generic velocity
UE Artery Flow Volume Measurements
Label
Unit
s
Type
Flow Diam
cm
Distance
Flow TAVM
cm/s Mean velocity
Meaning
Flow volumes velocity
UE Artery Resistivity Index and Pulsatility Index Measurements

The following table lists UE artery vessels. When you select any of the following
vessels from the analysis menu, the system automatically initiates a 2-point Doppler measurement.
Table 14-4 UE Artery Vessels
Label
TAVP
Axillary
Dist Brachial
Dist Radial
Dist Subclavian
Dist Ulnar
Mid Radial
Mid Subclavian
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Table 14-4 UE Artery Vessels

Label
TAVP
Mid Ulnar
Prox Brachial
Prox Radial
Prox Subclavian
Prox Ulnar
Where:
Label
338
Unit
s
Type
DV
cm/s Velocity
SV
cm/s Velocity
TAVP (PI)
cm/s Velocity
Axillary DVa
cm/s Velocity
Axillary SVa
cm/s Velocity
Axillary TAVP (PI)a
cm/s Velocity
Dist Brachial DVa
cm/s Velocity
Dist Brachial SVa
cm/s Velocity
Dist Brachial TAVP (PI)a
cm/s Velocity
Dist Radial DVa
cm/s Velocity
Dist Radial SVa
cm/s Velocity
Dist Radial TAVP (PI)a
cm/s Velocity
Dist Subclavian DVa
cm/s Velocity
Dist Subclavian SVa
cm/s Velocity
Dist Subclavian TAVP (PI)a
cm/s Velocity
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Unit
s
14
Type
Dist Ulnar DVa
cm/s Velocity
Dist Ulnar SVa
cm/s Velocity
Dist Ulnar TAVP (PI)a
cm/s Velocity
Mid Radial DVa
cm/s Velocity
Mid Radial SVa
cm/s Velocity
Mid Radial TAVP (PI)a
cm/s Velocity
Mid Subclavian DVa
cm/s Velocity
Mid Subclavian SVa
cm/s Velocity
Mid Subclavian TAVP (PI)a
cm/s Velocity
Mid Ulnar DVa
cm/s Velocity
Mid Ulnar SVa
cm/s Velocity
Mid Ulnar TAVP (PI)a
cm/s Velocity
Prox Brachial DVa
cm/s Velocity
Prox Brachial SVa
cm/s Velocity
Prox Brachial TAVP (PI)a
cm/s Velocity
Prox Radial DVa
cm/s Velocity
Prox Radial SVa
cm/s Velocity
Prox Radial TAVP (PI)a
cm/s Velocity
Prox Subclavian DVa
cm/s Velocity
Prox Subclavian SVa
cm/s Velocity
Prox Subclavian TAVP (PI)a
cm/s Velocity
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Unit
s
Label
Type
Prox Ulnar DVa
cm/s Velocity
Prox Ulnar SVa
cm/s Velocity
Prox Ulnar TAVP (PI)a
cm/s Velocity
a. You cannot add these measurements to the to the

Analysis menu. You can only add the name of the
vessel.
UE Vein Measurements
This section lists the following UE vein measurements:
"UE Vein 3-Axis Volume Measurements" on page 340
"UE Vein A/B Velocity Ratio Measurements" on page 340
"UE Vein Flow Volume Measurements" on page 341
UE Vein 3-Axis Volume Measurements
Label
Unit
s
Type
Meaning
Distance 1 cm
Distance 2 cm
Distance 3 cm
UE Vein A/B Velocity Ratio Measurements
Label
Velocity
A
340
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Unit
s
Type
Meaning
cm/s Velocit
y
Generic velocity

y
Generic velocity
14
UE Vein Flow Volume Measurements
Label
NOTE
Unit
s
Type
Flow Diam
cm
Distance
Flow TAVM
cm/s Mean velocity
Meaning
volume
Other measurements are available. See "UE Artery Measurements" on page 336.
LE Artery Measurements
This section lists the following LE artery measurements:
"LE Artery% Stenosis Measurements" on page 341
"LE Artery 3-Axis Volume Measurements" on page 342
"LE Artery A/B Velocity Ratio Measurements" on page 342
"LE Artery Flow Volume Measurements" on page 342
"LE Artery Resistivity Index and Pulsatility Index Measurements" on page 343
LE Artery% Stenosis Measurements
Label
Unit
s
Type
Meaning
Area 1 cm2
Area
Area 2 cm2
Area
Diam
1
cm
Diam
2
cm
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LE Artery 3-Axis Volume Measurements

Unit
s
Type
Label
Meaning
Distance 1 cm
Distance 2 cm
Distance 3 cm
LE Artery A/B Velocity Ratio Measurements
Label
Velocity
A
Unit
s
Type
Meaning
cm/s Velocit
y
Generic velocity

y
Generic velocity
LE Artery Flow Volume Measurements
Label
342
Unit
s
Type
Flow Diam
cm
Flow TAVM
cm/s Mean velocity
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Distance
Meaning
Flow volume's velocity
14
LE Artery Resistivity Index and Pulsatility Index Measurements

The following table lists LE artery vessels. When you select any of the following
vessels from the AIMTnalysis menu, the system automatically initiates a 2-point
Doppler measurement.
Table 14-5 LE Artery Vessels
Label
TAVP
CFA
Dist ATA
Dist Pero
Dist POP
Dist PTA
Dist SFA
Dorsalis Pedis
Ext Iliac
Iliac
Int Iliac
Mid ATA
Mid Pero
Mid PTA
Mid SFA
PFA
Prox ATA
Prox Pero
Prox POP
Prox PTA
Prox SFA
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14
Where:
Label
344
Unit
s
Type
DV
cm/s Velocity
SV
cm/s Velocity
TAVP (PI)
cm/s Velocity
CFA DVa
cm/s Velocity
CFA SVa
cm/s Velocity
CFA TAVP (PI)a
cm/s Velocity
Dist ATA DVa
cm/s Velocity
Dist ATA SVa
cm/s Velocity
Dist ATA TAVP (PI)a
cm/s Velocity
Dist Pero DVa
cm/s Velocity
Dist Pero SVa
cm/s Velocity
Dist Pero TAVP (PI)a
cm/s Velocity
Dist POP DVa
cm/s Velocity
Dist POP SVa
cm/s Velocity
Dist POP TAVP (PI)a
cm/s Velocity
Dist PTA DVa
cm/s Velocity
Dist PTA SVa
cm/s Velocity
Dist PTA TAVP (PI)a
cm/s Velocity
Dist SFA DVa
cm/s Velocity
Dist SFA SVa
cm/s Velocity
Dist SFA TAVP (PI)a
cm/s Velocity
Dorsalis Pedis DVa
cm/s Velocity
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Dorsalis Pedis SVa
cm/s Velocity
Dorsalis Pedis TAVP

(PI)a
cm/s Velocity
Ext Iliac DVa
cm/s Velocity
Ext Iliac SVa
cm/s Velocity
Ext Iliac TAVP (PI)a
cm/s Velocity
Iliac DVa
cm/s Velocity
Iliac SVa
cm/s Velocity
Iliac TAVP (PI)a
cm/s Velocity
Int Iliac DVa
cm/s Velocity
Int Iliac SVa
cm/s Velocity
Int Iliac TAVP (PI)a
cm/s Velocity
Mid ATA DVa
cm/s Velocity
Mid ATA SVa
cm/s Velocity
Mid ATA TAVP (PI)a
cm/s Velocity
Mid Pero DVa
cm/s Velocity
Mid Pero SVa
cm/s Velocity
Mid Pero TAVP (PI)a
cm/s Velocity
Mid POP DVa
cm/s Velocity
Mid POP SVa
cm/s Velocity
Mid POP TAVP (PI)a
cm/s Velocity
Mid PTA DVa
cm/s Velocity
Mid PTA SVa
cm/s Velocity
Mid PTA TAVP (PI)a
cm/s Velocity
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14
Mid SFA DVa
cm/s Velocity
Mid SFA SVa
cm/s Velocity
Mid SFA TAVP (PI)a
cm/s Velocity
PFAa
cm/s Velocity
Prox ATA DVa
cm/s Velocity
Prox ATA SVa
cm/s Velocity
Prox ATA TAVP (PI)a
cm/s Velocity
Prox Pero DVa
cm/s Velocity
Prox Pero SVa
cm/s Velocity
Prox Pero TAVP (PI)a
cm/s Velocity
Prox POP DVa
cm/s Velocity
Prox POP SVa
cm/s Velocity
Prox POP TAVP (PI)a
cm/s Velocity
Prox PTA DVa
cm/s Velocity
Prox PTA SVa
cm/s Velocity
Prox PTA TAVP (PI)a
cm/s Velocity
Prox SFA DVa
cm/s Velocity
Prox SFA SVa
cm/s Velocity
a. You cannot add these measurements to the Analysis menu. You can only add the name of the vessel.
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LE Vein Measurements
This section lists the following LE vein measurements:
"LE Vein 3-Axis Volume Measurements" on page 347
"LE Vein A/B Velocity Ratio Measurements" on page 347
"LE Vein Flow Volume Measurements" on page 347
LE Vein 3-Axis Volume Measurements

Unit
s
Type
Label
Meaning
Distance 1 cm
Distance 2 cm
Distance 3 cm
LE Vein A/B Velocity Ratio Measurements
Label
Velocity
A
Unit
s
Type
Meaning
cm/s Velocit
y
Generic velocity

y
Generic velocity
LE Vein Flow Volume Measurements
Label
Unit
s
Type
Flow Diam
cm
Distance
Flow TAVM
cm/s Mean velocity
Meaning
Vessel diameter
Flow time average
velocity peak
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NOTE
Other measurements are available. See "LE Artery Measurements" on page 341.
IMT Measurement
This section lists the Intima Media Thickness (IMT) measurements:
Label
Unit
s
Type
Dist CCA IMT
cm
Length
Dist ICA IMT
cm
Length
Mid CCA IMT
cm
Length
Mid ICA IMT
cm
Length
Prox CCA IMT
cm
Length
Prox ICA IMT
cm
Length
General Measurements
This section lists the following general labeled measurements by exam type:
"Abdominal Measurements" on page 349
"Prostate Measurements" on page 352
"Thyroid Measurements" on page 354
"Breast Measurements" on page 356
"Testicular Measurements" on page 357
"Superficial Measurements" on page 359
"Pediatric Hip Measurements" on page 361
Information about each measurementsuch as units, measurement type, and

meaningis included in the tables in each section.
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Instructions for performing the measurements are not included in the tables. To
learn how to perform labeled measurements, see "Performing a Labeled Measurement" on page 311.
Abdominal Measurements
This section lists the following abdominal measurements:
NOTE
"% Stenosis Measurements" on page 349
"A/B Velocity Ratio Measurements" on page 350
"Resistivity Index and Pulsatility Index Measurements" on page 351
"Bladder Volume Measurements" on page 352
"PV Bladder Volume Measurements" on page 352
The following types of abdominal measurements have side restrictions: Aortic

measurements can only be performed on the mid/main side. Renal measurements
can only be performed on the left and right side.
% Stenosis Measurements
Label
Type
Meaning
Aortic Area 1
Area
Aortic Area 2
Area
Aortic Diam 1
Distance
True or residual diameter
Aortic Diam 2
Distance
Area 1
Area
Area 2
Area
Diam 1
Distance
Diam 2
Distance
Renal Artery Area 1
Area

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Renal Artery Area 2
Area
Renal Artery Diam 1
Distance
Renal Artery Diam 2
Distance
A/B Velocity Ratio Measurements

Unit
s
Label
Type
Meaning
Ao Velocity A
cm/s Velocit
y
Generic velocity
Ao Velocity B
cm/s Velocit
y
Generic velocity
RA Velocity A
cm/s Velocit
y
Generic velocity
RA Velocity B
cm/s Velocit
y
Generic velocity
Velocity A
cm/s Velocit
y
Generic velocity
Velocity B
cm/s Velocit
y
Generic velocity
Label
350
Unit
s
Type
Ao Flow Diam
cm
Ao Flow TAVM
cm/s Mean velocity Flow volume's velocity
Flow Diam
cm
Flow TAVM
cm/s Mean velocity Flow volume's velocity
RA Flow Diam
cm
RA Flow TAVM
cm/s Mean velocity Mean velocity for flow volume
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Distance
Meaning
Distance
Distance
Flow volume's diameter

Flow volume's diameter
14
Resistivity Index and Pulsatility Index Measurements

Unit
s
Label
Type
Ao DV
cm/s Aortic diastolic velocity
Ao SV
cm/s Aortic systolic velocity
Ao TAVP (PI)
cm/s
RA DV
cm/s Renal Diastolic velocity
RA SV
cm/s Renal systolic velocity
RA TAVP (PI)
cm/s
Label
Unit
s
Type
Meaning
Aortic Distance 1 cm
Distance Height, length, or width
Distance 1
cm
Distance 2
cm
Distance 3
cm
Renal Distance 1
cm
Renal Distance 2
cm
Renal Distance 3
cm
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14
Bladder Volume Measurements
Label
Unit
s
Type
Meaning
Bladder H
cm
Length
Height
Bladder L
cm
Length
Length
Bladder W
cm
Length
Width
PV Bladder Volume Measurements
Label
Unit
s
Type
Meaning
PV Bladder H
cm
Length
Height
PV Bladder L
cm
Length
Length
PV Bladder W
cm
Length
Width
Prostate Measurements
This section lists the following prostate measurements:
352
"Prostate Volume Measurements" on page 353
"Bladder Volume Measurements" on page 353
"PV Bladder Volume Measurements" on page 353
"A/B Ratio Measurements" on page 354
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Prostate Volume Measurements

Unit
s
Label
Type
Meaning
Prostate H
cm
Length
Height
Prostate L
cm
Length
Length
Prostate W
cm
Length
Width
Bladder Volume Measurements

Unit
s
Label
Type
Meaning
Bladder H
cm
Length
Height
Bladder L
cm
Length
Length
Bladder W
cm
Length
Width
PV Bladder Volume Measurements

Unit
s
Label
Type
Meaning
PV Bladder H
cm
Length
Height
PV Bladder L
cm
Length
Length
PV Bladder W
cm
Length
Width
Label
Unit
s
Type
Meaning
Distance 1
cm
Length
Height, Length, or Width
Distance 2
cm
Length
Distance 3
cm
Length

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Label
Unit
s
Type
Flow diam
cm
Length
Flow TAVM
cm/s Mean velocity
Meaning
Vessel diameter
Time averaged velocity mean
A/B Ratio Measurements
Label
Unit
s
Type
Meaning
Velocity A
cm/s Velocity
Generic velocity
Velocity B
cm/s Velocity
Generic velocity

Label
Unit
s
Type
Meaning
SV
cm/s Velocity
Systolic velocity
DV
cm/s Velocity
Diastolic velocity
TAVP (PI)
cm/s Velocity
Time averaged peak velocity
Thyroid Measurements
This section lists the following thyroid measurements:
354
"Resistivity and Pulsatility Index Measurements" on page 355
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Unit
s
Label
Type
Meaning
Distance 1
cm
Length
Height, length, or width
Distance 2
cm
Length
Distance 3
cm
Length

Unit
s
Label
Type
Meaning
Flow diam
cm
Length
Vessel diameter
Flow TAVM
cm/s Mean velocity
Label
Unit
s
Type
Meaning
Velocity A
cm/s Velocity
Generic velocity
Velocity B
cm/s Velocity
Generic velocity
Resistivity and Pulsatility Index Measurements
Label
Unit
s
Type
Meaning
SV
cm/s Velocity
Systolic velocity
DV
cm/s Velocity
Diastolic velocity
TAVP (PI)
cm/s Velocity
Time averaged velocity

peak
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Breast Measurements
This section lists the following breast measurements:
"Mass Volume (110)" on page 356
Mass Volume (110)

Unit
s
Label
Type
Meaning
Mass # Dist 1
cm
Length
Mass # Dist 2
cm
Length
Mass # Dist 3
cm
Length
Label
Unit
s
Type
Meaning
Distance 1
cm
Length
Distance 2
cm
Length
Distance 3
cm
Length
Label
356
Unit
s
Type
Flow diam
cm
Flow TAVM
cm/s Mean velocity
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Length
Meaning
14
Label
Unit
s
Type
Meaning
Velocity A
cm/s Velocity
Generic velocity
Velocity B
cm/s Velocity
Generic velocity
Label
Unit
s
Type
Meaning
SV
cm/s Velocity
Systolic velocity
DV
cm/s Velocity
Diastolic velocity
TAVP (PI)
cm/s Velocity

peak
Testicular Measurements
This section lists the following testicular measurements:
"Testicle Volume" on page 358
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Testicle Volume
Unit
s
Label
Type
Meaning
Testicle L
cm
Length
Length
Testicle W
cm
Length
Width
Testicle H
cm
Length
Height

Unit
s
Label
Type
Meaning
Distance 1
cm
Length
Height, length, width
Distance 2
cm
Length
Distance 3
cm
Length

Label
Units
Type
Meaning
Flow diam
cm
Length
Vessel diameter
Flow TAVM
cm/s
Mean velocity
Label
358
Unit
s
Type
Meaning
Velocity A
cm/s Velocity
Generic velocity
Velocity B
cm/s Velocity
Generic velocity
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Label
Unit
s
Type
Meaning
SV
cm/s Velocity
Systolic velocity
DV
cm/s Velocity
Diastolic velocity
TAVP (PI)
cm/s Velocity

peak
Superficial Measurements
This section lists the following superficial measurements:
"% Stenosis" on page 359
% Stenosis
Label
Type
Meaning
Area 1
Area
Area 2
Area
Diam 1
Distance
Diam 2
Distance
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14

Unit
s
Label
Type
Meaning
Distance 1
cm
Length
Distance 2
cm
Length
Distance 3
cm
Length
Label
Unit
s
Type
Meaning
Flow diam
cm
Length
Flow TAVM
cm/s Mean velocity

volume
Label
Unit
s
Type
Meaning
Velocity A
cm/s Velocity
Generic velocity
Velocity B
cm/s Velocity
Generic velocity
Label
360
Unit
s
Type
Meaning
SV
cm/s Velocity
Systolic velocity
DV
cm/s Velocity
Diastolic velocity
TAVP (PI)
cm/s Velocity

peak
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Pediatric Hip Measurements

This section lists hip angle measurements. The hip angle component has no associated value. When you select Hip Angle from the menu, you can measure the
alpha and beta angles of the hip angles.
Label
Hip Angle
Unit
s
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Obstetric Measurements
The following table lists all obstetric measurements:
Label
Unit
s
Type
Meaning
2 Beat Pk-to-Pk
sec
Time
AC traced
cm
Circumference Traced abdominal circumference
ADap
cm
Length
Anterior-posterior abdominal
diameter
ADtrv
cm
Length
Transverse abdominal diameter
BPD
cm
Length
Biparietal diameter
CD
cm
Length
Cerebellar diameter
Cist Mag
cm
Length
Cisterna magna
CLAV
cm
Length
Clavicle length
CRL
cm
Length
Crown-rump length
Distance 1
cm
Length
3-axis volume length
Distance 2
cm
Length
Distance 3
cm
Length
Ductus Venosus DV
cm/s Velocity
Diastolic velocity of the ductus

venosus
Ductus Venosus SV
cm/s Velocity
Systolic velocity of the ductus

venosus
Ductus Venosus TAVP (PI)
cm/s Velocity
Mean velocity of the Ductus

Venosus
DV
cm2
Velocity
Diastolic velocity (for the PI and

RI calculation)
Ear
cm
Length
Ear length
FIB
cm
Length
Fibula length
FL
cm
Length
Femur length
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Two-beat, peak-to-peak time

interval
Label
Unit
s
Type
14
Meaning
Flow diam
cm
Length
Diameter for flow volume
Foot
cm
Length
Foot length
FTA traced
cm2
Area
Traced fetal trunk

cross-sectional area
GSD1
cm
Length
Gestational sac diameter one
GSD2
cm
Length
Gestational sac diameter two
GSD3
cm
Length
Gestational sac diameter three
HC traced
cm
Circumference Traced head circumference
HL
cm
Length
HrtC
cm
Circumference Heart circumference
IOD
cm
Length
Inner orbital diameter
Lat V
cm
Length
Lateral ventricle width
M Phalanx 5
cm
Length
Length of the middle phalanx on

the fifth digit
MCA DV
cm/s Velocity
Diastolic velocity of the middle

cerebral artery
MCA SV
cm/s Velocity
Systolic velocity of the middle

cerebral artery
MCA TAVP (PI)
cm/s Velocity
Time averaged velocity peak of

the middle cerebral artery
TAVP (PI)
cm/s Velocity
Time averaged velocity peak
TAVM
cm/s Velocity
NUCH
cm
Length
Nuchal thickness
OFD
cm
Length
Occipitofrontal diameter
OOD
cm
Length
Outer orbital diameter
Orbit 1
cm
Length
First orbit
Orbit 2
cm
Length
Second orbit
Humerus length
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Label
Unit
s
Type
Meaning
QUAD1
cm
Length
AFI dimension: quadrant 1
QUAD2
cm
Length
QUAD3
cm
Length
QUAD4
cm
Length
Renal AP
cm
Length
Renal anterior-posterior
Renal L
cm
Length
Renal length
RL
cm
Length
Radius length
SL
cm
Length
Spine length
SV
cm2
Velocity
Systolic velocity (for the PI and

RI calculation)
TC traced
cm
Circumference Traced thoracic circumference
TDap
cm
Length
Anterior-posterior thoracic
diameter
TDtrv
cm
Length
Transverse thoracic diameter
TL
cm
Length
Tibia length
TTD
cm
Length
Transverse trunk diameter
UL
cm
Length
Ulna length
Umbilical DV
cm/s Velocity
Diastolic velocity of the umbilical

artery
Umbilical SV
cm/s Velocity
Systolic velocity of the umbilical

artery
Umbilical TAVP (PI)
cm/s Velocity
Time averaged velocity peak
Velocity A
cm/s Velocity
Generic velocity
Velocity B
cm/s Velocity
Generic velocity
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Gynecology Measurements
The following tables list all gynecology measurements:
"Uterus Measurements" on page 365
"Ovarian Measurements" on page 366
Uterus Measurements
Label
Unit
s
Type
Meaning
Cervix
cm
Contour
Length
Cervix length
Endometrium
cm
Length
Endometrium thickness
UTH
cm
Length
Uterine height
UTL
cm
Length
Uterine length
UTW
cm
Length
Uterine width
Uterine DV
cm/s Velocity
Diastolic velocity of the uterine

artery
Uterine SV
cm/s Velocity
Systolic velocity of the uterine

artery
Uterine TAVP (PI)
cm/s Velocity
Time averaged velocity peak of

the uterine artery
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Ovarian Measurements
Label
Unit
s
Type
Length
Meaning
L follicle (116) Dist
cm
Diameter of left ovarian follicle

(116)
L ovary DV
cm/s Velocity
Left ovary diastolic velocity
Left ovary Mean (PI)
cm/s Velocity
Left ovary mean velocity
Left ovary SV
cm/s Velocity
Left ovary systolic velocity
LOH
cm
Length
Left ovarian height
LOL
cm
Length
Left ovarian length
LOW
cm
Length
Left ovarian width
R follicle (116) Dist
cm
Length
Diameter of right ovarian follicle

(116)
R ovary DV
cm/s Velocity
Right ovary diastolic velocity
R ovary SV
cm/s Velocity
Right ovary systolic velocity
Right ovary TAVP (PI)
cm/s Velocity
Right ovary mean velocity
ROH
cm
Length
Right ovary height
ROL
cm
Length
Right ovary length
ROW
cm
Length
Right ovary width
NOTES
366
You can perform up to five different diameter measurements on each follicle.

Only the average appears in the report. All instances appear in the report
work area.
You can measure up to 15 different follicles in each ovary. For example, R Follicle 3 Dist is the diameter of the third follicle in the right ovary.
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Unit
s
Label
Type
Flow diam
cm
Length
Flow TAVM
cm/s Velocity
Meaning
Diameter for flow volume
Mean velocity for flow volume

Unit
s
Label
Type
Meaning
Velocity A
cm/s Velocity
Generic velocity
Velocity B
cm/s Velocity
Generic velocity
Label
Unit
s
Type
Meaning
Distance 1 cm
Distance 2 cm
Distance 3 cm

Label
Unit
s
Type
Meaning
SV
cm/s Velocity
Systolic velocity
DV
cm/s Velocity
Diastolic velocity
TAVP (PI)
cm/s Velocity

volume
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Musculoskeletal Measurements
The following table lists the tendon measurements that are included in the Musculoskeletal option package.
Tendon Measurements (110)

Label
Unit
s
Type
Ankle # (110)
cm
Length
Knee # (110)
cm
Length
Shoulder # (110)
cm
Length
Tendon # (110
cm
Length
Wrist # (110)
cm
Length
Labeled Calculations by Exam Type

References are provided for many of the calculations and formulas. Clinical calculations are usually based on studies of large patient populations. The formulas that
are derived have some uncertainty or inaccuracy based on the correlation coefficient for the study involved. In many cases, these uncertainties are greater than
the inaccuracies of the ultrasound system measurement. Clinicians should always
be familiar with the clinical reference provided for each calculation before using
the system measurement and analysis data to make a clinical decision.
This section lists the following calculations:
368
"General Calculations" on page 369
"Cardiac Calculations" on page 380
"Obstetric Calculations" on page 386
"Gynecology Calculations" on page 389
"Vascular Calculations" on page 391
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The tables include the type and the meaning of the calculation. Instructions for
performing the calculations are not included in the tables. For general instructions
on performing calculations, see "Performing Calculations" on page 299.
See "Clinical References for Calculations" on page 439 for the formula, inherent
approximations and assumptions, and clinical references for each calculation.
General Calculations
This section lists the following general calculations:
"Abdomen Calculations" on page 369
"Prostate Calculations" on page 371
"Thyroid Calculations" on page 374
"Breast Calculations" on page 375
"Testicular Calculations" on page 376
"Superficial Calculations" on page 378
"Hip Angle Calculations" on page 380
Abdomen Calculations
This section lists the following abdomen calculations:
"% Stenosis Calculations" on page 370
"3-Axis Volume Calculations" on page 370
"Flow Volume Calculations" on page 370
"Resistivity Index and Pulsatility Index Calculations" on page 371
"Velocity Ratios Calculations" on page 371
"Renal-to-Aortic Ratio" on page 371
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% Stenosis Calculations
Typ
e
Label
Meaning
% Area sten
Percent area stenosis
% Diam sten
Percent diameter stenosis
Aortic % Area sten
Aortic % Diam sten
Renal Artery % Area sten
Renal Artery % Diam sten
3-Axis Volume Calculations

Label
Type
Meaning
Ao Volume
Volum
e
Ellipsoid three-axis volume
Renal Volume
Volum
e
Volume
Volum
e
Flow Volume Calculations

Label
370
Type
Meaning
Ao Flow vol
Volume
Flow volume via diameter
Flow vol
Volume
RA Flow vol
Volume
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Resistivity Index and Pulsatility Index Calculations

Label
Type
Aortic RI
Resistivity Index
Aortic PI
Pulsatility index using time-averaged mean of the peaks
S/D
Systolic-to-Diastolic ratio
Renal Artery RI
Resistivity index
Renal Artery PI
RI
Resistivity index
PI
Velocity Ratios Calculations

Label
Typ
e
Meaning
A/B Ratio
Rati
o
Generic A/B velocity ratio
A/B Ratio
Rati
o
A/B Ratio
Rati
o
Renal-to-Aortic Ratio
Label
RAR
Typ
e
Rati
o
Meaning
Renal aortic systolic velocity ratio
Prostate Calculations
The following tables list all prostate calculations.
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"Prostate Volume Calculation" on page 373
"Bladder Volume Calculation" on page 373
"PV Bladder Volume Calculation" on page 373
"3-Axis Volume Calculation" on page 373
"Flow Volume Calculation" on page 373
"A/B Ratio Calculation" on page 373
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Prostate Volume Calculation

Label
Units
cm3
Prostate Vol
Meaning
Volume of prostate
Bladder Volume Calculation

Label
Units
Bladder Vol
cm3
Meaning
Volume of bladder
PV Bladder Volume Calculation

Label
Units
PV Bladder Vol
cm3
Meaning
Post-void volume of bladder
3-Axis Volume Calculation

Label
Units
cm3
Volume
Meaning
Flow Volume Calculation

Label
Flow vol
Units
l/min
Meaning
Flow volume via diameter and
TAVM
A/B Ratio Calculation

Label
A/B Ratio
Unit
s
Ratio
Meaning
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Label
Meaning
PI
Pulsatility index
RI
Resistivity index
S/D
Systolic-diastolic Ratio
Thyroid Calculations
The following tables list all thyroid calculations.
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Label
Units
cm3
Volume
Meaning
Volume of Thyroid

Label
Flow vol
Units
l/min
Meaning
TAVM

Label
A/B Ratio
Unit
s
cm/s
Meaning
Generic A/B ratio

Label
Meaning
PI
Pulsatility index
RI
Resistivity index
S/D
Breast Calculations
The following tables list all breast calculations:
"Mass Volume (110) Calculation" on page 376
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Mass Volume (110) Calculation

Label
Units
Mass # Vol
cm3
Meaning

Label
Units
Volume
cm3
Meaning

Label
Flow vol
Units
l/min
Meaning
TAVM

Label
A/B Ratio
Unit
s
cm/s
Meaning
Generic A/B Ratio

Label
Meaning
PI
Pulsatility index
RI
Resistivity index
S/D
Testicular Calculations
The following tables list all testicular calculations:
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"Testicle Volume Calculation" on page 378
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Testicle Volume Calculation

Label
Units
cm3
Testicle Vol
Meaning
Volume of testicle

Label
Units
Volume
cm3
Meaning

Label
Flow vol
Units
l/min
Meaning
TAVM

Label
A/B Ratio
Unit
s
cm/s
Meaning
Generic A/B Ratio

Label
Meaning
PI
Pulsatility index
RI
Resistivity index
S/D
Superficial Calculations
The following tables list all superficial calculations:
378
"% Stenosis Calculations" on page 379
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% Stenosis Calculations
Typ
e
Label
Meaning
% Area sten
% Diam sten

Label
Volume
Type
Volume
Meaning

Label
Flow vol
Type
Volume
Meaning
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Label
A/B Ratio
Unit
s
cm/s
Meaning
Generic A/B ratio

Label
Meaning
PI
Pulsatility index
RI
Resistivity index
S/D
Hip Angle Calculations

The following table lists hip angle calculations.
Label
Type
Meaning
Hip angle A
Angle in degrees
Bony acetabular root line angle (bony root angle)
Hip angle B
Angle in degrees
Cartilage root line angle (cartilage root angle)
Cardiac Calculations
This section lists the following cardiac calculations:
"2D Mode/Physio Cardiac Calculations" on page 381
"Doppler/Physio Cardiac Calculations" on page 384
"M-mode/Physio Cardiac Calculations" on page 385
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2D Mode/Physio Cardiac Calculations

Label
Type
Meaning
AVA(V,D)
Area
Valve area (continuity formula) by velocity

time interval
AVA(ID)
Area
Valve area (continuity formula) by

maximum velocity
CO(bp-el)
Cardiac output Cardiac output (2D)
CO(Bullet)
CO(Cubed)
CO(LVOT)
Cardiac output Cardiac output (Doppler)
CO(MOD-bp)
CO(mod-Simp)
CO(MOD-sp2)
CO(MOD-sp4)
CO(sp-el)
CO(Teich)
EDV(Cubed)
Volume
Volume (cubed)
EDV(bp-el)
Volume
Volume (biplane)
EDV(Bullet)
Volume
Volume (bullet)
EDV(MOD-bp)
Volume
Volume (biplane MOD)
EDV(mod-Simp)
Volume
Volume (mod-Simp)
EDV(sp-el)
Volume
Volume (single-plane ellipse)
EDV(Teich)
Volume
Volume (Teich)
EF(bp-el)
EF
Ejection fraction
EF(Bullet)
EF
Ejection fraction
EF(Cubed)
EF
Ejection fraction
EF(MOD-bp)
EF
Ejection fraction
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Label
Type
Meaning
EF(mod-Simp)
EF
Ejection fraction
EF(MOD-sp2)
EF
Ejection fraction
EF(MOD-sp4)
EF
Ejection fraction
EF(sp-el)
EF
Ejection fraction
EF(Teich)
EF
Ejection fraction
ESV(bp-el)
Volume
Volume (biplane)
ESV(Bullet)
Volume
Volume (bullet)
ESV(Cubed)
Volume
Volume (cubed)
ESV(MOD-bp)
Volume
Volume (biplane MOD)
ESV(mod-Simp)
Volume
Volume (mod-Simp)
ESV(sp-el)
Volume
Volume (single-plane ellipse)
ESV(Teich)
Volume
Volume (Teich)
FAC
Fractional area change
FS
FS
Fractional shortening
LVLd % diff
% Difference of LV lengths
LVLs % diff
% Difference of LV lengths
LVmass(AL)d
Mass
Left ventricular mass at end diastole
LVmass(AL)dI
Mass index
Left ventricular mass at end diastole,

indexed by body surface area
LVmass(C)d
Mass
Left ventricular mass via the cubic formula

at end diastole
LVmass(C)dI
Mass index
Left ventricular mass via the cubic formula

at end diastole, indexed by body surface
area
LVOT Area
Area
Left ventricular outflow tract area
MM HR
BPM
Heart rate
MR ERO
Area
Mitral valve effective regurgitant orifice

area
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Label
Type
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Meaning
MR flow rate
Flow rate
Mitral valve regurgitation flow rate
MR PISA
Surface area
Mitral valve regurgitation proximal

isovolumic surface area
MR RF
Fraction
Mitral valve regurgitant fraction
MR volume
Regurgitant
volume
Mitral valve regurgitant volume
MV Flow Area
Area
Mitral valve flow area
Qp:Qs
Flow ratio
Ratio of pulmonic flow to systemic flow via

simplified Doppler echocardiographic
method
SV(bp-el)
Stroke volume Stroke volume (2D)
SV(Bullet)
SV(Cubed)
SV(LVOT)
Stroke volume Stroke volume (Doppler)
SV(MOD-bp)
SV(mod-Simp)
SV(MOD-sp2)
SV(MOD-sp4)
SV(MV)
Stroke volume Mitral valve stroke volume (Doppler)
SV(sp-el)
SV(Teich)
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Doppler/Physio Cardiac Calculations

Label
Type
Meaning
Ao max PG
Pressure gradient
Aortic flow maximum pressure gradient

(simplified Bernoulli)
Ao mean PG
Pressure gradient
Aortic flow mean pressure gradient (simplified

Bernoulli)
Ao P1/2t
Pressure half-time
Aortic flow pressure half-time
Aortic HR
BPM
Heart rate
AVA (I,D)
Area
Valve area (continuity formula) via velocity time

integral
AVA (V,D)
Area
Valve area (continuity formula) via maximum

velocity
CO(LVOT)
Cardiac output
Cardiac output via the left ventricular outflow

tract
MR ERO
Area
Mitral valve effective regurgitant orifice area
MR flow rate
Flow rate
Mitral valve regurgitation flow rate
MR RF
Fraction
Mitral valve regurgitant fraction
MR volume
Regurgitant volume
Mitral valve regurgitant volume
MV E/A
Ratio
Mitral valve E-to-A ratio
MV P1/2t
Pressure half-time
Mitral valve pressure half-time
MVA P1/2t
Area
Mitral valve area via P1/2t
PA P1/2t
Pressure half-time
Pulmonary insufficiency pressure half-time
Qp:Qs
Flow ratio
Ratio of pulmonic flow to systemic flow via

simplified Doppler echocardiographic method
RVSP(TR)
Pressure
Right ventricular systolic pressure via TR
SV(LVOT)
Stroke volume
Left ventricular outflow tract stroke volume

(Doppler)
SV(MV)
Stroke volume
Mitral valve stroke volume (Doppler)
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M-mode/Physio Cardiac Calculations

Label
Type
Meaning
Aortic HR
BPM
Heart rate
CO(bp-el)
Cardiac output Cardiac output (M-mode)
CO(Bullet)
CO(Cubed)
CO(LVOT)
CO(MOD-bp)
CO(mod-Simp)
CO(MOD-sp2)
CO(MOD-sp4)
CO(sp-el)
CO(Teich)
EDV(bp-el)
Volume
Volume (biplane)
EDV(Cubed)
Volume
Volume (cubed)
EDV(Teich)
Volume
Volume (Teich)
EF(bp-el)
EF
Ejection fraction
EF(Cubed)
EF
Ejection fraction
EF(Teich)
EF
Ejection fraction
ESV(bp-el)
Volume
Volume (biplane)
ESV(Cubed)
Volume
Volume (cubed)
ESV(Teich)
Volume
Volume (Teich)
FS
FS
Fractional shortening
LA/AO
Ratio
LA dimension to aortic root ratio
LVmass(C)d
Mass
Left ventricular mass via the cubic formula at end

diastole
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Label
Type
Meaning
LVmass(C)dI
Mass index
Left ventricular mass via the cubic formula at end

diastole, indexed by body surface area
MM HR
BPM
Heart rate
SV(bp-el)
SV(Cubed)
SV(Teich)
Obstetric Calculations
The following table lists all obstetric calculations.
Label
Type
Meaning
A/B
Ratio
AC
Circumference
Abdominal circumference
AFI
AFI
Amniotic fluid index
CI(BPD,OFD)
CI
Cephalic index
Ductus Venosus PI
Pulsatility index
Pulsatility index using time-averaged

mean of the peaks
Ductus Venosus RI
Resistivity index Resistivity index
Ductus Venosus S/D
Ratio
Systolic-to-diastolic ratio
EFW(AC,BPD)Hadl
Weight
Estimated fetal weight via AC and

BPD (Hadlock)
Normal fetal weight percentiles
EFW(AC,BPD)Sh
Weight
Estimated fetal weight via AC and

BPD (Shephard)
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Label
EFW(AC,FL)Hadl
Type
Weight
14
Meaning
Estimated fetal weight via AC and FL
(Hadlock)
EFW(AC,HC,FL)Hadl
Weight
Estimated fetal weight via AC, HC,

and FL (Hadlock)
EFW(B,H,A,F)Hadl
Weight
Estimated fetal weight via BPD, HC,

AC, and FL (Hadlock)
EFW(BPD,AD,FL)Tokyo
Weight
Estimated fetal weight via BPD,

ADap, ADtrv, and FL (Tokyo)
EFW(BPD,FTA,FL)Osaka
Weight
Estimated fetal weight via BPD, FTA,

and FL (Osaka)
Fetal HR
BPM
Fetal heart rate
FL/AC
Ratio
FL to AC ratio
FL/BPD
Ratio
FL to BPD ratio
Flow vol
Flow volume
Flow volume via diameter and TAVM
GA(AC)Hadlock
Age
Gestational age via AC (Hadlock)
GA(BPD)Hadlock
Age
Gestational age via BPD (Hadlock)
GA(BPD)Jeant
Age
Gestational age via BPD (Jeanty)
GA(BPD)Osaka
Age
Gestational age via BPD (Osaka)
GA(BPD)Tokyo
Age
Gestational age via BPD (Tokyo)
GA(CRL)Jeanty
Age
Gestational age via CRL (Jeanty)
GA(CRL)Osaka
Age
Gestational age via CRL (Osaka)
GA(CRL)Rempen
Age
Gestational age via CRL (Rempen)
GA(CRL)Robinson
Age
Gestational age via CRL (Robinson)
GA(CRL)Tokyo
Age
Gestational age via CRL (Tokyo)
GA(FL)Hadlock
Age
Gestational age via FL (Hadlock)

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Label
Type
Meaning
GA(FL)Jeanty
Age
Gestational age via FL (Jeanty)
GA(FL)Osaka
Age
Gestational age via FL (Osaka)
GA(FL)Tokyo
Age
Gestational age via FL (Tokyo)
GA(FTA)Osaka
Age
Gestational age via FTA (Osaka)
GA(GSD)Rempen
Age
Gestational age via GSD (Rempen)
GA(GSD)Tokyo
Age
Gestational age via GSD (Tokyo)
GA(HC)Hadlock
Age
Gestational age via HC (Hadlock)
GA(HL)Jeanty
Age
Gestational age via HL (Jeanty)
GA(HL)Osaka
Age
Gestational age via HL (Osaka)
GA(MSD)Hellman
Age
Gestational age via MSD (Hellman)
GA(SL)Tokyo
Age
Gestational age via SL (Tokyo)
GA(TC)Nimrod
Age
Gestational age via TC (Nimrod)
GA(TL)Jeanty
Age
Gestational age via TL (Jeanty)
GA(UL)Jeanty
Age
Gestational age via UL (Jeanty)
HC
Circumference
Head circumference computed
HC/AC
Ratio
Ratio of head circumference to

abdominal circumference
HrtC/TC
Ratio
HrtC-to-TC ratio
MCA PI
Pulsatility index
Pulsatility index
MCA RI
MCA S/D
Ratio
MSD
Diameter
Mean sac diameter
PI
Pulsatility index

mean of the peaks
RI
S/D
Ratio
TC
Circumference
Thoracic circumference computed
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Label
Type
Meaning
Umbilical PI
Pulsatility index
Pulsatility index using the

time-averaged mean of the peaks
Umbilical RI
Umbilical S/D
Ratio
Umbilical systolic-to-diastolic ratio
Volume
Volume
3-axis volume
Gynecology Calculations
The following tables list all gynecology calculations:
"Uterus Calculations" on page 390
"Ovarian Calculations" on page 390
"A/B Ratio Calculations" on page 391
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Uterus Calculations
Label
Type
Meaning
Uterine PI
Pulsatility index
Pulsatility index using the time-averaged

mean of the peaks
Uterine RI
Resistivity index
Resistivity index
Uterine S/D
Ratio
UTV
Volume
Uterine volume
Ovarian Calculations
Label
Type
Meaning
L Follicle Vol (1
16)
Volume
1-distance volume of the 1st16th follicle

in the left ovary
L Ovary PI
Pulsatility index
Left ovarian pulsatility index
L Ovary RI
Resistivity index
Left ovarian resistivity index
L Ovary S/D
Ratio
Left ovary systolic-to-diastolic ratio
LOV
Volume
Left ovary volume
R Follicle Vol (1
16)
Volume
1-distance volume of the 1st16th follicle

in the right ovary
R Ovary PI
Pulsatility index
Right ovarian pulsatility index
R Ovary RI
Resistivity index
Right ovarian resistivity index
R Ovary S/D
Ratio
Right ovary systolic-to-diastolic ratio
ROV
Volume
Right ovarian volume

Label
Flow vol
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Flow volume
Meaning
14
A/B Ratio Calculations

Label
A/B Ratio
Type
Ratio
Meaning

Label
Type
Meaning
PI
Pulsatility index

mean of the peaks
RI
Resistivity index
Resistivity index
S/D
Ratio
Vascular Calculations
The following tables list all vascular calculations:
"Vascular % Stenosis Calculations" on page 391
"Vascular Carotid Calculations" on page 392
"Vascular A/B Velocity Ratio Calculation" on page 392
"Vascular Flow Volume Calculation" on page 392
"Vascular Resistivity Index and Pulsatility Index Calculations" on page 392
"Vascular Volume Calculation" on page 397
Vascular % Stenosis Calculations
Label
Typ
e
Meaning
%Area Sten
%Diam Sten
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Vascular Carotid Calculations

Label
Type
ICA/CCA
DV
Diastolic
ratio
Meaning
Internal carotid artery diastolic velocity to common
carotid artery diastolic velocity ratio
ICA/CCA SV Systolic
ratio
Internal carotid artery systolic velocity to common

carotid artery systolic velocity ratio
Vascular A/B Velocity Ratio Calculation
Label
Typ
e
A/B Ratio Rati

o
Meaning
Vascular Flow Volume Calculation

Label
Flow vol
Type
Volume
Meaning
Vascular Resistivity Index and Pulsatility Index Calculations

Each of the calculations in the following table are Reported Calculations and
therefore, do not appear in the Analysis menu. Each of the vessels listed in the followin table include one RI and one S/D ratio calculation. For vessels that have a
labeled TAVP calculation, the analysis package also displays a PI calculation.
Label
Type
ACA PI
ACA RI
Resistivity index
ACA S/D
Axillary RI
Resistivity index
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Label
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Type
Axillary S/D
Bulb RI
Resistivity index
Bulb S/D
CFA RI
Resistivity index
CFA S/D
Dist ATA RI
Resistivity index
Dist ATA S/D
Dist Basilar PI
Dist Basilar RI
Resistivity index
Dist Basilar S/D
Dist Brachial RI
Resistivity index
Dist Brachial S/D
Dist CCA RI
Resistivity index
Dist CCA S/D
Dist ECA PI
Dist ECA RI
Resistivity index
Dist ECA S/D
Dist ICA PI
Dist ICA RI
Resistivity index
Dist ICA S/D
Dist Pero RI
Resistivity index
Dist Pero S/D
Dist POP RI
Resistivity index
Dist POP S/D
Dist PTA RI
Resistivity index
Dist PTA S/D
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Label
Type
Dist Radial RI
Resistivity index
Dist Radial S/D
Dist SFA RI
Resistivity index
Dist SFA S/D
Dist Subclavian RI
Resistivity index
Dist Subclavian S/D
Dist Ulnar RI
Resistivity index
Dist Ulnar S/D
Dorsalis Pedis RI
Resistivity index
Dorsalis Pedis S/D
Ext Iliac RI
Resistivity index
Ext Iliac S/D
Iliac RI
Resistivity index
Iliac S/D
Int Iliac RI
Resistivity index
Int Iliac S/D
MCA (M1) PI
Pulsitility index
MCA (M1) RI
Resisitivity index
MCA (M1) S/D
Mid ATA RI
Resistivity index
Mid ATA S/D
Mid Basilar PI
Mid Basilar RI
Resistivity index
Mid Basilar S/D
Mid CCA RI
Resistivity index
Mid CCA S/D
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Label
14
Type
Mid ECA RI
Resistivity index
Mid ECA S/D
Mid ICA RI
Resistivity index
Mid ICA S/D
Mid Pero RI
Resistivity index
Mid Pero S/D
Mid PTA RI
Resistivity index
Mid PTA S/D
Mid Radial RI
Resistivity index
Mid Radial S/D
Mid SFA RI
Resistivity index
Mid SFA S/D
Mid Subclavian RI
Resistivity index
Mid Subclavian S/D
Mid Ulnar RI
Resistivity index
Mid Ulnar S/D
PCA (P1) PI
PCA (P1) RI
Resistivity index
PCA (P1) S/D
PCA (P2) PI
PCA (P2) RI
Resistivity index
PCA (P2) S/D
PFA RI
Resistivity index
PFA S/D
PI
Prox ATA RI
Resistivity index
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Label
Type
Prox ATA S/D
Prox Basilar PI
Prox Basilar RI
Resistivity index
Prox Basilar S/D
Prox Brachial RI
Resistivity index
Prox Brachial S/D
Prox CCA RI
Resistivity index
Prox CCA S/D
Prox ECA RI
Resistivity index
Prox ECA S/D
Prox ICA RI
Resistivity index
Prox ICA S/D
Prox Pero RI
Resistivity index
Prox Pero S/D
Prox POP RI
Resistivity index
Prox POP S/D
Prox PTA RI
Resistivity index
Prox PTA S/D
Prox Radial RI
Resistivity index
Prox Radial S/D
Prox SFA RI
Resistivity index
Prox SFA S/D
Prox Subclavian RI
Resistivity index
Prox Subclavian S/D
Prox Ulnar RI
Resistivity index
Prox Ulnar S/D
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Label
14
Type
RI
Resistivity index
S/D
Vertebral PI
Vertebral RI
Resistivity index
Vertebral S/D
Vascular Volume Calculation

Label
Volume
Type
Volume
Meaning
3-axis volume
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Patient Studies, Image Review, and Reports
15
15 Patient Studies, Image Review, and

Reports
Patient Studies
A patient study includes demographic information, images, quantitative values, and
a summary of findings. All patient studies for one patient are saved in a patient
folder.
During an exam, all of the images you acquire are saved to the patient study, and a
report is automatically generated. At any time, you can view all of the images in
Image Review by pressing Review. You can view the report by pressing Report.
Creating Patient Studies

Before you begin acquiring images, you must create a patient study. If you do not,
you cannot capture, print, or save the images you acquire.
Creating a Patient Study

The way you create a patient study depends on whether or not you are using
Modality Worklist.
To learn how to create a patient study if you are using Modality Worklist, see
"Using Modality Worklist" on page 90.
To create a patient study if you are not using Modality Worklist
1. Press Patient.
2. In the Patient Identification window, click New.
3. Enter the demographic information about the patient, pressing Tab to move
from field to field.
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NOTES
If you enter a last name, but do not enter an MRN, an MRN is automatically
generated based on the current time and date. Philips recommends that you
enter the MRN.
The same MRN is used for a single patient folder.
If you create two studies with different patient names but with the same
MRN, a message is displayed that notifies you that the system will put both
studies in the same patient folder.
4. Click OK.
Editing Patient Demographic Information

To edit demographic information about the current patient
Press Patient.
If you are using Modality Worklist, select a patient from the Patient
Selection window.
2. In the Patient Identification window, click Edit.
3. Add or edit demographic information.
4. Click OK.
NOTE
The information shown in the Patient Identification window is for the current
preset. To display information related to a different exam type, click the Additional tab and select the appropriate type from the Additional Data Types
menu.
Saving a Patient Study

To save all of the changes you made to the current study, including
changes in the report work area
Press Review and click
The study is saved on your system.

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To save a study to a disk, you must export the study. See "Exporting Patient Studies" on page 430.
Closing a Patient Study

To close a study and save all of the changes you made
1. Press Review and click
2. Click Yes to confirm you want to save your changes.

The study is saved on your system.
NOTES
A study takes several seconds to close.

When you create or open a patient study, the active study is closed before the
new study is opened.
Managing Patient Studies

The procedures in this section will help you manage patient studies.
Restarting a Patient Study

To continue or restart a patient study that is saved on your system
NOTE
To restart a study, it must be less than 24 hours old.

1. Press Patient.
NOTE
If you have a Modality Worklist, click Manual Entry to access the Patient Identification window.
2. Click Restart.
3. In the Search for Study window, do one of the following:
Type information you know about the patient, such as the MRN or last
name, and click Search.
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To list all patient studies saved on your system, select All Dates from the
Study Date menu, and click Search.
4. Click a column header to sort by MRN, Name, Time, #Images, Type,

Performed By, or Referring Physician.
5. Use the trackball to move the icon over the patient study that you want to
restart.
6. Press Enter.
7. Click OK.
The Patient Identification window opens, populated with the selected
patient's demographic information.
8. Click OK.
Searching for a Patient Study

To search for a patient study
1. Press Review.
2. Click
To list all patient studies, select All Dates from the Study Date menu,
and click Search.
4. Click a column header to sort by MRN, Patient Name, #Images, Time,
Type, Performed By, or Referring Physician.
5. Use the trackball to move the icon over the patient study that you want to
open, and do one of the following:
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Double-click Enter twice.
Press Enter, and click Open Study.
Press Select, use the trackball to highlight Open, and press Enter.
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NOTE
To see all the studies for a given patient, you must search by all dates and not by
patient name.
Searching for a Patient Folder

A patient folder contains all of the patient studies for one patient with the same
MRN.
To search for a patient folder
1. Press Review to enter Image Review.
2. Click
3. In the Search for Folder window, do one of the following:
To search, type the last name or MRN in the Search for field, and then
select Last Name or MRN from the menu.
To list all of the patient folders saved on your system, type * (asterisk).
4. Click Search Now.

5. Click a column header to sort by MRN or Patient Name.
6. Use the trackball to move the cursor over the patient folder you want to
open, and do one of the following:
Double-click the file to open.
Press Enter and click Open Folder.
Press Select, use the trackball to highlight Open Folder, and press
Enter.
The studies in the folder are listed.

7. Use the trackball to move the cursor over the study you want to open, and
do one of the following:
Double-click the file to open.
Press Enter and click Open Study.
Press Select, use the trackball to highlight Open Folder, and then press
Enter.
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Deleting a Patient Folder

CAUTION
Deleting a patient folder deletes all of the studies contained in the folder.
To delete a patient folder
2. Click
3. In the Search for Folder window, do one of the following:
To search, type the last name or MRN in the Search for field, and then
select Last Name or MRN from the menu.
To list all of the patient folders saved on your system, type * (asterisk).
4. Click Search Now.

5. Click a column header to sort by MRN or Patient Name.
6. In the Search for Patient Folder window, use the trackball to move the
cursor over the patient folder to delete and press Select.
7. Use the trackball to highlight Delete.
8. Press Enter.
9. Click Yes to confirm.
Deleting a Patient Study

To delete a patient study
2. Click
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To list all patient studies, select All Dates from the Study Date menu,
and click Search.
4. Use the trackball to move the cursor over the patient study to delete and
press Select. To select more than one study, press and hold Ctrl or Shift.
5. Press Select.
6. Use the trackball to highlight Delete.
7. Press Enter.
8. Click Yes to confirm.
9. Click Close.
Viewing a Previous Study for the Current Patient

In Image Review, a tab appears for each patient study in the patient folder. The tab
lists the time and date of the study.
To view a previous patient study
Click the tab.
NOTES
Previous studies are read-only. You cannot modify or add images or data to
them.
If you are viewing a study that has a system-generated MRN, not all studies on
the current patient may appear.
Image Review
In Image Review, you can view frames and loops, delete frames and loops from
the patient study, edit loops, and close the study. You can also edit Stress Echo
loops, specify the preferred Stress Echo loop, and relabel Stress Echo views in
Image Review.
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Working in Image Review

In Image Review, you can perform a variety of tasks, including making measurements, playing loops, and working with 3D images.
Entering Image Review

To enter Image Review
Press Review.
Press Acquire (if you selected Switch to Thumbnails after acquire

completes on the Acquisition tab in the Setup window).
Acquire all of the loops for a view or a stage in a Stress Echo study.
About Single Images, Thumbnails, and Full-Screen Images

In the Image Review window, you can view images in three ways. You can view:
Several images in a grid format, called Thumbnails, within the Image Review
window.
A single image within the Image Review window. Use the scroll bars to see the
entire image.
A single full-screen image with no scroll bars.
To view Thumbnails when you are viewing a single image

Click
To view a single image when you are viewing thumbnails

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Double-click an image.
Move the cursor over an image, press Enter, and then click Play.
To view a full-screen image without scroll bars, click
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You cannot make changes to an image in Image Review unless you first reactivate
it.
Deleting an Image in Image Review

Throughout a study, you can mark images to be deleted. When you save the
study, the images are deleted.
To mark or unmark one or more images for deletion
1. To activate thumbnails, in Image Review, click
2. Move the cursor over the image.

3. Press Enter.
4. Press Clear.
5. Repeat step 2, step 3, and step 4 for other images you want to mark or
unmark for deletion.
The images are marked for deletion and are deleted when you save the study.
Adding a Caption or a Flag to an Image

You can add a caption or an image flag to an image. Image flags can be helpful
when you want to indicate which images will be used, for example, for a teaching
demonstration.
To add a caption or an image flag to an image
1. In Image Review, move the cursor over the image.
2. Press Select.
3. Use the trackball to highlight Caption/Flag, and press Enter.
4. Type the caption, or select an image flag from the list.
5. Click OK.
Viewing 3D or Panoramic Images in Image Review

In Image Review, you can view 3D data sets and panoramic data sets that you
acquired.
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Viewing a 3D or a Panoramic Data set

To view a 3D data set or a panoramic data set
1. To activate thumbnails in Image Review, click
2. Use the trackball to move the cursor over one of the following icons on the
bottom left corner of the image:
3D data set icon
Panoramic data set icon
3. Press Enter.
3D mode or Panoramic Imaging opens and the image is displayed.
4. To close 3D mode or Panoramic Imaging, do one of the following:
NOTE
Press 2D.
Press 3D/4D (to exit 3D mode only).
Press Pano.
The thumbnail of a 3D or a panoramic image is not an accurate representation of

the data set.
Printing Images in Image Review

To print a single image
2. If you are viewing a loop:
a. Click
to freeze the loop.
b. If necessary, use the Frame Select slide control to choose the frame you
want to print.
3. Press the Record key assigned to the printer you want to use.
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To print the Thumbnails view

1. Click
2. Press the Record key assigned to the printer you want to use.
About Reactivating Images

Reactivating an image in Image Review loads it into a Quick Review mode where
you can perform functions as though it were a live image. You can then insert
annotations, place body markers, and perform analysis functions, as well as
acquire the image.
About Reactivated Images

When you reactivate an image, its state depends on the state of the image during
Image Review.
All frames are loaded as they appeared in Image Review but you cannot scroll
or replay the loop.
If the image was looping in Image Review, the system reloads the image in
Replay mode.
If the image was stopped in Image Review, the system reloads the image to the
frame you selected in Image Review.
When you reactivate an image, the original measurements do not appear on the
image.
Restrictions
You cannot reactivate the following types of images:
3D still images or loops
Panoramic still images
Imported images
Non-calibrated images
PW doppler images that were acquired without first freezing the doppler
spectrum
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Reactivating an Image in Image Review

To reactivate an image
1. Select the image to reactivate.
Press Caliper, Trace, Calc.
Click
to reactivate the image.
The image appears on the display with
in the lower left corner.
3. Perform analysis functions as needed.

4. If needed, acquire a new image.
To return to Image Review
Press Review.
Using the Select Key in Image Review

To view the options that are currently available to you in Image Review
1. Press Select.
2. Highlight the option and press Enter.
Any of the following options may appear:
Option
Description
Put Image in Report
Places the image you are viewing in the report
Loop Edit
Allows editing of the loop start and end points
Export Image
Allows export in PC format of the image in review
Caption/Flag
Associates a flag or adds a comment to the image in

review
Relabel View
Displays choices to relabel the view of the image in

review
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Description
Format Thumbnails
Changes the number of thumbnails displayed across

each row
Delete Image
Marks the image in review for deletion
Show/Hide Measurements
Shows or hides the analysis overlay
Specifying the Image Selection

You can choose how many images are automatically selected to be played back
each time you select an image.
To specify the Image Selection
From the Image Select menu, select an option as follows:
To display only the images you choose, select Random.
To display two images simultaneously, select 2 up.
To display four images simultaneously, select 4 up.
To display six images simultaneously, select 6 up.
To display nine images simultaneously, select 9 up.
If you select 2 up, when you select one image, that image and the following image
are selected. If you click Play, those two images are played back simultaneously.
Specifying the Image Display

You can choose to display only those images that have an image flag, a caption, or
a study type.
To specify the image display
From the Image Display list, select an option as follows:
To display all images, select All Images.
To display images grouped by study, select By Study Type.
To display flagged images, select Flagged Images.
To display images with a caption, select Captioned Images.
To display only images with the image flags you specify, select Flag Combination.
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Playing Back Loops in Image Review

While viewing loops and frames in Image Review, you can do any of the following:
View one full-screen frame.
Play back one full-screen loop.
Play back up to nine images simultaneously.
Freeze the playback of a loop and select a frame within the loop.
Change the playback speed of a loop.
Synchronize the playback of multiple loops.
Compare images from different studies for the same patient.
Edit the endpoints of a loop.
Controlling the Playback of Loops in Image Review

While you are playing back a loop or loops in Image Review, you can control the
loop playback.
Freezing and Playing a Loop

To freeze the playback of a loop
Click
To continue playing back the loop

Click
Changing the Playback Speed

To change the playback speed
Use the Loop Speed slide control.
NOTE
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The default playback speed is 100%.
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Selecting a Frame in a Loop

To select a frame in a loop
1. To freeze the playback, click
2. To select the frame, use the Frame Select slide control.
Specifying the Synchronization Mode

When you are playing back more than one loop simultaneously, you can use the
trackball to select the following from the Synchronization Mode menu:
Free runThe loops play back continuously at the same speed.
Synch to both endsIf the loops are different lengths, the speed is adjusted
so that the loops all begin and end simultaneously.
Synch to beginningAll loops begin simultaneously and play back at the

same speed.
Viewing a Full-Screen Frame or Playing Back a Loop in Image

Review
To view a full-screen frame or play back a loop when you are in
Thumbnails
Move the cursor over the image, and do one of the following:
Double-click.
Press Enter, and click Play.
To view the image in a full-screen without scroll bars

Click
To view the previous loop or frame

Click
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To view the next loop or frame

Click
To stop playing the image in review

Press Freeze.
To view the previous or next image in the study
Press the left arrow or right arrow key.
To view the first or last image in the study
Press Home or End.
Playing Back More Than One Image in Image Review

You can play back up to nine images simultaneously in Image Review. The Image
Selection menu determines how you select the images that are played:
If you select Random from the Image Selection menu, you can select up to
nine individual images to play back at once.
If you select 2 up, 4 up, 6 up, or 9 up from the from the Image Selection
menu, when you click one image, a series of 2, 4, 6, or 9 sequential images is
automatically selected.
Playing Back Images That You Select

To play back more than one image when Random is selected from the
Image Selection menu
1. In Image Review in Thumbnail view, move the cursor over the first image.
2. Press Enter.
3. Repeat step 1 and step 2 for additional images.
4. Click Play.
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Playing Back a Series of Sequential Images

To play back more than one image in Image Review when 2 up, 4 up,
6 up, or 9 up is selected from the Image Selection menu
1. In Image Review in Thumbnail view, move the cursor over the first image.
2. Press Enter.
One or more additional images are automatically selected. For 2 up, two
images are selected, for 4 up, four images are selected, and so on.
3. Click Play.
To view the previous loops or frames
Click
To view the next loops or frames

Click
Comparing Images from Two Studies

To compare an image from the current study with an image from a
previous study in the same patient folder
1. In Image Review, move the cursor over the first image.
2. Press Enter.
3. Click the tab for the previous study.
4. Use the trackball to move the cursor over the second image.
5. Press Enter.
6. Click Play.
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Editing the Endpoints of a Loop

To edit the beginning or the end of a loop
1. In Image Review, click
to activate the Thumbnail view.

3. Double-click.
5. Press Select.
6. Use the trackball to highlight Loop Edit.
7. Press Enter.
8. To adjust the endpoints:
a. Use the trackball to move the cursor over the endpoint.
b. Press and hold Enter.
c. Move cursor with the trackball.
9. Click OK.
Reports
A report is automatically generated about a patient while you conduct an exam.
At any point during a study, you can view the automatically generated report by
pressing Report.
A report includes:
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Patient demographic information
Measurement and calculation information
Images that you add to the report
Cardiac wall motion scoring information
Obstetric trending graphs
Findings
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If the entire report is not visible on the display, you must use the scroll bars to the
right of and below the report to view the entire report.
Report Work Area

When you press Report, the report appears on the left, and the report work
area appears on the right. The report work area displays information about the
study and allows you to make changes to patient information, measurements, finding codes, comments, and obstetric graphs.
Displaying and Hiding the Report Work Area

The report work area appears to the right of the report.
To hide the report work area
Click
To display the report work area

Click
again.
Changing the Report Work Area

You can change the report work area to match the appropriate application package and group. See "Analysis and Reports Application Package/Group List" on
page 120.
To change the report work area
Select the appropriate preset from the Choose Report Work Area Type list
in the top right corner of the work area.
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Measurements and Calculations in a Report

When you perform a labeled measurement or calculation, the information is
automatically added to the report.
All instances of each measurement appear in the report work area. In obstetric
presets, the five most recent instances of each measurement appear in the report.
The others are enclosed in parentheses in the report work area.
NOTE
OB measurements that fall outside of normal guidelines will be inverse highlighted

in the report (a black box with white text) to call attention to them.
Finalizing a Report
When a report is finalized, you can no longer make changes to it. The next time
you open the study, a new version of the report is created.
To finalize a report
Save the report.
Create a new patient study.
Restart a patient study.
Open a different patient study.
Click
Viewing Report Versions

When you close a study, you can no longer make changes to the report. Each
time you open the study, a new version of the report is created.
To display all of the versions of the report
Click
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A tab appears for each version of every report for the current patient. The tabs
are labeled with the time and date that the report versions were created and the
version number.
To view an earlier version of the report
Click the tab.
Printing a Report
To print a report
Press Report and the Record key assigned to the printer you want to use.
NOTE
You cannot print a report to a networked DICOM printer. However, while viewing the report, you can press Acquire to store an image of a report. See "Saving
a Report as a Series of Images" on page 419.
Saving a Report as a Series of Images

If you want to be able to export a report in DICOM format, you can save the
report as a series of images.
To save a report as a series of images
Press Acquire while you are viewing the report.
The report appears in Thumbnails as a series of images.
When you export the study, these images of the report are exported with all of
the other images.
Adding an Image to a Report

You can add a still frame to a report. You cannot add a loop to a report.
To add a still frame to a report
1. If you are viewing a loop:
a. To freeze the loop, click
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b. If necessary, use the Frame Select slide control to choose the frame you
want add.
NOTE
If needed, you can show or hide measurements.

2. Move the cursor over the image and press Select.
.
Click
Use the trackball to highlight Put Image in Report, and then press
Enter.
4. Type an image caption in the Add Image dialog box, and click OK, or click
Cancel.
Manipulating Measurements in a Report

You can view the image associated with measurements that appear in a report;
edit, delete, and label measurements; and use the measurements in calculations.
To manipulate measurements that appear in a report
1. Press Report.
2. Click the Measure tab.
3. Move the trackball over the measurement you want to manipulate.
4. Press Select.
5. Use the trackball and Enter to highlight one of the following options:
DeleteConfirms that you want to delete the measurement.
EditAllows you to type a measurement value.
Show ImageDisplays the image associated with the selected measurement.
Use in CalcsAllows you to use the measurement in a calculation.
RelabelAllows you to relabel a measurement.
6. Press Enter.
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NOTES
You can also delete a measurement from the report work area by using the
trackball to highlight the measurement and pressing Clear.
You can display an image associated with a measurement only if you acquired
the image.
Adding Patient Information to a Report

You can add or change information about a patient in a report.
To add or change patient information in a report
1. Press Report.
2. Click the Information tab.
3. Move the cursor over a field and double-click.
4. Type the information.
5. To proceed to the next field, click Next.
6. Click OK.
Adding Interpretations to a Cardiac or a Vascular Report

You can select or manually type finding codes for various attributes of cardiac or
vascular structures. An interpretation summary determined by the finding code
appears in the report. You can use two different methods to add an interpretation
to a cardiac report: using the trackball or using the finding code.
To add an interpretation to the report by using the trackball
1. Press Report.
2. Click the Findings tab.
3. Click the button for the structure the interpretation relates to.
4. Move the cursor over a box in the list.
5. Press Select to display a list of finding codes.
6. Highlight the finding code or highlight Manual Text Entry if you want to
manually type a interpretation.
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7. Press Enter.
The interpretation appears in the report.
To add an interpretation to the report by using finding codes
1. Press Report.
3. Click the button for the structure the interpretation relates to.
Type the finding code in the Finding Code field. Press Return.
Type the first letter of the finding code in the Finding Code field. Press
Return. Use the trackball to select a code from the list. Press Enter.
Adding Visualizations and Observations to an Obstetric

Report
When you are in an obstetric preset, you can select or manually type obstetric
visualizations and observations, which appear in the report.
You can also type biophysical profile values that are used to calculate the biophysical profile total.
NOTE
Biophysical profiles do not appear in the report if they have no value.
To add a visualization, an observation, or biophysical profile

information to an obstetric report
1. Press Report.
3. Use the trackball to move the cursor over the Anatomy Visualized or the
Observations field.
4. For Anatomy Visualized, do one of the following:
Move the cursor over an item and click to select it.
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Select the Select All check box.
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5. For Observations, press Select and do one of the following:
Highlight the observation, select the choice in the dialog box that appears,
and click OK.
Highlight Manual Text Entry to type free text.
6. Press Enter.
The visualization or observation appears in the report.
7. Click Biophysical Profiles.
8. Deselect the appropriate N/A check box.
9. Type the profile number in the empty field.
The biophysical profile values appear on the Findings tab and in the report.
Adding Visualizations and Observations to a Gynecologic

Report
When you are in a gynecologic preset, you can select or manually type gynecologic visualizations and observations, which appear in the report.
To make observations about follicles
2. Click Follicles.
3. Select the appropriate check boxes for each follicle: Crenation or Cumulus.
4. Select Show on report.
To hide follicle observation information from the report
Deselect Show on report.
You can use two different methods to add a visualization or an observation to a
gynecologic report: using the trackball or using the finding code.
To add a visualization or an observation to a gynecologic report by
using the trackball
1. Press Report.
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3. Use the trackball to move the cursor over the Visualizations or the Observations field.
4. For visualizations, press Select.
5. To highlight the visualization, do one of the following:
Select the choice from the list and click OK.
Highlight Manual Text Entry to type a value.
6. Press Enter.
The visualization or observation appears in the report.
To add a visualization or an observation to a gynecologic report by
using finding codes
1. Press Report.
Type the finding code in the Finding Code field and go to step 6.
Type the first letter of the finding code.
4. Press Return.
5. Scroll to the appropriate finding code.
6. Press Enter.
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Adding Comments to a Report

You can use the Comments tab in the report work area to add comments and
summary statements to a report. On the Comments tab, you can also view the
list of images in the report and delete images from the report.
To add comments to a report
1. Press Report.
2. Click the Comments tab.
3. To make a comment, use the trackball to move the cursor into the Comments area, press Enter, and then type the comment.
4. To add a summary statement, use the trackball to move the cursor into the
Summary area. Press Select, use the trackball to highlight the summary
statement, and then press Enter.
5. To delete an image from the report, use the trackball and Enter to select the
name of the image from the Report Images field, and press one of the two
Clear keys.
Generating Obstetric Trending Graphs

When you are in an obstetrics preset, you can generate a trending graph for the
current study, studies saved on your system, and studies saved on a CD-R. You
can display data from up to nine studies on a graph. If you have data from more
than one fetus, the biometries are displayed on the trending graphs with different
symbols for each fetus. The trending graph appears in the report.
To generate a trending graph
1. Press Report.
2. Click the Trending tab.
3. Select a new value from the Fetal Weight menu, if necessary.
4. To change the x-coordinate for the graph, click AUA or LMP.
5. Select the biometries you want to use for the trending graphs by selecting the
appropriate tabs (Basic, Cranium, Long Bones, or Other) and check
boxes.
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NOTE
Some Biometries do not have a fetal growth curve associated with them and
therefore will not graph.
6. To import trending data, insert a CD-R that contains the trending data from
the previous study or studies.
7. Click Import Data.
Trending files from studies with the same MRN are imported from the CD-R.
8. Select the check boxes for the studies you want to use in the trending graph.
9. Click Update report.
The trending graph appears in the report.
10. To modify the trending graphs in the report, change the trending settings and
click Update report.
NOTE
To export obstetric trending data from the current study to a CD-R, click
Export data.
Formulas Used in Reports

The following formulas are used in reports. Click the name of any formula to see
the complete formula and associated references.
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Average Ultrasound Age
Biophysical Profile Total
Derived Gestational Age
EDC(AUA)
EDC(LMP)
Weight Percentiles
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Importing and Exporting

You can import and export patient studies, images, reports, and obstetric trending data.
Importing and Exporting in DICOM Format

DICOM format is used for patient studies that are transferred among computers
that make up an information management system and for studies that are
accessed by physicians at remote viewing stations.
You can export a patient study in DICOM format to an optical disk, to a CD-R, or
over a network.
You can import from an optical disk or a CD-R one or more studies that were
created on an HD11 system and that were saved in DICOM format.
NOTES
Exporting a study over a network is a feature of the DICOM Networking
option.
The DICOM Media option includes an optical disk drive. Any data that can be
exported to a CD-R can also be exported to an optical disk. You cannot
delete files from a CD-R, but you can write to it multiple times. The files on
an optical disk can be deleted so the optical disk can be used again.
You can adjust the brightness of images for viewing on DICOM viewers.
Exporting in PC Format
You can export images and reports in PC format:
Frames are saved as .bmp files.
Loops are saved as .avi files.
Reports are saved as HTML files.
You can export a frame, images, or a report to a CD-R or an optical disk.
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NOTES
You cannot import files saved in PC format (.bmp, .avi, or HTML files).
Files in PC format (.bmp, .avi, and HTML) are typically used to make copies of
images for training sessions and presentations.
You can adjust the brightness of images exported in PC format.
Importing and Exporting Obstetric Trending Data

You can import trending data from and export trending data to a CD-R. See
"Generating Obstetric Trending Graphs" on page 425.
Importing a Patient Study

You can import from an optical disk or a CD-R one or more patient studies that
were created on an HD11 system.
When you import a study, a new patient study is created. If a patient folder for
the MRN already exists, the new study is placed in the existing folder. If a folder
does not exist for that MRN, a new folder is automatically created.
NOTES
Importing a study does not open the study. To open a study, see "Searching for
a Patient Study" on page 402.
Importing a study from an optical disk or a CD-R is a component of the
DICOM Media option.
You can also import DICOM studies created on the EnVisor system.
is displayed on imported images that had their brightness adjusted when
exported.
To import one or more patient studies

2. Use the trackball and Enter to highlight the study you want to import.
3. To select more than one study, press and hold Ctrl or Shift.
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4. Click Import all or Import selected.
Exporting the Current Patient Study in DICOM Format

If you have the DICOM Media option, you can export a study to an optical disk or
a CD-R. If you have the DICOM Networking option, you can export a study
across a network to a DICOM PACS server. When you export a study in DICOM
format, the images and information are saved as DICOM files.
To export a patient study if you do not have the DICOM Media option, see
"Exporting Patient Studies" on page 430.
NOTES
If you have the DICOM Media option, studies exported to an optical disk or a
CD-R can be viewed on any DICOM viewer. If you do not have the DICOM
Media option, exported studies can only be viewed on HD11 systems.
When you export a still image, any measurements remain on the image.
When you export a loop, all measurements are removed before the loop is
exported. When you import the study, you cannot reactivate measurements
or perform new measurements.
When you export a study, some patient demographic information may not be
exported.
To export the current study in DICOM format

2. If necessary, close the study and save your changes when you are prompted.
3. Select the destination for the study by using the Export To Device menu.
NOTE
In the Export To Device menu, disk drives are identified with a drive letter and
a drive name. Networked DICOM servers and printers are identified as DICOM
PACS or DICOM printer.
4. Change the DICOM Image Format and Compression setting, if necessary.
5. Adjust the JPEG quality factor with the slide control, if necessary.
6. Click Start export.
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Exporting Patient Studies

You can export any patient study by using the Search for Study window. If you
have the DICOM Media option, studies exported to an optical disk or a CD-R can
be viewed on any DICOM viewer. If you do not have the DICOM Media option,
exported studies can only be viewed on HD11 systems.
If you have the DICOM Networking option, you can export a study across a network to a DICOM PACS server.
NOTES
When you export a still image, any measurements remain on the image.
When you export a loop, all measurements are removed before the loop is
exported. When you import the study, you cannot reactivate measurements
or perform new measurements.
When you export a study, some patient demographic information may not be
exported.
To export one or more studies

2. In the Search for Study window, click Search.

3. Use the trackball to move the cursor over the patient study you want to
export.
4.
To select more than one study, press and hold Ctrl or Shift.
5. Press Select.
6. Highlight Export or Export DICOM.
If you have the DICOM Media option, Export appears dimmed. If you do
not have the DICOM Media option, Export DICOM appears dimmed.
If an open study is selected, Export and Export DICOM appear

dimmed.
7. Press Enter.
8. Select the destination for the study by using the Export To Device menu.
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On the Export To Device menu, disk drives are identified with a drive letter
and a drive name. Networked DICOM servers and printers are identified as
DICOM PACS or DICOM printer.
9. Change the DICOM Image Format and Compression setting if needed.
10. Adjust the JPEG quality factor with the slide control if needed.
11. Click Start export.
About the Icons in the Search for Study Window

The following icons that appear next to the studies in the Search for Study window indicate the export status of the study:
Ico
n
NOTE
Name
Description
Study Exported
The study has been exported at least once to an

optical disk, to a CD-R, or over a network.
Study Queued for Export
The study is queued to be exported over a network.

When the system receives confirmation that the
study was exported successfully, the icon changes to
the Study Exported icon.
Export Failed
An attempt to export the study was made, but the

export failed.
Study Open
The study is currently open. You cannot export a

study that is currently open.
Image Added to Study
At least one image as been added to the study since

the last time the study was viewed.
If an export fails, exit Image Review and check the DICOM Job Manager window
(press Ctrl+J). Delete the failed job, and try to send it again manually from the
Search for Studies window. See "Exporting Patient Studies" on page 430. You
can also try to ping the server to see if there is a network problem. See "Assigning
DICOM Servers" on page 71.
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Setting the Brightness for an Automatic Export

If exported images appear too dark on a remote viewing station, you can adjust
the brightness by setting the display compensation. You can adjust the brightness
for individual manual exports or for all images that are sent in the Batch and
Send as you go modes.
To set the brightness for an automatic export
NOTE
You must close the study before you set the brightness.
1. Press Setup.
4. In the DICOM Setup window, click the Servers & Roles tab.
5. On the Servers and Roles window, click Modify in the Roles area.
7. In the Network Export Preferences window, click the Image Format
tab.
8. On the Image Format tab, click Display Compensation.
NOTE
The Number displayed on the Display Compensation button is the current

setting.
9. In the Display Compensation window, click the appropriate option:
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Optimized for CRTfor viewing on an remote viewing station with a

CRT monitor.
Optimized for LCDfor viewing on an remote viewing station with a

Tailor to you individual preferencemove the slider to the appropriate number. For information on how to determine the compensation
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page 433.
10. Click OK.
To set the brightness for Batch and Send as you go exports
See "Changing the Image Format for DICOM Export" on page 76.
Determining the Display Compensation Number

To determine the display compensation number best for your viewing
station
1. Create a study.
2. Export the study in DICOM format. See "Exporting the Current Patient Study
in DICOM Format" on page 429.
3. Deselect Use Storage SCP Settings.
4. Click Display Compensation.
5. In the Display Compensation window, select the appropriate monitor
(CRT or LCD) option and click OK.
6. View the exported images on the remote viewing station. If the brightness is
not acceptable, do one of the following:
a.
If the networked PACS is configured to ignore duplicate studies, have

your system administrator remove your study from the networked PACS.
b. Export the study in DICOM format.

c. Deselect Use Storage SCP Settings.
d. Click Display Compensation.
e. Click Tailor to your individual preference and adjust the slider to a
more acceptable setting.
NOTE
The slider is positioned at your previous selection.

f. Click OK.
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Exporting an Image in PC Format

You can export an individual frame or loop to a CD-R or an optical disk. Frames
are saved in .bmp format. Loops are saved in .avi format.
To export a frame or a loop
to activate the Thumbnails view.
2. Move the cursor over the image and double-click.

3. If you are viewing a loop, click
to freeze the loop.
4. If necessary, use the Frame Select slide control to choose the frame you
want to export.
Press Select, use the trackball to highlight Export Image, and press
Enter.
Click
6. For a loop, specify whether you want to export the current frame or the
whole loop.
7. Change any necessary settings.
8. Click Export.
9. Select the destination.
10. Type the file name for the image.
11. Click Save.
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Exporting Images in PC Format

You can export all of the images displayed in Thumbnails or just selected images
to an optical disk or a CD-R. The frames are saved in .bmp format. The loops are
saved in .avi format.
When you export images, you can specify whether you want to export the latest
version of the report with the images.
To export images in PC format
to activate the Thumbnails view.
2. To select one or more images, use the trackball and Enter.

3. Click
4. Specify whether you want to export all of the images or only the selected
images.
5. Specify whether you want to export the report.
6. Specify the .avi image quality.
7. To change the brightness of the exported images, click Display Compensation, click the appropriate option, and then click OK.
8. Click Export.
10. Type a base file name for the images and click Save.
Exporting a Report in PC Format

You can export a report to a CD-R or an optical disk. Reports are saved as HTML
files. When you export a report, you can specify whether you want to export all
of the images displayed in Thumbnails with the report.
NOTE
You cannot export a report over a network or to a DICOM printer.
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To export a report
1. Press Report.
2. Click
3. Specify whether to export images with the report and do one of the following:
If you export the report with the images, the Export Images in PC Format window opens.
a. Click Export.
b. Continue with step 4.
If you export the report without the images, continue with step 4.
5. Type a file name.
6. Click Save.
Exporting Images and Reports from Patient Studies in PC

Format
You can export images or images and reports from any patient study in PC format
by using the Search for Study window.
To export images and reports from one or more studies
2. In the Search for Study window, click Search.

3. Move the cursor over the patient study that contains the images you want to
export.
4. To select more than one study, press and hold Ctrl or Shift.
5. Press Select.
6. Use the trackball to highlight Export PC Format.
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If the open study is selected, Export PC Format appears dimmed.

7. Press Enter.
8. Specify whether you want to export the report.
9. Specify the .avi image quality.
10. Click Export.
12. Type a base file name for the images.
13. Click Save.
Exporting Data to a Third-Party Application

You can export data and patient demographic information to a third-party software application in any preset.
Before you export data to a third-party application, you must do the following:
Plug a null modem serial cable into your system to connect your system to
the computer that houses the third-party software application.
Assign a Record key to serial output. See "Assigning Record Keys" on

page 133.
To export the data from the current study to a third-party application

Press the Record key assigned to serial output while you are viewing the report.
NOTE
For information about the format of the exported data, see the HD11 Getting
Started.
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Clinical References for Calculations
16
16 Clinical References for Calculations

The formula used, inherent approximations and assumptions, and clinical references for each calculation are listed in this section.
Symbols
% Area Stenosis
The percentage of stenosis, S (%), formula, given a true lumen area, Atrue (cm2), and
the residual lumen area, Aresidual (cm2), is
Diagnostic ranges: 0% to 20%, normal; 20% to 60%, mild; 60% to 80%, moderate; 80% to
90%, severe; 90% to 99%, critical; 100%, occluded.
Jacobs, Norman M., et al. Duplex Carotid Sonography: Criteria for Stenosis, Accuracy,
and Pitfalls, Radiology, 154, 385391, 1985.
% Diameter Stenosis
The percentage of stenosis, S (%), formula, given a true lumen diameter, Dtrue (cm), and
the residual lumen diameter, Dresidual (cm), is
Diagnostic ranges: 0% to 20%, normal; 20% to 60%, mild; 60% to 80%, moderate; 80% to
90%, severe; 90% to 99%, critical; 100%, occluded.
Honda, Nobuo, et al. Echo-Doppler Velocimeter in the Diagnosis of Hypertensive
Patients: The Renal Artery Doppler Technique. Ultrasound in Medicine and Biology, Vol. 12,
No. 12, p. 945952, 1986.
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A
A-to-B Ratio
The formula for the A/B ratio, r (unitless), given the generic velocity, vA (cm/s), and the
generic velocity, vB (cm/s), is
AC (Abdominal Circumference)
Abdominal Circumference (cm) can be computed by two means: if AC(traced) is
present, then AC = AC(traced). If the two abdominal diameters, ADtrv and ADap,
are present, then
Kurtz, Alfred B., Goldberg, Barry B. Obstetrical Measurements in Ultrasound: A Reference

Manual, Year Book Medical Publishers, Inc., p. 33, 1988.
Shields J.R., et al. Fetal Head and Abdominal Circumferences: Ellipse Calculations Versus
Planimetry, Journal of Clinical Ultrasound. Vol. 15, 237239, May 1987.
Accel Slope
where delta v is the change in Doppler velocity (cm/s) and delta t is the time interval
change (sec).
Note: Use the maximum possible display magnification for best accuracy.
AFI (Amniotic Fluid Index)
The Amniotic Fluid Index is
Normal range for AFI: 8.118.0 cm.
Rutherford S., et al. Four Quadrant Assessment of Amniotic Fluid Volume. Journal of
Reproductive Medicine, Vol. 32, p. 587589, 1987.
Angle
If Ax < 0, then Ax = Ax
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If Ax > 180, then Ax = 360 Ax

where Ax is the a or b angle, Lx is the a or the b line angle, and Lb is the baseline angle.
Schuler, P., Graf, R. Sonographic Diagnosis of Hip Dysplasia and Hip Dislocation. 4.
Erg.Lig. 7, 1986, Ecomed Verlag. Reprint distributed by Siemens.
Aortic HR (Aortic Heart Rate)
Dorlands Illustrated Medical Dictionary, 27th ed., W. B. Sanders Co., Philadelphia, 1988, p.
1425.
Aortic Valve Area by the Continuity Equation
The valve area, Ax2 (cm2), by the continuity equation, using maximum velocities, Vx1
and Vx2 (cm/s), and flow diameter, Dx1 (cm):
where Aortic Valve Area (Continuity Equation, Max Velocity and Flow Diam) Calculations
Ax2
Dx1
Vx1
Vx2
AVA(V,D)
Diam 1
V1 max
V2 max
The valve area, Ax2 (cm2), via the continuity equation [92] [89], using velocity-time integrals, VTIx1 and VTIx2 (cm), and flow diameter, Dx1 (cm):
where:
Ax2
Dx1
VTIx1
VTIx2
AVA(I,D)
Diam 1
V1 VTI
V2 VTI
The Merck Manual of Diagnosis and Therapy, ed. 15. Robert Berkow, ed. Merck and Co.,
Inc., Rahway, N.J., 1987, p. 378.
Reichek N, et al. Anatomic Validation of Left Ventricular Mass Estimates from Clinical
Two-dimensional Echocardiography:Initial Results. Circulation, Vol. 67,No. 2, p.34852,
February 1983.
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Area
Note: The points on the circumference are assumed to be traced sufficiently close to
obtain an accurate result.
Area (I,D)
Oh, J.K. Prediction of the Severity of Aortic Stenosis by Doppler Aortic Valve Area
Determination: Prospective Doppler-Catheterization Correlation in 100 Patients. Journal
of the American College of Cardiology, Vol. 11, No. 6, pp. 12271234, June 1988.
Richards, K.L., et al. Calculation of Aortic Valve Area by Doppler Echocardiography: A
Direct Application of the Continuity Equation. Circulation, Vol. 73, No. 5, pp. 964969,
May 1986.
Area (V,D)
Oh, J.K. Prediction of the Severity of Aortic Stenosis by Doppler Aortic Valve Area
Determination: Prospective Doppler-Catheterization Correlation in 100 Patients. Journal
of the American College of Cardiology, Vol. 11, No. 6, p. 12271234 June 1988.
Richards, K.L., et al. Calculation of Aortic Valve Area by Doppler Echocardiography: A
Direct Application of the Continuity Equation, Circulation, Vol. 73, No. 5, p. 964969,
May 1986.
AUA (Average Ultrasound Age)
The Average Ultrasound Age formula is
where n varies from 1 to 12. The Average Ultrasound Age (AUA) is the average of all
(with one exception) the gestational ages that were generated during an exam from
acquired values. Gestational ages generated from corrected BPD are not included in the
AUA calculation. Also, only gestational ages that are generated from measurable values
contribute to the AUA. Gestational ages based on fetal biometric parameters only are
inputs to the AUA. GA(LMP), for instance, is not an input to AUA.
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You can mark gestational ages for inclusion in, or exclusion from, the AUA. An editable
marker field allows you to select which gestational ages should be included in the calculation of the AUA to be included in the report. The gestational age is preceded by a plus
sign (+) to indicate that the age will be included in the AUA, or a minus sign () to indicate that the age will be excluded from the AUA. This feature allows you to decide during
an obstetric exam that a particular gestational age is out of line with the others and
would inappropriately skew the AUA calculation. In this case, you can enter the edit
mode and deselect the calculation by replacing + with for that particular gestational
age.
When the system is powered on or you enter a new patient ID, the gestational ages are
marked by default for selection or deselection. All gestational ages are marked for inclusion by default, except for those biometries that have multiple associated authors. In
these cases, only one is marked on by default. This ensures that the AUA never includes
gestational age calculations based on the same biometry by different authors.
The following table lists the gestational age calculations available and their default states
in order of precedence:
Gestational Age
AUA Default State
GA(FL)Hadlock
GA(FL)Jeanty
GA(FL)Tokyo
GA(FL)Osaka
GA(HL)Jeanty
GA(HL)Osaka
GA(TL)Jeanty
GA(UL)Jeanty
GA(TC)Nimrod
GA(CRL)Robinson
GA(CRL)Jeant
GA(CRL)Remp
GA(CRL)Tokyo
GA(CRL)Osaka
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GA(BPD)Hadlock
GA(BPD)Jeanty
GA(BPD)Tokyo
GA(BPD)Osaka
GA(HC)Hadlock
GA(AC)Hadlock
GA(MSD)Hellman
GA(GSD)Remp
GA(GSD)Tokyo
GA(AA)Osaka
GA(VL)Tokyo
If you choose to override the defaults, the system enforces mutual exclusion when necessary. For example, three gestational ages based on biparietal diameter are available, one
by Hadlock, one by Jeanty, and one by Rempen. The default is the Hadlock calculation. If
you choose to override the Hadlock calculation, and use the Jeanty calculation, the system automatically deselects the Hadlock calculation and marks it with a minus sign ().
B
Biophysical Profile Total
The Biophysical Profile Total formula is
(Movement) + (Tone) + (Breathing) + (Amniotic Fluid Volume)
Category ranges: 02 or NA (NA indicates that the category will not contribute to the
biophysical profile total.)
Manning, F.A., et al. Fetal Assessment Based on Fetal Biophysical Profile Scoring. American Journal of Obstetrical Gynecology, Vol.162, p. 703709, 1990.
Bladder and PV Bladder Volume
The equation for ellipse volume, vol (cm3) from its three perpendicular axes, length
(Dimension 1), l, width (Dimension 2), w, and height (Dimension 3), h.
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C
CI (Cephalic Index)
The Cephalic Index (unitless) formula is
The CI(BPD,OFD) values for a normal human are 75.981.0.
Bezjian, Alex A. Normal and Abnormal Fetal Growth, presented at the Advanced Ultrasound Seminar, Lake Buena Vista, Florida, January 1982.
Dorlands Illustrated Medical Dictionary, 27th ed. W. B. Sanders Co., Philadelphia 1988, p.
830.
Hadlock F.P. et al. Estimating Fetal Age: Effects on Head Shape on BPD. American Journal
of Roentgenology, Vol. 137 p. 83851981.
Circumference
where Li,j,j is the line segment length between point i and point j, and where N is the
total number of points in the enclosed shape.
Note: The points on the circumference are assumed to be traced sufficiently close so
that the traced contour closely approximates the real circumference.
CO (Cardiac Output) (2D Mode and MMode)
The cardiac output, COx (normal range: 4 to 8 l/min), using the x volume method, given
the heart rate, HRx, and the stroke volume, SVx, is
where SVx = EDVx ESVx

and
COx
SVx
EDVx
ESVx
CO(sp-el)
SV(sp-el)
EDV(sp-el)
ESV(sp-el)
CO(bp-el)
SV(bp-el)
EDV(bp-el)
ESV(bp-el)
CO(Bullet)
SV(Bullet)
EDV(Bullet)
ESV(Bullet)
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CO(MOD-sp2)
SV(MOD-sp2)
EDV(MOD-sp2)
ESV(MOD-sp2)
CO(MOD-sp4)
SV(MOD-sp4)
EDV(MOD-sp4)
ESV(MOD-sp4)
CO(MOD-bp)
SV(MOD-bp)
EDV(MOD-bp)
ESV(MOD-bp)
CO(mod-Simp)
SV(mod-Simp)
EDV(mod-Simp)
ESV(mod-Simp)
CO(Cubed)
SV(Cubed)
EDV(Cubed)
ESV(Cubed)
CO(Teich)
SV(Teich)
EDV(Teich)
ESV(Teich)
Belenkie, Israel, et al. Assessment of Left Ventricular Dimensions and Function by

Echocardiography. American Journal of Cardiology, Vol. 31, June 1973.
CO (Cardiac Output) (Doppler)
The cardiac output, COx (l/min), using the Doppler velocity-time integral, VTIx (cm),
flow area, Ax (cm2), and heart rate, HRx (BPM), is
where
VTIx
CO(LVOT)
LV VI VTI
Ax
LVOT area
HRx
Aortic HR
Calafiore, P., Stewart, W.J. Doppler Echocardiographic Quantitation of Volumetric Flow

Rate. Cardiology Clinics, Vol. 8, No. 2, p. 191202, May 1990.
D
D-to-S Ratio
The formula for the diastolic-to-systolic ratio, r (unitless), given the systolic velocity, vs
(cm/s), and the end-diastolic velocity, vd (cm/s), is
Neumyer, Marsha M. et al. The Differentiation of Renal Artery Stenosis from Renal
Parenchymal Disease by Duplex Ultrasonography. Journal of Vascular Technology, Scientific
Article, p. 205216, October 1989.
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Decel Slope
where delta v is the change in vertical dimension Doppler velocity (cm/s) and delta t is
the time interval change (sec).
Note: Use the maximum possible display magnification for the most accurate calculation.
Derived GA (Gestational Age)
The gestational age computed from that of an earlier exam, where PrevExamGA is in
weeks, and the dates are in days, is
E
EDC(AUA)
The estimated date of confinement (date) given the average ultrasound age (date) formula
is
Hagen-Ansert, Sandra L. Textbook of Diagnostic Ultrasonography, 3rd ed. The C. V. Mosby
Co., 1989, p. 408.
EDC(LMP)
The estimated date of confinement (date) given the last menstrual period (date) formula
is
Hagen-Ansert, Sandra L., Textbook of Diagnostic Ultrasonography, 3rd ed., The C. V. Mosby
Co., 1989, p. 408.
EDV (Left Ventricular Volume at End Diastole)
Biplane Ellipse Formula
Folland, E.D., et al. Assessment of Left Ventricular Ejection Fraction and Volumes by
Real-Time, Two-Dimensional Echocardiography. Circulation, Vol. 60, No. 4, p. 760766,
October 1979.
Bullet Formula
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October 1979.
Cubed Formula
LVIDd 3
Dodge, H.T. Sandler, D.W., et al. The Use of Biplane Angiography for the Measurement
of Left Ventricular Volume in Man. American Heart Journal Vol. 60, pp. 762776, 1960.
Echocardiography. American Journal of Cardiology, pg. 31, June 1973.
Method of Discs, Biplane
where adi is the i-th disk diameter of LVAd ap2 MOD, bdi is the i-th disk diameter of
LVAd ap4 MOD, and L is the maximum length from LVAd ap2 MOD or LVAd ap4 MOD.
Schiller, N.B., et al. Recommendations for Quantification of the LV by Two-Dimensional
Echocardiography. Journal of the American Society of Echocardiography, Vol. 2, No. 5, p. 364,
SeptOct 1989.
Method of Discs, Single-Plane, Four-Chamber
where bdi is the i-th disk diameter of LVAd ap4 MOD and L is the length from LVAd ap4
MOD.
SeptOct 1989.
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Method of Discs, Single-Plane, Two-Chamber
where adi is the i-th disk diameter of LVAd ap2 MOD and L is the length from LVAd ap2
MOD.
Echocardiography. Journal of the American Society of Echocardiology, Vol. 2, No. 5, p. 364,
SeptOct 1989.
Modified Simpsons Formula
Weyman, Arthur E. Cross-Sectional Echocardiography. Lea & Febiger, 1985, p. 295.

October 1979.
Single-Plane Ellipse Formula
October 1979.
Teichholz Formula
Teichholz, L.E., et al. Problems in Echocardiographic Volume Determinations: Echocardiographic-Angiographic Correlations in the Presence or Absence of Asynergy. American
Journal of Cardiology, Vol. 37, p. 711, January 1976.
EF (Ejection Fraction)
Pombo, J.F., Left Ventricular Volumes and Ejection by Echocardiography, Circulation, Vol.
43, pp. 480490, 1971.
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EFW(AC,BPD) via Hadlock

The formula for the estimated fetal weight (g) via Hadlock, using abdominal circumference (range: 15.5 to 40.0 cm) and biparietal diameter (range: 3.1 to 10.0 cm) is
Hadlock F.P., et al. Sonographic Estimation of Fetal Weight, Radiology, Vol. 150, p. 535
540, 1984.
EFW(AC,BPD) via Shephard
The formula for the estimated fetal weight (g) via Shephard, using abdominal circumference (range: 15.0 to 40.0 cm) and biparietal diameter (range: 3.1 to 10.0 cm) is
Shephard M.J., et al. An Evaluation of Two Equations for Predicting Fetal Weight by
Ultrasound. American Journal of Obstetrics and Gynecology, Vol. 142, No. 1, p. 4754, January 1982.
EFW(AC,FL) via Hadlock
The formula for the estimated fetal weight (g) via Hadlock, using abdominal circumference (range: 15.0 to 40.0 cm) and femur length (range: 1.0 to 8.0 cm) is
Hadlock F.P., et al. Estimation of Fetal Weight with the Use of Head, Body, and Femur
Measurements: A Prospective Study. American Journal of Obstetrics and Gynecology, Vol.
151, No. 3,p. 333337, 1985.
EFW(AC,HC,FL) via Hadlock
The formula for the estimated fetal weight (g) via Hadlock, using abdominal circumference (range: 10.0 to 37.0 cm), head circumference (range: 10.0 to 40.0 cm), and femur
length (range: 1.0 to 8.0 cm) is
Hadlock, F.P., et al. Estimation of Fetal Weight with the Use of Head, Body, and Femur
Measurements: A Prospective Study, American Journal of Obstetrics and Gynecology, Vol.
151, No. 3,p. 333337, 1985.
EFW(BPD,AD,FL) via Tokyo
The formula for the estimated fetal weight (g) via Tokyo University, using biparietal diameter (range: 3.1 to 10.0 cm), abdominal diameter (anterior-posterior) (range: 5.0 to
450
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15.0 cm), abdominal diameter (transverse) (range: 5.0 to 15.0 cm), and femur length
(range: 1.0 to 8.0 cm) is
Norio Shinozuka, et al. Formulas for Fetal Weight Estimation by Ultrasound Measurements Based on Neonatal Specific Gravities and Volumes. American Journal of Obstetrics
and Gynecology, Vol. 157, No, 5, p. 11405, 1987.
EFW(BPD,FTA,FL) via Osaka
The formula for the estimated fetal weight (g) via Osaka University, using biparietal diameter (range: 3.1 to 10.0 cm), fetal trunk abdominal area (range: 20.0 to 180.0 cm2), and
femur length (range: 1.0 to 8.0 cm) is
Nobuaki Mitsuda, et al. Image Diagnosis of Fetal Growth. Obstetrical and Gynecological
Practice (in Japanese), Vol.37, No. 10, p 45970, 1988.
EFW(BPD,HC,AC,FL) via Hadlock
The formula for the estimated fetal weight (g) via Hadlock, using biparietal diameter
(range: 3.1 to 10.0), head circumference (range: 10.0 to 40.0 cm), abdominal circumference (range: 15.0 to 40.0 cm), and femur length (range: 1.0 to 8.0 cm) is
Hadlock F.P., et al. Sonographic Estimation of Fetal Weight. Radiology, Vol. 150, p. 535
540, 1984.
ESV (Left Ventricular Volume at End Systole)
Biplane Ellipse Formula
Real-Time, Two-Dimensional Echocardiography, Circulation, Vol. 60, No. 4, p. 760766,
October 1979.
Bullet Formula
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October 1979.
Cubed Formula
Dodge, H.T., Sandler, D.W., et al. The Use of Biplane Angiography for the Measurement
of Left Ventricular Volume in Man. American Heart Journal, Vol. 60, p. 762776, 1960.
Echocardiography. American Journal of Cardiology, pg. 31, June 1973.
Method of Discs, Biplane
where asi is the i-th disk diameter of LVAs ap2 MOD, bsi is the i-th disk diameter of LVAs
ap4 MOD, and L is the maximum length from LVAs ap2 MOD or LVAs ap4 MOD.
SeptOct 1989.
Method of Discs, Single-Plane, Four-Chamber
where bsi is the i-th disk diameter of LVAs ap4 MOD and L is the length from LVAs ap4
MOD.
SeptOct 1989.
Method of Discs, Single-Plane, Two-Chamber
452
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where asi is the i-th disk diameter of LVAs ap2 MOD and L is the length from LVAs ap2
MOD.
SeptOct 1989.
Modified Simpsons Formula
Weyman, Arthur E. Cross-Sectional Echocardiography. Lea & Febiger, Philadelphia, 1985, p.

295.
October 1979.
Single-Plane Ellipse Formula
October 1979.
Teichholz Formula
Teichholz, L.E., et al. Problems in Echocardiographic Volume Determinations: Echocardiographic-Angiographic Correlations in the Presence or Absence of Asynergy. American
Journal of Cardiology, Vol. 37, p. 711, January 1976.
F
FAC (Fractional_Area_Change_Percentage)
The fraction area change percentage, FAC, given the end-diastolic area, EDA (cm2), and
the end-systolic area, ESA (cm2) is
FAC = ((EDA ESA) / EDA) x 100
Lui et al. Comparison between Radionuclide Ejection Fraction and Fractional Area
Changes Derived from Transesophageal Echocardiography Using Automated Border
Detection. Anesthesiology, Vol. 85, No. 3, p. 468, September 1996.
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16
Fetal Heart Rate

The formula for heart rate, r (BMP), given the peak-to-peak interval over two beats, t
(sec), is
r = 120/t
FL-to-AC Ratio
The ratio (unitless) of femur length (cm) to abdominal circumference (cm) is
Hadlock F.P., et al. A Date-Independent Predictor of Intrauterine Growth Retardation:

Femur Length/Abdominal Circumference Ratio. American Journal of Roentgenology, Vol.
141, p. 979984, 1983.
Hadlock F.P., et al. Use of Femur Length/Abdominal Circumference Ratio in Detecting
the Macrosomic Fetus. Radiology, Vol. 154, p. 503505, 1985.
FL-to-BPD Ratio
The ratio (unitless) of femur length (cm) to biparietal diameter (cm) is
The typical range for FL/BPD is 0.776 (23 weeks gestational age) to 0.81 (40 weeks gestational age).
Hohler, C., Quetal, T. Comparison of Fetal Femur Length and Biparietal Diameter in
Late Pregnancy. American Journal of Obstetrics and Gynecology, Vol. 141, No. 7, p. 759762,
December 1981.
Flow Volume (Diameter)
The flow volume V (l/min) formula, given the flow diameter D (cm2) and the 2) and the
flow mean velocity MeanV (cm/s), is
Burns, P.N. The Physical Principles of Doppler and Spectral Analysis. Journal of Clinical
Ultrasound, Vol. 15, No. 9, P. 587, November/December 1987.
Follicle Volume
0.523 = D x D x D
where D = follicular distance
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Penzias A.S., et al. Ultrasound Prediction of Follicle Volume: Is the Mean Diameter
Reflective? Fertility and Sterility, Vol. 62, No. 6, p. 12746, December 1994.
FS (Fractional Shortening)

Echocardiography. American Journal of Cardiology, Vol. 31, June 1973.
G
GA(AC) via Hadlock
The formula for gestational age (wk+day) via Hadlock, using abdominal circumference
(AC range: 5.0 cm (12.0 weeks) to 38.0 cm (42.0 weeks)) is
Hadlock F.P., et al. Estimating Fetal Age: Computer Assisted Analysis of Multiple Growth
Parameters. Radiology, Vol. 152, p. 497501, 1984.
GA(BPD) via Hadlock
The formula for gestational age (wk+day) via Hadlock, using biparietal diameter (BPD
range: 1.5 cm to 10.1 cm) is
GA(BPD) via Jeanty
Gestational age (wk+day) via Jeanty, using biparietal diameter (BPD range: 2.8 to 7.9 cm).
The following table lists the percentiles in weeks for each value:
BPD
5th% 50th% 95th%
2.8
11.3
14.0
16.5
2.9
11.5
14.1
16.9
3.0
11.9
14.5
17.1
3.1
12.1
14.9
17.4
3.2
12.3
15.1
17.7
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3.3
12.5
15.3
18.0
3.4
12.9
15.5
18.3
3.5
13.1
15.9
18.5
3.6
13.5
16.1
18.9
3.7
13.7
16.4
19.1
3.8
14.0
16.7
19.4
3.9
14.3
17.0
19.7
4.0
14.5
17.3
19.9
4.1
14.9
17.5
20.1
4.2
15.1
17.9
20.5
4.3
15.4
18.1
20.9
4.4
15.7
18.4
21.1
4.5
16.0
18.7
21.4
4.6
16.3
19.0
21.7
4.7
16.5
19.3
22.0
4.8
16.9
19.5
22.3
4.9
17.1
19.9
22.5
5.0
17.5
20.3
22.9
5.1
17.9
20.5
23.1
5.2
18.1
20.9
23.5
5.3
18.5
21.1
23.9
5.4
18.9
21.5
24.1
5.5
19.1
21.9
24.5
5.6
19.5
22.1
24.9
5.7
19.9
22.5
25.1
5.8
20.1
22.9
25.5
5.9
20.5
23.1
25.9
16
6.0
20.9
23.5
26.1
6.1
21.1
23.9
26.5
6.2
21.5
24.1
26.6
6.3
21.9
24.5
27.1
6.4
22.1
24.9
27.5
6.5
22.5
25.3
27.9
6.6
22.9
25.5
28.3
6.7
23.3
26.0
28.5
6.8
23.9
26.4
29.0
6.9
24.0
26.7
29.4
7.0
24.4
27.1
29.9
7.1
24.9
27.5
30.1
7.2
25.1
27.9
30.5
7.3
25.5
28.3
30.9
7.4
26.0
28.7
31.3
7.5
26.4
29.1
31.7
7.6
26.9
29.5
32.1
7.7
27.1
29.9
32.5
7.8
27.5
30.3
33.0
7.9
28.0
30.7
33.4
Jeanty, Philippe. Obstetrical Ultrasound. McGraw Hill, 1983, p. 58.

GA(BPD) via Osaka
Gestational age (wk+day) via Osaka University, using biparietal diameter (BPD range: 1.3
to 9.4 cm).
BPD
GA
BPD
GA
BPD
GA
BPD
GA
1.33
10
4.20
18
6.67
26
8.62
34
1.72
11
4.53
19
6.95
27
8.80
35
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2.09
12
4.85
20
7.23
28
8.96
36
2.46
13
5.17
21
7.49
29
9.10
37
2.82
14
5.48
22
7.74
30
9.21
38
3.18
15
5.79
23
7.98
31
9.30
39
3.52
16
6.09
24
8.21
32
9.36
40
3.86
17
6.39
25
8.43
33
Practice (in Japanese), Vol. 37, No, 10, p. 145970, 1988.
GA(BPD) via Tokyo
Gestational age (wk+day) via Tokyo University, using biparietal diameter (BPD range: 2.0
to 9.47 cm).
BPD
GA
BPD
GA
BPD
GA
BPD
GA
2.00
12
4.71
20
7.12
28
8.92
36
2.40
13
5.04
21
7.38
29
9.08
37
2.76
14
5.35
22
7.64
30
9.23
38
3.10
15
5.67
23
7.88
31
9.36
39
3.38
16
5.97
24
8.12
32
9.47
40
3.72
17
6.27
25
8.34
33
4.05
18
6.56
26
8.55
34
4.39
19
6.84
27
8.74
35
Masahiko Mizuno, et al. Assessment of Fetal Growth Using Ultrasound Measurements.

Nichidoku Iho (Japanisch-Deutsche Medizinische Berichte) (in Japanese), Vol. 34, No. 3,
p. 537544, 1989.
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GA(CRL) via Jeanty

Gestational age (wk+day) via Jeanty, using crown-rump length (CRL range: 0.5 to 5.4
cm).
CRL
GA
CRL
GA
CRL
GA
0.5
6.3
2.5
9.4
4.5
11.3
0.6
6.5
2.6
9.5
4.6
11.4
0.7
6.7
2.7
9.5
4.7
11.5
0.8
6.8
2.8
9.7
4.8
11.5
0.9
7.1
2.9
9.9
4.9
11.7
1.0
7.3
3.0
9.9
5.0
11.9
1.1
7.4
3.1
10.0
5.1
11.9
1.2
7.5
3.2
10.1
5.2
11.9
1.3
7.8
3.3
10.1
5.3
12.0
1.4
7.8
3.4
10.3
5.4
12.1
1.5
8.1
3.5
10.4
1.6
8.1
3.6
10.6
1.7
8.4
3.7
10.6
1.8
8.5
3.8
10.7
1.9
8.5
3.9
10.9
2.0
8.9
4.0
10.9
2.1
8.9
4.1
11.0
2.2
9.0
4.2
11.1
2.3
9.1
4.3
11.1
2.4
9.1
4.4
11.1
Jeanty, Philippe, Obstetrical Ultrasound, McGraw Hill, 1983, p. 56.
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GA(CRL) via Osaka

Gestational age (wk+day) via Osaka University, using crown-rump length (CRL range: 0.8
to 6.5 cm). The following table lists the standard deviation in days:
CRL
GA
0.87
1.30
2.04
3.00
10
4.12
11
5.30
12
6.49
13
GA(CRL) via Rempen
Gestational age (wk+day) via Rempen, using crown-rump length (CRL range: 0.27 to 0.8
cm). The following table lists the standard deviation (SD) in days for each value:
460
CRL
GA
SD
CRL
GA
SD
0.2
6.0
3.8
10.4
0.3
6.1
3.9
10.5
0.4
6.3
4.1
10.7
0.5
6.4
4.2
10.9
0.6
6.5
4.4
11.0
0.7
6.7
4.5
11.1
0.8
6.9
4.7
11.3
0.9
7.0
4.8
11.4
1.0
7.1
5.0
11.6
1.1
7.3
5.2
11.7
1.2
7.4
5.3
11.9
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1.3
7.5
5.5
12.0
1.4
7.7
5.7
12.1
1.6
7.9
5.8
12.3
1.7
8.0
6.0
12.4
1.8
8.1
6.2
12.6
1.9
8.3
6.4
12.7
2.0
8.4
6.6
12.9
2.1
8.5
6.8
13.0
2.3
8.7
7.0
13.1
2.4
8.9
7.2
13.3
2.5
9.0
7.4
13.4
2.6
9.1
7.7
13.6
2.7
9.3
7.8
13.7
2.9
9.4
3.0
9.5
3.1
9.7
3.3
9.9
3.4
10.1
3.7
10.3
16
German Society for Gynecology and Obstetrics, Issue 15, Vol. 1, p. 2328, March 1991.
GA(CRL) via Robinson
The formula for gestational age (wk+day) via Robinson, using crown-rump length (CRL
range: 0.67 cm (6.3 weeks) to 8.2 cm (14.0 weeks)) is
Robinson, H.P., Fleming, J.E. A Critical Evaluation of Sonar Crown-Rump Length Measurements. British Journal of Obstetrics and Gynecology, Vol. 82, p. 702710, September
1975.
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GA(CRL) via Tokyo

Gestational age (wk+day) via Tokyo University, using crown-rump length (CRL range: 1.4
to 8.8 cm). The following table lists the associated standard deviation in days for each
value:
CRL
GA
CRL
GA
CRL
GA
CRL
GA
1.4
2.9
10
4.6
12
7.1
14
2.1
3.7
11
5.7
13
8.8
15

p. 537544, 1989.
GA(FL) via Hadlock
The formula for gestational age (wk+day) via Hadlock, using femur length (FL range: 0.7
to 8.2 cm) is
GA(FL) via Jeanty
The formula for gestational age (wk+day) via Jeanty, using femur length (FL range: 1.0 to
8.0 cm) is
The following table lists the percentiles in weeks for each value:
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FL
5th% 50th% 95th%
1.0
10.4
12.5
14.9
1.1
10.7
12.9
15.1
1.2
11.1
13.3
15.5
1.3
11.4
13.5
15.9
1.4
11.7
13.9
16.1
1.5
12.0
14.1
16.4
1.6
12.4
14.5
16.9
1.7
12.7
14.9
17.1
1.8
13.0
15.1
17.4
1.9
13.4
15.5
17.9
2.0
13.7
15.9
18.1
2.1
14.1
16.3
18.5
2.2
14.4
16.5
18.9
2.3
14.7
16.9
19.1
2.4
15.1
17.3
19.5
2.5
15.4
17.5
19.9
2.6
15.9
18.0
20.1
2.7
16.1
18.3
20.5
2.8
16.5
18.7
20.9
2.9
16.9
19.0
21.1
3.0
17.1
19.4
21.5
3.1
17.5
19.9
22.0
3.2
17.6
20.1
22.3
3.3
18.3
20.5
22.7
3.4
18.7
20.9
23.1
3.5
19.0
21.1
23.1
3.6
19.4
21.5
23.9
3.7
19.9
22.0
24.1
3.8
20.1
22.4
24.5
3.9
20.5
22.7
24.9
4.0
20.9
23.1
25.3
4.1
21.3
23.5
25.7
4.2
21.7
23.9
26.1
4.3
22.1
24.3
26.5
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4.4
22.5
24.7
26.9
4.5
22.9
25.0
27.1
4.6
23.1
25.4
27.5
4.7
23.5
25.9
28.0
4.8
24.0
26.1
28.4
4.9
24.4
26.5
28.9
5.0
24.9
27.0
29.1
5.1
25.1
27.4
29.5
5.2
25.5
27.9
30.0
5.3
26.0
28.1
30.4
5.4
26.4
28.5
30.9
5.5
26.9
29.1
31.3
5.6
27.3
29.5
31.7
5.7
27.7
29.9
32.1
5.8
28.1
30.3
32.5
5.9
28.5
30.7
32.9
6.0
28.9
31.1
33.3
6.1
29.4
31.5
33.9
6.2
29.9
32.0
34.1
6.3
30.1
32.4
34.5
6.4
30.7
32.9
35.1
6.5
31.1
33.3
35.5
6.6
31.5
33.7
35.9
6.7
32.0
34.1
36.4
6.8
32.4
34.5
36.9
6.9
32.9
35.0
37.1
7.0
33.3
35.5
37.7
16
7.1
33.7
35.9
38.1
7.2
34.1
36.4
38.5
7.3
34.5
36.9
39.0
7.4
35.1
37.3
39.5
7.5
35.5
37.7
39.9
7.6
36.0
38.1
40.4
7.7
36.4
38.5
40.9
7.8
36.9
39.1
41.3
7.9
37.3
39.5
41.3
8.0
37.9
40.0
42.1
Jeanty, Philippe, et al. Estimation of Gestational Age from Measurements of Fetal Long
Bones. Journal of Ultrasound Medicine, Vol. 3, p. 7579, February 1984.
GA(FL) via Osaka
Gestational age (wk+day) via Osaka University, using femur length (FL range: 0.9 to 7.2
cm).
FL
GA
FL
GA
FL
GA
FL
GA
0.94
13
3.03
20
4.78
27
6.19
34
1.26
14
3.30
21
5.01
28
6.36
35
1.57
15
3.57
22
5.22
29
6.53
36
1.88
16
3.83
23
5.43
30
6.69
37
2.18
17
4.08
24
5.63
31
6.84
38
2.47
18
4.32
25
5.82
32
6.98
39
2.75
19
4.56
26
6.01
33
7.12
40
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GA(FL) via Tokyo

Gestational age (wk+day) via Tokyo University, using femur length (FL range: 3.2 to 7.1
cm).
FL
GA
FL
GA
FL
GA
FL
GA
3.23
20
4.64
26
5.82
32
6.82
38
3.44
21
4.76
27
6.01
33
6.93
39
3.65
22
4.98
28
6.19
34
7.04
40
3.87
23
5.19
29
6.37
35
4.09
24
5.41
30
6.53
36
4.31
25
5.61
31
6.68
37

p. 537544, 1989.
GA(FTA) via Osaka
Gestational age (wk+day) via Osaka University, using fetal trunk area (FTA range: 5.6 to
87.0 cm2).
FTA
GA
FTA
GA
FTA
GA
FTA
GA
5.6
14
21.0
21
43.4
28
69.5
35
7.3
15
23.8
22
47.1
29
73.2
36
9.2
16
26.8
23
50.8
30
76.8
37
11.3
17
29.9
24
54.5
31
80.2
38
13.5
18
33.1
25
58.3
32
83.5
39
15.8
19
36.5
26
62.1
33
86.6
40
18.4
20
39.9
27
65.8
34
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GA(GSD) via Rempen

Gestational age (wk+day) via Rempen, using gestational sac diameter (GSD1 range: 0.2
to 7.3 cm). The following table lists the standard deviation (SD) in days:
GSD
GA
SD
GSD
GA
SD
GSD
GA
SD
GSD
GA
SD
0.2
4.9
10
2.1
7.0
10
3.8
9.1
10
5.6
11.6
10
0.3
5.0
10
2.2
7.1
10
3.9
9.4
10
5.8
11.9
10
0.4
5.1
10
2.3
7.3
10
4.0
9.4
10
5.9
12.0
10
0.6
5.3
10
2.4
7.4
10
4.1
9.6
10
6.0
12.1
10
0.7
5.4
10
2.6
7.6
10
4.2
9.7
10
6.2
12.4
10
0.8
5.6
10
2.7
7.7
10
4.4
9.9
10
6.3
12.6
10
1.0
5.7
10
2.8
7.9
10
4.5
10.0
10
6.4
12.7
10
1.1
5.9
10
2.9
8.0
10
4.7
10.3
10
6.5
12.9
10
1.2
6.0
10
3.0
8.1
10
4.8
10.4
10
6.6
13.0
10
1.3
6.1
10
3.1
8.3
10
4.9
10.5
10
6.8
13.3
10
1.4
6.3
10
3.3
8.4
10
5.0
10.7
10
6.9
13.4
10
1.6
6.4
10
3.4
8.6
10
5.1
10.9
10
7.0
13.5
10
1.7
6.6
10
3.5
8.7
10
5.2
11.0
10
7.1
13.7
10
1.8
6.7
10
3.6
8.9
10
5.4
11.3
10
7.2
14.0
10
2.0
6.9
10
3.7
9.0
10
5.5
11.4
10
7.3
14.1
10
German Society for Gynecology and Obstetrics, Issue 15, Vol. 1, p. 2328, March 1991.
GA(GSD) via Tokyo
Gestational Age (wk+day) via Tokyo University, using Gestational Sac Diameter (GSD1
range: 1.0 to 6.7 cm). The following table lists the associated standard deviation in days:
GSD
GA
1.0
1.6
2.2
2.7
7
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3.4
4.1
4.8
10
5.7
11
6.7
12

p. 537544, 1989.
GA(HC) via Hadlock
Given the Head Circumference (HC range: 5.635.7 cm), Gestational Age via Hadlock,
GA(HC)Hadl (in weeks) is
8.96 + 0.540(HC) + 0.0003(HC3)
GA(HL) via Jeanty
Gestational Age (wk+day) via Jeanty using Humerous Length (HL range: 1.06.9 cm)
equation is
9.6519438 + 2.6200391(HL) + 0.26105367(HL2)
The following table lists the associated percentiles in weeks for each value:
HL
468
5th% 50th% 95th%
HL
5th% 50th% 95th%
1.0
9.9
12.5
15.3
4.0
21.5
24.3
27.1
1.1
10.1
12.9
15.5
4.1
22.0
24.9
27.5
1.2
10.4
13.1
15.9
4.2
22.5
25.3
28.0
1.3
10.9
13.5
16.1
4.3
23.0
25.7
28.5
1.4
11.1
13.9
16.5
4.4
23.5
26.1
29.0
1.5
11.4
14.1
16.9
4.5
24.0
26.7
29.5
1.6
11.9
14.5
17.3
4.6
24.5
27.1
30.0
1.7
12.1
14.9
17.5
4.7
25.0
27.7
30.5
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1.8
12.5
15.1
18.0
4.8
25.5
28.1
31.0
1.9
12.9
15.5
18.3
4.9
26.0
28.9
31.5
2.0
13.1
15.9
18.7
5.0
26.5
29.3
32.0
2.1
13.5
16.3
19.1
5.1
27.1
29.9
32.5
2.2
13.9
16.7
19.4
5.2
27.5
30.3
33.1
2.3
14.3
17.1
19.9
5.3
28.1
30.9
33.5
2.4
14.7
17.4
20.1
5.4
28.7
31.4
34.1
2.5
15.1
17.9
20.5
5.5
29.1
32.0
34.7
2.6
15.5
18.1
21.0
5.6
29.9
32.5
35.3
2.7
15.9
18.5
21.4
5.7
30.3
33.1
35.9
2.8
16.3
19.0
21.9
5.8
30.9
33.5
36.5
2.9
16.7
19.4
22.1
5.9
31.4
34.1
36.9
3.0
17.1
19.9
22.5
6.0
32.0
34.9
37.5
3.1
17.5
20.3
23.0
6.1
32.5
35.3
38.1
3.2
18.0
20.7
23.5
6.2
33.1
35.9
38.7
3.3
18.4
21.1
23.9
6.3
33.9
36.5
39.3
3.4
18.9
21.5
24.3
6.4
34.4
37.1
39.9
3.5
19.3
22.0
24.9
6.5
35.0
37.7
40.5
3.6
19.7
22.5
25.1
6.6
35.5
38.3
41.1
3.7
20.1
22.9
25.7
6.7
36.1
38.9
41.7
3.8
20.5
23.4
26.1
6.8
36.9
39.5
42.3
3.9
21.1
23.9
26.5
6.9
37.4
40.1
42.9
16
Jeanty, Philippe, Rodesch, Frederic, Delbeke, Dominique, and Dumont, Jacques E. Estimation of Gestational Age from Measurements of Fetal Long Bones. Journal of Ultrasound
Medicine, Vol. 3,p. 75-79, Feb 1984.
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GA(HL) via Osaka

Gestational Age (wk+day) via Osaka University using Humorous Length (HL range: 1.01
6.16 cm). The following table lists the associated standard deviation in days:
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HL
GA
1.01
13w0d
1.31
14w0d
1.59
15w0d
1.87
16w0d
2.15
17w0d
2.41
18w0d
2.67
19w0d
2.91
20w0d
3.15
21w0d
3.38
22w0d
3.61
23w0d
3.82
24w0d
4.03
25w0d
4.23
26w0d
4.42
27w0d
4.60
28w0d
4.78
29w0d
4.94
30w0d
5.10
31w0d
5.25
32w0d
5.39
33w0d
5.53
34w0d
5.65
35w0d
5.77
36w0d
5.88
37w0d
5.98
38w0d
6.08
39w0d
6.16
40w0d
16
Aoki, Mineo. The Diagnosis and Treatment of IUGR. (in Japanese). Perineitaru Kea (Japanese Journal of Perinatal Care), Vol. 9, No. 5, p. 407-422, 1990.
Mitsuda, Nobuaki; Ohtsuki, Yoshiro; Sugita, Nagatoshi; Takagi, Tetsu; and Tanizawa,
Osamu. Image Diagnosis of Fetal Growth. (in Japanese). Sanfujinka No Jissai (Obstetrical
and Gynecological Practice), Vol. 37, No. 10, p. 459-70, 1988.
GA(MSD) via Hellman
Gestational Age (wk+day) via Hellman using Mean Gestational Sac diameter (Gestational
Sac Diameter range: 1.0 cm (5.0 weeks) to 6.0 cm (12.2 weeks)) equation is
(10((GSD1 + GSD2 + GSD3) / 3) + 25.43) / 7.02
Hellman LM, Kobayashi M, Fillisti L, Lavenhar M, and Cromb E. Growth and development of the Human Fetus Prior to the Twentieth Week of Gestation. American Journal of
Obstetrics and Gynecology, Vol. 103, p. 789-800, 1969.
GA(SL) via Tokyo
Gestational Age (wk+day) via Tokyo University using Spine Length (SL range: 4.058.47
cm). The following table lists the associated standard deviation in days:
SL
GA
4.05
21
4.39
22
4.71
23
5.01
24
5.30
25
5.57
26
5.82
27
6.06
28
6.30
29
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6.51
30
6.72
31
6.93
32
7.13
33
7.32
34
7.51
35
7.70
36
7.89
37
8.08
38
8.27
39
8.47
40

p. 537544, 1989.
GA(TC) via Nimrod
Gestational Age (wk+day) via Nimrod using Thoracic Circumference (TC range: 13.0
35.0 cm) equation is
(TC + 0.44) / 0.79
Nimrod, C, et al. Ultrasound Prediction of Pulmonary Populaces. Obstetrics and Gynecology, Vol. 68, p. 495-498, 1986.
GA(TL) via Jeanty
Gestational Age (wk+day) via Jeanty using Tibia Length (TL range: 1.06.9 cm) equation is
10.055043 + 3.1317668 x TL + 0.16814056 x (TL)2
472
TL
5th% 50th% 95th%
TL
5th% 50th% 95th%
1.0
10.5
13.4
16.3
4.0
22.4
25.3
28.1
1.1
10.9
13.7
16.5
4.1
22.9
25.7
28.5
1.2
11.1
14.1
17.0
4.2
23.3
26.1
29.1
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1.3
11.5
14.4
17.3
4.3
23.7
26.5
29.5
1.4
11.9
14.9
17.7
4.4
24.1
27.1
30.0
1.5
12.1
15.1
18.0
4.5
24.5
27.5
30.5
1.6
12.5
15.5
18.4
4.6
25.1
28.0
30.6
1.7
13.0
15.9
18.9
4.7
25.5
28.5
31.4
1.8
13.2
16.1
19.1
4.8
26.1
29.0
31.9
1.9
13.7
16.5
19.5
4.9
26.5
29.4
32.3
2.0
14.1
17.0
19.9
5.0
27.0
29.9
32.9
2.1
14.5
17.4
20.3
5.1
27.5
30.4
33.3
2.2
14.9
17.9
20.7
5.2
28.0
30.9
33.9
2.3
15.1
18.1
21.1
5.3
28.5
31.4
34.3
2.4
15.5
18.5
21.4
5.4
29.0
31.9
34.9
2.5
16.0
18.9
21.9
5.5
29.5
32.4
35.3
2.6
16.4
19.3
22.1
5.6
30.0
32.9
35.9
2.7
16.9
19.7
22.5
5.7
30.5
33.4
36.3
2.8
17.1
20.1
23.0
5.8
31.0
33.9
36.9
2.9
17.5
20.5
23.5
5.9
31.5
34.4
37.3
3.0
18.1
21.0
23.9
6.0
32.0
34.9
37.9
3.1
18.5
21.4
24.3
6.1
32.5
35.4
38.3
3.2
18.9
21.9
24.7
6.2
33.0
35.9
38.9
3.3
19.3
22.1
25.1
6.3
33.5
36.5
39.4
3.4
19.7
22.5
25.5
6.4
34.1
37.0
39.9
3.5
20.1
23.1
26.0
6.5
34.5
37.5
40.4
3.6
20.5
23.5
26.4
6.6
35.1
38.0
41.0
3.7
21.0
23.9
26.9
6.7
35.7
38.5
41.5
3.8
21.5
24.4
27.3
6.8
36.1
39.1
42.0
3.9
21.9
24.9
27.7
6.9
36.9
39.7
42.5
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GA(UL) via Jeanty
Gestational Age (wk+day) via Jeanty using Ulna Length (UL range: 1.06.4 cm) equation is
10.034368 + 2.8625722 x UL + 0.2912470 x (UL)2
474
UL
5th% 50th% 95th%
UL
5th% 50th% 95th%
1.0
10.1
13.1
16.1
4.0
23.1
26.1
29.1
1.1
10.5
13.5
16.5
4.1
23.5
26.7
29.7
1.2
10.9
13.9
16.9
4.2
24.1
27.1
30.3
1.3
11.1
14.1
17.3
4.3
24.7
27.7
30.9
1.4
11.5
14.5
17.7
4.4
25.1
28.3
31.3
1.5
11.9
15.0
18.0
4.5
25.9
28.9
31.9
1.6
12.3
15.4
18.4
4.6
26.3
29.4
32.4
1.7
12.7
15.7
18.9
4.7
26.9
29.9
33.0
1.8
13.1
16.1
19.1
4.8
27.4
30.5
33.5
1.9
13.5
16.5
19.5
4.9
28.0
31.1
34.1
2.0
13.9
16.9
20.0
5.0
28.5
31.5
34.7
2.1
14.3
17.3
20.4
5.1
29.1
32.1
35.3
2.2
14.7
17.7
20.9
5.2
29.7
32.9
35.9
2.3
15.1
18.1
21.1
5.3
30.3
33.4
36.4
2.4
15.5
18.5
21.5
5.4
30.9
34.0
37.0
2.5
16.0
19.0
22.1
5.5
31.5
34.5
37.7
2.6
16.4
19.4
22.5
5.6
32.1
35.1
38.3
2.7
16.9
19.9
22.9
5.7
32.9
35.9
38.9
2.8
17.3
20.3
23.4
5.8
33.4
36.4
39.5
2.9
17.7
20.9
23.9
5.9
34.0
37.1
40.1
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3.0
18.1
21.1
24.3
6.0
34.5
37.7
40.9
3.1
18.5
21.7
24.9
6.1
35.3
38.3
41.4
3.2
19.1
22.1
25.1
6.2
35.9
39.0
42.0
3.3
19.5
22.7
25.7
6.3
36.5
39.5
42.7
3.4
20.1
23.1
26.1
6.4
37.1
40.3
43.3
3.5
20.5
23.6
26.7
3.6
21.1
24.1
27.1
3.7
21.5
24.5
27.7
3.8
22.1
25.1
28.1
3.9
22.5
25.5
28.7
16
H
HC-to-AC Ratio
The ratio (unitless) of Head Circumference (cm) to Abdominal Circumference (cm) is
HC / AC
The typical range for HC/AC is 0.96 (13 weeks Gestational Age) to 1.23 (41 weeks Gestational Age).
Campbell S, Thoms A. Ultrasound Measurement of Fetal Head-to-Abdomen Circumference ratio in the Assessment of Growth Retardation. British Journal of Obstetrics and
Gynecology, Vol. 84, p. 165174, 1977.
Head Circumference
Head Circumference (cm) (normal range: 8.0 cm to 36.0 cm) may be computed by two
means:
If HC(traced) is present, then
2
BPD + OFD -)
(---------------------------------------2
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HC = HC(traced)
If the two head diameters, BPD and OFD, are present, then
Shields JR, et al. Fetal Head and Abdominal Circumferences: Ellipse Calculations Versus
Planimetry. Journal of Clinical Ultrasound, Vol. 15, p. 237239May 1987.
Manual. Year Book Medical Publishers, Inc., 1988, p. 33.
HrtC-to-TC Ratio
The ratio (unitless) of heart circumference (HrtC) (cm) to thoracic circumference (TC)
(cm) is
HrtC/TC
I
ICA-to-CCA Ratio
The formula for the ICA/CCA ratio, r (unitless), given the internal carotid artery systolic velocity, vICA (cm/s), and the common carotid artery systolic velocity, vCCA (cm/
s), is
Garth K., Carroll B., et al. Duplex Ultrasound Scanning of the Carotid Arteries with
Velocity Spectrum Analysis. Radiology, Vol. 147, p. 826, June 1983.
L
LA-to-AO Ratio
Roelandt, Joseph, Practical Echocardiology, vol. 1 of Ultrasound in Medicine Series, ed.

Denis White, Research Studies Press, 1977, p. 270.
SeptOct 1989.
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Length
where (X1,Y11) and (X2,Y2) are the endpoint coordinates of the line segment.
Note: When making small length measurements, use the maximum permissible display
magnification for the most accurate calculations.
LVLd % diff
LVLd % diff is the MOD long-axis (at end diastole) length percentage difference between
apical 4 and apical 2 views.

Echocardiography. Journal of the American Society of Echocardiography, Vol. 2, No. 5,
p. 358367, SeptOct 1989.
LVLs % diff
LVLs % diff is the MOD long-axis length at end systole percentage difference between
apical 4 and apical 2 views.

p. 358367, SeptOct 1989.
LVmass(AL)d
where
A1 represents LVAd sax epi, the LV epicardial SAX area at the level of the papillary muscle tips at end diastole
A2 represents LVAd sax PM, the LV endocardial SAX cavity area at the level of the papillary muscle tips at end diastole
L represents LVLd apical, the LV long-axis length at end diastole (via apical four-chamber
or two-chamber views)
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t is a representative myocardial wall thickness with the formula
Reichek, N., et al. Anatomic Validation of Left Ventricular Mass Estimates from Clinical
Two-Dimensional Echocardiography: Initial Results. Circulation, Vol. 67, No. 2, p. 348
352, February 1983.
p. 358367, SeptOct 1989.
Wyatt, H.L., et al. Cross-sectional Echocardiography: Analysis of Models for Quantifying
Mass in the Left Ventricle in Dogs. Circulation, Vol. 60, p. 11041113, 1979.
LVmass(AL)dI
LVmass(C)d
Left Ventricular Mass (grams) via the cubic equation (with the Devereux anatomic correction) using ASE M-mode measurements (at end-diastole). Reference: Devereux et al
The measurements of the interventricular septal thickness (IVSd), posterior wall thickness (LVPWd), and left ventricular inner dimension (LVIDd) are made at end-diastole
using leading-edge to leading-edge method as recommended by the American Society of
Echocardiography (ASE).
Devereux, R.B., et al. Echocardiographic Assessment of Left Ventricular Hypertrophy:

Comparison to Necropsy Findings, American Journal of Cardiology, Vol. 57, p. 450458,
1986.
Sahn, D., et al. The Committee on MMode Standardization of the American Society of
Echocardiography, Recommendations Regarding Quantitation in MMode Echocardiography: Results of a Survey of Echocardiographic Measurements. Circulation, Vol. 58,
No. 6, p. 10721083, 1978.
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LVmass(C)dI
LVOT Area
The calculated area, LVOTArea (cm2), of the Left Ventricular Outflow Tract is
LVOTArea = (pi/4) x (LVOTDiam)
Hagen-Ansert, Sandra L. Textbook of Diagnostic Ultrasound, ed. 3. The C.V. Mosby CO.,
1989, p. 73.
M
Mass Volume
Maximum Pressure Gradient

Short form:
where V2 is the maximum distal velocity (in cm/s).

The short form is clinically applicable in the case of stenosis where V2 > 4V1.
Yoganathan, Ajit P., et al. Review of Hydrodynamic Principles for the Cardiologist: Applications to the Study of Blood Flow and Jets by Imaging Techniques. Journal of the American College of Cardiology, Vol. 12, p. 13441353, 1988.
Maximum Pressure Gradient (Aortic Flow) (Full Bernoulli)
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Maximum Pressure Gradient (Aortic Flow) (Simplified Bernoulli)
Maximum Pressure Gradient (Aortic Insufficiency)
Callahan, Mark J., et al. Validation of Instantaneous Pressure Gradients Measured by

Continuous-Wave Doppler in Experimentally Induced Aortic Stenosis. American Journal
of Cardiology, Vol. 56, p. 989993, 1985.
Maximum Pressure Gradient (Mitral Regurgitation)
Stamm, R. Brad, et al. Quantification of Pressure Gradients Across Stenotic Valves by

Doppler Ultrasound. Journal of the American College of Cardiology, Vol. 2, No. 4, p. 707
718, 1983.
Maximum Pressure Gradient (Mitral Valve)
Maximum Pressure Gradient (Pulmonary Insufficiency)
Masuyama, T. et al. Continuous-wave Doppler Echocardiographic Detection of Pulmonary Regurgitation and Its Application to Noninvasive Estimation of Pulmonary Artery
Pressure. Circulation, Vol. 74, No. 3, p. 484492, 1986.
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Mean Pressure Gradient (Full Bernoulli)

Mean Pressure Gradient (Simplified Bernoulli)
Short form:
The short form is clinically applicable in the case of stenosis where V2 > 4V1.
MM HR (MMode or 2D Heart Rate)
Dorlands Illustrated Medical Dictionary, 27th ed., Philadelphia:W. B. Sanders Co., 1988, p.
1425.
MV E/A (Mitral Valve E-to-A Ratio)
Maron, Barry J., et al. Noninvasive Assessment of Left Ventricular Diastolic Function by
Pulsed Doppler Echocardiography in Patients with Hypertrophic Cardiomyopathy. Journal of the American College of Cardiology, Vol. 10, p. 733742, 1987.
MV Flow Area
The calculated Mitral Valve Flow area, MVFlowArea (cm2) is
MVFlowArea = (pi/4) x (MVDiam1 x MVDiam2)
Hagen-Ansert, Sandra L. Textbook of Diagnostic Ultrasound, ed. 3. The C.V. Mosby CO.,
1989, p. 73.
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MV P1/2t
where MV max vel is the peak velocity on the spectrum and MV Decel slope is the
slope of the spectrum as it declines from the max velocity.
Note: Position the crosshair along the deceleration slope as far away as possible from
the peak velocity point for the most accurate calculation.
Hatle, L., et al. Non-invasive Assessment of Atrioventricular Pressure Halftime by Doppler Ultrasound. Circulation, Vol. 60, p. 10961104, 1979.
MVA (P1/2t)
Note: Use points as far apart as possible on the deceleration slope and the maximum
permissible strip chart speed for the most accurate calculation.
Goldberg, Barry B., Kurtz, Alfred B. Atlas of Ultrasound Measurements. Year Book Medical
Publishers, Inc., 1990, p. 65.
Stamm, R. Brad, et al. Quantification of Pressure Gradients Across Stenotic Valves by
Doppler Ultrasound. Journal of the American College of Cardiology, Vol. 2, No. 4, p. 707
718, 1983.
O
Ovarian Volume
Length x Width x Thickness x 0.523
Andolf, Ellika, et al, Ultrasound Measurement of the Ovarian Volume, Acta Obstet
Gynecol Scand, 1987; 66:387389.
Qp-to-Qs Ratio
where DP represents the diameter of the effective flow area of the main pulmonary
artery, DS represents the diameter of the effective flow area of the aortic valve, VP rep482
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resents maximum velocity of the pulmonary flow, and VS represents the maximum
velocity of the aortic flow.
Cloez J.L., Schmidt, et al. Determination of Pulmonary to Systemic Blood Flow Ratio in
Children By a Simplified Doppler Echocardiographic Method. Journal of the American College of Cardiology, Vol. 11, No. 4, p. 825830, April 1988.
P
PI (Pulsatility Index Using Time-Averaged Mean of the Peaks)
The formula for pulsatility index, PI, given a maximum velocity, (Vmax in cm/s), a minimum velocity (Vmin in cm/s), and a mean velocity (Vmean in cm/s), is
Burns, Peter N. The Physical Principles of Doppler and Spectral Analysis. Journal of Clinical Ultrasound, Vol. 15, No. 9, p. 585, November/December 1987.
Pressure Half-Time
where max vel is the peak velocity on the spectrum and Decel slope is the slope of the
spectrum as it declines from one of the values for max vel listed in the following table:
Pressure
Half-Time
Max Vel
Decel Slope
Flow
Ao P1/2t
AI max vel
AI dec slope
Aortic flow
MV P1/2t
MV P1/2t max v
MV dec slope
Mitral flow
PI P1/2t
PI max vel
PA dec slope
Pulmonic flow
TV P1/2t
TV P1/2t max v
TV dec slope
Tricuspid flow
P1/2t
Dec max vel
Decel slope
Other flow
Note: Position the crosshair along the deceleration slope as far away as possible from
the peak velocity point for the most accurate calculation.
Hatle, L., et al. Non-invasive Assessment of Atrioventricular Pressure Halftime by Doppler Ultrasound. Circulation, Vol. 60, p. 10961104, 1979.
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Prostate Volume
Proximal Isovelocity Surface Area (PISA)

MR ERO (Mitral valve effective regurgitant orifice area) (cm2)
MR flow rate (Mitral valve regurgitation flow rate) (cm3/s)

MR PISA (Mitral valve regurgitation proximal isovolumic surface area) (cm2)
MR RF (Mitral valve regurgitant fraction) (%)
MR volume (Mitral valve regurgitant volume) (ml)
Enriquez-Sarano, M. Effective Regurgitant Orifice Area: A Noninvasive Doppler Development of an Old Hemodynamic Concept. Journal of the American College of Cardiology,
Vol. 23, No. 2, p. 44351, 1994.
Gardin, J. Doppler Color Flow Proximal Isovelocity Surface Area (PISA): An Alternative
Method of Estimating Volume Flow Across Narrowed Orifices, Regurgitant valves, and
Intracardiac Shunt Lesions. Echocardiography, Vol. 9, No. 1, p. 3941, 1992.
Shandas, R., et al. Experimental Studies to Define the Geometry of the Flow Convergence Region. Echocardiography, Vol. 9, No. 1 p. 4350, 1992.
Utsunomiya, T., et al. Regurgitant volume estimation in patients with mitral regurgitation: initial studies using the Color Doppler Proximal isovelocity surface area method.
Echocardiography, Vol. 9, No. 1, p. 6374, 1992.
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R
RAR (Renal-to-Aortic Ratio)
The equation for the RAR ratio, r (unitless), given the renal end-systolic velocity, R (cm/
s), and the aortic end-systolic velocity, A (cm/s), is:
RI (Resistivity Index)
The formula for resistivity index, RI (unitless), given a maximum velocity, Vmax (cm/s),
and a minimum velocity, Vmin (cm/s), for a vessel is
Burns, P.N. The Physical Principles of Doppler and Spectral Analysis. Journal of Clinical
Ultrasound, Vol. 15, No. 9, p. 586, November/December 1987.
RV Sys Press
Stevenson, J.G. Comparison of Several Noninvasive Methods for Estimation of Pulmonary Artery Pressure. Journal of the American Society of Echocardiography, Vol. 2, p. 157
171, June 1989.
Yock, Paul G. and Popp, Richard L. Noninvasive Estimation of Right Ventricular Systolic
Pressure by Doppler Ultrasound in Patients with Tricuspid Regurgitation. Circulation,
Vol. 70, No. 4, p. 657662, 1984.
S
S-to-D Ratio
The formula for the systolic-to-diastolic ratio, r (unitless), given the systolic velocity, vs
(cm/s), and the end-diastolic velocity, vd (cm/s), is
Ameriso, S., et al. Pulseless Transcranial Doppler Finding in Takayasus Arteritis. Journal
of Clinical Ultrasound, Vol. 18, p. 5926, September 1990.
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Stroke Volume (2D)
where the stroke volume, SVx (ml); the end-diastolic volume, x (ml); the end-diastolic volume, EDVx (ml); and the end-systolic volume, ESVx (ml), are
SVx
EDVx
ESVx
SV(sp-el)
EDV(sp-el)
ESV(sp-el)
SV(bp-el)
EDV(bp-el)
ESV(bp-el)
SV(Bullet)
EDV(Bullet)
ESV(Bullet)
SV(MOD-sp2)
EDV(MOD-sp2)
ESV(MOD-sp2)
SV(MOD-sp4)
EDV(MOD-sp4)
ESV(MOD-sp4)
SV(MOD-bp)
EDV(MOD-bp)
ESV(MOD-bp)
SV(mod-Simp)
EDV(mod-Simp)
ESV(mod-Simp)
SV(Cubed)
EDV(Cubed)
ESV(Cubed)
SV(Teich)
EDV(Teich)
ESV(Teich)
Gorge, G., et al. High Resolution Two-dimensional Echocardiography Improves the

Quantification of Left Ventricular Function. Journal of the American Society of Echocardiography, Vol. 5, p. 12534, 1992.
Roelandt, Joseph. Practical Echocardiology, vol. 1 of Ultrasound in Medicine Series. ed.
Denis White, Research Studies Press, 1977, p. 124.
Stroke Volume (Doppler)
where the stroke volume, SVx x (ml), using Doppler flow, given a velocity-time integral,
VTIxx (cm), and the flow area, Axx (cm2), are
SVx
486
VTIx
Ax
SV
V2 VTI
Flow area
SV(Ao)
Ao V2 VTI
Ao root area
SV(LVOT)
LV V1 VTI
LVOT area
SV(MV)
MV V2 VTI
MV flow area
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PA V2 VTI
MPA area
SV(MV)
MV V2 VTI
MV flow area
SV(TV)
TV V2 VTI
TV flow area
16
Hatle, Liv, Angelsen, Bjorn. Doppler Ultrasound in Cardiology: Physical Principles and Clinical
Applications, 2nd ed. Lea and Febiger, Philadelphia, 1985, p. 306.
Systolic Ratio
The formula for the systolic ratio, r (unitless), given the end-systolic velocity for vessel 1,
v1 (cm/s), and the end-systolic velocity for vessel 2, v2 (cm/s), is
Garth, K., et al. Duplex Ultrasound Scanning of the Carotid Arteries with Velocity Spectrum Analysis. Radiology, Vol. 147, p. 826, June 1983.
T
Testicle Volume
Thoracic Circumference
Thoracic Circumference (cm) may be computed by two means:
If TC(traced) is present, then
TC = TC(traced)
If the two thoracic diameters, TDtrv and TDap, are present, then
2
TDtrv + TDap -)
(--------------------------------------------2
Shields JR, et al. Fetal Head and Abdominal Circumferences: Ellipse Calculations Versus
Planimetry. Journal of Clinical Ultrasound, Vol. 15, p. 237239, May 1987.
Manual. Year Book Medical Publishers, Inc., 1988, p. 33.
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U
Uterine Volume
Length x Width x Thickness
Goldstein, S.R., et al. Estimation of Nongravida Uterine Volume Based on a Nomogram
of Gravid Uterine Volume: Its Value in Gynecologic Uterine Abnormalities. Obstetrics and
Gynecology, Vol, 72, No. 1, P. 8690, July 1988.
Levine, Sandra, Filly, Roy, Creasy, Robert K. Identification of Fetal Growth Retardation
by Ultrasonographic Estimation of Total Intrauterine Volume. Journal of Clinical Ultrasound, Vol. 7, p. 2126, 1979.
V
Velocity-Time Integral
The velocity-time integral (or flow integral) is the integral of the Doppler spectral instantaneous velocity (Vi) over the total time interval (T). The integral is approximated by the
following formula:
where T is the total time interval (the sum of all ti time increments).
Volume (Ellipsoid Three-Axis)
The formula for ellipse volume, vol (cm3), from its three perpendicular axes: length, l;
width, w; and height, h, is
Jeanty, Philippe. Measurement of Fetal Kidney Growth on Ultrasound. Radiology,
Vol, 144, p. 159162, July 1982.
Emamian, S.A., et al. Kidney Dimensions at Sonography: Correlation with Age, Sex, and
Habitus in 665 Adult Volunteers, American Journal of Radiology, Vol. 160, p. 8386, 1993.
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W
Weight Percentiles
To aid the clinician in diagnosing fetal weight discrepancies and discordant growth, weight
percentiles are available for each estimated fetal weight on the obstetrics report. These
indicate where the fetus lies in relation to the normal range of values, based on both clinical (expected GA or LMP) and ultrasound (AUA) data.
The fetal weight value is displayed within a shaded box (inverse video) if the percentile is
less than 10% or greater than 90%. In Analysis Setup, you can turn off weight percentiles
so they are not included in the report.
The following table of fetal weight smoothed percentiles (Brenner) is used by the system
to determine weight percentiles. The weights in the table are represented in grams:
Gestational
Age (wks)
10%
25%
50%
6.1
7.3
10
8.1
11
11.9
75%
90%
12
11.1
21.1
34.1
13
22.5
35.3
55.4
14
34.5
51.4
76.8
15
51.0
76.7
108
16
79.8
117
151
17
125
166
212
18
172
220
298
19
217
283
394
20
255
325
460
21
280
330
410
570
860
22
320
410
480
630
920
23
370
460
550
690
990
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16
24
420
530
640
780
1080
25
490
630
740
890
1180
26
570
730
860
1020
1320
27
660
840
990
1160
1470
28
770
980
1150
1350
1660
29
890
1100
1310
1530
1890
30
1030
1260
1460
1710
2100
31
1180
1410
1630
1880
2290
32
1310
1570
1810
2090
2500
33
1480
1720
2010
2280
2690
34
1670
1910
2220
2510
2880
35
1870
2130
2430
2730
3090
36
2190
2470
2650
2950
3290
37
2310
2580
2870
3160
3470
38
2510
2770
3030
3320
3610
39
2680
2910
3170
3470
3750
40
2750
3010
3280
3590
3870
41
2800
3070
3360
3680
3980
42
2830
3110
3410
3740
4060
43
2840
3110
3420
3780
4100
44
2790
3050
3390
3770
4110
Brenner, William, et al. A Standard of Fetal Growth for the United States of America.
American Journal of Obstetrics and Gynecology, Vol. 126, p. 555564, November 1976.
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Symbols
2D
1) A grayscale, real time, two-dimensional imaging mode. 2) A hard key that activates 2D
imaging. Pressing 2D when in any other imaging mode also exits that mode and returns to
2D mode, clearing all other modes and imaging features in use. Only the 2D control has
this functionality.
2D/M-mode Gain
A control panel knob that adjusts the gain, or overall brightness, of a 2D or an M-mode
image.
2D Hold
A Triggering mode soft key. If 2D Hold is off, then 2D image triggering is always in effect
in CW Spectral or in PW Spectral with Duplex/Triplex turned off.
2D Reference Image
The grayscale ultrasound image.
3D
An imaging mode in which a series of 2D images are acquired and then rendered into a
3-dimensional volume. Color and CPA modes can be used in 3D mode.
3D/4D
A hard key that activates the 3D/4D application.
3D/4D Mode
A soft key that enables you to change between acquisition modes. The modes available
depend on installed system options and what prove is selected.
3D Data Set
A series of 2D images from which a 3D volume is rendered.
3D Render
The mode in which you review and manipulate rendered 3D volumes and the associated
MPR images.
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Glossary
3D Volume
A 3D, 4D, or Fetal STIC image that has been constructed from a series of 2D images.
4D Acquisition
An imaging mode in which a stream of 3D volumes are acquired and rendered live.
A
Accept ROI
In 3D Render, a soft key that turns the Edit ROI feature off and accepts the changes you
made to the ROI.
Acquire
A hard key that starts image and loop acquisition. In 3D Render and Volume Cine, pressing Acquire saves a still image or Cine loop without the volume data set.
Acquire 3D Data
A soft key in 3D Render, 3D Swivel, and Volume Cine that acquires the 3D volume data
set.
Acquire Time
A soft key in Fetal STIC Preview that enables you to change the time of image acquisition
from the default.
Acquisition Icon
A small open box that appears on the bottom right corner of the display to the right of
the transducer frequency and depth when it is possible to acquire an image.
Activate body marker during Freeze and Dual
A setting on the System tab in the Setup window that enables you to have a body
marker automatically appear on the display during Dual Imaging and Freeze.
Adaptive Doppler
A feature of PW and CW Doppler that reduces the background noise in the spectral
trace and in the audio.
Adaptive Flow
A feature that changes the flow frequency to an optimal frequency for the selected transducer in the selected focal zone.
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Glossary
Adjust
In 3D/4D Imaging, an Image Control soft key that enables you to select whether changes
to the Image Controls and Render Controls affect the grayscale or the color settings.
This soft key selects between the Color Vision setting and the Grayscale Vision setting.
Angio Box
A box that appears on the image in Color Power Angio mode. The amplitude (intensity)
of flow in the angio box is represented with different hues.
Angle
1) In 3D/4D imaging, a soft key that adjusts the elevation angle of the 3D volume to be
acquired. With mechanical transducers, tells the system how far to go. With Freehand
FAN Geometry, tell the system how far the probe will tilt. 2) A control panel knob that
positions the angle-to-flow arrow parallel to and in the same direction as the blood flow
in PW Doppler. For a linear transducer, controls BW/Color/CPA steering direction.
Angle-to-Flow Arrow
An arrow that appears on the display in PW or CW Doppler along with the Doppler cursor line. Use the Angle knob to position the angle-to-flow arrow parallel to and in the
same direction as the blood flow.
Archive
In Panoramic Imaging, a soft key that saves the panoramic data set or still image to the
patients study. The title is saved with the data set. The title, labels, and measurements are
saved with the still image.
Arrow
A soft key available in image annotation that places an arrow on the display.
Assign Value
A soft key to assign the current measurement value to a labeled measurement of the
same type.
Audio
A soft key that turns Doppler audio on or off. Available only in PW Doppler Preview.
Auto Trace
A feature that automatically traces a frozen Doppler spectrum and uses the trace to calculate and display the results of Doppler measurements and calculations.
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Glossary
Autotrace Evaluation
A setting that determines whether the system should automatically trace spectral data
above the baseline, below the baseline, or both.
Automatic DICOM Export
A feature that automatically exports images over a network when you press Acquire or
when you save or close a study.
Automatic DICOM Printing
A feature that automatically sends images to a DICOM printer when you press Acquire
or when you save or close a study.
Automatic DICOM Study Deletion
A feature that automatically deletes a study as soon as all of its images are exported over
a network. Automatic DICOM study deletion is associated with automatic DICOM
export.
Autotrace Evaluation setting
A setting that enables you to specify how much of the waveform is evaluated and used by
Doppler Auto Trace and High Q Doppler.
Axis Icon
In 3D/4D and 3D Fetal Heart STIC, an icon that appears in the bottom left corner of
each view and that illustrates the relationship of the view to the X-Y-Z axes as the view is
manipulated.
B
B/W Suppress
1) A soft key that forces the width and position of the 2D scanning window to match the
width and position of the Color, Color Power Angio, or Color Tissue Doppler window.
Reducing the size of the window increases the frame rate. 2) A soft key that activates B/
W Suppress functionality. Available only with sector and curved linear array transducers
in Color, CPA, and Color Tissue Doppler modes.
Back
A soft key in 3D/4D Render and Swivel that exits the current mode and returns you to
3D Preview.
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Back to Preview
A soft key available during 3D sand Fetal STIC acquisition. Exits acquisition and returns to
the appropriate Preview mode.
Background Color
A setting on the System tab in the Setup window that allows you to choose either a
black or gray background color for the display.
Backlight Level
A setting on the System tab in the Setup window that controls the backlight illumination level for the control panel. Options are Low, Medium, and High. You can also
adjust the backlight level by pressing Ctrl+B.
Baseline
A key used in PW Doppler and CW Doppler that adjusts the spectral baseline position.
Beats
A soft key available in Physio and Trigger setup. Specifies how often (in number of
R-waves) the 2D image is updated.
Biopsy Guide
A feature that displays guide lines on the display to assist you in performing biopsies.
Available only with non-cardiac presets in 2D Mode and when using a transducer that
supports biopsy.
Biopsy
A soft key that activates the Biopsy Guide feature. The Biopsy soft key displays the
biopsy setting (Needle or Gun). If the selected transducer supports more than one needle position, a separate soft key (labeled with the transducer name) allows selection of
the crossover depth. Available only when you are in 2D Mode and a non-cardiac preset
and are using a transducer that supports biopsy.
Body Marker
1) A graphic that you can place on the display to indicate the part of the anatomy that you
are scanning. When you place the body marker, a transducer icon also appears. 2) A feature that enables you to add body marker graphics to the display. 3) A soft key available
when the Body Marker feature is active. It is the far left soft key on the display, and pressing it cycles through the body markers in the selected body marker set.
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Glossary
Body Marker Set

A soft key available when the Body Marker feature is active that enables you to specify
the set of body markers (grouped by exam type) from which you want to choose a single
marker to display on the display. Alternatively, you can change the body marker set by
changing the preset.
Border and Prompts
On the System tab in the Setup window, a button that opens a new window that
allows you to change the information that appears on the top of your display and other
settings. Also allows you to enable or disable the system prompts.
Box Position
A soft key to position the results box on the display.
Brightness
1)In 3D/4D imaging, a Render Controls soft key that creates a brighter image as the setting is increased. 2)The monitor Brightness control. You set the monitor brightness on
the Setup Window with the Monitor Adjust button.
Buffer
A temporary memory where images are accumulated for display.
C
Calc
A control panel hard key that activates the calculation features.
Calc Results
A soft key to display in the results box all measurements currently on the image, the last
measurement you performed, or no measurements.
Caliper
A control panel key that places a caliper on the display so that you can make measurements.
Cancel Acquire
A soft key that discontinues the acquisition of a panoramic data set.
CD Drive
A CD-R/RW drive on the front panel of the system, above the ECG connector.
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Chroma
1) A feature that improves image contrast resolution by replacing the grayscale map with
a color map. Choices are Off, Wheat, Beige, Sepia, Candle, Rose, Thallium, Slate,
and Rainbow. In M-mode and Doppler Mode, Chroma affects the spectrum when Trace
is highlighted on the bottom right corner of the display. It affects the reference image
when Image is highlighted. In 3D imaging, the Chroma map applied to the 3D volume
can change with the Vision setting. The Chroma map applied to the MPR views will
always match the 2D Chroma map and will not change with the Vision setting. 2) A soft
key that is used to select a color map to replace the grayscale map.
Clear
A soft key that erases measurements and annotations.
Color
1) An imaging mode in which the velocity and direction of flow are represented with different colors for direction and different shades for velocity. The colors being used appear
in the color bar in the upper right corner of the display. 2) A hard key that activates
Color mode.
Color Box
A box that appears on the image in Color Mode. The velocity and direction of flow in the
color box are represented with different colors for direction and different shades for
velocity.
Color Compare
A feature that enables you to view two versions of the same live image side by side. One
image is displayed in color; the other image is color suppressed.
Color Gain
A control panel knob that adjusts the intensity of the color in Color mode. Also adjusts
angio intensity in CPA mode and Doppler gain in Doppler modes.
Color M-mode
Working in Color and M-mode at the same time.
Color Power Angio (CPA)
A real-time, two-dimensional imaging mode that shows the amplitude (intensity) of flow
in color overlaying a grayscale image. The colors being used appear in the color bar on
the upper right corner of the display.
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Glossary
Color Power Angio (CPA) Compare

A feature that enables you to view two versions of the same live image side by side when
working in CPA mode. The image on the right shows angio flow and the image on the left
is flow-suppressed.
Color Power Angio Gain
A control panel knob that adjusts the intensity of the angio in CPA mode. Also adjusts
color intensity in Color mode, Doppler gain in Doppler modes, and the spectral trace in
Triplex.
Color Power Angio Suppress
A feature in CPA mode that temporarily removes angio data from a frozen angio image
without exiting CPA mode.
Color Power Angio Zoom
A feature that shows angio flow in a magnified image.
Color Suppress
A feature in Color mode that temporarily removes color data from a frozen color image
without exiting Color mode.
Color Zoom
A feature that shows color flow in a magnified image.
Compress
1) A feature that adjusts the compression of returning echoes, which affects the grayscale
display. Increasing Compress softens the image. Decreasing Compress produces a
high-contrast image. Not available in Freeze mode. 2) A soft key adjusts image compression.
Contrast
The monitor Contrast control. You set the monitor contrast on the Setup Window with
the Monitor Adjust button.
A type of harmonic imaging that is optimized for imaging with contrast agents. You can
use Contrast Harmonic Imaging with any imaging mode and preset.
Contrast Icon
An icon that appears on the lower left corner of the display and that summarizes information about the fusion settings in Contrast Harmonic Imaging.
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17
Contrast Option Key

A hard key that turns Contrast Harmonic Imaging on, enables three rows of soft keys,
and cycles through the Contrast fusion recipes.
Contrast Timer
1) In Contrast Harmonic Imaging, an on-screen timer measures the time elapsed since
the beginning of the delivery of a contrast bolus or infusion. 2) A soft key that displays,
starts, stops, and hides the Contrast Timer.
Control Panel
The main panel on the system that contains the imaging mode controls, a keyboard, a
trackball, and other frequently used controls.
CPA
1) Color Power Angio. 2) A hard key that activates Color Power Angio mode.
Crossover Depth
When Biopsy Guide is on, the vertical distance from the center of the transducer face to
the intersection of the needle path.
CW
1) Continuous-wave Doppler. 2) A hard key that activates continuous-wave Doppler.
CW Focus Diamond
A diamond shape that lies on the CW reference line. Use the trackball to place the CW
focus diamond over the area of interest.
CW Reference Line
A reference line that appears on the reference image. Use the trackball to place the CW
focus diamond on the CW reference line over the area of interest.
D
D Time
A soft key that moves the Diastolic point left or right.
D Velocity
A soft key that moves the Diastolic point up or down.
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Glossary
Date/Time
On the System tab in the Setup window, a button that launches a calendar, enabling
you to set the correct day and time.
Default Position
A soft key available when the Body Marker feature is active. Places a body marker that
you moved back in its default position on the display.
Default Preset
A preset that is installed with an imaging application package and that cannot be modified
or deleted.
Delay
A soft key available in Trigger setup. Specifies the number of milliseconds after the last 2D
image update to trigger the next one.
Delete Preset
A soft key that permanently deletes the current preset. You can only delete presets that
you created, not default presets. Available after you press Preset.
Depth
A control panel key that increases or decreases the distance from the face of the transducer to the deepest point in the displayed image. The current imaging depth is displayed
on the right side of the display.
Depth Marking
A setting on the System tab in the Setup window that controls whether and where the
depth markings appear.
Density
1) A feature that specifies the number of Color or Angio scan angles. 2) A soft key that
adjusts density. Use Density in conjunction with Packet. Increasing Density increases
resolution and decreases the frame rate. Decreasing Density decreases resolution and
increases the frame rate.
DICOM
1) Digital Imaging and Communications in Medicine (DICOM), a standard developed by
the American College of Radiology and the National Electrical Manufacturers Association
(ACR-NEMA) to allow medical images to be exchanged between instruments, computers, and hospitals. It includes a number of image file format options with respect to pixel
form and format, palette, compression, and so on. 2) On the System tab in the Setup
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window, a button that launches a new window where you can customize the systems
DICOM settings.
Display Dialog
A soft key available in Physio setup. Hides and displays the Setup window on the display.
Display Name
A soft key that hides or displays the name of the current preset on the display. Available
after you press Preset.
Distance Ruler
In 3D Render mode, a white bracket with calibration marks that appears on the lateral
edge of the active MPR or volume view, if it is from a motorized acquisition. You can turn
the ruler on and off by using the Setup window.
Doppler Auto Trace
Automatically traces a frozen Doppler spectrum over one heart cycle and uses the trace
to calculate and display the results of key Doppler measurements and calculations.
Doppler Gain
A control panel knob that adjusts the brightness of the spectral display in PW Doppler
and CW Doppler. Adjusting the Doppler Gain also affects the volume of the audio output. In Triplex, the Doppler Gain knob affects spectral trace when Gate is highlighted on
the Select menu. It affects the color or the angio gain when Size or Position is highlighted.
Doppler iSCAN
Doppler iSCAN Intelligent Optimization. A feature that automatically optimizes key
imaging settings during Doppler Trace acquisition. Available only when the system is in
PW or CW Doppler mode and the spectral trace is live.
Doppler Modes
Imaging modes that measure blood flow or tissue motion from detected frequency shifts
in returning sound waves. The frequency shifts can be used to produce audio signals, or
they can be displayed graphically in a Doppler spectral trace. Doppler modes are often
used to detect leaks, regurgitation, stenosis, and flow changes.
Doppler Scale Units
The units in which the Doppler spectrum is measured.
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Glossary
Dual
1) A hard key that turns dual imaging on and off. 2) A screen format in 3D/4D Render
and 4D and Fetal STIC acquisition in which two images are displayed side by side. 3) On
the System tab in the Setup window, a button that launches a window that allows you to
set your Dual Imaging buffer to Single Buffer dual or Two Buffer Dual.
Dual Imaging
A feature that allows you display two images side by side so that you can compare them.
You can choose which image is active and which is inactive, or you can freeze both images
and choose which one is active so that you can review the frames by using Quick Review.
Duplex
1) A feature that enables you to simultaneously display a live 2D image and a PW spectral
trace. Only available with transducers that support PW Doppler. 2) A soft key that turns
Duplex on and off. When On, forces Doppler iSCAN optimization off.
Dynamic Range
Also called compression. Controlled with the Compress soft key. Determines the
amount of acoustic dynamic range that appears on the screen. As the Compress setting is
lowered, the lower intensity signals get mapped to black, making them visually and quantitatively undetectable.
E
ECG Gain or Aux Gain
A soft key available in Physio setup. Adjusts the display size of the ECG or auxiliary trace.
ECG Invert or Aux Invert
A soft key available in Physio setup. Inverts the displayed ECG or auxiliary input trace.
ECG Position or Aux Position
A soft key available in Physio setup. Moves the ECG or auxiliary trace higher or lower on
the display.
Edit End
A Quick Review soft key that repositions the end of a loop being reviewed. Not available
in PW Doppler, CW Doppler, or M-mode.
Edit ROI
1) A feature that allows you to edit the size and position of the ROI of a 3D volume. 2) A
soft key that turns the Edit ROI feature on. To turn Edit ROI off, press Accept ROI.
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When Edit ROI is on, the Select menu displays two options: Size and Pan. Size
adjusts the size of the ROI. Pan adjusts the position of the image within the ROI.
Edit Start
A Quick Review soft key that repositions the starting point of a loop being reviewed. Not
available in PW Doppler, CW Doppler, or M-mode.
Elevation Angle
In 3D/4D imaging, the angle through which the transducer will pass in fanned mode. The
minimum and maximum values are transducer dependent for automated transducers.
Elevation angle can be adjusted with the Angle soft key.
Enable Prompts
A System Setup setting that controls whether or not system prompts will appear on the
bottom left corner of the display.
End Acquire
A soft key that ends the acquisition of the loop for the current Stress Echocardiography
stage. Available only during a multi-cycle acquisition stage when acquisition is paused.
Enter
A control panel key that is used in conjunction with the trackball to click an item or
choose a menu option. Use the trackball to highlight the item or option and press the
Enter key. Also used for a variety of other mode and feature-specific functions.
Erase Marker
A soft key available when the Body Marker feature is active. Removes the body marker
from the display and exits Body Markers.
Exam Type
A category of related presets.
Expanded
A display format in 3D Render, 4D acquisition, and Volume Cine in which one image is
displayed on the left side of the display, and the three other images are displayed on the
right side of the display. The expanded image on the left is larger than the other three
images.
Explain Text
A soft key to display a short definition of the current measurement. The Explain Text
soft key is only available when you are performing a labeled measurement.
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F
Fetal STIC
An imaging application within the 3D/4D application that acquires multiple fetal heart
cycles in a single sweep of a motorized transducer. Then it creates a volume Cine loop of
the fetal heart through a single composite heart cycle. The fetal heart rate is calculated
and displayed for confirmation. If the calculated heart rate is not approved, the STIC loop
is discarded and the system returns to Preview.
Fetus A, B, C, D
A soft key to identify the fetus to which the measurement value applies.
Filter
1) A feature that removes extraneous information (audible signals and Doppler displays
of frequencies below the selected level and color information due to tissue motion rather
than blood flow). In Doppler, Filter is only available when the spectral trace is live.
Increasing Filter decreases low-velocity information and noise. Decreasing Filter
increases sensitivity to low-velocity information. 2) A soft key that adjusts the Filter setting. 3) A Color mode soft key that removes extraneous color information caused by tissue motion rather than blood flow.
Finding Code
A predefined diagnostic code based on the assessment and diagnosis of a study.
Flash
In Contrast Harmonic Imaging, a soft key that, when pressed, momentarily destroys the
contrast agent in order to observe reperfusion.
Focal Caret
A caret that defines a focal zone, an area where the image is most clearly focused.
Focal Zone
1) A feature that enables you to add areas where the image is most clearly focused. You
can choose up to eight focal zones, depending on the imaging depth and transducer. Not
available with sector transducers. Up to four focal zones are available in Trapezoidal Imaging. Using multiple focal zones decreases the frame rate. 2) A soft key that offers up to
eight focal zones. Each time you press the Focal Zones soft key, you increase the number of focal zones or the space between them. When you reach the maximum number of
focal zones, pressing the Focal Zones soft key gives you one focal zone. In Zoom, pressing the up arrow on the Focal Zones soft key adds focal zones; it does not increase the
space between focal zones.
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Focus
A control panel key that you use to select the area where the image will be most clearly
focused.
Focus Diamond
In CW Doppler mode, a diamond that lies on the CW reference line. Use the trackball
to place the CW focus diamond over the area of interest.
Foot Switch
A switch near the bottom of the system that you operate with your foot. It has three
pedals, each one corresponding to a key on the system control panel. The foot switch
pedals have different functions in different situations.
Format
1) A predefined display layout in 3D/4D Render and 4D and Fetal STIC acquisition. Four
formats are available: Single, Dual, Quad, and Expanded. 2) A soft key that allows you
to change the screen layout in 3D Render and 4D and Fetal STIC acquisition. In OB presets and the cardiac fetal heart preset, it also activates the Volume view. For all other presets, the view that was active remains active in Full format.
Freehand 3D Imaging
3D image acquisition that is performed with standard imaging transducer and that
requires the user to move the transducer over the anatomy of interest in either a pivot
or dragging motion.
Freeze
A control panel key that freezes a live image and initiates Quick Review, which allows you
to scroll through the frames by using the trackball. Press the Freeze key again to
unfreeze an image. Unfreezing an image removes all measurements and calculations from
the image.
Frequency
1) The transducer frequency used for color or angio data. Frequency is available only for
transducers with multiple flow or Doppler frequencies. The Adaptive Freq setting is
available if the transducer supports Adaptive Flow. Adaptive Flow changes the flow frequency to an optimal frequency for that transducer for the selected focal zone. 2) A soft
key that adjusts the transducer frequency for Color or CPA data.
Full
A display format in 3D Render and 4D Acquisition in which only one image is displayed
on the screen at a time.
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Fusion
A hard key that cycles through the available fusion recipes in 2D mode. In Tissue Harmonic Imaging or Contrast Harmonic Imaging, pressing Fusion turns those modes off
and returns the system to 2D imaging. The fusion icon on the lower left corner of the
display summarizes information about the fusion setting.
Fusion Icon
An icon that appears on the lower left corner of the display and that summarizes information about the fusion settings in 2D mode, Tissue Harmonic Imaging, and Contrast
Harmonic Imaging.
Fusion Recipe
A predetermined group of settings that control the transmit and receive frequencies for
the transducer. Available in 2D mode, Tissue Harmonic Imaging, and Contrast Harmonic
Imaging. Also called fusion settings.
Fusion Settings
A pre-determined group of settings that control the transmit and receive frequencies for
the transducer. Available in 2D, Tissue Harmonic Imaging, and Contrast Harmonic Imaging. Also called fusion recipes.
G
Gain
A control panel knob that controls the image brightness.
Gain Save
A Stress Echo feature that saves the settings for each view in the current state and
restores them when you acquire the same view in the other stages.
Gate
A soft key that adjusts the width of the PW sample volume gate. There are 15 gate
widths available.
Geometry
1) In 3D/4D, a soft key that sets the type of freehand scanning motion you want to use.
When scanning with a standard imaging transducer, you can use Geometry to select
Fan or Linear. If you are using Fan, use Angle to specify the approximate angle you will
tilt the transducer during the acquisition of the 3D data set. If you are using Linear, use
Length to specify the approximate distance that you will move the transducer during the
acquisition of the 3D data set.
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Glass Body
A highly transparent grayscale Vision setting used in conjunction with a Color Vision setting.
Grayscale Surface
A 3D Vision setting in Grayscale render mode that shows the surface of the first tissue
structure encountered when projecting an image, such as a baby face in amniotic fluid.
H
Height/Weight Units
A setting on the System tab in the Setup window that controls whether the height and
weight units are displayed in metric or English.
Help
A hard key that launches the system Help application.
Hide ROI
A soft key that removes the region of interest (ROI) box from the image. Switches
between Hide ROI and Show ROI, which displays the ROI box on the image.
High Q Automatic Doppler Analysis
An automatic quantification on a live spectral image that analyzes the Doppler spectrum
and returns quantitative information on the speed and time duration of the spectrum at
various event points. It can perform this analysis over a single heart cycle, or over multiple heart cycles. Available in PW spectral mode.
High PRF (HPRF)
A system-mediated Doppler mode based on PW Doppler. Pulse repetition frequency
(PRF) and the transducer frequency determine the maximum velocity that can be measured using PW Doppler. HPRF extends the systems ability to accurately measure high
velocity at a given depth by establishing additional gates with echoes that coincide with
the selected gate echoes.
Home
1) The default position on the display for annotations, typically the top left corner. 2) A
soft key available during text, label, and arrow annotation that moves the cursor to the
default position.
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Hospital Information System (HIS)

The institutions network. Ultrasound systems and other devices are connected to the
HIS so that information can be shared between them and stored on servers.
I
Image Caption
In Image Review, a feature that enables you to add a caption to an image.
Image Controls
1) A set of controls that are used to modify a rendered 3D image. 2) A soft key that activates a set of controls used to modify a rendered 3D image.
Image Flag
In Image Review, a feature that enables you to add a flag to an image. Image flags can be
helpful when you want to indicate which images will be used, for example, for a teaching
demonstration.
Image Invert
A feature that enables you to reverse the order of the 2D frames and construct a new
3D image. Image Invert reverses the left/right orientation of the image.
Image Review
A mode in which you view the images you acquired. You can view frames and loops,
delete frames and loops from the patient study, edit loops, and close the study.
Image Size
A setting on the System tab in the Setup window that controls the size of the image
displayed on the display. Settings are Large and Medium.
Intelligent Doppler
A feature that helps you maintain an optimum cursor angle between the angle-to-flow
arrow and the PW cursor line by automatically moving the PW cursor line whenever the
angle-to-flow arrow is moved.
iSCAN Optimization
iSCAN Intelligent Optimization. A feature that allows you to automatically optimize the
TGC, Gain, and Compression settings for the current image.
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iSCAN Gain
A soft key available in the Setup window. Adjusts the default brightness of 2D iSCAN
generated images.
J
Job Manager
A user interface that shows the status of active DICOM network and print jobs. You can
access the Job Manager by pressing Ctrl+J.
K
Keyboard
The keyboard on the system control panel, which is used for typing information into
fields and for typing labels, titles, and Quick Text onto the display. To type a character
that appears on the bottom right corner of a keyboard key, press the World key (labeled
with a globe) and the keyboard key simultaneously. To type a character that appears on
the top right corner of a keyboard key, press the World key, the Shift key, and the keyboard key simultaneously.
Keyboard Entry
A soft key that enables you to enter a measurement value by using the keyboard.
L
L/R Invert
1) A feature that reverses the left/right orientation of the image. If you are in a non-cardiac preset, a small open circle called a transducer orientation dot appears in the upper
left corner of a noninverted image. A transducer orientation dot appears on the right of
an inverted image. In cardiac presets, the location of the transducer orientation dot is
reversed. Available only in live imaging. 2) A soft key that controls the left/right orientation of the image.
Label
A hard key that brings up a menu of text labels that you can drag and drop onto the display.
Left
1) A hard key that makes the image on the left side of the display the active image when
in dual imaging. 2) A soft key that is available when both the Body Marker feature and
dual imaging are active. It manipulates the body marker on the left-hand image.
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Length
1) In freehand 3D imaging, a soft key that adjusts the approximate distance you move the
transducer when the Linear Geometry soft key is selected. 2)Measurement of a distance
between two points.
LGC Slide Controls
Lateral Gain Control slide controls. They adjust the amplification of a returning 2D signal.
Use the left LGC slide control to control the left half of the image area. Use the right
LGC slide control to control the right half of the image area.
LGC Profile Display
A setting on the System tab in the Setup window that controls whether or not a horizontal line, the LGC profile, appears on upper right corner of the display to indicate the
LGC setting.
Locale
On the System tab in the Setup window, a button that opens a window that enables
you to change settings, such as language or currency, for your location.
Long/Trans
A soft key available during image annotation that cycles through the words Long and
Trans at the current cursor position on the display. If one of these words already
appears in the selected label, the Long/Trans soft key changes that word to the other
word (Long or Trans), rather than duplicating the word on the display.
Lt/Mid/Rt
A soft key available during image annotation that cycles through the words Lt, Mid, and
Rt at the current cursor position on the display. But if one of these words already
appears in the selected label, the Lt/Mid/Rt soft key changes that word to another word
in the list (Lt, Mid, or Rt).
LVO
Left ventricular opacification.
M
Magnify
A feature that enables you to incrementally enlarge the entire image, regardless of the
area you are interested in. It offers lower image quality but faster results than Zoom
because it does not require the same user actions that are required by Zoom. Magnify
can be performed on live and frozen images. Turn the Zoom knob to enable Magnify.
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Manual Doppler Trace

An imaging feature in which you manually trace the Doppler spectrum over one heart
cycle. The results of key Doppler measurements and calculations are displayed in the
results box.
Map
1) The postprocessing grayscale, color, or CPA map. 2) A soft key that allows you to
specify the postprocessing grayscale, color, or CPA map, depending upon the active
mode. (In 3D/4D rendering modes, the map is controlled with the Vol Map soft key.)
Map Invert
A soft key that reverses the colors that represent flow direction, switching from the
BART (Blue-Away, Red-Toward) format when Map Invert is off to the RABT (Red-Away,
Blue-Toward) format when Map Invert is on.
Marker
A hard key that activates the Body Marker feature and that places a body marker on the
display.
Max Angle
A soft key in 3D Swivel that shows the rightmost angle (vertical axis) or most upward
angle (horizontal axis).
Mic
The system microphone, located on the top left corner of the system monitor.
Min Angle
A soft key in 3D Swivel that shows the leftmost angle (vertical axis) or most downward
angle (horizontal axis).
M-mode
A grayscale time-motion display with a selectable scroll rate. Sometimes paired with a 2D
image, depending upon the display layout.
M-mode Format
A setting on the Mode tab in the Setup window that selects the screen format used
when an M-mode trace is displayed.
M-mode Preview
The initial system state after entering M-mode. Enables you to position the M-mode reference line before displaying the M-mode trace.
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M-mode Reference Line

A reference line that appears on the reference image in M-mode. Information about the
movement along the M-mode reference line appears in the M-mode trace.
M-mode Trace
Displays information about the movement along the M-mode reference line.
M-mode Zoom
1) In M-mode, the ability to magnify a portion of the reference image. In M-mode Zoom,
the M-mode trace represents only the information in the zoom box. 2) A control panel
knob that allows you to control M-mode Zoom.
Mmode
A control panel key that activates M-mode imaging.
MOD
Magneto-optical disk.
MOD Drive
Magneto-optical disk drive, included in you HD11 system if you purchased the DICOM
Media option. The MOD is reusable media that you can use to manually transfer studies
to a PACS system (if your network is down).
Modality Performed Procedure Step (MPPS)
A DICOM server setting that enables your system to send notification that the patient
procedure has been performed to the hospital information system (HIS).
Modality Worklist
A list of scheduled patients. You can choose a patient from the list, which appears in the
Patient Selection window. Available only if your system is connected to the hospital
information system (HIS). After you select a patient from the list, the Patient Identification window opens, populated with the patient's demographic information.
Monitor
The color video monitor included with the system. You can adjust the monitors brightness and contrast to best suit your environment. You can also raise, lower, and swivel the
control panel and monitor to make using the HD11 system as comfortable as possible.
Monitor Adjust
On the System tab in the Setup window, a button that launches a display that explains
how to adjust the monitor brightness and contrast for the current lighting conditions.
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Motorized 3D Imaging
3D image acquisition that is performed with a motorized transducer and that requires
the user to hold the transducer still, perpendicular to the anatomy of interest.
MPPS
Modality Performed Procedure Step. A feature associated with Modality Worklist. If you
specify an MPPS server, your system notifies the hospital information system when a
patient study is complete. The list of scheduled patients and patient billing information
can then be updated.
MPR
Multiplanar Reformatted view image.
MPR Chroma
In 3D/4D Imaging, in Grayscale render mode, an Image Controls soft key that enables you
to change the chroma setting for the MPR views.
MPR Graphics
A soft key available in 3D Render and 4D and Fetal STIC acquisition that allows you to
change the navigational crosshairs on the MPR view. Settings include the default partial
view to a full crosshair view or off completely. The navigational crosshairs display the orientation of the MPR view in relation to the volume view.
MRN
Medical record number. A unique alphanumeric identifier assigned to a specific patient.
Multi-Cycle Acquisition
In a Stress Echocardiography exam, a stage in which up to 200 loops (one per heart
cycle) are continuously acquired and saved to the study, allowing you to continuously
acquire loops for all views in a particular stage.
Multiplanar Reformatted (MPR) View
A view of a slice through a volume. The three MPR views show mutually perpendicular
slices and the point where the three views cross is the center point of the cross hairs.
You control which slices are shown by moving the crosshairs.
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N
Name Format
On the System tab in the Setup window, a button that opens a window that allows you
to change the format for displaying the patient name on the top border of the display and
in the patient report.
Needle Length
A text display when Biopsy Guide is on. It indicates the distance from the top of the needle guide to the needle length crosshair, which indicates the final location of the needle.
Needle Length Crosshair
A crosshair that appears on the display when Biopsy Guide is on. It indicates the presumed final location of the biopsy needle point. It can be moved with the trackball when
Needle is selected on the Select menu.
Next
A hard key in the center of the soft key panel that activates a different level of soft keys
for the active imaging mode.
O
Opacity
in 3D/4D imaging, a Render Controls soft key that controls the opacity map used to generate the volume projection. The opacity map varies the transparency as a function of signal amplitude or velocity.
On/Off
The hard key that turns the system on and off.
Optical Disk
A magneto optical disk, or optical disk, is a medium density, medium cost storage device.
MODs are available in several densities (1x, 2x, 4x, 8x, 12x) where 1x is equivalent to
325 MB per side.
Optimum Cursor Angle
Allows selection of the preferred angle that the system should try to maintain between
the PW cursor line and the angle-to-flow arrow when a linear transducer is selected and
the PW Steer control is set to Auto. Selections are: 0, 50, 55, 60, or 65.
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Option Keys
Hard keys, labeled Option 1 and Option 2, that you can assign to certain applications
before using the applications for the first time.
Output Power
The output power is displayed on the display. The output power is made up of the power
index (MI, TIS, TIC, or TIB) followed by the power level (displayed numerically).
P
Packet
A soft key available in Color and CPA modes that specifies the flow packet size, which
determines the number of times each color or angio scan angle is interrogated. Increasing
Packet increases color or angio sensitivity and decreases the frame rate. Decreasing
Packet decreases color or angio sensitivity and increases the frame rate.
PACS
Picture archiving and communication system. A server that stores DICOM-compliant
data.
Panoramic Data Set
In Panoramic Imaging, the series of 2D images that is compiled to show a larger area of
anatomy.
Panoramic Imaging
A 2D imaging feature in which you acquire a series of images, called the panoramic data
set, that are compiled to show a larger area of anatomy.
Panoramic Preview
The initial mode in Panoramic Imaging. You optimize and acquire the panoramic data set
in this mode.
Panoramic Render
In Panoramic Imaging, the post-acquisition mode that displays the rendered panoramic
image. You can manipulate the rendered image in this mode.
Patient
A hard key that opens the Patient Identification window or, if you are connected to
the Hospital Information System (HIS), the Patient Selection window.
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Patient Folder
The location where all the studies for one patient are stored.
Patient Identification
A window that opens when you press the Patient key, and into which you enter patient
information before starting a study. If your system is connected to Modality Worklist,
then the Patient Selection window opens instead.
Patient Selection
A window that opens when you press the Patient key, if your system is connected to
Modality Worklist. You choose the patient from the list before starting the study.
Patient Study
A compilation of demographic information, images, quantitative values, and a summary of
findings for a specific patient.
Patient Temp
A soft key that enables you to enter the patients temperature. Patient Temp is only
available when a TEE transducer is selected.
Pause Protocol
A soft key available in Stress Echocardiography that enables you to temporarily leave the
Stress Echo protocol so that you can acquire additional loops or frames outside it. When
a protocol is paused, the soft key label changes to Unpause Protocol. Press it to
resume the protocol.
Penetration
A fusion setting that is used to achieve image information at deeper depths. The Penetration setting can be helpful in scanning patients with larger body habitus.
Persist
1) A feature that averages consecutive frames to provide a smoother appearance with
less noise. Use lower persistence values for fast moving organs or tissues and higher persistence values for slower moving organs or tissues. Not available in triggered mode
imaging. 2) A soft key that allows you to choose the Persist value to provide a smoother
image with less noise.
Physio Panel
The panel, located on the front left side of the HD11 system, where you connect physios
to the system.
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Play/Resume/Stop
Soft keys in 3D Swivel. Reads Play if the Frameset must be calculated from scratch and
starts the swivel at the min angle. Reads Resume if renderings in the current Frameset
can be reused and starts from the angle current when Stop was pressed. Stop stops the
swivel at the current angle.
Play Direction
A soft key in 3D Swivel that determines whether the playing swivel angle sequences one
way or two way. One way steps from the min angle, in positive step size increments to
the max angle. Two way, the default, steps back and forth through the angle range.
Pointer
A hard key that enables you to place arrows on the display.
Power
In Contrast Harmonic Imaging, a soft key that allows you to fine tune the transmit power
relative to the maximum power of an individual system for a specific contrast agent. Provides a finer control of power than what is shown for the MI.
Preset
A group of settings that optimizes the system for a specific type of exam. Presets establish many initial settings, such as gain value, color map, filter, and items on the Label and
Measurement menus.
Preset Menu
A menu that is displayed when you press Preset and from which you select the preset
you want. The active exam type is displayed at the top of the menu; the presets that
belong to that exam type are listed underneath.
Preview
The initial mode after you activate 3D, 4D, and Fetal STIC applications. Enables you to
manipulate and optimize the live 2D image before acquiring the 3D data set.
Preview ROI
In 3D/4D imaging, the region of interest that you can optimize in Preview mode, before
beginning image acquisition.
Printer
A peripheral device that prints images.
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Priority
A soft key that you use to give priority to color data over grayscale data. Turn Priority
on when imaging small vessels and trickle flow. Turn Priority off to eliminate color that is
bleeding over vessel walls, but only when the lumen of the vessel is clearly seen in grayscale.
Probe
A hard key that you press to choose one of the transducers connected to the system.
Probe Size
A soft key that is available when the Body Marker feature is active. Changes the size and
shape of the transducer icon. Choices are: Large T, Small T, Arrow, Small
Crosshair.
PW
1) Pulsed Wave Doppler. 2) A hard key that activates PW Doppler mode.
PW Sample Volume Gate
The area in which the velocity is measured in PW Doppler. The information is displayed
in the PW spectral trace.
Q
Quad
In 3D Render and 4D and Fetal STIC acquisition, a screen layout with four images on it,
the three MPR images and the rendered 3D image.
Quad-Cycle Acquisition
In a Stress Echocardiography exam, an acquisition stage in which four consecutive loops
(one per heart cycle) are acquired and saved to the study.
Quick Calc
Calculations that are computed based on one unlabeled measurement primitive and are
then displayed in the results box with their unlabeled primitives. Quick Calcs are nonspecific, have no anatomic labeling, and are not averaged.
Quick Review
A feature that allows you to interrupt live imaging and scroll through a loop, scroll
through a trace, or to play back a loop.
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Quick Review Icon

In Quick Review, an icon that illustrates the start and end points of the loop as well as
how far through the loop you have scrolled.
Quick Text
A feature that enables you to type a text label on the display at any time. Simply position
the cursor with the four keyboard arrow keys and start typing.
R
Re-Acquire
In Panoramic Render, a soft key that returns the system to Panoramic Preview mode so
you can begin the acquisition of a new panoramic data set.
Reactivate
The term used to view and edit an acquired image in Acquired Image Review.
Rec 1, 2, 3
The label on the three Record keys.
Record Key
One of three hard keys that you can configure to control a peripheral, such as a printer
or VCR.
Redo
In Sculpt/Erase, a soft key that switches between Redo and Undo. Undo cancels the last
image manipulation. You can cancel up to the last 16 image manipulations by repeatedly
pressing Undo. Redo restores the last manipulation canceled by Undo.
Reject
A soft key in Doppler modes that is used to darken background noise in the spectrum.
Increase Reject for strong Doppler signals; decrease Reject for weak signals.
Render Controls
In 3D Render, a soft key that activates a sublevel of soft keys that enable you to modify
the individual settings that make up a Vision setting.
Render Mode
1) In 3D/4D imaging, one of three settings that determine which information to display in
the rendered 3D volume. Grayscale shows only grayscale with no color. Color shows
only color vessels with no grayscale. Color/Gray shows grayscale and color vessels.
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Color can be Color Velocity or CPA (Angio), depending on which was selected prior to
acquisition. Within each render mode, several Vision settings are available to choose
from. 2) A soft key that enables you to change the render mode.
Replay
A Quick Review and Volume Cine soft key that starts the play back of a loop and that
changes the playback speed. The selected playback speed appears on the soft key label.
Not available in PW Doppler, CW Doppler, or M-mode.
Report
A hard key that opens and closes the report window.
Report Work Area
The area that appears to the right of the patient report. It includes several tabs that allow
you to edit information that appears in the report.
Reported Calculations
Calculations that are not available in the Analysis menu but that are included in the
patient report.
Reset
1) A soft key that restores a 3D, a 4D, or a Panoramic image to its original state. In 3D
Render with Edit ROI on, the 3D volume is returned to its original, post-acquisition state.
If Edit ROI is off, the volume is returned to its last saved Edit ROI state. 2) In 3D Render,
an Image Controls soft key that restores all Render Controls and Image Controls soft key
settings to their original values for the selected Vision setting. 3) In Sculpt/Erase, a soft
key that eliminates all sculptures and erasures, restoring the original volume contents.
Resize
A soft key that changes the z-scale of freehand acquisitions. The scale can be resized from
0 to 100.
Resolution
1) In 3D/4D imaging, a setting that trades off the time it takes to acquire a volume against
the detail present in the volume. The values are: High, Med, and Low. 2) A soft key that
allows you to change the resolution setting in 3D imaging.
Review
A hard key that launches the image review feature.
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Right
1) A hard key that makes the image on the right side of the display the active image when
in dual imaging. 2) A soft key that is available when both the Body Marker feature and
Dual Imaging are active. It manipulates the body marker on the right-hand image.
Right/Left/Mid/Main
A soft key to specify the part of the anatomy being measured. The values depend on the
selected measurement or calculation.
ROI
Region of Interest.
ROI Box
1) In Panoramic Imaging, a rectangular Region of Interest box that appears on an image.
The area in the ROI box is the portion of the image that is acquired. The area in the ROI
box is the portion of the image that is acquired. 2) In 3D/4D Preview modes, a four-sided
ROI that is annular except when using freehand acquisitions with linear probes, when it is
rectangular.
Rotate
In 3D and 4D, a soft key that spins the image clockwise in 90-degree increments.
Rotate Probe
A soft key available when the Body Marker feature is active that rotates the transducer
icon. You can also rotate the transducer icon with the Angle knob.
S
S Time
A soft key to move the Systolic point left or right.
S Velocity
A soft key to move the Systolic point up or down.
S1 Time
A soft key to move the Systolic1 point left or right.
S1 Velocity
A soft key to move the Systolic1 point up or down.
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Save Preset
A soft key that you use to create a new preset or make changes to a preset that you created.
Save to CD
In Panoramic Imaging, a soft key that saves the displayed image as a .bmp file to CD.
Scale
A key used in CPA, Color, CW Doppler and PW Doppler modes that changes the pulse
repetition frequency (PRF). Adjust the Scale setting to display velocities and frequencies.
Scan Direction
In Panoramic Imaging, a soft key that specifies the direction the transducer will move during the acquisition of the data set: L to R (left to right) or R to L (right to left).
Scrolling Trace
A setting on the Mode tab on the Setup window that allows selection of the scrolling
style of Doppler spectral refresh instead of the erase bar style.
SCP
Service Class Provider. A server on a network.
Sculpt/Erase
In 3D Render and 4D Volume Cine, a soft key that enables you to remove unwanted data
from the 3D volume.
Security
On the System tab in the Setup window, a button that provides access to the system
security settings, which you can configure. You can password protect access to certain
system features and establish automatic logoff behavior.
Select
A hard key that changes the active function of the trackball. The possible functions of the
trackball for the current mode, transducer, and preset are listed on the bottom right corner of the display on the Select menu. The active trackball function is highlighted.
Select Menu
A list of functions that can be assigned to the trackball on the bottom right corner of the
display. The possible functions in the menu depend upon the current mode, transducer,
and preset. The active trackball function is highlighted. You can change the active function
by pressing the Select key.
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Select ECG or Select Aux

A soft key available in Physio setup. Changes the Gain, the Position, and the Invert soft
keys from ECG to Aux.
Selection Bracket
A four-cornered white bracket placed around the active view, which indicates that the
view can be manipulated with the system controls.
Set Home
A soft key available during image annotation that makes the current cursor position the
default position.
Setup
1) A feature that allows you to customize your system settings. 2) A hard key that activates the Setup feature and opens the Setup window.
Setup Window
A tabbed window that allows you to change system settings and settings for modes, applications, options, peripherals, and so on.
Show ROI
A soft key that displays the region of interest (ROI) box on the image. Switches between
Show ROI and Hide ROI, which removes the ROI box from the image.
Single Buffer
A system setting that allocates the number of memory buffers in which to store image
frames. In live 2D imaging, Single Buffer stores images in one buffer. When Dual mode is
activated, the single buffer is reduced in size and another buffer is added for the second
image. See also Two Buffer.
Single-Cycle Acquisition
In a Stress Echocardiography exam, a stage in which one loop is acquired and saved to the
study.
Skeletal
A 3D Vision setting in Grayscale render mode that shows the brightest structures in the
grayscale image.
Smooth
1) A soft key in 2D and 3D/4D modes that allows you to sharpen or soften an image. In
2D mode, Smooth is available for black-and-white images. In 3D/4D Preview modes,
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affecting the 2D image and in 3D Render modes for the volume. 2) In Doppler modes, a
soft key that allows you to change the appearance of the Doppler spectrum.
Soft Key Level Indicator
A vertical set of circles centered on the bottom of the display. The circles indicate how
many soft key levels are available and which level is active. The number of circles indicates
the number of available soft key levels, up to three. When only one soft key level is available, no indicator appears. The solid circle indicates the active soft key level. For Soft Key
sublevels in green, the circles are replaced by green double up arrows.
Soft Key Panel
The angled panel located below the system monitor that contains round buttons and soft
key controls. The functions of the soft keys change depending on the mode, the application, the preset, and the transducer. The function of each soft key is described above the
soft key on the bottom of the display. To use a soft key, press the up or the down arrow
on the key to choose or change the selection that appears above the key on the display.
Soft Key Sublevel
In 3D/4D and Fetal Echo Imaging, an additional set of soft keys that are available for some
features (for example, Swivel and Sculpt/Erase). A (>>) on the soft key label indicates that
a sublevel will become available when the soft key for that feature is pressed. Sublevel soft
key labels are green, as are the soft key level indicators.
Soft Keys
The keys above the system control panel and below the monitor. The functions of the
soft keys change depending on the mode, the application, the preset, and the transducer.
The function of each soft key is described above the soft key on the bottom of the display. To use a soft key, press the up or the down arrow on the key to choose or change
the selection that appears above the key on the display.
SonoCT Imaging
SonoCT Real-time Compound Imaging reduces speckle and improves image smoothness,
enhances contrast resolution, and improves contrast and definition of tissues interfaces.
It takes successive frames at different steering angles and blends them together.
Speed
A soft key in 3D Swivel that specifies the frame rate of the 3D volume swiveling. Speed
choices are Slow and Normal.
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Spectral Format
A setting on the Mode tab on the Setup window that allows selection of the screen format used in PW or CW Doppler Spectral modes.
Spectral Invert
A soft key that inverts the spectral display so that positive values (representing blood
movement toward the transducer) are shown beneath the Doppler baseline and negative
values (representing blood movement away from the transducer) are shown above.
Spectral Invert also swaps the stereo audio channels. Spectral Invert is available only
when the spectral trace is live.
Stage
A soft key available in Stress Echocardiography protocols that advances to the next stage
while you are acquiring loops. Available only after you have acquired at least one loop per
view in the current stage. Not available if you have acquired any loops in the next stage.
Stage-View Label
In Stress Echocardiography, the stage-view label lists the name of the current stage and
view on the display.
Steer
A soft key available in PW Doppler that specifies the PW cursor line angle for linear
transducers. When Left or Right is selected, the PW sample gate position is restricted
to a subset of the full image area determined by the PW cursor line angle. When Center
is selected, the PW cursor line runs vertically through the Doppler gate. When Auto is
selected, Intelligent Doppler is on. This automatically moves the PW cursor line, whenever the angle-to-flow arrow is moved, to maintain an optimum cursor angle between the
angle-to-flow arrow and the direction of the PW cursor line.
Step Size
A soft key in 3D Swivel that offers 3 step sizes (1, 3, and 6) with both left-right rotation and up-down rotation
Stop/Play
A soft key in 3D Swivel that stops and starts the swiveling of the 3D volume. If you pause
swirling, the soft key is labeled with Resume as long as the images are reusable.
Storage Bin
A compartment on the system in which you can store extra bottles of gel or other materials.
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A protocol-driven exam that allows a cardiologist to assess cardiac wall motion at various
heart rates by acquiring views of the heart at different stages of the exam. A Stress Echo
study consists of two to eight stages during which loops are acquired for up to eight anatomical views. Each loop is a sequence of frames captured at systole starting at the
R-wave.
Surface
A 3D Vision setting in both Color and Color Only Render Modes that is opaque, showing the surface of a vessel and hiding what is behind it. A 3D Vision setting in Grayscale
Render mode that shows the first surface encountered by a projection and hides what is
behind it.
Sweep
1) A soft key that controls the travel speed of the scrolling trace. Only available when the
trace is live. 2) A soft key available in Physio and Trigger setup. Controls the travel speed
of the ECG or the auxiliary trace.
Swivel
In 3D Render and 4D Volume Cine, a soft key that enables you to gyrate the 3D volume
around the x-axis or y-axis. The images produced can be stored as a cine loop or still
image.
Synchronization Mode
In Image Review, when you are playing back more than one loop simultaneously, you can
specify the synchronization mode, that is, whether and how the loops are synchronized
when they are played back.
System Handle
A part on the front of the system control panel, allowing you to move the system and
adjust the monitor system.
T
TDI
Tissue Doppler Imaging.
Text
A hard key that enables you to type text labels on the display.
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Texture
A fusion setting that is used to achieve image information at average depths. The Texture
setting optimizes the tissue texture at these depths.
TGC
Time Gain Control. On the HD11 system, you adjust TCC using the TCG slide controls
on the system control panel.
TGC Profile Display
A setting on the System tab in the Setup window that controls whether or not a vertical line, the TGC profile, appears on the upper right corner of the display to indicate the
TGC setting.
TEE Temperature Units
A setting on the System tab in the Setup window that controls whether the TEE temperature is displayed in Celsius or Fahrenheit.
Thermal Index
A setting on the System tab in the Setup window that controls the way the output
power is measured and displayed.
THI
1) Tissue Harmonic Imaging. 2) A hard key that enables Tissue Harmonic imaging and
changes the Tissue Harmonics recipe setting.
Threshold
A 3D Vision setting that removes the weakest pixels from the image. Accessible in the
Render Controls soft key sublevel.
Thumbnails
In Image Review, the presentation of the images in a grid format, called Thumbnails.
Timer
A soft key available in Stress Echocardiography protocols that starts the timer. If the
timer is running, pressing Timer hides the timer. Elapsed time is maintained while the
timer is hidden.
Title
In Panoramic Imaging, a soft key that enables you to add a title to image. Title is only
available after you press Label.
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Tissue Doppler Imaging

An imaging mode that optimizes settings to measure the movement of tissue, rather than
blood, using color or pulsed-wave Doppler.
A 2D imaging mode in which the transducer receives at twice the transmit frequency. Tissue Harmonic Imaging clears clutter from the image and can be helpful when imaging
areas that are filled with fluid, such as the gallbladder or heart chambers.
Trace
A control panel key. In CW Doppler Preview or PW Doppler Preview, it displays the CW
or the PW spectral trace, respectively. Otherwise, it displays the PW spectral trace.
When a Doppler spectral trace is displayed, press Trace to choose whether the spectral
trace or the image is live. The soft keys change depending on which element is live, and
they affect the element that is live.
Trackball
The possible functions of the trackball for the current mode, transducer, and preset are
listed on the Select menu on the bottom right corner of the display. The active trackball
function is highlighted. To change the active trackball function, press the Select key.
Transducer Connector Panel
The panel on the front of the system that contains the transducer connectors, into which
you plug the transducers.
Transducer and Gel Holders
The molded containers on either side of the control panel that hold the transducers and
bottles of gel while they are not in use.
Transducer Orientation Dot
A dot that appears at the upper left corner of a noninverted image.
Translucent
A 3D Color Vision setting in both Color and Color Gray Render Modes that displays
vessels with sufficient transparency to see their inner flow streams. A highly transparent
glass body grayscale Vision setting is used with this Color Vision setting.
Transparency
A 3D Vision setting that creates a more transparent image, allowing you to view far field
structures behind near field structures. Accessible by the Render Controls soft key
sublevel.
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Trap
A hard key that a turns Trapezoidal Imaging on or off.
Trapezoidal Imaging
An imaging feature that adds additional imaging area by changing a linear transducer's
rectangular image to a trapezoidal shape. The extended field of view is often useful in vascular and small parts presets. Turned on and off with the Trap soft key. Available in the
Vascular and General Imaging application packages with most linear transducers.
Triplex
1) A feature that enables you to simultaneously display a live 2D image with color or
angio and a PW Doppler trace. 2) A soft key that turns Triplex on and off.
Two Buffer
A system setting that allocates the number of memory buffers in which to store image
frames. In Two Buffer mode, two buffers are allocated, a Right buffer and a Left buffer.
You can work with two different images at once, without having to be in dual imaging.
You view these images in full screen and use the Left and Right hard keys to switch
between the images. To view these two images side by side, you must turn on Dual imaging. See also Single Buffer.
U
U/D Invert
A soft key that reverses the up/down orientation of the image. A small open circle called
a transducer orientation dot appears at the top of a noninverted image. An orientation
dot appears on the bottom of an inverted image. Available only in live imaging. Not available with linear or TEE transducers.
Undo
A Sculpt/Erase soft key that switches between Redo and Undo. Undo cancels the last
image sculpting or erasure. You can cancel up to the last 16 image manipulations by
repeatedly pressing Undo. Redo restores the last manipulation canceled by Undo.
Unpause Protocol
In Stress Echocardiography, a soft key that returns to the Stress Echo protocol after you
acquired additional loops or frames outside of the protocol.
Update
1) A control panel key used in Doppler modes. If Doppler is off or PW Preview is on
when Update is pressed, the system enters PW Spectral Doppler mode with Doppler
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2D Live off. If CW Preview is on when Update is pressed, the system enters CW Spectral Doppler mode with Doppler 2D Live off. If the system is in PW Spectral or CW
Spectral mode when Update is pressed, Doppler 2D Live is switched between off and
on. 2) A soft key available in Doppler modes that you use to specify how often (in 500-ms
increments from 500 to 7000 ms) the reference image is updated. Available only when no
ECG trace appears on the display and the spectral trace is live. Not available in Duplex or
Triplex or with a nonimaging transducer. If you do not want the reference image to be
updated, press Update and choose the 2D Hold On setting. 3) A soft key available in
Trigger setup. Sets the time interval (in milliseconds) between image updates when Trigger is set to Timer.
User-Defined Calculation
You can create your own calculations when you are in an OB/GYN preset. You can add
those calculations to the Calculations menu for OB/GYN presets.
V
View
1) A soft key available 3D Render, 4D Acquisition, and Volume Cine. Selects the viewpoint for the image display in the rendered 3D image. The View direction can be any of
the following: Front, Back, Right, Left, Top, or Bottom. 2) A soft key available in
Stress Echocardiography. Specifies the view you plan to acquire next.
View All
A soft key available when the Body Marker feature is active. Opens the Body Markers
dialog box that organizes the body markers by exam type. You can choose the body
marker that you want from the dialog box.
View Icon
In Stress Echocardiography, a rectangular view icon appears on the upper right corner of
the display that indicates how many views have been acquired for the current stage. The
rectangle contains four or eight squares, one for each possible view.
Vision
1) In 3D/4D imaging, a set of predefined values for the selected Render Mode. Vision settings control the aesthetics, or look, of the data set. The available Vision settings
depend upon the selected Render Mode. You can change the default Vision settings and
save them as a preset. 2) In 3D/4D imaging, a soft key that allows you to select a Vision
setting.
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Vol Chroma
In 3D/4D Imaging, in Grayscale render mode, an Image Controls soft key that enables you
to change the chroma setting for the rendered 3D image.
Vol Map
1) The postprocessing grayscale, color, or CPA map in 3D/4D imaging. The map applied
to the rendered 3D image can change with the Vision setting. The map applied to the
MPR views will always match the 2D map and will not change with the Vision setting. 2) A
soft key that allows you to specify the postprocessing grayscale, color, or CPA map in 3D/
4D imaging.
Volume
1) A control panel knob that controls the sound level in audio applications. 2) A 3D
image that has been rendered from 2D images. 3) A view that shows the rendered 3D
image.
Volume Cine
In 4D and Fetal STIC, a feature that enables you to play back acquired volumes as loops.
You can scroll through a set of volumes to choose one to manipulate.
W
Waveform
A soft key to display or hide an outline of the maximum and mean of a PW spectral trace.
The Waveform soft key is only available when the spectral trace is frozen. The
High Q Doppler settings determine whether the peak trace, the mean trace, or both are
displayed. Without High Q Doppler, both traces are displayed.
Wheel Controls
Locking devices on the front two system wheels that allow you to lock the wheels in
place, limit them to moving front and back, or to release them so they swivel and move in
any direction.
Wheels
The HD11 system is mounted on four swivel wheels for ease of portability.
World keys
On the system keyboard, two World keys are labeled with a globe. They appear on either
side of the spacebar. Use a World key to type the characters that appear on the right side
of some keys on the keyboard.
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X
X
A knob on the system control panel that enables you to rotate a 3D volume around the
x-axis. This knob is also used to adjust Volume and Power in other imaging modes.
XRES Adaptive Image Processing
A feature that enhances images without altering the image resolution. Improves contrast
resolution, reduces artifacts, improves visibility of tissue texture patterns, and improves
border definition and continuity.
XRES
A soft key that turns XRES Adaptive Image Processing on and off.
Y
Y
y-axis. This knob is also used to adjust the Gain in other imaging modes.
Z
Z
z-axis. This knob is also used to adjust the Angle in other imaging modes.
Zoom
1) A feature that enlarges a selected portion of a live image. The zoomed area has high
resolution because the patient anatomy is re-examined, not simply enlarged. 2) A knob
that controls Zoom and Magnify functionality. Pressing the control once displays the
acoustic zoom preview box. Pressing the control twice activates acoustic zoom. Rotating
the control activates video zoom.
Zoom Box
A box that appears on the image when you press the Zoom knob. The area in the zoom
box is magnified the second time you press the Zoom knob.
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Index
Numbers
1-point depth or velocity measurements,
299
2D mode, 153
imaging tips, 239
physio cardiac calculations, 380
Quick Calculations, 305
soft keys, 155
2-point measurement, 300
3D Fetal Echo STIC, 176, 203
3D mode, 176
acoustic artifacts, 177
acquiring a freehand data set, 180
acquiring a motorized data set, 181
changing orientation of volume, 188
changing view direction of volume, 189
data sets, 176
editing volumes, 192
freehand, 178
Image Controls soft keys, 195
image review, 183
motorized imaging, 178
Render, 183
Render display, 184
Render soft keys, 184
review fetal echo images in volume
cine, 202
saving cine loop, 191
soft keys, 182
swiveling volume, 190
working in preview modes, 180
3D/4D mode
activating, 179
control functionality, 179
display layouts, 185
Render Mode options, 196
settings, 128
vision settings, 197
zooming and magnifying images, 194
4D mode, 199
acquiring images, 200
review images in volume cine, 201
saving cine loop, 202
soft keys, 200
A
Abdomen
calculations, 369
measurements, 349
Accessories, 26
Acoustic output tables, 23
Acquiring, 151
4D images, 200
fetal echo images, 203
freehand 3D data set, 180
images outside of stress echo protocol,
264
loops for a multi-cycle acquisition
stage, 264
motorized 3D data set, 181
Acquisition
settings, 126
specifying preferences, 126
Stress Echo methods, 258
Activating body markers, 109
Adaptive Doppler, 111, 163
Aliased signals, unwrapping, 250
Aliased spectrum, unwrapping in PW
Doppler, 244
Analysis, 279
Annotation, 271
moving or deleting, 273
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Index
Application-package options, 99
Approving measurements, 296
Artifacts
3D imaging, 177
about ECG, 258
Contrast Harmonic Imaging, 214
minimizing ECG, 259
reducing, 244, 247
Attaching ECG leads, 140
Autotrace evaluation, changing, 112
B
Background color, changing, 108
Backing up presets and settings, 131
Backlight Level, 103
Beginning an exam, 150
Biopsy
moving needle length crosshair, 209
Biopsy Guide, 207
Body markers, 275
activating, 109
activating during freeze and dual, 103
choosing, 275
moving, 276
placing on display, 275
soft keys, 277
using in dual imaging, 278
Boxes, resizing and repositioning, 171
Breast
calculations, 375
measurements, 356
C
Cables, 140
Calculations, 298
abdomen, 369
accuracy, 281
breast, 375
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by exam type, 368

cardiac, 380
creating user-defined by using a
formula, 121
customizing menu, 119
deleting user-defined, 124
gynecology, 389
hip angle, 380
obstetric, 386
performing, 121, 299
PISA, 286
prostate, 371
superficial, 378
testicular, 376
thyroid, 374
vascular, 391
volume methods, 284
Calipers, 296
specifying line type, 116
Cancelling DICOM print jobs, 88
Cardiac
calculations, 380
Doppler Quick Calculations, 306
measurements, 316
CD drive, 44
CD, user information, 23
CDs
backing up presets and settings, 131
browsing contents, 63
erasing, 64
loading and ejecting, 63
restoring presets and settings, 132
choosing an option on the display, 54
CIVCO, 26
clicking an item on the display, 54
Closing patient studies, 401
Color Compare, 172
Color M-mode, 159
Color mode, 170
artifacts, 177
Index
compare, 172
imaging tips, 248
improving filling, 249, 252
troubleshooting, 248
using Color Compare, 172
using color suppress, 172
Color Power Angio mode, 173
artifacts, 177
imaging tips, 251
soft keys, 175
suppress, 174
using Compare, 175
Comments, 425
Compare
Color Power Angio mode, 175
images from two studies, 415
Configuring foot switch, 134
Connecting ECG cables and attaching
leads, 140
Contrast agent, improving visibility, 212
acoustic artifacts, 214
principles, 214
settings, 212
soft keys, 211
Control panel, 43
positioning, 52
control panel, using, 54
Conventions
user information, 24
CPA. See Color Power Angio mode
Cursor tracking, controlling, 114
Customer comments, 25
Customizing your system, 95
CW Doppler mode, 167
imaging tips, 245
increasing sensitivity, 246
viewing audible signals, 246
D
Data sets
acquiring Panoramic, 223
saving Panoramic, 228
Date, setting, 52
Deleting
images, 407
labels or arrows, 273
measurements, 298
patient folders, 404
patient studies, 404
presets, 98
user-defined calculations, 124
Demographics, editing patient, 400
Depth markings, 104
Diagnostic applications for system, 37
DICOM
assigning servers, 71
cancelling print jobs, 88
changing printer settings, 86
changing the image export format, 76
entering settings, 68
features, 67
Networking option, 99
setting up automatic export, 74
setting up automatic printing, 83
Disks
backing up presets and settings, 131
specifying disk full strategy, 128
Display
placing arrows on, 273
placing body markers on, 275
placing labels on, 271
removing preset names from, 98
resizing and repositioning images, 152
Doppler Auto Trace, 289
changing Autotrace evaluation setting,
112
defaulting to, 116
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535
Index
multi-cycle, 291
soft keys, 291
Doppler mode
alignment, 281
cardiac calculations, 380
changing settings, 110, 163
CW, 167
iSCAN Intelligent Optimization, 164
nonimaging, 164
performing manual trace
measurements, 292
setting trigger type, 142
soft keys, 160
Tissue, 169
turning Intelligent Doppler on or off,
163
using PW, 161
Drivers, installing peripheral software, 135
Dual Imaging, 215
indicators, 217
selecting type, 106
using body markers, 278
using Quick Review, 219
Duplex, 165
soft keys, 166
Dynamic range, decreasing, 213
E
ECG artifacts
description, 258
minimizing, 259
ECG cables and leads, 140
Echoes, reducing, 242
Ejecting CDs and MODs, 63
Ellipse measurements, 301
Enter key, 54
Erasing CDs and MODs, 64
536
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Exam
beginning, 150
performing basic, 145
Exam type
calculations, 368
labeled measurements, 316
presets and, 96
Exporting, 427
images from patient studies in PC
format, 436
images in PC format, 434
setting up automatic DICOM, 74
F
Fetal echo
acquiring images, 203
soft keys, 204
Fetal growth graphs, selecting, 125
Fetal heart rate, 205
Fetal weight options, setting, 125
Finding codes, 421
Finding help topics, 31
Foot switch, configuring, 134
Formatting MODs, 64
Formulas
report, 426
sources of measurement error, 281
Frame rate
increasing, 250
increasing in Color Mode, 253
Freehand
3D, 178
acquiring 3D data set, 180
imaging technique, 178
Fusion
icons, 154
settings, 154
Index
G
Gain
adjusting, 213
default iSCAN, 221
Graphs, 425
Gynecology
calculations, 389
measurements, 365
H
Height/Weight Units, 103
Help, 23, 29
Help viewer, 30
High Pulse Repetition Frequency (HPRF)
Doppler, 163
High Q feature, 293
changing Autotrace Evaluation settings,
290
changing setting, 117
Hip angle
calculations, 380
performing measurements, 313
I
Icons
fusion, 154
Search for Study window, 431
transducer, 275
View, 262
Image acquisition modes, 38
Image Review, 405
3D, 183
adding an image to a report, 419
adding captions or flags to images, 407
controlling loop playback, 415
deleting an image, 407
editing loops, 416
Panoramic, 224
playing back loops, 414

viewing full-screen loops or frames, 412
Images
acquiring, 151
acquiring 4D, 200
acquiring fetal echo, 203
acquiring outside of stress echo
protocol, 264
adding a caption or flag, 407
adding to reports, 419
changing size, 108
comparing, 415
deleting, 407
exporting in PC format, 434
making measurements on 2D MPR, 188
printing, 408
reducing contrast or grain, 241
specifying selection, 411
updating 2D reference in CW Doppler,
247
updating 2D reference in PW Doppler,
245
Imaging features, 207
Imaging modes, 149
Imaging tips, 239
2D mode, 239
Color Mode, 248
Color Power Angio, 251
CW Doppler, 245
M-mode, 242
PW Doppler, 243
Importing, 427
IMT measurements, performing trace, 315
Increasing frame rate, 253
Indicators, Dual Imaging, 217
Input method editor, 139
Installing
options, 101
peripheral software drivers, 135
Intelligent Doppler, turning on or off, 163
HD11 User Reference
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537
Index
Interpretations, 421
iSCAN Intelligent Optimization, 220
live 2D and, 220
J
Japanese characters, 138
K
keyboard shortcuts, 55
L
Labeled measurements, 311
by exam type, 316
performing, 311
soft keys, 312
Labels, 271
changing, 272
changing settings, 115
deleting, 273
modifying, 272
moving, 273
placing on display, 271
placing on Panoramic images, 228
Stage-View, 262
typing a label, 272
using soft keys, 274
Language input, 137
changing, 137
Leads, 140
LGC Profile Display, 104
Limb deficit artifacts, 177
Live 3D. See 4D mode
Live imaging, printing in, 151
Loading and ejecting CDs and MODs, 63
Loops
acquiring, 151
acquiring for a multi-cycle acquisition
stage, 264
538
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4535 611 65311
acquiring for a single-cycle or

quad-cycle acquisition stage, 263
editing, 416
playing back in Image Review, 414
playing back Quick Review, 230
playing back Stress Echo, 269
selecting preferred Stress Echo, 267
setting acquisition preferences, 126
setting duration, 127
setting length, 127
viewing full-screen, 412
Low-velocity signals
displaying, 247
displaying in PW Doppler, 245
M
Magnify, 235
Magnifying
images in 3D/4D, 194
live and frozen images, 236
Panoramic images, 226
rendered 3D images, 194
Measurements, 295
1-point depth or velocity, 299
2D MPR images, 188
2-point, 300
abdominal, 349
accuracy, 281
approving, 296
assigning values, 313
breast, 356
cardiac meta-measurements, 325
customizing menu, 119
deleting, 298
displaying values, 297
ellipse, 301
gynecology, 365
labeled, 311
manipulating in a report, 420
Index
manual Doppler trace, 292

Method of Disk, 303
musculoskeletal, 368
pediatric hip, 361
performing hip angle, 313
performing IMT linear, 315
performing IMT trace, 315
performing on Panoramic images, 226
performing protocol, 312
PISA, 286
primitives, 283
prostate, 352
protocol, 312
reactivating, 297
sources of errors, 281
specifying circumference method, 115
specifying the caliper connection, 116
superficial, 359
testicular, 357
thyroid, 354
trace, 302
unlabeled, 299
vascular, 326
measurements
meta-measurements, 325
Method of Disks measurements, 117, 303
M-mode, 156
cardiac calculations, 380
changing format settings, 110
color, 159
format, 158
imaging tips, 242
increasing size in M-mode trace, 243
reducing noise in M-mode trace, 242
soft keys, 158
trace scrolling, 158
turning reference line on or off, 114
using Zoom, 237
MOD drive, 44
Modality worklist, 89
setting up, 91
Mode settings, changing, 109
Modem, connecting, 58
MODs
browsing contents, 63
erasing, 65
formatting, 64
loading and ejecting, 63
settings, 129
Monitor, video, 43
Motion artifacts, 177
Motorized 3D data set, acquiring, 181
Moving
2D reference line in Stress Echo, 265
arrows, 273
body markers, 276
labels, 273
reference lines, 152
transducer icons, 276
Moving the system, 60
MPR
images, 188
views, 188
Multi-cycle Doppler Auto Trace, 291
Musculoskeletal measurements, 368
N
Name representation, 138
Needle, moving crosshair, 209
Noise
reducing in M-mode trace, 242
reducing in the spectrum, 247
Nonimaging Doppler, 164
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539
Index
O
OB/GYN
creating user-defined calculations by
table, 122
creating using-defined calculations by
formula, 121
Obstetric
calculations, 386
measurements, 362
trending graphs, 425
OmniPlane transducer adapter, 58
On/Off button, 42, 51
On-Board Diagnostics option, 99
Opening Help, 29
Option keys
assigning, 102
Options
3D/4D Render Mode, 196
clinical, 39
imaging and connectivity, 40
installing, 101
packages, 99
Output tables, acoustic, 23
P
Panoramic
accuracy of images, 222
acquiring a data set, 223
Image Review, 224
imaging, 222
magnifying images, 226
moving images around the display, 225
performing measurements on images,
226
placing a title above an image, 227
placing labels on images, 228
Render soft keys, 225
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4535 611 65311
saving images, 228

Patient folders
deleting, 404
editing demographics, 400
searching for, 403
viewing previous studies, 405
Patient studies, 399
beginning an exam, 150
closing, 401
creating, 399
deleting, 404
exporting, 430
restarting, 401
saving, 400
searching for, 402
viewing previous, 405
Pediatric hip measurements, 361
Performing
1-point depth or velocity
measurements, 299
2-point measurements, 300
basic exam, 145
calculations, 299
ellipse measurements, 301
labeled measurements, 311
Method of Disks (MOD)
measurements, 117
Method of Disks measurements, 303
protocol measurements, 312
Stress Echo studies, 261
trace measurements, 302
wall motion scoring, 269
Physio
panel, 46
settings, 139
soft keys, 141
PISA measurements and calculations, 286
Postprocessing map, specifying, 213
Index
Presets, 95
application-package options, 99
backing up to a disk, 131
backing up to CD, 131
creating, 97
creating Stress Echo, 256
deleting, 98
modifying, 97
modifying Stress Echo, 257
removing name from display, 98
restoring, 132
selecting, 96
using soft keys, 98
Preview modes, 180
Printers
changing DICOM printer settings, 86
types of, 46
Printing
cancelling DICOM print jobs, 88
Help topics, 34
reports, 419
setting up automatic DICOM, 83
Prostate
calculations, 371
measurements, 352
Protocol measurements, 312
Pseudoclefting and pseudonarrowing
artifacts, 178
Pulsatility index, 287
PW Doppler mode, 160
imaging tips, 243
increasing sensitivity, 243
turning Adaptive Doppler on or off,
111
viewing audible signals, 244
PW sample volume gate, repositioning, 162
Q
Quick Calcs, 304
choosing, 117
Quick Guide, 23
Quick Review, 229
playing back a loop, 230
soft keys, 230
using in Dual Imaging, 219
Quick Text, 271
R
Reactivating measurements, 297
Record keys, assigning, 133
Reference line
moving, 152
moving in Stress Echo, 265
Render Mode, changing, 196
Reports, 416
adding comments, 425
adding finding codes, 421
adding images, 419
adding interpretations, 421
formulas, 426
manipulating measurements in, 420
printing, 419
viewing versions, 418
Repositioning and resizing images, 152
Resistivity index, 287
Resizing Help panes, 31
Resizing images, 152
Restarting a patient study, 401
Restoring presets and settings, 132
Resuming a Stress Echo study, 266
ROI
editing, 187
using in Stress Echo, 265
Rotating
arrows, 273
HD11 User Reference
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541
Index
transducer icon, 277
S
Saving
Screen pixel resolution, 281
Scrolling
controlling spectral trace, 169
spectral trace, 168
Searching
for patient folders, 403
for studies, 402
Select key, 54
Sensitivity
increasing CW Doppler, 246
increasing PW Doppler, 243
Servers, assigning DICOM, 71
Settings
3D/4D, 128
3D/4D vision, 197
Acquisition, 126
backing up, 131
CDs, 129
changing Autotrace Evaluation, 112
changing default Tissue Doppler, 113
DICOM printer, 86
Doppler, 163
entering DICOM, 68
fetal weight options, 125
fusion, 154
High Q, 117
loop duration, 127
modality worklist, 92
peripherals, 129
physio, 141
restoring, 132
stress, 139
system, 105
542
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4535 611 65311
triggering, 143
Signals
displaying low-velocity, 247
displaying low-velocity in PW Doppler,
245
viewing audible CW Doppler, 246
viewing audible PW Doppler, 244
Single Buffer, 216
Size, increasing in M-mode trace, 243
Slice, 188
soft key levels, 53
soft key sublevel, 54, 183
Soft keys
2D, 155
3D, 182
3D Image Controls, 195
3D Render, 184
4D, 200
Annotation, 274
Body Marker, 277
Doppler Auto Trace, 291
Doppler freeze, 161
Doppler Preview, 160
Doppler Spectral, 160
Duplex, 166
Fetal Echo, 204
Labeled Measurement, 312
M-mode, 158
Physio, 141
Preset, 98
preset, 98
Quick Review, 230
Stress Echo, 262
Swivel, 192
Triggering, 144
Triplex, 167
using, 53
Soft tissue, increasing visibility of, 241
Index
SonoCT icon, 231

SonoCT imaging modes, 232
SonoCT Real-time Compound Imaging,
231
special characters, 55
Spectral M-mode trace scrolling, 111
Spectral trace, 169
about scrolling, 168
changing the format, 112
controlling the scrolling, 169
Spectrum
unwrapping aliased, 250
unwrapping aliased in PW Doppler, 244
Sphygmomanometer errors, 281
Stage-View label, 262
Stopping a Stress Echo study, 266
Stress Echo, 255
acquiring images outside the protocol,
264
acquisition, 261
acquisition methods, 258
creating a preset, 256
modifying a preset, 257
moving the 2D reference line, 265
option, 99
performing studies, 261
playing back loops, 269
protocols, 257
relabeling views, 268
review, 267
setup, 256
soft keys, 262
stopping and resuming a study, 266
using a VCR during a study, 260
using soft keys, 262
using the ROI box, 265
using the timer, 260
viewing loops for a view, 268
Studies
comparing images from two, 415
creating new, 399

creating patient, 399
deleting, 404
performing Stress Echo, 261
restarting, 401
saving, 400
searching for, 402
setting up automatic deletion, 80
stopping and resuming Stress Echo, 266
using a VCR during Stress Echo, 260
using the timer during Stress Echo, 260
viewing previous, 405
Superficial
calculations, 378
measurements, 359
Supplies, 26
Suppress
Color, 172
Sweep speed, 281
Swivel soft keys, 192
System
changing system-wide settings, 102
moving, 60
preparing, 51
System settings
backing up, 131
changing, 105
time and date, 52
T
Tables, acoustic output, 23
TEE temperature units, 103
Testicular
calculations, 376
measurements, 357
TGC profile display, 104
Thermal Index, 104
Thyroid
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543
Index
calculations, 374
measurements, 354
Time and time zone, setting, 52
Timers during stress echo studies, 260
Tissue Doppler, 169
changing default settings, 113
Tissue Harmonic Imaging, 232
using, 233
Titles, placing above Panoramic image, 227
Trace
performing measurements, 117, 302
reducing noise in M-mode, 242
scrolling of spectral, 169
trackball function, 54
Transducers
by type, 47
connecting, 56
connector panel, 44
moving icons, 276
removing, 57
rotating icons, 277
specifying icon shape, 277
using OmniPlane Adapter, 58
Trapezoidal Imaging, 233
Trending graphs, 425
Triggering, 142
setting type in Doppler modes, 142
soft keys, 144
using in Contrast Harmonic Imaging,
214
Triplex, 165
soft keys, 167
Troubleshooting, 239
2D mode, 239
Color Mode, 248
CW Doppler, 245
M-mode, 242
PW Doppler, 243
544
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Turning system on and off, 51

Two Buffer, 216
U
Unlabeled measurements, 299
Unwrapping aliased signals, 250
Unwrapping aliased spectrum in PW
Doppler, 244
Updating 2D reference image in CW
Doppler, 247
Updating 2D reference image in PW
Doppler, 245
Upgrades, system, 25
User-defined calculations
creating by formula, 121
creating by table, 122
deleting, 124
editing, 123
V
Values, assigning measurement, 313
Vascular
calculations, 391
measurements, 326
VCRs
model numbers, 46
options, 99
recalibrating an image in playback, 65
using during Stress Echo studies, 260
Velocity, end-diastolic vs. minimum, 287
Video monitor, 43
positioning, 52
View icon, 262
Viewing
frames, 412
full-screen loops, 412
previous studies for current patient,
405
Index
report versions, 418

Vision settings
3D/4D, 197
changing, 198
Volume
calculations, 286
changing the orientation of 3D, 188
changing view direction of 3D, 189
editing 3D, 192
swiveling 3D, 190
W
Wall motion scoring, 269
Wheels, 61
World keys, 55
X
XRES Adaptive Image Processing, 234
Z
Zoom, 235
M-mode, 237
using Color and Color Power Angio,
236
using during live imaging, 235
Zooming
images in 3D/4D, 194
live images, 194
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545
Index
546
HD11 User Reference

4535 611 65311

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HD11 Ultrasound System

Copyright 2005 Koninklijke Philips Electronics N.V.

All rights reserved

Manufactured by Philips Ultrasound

CE marking is for Council Directive 93/42/EEC.

HD11 User Reference

CD and MOD Drives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44

HD11 User Reference

Automatic DICOM Export . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72

Removing the Preset Name from the Display . . . . . . . . . . . . . . . . . . . . . . . . . . . .98

HD11 User Reference

Customizing the Measurements and Calculations Menus . . . . . . . . . . . . . . . . . .119

Displaying the Input Method Editor Status Window. . . . . . . . . . . . . . . . . . . . . .139

HD11 User Reference

Using Color M-mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159

Color Power Angio (CPA) Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173

HD11 User Reference

About 3D/4D Render Mode Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .196

iSCAN Intelligent Optimization . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .220

HD11 User Reference

Imaging Tips for Color Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .248

HD11 User Reference

Using the ROI Box in Stress Echo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .265

About Measurement Primitives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .283

HD11 User Reference

Performing a Protocol Measurement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .312

Labeled Calculations by Exam Type. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .368

HD11 User Reference

Deleting an Image in Image Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .407

Adding Comments to a Report . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .425

HD11 User Reference

HD11 User Reference

HD11 User Reference

1 Read This First

About Your User Information

Compact Disc (CD): Includes all of the user information.

User Reference: A printed version of the Help that is localized to specific

Quick Guide: Contains procedures, imaging tips, and information on system

Acoustic Output Tables: Included on the CD, it contains information about

HD11 User Reference

Read This First

Medical Ultrasound Safety: Included on the CD, it contains information on

About Your Compact Disc

User Information Conventions

Hypertext links appear in blue.

Symbols appear as they appear on the system.

HD11 User Reference

Read This First

Upgrades and Updates

For U.S. customers, call Philips Ultrasound Customer Service at

HD11 User Reference

Read This First

Ordering Supplies and Accessories

HD11 User Reference

Read This First

Asia Pacific Headquarters

HD11 User Reference

Read This First

HD11 User Reference

tab to view the contents of the Help.

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