You are on page 1of 322

HD3 Ultrasound System

Getting Started
4535 612 13861 Rev B
July 2005

Copyright 2005 Koninklijke Philips Electronics N.V. All rights reserved

Printed in USA

Distributed 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.
Manufactured in Korea.
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.

HD3 Getting Started


4535 612 13861

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.
Chroma, Color Power Angio, and HD3 are trademarks of Koninklijke Philips Electronics N.V.
Non-Philips product names may be trademarks of their respective owners.

HD3 Getting Started


4535 612 13861

HD3 Getting Started


4535 612 13861

Contents
1 Read This First . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Intended Audience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Warnings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .21
Warning Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .22
About Your User Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
User Information Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
About Your Compact Disc . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .23
Conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
System Conventions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
User Information Conventions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .24
Upgrades and Updates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .25
Customer Comments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
Free Gift Offer: Customer Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .26
Ordering Supplies and Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .27
Customer Service. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .28
2 Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Electrical Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .29
Electrostatic Discharge. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
Guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .30
Defibrillators. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31
Pacemakers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .31
Installation Requirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32
AC Power Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .32
Peripherals Connections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .33
Mechanical Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .34
HD3 Getting Started
4535 612 13861

Contents

Symbols . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .35
Biological Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
Latex Materials and Patient Contact . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .39
Repetitive Strain Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40
Infection Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .40
ALARA Education Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
Applying ALARA. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .41
Direct Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .42
Indirect Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .43
Receiver Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
An Example of Applying ALARA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
Additional Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .44
Output Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .45
Mechanical Index (MI) Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .46
Thermal Index (TI) Displays. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .47
Mechanical and Thermal Indices Display Precision and Accuracy . . . . . . . . .47
Control Effects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
Controls Affecting the Indices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
Power . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
2D Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .49
Color and Power Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .50
M-Mode and Doppler Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
Other . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .51
Related Guidance Documents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .52
Acoustic Output and Measurement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .53
In Situ, Derated, and Water Value Intensities . . . . . . . . . . . . . . . . . . . . . . . . .53
Conclusions Regarding Tissue Models and Equipment Survey . . . . . . . . . . . .55
Acoustic Output Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .56
Acoustic Measurement Precision and Uncertainty . . . . . . . . . . . . . . . . . . . . .56
6

HD3 Getting Started


4535 612 13861

Contents

Electromagnetic Compatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .58


EMC Testing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
Electromagnetic Emissions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .59
Approved Cables, Transducers, and Accessories for EMC . . . . . . . . . . . . . .60
Approved Cables for Electromagnetic Compliance . . . . . . . . . . . . . . . . . . . .60
Approved Transducers for Electromagnetic Compliance. . . . . . . . . . . . . . . .61
Approved Accessories for Electromagnetic Compliance . . . . . . . . . . . . . . . .61
Electromagnetic Immunity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .63
Recommended Separation Distance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .67
Avoiding Electromagnetic Interference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .69
Restrictions for Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70
Immunity Level Test Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .70
3 System Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71
System Capabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71
Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .71
Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .72
Image Capture and Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73
Standard System Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .73
Optional System Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
Imaging Capabilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
Review and Connectivity Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
Peripheral Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .74
System Components . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75
Video Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .75
Control Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .76
Storage Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77
Peripherals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .77
Transducer Connections and Cable Management. . . . . . . . . . . . . . . . . . . . . . . . .77
Foot Switch. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .78
HD3 Getting Started
4535 612 13861

Contents

On/Off Button . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79


Rear Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .79
Power Switch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80
Wheel Brakes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .80
4 Preparing the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 81
Connecting Devices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .81
Connecting a Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82
Connecting the Color Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .82
Connecting a Report Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .83
About External VCRs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86
Connecting an External VCR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .86
Connecting to a Network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .88
Moving the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .90
Preparing and Moving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91
Setting Up After Moving. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .91
Transporting the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .92
5 Using the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 95
Turning the System On and Off. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .95
Setting the System Time and Date. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
Setting the System Language . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
Using the Wheel Brakes. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .96
Adjusting the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97
Positioning the Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .97
Adjusting the Monitor Brightness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .98
System Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99
Controls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99
Control Knob . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .99
Soft Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .100
8

HD3 Getting Started


4535 612 13861

Contents

Function Keys . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .100


Using the Trackball, and the Select, Enter, and Exit Controls . . . . . . . . . . . . . .101
Positioning the Control Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102
Using the Keyboard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .102
Imaging Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .103
Connecting and Selecting Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .104
Printing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106
Adjusting Print Quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .106
Black-and-White and Color Image Printers. . . . . . . . . . . . . . . . . . . . . . . . . . . . .107
Report Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .107
DICOM Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .107
Recording to a VCR . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .108
Storing Images. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .108
Using the Removable Media Drives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .109
Loading and Ejecting Media . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .109
Formatting Disks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .110
6 Customizing Your System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .111
Using Setups . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .111
Changing System Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .111
Changing Measure Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .112
Changing DICOM Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113
Changing Option Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113
Changing Peripherals Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113
Performing Administrative Functions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113
Presets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .113
Options . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .115
7 Transducer Care and Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117
Handling Transducers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117
HD3 Getting Started
4535 612 13861

Contents

Inspecting Transducers for Damage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .117


Storing Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .118
Storage for Transport . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .118
Daily and Long-Term Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119
Disinfectants and Gels Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .119
Latex Product Alert . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .121
Transmissible Spongiform Encephalopathy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .122
Acoustic Coupling Medium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123
Gels Statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .123
Cleaning, Disinfecting, and Sterilizing Transducers . . . . . . . . . . . . . . . . . . . . . . . . . .123
Choosing a Disinfectant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .124
General Cleaning Procedures for All Transducers . . . . . . . . . . . . . . . . . . . . . . .125
Disinfecting Transducers with Wipes and Sprays (Low-Level Disinfection) . . .126
Cleaning and Disinfecting Cables and Connectors with Wipes and Sprays . . . .127
Disinfecting Transducers by Immersion (High-Level Disinfection) . . . . . . . . . . .131
Disinfecting Endocavity Transducers by Immersion . . . . . . . . . . . . . . . . . . . . . .132
Sterilizing Transducers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .133
Disinfectants Compatibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .136
Disinfectant Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .137
Factors Affecting Disinfectant Efficiency . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .137
Disinfectants Compatibility Table . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .138
Transducer Supplies and Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .138
8 Patient Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Entering Patient Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .141
Searching for a Patient File . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .142
Editing a Patient File . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .142
Ending an Exam. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .142
Deleting a Patient File. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .143
10

HD3 Getting Started


4535 612 13861

Contents

9 Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .145
2D Imaging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .145
Optimizing the Image with 2D Opt . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .146
2D Depth Setting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .146
Focal Zone Positioning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .147
Gray and Chroma Maps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .147
Dual Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .148
Zoom Magnification . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149
Cine Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149
Tissue Harmonic Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .149
Acoustic Power Output . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150
Time Gain Compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .150
Text Annotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151
Body Markers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .151
M-mode Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .152
Color and Color Power Angio (CPA) Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153
Color Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .153
CPA Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154
Color Maps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .154
Color or CPA Steer Angle. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155
Pulsed-Wave Doppler Imaging. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .155
Inverting the Display. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157
Updating the Image Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .157
Sweep Speed. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .158
Steering Angle. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .158
Wall Filters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .158
Doppler Zero Baseline. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159
Doppler Scale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .159
Doppler Angle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .160
HD3 Getting Started
4535 612 13861

11

Contents

Audio Volume. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .160


3D Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161
Suggestions for Acquiring 3D Images. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161
2D Imaging Effects on 3D Acquisition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .161
Acquiring a 3D Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .162
Viewing and Manipulating a 3D Image . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .163
Adjusting the Threshold . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .163
Adjusting the Gamma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .163
Adjusting the ROI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .164
Changing the Rotation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165
Changing the Position. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .165
Changing the Image Size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166
Using Cut Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .166
Reverting Back to the Original 3D Image . . . . . . . . . . . . . . . . . . . . . . . . . . .166
Using Color Map . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .167
10 Biopsy Guides . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Attaching and Removing a Biopsy Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .169
Using the Biopsy Guideline Display . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .170
Verifying the Biopsy Guide Alignment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .171
Biopsy Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .173
Ordering Biopsy Guides and Accessories . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .174
11 Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Performing Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .175
2D Distance Measurement. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176
2D Circumference and Area Measurements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .176
2D Volume Measurement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .178
2D Hip Joint . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .178
M-Mode Distance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179
12

HD3 Getting Started


4535 612 13861

Contents

Doppler Velocity . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .179


Doppler Velocity Ratio. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180
Measurement Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180
2D Measurement Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .180
Doppler Measurement Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181
Color and CPA Measurement Accuracy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181
Display Size and Measurement Accuracy. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .181
Cursor Placement and Measurement Accuracy . . . . . . . . . . . . . . . . . . . . . . . . .181
Speed of Sound. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .182
Doppler Alignment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .182
Aliasing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .182
Velocity Resolution in Doppler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .183
Acquisition and Algorithmic Errors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .183
Formulas . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .183
Accuracy Tables . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .184
2D Mode. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .184
M-Mode . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .185
Doppler. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .185
12 Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187
Starting Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187
Exam Review Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .187
Selecting and Viewing Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188
Exam List. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188
Exam List Tools . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .188
Searching for Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .189
Sorting Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .191
Preview Box . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .191
Previewing Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .192
Viewing Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .192
HD3 Getting Started
4535 612 13861

13

Contents

Image Layout. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .193


Comparing Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .193
Magnifying Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .194
Deleting Exams and Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .194
Adding and Editing Comments in Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .195
Measurements in Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .196
Distance Measurements in Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .196
Ellipse Measurements in Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .196
Text Annotation in Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .197
Transferring Exams and Images . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .198
Exporting Images for PC Viewing. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .199
Backing Up and Restoring Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .200
Printing Exams and Images from Review . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .201
Printing Images to a Report Printer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .201
Printing Images or Exams to a DICOM Printer. . . . . . . . . . . . . . . . . . . . . . . . . .202
13 Patient Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 203
Working with Reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .203
Biophysical Profile and Maternal Survey . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .205
Fetal Description . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .205
Graphs. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .205
Open Line Transfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .206
14 Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 209
Cardiac Calculations. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .209
Simpson: 2D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .210
LV Vol A/L: 2D . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .211
2D Measure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .212
M-Mode Cardiac Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .212
Doppler Cardiac Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .213
14

HD3 Getting Started


4535 612 13861

Contents

PISA Radius and Alias Velocity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .214


Patient Heart Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .215
Doppler Trace Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .215
Gynecology Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .216
Obstetrics Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .217
Gestational Age . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .217
OB Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .219
EDD Based on LMP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .221
Fetal Heart Rate . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .222
Amniotic Fluid Index (AFI) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .223
Ratios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .224
Fetal Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .224
Estimated Fetal Weight Formula . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .225
Fetal Echo Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .225
Urology Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .226
Vascular Calculations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .227
Peak Velocity (PSV, EDV, E, A, and V). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .227
Percent Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .228
Vessel Area and Distance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .229
15 Maintaining the System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .231
Cleaning the System, the Cables, and the Connectors . . . . . . . . . . . . . . . . . . . . . . .231
Disinfecting System Surfaces . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .233
Maintaining the System Control Panel . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .234
Cleaning the Trackball . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .234
Cleaning and Maintaining Peripherals. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .235
VCR. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .235
Video Printers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .235
Replacing the System Battery. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .236
HD3 Getting Started
4535 612 13861

15

Contents

Disposing of Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .236


Preventive Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .236
16 System Administration. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 239
Backing Up and Restoring Presets and Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . .239
Installing Software and Updating Drivers. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .240
Viewing System Information and Logs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .241
About Service Tools. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .242
Configuring Network Settings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .242
Testing Network Settings. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .244
Troubleshooting Failed Tests . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .245
17 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Cardiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .247
Fetal Echo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .251
General . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .251
Body Surface Area (BSA) in Square Meters. . . . . . . . . . . . . . . . . . . . . . . . . . . . .251
Gynecology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .252
Hip Angle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .252
Obstetrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .252
Gestational Age (G.A.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .252
Abdominal Circumference (AC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .252
Antero-Posterior Diameter (APD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .252
Antero-Posterior Thorax Diameter (APTD) . . . . . . . . . . . . . . . . . . . . . . . .253
Biparietal Diameter (BPD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .253
Cerebellum (CEREB) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .254
Clavicle Length (CLAV) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .254
Crown-Rump Length (CRL). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .254
Femur Length (FL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .254
Gestational Sac (GS). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .255
16

HD3 Getting Started


4535 612 13861

Contents

Head Circumference (HC). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .256


Humerus Length (HUM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .256
Middle Abdominal Diameter (MAD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .257
Occipito-Frontal Diameter (OFD). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .257
Outer Ocular Distance (OOD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .257
Tibia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .257
Transverse Abdominal Diameter (TAD) . . . . . . . . . . . . . . . . . . . . . . . . . . . .257
Transverse Thorax Diameter (TTD). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .258
Ulna Length. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .258
Fetal Growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .258
Abdominal Circumference (AC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .258
Biparietal Diameter (BPD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .259
Cerebellum (CER) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .259
Clavicle Length (CLAV) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .259
Femur Length (FL) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .259
Fetal Trunk Area (FTA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .260
Head Circumference (HC). . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .260
Humerus Length (HUM) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .261
Middle Abdominal Diameter (MAD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .261
Radius Length (RAD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .261
Tibia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .262
Ulna. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .262
Estimated Fetal Weight (EFW) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .262
Abdominal Circumference (AC) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .262
Abdominal Circumference, Biparietal Diameter (AC, BPD). . . . . . . . . . . . .262
Abdominal Circumference, Femur Length (AC, FL) Hadlock1. . . . . . . . . . .262
Abdominal Circumference, Biparietal Diameter, Femur Length (AC, BPD, FL)
Hadlock2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .263
Abdominal Circumference, Femur Length, Head Circumference (AC, FL, HC)
Hadlock3. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .263
HD3 Getting Started
4535 612 13861

17

Contents

Abdominal Circumference, Biparietal Diameter, Femur Length, Head Circumference (AC, BPD, FL, HC) Hadlock4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .263
Antero-Posterior Thorax Diameter, Biparietal Diameter, Transverse Thorax
Diameter (APTD, BPD, TTD) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .263
Antero-Posterior Thorax Diameter, Biparietal Diameter, Femur Length,
Transverse Thorax Diameter (APTD, BPD, FL, TTD) . . . . . . . . . . . . . . . . .263
Biparietal Diameter, Femur Length, Fetal Trunk Area (BPD, FL, FTA) . . . .263
Biparietal Diameter, Transverse Thorax Diameter (BPD, TTD) . . . . . . . . .264
Estimated Fetal Weight Growth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .264
Fetal Ratios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .264
FL/AC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .264
HC/AC . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .264
Vascular. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .265
18 Specifications. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267
Physical Dimensions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267
Height . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267
Depth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267
Width . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267
Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267
Grayscale . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267
Monitor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .267
Input and Output Signals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .268
Peripherals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .269
Modality Interface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .269
Electrical Parameters . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .269
Languages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .269
Pressure Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270
Operating . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270
Storage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270

18

HD3 Getting Started


4535 612 13861

Contents

Humidity Limits (Operating) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270


Temperature Limits . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .270
Safety Requirements. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .271
19 Glossary. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .273
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .313

HD3 Getting Started


4535 612 13861

19

Contents

20

HD3 Getting Started


4535 612 13861

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 manual is intended for sonographers, physicians, and biomedical engineers
who operate and maintain the ultrasound system.

Warnings
Before using the system, read these warnings and cautions and the "Safety" section of this manual.
WARNINGS

Do not remove system covers; hazardous voltages are present inside the system. To avoid electrical shock, only use the power cord supplied and only connect it to a properly grounded wall (wall/mains) outlet.

Do not operate the system in the presence of flammable anesthetics. Explosion can result.

Medical equipment needs to be installed and put into service according to the
special electromagnetic compatibility (EMC) guidelines provided in "EMC Testing" on page 59.

The use of portable and mobile radio-frequency (RF) communications equipment can affect the operation of medical equipment.

HD3 Getting Started


4535 612 13861

21

Read This First

CAUTIONS

This system has Boot from CD enabled by default. If you insert an unauthorized bootable CD and turn the system on, the installation software on that
CD could overwrite the ultrasound system software. This could introduce a
security vulnerability or render your system inoperable. Using an unauthorized CD in the system also voids your warranty.

The BIOS on the system is not password protected. Any user can access the
system BIOS and change system settings. Unauthorized access to the system
BIOS could render your system inoperable and voids your warranty.

Warning Symbols
The system uses the following warning symbols (Table 1-1). For additional symbols used on the system, see "Symbols" on page 35.
Table 1-1 Warning Symbols
Symbol

Description
Documentation: The product is marked with this symbol
when it is necessary to refer to the user information.
Dangerous voltages: This symbol appears adjacent to
high-voltage terminals. It indicates the presence of voltages
greater than 1,000 Vac (600 Vac in the United States).
ESD (electrostatic discharge): The product is marked with this
symbol to warn the user not to touch exposed pins. Touching
exposed pins can cause electrostatic discharge, which can
damage the product.

22

HD3 Getting Started


4535 612 13861

Read This First

About Your User Information


This manual is part of your user information.

User Information Components


The user information provided with your system includes the following components:

Compact Disc (CD): Includes all of the user information, except the Operating Notes.

Getting Started: Introduces you to system features and concepts, and helps
you set up your ultrasound system. It includes procedures for basic operation
as well as comprehensive instructions for using the system. It also includes a
glossary, containing descriptions of all controls and display elements, and additional reference information.

Quick Guide: The Quick Guide is provided with the system, and is also
included on the CD. It contains procedures 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.

Medical Ultrasound Safety: Included on the CD, it contains information on


bioeffects and biophysics, prudent use, and implementing ALARA (as low as
reasonably achievable).

Operating Notes: Contains information that clarifies certain system


responses that might be misunderstood or cause user difficulty.

Shared Roles for System and Data Security: Contains guidelines to help
you understand how the security of your ultrasound system could be compromised and information on Philips efforts to help you prevent security
breaches.

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.
HD3 Getting Started
4535 612 13861

23

Read This First

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.

System Conventions
These conventions are used in the system:

The trackball, the Enter control, and the Select control work together
somewhat like a computer mouse. Moving the trackball is like moving the
mouse. Pressing Enter is like pressing the left mouse button. Pressing Select
is like pressing the right mouse button.

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

To display a list, click the down arrow. To scroll through a list, click the arrows
at either end of the scroll bar or drag the scroll bar up or down.

Press Control to activate the Control menu. To highlight items in the menu
or to increase, decrease, or change settings, turn Control or use the trackball. To select an item, press Control or press Enter or Select. Press Exit
to close the Control menu.

The control panel includes buttons, soft keys, knobs, slide controls, an alphanumeric keyboard, and a trackball. Press a button to activate or deactivate its
function. Turn a knob to change the selected setting. Move a slide control to
change its setting. Roll the trackball in the direction that you want to move a
caliper or object.

User Information Conventions


The user information follows these conventions:

24

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.

HD3 Getting Started


4535 612 13861

Read This First

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 probes both are referred to as transducers, unless the distinction is important to the meaning of the text.

Click or select means to move the cursor to an object and press Select or
Enter.

Drag means to place the cursor over an object and then press and hold Enter
while moving the trackball. Use this method to move an object on the screen.

On the Control menu, select means to highlight an item by turning Control


and then pressing Control.

Information that is essential for the safe and effective use of the ultrasound system
appears throughout this manual as follows:
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.

HD3 Getting Started


4535 612 13861

25

Read This First

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 28.

You can also send e-mail to Philips Ultrasound Technical Communications at the
following address:
bothell.techpubs@philips.com

Free Gift Offer: Customer Survey


We would like your feedback on the user information for your Philips ultrasound
system. Please go to www.medical.philips.com/goto/hd3survey to complete an
online survey, and we will send you a free gift. Thank you!

26

HD3 Getting Started


4535 612 13861

Read This First

Ordering Supplies and Accessories


You can order transducer covers 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)

NOTE

Fax:

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

E-mail:

info@civcomedical.com

Internet:

civco.com

To order biopsy guides, contact your Philips representative or an authorized distributor.

HD3 Getting Started


4535 612 13861

27

Read This First

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
888-647-4285 or +1 425-487-7000
Asia Pacific Headquarters
Level 9, Three Pacific Place
1 Queens Road East
Wanchai
Hong Kong
+852 2821 5888
European Headquarters (also serves Africa and the Middle East)
Philips Medizin Systeme Bblingen GmbH
Hewlett-Packard-Str. 2
71034 Bblingen
Germany
+49 40 5078 4532
Latin American Headquarters
1550 Sawgrass Corporate Parkway, Suite 300
Sunrise, FL 33323
USA
+1 954-835-2600

28

HD3 Getting Started


4535 612 13861

2 Safety
Read this section before you use the HD3 Ultrasound System.
Before you use any transducer for the first time, be sure to read all applicable
usage, patient-safety, operator-safety, and electrical-safety guidelines in this manual.
If you have any comments or questions about safety, contact your Philips representative.

Electrical Safety
This equipment has been verified by a recognized third-party testing agency as a
Class I device with Type BF isolated patient-applied parts. For maximum safety
observe these warnings:
WARNINGS

Do not remove the system covers.

Do not attempt to service the system yourself. Only qualified personnel


should service the system.

Do not touch accessible connector pins and the patient simultaneously.

Be very careful not to touch internal electrical circuits. Accidently contacting


internal electrical circuits could cause serious injury.

To avoid electrical shock, use only the supplied power cord and connect it
only to a properly grounded wall outlet.

Connect all equipment supplied with the system only to the 110-Vac or
220-Vac outlets provided. Connecting equipment supplied with the system to
a wall outlet can cause excessive enclosure leakage current.

Do not connect items to the ultrasound system that are not specified by
Philips as part of the system.

Do not connect additional multiple-socket outlets or extension cords to the


system.

HD3 Getting Started


4535 612 13861

29

Safety

WARNING

Do not remove system covers. To avoid electrical shock, use only the supplied
power cord and connect only to a properly grounded wall (wall/mains) outlet.

Electrostatic Discharge
Electrostatic discharge (ESD), commonly referred to as a static shock, is a naturally occurring phenomenon. ESD is most prevalent during conditions of low
humidity, which can be caused by heating or air-conditioning. During low-humidity
conditions, electrical charges naturally build up on individuals and objects and can
create static discharges.

Precautions
The following cautions can help to reduce ESD effect:
CAUTIONS

Do not touch transducer connector pins or the systems transducer


receptacle.

Handle the transducer by the metal connector shell.


Make contact with a metal surface of the system before connecting a transducer to the system.

On connectors that display the ESD sensitivity symbol

, do not touch

the connector pins, and always observe the preceding ESD precautions when
handling or connecting transducers.

Guidelines
WARNING

To protect your safety, you must follow ESD guidelines when performing service
and maintenance procedures.
CAUTION

If you use a vacuum cleaner to clean the interior of the system or any ESD-sensitive part of the system, take the necessary static discharge precautions to avoid
damaging the electronics.

30

HD3 Getting Started


4535 612 13861

Safety

Follow these electrostatic discharge (ESD) guidelines when performing service or


maintenance procedures to avoid the possibility of inadvertent deterioration or
destruction of sensitive electronic components:

Avoid working in carpeted areas that are not approved for ESD.

Use a grounding wrist strap to be properly grounded. The system should be


plugged into the power outlet and turned off.

Use a grounding mat for assembly work on sensitive areas.

Defibrillators
Observe the following precautions when using a transducer when a defibrillation
is required.
WARNINGS

Before defibrillation, always remove the transducer from the patient.


Before defibrillation, always disconnect the transducer from the system.
Consider that a disposable transducer cover provides no protective electrical
insulation against defibrillation.

A small hole in the outer layer of the transducer opens a conductive path to
grounded metal parts of the transducer. The secondary arcing that could
occur during defibrillation could cause patient burns. The risk of burns is
reduced, but not eliminated, by using an ungrounded defibrillator.
Use defibrillators that do not have grounded patient circuits. To determine
whether or not a defibrillator patient circuit is grounded, see the defibrillator service guide, or consult a biomedical engineer.

Pacemakers
Philips ultrasound equipment in normal operation, as with other medical electronic diagnostic equipment, uses high-frequency electrical signals that can interfere with pacemaker operation. Though the possibility of interference is slight, be
alert to this potential hazard and stop system operation immediately if you note
interference with a pacemaker.

HD3 Getting Started


4535 612 13861

31

Safety

Installation Requirements
The HD3 system is designed to be installed by qualified service personnel.
CAUTIONS

This system has Boot from CD enabled by default. If you insert an unauthorized bootable CD and turn the system on, the installation software on that
CD could overwrite the ultrasound system software. This could introduce a
security vulnerability or render your system inoperable. Using an unauthorized CD in the system also voids your warranty.

The BIOS on the system is not password protected. Any user can access the
system BIOS and change system settings. Unauthorized access to the system
BIOS could render your system inoperable and voids your warranty.

AC Power Requirements
Your system should only be plugged into an AC outlet that can handle intermittent currents of up to 15 A (for 110 Vac) or 10 A (for 220 Vac).
An equipotential terminal is provided on the rear panel of the system. Use this
when redundant earth ground is necessary according to IEC 60601-1-1.
WARNING

No life-support devices should be connected to the same circuit as the ultrasound system.
For optimal performance, your ultrasound system should be connected to a circuit dedicated solely for the ultrasound system. In cases where there are severe
transients or noise in the power line, the use of a power line conditioner or an
uninterruptible power supply (UPS) may be necessary.

32

HD3 Getting Started


4535 612 13861

Safety

Peripherals Connections
Do not connect AC power cords for peripherals to the AC power outlets on the
system unless the peripherals are specified by Philips as part of the system. The
risks associated with connecting such equipment to the outlets provided include:

Excessive power draw, resulting in possible fire or electrical-shock hazards

High-impedance ground connection

Electromagnetic interference with other system devices

The outlets installed on this system are rated 110 Vac or 220 Vac. Use the outlets
only for supplying power to equipment that is intended to be part of the system.
Do not connect additional multiple socket outlets or extension cords to the system.
WARNINGS

If you use peripheral equipment powered from an electrical source other than
the ultrasound system, the combination of the peripheral equipment and the
ultrasound system is considered to be a medical system. It is your responsibility to comply with IEC 60601-1-1 and to test the medical system according to
the requirements. If you have questions, contact your Philips representative.

Do not use nonmedical peripherals within 1.8 m (6 ft) of a patient unless the
nonmedical peripherals receive power from an isolated power outlet on the
Philips ultrasound system or from an isolation transformer that meets medical
safety standards.
Philips ultrasound systems are tested to the requirements of IEC 60601-1 and IEC
60601-1-1, with system peripherals that are powered by the built-in isolation
transformer. The system peripherals meet general electrical safety usage requirements, but not necessarily medical device standards.
Devices connecting to the network interface of the ultrasound system must comply with the applicable IEC or national standards. In addition, the device must be
certified to IEC 60950 or equivalent.
The use of cables, transducers, or accessories not supplied with the HD3 system
can result in increased electromagnetic emissions or decreased electromagnetic
immunity of the system. For more information on electromagnetic immunity, see
"Electromagnetic Immunity" on page 63.
HD3 Getting Started
4535 612 13861

33

Safety

Mechanical Safety
WARNINGS

Be aware of the casters, especially when moving the system. The system is
heavy (its weight depends upon its configuration), and it could cause injury to
you or others if it rolls over feet or into shins. Exercise caution when going up
or down ramps.

Position external hardcopy devices away from the system. Ensure that they
are secure. Do not stack them on the system.
CAUTIONS

Ensure that the cables for all patient-applied parts are secure. Use the cable
management system to ensure that transducer cables are protected from
damage.

When moving the system or attempting to overcome an obstacle, do not pull


or lift the system by the transducer cable holders.

Moving the System


The system has brakes for the front wheels. Press down on the brake with your
foot to lock and lift up to unlock. Release the brakes when moving the system.
To maneuver the system in tight spaces, use repeated back-and-forth movements
to position the system.
If the system behaves abnormally after moving, contact Philips Ultrasound Customer Service immediately. The components are installed securely and can withstand considerable shock, however, excessive shock can cause a system failure.

34

HD3 Getting Started


4535 612 13861

Safety

Symbols
The following (Table 2-1) is a list of the symbols used on the ultrasound system
and their meanings.
Table 2-1 Symbols On the System
Isolated patient connection (Type BF).

Isolated patient connection intended for intraoperative use,


including direct cardiac application (Type CF).
The patient-applied part provides a degree of protection
from electrical shock. This symbol indicates that the
patient-applied part is defibrillator-proof. The patient-applied
part is suitable for all patient applications including direct
cardiac applications.
The connector near this symbol receives alternating voltages.
Protective earth ground.
Identifies fuse boxes or their location. For continued
protection from fire or shock, replace only with the same
type and rating fuse.
This isolated output auxiliary power is provided for
connection of the Philips-approved remote accessories.
Date of manufacture.

ESD (electrostatic discharge): The product is marked with


this symbol to warn the user not to touch exposed pins.
Touching exposed pins can cause electrostatic discharge,
which can damage the product.
1

On the power switch, represents ON (1) and OFF (0).

0
HD3 Getting Started
4535 612 13861

35

Safety

Table 2-1 Symbols On the System (Continued)


Identifies the On/Off button on the system control panel.

Documentation: The product is marked with this symbol


when it is necessary to refer to the user information.
Identifies equipotential ground.

Indicates that interference may occur in the vicinity of


equipment marked with this symbol.
IPx-1

Indicates that this device is protected against vertically falling


water drops.

IPx-7

Indicates that this device is protected against the effects of


temporary immersion. This degree of protection can apply
to transducers.
This symbol indicates that the system display contains
mercury. Dispose properly in accordance with local, state, or
federal laws.
This symbol also indicates separate collection for electrical
and electronic equipment in compliance with the Waste
Electrical and Electronic Equipment (WEEE) Directive.
Dispose properly in accordance with local, state, or federal
laws.
Indicates separate collection for electrical and electronic
equipment in compliance with the Waste Electrical and
Electronic Equipment (WEEE) Directive.

Right and left audio output

36

HD3 Getting Started


4535 612 13861

Safety

Table 2-1 Symbols On the System (Continued)


Color composite video output

Microphone input
Print trigger
Black-and-white composite video output

S-Video connection

Ethernet connection
USB input/output port

VGA
Foot switch
ECG input

HD3 Getting Started


4535 612 13861

37

Safety

The following symbols (Table 2-2) are used inside the system:
Table 2-2 Symbols Used Inside the System
Dangerous voltages: This symbol appears adjacent to
high-voltage terminals. It indicates the presence of voltages
greater than 1,000 Vac (600 Vac in the United States).
Equipotential ground

The following symbols (Table 2-3) appear on the product packaging to indicate
environmental considerations.
Table 2-3 Symbols On the Product Packaging
Atmospheric pressure range of 700 to 1,060 hPa for
transport and storage.
Relative humidity range of 20% to 90% (noncondensing) for
transport and storage.
Ambient temperature range 20oC to +60oC (4F to
+140F) (noncondensing) for transport and storage. (Does
not apply to media.)

38

HD3 Getting Started


4535 612 13861

Safety

Biological Safety
This section contains information about biological safety and a discussion of the
prudent use of the system.
A list of precautions related to biological safety follows; observe these precautions when using the system. For more information refer to Medical Ultrasound
Safety on your system user-information compact disc.
WARNINGS

Do not use the system if an error message appears on the video display indicating that a hazardous condition exists. Note the error code, turn off power
to the system, and call your customer service representative.

Do not use a system that exhibits erratic or inconsistent updating. Discontinuities in the scanning sequence are indicative of a hardware failure that must
be corrected before use.

Perform ultrasound procedures prudently. Use the ALARA (as low as reasonably achievable) principle.

Use only acoustic standoffs that have been approved by Philips Ultrasound.
Verify the alignment of the biopsy guide before use. See "Biopsy Guides" on
page 169.

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

Biopsy guide transducer covers can contain natural rubber latex, which may
cause allergic reactions in some individuals. Refer to the FDA Medical Alert on
Latex Products, dated March 29, 1991, in "Latex Product Alert" on page 121.

Latex Materials and Patient Contact


The HD3 Ultrasound System and transducers do not contain natural rubber latex
on any patient- or operator-contact surfaces. Natural rubber latex is not used on
any ultrasound transducer discussed in this manual.

HD3 Getting Started


4535 612 13861

39

Safety

WARNING

Latex is commonly used in sheaths (transducer covers) marketed to help with


infection control in transesophageal, endocavity, and intraoperative imaging applications and during biopsies. Examine the packaging to confirm latex content.
Studies have shown that patients can experience allergic reactions with natural
rubber latex. The U.S. Food and Drug Administration published a medical alert on
latex products dated March 29, 1991. For more information, see "Latex Product
Alert" on page 121.

Repetitive Strain Injury


Repetitive ultrasound scanning has been associated with carpal tunnel syndrome
(CTS) and related musculoskeletal problems. Some investigators have looked at a
large population of sonographers with different types of equipment. An article,
with feedback from a smaller geographical area, makes the following recommendations:

Maintain your joints in optimum positions with a balanced posture while scanning.

Allow frequent breaks to give soft tissue a chance to recuperate from awkward positions and repetitive movement.

Avoid gripping the transducer with excessive force.

For more information on repetitive strain injury, see the following:

Pike, Ian et al. Prevalence of Musculoskeletal Disorders and Related Work


and Personal Factors Among Diagnostic Medical Sonographers. Journal of
Diagnostic Medical Sonographers, Vol. 13, No. 5: 219-227, September 1997.

Necas, Martin. Musculoskeletal Symptomatology and Repetitive Strain Injuries in Diagnostic Medical Sonographer. Journal of Diagnostic Medical Sonographers, 266-273, November/December 1996.

Infection Control
There are issues related to infection control for you, the operator, as well as the
patient. You should follow the infection control procedures established in your
clinic or hospital for both the protection of the staff and the patient. For more
information on infection control, see "Cleaning, Disinfecting, and Sterilizing Transducers" on page 123 and "Maintaining the System" on page 231.
40

HD3 Getting Started


4535 612 13861

Safety

ALARA Education Program


The guiding principle for the use of diagnostic ultrasound is defined by the as low
as reasonably achievable (ALARA) principle. The decision as to what is reasonable has been left to the judgement and insight of qualified personnel. No set of
rules can be formulated that would be sufficiently complete to dictate the correct
response to every circumstance. By keeping ultrasound exposure as low as possible, while obtaining diagnostic images, users can minimize ultrasonic bioeffects.
Since the threshold for diagnostic ultrasound bioeffects is undetermined, it is the
sonographers responsibility to control total energy transmitted into the patient.
The sonographer must reconcile exposure time with diagnostic image quality. To
ensure diagnostic image quality and limit exposure time, an ultrasound system
provides controls that can be manipulated during the exam to optimize the
results of the exam.
The ability of the user to abide by the ALARA principle is important. Advances in
diagnostic ultrasound not only in the technology but in the applications of that
technology, have resulted in the need for more and better information to guide
the user. The output display indices are designed to provide that important information.
There are a number of variables which affect the way in which the output display
indices can be used to implement the ALARA principle. These variables include
indice values, body size, location of the bone relative to the focal point, attenuation in the body, and ultrasound exposure time. Exposure time is an especially
useful variable, because it is controlled by the user. The ability to limit the index
values over time supports the ALARA principle.

Applying ALARA
The system imaging mode used depends upon the information needed. 2D and
M-Mode imaging provide anatomical information, while Doppler, Color Power
Angio (CPA), and Color imaging provide information about blood flow. A scanned
mode, like 2D, CPA, or Color, disperses or scatters the ultrasonic energy over an
area, while an unscanned mode, like M-mode or Doppler, concentrates ultrasonic
energy. Understanding the nature of the imaging mode being used allows the
sonographer to apply the ALARA principle with informed judgement. Additionally,
the transducer frequency, system setup values, scanning techniques, and operator
experience allow the sonographer to meet the definition of the ALARA principle.
HD3 Getting Started
4535 612 13861

41

Safety

The decision as to the amount of acoustic output is, in the final analysis, up to the
system operator. This decision must be based on the following factors: type of
patient, type of exam, patient history, ease or difficulty of obtaining diagnostically
useful information, and the potential localized heating of the patient due to transducer surface temperatures. Prudent use of the system occurs when patient
exposure is limited to the lowest index reading for the shortest amount of time
necessary to achieve acceptable diagnostic results.
Although a high index reading does not mean that a bioeffect is actually occurring,
a high index reading should be taken seriously. Every effort should be made to
reduce the possible effects of a high index reading. Limiting exposure time is an
effective way to accomplish this goal.
There are several system controls that the operator can use to adjust the image
quality and limit the acoustic intensity. These controls are related to the techniques that an operator might use to implement ALARA. These controls can be
divided into three categories: direct, indirect, and receiver controls.

Direct Controls
Application selection and the Power control directly affect acoustic intensity.
There are different ranges of allowable intensity or output based on your selection. Selecting the correct range of acoustic intensity for the application is one of
the first things that occurs in any exam. For example, peripheral vascular intensity
levels are not recommended for fetal exams. Some systems automatically select
the proper range for a particular application, while others require manual selection. Ultimately, the user has the responsibility for proper clinical use. This ultrasound system provides both automatic or default and manual or user-selectable
settings.
Power has direct impact on acoustic intensity. Once the application has been
established, the Power control can be used to increase or decrease the intensity
output. The Power control allows you to select intensity levels less than the
established maximum. Prudent use dictates that you select the lowest output
intensity that is consistent with good image quality.

42

HD3 Getting Started


4535 612 13861

Safety

Indirect Controls
The indirect controls are those that have an indirect effect on acoustic intensity.
These controls affect imaging mode, pulse repetition frequency, focus depth, pulse
length, and transducer selection.
The choice of imaging mode determines the nature of the ultrasound beam. 2D is
a scanning mode, Doppler is a stationary or unscanned mode. A stationary ultrasound beam concentrates energy in a single location. A moving or scanned ultrasound beam disperses the energy over an area and the beam is concentrated on
the same area for a fraction of the time as that of an unscanned mode.
Pulse repetition frequency or rate refers to the number of ultrasound bursts of
energy over a specific period of time. The higher the pulse repetition frequency,
the more pulses of energy in a period of time. Several controls affect pulse repetition frequency: focal depth, display depth, sample volume depth, color sensitivity,
number of focal zones, and sector width controls.
Focus of the ultrasound beam affects the image resolution. To maintain or
increase resolution at a different focus requires a variation in output over the
focal zone. This variation of output is a function of system optimization. Different
exams require different focal depths. Setting the focus at the proper depth
improves the resolution of the structure of interest.
Pulse length is the time during which the ultrasonic burst is turned on. The longer
the pulse, the greater the time-average intensity value. The greater the time-average intensity, the greater the likelihood of temperature increase and cavitation.
Pulse length or burst length or pulse duration is the output pulse duration in
pulsed Doppler. Increasing the Doppler sample volume increases the pulse length.
Transducer selection indirectly affects intensity. Tissue attenuation changes with
frequency. The higher the transducer operating frequency, the greater the attenuation of the ultrasonic energy. A higher transducer operating frequency requires
more output intensity to scan at a deeper depth. To scan deeper at the same output intensity, a lower transducer frequency is required. Using more gain and output beyond a point, without corresponding increases in image quality, can mean
that a lower frequency transducer is needed.

HD3 Getting Started


4535 612 13861

43

Safety

Receiver Controls
Receiver controls are used by the operator to improve image quality. These controls have no effect on output. Receiver controls only affect how the ultrasound
echo is received. These controls include gain, TGC, dynamic range, and image
processing. The important thing to remember, relative to output, is that receiver
controls should be optimized before output is increased. For example: before
increasing output, optimize gain to improve image quality.

An Example of Applying ALARA


An ultrasound scan of a patients liver begins with selecting the appropriate transducer frequency. After selecting the transducer and the application, which are
based on patient anatomy, adjustments to output power should be made to
ensure that the lowest possible setting is used to acquire an image. After the
image is acquired, adjusting the focus of the transducer, and then increasing the
receiver gain to produce a uniform representation of the tissue follows. If an adequate image can be obtained with the increase in gain, then a decrease in output
should be made. Only after making these adjustments should you increase output
to the next level.
Having acquired the 2D display of the liver, Color can be used to localize blood
flow. As with the 2D image display, gain and image processing controls must be
optimized before increasing output.
Having localized the blood flow, use the Doppler controls to position the sample
volume over the vessel. Before increasing output, adjust velocity range or scale
and Doppler gain to obtain an optimal Doppler trace. Only if maximum Doppler
gain does not create an acceptable image do you increase output.
In summary: select the correct transducer frequency and application for the job;
start with a low output level; optimize the image using focus, receiver gain, and
other imaging controls; if the image is not diagnostically useful at this point, then
increase output.

Additional Considerations
Ensure that scanning time is kept to a minimum, and ensure that only medically
required scanning is performed. Never compromise quality by rushing through an
exam. A poor exam may require a follow-up, which ultimately increases exposure
44

HD3 Getting Started


4535 612 13861

Safety

time. Diagnostic ultrasound is an important tool in medicine, and, like any tool, it
should be used efficiently and effectively.

Output Display
The system output display comprises two basic indices: a mechanical index and a
thermal index. The thermal index further consists of the following indices: soft
tissue (TIs), and bone (TIb). One of these two thermal indices will be displayed at
all times. Which one depends upon the system preset or user choice, depending
upon the application at hand.
The mechanical index is continuously displayed over the range of 0.0 to 1.9, in
increments of 0.1.
The thermal index consists of the two indices, and only one of these is displayed
at any one time. Each transducer application has a default selection that is appropriate for that combination. The TIb or TIs is continuously displayed over the
range of 0.0 to maximum output, based on the transducer and application, in
increments of 0.1.
The application-specific nature of the default setting is also an important factor of
index behavior. A default setting is a system control state which is preset by the
manufacturer or the operator. The system has default index settings for the transducer application. The default settings are invoked automatically by the ultrasound
system when power is turned on, new patient data is entered into the system
data base, or a change in application takes place. Figure 2-1 illustrates the implementation of the output display.

HD3 Getting Started


4535 612 13861

45

Safety

Figure 2-1 On-Screen TI and MI


TI and MI values

The decision to display one or the other of the three thermal indices should be
based on the following criteria:

Appropriate index for the application: TIs is used for imaging soft tissue; and
TIb for a focus at or near bone.

Mitigating factors that might create artificially high or low thermal index readings: location of fluid or bone, or blood flow. For example, is there a highly
attenuating tissue path so that the actual potential for local zone heating is less
than the thermal index displays.

Scanned modes versus unscanned modes of operation affect the thermal


index. For scanned modes, heating tends to be near the surface; for
unscanned modes, the potential for heating tends to be deeper in the focal
zone.

Always limit ultrasound exposure time. Do not rush the exam. Ensure that
the indices are kept to a minimum and that exposure time is limited without
compromising diagnostic sensitivity.

Mechanical Index (MI) Display


Mechanical bioeffects are threshold phenomena that occur when a certain level of
output is exceeded. The threshold level varies, however, with the type of tissue.
The potential for mechanical bioeffects varies with peak pressure and ultrasound
46

HD3 Getting Started


4535 612 13861

Safety

frequency. The MI accounts for these two factors. The higher the MI value, the
greater the likelihood of mechanical bioeffects occurring. There is no specific MI
value that means that a mechanical effect is actually occurring. The MI should be
used as a guide for implementing the ALARA principle.

Thermal Index (TI) Displays


The TI informs the user about the conditions that exist that might lead to an
increase in temperature at the surface of the body, within the body tissue, or at
the point of focus of the ultrasound beam on bone. That is, the TI informs the
user of the potential for temperature rise in body tissue. It is an estimate of temperature increase in body tissue with specific properties. The actual amount of
any temperature rise is influenced by factors such as tissue type, vascularity, mode
of operation and others. The TI should be used as a guide for implementing the
ALARA principle.
The bone thermal index (TIb) informs the user about potential heating at or near
the focus after the ultrasound beam has passed through soft tissue or fluid, for
example, at or near second or third trimester fetal bone.
The soft tissue thermal index (TIs) informs the user about the potential for heating within soft homogeneous tissue.
You can select either TIs or TIb using the TIs/TIb selection on the Display setups.

Mechanical and Thermal Indices Display Precision and Accuracy


The MI and TI precision is 0.1 unit on the system.
The MI and TI display accuracy estimates for the system are given in Acoustic Output Tables on the system user-information compact disc. These accuracy estimates
are based on the variability range of transducers and systems, inherent acoustic
output modeling errors and measurement variability, as discussed below.
The displayed values should be interpreted as relative information to help the system operator achieve the ALARA principle through prudent use of the system.
The values should not be interpreted as actual physical values in interrogated tissue or organs. The initial data that is used to support the output display is derived
from laboratory measurements based on the AIUM measurement standard. The
measurements are then put into algorithms for calculating the displayed output
values.
HD3 Getting Started
4535 612 13861

47

Safety

Many of the assumptions used in the process of measurement and calculation are
conservative in nature. Over-estimation of actual in situ intensity exposure, for
the vast majority of tissue paths, is built into the measurement and calculation
process. For example:

The measured water tank values are derated using a conservative, industry
standard, attenuation coefficient of 0.3 dB/cm-MHz.

Conservative values for tissue characteristics were selected for use in the TI
models. Conservative values for tissue or bone absorption rates, blood perfusion rates, blood heat capacity, and tissue thermal conductivity were selected.

Steady State temperature rise is assumed in the industry standard TI models,


and the assumption is made that the ultrasound transducer is held steady in
one position long enough for steady state to be reached.

A number of factors are considered when estimating the accuracy of the displayed
values: hardware variations, estimation algorithm accuracy, and measurement
variability. Variability among transducers and systems is a significant factor. Transducer variability results from piezoelectric crystal efficiencies, process-related
impedance differences, and sensitive lens focusing parameter variations. Differences in system pulser voltage control and efficiencies is also a contributor to
variability. There are inherent uncertainties in the algorithms used to estimate
acoustic output values over the range of possible system operating conditions and
pulser voltages. Inaccuracies in laboratory measurements are related to, among
others, differences in hydrophone calibration and performance, positioning, alignment, and digitization tolerances, and variability among test operators.
The conservative assumptions of the output estimation algorithms of linear propagation, at all depths, through a 0.3 dB/cm-MHz attenuative medium is not considered in the accuracy estimate for the display. Neither linear propagation, nor
uniform attenuation at the 0.3 dB/cm-MHz rate, occur in water tank measurements or in most tissue paths in the body. In the body, different tissues and organs
have dissimilar attenuation characteristics. In water, there is almost no attenuation. In the body, and in particular, in water tank measurements, non-linear propagation and saturation losses occur as pulser voltages increase.
Therefore, the display accuracy estimates are based on the variability range of
transducers and systems, inherent acoustic output modeling errors, and measurement variability. Display accuracy estimates are not based on errors in, or caused
48

HD3 Getting Started


4535 612 13861

Safety

by measuring according to, the AIUM measurement standards, or the effects of


non-linear loss on the measured values.

Control Effects
Controls Affecting the Indices
As various system controls are adjusted, the TI and MI values may change. This
will be most apparent as the Power control is adjusted; however, other system
controls will affect the on-screen output values.

Power
Power controls the system acoustic output. Two real-time output values are on
the screen: a TI and MI. They change as the system responds to Power adjustments.
In combined modes, such as simultaneous Color, 2D and pulsed-wave Doppler,
the individual modes each add to the total TI. One mode will be the dominant
contributor to this total. The displayed MI will be from the mode with the largest
MI.

2D Controls
Image Width
Narrowing the image width may increase frame rate. This action will increase the
TI. Pulser voltage may be automatically decreased using the software controls to
keep the TI below the system maximums. A decrease in pulser voltage will
decrease MI.
Zoom
Using the Zoom control to increase the zoom magnification may increase frame
rate. This action will increase the TI. The number of focal zones may also increase
automatically to improve resolution. This action may change MI since the peak
intensity can occur at a different depth.

HD3 Getting Started


4535 612 13861

49

Safety

Focal Zones
More focal zones may change both the TI and MI by changing frame rate or focal
depth automatically. Lower frame rates decrease the TI. MI displayed will correspond to the zone with the largest MI value.
Focus
Changing the focal depth will change MI. Generally, higher MI values will occur
when the focal depth is near the natural focus of the transducer.

Color and Power Controls


Sensitivity
Increasing the color sensitivity may increase the TI. More time is spent scanning
the color image. Color pulses are the dominant pulse type in this mode.
Color Box Size
Narrower color box size will increase color frame rate and the TI will increase.
The system may automatically decrease pulser voltage to stay below the system
maximum. A decrease in pulser voltage will decrease the MI. If pulsed Doppler is
also enabled then pulsed Doppler will remain the dominant mode and the TI
change will be small.
Scale
Using the Scale control to increase the color velocity range may increase the TI.
The system may automatically adjust pulser voltage to stay below the system maximums. A decrease in pulser voltage will also decrease MI.
Color Size and Position
A narrower 2D width in Color imaging will increase color frame rate. The TI will
increase. MI will not change. If pulsed Doppler is also enabled, then pulsed Doppler will remain the dominant mode and the TI change will be small.

50

HD3 Getting Started


4535 612 13861

Safety

M-Mode and Doppler Controls


Sweep
M-mode and Doppler sweep speed adjustments will not affect the MI. When
M-mode sweep speed changes, TI changes.
Simultaneous and Update Methods
Use of combination modes affects both the TI and MI through the combination of
pulse types. During simultaneous mode, the TI is additive. During auto-update
and duplex, the TI will display the dominant pulse type. The displayed MI will be
from the mode with the largest MI value.
Sample Volume Size and Position
When Doppler sample volume depth is increased the Doppler PRF may automatically decrease. A decrease in PRF will decrease the TI. The system may also automatically decrease the pulser voltage to remain below the system maximum. A
decrease in pulser voltage will decrease MI.

Other
2D, Color, Mmode, CPA, and PW
When a new imaging mode is selected (except 3D imaging, which is based on
images in system memory), both the TI and MI may change to default settings.
Each mode has a corresponding pulse repetition frequency and maximum intensity point. In combined or simultaneous modes, the TI is the sum of the contribution from the modes enabled and MI is the MI for the focal zone and mode with
the largest derated intensity. The system will return to the previously selected
state if a mode is turned off and then reselected.
Transducer
Each transducer type has unique specifications for contact area, beam shape, and
center frequency. Defaults are initialized when you select a transducer. Factory
defaults vary with transducer, application, and selected mode. Defaults have been
chosen below the FDA limits for intended use.

HD3 Getting Started


4535 612 13861

51

Safety

Depth
An increase in 2D depth will automatically decrease the 2D frame rate. This
would decrease the TI. The system may also automatically choose a deeper 2D
focal depth. A change of focal depth may change the MI. The MI displayed is that
of the zone with the largest MI value.
Application
Acoustic output defaults are set when you select an application. Factory defaults
vary with transducer, application, and mode. Defaults have been chosen below the
FDA limits for intended use.

Related Guidance Documents


For more information about ultrasonic bioeffects and related topics refer to the
following:
1. AIUM Report, January 28, 1993, Bioeffects and Safety of Diagnostic Ultrasound
2. Bioeffects Considerations for the Safety of Diagnostic Ultrasound, J Ultrasound
Med., Sept. 1988: Vol. 7, No. 9 Supplement
3. Acoustic Output Measurement Standard for Diagnostic Ultrasound Equipment. (AIUM, NEMA. 2004)
4. Acoustic Output Labeling Standard for Diagnostic Ultrasound Equipment
(AIUM, 2004)
5. Second Edition of the AIUM Output Display Standard Brochure, Dated March
10, 1994. (A copy of this document is shipped with each system.)
6. Information for Manufacturers Seeking Marketing Clearance of Diagnostic
Ultrasound Systems and Transducers. FDA. September 1997. FDA.
7. Standard for Real-Time Display of Thermal and Mechanical Acoustic Output
Indices on Diagnostic Ultrasound Equipment. (AIUM, NEMA. 2004)
8. WFUMB. Symposium on Safety of Ultrasound in Medicine: Conclusions and
Recommendations on Thermal and Non-Thermal Mechanisms for Biological
Effects of Ultrasound, Ultrasound in Medicine and Biology, 1998: Vol. 24, Supplement 1.

52

HD3 Getting Started


4535 612 13861

Safety

Acoustic Output and Measurement


Since the initial use of diagnostic ultrasound, the possible human biological effects
(bioeffects) from ultrasound exposure have been studied by various scientific and
medical institutions. In October 1987, the American Institute of Ultrasound in
Medicine (AIUM) ratified a report prepared by its Bioeffects Committee (Bioeffects Considerations for the Safety of Diagnostic Ultrasound, J Ultrasound Med.,
Sept. 1988: Vol. 7, No. 9 Supplement), sometimes referred to as the Stowe
Report, which reviewed available data on possible effects of ultrasound exposure.
Another report Bioeffects and Safety of Diagnostic Ultrasound, dated January
28, 1993, provides more current information.
The acoustic output for this system has been measured and calculated in accordance with the Acoustic Output Measurement Standard for Diagnostic Ultrasound Equipment (AIUM, NEMA 2004), the Standard for Real-Time Display of
Thermal and Mechanical Acoustic Output Indices on Diagnostic Ultrasound
Equipment (AIUM, NEMA 2004), and the September, 1997 FDA document
Information for Manufacturers Seeking Marketing Clearance of Diagnostic Ultrasound Systems and Transducers.

In Situ, Derated, and Water Value Intensities


All intensity parameters are measured in water. Since water does not absorb
acoustic energy, these water measurements represent a worst case value. Biological tissue does absorb acoustic energy. The true value of the intensity at any
point depends on the amount and type of tissue and the frequency of the ultrasound that passes through the tissue. The intensity value in the tissue, In Situ, has
been estimated by using the following formula:

HD3 Getting Started


4535 612 13861

53

Safety

In Situ = Water [e-0.23alf]


where:

In Situ
Water
e
a
Tissue
Brain
Heart
Kidney
Liver
Muscle
l
f

=
=
=
=
=
=
=
=
=
=
=
=

In Situ Intensity Value


Water Value Intensity
2.7183
Attenuation Factor
a(dB/cm-MHz)
0.53
0.66
0.79
0.43
0.55
Skin line to measurement depth (cm)
Center frequency of the transducer/system/mode
combination (MHz)

Since the ultrasonic path during an examination is likely to pass through varying
lengths and types of tissue, it is difficult to estimate the true In Situ intensity. An
attenuation factor of 0.3 is used for general reporting purposes; therefore, the In
Situ value which is commonly reported uses the formula:
In Situ derated = Water [e-0.069lf]
Since this value is not the true In Situ intensity, the term derated is used.
Mathematical derating of water based measurements using the 0.3 dB/cm-MHz
coefficient, may yield lower acoustic exposure values than would be measured in a
homogenous 0.3 dB/cm-MHz tissue. This is true because non-linearly propagating
acoustic energy waveforms experience more distortion, saturation, and absorption in water than in tissue, where attenuation present all along the tissue path
will dampen the buildup of non-linear effects.
The maximum derated and the maximum water values do not always occur at the
same operating conditions; therefore, the reported maximum water and derated
values may not be related by the In Situ (derated) formula. For example: a
multi-zone array transducer that has maximum water value intensities in its deepest zone also has the smallest derating factor in that zone. The same transducer
may have its largest derated intensity in one of its shallowest focal zones.

54

HD3 Getting Started


4535 612 13861

Safety

Conclusions Regarding Tissue Models and Equipment Survey


Tissue models are necessary to estimate attenuation and acoustic exposure levels
In Situ from measurements of acoustic output made in water. Presently, available
models may be limited in their accuracy because of varying tissue paths during
diagnostic ultrasound exposures and uncertainties in acoustical properties of soft
tissues. No single tissue model is adequate for predicting exposures in all situations from measurements made in water, and continued improvement and verification of these models is necessary for making exposure assessments for specific
applications.
A homogeneous tissue model with an attenuation coefficient of 0.3 dB/cm-MHz
throughout the beam path is commonly used when estimating exposure levels.
The model is conservative in that it overestimates the In Situ acoustic exposure
when the path between the transducer and the site of interest is composed
entirely of soft tissue, because the attenuation coefficient of soft tissue is generally
higher than 0.3 dB/cm-MHz. When the path contains significant amounts of fluid,
as in many first and second-trimester pregnancies scanned transabdominally, this
model may underestimate the In Situ acoustical exposure. The amount of underestimation depends on each specific situation.
Fixed-path tissue models, in which soft tissue thickness is held constant, sometimes are used to estimate In Situ acoustical exposures when the beam path is
longer than 3 cm and consists largely of fluid. When this model is used to estimate maximum exposure to the fetus during transabdominal scans, a value of 1
dB/MHz may be used during all trimesters.
The maximum acoustic output levels of diagnostic ultrasound devices extend over
a broad range of values:

A survey of 1990-equipment models yielded mechanical index (MI) values


between 0.1 and 1 at their highest output settings. Maximum MI values of
approximately 2 are known to occur for currently available equipment. Maximum MI values are similar for real-time 2D, M-mode, pulsed Doppler, and
Color flow imaging.

Computed estimates of upper limits to temperature elevations during transabdominal scans were obtained in a survey of 1988 and 1990 pulsed Doppler
equipment. The vast majority of models yielded upper limits less than 1
degree C and 4 degrees C for exposures of first-trimester fetal tissue and secHD3 Getting Started
4535 612 13861

55

Safety

ond-trimester fetal bone, respectively. The largest values obtained were


approximately 1.5 degrees C for first-trimester fetal tissue and 7 degrees C
for second-trimester fetal bone. Estimated maximum temperature elevations
given here are for a fixed-path tissue model and are for devices having ISPTA
values greater than 500 mW/cm2. The temperature elevations for fetal bone
and tissue were computed based on calculation procedures given in Sections
4.3.2.1-4.3.2.6 in Bioeffects and Safety of Diagnostic Ultrasound (AIUM, 1993).
Information regarding the concept of ALARA (As Low As Reasonably Achievable)
and possible ultrasound bioeffects is described in the brochure, Medical Ultrasound
Safety, developed by the American Institute of Ultrasound in Medicine (AIUM).

Acoustic Output Tables


Acoustic output tables are in Acoustic Output Tables on your system user-information compact disc.

Acoustic Measurement Precision and Uncertainty


All table entries have been obtained at the same operating conditions that give
rise to the maximum index value in the first column of the tables. Measurement
precision and uncertainty for power, pressure, intensity, and center frequency are
shown inTable 2-4 and Table 2-5.

56

HD3 Getting Started


4535 612 13861

Safety

Table 2-4 Acoustic Measurement Precision


NOTE

Per Section 6.4 of the Output Display Standard, measurement precision on the
following quantities is determined by making repeated measurements and stating
the standard deviation as a percentage.

Quantity

Precision
(Percentage Standard Deviation)

Pr is the un-derated peak rarefactional Pr.: 5.4%


pressure measured in MegaPascals.
Wo is the ultrasonic power in
milliWatts.

6.2%

fc is the center frequency in MHz


(NEMA UD-2 definition).

<1%

PII.3 is the derated spatial-peak pulse


intensity integral in Joules/cm2.

PII.3: 3.2%

Table 2-5 Acoustic Measurement Uncertainty

Quantity

Measurement Uncertainty
(percentage, 95% confidence
value)

Pr is the un-derated peak rarefactional Pr: 11.3%


pressure measured in MegaPascals.
Wo is the ultrasonic power in
milliWatts.

10%

fc is the center frequency in MHz


(NEMA UD-2 definition).

4.7%

PII.3 is the derated spatial-peak pulse


intensity integral in Joules/cm2.

PII.3:

+18% to -23%

HD3 Getting Started


4535 612 13861

57

Safety

Electromagnetic Compatibility
Electromagnetic compatibility (EMC) is defined as the ability of a product, a device,
or a system to function satisfactorily in the presence of the electromagnetic phenomena that exists in the location of the product, the device, or the system being
used; and, in addition, to not introduce intolerable electromagnetic disturbances
to anything in that same environment.
Electromagnetic immunity is the ability of a product, a device, or a system to function satisfactorily in the presence of electromagnetic interference (EMI).
Electromagnetic emissions is the ability of a product, a device, or a system to introduce intolerable electromagnetic disturbances into the use environment.
The HD3 Ultrasound System has been manufactured in compliance with existing
electromagnetic compatibility requirements. Use of this system in the presence of
an electromagnetic field can cause momentary degradation of the ultrasound
image. If this occurs often, review the environment in which the system is being
used to identify possible sources of radiated emissions. These emissions could be
from other electrical devices used within the same room or an adjacent room, or
from portable and mobile RF communications equipment such as cellular phones
and pagers, or from the existence of radio, television, or microwave transmission
equipment located nearby. In cases where electromagnetic interference (EMI) is
causing disturbances, it may be necessary to relocate your system.
The system complies with International Standard CISPR 11 for radiated and conducted electromagnetic disturbances. Compliance with this standard allows the
system to be used in all establishments other than domestic and those directly
connected to the public low-voltage power supply network that supplies buildings
used for domestic purposes.
CAUTION

Medical equipment has special precautions regarding EMC and needs to be


installed and put into service according to the EMC information provided in the
systems accompanying documents.
"EMC Testing" on page 59 includes information on electromagnetic emissions and
immunity as it applies to the system. Ensure that the operating environment of
your system meets the conditions specified in the referenced information. Oper-

58

HD3 Getting Started


4535 612 13861

Safety

ating the system in an environment that does not meet these conditions may
degrade system performance.
The information and warnings contained in this and other sections should be
observed when installing and using the HD3 Ultrasound System to ensure its
EMC.
The HD3 Ultrasound System will remain safe and will provide the following essential performance if it is operated within the electromagnetic environment listed in
Table 2-9:

Imaging (See "Electromagnetic Immunity" on page 63 for conducted immunity


limitations and rationale.)

Doppler audio and spectral display

Measurements

Acoustic output

VCR recording

Printing using the system printers

Patient information

Date/time information

WARNING

Using cables, transducers, or accessories with the system other than those specified for use with the system may result in increased emissions or decreased
immunity of the system.

EMC Testing
The testing for EMC of this system has been performed according to the international standard for EMC with medical devices (IEC 60601-1-2). This IEC standard
was adopted in Europe as the European norm (EN 60601-1-2).

Electromagnetic Emissions
The HD3 Ultrasound System is intended for use in the electromagnetic environment specified in Table 2-6. The customer or the user of the HD3 Ultrasound
System should assure that it is used in such an environment.
HD3 Getting Started
4535 612 13861

59

Safety

Table 2-6 Electromagnetic Emissions


Emissions Test

Compliance

Electromagnetic Environment
Guidance

RF emissions CISPR 11

Group 1

The HD3 Ultrasound System uses RF


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

RF emissions CISPR 11

Class A

Harmonic emissions
IEC 61000-3-2

Class A

Voltage fluctuations/
flicker emissions
IEC 61000-3-3

Complies

The HD3 Ultrasound System is suitable


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

Approved Cables, Transducers, and Accessories for EMC


The following sections provide lists of cables and accessories approved for electromagnetic compliance for use with the HD3 Ultrasound System:

"Approved Cables for Electromagnetic Compliance" on page 60

"Approved Transducers for Electromagnetic Compliance" on page 61

"Approved Accessories for Electromagnetic Compliance" on page 61

For a list of transducers approved for electromagnetic compliance for use with
the HD3 Ultrasound System, see "Transducers" on page 72.

Approved Cables for Electromagnetic Compliance


WARNING

The use of cables, transducers, and accessories other than those specified may
result in increased emissions of the HD3 Ultrasound System.
Cables connected to the HD3 Ultrasound System may affect its emissions. Use
only the cable types and lengths listed in Table 2-7.

60

HD3 Getting Started


4535 612 13861

Safety

Table 2-7 Approved Cables for Electromagnetic Compliance


Cable

Type

Length

BNC

Coaxial, shielded

1.8 m (5.9 ft)

LAN

Unshielded

3 m (9.8 ft)

Line Out

Unshielded

1.8 m (5.9 ft)

Microphone

Unshielded

1.5 m (4.9 ft)

RCA

Coaxial, Unshielded

1.8 m (5.9 ft)

USB (2)

Shielded

1 m (3.28 ft)

Video (15 pin)

Shielded

1.5 m (4.9 ft)

Approved Transducers for Electromagnetic Compliance


The imaging transducers used with the HD3 Ultrasound System may affect its
emissions. The transducers listed in Table 3-1, when used with the HD3 Ultrasound System, have been tested to comply with the Group 1, Class A emissions
as required by International Standard CISPR 11.

Approved Accessories for Electromagnetic Compliance


Accessories used with the HD3 Ultrasound System may affect its emissions. The
accessories listed in Table 2-8, when used with the HD3 Ultrasound System, have
been tested to comply with the Group 1, Class A emissions as required by International Standard CISPR 11.
When connecting other customer-supplied accessories to the system, such as a
remote video monitor or a computer, it is the users responsibility to ensure the
electromagnetic compatibility of the system. Use only CISPR 11 or CISPR 22
Class A or B compliant devices.

HD3 Getting Started


4535 612 13861

61

Safety

Table 2-8 Approved Accessories for Electromagnetic Compliance


Accessory

Manufacturer

Model Number

Ultrasonic Imaging
Transducer

Philips

Use only Philips


transducers.

VCR

Mitsubishi

HS-MD3000UA (NTSC)
HS-MD3000EA (PAL)

Black-and-White Printer

Sony

UP-895MD

Color Printer

Sony

UP-21MD

Report Printers

Hewlett-Packard

HP DeskJet 880C
HP DeskJet 895cxi
HP DeskJet 6122
HP LaserJet 1200
HP DeskJet 5550
HP Deskjet 5650
Business Inkjet 1200d
HP Laserjet 1320
For instructions on viewing
the current list of printers
available for use with the
system, see "Connecting a
Report Printer" on page 83.

62

HD3 Getting Started


4535 612 13861

Safety

Electromagnetic Immunity
The HD3 Ultrasound System is intended for use in the electromagnetic environment specified in Table 2-9. The customer or the user of the HD3 Ultrasound
System should ensure that it is used in such an environment.
NOTES

The guidelines specified in Table 2-9 may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures,
objects, and people.
UT is the AC mains voltage before application of the test level.
At 80 and 800 MHz, the separation distance for the higher frequency range
applies.
Table 2-9 Electromagnetic Immunity

Immunity Test
Electrostatic
discharge (ESD)

IEC 60601 Test


Level
6 kV contact
8 kV air

IEC 61000-4-2

Electrical fast
transient/burst
IEC 61000-4-4

2 kV for power
supply lines

Surge
IEC 610004-5

1 kV differential
mode

1 kV for input/
output lines

2 kV common
mode

Compliance
Level

Electromagnetic
Environment Guidance

Same as
IEC 60601 test
level

Floors should be wood,


concrete, or ceramic tile. If
floors are covered with
synthetic material, the
relative humidity should be
at least 30%.

Same as
IEC 60601 test
level

Mains power quality should


be that of a typical
commercial or hospital
environment.

Same as
IEC 60601 test
level

Mains power quality should


be that of a typical
commercial or hospital
environment.

HD3 Getting Started


4535 612 13861

63

Safety

Table 2-9 Electromagnetic Immunity (Continued)


IEC 60601 Test
Level

Immunity Test
Voltage dips,
short
interruptions,
and voltage
variations on
power supply
input lines
IEC 61000-4-11

Compliance
Level

< 5% UT

< 5% UT

< 5% UT

< 5% UT

Electromagnetic
Environment Guidance

Mains power quality should


be that of a typical
> 95% dip in UT for > 95% dip in UT commercial or hospital
0.5 cycle
for 0.5 cycle
environment. If you require
continued operation during
40% UT
40% UT
power mains interruptions,
60% dip in UT for
60% dip in UT for Philips recommends that
5 cycles
4 cycles
the system be powered
from an uninterruptible
70% UT
70% UT
power supply or a battery.
30% dip in UT for
30% dip in UT for
25 cycles
25 cycles

> 95% dip in UT for > 95% dip in UT


5 seconds
for 5 seconds
Power frequency 3 A/m
(50/60 Hz)
magnetic field

Same as IEC
60601 test level

Power frequency magnetic


fields should be at levels
characteristic of a typical
location in a typical
commercial or hospital
environment.

0.01 V

For recommended
separation distances, see
"Recommended Separation
Distance" on page 67.

IEC 61000-4-8

Conducted RF

3 Vrms

IEC 61000-4-6

150 kHz to 80 MHz

Radiated RF

3 V/m

IEC 61000-4-3

Same as IEC
80 MHz to 2.5 GHz 60601 test level

Cables, transducers, and accessories connected to the system may affect its
immunity to the electromagnetic phenomena listed in Table 2-9. Use only cables,
transducers, and accessories listed in "Approved Cables, Transducers, and Accessories for EMC" on page 60 to minimize the change of performance degradation
of the HD3 Ultrasound System due to these types of electromagnetic phenomena.
64

HD3 Getting Started


4535 612 13861

Safety

CAUTION

If the system is connected to other customer-supplied equipment, such as a local


area network (LAN) or a remote printer, Philips cannot guarantee that the
remote equipment will work correctly in the presence of electromagnetic phenomena.
Although most remote devices will likely comply with their applicable standards
for immunity, those device requirements may not be as stringent as those
required for medical equipment. It is the responsibility of the installer and user of
this remote customer-supplied equipment to ensure that it functions properly in
the electromagnetic environment where the system is installed. For this reason,
Philips does not provide a list of compatible accessories. Philips suggests that the
installer or user of such a system consult with experts in the field of electromagnetic compatibility and safety for guidance to ensure the safe and effective use of
the created system.
Electromagnetic interference may appear in many ways on the HD3 Ultrasound
System and depends on the mode the equipment is operating in, the imaging control settings, the type of transducer being used, the type of electromagnetic phenomena, and the intensity level of the phenomena.
NOTE

Electromagnetic phenomena are not always present and may be transitory in


nature. It may be extremely difficult to identify the source of the interference.

CAUTION

When interference is present or intermittent, use caution when continuing to use


the HD3 Ultrasound System.
NOTE

Table 2-10 describes a few typical interferences seen in imaging systems. It is not
possible to describe all manifestations of interference because it depends on many
parameters of the transmitting device such as the type of modulation used by the
signal carrier, the source type, and the transmitted level. It is also possible for the
interference to degrade the imaging systems performance and not be visible in
the image. If the diagnostic results are suspicious, other means should be used to
confirm the diagnosis.

HD3 Getting Started


4535 612 13861

65

Safety

Table 2-10 Typical Interference on Ultrasonic Imaging Systems


Imaging
Mode
2D or 3D

ESD1

RF2

Power Line3

Change of operating
mode, system
settings, or system
reset.

For sector imaging


transducers, white radial
bands or flashes in the
centerlines of the image.

Brief flashes in the


displayed or
recorded image.

For linear imaging


transducers, white
vertical bands,
sometimes more
pronounced on the
sides of the image.

White dots, dashes,


diagonal lines, or
diagonal lines near
the center of the
image.

Color

Color flashes, radial or


vertical bands, increase
in background noise, or
changes in image color.

Color flashes, dots,


dashes, or changes in
the color noise level.

Doppler

Horizontal lines in the


spectral display, tones
and abnormal noise in
the audio, or both.

Vertical lines in the


spectral display,
popping noise in the
audio, or both.

M-mode

Increase in the image


background noise or
white M-mode lines.

White dots, dashes,


diagonal lines, or
increase in image
background noise.

1.
2.
3.

66

Electrostatic discharge (ESD) caused by discharging of electric charge build-up on insulated


surfaces or persons.
Radio frequency (RF) energy from RF transmitting equipment such as portable phones,
hand-held radios, wireless devices, commercial radio and TV stations, and so on.
Conducted interference on power lines or connected cables caused by other equipment such
as switching power supplies, electrical controls, and natural phenomena such as lightning.

HD3 Getting Started


4535 612 13861

Safety

Recommended Separation Distance


Table 2-11 provides guidance on the distances any radio frequency (RF) transmitting equipment should be kept away from the HD3 Ultrasound System to reduce
the risk of interference with the imaging system. Portable and mobile RF communications equipment should be used no closer to any part of the system, including
cables, than the recommended separation distance calculated from the equation
applicable to the frequency of the transmitter. Field strengths from fixed RF transmitters, as determined by an electromagnetic site survey1 should be less than the
compliance level in each frequency range as noted in Table 2-9. Interference may
occur in the vicinity of equipment marked with the following symbol:

NOTES

For transmitters rated at a maximum output power not listed in Table 2-11,
the recommended separation distance d in meters (m) can be estimated using
the equation applicable to the frequency of the transmitter, where P is the
maximum output power rating of the transmitter in watts (W) according to
the transmitter manufacturer.
At 80 MHz and 800 MHz, the higher frequency range applies.
The recommended separation distance guidelines in Table 2-11 may not apply
to all situations. Electromagnetic propagation is affected by absorption and
reflection from structures, objects, and people.

Table 2-11, in conjunction with Table 2-9, provides guidance on conducted and
radiated interference from portable and fixed RF transmitting equipment.
The conducted RF test level is 3 V and the HD3 Ultrasound System has a compliance level of 0.01 V.
1.

Field strengths from fixed transmitters such as base stations for radio (cellular/cordless) telephones and land mobile radios, amateur radio, AM and RM radio broadcast, and TV broadcast
cannot be predicted theoretically with accuracy. To assess the electromagnetic environment
due to RF transmitters, an electromagnetic site survey should be considered. If the measured
field strength in the location in which the system is used exceeds the applicable RF compliance level in Table 2-9, the system should be observed to verify normal operation. If abnormal
performance is observed, additional measures may be necessary, such as reorienting or relocating the system.
HD3 Getting Started
4535 612 13861

67

Safety

Table 2-11 lists the recommended separation distances for the HD3 Ultrasound
System.
Table 2-11 Recommend Separation Distances

Rated
Maximum
Output
Power of
Transmitter
(Watts)

Separation Distances According to Frequency of


Transmitter (Meters)
150 kHz to
80 MHz

80 to 800 MHz

800 MHz to
2.5 GHz

0, 01

35 m

0.12 m

0.24 m

0, 1

110 km

0.38 m

0.76 m

350 m

1.2 m

2.4 m

10

1.1 km

3.8 m

7.6 m

100

3.5 km

12 m

24 m

The conducted RF test level is 3 V, and the system has a compliance level of
0.01 V. For the system, this means that the imaging system is extremely sensitive
to RF interference in the transducer passband. For example, for a 5-MHz imaging
transducer, the frequency range of interference from a 3-V/m field may be from 2
to 10 MHz, and manifests as itself as described in Table 2-10.
The 0.01-V level is where the interference becomes acceptable to some clinical
specialists.
NOTE

Sensitivity to interference is dependent on operating mode and imaging control


settings. The system has been tested while set to its maximum gain setting, making it very susceptible to interference. You might not use your system at this setting, but it represents a worse-case condition.
The order of increasing sensitivity, using these settings, as a function of operating
mode is 2D mode, 3D mode, M-mode, Color mode, and PW Doppler mode. The
system is more sensitive to interference in the PW Doppler operating mode but
the probability of interference is lower than 2D mode or Color mode because

68

HD3 Getting Started


4535 612 13861

Safety

the susceptible frequency range is less. Therefore, you are more likely to see
interference in 2D or Color modes.
As an example, if a portable transmitter has maximum radiated power of 1 W and
an operating frequency of 156 MHz, it should only be operated at distances
greater than 1.2 m (3.9 ft) from the system. Likewise, a 0.01-W Bluetooth wireless LAN device operating at 2.4 GHz should be placed no closer than 0.24 m
(10 in) from any part of the system.

Avoiding Electromagnetic Interference


A medical device can either generate or receive electromagnetic interference.
The EMC standards describe tests for both emitted and received interference.
Emission tests deal with interference generated by the device being tested. Philips
ultrasound systems do not generate interference in excess of the referenced standards.
An ultrasound system is designed to receive signals at radio frequencies and is
therefore susceptible to interference generated by RF energy sources. Examples
of other sources of interference are medical devices, information technology
products, and radio and television transmission towers. Tracing the source of
radiated interference can be a difficult task. Customers should consider the following in an attempt to locate the source:

Is the interference intermittent or constant?

Does the interference show up only with one transducer or with several
transducers?

Do two different transducers operating at the same frequency have the same
problem?

Is the interference present if the system is moved to a different location in the


facility?

The answers to these questions will help determine if the problem resides with
the system or the scanning environment. After you answer the questions, contact
your Philips service representative.

HD3 Getting Started


4535 612 13861

69

Safety

Restrictions for Use


The physician needs to determine if an artifact caused by radiated interference
will have a negative impact on image quality and the subsequent diagnosis.

Immunity Level Test Results


The EMC standards state that manufacturers of patient-coupled equipment must
specify immunity levels for their systems. It is recognized that this type of device is
designed to receive and amplify low-level signals in the same bandwidth as the
interference.
Immunity is defined in the standard as the ability of a system to perform without
degradation in the presence of an electromagnetic disturbance. Degradation in
image quality is a qualitative assessment that can be subjective. The simplest way
to assess degradation is to note when the first sign of an artifact is seen in the
image. This method has two advantages. It removes the issue of subjective decision making and it provides the most stringent test results.
Be cautious when comparing immunity levels of different ultrasound systems. The
criteria used for degradation is not specified by the standard and may vary with
the manufacturer.
Testing has been performed on each class of Philips transducer for every operating mode over a wide range of frequencies.
Table 2-12 lists the results of immunity testing. Testing was performed on a typical
ultrasound system configuration.
Table 2-12 Immunity Testing Results
Radiated Immunity

EN 61000-4-3:2002 3 Vrms from 80-2500 MHz,


amplitude modulated 80% at 1 kHz

Fast Transient Immunity

EN 60601-4-4:1995 2 kV power line, 1 kV signal line

Surge Immunity

EN 61000-4-5:1995 0.5, 1, 2 kV common mode,


0.5, 1 kV differential mode

70

HD3 Getting Started


4535 612 13861

3 System Overview
Use this section to acquaint yourself with the system and its components.

System Capabilities
The system is intended for general imaging. The cart is ergonomically designed to
be both highly mobile and adjustable for a range of users and operating conditions. You can use the system for 2D, 3D, M-mode, Doppler, Color, and Color
Power Angio (CPA) imaging. The system provides measurement tools, calculations, options, and DICOM network capabilities.

Measurements
The system provides tools and controls for measuring distance, area, and volume.
Repeatedly pressing Caliper cycles through each of the available measurements,
as follows, depending on the selected imaging mode:

2D Distance (Line)

2D Distance (Trace)

2D Ellipse

2D Trace

2D Hip Joint

3D Volume: 3 Distance, 1 Distance, Distance and Ellipse

M Distance

Doppler Velocity

Doppler Velocity (A/B)

Doppler Trace

HD3 Getting Started


4535 612 13861

71

Transducers
Table 3-1 lists the supported transducers and their appications. You can have two
transducers connected to the system at one time.
You must be thoroughly familiar with the operation of the system to operate the
transducers described in this section.
For information and instructions on maintaining transducers, see "Transducer
Care and Maintenance" on page 117. For procedures on using transducer covers,
refer to the instructions provided with the covers.
Table 3-1 lists the transducers and associated applications that are supported by
the system.
Table 3-1 Transducers and Their Applications
Transducers
Applications
Abdominal

C4-2

C5-2

C7-3

C9-4ec

Small parts and superficial


Pediatric

X
X

Musculoskeletal

Obstetrical

Gynecological and fertility

Prostate

Vascular
Cardiac Adult

L9-5

X
X

To order biopsy kits, transducer covers, supplies, and accessories, see "Transducer Supplies and Accessories" on page 138.

HD3 Getting Started


4535 612 13861

72

Image Capture and Review


You can capture and if you have purchased the option, review images that can be
stored on compact discs (CD-RW), magneto optical (MO) disks, USB flash drive,
or sent over a network to an archive server or a printer.
Peripheral devices are available for recording and printing images and exams. You
can add a VCR to the system and connect a black-and-white page printer or a
color page printer. You can also connect a report printer.

Standard System Features


The following are standard features on the system:

Real time 2D grayscale imaging

M-mode

Pulsed-wave (PW) spectral Doppler

Combined modes

Cine for a maximum of 256 frames and Loop Review for up to 2048 lines

Real-time 2D filter (Edge Enhance)

Measurement and data reporting packages

Support for peripheral output devices

HD3 Getting Started


4535 612 13861

73

Optional System Features


In addition to the standard features available in the system, the following features
are available as purchasable options.

Imaging Capabilities

Color imaging

Color Flow Mapping

Color Power Angio (CPA) imaging

Harmonic imaging

Freehand 3D

Trapezoid imaging (available with linear transducers)

Review and Connectivity Options

Image review

DICOM networking

Peripheral Options

MO disk

Black-and-white printer

Color printer

Inkjet or laser printer

VCR

Foot switch (two pedals)

HD3 Getting Started


4535 612 13861

74

System Components
The system is housed in an ergonomic cart. The control panel and monitor unit is
adjustable to accommodate a wide range of operator heights. Adjustable components can be locked in place so the cart can be safely moved. The major components include the monitor, control panel, CD-RW drive, transducer receptacles,
cart shelf, rear-panel connections, and the power switch. (Figure 3-1).
Figure 3-1 System Components
Monitor
Control
panel
Cart shelf
CD-RW
drive
Rear-panel
connections

Transducer
receptacles

Power switch

Video Monitor
The articulated monitor is adjustable to accommodate different operating positions and operator heights. The monitor can also be folded down to the control
panel for moving the system. See "Adjusting the Monitor" on page 97 for details.

HD3 Getting Started


4535 612 13861

75

Control Panel
The control panel contains the main imaging controls (Figure 3-2). Those controls
include buttons, knobs, TGC slide controls, and a trackball. The control panel
also allows you to select transducers, enter patient data, review and annotate
images, perform measurements and calculations, and change setups.
You can adjust the height of the control panel by pulling the handle and pushing
the control panel down or pulling it up. The monitor and control panel move
together.
The "Glossary" lists and describes each component on the control panel.
Figure 3-2 Control Panel

HD3 Getting Started


4535 612 13861

76

Storage Devices
The CD-RW drive is on the front of the system (Figure 3-3). The connections for
the MO drive and USB flash memory (both optional) are on the rear panel
(Figure 3-5).
Figure 3-3 Printer, CD-RW Drive, and Transducer Receptacle Locations

Transducer
receptacles

Black-and-white
printer bay

CD-RW drive

Peripherals
The black-and-white printer is in the front of the system (Figure 3-3). The top of
the system cart has room for a color printer or a VCR.

Transducer Connections and Cable Management


Two transducer receptacles are on the front of the system (Figure 3-3). Transducer and gel holders are on each side of the control panel, and four cable management brackets are underneath the control panel (Figure 3-4).

HD3 Getting Started


4535 612 13861

77

Figure 3-4 Cable Management Brackets and Transducer/Gel Holders

Transducer and
gel holders

Cable
management
bracket

Foot Switch
The foot switch connection is on the rear panel (Figure 3-5). The foot switch is
not included with the system; it is an option.
Failure to follow these warnings can affect both patient and operator safety.
WARNINGS

Do not operate the system in the presence of flammable anesthetics. Doing


so could lead to an explosion.

Do not use the foot switch in the operating room. IEC 60601-1-1 specifies
that foot-operated control devices used in the operating room must be of
watertight construction. The foot switch supplied with the ultrasound system
meets only IPX1 drip-proof construction requirements.

HD3 Getting Started


4535 612 13861

78

On/Off Button
The On/Off button is on the upper left corner of the control panel.

Rear Panel
The rear panel of the system contains the receptacles for the peripheral devices,
network devices, USB flash and MO drives. (Figure 3-5)
Figure 3-5 Rear Panel

Right and left


audio

Microphone

Ethernet
connection
USB input/
output ports

Foot switch
connector

HD3 Getting Started


4535 612 13861

79

Power Switch
The power cord connections and power switch are on the lowest part on the
rear of the system (Figure 3-6).
Figure 3-6 Power Switch

Wheel Brakes
The front wheels can be locked. For more information, see "Using the Wheel
Brakes" on page 96.

HD3 Getting Started


4535 612 13861

80

4 Preparing the System


The information and procedures in this section will help you prepare the system
for use. Preparations include connecting devices and preparing the system for
moving or transporting.

Connecting Devices
In addition to the devices installed in the system cart, the system supports external devices. These devices include printers and a VCR. You can connect one
device (color printer, report printer, or VCR) to the one auxiliary power outlet
on the rear of the system (Figure 3-6).
CAUTIONS

Using accessories, transducers, peripherals, or cables not supplied with the


ultrasound system or recommended by Philips can affect the system in the
form of increased radio frequency emissions or decreased immunity to external electromagnetic interference.

When using additional peripheral equipment powered from an electrical


source other than the ultrasound system, the combination is considered to be
a medical system. It is your responsibility to comply with IEC 60601-1-1 and
test the system to those requirements. For more information on peripheral
devices, see the "Safety" section. If you have questions, contact your Philips
representative.

Do not use nonmedical peripherals within 1.8 m (6 ft) of a patient, unless the
nonmedical peripherals receive power from an isolated power outlet on the
Philips ultrasound system, or from an isolation transformer that meets medical safety standards.
NOTE

Only devices purchased from Philips are covered under a Philips service agreement or warranty, and Philips will service only those devices.

Getting Started
4535 612 13861

81

Preparing the System

Connecting a Printer
The Sony black-and-white printer (UP-895MD) is installed at the factory and connected directly to the Print button on the system control panel. When you press
Print, the image is printed to the black-and-white printer.
You can connect the following printers to your system:

Sony color printer (UP-21MD)

Report printer

Connecting the Color Printer


When you purchase the color printer, the following cables are connected to the
system at the factory, and routed to the top of the system cart.

S-Video cable

Power cord

If your system only includes the color printer (and not the black-and-white
printer), the print trigger cable is already connected to the print trigger connector (

) on the back of the system which is directly connected to the Print

button on the system control panel. When you press Print, the image is printed
to the color printer.
If your system also includes a black-and-white printer, the print trigger cable is not
connected and should not be used. Instead, an RM-91 remote print unit is
included in the accessory box. You must use the RM-91 remote print unit to print
images to the color printer. Otherwise, if you connect the print trigger cable to
the system and to the color printer and press Print, the image prints on both
printers.

82

Getting Started
4535 612 13861

Preparing the System

To connect the color printer


1. Turn off the system and unplug the power cord from the power source.
2. Connect the S-Video cable from the back of the system to the Input S
Video connector on the back of the printer.
3. Do one of the following, depending on your configuration:

If your configuration also includes a black-and-white printer, connect the


RM-91 remote control unit to the Remote 2 connector on the back of
the printer. Using the velcro strips provided, adhere the print button end
of the RM-91 remote control unit to the systems control panel or to the
cart.

If your configuration only includes the color printer, connect the print trigger cable to the Remote 2 connector on the back of the printer. (You do
not need to connect or use the RM-91 cable.)
4. Connect the printers power cord to the back of the printer and make sure
the other end is connected to the auxiliary power outlet on the system.
5. Turn on the printer, and then turn on the system.

Connecting a Report Printer


Use the report printer to print reports, exams, and images in Review. Connecting
a report printer includes the following steps:
1. Verifying that the printer is compatible with the system
2. Connecting the report printer
3. Configuring the printer for use
To view the list of compatible report printers
1. Press Set Up (F10).
2. In the setups, click Peripherals.
3. Click Printer and verify that the printer you are installing is listed.
4. Click Cancel.

Getting Started
4535 612 13861

83

Preparing the System

To connect a report printer


1. Turn off the system and unplug the power cord from the power source.
2. Connect the USB cable to the back of the printer, and connect the other end
to the back of the system (Figure 4-1).
3. Connect the printers power cord to the back of the printer, and plug the
other end into the auxiliary power outlet on the system.
4. Turn on the printer, and then turn on the system.
To configure the report printer
1. Press Set Up (F10).
2. In the setups, click Peripherals.
3. Click Printer and select the printer from the list.
4. Click Save.

84

Getting Started
4535 612 13861

Preparing the System

Figure 4-1 Connecting an External Printer

Print trigger
(for color printer)
S-Video connector
(for color printer)
USB connector
(for report printer)

Getting Started
4535 612 13861

85

Preparing the System

About External VCRs


You can connect the Mitsubishi HS-MD3000UA (NTSC) or HS-MD3000EA (PAL)
VCR to your ultrasound system as an external device.
You can only control the VCR through the VCR panel controls or the VCRs
remote control. The system does not support VCR control through the system
control panel. You can record images onto videotape using the VCR, but you cannot play back images on the ultrasound system.

Connecting an External VCR


When you purchase the VCR, the following cables are connected to the system at
the factory, and routed to the top of the system cart.

S-Video cable

Power cord

To connect an external VCR


1. Turn off the system and unplug the power cord from the power source.
2. Connect the audio cable between the AUDIO IN on the VCR and the R and
L connectors on the system (Figure 4-2).
3. Connect the S-Video cable to the S-VIDEO IN on the VCR and make sure
the other end is connected to the S-Video connector on the system.
4. Connect the VCRs power cord into the back of the VCR and make sure the
other end is plugged into the auxiliary power outlet on the system.
5. Turn on the VCR, and then turn on the system.

86

Getting Started
4535 612 13861

Preparing the System

Figure 4-2 Connecting an External VCR

Audio R and L

S-Video

Getting Started
4535 612 13861

87

Preparing the System

Connecting to a Network
To use connectivity features, the system must be connected to a network. The
ethernet receptacle on the rear panel supports both 10-base-T and 100-base-T
formats. The system is configured for network connectivity by a Philips field service engineer or your network administrator.
To connect the system to a network
1. Turn off system power.
2. Connect one end of the provided network connection cable to the wall
receptacle for your network.
3. Connect the other end of the cable to the rear panel of the system
(Figure 4-3).
4. To configure the network settings, see "Configuring Network Settings" on
page 242.

88

Getting Started
4535 612 13861

Preparing the System

Figure 4-3 Network Receptacle

Network
receptacle

Getting Started
4535 612 13861

89

Preparing the System

Moving the System


Observe the following warnings and cautions before moving the system.
WARNINGS

Be aware of the casters, especially when moving the system. The system could
cause injury to you or others if it rolls over feet or into shins. Exercise caution
when going up or down ramps.

When attempting to overcome an obstacle, do not push the system from


either side with excessive force, which could cause the system to tip over.

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

When positioning the articulated monitor, move it carefully to avoid pinching


hands or extremities against other objects, such as a bed rail.

Never park the system on an incline.


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

Before moving the system, ensure that the monitor is folded down to the control panel.
CAUTIONS

Ensure that the cables for all patient-applied parts are secure before moving
the system. Use the cable management system to ensure that transducer
cables are protected from damage.

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

90

Getting Started
4535 612 13861

Preparing the System

Preparing and Moving


To prepare and move the system
1. Press and hold the On/Off button for two seconds to turn the system off.
2. When the system shuts down, set the power switch on the back of the system to off.
3. Disconnect all external cables, including those to power, network, telephone,
and external devices. Secure all cables, transducers, and accessories so that
they do not interfere with the wheels.
4. Squeeze the lever on the front handle and use the handles to push the control
panel to its lowest position.
5. Position the monitor so that it is folded down, facing the control panel.
6. If the wheel brakes are engaged, press the brake release control on each
wheel to release the wheel brakes.
7. Move the cart using the front handles.

Setting Up After Moving


CAUTION

If the system behaves abnormally after moving contact Philips Ultrasound Customer Service immediately. The components are installed securely and can withstand considerable shock; however, excessive shock can cause a system failure.
To set up the system after moving it
1. With the system in position and the brake set, connect the power, network,
modem, and other cables from the system to the appropriate wall receptacles.
2. Squeeze the release lever on the front handle and position the control panel
to the desired position.
3. Adjust the monitor as needed.
4. Press the power switch on the back of the system to the On position.
5. Press and hold the On/Off button down for two seconds to turn on the system.

Getting Started
4535 612 13861

91

Preparing the System

Transporting the System


Follow these guidelines to transport the system in a vehicle:

Before transporting the system in a vehicle, remove the transducers from the
holders. To protect the transducers, put them in a packing box.

Transport the system in the upright position. Never transport the system on
its back or side.

The strap used to secure the system in a vehicle should not be located across
any of the systems plastic side panels. Secure the strap so that it is located as
low as possible across the lift column.

Be sure that the transporting vehicle can handle the weight and volume of the
system or systems plus the passengers.

Be sure the load capacity of the loading lift can accommodate the weight of
the ultrasound system. Philips recommends a minimum capacity of 227 kg
(500 lb).

WARNING

Never ride on the loading lift with the ultrasound system. Your weight coupled
with the systems weight may exceed the lifts load capacity.

92

Load and unload the system when the transporting vehicle is parked on a level
surface. If the parking surface is unlevel, make sure the brakes are applied to
both wheels.

The weight of the system on the extended loading lift may cause the transporting vehicle to tilt, which could cause personal injury or system damage.

Always secure the ultrasound system while it is on the loading lift so that it
cannot roll. Use wood chocks, restraining straps, or other similar types of
constraints. Do not attempt to manually hold it in place.

Be sure the ultrasound system is firmly secured while it is inside the transporting vehicle. Make sure the brakes are applied to both wheels during transport. Any movement, coupled with the weight of the system, could cause it to
break loose.

Getting Started
4535 612 13861

Preparing the System

To prepare the system for transport


1. Prepare the system as described in "Moving the System" on page 90.
2. Remove all transducers, cables, and accessories that are not attached to the
system.
3. Using a lift gate or a secured ramp, load the system into the vehicle.
4. Once the system is in place, press the brake lever down on each wheel to
engage the brakes.
5. Place wheel chocks on the wheels to prevent the system from rolling.
6. Secure the strap so that it is located as low as possible across the lift column.

Getting Started
4535 612 13861

93

94

Preparing the System

Getting Started
4535 612 13861

5 Using the System


This section provides information on using your system.
CAUTIONS

This system has Boot from CD enabled by default. If you insert an unauthorized bootable CD and turn the system on, the installation software on that
CD could overwrite the ultrasound system software. This could introduce a
security vulnerability or render your system inoperable. Using an unauthorized CD in the system also voids your warranty.

The BIOS on the system is not password protected. Any user can access the
system BIOS and change system settings. Unauthorized access to the system
BIOS could render your system inoperable and voids your warranty.

Turning the System On and Off


The power switch is located on the lower back of the system. The On/Off button is located in the upper left corner of the control panel.
To turn the system on or off

When the system is off, press the power switch to the ON position. Press and
hold On/Off for two seconds to turn it on.

When the system is on, press and hold On/Off for two seconds to start the
shutdown process and to turn off the system completely.

CAUTION

If you unplug your system before the shutdown message appears, you may corrupt files and lose patient data. Do not unplug the system from the wall outlet
until the system is completely off.
To break the connection from the main power supply, turn off the power switch
on the back of the system and remove the ultrasound system plug from the wall
outlet.

HD3 Getting Started


4535 612 13861

95

Using the System

Setting the System Time and Date


Before using the system for the first time, you need to set the current time and
date in the system.
To set the current time and date
1. Press Set Up (F10).
2. Click the System tab, and then click the Local tab.
3. Click Set.
4. In the Date and Time Setup dialog box, click the up or down arrows to
specify the current year, month, day, hour, and minute.
5. Click OK.
6. On the Local tab, select the date and time format you want to use.
7. Click Save.

Setting the System Language


To set the system language
1. Press Set Up (F10).
2. Click the System tab, and then click the Local tab.
3. On the Local tab, select the language you want to use.
4. Click Save.

Using the Wheel Brakes


The front wheels include brakes that you can engage to help keep the system in
place during use (Figure 5-1).
To use the wheel brakes

96

To engage the brake, press down on the brake control.

To release the brake, press down on the brake release control.

HD3 Getting Started


4535 612 13861

Using the System

Figure 5-1 Wheel Brakes


Brake control

Brake release control

Adjusting the Monitor


The monitor is mounted on an articulated arm that lets you position it vertically
and left and right. You can adjust the brightness of the monitor image to compensate for ambient light.

Positioning the Monitor


You can adjust the position of the monitor to suit different operating positions
and operator heights. The monitor can be tilted up and down and swiveled left
and right.
To adjust the monitor position
Grasp it by the sides and tilt or swivel it. (Figure 5-2)

HD3 Getting Started


4535 612 13861

97

Using the System

Figure 5-2 Adjusting the Monitor

Adjusting the Monitor Brightness


Use the brightness controls on the control panel to set the brightness.
To adjust the brightness
Do either of the following to adjust the brightness:

98

To increase the brightness, press

(F12).

To decrease the brightness, press

(F11).

HD3 Getting Started


4535 612 13861

Using the System

System Controls
The system controls are categorized as follows:

Controls

Control knob

Soft keys

Function keys

All controls are referred to by their label on the control panel. All controls and
control settings are explained in the glossary.

Controls
The system control panel includes toggle switches, push buttons, a trackball, TGC
slide controls, and knobs.

Control Knob
The left side of the display is reserved for mode-specific and calculations menus.
Use the Control knob to select a Control menu item and values for the item.
Many of the imaging and calculation controls appear in this area instead of as hard
controls or soft keys. The Control knob is dual-purpose: Pressing it initiates an
action; turning it changes the value of a parameter or moves up or down the
menu.
To use the Control knob
1. Press Control to activate the Control menu.
2. Do any of the following:
To highlight items in the menu, turn Control or use the trackball.
To select an item, press Control or press Enter.
To increase, decrease, or change settings, turn Control or use the trackball.
3. Press Exit to close the Control menu.

HD3 Getting Started


4535 612 13861

99

Using the System

Soft Keys
The soft key labels appear across the bottom of the display. They assume different
values based on system mode. They provide quick access to those functions. The
soft keys correspond to the buttons labeled 1 through 5 across the top of the
control panel.
To use the soft keys
1. On the control panel, press the soft key that corresponds to the soft key label
on the display.
2. To display additional soft keys, if available, press Next.

Function Keys
The function keys (F1 through F7, F9, and F10) appear across the top of the keyboard, for quick access to various function. Each function key is labeled. For
example, press End Exam (F7) to save and end an exam. Press Set Up (F10) to
view and change setups.
For a description of each function key, see the "Glossary".

100

HD3 Getting Started


4535 612 13861

Using the System

Using the Trackball, and the Select, Enter, and Exit Controls
The trackball and the three controls around it are used to perform various system functions (Figure 5-3).
Figure 5-3 Trackball and Controls

The trackball moves cursors or elements on the display.


Select is used in various conditions to complement Enter. For example in zoom,
pressing Select changes the size of the box, while Enter is used to apply the
zoom change.
Enter applies, initiates, and completes actions such as measurements.
Exit takes the system out of a mode of operation or functions as a right mouse
click.
All of these controls are not active all of the time; their functions depend upon
the active system mode. Their use is described within the context of several of
the procedures included in this manual.

HD3 Getting Started


4535 612 13861

101

Using the System

Positioning the Control Panel


You can move the control panel and monitor up and down as needed to accommodate different operator heights and comfort.
To raise or lower the control panel and monitor
1. Squeeze either button in the center of the system handle (Figure 5-4).
2. Raise or lower the control panel as needed.
3. To lock the control panel in place, release the handle or buttons.
Figure 5-4 Positioning the Control Panel

Using the Keyboard


Use the keyboard on the control panel to type information into text fields and to
type labels, titles, and text labels onto the display.

102

HD3 Getting Started


4535 612 13861

Using the System

Imaging Display
The display looks somewhat different depending on the mode, application, preset,
and transducer. However, the imaging area, soft key labels, settings, and patient
information always remain in the same location (Figure 5-5).
Figure 5-5 Imaging Display
Exam type and institution

Transducer
MI and TI values

Patient information

Exam date
and time
2D image
parameters

Imaging area
Control menu

Soft key labels

HD3 Getting Started


4535 612 13861

103

Using the System

Connecting and Selecting Transducers


Your system can be configured so that you can connect up to two transducers at
one time.
CAUTION

The ESD (electrostatic discharge) symbol appears next to the transducer


connectors to warn you not to touch exposed pins. Touching exposed pins can
cause electrostatic discharge, which can damage the product.
Follow these guidelines when connecting transducers:

Never force a transducer into place. If you feel any resistance, reposition the
transducer connector and try again.

If No Transducer is displayed, either the system is running an identification


check, or the transducer is not properly connected. Reposition the transducer connector and try again.

Before disconnecting a transducer, be sure to unlock the connector by turning


the latch to the unlocked position.

To connect a transducer
1. Turn the transducers latch to the unlocked position and plug the transducer
into the slot (Figure 5-6).
2. Turn the latch clockwise to the locked position.

104

HD3 Getting Started


4535 612 13861

Using the System

Figure 5-6 Connecting a Transducer

To select a transducer
1. Press Preset.
2. Select the transducer you want to use.
3. Select the exam type and preset you want to use.
4. Click OK.
When you turn on your system, the most recently used preset is active. Before
you begin an exam, check to make sure that the appropriate preset is active.
The system has up to five default presets from which to choose. You cannot
delete these default presets. However, they provide a starting point from which
you can create your own presets. For details on creating a preset, see "Presets"
on page 113.

HD3 Getting Started


4535 612 13861

105

Using the System

Printing
You can print using an internal device or an external device. The device can be a
color printer, black-and-white printer, or a report printer. The system interface
for printing is consistent across the range of compatible devices. For internal
devices, the primary system print controls are located on the system control
panel. The different print devices and their controls are all covered in the device
manufacturers operating instructions, which are included with each device
shipped by Philips Ultrasound.
WARNING

All OEM devices, when external to the system, must be connected to a grounded
outlet. Do not defeat the ground.
CAUTION

Do not operate a device if condensation is present inside the device. Before operating the device, replace a damp paper roll. The paper roll can be used after all
traces of condensation are gone.

Adjusting Print Quality


Examine the print for print quality. If print quality is unacceptable, refer to the
manufacturers instructions for printer control adjustments that affect print quality.
NOTES

106

Do not touch prints with wet hands, or the prints may fade.
Store prints in a low-humidity location away from direct sunlight to avoid discoloration or deterioration of the image.
When print paper absorbs volatile organic solvents such as alcohol, ether, and
ketone, the image will discolor or fade. Cellophane tapes and soft vinyl chlorides also may cause discoloration or fading. Also, avoid contact with wet
diazo copies, as the image may fade away.
Dirt or dust on the paper can result in poor-quality prints. Advance or feed
the paper until clean paper is visible.
Paper loading instructions and diagrams are sometimes located inside the
device door.
If the paper is stuck or jammed, refer to the information in the manufacturers
instructions on correcting paper jams.

HD3 Getting Started


4535 612 13861

Using the System

Black-and-White and Color Image Printers


The black-and-white printer is used to print black-and-white screen images You
can use the Print control to print with the black-and-white printer. Depending
on your configuration, you can use either the Print control or the RM-91 remote
print unit to print with the color printer.
The black-and-white printer is installed and configured at the factory. For instructions on connecting the color printer, see "Connecting the Color Printer" on
page 82.
To print to the black-and-white printer
1. Acquire the desired image.
2. Press Print.
To print to the color printer
1. Acquire the desired image
2. Do one of the following, depending on your configuration:

If your system only includes the color printer, press Print.

If your system includes both a black-and-white and color printer, press the
remote Print button that is mounted on the system control panel.

Report Printer
You can use a compatible report printer to print reports or text. A report printer
is much more cost-effective than an image printer, especially when printing text.
For instructions on connecting a report printer, see "Connecting a Report
Printer" on page 83. For instructions on printing to a report printer, see "Printing
Exams and Images from Review" on page 201.

DICOM Printer
You can print entire exams or specific images to a DICOM printer, if your system
is connected and configured to a DICOM printer. For information on configuring
a DICOM printer, see "Configuring Network Settings" on page 242. For information on printing to a DICOM printer, see "Printing Exams and Images from
Review" on page 201.
HD3 Getting Started
4535 612 13861

107

Using the System

Recording to a VCR
NOTES

A VCR is not included with the system; it is an option.


You can not play back the VCR recording on the HD3 ultrasound system; you
can only record.

An S-VHS VCR is recommended for recording ultrasound images. A copy of the


manufacturers operating instructions for your VCR is included with the VCR.
Please read the manufacturers operating instructions before connecting, operating, or adjusting the VCR. The VCR accommodates different sizes of videocassette tapes with different recording and playback times. Use only the cassette
tapes compatible with the VCR.
The VCR has a video indexing system; refer to the VCR operating instructions for
information.
For instructions on connecting the VCR, see"Connecting an External VCR" on
page 86.
CAUTIONS

Do not insert a videotape before the system has completed the initialization
and warm-up phase.

Periodically clean the external surfaces of a device with a soft cloth. Stubborn
stains may be removed with a cloth lightly dampened with a mild detergent
solution.
To use the VCR to record
1. Ensure the patient data is accurate.
2. Press Record on the VCR.

Storing Images
You can store images to the system hard disk by pressing Acquire. You can
export images to a magneto-optical (MO) disc, a USB flash drive, or to a compact
disc (CD) using Export in Review.

108

HD3 Getting Started


4535 612 13861

Using the System

Using the Removable Media Drives


Use Storage Manager to do the following:

Eject and format MO disks

Safely unplug USB flash drives

Eject a CD from the CD-RW drive

Loading and Ejecting Media


To load and eject a CD
1. To open the tray, press the Eject button located below the CD-RW 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 MO disk
1. To load the MO disk, insert the MO disk into MO disk drive.
2. To eject the MO disk, press the small button located on the MO disk drive.
To insert and safely unplug a USB flash drive
CAUTION

Failure to perform the following procedure to safely unplug the USB flash drive
could result in loss of data and could damage the USB flash drive.
1. Insert the USB flash drive into one of the USB ports on the back of the system.
2. To safety remove a USB flash drive, press F9.
3. In the Flash section of the Storage Manager window, click Unplug.
4. Click OK in response to the prompt to safely remove the drive.
5. Remove the USB flash drive from the USB port.

HD3 Getting Started


4535 612 13861

109

Using the System

Formatting Disks
Use Storage Manager to reformat magneto-optical disks and CD-RW disks so
that they can be reused. To write over obsolete data on a disk, you must first format the disk.
CAUTION

Formatting a disk erases all of the data on the disk.


To format an MO disk or CD-RW
1. Insert the disk into the disk drive.
2. Press the Storage Manager (F9) key to open the Storage Manager.
3. In the MO or CDROM section, click Format.
4. To continue, click OK.
5. When a message indicates that formatting is complete, click OK.

110

HD3 Getting Started


4535 612 13861

6 Customizing Your System


Using Setups
There are several categories of setups:

System

Measure

DICOM

Option

Peripherals

Admin

To use setups
1. Press Set Up (F10).
2. Click the tab at the top of the display to view or change the current settings.
3. On any of the setup displays, type the text or make the selections necessary
to set up your system.
4. Click Save.
NOTE

All setup items are referred to by their label in the setups displays. All setups and
settings are explained in the glossary.

Changing System Settings


Click the System tab to view and change the following settings:

Click the Local tab to view and change the name of your institution, and the
current date and time, to specify the language, to specify whether or not the
Caps Lock setting is on or off at startup, and to have the system automatically create a medical record number (MRN) for new patients

Click the Display tab to view and change image display information, including
the length of Auto Freeze time, the post map and image information, TCG

HD3 Getting Started


4535 612 13861

111

Customizing Your System

line and TI display settings, the size of the 2D image, and the settings for
Simultaneous mode.

Changing Measure Settings


Click the Measure tab to view and change the following settings:

Click the General tab to change the following:

Result box display count

Circumference and area method

Default volume method

Distance method

Caliper display unit

Track ball speed

Result display

Doppler Y-axis unit


Doppler Trace direction

Click the OB tab to view and change the following settings:

Display of the SD value

Fetal weight information

MCA/UA graph layouts


Backup and restore options for user defined OB tables

Analysis setup settings

References settings

112

Click the Fetal Echo tab to view and change the LV volume calculation
method.

Click the Cardiac tab to view and change 2D circumference and area method
settings, and LV volume calculation method.

Click the Urology tab to view and change the volume method calculations
and the predicted PSA correction factor.

HD3 Getting Started


4535 612 13861

Customizing Your System

Changing DICOM Settings


Click the DICOM tab to specify DICOM settings, and to add, edit, and delete
DICOM services. For more information, see "Configuring Network Settings" on
page 242.

Changing Option Settings


Click the Options tab to view the System Key and to install options.

Changing Peripherals Settings


Click the Peripherals tab to view and change the video output type, to select
the report printer, and to configure the foot switch.

Performing Administrative Functions


Click the Admin tab to back up and restore presets and system settings, install
software, update device drivers, and to display system information, keystroke and
DICOM logs, and to access service tools.

Presets
User presets are available for each exam type. You can select settings for various
system parameters, and the system automatically invokes these settings when you
select your user preset.
Presets and exam types are associated with transducers. Make sure you have the
appropriate transducer connected to the system to access the presets for that
transducer and exam type.
Use the system controls to create the settings for your preset. (You can select a
system mode, an image orientation, the number of focal zones, and so on.)
For information on creating OB presets, see "Obstetrics Calculations" on
page 217.

HD3 Getting Started


4535 612 13861

113

Customizing Your System

To create a preset
1. Connect the transducer to use with the preset you want to create.
2. Press Preset.
3. In the Preset display, select an existing exam type and preset on which you
want to base the new preset and click OK.
4. Select the imaging mode and apply the imaging settings as needed for the new
preset.
5. Press Preset.
6. In the Preset display, select the exam type and click New.
7. When a new preset named User appears in the Presets section, do one of
the following:
To save the new preset as User, click Save.

To save the new preset with a meaningful name, click Rename. Enter the
new preset name and click OK, and then click Save.

To select a preset
1. Make sure the appropriate transducer is connected to the system.
2. Press Preset.
3. In the Preset display, select the transducer, exam type, and preset, and click
OK.
To rename a preset
1. Make sure the appropriate transducer is connected to the system.
2. Press Preset.
3. In the Preset display, select the transducer, exam type, and preset, and click
Rename.
4. In the Rename dialog box, enter the new name for the preset and click OK.
5. To save the preset with the new name, click Save.

114

HD3 Getting Started


4535 612 13861

Customizing Your System

To delete a preset
NOTE

You cannot delete an active preset. Make sure the preset is not in use before you
try to delete it.
1. Make sure the appropriate transducer is connected to the system.
2. Press Preset.
3. In the Preset display, select the transducer, exam type, and preset, and click
Delete.
4. Click OK to close the Preset display.

Options
In addition to the standard features available in the system, other features are
available as purchasable options. The types of options available include imaging
capabilities, image review and archiving tools, connectivity options, and peripheral
devices. For a list of options available for your system, see "Optional System Features" on page 74.
Contact your Philips representative for information on installing options.

HD3 Getting Started


4535 612 13861

115

116

Customizing Your System

HD3 Getting Started


4535 612 13861

7 Transducer Care and Maintenance


This section contains the following information on the general care, handling,
cleaning, and storing of HD3 transducers.

Handling Transducers
Although a transducer is designed for durability, use care when handling it. Dropping or banging the transducer can damage the acoustic lens and piezoelectric
crystals. Cuts in the transducer cable or cracks in the housing can destroy the
electrical safety features of the transducers. This damage is not covered by the
warranty or your service contract.
When you are not using the transducer, place it in the transducer holder located
on the side of your system to assure safe, convenient storage. For more information on storing transducers, see "Storing Transducers" on page 118.
CAUTION

When you are shaking an ultrasound gel bottle, be careful not to hit the transducer face with the tip of the bottle. Striking the transducer face with a hard
object can damage the transducer. This damage is not covered by the warranty or
your service contract.

Inspecting Transducers for Damage


All transducers are exposed to potentially damaging situations during use and
cleaning. Before use, check each transducer for the following signs of damage:

Cracks on the handle

Cracks on the nose piece

Cuts or gouges on the lens material

Swelling of the lens material

Cracks on or other signs of damage to the cable strain reliefs

Cracks or other signs of damage to the connector

Bent or damaged pins on the connector

Signs of damage to the cable or inflexibility of the cable


HD3 Getting Started
4535 612 13861

117

Transducer Care and Maintenance

WARNINGS

Although no hazardous voltages are present during normal use, if there is a


crack in the transducer, it is possible for the operator to feel a tingle that
could result in a reaction and potential injury. Cracks also interfere with standard cleaning procedures.

If you see any sign of damage to the transducer, immediately discontinue use
of the transducer.

Storing Transducers
This section provides information on storing transducers for transport, and daily
and long-term storage.

Storage for Transport


If a carrying case is provided with your transducer, always use the carrying case to
transport the transducer from one site to another.
Follow these guidelines to properly store transducers for transport:

118

Make sure that the transducer is clean and disinfected before placing it in the
case to avoid contaminating the foam that lines the carrying case.

Place the transducer in the case carefully to prevent kinking of the cable.

Before closing the lid, make sure no part of the transducer is protruding from
the case.

Wrap the case in plastic material containing air pockets (such as bubble
wrap), and pack the wrapped case in a cardboard carton.

HD3 Getting Started


4535 612 13861

Transducer Care and Maintenance

Daily and Long-Term Storage


Follow these guidelines to protect your transducer:

Always store transducers in the transducer holders on the side of your system or on a securely mounted wall rack when you are not using them.

Make sure the transducer holders are clean before storing transducers. For
details on cleaning the system, see "Cleaning the System, the Cables, and the
Connectors" on page 231.

Avoid storing transducers in areas of temperature extremes or in direct sunlight.

Store transducers separately from other instruments to avoid inadvertent


transducer damage.

When storing transducers, use the cable-management clips to secure the


transducer cable.

Before storing transducers, make sure they are thoroughly dry.

Disinfectants and Gels Safety


Observe the following warnings and cautions when using disinfectants and gels.
More specific warnings and cautions are included within the various procedures
and on the labels of the cleaning or disinfection solutions.
WARNING

Disinfectants listed in Table 7-2 are recommended because of their chemical compatibility with product materials, not their biological effectiveness. For the biological
effectiveness of a disinfectant, see the guidelines and recommendations of the disinfectant manufacturer, the U.S. Food and Drug Administration, and the U.S. Centers for Disease Control.

HD3 Getting Started


4535 612 13861

119

Transducer Care and Maintenance

WARNINGS

The level of disinfection required for a device is dictated by the type of tissue
it will contact during use. Ensure the disinfectant type is appropriate for the
type of transducer and the transducer application. For information on the levels of disinfection requirements, see "Choosing a Disinfectant" on page 124.
Also, see the disinfectant label instructions and the recommendations of the
Association for Professionals in Infection Control, the U.S. Food and Drug
Administration, and the U.S. Centers for Disease Control.

Some transducers cannot be sterilized. For intraoperative procedures,


high-level disinfections and the use of a sterile transducer cover and gel (as
described in the instructions provided with the transducer cover) is an
accepted method of infection control. See the FDA Guidance document
Information for Manufacturers Seeking Marketing Clearance of Diagnostic
Ultrasound Systems and Transducers, September 30, 1997. The guidance
document is located on the following Web site:
www.fda.gov/cdrh/ode/ulstran.pdf

The use of protective transducer covers and coupling gel is recommended for
clinical applications of all endocavity transducers. Use a sterile protective
transducer cover with sterile ultrasound transmission gel during biopsy examinations.

Do not apply the transducer cover and gel until you are ready to perform the
procedure. Transducers should not be left soaking in gel.

Transducer covers can contain natural rubber latex, which may cause allergic
reactions in some individuals. See "Latex Product Alert" on page 121.
For information on ordering transducer covers, contact CIVCO (See "Transducer
Supplies and Accessories" on page 138).

120

HD3 Getting Started


4535 612 13861

Transducer Care and Maintenance

Latex Product Alert


Philips Ultrasound Systems and transducers do not contain natural rubber latex
on any patient- or operator-contact surfaces. Natural rubber latex is not used on
any ultrasound transducer, including transthoracic, intraoperative, and transesophageal echocardiographic (TEE) transducers. It also is not used on Philips ECG
cables.
The following section provides information from the FDA regarding allergic reactions to latex-containing medical devices.
FDA Medical Alert, March 29, 1991, Allergic Reactions
to Latex-Containing Medical Devices
Because of reports of severe allergic reactions to medical devices containing latex
(natural rubber), the FDA is advising health care professionals to identify their
latex sensitive patients and be prepared to treat allergic reactions promptly.
Patient reactions to latex have ranged from contact urticaria to systemic anaphylaxis. Latex is a component of many medical devices, including surgical and examination gloves, catheters, intubation tubes, anesthesia masks, and dental dams.
Reports to the FDA of allergic reactions to latex-containing medical devices have
increased lately. One brand of latex cuffed enema tips was recently recalled after
several patients died as a result of anaphylactoid reactions during barium enema
procedures. More reports of latex sensitivity have also been found in the medical
literature. Repeated exposure to latex both in medical devices and in other consumer products may be part of the reason that the prevalence of latex sensitivity
appears to be increasing. For example, it has been reported that 6% to 7% of surgical personnel and 18% to 40% of spina bifida patients are latex sensitive.
Proteins in the latex itself appear to be the primary source of the allergic reactions. Although it is not now known how much protein is likely to cause severe
reactions, the FDA is working with manufacturers of latex-containing medical
devices to make protein levels in their products as low as possible.
FDAs recommendations to health professionals in regard to this problem are as
follows:

When taking general histories of patients, include questions about latex sensitivity. For surgical and radiology patients, spina bifida patients and health care
workers, this recommendation is especially important. Questions about itchHD3 Getting Started
4535 612 13861

121

Transducer Care and Maintenance

ing, rash or wheezing after wearing latex gloves or inflating a toy balloon may
be useful. Patients with positive histories should have their charts flagged.

If latex sensitivity is suspected, consider using devices made with alternative


materials, such as plastic. For example, a health professional could wear a
non-latex glove over the latex glove if the patient is sensitive. If both the
health professional and the patient are sensitive, a latex middle glove could be
used. (Latex gloves labeled Hypoallergenic may not always prevent adverse
reactions.)

Whenever latex-containing medical devices are used, especially when the


latex comes in contact with mucous membranes, be alert to the possibility of
an allergic reaction.

If an allergic reaction does occur and latex is suspected, advise the patient of a
possible latex sensitivity and consider an immunologic evaluation.

Advise the patient to tell health professionals and emergency personnel about
any known latex sensitivity before undergoing medical procedures. Consider
advising patients with severe latex sensitivity to wear a medical identification
bracelet.

The FDA is asking health professionals to report incidents of adverse reactions to


latex or other materials used in medical devices. (See the October 1990 FDA
Drug Bulletin.) To report an incident, call the FDA Problem Reporting Program,
operated through the U.S. Pharmacopeia toll-free number: 800-638-6725. (In
Maryland, call collect 301-881-0256.)
For a single copy of a reference list on latex sensitivity, write to: LATEX, FDA,
HFZ-220, Rockville, MD 20857.

Transmissible Spongiform Encephalopathy


WARNING

If a sterile transducer cover becomes compromised during an intraoperative


application involving a patient with transmissible spongiform encephalopathy, such
as Creutzfeldt-Jakob disease, follow the guidelines of the U.S. Center for Disease
Control and this document from the World Heath Organization: WHO/CDS/
CSR/APH/2022.3, WHO Infection Control Guidelines for Transmissible Spongiform
Encephalopathies. The transducers for your system cannot be decontaminated
using a heat process.
122

HD3 Getting Started


4535 612 13861

Transducer Care and Maintenance

Acoustic Coupling Medium


For proper transmission of the acoustic beam, use the ultrasound transmission
gel supplied by or recommended by Philips, or another glycol-, glycerol-, or
water-based acoustic coupling medium.
CAUTION

Do not use mineral oil, oil-based couplants, gels with lotions or emollients of any
kind, or other unapproved materials because they might damage the transducer.

Gels Statement
Couplant gels that do not contain mineral oil or lotion are acceptable for use.
Some recommended gels include:

Aquasonic 100

Aquasonic Clear

Carbogel-ULT

ECG Gel (Nicom)

Nemidon Gel

Ultraphonic

Scan

Cleaning, Disinfecting, and Sterilizing Transducers


This section provides the information and instructions for cleaning, disinfecting,
and sterilizing transducers, cables, and connectors.
NOTE

This section contains the latest cleaning and disinfection information for all supported transducers as of the date of this publication. It is important, however, that
you periodically check the following Philips Web site for the very latest cleaning
and
disinfection
guidelines
for
all
supported
transducers:
www.medical.philips.com/transducercare

HD3 Getting Started


4535 612 13861

123

Transducer Care and Maintenance

Choosing a Disinfectant
To choose an appropriate disinfectant, you first must determine the required level
of disinfection, based on the device classification (Table 7-1).
Table 7-1 Levels of Disinfection Requirements
Classification

Level of Disinfection

Critical

Device enters otherwise sterile


Sterilization1
tissue (for example, intraoperative
applications)

Semi-critical

Device contacts mucous


membranes (for example,
endocavity applications)

High (tuberculocidal)

Noncritical

Device contacts intact skin

Intermediate or low

1.

124

Definition

High-level disinfection and the use of a sterile gel and a transducer cover, as described in the
instructions provided with the transducer cover, is an accepted method of infection control
for ultrasound transducers. See the FDA Guidance document Information for Manufacturers
Seeking Marketing Clearance of Diagnostic Ultrasound Systems and Transducers, September
30, 1997, at the following Web site: www.fda.gov/cdrh/ode/ulstran.pdf.

HD3 Getting Started


4535 612 13861

Transducer Care and Maintenance

General Cleaning Procedures for All Transducers


These general cleaning instructions are indicated for all transducers. It is important that you clean the transducer and cable according to the following procedures.
CAUTIONS

Transducers must be cleaned after each use. Cleaning the transducer is an


essential step before effective disinfection or sterilization. Be sure to follow
the manufacturers instructions when using disinfectants.

Do not allow sharp objects, such as scalpels or cauterizing knives, to touch


transducers or cables.

When handling a transducer, do not bump the transducer on hard surfaces.


Do not use a surgeons brush when cleaning transducers. The use of even soft
brushes can damage transducers.

During cleaning, disinfection, and sterilization, orient the parts of the transducer that must remain dry higher than the wet parts until all parts are dry.
This will help keep liquid from entering permeable areas of the transducer.
To clean a transducer
1. After every patient exam, wipe the ultrasound transmission gel off of the
transducer.
2. Disconnect the transducer from the system and remove any transducer covers, biopsy guides, or tip guards.
3. Use a soft cloth lightly dampened in a mild soap or an enzymatic cleaner (in
accordance with the manufacturers instructions) to remove any particulate
matter or body fluids that remain on the transducer or cable. Enzymatic
cleaners should have a pH of 6.0 to 8.0. These cleaners are further diluted
during use. For a list of approved enzymatic cleaners, see Table 7-2.
4. To remove remaining particulate and cleaning residue, rinse thoroughly with
water up to the immersion point (see Figure 7-3).
5. Wipe with a dry cloth.

HD3 Getting Started


4535 612 13861

125

Transducer Care and Maintenance

Disinfecting Transducers with Wipes and Sprays (Low-Level


Disinfection)
To disinfect transducers, you can use either an immersion method or a wipe
method with a disinfectant recommended by Philips Ultrasound. Use the method
that is biologically appropriate, as described in "Choosing a Disinfectant" on
page 124.
This section provides instructions on using the wipe or spray method. For information on the immersion method, see "Disinfecting Transducers by Immersion
(High-Level Disinfection)" on page 131.
To use the wipe or spray method to disinfect transducers
NOTE

Transducers can be disinfected using the wipe method only if the product labeling
of the compatible disinfectant you are using indicates it can be used with a wipe
method.

WARNING

Always use protective eyewear and gloves when cleaning and disinfecting any
equipment.
1. After cleaning the transducer and cable, wipe or spray the transducer and
cable with a low-level disinfectant. Allow for the manufacturers recommended contact time. For a list of compatible disinfectants, see Table 7-2.
2. Remove any residue with a water-moistened soft cloth. Do not allow any
solutions to air dry on the transducer.
CAUTION

The use of 70% isopropyl alcohol (rubbing alcohol) on transducers is restricted


(Figure 7-1). Wipe only the distal tip of the transducer up to 2.5 cm (1 in) from
the strain relief/housing joint with an isopropyl alcohol solution. Do not wipe the
strain relief/housing joint, the strain relief, or the cable with isopropyl alcohol. Isopropyl alcohol can cause damage to these parts of the transducer. This damage is
not covered by the warranty or your service contract.

126

HD3 Getting Started


4535 612 13861

Transducer Care and Maintenance

Figure 7-1 Restricted Use of Isopropyl Alcohol to Clean Transducers


Strain relief

Strain relief/housing joint

Cable

2.5 cm
(1 inch)

Do not use alcohol in this area

Housing

You can use


alcohol in
this area

3. Examine the device and cable for damage such as cracks, splitting, sharp edges,
or projections. If damage is evident, discontinue use of the device and contact
your Philips Ultrasound representative.

Cleaning and Disinfecting Cables and Connectors with Wipes


and Sprays
Use this method to disinfect the cables and connectors for all transducers that
can be disinfected using a recommended wipe or spray disinfectant.
WARNING

Always use protective eyewear and gloves when cleaning and disinfecting any
equipment.

HD3 Getting Started


4535 612 13861

127

Transducer Care and Maintenance

CAUTION

Attempting to disinfect a cable or connector by using a method other than the


one included here can damage the device and will void the warranty. Orient the
parts that must remain dry higher than the wet parts until all parts are dry.
To clean and disinfect cables and connectors
1. Disconnect the device from the system.
2. Orient the device and the connector so they are both facing up (Figure 7-2).
CAUTIONS

Do not allow any type of fluid to enter the connector. Fluid in the connector
may void the transducer or device warranty.

Do not use a brush on the connector label.


3. Use a soft cloth lightly dampened in a mild soap or detergent solution to clean
the cable and the connector. A soft-bristled brush can be used to clean only
the metal surfaces of the connector. Do not allow any type of fluid to enter
the device. Be careful that fluid does not enter through the strain relief,
through the connector, through the electrical contacts, or through the areas
surrounding the locking lever shaft and the strain relief (Figure 7-2).
WARNING

If a premixed solution is used, be sure to observe the solution expiration date.


CAUTIONS

You can use an alcohol solution for disinfection on the connector only. Ensure
the solution is only 70% alcohol or less. Solutions of more than 70% alcohol
can cause product damage (Figure 7-1).

Do not use any alcohol or alcohol-based products on the cable.


Avoid disinfectant contact with the connector label.
4. Mix the disinfection solution compatible with your cable (see Table 7-2)
according to label instructions for solution strength.
5. Wipe or spray the cable and connector with the disinfectant, following disinfectant label instructions for wipe durations, solution strengths, and duration
of disinfectant contact with the cable. Ensure that the solution strength and
128

HD3 Getting Started


4535 612 13861

Transducer Care and Maintenance

duration of contact are appropriate for the intended clinical use of the device.
Ensure that the disinfectant solution does not enter the device or the connector or come into contact with the connector label.
6. Air dry or towel dry with a sterile cloth according to the instructions on the
disinfectant label.
7. Examine the device and cable for damage such as cracks, splitting, sharp edges,
or projections. If damage is evident, discontinue use of the device and contact
your Philips Ultrasound representative.

HD3 Getting Started


4535 612 13861

129

Transducer Care and Maintenance

Figure 7-2 Disinfecting Cables and Connectors


For cable disinfection, orient the device and the connector facing
up (strain reliefs on the bottom)
Locking lever shaft

Connector
strain relief

Strain
relief

Wipe strain reliefs, cable, and connector


with a compatible disinfectant

130

Electrical
contacts

HD3 Getting Started


4535 612 13861

Transducer Care and Maintenance

Disinfecting Transducers by Immersion (High-Level


Disinfection)
This section provides information about using the immersion method to disinfect
transducers. Endocavity transducers require unique methods for disinfection by
immersion. For details, see "Disinfecting Endocavity Transducers by Immersion"
on page 132.
WARNING

If a premixed disinfectant is used, be sure to observe the expiration date.


CAUTIONS

Using non-recommended disinfectants, incorrect solution strengths, or


immersing a transducer deeper or for a longer contact time can damage or
discolor the transducer and will void the transducer warranty.

Do not immerse transducers longer than the minimum time needed for your
level of disinfection. For information on the levels of disinfection requirements, see "Choosing a Disinfectant" on page 124.
To disinfect transducers by using the immersion method
1. Clean the transducer according to the "General Cleaning Procedures for All
Transducers" on page 125.
2. Mix the disinfection solution compatible with your transducer (see Table 7-2)
according to label instructions for solution strength. A disinfectant listed in
Table 7-2 with the footnote FDA 510(k) cleared is recommended in the U.S.
3. Immerse the transducer into the appropriate disinfectant for your transducer
(see Figure 7-3). Follow the instructions on the disinfectant label for the duration of transducer immersion. Do not immerse transducers longer than the
minimum time needed for your level of disinfection.
4. Using the instructions on the disinfectant label, rinse the transducer up to the
point of immersion, and then air dry or towel dry with a sterile cloth.
5. Examine the transducer for damage, such as cracks, splitting, fluid leaks, or
sharp edges or projections. If damage is evident, discontinue use of the transducer and contact your Philips Ultrasound representative.

HD3 Getting Started


4535 612 13861

131

Transducer Care and Maintenance

Figure 7-3 Immersing Transducers

Immerse this section only, up to


5.08 cm (2 in) from strain relief
on connector.

Disinfecting Endocavity Transducers by Immersion


For transducers used in endocavity procedures, high-level disinfection by immersion and the use of a sterile transducer cover and sterile ultrasound transmission
gel is an accepted method of infection control.
To disinfect endocavity transducers by immersion
1. Clean the transducer according to the "General Cleaning Procedures for All
Transducers" on page 125.
2. Mix the disinfection solution compatible with your transducer (see Table 7-2)
according to label instructions for solution strength. A disinfectant listed in
the search results with the footnote FDA 510(k) cleared is recommended in
the U.S.

132

HD3 Getting Started


4535 612 13861

Transducer Care and Maintenance

3. Immerse the transducer into the appropriate disinfectant for your transducer
(Figure 7-3). Follow the instructions on the disinfectant label for the duration
of transducer immersion. Do not immerse transducers longer than the minimum time needed for your level of disinfection. For information on the levels
of disinfection requirements, see "Choosing a Disinfectant" on page 124.
4. Using the instructions on the disinfectant label, rinse the transducer up to the
point of immersion, and then air dry or towel dry with a sterile cloth.
5. Examine the transducer for damage, such as cracks, splitting, fluid leaks, or
sharp edges or projections. If damage is evident, discontinue use of the transducer and contact your Philips Ultrasound representative.

Sterilizing Transducers
Sterilization is required if the device is classified as a critical device, and is used
without a sterile cover or if the sterile cover is breached.
WARNINGS

Always use protective eyewear and gloves when cleaning, disinfecting, or sterilizing any equipment.

In neurosurgical applications, sterilized transducers should be used with a


pyrogen-free transducer cover.

If a premixed solution is used, be sure to observe the solution expiration date.

HD3 Getting Started


4535 612 13861

133

Transducer Care and Maintenance

CAUTIONS

Transducers must be cleaned after each use. Cleaning the transducer is an


essential step before effective disinfection or sterilization. Be sure to follow
the manufacturers instructions when using disinfectants.

Sterilize transducers by using only liquid solutions. Using autoclave, gas (EtO),
or other methods not approved by Philips Ultrasound will damage your transducer and void your warranty.

Do not allow sharp objects, such as scalpels and cauterizing knives, to touch
transducers or cables.

When handling a transducer, do not bump the transducer on hard surfaces.


Ensure the solution strength and duration of contact are appropriate for sterilization. Be sure to follow the manufacturers instructions.
To sterilize a transducer
1. Clean the transducer according to the "General Cleaning Procedures for All
Transducers" on page 125.
2. Mix the sterilization solution compatible with your transducer (see Table 7-2
to find compatible sterilization solutions) according to label instructions for
solution strength. A disinfectant listed in the search results with the footnote
FDA 510(k) cleared is recommended in the U.S.
3. Immerse the transducer in the sterilization solution (see Figure 7-4).
4. Follow the instructions on the sterilization label for the duration of transducer immersion required for sterilization.
5. Remove the transducer from the sterilization solution after the recommended
sterilization time has elapsed.
6. Using the instructions on the sterilization label, rinse the transducer in sterile
water up to the point of immersion, and then air dry or towel dry with a sterile cloth.
7. Examine the transducer for damage, such as cracks, splitting, fluid leaks, or
sharp edges or projections. If damage is evident, discontinue use of the transducer, and contact your Philips Ultrasound representative.

134

HD3 Getting Started


4535 612 13861

Transducer Care and Maintenance

Figure 7-4 Immersing Sterilizable Transducers

Immerse this section only, up to


5.08 cm (2 in) from strain relief
on connector.

HD3 Getting Started


4535 612 13861

135

Transducer Care and Maintenance

Disinfectants Compatibility
Read this information before performing disinfection and sterilization procedures.
It discusses recommended disinfectants and choosing an appropriate disinfectant
for the required level of disinfection. You must check Table 7-2 for a list of the
chemical compatible disinfectants and cleaners associated with specific transducers. In addition, the table lists if a device can be sprayed, wiped, or soaked with
the disinfectants.
WARNINGS

Not all disinfectants are effective against all types of contamination. Ensure the
disinfectant type is appropriate for the type of transducer and that the solution strength and time of contact are appropriate for the intended clinical use.

Disinfectants listed in this section are recommended because of their chemical


compatibility with product materials, not their biological effectiveness. For the
biological effectiveness of a disinfectant, see the guidelines and recommendations of the disinfectant manufacturer, the FDA, the Association for Professionals in Infection Control, the U.S. Food and Drug Administration, and the
U.S. Centers for Disease Control.

If a premixed solution is used, be sure to observe the solution expiration date.


Always use protective eyewear and gloves when cleaning and disinfecting any
equipment.
CAUTION

Using a non-recommended disinfection solution, using an incorrect solution


strength, or immersing a transducer deeper or longer than recommended can
damage the device and will void the warranty.

136

HD3 Getting Started


4535 612 13861

Transducer Care and Maintenance

Disinfectant Types
WARNING

The level of disinfection required for a device is dictated by the type of tissue it
will contact during use. Ensure the disinfectant type is appropriate for the type of
transducer and the transducer application. For information on the levels of disinfection requirements, see "Disinfectants Compatibility" on page 136 and "Choosing a Disinfectant" on page 124. For more information, see the disinfectant label
instructions and the recommendations of the Association for Professionals in
Infection Control, the U.S. Food and Drug Administration, and the U.S. Centers
for Disease Control.
CAUTION

If you use an alcohol solution for disinfection, ensure the solution is only 70%
alcohol or less. Solutions of more than 70% alcohol can cause product damage.
Do not use alcohol on the transducers strain relief or cable.
See "Cleaning, Disinfecting, and Sterilizing Transducers" on page 123 for standard
industry recommendations on disinfection, for information that can help you
choose an appropriate disinfectant for the required level of disinfection, and for
transducer-specific instructions.

Factors Affecting Disinfectant Efficiency


The following factors will affect the efficiency of a disinfectant solution:

Duration of exposure

Age of the solution

Concentration and potency of the disinfectant

Quantity and location of the contamination

Resistance of the contaminate

Organic matter on the item to be disinfected

HD3 Getting Started


4535 612 13861

137

Transducer Care and Maintenance

Disinfectants Compatibility Table


Table 7-2 lists the disinfectants compatible with the transducer available for your
system.
If you require more information:

In North America, call Philips Ultrasound Customer Service at 800-433-3246.

Outside North America, contact your local Philips Ultrasound representative.

Transducer Supplies and Accessories


See "Ordering Supplies and Accessories" on page 27.

138

HD3 Getting Started


4535 612 13861

Transducer Care and Maintenance

All

Spray/
Wipe

Alcohol

CIDEX OPA 1

USA

Soak 2

Ortho-phthalaldehyde

CIDEX Plus 1

USA

Soak 2

Glutaraldehyde

Enzol

USA Pre-cleaner
D

Soak 2

T,C

T,C T,C

L9-5

C7-3

Active Ingredient

70% Isopropyl
Alcohol

Gigasept FF

C5-2

C4-2

Qualified
Use

C9-4ec

Solution

Country
of Origin

Table 7-2 Disinfectants Compatibility

T,C T,C

T,C T,C T,C T,C T,C

Enzymes

T,C

Succindialdehyde
dimethoxy
tetrahydrofuran

T,C

T,C T,C
N

Klenzyme

USA Pre-cleaner

Enzymes

T,C T,C T,C T,C

MetriZyme

USA Pre-cleaner

Enzymes

T,C T,C T,C T,C

Mild Soap
Solution

All

Pre-cleaner

Surfactants/Soap

T,C

Milton

AUS

Spray/
Wipe

Sodium
Hypochlorite

T,C

Nuclean

USA

Soak

Glutaraldehyde

T,C

Sani-Cloth HB

USA

Wipe

Quat. Ammonia

T,C T,C T,C T,C

Sporax II

USA

Soak

Hydrogen Peroxide

T,C

T-Spray

USA

Spray/
Wipe

Quat. Ammonia

T,C T,C T,C T,C

T-Spray II

USA

Spray/
Wipe

Quat. Ammonia

T,C

Wavicide -01 1

USA

Soak 2

Glutaraldehyde

T,C T,C

C = Approved for use on the cable


N = Not approved for use
T = Approved for use on the transducer
H = Approved for use on the handle only

1 FDA 510(k) cleared


2 Soak or per product
instructions

T,C

AUS = Australia
D = Germany
E = England
F = France
USA = United States of America

HD3 Getting Started


4535 612 13861

139

140

Transducer Care and Maintenance

HD3 Getting Started


4535 612 13861

8 Patient Information
The system uses a medical record number (MRN) to identify a patient. You can
enter the MRN, or you can have the system create one automatically. Filed
images, fetal growth graphs, and reports are stored based on the patient MRN.
The patient information form also includes sections for you to enter study information. The last menstrual period date is important for OB exams. The number
of gestations will automatically arrange patient report data for each fetus.
For cardiac exams, enter values for the height and weight of the patient. The system calculates the body surface area, and uses it to calculate any cardiac indices.

Entering Patient Information


Use the patient information form to enter patient information and information
about the study.
NOTE

You must enter a unique MRN for each patient, otherwise the patient information
is not saved in the system. For information on automatically generating an MRN
for each new patient, see "Changing System Settings" on page 111.

To enter the patient information


1. Press Patient.
2. On the patient information form, click New.
3. Enter the patient information. (Press the Tab key to move the cursor from
field to field.)
4. When you are finished, click OK.
You can also search for a patient and display the patients study information on the
patient information form.

HD3 Getting Started


4535 612 13861

141

Patient Information

Searching for a Patient File


You can search for a patient file by using the name or MRN of the patient.
To search for a patient file
1. Press Patient.
2. On the Patient Information display, click Search.
3. In the Search dialog box, enter the MRN or name of the patient whose exam
you want to locate. (The search begins when you enter the first few letters or
numbers of the name or MRN.)
4. Highlight the search result you want and click Select.
5. Click OK to display the selected patient file.

Editing a Patient File


You can edit the information in the fields of the patient information display. However, you cannot change the patients MRN.
To edit a patient file
1. Press Patient.
2. Use Search to find the patient file you want to edit.
3. With the patient file displayed, click Edit.
4. Edit the patient file information as needed and click OK.

Ending an Exam
Ending an exam saves the patient and exam information.
To end an exam
Press End Exam (F7).

142

HD3 Getting Started


4535 612 13861

Patient Information

Deleting a Patient File


You can delete a patient file by using the name or MRN of the patient.
To delete a patient file
1. Press Patient.
2. On the patient information display, click Search.
3. In the Search dialog box, enter the MRN or name of the patient whose exam
you want to locate and delete. (The search begins when you enter the first
few letters or numbers of the name or MRN.)
4. Highlight the search result you want and click Delete.
5. Click OK to confirm deletion of the patient file.

HD3 Getting Started


4535 612 13861

143

Patient Information

144

HD3 Getting Started


4535 612 13861

9 Imaging
The system supports the following imaging modes:

2D mode

M-mode

Pulsed-wave (PW) Doppler

Color Power Angio (CPA) imaging

Color Doppler imaging

3D mode

Tissue Harmonic Imaging (THI) is activated from the soft key controls.
During any imaging mode there is image information on the display. If you have
activated multiple imaging modes, there will be corresponding image information
for each imaging mode. You can turn off the image information in the setups.
Imaging mode information is displayed on the right side of the display.
For information on using Control, see "Control Knob" on page 99. For a description of each menu item and soft key, see the "Glossary".

2D Imaging
2D imaging is a method of image display in which the amplitude envelope of the
echo signal is represented by modulation of the brightness of the corresponding
image point. The display position of the echo is determined from the position and
angulation of the ultrasound beam and the transit time of the acoustic pulse.
When you turn on the system, it automatically starts 2D imaging.
Use the Control menu to change parameters during 2D imaging.
To use 2D imaging
1. Press Preset to select a transducer and an imaging preset.
2. To change the gain, turn Gain. The gain setting appears on the display as 2D
Gn, where n is the value assigned to the gain setting. The gain setting appears

HD3 Getting Started


4535 612 13861

145

Imaging

in the image information along with the settings for persistence, frame rate,
and power (P).
3. Press Control to adjust the following 2D menu items as needed:

Persistence

Compression

Edge Enhance

Reject

Focal Zones

Frame Rate

Image Width

U/D Invert

Power

2D Post

Utility

To return to 2D-only imaging from any imaging mode, press 2D.

Optimizing the Image with 2D Opt


Use 2D Opt soft key to optimize the system for body habitus.
The general (Gen) setting provides a normal setting. For greater penetration, use
the penetration (Pen) setting. The penetration setting takes advantage of the
lower frequency portions of the transducer bandwidth and results in greater penetration and sharper edge or border emphasis than the default setting. You can
use the resolution (Res) setting for greater resolution. The resolution setting
takes advantage of the higher frequency portions of the transducer beamwidth
and results in an image with greater spatial resolution than the default setting.

2D Depth Setting
The depth scale is marked off in centimeters and allows you to determine the
depth of the echoes. Each small marker in the depth scale represents 0.5 cm in
depth, and each medium marker represents 1 cm in depth. The triangular marker
to the right of the depth scale is the focal zone for the transducer.
146

HD3 Getting Started


4535 612 13861

Imaging

Use the Depth control to change the depth scale. Depending upon your selection, there could be as many as five focal zone markers on the depth scale for a
given transducer. Use Focus to adjust the depth of the focal zones.
When you change the depth, the 2D image display, the depth scale, TI and MI values, frame rate, and the focal depth can change. When you change the depth, you
may also need to change the focal zone to enhance the area of interest.
To adjust the depth scale and focal zones
1. Press Depth up or down to change the depth scale.
2. Press Focus up or down to adjust the focal zone.

Focal Zone Positioning


Each frequency and type of transducer has a set of transmit focal zones that are
fixed at specific depths. The triangular markers to the right of the depth scale tells
you where the focal zone or focal zones occur for a given transducer.
To change the focal zone number and positioning
1. Press Control and select Focal Zones.
2. To increase or decrease the number of focal zones, press the Focus + or
Focus - soft keys.

Gray and Chroma Maps


You can press Control to access a menu from which you can look at a graph representing the selected gray map, select a different gray map, and create a userdefined gray map. You can do this for 2D, M-mode, and Doppler gray maps. You
can also vary the color of the Chroma maps.
To view and select gray maps
1. Press Control and select 2D Post.
2. To look at a gray map, select 2D Map and use Control to highlight the map
names and see the graphs at the bottom of the menu.
3. Select the map you want.

HD3 Getting Started


4535 612 13861

147

Imaging

To edit and save gray maps


1. Press Control and select 2D Post.
2. Select 2D Map, and press and turn Control to select a user-defined map.
3. Turn Control and select Edit. The gray map appears on the image.
4. Press Select to activate each point on the map and to change the map as
needed.
5. Use the soft keys as needed to add or delete points.
6. Press the Apply soft key to apply the new map.
7. Press the Save soft key to save the map.
To select and change Chroma maps
1. In 2D imaging, press Control and select 2D Post.
2. Press Control to turn on Chroma.
3. Turn Control and select Color.
4. Press Control to activate Color and turn Control to adjust the color settings.

Dual Imaging
Using dual imaging, you can position two images side-by-side on the display. Pressing Dual enables the dual images display. Once the dual images display is enabled,
you can alternate image activity between the two images using Dual or Enter.
The

image orientation icon appears in the active image.

To use dual imaging


1. In 2D, Color, or CPA imaging, press Dual. The image shifts to the left of the
display.
2. Press Dual a second time to activate the second image, which appears to the
right of the other 2D image.
3. Press Dual to alternate the update between the two images.
4. Press 2D to exit the dual display.

148

HD3 Getting Started


4535 612 13861

Imaging

Zoom Magnification
You can select a portion of the image to magnify using zoom. You can magnify a
region of interest in the 2D, Color, or CPA image for closer examination. In Mmode imaging, you can set the region of interest in the 2D image and concentrate
on the M-mode information defined by the M-line within the region of interest.
M-mode information shallower or deeper than that defined by the region of interest is not displayed.
To use zoom
1. During 2D imaging, press Zoom.
2. Press Select to adjust the size of the region of interest.
3. Press Select again to adjust the position of the region of interest.
4. Press Enter or Zoom to magnify the image.
5. Press Exit to return to a normal image.

Cine Review
Freeze stops image acquisition and enables Cine operation.
To use Cine review
1. Obtain an image sequence and press Freeze.
2. Use the trackball to move through the Cine sequence frame-by-frame. (The
frame counter is at the top of the display. It changes as you move through the
frames.)
3. Press Enter to play and stop the Cine sequence.

Tissue Harmonic Imaging


Tissue Harmonic Imaging (THI) uses the harmonic frequencies generated by tissue. The fundamental transmit frequency results in a harmonic frequency echo.
The harmonic frequency received from the tissue is a multiple of the fundamental
transmit frequency. The fundamental and any accompanying artifacts are missing
from the harmonic frequency that the system receives. The artifact reduction, and

HD3 Getting Started


4535 612 13861

149

Imaging

the concomitant reduction in haze and clutter, increases contrast resolution and
improves border delineation. THI is useful in difficult-to-image patients.
Press the Harmonic soft key to start Tissue Harmonic Imaging.

Acoustic Power Output


When you adjust Power, you directly control the system acoustic power output.
The acoustic power output is interpreted on the display as a thermal index (TI)
and a mechanical index (MI). A value for power (P) is also displayed in the image
information.
To adjust the acoustic power output
1. Press Control and select Power.
2. Turn Control to adjust the power.

Time Gain Compensation


Time gain compensation (TGC) allows compensation for the attenuation of echoes over time. With the TGC slide controls, you can selectively apply gain to different depth ranges. By selecting TGC Line in the System Display setups, you
can display the TGC line along the right side of the image to see the relative gain
setting at each depth range.
To use TGC

150

To increase the gain in the corresponding depth range of the image, slide the
TGC slide control to the right. Observe the TGC Line and how it varies at
the depth affected by the TGC slide control.

To decrease the gain in the corresponding depth range of the image, slide the
TGC slide control to the left.

HD3 Getting Started


4535 612 13861

Imaging

Text Annotation
You can use the keyboard or the soft keys to add text and indicators to the image
display.
To annotate the image display
1. Press Text (F1).
2. Position the text cursor on the display.
3. Do any of the following:

Type the text that you want to appear on the display.

To remove text and indicators from the display, press Clear.

4. To exit text annotation, press Exit.

Body Markers
You can add body markers to the display and edit the available sets of body markermarkers.
To display and edit body markers
1. Press Marker to display a row of body markers soft keys. Pressing Marker
again or Next may display additional body markers.
2. Press a soft key to select the corresponding body marker.
3. Position the transducer indicator on the body marker, and turn Control to
change the transducer indicator direction.
4. Press Select and position the body marker on the display.
5. Press Enter to fix the location of the body marker.
6. To remove a body marker, press Clear.
To use the pointer
1. Press Pointer (F5) to display an arrow pointer.
2. To change the pointer direction, turn Control.
3. To anchor the pointer and activate another pointer, press Enter.
4. To clear the pointer, press Clear.
HD3 Getting Started
4535 612 13861

151

Imaging

M-mode Imaging
M-mode, or motion mode, is normally used with the 2D image. M-mode is a
method of display in which tissue interface position or depth is displayed along the
vertical axis and time is displayed along the horizontal axis. Over time, the movement of the anatomy along the M-line, which is displayed on the 2D image, creates
a scrolling display. M-mode is used frequently to display echocardiographic data in
which heart wall motion and valve motion are displayed as functions of time.
NOTE

During 2D imaging, you can preset the M-line location by pressing the Mline key
(F4) and using the trackball.

To use M-mode imaging


1. Press Mmode to start M-mode imaging.
2. Move the M-line to the location on the 2D image from which you want the
M-mode display to be derived.
3. Turn Gain to change the 2D and M-mode gain. The gain setting on the display
appears as [2D/M] Gn, where n is the value assigned to the gain setting. The
gain setting appears in the image information along with the other 2D/Mmode image information.
4. Use the soft keys to change the parameters as needed.
5. Press Control to adjust the following 2D/M menu items as needed:

152

Persistence

Compression

Edge Enhance

Reject

Frame Rate

Harmonic

L/R Invert

Zoom

Image Width

U/D Invert

HD3 Getting Started


4535 612 13861

Imaging

Power

2D Post

M Post

Utility

Color and Color Power Angio (CPA) Imaging


Color and CPA imaging use Doppler principles to generate images.

Color Imaging
Color imaging uses Doppler principles to generate a color image of flow velocity,
variance, power, or velocity and variance. The color image is overlayed on the 2D
image; its size and position can be adjusted within the 2D image.
To use color imaging
1. Press Color to start Color imaging.
2. Move the position of the Color box. Press Select to change the size of the
color box.
3. Turn Gain to change the Color gain. The Color gain setting on the display
appears as [C] Gn, where n is the value assigned to the gain setting. The gain
setting appears in the image information along with the color settings for frequency (kHz), persistence (FA), filter (F), and sensitivity.
4. Press Control to adjust the Color menu items as needed:

Persistence

Priority

Sensitivity

Color Mode

Display

Power

Color Post

Utility

5. Press the soft keys as needed.


HD3 Getting Started
4535 612 13861

153

Imaging

CPA Imaging
In CPA imaging, the colors are related to the power or energy inherent in blood
cell motion. The CPA image is overlaid on the 2D image; its size and position can
be adjusted within the 2D image.
To use CPA imaging
1. Press CPA to start CPA imaging.
2. Move the position of the CPA box. Press Select to change the size of the
CPA box.
3. Turn Gain to change the CPA gain. The gain setting on the display appears as
[CPA] Gn, where n is the value assigned to the gain setting. The gain setting
appears in the image information along with frequency (kHz), persistence
(FA), filter (F), and sensitivity.
4. Press Control to adjust the following CPA menu items as needed:

Persistence

Priority

Sensitivity

Display

Power

CPA Post

Utility

5. Press the soft keys as needed.

Color Maps
You can press Control to access a menu from which you can select among several Color or CPA maps, set up color capture, and create a color tag.
To select a color map
1. Press Color or CPA.
1. Press Control and select Color Post.
2. Select Color Map and turn Control to select the map you want.
154

HD3 Getting Started


4535 612 13861

Imaging

To capture color
1. Press Control and select Color Post.
2. In the Color Post menu, select Capture.
3. In the Capture menu, highlight Capture and press Control to turn on capture.
4. Highlight Frame and turn Control to set the number of frames.
To tag color
1. Press Control and select Color Post.
2. Select Color Tag.
3. In the Color Post menu, select Color Tag.
4. In the Color Tag menu, highlight Color Tag and press Control to turn on
color tag.
5. Highlight Tag Pos and turn Control to set the tag position.
6. Highlight Tag Width and turn Control to set the tag width.

Color or CPA Steer Angle


NOTE

A linear transducer must be active to use Steer.

To improve the Color or CPA angle


1. Press the Steer soft key.
2. Use the trackball to steer the Color or CPA box.

Pulsed-Wave Doppler Imaging


Pulsed-wave (PW) Doppler imaging uses Doppler principles to generate a scrolling display in which a spectrum of frequencies within a sample volume are displayed relative to time. The PW Doppler display appears with the 2D image and
can be updated simultaneously with the 2D image.
NOTE

High PRF is available for use with the C4-2, C5-2, and C7-3 transducers. You can
use High PRF with any preset.
HD3 Getting Started
4535 612 13861

155

Imaging

To use PW Doppler imaging


1. Press PW.
2. Change the sample volume depth.
3. Press Select to select the SV size and position.
4. To open or close the gate, roll the trackball up or down.
5. If you are using a linear transducer, press Control and adjust the steer angle
as needed.
6. Press the Angle soft key to set the Doppler angle to -60 degrees, 0, or to
+60 degrees, if necessary.
7. Press and turn Control to adjust the angle in 1-degree increments.
8. Turn Gain to change the PW gain. The gain setting on the display appears as
[PW] Gn, where n is the value assigned to the gain setting. The gain setting
appears in the image information along with filter (F), Doppler frequency
(kHz), SV depth (cm) and size (mm), and Doppler angle.
9. Press Control to adjust the following PW menu items as needed:

Volume

Smooth

Compression

Simultaneous

Display

PW Size

Sweep

Power

PW Post

Utility

10. Press the soft keys as needed.

156

HD3 Getting Started


4535 612 13861

Imaging

Inverting the Display


You can display positive velocities or frequencies above the baseline with negative
ones below the baseline, or you can display negative velocities or frequencies
above the baseline with positive ones below the baseline. Press the Invert soft
key to switch between those options. The velocity or frequency scale changes
accordingly. During Color imaging, Invert inverts the color or map.
.

Updating the Image Display


In duplex mode, 2D and PW imaging modes appear on the display at once. Press
Enter to alternate updating between the two imaging modes. Select Simultaneous from the Control menu to activate both imaging modes.
Duplex and simultaneous update are available for 2D and Doppler imaging.
Simultaneous is the simultaneous update and display of 2D, Color or CPA, and
Doppler imaging and can be used to decrease exam time and improve efficiency.
To update the image display
1. In 2D imaging (without the M-line displayed), press PW.
2. When the Doppler display appears, it is inactive. Press Enter to activate the
scrolling display.
3. Press Enter to alternately activate 2D or Doppler imaging.
To use duplex
1. In 2D imaging, press PW.
2. Press Control to turn on Simultaneous or press Enter to cycle between
an update mode or duplex imaging.
To use Simultaneous
1. In 2D imaging, press Color and press PW.
2. Press Control to turn on Simultaneous or press Enter to cycle between
an update mode or duplex imaging.

HD3 Getting Started


4535 612 13861

157

Imaging

Sweep Speed
During Doppler imaging, you can change the sweep speed of the scrolling display
by pressing Control and using the trackball to select the sweep. During M-mode
imaging, you can use the Sweep soft key to change the sweep speed.
There are four sweep speeds. Each press of sweep control changes the sweep
speed. A medium sweep speed is suitable for normal use, but a fast sweep speed
may be useful to show the shape of some flow information. If, for example, a flow
pattern is to be analyzed carefully to calculate a mean pressure gradient, then it is
much easier to do this at a faster speed than at a slower speed. When the Doppler sweep speed is changed, the Doppler display and memory review buffer are
cleared of data before a different sweep speed begins.
There are three sizes of time markers in the scrolling displays. The largest time
marker denotes a time of 1 second, the smaller time marker denotes 0.2 second,
and the smallest time marker denotes 0.1 second. The smallest time marker
appears in the faster sweep speeds.

Steering Angle
During Doppler imaging, you may need to steer the ultrasound beam to get a better Doppler angle with a linear array transducer.
The steering of the ultrasound beam for the linear array is independent of angle
correction. Angle correction is used to calibrate the velocity scale for the angle
that exists between the ultrasound beam and blood flow. The steering angle does
not directly affect the calibration of the velocity scale.
NOTE

A linear transducer must be active to use Steer to improve the Doppler angle.

To improve the Doppler angle


1. Press Control and select Steer.
2. Press Control to cycle the angle among the settings.

Wall Filters
Wall filters are used in Doppler, Color, and CPA imaging. They eliminate vesselwall or cardiac-wall motion noise that is low in frequency but high in intensity. A
wall filter high enough to remove the audible thumping of the cardiac walls but
158

HD3 Getting Started


4535 612 13861

Imaging

sensitive enough to retain grayscale spectral information near the baseline is ideal.
There are four wall filter settings: F0, F1, F2, and F3.
To change the wall filter for the active display
1. Press the Filter soft key.
2. Press Control to change the wall filter.

Doppler Zero Baseline


A Doppler scale is divided by a zero baseline. The baseline extends the height of
the Doppler display.
To adjust the zero baseline
1. Press the Baseline soft key.
2. Turn Control to adjust the baseline for the display of higher velocity Doppler
signals.

Doppler Scale
The frequency or velocity scale is located along the left border of the Doppler
display. Depending upon your selection, the scale is calibrated in frequency units
(kHz) or velocity units (cm/s). You can change the units by which the scale is calibrated in the setups.
The Doppler scale is also affected by other control changes. For example, when
you change the Doppler angle, the Doppler scale changes. Incorrectly setting the
Doppler angle will result in an inaccurate Doppler display. Angle correction along
the axis of the vessel under study is critical for Doppler display accuracy.
To change the Doppler scale
1. Press Set Up (F10).
2. In the setups, click the Measure tab and then click the General tab.
3. For the Doppler Mode Y-axis Unit, select either cm/s or kHz.
4. Click Save.

HD3 Getting Started


4535 612 13861

159

Imaging

To adjust the scale


1.

Press the Scale soft key.

2. Turn Control to adjust the spectral display for higher or lower velocity flow.

Doppler Angle
Angle correction adjusts the Doppler scale to account for the angle between the
direction of the reflector motion and the direction of propagation of the ultrasound beam (Doppler angle). The range of this control is -60 to +60. Use the
Angle soft key to display and adjust the position parallel to flow, which appears
on the sample volume.
WARNING

Incorrectly setting the Doppler angle results in an inaccurate Doppler display.


Angle correction along the axis of the vessel under study is critical for Doppler
display accuracy.
To use Doppler angle correction
1. During Doppler imaging, position the sample volume, and press Select to
adjust the sample volume size.
2. Press the Angle soft key to set the Doppler angle to -60 degrees, 0, or to
+60 degrees, if necessary.
3. Press Angle to display the direction cursor.
4. Turn Control to change the Doppler angle in 1-degree increments.
5. Position the angle parallel to flow.

Audio Volume
You use the Control knob to control the volume of the audio emitted from the
speakers. The volume is on when the system starts up.
To adjust the system audio volume
In PW imaging, press Control and turn the knob right to increase the volume, or
left to decrease the volume.

160

HD3 Getting Started


4535 612 13861

Imaging

3D Imaging
The Freehand 3D option lets you acquire an uncalibrated series of 2D frames in
Cine memory for 3D acquisition and rendering. After acquisition, the system renders a 3D volume image from the 2D frames. You can use all conventional transducers for Freehand 3D imaging.
Once images are acquired, 3D View lets you adjust the thresholds, rotate 2D
multiplanar images, rotate volume images, cut extraneous image information,
magnify images, and view Cine sequences.

Suggestions for Acquiring 3D Images


The following are suggestions for acquiring high-quality 3D images:

To view a 3D fetus image full in the face, put the fetus head on the image orientation marker so that it makes a coronal plane. Scan the fetus from fetal
back to abdomen.
It is easier to find the fetal face and view it as a 3D image if you scan on the
coronal plane instead of the previous sagittal plane.

Adjust the contrast of the desired tissues before you begin volume scanning.

Only the image data within the ROI is rendered; objects outside of the ROI
are not included in the rendering process.

Make sure the size of ROI is not too big; the ROI size greatly affects the rendering speed.

The surface of the examined objects should be insulated by hypoechoic tissue


against anything that does not generate echo, for example, amniotic fluid.
Otherwise, the contour of object surface cannot be defined.

2D Imaging Effects on 3D Acquisition


With a standard transducer in 3D imaging mode, the system uses the 2D images
acquired and stored in Cine memory to create a 3D image. Because the quality of
the volume images is dependent upon the quality of the 2D imaging technique,
special attention should be paid to the quality of the 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

HD3 Getting Started


4535 612 13861

161

Imaging

adjust focal zones to change the frame rate. You can use any transducer for this
type of freehand 3D imaging.
In 3D imaging, the images are gathered based on an assumed spatial relationship
between the images.
In 3D imaging, using a standard transducer, you drag (slide), pivot (tilt), or rotate
the transducer at the region of interest to acquire the images. If you drag the
transducer, hold the transducer with the same angular relationship to the skin
throughout the motion to keep the image planes parallel to each other. If you are
tilting the transducer, pivot the transducer at an even rate, keeping the face of the
transducer in the same position on the skin. If you are rotating the transducer,
rotate the transducer 180 degrees at an even rate, keeping the face of the transducer in the same position on the skin or in the cavity. Move the transducer at a
constant rate for equally-spaced images.

Acquiring a 3D Image
To acquire the 3D image
1. Press 2D to make sure the system is in 2D imaging mode.
2. Set up the system for the best image quality for the application.
3. Preview the site to determine where to start and stop the sweep. Follow standard AIUM protocols to ensure a standardized orientation of the 2D multiplanar views.
4. Position the transducer over the scanning region.
5. Press 3D (F2).
6. Press Select and adjust the position and size as needed.
7. Press Enter to begin scanning. A status bar at the bottom of the display
shows the progress of the frame acquisition.
8. If necessary, press Exit to cancel scanning and to start a new acquisition.
When scanning is complete, a status bar shows the 3D rendering progress. When
rendering is complete, the 3D View display appears.

162

HD3 Getting Started


4535 612 13861

Imaging

Viewing and Manipulating a 3D Image


Use 3D View to view and change the 3D images.

Adjusting the Threshold


For surface structures, you can adjust the low and high thresholds to improve
border recognition. Threshold settings do not affect transparency.
Low threshold eliminates small echoes or noise, providing a better view of surface
structures.
High threshold, normally not adjusted, eliminates echoes above the threshold setting. If the surface rendering algorithm reaches a grayscale value higher than the
threshold value, then this value becomes the surface border. In effect, you can
determine the surface border by setting the high threshold to the maximum setting.
To change threshold settings
1. Press and hold Enter and drag the High Threshold or Low Threshold
slider to the right or left as needed. As you move the slider, the image updates
in the Preview display.
2. Release Enter to process the image with the updated settings.

Adjusting the Gamma


You can adjust the bias and position of the grayscale curve applied to the ABC
multiplanar 2D images and the 3D volume image.
To adjust the gamma values
1. Press and hold Enter and drag the Bias or Position slider to the right or left
as needed (Figure 9-1). As you move the slider, the image is updated in the
Preview display.
2. Press Select to process the image with the updated settings.

HD3 Getting Started


4535 612 13861

163

Imaging

Figure 9-1 Gamma Settings

Adjusting the ROI


The ROI X, Y, and Z sliders (Figure 9-2) let you select and adjust the axis of the
3D volume that will be included in the 3D image. As you change the sliders, the
reference images and the volume change accordingly. Attempt to set the axes so
that you see just the part of the multiplanar 2D image that you want to include in
the 3D image.
Figure 9-2 3D ROI Sliders

To adjust the ROI


1. Press and hold Enter and drag the X, Y, and Z sliders to the right or left as
needed.
2. Press Select to process the image with the updated ROI settings.

164

HD3 Getting Started


4535 612 13861

Imaging

Changing the Rotation


Rotation enables an improved view of the region of interest. The availability of the
rotation varies with the display.
There are three methods for rotating a 3D image: clicking Rotation and using
the trackball, pressing and holding Enter and using the trackball, or by using the
ROT soft keys to rotate images 90 degrees. This section provides instructions for
each method.
To rotate a 3D image by clicking Rotation
1. Click Rotation.
2. Rotate the 3D image as follows:

To rotate on the X axis, move the trackball up or down.

To rotate on the Y axis, move the trackball left or right.

To rotate on the Z axis, press and hold Enter and rotate the trackball.
The image is displayed in the Preview as you change the rotation.
3. To apply the rotations, press Exit.
To change the rotation using the soft keys
1. Do any of the following:

Press the associated soft key to rotate the image 90 degrees to each axis.

Press the Shift Left or Shift Right soft key to shift the image right or
left.
2. Press Select to process the image with the updated ROT settings.

Changing the Position


As you change the position, the image is displayed in the Preview section of the
3D View display.
To change the position
1. Click Position and change the position of the image. As you change the position, the image is displayed in the Preview section.
2. To save the position, press Exit.
HD3 Getting Started
4535 612 13861

165

Imaging

Changing the Image Size


You can change the size of the 3D image by clicking Magnification. The benefit
of a large image is better resolution; the benefit of a small image is faster calculation.
To change the size of an image
1. Click Magnification and move the trackball right to increase the image size,
or left to decrease the size. As you change the size, the image is displayed in
the Preview section.
2. To save the magnification, press Exit.

Using Cut Mode


Use Cut Mode to erase extraneous sections of the image.
To erase portions of a 3D image
1. Click Cut Mode and push one of the following soft keys:

Inside Contour to trace an area on the image and cut the inside section

Point Eraser to use the eraser function to cut sections

2. Move the erase cursor as needed and press Enter.


3. To save the changes, press Exit.
4. To cancel a single or all cut functions, do one of the following:

Press the Undo soft key to undo the last cut.

Press the Undo All soft key to undo all cut functions.

Reverting Back to the Original 3D Image


To revert back to the original 3D image
Click Initial 3D View or press the Initial 3D View soft key.

166

HD3 Getting Started


4535 612 13861

Imaging

Using Color Map


Use Color Map to change the color of the 3D image.
To use change the color of the 3D image
1. Click Color Map.
2. On the Color Map menu, click the color you want to use, and then click
OK.

HD3 Getting Started


4535 612 13861

167

168

Imaging

HD3 Getting Started


4535 612 13861

10 Biopsy Guides
Biopsy guides are used to assist in the guidance of a biopsy tool. The system generates a guideline that represents the anticipated path of the biopsy tool. The echoes of the anatomical target and the tool are displayed on the video display and
assist in guiding the biopsy tool to the target.

Attaching and Removing a Biopsy Guide


Detailed information about attachment and removal of biopsy guides is shipped
with the biopsy starter kits, guides, and brackets.
WARNINGS

Inspect all components. Ensure that the biopsy guide you are using is the correct one for the transducer, the system, and system software. Your Philips
Ultrasound customer service representative can verify this information for
you.

Alignment verification must be performed at the selected depth for the


intended procedure, prior to a biopsy procedure. See "Verifying the Biopsy
Guide Alignment" on page 171.

Use only Philips-approved biopsy guides, brackets, supplies, components, and


accessories. Other brands may not properly fit Philips Ultrasound transducers. Improper installation may result in patient discomfort.

Some biopsy guides must be installed over a sterile transducer cover.


Biopsy guides must be sterilized after each use. For procedures on cleaning
and sterilizing biopsy guides, refer to the instructions provided with the biopsy
guides.

Most transducers can only be disinfected; they cannot be sterilized. Only the
transducer cover provides the sterile barrier.

HD3 Getting Started


4535 612 13861

169

10

Biopsy Guides

Using the Biopsy Guideline Display


WARNING

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.
The system generates a biopsy guideline through the displayed real-time ultrasound image to indicate the anticipated path of the needle. You can use this guideline to ensure that the needle or instrument is following the correct path.
When the biopsy display is active, a biopsy guideline is displayed on the left side of
the screen during normal image presentation and on the right side when the
image presentation is reversed. Image presentation is defined by the location of
the orientation marker.
When depth is changed, the biopsy display is redrawn to reflect the new relationships at the new depth setting.
To calibrate the biopsy guideline
NOTE

The biopsy guideline must be calibrated for each transducer.


1. Press Control and select Utility.
2. On the Utility menu, select Biopsy.
3. On the Biopsy menu, select Biopsy Edit. A message prompts you to use
caution when editing the biopsy guideline.
4. Click OK.
5. Press Select to select the start or angle, or use the soft keys as needed.
6. To save the biopsy guideline, press the Save soft key. A message warns you
that the original biopsy guidelines cannot be recovered.
7. Do one of the following:
To save the new biopsy guideline, click OK.

170

To retain the original biopsy guideline, click Cancel.

HD3 Getting Started


4535 612 13861

Biopsy Guides

10

To show or hide the biopsy guideline


NOTE

When you first use the system, the biopsy guideline does not display until after
the guideline is calibrated.
After calibrating the biopsy guideline, press Biopsy (F3) to show or hide the
guidline.

Verifying the Biopsy Guide Alignment


Perform the alignment verification before the biopsy procedure. The alignment
verifies the system, transducer, and biopsy guide relationships.
WARNINGS

Alignment verification is necessary prior to performing procedures with the


biopsy guide.

Do not use the biopsy guide if the needle is not following the intended path.
The needle used for this alignment verification must not be used for the actual
procedure. Always use a new, sterile needle for each biopsy procedure.

To assist in an accurate projection of the needle, use a straight, new needle for
each alignment procedure.
Do not use the biopsy guide if the needle is not following its indicated path. Contact a Philips Ultrasound customer service representative.
The following items are needed for the alignment verification:

Transducer

Biopsy guide or bracket and needle guide (The type of bracket and needle
guide you use depends upon the transducer you are using. For the correct
bracket and guide, contact Philips customer service.)

Sterile procedure kit (disposable)

New, straight, biopsy needle

Beaker of water (or water bath)

HD3 Getting Started


4535 612 13861

171

10

Biopsy Guides

To verify alignment of the biopsy guide


1. Attach the biopsy guide.
2. Set the system depth for the procedure to be performed.
3. Display the biopsy guideline as described in "To show or hide the biopsy
guideline".
4. Immerse the transducer no more than 6 mm (0.25 in) into the water bath.
5. Insert a straight, new needle into the biopsy guide.
6. Move the needle down into the water bath until its ultrasound image is visible
on the video display.
WARNING

If the needle enters from the unexpected side of the display, verify that the biopsy
guide is correctly mounted on the transducer and that the orientation of the
transducer is correct. If the needle is still not following the expected path along
the guideline, do not use the biopsy guide. Contact your Philips Ultrasound customer service representative.
7. Verify that the needle, as seen on the video display, falls along the guideline
along the entire depth of the guideline display. The biopsy guideline is only
intended to provide an indication of the expected path of the needle. Actual
position must be verified by identifying the echoes from the needle.

172

HD3 Getting Started


4535 612 13861

Biopsy Guides

10

Biopsy Procedure
WARNINGS

Alignment verification should be performed at the selected depth prior to the


biopsy procedure to ensure that the biopsy guide and the needle have been
installed properly.

Use a straight, new needle for each procedure.


The biopsy guideline is intended only to provide an indication of the expected
path of the needle. Actual position must be verified by identifying the echoes
from the needle.

If the needle is not following the expected path, discontinue the procedure
and contact your Philips Ultrasound customer service representative.

Thin needles can bend when entering tissue. Actual position must be verified
by identifying the echoes from the needle.

Reverberation or other tissue artifacts may produce false needle images,


which can cause confusion in locating the actual needle image. Ensure the needle path is along the guideline, and that you are not using a false needle image
to locate the needle.

Philips Ultrasound does not recommend anatomical survey of the prostate


with the biopsy guide attached.
To perform a biopsy procedure
1. Install the transducer cover and the biopsy guide.
2. Set the system controls for the biopsy procedure.
3. Orient the transducer to match image presentation. Use the 2D scan plane
orientation marker.
4. If necessary, apply sterile acoustic coupling gel to the patient.
5. Begin scanning the patient. Position the transducer so that the puncture target
is intersected by the guideline displayed on the screen.
6. Insert the needle into the needle guide groove closest to the transducer.
7. Perform the puncture by sliding the needle through the groove in the guide
until the needle, as shown on the display, intercepts the target.
HD3 Getting Started
4535 612 13861

173

10

Biopsy Guides

8. If you are using a biopsy guide bracket and procedure kit, you can remove the
transducer from the patient while the needle is still inserted in the patient:
Separate the needle from the biopsy guide by pulling the tab up so that the pin
snaps out of the needle guide.
9. Remove the biopsy guide after use, as described in the instructions included
with the biopsy guide or bracket.

Ordering Biopsy Guides and Accessories


See "Ordering Supplies and Accessories" on page 27.

174

HD3 Getting Started


4535 612 13861

11 Measurements
Several measurement tools are available for the different types of measurements.
The number of measurements you can perform on one image depends upon the
measurement tool used.

Performing Measurements
The following procedure lists the basic steps for performing measurements.
To perform measurements
1. Press Caliper. The image is frozen when a measurement is started.
2. To cycle through the available measurements for the selected imaging mode,
continue pressing Caliper.
3. To position the cursors, use the trackball.
4. To activate a second caliper, press Enter.
5. To alternate between cursors, press Select.
6. To complete a measurement and start a new measurement, press Enter.
7. To cancel a measurement, press Exit.
8. To remove measurements from the display, press Clear.
9. To resume scanning after performing a measurement, press Freeze.
See the subsections on individual measurement types for more information about
making measurements.
NOTE

Ensure that you follow current medical practices when identifying specific measurement points on an image.
The system displays measurement results in a default location in the lower right of
the display. For information on changing the number of measurements displayed,
or hiding the measurement results, see "Changing Measure Settings" on page 112.

HD3 Getting Started


4535 612 13861

175

11

Measurements

2D Distance Measurement
Four distance measurements can be performed on one image. The ratio results
between the first two and between the second two distance measurements are
displayed as percentages (%).
To perform a 2D distance measurement
1. Obtain the desired image.
2. Press Caliper. The image freezes, and a measurement cursor appears.
3. If necessary, press Caliper again, or press one of the soft keys, to change the
measurement tool.
4. Position the cursor at the first point of the measurement.
5. Press Enter to display the second cursor.
6. Place the cursor at the end of the measurement to display results.
7. If necessary, press Enter to lock the measurement, display another cursor,
and do one of the following:

Repeat step 4 through step 6 to make another measurement with the new
set of calipers.

Select a different measurement tool.

2D Circumference and Area Measurements


2D circumference and area measurements are made using either the 2D Ellipse
or the 2D Trace tool. Four circumference and area measurements can be performed on one image.
To perform a 2D trace circumference and area measurement
1. Obtain a 2D image.
2. Press Caliper. The image freezes, and a measurement cursor appears.
3. If necessary, press Caliper again or the associated soft key to change the
measurement tool to 2D Trace.

176

HD3 Getting Started


4535 612 13861

Measurements

11

4. Position the cursor on the perimeter of the shape to be measured and then
press Enter. The results are displayed, and a new cursor appears. The results
are updated as you move the cursor.
5. Guide the cursor around the perimeter of the shape. As you move the cursor,
the shape is traced on the display. When the cursor is near the starting point,
the trace automatically closes. The measurement is locked, and the results are
displayed. A new cursor appears for the next measurement.
6. Repeat step 4 and step 5 to make additional 2D trace circumference and area
measurements.
7. To resume scanning, press Freeze.
To perform a 2D ellipse circumference and area measurement
1. Obtain a 2D image.
2. Press Caliper. The image freezes, and a measurement cursor appears.
3. If necessary, press Caliper again or the associated soft key to change the
measurement tool to 2D Ellipse.
4. Position the cursor on the perimeter of the shape to be measured and then
press Enter. The results are displayed, and a new cursor appears. The results
are updated as you move the cursor.
5. Position the new cursor at the second point of the shape and then press
Enter. The position of the ellipse is fixed, and the expanse of the ellipse
becomes adjustable. The results are updated as you move the cursor.
NOTE

You can press Select to release the second cursor point.


6. If necessary, press Enter to lock the measurement and repeat step 4 and
step 5 to make additional 2D circumference and area measurements.
7. To resume scanning, press Freeze.

HD3 Getting Started


4535 612 13861

177

11

Measurements

2D Volume Measurement
Volume measurements are made using either the 1 Distance, 3 Distance, or
Distance + Ellipse tools. You can perform four volume measurements on one
image using the 1 Distance tool, three volume measurements using the 3 Distance tool, and two volume measurements using the Distance + Ellipse tool.
To perform a volume measurement
1. Obtain a 2D image.
2. Press Caliper.
3. Press the Volume soft key.
4. Press Volume again to change the measurement tool to 1 Distance, 3 Distance, or Distance + Ellipse.
5. Perform the appropriate distance or ellipse measurements.
6. To resume scanning, press Freeze.

2D Hip Joint
The 2D hip joint measurement provides both an alpha and beta angle result.
Performing a hip joint measurement
1. Obtain a 2D image of the infants hip at the trochanter major.
2. Press Caliper. The image freezes, and a measurement cursor appears.
3. Press the Distance soft key.
4. If necessary, press Distance again to change the measurement tool to 2D
Hip Joint.
5. Move the cursor to the osseous acetabular convexity and press Enter.
6. Move the active cursor to the point where the joint capsule and the perichondrium unite with the iliac bone and press Enter.
7. Move the active cursor to the lower edge of the os ilium and press Enter.
The alpha angle result is displayed, and a new cursor appears. The result is
updated as you move the cursor.

178

HD3 Getting Started


4535 612 13861

Measurements

11

8. Move the active cursor to the osseous acetabular convexity and press Enter.
The roof line is locked and a new cursor appears for the inclination line.
9. Move the cursor to the labrum acetabular and press Enter. The beta angle
results are displayed, and a new cursor appears. The results are updated as
you move the cursor.
10. Move the cursor to the osseous acetabular convexity and press Enter. The
measurement is complete.
11. To resume scanning, press Freeze.

M-Mode Distance
You can perform distance measurements on an M-mode display. Four measurements can be performed on one image.
To perform an Mmode distance measurement
1. Obtain an M-mode image.
2. Press Caliper. The image freezes, and a measurement cursor appears.
3. Position the cursor at the first point of the measurement and then press
Enter. The results are displayed, and a new cursor appears. The results are
updated as you move the cursor.
4. Position the cursor at the second point of the measurement. The measurement is complete, and the results are displayed.
5. To make additional M-mode time, distance, and velocity measurements, press
Enter to display a new measurement cursor and repeat step 3 and step 4.
6. To resume scanning, press Freeze.

Doppler Velocity
You can perform two measurements on a Doppler display.
To perform a Doppler velocity measurement
1. Obtain a Doppler display.
2. Press Caliper. The image freezes, and a measurement cursor appears.

HD3 Getting Started


4535 612 13861

179

11

Measurements

3. Position the cursor at the first point of the measurement and press Enter.
The results are displayed, and a new cursor appears. The results are updated
as you move the cursor.
4. Position the cursor at the second point of the measurement. The results are
displayed.
5. To make additional Doppler velocity measurements, press Enter and repeat
step 3 and step 4.
6. To resume scanning, press Freeze.

Doppler Velocity Ratio


You can perform measurements on Doppler images that provide velocity ratio
results between two points set on a Doppler waveform. Two velocity measurements can be performed on one image. Starting velocity results, ending velocity
results, and velocity ratios are available.
To obtain a Doppler velocity ratio
1. Obtain a Doppler display.
2. Press Caliper. The image freezes, and a measurement cursor appears.
3. If needed, press Caliper again to change the measurement type to Doppler
Velocity (A/B).
4. Perform the appropriate measurements.
5. To resume scanning, press Freeze.

Measurement Accuracy
This section provides information about measurement accuracy for each time of
imaging.

2D Measurement Accuracy
Resolution is proportional to the transducer frequency. Penetration is inversely
proportional to the transducer frequency. Resolution is always best near the focal
zone of the transducer where the ultrasound beam is narrowest. The user sets
the focal point depth. Measurements are most accurate near the focal depth, and
less accurate away from the focal point as the acoustic beam widens.
180

HD3 Getting Started


4535 612 13861

Measurements

11

Doppler Measurement Accuracy


Lower frequency transducers are capable of measuring higher velocity flows. Sample volume size is limited laterally by the acoustic beam. Penetration is best with
low frequency transducers.

Color and CPA Measurement Accuracy


There is no measurement or calculations protocol designed specifically for Color
or Color Power Angio imaging. The accuracy of measurements made in Color are
subject to the same limitations as a similar type of measurement made on a grayscale image. Do not use Color values for precise flow velocity quantification in
any application. Color flow values are estimates of the mean velocity, and will not
necessarily represent peak velocities. The method of choice for quantifying flow
for any application is spectral analysis using pulsed or continuous-wave Doppler.

Display Size and Measurement Accuracy


The precision with which a cursor can be placed in an image can be improved by
making sure that the area of interest fills as much of the screen as possible. In 2D
imaging, distance and area measurements are improved by minimizing the display
depth and using the zoom function where possible. In M-mode and Doppler, time
measurements are improved by using the highest possible sweep speed. In Doppler, velocity measurement accuracy is improved by using the smallest possible
vertical scale setting.

Cursor Placement and Measurement Accuracy


When making a measurement, accurate placement of the cursor is essential. To
improve cursor placement precision: use the video controls and the imaging controls to adjust the display for maximum sharpness; use leading (closest to the
transducer) edges or borders for start and stop points of the measurement; maintain a consistent transducer orientation for each type of measurement.

HD3 Getting Started


4535 612 13861

181

11

Measurements

Speed of Sound
Ultrasound imaging and Doppler algorithms assume that the speed of sound is
constant at 1,540 meters per second. However the speed of sound varies for different tissue types. In cardiovascular applications where soft tissues, blood, and
fatty layers are all involved, the error is random, but is typically on the order of
two to five percent. Ensure that your tissue-equivalent phantom meets the following specification: speed of sound = 1,540 m/sec. If your tissue-equivalent phantom
does not meet this specification, linear measurements derived using your tissueequivalent phantom will be inaccurate.

Doppler Alignment
Doppler velocity measurements are most accurate when the acoustic beam is
aligned parallel with blood flow. Deviations from the parallel alignment of up to 20
degrees for Doppler angles result in measurement errors of 6% or less. For larger
alignment errors (Doppler angles exceeding 20 degrees), the measurement accuracy falls off rapidly, and use of angle correction is recommended (vascular applications only). The Doppler angle correction appears in the patient report with
the Doppler measurements.

Aliasing
Pulsed-wave Doppler uses signal sampling techniques to compute a frequency (or
velocity) spectrum. A theoretical limit exists for the maximum measurable velocity. When measuring high velocities, the sampling rate, which is determined largely
by the sample volume depth, may be insufficient; and velocity wraparound (aliasing) may occur. A possible result could be that normal, high-velocity, laminar flows
would be perceived as turbulence. Aliasing can be minimized, in some cases, by
moving the baseline, increasing the velocity scale, or using a lower frequency
transducer. In continuous-wave Doppler, aliasing is virtually eliminated.

182

HD3 Getting Started


4535 612 13861

Measurements

11

Velocity Resolution in Doppler


In computing velocity spectra, the velocity field (the area where flow exists) is
assumed to be stationary. In cardiovascular applications, velocity fields do not
remain constant, owing to the pumping action of the heart. The dynamics of
blood flow places a practical upper limit on velocity resolution and spectral edge
sharpness. The acoustic beam width determines the extent to which velocities
can be differentiated in composite blood flow patterns.

Acquisition and Algorithmic Errors


In general, there are two types of errors which can be introduced into a displayed
measurement. Acquisition errors are introduced by ultrasound machine electronics, relating to the front end signal acquisition, signal conversion, and the display of
the image on the screen. These machine errors also introduced by generation of a
pixel scale factor, application of that factor to the cursor position(s) on the
screen, and the subsequent measurement display. Cursors and readouts must be
used against a known phantom image displayed on the screen; it is impossible to
state or test a tolerance of a machine acquisition error by itself.
Algorithmic error is the error introduced by taking the basic measurements with
acquisition errors as input to higher order calculations for display to the user. This
error is associated with floating point versus integer type math, and is also subject
to errors introduced by rounding versus truncating results for a given level of significant digit display of the values. The acquisition errors of the inputs are not carried forward into these higher calculations.

Formulas
Some formulas used in clinical applications are based on assumptions or approximations, for example:

Volume formulas may assume a specific three-dimensional shape.

Pressure formulas use a simplified version of equations from fluid mechanics.

All formulas used in the ultrasound system are based on extensive clinical references from medical literature.

HD3 Getting Started


4535 612 13861

183

11

Measurements

Accuracy Tables
The measurements provided by the system do not define a specific physiological
or anatomic parameter. Rather, what is provided is a measurement of a physical
property such as distance or velocity for evaluation by the clinician.
For each of the measurements available on the system, the measurement accuracy
and range, over which that accuracy is valid, is shown in the following tables. Measurement accuracy is also constrained by the caliper placement capability limit.
The RMI413 phantom is used for all 2D and M-mode measurement accuracy
tests.
The RMI1425A phantom is used for the Doppler measurement accuracy tests.
Unless specified by a transducer or an application, all linear distance movements
have the following accuracy requirements.

2D Mode
The 2D mode measurement ranges and accuracy shown in Table 11-1 use the following equations:

184

Distance error (2% or 2 mm) = Image Pixel error (1% or 1 mm) + Hardware
error (1% or mm)

Area error (4%) = Distance 1 x Distance 2

Volume error (8%) = Distance 1 x Distance 2 x Distance 3

Circumference error (3% or 5 mm) = Distance error (2% or 2 mm) + Calculation precision (1% or 3 mm)

HD3 Getting Started


4535 612 13861

Measurements

11

The phantom used is a multi-purpose phantom, RMI 413, from GAMMAX, Inc.
USA.
Table 11-1 2D Mode Measurements Ranges and Accuracy
Measurement Type

Range

Accuracy

Axial Distance

0.01-23.00 cm

+/- 2% or +/- 2 mm

Lateral Distance

0.01-26.00 cm

+/- 2% or +/- 2 mm

Diagonal Distance

0.01-25.00 cm

+/- 2% or +/- 2 mm

Area

0.01-580.00 cm2

+/- 4%

Circumstance

0.01-97.00 cm

+/- 3% or +/- 5 mm

M-Mode
The M-mode measurement ranges and accuracy shown in Table 11-2 use the following equations:

Distance error (2% or 2 mm) = Image Pixel error (1% or 1 mm) + Hardware
error (1% or 1 mm)

Time error (2% or 0.2 sec) = Image Pixel error (1% or 0.1 sec) + Hardware
error (1% or 0.1 sec)

Velocity error (4%) = Distance/Time

The phantom used is a multi-purpose phantom, RMI 413, from GAMMAX, Inc.
USA.
Table 11-2 M-mode Measurement Ranges and Accuracy
Measurement Type

Range

Accuracy

Depth

0.01-22.00 cm

+/- 2% or +/- 2 mm

Time

0.01-4.30 sec

+/- 2% or 0.2 sec

Velocity

0.01-1000 cm /sec

+/- 4%

Doppler
The phantom used is a Doppler QA phantom, RMI 1425A, from GAMMAX, Inc.,
USA.
HD3 Getting Started
4535 612 13861

185

11

Measurements

The accuracies in Table 11-3 arise from positioning cursors on the Doppler display and performing subsequent measurements. Therefore, the velocity tests can
be used to check these values since the values are not an indication of the underlying absolute velocity assurance. The absolute velocity accuracy is tested using a
series of phantom measurements.
Accuracy is defined as the difference between a calibrated phantom velocity and
that annotated, as the time averaged mean from the system. The time-averaged
mean is calculated as the average over a determined period of time of the intensity weighted mean of the spectrum.
All transducers have been tested to ensure that the time averaged mean velocity
falls within +/- 15% of that annotated on the phantom. Due to constraints by the
Doppler phantom, these tests have been conducted in the range 15 cm/sec to
110 cm/sec.
Table 11-3 Doppler Measurement Ranges and Accuracy
Measurement Type

186

Range

Accuracy

Time

0.01-4.30 sec

+/- 2% or 0.2 sec

Velocity

0.15-200.00 cm/sec

+/- 15%

HD3 Getting Started


4535 612 13861

12 Review
NOTE

Review is not included with the system; it is an option.


In Review, you can look at the images that you stored. You can also send, print,
back up, and search your stored images. You can store images in image memory
on the ultrasound system hard disk, a read/write compact disc (CD-RW), an MO
disk, a USB memory device, or DICOM-compatible devices on a network. You
can display images within an exam in a variety of layouts, and you can display and
compare images from different exams. You can also annotate reports and images.

Starting Review
Press Review to display Exam Review, which opens with an array of tools along
the top of the display, selections on the left side, and an image preview along the
bottom.
The center of the Exam Review display is used for viewing and comparing exam
images in the layout you select.
You can switch back and forth between Review and live imaging without losing
your work in Review. To return to live imaging, press Review.

Exam Review Tools


A collection of tools is available on the toolbars of the Exam Review display.
These tools provide a variety of functions, such as printing images, transferring
files, and working with exam reports.
Use the Exam Review toolbar (Figure 12-1) to review images in the exam.

HD3 Getting Started


4535 612 13861

187

12

Review

Figure 12-1 Exam Review Toolbar


Distance

Ellipse

Add text

Export

Print images

Font style

Add comment

Layouts

Magnifier
Delete Image

DICOM print
DICOM send

Selecting and Viewing Exams


To review exams, you first select them in the Exam List. You can select and load
multiple exams for review. The Exam List also provides features that allow you
to back up and delete exams and convert images to different file formats.

Exam List
The Exam List is a list of exams stored on the selected disk drive. Drives can
include the system hard disk, a CD-RW, an MO disk, a USB memory device, and
network drives. The Exam List includes an array of options that allow you to
search, view, transfer, and print exams. There is also an indicator that shows the
disk space available.

Exam List Tools


A collection of tools is available on the toolbar of the Exam List display. These
tools provide a variety of functions, such as reviewing selected exams, deleting
exams, exporting, transferring, and backing up and restoring exams.
Use the Exam List toolbar (Figure 12-2) to work with exams.

188

HD3 Getting Started


4535 612 13861

Review

12

Figure 12-2 Exam List Toolbar


Review exams

Restore exams

Delete exams

Back up exams

Export

DICOM Print
DICOM Send

When you start Review for the first time after the system is powered up, no
exams are in the Review display. To select exams and viewing options, you must
display the Exam List.
To use the Exam List
1. If the Review display is not already open, press Review.
2. Click Exam Search on the Review display. If an exam is already opened, the
current exam is displayed in the Exam window.
3. To view exams that are stored on another drive, select the drive in the
Source menu.

Searching for Exams


To find an exam quickly, perform a search for it using the patient medical record
number (MRN), patient name, or exam date. The system searches only the disk
selected in the Source menu. You can enter a partial patient MRN or patient
name. To search by exam date, you can enter a single date or specify to search for
exams within a specified period (today, one week, one month, three months, one
year).

HD3 Getting Started


4535 612 13861

189

12

Review

To search by patient name or MRN


1. In the Exam List, click in the MRN or Patient Name field.
2. Type the name or number, or type as many characters at the beginning of the
name or number as you know.
3. Click Search. The exams that match the search criteria are listed.
4. Do any of the following:
To select an exam, click it.

To select additional exams, click each one.

To deselect an exam, click it again.


5. Click Review exams on the toolbar to load the selected exam or exams.
To search by exam date
1. In the Exam List, click in the first Date field.
2. Using the appropriate date format, do one of the following:

To search using a specific exam date, type the date.

To search using a range, select the time period from the list.

3. Click Search. The exams that match the search criteria are listed.
4. Do any of the following:
To select an exam, click it.

To select additional exams, click each one.

To deselect an exam, click it again.


5. Click Review exams on the toolbar to load the selected exam or exams.

190

HD3 Getting Started


4535 612 13861

Review

12

Sorting Exams
You can sort the exams displayed in the Exam List by any of the exam data categories. For example, you might find it useful to sort the list by name, by exam
date, or by exam type. Categories are sorted alphabetically or numerically,
depending on the content. In addition, categories can be in either ascending or
descending order.
To sort the Exam List
1. Click a category title.
2. To reverse the sort order, click the title again.

Preview Box
The preview box at the bottom of the Review display provides different functions, depending on the current viewing mode and display. The preview box can
help you with these tasks:

In the Exam Search, preview the images in an exam before you load it.

In the Review display, quickly find and display images.

In Compare view mode, select and place images in the Review display for
comparison.

The preview box displays seven images in the Review display and eight images in
the Exam List. The images displayed in the Review display layout are outlined in
yellow in the preview box.

HD3 Getting Started


4535 612 13861

191

12

Review

Previewing Images
You can do any of the following to preview images:

To preview images in the Exam List, select the desired exam.

To display the preview images in the Review display, click an image in the preview box.

To display the next or previous set of preview images, click the arrows on the
right side of the preview box.

To display images for comparison, select an exam in the Opened exams list,
click an image in the preview box, and then click a frame in which to display
the image.

Viewing Images
In the Review display, you can view images in the preview box and in the selected
layout. The Opened exams list and the preview box help you find exams and
display images.
To view images
1. In the Exam List, select the exam or exams and click Review exams on the
toolbar.
2. For Source, click the disk drive on which your exams are stored.
3. In the Opened exams list, click the exam you want to display first.
4. To view an image at its full size, double-click it in the layout.
5. Use the right, left, up, and down arrows to display images and preview sets of
images.
6. Click Close to return to the Exam window.

192

HD3 Getting Started


4535 612 13861

Review

12

Image Layout
In the Exam Review display, use Layouts on the toolbar to select the format,
or layout, in which images are displayed. You can display up to nine images at one
time when the Exam view mode is selected. Up to four images can be displayed
when Compare is selected.
To select an image layout
1. Click Layouts in the Exam Review display.
2. In the Images Layout dialog box, click the layout option to use to display
images.
3. Click OK.

Comparing Images
The compare mode allows you to compare four images from up to four exams.
Layout presets are limited when Compare Exams is selected.
To compare images
1. Open the exams you want to compare.
2. In the Exam Review, click Compare Exams.
3. In the Opened exams list, click the exam with the images you want to display.
4. To place images in the layout for comparison, click an image in the preview
box, then click a display window to paste the image.
5. Repeat step 3 and step 4 to include images from up to four exams.
6. To display the next or previous set of preview images, click
right side of the preview box.

or

on the

7. To view an image in its full size, click it in the layout. To view another image,
click it in the preview box. Click the image again to return to the previous
view.

HD3 Getting Started


4535 612 13861

193

12

Review

Magnifying Images
The Magnifier tool lets you enlarge the portion of an image under the tool. You
can move the magnified area over the image area while the tool is active.
NOTE

Magnifier is available only when viewing multiple images. For details, see "Image
Layout" on page 193.

To magnify images
1. In the Exam Review, click the Magnifier on the toolbar.
2. With the cursor over an image, press and hold Enter to magnify the area
under the tool.
3. Move the magnifier cursor to view other areas or images.
4. Click the Magnifier again to exit.

Deleting Exams and Images


The Exam List allows you to delete exams stored on any drive listed in the
Drive menu. If you accidentally delete an exam, and the exam has been backed
up, you can restore the exam. See "Backing Up and Restoring Exams" on page 200
for more information.
To delete exams
1. In the Exam List, select one or more exams.
2. Click Delete exams.
3. In the Delete dialog box, click OK.

194

HD3 Getting Started


4535 612 13861

Review

12

To delete images
You can delete stored images from an exam, one at a time. If you accidentally
delete an image from an exam that has been backed up, you can restore the entire
exam.
1. In the Exam Review display, select the image or images you want to delete.
To select multiple images, press and hold Ctrl while selecting each image.
2. Click Delete Image.
3. In the Delete dialog box, click OK to delete the image.

Adding and Editing Comments in Review


The Add comments tool allows you to add a comment for an exam or edit an
existing comment. You can type text in the Comment area and enter a name for
Physician. You cannot enter or change information for Patient, Exam, or
Date of Report.
NOTE

The comments you enter in Review are not associated with the report.

To add comments in Review


1. Select an exam by doing one of the following:
In the Exam List, select the exam and click Review exam.
In the Exam Review display, click the exam in the Opened exams list.
2. Click the Add comment tool on the toolbar.
3. Type your comments in the Comment area and enter the physicians name in
the Physician field if necessary.
4. Click OK.

HD3 Getting Started


4535 612 13861

195

12

Review

Measurements in Review
Using the measurement tools on the toolbar in the Exam Review display, you
can make distance and ellipse (area and circumference) measurements. An image
must be full size before you can make measurements on it.

Distance Measurements in Review


The Distance tool in Review allows you to measure 2D distances on a full-size
image. The measurement result is displayed next to the second measurement
point.
To perform a distance measurement in Review
1. If the image is not already full size, double-click it to make it full size. You can
also use the Layouts tool on the toolbar and change the layout to Single.
2. Click the Distance tool in the toolbar.
3. Click in the image where you want to start the measurement. A second caliper is displayed.
4. Move the second caliper to the end point.
5. To display another caliper, press Enter.
6. To save a copy of the image with the new measurements, press Acquire.
7. To deactivate the tool, press Exit.

Ellipse Measurements in Review


The Ellipse tool in Review allows you to measure 2D circumference and area on
a full-size image. The measurement result is displayed next to the second measurement point.
To perform an ellipse measurement in Review
1. If the image is not already full size, double-click it to make it full size.
2. Click the Ellipse tool in the toolbar.
3. In the image, click an apex of the object you want to measure, and then drag
to the other apex and click again.
4. Using the trackball, adjust the shape of the ellipse to approximate the object.
196

HD3 Getting Started


4535 612 13861

Review

12

5. To save a copy of the image with the new measurements, press Acquire.
6. When finished, click Close.
To clear all measurements
1. Click Close Selected Exam.
2. Use the Exam List to reopen the exam if needed.

Text Annotation in Review


The Add Text tool in the Exam Review display lets you add text to any full-size
image.
To add text annotation in Exam Review
1. Click the Add Text tool on the toolbar. The cursor changes to a letter and
the image is displayed as full-size.
2. Position the tool in the image where you want to add annotation type the
text.
3. To erase text, press the Backspace key.
4. Press Enter at the end of each line.
5. To add text in a new location, move the cursor and begin typing.
6. To erase text, press the Backspace key.
7. To exit text annotation, click Close or press Exit.
To format annotation text
1. In the Exam Review toolbar, click the Font style tool.
2. In the Text Font Setup dialog box, do the following as needed:

For Font Color, select a text color. On most images, white is recommended.

For Font Size, select a text size in points. A size of 11 points is recommended.

3. Click OK.

HD3 Getting Started


4535 612 13861

197

12

Review

Transferring Exams and Images


You can transfer exams and images between DICOM-compatible servers on a
network. Use the Exam List to transfer all exam images; use the Exam Review
to transfer selected images.
NOTE

If your systems network settings are configured as Send as You Go or Batch


mode, images are automatically sent to the server you specified. If your settings
are configured as Manual, use the DICOM Send or DICOM Print functions
to send images to the DICOM server. For more information on network settings,
see "Configuring Network Settings" on page 242.

To transfer exams over a network


1. In the Exam List, select the exams you want to transfer.
2. Click DICOM Send.
3. In the DICOM Send dialog box, do one of the following:

Select a destination in the list.

Click Modify and edit the information for the selected destination.

Click Add to create a new destination and add the required information.

Click Delete to delete the selected destination.

Click Test to test the connection to the server. If the test fails, contact
your network administrator.

4. Click Send to transfer the selected exams. A progress indicator appears.


5. In the message indicating the send is complete, click OK.
6. Click Close.
To transfer images over a network
1. In the Exam Review, select the images you want to transfer.
2. Click DICOM send. A message is displayed indicating the number of images
selected to send. If you did not select any images, the message prompts you to
send all images.
3. Click OK.
198

HD3 Getting Started


4535 612 13861

Review

12

4. In the DICOM Send dialog box, do one of the following:

Select a destination in the list.

Click Modify and edit the information for the selected destination.

Click Add to create a new destination and add the required information.

Click Delete to delete the selected destination.

Click Test to test the connection to the server. If the test fails, contact
your network administrator.

5. Click Send to transfer the selected images.

Exporting Images for PC Viewing


The Export tool in Exam Review and Exam List allows you to export an
image in BMP, JPEG, TIFF, AVI, or DICOM image format so it can be viewed on a
personal computer.
NOTES

If you select multiple images to export, all images are exported under the
same filename. The system appends an incremental number to each filename.
Once you export an image, you cannot import it back into the system. However, images that you export remain on the system; they are not deleted during the export operation.

To export images for PC viewing


1. Do either of the following:
To export all images in an exam, open the Exam List.
To export selected images, open the Exam Review.
2. Do either of the following, depending on the display:
In the Exam list, select the exam or exams for the images you want to
export.
In the Exam Review, select the image you want to export. To select multiple images, press and hold the Ctrl key while selecting each image.
3. Click the Export tool on the toolbar.
4. In the Export dialog box, select a disk drive for Drive.
HD3 Getting Started
4535 612 13861

199

12

Review

5. Select an image format for File Format.


6. Type a name for File Name.
7. Select a destination folder for Directory or type the Directory Name and
then click Export. A progress bar indicates the export status.
8. To exclude patient information, click Hide Patient Information.
9. When a message indicates that the export is done, click OK.

Backing Up and Restoring Exams


From the Exam List, you can archive exams that are stored on the system hard
drive onto either a CD-RW, an MO disk, or a USB flash device.
You can use the Restore exam option in the Exam List to restore backed-up
exams to the system hard drive.
To back up exams
1. Insert the CD-RW or MO disk, or insert the USB flash into the USB port.
2. In the Exam List, select the exam or exams, and then click Backup exam.
3. Select the backup media type: CD-RW, MO, or Flash.
4. Click OK to begin the backup. A progress indicator appears.
5. In the Backup completion dialog box, click OK if you want the backed-up
exams deleted from the hard disk, or click Cancel if you want to keep them
on the hard disk.
To retrieve exams stored on backup media
1. Insert the back-up CD-RW or MO disk into the drive, or insert the USB flash
device into the USB port.
2. Select the drive where the exams are stored. Select from CD-RW, MO, or
Flash for Drive.
3. Select the exam or exams that you want to retrieve and then click Restore
exam.
4. Click OK to restore the selected exams. A progress indicator appears.

200

HD3 Getting Started


4535 612 13861

Review

12

5. In the Restore completion dialog box, click OK if you want the restored
exams deleted from the backup media, or click Cancel if you want to keep
them on the backup media.

Printing Exams and Images from Review


Review offers you a variety of options for printing exam images and reports. The
system supports printing to an external report printer and to DICOM printers. In
addition, you can print entire exams or specific images when using DICOM printers.

Printing Images to a Report Printer


The Print Images tool in Review lets you print images and a brief report to an
external printer connected to the system.
To print images to a report printer
1. In Exam Review, do one of the following:
To print specific images, press and hold the Ctrl key and then click the
images you want to print and click OK.
To print all images in the selected exam, go to step 2.
2. Click the Print Images tool on the toolbar. A message indicates the number
of images selected to print, or that no images were selected and to print all
images.
3. Click OK.
4. In the Print Layouts dialog box, select the printing options, and then click
OK.

HD3 Getting Started


4535 612 13861

201

12

Review

Printing Images or Exams to a DICOM Printer


DICOM Print in Exam Review allows you to send specific images to a
DICOM-compatible printer. You can select and send up to 16 images.
DICOM Print in the Exam List lets you send exams to a DICOM-compatible
printer.
To print images or exams to a DICOM printer
1. Do one of the following:

To print images, In Exam Review, select the images you want to print. To
select multiple images, press and hold Ctrl and click the images you want
to print.

To print exams, in the Exam List, select the exams you want to print.

2. Click the DICOM Print tool in the toolbar.


3. In the DICOM Print dialog box, do one of the following:

Select a destination in the list.

Click Modify and edit the information for the selected destination.

Click Add to create a new destination and add the required information.

Click Delete to delete the selected destination.

Click Test to test the connection to the server. If the test fails, contact
your network administrator.

4. Click Print to print the selected images. A progress indicator appears.


5. When a message indicates the printing is complete, click OK.
6. Click Close.

202

HD3 Getting Started


4535 612 13861

13 Patient Reports
There following patient reports are available, depending upon the selected transducer and exam type:

Cardiology

Fetal Echo

Gynecology

Obstetrics

Urology

Vascular

You should verify the patient data when you look at a patient report. When you
enter a new patient, all measurement data and calculations for the previous
patient are removed from the patient report.
NOTE

When you close the patient exam, the information saved in the patients report is
no longer available.

Working with Reports


This subsection provides instructions for displaying, editing, printing, and exporting patient reports.
To display patient reports
1. Press Report to display the patient report.
2. Use the selections at the top of the patient report to navigate through the
patient report.
To edit the patient report
1. Press Report to display the patient report.
2. Click the Edit tab.
3. Click Page Up and Page Down to display the report page that you want.

HD3 Getting Started


4535 612 13861

203

13

Patient Reports

4. Move the cursor to the text entry fields and do either of the following:
To enter text directly into a field, press Enter and type the text.

Select items from the lists.

5. Enter data into the patient report.


6. Click OK to save the patient data.
To print the patient report
1. Press Report to display the patient report.
2. Click Print to print the report.
3. In the Print dialog box, select the printer and paper and click Print.
To export the patient report
1. Press Report to display the patient report.
2. Click Export to export the report.
3. In the Export Report dialog box, specify or select the following:

File Name: The file name defaults to the report type and the date and
time of the report. For example, OB-20050209-0952. You can change the
file name as needed.

Location: Specify the export destination.

File Format: Select Excel, to format the report for a spreadsheet application, or Text format.

Storage Manager: Select this option to open the Storage Manager


window.

4. Click OK.

204

HD3 Getting Started


4535 612 13861

Patient Reports

13

Biophysical Profile and Maternal Survey


You can enter values into a biophysical profile and maternal survey from the
patient report.
To enter a biophysical profile and maternal survey
1. Press Report to display the patient report.
2. Click the Edit tab.
3. Click Page Up and Page Down to display the biophysical profile.
4. Move the cursor to the text entry fields and press Enter, or select items
from the menu to enter data (0, 1, or 2) into the biophysical profile and
maternal survey for each characteristic.
5. Click OK.

Fetal Description
The fetal description can be completed by editing the patient report.
To complete the fetal description
1. Press Report to display the patient report.
2. Click the Edit tab.
3. Click Page Up and Page Down to display the fetal description portion of
the patient report.
4. Move the cursor to the text entry fields and press Enter.
5. Select or enter data in the fetal description and fetal abdomen fields.
6. Click OK.

Graphs
The graphs allow you to visually track fetal growth by graphing a growth parameter against gestational age for all exam dates for that gestation. All growth parameters for each sequential exam throughout the gestational period are graphed
using LMP as the basis for gestational age. Each individual growth parameter is

HD3 Getting Started


4535 612 13861

205

13

Patient Reports

archived and graphed using patient MRN, date of exam, and LMP as its identifying
source. You can also look at a tabular history of the gestation based on LMP.
NOTE

The same patient name, patient MRN number, and LMP must be entered for each
exam for the graph and report to be stored automatically on the system hard
drive.

To view OB graphs
1. On the patient report, click the Graph tab. A graph appears showing the current measured parameter and points on the graph that correlate to measurements performed on each exam date.
2. Click Item to select a different graph.
3. Click History to view tabular history of the gestation based on the gestational age or the date the exam was performed.

Open Line Transfer


Open Line Transfer allows patient report data to be sent to an offline printer,
computer, or workstation. The printer, computer, or workstation to which you
intend to send data must be set up for serial data transfer as follows:

NOTE

9,600 Baud

8-bit data

No parity

1 stop bit

A USB to RS-232 adapter is required to connect the RS-232 cable and perform an
open line transfer.

To perform an Open Line Transfer


1. Connect the USB to RS-232 adapter to the back of the system.
2. Connect the RS-232 cable to the adapter.
3. Perform any measurements as needed.
4. Press Report to display the patient report.
206

HD3 Getting Started


4535 612 13861

Patient Reports

13

5. Click Export.
6. In the Export Report dialog box, select Open Line Transfer to export the
report to a remote printer, computer, or workstation.
7. Click OK.

HD3 Getting Started


4535 612 13861

207

13

208

Patient Reports

HD3 Getting Started


4535 612 13861

14 Calculations
Calculations comprise menus, protocols, measurements, calculations, and patient
reports for the applications included in the system. The protocols consist of a
menu of measurement types. You select a measurement type, and the system displays cursors with which you make measurements. Once the cursors have been
positioned and fixed, the system uses the measurement values to make calculations and create a patient report. The measurements and calculations are
included in a patient report.
If the application, transducer, and imaging mode combination allows it, you can
select different menus for the same patient. This capability allows flexibility when
related applications and calculations are desired.
The calculations in the system are based on medical references. For detailed
information on the references, see the "References" section.
NOTE

When you first press Calc, a message prompts you to press the space bar for a
simple setup. If you press the space bar, the Setting Measure Method dialog
box enables you to specify the 2D circumference and area method, the distance
method, and the Doppler trace direction.

Cardiac Calculations
The cardiac calculations include protocols for 2D, M-mode, and Doppler.

HD3 Getting Started


4535 612 13861

209

14

Calculations

Simpson: 2D
Simpsons rule is used to measure the left ventricular volume from a trace of the
endocardium in or at end diastole and end systole. The system automatically
traces and calculates the volume of 20 evenly spaced discs from the apex to the
base of the left ventricle in end diastolic and systolic frames. The SV, CO CI, EF,
and FS are calculated from the EDV and ESV calculations in Simpsons rule.
To measure LV volume using Simpsons rule
1. Using Cine review, obtain the desired 2D images and concurrent ECG traces.
2. Press Calc.
3. On the Cardiac menu, select Simpson.
4. On the Simpson menu, select the measurement you want to perform.
5. Position the cursor on the left ventricular wall.
6. Press Enter to fix the cursor position and start the measurement.
7. Move the cursor to trace the inner left ventricular wall. The area calculation
appears at the bottom of the display, and a second type of measurement cursor appears.
8. Position the cursor at the annulus and press Enter to fix the cursor position.
A second cursor is displayed on the image.
9. Press Enter to fix the cursor and to end the measurement. The disks are distributed along the dotted line that describes the distance from annulus to
apex. The stroke volume (SV) and ejection fraction (EF) calculations appear at
the bottom of the display when the appropriate measurements are completed.
A check mark appears to the left of the measurement name in the menu, indicating that the measurement is complete.
10. Select the measurement that you want to perform next, for example: A4C
Systole.
11. Repeat step 4 through step 10, as required, to complete the measurements
for the Simpson protocol.

210

HD3 Getting Started


4535 612 13861

Calculations

14

LV Vol A/L: 2D
You can also use the area and length of the left ventricle to obtain the left ventricular volume calculations.
To measure area and length of the LV to calculate LV volume
1. Obtain the desired 2D images and concurrent ECG trace and press Freeze.
2. Press Calc.
3. On the Cardiac menu, select Vol. A/L.
4. On the Vol. A/L menu, select the measurement you want to perform.
5. Position the cursor on the left ventricular wall.
6. Press Enter to fix the cursor position and start the measurement.
7. Move the cursor to trace the inner left ventricular wall. The calculation
appears at the bottom of the display, and a second type of measurement cursor appears.
8. Position the cursor at the annulus.
9. Press Enter to fix the cursor position at the annulus. A second cursor
appears on the image.
10. Position the cursor at the apex. The calculations appear at the bottom of the
display and update as you move the cursor.
11. Press Enter to fix the cursor and end the measurement.
12. Select the measurement that you want to perform next, and repeat step 4
through step 11 to complete the measurements for the Vol. A/L protocol.

HD3 Getting Started


4535 612 13861

211

14

Calculations

2D Measure
You can calculate several cardiac parameters using 2D Measure. LV volume in
diastole and systole, stroke volume, cardiac output, ejection fraction, and LV mass
are calculated from the distance measurements in the 2D Measure protocol.
To perform a Cardiac 2D measure
1. Obtain the desired 2D images and concurrent ECG trace and press Freeze.
2. Press Calc.
3. On the Cardiac menu, select 2D Measure.
4. On the 2D Measure menu, select the measurement you want to perform.
5. Position the cursor.
6. Press Enter to fix the cursor position and display the second cursor.
7. Move the active cursor. The results update as the distance changes.
8. Press Enter to fix the cursor position.
9. Highlight the measurement that you want to perform next.
10. Repeat step 4 through step 8 to complete the measurements for the 2D
Measure protocol.

M-Mode Cardiac Calculations


The Cardiac calculations include protocols for left ventricle, aorta/left atrium
(Ao/LA), and mitral valve (MV).
The measurements in the M-mode protocols can be performed individually, or
you can select All. All provides a programmed sequence of measurement points
that comprise the individual measurements within the protocol. If you select All,
and locate the measurement points, the system automatically makes the calculations from those points.
For example, if you select All from the Lt Ventricle (M) menu, and follow the
protocol, the system automatically calculates the stroke volume, LV mass, ejection
fraction, fractional shortening, and the ventricular volume at systole and diastole.
If you decide to perform the individual measurements for the Lt Ventricle (M)
protocol, then only the calculations for the specific measurements that you per212

HD3 Getting Started


4535 612 13861

Calculations

14

form appear. The protocol for All on the Lt Ventricle (M) menu does not
include the right ventricle measurements.
To obtain M-mode cardiac calculations
1. Obtain the desired M-mode display and press Freeze.
2. Press Calc to display the calculation menu.
3. On the Cardiac menu, select the desired M-mode protocol. The M-mode
protocols are designated with (M).
4. On the protocol, select All or the individual measurement. The M-mode time
measurement cursor appears on the M-mode display.
5. Move the cursors, and press Enter to fix the cursors and define the measurement points. The measurement values and calculations appear at the bottom
of the display.

Doppler Cardiac Calculations


The Cardiac menu includes Doppler protocols for the left ventricle outflow
tract (LVOT), mitral valve, aortic valve, tricuspid valve, pulmonic valve, pulmonic
veins, and Qp:Qs.
Limited Trace is used to mark two points on the Doppler waveform The system automatically traces the intervening points between the two points that you
mark, and calculates and displays the peak velocities and the velocity time integral
(VTI). The Manual Trace is used to manually trace the waveform from which the
peak velocities and the VTI are calculated. You can mark peak velocities using the
Peak V menu item. You can measure time intervals using the time cursors. The
system prompts you for the appropriate measurement.

HD3 Getting Started


4535 612 13861

213

14

Calculations

To obtain Doppler cardiac calculations


1. Obtain the desired Doppler display and press Freeze.
2. Press Calc to display the calculations menu.
3. On the Cardiac menu, select the desired Doppler protocol.
4. On the Doppler protocol, select the type of Doppler tool you want.
5. Move the cursors, and press Enter to fix the cursors and define the measurement points. The measurement values and calculations appear at the bottom
of the display, and additional calculations appear in the patient report.

PISA Radius and Alias Velocity


The PISA (proximal isovelocity surface area) radius and alias velocity calculations
tools are available from the Regurg protocols. Using the PISA method, the flow
rate can be calculated from the flow convergence region proximal to a stenotic or
regurgitant orifice. The proximal isovelocity surface area can be seen on the
Color image as a semicircular red/blue aliasing zone. The velocity at this zone
equals the Nyquist limit.
Measuring PISA radius and alias velocity
1. Obtain a Color image proximal to the stenotic or regurgitant orifice.
2. Press Freeze.
3. Press Calc to display the Cardiac calculations menu.
4. Select a Regurg protocol.
5. Select PISA Radius. A cursor appears on the display.
6. Use the trackball and Enter to measure the radius of the flow convergence
region proximal to the stenotic or regurgitant orifice. The radius and area are
calculated and displayed.
7. Select PISA-Alias Vel. The alias velocity is displayed, and the flow rate is calculated and displayed. A check mark appears to the left of PISA Radius and
PISA-Alias Vel. The results appear on the display and are entered into the
patient report.

214

HD3 Getting Started


4535 612 13861

Calculations

14

Patient Heart Rate


You can measure heart rate on scrolling displays. Heart rate measurement results
are displayed in beats per minute (bpm). You can also select the number of heart
cycles over which you want the cumulative heart rate calculated.
To measure heart rate
1. Obtain a scrolling display.
2. Press Freeze.
3. Press Calc to display a calculation menu.
4. Select Patient Heart Rate. The heart cycle icon and a measurement line
cursor appears.
5. Turn Control to select the desired number (1 to 20) of heart cycles.
6. Position the cursor at a point in the heart cycle and press Enter. Another
cursor appears.
7. Move the cursor to an equivalent point in the next heart cycle. The results are
updated as you move the cursor.
8. To resume scanning, press Freeze.

Doppler Trace Calculations


The limited and manual trace tools are available from several of the calculations
protocols.
To perform Doppler trace measurements
1. Obtain the desired Doppler display.
2. Press Freeze.
3. Press Calc to display the calculations menu.
4. Select a protocol.
5. Select a trace method. Depending on the protocol, you can have two choices:
If you select Limited, position the cursor at the beginning of the Doppler
waveform, and press Enter. Move the second cursor to the end of the
Doppler waveform, and press Enter. The results appear.
HD3 Getting Started
4535 612 13861

215

14

Calculations

If you selected Manual, position the cursor at the beginning of the Doppler waveform, and press Enter. Trace the Doppler waveform, and press
Enter at the end of your trace. The results appear.
A check mark appears to the left of Limited or Manual in Doppler protocol
to indicate the measurement was completed and entered into the patient
report.

Gynecology Calculations
In gynecology calculations, the Uterus, Lt. and Rt. Ovary, Lt. and Rt. Follicles, and Lt. and Rt. Kidney protocols are 2D protocols. The 2D protocols
require distance measurements, which in some cases calculate a volume; for
example, Lt. and Rt. Follicles. The ovarian artery protocols are Doppler protocols. The Doppler protocols use the PSV and the EDV calculations tools to calculate resistive index (RI) and systole/diastole (S/D) ratio.
To perform gynecology calculations
1. Obtain the desired image and press Freeze.
2. Press Calc.
3. From the Gynecology menu select a gynecology protocol.
4. On the gynecology protocol, select a measurement.
5. Move the measurement cursors and press Enter to fix the cursors and display the next one.
The measurement ends when the last cursor is fixed. A check mark appears to
the left of the measurement name in the protocol to indicate the measurement is
complete. The values and related calculations are entered into the patient report.

216

HD3 Getting Started


4535 612 13861

Calculations

14

Obstetrics Calculations
The Obstetrics calculations include setups, protocols, and measurements.
NOTE

If you create an Analysis Setup menu, you can only choose a maximum of 18
items from the Available list.
The system uses several methods to calculate gestational age (GA). Gestational
age calculation requires the use of tables, which you can select in the Measure
setups. You can also create customized tables.

NOTE

In the patient information form, if you entered 2, 3, or 4 in the Fetal # field, indicating multiple fetuses, you can press Select to access the additional fetuses.
(The letter next to the word OB in the menu corresponds to the number of the
fetus in the case of multiple gestations.)
In addition to the Fetal Biometry protocol, and other protocols that you might
create, there are the amniotic fluid index (AFI) protocol and several Doppler
protocols including the following: Umb. Artery, MCA or (Middle Cerebral
Artery), Lt. and Rt. Uterine Artery, Placenta Artery, Lt. and Rt. Fetal
Carotid, Fetal Aorta, Ductus Venosus, and Fetal HR. The Limited Trace
and Manual Trace menu items provide varying levels of trace control for these
protocols. You can also mark peak systolic velocity (PSV) and end diastolic velocity (EDV) from which the peak pressure gradient, systole/diastole ratio, and the
resistive index are calculated.

Gestational Age
You can obtain a calculation of gestational age by using the Fetal Biometry or
General protocols.
To calculate gestational age
1. Obtain the desired image and press Freeze.
2. Press Calc until the OB menu appears.
3. Select Fetal Biometry from the OB menu.
4. If necessary, press Select to select the next fetus.
HD3 Getting Started
4535 612 13861

217

14

Calculations

5. On the Fetal Biometry protocol, select the measurement that you want to
perform.
6. Use the trackball and press Enter to perform the measurement. A check
mark appears to the left of the selected measurement in the OB menu to
indicate the measurement is complete and the values are entered in the
patient report. Each time you make a measurement, a new gestational age
(G.A.), standard deviation (SD), and estimated due date (EDD) values are displayed. (In the patient report, the three most recent measurements and their
average are displayed.)
To create an analysis preset
1. Press Set Up (F10).
2. Click the Measure tab, and then click the OB tab.
3. In the Analysis Setup section, click the plus sign (+) to create a new analysis
preset menu item.
4. In the New Preset dialog box, enter the name as you want it to appear on
the OB menu and a description, and click OK.
5. In the Available list, to the right, highlight the measurement that you want to
include and move it to the Selected list on the left by clicking <<. You can
remove a measurement by using >>. You can also change the order in which
the measurements appear by using ^^ and vv to move the measurements up
or down.
6. When you have included all of the measurements in the preset, you can click
the GA and Fetal Growth references to assign an investigator to each measurement, or to create a user-defined table or equation for the measurements. For details on creating new tables, see "To create user-defined OB
calculations" on page 219, and for equations, see "To enter an equation" on
page 220.
7. Click Save.

218

HD3 Getting Started


4535 612 13861

Calculations

14

OB Analysis
You can select from several investigators for some fetal tables, but for others
there are no tables available.
To select fetal tables
1. Press Set Up (F10).
2. Click the Measure tab, and then click the OB tab.
3. In Analysis Setup section, click a measurement in the Selected list.
4. In the References section, select an investigator for the GA and Fetal
Growth for the selected measurement.
5. In the Fetal Weight section, select an investigator for EFW or EFW
Growth, the Unit, and the Display SD value.
6. Select Yes or No to display the SD (standard deviation) value.
7. Click Save.
NOTE

When you select a growth table, the measurement on which that table is based
must be performed before you can look at the graph in the patient report.

To create user-defined OB calculations


1. Press Set Up (F10).
2. Click the Measure tab, and then click the OB tab.
3. In the Analysis Setup section, select an OB protocol from the Menu
Name menu (for example, Fetal Biometry).
4. Select the measurement.
5. Click the plus sign (+) associated with the table you want to create (GA,
Fetal Growth, EFW, or EFW Growth).
6. In the dialog box, enter the calculation name and description, and select
Table or Equation.
7. Click OK.
8. To enter a table, select the Table Type, use + and - to add or subtract table
rows, and enter measurement and age information into the table. The actual
HD3 Getting Started
4535 612 13861

219

14

Calculations

data depends upon the table type you selected. (You must press Enter after
each entry to enter the data and move to the next field.)
9. Enter the unit information and table type as needed.
10. Click Save to save your user-defined table. Your table appears in OB setups.
To enter an equation
1. Press Set Up (F10).
2. Click the Measure tab, and then click the OB tab.
3. In the Analysis Setup section, select an OB protocol from the Menu
Name menu (for example, Fetal Biometry).
4. Select the measurement.
5. Click the plus sign (+) associated with the equations you want to create (GA,
Fetal Growth, EFW, or EFW Growth).
6. In the dialog box, enter the table name and description.
7. Click OK.
8. Enter the equation using the available symbols shown.
9. Enter the input and output units, the high and low value ranges, and the standard deviation.
10. Click Save to save your equation. Your equation will appear in the OB setups.
To delete a user-defined calculation
1. Press Set Up (F10).
2. Click the Measure tab, and then click the OB tab.
3. In the Analysis Setup section, select the measurement to delete from the
Selected list.
4. Click the minus sign (-) associated with the investigators name in the References or Fetal Weight sections as needed.
5. Click Save.

220

HD3 Getting Started


4535 612 13861

Calculations

14

To view user-defined calculations and equations


1. Press Set Up (F10).
2. Click the Measure tab, and then click the OB tab.
3. In the Analysis Setup section, select the measurement to delete from the
Selected list.
4. Click the ellipsis (...) associated with the investigators name in the References or Fetal Weight sections as needed.

EDD Based on LMP


For this calculation, supply the first day of the patients last menstrual period
(LMP) in the patient data. The system uses a standard 40 weeks as the normal
pregnancy period.
To calculate EDD based on LMP
1. Press Patient.
2. Click New.
3. Enter the new patient information, including the LMP. The gestational age
(GA) and estimated due date (EDD) are calculated using the LMP.
NOTE

If a new date is manually entered into the EDD field, the system recalculates the
LMP and GA. If a new age is manually entered into the GA field, the system recalculates the LMP and EDD.
4. Click OK.

HD3 Getting Started


4535 612 13861

221

14

Calculations

Fetal Heart Rate


You can measure fetal heart rate on scrolling displays. Heart rate measurement
results are displayed in beats per minute (bpm). You can also select the number of
heart cycles over which you want the cumulative heart rate calculated.
To measure fetal heart rate
1. Obtain a scrolling display.
2. Press Freeze.
3. Press Calc until the Fetal Echo menu is displayed.
4. Select Fetal HR. The heart cycle icon and a measurement line cursor
appears.
5. Turn Control to select the desired number (1 to 20) of heart cycles.
6. Position the cursor at a point in the heart cycle and press Enter. Another
cursor appears.
7. Move the cursor to an equivalent point in the next heart cycle. The results are
updated as you move the cursor.
8. To resume scanning, press Freeze.

222

HD3 Getting Started


4535 612 13861

Calculations

14

Amniotic Fluid Index (AFI)


AFI is calculated from the sum of four distance measurements. The maternal
abdomen is divided into four quadrants, and the vertical distance of the largest
pocket of fluid in each quadrant is measured. The measurements obtained from
each quadrant are added together.
To calculate amniotic fluid index
1. Obtain an image of a quadrant of the maternal abdomen, and press Freeze.
2. Press Calc, and select AFI from the OB menu.
3. Select the AFI protocol. A measurement cursor appears.
4. Position the first cursor at the start of the measurement.
5. Press Enter to fix the cursor and display a second cursor.
6. Position the second cursor.
7. Press Enter to end the measurement.
8. Press Freeze, and scan the next quadrant.
9. Scan over the next quadrant of interest, and press Freeze.
10. Continue measuring in this manner, until all four quadrants of the maternal
abdomen have been measured. After the fourth measurement, the sum of the
four distances appears on the display and in the patient report.

HD3 Getting Started


4535 612 13861

223

14

Calculations

Ratios
When you have made the OB measurements, the ratios are automatically calculated. The range of each ratio (Table 14-1) is displayed in the patient report.
Table 14-1 OB Ratios
Ratio

Gestational Age

Ratio Range

BPD/OFD

14-40 weeks

70-86

FL/BPD

23-40 weeks

Not available

HC/AC

13-40 weeks

114-131

FL/AC

21-42 weeks

20-24

FL/HC

Not available

Not available

FL/Foot

Not available

Not available

The BPD/OFD ratio is also called the Cephalic Index (CI). Ratios not within the
valid gestational age range will not be calculated.

Fetal Weight
Fetal weight is calculated from the following OB measurements:

AC, FL

HC, AC, FL

BPD, AC, FL

BPD, HC, AC, FL

BPD, TTD

BPD, AC

Fetal weight is automatically calculated and displayed in the report when the
required measurements are performed.

224

HD3 Getting Started


4535 612 13861

Calculations

14

Estimated Fetal Weight Formula


In the setups, you select an EFW formula. When you perform the measurements
included in the EFW formula, the fetal weight calculation appears on the display
with the individual measurement result.
To calculate EFW
1. Press Set Up (F10).
2. On the Measure display, click OB.
3. Select EFW. A list of investigators appears.
4. Select the investigator that you want to use for the fetal weight calculations
and click the ellipsis (...). The required measurements appear on the OB
setup display; for example, EFW-Hansmann(BPD,TTD).
5. Click the ellipsis (...) to look at the equation used to calculate EFW.
6. Click Save.
For information on entering a new EFW table or equation, see "OB Analysis" on
page 219.

Fetal Echo Calculations


The Fetal Echo calculation menu items are divided into diagnosis modes. The
calculation items for 2D mode are 2D Echo and CTAR (Cardio-Thorax Area
Ratio), and the one for M-mode is Fetal M-mode, with which you can calculate
fetal volume.
Calculation parameters in the Doppler mode include MPA (Main Pulmonary
Artery), Duct. Art (Ductus Arteriosus), IVC (Inferior Vena Cava), Duct. Ven
(Ductus Venosus), Ascending Aorta, Descending Aorta, MV Inflow,
MV Regurg, TV Inflow, TV Regurg, and PLI (Preload Index).

HD3 Getting Started


4535 612 13861

225

14

Calculations

To obtain fetal echo calculations


1. Obtain the desired Doppler or 2D display and press Freeze.
2. Press Calc to display the calculations menu.
3. On the Fetal Echo menu, select a protocol.
4. Select the tool you want to use.
5. Use the trackball and press Enter to perform the measurement. When you
complete the measurement, a check mark appears to the left of the tool to
indicate the measurement is complete and entered in the patient report.

Urology Calculations
The Urology menu includes urology protocols for the Prostate Volume,
T-Z Prostate Volume, Bladder Volume, Left and Right Kidney Volume,
and Residual Volume.
In addition, you can measure vessel area and vessel distance. Those values are
used to calculate the volume flow.
The Limited Trace and Manual Trace menu items provide varying levels of
trace control. You can also mark peak systolic velocity (PSV) and end diastolic
velocity (EDV) from which the peak pressure gradient, systole/diastole ratio, and
the resistive index are calculated.
To obtain urology calculations
1. Obtain the desired Doppler or 2D display and press Freeze.
2. Press Calc to display the calculations menu.
3. On the Urology menu, select a urology protocol.
4. Select the tool you want to use.
5. Use the trackball and press Enter to perform the measurement. When you
complete the measurement, a check mark appears to the left of the tool to
indicate the measurement is complete and entered in the patient report.

226

HD3 Getting Started


4535 612 13861

Calculations

14

Vascular Calculations
The Vascular menu includes vascular protocols for the carotid arteries, a peripheral vascular protocol, and a heart rate protocol. The Limited Trace and Manual Trace menu items provide varying levels of trace control. You can also mark
peak systolic velocity (PSV) and end diastolic velocity (EDV) from which the peak
pressure gradient, systole/diastole ratio, and the resistive index are calculated.
To obtain vascular calculations
1. Obtain the desired Doppler or 2D display and press Freeze.
2. Press Calc to display the calculations menu.
3. On the Vascular menu, select a protocol: Rt CCA, Rt ECA, Rt ICA, Lt
CCA, Lt ECA, Lt ICA, Peripheral, or Patient Heart Rate.
4. Select the tool you want to use (for example, Limited Trace).
5. Use the trackball and press Enter to perform the measurement. When you
complete the measurement, a check mark appears to the left of the tool to
indicate the measurement is complete and entered in the patient report.

Peak Velocity (PSV, EDV, E, A, and V)


You can measure peak velocities using the PSV and EDV calculations tools in the
Vascular calculations. You can measure peak E, A, and V velocities in select cardiology protocols. The calculations derived from your measurements vary, depending upon the protocol you use. If you measure PSV and EDV, the peak gradient
(Gp), systole/diastole (S/D), and the resistive index (RI) are calculated.
To calculate peak velocity
1. Obtain a Doppler display.
2. Press Freeze.
3. Press Calc to display the calculations menu.
4. Select a protocol.
5. Select the peak velocity tool. A cursor appears on the Doppler display.
6. Move the cursor to the peak systolic velocity or the end diastolic velocity. The
results are updated as the cursor is moved.
HD3 Getting Started
4535 612 13861

227

14

Calculations

7. Press Enter.
8. Repeat step 5 through step 7 for the remaining parameters, as necessary.
A check mark appears to the left of the protocol. The calculations are displayed
and entered into the patient report.

Percent Stenosis
The percent of a vessel that is stenosed relative to the full vessel diameter or area
can be calculated using either two area measurements or two distance measurements. From these measurements the percent of stenosis is calculated and displayed. If you select %StA, you will use the ellipse tool to measure the full-vessel
circumference and the 2D trace tool to measure the stenosed vessel circumference. The diameter measurements are correspondingly performed at the full vessel diameter and the stenosed vessel diameter.
To perform a percent area or diameter stenosis measurement
1. Obtain the desired 2D image.
2. Press Freeze.
3. Press Calc to display the calculations menu.
4. Select a protocol.
5. On the protocol, select %StA or %StD.
If you select %StA, then use two area traces (the first an ellipse, the second a trace), displayed by the protocol, to perform two area measurements: one tracing the full circumference of the vessel, and the other
tracing the reduced circumference resulting from the stenosis.

228

If you select %StD, then use the two sets of cursors displayed by the protocol to perform two distance measurements: one across the full diameter
of the vessel, and the other across the reduced diameter resulting from
the stenosis.

HD3 Getting Started


4535 612 13861

Calculations

14

Vessel Area and Distance


You can measure vessel area (Avesl) and vessel distance (Dvesl) using the Vesl.
Area and Vesl. Dist. calculations tools in the Vascular protocols.
To measure vessel area and distance
1. Obtain a 2D, Color, or CPA display of a vessel.
2. Press Freeze.
3. Press Calc to display the Vascular calculations menu.
4. Select Vesl. Area or Vesl. Dist. A cursor appears on the display.
5. Move the cursor to the vessel wall.
6. Press Enter.
7. Outline the vessel area, or move the second cursor to the opposite vessel
wall for the vessel distance.
8. Press Enter. A check mark appears to the left of Vessel Area or Vessel
Dist. in the protocol. The results appear on the display and are entered into
the patient report.

HD3 Getting Started


4535 612 13861

229

14

230

Calculations

HD3 Getting Started


4535 612 13861

15 Maintaining the System


It is important to clean and maintain the ultrasound system and peripherals. Thorough cleaning is particularly important for pieces of peripheral equipment because
they contain electromechanical devices. If exposed to constant and excessive
environmental dust and humidity, these devices will suffer in both performance
and reliability.
It is essential to clean the transducers used with your ultrasound system. The
cleaning procedures vary for the different types of transducers and their uses. For
detailed instructions on how to clean and maintain each type of transducer used
with the system, see the "Transducer Care and Maintenance" section.

Cleaning the System, the Cables, and the Connectors


Use this method to clean the system, the cables, and the connectors. The system
and cables can be cleaned using a mild soap solution. If the equipment has come in
contact with blood or infectious material, clean the equipment with an 70% solution of isopropyl alcohol. For instructions on disinfecting system surfaces, see
"Disinfecting System Surfaces" on page 233.
WARNING

Always use protective eyewear and gloves when cleaning and disinfecting any
equipment.
CAUTIONS

Attempting to disinfect a cable or connector by using a method other than the


one included here can damage the device and voids the warranty.

Orient the parts that must remain dry higher than the wet parts until all parts
are dry.
To clean the display; the system control panel; and all the external
surfaces of the system and the cart
1. Before cleaning, turn off the system and unplug the power cord from the
power source.
2. Wipe with a soft cloth moistened with soap and water.
HD3 Getting Started
4535 612 13861

231

15

Maintaining the System

CAUTION

Do not spill or spray liquid on the controls, into the system cabinet, or into the
transducer connection receptacle.
3. Remove any solid matter around the keys or the controls with a cotton swab
or toothpick to ensure that solids are not pushed into the cabinet.
4. If blood or other infectious material comes in contact with the system or any
cable other than a transducer cable, wipe with a 70% solution of isopropyl
alcohol.
CAUTION

If blood or other infectious material comes in contact with a transducer or transducer cable, do not wipe with isopropyl alcohol until you have read "Cleaning,
Disinfecting, and Sterilizing Transducers" on page 123 for specific cleaning guidelines. Isopropyl alcohol should not be used on some parts of the transducer and
should never be used on any parts of the transducer cable. Additional cleaning
agents are also available for transducers.
5. Remove any residue with a cloth moistened with sterile water.
6. Be sure to dry the equipment to prevent potential corrosion.

232

HD3 Getting Started


4535 612 13861

Maintaining the System

15

Disinfecting System Surfaces


The exterior surfaces of the system can be disinfected using a recommended disinfectant with a wipe method. The following products are approved for use on the
system:

Mild soap solution

70% Isopropyl alcohol (IPA)

Theracide Plus

Sani-Cloth (all)

Use the following procedure to disinfect system surfaces.


WARNING

Always use protective eyewear and gloves when cleaning and disinfecting any
equipment.
CAUTIONS

Use only recommended disinfectants on system surfaces. Immersion-type disinfectants are not tested for use on system surfaces.

If you use an isopropyl alcohol solution for disinfection, ensure the solution is
only 70% alcohol or less. Solutions of more than 70% alcohol can cause product damage.
To clean and disinfect system surfaces
1. Turn off the system and disconnect the system power cord from the wall outlet.
2. Use a soft cloth lightly dampened in a mild soap or detergent solution to clean
exterior surfaces on the system.
3. Mix the disinfection solution compatible with your system (see the list above)
according to label instructions for solution strength.
CAUTION

Do not spray disinfectant directly on system surfaces. Doing so may cause disinfectant to leak into the system, damaging the system and voiding the warranty.

HD3 Getting Started


4535 612 13861

233

15

Maintaining the System

4. Wipe system surfaces with the disinfectant, following disinfectant label


instructions for wipe durations, solution strengths, and disinfectant contact
duration. Ensure the solution strength and duration of contact are appropriate
for the intended clinical application.
5. Air dry or towel dry with a sterile cloth according to the instructions on the
disinfectant label.
6. Because the system is a piece of medical equipment that contains several circuit boards, extensive service diagnostics, and complex operating software,
Philips recommends that only trained personnel service the system.

Maintaining the System Control Panel


The system control panel and other outer surfaces are most likely to be affected
by liquid spills and other materials such as excessive amounts of gel. These materials may seep into electrical components under the panel and cause intermittent
failures. During preventive maintenance, look for such potential problems including loose knobs and worn controls.
Regularly clean the outside of the system as described in "Cleaning the System,
the Cables, and the Connectors" on page 231.

Cleaning the Trackball


Cleaning the trackball regularly prolongs its useful life and prevents service calls.
To clean the trackball
1. With your fingers, unscrew the ring around the trackball.
2. Put your finger in the access hole underneath the trackball, and push the
trackball up.
3. Clean the trackball and the mounting area with a lint-free cloth or a small
brush.
4. Place the ball back on the mounting area.
5. With your fingers, screw the ring back on.

234

HD3 Getting Started


4535 612 13861

Maintaining the System

15

Cleaning and Maintaining Peripherals


For information about cleaning the system peripherals, see the manufacturers
manual that accompanied the peripheral, or contact your local Philips representative. The procedures generally require the removal of the unit from the cart and
therefore should be performed by appropriate service personnel.

VCR
The VCR requires the following maintenance.
To clean the video heads
1. Disconnect the VCR cables from the system.
2. Remove the VCR from the cart.
3. Remove the top cover.
4. Thoroughly clean the individual video heads, using an appropriate solvent and
a lint-free cloth or chamois.
To clean the videotape path
Using an appropriate solvent and lint-free cloth or chamois, clean the entire videotape path as well as the audio and control heads. If you need to lubricate the
heads, use a very light oil and be very careful not to contaminate the videotape
path.

Video Printers
Optional devices, such as video printers, require that you periodically partially disassemble the print heads to effectively remove paper debris and abrasive material.
To minimize maintenance, consistently use high-quality paper coated with an antistatic protecting chemical. Because dirty sensor surfaces are often the cause of
malfunction, it is important to keep the sensors clean.

HD3 Getting Started


4535 612 13861

235

15

Maintaining the System

Replacing the System Battery


The systems lithium battery, located inside the system electronics, maintains configuration settings at all times, even when the system is off.
The memory backup life of the battery is approximately 3 years if left unplugged.
When the system is plugged in, the standby current from the power supply
extends the life of the battery. The battery rating is CR2032 3-V Single Cell, 220
mAh.
If, however, the system battery loses its charge, the system defaults to the standard configuration settings, and the system clock may fail to show the correct
time. However, there are no patient safety concerns. To replace the battery, contact your Philips service representative.
WARNING

There is a danger of explosion if the battery is replaced incorrectly. The battery


should be replaced only with the same or equivalent type recommended by the
equipment manufacturer. Used batteries must be discarded according to the manufacturers instructions and local ordinances.

Disposing of Equipment
Dispose of the ultrasound system according to local ordinances. Dispose of
peripheral equipment in accordance with the manufacturers instructions and local
ordinances.

Preventive Maintenance
Philips recommends basic preventive maintenance that is intended to minimize
the possibility of unexpected failure. Most recommendations rely on thorough
cleaning.
Thorough cleaning is particularly important for pieces of peripheral equipment
because they contain electromechanical devices. If exposed to constant and
excessive environmental dust and humidity, these devices will suffer in both performance and reliability.
The frequency of system preventive maintenance plays a key role in extending or
eliminating downtime due to poor performance or unexpected breakdown.
Table 15-1 offers recommendations, but you can make necessary adjustments
236

HD3 Getting Started


4535 612 13861

Maintaining the System

15

based on factors such as the frequency of usage and environmental conditions. In


all cases, Philips recommends that you frequently check safety-related items.
Table 15-1 Recommended Frequency of Maintenance Tasks
Item

Frequency

Task

Transducers

Before each
use

Cart

As necessary Clean as instructed. Wheels have


sealed bearings, and no lubrication
is necessary.

"Cleaning the
System, the Cables,
and the
Connectors" on
page 231

Trackball

3 months

Clean as instructed.

"Cleaning the
Trackball" on
page 234

VCR

6 months

Clean video heads and tape path.

"VCR" on page 235

Video
printers

6 months

Clean print head, rollers, and


sensors.

"Video Printers" on
page 235

Fan

1 year

Check for good airflow without


excessive noise.

Service
documentation

Safety

1 year

Perform ground impedance/leakage


tests.

Check for cracks, bent pins, or


other abnormalities.

See
"Inspecting
Transducers for
Damage" on
page 117

HD3 Getting Started


4535 612 13861

237

15

238

Maintaining the System

HD3 Getting Started


4535 612 13861

16 System Administration
The system includes several features that can help the system administrator manage presets and system settings, install software, update drivers, and view system
information for troubleshooting purposes. This section also describes how to
configure network settings for use with the DICOM option to print and send
information across a network.

Backing Up and Restoring Presets and Settings


Use the Admin tab in the setups to backup and restore presets and system settings. You can specify which presets to back up, or you can select all presets, and
select the backup destination. System settings, DICOM settings, and options are
automatically saved when you perform a backup.
NOTE

For information on backing up and restoring patient exams, see the "Review" section.

To back up presets and settings


1. Press Set Up (F10).
2. Click the Admin tab.
3. In the Presets and Settings area, click Backup.
4. Select the presets you want to back up. To select all presets, click Select All.
5. Click the backup destination (CD, MOD, USB Memory).
6. Click Start.
7. Click Close when done.
To restore presets and settings
1. Press Set Up (F10).
2. Click the Admin tab.
3. In the Presets and Settings area, click Restore.
4. Insert the media that contains the data to restore.
HD3 Getting Started
4535 612 13861

239

16

System Administration

5. Select the presets you want to restore. To select all presets, click Select All.
6. If necessary, select the additional information to restore (system settings,
DICOM settings, and options).
7. Click Start.
8. Click Close when done.
9. When a message prompts you to overwrite the existing data, do one of the
following:
To overwrite all existing data, click Yes to All.
To overwrite selected data, click Yes.

To retain all existing data, click No to All.

To retain selected data, click No.

Installing Software and Updating Drivers


Use the Admin tab in setups to install new system software and to update device
drivers.
CAUTION

Only install software or drivers received from an authorized Philips representative. Installing unauthorized software could render your system inoperable and
voids your warranty.
To install software or update device drivers
1. Press Set Up (F10).
2. Click the Admin tab.
3. Do either of the following:

To install software, in the Software and Drivers area, click Install.

To update drivers, in the Software and Drivers area, click Update.


4. In the dialog box, click Source and select the source on which the software
installation files are located.

240

HD3 Getting Started


4535 612 13861

System Administration

16

5. Select the software or drive file or files you want to install or update and click
Start. The system displays status messages and progress indicators as the
operation is performed.

Viewing System Information and Logs


Use the Admin tab in setups to display system information, and to view keystroke and DICOM activity logs.
Use the Keystroke Log and the DICOM Log to specify log settings and to view
log files, copy log files onto removable media, and to delete log files.
To display system information
1. Press Set Up (F10).
2. Click the Admin tab.
3. In the Service area, click Show to display system information.
4. Use the scroll bars to view the system information.
5. Click Close when done.
To display the keystroke or DICOM log
NOTE

You can view only one keystroke log at a time. However, you can copy or delete
multiple keystroke logs.
1. Press Set Up (F10).
2. Click the Admin tab.
3. In the Service area, click Open to open the keystroke or DICOM log.
4. In the dialog box, do the following:
Enter the number of days a log file should be active. For example, if you
enter 31 days, the log file is deleted if it is older than 31 days.
Enter the maximum size of the log file in kilobytes.
5. To view a log file, select the log file and click View selected file.
6. To copy a log file or files, select the file or files, select the removable media
destination, and click Copy selected files.
HD3 Getting Started
4535 612 13861

241

16

System Administration

7. To delete a file after copying, select the Delete files after copy check box.
8. Click Close.

About Service Tools


Service Tools in the Admin setups display are password-protected and should
be used only by Philips-authorized personnel to view and change system settings.
Because the system is a piece of medical equipment that contains several circuit
boards, extensive service diagnostics, and complex operating software, Philips recommends that only trained personnel service the system.

Configuring Network Settings


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.
Before you connect to a DICOM network, you need to configure the systems
network settings. The steps involved in configuring network settings include
entering server information and assigning servers in DICOM setup and specifying
the DICOM store and print functions. Check with your network administrator
for the specific values that you need to enter. For a description of each field, see
the "Glossary".
To enter network setting information for your system
1. Press Set Up (F10).
2. Click the DICOM tab.
3. Enter the AE Title and if necessary, enter the Port number if it is different
from the default (104).
4. If necessary, enter the Station Name if your facility uses a station name.
5. Click System Network Settings to enter additional required information.

242

HD3 Getting Started


4535 612 13861

System Administration

16

6. In the System Network Settings dialog box, enter or specify the following
for your system:

Host name

Whether your system uses dynamic IP configuration

IP address, subnet mask, and default gateway (required only if you are not
using a dynamic IP configuration)

IP address of the primary DNS server (if needed)

IP address of the secondary DNS server (if needed)

7. Click Apply to apply the settings.


8. When a message indicates the network settings are applied, click OK.
9. Click Save to save the settings and close the DICOM tab.
To add DICOM server information
1. Press Set Up (F10).
2. Click the DICOM tab.
3. Click Add to add server configuration information.
4. In the Server Configuration dialog box, enter or specify the following
information for the DICOM server:

Service (Store or Print)

Alias name

AE Title

IP Address

Port

Retry Timeout (if necessary)

Maximum Retries (if necessary)

Specify the Transfer Mode. Select from: Send As You Go, to send each
image as it is acquired; Batch, to automatically send images over the network when you close the exam; Manual, to send selected images one at a
time.

HD3 Getting Started


4535 612 13861

243

16

System Administration

5. If you selected Print as the service in step 4, additional printer setups appear
in the Server Configuration dialog box. Verify the settings as needed.
6. Click OK.
7. Click Save to save the settings and close the DICOM tab.
To edit DICOM server information
1. Press Set Up (F10).
2. Click the DICOM tab.
3. Select the server you want to edit and click Edit.
4. Edit the information as needed and click OK.
5. Click Save to save the settings and close the DICOM tab.
To delete a DICOM server
1. Press Set Up (F10).
2. Click the DICOM tab.
3. Select the server you want to delete and click Delete.
4. Click Save to save the settings and close the DICOM tab.

Testing Network Settings


When you test a network setting, the system performs two tests:

TCP/IP Ping to verify that it can connect to the specified IP address

DICOM Verify (C-ECHO command) to verify that it can connect to the specified DICOM server

To test a DICOM server connection


1. Press Set Up (F10).
2. Click the DICOM tab.
3. Select the server you want to test and click Test.
4. When a message displays the test results, click OK.

244

HD3 Getting Started


4535 612 13861

System Administration

16

Troubleshooting Failed Tests


If the TCP/IP Ping test fails, make sure the IP address and port number specified
for your system and for the DICOM server are correct.
If the DICOM Verify test fails, make sure the AE Title specified for your system
and for the DICOM server are correct. The AE Title is case-sensitive; make sure
you have entered it correctly.
If the DICOM server is using high-security settings, you may need to add your
systems AE Title and IP address to the servers list of systems that are authorized
to access it.

HD3 Getting Started


4535 612 13861

245

16

246

System Administration

HD3 Getting Started


4535 612 13861

17 References
Cardiology
Table 17-1, Table 17-2, and Table 17-3 contain the cardiology calculations for the
2D, M-mode, and Doppler protocols. The reference numbers in these tables refer
to Table 17-4, which lists the references for the calculations.
Table 17-1 2D Cardiology Protocols
Cardiology
Protocol
Simpson

Vol A/L

Calculation

Reference
Number
(Table 17-4)

A4C Diastole/A4C Systole

A2C Diastole/A2C Systole

Bi. Dias Vol./Bi. Sys Vol.

Stroke Volume

Stroke Volume Index

Cardiac Output

Cardiac Index

Ejec Frac

LV Vol. Diastole/LV Vol.


Systole

Stroke Volume

Stroke Volume Index

Cardiac Output

Cardiac Index

Ejec Frac

HD3 Getting Started


4535 612 13861

247

17

References

Table 17-1 2D Cardiology Protocols (Continued)


Cardiology
Protocol
2D Measure

Calculation
IVSd/IVSs

LVDd/LVDs

LVPWd/LVPWs

LV Vol. d/LV Vol. s

LV Mass

Reference
Number
(Table 17-4)

9, 10, 11

Stroke Volume

Stroke Volume Index

Cardiac Output

Cardiac Index

Ejec Frac

LV Mass

6, 7, 8

All calculations

Table 17-2 M-Mode Cardiology Protocols


Cardiology
Protocol
Left Ventricle

Calculation
LV Vol. d/LV Vol. s

Mitral Valve
248

HD3 Getting Started


4535 612 13861

9,10,11

Stroke Volume

Cardiac Output

Ejec Frac

Frac Short

LV Mass
Ao/LA

Reference
Number
(Table 17-4)

6, 7, 8

LV Mass Index

Ao Cusp Sep

Ao Root Dia

All calculations

References

17

Table 17-3 Doppler Cardiology Protocols


Cardiology
Protocol

Calculation

Reference
Number
(Table 17-4)

MV Inflow

All calculations

MV Regurg

All calculations

3,5

LVOT Doppler

All calculations

AoV Systolic

All calculations

3,12

AoV Regurg

All calculations

3,5

TV Inflow

All calculations

TV Regurg

All calculations

3,5

PV Inflow

All calculations

PV Regurg

All calculations

3,5

Pulm Veins

All calculations

Qp:Qs

All calculations

Table 17-4 References for Cardiology and Fetal Echo Calculations


Number

Reference

Feigenbaum, H. Echocardiography, Fifth Edition. Lea & Febiger, Philadelphia,


1994.

Laurenceau, J. L., Malergue, M.C. The Essentials of Echocardiography. Le


Hague: Martinus Nijhoff, 1981.

Oh, J.K., Seward, J.B., Tajik, A.J. The Echo Manual. Boston: Little, Brown
and Company, 1994.

Schiller, N.B., Shah, P.M., Crawford, M., et. al. Recommendations for
Quantitation of the Left Ventricle by Two-Dimensional
Echocardiography. Journal of American Society of Echocardiography.
September-October 1989, 2:362.

Schmailzl, K.J.G., Ormerod, O. Ultrasound in Cardiology. Blackwell Science,


Cambridge, 1994.
HD3 Getting Started
4535 612 13861

249

17

References

Table 17-4 References for Cardiology and Fetal Echo Calculations


Number

250

Reference

Byrd, B.F., et. al. Left ventricular mass and volume/mass ratio
determined by two-dimensional echocardiography in normal adults.
Journal of American College of Cardiology. 6, 1021, 1985.

Devereux, R.B., et al. Echocardiographic Assessment of Left Ventricular


Hypertrophy: Comparison to Necropsy Findings. American Journal of
Cardiology, 1986, Vol. 57, p. 450-458.

Sahn, D., DeMaria, A., Kisslo, J., Weyman, A. The Committee on


M-mode Standardization of American Society of Echocardiography,
Recommendations Regarding Quatitation in M-Mode
Echocardiography: Results of a Survey of Echocardiographic
Measurements. Circulation, 1978, Vol. 58, No. 6, p. 1072-1083.

Teichholz, L.E., Kreulen, T., Herman, M.V., et. al. Problems in


echocardiographic volume determinations:
echocardiographic-angiographic correlations in the presence or absence
of asynergy. American Journal of Cardiology, 1976, 37:7.

10

Pombo, J.F., et.al. Left Ventricular Volumes and Ejection Fraction by


Echocardiography. Circulation, Vol. XLIII, 482, April, 1971.

11

Harry, Mark, J. Basic Echocardiography. Iowa Heart Center. January, 1997.

12

Otto, C.M., Pearlman, A.S., et. al. Simplification of the Doppler


Continuity Equation for Calculating Stenotic Aortic Valve Area. Journal
of American Society of Echocardiography, 1:155-157, 1988.

HD3 Getting Started


4535 612 13861

References

17

Fetal Echo
Table 17-5 contains the fetal echo calculations The reference numbers in this table
refers to Table 17-4, which lists the references for the calculations.
Table 17-5 Fetal Echo Protocols
Fetal Echo
Protocol
2D

Calculations

Reference
Number
(Table 17-4)

CO

EF

SV

LV Vol. d/LV Vol. s


Cardio-Thorax Area All calculations
Ratio (CTAR)

9, 10, 11
9

Fetal HR

HR = # beats * 60/time
(bpm: bit/minute)

MV Inflow

All calculations

TV Inflow

All calculations

MV Regurg

All calculations

3, 5

TV Regurg

All calculations

3, 5

General
Goldberg, B.B., Kurtz, A.B. Atlas of Ultrasound Measurements. Year Book Medical
Publishers, 1990.

Body Surface Area (BSA) in Square Meters


Grossman, W. Blood Flow Measurement: Hemodynamic Principles. Cardiac
Catheterization and Angiography, 1980, p. 90.

HD3 Getting Started


4535 612 13861

251

17

References

Gynecology
Beyer, W.H. Standard Mathematical Tables, 28th Edition. CRC Press, Boca Raton,
Florida, 1987, page 131.

Hip Angle
Goldberg, B.B., Kurtz, A.B. Atlas of Ultrasound Measurements. Year Book Medical
Publishers, 1990, p. 20-30.

Obstetrics
Gestational Age (G.A.)
Abdominal Circumference (AC)
Campbell, Professor Campbells Group at Harris Birthright Centre, Kings College
Hospital.
Hadlock, F., Deter, R.L., Harrist, R.B., Park, S.K. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 1984,
152: 497-501. (Biometric Age and Growth Equations)
Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, 1986, p.431.
Merz, E., Goldhofer, W., Timor-Tritsch, E. Ultrasound in Gynecology and Obstetrics.
Textbook and Atlas, 308-338, Georg Thieme Verlag, 1991.
Tokyo. Japan Journal of Medical Ultrasonics, Vol. 23, No. 12, 1996.
Y.G Park, The Standardization of Fetal Body Parts According to the Normal
Korean Gestational Age in Ultrasound. Korean Ultrasound Institute, Vol. 14, No. 2,
1995.

Antero-Posterior Diameter (APD)


Hansmann, M., Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics
and Gynecology. Springer-Verlag, New York, 1986, p. 431. (or Ultraschallbiometrie
im II. und III. Trimester der Schwangerschaft. Gynkologe 9:133, 1976, p. 138.)

252

HD3 Getting Started


4535 612 13861

References

17

Antero-Posterior Thorax Diameter (APTD)


Hansmann, M., Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics
and Gynecology. Springer-Verlag, New York, 1986. (or Ultraschallbiometrie im II.
und III. Trimester der Schwangerschaft. Gynkologe 9:133, 1976, p. 138.)

Biparietal Diameter (BPD)


Campbell, Professor Campbells Group at Harris Birthright Centre, Kings College
Hospital.
Chitty, L.S., Altman, D.G. New Charts for Ultrasound Dating of Pregnancy.
Ultrasound in Obstetrics and Gynecology. Vol. 10: 174-191, 1997. (Out-In and
Out-Out)
Hadlock, F., Deter, R.L., Harrist, R.B., Park, S.K. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 1984,
152: 497-501. (Biometric Age and Growth Equations).
Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, 1986, p.440, Table 4.
Jeanty, P., Romero, R. Obstetrical Ultrasound. McGraw-Hill Book Company, pages
57-61, 1984.
Kurtz, Biometric in der Fruhgravidatat (I. Tremenon), Der Frauenazt, 32, 4/1991.
Merz, E., Goldhofer, W., Timor-Tritsch, E. Ultrasound in Gynecology and Obstetrics.
Textbook and Atlas, 308-338, Georg Thieme Verlag, 1991.
Osaka University Method 1989, 3 by University Of Osaka.
Sabbagha, R.E., et. al. Standardization of Sonar Cephalometry and Gestational
Age. Obstetrics and Gynecology, Vol. 52, No. 4: 403, October, 1978.
Tokyo. Japan Journal of Medical Ultrasonics, Vol. 23, No. 12, 1996.
Y.G Park, The Standardization of Fetal Body Parts According to the Normal
Korean Gestational Age in Ultrasound. Korean Ultrasound Institute, Vol. 14, No. 2,
1995.

HD3 Getting Started


4535 612 13861

253

17

References

Cerebellum (CEREB)
Altman D.G., Chitty L.S., New Charts for Ultrasound Dating of Pregnancy. Ultrasound in Obstetrics and Gynecology, Vol. 10, 174-191, 1997.
Hill, Lyndon, M., et. al. The Transverse Cerebellar Diameter in Estimating Gestational Age in the Large for Gestational Age Fetus. Obstetrics and Gynecology, Vol.
75, No. 6, 981-985, June 1990.

Clavicle Length (CLAV)


Yarkoni, S., et. al. Clavicular Measurement: A New Biometric Parameter for Fetal
Evaluation. Journal of Ultrasound in Medicine, 4:467-470, September, 1985.

Crown-Rump Length (CRL)


Australian Society for Ultrasound in Medicine, Policies and Statements, [D7]
Statement On Normal Ultrasonic Fetal Measurements (Revised May 2001).
Hadlock, F., Shah, Y.P., Kanon, D.J., Math, B., Lindsey, J.V. Fetal Crown-Rump
Length: Re-Evaluation of Relation to Menstrual Age (5-18 weeks) with High-Resolution Real-Time Ultrasound. Radiology, 182: 501-505, 1992.
Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, 1986, p.439, Table 3.
Nelson, L. Comparison of Methods for Determining Crown-Rump Measurement
by Real-Time Ultrasound. Journal of Clinical Ultrasound, 9: 67-70, February, 1981.
Osaka University Method 1989, 3 by University Of Osaka.
Y.G Park, The Standardization of Fetal Body Parts According to the Normal
Korean Gestational Age in Ultrasound. Korean Ultrasound Institute, Vol. 14, No. 2,
1995.
Robinson, H.P., Fleming, J.E.E. British Journal of Obstetrics and Gynecology, 82:
702-710, September 1975.
Tokyo, Japan Journal of Medical Ultrasonics, Vol. 23, No. 12, 1996.

Femur Length (FL)


Australian Society for Ultrasound in Medicine, Policies and Statements, [D7]
Statement On Normal Ultrasonic Fetal Measurements (Revised May 2001).
254

HD3 Getting Started


4535 612 13861

References

17

Campbell, Professor Campbells Group at Harris Birthright Centre, Kings College


Hospital.
Chitty, L.S., Altman, D.G. New Charts for Ultrasound Dating of Pregnancy.
Ultrasound in Obstetrics and Gynecology. Vol. 10: 174-191, 1997.
Hadlock, F., Deter, R.L., Harrist, R.B., Park, S.K. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 1984,
152: 497-501. (Biometric Age and Growth Equations)
Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, 1986, p. 431.
Hohler, C. W., Quetel, T. A. Fetal Femur Length: Equations for Computer Calculatin of Gestational Age from Ultrasound Measurements. American Journal of
Obstetrics and Gynecology, Vol. 143, No. 4: 479-481, June 15, 1982.
Jeanty, P., Rodesch, F., Delbeke, D., Dumont, J., Estimation of Gestational Age
from Measurements of Fetal Long Bones. Journal of Ultrasound Medicine, 3: 75-79,
February, 1984.
Merz, E., W. Goldhofer, E. Timor-Tritsch. Ultrasound in Gynecology and Obstetrics.
Textbook and Atlas, Georg Thieme Verlag, 308-338, 1991.
Y.G Park, The Standardization of Fetal Body Parts According to the Normal
Korean Gestational Age in Ultrasound. Korean Ultrasound Institute, Vol. 14, No. 2,
1995.
Osaka University Method 1989, 3 by University Of Osaka.
Tokyo, Japan Journal of Medical Ultrasonics, Vol. 23, No. 12, 1996.

Gestational Sac (GS)


Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, 1986, p. 431.
Hellman, L.M., et.al. Growth and development of the human fetus prior to the
20th week of gestation. American Journal of Obstetrics and Gynecology.
Nyberg, David, A., Hill, Lyndon, M., Bohm-Velez, Marcela., Mendelson, Ellen, B.
Transvaginal Ultrasound. Mosby Yearbook, p.76. 1992.
Japan Journal of Medical Ultrasonics, Vol. 23, No. 12, 1996.
HD3 Getting Started
4535 612 13861

255

17

References

Head Circumference (HC)


Australian Society for Ultrasound in Medicine, Policies and Statements, [D7]
Statement On Normal Ultrasonic Fetal Measurements (Revised May 2001).
Campbell, Professor Campbells Group at Harris Birthright Centre, Kings College
Hospital.
Chitty, L.S., Altman, D.G. New Charts for Ultrasound Dating of Pregnancy.
Ultrasound in Obstetrics and Gynecology. Vol. 10: 174-191, 1997. (Out-In and
Out-Out)
Hadlock, F., Deter, R.L., Harrist, R.B., Park, S.K. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 1984,
152: 497-501. (Biometric Age and Growth Equations)
Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, 1986, p. 431.
E. Merz, W. Goldhofer, E. Timor-Tritsch. Ultrasound in Gynecology and Obstetrics.
Textbook and Atlas, Georg Thieme Verlag, 308-338, 1991.
Y.G Park, The Standardization of Fetal Body Parts According to the Normal
Korean Gestational Age in Ultrasound. Korean Ultrasound Institute, Vol. 14, No. 2,
1995.

Humerus Length (HUM)


Australian Society for Ultrasound in Medicine, Policies and Statements, [D7]
Statement On Normal Ultrasonic Fetal Measurements (Revised May 2001).
Jeanty, P., Rodesch, F., Delbeke, D., Dumont, J. Estimation of Gestational Age
from Measurements of Fetal Long Bones. Journal of Ultrasound in Medicine 3:75-79,
February, 1984.
Merz, E., et. al. Ultrasonic Mensuration of Fetal Limb Bones in the Second and
Third Trimesters. Journal of Clinical Ultrasound, 15: 175-183, March/April, 1987.
Osaka University (from Nakai), Medison, Japan, January 15, 2001.
Y.G Park, The Standardization of Fetal Body Parts According to the Normal
Korean Gestational Age in Ultrasound. Korean Ultrasound Institute, Vol. 14, No. 2,
1995.

256

HD3 Getting Started


4535 612 13861

References

17

Middle Abdominal Diameter (MAD)


Eik-Nes SH, Jorgensen NP, Grottum P, Lokvik B., Normal range curves for the
intrauterine growth of the fetal abdominal diameters. Submitted JCU.
Campbell, S. Ultrasound Measurement of the Fetal Head to Abdomen Circumference Ratio in the Assessment of Growth Retardation. British Journal of Obstetrics and Gynecology, Vol. 84, 165-174, March 1977.

Occipito-Frontal Diameter (OFD)


Australian Society for Ultrasound in Medicine, Policies and Statements, [D7]
Statement On Normal Ultrasonic Fetal Measurements (Revised May 2001).
Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, p.431, 1986.
Y.G Park, The Standardization of Fetal Body Parts According to the Normal
Korean Gestational Age in Ultrasound. Korean Ultrasound Institute, Vol. 14, No. 2,
1995.

Outer Ocular Distance (OOD)


Jeanty, P., et. al. The Binocular Distance: A New Way to Estimate Fetal Age. Journal of Ultrasound in Medicine, 3:241-243. June 1984.

Tibia
Jeanty, P., Rodesch, F., Delbeke, D., Dumont, J. Estimation of Gestational Age
from Measurements of Fetal Long Bones. Journal of Ultrasound in Medicine 3:75-79,
February, 1984.
Merz, E., et. al. Ultrasonic Mensuration of Fetal Limb Bones in the Second and
Third Trimesters. Journal of Clinical Ultrasound, 15: 175-183, March/April, 1987.

Transverse Abdominal Diameter (TAD)


Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, p. 440, 1986.

HD3 Getting Started


4535 612 13861

257

17

References

Transverse Thorax Diameter (TTD)


Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, p.431, 1986

Ulna Length
Jeanty, P., Rodesch, F., Delbeke, D., Dumont, J. Estimation of Gestational Age
from Measurements of Fetal Long Bones. Journal of Ultrasound in Medicine 3:75-79,
February, 1984.

Fetal Growth
Abdominal Circumference (AC)
Australian Society for Ultrasound in Medicine, Policies and Statements, [D7]
Statement On Normal Ultrasonic Fetal Measurements (Revised May 2001).
Campbell, S., Chitty, L.S. Charts of Fetal Size: Abdominal Measurements. British
Journal of Obstetrics and Gynecology.
Chitty, L.S., Altman, D.G., et. al. Chart of Fetal Size: 2 Head Measurement. British
Journal of Obstetrics and Gynecology. Vol. 101, 125-131, 1994. (Measured and
Derived.)
Hadlock, F., Deter, R.L., Harrist, R.B., Park, S.K. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 1984,
152: 497-501. (Biometric Age and Growth Equations).
Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, 1986, p. 179 (Jeanty).
Merz, E. Sonographische Diagnostikin Gynakologie und Geburtshilfe: Lehrbuch
und Atlas, Table 5, p. 283. Stuttgart, New Yourk: Georg Thieme.
Y.G Park, The Standardization of Fetal Body Parts According to the Normal
Korean Gestational Age in Ultrasound. Korean Ultrasound Institute, Vol. 14, No. 2,
1995.
Tokyo. Japan Journal of Medical Ultrasonics, Vol. 23, No. 12, 1996.

258

HD3 Getting Started


4535 612 13861

References

17

Biparietal Diameter (BPD)


Australian Society for Ultrasound in Medicine, Policies and Statements, [D7]
Statement On Normal Ultrasonic Fetal Measurements (Revised May 2001).
Chitty, L.S., Altman, D.G., et. al. Chart of Fetal Size: 2 Head Measurement. British
Journal of Obstetrics and Gynecology. Vol. 101, 35-43, 1994. (Out-In and
Out-Out)
Hadlock, F., Deter, R.L., Harrist, R.B., Park, S.K. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 1984,
152: 497-501. (Biometric Age and Growth Equations).
Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, 1986, p.176.
Merz, E., et. al. Ultrasonic Mensuration of Fetal Limb Bones in the Second and
Third Trimesters. Journal of Clinical Ultrasound, 15: 175-183, March/April, 1987.
Osaka University (Yayoi Matsubara), Medison, Japan, April 8, 2002.
Y.G Park, The Standardization of Fetal Body Parts According to the Normal
Korean Gestational Age in Ultrasound. Korean Ultrasound Institute, Vol. 14, No. 2,
1995.
Tokyo. Japan Journal of Medical Ultrasonics, Vol. 23, No. 12, 1996.

Cerebellum (CER)
Goldstein. Cerebellar Measurements with Ultrasonography in the Evaluation of
Fetal Growth and Development. American Journal of Obstetrics and Gynecology.
156: 1065-1069, 1987.

Clavicle Length (CLAV)


Yarkoni, S., et. al. Clavicular Measurement: A New Biometric Parameter for Fetal
Evaluation. Journal of Ultrasound in Medicine, 4:467-470, September, 1985.

Femur Length (FL)


Australian Society for Ultrasound in Medicine, Policies and Statements, [D7]
Statement On Normal Ultrasonic Fetal Measurements (Revised May 2001).

HD3 Getting Started


4535 612 13861

259

17

References

Campbell, S. Chitty, I., Chart of Fetal Size: 4. Femur Length. British Journal of
Obstetrics and Gynecology. Vol. 101, 132-135, Table 1.
Chitty, L.S., Altman, D.G., et. al. Chart of Fetal Size: 4. Femur Length. British Journal of Obstetrics and Gynecology. Vol. 101, 132-135, 1994.
Hadlock, F., Deter, R.L., Harrist, R.B., Park, S.K. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 1984,
152: 497-501. (Biometric Age and Growth Equations).
Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, 1986, p.176.
Jeanty, P., Romero. R. Normal Values for the Leg. Prenatal Diagnosis of Congenital
Anomalies, Table 10-4, p. 324, Norwalk: Appleton & Lange.
Merz, E., Grupner, A., Kern, F. Mathematical Modeling of Fetal Limb Growth.
Journal of Clinical Ultrasound, 17:179-185, March/April, 1989.
Osaka University Method 1989, 3 by University Of Osaka.
Tokyo. Japan Journal of Medical Ultrasonics, Vol. 23, No. 12, 1996.
Y.G Park, The Standardization of Fetal Body Parts According to the Normal
Korean Gestational Age in Ultrasound. Korean Ultrasound Institute, Vol. 14, No. 2,
1995.

Fetal Trunk Area (FTA)


Osaka University Method 1989, 3 by University Of Osaka.

Head Circumference (HC)


Australian Society for Ultrasound in Medicine, Policies and Statements, [D7]
Statement On Normal Ultrasonic Fetal Measurements (Revised May 2001).
Chitty, L.S., Altman, D.G., et. al. Chart of Fetal Size: 2 Head Measurement. British
Journal of Obstetrics and Gynecology. Vol. 101, 35-43, 1994. (Measured and
Derived).
Hadlock, F., Deter, R.L., Harrist, R.B., Park, S.K. Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 1984,
152: 497-501. (Biometric Age and Growth Equations).

260

HD3 Getting Started


4535 612 13861

References

17

Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and


Gynecology. Springer-Verlag, New York, 1986, p.176.
Merz, E. Sonographische Diagnostikin Gynakologie und Geburtshilfe: Lehrubuch
und Atlas, p. 135, 283. Stuttgart, New York: Georg Thieme.
Y.G Park, The Standardization of Fetal Body Parts According to the Normal
Korean Gestational Age in Ultrasound. Korean Ultrasound Institute, Vol. 14, No. 2,
1995.

Humerus Length (HUM)


Australian Society for Ultrasound in Medicine, Policies and Statements, [D7]
Statement On Normal Ultrasonic Fetal Measurements (Revised May 2001).
Jeanty, P., Romero, R. Obstetrical Ultrasound. New York, McGraw-Hill, 1983, p.
190.
Merz, E., Grupner, A., Kern, F. Mathematical Modeling of Fetal Limb Growth.
Journal of Clinical Ultrasound, 17:179-185, March/April, 1989.
Osaka University (from Nakai), Medison, Japan, January 15, 2001.
Y.G Park, The Standardization of Fetal Body Parts According to the Normal
Korean Gestational Age in Ultrasound. Korean Ultrasound Institute, Vol. 14, No. 2,
1995.

Middle Abdominal Diameter (MAD)


Eik-Nes SH, Jorgensen NP, Grottum P, Lokvik B., Normal range curves for the
intrauterine growth of the fetal abdominal diameters. Submitted JCU.
Campbell, S. Ultrasound Measurement of the Fetal Head to Abdomen Circumference Ratio in the Assessment of Growth Retardation. British Journal of Obstetrics and Gynecology, Vol. 84, 165-174, March 1977.

Radius Length (RAD)


Merz, E. Fetal Biometry. Radiology, 1083: 147:602.

HD3 Getting Started


4535 612 13861

261

17

References

Tibia
Jeanty, P., Romero, R. Obstetrical Ultrasound. New York, McGraw-Hill, 1983, p.
192.
Merz, E., Grupner, A., Kern, F. Mathematical Modeling of Fetal Limb Growth.
Journal of Clinical Ultrasound, 17:179-185, March/April, 1989.

Ulna
Merz, E. Fetal Biometry. Radiology, 1083: 147:602.

Estimated Fetal Weight (EFW)


Abdominal Circumference (AC)
Campbell, S., Wilkin, D. Ultrasonic Measurement of Fetal Abdomen Circumference in the Estimation of Fetal Weight. British Journal of Obstetrics and Gynecology,
Vol. 82, 9: 689-697, September 1975.

Abdominal Circumference, Biparietal Diameter (AC, BPD)


Hadlock, F., et. al. Sonographic Estimates of Fetal Weight. Radiology,
1984:150:535-540.
Merz, E., Goldhofer, W., Timor-Tritsch, E.Ultrasound in Gynecology and Obstetrics.
Textbook and Atlas, Georg Thieme Verlag, 308-338, 1991.
Shepard, M., Richards, V., Berkowitz, R., Warsof, S., Hobbins, J. An Evaluation of
Two Equations for Predicting Fetal Weight by Ultrasound. American Journal of
Obstetrics and Gynecology, Vol. 142, No. 1:47-54, January 1, 1982.

Abdominal Circumference, Femur Length (AC, FL) Hadlock1


Hadlock, F., Harrist, R.B., Sharman, R.S., Deter R.L., Park, S.K. 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: 333-337, February 1, 1985.

262

HD3 Getting Started


4535 612 13861

References

17

Abdominal Circumference, Biparietal Diameter, Femur Length (AC,


BPD, FL) Hadlock2
Hadlock, F., Harrist, R.B., Sharman, R.S., Deter R.L., Park, S.K. 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: 333-337, February 1, 1985.

Abdominal Circumference, Femur Length, Head Circumference (AC,


FL, HC) Hadlock3
Hadlock, F., Harrist, R.B., Sharman, R.S., Deter R.L., Park, S.K. 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: 333-337, February 1, 1985.

Abdominal Circumference, Biparietal Diameter, Femur Length, Head


Circumference (AC, BPD, FL, HC) Hadlock4
Hadlock, F., Harrist, R.B., Sharman, R.S., Deter R.L., Park, S.K. 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: 333-337, February 1, 1985.

Antero-Posterior Thorax Diameter, Biparietal Diameter, Transverse


Thorax Diameter (APTD, BPD, TTD)
Tokyo. Japan Journal of Medical Ultrasonics, Vol. 23, No. 12, 1996.

Antero-Posterior Thorax Diameter, Biparietal Diameter, Femur Length,


Transverse Thorax Diameter (APTD, BPD, FL, TTD)
Tokyo. Japan Journal of Medical Ultrasonics, Vol. 23, No. 12, 1996.

Biparietal Diameter, Femur Length, Fetal Trunk Area (BPD, FL, FTA)
Osaka

HD3 Getting Started


4535 612 13861

263

17

References

Biparietal Diameter, Transverse Thorax Diameter (BPD, TTD)


Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, 1986.

Estimated Fetal Weight Growth


Brenner, W.E., Edelman, D.A., Hendricks, C.H., A Standard of Fetal Growth for
the United States of America. American Journal of Obstetrics and Gynecology, Vol.
126, p. 555-564, November 1976.
Doubilet, Peter M., Benson, Carol B., Nadel, Allan S., Ringer, Steven A., Improved
Birth Weight Table for Neonates Developed from Gestations Dated by Early
Ultrasonography. American Institute of Ultrasound in Medicine Journal of Ultrasound Medicine, Vol. 16, p. 241-249, 1997.
Hadlock, F., Deter, R.L., Harrist, R.B., Park, S.K., Estimating Fetal Age: Computer-Assisted Analysis of Multiple Fetal Growth Parameters. Radiology, 152:
497-501, 1984 (Biometric Age and Growth Equations).
Hansmann, Hackeloer, Staudach, Wittman. Ultrasound Diagnosis in Obstetrics and
Gynecology. Springer-Verlag, New York, 1986, p. 186.
Osaka University (Yayoi Matsubara), Medison, Japan, April 8, 2002.
Tokyo. Japan Journal of Medical Ultrasonics, Vol. 23, No. 12, 1996.

Fetal Ratios
FL/AC
Hadlock, F., Deter, R., Harrist, R., Roecker, E., Park, P.A. Date-Independent Predictor of Intrauterine Growth Retardation: Femur Length/Abdominal Circumference Ratio. American Journal of Radiology, 141: 979-984.

HC/AC
Campbell, S. Ultrasound Measurement of the Fetal Head to Abdomen Circumference Ratio in the Assessment of Growth Retardation. British Journal of Obstetrics and Gynecology, Vol. 84, 165-174, March 1977.

264

HD3 Getting Started


4535 612 13861

References

17

Vascular
Jacob, N. M. et. al. Duplex Carotid Sonography: Criteria for Stenosis, Accuracy,
and Pitfalls. Radiology, 154: 385-391, 1985.

HD3 Getting Started


4535 612 13861

265

17

266

References

HD3 Getting Started


4535 612 13861

18 Specifications
Physical Dimensions
Height
Lowest position: 1,280 mm (50.4 in)
Highest position: 1,455 mm (57.3 in)

Depth
With no peripherals: 798 mm (31.4 in)

Width
With no peripherals: 505 mm (19.9 in)

Weight
With no peripherals, including the monitor: 61.2 kg (135 lb)

Grayscale
256 levels

Monitor
The monitor is a non-interlace 26.4 cm (10.39 in) color TFT LCD. You can:

Lower it down to the control panel for transportation and storage

Rotate it on a central axis

Tilt it forward and backward for optimal viewing

HD3 Getting Started


4535 612 13861

267

18

Specifications

Input and Output Signals


Table 18-1 lists and describes the input and output signals.
Table 18-1 Input and Output Signals
Signal
Audio Right/Left

Input or
Output
Output

Description
Right Audio: Red
Left Audio: White

Black-and-white
printer

Output

1.0 Vpp/75 ohms/unbalanced

LAN port

Input/Output

Network connection

Microphone

Output

Microphone

Print trigger

Output

Print trigger

S-VHS

Output

NTSC/PAL
Chrominance: 0.286 Vpp/75 ohms/
unbalanced
Luminance: 1.0Vpp/75 ohms/unbalanced
Interlace monitor

Transducer

Input

2 transducer connector ports on the


front of the system

USB Ports (2)

Input/Output

USB flash memory device


MO disk drive
Plain paper printer

VGA

Output

1 port

Composite video

Output

NTSC/PAL
1.0 VIP/75 ohms/unbalanced

268

HD3 Getting Started


4535 612 13861

Specifications

18

Peripherals
The system supports the following peripherals:

CD-RW drive

Foot switch (2 pedals)

MO disk drive

Printers: black-and-white, color, inkjet, and laser

VCR

Modality Interface
DICOM standard

Electrical Parameters

100-127 V, 50-60 Hz

200-240 V, 50-60 Hz

Languages

English

French

German

Italian

Spanish

HD3 Getting Started


4535 612 13861

269

18

Specifications

Pressure Limits
Operating
697 hPa to 1,013 hPa
0 to 3,048 m (0 to 10,000 ft)

Storage
572 hPa to 1,013 hPa
0 to 4,572 m (0 to 15,000 ft)

Humidity Limits (Operating)


Low: 10C; 40% to 95% (Relative Humidity)
High: 40C; 15% to 95% (Relative Humidity)

Temperature Limits

270

Operating: 10C to 40C (50F to 104F)

Storage: -20C to 60C (-4F to 140F)

HD3 Getting Started


4535 612 13861

Specifications

18

Safety Requirements

Classification:
Class I equipment with Type BF applied parts
Ordinary Equipment

Non-AP/APG

Electromechanical safety standards met:


CSA C22.2 No. 601.1, Canadian Standards Association, Medical Electrical
Equipment

EN 60601-1:1990, including Amendments 1 and 2, European Norm, Medical Electrical Equipment

EN 60601-1-2:2001, European Norm, Collateral Standard, Electromagnetic Compatibility

IEC 61157:1992, International Electrotechnical Commission, Requirements for the declaration of the acoustic output of medical diagnostic
ultrasonic equipment
UL 60601-1:2003, Underwriters Laboratories, Medical Electrical Equipment

Agency approvals:
Canadian Standards Association (CSA)
ISO 13485:1996, Quality Assurance Standard
CE marked to the European Community Medical Device Directive 93/42/
EEC as a Class IIa device

Philips Ultrasound reserves the right to change specifications contained herein or


discontinue manufacture at any time without prior notice. Current specifications
are supplied with each system purchased or are available from your Philips Ultrasound representative.

HD3 Getting Started


4535 612 13861

271

18

272

Specifications

HD3 Getting Started


4535 612 13861

19 Glossary
For definitions of ultrasound terms not covered here, refer to the American Institute of Ultrasound in Medicine, recommended ultrasound terminology, Second Edition, 1997.
%Stenosis
Percent Stenosis. An area or distance measurement used to calculate the percent of
stenosis in a vessel.
1 Distance
In the Measure setups, a General setting default volume method that uses one distance
measurement to estimate the volume of an object.
2D
(1) Two-dimensional. Pressing this control starts 2D imaging. (2) In 3D imaging, used to
display a full-size multiplanar 2D image.
2D Circumference and Area Method
In the Measure setups, a setting used to select ellipse or trace as the default area
method.
2D Image Size
In the General setups, a Display setting used to select the size of the 2D image: 100
percent, 95 percent, and 90 percent.
2D Map
A 2D Post menu item used to select, view, and create 2D maps.
2D Post
A BW Postmap menu item used to display another menu from which you can select a
2D map, edit a 2D map, select a Chroma map, and edit a Chroma color.
3 Distances
In the Measure setups, a General setting default volume method that uses three distance measurements to estimate the volume of an object.
3D
Three-dimensional. A function key (F2) that starts 3D imaging.

HD3 Getting Started


4535 612 13861

273

19

Glossary

A
area
A2C
Apical two chamber
A4C
Apical four chamber
Aborta
Abortion. In the study information, on the patient information form, a number can be
entered in this field for the number of abortions or miscarriages a woman has experienced.
Above
In Measure setups, a Doppler Trace Mode setting used to include only the displayed
Doppler data above the baseline in calculations.
AC
Abdominal circumference
Acc
Acceleration
Accession number
A 16-character number that may be assigned to each patient file for information management purposes.
Acquire
A control used to save the current image to the systems hard disk.
AD
Abdominal diameter
Admin
A setups category to back up and restore presets and settings, to install and update software and drivers, and to access system information, logs, and service tools.
AE
Application entity

274

HD3 Getting Started


4535 612 13861

Glossary

19

AE title
Application entity title. A DICOM standard name assignment given to a DICOM device.
The ultrasound system and all devices configured for DICOM operations have AE titles,
and they are used in DICOM setups. Additional information about AE titles can be found
in the DICOM conformance statements for the various entities.
AFI
Amniotic Fluid Index
AIUM
American Institute of Ultrasound in Medicine
Alias
A DICOM setting. A data-entry field into which you enter an alias for the device you are
configuring for DICOM operation with the ultrasound system. An alias is an arbitrary
name you assign to the device being configured. It is used for your reference in messages
and dialog boxes and does not need to be the same as the AE title.
All
(1) In Measure setups, a Doppler Trace Mode setting used to include all of the displayed Doppler data in calculations. (2) A calculations protocol that provides a programmed sequence of measurement points that comprise the individual measurements
within the protocol.
Angle
A soft key used to correct the angle between the beam axis and the direction of blood
flow. Press this soft key to select a Doppler correction angle of 0, 60, or -60 degrees.
Ao
Aorta
AoV
Aortic valve
APD
Antero-posterior diameter
APTD
Antero-posterior trunk diameter

HD3 Getting Started


4535 612 13861

275

19

Glossary

Area
A control used to start an area measurement. Area and circumference are calculated and
displayed for this measurement.
Area + Distance
In the Measure setups, a General setting default volume method that uses a distance
measurement and an area measurement to estimate the volume of an object.
Auto Freeze
In the General setups, a Display setting used to automatically cause the system to
enter freeze after a 10-minute hiatus in control activity.
Auto MRN Creation
In System setups, a setting used to automatically create an MRN for each new patient.
AV
Aortic valve
Av, Avg.
Average
AVA
Aortic valve area
Average Value
In Measure setups, a General setting used to display the average of up to three measurements as the default result display in the patient report.
Backspace
A key used to move the data-entry cursor back a space.
Backup and Restore
In Measure setups, an OB setting used to back up OB user-defined tables and equations
to removable media, and to restore OB user-defined tables and equations to the system
hard disk.
Backup Presets and Settings
In Admin setups, settings to back up and restore presets, system settings, DICOM settings, and options.
Baseline
A soft key that shifts the zero baseline in Doppler and Color imaging.
276

HD3 Getting Started


4535 612 13861

Glossary

19

Below
In Measure setups, Doppler Trace Mode setting used to include only the displayed
Doppler data below the baseline in calculations.
Bias
In 3D imaging, a slider used to adjust the gamma curve for the ABC multiplanar 2D
images and the 3D volume image.
Bio
Biophysical
Biopsy
(1) A Utility menu used to hide or show the biopsy guideline. (2) A function key (F3)
that you can use to hide or show the biopsy guideline after setting up the guideline.
biopsy guideline
A guideline through the ultrasound image indicating the anticipated path of the biopsy
needle.
Boot Up Case Lock Status
In System setups, a Local setting to specify whether the Caps Lock key is on or off
when the system starts.
Border Density
A DICOM setup used to set border density to white or black.
BPD
Biparietal diameter
BPM
Beats per minute
Brightness
Function keys used to adjust the brightness of the monitor image to compensate for
ambient light.
BSA
Body surface area. In the study information, on the patient information form, a text field
in which the BSA appears. The BSA is calculated from the height and weight values that
you enter into the study info.
HD3 Getting Started
4535 612 13861

277

19

Glossary

C, c
Color, circumference, curved
CPA Post
A Control menu item used to display the CPA Post menu.
C Pos.
A control on the display that lets you increase or decrease the color ROI position.
C Size
A control on the display that lets you increase or decrease the color ROI size.
Calc
(1) A control that displays a menu of protocols or measurements associated with a the
current system application. (2) Calculations.
Caliper
(1) A control that displays the measurements available for the selected imaging mode. (2)
An on-screen indicator used to make measurements.
Caliper Display Unit
In Measure setups, a General setting used to display the caliper in either centimeters
or millimeters.
Capture
A Color Post menu item and menu used to turn color capture on or off and to set the
number of frames include in the capture. Color capture is used in both Color and CPA
imaging, during real-time, to calculate the highest mean velocity per pixel from a series of
color frames and display a composite image that is the sum of the highest mean velocities.
Cardiac
(1) A category of Measure setups, including the 2D circumference and area method and
M-mode volume calculation method. (2) A set of calculations.
Caution
Information in the manual that describes precautions necessary to protect the equipment.
cavitation
A mechanical bioeffect that refers to the reaction to ultrasound energy of bubbles or
pockets of gas or vapor in tissue or fluid.
278

HD3 Getting Started


4535 612 13861

Glossary

19

CCA
Common carotid artery
CD-RW
Compact disc, rewritable
Cereb
Cerebellum
Chroma
A 2D Post menu item that turns the Chroma map on or off.
CI
Cephalic Index, Cardiac Index
Cine
A process for digitally acquiring and reviewing a series of sequential images.
Circ/Area Method
In the Measure setups, a setting used to select ellipse or trace as the default area
method.
Cist
Cisterna magna
Clav
Clavicle
Clear
A control used to clear text annotation from the display.
CO
Cardiac output
Color
(1) A control used to start color imaging. (2) On the Control menu, a menu item used
to set the color of a 2D Chroma map. (3) A DICOM server field used to set the printer
type to grayscale or color. (4) A 2D Post menu item used to edit the color of the
Chroma maps.

HD3 Getting Started


4535 612 13861

279

19

Glossary

Color Mode
(1) A Color menu item used to select velocity, power, or variance Color display modes.
(2) 3D view used to set the thresholds and mix of the 3D image.
Color Post
A Control menu item used to display the Color Post menu.
Color Postmap
A Control menu item used to display the post menus, from which you can select a
Color map.
Color Power Angio (CPA) imaging
(1) A control used to start CPA imaging. (2) An imaging mode where the colors are
related to the power or energy inherent in blood cell motion.
Color Priority
A Color and CPA menu item that selects the balance between Color and 2D or
black-and-white.
Color Tag
A Color Post menu item and a menu used to turn a color tag on or off, set the position
of the color tag, and set the color width of the color tag. Color tags are used in Color
imaging to identify velocities of interest in the Color image.
Compare
In Review, a view mode that allows you to select images and display them in the layout
positions you determine.
Compression
A Control menu item used to select the system compression. Compression of signal
amplitudes extending from the largest unsaturated signal to the smallest signal just discernible above system noise. On the display, compression is expressed in decibels (dB).
Low dynamic range implies high contrast images, while high dynamic range implies the full
use of the gray scale.
Connect Timeout
A DICOM setting used to specify the number of times to attempt a connection.

280

HD3 Getting Started


4535 612 13861

Glossary

19

Control
A knob on the control panel. Press Control to display the menu. Turn Control to highlight a menu item, and press Control to select the menu item, and then turn the Control to set the value of the menu item.
control panel
The primary user interface that includes the imaging controls, soft keys, keyboard, and
trackball.
Copies
A print setting used to set the number of copies that will be printed for each print operation.
CPA
Color Power Angio imaging. A control used to turn on CPA imaging.
CRL
crown rump length
Cubed
A calculation setting used as the default method to calculate left ventricular volume.
Current Exam
In Review, a selection used to display the images saved for the current exam.
current patient
The patient name displayed on the patient information form. When you enter the patient
name, patient MRN, or both, a patient file is opened.
cursor
Any one of several user-controlled graphic objects used to pinpoint the location of an
object on the screen.
curved array
A transducer with parallel elements in a curved layout.
Custom Field
In the study information, on the patient information form, a text field into which you can
enter information.

HD3 Getting Started


4535 612 13861

281

19

Glossary

Cut Mode
In 3D imaging, used to erase sections of the 3D image.
D, d
Day, density, diameter, diastole, diastolic, distance, Doppler
Data On/Off
A function key (F6) to show or hide mode-specific data on the display.
Date
In System setups, a setting text-entry field used to set the system date and date format.
Date Format
In the System setups, a Date setting used to select the date format from three options.
Day of cycle
In the study information, on the patient information form, a number can be entered for
this value.
dB
Decibel
Dec
Deceleration
default gateway
The gateway in a network that the system uses to access another network.
Default Volume Method
In the Measure setups, a General setting that allows you to choose which volume
method is the default when you begin a volume measurement.
Del
Delete
Demo Images
A Utility menu item used to show demonstration images.
Density
A soft key used to select line density settings for the 2D image. Increasing line density
decreases frame rate.
282

HD3 Getting Started


4535 612 13861

Glossary

19

Depth
A control used to select the imaging depth.
Description
(1) In the study information, on the patient information form, a text field into which you
can enter some pertinent descriptive information for the current patient. (2) In the Measure setups, an OB text field to describe the selected menu name.
Destination
A DICOM setup used to select either magazine or processor for the DICOM printer.
Dia
Diastole, diastolic, diameter
Diag. Physician
Diagnosing Physician. In the study information, on the patient information form, the name
of this physician can be entered in this text field.
dialog box
A system display element that requires your interaction or response.
Dias
Diastole, diastolic
DICOM
Digital Imaging and Communication in Medicine. A standard for network communication.
DICOM Log
In Admin setups, a dialog box used to specify log settings, view selected log files, and
copy and delete DICOM logs. DICOM logs are used for troubleshooting transmission
issues.
DICOM Print
In Review, prints the selected review image to a configured DICOM printer. When
selected, a DICOM Print dialog box appears, which can be used to add, modify, delete,
test, send, or cancel the DICOM print operation.
DICOM Send
In Review, sends the selected review image to configured DICOM storage device. When
selected, a DICOM Storage dialog box appears, which can be used to add, modify,
delete, test, send, or cancel the DICOM store operation.
HD3 Getting Started
4535 612 13861

283

19

Glossary

DICOM setups
A category of system setups covering connectivity to servers, network servers, and network printers.
Display
(1) A Color and CPA menu item that selects the display of color, black-and-white, or
both. (2) In General setups, a group of setups used to set several imaging display parameters. (3) A menu item that selects the size of the scrolling display format.
Display SD
In the Measure setups, an OB setting used set the value of the standard deviation.
Select from No, SD, or Percentile.
Display SD Value
In the Measure setups, an OB setting used to specify whether the standard deviation is
displayed.
Distance
(1) A soft key used to start a distance measurement. (2) A selection in Review that begins
a distance measurement.
Distance Method
In the setups, a Display setting used to select the connecting measurement points. Select
from line or trace as the default distance method.
Dopp
Doppler
Doppler Trace Direction
In the Measure setups, a General setting used to select the area from which Doppler
calculations will be derived: above the baseline, below the baseline, or all of the displayed
Doppler data.
Doppler Y-Axis Unit
In the Measure setups, a General setting used to select velocity or frequency units for
the vertical axis of the PW Doppler display.
Drive
In Review, a menu used to select the exam list from the hard disk, the CD-ROM, or the
MO disk.

284

HD3 Getting Started


4535 612 13861

Glossary

19

Dual
A control used to display the dual image format. May be used to compare two images or
to line up two different parts of one structure to see more of the structure.
Dur
duration
E
Velocity in ventricular systole
ec
Endocavity transducer
ECA
External carotid artery
EDD
Estimated due date. If the LMP is entered into the study information on the patient information form before the established due date is entered, the EDD is calculated from the
LMP. If the EDD is entered before LMP is entered, LMP is calculated from the EDD, and
this denoted in the patient report.
Edge Enhance
A 2D menu item used to enhances edges and border areas, giving better object perspective to the image.
Edit
A menu item used to create a gray map and a Chroma map.
EDV
End diastolic velocity, end diastolic volume
EF
Ejection fraction
EFW
Estimated Fetal Weight. In Measure setups, an OB setting used to select the investigators that you want to use to calculate the EFW.
EFW Growth
Estimated Fetal Weight Growth. In Measure setups, an OB setting used to display the
growth percentile depending on the reference you select.
HD3 Getting Started
4535 612 13861

285

19

Glossary

Ejec Frac
Ejection fraction
Ellipse
A 2D Circumference and Area Method setting used to set the default area measurement method.
Empty Density
A DICOM setup used to set the density of empty cells to black or white.
End Exam
A function key (F7) used to save and end a patient exam.
Endo
Endocardium
Endocavity transducer
A transducer that is inserted into the rectum or vagina for imaging in those areas. Typically used to study the prostate or ovaries.
Enter
A control used to apply, initiate, or complete an action.
Epi
Epicardium
EPSS
E point septal separation
ERO
Effective regurgitant orifice
Esc
Escape
ESV
End systolic volume
ET
Ejection time

286

HD3 Getting Started


4535 612 13861

Glossary

19

Ex
Excursion
Exam
In Review, a view mode that displays the images in the selected layout in the order in
which they were acquired.
Exam List
Selecting Open in Review displays the Exam List, from which you can select a drive, a
patient, search for an exam, and perform various functions in Review.
Exam Navigator
In Review, a listing of patient exams from which you can select an exam by clicking on the
exam date for the desired patient.
Exit
A control used to end functions and exit displays.
Exp. Ovul.
Expected Ovulation. In the study information, on the patient information form, this date
can be entered.
F
Female, fetal
FA
Frame averaging (persistence)
Fetal #
In the study information, on the patient information form, the number of fetuses. Enter a
number between 1 and 4.
Fetal Biometry
In OB setups, a system OB preset used to calculate ultrasound and average ultrasound
age or estimated fetal weight from fetal measurements.
Fetal Growth
In Measure setups, an OB setting used to specify the references used for fetal growth
calculations.
Fib
Fibula
HD3 Getting Started
4535 612 13861

287

19

Glossary

Film Size
A DICOM setup used to set the film size for a DICOM print.
Filter
Soft keys used to select a high-pass filter that removes high-amplitude, low-frequency signal content from the Doppler, CPA, and Color echo.
FL
Femur length
Flash
USB memory device
Fmean
Mean frequency
Focal point
The point where the focal plane and the beam axis intersect.
Focal Position
(1) A control used to set focal depth. (2) A set of transmit focal zones that are fixed at
specific depths for each frequency and type of transducer.
Focal Zones
(1) A Control menu item used to select the number of focal zones. (2) That portion of a
focused ultrasound beam extending axially on either side of the focal point in which the
amplitude of an echo from a standard echo source is not reduced more than 6 dB. The
focal zone is the region of optimal resolution. It is possible to have multiple focal zones in
a single image by using more than one transmit/receive cycle per column, with each one
having its own focal zone.
Focus
A control used to increase and decrease the focus.
Focus +, Soft keys used to select the number of focal zones.
foot switch
The foot switch is a dual foot switch consisting of right and left pedals. You can configure
the pedals in the Peripherals setups for the following functions: dual, freeze, update, and
store.
288

HD3 Getting Started


4535 612 13861

Glossary

19

Format
A print setup used to select the print format. Select from images only, reports only, or
images and reports.
Fpeak
Peak frequency
FPS
Frames per second
Frac Short
Fractional shortening
Frame
A Capture menu item used to set the number of frames used in the Color capture. The
frame setting is used to calculate the highest mean velocity per pixel from a series of
color frames and display a composite image with the sum of those velocities.
Frame Rate (FPS)
A 2D menu item used to set the number of acquisition image updates per second. On
the display frame rate is expressed in frames per second (FPS).
Freeze
A control used to stop or start image acquisition.
Freq.
Frequency
FTA
Fetal trunk area
F.W.
Fetal weight
G
Gain, pressure gradient
GA
Gestational Age. (1) A date in the study information, on the patient information form,
calculated from LMP. (2) In Measure setups, an OB setting used to specify the references used to calculate the GA.
HD3 Getting Started
4535 612 13861

289

19

Glossary

Gain
(1) A control used to adjust the gain. (2) The total system gain is the ratio of the output
signal amplitude to the input signal amplitude. On the system display, gain is expressed as
a number from G0 to G100, in increments of 1, for each active imaging mode.
Gamma
(1) An imaging mode menu item used to adjust the displayed gray levels. (2) In 3D imaging, an image setting used to adjust the bias and position of the grayscale curve applied to
the image.
Gen.
General (frequency display)
Gender
In the study information, on the patient information form, a text field into which you
select the current patients gender.
General
(1) A category of setups including the institution, date, time, display setups, thermal index
display selection, 2D image size, and access to measurement setups. (2) A category of the
OB setups including presets, pregnancy weeks, and fetal weight units. (3) In the OB setups, a system OB preset. The General preset includes more measurement types than
the Fetal Biometry preset.
Gibson
An M Mode Volume Calculation setting used as the default method to calculate left
ventricular volume.
Gmean
Mean pressure gradient
Gpeak
Peak pressure gradient
Gravida
In the study information, on the patient information form, the number of pregnancies a
woman has had can be entered in this field.
Gray Maps
A video depiction of the gray scale that is displayed on the system monitor.

290

HD3 Getting Started


4535 612 13861

19

Glossary

Gray Mode
A 3D setup used to set the low threshold (Th. Low) and high threshold (Th. High).
gray scale
The scale used to assign shades of gray to different signal amplitudes. The brightness of
the dot representing a particular signal is proportional to the signal amplitude. The gray
scale varies from black to white through a specified range of gray shades.
GS
Gestational sac
hard disk
An electronic storage device installed in the ultrasound system used to store ultrasound
images. Capacity depends upon the size of the hard disk and the type of images stored on
the hard disk. Color images require more memory than black-and-white images.
Harmonic
A soft key and 2D/M menu item used to start Tissue Harmonic Imaging (THI).
HC
Head circumference
HDD
Hard disk drive
Height
In the study information, on the patient information form, a text field into which you
enter the current patients height. This value and the value you enter for the patients
weight are used to calculate BSA.
HGen.
Harmonic and General (frequency display)
High PRF
A tool available when using certain transducers during PW Doppler imaging that lets you
obtain higher velocities.
High Threshold
A 3D View control used to set the high threshold in the grayscale parts of the 3D image.
HPen.
Harmonic and Penetration (frequency display)
HD3 Getting Started
4535 612 13861

291

19

Glossary

HR
Heart rate. In the study information, on the patient information form, a text field into
which you enter the current patients heart rate.
HRes.
Harmonic and Resolution (frequency display)
HUM
Humerus
ICA
Internal carotid artery
image
An ultrasound display or a report screen.
Image Layouts
In Review, a dialog box that appears when you select Layout, from which you select or
create the Review image layout.
Image Print
A DICOM setup that allows you to set the number of prints for the selected DICOM
printer.
image printer
A printer used to print ultrasound images.
Image Width
A Control menu item used to display and adjust the size of the image width.
Indication
In the study information, on the patient information form, a text field into which you
enter any pertinent indications for the current patient exam.
Initial 3D View
In 3D imaging, a soft key and a selection used to reset the display to the original image,
previous to any image manipulation.
Input Unit
In the OB setups, the unit information for the input units for the selected measurement.

292

HD3 Getting Started


4535 612 13861

Glossary

19

Install Software
In the Admin setups, a dialog box used install system software from selected media.
Institution
In the System setups, a Local data-entry field used to enter the name of the hospital,
clinic, or other appropriate entity.
intensity
A measure of the amount of acoustic energy flowing through a unit area that is perpendicular to the direction of the energy flow. Expressed as power per unit area in units of
Watts/cm2. Intensity can be averaged over space, over time, or expressed as peak values
over space or time.
Invert
A soft key used to invert the Doppler data relative to the baseline.
IOD
Inner ocular distance
IP Address
Internet Protocol. In the DICOM setups, a text field into which you enter the IP address
for the device you are configuring for DICOM operation with the ultrasound system.
IVRT
Isovolumic relaxation time
IVS
Interventricular septum
Keystroke Log
In the Admin setups, a dialog box used to specify log settings, view selected log files, and
copy and delete keystroke logs. Keystroke logs are used for troubleshooting purposes.
L
Length, left, linear
L/R Invert
Left/Right. A 2D/M menu item that inverts the horizontal orientation of the 2D image.
LA
Left atrium, left arm
HD3 Getting Started
4535 612 13861

293

19

Glossary

Language
In System setup, a Local setting used to select the language that appears on the display.
Last Measured Value
In the Measure setups, a General Report Display setting used to display the last measurement as the default result display in the patient report.
Lat
Lateral
Layout Options
In Review, a selection used to display the Image Layouts dialog box, from which you
select or create the Review image layout.
Layouts
In print setups, a selection used to select the number of columns and rows to print.
Line density
Line density refers to the number of lines of ultrasound data that make up the image.
Line Pos.
A control to change the line position.
linear array
Transducer in which a large number of long, narrow elements are placed side by side. A
subset of the elements is used to produce each column of data. This subset, called the
aperture, is shifted across the transducer to produce an array of parallel columns which
form a rectangular image on the display.
LMP
Last menstrual period. A date entered into the study information, on the patient information form, used to calculate gestational age (GA).
Lock
In the Option setups, the Lock button indicates that the option is installed on the system.
Low Threshold
A 3D View control used to set the low threshold in the grayscale parts of the 3D image.
Lt.
Left
294

HD3 Getting Started


4535 612 13861

Glossary

19

LV
Left ventricle, lateral ventricle
LVD
Left ventricle dimension
LVOT
Left ventricular outflow tract
LVPW
Left ventricular posterior wall
LV Volume Calculation
In the Measure setups, a setting that lets you specify which left ventricle calculation
method to use.
M
Motion, mega-, male
M Mode Volume Calculation
(1) In the Measure setups, an OB setting used to select the equation used for calculating
the fetal echo. (2) In the Measure setups, a Cardiac setting used to select the equation
for calculating left ventricular volume from an M-mode display. Teichholz, Cubed, and
Gibson are available.
M Post
A Control menu item used to display another menu from which you can select an M
map, edit an M map, select a Chroma map, and edit a Chroma color.
M-mode
The M stands for motion. The motion occurs over time, which is represented by a
scrolling Mmode display.
MA
Menstrual age
Magnification
(1) In 3D imaging, a slider used to change the size of the 3D image from 0.25 to 4.0 times
normal. (2) A DICOM setting used to set the film printer magnification to Replicate,
Bilinear, Cubic, or no magnification.

HD3 Getting Started


4535 612 13861

295

19

Glossary

Magnify
In Review, an icon to magnify an area of interest.
maps
Maps are used to encode ultrasound information for video display based on the system
mode. There are several different types of maps: M maps, Chroma maps, CPA maps, 2D
maps, and Color maps.
Marker
A control used to display the a group of body markers.
Max
Maximum
Max Density
A DICOM setup used to specify the maximum density of the image.
Maximum Retries
A DICOM setting to specify the maximum number of times the system tries to attempt
the print or send operation.
MCA
Middle cerebral artery
MCA/UA Graph
In the Measure setups, an OB setting used to display a graph of the middle cerebral
artery (MC) to the umbilical artery (UA).
Measure setups
A category of setups comprising general, OB, fetal echo, cardiac, and urology setups.
Medium Type
A DICOM setup used to set the film type to paper, clear, or blue film for a DICOM
print.
Menu Name
In the Measure setups, an OB setting in Analysis to specify the name of the analysis
preset.
MI
Mechanical Index
296

HD3 Getting Started


4535 612 13861

19

Glossary

Mid
Middle
Min
Minimum
Min Density
A DICOM setup used to specify the minimum density of the image.
Mline
A function key (F4) used to display the M-line. The M-line is the 2D column from which
the M-mode display is derived.
Mmode
A control used to start M-mode acquisition.
MO
Magneto-optical
MP
Middle phalanx
MRN
Medical record number. On the patient information form, a unique number that can be
automatically generated for each new patient.
MV
Mitral valve
MVA
Mitral valve area
Name
On the patient information form, a text field into which you enter the patients name.
Next
A control used to view additional soft keys.
No.
Number

HD3 Getting Started


4535 612 13861

297

19

Glossary

Note
Information in the manual that provides additional system knowledge.
NTSC
(1) National Television Standards Committee. Standard video signal for all broadcast TV
in the North America. (2) In the Peripherals setups, a VCR type setting.
Number of Copies
A DICOM setting used to set the number of copies that will be printed for each
DICOM print operation.
OB
Obstetrics
OB setups
A category of Measure setups comprising the range of measurement types, a list of
investigators, fetal tables, and options for creating new analysis presets.
OEM
Original equipment manufacturer
OFD
Occipital-frontal diameter
OOD
Outer ocular distance
Open
In Review, a selection used to open the exam list.
Open Line Transfer
A serial port setting used to set up the serial port for a report printer.
Opt.
Optimize
Option
A category of setups that displays the software serial number and a list of installed
options with relevant passwords for the options.
Orientation
A printer or DICOM setting used to set the orientation to portrait or landscape.
298

HD3 Getting Started


4535 612 13861

Glossary

19

Output Unit
In OB setups, the unit information for the output units for the selected measurement.
P, p
Pressure, power
PAL
(1) Phase Alternating Line. European video standard. (2) In the Peripherals setups, a
VCR type setting.
Para
In the study information, on the patient information form, a number can be entered in
this text field to identify the times a woman has produced a viable infant (weighing 500
grams or more, or of over 20 weeks gestation), regardless of whether the infant is alive
at birth. Multiple births are considered to be single parous experience.
Patient
A control used to display the patient information form, where you can enter new patient
data, editing existing patient data, and search for patient files.
patient data
Includes images, graphics, and other information associated with a specific patient from
an ultrasound or other type of medical exam.
patient file
A file created when you enter patient data.
PD
Pulse duration
Pen.
Penetration
Per
Persistence
Peripherals
A category of setups including settings for the video output type, printer, foot switch, and
network settings.

HD3 Getting Started


4535 612 13861

299

19

Glossary

Persistence (FA)
A menu item on the 2D/M, Color, and CPA menus. On the display, the persistence setting is expressed as a frame-averaging (FA) setting for the active imaging mode.
PET
Pre-ejection time
PHT
Pressure half-time
PI
Pulsatility Index
PISA
proximal isovelocity surface area
Plac. Loc.
placental location
PLI
Preload Index
Pointer
A function key (F5) used to display one or several arrows for indicating objects on the
display.
Pombo
A calculation setting used as the default method to calculate left ventricular volume.
Port Number
A DICOM setup used to enter the port number for the ultrasound system. The port
number is normally 104 for ultrasound operations.
Pos. L
A soft key used to position the image to the left.
Pos. R
A soft key used to position the image to the right.
Position
In 3D imaging, a slider used to select a multiplanar 2D image, using a cutting line horizontally and vertically across the selected image.
300

HD3 Getting Started


4535 612 13861

Glossary

19

Post Map
A Display setup used to turn the post-processing map on or off.
Power
A Control menu item used to adjust acoustic output.
Predicted PSA Correction Factor
In the Measure setups, a Urology setting to specify the predicted prostate specific antigen (PSA) correction factor.
Pregnancy Weeks
In the Measure setups, an OB setting used to set the pregnancy duration by weeks.
Preset
(1) A control used to open the Preset display. (2) A Utility menu used to create user
presets and restore them as needed. (3) In the OB setups, a display used to create analysis menus. (4) A display that lets you select the transducer, exam type, and presets, and
also rename, save, delete, and enter new presets.
Primary Name Server (IP)
In the DICOM setups, the IP address of the primary server.
Print
A control used to print an image or report.
Print Images
In Review, displays a Print Layouts dialog box, from which you select the printer, layout,
range, orientation, format, and number of copies. The OK selection displays the Print
dialog box, from which you print the selected images.
Printer
In the Peripherals setups, a category used to specify the default printer.
Priority
A CPA menu item used to set the write priority threshold for the CPA display. Priority is
the threshold value at which the 2D grayscale echo information is considered strong
enough to indicate a solid structure such as a heart wall, rather than blood flow, even
though that structure may be moving.

HD3 Getting Started


4535 612 13861

301

19

Glossary

Protocol
A series of parameters and their calculations associated with a specific application or clinical option.
PSV
Peak systolic velocity
Pulse repetition frequency (PRF)
The number of ultrasound pulses per second, measured in hertz.
PV
Pulmonary valve
PW
(1) Pulsed-wave Doppler. (2) A control to start pulsed-wave Doppler imaging.
PW Post
A PW menu item used to select PW maps, turn Chroma maps on and off, and to set the
color values.
PW Size
A PW menu item used to select the Doppler display size. Select from normal, large, or
small.
Q
Quadrant, quantification
RA
Right arm
Rad
Radius
REF, Ref
Referring, reference
Ref. Physician
Referring physician. In the study information, on the patient information form, a text field
into which the referring physicians name can be entered.
Regurg
Regurgitation
302

HD3 Getting Started


4535 612 13861

19

Glossary

Reject
A selection on the 2D menu that displays different image depths.
Rendering
In 3D imaging, a display used to select the rendering effects for the 3D volume image.
Report
A control used to open the Report display.
Report printer
An optional device connected to the ultrasound system to print analysis reports or
graphs onto paper.
Res.
Resolution (frequency display)
Results Box Display
In the Measure setups, a setting used to specify the number of results to display.
Retry Count
A DICOM setup used to set the number of times the ultrasound system will attempt to
perform a print or store operation to the network devices for which it is configured.
Retry Timeout
A DICOM setup used to specify the number of times to retry sending the requested
operation.
Review
A control used to open the Review display, from which you can view the current exam
images, open the exam list, select a view mode, select a layout, print images, magnify
images, export images, display a report, add voice or text annotation, perform selective
send or print DICOM operations, and change review settings.
RGB
Red, green, blue
RI
Resistive Index
RL
Right leg
HD3 Getting Started
4535 612 13861

303

19

Glossary

ROI
(1) Region of interest. (2) In 3D imaging, sliders used to adjust the size of the 3D volume
image.
ROT, Rot
(1) Rotation. (2) In 3D imaging, sliders used to select the direction through which the 3D
volume image rotates.
Rt.
Right
S, s
Systole, systolic, sector
S/D
Systole/diastole
S/W Version
Software version. In the Admin setups, a Display System Info field that shows the
software version that is currently installed on the system.
sample volume
The listening region or the volume of blood being sampled by a beam of ultrasound during pulsed Doppler. Sample volume size is defined by the length of the pulse and the
width of the ultrasound beam.
Scale
A soft key used to select the range of the velocity or frequency display by varying the
pulse repetition frequency of the Doppler, Color, or CPA signal.
SD
Standard deviation
SD Type
In the OB setups, a setting for the table type for the selected editors table data. The
range of deviation for the calculation is based on a standard deviation.
SDev Unit
In OB setups, the unit information for the standard deviation units for the selected measurement.

304

HD3 Getting Started


4535 612 13861

Glossary

19

Search Results
On the patient information form, the search results include the MRN, name, and birth
date of the patients matching the search criteria entered.
Secondary Name Server (IP)
In the DICOM setups, the IP address of the secondary server.
sector array
A transducer type with an array of transducer elements that are electronically time-phase
coordinated to generate a focused and steerable wavefront.
Sector Width
A 2D menu item used to change the 2D sector width.
Select
A control used to select settings for menu items.
Sensitivity
A Color and CPA menu item that selects the number of pulses used to generate a line
of the Color Velocity or Variance display.
Sep
Separation
Service Tools
In the Admin setups, a feature used by Philips-authorized service personnel to access
and run service tools on the system.
Set Up
A function key (F10) that displays the system setups: System, Measure, DICOM,
Option, Peripherals, and Admin.
Setting
In the Preset display, a menu item from which to select the preset associated with the
selected transducer and application.
Service
A DICOM setting text field into which you enter the service type of the device you are
configuring for DICOM use with the ultrasound system.
Shift Left
A soft key used in 3D imaging to position the image to the left.
HD3 Getting Started
4535 612 13861

305

19

Glossary

Shift Right
A soft key used in 3D imaging to position the image to the right.
Short
Shortening
Simultaneous
(1) In the System setups, a Display setting to allow 2D/Doppler, 2D/Color/Doppler, or
to turn off simultaneous mode. (2) A Control menu item to turn simultaneous mode on
or off.
sl
Slope
Smooth
A PW menu setting that lets you specify the spectrum blurring.
soft keys
Across the bottom of the display, these labels correspond to the five controls across the
top of the control panel. You press the controls on the control panel to activate the function designated on the display.
Sonographer
In the study information, on the patient information form, a text field into which the
sonographers name can be entered.
SOP
Service object pair
St
Stenosis
Station Name
A DICOM setup used to enter the station name for the ultrasound system. The station
name is an arbitrary name given to the ultrasound system for internal departmental identification purposes.
Steer
A soft key used to select among five steering angles for linear-array Doppler, Color, and
CPA imaging.

306

HD3 Getting Started


4535 612 13861

Glossary

19

Storage Manager
A function key (F9) used to format and eject MO disks and CD-RWs, and to safely
unplug a USB flash memory device.
subnet mask
A number used to identify the sub-network ID and the host ID from an IP address. All
the hosts in a sub-network have the same subnet mask.
SV
Stroke volume, sample volume, systolic velocity
SV Pos.
A select on the display to increase or decrease the sample volume position.
SV Size
A selection on the display to increase or decrease the sample volume size.
Sweep
A Control menu item used to adjust the sweep speed of the scrolling display.
Sys
systole, systolic
System Network Settings
In the DICOM setups, a selection used to specify network settings.
System Key
An Option setup that lists the identification number used by Philips representatives to
generate the codes needed to unlock and install options.
T, t
time
Table Type
In the OB setups, the settings Range Type, SD Type, or Value Only are the settings
available for the table type. The table type setting describes the type of variation used for
the fetal calculation.
Tables
A tab in the OB setups used to select, view, and create gestational age (G.A.), fetal
growth, or fetal weight tables.
HD3 Getting Started
4535 612 13861

307

19

Glossary

TAD
transverse abdominal diameter
Tag Position
A menu item used to set the position of the color tag.
Tag Width
A Color Tag menu item used to set the width of the color tag.
Teichholz
An M Mode Volume Calculation setting used as the default method to calculate left
ventricular volume.
Text
A function key (F1) used to activate a text cursor on the display.
TGC
Time gain compensation
TGC Line
In the setups, a Display setting used to show or hide the TGC display.
TGC slide controls
Controls used to adjust the time gain compensation.
Th.
Threshold
Thermal Index (TI)
A displayed index that provides information about the conditions that exist that might
lead to an increase in temperature at the surface of the body, within the body tissue, or
at the point of focus of the ultrasound beam on bone.
THI
Tissue Harmonic Imaging. A control used to start THI. THI is the reception and processing of harmonic frequencies generated by tissue.
TI
Thermal Index

308

HD3 Getting Started


4535 612 13861

Glossary

19

TI Display
In the System setups, a Display setting used to select the thermal index in the output
display: Thermal Index for bone (TIb) or Thermal Index for soft tissue (TIs).
TIB, TIb
Thermal Index, Bone
Time
In the System setups, a Local field used to set the system time.
Time Format
In the General setups, a Time setting used to select the 12-hour or 24-hour time format.
time gain compensation (TGC)
A process of changing signal amplification to compensate for ultrasound beam attenuation, transducer focusing, and pulse frequency. The purpose of TGC is to permit display
of images of equal echogenicity (echo generating capability) to appear with equal brightness regardless of depth. Echoes from greater depths require more gain than echoes
from shallower depths.
TIS, TIs
Thermal Index, Soft Tissue
Top/Bottom
A scroll format setting.
Trace
A 2D Circumference and Area Method setting used to set the default area measurement method.
trackball
A control used to move objects on a display.
Track Ball Speed
In the Measure setups, a General setting used to select the response of the trackball as
you move objects on the display.
Transfer Mode
A DICOM setting used to specify the mode of transfer. Select from Batch, Manual,
Print, or Send as You Go.
HD3 Getting Started
4535 612 13861

309

19

Glossary

Trapezoid
A 2D menu item used to enable trapezoidal imaging with specific linear array transducers. Changing system depth changes the image shape. Trapezoidal imaging increases the
field of view at shallower depths while imaging in 2D mode.
TTD
Transverse trunk diameter
TV
Tricuspid valve
TVA
Tricuspid valve area
TVI
Time velocity integral
Type 1-5
Map menu selections for the imaging modes.
U/D Invert
A Control menu item that lets you invert the image display up or down.
UIF
User interface
Umb.
Umbilical
Unit
In the Measure setups, an OB setting used to specify the unit of measurement (grams,
ounces, or pounds).
Unlock
In the Option setups, indicates that the option is not installed on the system. A code is
required to install the option.
Update Device Drivers
In the Admin setups, a dialog box used to update system device drivers from selected
media.

310

HD3 Getting Started


4535 612 13861

Glossary

19

User 1-5
(1) User 1 through 5 are settings on the Preset display of the Control menu. (2) User
1 and 2 are available for the creation of user maps for 2D, M-mode, and PW Doppler.
Utility
A Control menu item used to display the Utility menu, from which you can select and
display the following menus: Biopsy, Preset, and Demo Images.
V, v
Velocity, vaginal
Value Only
In the OB setups, a setting for the table type for the selected editors table data. The
deviation for the calculation can be based on a value determined by the editor of the
table.
Vel.
Velocity
Vent
Ventricle
VF
Volume flow
Video Output Type
A Peripherals setup setting used to select NTSC or PAL as the video output type.
Vm
Mean velocity
VOL, Vol.
Volume
Volume
A PW Control menu item used to adjust system audio volume.
Volume Method
In the Measure setups, a Urology setting used to select the method for calculating volume.

HD3 Getting Started


4535 612 13861

311

19

Glossary

Warning
Information that describes precautions necessary to protect you and the patient.
W
Weeks
Weight
In the study information, on the patient information form, a text field into which you
enter the current patients weight. This value and the value you enter for the patients
height are used to calculate BSA.
X
A control used to display X-planes in a 3D image.
Y
(1) Year. (2) A control used to display Y-planes in a 3D image.
YS
Yolk sac
Z
A control used to display Z-planes in a 3D image.
Zm Pos.
A control on the display to change the ROI position.
Zm Size
A control on the display to change the ROI size.
Zoom
A control, soft key, and Control menu item used to zoom the image, after which you can
use the trackball to pan areas of the image in real-time or freeze.

312

HD3 Getting Started


4535 612 13861

Index
Numbers
2D
cardiac calclulations, 210
circumference and area, 176
depth setting, 146
distance, 176
hip joint, 178
imaging, 145
measurement accuracy, 180
optimization, 146
volume measurements, 178
2D Measure, 212
3D imaging, 161
acquiring images, 161, 162
using 3D View, 163

A
AC power requirements, 32
Accessories, 27
approved for electromagnetic
compliance, 61
Accuracy
acquisition and algorithmic errors, 183
measurement, 180
tables, 184
Acoustic coupling medium, 123
Acoustic measurement
precision, 57
safety, 53, 56
uncertainty, 57
Acoustic output
adjusting power, 150
safety, 53
tables, 23
tissue models, 55

Acquiring 3D images, 162


AFI calculations, 223
ALARA
applying, 41
direct controls, 42
education program, 41
example of applying, 44
indirect controls, 43
output display, 45
receiver controls, 44
related guidance documents, 52
Alcohol use on transducers, 127
Alias velocity, 214
Aliasing, 182
Allergic reactions to latex, 121
Angle
Doppler, 160
hip joint, 178
improving color or CPA steer, 155
steering, 158
Annotation, text, 151, 197
Assistance, 28
Attaching biopsy guides, 169
Audio volume, 160

B
Backups
exams, 200
presets and system settings, 239
restoring exams, 200
Baseline, Doppler zero, 159
Battery, system, 236
Biological safety, 39
Biophysical profile and maternal survey,
205
Biopsy guides
HD3 Getting Started
4535 612 13861

313

Index

attaching and removing, 169


biopsy procedure, 173
verifying alignment, 171
Body markers, displaying and editing, 151
Body Surface Area (BSA), 251
Brightness, adjusting, 98

C
Cables
cleaning and disinfecting, 127
electromagnetic compliance, 60
management clips, 77
preparing to move the system, 91
protecting from damage, 90, 128
Calculations, 209
2D measure, 212
AFI, 223
alias velocity, 214
cardiac, 209, 247
deleting user-defined, 220
Doppler cardiac, 213
Doppler trace, 215
EDD based on LMP, 221
fetal echo, 225
fetal heart rate, 222
fetal tables, 219
gestational age, 217
gynecology, 216
LV Vol A/L, 211
M-mode cardiac, 212
obstetrics, 217
patient heart rate, 215
peak velocity, 227
PISA radius, 214
Simpsons rule, 210
urology, 226
vascular, 227
vessel area and distance, 229
viewing user-defined, 221
314

HD3 Getting Started


4535 612 13861

Cardiac
calculations, 209
references, 247
Carpal tunnel syndrome (CTS), 40
Cart maintenance, 231
CD, user information, 23
CD-RW, loading and ejecting, 109
Chroma maps, selecting and changing, 148
Cine Review, 149
CIVCO Medical Instruments Company, 27
Cleaning
peripherals, 235
system, cables, and connectors, 231
trackball, 234
transducers, 117
Color
capturing, 155
changing 3D images, 167
connecting printer, 83
imaging, 153
maps, 154
measurement accuracy, 181
tagging, 155
Color Power Angio (CPA) imaging, 154
Comments, in Review, 195
Comparing images in Review, 193
Compliance, electromagnetic, 60
Configuring
network settings, 242
report printers, 84
Connecting
devices, 81
network, 88
printers, 82
transducers, 104
VCRs, 86
Connections
cleaning, 231
network, 88
peripherals, 33

Index

Control panel
overview, 76
positioning, 102
Controls affecting the indices
direct controls, 42
indirect controls, 43
Conventions
system, 24
user information, 24
Covers, transducer, 120
Creating
new OB equations, 220
OB-related tables, 219
presets, 114
Creutzfeldt-Jakob disease, 122
Critical device classification, 124
Cursor, placement and measurement
accuracy, 181
Customer comments, 26
Customer service, 28

D
Damage, inspecting transducers, 117
Data On/Off key, 282
Defibrillators, 31
Deleting
calculations, 220
DICOM servers, 244
exams in Review, 194
images, 195
patient files, 143
presets, 115
Depth
2D, 52
adjusting scale, 147
Device class, 29
Devices, connecting, 81
DICOM
adding server information, 243

deleting servers, 244


editing server information, 244
testing connections, 244
DICOM Print, 202
DICOM Send, 198
Disinfectants
choosing, 124
compatibility table, 138
factors affecting efficiency, 137
types, 137
Disinfecting
cables and connectors, 127, 136
endocavity transducers, 132
high-level, 131
low-level, 126
transducers, 132
Display
imaging, 103
MI and TI, 46
output, 45
size and measurement accuracy, 181
Disposal of equipment, 236
Distance measurements, 176, 196
Doppler
alignment, 182
angle, 160
cardiac calculations, 213
inverting display, 157
measurement accuracy, 181
scale, 159
trace calculations, 215
updating display, 157
velocity measurement, 179
velocity ratio, 180
velocity resolution, 183
zero baseline, 159
Dual imaging, 148

HD3 Getting Started


4535 612 13861

315

Index

E
Editing
body markers, 151
comments, 195
DICOM server information, 244
grayscale maps, 148
patient files, 142
patient reports, 203
EFW calculations, 225
EFW growth, 220
Electrical parameters, 269
Electromagnetic
compatibility, 41, 70
emissions, 59
immunity, 63
interference, 65
Electromagnetic compliance
approved accessories, 61
approved cables, 60
approved transducers, 61
Electrostatic discharge (ESD), 30
Ellipse
2D measurements, 177
measurements in Review, 196
performing measurements, 196
Ending exams, 142
Enter control, 101
Equations
entering user-defined, 220
viewing user-defined, 221
Equations, creating new, 220
Equipment disposal, 236
Erasing, image portions in 3D View, 166
Estimated fetal weight (EFW), 262
Exam List, 188
Exam Review, 187
Exams
backing up, 200
ending, 142
316

HD3 Getting Started


4535 612 13861

restoring backed-up, 200


searching for, 189
selecting and reviewing, 188
sorting, 191
transferring over a network, 198
Exit control, 101
Exporting
images for PC viewing, 199
patient reports, 204

F
Fan, 237
FDA medical alert, allergic reactions to
latex, 121
Fetal description report, 205
Fetal echo, 251
Fetal echo calculations, 225
Fetal growth
creating new equations, 220
references, 258
Fetal heart rate, 222
Fetal ratios, 264
Fetal tables, 219
Fetal weight calculations, 224
Filters, 158
Focal zones, 147
Foot switch, 78
Formulas, 183
Freeze, 149

G
Gamma in 3D View, 163
Gels, recommended, 123
General references, 251
Gestational age
calculations, 217
creating new equations, 220
creating new tables, 219

Index

references, 252
Glossary, 273
Graphs, patient report, 205
Gray maps, viewing and selecting, 147
Gray shades, 267
Gynecology
calculations, 216
references, 252

H
Heart rate
fetal, 222
patient, 215
vascular protocol, 227
Hiding biopsy guideline, 170
High-level disinfection, 131
Hip angle references, 252
Hip joint measurement, 178
Humidity limits, 270

I
Image printers, 107
Images
changing size in 3D View, 166
comparing in Review, 193
deleting in Review, 195
exporting for PC viewing, 199
magnifying in Review, 194
previewing in Review, 192
printing to a report printer, 201
selecting layout, 193
storing, 108
transferring over a network, 198
viewing in Review, 192
Imaging, 145
Imaging display, 103
Immersing sterilizable transducers, 135
Immersion,disinfecting transducers, 131

Immunity test level results, 70


INIT 3D, 166
Initial 3D View, 166
Input signals, 268
Installation requirements, 32
Installing software, 240
Interference, 66
Inverting the display, 157

K
Keyboard, 102
Keystroke log, displaying, 241

L
Language, setting system, 96
Loading and ejecting media, 109
Log files, 241
Low-level disinfection, 126
LV Vol A/L, 211

M
Magnifying images, 194
Maintenance
cart, 231
cleaning the system, cable, and
connectors, 231
control panel, 234
fan, 237
peripherals, 235
preventive, 236
recommended frequency of, 236
transducers, 237
VCR, 235, 237
of video printers, 235
Maps
Chroma, 147
color, 154
grayscale, 147
HD3 Getting Started
4535 612 13861

317

Index

selecting and changing Chroma, 148


using color in 3D View, 167
Measurement accuracy, 180
Measurements, 175
2D distance, 176
2D hip joint, 178
2D volume, 178
accuracy, 180
available tools, 71
clearing in Review, 197
diameter stenosis, 228
distance in Review, 196
Doppler velocity, 179
Doppler velocity ratio, 180
ellipse in Review, 196
in Review, 196
M-mode distance, 179
percent area, 228
performing in Review, 196
Mechanical and thermal indices display
precision and accuracy, 47
Mechanical index (MI) display, 46
Medical ultrasound safety, 23, 39
Mline key, 152, 297
M-mode
cardiac calculations, 212
distance, 179
distance measurement, 179
imaging, 152
MO disk
formatting, 110
loading and ejecting, 109
Modality interface, 269
Monitor, system, 267
Moving the system
safety precautions, 90
setting up after, 91
transporting the system, 92

318

HD3 Getting Started


4535 612 13861

N
Network connection, 88
Neurosurgical applications, 133
Noncritical device classification, 124

O
OB references, 252
estimated fetal weight, 262
fetal growth, 258
fetal ratios, 264
gestational age, 252
Obstetrics
calculations, 217
creating an analysis preset, 218
ratios, 224
viewing graphs, 206
On/Off button, 36, 79
Open Line Transfer, 206
Operating notes, 23
Options, 74, 115
Output
acoustic tables, 23
display, 45
power, 49

P
Pacemakers, 31
Patient files
deleting, 143
editing, 142
entering information, 141
searching for, 142
Patient heart rate, 215
Patient reports, 203
printing, 204
Peak velocity calculations, 227
Peripherals, 269
cleaning and maintaining, 235

Index

connections, 33
locating, 77
Physical dimensions, 267
PISA radius, 214
Pointer key, 151, 300
Position, changing in 3D View, 165
Power switch, 80, 95
Power, output, 49, 150
Power, peripherals, 81
Power, system
On/Off button, 95
switch, 95
Presets, 113
backing up, 239
creating, 114
creating analysis, 218
deleting, 115
renaming, 114
selecting, 114
Pressure limits, 270
Preventive maintenance, 236
Preview box, 191
Print quality, 106
Printers
configuring report, 84
connecting color, 83
connecting report, 83
DICOM, 107
maintaining video, 235
report, 107
viewing list of system-compatible, 83
Printing, 106
adjusting print quality, 106
images to a DICOM printer, 202
images to a report printer, 201
patient reports, 204
remote print unit, 82
to black-and-white printer, 107

Q
Quick Guide, 23

R
Radio frequency (RF), 67
Rear panel, 79
Receiver controls, 44
Receptacles
network, 89
transducer, 75
Recording, 108
References
cardiology, 247
fetal echo, 251
general, 251
gynecology, 252
hip angle, 252
OB, 252
vascular, 265
Remote print unit, 82
Removing biopsy guides, 169
Renaming presets, 114
Repetitive strain injury (RSI), 40
Report printer, 107
connecting, 83
Reports, 203
Restoring
backed-up exams, 200
presets and system settings, 239
Restrictions for use, 70
Review, 73, 187
adding comments, 195
annotation, 197
clearing measurements, 197
comparing images, 193
deleting exams, 194
deleting images, 195
ellipse measurements, 196
HD3 Getting Started
4535 612 13861

319

Index

image layout, 193


magnifying images, 194
performing distance meausurements,
196
performing measurements, 196
Preview box, 191
previewing images, 192
printing images to a DICOM printer,
202
printing images to a report printer, 201
starting, 187
viewing images, 192
RM-91 remote print unit, 82
ROI, adjusting in 3D View, 164
Rotation, adjusting in 3D View, 165

S
Safety, 29
acoustic measurement, 53
acoustic output, 53
ALARA principle, 41
biological, 39
electrical, 29
EMC, 58
ESD, 30
guidance documents, 52
In situ, derated, and water value
intensities, 53
latex and patient contact, 39
mechanical, 34
mechanical index, 46
medical ultrasound, 23
moving the system, 90
requirements, 271
thermal index, 47
tissue models and equipment survey,
55
using disinfectants and gels, 119
Scale
320

HD3 Getting Started


4535 612 13861

depth, 146
Scale, Doppler, 159
Searching
for a patient file, 142
for exams, 189
Select control, 101
Selecting
presets, 114
transducers, 105
Servers, DICOM, 243
Setting Measure Method dialog box, 209
Settings
administrative, 113
changing, 111
DICOM, 113
measurement, 112
option, 113
peripheral, 113
Setups, 111
Showing biopsy guideline, 170
Simple setup, 209
Simpsons rule, 210
Software, installing, 240
Sorting exams, 191
Specifications, system, 267
Speed of sound, 182
Steering angle, 158
Sterilizing
transducers, 133
Storage devices, 77
Storage Manager, 109
Storing images, 108
Storing transducers
daily and long term, 119
for transport, 118
Supplies, 27
Sweep speed, 158
System
administration, 239
backing up and restoring settings, 239

Index

battery, 236
changing settings, 111
cleaning, 233
conventions, 24
displaying information, 241
maintaining control panel, 234
moving, 90
On/Off button, 36, 95
power switch, 35, 95
specifications, 267

T
Tables
acoustic output, 23
creating new, 219
disinfectants compatibility, 138
fetal, 219
Temperature limits, 270
Testing DICOM connections, 244
Text annotation, 151, 197
Text key, 308
TGC, 150
Thermal indices, 45, 47
Threshold, adjusting in 3D View, 163
Time gain compensation (TGC), 150
Tissue Harmonic Imaging (THI), 149
Tools
Exam List, 188
Exam Review, 187
Trackball, 101
Transducers
acoustic coupling medium, 123
applications, 72
approved for electromagnetic
compliance, 61
connecting, 104
covers for, 120
disinfecting, 132
disinfecting by immersion, 131

disinfecting with wipes and sprays, 126


handling, 117
immersing sterilizable, 135
inspecting for damage, 117
low-level disinfection, 126
receptacles, 77
selecting, 105
sterilizing, 133
storing, 118
using alcohol on, 127
Transferring exams and images, 198
Transporting the system, 92
preparations, 91
safety precautions, 90
setting up after, 91

U
Ultrasound transmission gel, 123
Updating
device drivers, 240
Upgrades, system, 25
Urology calculations, 226
USB flash memory devices, 109
User information CD, 23
User information set, description, 23

V
Vascular
calculations, 227
references, 265
VCR
connecting external, 86
maintaining, 235, 237
recording to, 108
Velocity, 179
Velocity ratio, 180
Verifying biopsy guide alignment, 171
Vessel area and distance, measuring, 229
HD3 Getting Started
4535 612 13861

321

Index

Video monitor, 75
Video printers, maintaining, 235, 237
Volume, 2D measurement, 178
Volume, audio, 160

W
Wall filters, 158
Wheels, 80
World Heath Organization, 122

Z
Zoom, 149

322

HD3 Getting Started


4535 612 13861