Vivid s5 s6 User Manual

GE Medical Systems
Technical
Publications
Vivid S5/Vivid S6
User Manual
Volume 1
Direction R2424458-100
Rev. 2
Operating Documentation
Copyright © 2010 By General Electric Co.
Regulatory Requirements
This product complies with regulatory requirements of the
following European Directive 93/42/EEC concerning medical
devices.
This manual is a reference for the Vivid S5 and Vivid S6. It

applies to all versions of the 10.2.x software for the Vivid S5
and Vivid S6 ultrasound systems.
g GE Medical Systems
MANUAL STATUS  GE Medical Systems. All rights reserved. No part of this
R2424458-100 manual may be reproduced, stored in a retrieval system, or
07 February 2010 transmitted, in any form or by any means, electronic,
mechanical, photocopying, recording, or otherwise,
Doc ID: DOC0600341
without the prior written permission of GE Medical
PRELIMINARY
Systems.
COMPANY DATA GE Medical Systems, Israel Ltd.
4 Etgar Street
39120 Tirat Carmel
Israel
Tel: (+972) 4851 9555 Fax: (+972) 4851 9500
GE Medical Systems Information Technologies GmbH,

Munzinger Strasse 5 D-79111 Freiburg, Germany
Tel: (+49) 761 45 43 0 Fax: (+49) 76145 43 233
Table of Contents
Table of Contents
Revision History
List of effective pages................................................................. xv
Introduction
Attention......................................................................................... 1
Prescription Device ....................................................................... 1
Safety.............................................................................................. 1
Principles of Operation ................................................................. 2
Interference caution ...................................................................... 2
Indications for use ........................................................................ 3
Contraindications .......................................................................... 3
Documentation .............................................................................. 3
Manual contents ................................................................... 4
Conventions used in this manual ................................................ 5
Regulatory requirements .............................................................. 6
Contact information ...................................................................... 7
Chapter 1
Safety
Introduction.................................................................................. 15
Hazard symbols .................................................................. 16
Owner responsibility ................................................................... 17
Important safety considerations ................................................ 18
Notice against user modification......................................... 18
Regulatory information ............................................................... 19
Directives ............................................................................ 19
Product Classifications ....................................................... 19
Conformity to Standards ..................................................... 19
Certifications ....................................................................... 21
Software License Acknowledgements ................................ 21
Device labels................................................................................ 22
Label Locations................................................................... 22
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Table of Contents
Label Icon Description......................................................... 23

Acoustic output............................................................................ 26
Definition of the acoustic output parameters ....................... 26
ALARA................................................................................. 26
Safety statement ................................................................. 27
System controls affecting acoustic output ........................... 27
OB Exam ....................................................................................... 29
Exam Preparation................................................................ 29
Acoustic Output Considerations ................................................ 30
Concerns surrounding fetal exposure ................................. 30
Patient safety................................................................................ 31
Patient identification ............................................................ 31
Diagnostic information......................................................... 31
Patient guidance.................................................................. 32
Probe Safety ................................................................................. 32
Mechanical hazards ............................................................ 32
Electrical Hazard ................................................................. 33
Biological hazards ...............................................................34
Personnel and equipment safety................................................ 35
Explosion hazard................................................................. 35
Electrical hazard.................................................................. 35
Smoke and fire hazard ........................................................36
Biological hazard ................................................................. 36
Pacemaker hazard .............................................................. 36
LCD Monitor ........................................................................ 37
Electrical safety............................................................................ 39
Internally connected peripheral devices .............................. 39
External Connection of other peripheral devices................. 39
Allergic reactions to latex-containing medical devices ........... 40
Use of ECG ................................................................................... 41
Use of Defibrillator ....................................................................... 41
Use of Electrosurgical Unit ......................................................... 41
Electromagnetic Compatibility (EMC) ........................................ 42
EMC performance ...............................................................43
Declaration of Emissions..................................................... 44
Declaration of Immunity....................................................... 44
Notice upon Installation of Product...................................... 44
General notice ..................................................................... 45
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Table of Contents
Peripheral Update for EC countries .................................... 46

Patient Environmental Devices .................................................. 48
Acceptable devices............................................................. 49
Unapproved devices ........................................................... 49
Accessories, options, and supplies..................................... 49
Environmental protection .................................................... 50
Chapter 2
Getting started
Introduction.................................................................................. 52
Preparing the unit for use........................................................... 53
Site requirements................................................................ 53
Connecting the unit............................................................. 54
Switching On/Off................................................................. 61
Moving and transporting the unit .............................................. 64
Wheels................................................................................ 64
Moving the unit ................................................................... 64
Transporting the unit........................................................... 66
Reinstalling at a new location ............................................. 67
Preparing Vivid S5/Vivid S6 for scanning ........................... 67
Unit acclimation time........................................................... 68
System description ..................................................................... 69
System overview................................................................. 69
Control panel ...................................................................... 71
The Scanning screen.......................................................... 84
Three-Pedal Footswitch operation...................................... 87
Connecting and disconnecting probes ............................... 87
Adjusting the Display Monitor ............................................. 90
Starting an examination.............................................................. 95
Creating a new Patient record or starting an examination from
an existing patient record.................................................... 95
Selecting a Probe and an Application............................... 100
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Table of Contents
Chapter 3
Basic scanning operations
Assignable keys and Soft Menu Rocker .................................. 103
Using the Assignable Keys Soft Menu .............................. 104
Using the Soft Menu Rocker ............................................. 107
Trackball operation ....................................................................108
Trackball assignment ........................................................ 108
The system menu.............................................................. 109
Cineloop operation ....................................................................110
Cineloop overview .............................................................110
Cineloop controls............................................................... 111
Using cineloop................................................................... 112
Storing images and cineloops .................................................. 113
To store a single image ..................................................... 113
To store a cineloop............................................................ 113
Removable Media....................................................................... 114
Intended use...................................................................... 114
Supported removable media ............................................. 115
Zoom ........................................................................................... 120
To Magnify an image (Display zoom)................................ 120
To activate the HR zoom................................................... 120
Performing measurements........................................................ 121
To perform measurements ................................................ 121
Physiological trace ....................................................................122
Connecting the internal ECG............................................. 122
Physio controls .................................................................. 126
Displaying the ECG trace .................................................. 126
Adjusting the display of the ECG trace.............................. 126
Annotations ................................................................................ 128
To insert an annotation......................................................128
To edit annotation.............................................................. 131
To erase annotation .......................................................... 131
Configuration of the pre-defined annotation list................. 132
Bodymarks ........................................................................ 134
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Table of Contents
Chapter 4
Scanning Modes
Introduction................................................................................ 139
2D-Mode ..................................................................................... 140
2D-Mode overview............................................................ 140
2D-Mode controls ............................................................. 142
Using 2D ........................................................................... 148
Optimizing 2D ................................................................... 148
M-Mode ....................................................................................... 150
M-Mode overview ............................................................. 150
M-Mode controls ............................................................... 151
Using M-Mode .................................................................. 153
Optimizing M-Mode........................................................... 155
Color Mode................................................................................. 157
Color Mode overview ........................................................ 157
Color M-Mode overview.................................................... 158
Color Mode controls.......................................................... 159
Using Color Mode ............................................................. 162
Optimizing Color Mode ..................................................... 163
PW and CW Doppler.................................................................. 164
PW and CW Doppler overview ......................................... 164
PW and CW Doppler controls........................................... 165
Using PW/CW Doppler modes ......................................... 167
Optimizing PW/CW Doppler modes.................................. 168
Tissue Velocity Imaging (TVI)........................................... 169
Tissue Tracking ................................................................ 173
Strain rate................................................................................... 178
Strain rate overview .......................................................... 178
Strain rate controls............................................................ 179
Using Strain rate ............................................................... 181
Optimizing Strain rate ....................................................... 181
Strain .......................................................................................... 183
Strain overview ................................................................. 183
Strain controls................................................................... 184
Using Strain ...................................................................... 186
Optimizing Strain .............................................................. 186
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Table of Contents
Tissue Synchronization Imaging (TSI) ..................................... 188

TSI overview...................................................................... 188
TSI controls ....................................................................... 189
Using TSI...........................................................................191
Optimizing TSI................................................................... 192
Additional scanning features.................................................... 193
LogiqView.......................................................................... 193
Compound......................................................................... 194
B-Flow ............................................................................... 195
Blood flow imaging ............................................................ 195
Virtual Convex ................................................................... 196
Chapter 5
Stress Echo
Introduction ................................................................................ 198
Selection of a stress test protocol template............................ 199
Image acquisition....................................................................... 200
Starting acquisition ............................................................ 201
Continuous capture mode ................................................. 205
Analysis ............................................................................. 213
Quantitative TVI Stress echo analysis ..................................... 218
Accessing QTVI Stress analysis tools............................... 219
Vpeak measurement ......................................................... 220
Tissue Tracking ................................................................. 223
Quantitative analysis ......................................................... 223
References ........................................................................ 224
Editing/creating a template ....................................................... 225
Entering the Template editor screen .................................225
Template editor screen overview ...................................... 226
Editing/Creating a template ...............................................229
Chapter 6
Contrast Imaging
Introduction ................................................................................ 234
Cardiac imaging ................................................................ 234
Non-cardiac imaging ......................................................... 235
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Data acquisition......................................................................... 235

Left Ventricular Contrast Imaging ..................................... 235
LV Contrast overview................................................................ 236
LV Contrast controls ......................................................... 236
Using LV Contrast............................................................. 238
Optimizing LV Contrast..................................................... 239
Vascular Contrast Imaging ....................................................... 240
Abdominal Contrast Imaging ................................................... 241
Chapter 7
Measurement and Analysis
Introduction................................................................................ 246
About Measurement results display.................................. 247
The Assign and Measure modality .......................................... 248
Starting the Assign and Measure modality ....................... 248
Entering a study and performing measurements.............. 249
Measure and Assign modality.................................................. 251
Starting the Measure and Assign modality ....................... 251
Post-measurement assignment labels.............................. 252
Cardiac measurements ............................................................. 255
2D Measurements ............................................................ 255
M-Mode Measurements.................................................... 259
Doppler Measurements .................................................... 262
TSI Measurements ........................................................... 266
Automated Function Imaging............................................ 273
AutoEF Measurements ..................................................... 292
Vascular measurements ........................................................... 302
B-Mode measurements .................................................... 302
Intima-Media Thickness.................................................... 303
M-Mode Measurements.................................................... 308
Doppler measurements .................................................... 309
Pediatric Calculations ............................................................... 314
Overview........................................................................... 314
Hip Dysplasia Calculation ................................................. 315
Making Hip Dysplasia Measurement ................................ 315
Performing an OB exam............................................................ 317
Patient entry...................................................................... 317
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Table of Contents
Selecting probe and OB application .................................. 321

OB Measurements and calculations ........................................322
Introduction........................................................................ 322
B-Mode measurements ..................................................... 323
M-Mode measurements .................................................... 330
Doppler Mode Measurements ........................................... 330
OB parameter configuration ..................................................... 333
Configuring OB M&A according to geographical regions .. 333
Measurement package configuration....................................... 338
Measurement package configuration - example ............... 338
User-defined formulas ............................................................... 343
User-defined formula - example ........................................343
About units ........................................................................ 349
Measurement result table.......................................................... 351
Minimizing the Measurement result table..........................351
Moving the Measurement result table ............................... 351
Deleting measurements .................................................... 352
Worksheet................................................................................... 353
Overview ...........................................................................353
Using Worksheet ............................................................... 354
OB worksheet ............................................................................. 356
Patient data ....................................................................... 357
Measurement information.................................................. 357
Calculation information......................................................358
OB graphs................................................................................... 359
Overview ...........................................................................359
Fetal Growth Curve Graph ................................................ 360
Fetal Trending ................................................................... 364
Fetal Growth Bar Graph .................................................... 365
OB-Multigestational ................................................................... 366
Multiple Fetus ....................................................................366
GYN Measurements ................................................................... 370
Introduction........................................................................ 370
To Start a Gynecology Exam ............................................ 370
B-Mode Measurements.............................................................. 371
Uterus length, width, and height........................................371
Ovary length, width, and height......................................... 372
Follicle measurements length, width, and height .............. 373
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Table of Contents
Endometrium thickness (Endo)......................................... 373

M-Mode Measurements............................................................. 374
Doppler Mode Measurements .................................................. 374
Chapter 8
Quantitative Analysis
Introduction................................................................................ 377
Accessing the Quantitative analysis package........................ 378
In replay mode .................................................................. 378
In live ................................................................................ 378
Quantitative Analysis window.................................................. 379
Overview........................................................................... 379
Generation of a trace................................................................. 386
About the sample area...................................................... 386
To generate a trace .......................................................... 386
Manual tracking of the sample area (dynamic anchored
sample area)..................................................................... 387
Zooming in the Analysis window....................................... 388
Deletion of a trace ..................................................................... 389
To delete all traces ........................................................... 389
To delete one specific trace.............................................. 389
Saving/retrieving Quantitative analysis .................................. 389
Frame disabling ......................................................................... 390
Disabling frames ............................................................... 390
Re-enabling all frames...................................................... 390
Optimizing sample area ............................................................ 392
Reshaping a sample area................................................. 392
Labelling a sample area.................................................... 393
Optimizing the trace display..................................................... 394
Optimizing the Y-axis........................................................ 394
Trace smoothing ............................................................... 395
Switching modes or traces....................................................... 397
To switch mode................................................................. 397
To switch trace.................................................................. 397
Cine compound ......................................................................... 398
Anatomical M-Mode................................................................... 399
Introduction ....................................................................... 399
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Table of Contents
Using Anatomical M-Mode ................................................ 399

Optimizing Anatomical M-Mode ........................................401
Chapter 9
Archiving
Introduction ................................................................................ 405
Storing images and cineloops .................................................. 406
Storing an image ............................................................... 407
Storing a cineloop.............................................................. 407
Saving images and cineloops to a standard format .......... 408
MPEGVue/eVue ................................................................ 410
Retrieving and editing archived information........................... 413
Locating a patient record................................................... 413
Selecting a patient record and editing data in the archive. 418
Deleting archived information............................................ 422
Moving examinations......................................................... 424
Review images in archive.......................................................... 426
Review the images from a selected examination .............. 426
Select images from the Image list screen ......................... 427
Connectivity................................................................................ 431
The dataflow concept ........................................................ 431
Stand-alone scanner scenario........................................... 434
A stand-alone scanner and a stand-alone EchoPAC PC
environment....................................................................... 435
A scanner and EchoPAC PC in a direct connect
environment....................................................................... 437
A scanner and EchoPAC PC in a network environment ... 441
A scanner and a DICOM server in a network.................... 443
Export/Import patient records/examinations........................... 452
Exporting patient records/examinations ............................ 452
Importing patient records/examinations ............................ 460
Disk Management....................................................................... 464
Configuring the Disk management function ...................... 465
Running the Disk management function ........................... 468
Data Backup and Restore ................................................. 471
DICOM spooler ...........................................................................479
Starting the DICOM spooler .............................................. 479
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Table of Contents
Database import from Vivid 3 or Vivid 4.................................. 482

Transfer Procedure........................................................... 482
Installing the Vivid 3/4 Data Viewer .................................. 485
Using the Vivid 3/4 Data Viewer ....................................... 488
Chapter 10
Report
Introduction................................................................................ 492
Creating a report........................................................................ 493
Working with the report function ....................................... 493
To print a report ................................................................ 496
To store a report ............................................................... 496
Retrieving an archived report............................................ 497
Deleting an archived report............................................... 497
Structured Findings .................................................................. 498
Prerequisite....................................................................... 498
Starting Structured Findings ............................................. 499
Structured Findings structure............................................ 499
Using Structured Findings ................................................ 501
Structured Findings configuration ..................................... 504
Direct report ............................................................................... 514
Creating comments........................................................... 514
Creating pre-defined text inputs........................................ 515
Report designer ......................................................................... 516
Accessing the Report designer......................................... 516
Report designer overview ................................................. 516
Designing a report template.............................................. 519
Saving the report template................................................ 530
To exit the Report designer .............................................. 530
Report templates management ................................................ 531
Configuration of the Template selection menu ................. 532
Export/Import of Report templates.................................... 533
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Table of Contents
Chapter 11
Probes
Probe overview...........................................................................537
Supported probes.............................................................. 537
Vivid S5 Probe/Application Overview ................................ 542
Vivid S6 Probe/Application Overview ................................ 543
Maximum probe temperature ............................................ 544
Probe orientation ............................................................... 545
Probe labelling................................................................... 546
Environmental Requirements ............................................ 547
Probe Integration ....................................................................... 548
Selecting probes................................................................ 548
Connecting the probe ........................................................ 548
Activating the probe........................................................... 550
Disconnecting the probe.................................................... 551
Care and Maintenance ............................................................... 552
Planned maintenance........................................................ 552
Inspecting the probe.......................................................... 553
Special handling instructions............................................. 554
Cleaning and disinfecting probes ...................................... 556
Probe safety................................................................................ 562
Biopsy .........................................................................................563
Precaution concerning the use of biopsy procedures ....... 563
Preparing the Biopsy guide attachment ............................ 565
Displaying the Guide zone ................................................ 569
Endocavitary Probe Biopsy Guide Assembly .................... 571
Biopsy needle path verification.......................................... 573
Starting the biopsy procedure ........................................... 573
Cleaning, disinfection and disposal ................................... 573
Surgery/Intra-operative Use ......................................................574
Preparing for Surgery/Intra-operative Procedures ............574
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Table of Contents
Chapter 12
Peripherals
Introduction................................................................................ 576
Printing ....................................................................................... 577
To print an image.............................................................. 577
Specifications for peripherals .................................................. 577
DVR (Digital Video Recorder) ................................................... 578
Overview........................................................................... 578
Using the DVR .................................................................. 578
Configuring the DVR......................................................... 581
Reviewing the DVR Media Externally ............................... 581
Chapter 13
Presets and System setup
Introduction................................................................................ 585
Starting the Configuration package......................................... 588
To open the Configuration package.................................. 588
Overview..................................................................................... 589
Imaging....................................................................................... 590
The Global setup sheet..................................................... 590
Application ........................................................................ 593
Application menu .............................................................. 596
Measure Text.............................................................................. 598
The measurement menu sheet......................................... 598
Configuration of the Measurement menu ......................... 601
The Advanced sheet.................................................................. 603
Parameter configuration ................................................... 603
The Modify Calculations sheet................................................. 604
Parameter configuration ................................................... 604
The OB table sheet........................................................... 605
Report ......................................................................................... 611
The diagnostic codes sheet .............................................. 612
The Comment texts sheet................................................. 613
Connectivity ............................................................................... 616
Dataflow............................................................................ 616
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Additional outputs.............................................................. 623

Tools..................................................................................625
Formats ............................................................................. 626
TCP-IP............................................................................... 632
System ........................................................................................ 633
The system settings .......................................................... 633
About........................................................................................... 635
Administration............................................................................ 636
Users ................................................................................. 637
Unlock Patient ................................................................... 640
Chapter 14
User maintenance
System Care and Maintenance ................................................. 642
Inspecting the system........................................................ 642
Cleaning the unit ............................................................... 643
Prevention of static electricity interference........................ 645
System self-test.......................................................................... 646
System malfunction ........................................................... 646
Using InSite ExC ........................................................................ 650
InSite ExC Functionalities ................................................. 650
Initiating a Request for Service (RFS)............................... 650
Clinical Lifeline Mode ........................................................ 653
Exiting InSite ExC.............................................................. 654
Index
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R2424458-100 Rev. 2
Revision History
Revision History
Revision Date Reason for Change
1 19 July 2009 Initial release
2 07 February 2010 Updates and additions
List of effective pages
Revision Effective Pages
1 All
2 All
Please verify that you are using the latest revision of this
document. If you need to know the latest revision, contact your
distributor, local GE Sales Representative or in the USA call the
GE Medical Systems Clinical Answer Center at:
1-800-682-5327 or 1-262-524-5698.
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Revision History
xvi Vivid S5/Vivid S6 User Manual

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Introduction
Introduction
The Vivid S5/Vivid S6 ultrasound systems are light-weight, high
performance innovative ergonomic mobile digital ultrasound
imaging systems.
Both systems provide image generation in 2D (B) Mode, Color
Doppler, Power Doppler (Angio), M-Mode, Color M-Mode, PW
and CW Doppler spectra, LVO Contrast, B-Flow, BFI option
applications.
Vivid S6 offers additional modes, like TVI or Tissue Tracking,
and options like TSI (Tissue Synchronization Imaging) and
SI/SRI (Strain/Strain-rate imaging.
The fully digital architecture of the Vivid S5/Vivid S6 unit allows
optimal usage of all scanning modes and probe types,
throughout the full spectrum of operating frequencies.
Attention
This manual contains necessary and sufficient information to
operate the system safely. Advanced equipment training may
be provided by a factory trained Applications Specialist for the
agreed-upon time period.
Read and understand all instructions in the User's Manual
before attempting to use the Vivid S5/Vivid S6 ultrasound unit.
Keep the manual with the equipment at all time. Periodically
review the procedures for operation and safety precautions.
Prescription Device
For USA only:
United States law restricts this device to sale or use by, or on the
CAUTION
order of a physician.
Safety
All information in Chapter 1, "Safety" on page 13, should be
read and understood before operating the Vivid S5/Vivid S6
ultrasound unit.
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Introduction
Principles of Operation
Medical ultrasound images are created by computer and digital
memory from the transmission and reception of mechanical
high-frequency waves applied through a transducer. The
mechanical ultrasound waves spread through the body,
producing an echo where density changes occur. For example,
in the case of human tissue, an echo is created where a signal
passes from an adipose tissue (fat) region to a muscular tissue
region. The echoes return to the transducer where they are
converted back into electrical signals.
These echo signals are highly amplified and processed by
several analog and digital circuits having filters with many
frequency and time response options, transforming the
high-frequency electrical signals into a series of digital image
signals which are stored in memory. Once in memory, the
image can be displayed in real-time on the image monitor. All
signal transmission, reception and processing characteristics
are controlled by the main computer. By selection from the
system control panel, the user can alter the characteristics and
features of the system, allowing a wide range of uses, from
obstetrics to peripheral vascular examinations.
Transducers are accurate, solid-state devices, providing
multiple image formats. The digital design and use of
solid-state components provides highly stable and consistent
imaging performance with minimal required maintenance. A
sophisticated system design with computer controlled
extensive features and functions make the Vivid S5 and
Vivid S6 easy systems to use and very user friendly.
Interference caution
Use of devices that transmit radio waves near the unit could
cause it to malfunction.
CAUTION
Devices not to be used near this equipment:

Devices which intrinsically transmit radio waves such as
cellular phones, radio transceivers, mobile radio transmitters,
radio-controlled toys, and so on, should not be operated near
the unit.
2 Vivid S5/Vivid S6 User Manual

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Introduction
Medical staff in charge of the unit are required to instruct

technicians, patients, and other people who may be around the
unit, to fully comply with the above recommendations.
Indications for use

The Vivid S5/Vivid S6 ultrasound unit is intended for the
following applications:
• Abdominal
• Cardiac
• Musculoskeletal including Superficial
• Small Organ
• Pediatric
• OB/Gyn
• Fetal Heart
• Transesophageal
• Peripheral Vascular
• Neonatal Cephalic
• Adult Cephalic
• Intraoperative
This machine should be used in compliance with law. Some

jurisdictions restrict certain uses, such as gender determination.
CAUTION
Contraindications
The Vivid S5/Vivid S6 ultrasound unit is not intended for

ophthalmic use or any use causing the acoustic beam to pass
DANGER through the eye.
Documentation
Vivid S5/Vivid S6 documentation consists of two manuals:
• The Basic User Manual (TRANSLATED) provides
information needed by the user to operate the system
safely. It describes the basic functions of the system, safety
features, operating modes, measurements/calculations,

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Introduction
probes, and user care and maintenance.

Note: Probe information displayed on screen examples
does not necessarily reflect the probes available on your
ultrasound system. Please refer to the Probes chapter for
a listing of available probes and features.
• The Advanced Reference Manual (ENGLISH ONLY)
contains M&A formulas and parameter-names, data tables,
such as OB and Acoustic Output tables.
Note: The documentation kit provides the Basic User
Manual and Advanced Reference Manual in electronic
format only. The CD-ROM includes English and all
translations. Paper documentation may be ordered.
The Vivid S5/Vivid S6 documentation is written for users who
are familiar with basic ultrasound principles and techniques.
They do not include sonographic training or detailed clinical
procedures.
Note: The original documentation was written in English.
Manual contents
The Vivid S5/Vivid S6 User's Manual is organized to provide
the information needed to start scanning immediately.
Some of the functions or features described in this manual are
optional and may not be available in the configuration of your
specific system.
The safety instruction must be reviewed before operation of the
unit.
CAUTION
Finding information
Table of Contents, lists the main topics and their location.
Headers and Footers, give the chapter name and page
number.
Index, provides an alphabetical and contextual list of topics.

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Introduction
Conventions used in this manual

2-column layout, the right column contains the main text. The
left column contains notes, hints, and warnings.
Keys and buttons, on the control panel are indicated by over
and underlined text (ex. 2D refers to the 2D mode key)
Bold type, describes button names on the screen.
Italic type: describes program windows, screens and dialogue
boxes.
Safety icons, highlight safety issues as described in
"Introduction" on page 15.
Product icons, indicate product variant features as follows:
Indicates that the relevant feature exists in the standard configuration

of Vivid S6 and is not available on Vivid S5.
Indicates that the relevant feature exists as an option of the Vivid S6

and is not available on Vivid S5.
Indicates that the relevant feature exists as an option on both Vivid S6

and Vivid S5 systems.

of Vivid S6 and is available as an option on Vivid S5.

of Vivid S5 and is not available on Vivid S6.

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Introduction
Indicates that a specific hazard is known to exist which through

inappropriate conditions or actions, will cause:
DANGER • Severe or fatal personal injury
• Substantial property damage

WARNING • Severe personal injury
Indicates that a potential hazard may exist which through

inappropriate conditions or actions, will or can cause:
CAUTION • Minor injury
• Property damage
Regulatory requirements
The Vivid S5/Vivid S6 ultrasound unit confirms to directives,
classifications, and standards, as described in "Regulatory
information" on page 19.

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Introduction
Contact information
If additional information or assistance is needed, please
contact the local distributor or the appropriate support resource
listed bellow:
Internet
http://www.gehealthcare.com
http://www.gehealthcare.com/usen/ultrasound/products/probe_care.html
USA
GE Healthcare Tel: (1) 800-437-1171
Ultrasound Service Engineering Fax: (1) 414-721-3865
9900 Innovation Drive
Wauwatosa, WI 53226
Clinical Questions
For information in the United States, Canada, Mexico Tel: (1) 800-682-5327
and parts of the Caribbean, call the Customer Answer or (262) 524-5698
Center.
In other locations, contact your local Applications,
Sales or Service Representative.
Service Questions
For service in the United States, call GE CARES Tel: (1) 800-437-1171
In other locations, contact your local Service
Representative.
Accessories Catalog Requests

To request the latest GE Accessories catalog or Tel: (1) 800-643-6439
equipment brochures in the United States, call the
Response Center.
Placing an Order
To place an order, order supplies or ask an Tel: (1) 800-472-3666
accesory-related question in the United States, call
the GE Access Center.

R2424458-100 Rev. 2
Introduction
Canada
Ultrasound Service Engineering
9900 Innovation Drive Tel: (1) 262-524-5698
Wauwatosa, WI 53226
Customer Answer Center
Latin and South America

Ultrasound Service Engineering
9900 Innovation Drive Tel: (1) 262-524-5698
Wauwatosa, WI 53226
Customer Answer Center
Europe
GE Ultraschall Tel: 0130 81 6370 toll free
Deutschland GmbH & Co. KG Tel: (33) 130-831-300
Beethovenstraße 239 Fax: (49)(0) 212-28-02-431
Postfach 11 05 60
D-42655 Solingen
Asia
GE Medical Systems Asia (Singapore) Tel: (65) 291-8528
Service Department - Ultrasound Fax: (65) 272-3997
298 Tiong Bahru Road # 15-01/06
Central Plaza
Singapore 168730
Japan
GE Healthcare Japan Corporation Tel: (81) 426-48-2950
Customer Service Center Fax: (81) 426-48-2902
Argentina
GEME S.A. Tel: (1) 639-1619
Miranda 5237 Fax: (1) 567-2678
Buenos Aires - 1407
Austria
General Electric Austria GmbH Tel: +43 1 972 72-0
Euro Plaza, Geb. E, Technologiestr. 10 Fax: +43 1 972 72-2222
A-1120 Vienna, Austria

R2424458-100 Rev. 2
Introduction
Belgium
GE Medical Systems Benelux Tel: +32 (0)2 719 73 11
Kouterveldstraat 20 Fax: +32 (0)2 719 72 05
B-1831 Diegem
Brazil
GE Sistemas Médicos Tel: 0800-122345
Av Nove de Julho 5229 Fax: (011) 3067-8298
Paraiso
Cep: 01407-907 - São Paulo, SP
China
GE Healthcare - Asia Tel: (8610) 5806-9403
No. 1, Yongchang North Road Fax: (8610) 6787-1162
Beijing Economic & Technology Development Area
Beijing 100176, China
Denmark
GE Medical Systems (Denmark) A/S Tel: +45 4348 5400
Park Allé 295 Fax: +45 4348 5399
2605 Broenby
France
GE Healthcare France Tel: +33 1 34495231
11 avenue Morane Saulnier Fax: +33 1 34495202
78457 VELIZY CEDEX
Germany
GE Ultraschall Tel: (49) 212.28.02.207
Deutschland GmbH & Co. KG Fax: (49) 212.28.02.431
Beethovenstraße 239
Postfach 11 05 60
D-42655 Solingen
Greece
GE Medical Systems Hellas AP. Τηλ.: +30 210 9690990
Λεωφόρος Κύπρου 156 AP. Φαξ: +30 210 9625931
TΚ 164 51, ΑΡΓΥΡΟΥΠΟΛΗ

R2424458-100 Rev. 2
Introduction
Italy
GE Medical Systems Italia S.p.A. Tel: +39 0226001111
Via Galeno 36 Fax: +39 0226001599
20126 Milano
Luxembourg Tel: 0800 2603 toll free
Mexico
GE Sistemas Médicos de Mexico S.A. de C.V. Tel: (5) 228-9600
Rio Lerma #302, 1° y 2° Pisos Fax: (5) 211-4631
Colonia Cuauhtémoc
06500-México, D.F.
Netherlands
GE Medical Systems Nederland B.V. Tel: 06-022-3797 toll free
Atoomweg 512 Fax: (31)-304-11702
NL-3542 AB Utrecht
Poland
GE Medical Systems Polska Sp. z o.o. Tel: +48223308300
UI. Wołoska 9 Fax: +48223308383
02-583 Warszawa
Portugal
GE Portuguesa, S.A. Tel: (+351) 21 4251309
Avenida do Forte, 6 - 6A Fax: (+351) 21 4251343
Edificio Ramazzotti
2790-072 Carnaxide
Russia
GE Healthcare LLC Tel: +7 495 739 69 31
18 Krasnopresnenskaya Nab., Fax: +7 495 739 69 32
Moscow 123317,
Russian Federation
Spain
GE Healthcare Tel: +34 91 663 25 00
Edificio Gobelas I Fax: +34 91 663 25 01
C/ Gobelas 35-37
E- 28023-Madrid

R2424458-100 Rev. 2
Introduction
Sweden
GE Medical Systems Sverige AB Tel: +46 8 559 50 000
FE-314, Solnastrandväg 98 Fax: +46 8 559 500 15
Se-171 75 Stockholm
Switzerland
GE Medical Systems (Schweiz) AG Tel: +41 44 8099292
Europastrasse 31 Fax: +41 44 8099222
CH-8152 Glattbrugg
Turkey
GE Healthcare Tel: 90 (212) 366 29 00
Sun Plaza Fax: 90 (212) 366 29 99
Dereboyu Sok. No 24/7
34398 Maslak
Istanbul
United Kingdom
GE Healthcare - Ultrasound, Tel: +44 1234 340881
2 Napier Road, Fax: +44 1234 266261
Bedford,
MK41 0JW
Other countries NO TOLL FREE

Tel: int. code + 33 1 39 20 0007
Manufacturer
GE Medical Systems, Israel, Ltd. Tel: (+972) 4851 9555
Einstein Bldg 4, Etgar st. Fax: (+972) 4851 9500
P.O. Box 2006
Tirat Carmel 39120, Israel

R2424458-100 Rev. 2
Introduction

R2424458-100 Rev. 2
Safety
Chapter 1
Safety
• Introduction ................................................................................... .... 15

• Hazard symbols ......................................................................... 16
• Owner responsibility .................................................................... .... 17
• Important safety considerations ................................................. .... 18
• Notice against user modification ................................................ 18
• Regulatory information ................................................................ .... 19
• Directives ................................................................................... 19
• Product Classifications ............................................................... 19
• Conformity to Standards ............................................................ 19
• Certifications .............................................................................. 21
• Software License Acknowledgements ....................................... 21
• Device labels ................................................................................. .... 22
• Label Locations .......................................................................... 22
• Label Icon Description ................................................................ 23
• Acoustic output ............................................................................. .... 26
• Definition of the acoustic output parameters .............................. 26
• ALARA ....................................................................................... 26
• Safety statement ........................................................................ 27
• System controls affecting acoustic output .................................. 27
• OB Exam ........................................................................................ .... 29
• Exam Preparation ...................................................................... 29
• Acoustic Output Considerations ................................................. .... 30
• Concerns surrounding fetal exposure ........................................ 30
• Patient safety ................................................................................. .... 31
• Patient identification ................................................................... 31
• Diagnostic information ................................................................ 31
• Patient guidance ........................................................................ 32

R2424458-100 Rev. 2
Safety
• Probe Safety .................................................................................. ..... 32

• Mechanical hazards .................................................................... 32
• Electrical Hazard ......................................................................... 33
• Biological hazards ....................................................................... 34
• Personnel and equipment safety ................................................ ..... 35
• Explosion hazard ........................................................................ 35
• Electrical hazard ......................................................................... 35
• Smoke and fire hazard ................................................................ 36
• Biological hazard ........................................................................ 36
• Pacemaker hazard ......................................................................36
• LCD Monitor ................................................................................ 37
• Electrical safety ............................................................................ ..... 39
• Internally connected peripheral devices ..................................... 39
• External Connection of other peripheral devices ........................ 39
• Allergic reactions to latex-containing medical devices ............ ..... 40
• Use of ECG .................................................................................... ..... 41
• Use of Defibrillator ....................................................................... ..... 41
• Use of Electrosurgical Unit .......................................................... ..... 41
• Electromagnetic Compatibility (EMC) ........................................ ..... 42
• EMC performance ....................................................................... 43
• Declaration of Emissions ............................................................ 44
• Declaration of Immunity .............................................................. 44
• Notice upon Installation of Product ............................................. 44
• General notice ............................................................................ 45
• Peripheral Update for EC countries ............................................ 46
• Patient Environmental Devices ................................................... ..... 48
• Acceptable devices ..................................................................... 49
• Unapproved devices ................................................................... 49
• Accessories, options, and supplies ............................................. 49
• Environmental protection ............................................................ 50

R2424458-100 Rev. 2
Safety
Introduction
This section describes the important safety measures which
should be taken before operating the Vivid S5/Vivid S6
ultrasound unit. Procedures for simple care and maintenance
of the unit are also described.
Various levels of safety precautions may be found on the
equipment, and different levels of severity are identified by one
of the following icons that precede precautionary statements in
the text.
The following icons and conventions are used to indicate
precautions:
DANGER • Severe or fatal personal injury

WARNING • Severe personal injury
Indicates that a potential hazard may exist which through

inappropriate conditions or actions, will or can cause:
CAUTION • Minor injury
• Property damage
Note: Indicates precautions or recommendations that should be

used in the operation of the ultrasound system, specifically:
• Maintaining an optimum system environment
• Using this Manual
• Notes to emphasize or clarify a point
Other precautions or prudent-use recommendations are
indicated in the note sections in the left column. These are:
• Use of the Vivid S5/Vivid S6 ultrasound unit as a
prescription device, under the order of a physician.
• Maintaining an optimum unit environment.
• Reference to the User's Manual.

R2424458-100 Rev. 2
Safety
Hazard symbols
Icon description
Potential hazards are indicated by the following icons:
Icon Potential hazard Usage Source
• Patient/user infection due to • Cleaning and care ISO 7000

contaminated equipment instructions No. 0659
• Sheath and glove
guidelines
• Electrical micro-shock to • Probes

patient, e.g., ventricular • ECG (if applicable)
• Connections to back panel
• Console, accessories or • Moving

optional storage devices • Using brakes
that can fall on patient, user, • Transporting
or others.
• Collision with persons or
objects may result in injury
while maneuvering or during
system transport.
• Injury to user from moving
the console
• Patient injury or tissue • ALARA, the use of Power

damage from ultrasound Output following the 'as
radiation low as reasonably
achievable' principle
• Risk of explosion if used in • Flammable anesthetic

the presence of flammable
anesthetics
• Patient/user injury or • Replacing fuses

adverse reaction from fire or • Outlet guidelines
smoke
• Patient/user injury from
explosion and fire

R2424458-100 Rev. 2
Safety
Owner responsibility
For USA only:
Federal law restricts this device to use by, or on the orders of, a
CAUTION
physician.
It is the responsibility of the owner to ensure that anyone

operating the system reads and understands this section of the
manual. However, there is no representation that the act of
reading this manual renders the reader qualified to operate,
inspect, test, align, calibrate, troubleshoot, repair or modify the
system. The owner should make certain that only properly
trained, fully-qualified service personnel undertake the
installation, maintenance, troubleshooting, calibration and
repair of the equipment.
The owner of the Vivid S5/Vivid S6 ultrasound unit should
ensure that only properly trained, fully qualified personnel are
authorized to operate the system. Before authorizing anyone to
operate the system, it should be verified that the person has
read, and fully understands, the operating instructions
contained in this manual. It is advisable to maintain a list of
authorized operators.
Should the system fail to operate correctly, or if the unit does
not respond to the commands described in this manual, the
operator should contact the nearest field GE Medical Systems
Service Office.
For information about specific requirements and regulations
applicable to the use of electronic medical equipment, consult
the local, state and federal agencies.

R2424458-100 Rev. 2
Safety
Important safety considerations

Notice against user modification
Never modify this product, including system components,
software, cables, and so on. User modification may cause
safety hazards and degradation in system performance. All
modification must be done by a GE qualified person.
The equipment is not suitable for use in the presence of
flammable anesthetic mixture with air or with Oxygen or Nitrous
Oxide.
This section includes considerations for the

following
• Patient safety
• Personnel and equipment safety
The information contained in this section is intended to
familiarize the user with the hazards associated with the use of
the unit, and to alert them to the extent to which injury and
damage may occur if the precautions are not observed.
Improper use can result in serious injury. The user must be
thoroughly familiar with the instructions and potential hazards
CAUTION involving ultrasound examination before attempting to use the
device. Training assistance is available from GE Medical
Systems if needed.
Users are obligated to familiarize themselves with these safety

considerations and to avoid conditions that could result in injury
or damage.

R2424458-100 Rev. 2
Safety
Regulatory information
Any changes to accessories, peripheral units or any other part of
the system must be approved by the manufacturer. Ignoring this
CAUTION advice may compromise the regulatory approvals obtained for
the product.
Directives
The GE Healthcare Ultrasound product families are tested to
meet all applicable requirements in relevant EU Directives and
European/International standards.
• Council Directive 93/42/EEC concerning MDD (Medical
Devices Directive): the CE label affixed to the product
testifies compliance to this Directive.
The location of the CE marking is specified in "Device
labels" on page 22.
Product Classifications
The Vivid S5/Vivid S6 ultrasound unit confirms to the following
classifications, in accordance with the IEC/EN 60601-1:6.8.1:
• According to 93/42/EEC Medical Device Directive, this is
Class IIa Medical Device.
• According to IEC/EN 60601-1, Equipment is Class I, Type
B with BF or CF Applied Parts.
• According to CISPR 11, this is Group 1, Class B ISM
Equipment.
• According to IEC 60529, the footswitch rate IPx8 is suitable
for use in surgical rooms.
• Classification according to the degree of protection against
ingress of water as detailed in the current edition of IEC 529
(section 6.1.1): Ordinary for Main Unit (PC), IPX1, IPX7,
IPX8 for ultrasound probes (transducers).
Conformity to Standards
To fulfill the requirements of relevant EC directives and/or
European Harmonized/International standards, the following
documents/standards have been used:
• International Electrotechnical Commission (IEC).

R2424458-100 Rev. 2
Safety
• IEC/EN 60601-1: Medical Electrical Eqiupment, Part 1

General Requirements for Safety
• IEC/EN 60601-1-2: Medical electrical equipment -
Part 1-2: General requirements for safety - Collateral
standard: Electromagnetic compatibility - Requirements
and tests
• EN 55011/ CISPR11+A2 ED3.2: Emitted noise
according to Class B requirements + Electromagnetic
Susceptibility
• IEC/EN 60601-1-4: Medical electrical equipment - Part
1-4: General requirements for safety - Collateral
standard: Programmable electrical medical systems
• IEC/EN 60601-1-6: Medical electrical equipment - Part
1-6: General requirements for basic safety and essential
performance - Collateral Standard: Usability
• IEC/EN 60601-2-37: Medical Electrical Equipment Part
2-37: Particular Requirements for the Safety of
Ultrasonic Medical Diagnostic and Monitoring
Equipment
• EN60601-1-1: 2001 - Medical Electrical Equipment Part
1-1: General Requirements for Safety Collateral
Standard: Safety Requirements for Medical Electrical
Systems
• International Organization of Standards (ISO)
• ISO 10993-1: Biological Evaluation of Medical Devices -
Part 1: Evaluation & Testing
• ISO 10993-5: Biological Evaluation of Medical Devices -
Part 5: Tests for In Vitro Cytotoxicity
• ISO 10993-10:Biological evaluation of medical devices -
Part 10: Tests for irritation and delayed-type
hypersensitivity
• Underwriters' Laboratories, Inc. (UL), an independent
testing laboratory.
• UL 60601-1 Medical Electrical Equipment, Part 1
General Requirements for Safety.
• Canadian Standards Association (CSA).
• CSA 22.2, 601.1 Medical Electrical Equipment, Part 1
General Requirements for Safety.

R2424458-100 Rev. 2
Safety
• NEMA/AIUM Acoustic Output Display Standard (NEMA

US-3, 1998).
• Medical Device Good Manufacturing Practice Manual
issued by the FDA (Food and Drug Administration,
Department of Health, USA).
Certifications
• Quality management standards for medical devices:
General Electric Medical Systems is ISO 9001 and
ISO13485 certified.
Software License Acknowledgements

• WindowBlinds ™ OCX © Stardock ®

R2424458-100 Rev. 2
Safety
Device labels
Label Locations
1 2
Label 1 - Vivid S5 100-120V Label 2 - Vivid S5 220-240V
3 4
Label 3 - Vivid S6 100-120V Label 4 - Vivid S6 220-240V
1 2
3 4
5
5
Label 5 - Universal Label, for all systems Vivid S5/Vivid S6 label locations
Figure 1-1: System Label and Location

R2424458-100 Rev. 2
Safety
Label Icon Description

The following table describes the purpose and location of
safety labels and other important information provided on the
equipment.
Label Purpose Location
Identification and • Manufacturer's name and address Bottom of unit

Rating Plate • Date of Manufacture
• Model and serial numbers
• Electrical ratings (Volts, Amps,
phase, and frequency)
• Device Listing/Certification Labels
Equipment Type BF, in which Probe connectors.

protection against electric shock does
not rely on basic insulation only.
Provides additional safety
precautions such as double insulation
or reinforced insulation, because
there is no provision for protective
earthing or reliance upon installation
conditions.
Equipment Type CF, indicates ECG connector

equipment having a floating applied
part having a degree of protection
suitable for direct cardiac contact.
Bottom of unit.
Alternating current Various
This symbol indicates that the waste Bottom Cover

of electrical and electronic equipment
must not be disposed as unsorted
municipal waste and must be
collected separately. Please contact
an authorized representative of the
manufacturer for information
concerning the decommissioning of
your equipment.

R2424458-100 Rev. 2
Safety
Protective earth (ground) Internal
Earth (ground) Internal
Equipotentiality: indicates terminal to Bottom of unit

be used for connecting equipotential
conductors when interconnecting
(grounding) with other equipment.
Connection of additional protective
earth conductors or potential
equalization conductors is not
necessary in most cases and is only
recommended for situations involving
multiple equipment in a high-risk
patient environment to provide
assurance that all equipment is at the
same potential and operates within
acceptable leakage current limits. An
example of a high-risk patient would
be a special procedure where the
patient has an accessible conductive
path to the heart such as exposed
cardiac pacing leads.
Attention - Consult accompanying Various

documents: alerts the user to refer to
the user documentation when
complete information cannot be
provided on the label.
This marking on the control panel is
especially intended to alert the user
to consult the user manual for use
BEFORE operation of the system.
CAUTION - Dangerous voltage: used Various

to indicate electric shock hazards.

R2424458-100 Rev. 2
Safety
Apply a short push on the ON/OFF Keyboard

button to shut down the system.
CAUTION: This Power Switch DOES
NOT ISOLATE Mains Supply.
This product consists of devices that

may contain mercury, which must be
recycled or disposed of in
accordance with local, state, or
country laws. (Within this system, the
backlight lamps in the monitor display
contain mercury.)
Date of manufacture: The date Rear of unit

could be a year, year and month, or
year, month and day, as appropriate.
See ISO 8601 for date formats.
Catalog or model number Rear of unit
Serial number Rear of unit
Direct Current: For products to be Rear of unit

powered from a DC supply.
GOST-R Mark: per Law of the Bottom of unit

Russian Federation No. 184-FZ. The
field 0000 will contain the number of
the institute that issued the GOST
label.
Prescription Device Label for United Bottom of unit

States per 21 CFR 801.109(b)(1)

R2424458-100 Rev. 2
Safety
Acoustic output
Definition of the acoustic output
parameters
Thermal Index
TI is an estimate of the temperature increase of soft tissue or
bone. There are three thermal index categories:
• TIS: Soft tissue thermal index. The main TI category. Used
for applications that do not image bone.
• TIB: Bone thermal index (bone located in a focal region).
Used for fetal application.
• TIC: Cranial bone thermal index (bone located close to the
surface). Used for transcranial application.
Mechanical Index
MI is the estimated likelihood of tissue damage due to
cavitation. The absolute maximum limits of the MI is 1.9 as set
by the FDA 510 (k) guidance of 1997.
Note: Further explanation on "cavitation" appears in the
Reference Manual Chapter 3 - Nonthermal Bioeffects.
Ispta
The Ispta is the Spatial Peak Temporal Average Intensity. The
absolute maximum limit of Ispta is 720 MW/cm2 as set by the
FDA 510(k) guidance of 1997.
ALARA
Ultrasound procedures should be performed using output
levels and exposure times As Low As Reasonably Achievable
(ALARA) while acquiring clinical information.
Training
During each ultrasound examination the user is expected to
weigh the medical benefit of the diagnostic information that
would be obtained against the risk of potential harmful effects.
Once an optimal image is achieved, the need for increasing
acoustic output or prolonging the exposure cannot be justified.

R2424458-100 Rev. 2
Safety
It is recommended that all users receive proper training in

applications before performing them in a clinical setting. Please
contact the local GE sales representative for training
assistance.
Safety statement
GE Medical Systems safety statement
Although no harmful biological effects have been demonstrated
for ultrasound frequencies, intensities and exposure times used
in examination with the GE Vivid S5/Vivid S6 system, GE
Medical Systems recommends using the lowest acoustic
output settings which will produce diagnostically acceptable
information.
System controls affecting acoustic

output
The operator controls that directly affect the acoustic output are
discussed in the Acoustic Output Data Tables in the Reference
Manual. These tables show the highest possible acoustic
intensity for a given mode, obtainable only when the maximum
combination of control settings is selected. Most settings result
in a much lower output. It is important to note the following:
• The duration of an ultrasound examination is as important
as the acoustic output, since patient exposure to output is
directly related to the exposure time.
• Better image quality yields faster clinical results, making it
possible to complete the relevant ultrasound examination
more rapidly. Therefore, any control that improves the
quality of the examination can help to reduce patient
exposure, even though it may not directly affect acoustic
output.
Probe selection
As long as the appropriate application is available, any probe
can be used with the knowledge that the intensities fall at, or
below, those stated in the Acoustic Output Data Tables. The
duration of patient exposure is most likely minimized with the
use of a probe that is optimized to provide resolution and focal
depth, appropriate to the examination.

R2424458-100 Rev. 2
Safety
Application selection
Selecting the probe and application preset appropriate to a
particular ultrasound examination automatically provides
acoustic output limits within FDA guidelines for that application.
Other parameters which optimize performance for the selected
application are also set automatically, and should assist in
reducing the patient exposure time. See page 100, for
information on selecting probes and application presets.
Changing imaging modes

Acoustic output depends on the imaging mode selected. The
choice of mode (2D, M-Mode, Doppler or Color Flow)
determines whether the ultrasound beam is stationary or in
motion. This greatly affects the energy absorbed by the tissue.
See Chapter 4, "Scanning Modes" on page 137, for complete
information on changing imaging modes.
When operating in a combined mode, such as 2D and M-Mode,
the total acoustic output comprises contributions from each
individual mode. Depending on the modes in use, either or both
output indices may be affected.
The user can override the default settings, but care should be
taken to observe the displayed MI and TI values.
Power
It is possible to change the power in all operating modes so that
the operator can use the ALARA principle.

R2424458-100 Rev. 2
Safety
OB Exam
Exam Preparation
Prior to an ultrasound examination, the patient should be
informed of the clinical indication, specific benefits, potential
risks, and alternatives, if any. In addition, if the patient requests
information about the exposure time and intensity, it should be
provided. Patient access to educational materials regarding
ultrasound is strongly encouraged to supplement the
information communicated directly to the patient. Furthermore,
these examinations should be conducted in a manner and take
place in a setting which assures patient dignity and privacy.
• Prior material knowledge and approval of the presence of
nonessential personnel with the number of such personnel
kept to a minimum.
• An intent to share with the parents per the physician's
judgment, either during the examination or shortly
hereafter, the information derived.
• An offer of choice about viewing the fetus.
• An offer of choice about learning the sex of the fetus, if such
information becomes available.
Ultrasound examinations performed solely to satisfy the
family's desire to know the fetal sex, to view the fetus, or to
obtain a picture of the fetus should be discouraged.

R2424458-100 Rev. 2
Safety
Acoustic Output Considerations
The Vivid S5/Vivid S6 system is a multi-use device which is

capable of exceeding FDA Pre-enactment acoustic output
WARNING (spatial peak-temporal average) intensity limits for fetal
applications.
It is prudent to conduct an exam with the minimum amount and

duration of acoustic output necessary to optimize the image's
CAUTION diagnostic value.
Concerns surrounding fetal exposure

Always be aware of the acoustic output level by observing the
Acoustic Output Display. In addition, become thoroughly
familiar with the Acoustic Output Display and equipment
controls affecting output.

R2424458-100 Rev. 2
Safety
Patient safety
Patient identification
The concerns listed in this section can seriously affect the safety
of the patient undergoing a diagnostic ultrasound examination.
WARNING
Always include proper identification with all patient data and

verify the accuracy of the patient's name and/or identity number
when entering such data. Ensure that the correct patient ID is
provided on all recorded data and hard copy prints.
Identification errors could result in an incorrect diagnosis.
Note: For further information on patient identification, see
"Starting an examination" on page 95.
Diagnostic information
The images and calculations provided by the system are
intended for use by competent users, as a diagnostic tool. They
are explicitly not to be regarded as the sole, irrefutable basis for
clinical diagnosis. Users are encouraged to study the literature
and reach their own professional conclusions regarding the
clinical utility of the system.
The user should be aware of the product specifications and of
the system accuracy and stability limitations. These limitations
must be considered before making any decision based on
quantitative values. If in doubt, the nearest GE Medical
Systems Service Office should be consulted.
Equipment malfunction or incorrect settings can result in
measurement errors or failure to detect details in the image.
The user must become thoroughly familiar with the operation of
the unit in order to optimize its performance and to recognize
possible malfunctions. Application training is available through
the sales representative.
Be certain to ensure privacy data of patient information.
CAUTION

R2424458-100 Rev. 2
Safety
Patient guidance
Remember to assist the patient when moving up to the

examination bed, moving down from the bed, or when moving in
CAUTION the vicinity of the system.
Make sure to keep the patient in full view at all times and never
leave the patient unattended while on the examination bed.
Probe Safety
This section includes information on hazards to both the user
and the equipment, as follow:
• Mechanical hazards
• Electrical hazards
• Biological hazards
Mechanical hazards
Damaged probes or improper use and manipulation of the
transesophageal probe may result in injury or increased risk of
infection. Inspect probes frequently for sharp, pointed or rough
surface damage that could cause injury or tear protective
barriers (gloves and sheaths).
Never use excessive force when manipulating intracavity
probes. Become familiar with all instructions and precautions
provided with special purpose probes.
The use of damaged probes can result in injury or increased
risk of infection. Inspect probes often for sharp, pointed, or
rough surface damage that could cause injury or tear protective
barriers. Become familiar with all instructions and precautions
provided with special purpose probes.
Observe immersion levels as displayed in Figure 11-5, page 559.
WARNING
Inspect probes for sharp edges or rough surfaces that could
injure sensitive tissue.
DO NOT bend or pull the cable forcefully, to avoid mechanical
shock or impact to the probe.

R2424458-100 Rev. 2
Safety
Allowing the machine to transmit acoustic output with the probe

not in use (or in its holder) can cause the transducer to build up
CAUTION heat. Always turn off acoustic output or freeze the image when
not in use. The system's acoustic output remains transmitting
when the user controls are being used.
The system is equipped with an Auto Freeze feature which
disables acoustic output and freezes the image when the
machine is not in use.
Ultrasound transducers are sensitive instruments which can

easily be damaged by rough handling. Take extra care not to
CAUTION drop transducers and avoid contact with sharp or abrasive
surfaces. A damaged housing, lens or cable can result in patient
injury or serious impairment or operation.
Transesophageal probe safety

Never use excessive force when manipulating the
transesophageal probe. The detailed operator manual
enclosed with the transesophageal probe must be read
carefully.
Electrical Hazard
Probes are driven by electricity, which can injure the patient or
user when exposed to contact with conductive solution.
A damaged probe may increase the risk of electric shock if
conductive solutions come in contact with internal live pads.
Inspect probes often for cracks or openings in the housing and
holes in and around the acoustic lens, or other damage that
could allow moisture to enter. Become familiar with the use and
care precautions described in Chapter 11, "Probes" on
page 535.

R2424458-100 Rev. 2
Safety
Do not immerse the probe into any liquid beyond the level shown
in Figure 11-5, page 559. Never immerse the probe connector or
WARNING adaptors into any liquid.
Do not subject the probe to mechanical shock or impact, which
may result in cracks or chips in the housing and degrade
performance.
Inspect the probe before and after each use, as described on
page 553, for damage or degradation to the housing, strain relief,
lens and seal.
DO NOT apply excessive force to the probe cable, to prevent
insulation failure.
Electrical leakage checks should be performed regularly by a GE
service representative or qualified hospital personnel, according
to the procedures described in EN 60601-1/IEC 60601-1 §19.
Ultrasound can produce harmful effects in tissue and potentially

result in patient injury. Always minimize exposure time and keep
CAUTION ultrasound levels low when there is no medical benefit. Use the
principle of ALARA (As Low As Reasonably Achievable),
increasing output only when needed to obtain diagnostic image
quality. Observe the acoustic output display and be familiar with
all controls affecting the output level. See the Bioeffects section
of the Acoustic Output chapter in the Advanced Reference
Manual for more information.
Biological hazards
Transesophageal probes require a special handling. Refer to the
user documentation enclosed with these probes.
CAUTION
To minimize disease transmission, legally marketed and sterile

pyrogen-free sheaths should be used for each probe
recommended for intra-cavity procedures.
Adequate cleaning and disinfection are essential to prevent
disease transmission. It is the responsibility of the user to verify
and maintain the effectiveness of the infection control
procedures in use.

R2424458-100 Rev. 2
Safety
Personnel and equipment safety

The hazards listed below can seriously affect the safety of
personnel and equipment during a diagnostic ultrasound
DANGER examination.
Explosion hazard
Never operate the equipment in the presence of flammable or
explosive liquids, vapors or gases. Malfunctions in the unit, or
sparks generated by fan motors, can electrically ignite these
substances. Operators should be aware of the following points
to prevent such explosion hazards.
• If flammable substances are detected in the environment,
do not plug in or turn on the system.
• If flammable substances are detected after the system has
been turned on, do not attempt to turn off the unit, or to
unplug it.
• If flammable substances are detected, evacuate and
ventilate the area before turning off the unit.
Electrical hazard
The internal circuits of the unit use high voltages, capable of
causing serious injury or death by electrical shock.
WARNING
If any defects are observed or malfunctions occur, stop

operating the equipment and perform the proper action for the
patient. Inform a qualified service person and contact a Service
Representative for information.
To avoid injury
• Do not remove the unit's protective covers. No
user-serviceable parts are inside. If servicing is required,
contact qualified technical personnel.
• Connect the attachment plug to a hospital-grade grounding
outlet to ensure adequate grounding.
• Never use any adaptor or converter of a three-prong-to
two-prong type to connect with a mains power plug. The
protective earth connection will loosen.

R2424458-100 Rev. 2
Safety
• Do not place liquids on or above the unit. Conductive fluids

seeping into the active circuit components may cause a
short-circuit, which could result in an electrical fire.
• An electrical hazard may exist if any light, monitor or visual
indicator remains on after the unit is turned off.
Fuses blown within 36 hours of being replaced may indicate a
malfunctioning electrical circuit within the system. In this event,
the unit must be checked by GE Medical Systems service
personnel. No attempt should be made to replace the fuses
with others of a higher rating.
Do not use this equipment if a safety problem is known to exist.
Have the unit repaired and performance verified by qualified
CAUTION service personnel before returning to use.
Smoke and fire hazard

The system must be supplied from an adequately rated
electrical circuit. The capacity of the supply circuit must be as
specified.
Biological hazard
For patient and personnel safety, beware of biological hazards
while performing transesophageal procedures. To avoid the
risk of disease transmission:
• Use protective barriers (gloves and probe sheaths)
whenever necessary. Follow sterile procedures as
required.
• Thoroughly clean probes and reusable accessories after
each patient examination and disinfect or sterilize as
needed. Refer to Chapter 11, "Probes" on page 535, for
probe use and care instructions.
• Follow all in-house infection control policies as they apply
to personnel and equipment.
Pacemaker hazard
The possibility of the system interfering with pacemakers is
minimal. However, as this system generates high frequency
electrical signals, the operator should be aware of the potential
hazard this could cause.

R2424458-100 Rev. 2
Safety
To avoid injury or system damage, NEVER place any object or

liquid on the monitor.
CAUTION
Archived data is managed at the individual sites. Performing data

backup (to any device) is recommended.
CAUTION
Do not unpack the Vivid S5/Vivid S6. This must be performed by

qualified service personnel only.
CAUTION
Do not use the Vivid S5/Vivid S6 Ultrasound system ECG wave

for diagnosis and monitoring.
CAUTION
DO NOT load non-system software on the system computer.
CAUTION
LCD Monitor
• DO NOT place a finger, hand or any object on the joint of
the monitor or monitor arm to avoid injury when moving the
monitor and monitor arm.
• To avoid result of injury or system damage, NEVER place

any object or liquid on the monitor, whether in the home or
flip down/transport position.
• DO NOT place any object on the ventilation slots on the
upper rear side of the monitor cabinet. Blocking the
ventilation slots prevents proper airflow and may result in
fire, electric shock, or equipment damage.
• Keep small objects or liquids away from the LCD monitor.

R2424458-100 Rev. 2
Safety
Small objects or liquid may accidentally fall through the

ventilation slots into the cabinet or spill into the cabinet
which may result in fire, electric shock, or equipment
damage.
If an object or liquid falls/spills into the cabinet, unplug the
system immediately. Call a Service Representative for
information.
• DO NOT scratch or press on the panel with any sharp
objects, such as a pencil or pen, as this may result in
damage to the panel.

R2424458-100 Rev. 2
Safety
Electrical safety
Internally connected peripheral devices
The system, together with peripheral devices, such as video
tape recorders and printers, meets UL 60601-1 and
IEC 60601-1 (1988) standards for electrical isolation and
safety. These standards are applicable only when the specified
peripheral devices are plugged into the AC outlets provided in
the unit.
External Connection of other peripheral

devices
External devices can be used only if CE marked and in
compliance with related standards (EN 60601-1 or EN 60950).
CAUTION Conformance to EN 60601-1-1 (2000) must be verified.
External devices meeting EN 60950 should be kept outside of the
patient environment, as defined in IEC 60601-1-1 (2000).
Other external devices, such as laser cameras, printers, VCRs

and external monitors, usually exceed allowable leakage limits
and, when plugged into separate AC outlets that are then
connected to the unit, are in violation of patient safety
standards. Suitable electrical isolation of such external AC
outlets may be required in order to meet UL2601-1 and
IEC 60601-1 (1988) standards for electrical leakage.

R2424458-100 Rev. 2
Safety
Allergic reactions to latex-containing

medical devices
Due to reports of severe allergic reactions to medical devices
containing latex (natural rubber), the FDA advises health-care
professionals to identify latex-sensitive patients, and be
prepared to treat allergic reactions promptly. Latex is a
component of many medical devices, including surgical and
examination gloves, catheters, incubation tubes, anesthesia
masks and dental dams. Patient reaction to latex has ranged
from contact urticaria, to systemic anaphylaxis.
For more details regarding allergic reaction to latex, refer to
FDA Medical Alert MDA91-1, March 29, 1991 Medical Alert on
latex products.

R2424458-100 Rev. 2
Safety
Use of ECG
Do not use the Vivid S5/Vivid S6 Ultrasound system ECG wave
for diagnosis and monitoring.
CAUTION
Use of Defibrillator
Do not use the Vivid S5/Vivid S6 Ultrasound system with
Defibrillator. This equipment does not have defibrillator-
CAUTION approved applied parts.
Remove the TEE probe from the patient when defibrillators are
used.
CAUTION
Use of Electrosurgical Unit

To avoid skin burns in surgical use, do not place ECG electrodes
in current path between Electrosurgical Unit (ESU) active and
CAUTION dispersive electrodes. Keep ESU cables away from ECG leads.
This equipment provides no special means of protection from

high frequency (HF) burns that may result from using an
electrosurgical unit (ESU). To reduce the risk of HF burns,
avoid contact between the patient and ultrasound transducer
while operating the ESU. Where contact cannot be avoided, as
in the case of TEE monitoring during surgery, make sure the
transducer is not located between the ESU active and
dispersive electrodes and keep the ESU cables away from the
transducer cable.

R2424458-100 Rev. 2
Safety
Electromagnetic Compatibility (EMC)

NOTE: This unit carries the CE mark. It complies with
regulatory requirements of the European Directive 93/42/EEC
concerning medical devices. It also complies with emission
limits for a Group 1, Class B Medical Device as stated in
IEC/EN 60601-1-2 (2001).
All types of electronic equipment may characteristically cause
electromagnetic interference with other equipment, transmitted
either through air or connecting cables. The term
Electromagnetic Compatibility (EMC), indicates the capability
of the equipment to curb electromagnetic influence from other
equipment, while at the same time not affecting other
equipment with similar electromagnetic radiation.
Radiated or conducted EMC can cause distortion, degradation,
or artifacts in the ultrasound image which could potentially
obscure diagnostic information.
There is no guarantee that interference will not occur in a
particular installation. If this equipment is found to cause or
respond to interference, which may be determined by turning
equipment on and off, qualified service personnel should
attempt to correct the problem by one or more of the following
measures:
• Re-orient or re-locate the affected device.
• Increase the separation between the unit and the affected
device.
• Power the equipment from a source other than that of the
affected device.
• Consult the service representative for further suggestions.
The manufacturer is not responsible for any interference or
responses caused by the use of interconnecting cables other
than those recommended, or by unauthorized changes or
modifications to this unit. Unauthorized changes or
modifications could void the user's authority to operate the
equipment.
To comply with the regulations on electromagnetic interference,
all interconnecting cables to peripheral devices must be
shielded and properly grounded. Use of cables not properly
shielded and grounded may result in the equipment causing or

R2424458-100 Rev. 2
Safety
responding to radio frequency interference, in violation of the

European Union Medical Device Directive and FCC
regulations.
Do not use devices which intentionally transmit RF signals, for
example, cellular phones, transceivers, or radio controlled
products, in the vicinity of this equipment as it may cause
performance outside the published specifications. Keep the
power to these types of devices turned off when near this
equipment.
EMC performance
Portable and mobile radio communications equipment (e.g.
two-way radio, cellular/cordless telephones, wireless computer
networks), other than those supplied by GE, should be used no
closer to any part of this system, including cables, than
determined according to the following method:
Table 1-1: Portable and mobile radio communications equipment distance requirements
Frequency range: 150 kHz - 80 MHz 80 MHz - 800 MHz 800 MHz - 2.5 GHz
Calculation d=[3.5/V1] square d = [3.5/E1] square d = [7/E1] square

Method: root of P root of P root of P
Where: d= separation distance in meters, P = rated power of the transmitter,

V1=compliance value for conducted RF, E1 = compliance value for radiated RF
If the maximum
transmitter power
in watts is rated The separation distance in meters should be:
5 2.6 2.6 5.2
20 5.2 5.2 10.5
100 12.0 12.0 24.0

R2424458-100 Rev. 2
Safety
Declaration of Emissions
This system is suitable for use in the following environment.
The user must assure that it is used only in the electromagnetic
environment as specified.
Table 1-2: Declaration of Emissions
Emission Type Compliance Electromagnetic Environment
CISPR 11 Group 1 This system uses RF energy only for its

RF Emissions Class B internal function. Therefore, RF
emissions are very low and are not likely
to cause any interference in nearby
electronic equipment. It is suitable for use
in all establishments, including domestic
establishments and those directly
connected to the public low-voltage
power supply network that supplies
buildings used for domestic purposes.
IEC 61000-3-2 Class B 230V 50Hz

Harmonic
Disturbance
Emissions
IEC 61000-3-3 Complies

Voltage
Fluctuations/Flicker
Emissions
Declaration of Immunity
This system is suitable for use in the following environment.
The user must assure that the system is used according to the
specified guidance and only in the electromagnetic
environment listed.
Notice upon Installation of Product

Separation distance and effect from fixed radio
communications equipment: field strengths from fixed
transmitters, such as base stations for radio (cellular/cordless)
telephones and land mobile radios, amateur radio, AM and FM
radio broadcast, and TV broadcast transmitter cannot be
predicted theoretically with accuracy. To assess the

R2424458-100 Rev. 2
Safety
electromagnetic environment due to fixed RF transmitters, an

electromagnetic site survey should be considered. If the
measured field strength in the location in which the ultrasound
system is used exceeds the applicable RF compliance level as
stated in the immunity declaration, the ultrasound system
should be observed to verify normal operation. If abnormal
operation is observed, additional measures may be necessary,
such as re-orienting or relocating the ultrasound system or
using an RF shielded examination room may be necessary.
1. Use either power supply cords provided by GE Medical
Systems or ones designated by GE Medical Systems.
Products equipped with a power source plug should be
plugged into the fixed power socket which has the
protective grounding conductor. Never use any adaptor or
converter to connect with a power source plug (e.g.
three-prong-to-two-prong converter).
2. Locate the equipment as far away as possible from other
electronic equipment.
3. Be sure to use only the cables provided by or designated by
GE Medical Systems. Connect these cables following the
installation procedures (e.g. wire power cables separately
from signal cables).
4. Lay out the main equipment and other peripherals following
the installation procedures described in the Option
Installation manuals.
General notice
1. Designation of Peripheral Equipment Connectable to This
Product.
The equipment indicated in Chapter 12, "Peripherals" on
page 575 can be hooked up to the product without
compromising its EMC performance. Avoid using
equipment not designated in the list. Failure to comply with
this instruction may result in poor EMC performance of the
product.
2. Notice against User Modification The user should never
modify this product. User modifications may cause
degradation in EMC performance. Modification of the
product includes changes in:
• Cables (length, material, wiring, etc.)
• System installation/layout

R2424458-100 Rev. 2
Safety
• System configuration/components
• Securing system parts (cover open/close, cover
screwing)
3. Operate the system with all covers closed. If a cover is
opened for some reason, be sure to shut it before starting/
resuming operation.
4. Operating the system with any cover open may affect EMC
performance.
Peripheral Update for EC countries

The following is intended to provide the users in EC countries
with updated information concerning the connection of the
Vivid S5/Vivid S6 to image recording and other devices or
communication networks.
The Vivid S5/Vivid S6 has been verified for overall safety,
compatibility and compliance with the following on-board image
recording devices:
• Sony UP-D895 MD/D897MD Digital Printer
• Sony UP-D23 MD Digital Color Printer
• HP DeskJet 460 Series Inkjet printer
• HP OfficeJet Pro K5400 Series Inkjet printer
The Vivid S5/Vivid S6 has also been verified for compatibility,
and compliance for connection to a local area network (LAN)
via the rear panel Ethernet connection, provided the LAN
components are IEC/EN 60950 compliant.
Connection may also be made to a CE Marked and IEC/ EN
60950 compliant modem using one of the serial or USB ports
on the system.
The Vivid S5/Vivid S6 may also be used safely while connected
to devices other than those recommended above if the devices
and their specifications, installation, and interconnection with
the system conform to the requirements of IEC/EN 60601-1-1.
General precautions for installing an alternate on-board device
would include:
• The added device must have appropriate safety standard
conformance and CE Marking.
• The total power consumption of the added devices, which

R2424458-100 Rev. 2
Safety
connect to Vivid S5/Vivid S6 and are used simultaneously,

must be less than or equal to the rated supply of the
Vivid S5/Vivid S6.
• There must be adequate heat dissipation and ventilation to
prevent overheating of the device.
• There must be adequate mechanical mounting of the
device and stability of the combination.
• Risk and leakage current of the combination must comply
with IEC/EN 60601-1.
• Electromagnetic emissions and immunity of the
combination must conform to IEC/EN 60601-1-2.
General precautions for installing an alternate off-board,
remote device or a network would include:
• The added device(s) must have appropriate safety
standard conformance and CE Marking.
• The added device(s) must be used for their intended
purpose having a compatible interface.
• Signal or mains isolation devices and additional protective
earth may be needed to assure compliance with IEC/EN
60601-1-1.
The connection of equipment or transmission networks other

than as specified in the user instructions can result in an electric
CAUTION shock hazard or equipment malfunction. Substitute or alternate
equipment and connections requires verification of compatibility
and conformity to IEC/EN 60601-1-1 by the installer. Equipment
modifications and possible resulting malfunctions and
electromagnetic interference are the responsibility of the owner.

R2424458-100 Rev. 2
Safety
Patient Environmental Devices
1. Rear Panel (numbers 12 through19 not used in figure)

2. Peripheral Devices Power 20. LCD
3. Ethernet network 21. LCD Folding Lever
4. Rear USB Ports 22. Up/Down & Left/right swivel release levers
5. Audio Output 23. Front USB Ports
6. DVI Video output 24. RS Probe Connectors
7. Power Line Circuit Breaker 25. LOGIQ Probe Connector (Vivid S6 only)
8. Ground Line 26. Non-imaging Pencil Probe Connector
9. Power Line (AC~) 27. ECG connector
10. DVD Drive
11. Hard-Copy Printer
Figure 1-2: Patient Environmental Devices

R2424458-100 Rev. 2
Safety
Acceptable devices
The Patient Environmental devices shown on the previous
page are specified to be suitable for use within the PATIENT
ENVIRONMENT.
DO NOT connect any probes or accessories without approval by
GE within the PATIENT ENVIRONMENT.
CAUTION
See "Peripheral Update for EC countries" on page 46 for more
information.
Unapproved devices
DO NOT use unapproved devices.
If devices are connected without the approval of GE, the warranty
CAUTION
will be INVALID.
Any device connected to the Vivid S5/Vivid S6 must conform to
one or more of the requirements listed below:
• IEC standard or equivalent standards appropriate to devices.
• The devices shall be connected to PROTECTIVE EARTH
(GROUND).
Accessories, options, and supplies

Unsafe operation or malfunction may result. Use only the
accessories, options and supplies approved or recommended in
CAUTION these instructions for use.

R2424458-100 Rev. 2
Safety
Environmental protection
System and battery disposal
the waste of electrical and electronic equipment must not be
disposed as unsorted municipal waste and must be collected
separately. Please contact an authorized representative of the
manufacturer for information concerning the decommissioning
of your equipment.
This product consists of devices that may contain mercury,

which must be recycled or disposed of in accordance with local,
state, or country laws. (Within this system, the backlight lamps
in the monitor display contain mercury.)

R2424458-100 Rev. 2
Getting started
Chapter 2
Getting started
• Introduction ................................................................................... .... 52

• Preparing the unit for use ............................................................ .... 53
• Site requirements ....................................................................... 53
• Connecting the unit .................................................................... 54
• Switching On/Off ........................................................................ 61
• Moving and transporting the unit ................................................ .... 64
• Wheels ....................................................................................... 64
• Moving the unit ........................................................................... 64
• Transporting the unit .................................................................. 66
• Reinstalling at a new location ..................................................... 67
• Unit acclimation time .................................................................. 68
• System description ....................................................................... .... 69
• System overview ........................................................................ 69
• Control panel .............................................................................. 71
• The Scanning screen ................................................................. 84
• Three-Pedal Footswitch operation ............................................. 87
• Connecting and disconnecting probes ....................................... 87
• Adjusting the Display Monitor ..................................................... 90
• Starting an examination ............................................................... .... 95
• Creating a new Patient record or starting an examination from an
existing patient record ................................................................ 95
• Selecting a Probe and an Application ...................................... 100

R2424458-100 Rev. 2
Getting started
Introduction
Only qualified physicians or ultrasound sonographers should
perform scans of patients for medical diagnostic reasons.
Request training, if needed.
Ensure that unauthorized personnel do not tamper with the
unit.
Service representatives authorized by GE Medical Systems will
unpack and install the unit. Do not attempt to install the unit
alone.
Never set liquids on the unit in order to avoid spillage into the
unit or the control panel. Maintain a clean environment. Turn off
the circuit breaker before cleaning the unit. Refer to "System
Care and Maintenance" on page 642 for cleaning instructions.
To carry out regular preventative maintenance refer to
Chapter 14, "User maintenance" on page 641.
All the warnings in "Important safety considerations" on

page 18, should be read and understood before operating the
WARNING unit.

R2424458-100 Rev. 2
Getting started
Preparing the unit for use

The Vivid S5/Vivid S6 ultrasound unit must operate within the
proper environment and in accordance with the requirements
described in this section. Before using the system, ensure that
the requirements are met.
Site requirements
Optimal operation of the unit can be obtained by implementing
the following requirements:
Power requirements
The Vivid S5/Vivid S6 ultrasound unit uses a separate power
outlet for 100 – 120 VAC or 240 VAC, 50–60 Hz.
Operating the unit with the wrong voltage range causes
damages, voiding the factory warranty.
WARNING
Operating Environment
Ensure that there is sufficient air flow around the
Vivid S5/Vivid S6 ultrasound unit when installed or operated.
Environmental requirements
The Vivid S5/Vivid S6 ultrasound unit requires constant
maintenance of its operational environment. Different
temperature and humidity requirements are specified for
operation, storage and transportation.
Table 2-1: Vivid S5/Vivid S6 temperature and humidity requirements
Requirement Temperature Humidity Air Pressure
Operational 10–40 °C 30–85% 700–1060 hPa
Storage -10–60 °C 30–70% 700–1060 hPa
Transport -10–60 °C 30–70% 700–1060 hPa

R2424458-100 Rev. 2
Getting started
Electromagnetic interferences
The Ensure that the unit is protected from electromagnetic
Vivid S5/Vivid S6 interferences as follows:
ultrasound unit is
approved for use in • Operate the unit at least 4.5 meters (fifteen feet) away from
hospitals, clinics equipment that emits strong electromagnetic radiation.
and other environ- • Shield the unit when operating it in the vicinity of radio
mentally qualified
broadcasting equipment, if necessary.
facilities, in terms of
the prevention of ra-
dio wave interfer- Connecting the unit
ence. Operation of
the unit in an inap- A GE-qualified person should perform the initial system
propriate environ- installation.
ment can cause
electronic interfer- Connecting the Vivid S5/Vivid S6 ultrasound unit involves
ence to radios and preliminary checks of the power adaptor unit and cord, voltage
television sets situ- level and compliance with electrical safety requirements.
ated near the medi-
cal equipment. Use only power supply cords, cables and plugs provided by or
designated by GE Medical Systems.
Ensure that the power cord and plug are intact and that the
power plug is the proper hospital-grade type (where required).
The unit should be connected to a fixed power socket which
has the protective grounding connector. Never use an
extension cord or adapter plug.
Failure to provide an adequate earth circuit can cause electrical
shock, resulting in serious injury.
WARNING
Connection of additional protective earth conductors or

potential equalization conductors is not necessary in most cases
WARNING and is only recommended for situations involving multiple
equipment in a high-risk patient environment to provide
assurance that all equipment is at the same potential and
operates within acceptable leakage current limits. An example of
a high-risk patient would be a special procedure where the
patient has an accessible conductive path to the heart such as
exposed cardiac pacing leads

R2424458-100 Rev. 2
Getting started
Voltage level check

Check the label near the circuit breaker on the rear side of the
system (Figure 2-1 or Figure 2-2).
Figure 2-1: Vivid S5 rating labels
Figure 2-2: Vivid S6 rating labels
Check the voltage range indicated on the label:

• 100–120 VAC, 50/60 Hz, 5 A
Or
• 230 VAC, 50/60 Hz, 2.5 A
If the mains supply is not within the specified range, do not

connect the unit to the power source. Contact the dealer to have
WARNING the unit adjusted to the specific mains supply.
Figure 2-3: Universal label

R2424458-100 Rev. 2
Getting started
Connecting to the electrical outlet

POWER OUTAGE MAY OCCUR. The Vivid S5/Vivid S6 requires a
dedicated single branch circuit. To avoid circuit overload and
WARNING possible loss of critical care equipment, make sure you DO NOT
have other equipment operating on the same circuit.
The unit’s power must be supplied from a separate, properly
rated outlet to avoid risk of fire. Refer to "Power requirements"
on page 53 for rating information.
The power cord should not, under any circumstances, be altered
to a configuration rated less than that specified for the current.
Do not use an extension cord or adapter plug.
1. Ensure that the wall outlet is of appropriate type, and that

the power switch is turned off.
2. Uncoil the power cable, allowing sufficient slack so that the
unit can be moved slightly.
3. Attach the power plug to the system and secure it in place
by using the retaining clamp.
4. Secure the power plug in the wall outlet.
a. Retaining clamp for power plug
Figure 2-4: Power plug
Ensure that the retaining clamp for the power plug is fixed firmly.
CAUTION

R2424458-100 Rev. 2
Getting started
Use caution to ensure that the power cable does not disconnect
during system use. If the system is accidentally unplugged, data
CAUTION may be lost.
To avoid risk of fire, the system power must be supplied from a

separate, properly rated outlet.
WARNING
Under no circumstances should the AC power plug be altered,
changed, or adapted to a configuration rated less than specified.
Never use an extension cord or adapter plug.
To help assure grounding reliability, connect to a "hospital

grade" or "hospital only" grounded power outlet.
1. 100-120 VAC, 1200 VA Plug and Outlet Configuration

2. 220-240 VAC, 1200 VA Plug and Outlet Configuration
Figure 2-5: Example Plug and Outlet Configurations
Battery
The System contains an internal battery (optional), which is not
user-accessible. The internal battery acts as a limited
alternative power source, which becomes active when the AC
power fails or AC cable is abruptly pulled out.
Display turns off and no scanning is possible while in battery
mode. For further information about use of the battery see
section "Battery Power Mode" on page 63.
The battery may Battery technology
only be disassem-
bled and re-assem-
The lithium ion technology used in the system’s battery is
bled by an significantly less hazardous to the environment than the lithium
authorized metal technology used in some other batteries (such as watch
field-service engi- batteries). Used batteries should not be placed with common
neer. household waste products. Contact local authorities for the
location of a chemical waste collection program nearest you.

R2424458-100 Rev. 2
Getting started
Viewing Current Battery Status

When the system is running, a status icon is displayed in the
system Status bar to indicate the current battery status.
Table 2-2: Battery status icons
Icon Status Description
AC Power is ON; no battery present
AC Power is ON; battery is fully charged (80%-100%)
AC Power is ON; battery is partially charged (40%-80%)
AC Power is ON; battery is almost empty (10%-40%)
Note: The % values mentioned above may fluctuate by up to +/- 3 %

points.
View Detailed Battery Status

In order to view further details about the battery status, click on
the battery-status icon. A more detailed status description
appears.
A special message may appear, suggestion to replace the
battery soon. This message may appear when the battery has
aged to such an extent that even after prolonged charging it will
not hold enough charge.
Peripherals/Accessory connection
The external Peripherals / accessories connectors are situated
on the rear side of the unit See Figure 2-6.
Refer to page 575 Peripherals/Accessory Connector Panel
for further informa-
tion on peripherals.
Vivid S5/Vivid S6 peripherals and accessories can be properly
connected using the rear connector panel.
Use only approved peripherals, accessories or probes.
DO NOT connect any accessories or probes without approval by GE
CAUTION

R2424458-100 Rev. 2
Getting started
1. Two isolated AC sockets for peripherals (Max. 250VA total)

2. LAN 10/100 Base-TX Ethernet network connector
3. Two interchangeable USB ports (digital printers or other peripherals)
4. Audio output
5. DVI video output connection to external display
Figure 2-6: Peripherals/Accessory Connector Panel
Accessory equipment connected to the analogue and digital

interfaces must be certified according to the respective IEC
WARNING standards (e.g. IEC 60950 for data processing equipment and
IEC 60601-1 (1988) for medical equipment). Any person
connecting additional equipment to the signal input part or
output part is configuring the medical system, and is therefore
responsible that the system complies with the requirements of
the system standard IEC 60601-1-1 (2000). If in doubt, consult the
technical service department or your local representative.
Do not touch the conducting parts of the USB or Ethernet cables
when connecting equipment to the unit.

R2424458-100 Rev. 2
Getting started
The connection of equipment or transmission networks other

than as specified in these instructions can result in electric
CAUTION shock hazard. Alternate connections will require verification of
compatibility and conformity to IEC/EN 60601-1-1 by the installer.
Table 2-3: Contents of the Rear Panel
Socket Signal type Device type Note
DVI-I Out DVI-I output high External monitor

resolution video
USB Universal serial USB Cable /

bus x2 Device
Ethernet 10/100 Base-TX Network device

Ethernet IEEE
8023
Network device

R2424458-100 Rev. 2
Getting started
Switching On/Off
To switch on the unit:
1. Switch on the circuit breaker on the rear of the unit (see
Figure 2-6).
2. Press (on/off button) on the top left of the control panel
(see Figure 2-11).
After initialization the default scanning screen (2D mode) is
displayed, the active probe being the one connected to the
left most connector socket.
When turning ON LEDs
a system while sys-
tem is in standby, it
There are two LEDs above the On/Off switch that indicate the
takes a few seconds status of the system.
before it responds.
Do not push the Indicates power status.
on/off button again
during this period After pressing the On/Standby switch, the system
(A second push will power is ON and this LED is lit.
initiate a full shut- Color: Green
down).
Indicates battery status.
When the battery is charged, the LED is green.
When the battery power is low, the LED is orange.
Color: Green and Orange
Password Protection
Log In
By factory Login During the turn-on process the system may require the user to
default, the Opera- enter a password in order to operate it. Personal IDs and
tor ID is USR and associated passwords can be configured in the
there is no need to
enter a password
Vivid S5/Vivid S6. See "Presets and System setup" on
page 583 for more information.
If IDs and passwords have been entered and "Use Auto Logon"
is Off (see "Users" on page 637 for details), the Operator Login
window appears, requesting for an ID and password when
Power up sequence is completed, or when it is required.

R2424458-100 Rev. 2
Getting started
1. Operator: Select the relevant Operator name

2. Password: Enter the Operator’s password
3. Emergency: Data stored for the duration of the current examination only
4. Log on: Select type of Log on (for example, Standard logon)
5. Cancel: Cancel Log on
Figure 2-7: Operator Login Window
Switching off the unit

When the Vivid S5/Vivid S6 is switched off, the system
performs an automatic shutdown sequence. The unit can be
switched off into one of three states.
• Full shutdown: the entire system is shut down. Full
shutdown is recommended if the system is not intended to
be used for a whole day or longer. It is recommended to
perform a full shutdown at least once a week. This will
prevent extreme memory fragmentation, which might cause
some computer slowdown.
• Standby mode: most of the system is powered down, but
a certain portion of the unit remains energized. The standby
mode allows a shorter reboot time when the system is used
on a daily basis or moved from one place to another.
• Battery mode: When AC power is interrupted, the screen
and keyboard are powered down. The rest of the system is
still powered ON. The fans are heard. When AC power is
resumed, the system will turn ON in less than 10 seconds
(see "Battery Power Mode" on page 63).

R2424458-100 Rev. 2
Getting started
Full shutdown
After switching off 1. Press (on/off button) on the top left of the control panel.
the system, wait at The Exit dialogue window is displayed.
least ten seconds be-
fore turning it on
again.
Figure 2-8: The Exit dialogue window
In case of total lock- 2. Select Shutdown.

up of the system, The shutdown process takes a few seconds and is
hold the on/off but- completed when the control panel illumination is turned off.
ton down a few sec-
onds to turn the
Booting up from Full Shut-down mode may take about 60
system off. seconds.
Standby mode
1. Press (on/off button) on the top left of the control panel.
The Exit dialogue window is displayed (Figure 2-8).
2. Select Standby.
The system enters Standby mode.
Booting up from Standby mode may take about 20
seconds.
Note: Whenever the system is fully shut down or put in
standby mode, the system will automatically perform "End
Exam" to save all data and images of the current patient
into the archiving system.
Turning on the system at the new location

1. Plug the AC cable into a proper power outlet.
2. Press (on/off button) (Figure 2-11).
Battery Power Mode
When the system is operating normally, if the AC power is
interrupted or the power cable is removed from the wall outlet
the screen and keyboard will turn off, but the rest of the system

R2424458-100 Rev. 2
Getting started
will continue to operate in "Battery Mode", powered by the

internal battery.
While in battery mode, if the AC power is restored within 10
minutes, the system will turn back on within less than 10
seconds.
While in Battery-power mode the system will maintain the
current patient active and not perform "End-Exam". As a result,
when power is restored, the current patient's details and stored
images are readily available on display.
If the AC power is not restored within 10 minutes, the system
will shut-down into Standby mode.
If AC is not restored, the system can remain in Standby mode
for approximately 1 hour using the internal battery power
(assuming battery is fully charged and relatively new). If left for
more than about 1 hour while in standby-mode without AC
power, the system will switch from Standby in to full Shut-down
mode.
Moving and transporting the unit

Wheels
The front wheels of the unit are controlled by the break-pedals
situated above each wheel.
The rear wheels of the unit are controlled by the swivel lock /
release pedals situated above each wheel (see item 10 in
Figure 2-11).
Examine the wheels frequently for defects to avoid breaking or
jamming.
Moving the unit

To prepare the unit to be moved
1. Turn system Off to Full shut-down or Standby mode.
2. Remove the AC plug from the power outlet.
3. Wrap the AC power cord to ensure cord is not hanging in
the wheel area or beyond the sides of the system.

R2424458-100 Rev. 2
Getting started
4. Pull the left handle and swivel the keyboard so it will lock in
its central position (see page 93).
5. Disconnect all external cables linking the unit to any
off-board peripheral devices and network. (Note the marks
on each cable to reconnect them later).
6. Place all probes securely in proper probe holders. Ensure
that the probe cables do not protrude from the side of the
unit or interfere with the wheels, or foot area. Hang the
cords on respective hooks provided, ensuring cords are
secure and out of lower portion of the system and do not
extend beyond the sides of system.
7. Ensure that no loose items are left on the unit.
8. If intending to travel over bumpy surface or if more visibility
is required during transportation, fold the LCD screen
forward to a horizontal position (see "Position Adjustment"
on page 92).
Before folding the LCD monitor, please make sure that the gel
bottle is placed with the dispenser tip down into gel holder or
CAUTION moved sideways in order not touch the monitor's faceplate.
9. Unlock the front-wheel’s brakes.

10. Lock the rear wheel brakes (Swivel Brake) for long travel or
free it for short distance traveling where maneuvering is
needed.
Once all cables and cords are wrapped and secure out of
the lower portion of the system, not extending beyond
sides of system, you are ready for transport.
To ensure safety while moving the unit

1. Ensure that the keyboard console is in central-locked
position.
Ensure that the hands of the patient are away from the console
when moving the system or keyboard console.
WARNING
2. Proceed cautiously when crossing door or elevator

thresholds. Grasp the front handle grips and push or pull or
use the rear handle bar for pushing the system. Do not
attempt to move the unit using cables or probe connectors.

R2424458-100 Rev. 2
Getting started
Take extra care while moving the unit on inclines. Do not

hang or lean body weight on the handles.
The rear handle should only be used for pushing the system, not
for pulling, The system might become unstable when hitting an
CAUTION obstacle while pulled with the rear handle.
3. Ensure that the unit does not strike the walls or door
frames.
4. Ensure the pathway is clear, and probe cables are secure
not to catch onto anything in the path (including wheels and
feet).
5. Move the unit slowly and carefully.
Avoid ramps that are steeper than 10 degrees.
CAUTION
Probe cables may get caught on external devices, such as doors,

medical devices in the transporting path, wheels, or feet. Please
WARNING ensure cords are wrapped properly, not extended beyond sides
of system and out of the way for portables.
Transporting the unit

Take extra care when transporting the unit by vehicle. In
addition to the moving precautions listed on page 64, follow the
procedure described below.
1. Disconnect all probes and secure them in their boxes.
2. Lower the system's keyboard to its minimum height.
3. Park the vehicle on a level surface for loading and
unloading.
4. Secure the unit while it is on the lift, to prevent rolling. Do
not attempt to hold it in place by hand. Cushion the unit and
strap the lower part so that it does not break loose.
5. Ensure that the unit is secured inside the vehicle. Secure it
with straps to prevent movement while in transit.
6. Drive cautiously to prevent vibration damage.

R2424458-100 Rev. 2
Getting started
Reinstalling at a new location

1. When the unit is in place at a new location, lock the wheel
brakes (see "Moving and transporting the unit" on page 64).
2. Follow the installation procedure described on "Connecting
the unit" on page 54.
Preparing Vivid S5/Vivid S6 for scanning

1. Lock front Wheel brakes
2. Un-Wrap the AC power cord and plug into power source.
3. Lift the LCD screen to the fully open position while pulling
out the lock. Secure the Monitor at full upright position.
4. Turn the system on.
5. Connect external cables if needed (LAN, USB, etc.).
6. Probe being used to scan should be ready, with cables
clear of foot area and wheels by wrapping un-used portion
of the cord on respective hooks provided.
7. Adjust keyboard's height and swivel (see page 93).
Note: Ensure that the probe cables do not protrude from the
unit or interfere with the wheels, or foot area. The Hanging
cords may cause damage to system if lodged or hooked onto
nearby items. By ensuring cords are secure and out of lower
portion of the system, this may provide a more secure
atmosphere and avoid unnecessary damage.
Avoiding possible hazards

• Avoid dragging cables on the floor. In cases where the
wheel rolls over cable or person pushing the system steps
on cables, it may generate severe force to break the cable
or the connector.
• Avoid hanging cables beyond sides of the system. When
system is moved, these cables may be caught in
door-knobs or other medical equipment and apply severe
forces that may break probe cables or connectors.
• Check that the Gel bottle is not interfering with the folding
screen. The gel bottle needs to be placed with dispenser tip
down into gel holder or moved sideways in order not to
push on the LCD frame (see Figure 2-9).

R2424458-100 Rev. 2
Getting started
Proper Gel bottle storage Improper Gel bottle storage
Figure 2-9: Proper Gel bottle storage
Unit acclimation time

Following transport the unit may be very cold or hot. Allow the
unit to acclimate before being switched on. Acclimation will
take one hour for each 2.5 oC increment when the unit’s
temperature is below 10 oC or above 40 oC.
oC 0 2.5 5 7.5 10 35 40 42.5

oF 32 36.5 41 45.5 50 95 104 108.5
Hours 4 3 2 1 0 0 2 3
oC 45 47.5 50 52.5 55 57.5 60
oF 113 117.5 122 126.5 131 135.5 140
Hours 4 5 6 7 8 9 10

R2424458-100 Rev. 2
Getting started
System description
System overview
Figure 2-10: Vivid S5/Vivid S6 System Overview
Note: Above figure is Vivid S6.

R2424458-100 Rev. 2
Getting started
1. LCD Display Monitor: Swivels to the left and right, tilts

backwards and forwards.
2. Display Monitor Spring-lock Release: Pull knob and fold
screen forward to a horizontal position. To unfold the
screen pull the same knob and lift the screen up.
3. Accessory tray (removable)
4. Rear Handle
5. Probe and gel holders: Removable for cleaning. Situated
on either side of the Control panel.
6. Up/down "Flex-Fit" arm
7. DVD Drive
8. Black and white video printer
9. Fans Service Cover
10. Rear Wheels: Swivel wheels. May be swivel-locked
11. Foot Rest (removable)
12. Front Wheels: Each wheel may be braked.
13. Control panel: Contains all the buttons, softkeys and the
alphanumeric keyboard used to operate the system.
14. USB Port
15. Probe cable hooks: Located on each side in the front and
rear of system
16. Front Handle
17. Console swivel operating handle: Situated on the right
side under the control panel
Console lifting operating handle: Situated on the left
side under the control panel
18. Probe ports: Three RS-type Probe sockets
19. Pencil probe socket
20. ECG connector socket: Also supporting the external ECG
input
21. Large probe socket: (Available on Vivid S6 only)
Supporting the TEE probes only
22. RS-Socket locking latch

R2424458-100 Rev. 2
Getting started
Control panel
The following pictures illustrate the layout of the
Vivid S5/Vivid S6 control panel. The buttons and controls are
grouped together for ease of use. A detailed description of the
buttons is provided on the following pages.
1. Power status LEDs and light-sensor 7. Speakers

2. On/off button 8. Softmenu 4-way Rocker
3. Softmenu keys and rotaries 9. Alphanumeric Function keys
4. Alphanumeric Keyboard 10. Speaker volume rotary
5. 2D-gain and active-gain rotaries 11. Scan-mode keys
6. TGC sliders 12. Trackball and related keys
13. Freeze keys
Figure 2-11: Vivid S5/Vivid S6 Control Panel
Note: Above figure is Vivid S6.

R2424458-100 Rev. 2
Getting started
Key illumination
The keys on the control panel are illuminated according to their
availability:
• Illumination in green: the key function is currently active.
• Illumination in white: the key function is available (but not
active) in the current state of the scanner.
• No illumination: The key is not available in the current
state of the scanner.
Power On/Off key
Key Description
Turns the unit ON and OFF.

Sets the unit to Standby.
Navigation keys
The following buttons on the top left of the control panel are
used for navigating different screens and packages on the
scanner. They are related to either pre or post-examination
operations. Each of these operations are described in more
detail in the following chapters.
Key Description
Displays the Archiving opening page. Enables

the user to perform the following functions:
• Create a new patient record
• Edit the current patient’s information
• Browse the Patient List to search for patient
records
• End the current examination
For further information, refer to page 95.
Displays the Select Probe and Application dialog

box that enables the users to select the desired
probe and application preset for the current
examination. For information about selecting
probes, refer to page 100 and page 535.

R2424458-100 Rev. 2
Getting started
Key Description
Enters Stress Echo mode (optional). The

Protocol screen is displayed showing the default
stress protocol for the current probe.
Displays the Measurement worksheet where the

user may edit or delete measurements, change
averaging etc. Refer to page 353 for details on
how to operate the worksheet.
Brings the scanner into the Image review mode,

that enables the user to select images from the
clipboard for analysis, activate the image
browser or enter the Image Review screen
where bigger previews of the images are shown
for image selection. Refer to page 426 for details
on the review of images.
Displays the examination report.

R2424458-100 Rev. 2
Getting started
Scan Mode Selection keys

The following keys are used to select the required scan mode,
and to select additional tools that enhance the application’s
capabilities. Refer to page 137 for detailed information about
scanning.
Note: The TVI button is blank on Vivid S5.
Note Key Description
Displays the 2D live acquisition mode that is the

default scanning screen for the unit. For further
information on 2D scanning, refer to page 140.
M-Mode can be Displays the M-Mode examination screen and

added from a enables M-Mode functions. Used for viewing motion
2D scan also in patterns. For further information, refer to page 150.
replay.
Displays the examination screen in Color Flow

Mapping mode. Used to display color-coded blood
flow information. For further information, refer to
page 157.
Displays the examination screen in Pulsed Wave

Doppler mode. Used for displaying the Doppler
spectrum of blood flow at a selected part of the
anatomy. For further information, refer to page 164.
CW mode is not Displays the examination screen in Continuous

available on all Wave Doppler mode. Allows examination of blood
scanning flow data all along the Doppler CW cursor. For
probes. further information, refer to page 164.
Displays the tissue velocity overlay on 2D and

M-Mode scans. If TVI is on, the Doppler modes
(PW/CW) will also be optimized for tissue velocity.
For further information, refer to page 169.
Note: TVI is optional on Vivid S5. The TVI button is
always installed even if option is not installed.

R2424458-100 Rev. 2
Getting started
Note Key Description
Depending on the options installed on the scanner,

this key will bring up the softkey menu for selection
of additional optional scanning modes, such as
AMM, TVI, DTI, TSI, SRI, SI, etc.
The Quantitative Analysis option will also appear (if
installed) as a softkey button named Q Analysis.
Note: Some functions are available only on
Vivid S6.
Basic Mode Parameter Adjustment Controls

The following controls are used to modify and adjust the unit’s
display to best suit the user’s requirements, such as color, gain,
zoom and image depth, according to the mode being operated
by the user.
Controls Description
Gain rotary Controls the total gain of the gray scale images
in 2D Mode.
ATO (Automatic tissue optimization) - while in 2D
press the rotary knob to optimize 2D image
automatically.
Active mode Controls the total gain of other activated modes,

rotary such as, M-Mode, Color, PW, or CW Doppler
modes.
In combined mode, switches between the mode
specific assignable controls without having to
exit each mode in order to control it.
TGC Six sliding keys that compensate for

depth-related attenuation in an image. The upper
slider corresponds to the smallest depth.

R2424458-100 Rev. 2
Getting started
Controls Description
Depth Controls the displayed depth of tissue scan. Has

no effect in replay.
Toggles the cursor display on/off in 2D scanning

mode.
Changes the Doppler unltrasound beam angle

on linear probes. The steering angles are fixed
for each linear probe. This key has no effect with
sector imaging probes.
Zoom Controls image magnification. Press to activate

"HR-Zoom" mode. Rotate clockwise to activate
"Display-zoom" mode and increase zoom factor.
Rotate counterclockwise to decrease and turn off
zoom (see "Zoom" on page 120).
Auto While in 2D it activates ATO - Automatic Tissue

Optimization to optimize 2D image automatically
(see page 144).
While in CW or PW Doppler it activates ASO -
Automatic Spectrum Optimization to optimize the
Doppler spectrum.
Flex This button can be configured to function as any

button on the keyboard (see page 590).
Note: with the exception of alphanumeric and
soft-menu sections.

R2424458-100 Rev. 2
Getting started
Freeze keys
The freeze keys are used to freeze images and cine loops in all
modes for on-line analysis.
Key Description
Stops or restarts all data acquisition. When scan

is frozen, the Trackball can be used to scroll
through the cine loop.
Activates or freezes 2D mode. In simultaneous

mode, pressing 2D FREEZE will activate or
deactivate the 2D image, leaving the other mode
display unchanged. In freeze mode, stops/starts
the cineloop.
Display Format Key
Key Description
Toggles the display priority of 2D-Mode or

Doppler/M-Mode and top/bottom or side by side
display when working in combined mode.
Enables multiple image display windows in

which two or four images can be viewed
simultaneously. When reducing the number of
images, the active window will always been kept.
Toggles the active window in multiple imaging

mode. The active window is indicated by a
highlighted frame. All imaging controls are
normally applied only to the active window.
Same arrows are used while reviewing images
from clipboard, the active frame may be stepped
forward or backwards to review the next or
previous image.

R2424458-100 Rev. 2
Getting started
Store Button
Key Description
Store Stores the currently active imaging window to

disk. The stored information depends on the
configuration of the current application.
Stored images are shown on the clipboard.
Measurement controls
The following keys are used to take measurements and
perform calculations.
Key Description
Activates the Measurement & Analysis (M&A)

calculation program. This program is context
sensitive and will display relevant measurements
to the current mode and application. See
page 243 for further details on M&A.
Activates measurement tools (unassigned

measurement). See page 243 for further details
on M&A.
Print and Record Control
Key Description
Record When the DVR option is installed and DVR

media has been mounted, the Record button will
activate or pause the real-time recording of the
displayed image (See page 578 for details)
Note: This button is available even if the DVR
option is not installed.
P1 Prints the current imaging screen content to a

selected (configurable) printer. For more
information about printing (see page 577). The
PRINT key can also be configured for alternative
storing of images (see page 623).

R2424458-100 Rev. 2
Getting started
Key Description
P2 Prints the current imaging screen content to a

printer assigned to a second port (configurable).
The default factory configuration is set to
"Secondary Capture". For more information see
page 623.
Trackball operation
The Trackball area consists of the trackball and five
surrounding keys. Three of these have the very same function
(the SET function) for ergonomic reasons.
Key Description
Trackball Used for navigation and together with the

surrounding keys, to move, select or activate
objects on the screen.
Trackball Controls the trackball assignments between the

Button mode-specific options. By pressing TRACKBALL,
the trackball function will cycle through the
possible assignments, which are indicated in the
lower right corner of the screen (see page 108).
Set Depending on the situation (see Figure 3-3,

page 109):
• Performs the selected control or highlighted
menu item.
• Toggles between the Trackball functions within
the active group.
The key is duplicated for ergonomic reasons.

R2424458-100 Rev. 2
Getting started
Key Description
Update/Menu In Freeze, activates menu with additional options

and controls not available from the assignable
keys.
In live mode, toggles between 2D imaging and
live time-motion imaging (Doppler/M-Mode).
Assignable keys and rotary knobs (soft keys)

The functions of the assignable keys and rotaries vary
according to the mode and/or module in which the user is
working.
Key Description
Soft Rotaries Four assignable rotary knobs, whose

mode-specific functions vary according to the
scan mode and position that is currently active.
These assignable rotaries are used both as
rotary-control knobs and as on/off toggles for
different controls on the menu The assigned
functions are indicated above the rotary on the
LCD display. The mode-specific functions for
these rotary knobs are described in Chapter 4,
"Scanning Modes" on page 137.
Assignable Four assignable buttons, whose mode-specific

Buttons functions vary according to the scan mode and
position that is currently active. These
assignable buttons are used as on/off toggles for
different controls on the menu. The assigned
functions are indicated above the button on the
LCD display. The mode-specific functions for
these buttons are described in Chapter 4,
"Scanning Modes" on page 137.

R2424458-100 Rev. 2
Getting started
The soft menu rocker
Key Description
Soft Menu A 4-way rocker used to access mode-specific

Rocker menus, select a menu option and adjust
option-related values.
• The vertical arrows are used to select the menu
options.
• The horizontal arrows are used to adjust the
values.
The mode-specific menus are described in
Chapter 4, "Scanning Modes" on page 137.
The Alphanumeric Function keys
Key Description
Help Displays the on-line version of the user manual.
Config/Diag Displays the configuration dialog box, allowing

user configuration of various settings on the
scanner.
Diagnostics of the system is activated by
pressing Shift > CONFIG.
LCD To activate LCD adjustments controlled by

softkeys.
Biopsy Displays the biopsy path marker.
Bodymark Displays the available body marks for the current

application.
Page Erase Erases all previously-typed annotations (and

body marks).

R2424458-100 Rev. 2
Getting started
Key Description
Physio Provides access to controls for ECG trace. The

ECG controls appear on the soft-menu.
Arrow Displays an arrow that can be used to point at a

specific structure in the image.
Text Enables text annotation to be inserted on the

image. The annotations can be typed or selected
from a (configurable) menu.
Playback For future use
Delete Can be used to delete text during text

annotation.
List of shortcuts on alphanumeric keyboard
Key Description
Alt+E Allows to eject a device like MOD, CD or memory

card.
Alt+L Allows to adjust intensity of keyboard backlight.
Alt+P Allows to view and control printer spooler.
Alt+S Allows to view and control DICOM spooler. (see

"DICOM spooler" on page 479) The DICOM
spooler is used for checking the current job's
status when a job is saved or when the total
spooler status on the right of the Archive
windows displays an error.
Alt+D Allows to comment and save logfiles for

diagnostics (see Chapter 14, "Adding Problem
description" on page 646).
Alt+B Allows to insert a "bookmark" into the system

failure log ("Adding bookmarks" on page 646)
Shift+Config Allows to run various diagnostics.

R2424458-100 Rev. 2
Getting started
Key Description
Fn (function) Allows to view clipboard images sequentially

key + PgUp or forward or backwards.
PgDn
Alt + F1 Activates the “Front-panel Simulator” for the use

of system-diagnostics. Do not activate this
function. It is to be used only by a service
representative.

R2424458-100 Rev. 2
Getting started
The Scanning screen
1. Current patient ID data 16. Watermark area for screen calibration

2. Date & time of original image 17. Soft menu control button
3. Institution 18. Tracknall assignment
4. Operator ID 19. Rotary soft-menu control
5. Application & Temperature indicator for TEE 20. Soft menu toggle button
probe 21. Clipboard image number
6. Probe 22. Loop icon
7. Mechanical & Thermal Index 23. Service and iLinq, Caps on/off
8. Current date & time DVR (option) status and 24. Clipboard
counter indicators
25. ECG trace and Heart-rate
9. Heart rate
26. Depth scale
10. Parameter window - all modes
27. Focus marker
11. Greyscale/Color bar
28. TEE Scan plane indicator
12. Soft menu window
29. Probe orientation marker
13. Clipboard navigator
30. Measurement result table (measurement mode)
14. Cine progress bar
31. Logo
15. Current menu name
Figure 2-12: The scanning screen

R2424458-100 Rev. 2
Getting started
The scanning screen is divided in several areas as follows:
The title bar

From the left:
The patient infor- Patient Information
mation displayed on
the Title bar is con-
Displays the information that uniquely identifies the patient,
figurable (see such as patient name, identification number and birth date.
page 592). This information is entered in the New patient window, as
described on page 95.
Institution name
The institution name is entered from the configuration package.
See page 633 for more detailed information.
Operator ID
Identification code of the operator. See page 637 for creating
operator ID’s.
Date and time
Displays the current date and time or for a retrieved image, the
date and time at which it was stored.
Probe and Application
Displays the currently selected probe and application or for
retrieved image the probe and application that were used. See
page 100 and page 548 for further information on how to select
probe and application.
Live scanning related information
Displays, if available, the current values for
• Mechanical Index (MI), for the current active image
• Thermal Index (TI), for the current active image
• Probe temperature (for TE probe)
• Heart rate (HR)
DVR Status and counter indicators
Displays the DVR counter as it changes in real time, and a
status icon, which indicates the current operating status of the
DVR.

R2424458-100 Rev. 2
Getting started
Archive Information
Displays the currently selected patient and image archives.
Parameters window
Displays scan mode or application specific parameters. In
scanning mode the parameters for the active mode are
highlighted. This window also displays zoom information,
stress template, and image groups in image browser.
Soft menu window

Displays the mode specific controls operated from the 4-way
rocker on the control panel. The mode-specific menus are
described in Chapter 4, "Scanning Modes" on page 137. For
operating procedure of the 4-way rocker see page 107.
Clipboard
Displays the thumbnail images representing the acquired data
during the current examination.
The status bar

Consists of four information fields as follows:
Service "Insite Express Connection" (ExC) icon
Enable access to the GE Healthcare on-line service center.
Connectivity status icon
Displays the network status: Connected or disconnected.
Prompt/status field
Displays system messages or prompts the user for actions.
Trackball assignments fields
Displays the available assignments of the trackball. The current
assignment is highlighted.
The acquisition window

Displays the ultrasound image with relevant indicators such as
depth, focus, probe orientation marker, physiological traces etc.

R2424458-100 Rev. 2
Getting started
Three-Pedal Footswitch operation

The footswitch is used to free the hands of common key
operations, such as select keys, video recording, etc. The three
switches have different function assignments depending on the
current application (see page 593).
The standard footswitch is not for use in the operating room.
WARNING
To connect the footswitch

• Connect the footswitch to the USB input on the External
connector (see Figure 2-6, page 59).
Connecting and disconnecting probes

The connector panel situated in the front of the Vivid S6 has
three imaging probe ports type RS, one imaging probe port
type OR, and one pencil probe port.
The connector panel situated in the front of the Vivid S5 has

three imaging probe ports type RS and one pencil probe port.
Handle the probes gently while connecting and disconnecting.
CAUTION
Do NOT touch the patient and any of the connectors on the

ultrasound unit simultaneously, including ultrasound probe
WARNING connectors.
To connect a probe (Small connector - type

RS)
1. Hold the probe connector vertically with the cable pointing
upward.
2. Push the connector locking handle to the right-most
position.
3. Align the connector with the probe port and carefully push
into place.
4. Push the connector locking handle to the left-most position.

R2424458-100 Rev. 2
Getting started
5. Position the probe cable so that it is not resting on the floor.

Take the following precautions with the probe cables:
• Keep free from the wheels.
CAUTION • Do not bend the cables
• Do not cross cables between probes
Figure 2-13: RS Probe Connection Locking Lever
Fault conditions can result in electric shock hazard. Do not touch

the surface of probe connectors which are exposed when the
CAUTION probe is removed. Do not touch the patient when connecting or
disconnection a probe.
To connect a probe (Large connector - type

OR)
upward.
2. Turn the connector locking handle to the horizontal
position.
into place.
4. Rotate the locking handle to the full vertical position to lock
in place.
Cable Handling
Take the following precaution with probe cables:
• Do not bend the cable acutely.

R2424458-100 Rev. 2
Getting started
Deactivating the Probe

Press the FREEZE key to deactivate the probe. When
deactivating the probe, the probe is automatically placed in
Standby mode.
Disconnecting the Probe

Probes can be disconnected at any time. It is recommended
that the probe should not be active when being disconnected.
To disconnect a probe (Small connector - type RS):
1. Freeze the image by pressing FREEZE.
2. Press the connector locking lever towards the left to unlock
the connector.
3. Pull the probe and connector straight out of the probe port.
4. Carefully slide the probe and connector away form the
probe port and around the right side of the keyboard.
5. Ensure the cable is free.
6. Be sure that the probe head is clean before placing the
probe in its storage case.
To disconnect a probe (Large connector - type OR):
1. Rotate the lock handle counter-clockwise to the horizontal
position to unlock the connector.
2. Pull the connector straight out of the probe port.
Transporting Probes
When transporting a probe a long distance, store it in its
carrying case.
Storing Probes
It is recommended that all probes be stored in the carrying
case provided.
• First place the probe connector into the carrying case
• Carefully wind the cable into the carrying case.
• Carefully place the probe head into the carrying case.
DO NOT use excessive force or impact the probe face.

R2424458-100 Rev. 2
Getting started
Adjusting the Display Monitor

Image Adjustment
Adjusting the monitor's contrast and brightness is one of the
most important factors for proper image quality. If these
controls are set incorrectly, the Gain, TGC, Dynamic Range
and even Power Output may have to be changed more often
than necessary to compensate.
On Vivid S6 it is recommended to activate the automatic
screen-adjustment feature for best results. When the screen
auto-adjustment is not active, the LCD screen controls may
need periodic adjustment due to changes in ambient light. On
the bottom right corner of the screen you should be able to see
a faint dark, yet visible, letter V which is called "Watermark"
(see Figure 2-12, item 22). If the watermark is not visible it is
because the screen is adjusted too dark relative to the
surrounding bright ambient light conditions. In this situation the
screen brightness should be adjusted.
Note: For best results make sure the watermark is always
visible.
Using LCD adjustment Soft menu Controls
When pressing the LCD button on the alphanumeric keyboard,
a special soft-key menu will appear. This menu contains
various screen controls which allow the user to optimize the
screen setting.
Note: On the LCD monitor, the brightness adjustment comes
before contrast.
Brightness Rotary
This is the main control to adjust screen brightness to
compensate for different ambient light.
When soft-rotary is rotated the brightness adjustment tool
appears at bottom of screen, as shown in Figure 2-14.
Figure 2-14: Brightness control

R2424458-100 Rev. 2
Getting started
In a totally dark room it is recommended to set brightness down

all the way (all rectangles are empty).
Make sure the wa- When ambient light becomes brighter and watermark becomes
termark is visible at less visible, increase the brightness till watermark is visible
all time. again.
Contrast Rotary
This control is used to adjust screen contrast.
When soft-rotary is rotated the Contrast adjustment tool
Figure 2-15: Contrast control
Make sure the wa- In a totally dark room it is recommended to lower the contrast
termark is visible at somewhat. In a well-lit or semi-lit room it is recommended to
all time. set contrast to its maximal setting.
Blue Tint Rotary
This control is used to adjust blue-tint or color-temperature of
the white colors.
When soft-rotary is rotated the Blue-tint adjustment tool
Figure 2-16: Blue tint control
This may be adjusted to suite your preference.

External screen button
Activate this button when connecting the system to an external
display. It will allow you to optimize Contrast / Brightness and
blue-tint to suit the particular external display.
When the button is de-activated, the previous settings that
were optimized for the internal display will be restored.

R2424458-100 Rev. 2
Getting started
Test pattern
When adjusting an external display or any peripheral hard-copy
device, you may turn this function ON to generate a
screen-calibration pattern.
Using Automatic Brightness adjustment
On Vivid S6 it is possible to set up the Automatic screen
adjust feature. This will attempt to maintain a well-adjusted
screen under all ambient light conditions by using a special
built-in light-sensor.
Auto-sensor button
In case Brightness When this button is turned ON, the system will monitor and
setting is re-adjust- automatically adjust screen's brightness when ambient light
ed manually the conditions have changed.
Auto sensor feature
will be turned off. It is recommended to leave the Auto-Sensor ON by default for
the duration of the system's operation.
Auto Adjust button
When this button is depressed the system will perform a
one-time screen adjustment, based on the current ambient
light.
Position Adjustment
The monitor position can be adjusted for easy viewing.
• The monitor can be rotated around its central pivot point.
• The monitor can be tilted for the optimum viewing angle.
• The monitor can be flipped forward to a horizontal position
for screen-protection, improved visibility and reduced
height while moving or transporting the system.
Do NOT place objects on the monitor.
CAUTION
To swivel the LCD monitor

Grab the left and right sides of the LCD monitor frame and
swivel the monitor to the desired position.

R2424458-100 Rev. 2
Getting started
To tilt the LCD monitor

Grab the top side of the LCD monitor frame and pull or push to
tilt the monitor to the desired position.
To reduce system's height, or if more visibility is required during
transportation, fold the LCD monitor forward to a horizontal
position, it will lock horizontally in place.
To fold the LCD monitor Horizontally
Pull out the spring-loaded locking knob to release the display's
locking mechanism (see Figure 2-17), pull and lower the
display towards you. When fully horizontal release the knob.
To unfold the LCD monitor
Lift the display and pivot it to a vertical position. Adjust the tilt of
the display to the desired position.
Before folding the LCD monitor, please make sure that the gel
bottle is placed with the dispenser tip down into gel holder or
CAUTION moved sideways in order not touch the monitor's faceplate.
Figure 2-17: Monitor position adjustment
Control Panel adjustment

The system Control panel can be freely adjusted to swivel or
move up/down. There are two brake handles located under the
control panel.

R2424458-100 Rev. 2
Getting started
To swivel the control panel left or right

1. Pull and hold the left brake handle, located under the
control panel.
The control panel can now be freely rotated left or right.
2. When reaching the desired swivel angle, release the
swivel-brake handle.
The control panel will remain at the set angle.
Note: The LCD monitor will swivel together with the
control-panel. In addition the LCD may be swiveled
independently of the control-panel.
To move the control panel up or down
1. Pull and hold the right-hand handle, located under the
control panel.
The control panel can now be freely adjusted up or down.
2. When reaching the desired height, release the
height-adjust handle.
The control panel will remain at the set height.
Note: When the control panel is lowered it moves towards the
operator. When panel is raised it also moves away from the
operator.
Note: When preparing the system to be moved, pull the left
handle and bring the control panel to a center position. Swivel it
slightly till a locking click is heard.

R2424458-100 Rev. 2
Getting started
Starting an examination
Beginning an exam consists of three steps:
• Creating a new patient record or starting a new examination
from an existing patient record (see below)
• Selecting Probe and Application (see page 100)
• Start scanning (see page 100)
Creating a new Patient record or

starting an examination from an
existing patient record
Starting an examination
1. Press PATIENT.
The Patient Handling screen is displayed.
Figure 2-18: The Patient Handling Screen
2. Press CREATE NEW PATIENT.

To create an opera- If the unit is password protected a Log In window will
tor ID, see appear asking for operator ID and password (as explained
page 637. in Figure 2-19).
Note: In case the password is not known, press
Emergency. This allows you to scan with the system,
without accessing long-term archiving of the exam.

R2424458-100 Rev. 2
Getting started
1. Data stored only for

the duration of the
current examination
2. Select the operator
Figure 2-19: The Operator login window
3. Press Log on when completed.

The Search/Create Patient window is displayed (see
Figure 2-20).
4. Type the patient Last Name, and/or ID.
Do NOT use '\' or '^' in patient information fields, as these
characters might cause problems with some DICOM devices.
CAUTION
The unit can be con- When default configured, the system automatically
figured to automati- searches to see if the patient is already in the database.
cally generate a The result of this search is displayed in the Patient List
patient ID (see
page 626).
field.
If the Patient name is on the patient record list:
To restrain the • Trackball to the actual patient and double-click the
search to special Trackball SET key (or press SET once and then Select
category of patient patient).
record, press More
and use the search- The unit is ready for scanning or the Patient information
ing filters. window is displayed (Figure 2-21) depending on system
configuration (see page 626).
If the Patient name is not on the patient record list:
The automatic • Press Create Patient.
search tool display-
The unit is ready for scanning or the Patient information
ing matching pa-
tient information in window is displayed (Figure 2-21) depending on system
the Patient list can configuration (see page 626).
be turned off (see
page 626). If the unit is configured to display the Patient information
window, follow the steps below:
1. Enter additional patient information if required.

R2424458-100 Rev. 2
Getting started
Select between cardiac, vascular etc. to enter application

specific patient info (Displayed when the button More is
depressed, see Figure 2-21.).
Press EXAM. LIST to 2. Press Begin exam or any active scanning key to start the
display the previous examination.
examinations and In the scanning screen, the patient information is displayed
diagnosis informa-
tion for the selected
on the left side of the Title bar (see Figure 2-22).
patient. Enter addi-
tional patient infor-
mation if required.
1. Press one of the headings to sort the list 4. Dataflow menu

accordingly. 5. Advanced search tool: The system can be
2. Select the column heading border and drag to configured to display the Advanced search tool
adjust column width. as default (see page 629).
3. Expended Patient record displaying belonging
examinations.
Figure 2-20: The Search/Create Patient window

R2424458-100 Rev. 2
Getting started
1. The date format is configurable (see page 633). 3. The Address field is configurable (see
2. The window can be configured to display the page 626).
expanded patient info as default (see page 626). 4. Select patient information category.
Figure 2-21: The Patient Information window
1. The patient information on the scanning screen is configurable (see page 590).
Figure 2-22: The Patient information on the scanning screen

R2424458-100 Rev. 2
Getting started
Using other ID
The Vivid S5/Vivid S6 system supports an additional field for
Patient ID number referred to as "Other Patient ID". This is an
optional data field and may be accessed via the Patient List
screen and clicking the "More" button. The rules applicable to
the "Patient ID" data and the "Patient ID" filter also apply to the
"Other Patient ID" field.
The "Other Patient ID" field is part of the DICOM protocol and if
used, will appear on the patient demographic data viewed on
DICOM viewers.
Ending an Examination
1. Press PATIENT.
The Patient Handling screen is displayed.
2. Select End Exam on the Patient Handling Screen
(Figure 2-18).
If the images on the clipboard were not previously stored a
prompt window is displayed where the user can choose to
store all, none or a selection of the images saved to the
clipboard.
3. Select:
• All: to store all images and end the exam
• None: to end the exam without storing any images
• Select: to select the images to store from the Review
screen and end the exam.
Connectivity on the Vivid S5/Vivid S6

ultrasound unit
Refer to page 431 The connectivity on the Vivid S5/Vivid S6 Ultrasound unit is
for further informa- based on the Dataflow concept. A Dataflow is a set of
tion on connectivity pre-configured services (e.g. DICOM services like storage,
setup.
worklist, verify etc. or other service types like video print,
standard print or messaging). When starting an examination,
the user selects a pre-configured Dataflow that will
automatically customize the ultrasound unit to work according
to the services associated to the Dataflow.

R2424458-100 Rev. 2
Getting started
Selecting a Probe and an Application

The combination Probes and their related applications are selected from the
Probe-Application Probes and applications pop-up menus as described below.
may be user-de- Only probes currently connected are displayed in the pop-up
fined. See page 593
for information on
menu. Only applications appropriate for the type of probe
probe/application selected are shown.
configuration.
To select a probe and an application
1. Press PROBE on the control panel.
A list of the connected probes is displayed.
2. Trackball to the desired probe.
3. Press SET.
An Application menu for the selected probe is displayed.
4. Trackball to the desired application.
To select a probe 5. Press SET to launch the application.
with the default ap-
plication, press SET
twice on the actual
probe.
Make sure that the probe and application names displayed on the
screen correspond to the actual probe and application selection.
CAUTION
Check that the correct TI category is displayed (see Chapter 1,
"Thermal Index" on page 26). TIB must be displayed when a fetal
application is selected.

R2424458-100 Rev. 2
Chapter 3
This chapter describes basic operations related to scanning.
Some operations described in this chapter are fully described
in the respective chapters throughout the manual.
This chapter includes the following information:
• Assignable keys and Soft Menu Rocker ..................................... .. 103

• Using the Assignable Keys Soft Menu ..................................... 104
• Using the Soft Menu Rocker .................................................... 107
• Trackball operation ....................................................................... .. 108
• Trackball assignment ............................................................... 108
• The system menu ..................................................................... 109
• Cineloop operation ....................................................................... .. 110
• Cineloop overview .................................................................... 110
• Cineloop controls ..................................................................... 111
• Using cineloop .......................................................................... 112
• Storing images and cineloops ..................................................... .. 113
• To store a single image ............................................................ 113
• To store a cineloop ................................................................... 113
• Removable Media .......................................................................... .. 114
• Intended use ............................................................................ 114
• Supported removable media .................................................... 115
• Zoom .............................................................................................. .. 120
• To Magnify an image (Display zoom) ....................................... 120
• Performing measurements .......................................................... .. 121
• To perform measurements ....................................................... 121
• Physiological trace ....................................................................... .. 122
• Connecting the internal ECG ................................................... 122
• Physio controls ......................................................................... 126
• Displaying the ECG trace ......................................................... 126

R2424458-100 Rev. 2
• Adjusting the display of the ECG trace ..................................... 126

• Annotations ................................................................................... ... 128
• To insert an annotation .............................................................128
• To edit annotation ..................................................................... 131
• To erase annotation .................................................................. 131
• Configuration of the pre-defined annotation list ........................ 132
• Bodymarks ................................................................................ 134

R2424458-100 Rev. 2
Assignable keys and Soft Menu Rocker
1. Active mode & status

2. Filling gauge (progress bar)
3. Selected control shows highlighted
frame
4. Cine-buffer control gauge
Figure 3-1: A: the 4-Way Rocker; B: Soft Menu; C: the assignable

keys on the control panel.
To toggle between The function of the assignable keys and the controls assigned
modes in combined to the soft menu vary according to the mode in which the
mode, press ACTIVE system is running. A detailed description of each function is
MODE.
provided with each scanning mode in the following imaging
mode sections. In combined modes (i.e. combined Color flow
and PW Doppler), one mode is active (live) while the other is
frozen. In this case, the assignable keys and rotary knobs
controls parameters associated with the active mode.
Switching the active mode will change the key and rotary
assignments accordingly.

R2424458-100 Rev. 2
Using the Assignable Keys Soft Menu

The bottom of the display screen contains a graphics area of
soft-menu with assignable keys and rotaries. This area of the
screen is designed to match a parallel set of physical buttons
(the assignable keys and rotaries [refer to Figure 3-1]), located
on the upper portion of the control panel. An example of a
soft-menu is shown in below.
Figure 3-2: The Assignable Keys and Soft Menu
The soft-menu provides access and user control of different

system parameters.
The contents of the soft-menu is different for every system
mode. This provides access to the relevant settings in each of
the different modes.
There are several different control key elements in the
soft-menu area, as follows:
Variable Single parameter rotary knob
In this example, the “Baseline” parameter can be increased by

rotating the corresponding rotary knob clockwise. The same
parameter can be decreased by rotating the same rotary knob
counterclockwise. Upon rotating the knob the arch on the
graphics changes its length to reflect the change in the value of
the controlled parameter.

R2424458-100 Rev. 2
An alternative method for modifying the parameter associated

with this button is to click with the mouse pointer on the
relevant side of the rotary graphics on screen.
Variable Dual parameter button
In this example the rotary knob has access to either “Frame

Rate” or “Low Vel. Reject” parameters.
When the “Frame Rate” upper label is highlighted, the
parameter “Frame Rate” can be increased by turning the
rotary clockwise and decreased by turning the rotary
counterclockwise.
When pressing the rotary knob, the bottom label (“Low vel.
Reject” in this example) will be highlighted. In this case, from
now on, turning the assignable rotary knob will either increase
or decrease respectively the value of the lower (highlighted)
parameter.
At this point, pressing the rotary knob will, again, associate the
rotary with the upper labeled parameter.
An alternative method for modifying one of the parameters
associated with this rotary is to click with the mouse pointer on
the relevant side of the assignable rotary graphic.
On/Off Toggle button
In this example the active green indicator indicates that the

“Simultan.” setting is set ON.

R2424458-100 Rev. 2
The user can press the matching upper button to toggle the
“Simultan.” function ON or OFF.
The lower button functions slightly differently, it has no green
indicator.
The button indicates "Left / Right" control. The light-colored font
changes location upon each button press, indicating if "left" or
"right" status is currently active.
Alternatively, the user can click with the mouse pointer on the
relevant button graphic instead of pressing the actual button.
Soft Menu rocker button
The circular button on the bottom-right area of the screen acts

as a soft-menu rocker button. It has access to a different type
of soft-menu which pops up on the right portion of the screen.

R2424458-100 Rev. 2
Using the Soft Menu Rocker

The Soft menu Rocker on the control panel enables the
adjustment of controls mapped in the Soft menu Window (see
Figure 3-1).
The first row of the soft menu indicates the name of the active
mode and its status (freeze/live). The following rows list the
mode-specific controls.
The relative setting of each control is indicated by a gauge bar
filling the cell as the control value increases. The number
appearing on each of the gauge bars indicates the value
associated with the relevant control.
To select a control from the menu

1. Press any part of the 4-way rocker to display the soft menu.
2. Press the vertical arrows on the 4-way Rocker to navigate
up or down through the menu.
The frame of the selected row is highlighted.
To adjust values
Note: when soft • Press one of the horizontal arrows on the 4-way Rocker to
menu is not access- adjust the setting of the selected control.
ed for a defined peri-
od of time it will - Right arrow increases control setting.
time-out and disap- - Left arrow decreases control setting.
pear from the dis-
play. (See page 633
for information on
how to configure
timeout).

R2424458-100 Rev. 2
Trackball operation
Different functions can be assigned to the trackball depending
on the current active mode. The trackball functions are
organized in functional groups. The trackball functional groups
are displayed in the lower right corner of the screen. Each
group can have one or more controls that can be selected
using the keys on the trackball area as described below.
The trackball area consists of:
• The trackball: used as a cursor control in acquisition mode,
scrolling control in freeze mode and as a selecting tool (like
a mouse cursor) in post-processing mode.
• Three SET keys (identical): depending on the situation,
the SET keys toggle between the trackball functions within
the active functional group or perform the selected control
or highlighted menu item.
• The TRACKBALL key: toggles between the trackball
functional groups.
• The UPDATE MENU key: enables quick access to various
functions form a pop-up menu (see Figure 3-3).
Trackball assignment
The trackball has a multi-mode function. The functions
available from the trackball are mode dependent. The available
trackball functions for the active mode are displayed on the
right side of the Status line (Figure 3-3).
To change trackball assignment

• Press TRACKBALL in the Trackball area until the desired
function is selected highlighted.

R2424458-100 Rev. 2
The system menu

The system menu enables a quick access to image related
functions (see Figure 3-3).
1. Trackball key: select trackball assignment from the functions available in the Status line.
2. Set key: perform the selected control or highlighted menu item
3. Update Menu key: select the operation to perform from the pop-up System menu.
(Menu contents may change. Figure shows a typical menu)
Figure 3-3: The Trackball area

R2424458-100 Rev. 2
Cineloop operation
When no ECG is When the scan mode is frozen, the unit automatically displays
connected, a cine cineloop boundary markers on either side of the last detected
gauge is displayed heart cycles. The cineloop boundaries can be adjusted using
indicating the cur-
rent frame. in the
the cineloop assignable controls to cover one or more heart
cineloop. cycles.
Cineloop overview
1. ECG 4. Right marker

2. Left marker 5. Heart rate or Cine speed (in replay)
3. Current frame 6. Cine frame number values
Figure 3-4: The cineloop controls display

R2424458-100 Rev. 2
Cineloop controls
Cineloop assignable controls
Left / Right Marker
Move the left and right markers to expand or trim the cineloop
boundaries.
Cycle select
Selects the heart cycle to be played back.
Number of cycle
Controls the number of heart cycles to be included in the loop.
Select All
Select all heart cycles.
First cycle / Last cycle
Selects the first or last heart cycle to be played back.
Cineloop
Starts cineloop acquisition.
Cineloop Freeze Control
2D Freeze
Toggles between replay and freeze modes.
Cineloop trackball controls
Scroll
When the scan mode is frozen, trackball to move the current
marker and review the images
Cine speed
In cine replay mode, move the trackball left or right to adjust the
speed of the cineloop playback.

R2424458-100 Rev. 2
Using cineloop
Selection of a cineloop
1. Press FREEZE.
The left and right markers on the ECG trace are displayed
on either side of the last detected heart cycle.
2. Press the 2D FREEZE button to un-freeze the cineloop and
let it run between the default setting of left and right borders.
3. To modify setting of the left or right borders, press the
CINELOOP assignable.
The selected heart beat is played back.
4. Press on the assignable CYCLE SELECT to move from heart
beat to heart beat to select the heart cycle of interest.
To jump directly to 5. Press on the assignable NUM CYCLES to increase or
the first or to the decrease the number of heart beats to be played back.
last heart beat press
the assignables 6. Adjust LEFT MARKER and RIGHT MARKER assignables to trim
FIRST CYCLE or or expand the cineloop boundaries.
LAST CYCLE.
Adjustment of cineloop playback
1. If in freeze mode, press the assignable 2D FREEZE to start
cineloop replay.
2. Use the Trackball to increase or decrease the speed of the
cineloop playback.
The speed factor is displayed on the right side of the ECG
(see Figure 3-4).
To view a cineloop frame by frame

1. If not in freeze mode, press the 2D FREEZE button to freeze
the cineloop.
2. Use the Trackball to scroll through the cineloop frame by
frame.
Or
Use the Speed/Frame softkey button.

R2424458-100 Rev. 2
Storing images and cineloops

Images stored on Images and cine-loops can be stored at any time during the
the clipboard dur- scanning session. A thumbnail of the stored image is displayed
ing the scanning on the clipboard on the scanning screen. An icon will also be
session are for im-
mediate purposes.
displayed in the Image Browser and Image Selection screens.
At the end of the ex- Protocol based stored images (Stress option) will also be
amination, the data
should be archived
displayed in the protocol grid in the Parameters window.
in the patient ar- The amount of data stored from 2D live is defined by the
chiving system (re-
fer to page 403).
settings of the current application. The application setting
controls the number of cycles included (or time span if ECG is
not active), time span before R-wave etc. (refer to page 590
and page 593 for further information).
The amount of data stored in images from 2D replay is
determined by the defined cineloop.
Images can be stored in either DICOM and GE Raw Data
formats or DICOM format only, depending on the dataflow
configuration (refer to page 616 for further information).
To store a single image

1. Press FREEZE.
2. Press STORE to store the image digitally.
The thumbnail of the image is displayed on the clipboard.
See also page 406 for further information.
To store a cineloop
While in scanning mode, press the STORE button to store the
last heart-cycle loop. It is possible to configure this function in
several ways. Cineloops may be stored directly or after
preview, depending on how the system is configured.
While in cine-loop preview mode press STORE to store the
selected loop.
Cineloop length and loop selection is adjustable in several
ways. The procedure for cineloop storage is described on
page 406.

R2424458-100 Rev. 2
Removable Media
Intended use
Removable media can be used for the following purposes:
• Long-term image storage: the final destination of the
images, after they are moved out of the system harddisk by
using the Disk Management feature (see "Disk
Management" on page 464).
• Backup of patient database and system configuration
presets (see "Data Backup and Restore" on page 471)
• Patient archive sneaker-net: copy a set of patient records
between a scanner and EchoPAC PC using the
Import/Export feature (see "Export/Import patient
records/examinations" on page 452) with a removable
media.
• DICOM export to copy a set of patient records to a third
party DICOM review station.
• MPEGVue export: review exported images on a Windows
computer (see "Export/Import patient
records/examinations" on page 452).
• Excel export: exports demographics, measurements and
reporting data from the unit to a third party reporting
application using a removable media (see "Export/Import
patient records/examinations" on page 452).
• Copy of system configuration presets between to units
using the Backup/Restore feature (see "Data Backup and
Restore" on page 471).
• Save images as JPEG or AVI for review on a regular
computer.

R2424458-100 Rev. 2
Supported removable media

The following removable media options can be used for data
storage:
• 5 1/4” Magneto Optical disk (from Sony only, 1.3, 2.3, 2.6,
5.4, 8.6 and 9.1 Gb)
• USB Flash Card
Use only shielded USB Flash cards that are verified for EMC
performance according to EN55011 Class A or B. The use of
CAUTION other USB Flash cards may cause interference on the system
itself or on other electronic devices.
DO NOT USE devices containing embedded U3 technology

programs as these might interfere with the proper operation of
CAUTION the Vivid S5/Vivid S6 system.
• CD-R (CD-RW is not supported.)

• DVD-R or DVD+R (use 8x or higher speed.)
DVD+RW media is used for DVR video recording only and can
not be used for archive data-storage (see "DVR (Digital Video
Recorder)" on page 578)
Use only 24x or higher CD-R.
CAUTION
About removable media and long-term image

storage
We recommend running the Disk management feature with
MOD media for long-term image storage, because of the
longevity and reliability of these media. It is not recommended
to use CD or DVD for long-term storage, because of weaker
performance in general when it comes to longevity and
reliability. However, Disk management does not prevent the
use of CD/DVD for long-term image storage. If CD/DVD is used
it is recommended to use Archival Grade or Medical Grade
CD/DVD.

R2424458-100 Rev. 2
No matter which media is used, it is always highly

recommended to take a backup of the media, which is the
responsibility of the customer.
The system does not offer functionality for taking backup of
images saved on long-term storage media.
Recommendation concerning CD and DVD

handling
To avoid data loss, never touch the recordable surface of a
disk. Handle the disk only by the outer edge. Do not place it
face down on a hard surface. Fingerprints or scratches will
make the disk unusable. Before usage, verify that disk surface
has no visible scratches. If there are any scratches, do NOT
use the disk.
Writing on CD or DVD media

Use specifically recommended for writing on CD or DVD
media. Never use a solvent-based permanent marker on such
media. The following pens are recommended:
• Dixon Ticonderoga "Redi Sharp Plus"
• Sanford "Powermark"
• TDK "CD Writer"
• Smart and Friendly "CD Speed Marker"
Formatting removable media

MOD, CD-R, DVD+R, and DVD-R media must be formatted
before use, as described in below.
Formatting may be done in two methods:
1. Formatting just prior to using the media, as described in
"Exporting patient records/examinations" on page 452.
2. Preparation well ahead of time as described in the following
section.
The formatting process will erase any data present on the disk.
CAUTION

R2424458-100 Rev. 2
To Format a removable media

Removable media 1. Insert the media into the drive.
used during Disk
2. Press CONFIG.
space management
or Backup do not 3. If required, log on to the system. The Configuration
need to be format- package is opened.
ted; the formatting
process is part of
4. Select the category Connectivity and select the sheet
these procedures. Tools (see Figure 3-5).
Figure 3-5: The Tools Sheet
5. Select the removable media from the Media pop-up menu.

6. Enter a name for the removable media in the Label field.
Note: Only the following characters and signs can be used
when labelling a media: A-Z, a-z, 0-9, underscore (_) and
hyphen (-). Do not use more than 11 characters or signs.
Do not use space.
7. Select Format. A confirmation window is displayed.
8. Select OK to continue.
9. Wait for the display of the Information window indicating
that the formatting process is completed.
10. Select OK to continue.
11. Eject the media as described below.

R2424458-100 Rev. 2
Note: Removable media used during Disk space management,

Backup, Export or "Save-As..." do not need to be formatted in
advance as the formatting process is part of these procedures
if required.
Additional networking functions

Additional networking functions contained in this tab are
described below.
Note: Before using any of these functions, verify that the
destination PC / Network has been set up with a shared folder
(remote path) with user permissions. Configuring the shared
folder for the first time will involve your GE field-service
engineer.
Save As PDF to network path
Save As PDF Network Path is used for saving Reports as
PDFs to a destination PC or network.
1. Under "Save As PDF Network Path", in the Remote Path
field, type the remote path. For example type: \\IP
ADDRESS\DIRECTORY, where directory is the name of
the shared folder in the destination PC.
2. Click Check to verify the connection.
Note: When clicking the Check button, you might momentarily
see a "failed" message that disappears if you click Check a
second time. The system will then confirm the setting.
Remote Path
1. Under "Setting for Remote Path used for Save As...", type
the remote path as follows:
\\IP ADDRESS\DIRECTORY
2. Click Check to verify the connection.
Configurable Remote Path User
It is possible to configure an additional user name and
password for all remote paths. These settings are only used if
the system fails to log on the default user and password.
• Under Configurable Remote Path User, type the desired
user name and password as configured on the destination
PC (this is the password usually assigned by the local IT
person).

R2424458-100 Rev. 2
Ejecting removable media

Do not eject the CD 1. Press the "Eject" button on top of the alphanumeric
using the button on keyboard, or use the shortcut ALT+E to eject the media.
the CD drive. The Eject device menu is displayed (Figure 3-6).
Figure 3-6: The Eject device menu
2. Select the relevant media.

The selected media is ejected.
When ejecting a MOD, the disk is half way ejected from the MOD
station. To avoid unintentional automatic re-insertion, take out
CAUTION the MOD from the MOD station.
Removing USB devices while in standby mode: Introduce or

remove USB devices only while system is in full shut-down
mode, or while system is turned ON, using the proper Eject
command (ALT+E). Removing USB device while system is in
Standby may cause system failure.
Media corruption as result of AC power failure: While doing
any type of CD/DVD media-writing session, such as export,
backup, disk-management, save As etc. the system may issue
different error messages in case a writing-error has been
detected.
In the special case where the AC power to the DVD drive is
interrupted in the midst of media-writing session, some error
messages may be misleading.
It is therefore required that whenever such a failure has
occurred, the user should repeat the whole session onto a new
media. It is assumed that the previous session has failed.
Recording images on DVR

DVR recording is started and stopped from the RECORD
button on the control panel. The status of the DVR is indicated
by a symbol on the Title bar (for detail about how to use DVR
recorder, refer to "DVR (Digital Video Recorder)" on page 578).

R2424458-100 Rev. 2
Zoom
The Vivid S5/Vivid S6 supports two types of zoom: the display
zoom and the high resolution (HR) zoom.
• The Display zoom (sometimes called "Read" zoom)
magnifies the image display in both frozen and live 2D,
M-Mode and combined modes.
• The HR zoom (sometimes called "Write" zoom)
concentrates the image processing to a user selectable
portion of the image, resulting in an improved image quality
and a higher frame rate in the chosen ROI.
To Magnify an image (Display zoom)

The Display zoom is 1. Rotate the Zoom knob clockwise.
available in live and The resulting magnified image appears in the acquisition
replay. window while the un-magnified image is displayed in the
control window showing the outlined zoom region.
2. Use the Trackball to position the zoom area over the
desired portion of the image.
3. To turn off the Display zoom, rotate the Zoom knob
counterclockwise, or press it twice.
Note: While in Display zoom, pressing the zoom knob once will
activate HR zoom, as explained below.
To activate the HR zoom

As a default setting, 1. Press the Zoom knob.
the zoom area is The resulting zoomed image appears in the acquisition
centered to the cur- window and a frozen reference image is displayed in the
sor/color area if
present.
control window showing the outlined zoom region.
2. Use the Trackball to position the zoom area over the
desired portion of the image.
3. Increase size as desired by turning the zoom knob
clockwise.
4. To turn off the HR zoom, press the Zoom knob once, or
rotate it counter clockwise until zoom reference image
disappears.
Note: While zooming in any zoom method, pressing SET once
allows using the trackball to modify zoom ROI dimensions and
zoom magnification factor.

R2424458-100 Rev. 2
Performing measurements
To perform measurements
• Press MEASURE to enter the Measurement mode.
Refer to page 243 for further information.
Or
• Press CALIPER to perform simple generic measurements.

R2424458-100 Rev. 2
Physiological trace
The physiological module consists of a single connector, which
can accept either a set of electrodes cable or an External-ECG
cable, capable of handling external ECG signals from other
diagnostic ECG devices.
The scanned image that is displayed is synchronized with the
ECG trace. In M-Mode or Doppler, the traces are synchronized
to that particular mode's sweep.
The operator can control the gain, the position and the sweep
rate of the traces using the assignables on the control panel.
Use only GE Medical Systems accessories Conductive parts of
electrodes and associated connectors for applied parts,
CAUTION including neutral electrodes should not contact other conductive
parts, including earth.
Simultaneous use of two or more applied parts will cause
summation of patient leakage currents.
Connecting the internal ECG

The ECG cable is a modular cable consisting of two different
cables parts:
• The Trunk: a single cable connecting to the system at one
end, and providing a cable splitter device at the other end.
• The triple color-coded electrode cable: to be inserted in
the splitter device. Each electrode cable hooks up to the
appropriate stick-on electrode by a color-coded clip type
connector.
The color-coding of the electrodes follows one of two standards
that are common in different parts of the world. The cable
splitter device has a drawing defining the color codes, names
and body location for the two standard color codes. Refer to the
Table 3-1.

R2424458-100 Rev. 2
Table 3-1: ECG Electrode Placement table
AHA (USA) IEC (Europe, Asia, ROW)
Black (LA) p/n 412680-104 Yellow (L) p/n 412680-106
White (RA) p/n 412680-102 Red (R) p/n 412680-108
Green (RL) p/n 412680-103 Black (N) p/n 412680-107
LL Unassigned F Unassigned
V Unassigned C Unassigned
Trunk cable p/n 412931-001 Trunk cable p/n 412931-002
To connect the internal ECG

1. Connect the ECG trunk cable into the rectangular-shaped
socket marked ECG on the patient I/O panel. The patient
I/O panel is located in the front left of the ultrasound unit
(see Figure 3-7).

R2424458-100 Rev. 2
2. Hook up the electrode cables to the electrodes, following

the appropriate convention (see Table 3-1).
Connecting External ECG

A special External cable kit that can be ordered as
p/n H45021DE. The kit contains a 20-foot coax cable with
some additional connectors and adapters to allow interfacing
with various external ECG monitors. The type of adapter
should match the connector recommended by the ECG monitor
vendor.
1. ECG Connector port

2. CW pencil probe port
Figure 3-7: The Patient ECG Connector Port
Connecting ECG electrodes for Pediatrics

It is possible to use pre-attached miniature disposable ECG
electrodes for pediatrics and neonatal use.
A special adapter is available allowing the connection of
pre-wired electrodes using a DIN 1.55 type connector into the
"MultiLink" ™ trunk ECG cable (see Figure 3-8).

R2424458-100 Rev. 2
Figure 3-8: DIN 1.55 type connector
The electrodes should connect to their corresponding locations

as shown on Figure 3-9.
Figure 3-9: Electrode connections

R2424458-100 Rev. 2
Physio controls
Physio assignable controls
Common controls
Horizontal sweep
Adjust the refresh rate of the physiological trace. This control is
active only in 2D and color modes. The sweep speed of the
physio traces in M-Mode and Doppler is identical to the
M-Mode or Doppler horizontal sweep adjusted by the user.
Gain
Enables the user to change the amplitude of the physiological
trace displayed on the screen.
Position
Enables the user to move the physiological trace on the screen.
ECG
Turns the ECG trace on and off.
Invert
Inverts the ECG trace upside down.
QRS visible
Shows/hides the QRS marker on the ECG.
Displaying the ECG trace

To turn the ECG Cardiac applications
display off, press
PHYSIO and press The ECG is turned on by default in all cardiac applications.
the assignable ECG
Other applications
1. Press PHYSIO on the control panel to get access to the ECG
controls.
2. Press the assignable ECG to display the trace.
Adjusting the display of the ECG trace

Adjusting the ECG trace sweep speed
1. Press PHYSIO on the control panel.

R2424458-100 Rev. 2
2. Adjust the assignable button HORIZONTAL SWEEP to change

the sweep speed.
Adjusting the ECG trace amplitude

The ECG signal's 1. Press PHYSIO on the control panel.
amplitude may vary
2. Adjust the assignable button GAIN to adjust the amplitude of
between patients
due to different skin the trace.
moisture and other
physiological pa- Adjusting the ECG trace position
rameters. 1. Press PHYSIO on the control panel.
2. Adjust the assignable button POSITION to move the trace
vertically.
Do not use the Vivid S5/Vivid S6 Ultrasound system ECG physio

waveform for diagnosis and monitoring.
CAUTION

R2424458-100 Rev. 2
Annotations
Text annotations may be inserted anywhere on the screen. The
annotation can be free text or a pre-selected text from a
mode-specific annotation menu or a user-defined library.
Annotations (text, arrow or body mark) are created on separate
layers. When viewing annotated images on a different system or
CAUTION when zooming the image, the position of the annotations on the
image may be slightly changed.
1. Select to display annotation for other

applications
2. Exit
3. Edit previous annotation
4. Pre-defined application-specific
annotations
Figure 3-10: The mode-specific annotation menu
To insert an annotation
Free text
While typing, use 1. Type the required text.
BACKSPACE to de- A suggested word corresponding to the entered characters
lete backward. is displayed while typing. Press TAB to enter the suggested
word.
2. Trackball the text entered to the insertion position.
3. Press SET to add the annotation.
Pre-defined annotation
Word selection from the Annotation menu
1. Press the alphanumeric key TEXT.
A list of application-specific pre-defined texts is displayed
(see Figure 3-10).

R2424458-100 Rev. 2
To display a list from another application, select the

heading and choose another application.
2. Trackball to the required abbreviation.
3. Press SET.
4. Trackball to the position at which the annotation is to be
inserted.
5. Press SET to add the annotation.
To draw an arrow
1. Press Arrow in the Annotation menu.
2. Trackball to the start position of the arrow to draw.
3. Press SET to anchor the arrow.
4. Trackball to the end position of the arrow to draw.
5. Press SET to fix the arrow.
Word selection from the Library
Pre-defined text can be organized in a user configurable,
application dependent library with three different sections. The
user can easily select a pre-defined text from the Library using
the ARROW keys.
Creating a Library
1. Press CONFIG.
2. In the Configuration package, select Meas/Text category.
3. In the Meas/Text category, select Customize.
The Customize sheet is displayed (see Figure 3-11).
4. Select a pre-defined text in the Application pane.
5. Select Add in the desired section.
6. Repeat step 4 and 5 to populate the library.
7. To remove a pre-defined text from the library, select the
pre-defined text to remove and press Del, and press Save
(see Figure 3-11 item 7)
8. To order the pre-defined text in a section, select the
pre-defined text to move and select Up or Down buttons to
move the word accordingly.
9. To exchange sections order, enter the sections to swap
next to Swap columns button and press Swap columns.
10. Customized text may be added to the Application pane by
the special window on the lower area of the Customize
sheet.

R2424458-100 Rev. 2
11. Press Save to store the library.
1. The Application pane

2. Library section
3. Insert selected pre-defined text in the section.
4. Remove selected pre-defined text from the section.
5. Move pre-defined text within the section.
6. Re-order sections.
7. Save Library
Figure 3-11: The Customize sheet
Using the Library

1. Press any ARROW key.
The pre-defined texts from the last used group are
displayed in the Status bar at the bottom of the screen,
with the active word within square brackets.
2. To select a pre-defined text within a section, press ARROW
UP or ARROW DOWN until the desired word is selected.
3. To change section, Press LEFT ARROW until the desired
section is displayed in the Status bar.
4. To insert the selected pre-defined text, press RIGHT ARROW.

R2424458-100 Rev. 2
To edit annotation
1. Press the alphanumeric key TEXT.
2. Press Edit in the Annotation menu.
The pointer is changed to a cross marker.
3. Trackball to the annotation to edit.
4. Press SET.
Once selected, the annotation can be moved freely.
The text can be edited using the following alphanumeric
keys:
• RIGHT ARROW: moves the text cursor forward.
• LEFT ARROW: moves the text cursor backward.
• TAB: moves the text cursor by word forward.
• BACKSPACE: deletes backward.
• DELETE: deletes the selected word.
5. Do the appropriate changes to the annotation.
6. Press SET to anchor the edited annotation.
To erase annotation
To erase all annotations on the screen in one operation, press
the alphanumeric key PAGE ERASE.
To erase annotation words one at a time, hit DELETE button on
the alphanumeric keyboard. Each button-press will delete a
single word in reversed order.

R2424458-100 Rev. 2
Configuration of the pre-defined

annotation list
1. Press CONFIG.
3. In the Meas/Text category select Annotation.
The Annotation sheet is displayed where the user can add,
delete or re-arrange the annotation text (see Figure 3-12).
To re-arrange the annotation list

1. Trackball to the actual annotation text.
2. Press SET.
3. Press the relevant button (i.e. Delete, Move up or Move
down) to apply change.
4. Press save to store the new annotation list.
To add an annotation text

1. Trackball to the text entry field (see Figure 3-12).
2. Press SET to activate the text cursor.
3. Type the new annotation text.
4. Press add.
The new annotation text is added at the end of the list.
5. Press save to store the new annotation list.

R2424458-100 Rev. 2
1. Rearrange list
2. Delete selected text
3. Reset to factory default
4. Add new text to the list
5. Enter new text
Figure 3-12: The Annotation Menu Configuration Dialog Box

R2424458-100 Rev. 2
Bodymarks
Bodymarks are small graphic images that represent the
anatomy being examined. Using bodymarks, the user can
indicate the position that the probe was in during the
examination.
Inserting a bodymark
1. Press the alphanumeric key BODYMARK.
The Bodymark menu is displayed showing a selection of
bodymarks relative to the selected exam category.
1. Select and display bodymark list for

other applications
2. Exit bodymark menu
3. Erase bodymark
4. Bodymark list for the current
application
Figure 3-13: The Bodymark menu
2. Trackball to the desired bodymark and press SET.

The bodymark with a probe marker is displayed on the
scanning screen.
1. Probe marker
Figure 3-14: The bodymark with probe marker
3. Using the trackball, adjust the position of the probe marker

and press SET.
4. Using the trackball, adjust the probe marker orientation and
press SET.

R2424458-100 Rev. 2
Deleting a bodymark
1. Press the alphanumeric key BODYMARK.
The Bodymark menu is displayed
2. Select Erase.
When pressing PAGE ERASE on alphanumeric keyboard the
bodymark will be erased, provided it has been configured this
way.
To change the configuration
1. Press CONFIG.
3. In the Meas/Text category select Annotation (see
Figure 3-12).
4. Check or uncheck the "Delete on Page erase" option.

R2424458-100 Rev. 2

R2424458-100 Rev. 2
Scanning Modes
Chapter 4
Scanning Modes
• Introduction ................................................................................... .. 139

• 2D-Mode ......................................................................................... .. 140
• 2D-Mode overview ................................................................... 140
• 2D-Mode controls ..................................................................... 142
• Using 2D .................................................................................. 148
• Optimizing 2D ........................................................................... 148
• M-Mode .......................................................................................... .. 150
• M-Mode overview ..................................................................... 150
• M-Mode controls ...................................................................... 151
• Using M-Mode .......................................................................... 153
• Optimizing M-Mode .................................................................. 155
• Color Mode .................................................................................... .. 157
• Color Mode overview ............................................................... 157
• Color M-Mode overview ........................................................... 158
• Color Mode controls ................................................................. 159
• Using Color Mode .................................................................... 162
• Optimizing Color Mode ............................................................. 163
• PW and CW Doppler ..................................................................... .. 164
• PW and CW Doppler overview ................................................. 164
• PW and CW Doppler controls .................................................. 165
• Using PW/CW Doppler modes ................................................. 167
• Optimizing PW/CW Doppler modes ......................................... 168
• Tissue Velocity Imaging (TVI) .................................................. 169
• Tissue Tracking ........................................................................ 173
• Strain rate ...................................................................................... .. 178
• Strain rate overview ................................................................. 178
• Strain rate controls ................................................................... 179

R2424458-100 Rev. 2
Scanning Modes
• Using Strain rate ....................................................................... 181

• Optimizing Strain rate ............................................................... 181
• Strain ............................................................................................. ... 183
• Strain overview ......................................................................... 183
• Strain controls ...........................................................................184
• Using Strain .............................................................................. 186
• Optimizing Strain ...................................................................... 186
• Tissue Synchronization Imaging (TSI) ....................................... ... 188
• TSI overview ............................................................................. 188
• TSI controls ............................................................................... 189
• Using TSI ..................................................................................191
• Optimizing TSI .......................................................................... 192
• Additional scanning features ...................................................... ... 193
• LogiqView ................................................................................. 193
• Compound ................................................................................ 194
• B-Flow ....................................................................................... 195
• Blood flow imaging ....................................................................195
• Virtual Convex .......................................................................... 196

R2424458-100 Rev. 2
Scanning Modes
Introduction
The Vivid S5/Vivid S6 ultrasound scanner provides several
basic scanning modes and several options for combining the
use of these modes.
The following scanning modes are described in this chapter:
• 2D Mode Imaging
• M-Mode Imaging
• Anatomical M-Mode
• Color Mode Imaging
• Doppler Mode Imaging
• Angio
• Tissue Velocity Imaging
• Tissue Tracking
• Tissue Synchronization Imaging
• BFlow
• BFI (B-Flow Imaging)
• Strain / Strain-Rate imaging
Note: Some optional scan-modes listed above are not
available on Vivid S5.
See page 406 for When performing an examination using any of these modes,
further information images and image sequences (cineloops) can be stored. The
on image and examination or part of it can also be stored on DVD, CD, and
cineloop storage.
other various media, depending on available options.

R2424458-100 Rev. 2
Scanning Modes
2D-Mode
2D-Mode overview
1. Focus marker
3. Status window
4. Soft menu
Figure 4-1: The 2D screen (cardiac)

R2424458-100 Rev. 2
Scanning Modes
1. Assignable keys: 4. Soft menu

• Width • Compress R
• Frequency • Reject R
• Focus Pos • Dynamic Range
• Frame rate • DDP R
• Up/Down R • Speckle reduce R
• Left/Right R • Contour
• Cineloop (in Freeze, only) • Diff On/Off
• Dual focus • Power
• B color maps 5. Freeze
• Tilt 6. 2D
2. Zoom 7. Gain
3. Depth
Controls marked with R are also available in freeze and cine replay
Figure 4-2: The 2D controls on the front panel

R2424458-100 Rev. 2
Scanning Modes
The 2D mode displays a two-dimensional gray scale image of

the tissue within the probe's field of view. 2D mode can be
combined with:
In combined mode, • M-Mode, see "M-Mode" on page 150
press ACT. MODE to
• Color Mode, see "Color Mode" on page 157
toggle between
modes and access to • CW or PW Doppler Mode, see "PW and CW Doppler" on
the mode specific page 164
controls.
• Color and Doppler Modes (triplex)
2D-Mode controls
2D assignable controls
Width
Controls the size or angular width of the 2D image sector. A
smaller angle generally produces an image with a higher frame
rate.
Focus Pos
Changes the location of the focal point(s). A triangular focus
marker indicates the depth of the focal point.
Note: On convex and linear probes there are two additional
optional focus controls:
• Focus number: Allows to control the number of focal point.
• Focal Spread: Allows to control the distance among the
different focal points
Frame rate
Adjusts frame rate (FPS). The relative setting of the frame rate
is displayed in the status window. When adjusting frame rate,
there is a trade off between spatial and temporal resolution.
Tilt
Enables the axis of the 2D image to be tilted to the left or right.
By using this control in combination with angle control the
image can be “aligned” to the direction of interest, and frame
rates be optimized. By default the axis of symmetry of a 2D
image is vertical. (Applicable only for cardiology applications).

R2424458-100 Rev. 2
Scanning Modes
Frequency
On some low fre- Enables the adjustment of the probe's operating frequency.
quencies, the sys- The selected frequency is displayed in the status window. For
tem switches some probes/applications the lowest frequency settings will be
automatically to
second-harmonic
Octave imaging settings.
mode. The word Note: While changing the Frequency value on display, the
“Octave” appears
in the status win-
operator actually selects different transmit patterns associated
dow. with that value, which includes transmit pulse shape, frequency
and transmit sequence.
Octave
Enables quick switching over between Octave imaging and
corresponding fundamental frequencies, without rotating the
Frequency selection rotary knob.
Invert
• Left/Right Invert: enables a mirror image of the 2D image
to be created. The left/right reference marker V moves to
the other side of the image.
• Up/Down Invert: enables the 2D image to be flipped
180 degrees.
Dual focus
Activates Dual focus mode (optionally available in cardiology
applications only). To adjust the location of the Dual focus,
activate the FOCUS assignable.
B Color maps
Displays a color map menu to optimize the greyscale
presentation. The menu enables an option from a list of
non-linear gray-curves or different 2D-colorized curves to be
selected. Use the assignable rotary knob to highlight and
activate the desired map.
Compound
Compound is a process of combining three frames from
different steering angles into a single frame. The combined
single image has the benefits of reduced speckle noise,
reduced clutter, and continuity of specular reflectors. Therefore,
this technique can improve contrast resolution.

R2424458-100 Rev. 2
Scanning Modes
When active, the focal marker indicators change shape (see

"Focal Marker Shapes" on page 150 - compound is available
on Linear array and on 4C-RS curved array probes).
Virtual Convex
Virtual Convex is designed to provide a wider field of view in
the far field, and is available on linear probes. While in
2D-mode, use the Virtual Convex soft-key to turn virtual
convex ON or OFF. When Virtual convex is turned on, you may
enter other scanning modes such as Color, Doppler or M-mode
and virtual convex will remain active on the 2D image.
Note: While Virtual Convex is turned on, the Zoom function will
always activate in "Display-zoom" mode only.
Cineloop (in Freeze only)
Allocates different cineloop control functions to the assignable
soft keys.
Gain
When rotated clockwise, increases the overall gain applied to
the received echo signals equally for all depth.
Time Gain Compensation (TGC)

Compensates for depth-related attenuation in an image. The
sliders nearest the operator affect the far field. TGC amplifies
returning signals to correct for the attenuation caused by tissue
at increasing depths.
Automatic Tissue Optimization (ATO)

ATO provides an automatic optimization of the 2D image by
adjusting the gray scale curve. Press the Auto button or the 2D
GAIN rotary to toggle ATO on or off. When activated, ATO is
displayed in the information window.
Depth
Sets the maximum (far field) distance that will be imaged.
Decreasing the depth may allow higher frame rates.

R2424458-100 Rev. 2
Scanning Modes
2D Soft menu controls

Compress
Controls the amount of contrast in the 2D image. An index
number is displayed in the status window to indicate the
relative level of compression.
Reject
Adjust reject level. When this control is increased, low-level
echoes are rejected and appear darker in the 2D image. An
index number is displayed in the status window to indicate the
relative level of rejection.
Dynamic Range
Enables control of the dynamic range or contrast of the image.
When dynamic range is set high, the image is softer and more
low-level data is visible.
Smart Depth
For every setting of scan-depth there is an optimal Frequency /
Transmit Pattern setting.
The Frequency/Transmit Pattern should be optimized to
produce both a clean signal, and maximal spatial resolution.
With Smart Depth turned ON, the system will optimize the
Frequency/Transmit Pattern to follow above guideline, and
automatically set optimal setting for the currently selected
depth.
The Frequency control value displayed on screen will be
modified to display the updated value with every change of
depth setting by the operator.
The operator may change the Frequency control at any time to
any desired Frequency/Transmit Pattern.
If the depth setting is changed anytime after the user has
manually modified the frequency, the system will attempt to
optimize the Frequency/Transmit Pattern, taking into account
the different frequency-preference as set by the manual
modification by the user.
With Smart Depth turned OFF, the Frequency control setting
will remain unchanged even when depth setting is changed.

R2424458-100 Rev. 2
Scanning Modes
DDP (Data Dependent Processing)

Performs temporal processing which reduces random noise
without affecting the motion of significant tissue structures. An
index number is displayed in the status window (under Proc) to
indicate the relative DDP level.
Contour/Edge Enhance
Controls image processing related to the extent of edge
enhancement applied to an image.
Diff On/Off
Affects the level of reverberations in the image. When turned
On, the frame rate (or the number of focal zones) will decrease,
while the reverberations will be attenuated. (Applicable only for
cardiology applications).
Power
When power is re- Controls the amount of acoustic power applied in all modes.
duced, it reduces When power is set to maximum, it is equal to or less than the
the signal-to-noise maximum acoustic power permitted by the FDA. The Thermal
ratio, so that the im-
age may become
Index (TI) and the Mechanical Index (MI) are displayed on the
noisier. screen.
Ultra Definition (UD) Clarity
This control is effective in Cardiology applications only. This
control reduces the unwanted effects of speckle in the
ultrasound image. Image speckle usually appears as a grainy
texture in otherwise uniform areas of tissue. Its appearance is
related to image system characteristics, rather than tissue
characteristics, so that changes in system settings, such as
probe type, frequency, depth, and others, can change the
appearance of the speckle.
Too much speckle can impair image quality and make it difficult
to see the desired detail in the image. Likewise, too much
filtering of speckle can mask or obscure desired image detail.
Extra care must be taken to select the optimal Speckle
reduction level.
Ultra Definition (UD) Speckle Reduce
This control is used to reduce the amount of speckle in
non-cardiology applications.

R2424458-100 Rev. 2
Scanning Modes
Ultra Definition (UD) Adaptive reject

Conventional "Reject" function reduces noise by reducing low
gray levels. It does so by changing the gray-map of the whole
image. Noise is reduced but information in the myocardium
may also be lost.
"Adaptive reject" also reduces noise by reducing low gray
levels. The intensity reduction is done adaptively for each pixel
in the image and does not affect the gray-map. As a result,
pixels that are close to boundaries and tissue structures are
less affected than with conventional reject method.
Clear Vessel
This feature is available on linear probes while in live scanning
under the "Carotid" application. While scanning the common
carotid artery in a longitudinal scan, the "Clear Vessel" function
is designed to optimize the acquired image by automatically
adjusting the TGC of the system to remove noise artifacts
within the vessel without affecting surrounding tissue
structures.
Operation
1. Use the Carotid preset with a linear probe.
2. Make sure the "Clear Vessel" soft-key is turned ON.
The label CLR will appear on the upper right area of the
image.
3. Scan the common carotid artery longitudinally.
4. While in live scan, when the image of the carotid is
acquired, and the "Clear Vessel" function is active, it will
automatically optimize the image, in real-time, removing
some of the noise artifacts inside the vessel.
The label CLR appears in white whenever "Clear Vessel"
is active, and becomes dark-gray whenever "Clear Vessel"
is not active, because scanning conditions do not allow
"Clear Vessel" to detect the vessel correctly (Figure 4-3).

R2424458-100 Rev. 2
Scanning Modes
Clear Vessel is active Clear Vessel is ON but inactive Clear Vessel is OFF
Figure 4-3: Clear Vessel indications
The “Clear Vessel” function may be turned OFF or ON at any

time by the user. When turned OFF, the CLR label totally
disappears from the screen.
Note: “Clear Vessel” can become active and functional only
while the image of the common carotid vessel occupies most of
the width of the image and is relatively linear throughout the
image. In case the vessel is curved or twisted the function will
become non-active and the CLR label will change to a
dark-gray color.
Note: When investigating anatomical structures of very low
echogenicity within the common carotid vessel the user may
turn off “Clear Vessel” in order to assure the visualization of all
reflected echoes, even if obscured by surrounding noise.
Using 2D
Refer to page 593 The 2D-Mode is the system's default mode.
about creating pre-
1. Press 2D on the control panel to access 2D mode.
sets.
Check the Display's 2. Optimize the image by adjusting the image controls
brightness and con- described in the previous section.
trast setting before If necessary use preset for optimum performance with
adjusting the unit
imaging controls
minimum adjustment.
(see page 90).
Optimizing 2D
The following controls can be adjusted to optimize the 2D Mode
display:
• Use the Gain and TGC controls to optimize the overall
image.
• Use the Depth control to adjust the range to be imaged.

R2424458-100 Rev. 2
Scanning Modes
• Use the Focus control to center the focal point(s) around

the region of interest.
• Use the Frequency (move to higher frequencies) or the
Frame rate control (move to lower frame rate) to increase
resolution in image
• Use the Frequency (move to lower frequency) to increase
penetration.
• Use the Reject control to reduce noise in the image.
• Use the DDP control to optimize imaging in the blood flow
regions and make a cleaner, less noisy image.
• Use UD Clarity (Cardiac) or UD Speckle reduce
(non-cardiac) to reduce image speckle. Extra care must be
taken to select the optimal Speckle reduction level, as too
much filtering of speckle can mask or obscure desired
image detail.
• Use Adaptive reject (Cardiac) to reduce near field haze
and blood pol artifact without diluting tissue appearance of
moving structures.
• Press Color maps and select a grey map from the menu on
screen.
Always use the minimum power required to obtain acceptable

images in accordance with applicable guidelines and policies.
WARNING
The Wide Aperture function may improve image quality by

increasing spatial resolution and signal-to-noise ratio. This
feature involves special processing which allows to improving
the beam focus at large depth by increasing the number of
probe's elements involved in producing the ultrasound beam.
Wide aperture function can not be controlled manually by the
user When using linear or convex probes, the wide aperture
feature may turn on or off automatically, depending on various
scanning settings. In particular it turns on while placing the
focus marker at relatively large depth. Wide aperture
automatically turns off when focus is moved to a shallow
region.

R2424458-100 Rev. 2
Scanning Modes
Focal Marker Shapes

The focal marker shape changes to indicate different imaging
modes, as shown below:
• : Standard focal marker.
• : Wide Aperture is turned ON.
• : Compound mode is ON.
• : Coded Phased Inversion (CPI) mode is ON.
M-Mode
M-Mode overview
1. Time motion cursor conventional M-Mode

2. Depth Scale
3. Focus Marker
4. Time Scale
Figure 4-4: The cardiac M-Mode screen (top/bottom)
This unit has three types of M-Mode:

• Conventional M-Mode (MM): displays a distance/time plot
of a cursor line in the axial plane of the 2D-image.

R2424458-100 Rev. 2
Scanning Modes
• Anatomical M-Mode (AMM): displays a distance/time plot

from a cursor line, which is independent from the axial
plane. AMM is available in greyscale, color, or in the
optional modes: TVI, Tissue Tracking, Strain rate, and
Strain modes.
• Curved Anatomical M-Mode (CAMM): displays a
distance/time plot from a free-drawn cursor line. CAMM is
available in greyscale, color, and optional TVI, Tissue
Tracking, Strain rate and Strain modes.
M-Mode and 2D Mode display areas can be side by side or
top/bottom. Conventional M-Mode can be combined with Color
(see "Color M-Mode overview" on page 158).
Note: The sweep speed information displayed in the bottom
right corner of the image represents the user selected sweep
speed and should be used only as a reference to confirm that
the image was acquired at the selected sweep speed. It is not
to be used for measurements or analysis. This is not an
absolute value, but simply a reference number. Users
performing studies using standardized protocols may find this
sweep speed information useful for reading studies from other
institutions.
M-Mode controls
M-Mode assignable controls
Horizontal sweep
Adjusts the horizontal refresh rate of the M-Mode area of the
display. Horizontal sweep does not change the acquisition
resolution, so that user can change the horizontal sweep in
replay (with no loss of quality).
On some low fre- Frequency
quencies, the sys-
tem switches
Enables the adjustment of the probe's operating frequency.
automatically to The selected frequency is displayed in the status window. For
second-harmonic some probes/applications the lowest frequency settings will be
mode. The word Octave imaging settings.
“Octave” appears
in the status win- Note: While changing the Frequency value on display, the
dow. operator actually selects different transmit patterns associated
with that value, which includes transmit pulse shape, frequency

R2424458-100 Rev. 2
Scanning Modes
Octave
Enables quick switching over between Octave imaging and
corresponding fundamental frequencies, without rotating the
Frequency selection rotary knob.
Focus Pos
Changes the location of the focal point(s). A triangular focus
marker indicates the depth of the focal point.
Up/Down
Flips the M-Mode display 180 degrees.
Color maps
Displays a color map menu to optimize the greyscale
non-linear gray-curves or different colorized curves to be
selected. Use the trackball to point to a color map and press
SET to activate the desired map.
AMM
Anatomical M-Mode (option) is only available for cardiac
applications. See further information in "Anatomical M-Mode"
on page 154.
Compress
Controls the amount of contrast in the image. An index number
is displayed in the status window to indicate the relative level of
compression.
Reject
Adjust reject level. When this control is increased, low-level
echoes are rejected and appear darker in the image. An index
number is displayed in the status window to indicate the
relative level of rejection.

R2424458-100 Rev. 2
Scanning Modes
M-Mode Soft menu controls

Power
age, spectrum or
color scan may be- screen.
come noisier.
Dynamic Range
Enables control of the dynamic range or contrast of the image.
When dynamic range is set to High, the image is softer and
more low-level data is visible.
Contour/Edge Enhance
Controls image processing related to the extent of edge
enhancement applied to an image.
Using M-Mode
Conventional M-Mode (greyscale)
1. While in 2D-Mode press cursor on the control panel.
2. Use the trackball to position the cursor over the required
area of the image.
Gain, Frequency, 3. Press M - the M-mode sweep will start to sweep.
Focus, Dynamic
4. Adjust horizontal sweep, Gain, Frequency, Focus, Dynamic
Range and Com-
pression affect also Range, compression and Contour to optimize the display if
the 2D image. necessary.
5. Press FREEZE to stop imaging.
OR
1. While in 2D-Mode press M on the control panel. The
M-mode sweep will start to sweep.
area of the image.
Range, Compression and Contour to optimize the display if
necessary.

R2424458-100 Rev. 2
Scanning Modes
Conventional Color M-Mode

1. While in Color Mode press cursor on the control panel.
area of the image.
3. Press M - the Color M-mode sweep will start to sweep.
OR
1. While in Color Mode press M on the control panel. The
Color M-mode sweep will start to sweep.
area of the image.
Range, Compression and Contour to optimize the display if
necessary.
Anatomical M-Mode
Anatomical M-Mode is only available for cardiac applications.
Anatomical 1. Enter live M-mode.
M-Mode can also be
2. Press the assignable AMM soft key to enter Live
used with previous-
ly acquired digitally Anatomical M-mode. Continue to step 4 below.
stored 2D images.
OR
While in 2D-Live or 2D-Freeze modes, press ALT button and
press the assignable AMM soft-key
OR
1. From the 2D Live, press FREEZE.
2. Press M to access the Freeze Anatomical M-Mode.
The Trackball as- 3. Use the trackball to position the cursor over the required
signable Pos (Posi- area of the image.
tion) is activated.
The Trackball as- 4. Press SET to allow free rotation of the solid full-length cursor
signable Angle is line throughout the 2D image.
activated.
5. Rotate the solid cursor line to the desired direction.
The Trackball as- 6. Press SET twice and reposition the intersection point to the
signable Pos is acti- desired position along the cursor line.
vated.
7. Repeat steps 4. and 5. to change the angle of the solid
cursor line if necessary.

R2424458-100 Rev. 2
Scanning Modes
The M-Mode area of 8. Press TRACKBALL to activate scrolling control on the

the display updates trackball.
as the M-Mode sig-
nal is constructed. 9. Use the trackball to scroll through the data acquired at that
location. The M-Mode display will vary accordingly.
Curved Anatomical M-Mode

Curved Anatomi- 1. From the 2D or M-Mode view press ALT.
cal M-Mode can al- The alternative modes appear on the assignable display.
so be used with
previously ac- 2. Press CURVED AMM.
quired digitally 3. Use the trackball to position the starting point of the time
stored 2D images. motion curve.
The time motion 4. Press SET to anchor the starting point of the time motion
curve can be edited curve.
by following the
curve back to the de- 5. Use the trackball to position the second point of the time
sired point and re- motion curve.
drawn as desired. 6. Press SET to anchor the second point of the time motion
Following the curve
curve.
back to the starting
point will delete the 7. Repeat step 5. and 6. up to seven times to draw a complete
time motion curve. time motion curve.
Optimizing M-Mode
Refer to page 593 The use of preset gives optimum performance with minimum
about creating pre- adjustment. If necessary, the following controls can be adjusted
sets. to further optimize the M-Mode display:
• Adjust Horizontal sweep to optimize the display resolution.
• Adjust Gain and TGC controls to adjust the range to be
imaged.
Except for Con- • Use the Frequency (move to higher frequencies) or the
tour, all the con- Frame rate control (move to lower frame rate) to increase
trols listed in the resolution in image.
optimizing
M-Mode section • Use the Frequency (move to lower frequency) to
will also affect the increase penetration.
2D image.
• Adjust Focus to move the focal point(s) around the region
of interest in the M-Mode display.
• Adjust Dynamic range to optimize the useful range of
incoming echoes to the available greyscale.
• Adjust Compress and Contour to further optimize the
display.
• Adjust Reject to reduce noise while taking care not to

R2424458-100 Rev. 2
Scanning Modes
eliminate significant low-level diagnostic information.

R2424458-100 Rev. 2
Scanning Modes
Color Mode
Color Mode overview

2. Color bar
3. Color sector marker
4. Status window
5. Soft menu
Figure 4-5: The Color Mode screen

R2424458-100 Rev. 2
Scanning Modes
Color M-Mode overview
1. Time motion cursors

2. Color bar
3. Focus marker
4. Flow sector marker
5. Time scale
6. Status window
7. Soft menu
Figure 4-6: The Color M-Mode screen (top/bottom display)

R2424458-100 Rev. 2
Scanning Modes
Color Mode controls

Color Mode assignable controls
Horizontal sweep (Color M-Mode only)
Adjusts the horizontal refresh rate of the M-Mode area of the
display.
Scale
Adjusts the repetition rate of the Doppler pulses transmitted to
acquire the data for color flow mapping. The Scale (Nyquist
limit) should be adjusted so that no aliasing occurs, while still
having good resolution of velocities. The Nyquist limit should
be somewhat above the maximum velocity found in the data.
Baseline
Adjusts the color map to emphasize flow either toward or away
from the probe. Baseline is available in both Live and Freeze.
Frame rate
Controls the Frame-rate by changing line density. When
adjusting frame rate, there is a trade off between spatial and
temporal resolution.
LVR (Low Velocity Rejection)
Color data produced LVR, also called Wall motion filter, enables the extent of low
by very low flow velocity removal to be adjusted.
may cause interfer-
ence. Invert
Enables the color scheme assigned to positive and negative
velocities to be inverted. Invert is available in live and cine
replay.
Variance
Controls the amount of variance data added to a color display.
Variance enables computer-aided detection of turbulent flow
(e.g. jets or regurgitation). Variance is available in live and cine
replay.
Simultaneous
Enables simultaneous display of 2D and Color mode,
side-by-side.

R2424458-100 Rev. 2
Scanning Modes
Color maps
Displays a menu of color map options. Use the assignable
rotary knob to point to a color map and activate the desired
color map. Each color map is assigning different color hues to
different velocities.
Cineloop (in Freeze, Color 2D mode only)
Allocates different cineloop control functions to the assignable
soft keys.
Tissue priority
Emphasize either the color of the color mode or the greyscale
tissue detail of the 2D image. Tissue priority is available in both
Live and Freeze.
Color-Mode Soft menu controls
Sample volume
Adjusts the size of the color flow Doppler sampling area. Lower
setting gives better flow resolution while a higher setting
increases sensitivity and helps to locate turbulent flows.
DDP (Data Dependant Processing)
Performs temporal processing, which reduces random noise
without affecting the motion of significant tissue structures.
Frequency
Enables the adjustment of the transmission frequency to
control the sensitivity or the level of penetration. The selected
frequency is displayed in the status window. Adjusting
Frequency may affect Sample Volume and LVR settings.
Note: While changing the Frequency value on display, the
operator actually selects different transmit patterns associated
with that value, which includes transmit pulse shape, frequency
Smart Depth
For best sensitivity in color-mode, the Color
Frequency/Transmit Pattern used should be optimized as a
function of the location of the color-ROI.

R2424458-100 Rev. 2
Scanning Modes
When ROI is set to a deep region in the body it is

recommended to decrease the Color Frequency value setting
in order to improve reception of the Doppler signals.
When ROI is position in a shallow region, it is recommended to
increase the Color Frequency value setting in order to increase
the spatial resolution of the color image.
With Smart Depth turned ON, the system optimizes the Color
Frequency/Transmit Pattern using the above guideline, and
automatically sets an optimal setting to correspond with the
current location of Color-ROI. The associated Frequency value
displayed on screen changes accordingly.
The operator may change the Frequency control at any time to
any desired setting, overriding any automatic settings.
With Smart Depth turned OFF, the Frequency control setting
remains unchanged even while ROI depth setting is changed.
Lateral Averaging (Color 2D only)
Smoothes the image by averaging collected data along the
same horizontal line. An increase of the lateral averaging will
reduce noise, but this will also reduce the lateral resolution.
Radial Averaging
Use Averaging con- Smooths the image by averaging collected data along the
trols with caution same radial line. An increase of the radial averaging will reduce
so as not to obscure noise, but this will also reduce the radial resolution.
significant diagnos-
tic information Power
age may become
noisier. screen.
Trackball controls
ROI (Region Of Interest) size
When the trackball command Size is selected (see also
"Trackball operation" on page 108), the height and width of the
color area (or ROI) is adjusted from the trackball.

R2424458-100 Rev. 2
Scanning Modes
ROI (Region Of Interest) position

When the trackball command Pos (position) is selected (see
also "Trackball operation" on page 108), the position of the
color area (or ROI) is adjusted with the trackball.
Using Color Mode

Color 2D
1. From an optimized 2D image press COLOR.
The assignable con- 2. Use the trackball to position the ROI frame over the area
trols of the trackball to be examined.
are displayed in the
trackball status bar 3. Press SET. The instruction Size should be highlighted in the
in the bottom right trackball status bar. If not, press SET again to select Size.
corner of the screen. NOTE: If the trackball control Pointer is selected, press
TRACKBALL to be able to select between Position and Size
controls.
4. Use the trackball to adjust the dimensions of the ROI.
To enlarge or narrow the ROI, move the trackball to the
left or right.
To lengthen or shorten the ROI, move the trackball up or
down.
5. Press SET when the desired size is obtained, to allow
repositioning of the ROI if desired.
Color M-Mode
1. From M-Mode press COLOR, or from Color-Mode press M.
The assignable con- 2. Use the trackball to position the color area in the M-Mode
trols of the trackball display.
are displayed in the
trackball status bar. 3. Press the SET button. The instruction Size should be
highlighted in the trackball status bar. If not, press SET
again to select Size.
NOTE: If the trackball control Pointer is selected, press
controls.
4. Use the trackball to adjust the dimension of the color area.
To enlarge the color area, move the trackball up
To narrow the color area, move the trackball down.
5. Press SET when the desired size is obtained.

R2424458-100 Rev. 2
Scanning Modes
Optimizing Color Mode

sets. to further optimize the Color Mode display:
• Adjust the Active mode gain to set the gain in the color
flow area.
The scale value may • Adjust Scale to the highest setting that provides adequate
affect FPS, Low Ve- flow detection.
locity Reject, and
Sample Volume. • Adjust Low Velocity Reject to remove low velocity blood
flow and tissue movement that reduces image quality.
• Adjust Variance to detect flow disturbances.
• Adjust Sample volume (SV) to a low setting for better flow
resolution, or a higher setting to more easily locate
disturbed flows
Frequency setting • Adjust Frequency to optimize the color flow display. Higher
may affect FPS, SV settings improve resolution. Lower settings improve depth
and Low Velocity penetration and sensitivity. This does not affect the
Reject.
frequency used for 2D and M-Mode.
The Power setting • Adjust Power to obtain an acceptable image using the
affects all other op- lowest setting possible.
erating modes.
Adjust the following settings to further optimize display of the
image:
• Use Invert to reverse the color assignments in the color
flow area of the display.
• Use Tissue priority to emphasize either the color flow
overlay, or the underlying greyscale tissue detail.
• Use Baseline to emphasize flow either toward or away
from the probe.
• Use Radial and Lateral Averaging to reduce noise in the
color flow area. Radial and Lateral Averaging smooths the
image by averaging collected data along the same
horizontal line. An increase of the lateral averaging will
Use all noise reduction controls with care. Excessive

application may obscure low level diagnostic information.
CAUTION

R2424458-100 Rev. 2
Scanning Modes
PW and CW Doppler
PW and CW Doppler overview
1. Sample volume (PW only)

2. Angle correction marker
3. Velocity scale
4. Low velocity reject
5. Nyquist velocity
6. Doppler baseline
7. Frequency scale (optional, see page 589)
8. Status window
9. Soft menu
Figure 4-7: The PW/CW Doppler Mode screen
Note: The sweep speed information displayed in the bottom

right corner of the image represents the user selected sweep
speed and should be used only as a reference to confirm that
the image was acquired at the selected sweep speed. It is not
to be used for measurements or analysis. This is not an
absolute value, but simply a reference number. Users
performing studies using standardized protocols may find this
sweep speed information useful for reading studies from other
institutions.

R2424458-100 Rev. 2
Scanning Modes
PW and CW Doppler controls

PW and CW Doppler assignable controls
Horizontal sweep
Adjusts the horizontal refresh rate of the Doppler area of the
display. Horizontal sweep is available in live and cine replay.
Baseline
Enables the Doppler baseline to be shifted up and down. The
default Doppler baseline is set at the center of the vertical
aspect of the Doppler display, dividing evenly the flow toward
and away from the probe. By adjusting the baseline a larger
portion of the analysis is assigned to the flow direction present.
Baseline is available in live and cine replay.
Maximum velocity Scale
depends on sample
volume size, sample
Enables the vertical scale of the Doppler spectrum and the
volume position maximal detectable velocity to be modified. Velocity range
and frequency set- directly controls the pulse repetition frequency, which is
tings. responsible for the setting of the Nyquist limit (the ability to
detect maximum velocity without aliasing).
Low velocity reject
Enables the low velocity portions of the spectrum to be filtered,
since the Doppler spectrum and audio may contain strong
wall-motion signals. The amount of Low Velocity Reject. is
indicated by the green vertical bar at the right end of the
baseline.
Occasionally, high Audio Vol.
audio volume may
cause interruptions
Enables the loudspeaker volume control.
or horizontal tonal
noise in CW dis-
play, in such a case
lower the audio
gain.
If the Doppler mode Invert

is combined with
Color mode, the col-
Enables the Doppler spectrum to be flipped 180 degrees, so
or map will be also that negative velocities are displayed above the baseline and
inverted. positive velocities below the baseline. Invert in PW is available
in live and cine replay; invert in CW is available only in live
mode.

R2424458-100 Rev. 2
Scanning Modes
LPRF (PW mode)

Sets the pulse repetition frequency for the PW Doppler
acquisition of flow data. Enables toggling between high and low
Pulse Repetition Frequency (PRF). When the Doppler PRF is
raised beyond a certain limit, more than one Doppler gate is
displayed on the screen.
D Color maps
Displays a drop down menu of different Doppler colorization
maps. Use the assignable rotary knob to select the desired
map and activate the map.
PW/CW Doppler Soft menu controls

Quick angle and Angle correction
In non-cardiac ap- Enables correction of the Doppler velocity scale by defining the
plications, Angle angle between the Doppler beam and the investigated blood
correction is con- vessel or blood flow. A thin cross bar on the Doppler cursor will
trolled from the
Trackball.
rotate as the control is adjusted. Angle correction is available in
both Live and Freeze.
Quick angle adjusts the angle by 60 degrees.
Angle correction adjusts the angle between zero and
90 degrees with one degree increment.
Sample volume
In PW mode, set the longitudinal size of the region to be
sampled for measurement. Adjusting Sample volume may
affect the PRF (Nyquist limit) settings. SV does not apply to
CW mode, where the volume sampled is the full length of the
area indicated by the cursor line.
Compress
Enables control over the contrast of the Doppler spectrum.
When compression is raised, the spectrum image becomes
softer and some low level background noise may appear.
Compress is available in both Live and Freeze.
Reject
Enables undesirable background noise to be removed from the
Doppler spectrum resulting in a darker background. Reject is
available in both Live and Freeze.

R2424458-100 Rev. 2
Scanning Modes
Frequency
Adjusts the transmission frequency in Doppler to control
sensitivity or level of penetration. The selected frequency is
displayed in the status window. Adjusting Frequency may affect
Sample Volume (PW) and LVR settings.
Power
age may become
noisier. screen.
Using PW/CW Doppler modes
Controls and opera- There are two ways to start PW/CW Doppler:
tions for PW and
CW mode are the Alternative 1
same unless other-
wise noted. 1. Press PW or CW. A scanning screen is displayed with a
Doppler cursor on the 2D mode image and a Doppler
spectrum in the lower part of the screen.
2. Use the trackball to position the Doppler cursor line and in
PW the sample volume location over the area of interest.
Sample Volume ad- 3. In PW, with the Soft menu rocker key, adjust the sample
justment may affect Volume (SV):
the Scale, Frame To enlarge the SV, press the Right arrow of the rocker
rate and LV rej. set-
tings.
To narrow the SV, press the Left arrow of the rocker.
Alternative 2
1. Press CURSOR on the control panel. A cursor line is
displayed on the 2D image.
2. With the trackball adjust the position of the cursor line.
3. Press PW or CW.

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Optimizing PW/CW Doppler modes

sets to further optimize the PW/CW modes display:
• Adjust the Active mode gain to set the gain in the spectral
Doppler area.
• Adjust Low velocity reject to reduce unwanted low
velocity blood flow and tissue movement.
• In PW mode, adjust Sample volume to low setting for
better resolution, or higher setting to more easily locate the
disturbed flows.
• Adjust the Compress setting to balance the effect of
stronger and weaker echoes and obtain the desired
intensity display.
Frequency and • Adjust Frequency to optimize flow display. Higher setting
Frame rate settings will improve resolution and the lower setting will increase
may affect the Low the depth penetration.
Velocity Reject.
• Adjust Frame rate to a higher setting to improve motion
detection, or to a lower setting to improve resolution.
The Doppler Power • Adjust Power to obtain an acceptable image using the
setting affects only lowest setting possible. This is particularly important in CW
Doppler operating mode, as the energy duty cycle is 100% (constant).
modes.
Use all noise reduction controls with care. Excessive
application may obscure low level diagnostic information.
CAUTION
Adjust the following settings to further optimize the display of

the image.
• Use the Horizontal sweep to optimize the sweep speed.
• To view signal detail, use the Velocity range to enlarge the
vertical spectral Doppler trace.
• Use Invert to reverse the vertical component of the spectral
Doppler area of the display.
When Zoom is ac- • Use Angle correction to steer the ultrasound beam to the
tive while in PW or blood flow to be measured (Not typically required during
CW modes, use the cardiac studies).
Depth rocker but-
ton to adjust the
zoom magnifica-
tion factor

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Using ASO
Press the "Auto" button while in PW or CW modes. This will
activate the ASO function. Automatic Spectrum Optimization
(ASO) is used to automatically adjust baseline and scale of
current PW/CW spectrum to optimize the spectral display. It will
avoid the display of a folded spectrum and stretch the spectrum
vertically as large as possible.
ASO optimization is not continuous but performed
instantaneously each time the button is pressed.
Tissue Velocity Imaging (TVI)
TVI overview
1. TVI sector marker

2. Status window
3. Soft menu
Figure 4-8: The TVI Mode screen
Tissue Velocity Imaging (TVI) calculates and color-codes the

velocities in tissue. The tissue velocity information is acquired
by sampling of tissue Doppler velocity values at discrete points.
The information is stored in a combined format with greyscale

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imaging during one or several cardiac cycles with high

temporal resolution.
TVI controls
TVI assignable controls
2D width
Controls the angular width of the 2D image sector.
Lower scale value Scale
allows greater depth
and lower Nyquist
Adjusts the repetition rate of the Doppler pulses transmitted to
limit. acquire the data for color mapping. The Scale value influences
the Nyquist limit (the ability to detect maximal velocity without
color-aliasing).
Baseline
Adjusts the color map to emphasize tissue motion either toward
or away from the probe. Baseline is available in both Live and
Freeze.
Frame rate
Controls the line density. When adjusting frame rate, there is a
trade off between spatial and temporal resolution.
Invert
tissue velocities to be inverted. Invert is available in live and
cine replay.
TSI
Starts TSI mode (see page 188).
Simultaneous
Enables simultaneous display of 2D image and 2D image with
TVI color.
TVI visible
Turns TVI display on/off. When TVI display is turned off the TVI
acquisition is still in turned on and raw-data is still acquired but
remains hidden from the display.

R2424458-100 Rev. 2
Scanning Modes
Color maps
rotary knob to select and activate a desired color map. Each
color map is assigning different color hues to different
velocities.
Q-Analysis (in Freeze only)
Starts the Quantitative analysis application (see Chapter 8,
"Quantitative Analysis" on page 375).
Alternative assignable controls
Press ALT to access the following modes:
• Tissue Synchronization Imaging (see page 188)
• Tissue Tracking (see page 173)
• Curved Anatomical M-Mode (see page 155)
• Strain rate (see page 178)
• Strain (see page 183)
TVI Soft menu controls
Compress
Controls the amount of color compression. The color bar is
adjusted accordingly.
Tilt
Enables the axis of the 2D image to be tilted to the left or right.
By using this control in combination with angle control the
image can be “aligned” to the direction of interest, and frame
rates be optimized. By default the axis of symmetry of a 2D
image is vertical. Tilting of the 2D image will tilt the TVI ROI
along with it.
Threshold
Controls the level of greyscale intensity that is used as a
threshold for color.
Transparency
Controls the degree of transparency of the TVI color.
Frequency
control the sensitivity or the level of penetration.

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Lateral Averaging
Use Averaging con- Smooths the image by averaging collected data along the
trols with caution same horizontal line. An increase of the lateral averaging will
so as not to obscure reduce noise, but this will also reduce the lateral resolution.
significant diagnos-
tic information Radial Averaging
Smooths the image by averaging collected data along the
same radial line. An increase of the radial averaging will reduce
noise, but this will also reduce the radial resolution.
When power is re- Power
duced, it reduces
the signal-to-noise
Controls the amount of acoustic power applied in all modes.
ratio, so that the im- When power is set to maximum, it is equal to or less than the
age may appear maximum acoustic power level permitted by regulatory
noisier. standards. The Thermal Index (TI) and the Mechanical Index
(MI) are displayed on the screen.
Using TVI
1. Select the desired probe.
2. While in 2D mode press TVI on the control panel, then select
TVI soft-key.
3. Use the trackball to position the ROI frame over the area
to be examined.
The assignable con- 4. Press SET. The instruction Size should be highlighted in the
trols of the trackball trackball status bar. If not, press SET again to select Size.
are displayed in the Note: If the trackball control Pointer is selected, press
trackball status bar
in the bottom right
corner of the screen. controls.
To enlarge or narrow the ROI, move the trackball to the
left or right.
To lengthen or shorten the ROI, move the trackball up or
down.
Optimizing TVI
sets. to further optimize the TVI display:

R2424458-100 Rev. 2
Scanning Modes
The Scale value also • To reduce quantification noise (variance), the Nyquist limit
affects the frame should be as low as possible, without creating aliasing. To
rate. There is a trade reduce the Nyquist limit: Reduce the Scale value from the
off between the
frame rate and
assignables on the control panel.
quantification
noise.
PW will be opti- • TVI provides velocity information only in the beam direction.
mized for Tissue The apical view typically provides the best window since the
Velocities when ac- beams are then approximately aligned to the longitudinal
tivated from inside
TVI.
direction of the myocardium (except near the apex). To
obtain radial or circumferential tissue velocities, a
parasternal view must be used. However, from this window
the beam cannot be aligned to the muscle for all the parts
of the ventricle.
Tissue Tracking
Tissue Tracking overview

2. Tissue Tracking color bar
3. Status window
4. Soft menu
5. Track start and track end markers
6. Tracking start and end from R-peak
Figure 4-9: The Tissue Tracking Mode screen

R2424458-100 Rev. 2
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Tissue Tracking calculates and color-codes the displacement in

the tissue over a given time interval, typically the systole. The
displacement is defined as the distance the tissue move during
this time interval. The displacement is found as the time
integral (sum) of the tissue velocities during this interval.
Only displacements in the beam direction are found. Only
positive (systolic) displacements are mapped into colors,
negative displacements are mapped into greyscale.
Tissue Tracking controls

Tissue Tracking assignable controls
Tracking start
The time after ECG R-peak when the integration should start.
Tracking end
The time after tracking start when the integration should end.
Tracking scale
Controls the color cut-off value of max displacement displayed.
The chosen values is shown on the color bar when the
assignable is activated.
Frame rate
Invert
tissue velocities to be inverted. Invert is available in live and
cine replay.
TSI
Simultaneous
Tissue Tracking color.

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Color maps
rotary knob to select and activate a desired color map.
Q-Analysis (in Freeze only)
Press ALT to access the following modes:
Tissue Tracking Soft menu controls
2D width
Tilt
Enables the axis of the 2D image to be tilted to the left or to the
right. By default the axis of the 2D image is vertical.
Threshold
Controls the level of greyscale intensity that is used as a
Transparency
Controls the degree of transparency of the Tissue Tracking
color.
Frequency
Use Averaging con- Lateral Averaging
trols with caution
so as not to obscure
significant diagnos- same horizontal line. An increase of the lateral averaging will
tic information reduce noise, but this will also reduce the lateral resolution.

R2424458-100 Rev. 2
Scanning Modes
Radial Averaging
same radial line. An increase of the radial averaging will reduce
noise, but this will also reduce the radial resolution.
Power
Controls the amount of acoustic power applied. When power is
reduced the signal to noise ratio is reduced, so that the image
may become noisier.
Cine Compound (Freeze only)
Calculates and displays cineloops generated from a temporal
averaging of multiple consecutive heart cycles. The number of
cycles averaged is controlled from the Soft menu rocker. The
number of averaged cycles displayed on the top left corner.
Using Tissue Tracking

1. From 2D or TVI Modes, press ALT on the control panel and
select the TISSUE TRACKING assignable.
2. Adjust TRACKING START (assignable) close to the R-peak.
3. Adjust TRACKING END (assignable) near the T-wave.
to be examined.
in the bottom right
Optimizing Tissue Tracking

• To reduce quantification noise (variance), the Nyquist limit
should be as low as possible, without creating aliasing. To
reduce the Nyquist limit, reduce the scale while in TVI.
• To check for aliasing, freeze the loop and apply velocity
trace (Press FREEZE and Q-ANALYSIS), see also Chapter 8,
• The main use of Tissue Tracking is to map positive systolic
displacements. This means that TRACKING START and
TRACKING END assignables should be adjusted to pick out
the systolic phase of the cardiac cycle: Adjust Tracking

R2424458-100 Rev. 2
Scanning Modes
start close to the R-Peak. Adjust Tracking end near the

T-wave.
• Negative displacement can be mapped by pressing INVERT.
TRACKING START and TRACKING END must then be adjusted
to pick out the diastolic phase of the cardiac cycle.
• The maximum displacement that is color-coded can be
adjusted using the TRACKING SCALE assignable. If set too
low, most of the wall will show the color indicating maximum
displacement. If set too high, the maximum displacement
color is never reached.
• Tissue Tracking provides velocity information only in the
beam direction. The apical view typically provides the best
window since the beams are then approximately aligned to
the longitudinal direction of the myocardium (except near
the apex).

R2424458-100 Rev. 2
Scanning Modes
Strain rate
Strain rate overview

2. Status window
3. Soft menu
4. Strain sample size
Figure 4-10: The Strain rate mode screen
Strain rate calculates and color-codes the deformation per unit

time i.e the speed at which the tissue deformation occurs.
Strain rate is defined as the spatial gradient of velocity data.

R2424458-100 Rev. 2
Scanning Modes
Strain rate controls

Strain rate assignable controls
2D width
SRI scale
Defines the scale for the color coding of the strain rate.
Frame rate
Invert
Enables the color scheme assigned to strain rate to be
inverted. Invert is available in live and cine replay.
TSI
Simultaneous
Strain rate color.
Color maps
Displays a menu of color map options. Use the trackball to
point a color map and press SET to activate a desired color
map.
Q-analysis (in Freeze only)

Press ALT to access to the following modes:

R2424458-100 Rev. 2
Scanning Modes

Strain rate Soft menu controls

Strain length
Determines the strain sample volume size. There is a trade-off
between noise and spatial resolution controlled by the Strain
length. To minimize noise the Strain length should be
maximized. A value of 12mm is typical for adult cardiac patients
(see "Optimizing Strain rate" on page 181).
SRI Reject
Adjust the cut-off level of the low Strain rate to be discarded
when generating the color image. Rejected values are
displayed in green.
Compress
Controls the amount of color compression. The color bar is
adjusted accordingly.
Transparency
Control the degree of transparency of the strain rate color.
Threshold
Controls the level of greyscale intensity that is used as
Frequency
Lateral Averaging
Use Averaging con- Radial Averaging
trols with caution
significant diagnos- same radial line. An increase of the radial averaging will reduce
tic information. noise, but this will also reduce the radial resolution.

R2424458-100 Rev. 2
Scanning Modes
Power
may become noisier.
Using Strain rate

1. From TVI Mode, press ALT on the control panel and press
STRAIN RATE.
to be examined.
in the bottom right
Optimizing Strain rate

• To reduce quantification noise (variance), the Nyquist limit
should be as low as possible, without creating aliasing. To
reduce the Nyquist limit, reduce the scale while in TVI.
• To check for aliasing, freeze the loop and apply velocity
trace (Press FREEZE and Q-ANALYSIS), see also Chapter 8,
• Strain rate provides velocity information only in the beam
direction. The apical view typically provides the best
the apex).
• There is a trade-off between noise and spatial resolution
controlled by the Strain length. To minimize noise the
Strain length should be maximized. A value of 12mm is
typical for adult cardiac patients.

R2424458-100 Rev. 2
Scanning Modes
• The maximum Strain rate that is color-coded can be

adjusted using the SRI SCALE assignable. If set too low,
most of the wall will show the color indicating maximum
Strain rate. If set too high, the maximum Strain rate color is
never reached.
• Low strain rates may be masked out with a green color
using the SRI Reject control.

R2424458-100 Rev. 2
Scanning Modes
Strain
Strain overview

2. Strain color bar
3. Status window
4. Soft menu
5. Strain start and end markers
6. Strain start and end from R-peak and Strain sample size
Figure 4-11: The Strain mode screen
Strain calculates and color-codes the extent of tissue

deformation (lengthening or shortening) relative to the original
size over a given time interval, typically the systole.

R2424458-100 Rev. 2
Scanning Modes
Strain controls
Strain assignable controls
Strain start
The time after ECG R-peak when the strain calculation should
start. The strain start time is displayed on the screen and is
represented on the ECG by a red marker.
Strain end
The time after strain start when the strain calculation should
end. The strain end time is displayed on the screen and is
represented on the ECG by a red marker.
Strain scale
Defines the scale for the color coding of the tissue deformation.
Frame rate
trade-off between spatial and temporal resolution.
Invert
Enables the color scheme assigned to shortening and
elongation tissue deformation to be inverted. Invert is available
in live and cine replay.
TSI
Simultaneous
Strain color.
Color maps
Displays a menu of color map options. Use the trackball to
point a color map and press SET to activate a desired color
map.

R2424458-100 Rev. 2
Scanning Modes

2D width (More menu)

Strain Soft menu controls

Strain length
Determines the strain sample volume size. There is a trade-off
between noise and spatial resolution controlled by the Strain
length. To minimize noise the Strain length should be
maximized. A value of 12mm is typical for adult cardiac patients
(see "Optimizing Strain" on page 186).
Strain Reject
Adjust the cut-off level of the low tissue velocity to be discarded
when generating the color image. Rejected values are
uncolored.
Threshold
Transparency
Control the degree of transparency of the strain color.
Frequency

R2424458-100 Rev. 2
Scanning Modes
Lateral Averaging
Use Averaging con- Radial Averaging
trols with caution
significant diagnos- same radial line. An increase of the radial averaging will reduce
tic information. noise, but this will also reduce the radial resolution.
Power
may become noisier.
Using Strain
1. From TVI Mode, press ALT on the control panel and press
STRAIN.
2. Adjust STRAIN START close to the R-peak.
3. Adjust STRAIN END near the T-wave.
to be examined.
in the bottom right
Optimizing Strain
• From an optimized Strain rate display adjust strain tracking
to pick out the systolic phase.
• The main use of Strain is to map negative systolic
deformation. This means that STRAIN START and STRAIN
END should be adjusted to pick out the systolic phase of the

R2424458-100 Rev. 2
Scanning Modes
cardiac cycle: Adjust STRAIN START close to the R-Peak.

Adjust STRAIN END near the T-wave.
• Positive deformation can be mapped by pressing INVERT.
STRAIN START and STRAIN END must then be adjusted to pick
out the diastolic phase of the cardiac cycle.
• The maximum deformation that is color-coded can be
adjusted using the STRAIN SCALE assignable. If set too low,
most of the wall will show the color indicating maximum
deformation. If set too high, the maximum deformation color
is never reached.
• Strain provides velocity information only in the beam
direction. The apical view typically provides the best
the apex).
• Low strain values may be masked out with a different color
using the SI Reject control.

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Scanning Modes
Tissue Synchronization Imaging (TSI)

TSI overview
1. TSI start/end and TSI Cut-off

2. TSI start and end markers
3. QRS marker
4. TSI color bar
5. Status window
6. Soft menu
Figure 4-12: The TSI mode screen
TSI calculates and color-codes the time from onset of QRS to a

detected event, typically the time to peak systolic velocity.

R2424458-100 Rev. 2
Scanning Modes
TSI controls
TSI assignable controls
Invert
Invert is available for TEE acquisitions. When applied, the time
to peak negative velocity is calculated (instead of the time to
peak positive velocity). Invert makes it possible to use TSI on
TEE acquisitions where the image sector is inverted.
Frame rate
trade-off between spatial and temporal resolution.
TSI
Starts/stops TSI Mode.
TSI Start
This rotary allows manual adjustment of TSI starting point.
TSI End
This rotary allows manual adjustment of TSI ending point.
Note: While in Freeze, press MORE to see the TSI Start / End
controls.
Simultaneous
TSI color.
Color maps
rotary knob to select and activate a desired color map.

R2424458-100 Rev. 2
Scanning Modes

Physio assignable control

Press PHYSIO and MORE twice to access to the following
control:
QRS visible
Shows/hides the QRS marker on the ECG.
TSI Soft menu controls

TSI Cut-off
Controls the cut-off time: using this control it is possible to color
all parts of the TSI image that has a time to peak less than a
certain cutoff time.
Threshold
Transparency
Control the degree of transparency of the TSI color.
Frequency
Power
reduced the signal to noise ratio is also reduced, so that the
image may become noisier.

R2424458-100 Rev. 2
Scanning Modes

Using TSI
TSI requires correct QRS detection to function properly.
Therefore always check that the yellow circle markers on the
CAUTION ECG are positioned correctly on each QRS complex before
proceeding with the analysis.
1. Ideally, perform the AVO and AVC Event Timing

measurements prior to starting TSI. See "Event timing
measurements" on page 265.
2. From TVI, or Tissue Tracking mode, select TSI.
3. Optionally adjust THRESHOLD.
to be examined.
in the bottom right
TSI markers adjustments

The default TSI markers settings are:
• TSI start: The time of the Event Timing measurement
Aortic Valve Opening (AVO). (If no AVO measurement is
available, 60 ms from the detected QRS is used.)
• TSI end: The time of the Event Timing measurement Aortic
Valve Closure (AVC). (If no AVC measurement is available,
an estimated time of end systole + 200 ms. is used.)
The system can be configured to automatically adjust the TSI
start marker to Aortic Valve Opening, providing that this event
is measured. If not measured, the default setting is used
(60 ms).
The system can be configured to automatically adjust the TSI
end marker relatively to the to Aortic Valve Closure (AVC) or
Mitral Valve Opening (MVO) event, providing that these events
are measured. If not measured, the TSI end marker is adjusted
relatively to the estimated End Systole.

R2424458-100 Rev. 2
Scanning Modes
The configuration alternatives are:

• TSI start: 60 ms, 80, 100, 120, AVO or Manual control
• TSI end: AVC - 200 ms, AVC - 150 ms, AVC - 100 ms,
AVC - 50 ms, AVC, AVC + 50 ms, AVC + 100 ms,
AVC + 150 ms, AVC + 200 ms, MVO, MVO + 100 ms,
MVO + 160 ms, MVO + 200 ms, MVO + 260 ms or Manual
control.
Note: Manual adjustment of TSI start and TSI end markers
is available. Press MORE and adjust TSI START and TSI END.
To store the modified marker settings, press IMG STORE
and choose the configuration setting Manual control to
avoid automatic adjustment of the markers.
To configure TSI markers:
1. Press CONFIG and select the category Measure.
2. In the Measure category, select the sheet Advanced.
3. In the Application specific parameters section adjust TSI
Start and TSI End parameters by selecting a new value
from the combo menu displayed upon selection.
Optimizing TSI
• Use apical view when imaging and ensure that both LV
walls and opposing walls are in the view.
• Activate TSI from an optimized TVI display.
• Low time to peak values may be masked out with a different
color using the TSI Cutoff control.
• Optimize 2D gain for clean chamber
• ATO can be used
• Clean ECG trace
• Acquire one or more complete heart cycles
• Default TSI start and end times are suggested
• When analyzing TEE images where systolic velocities are
negative, the detection mode may be changed to "Time to
peak negative velocity" using the Invert control.

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Scanning Modes
Additional scanning features

LogiqView
LogiqView provides the ability to construct and view a static 2D
image which is wider than the field of view of a given
transducer. This feature allows viewing and measurements of
anatomy that is larger than what would fit in a single image.
Examples include scanning of vascular structures and
connective tissues in the arms and legs.
LogiqView constructs the extended image from individual
image frames as the operator slides the transducer along the
surface of the skin in the direction of the scan plane. The
quality of the resulting image is somewhat user-dependent and
requires some additional skill and practice to develop proper
technique.
LogiqView is available with linear probes in 2D mode only.
Note: LogiqView is available only when Compound (see
below) is turned off.
Using LogiqView
1. Perform a detailed examination of the anatomy/pathology.
Optimize parameters for tissue texture and visible window
prior to activating LogiqView.
2. Press the assigned key LOGIQVIEW.
3. To start acquiring the image, press 2D FREEZE. Scan slowly
and in a uniform motion lengthwise.
• Continuous contact is required throughout the length of
the extended image.
• Always keep the transducer perpendicular to the skin
surface.
• Keep the motion within the same scan plane.
• Do not make abrupt changes in speed of motion.
4. If required, press 2D FREEZE again to restart the acquisition.
5. To complete the scan, press FREEZE.
6. Adjust the assigned rotary LOGIQVIEW ROTATE to rotate
the acquisition.
7. Perform measurements.
8. Press IMG STORE.

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Scanning Modes
Note: Measurement error is within 5% of the distance you

measured for all linear probes.
Hint: When you scan, scan slowly and in a uniform motion
lengthwise, end-to-end (with or against the probe orientation
marker). LOGIQView acquires images via leading edge vectors
(and does not acquire slices, as in CINE). The image is being
stored as you perform the scan and you can watch the
LOGIQView as it is being acquired.
Uniform Motion
The quality and usefulness of LOGIQView images is affected
by transducer motion. Incorrect technique can contribute to
image distortion.
Guidance and precautions for uniform motion:
• Continuous contact is required throughout the length of the
extended image. DO NOT lift the transducer from the skin
surface.
• Always keep the transducer perpendicular to the skin
surface. DO NOT rock the transducer.
• Keep the motion within the same scan plane, if possible.
DO NOT slide the transducer laterally.
• Lateral turning (change in direction to follow anatomical
structure) can be accommodated with slower motion. DO
NOT make abrupt changes in direction.
• The system accommodates a reasonable range of motion
velocity. DO NOT make abrupt changes in speed of motion.
Deeper scans generally require reduced speed.
Compound
Compound is a process of combining several frames from
different steering angles into a single frame. The combined
single image has the benefits of reduced speckle noise,
reduced clutter, and continuity of specular reflectors. Therefore,
this technique can improve contrast resolution.
Compound is available with linear and 4C-RS curved probes in
2D live mode, or in the 2D image while in Color mode.
Compound is on by default.

R2424458-100 Rev. 2
Scanning Modes
Using compound
• Press the COMPOUND assigned key.
A compounded image is produced.
B-Flow
B-Flow provides an intuitive representation of non quantitative
hemodynamics in vascular structures. B-Flow enables
visualization of complex hemodynamics and highlights moving
blood and tissue. There are no artifacts such as bleeding,
blooming, or aliasing.
B-Flow is available Color flow mode with linear probes only.
Using B-Flow
1. While in Color flow, press the assigned key B-FLOW.
2. Adjust the soft menu control TEXTURE GAIN. Increased
gain enhances hemodynamic.
The greater the speed, the better the image scatter density and
size. If the scan direction is the same as the flow direction, then
the image scatter is elongated; if the scan direction is the
opposite as the flow direction, then the image scatter is tighter.
Therefore, have the scan direction opposite to that of flow
direction. Switch the way you hold the probe, with the probe
orientation marker inferior to maintain correct orientation on the
monitor. Flow starts from where the focal zone is located.
Blood flow imaging
Blood flow imaging (BFI) is a Color flow mode with added
speckle information. The speckle information visualizes the
blood flow direction.
Note: When scanning in BFI triplex mode it is normal to have a
time delay between the Doppler display/Doppler audio and the
BFI color display.
Using blood flow imaging

1. While in Color flow, press the assigned key BFI.
2. Adjust Flow speckle. Increased Flow speckle enhances
hemodynamics.

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Scanning Modes
3. Adjust the soft menu control BFI GAIN. Increased gain

enhances hemodynamic. See page 163 for Color flow
image optimization.
Virtual Convex
Virtual Convex is designed to provide a wider field of view in
the far field, and is available on linear probes. While in
2D-mode, use the Virtual Convex soft-key to turn virtual
convex ON or OFF. When Virtual convex is turned on, you may
enter other scanning modes such as Color, Doppler or M-mode
and virtual convex will remain active on the 2D image.
Note: While Virtual Convex is turned on, the Zoom function will
always activate in "Display-zoom" mode only.

R2424458-100 Rev. 2
Stress Echo
Chapter 5
Stress Echo
• Introduction ................................................................................... .. 198

• Selection of a stress test protocol template .............................. .. 199
• Image acquisition .......................................................................... .. 200
• Starting acquisition ................................................................... 201
• Continuous capture mode ........................................................ 205
• Analysis .................................................................................... 213
• Quantitative TVI Stress echo analysis ........................................ .. 218
• Accessing QTVI Stress analysis tools ...................................... 219
• Vpeak measurement ................................................................ 220
• Tissue Tracking ........................................................................ 223
• Quantitative analysis ................................................................ 223
• References ............................................................................... 224
• Editing/creating a template .......................................................... .. 225
• Entering the Template editor screen ........................................ 225
• Template editor screen overview ............................................. 226
• Editing/Creating a template ...................................................... 229

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Introduction
The Vivid S5/Vivid S6 ultrasound unit provides an integrated
stress echo package option, with the ability to perform image
acquisition, review, image optimization, and wall segment
scoring and reporting for a complete, efficient stress echo
examination.
The stress package provides protocol templates for exercise,
as well as, pharmacological stress examinations. In addition to
preset factory protocol templates, templates can be created or
modified to suit users' needs. Users can define various quad
screen review groups, in any order and combination, that will
suit their normal review protocol. When reviewing stress
examination images, the images are viewed at their original
image quality, and different post-processing and zoom factors
may be applied to the images under review for effective image
optimization. The protocol template may be configured for
Continuous capture.
A stress echo examination consists of three steps:
• Selection of a stress test protocol template (page 199)
• Image acquisition (page 200)
• Stress analysis (page 213)

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Selection of a stress test protocol template

1. Press PROTOCOL to enter the stress echo mode.
The Protocol screen is displayed (see Figure 5-1) showing
the default stress protocol for the current probe.
To create or edit a 2. To use the current template:
template see Turn freeze off to initiate scanning.
page 225. To use another template:
Press the assignable TEMPLATE.
The template list is displayed.
3. Trackball to the desired template.
4. Press SET.
5. Turn freeze off to initiate scanning using the new template.
1. Projection selection
2. Level
3. Current acquisition
4. Projection
5. Group of views
Figure 5-1: The Protocol screen

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Image acquisition
Images are acquired in a pre-defined order, according to the
selected template. The highlighted cell (green) of the matrix,
displayed in the Clipboard window indicates which view is
currently being acquired (see Figure 5-2). The names of both
the view and the level for the current cell is displayed on the top
corner of the image area and under the template matrix.
1. Current view label

2. Template matrix
3. Current view (Green cell)
4. Timers
Figure 5-2: The stress mode acquisition screen

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Starting acquisition
To use the Timer, 1. Turn freeze off to initiate scanning.
see page 204.
2. Perform a scan that conforms with the view that is
highlighted in the template matrix on the Clipboard window.
Smart Stress is If the selected template has the option Smart Stress
turned on by de- turned on (this option is available only on Vivid S6) (see
fault in factory tem- page 228), a subset of the image acquisition settings for
plates.
each view in the baseline level will be stored and
automatically reused in the corresponding views in the
next levels.
3. Press STORE.
For further infor- • If the actual stress level is configured to preview
mation on stress cineloop before storing, use the cineloop controls to
test configuration, select the most appropriate heart cycle and, if desired
see page 225.
adjust the loop markers (see "Cineloop operation" on
page 110 for further information). Press STORE to save
the selected cineloop.
• If the actual stress level is not configured to preview
cineloop before storing, the system will automatically
store the last cardiac cycle.
When storage of the cineloop is completed, the actual
highlighted cell in the template matrix displays a 2D icon
indicating that the view has been acquired. After storing
the loop, the system automatically highlights the next view
in the matrix to be acquired.
For further infor- Stress levels can be configured for side by side
mation on stress display/comparison of the reference loop from baseline or
test configuration, previous level and the loop to acquire (see Figure 5-3).
see page 225.
4. Repeat previous steps until all required views are
completed.
If using DICOM Server dataflow for stress-echo acquisition,
images should not be saved to permanent archive before the
CAUTION complete protocol exam is acquired.
The template used can be configured so that analysis is

automatically started, displaying the first protocol group. The
wall segment scoring diagrams for each view is displayed in the
Parameters window on the right side of the screen (see
Figure 5-9, page 215).

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1. Current acquisition loop

2. Corresponding reference loop
Figure 5-3: Display of the Reference loop during acquisition
Protocol Pause function

During the stress acquisition it is possible to temporarily exit the
protocol acquisition mode to acquire images in any mode
outside the stress protocol.
1. To temporarily exit the protocol mode, press PROTO.IN/OUT
soft-key button.
2. Acquire the desired images outside the protocol.
3. Press the 2D mode button.
4. Press PROTO.IN/OUT soft-key button to restart the protocol
acquisition mode and resume the stress acquisition.
Selecting a view during acquisition

A fixed protocol is provided for scanning, based on the selected
template. The system automatically highlights the next view to
be acquired in the template matrix, as images are stored.

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However, the order of scanning may be changed manually as

follows:
Manual selection of a view during acquisition
1. Use the arrow keys on the alphanumeric keyboard to
highlight the cell that represents the view that is to be
acquired.
The selected cell in the template matrix is highlighted in
red, indicating non-default position and is blinking if it
contains a previously stored acquisition.
2. Turn freeze off to initiate scanning.
3. Scan and save the selected loop as explained in the
previous section.
After storage the system automatically highlights the next
available view to be acquired.
Replacing an acquired image

1. Use the arrow keys on the alphanumeric keyboard to
highlight the cell that represents the view that is to be
replaced.
The selected cell in the template matrix is highlighted in
red, indicating non-default position.
2. Turn freeze off to initiate scanning.
3. Scan and save the selected loop as explained in the
previous section.
4. Select in the dialog window if you want to Replace or Keep
the existing loop.
• Replace: the original image is deleted from the
examination and replaced by the acquired image.
• Keep: the original image is replaced by the acquired
image, but it is not deleted from the examination.
Note: When selecting Keep, both the new and the old
image will be associated with the current protocol cell and
you may later perform Wall Motion Scoring for this level in
the protocol using either the new or the old image. The
new image may be opened from the protocol, while the old
image may be opened manually from the clipboard.
After storage the system automatically highlights the next
available view to be acquired.

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Moving an acquired image

An Image can be moved from one cell to another during
acquisition. There are two ways to move images:
Procedure 1
1. When in the Protocol screen, press MORE (assignable
menu).
2. Press the assignable MOVE IMAGES.
3. Trackball to the image to move (source cell).
4. Press SET.
5. Trackball to the destination cell.
6. Press SET.
The image is moved from the source cell to the destination
cell.
Procedure 2
1. In the Protocol screen, trackball to the cell containing the
image to move (source cell).
2. Press and hold down SET.
3. With the SET key still depressed, trackball to the destination
cell.
4. Release the SET key.
The image is moved from the source cell to the destination
cell.
Stored images can- If the destination cell contains an image, the images from the
not be moved. source and destination cells will be exchanged when moving
an acquired image.
Timers
Two timers can be displayed in the Stress mode acquisition
screen, beside the template matrix (see Figure 5-4).

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1. Timers display
Figure 5-4: The timers in the acquisition screen
• T1 displays the elapsed time from the start of the stress

examination.
• T2 starts when entering live scanning on the second stress
level
Both T1 and T2 timers can be manually stopped and restarted
during the acquisition from the System Menu (Press MENU on
the control panel).
The display of T1 and T2 is user-configurable (see page 225).
Continuous capture mode

Continuous capture mode enables the user to perform
acquisition continuously for all views at any level depending on
the selected template configuration. Continuous capture
consists of temporary saving images acquired in a storage
buffer. To enable best possible use of the limited storage buffer
capacity, a Pause/Capture mode is provided, as opposed to the
normal Freeze/Scan mode. The Pause mode enables scanning

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and live display on the screen, without any capture, thereby

leaving the buffer available.
To run Continuous capture, the user has to select a template
where this feature is activated (see page 225 about template
configuration).
The buffer bar

When entering a level with Continuous capture enabled, a
Buffer bar is displayed in the Info window (see Figure 5-5). The
Buffer bar displays the following information:
• The unit's scanning state:
• PAUSE (live scanning without storing)
• CAPTURE (live scanning with storing to buffer)
• The percentage of the buffer that is filled
• The buffer filling progression showed by a green filling
gauge
• The capturing sessions, reflected by the red lines along the
Buffer bar

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1. Scanner's state
2. Capture session
3. Pause session
4. Buffer gauge
5. Percentage of filled buffer
Figure 5-5: The buffer bar in Continuous capture
Controlling the capture process

When entering a stress level with Continuous capture enabled,
the unit is automatically set in Pause mode.
1. Press STORE or 2D FREEZE to start image capture.
“Capture” is displayed in the buffer bar, the gauge starts
filling and the percentage of filled memory buffer increases
(see Figure 5-5, page 207).
2. Press STORE or 2D FREEZE again to stop capture.
“Pause” is displayed in the buffer bar.
When 90% of the memory buffer is filled up, the text display in
the buffer bar turns red.
The unit enters Freeze mode automatically once the buffer is
full and the captured loops are displayed in the Continuous
capture selection screen (see below).

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Running Continuous capture

1. Do all your pre-stress acquisitions in the Cardiac
application.
The application Ex- 2. Press PROTOCOL to enter the stress echo mode.
ercise should be The Protocol screen is displayed (see Figure 5-1,
used in order to get page 199).
maximum continu-
ous capture buffer. 3. Press Template.
The template list is displayed.
4. Select the template Exercise 2x4.
The Exercise proto- 5. Press Begin/Cont.
col template is auto-
6. Acquire the resting loops in all four views.
matically selected
when the applica- 7. Once the fourth loop is acquired the system enter into a
tion Exercise is ac- waiting mode where Continuous Capture is in pause state
tive. awaiting the patient to exercise.
Note: Make sure the system is set to Exercise preset
before starting peak-stress acquisition.
8. When the patient is back on the bed, press STORE or 2D
FREEZE. The Continuous capture acquisition is started.
9. Acquire all your views.
The memory buffer gauge increases (Figure 5-5). When
memory filling exceeds 90%, the percent number turns
red.
10. Press FREEZE to finish.
11. Press the SELECT CYCLE assignable.
The Continuous capture selection screen is displayed (see
If the buffer is filled up the system will automatically display
the Continuous capture selection screen.
Refer to the next section if additional image acquisition is
necessary after the buffer is filled up.
12. Assign the cineloops to the four views (see page 211).
A dialogue window is displayed asking whether the entire
Continuous capture acquisition should be saved or not.
Using Store all to 13. Press Delete to discard the loop
save the entire loop OR
may take up to 15 Press Select later if you want to reselect any loops (open
seconds on Local-
Arch-IntHD and
the capture again from the Protocol screen).
several minutes on OR
LocalArch-MOD. Press Store all to keep the entire loop.
14. Perform Analysis and scoring (see page 213).

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Continuous capture with additional image acquisition

After acquiring Continuous capture, additional images can be
stored to the clipboard before the patient's heart rate decreases
toward recovery level. These additional images may be
acquired with other scanning modes (using the same probe
and application), before doing image assignment to the views:
1. Perform Continuous capture as described above (steps 1
to 10).
2. Press PROTOCOL twice on the control panel. Live scanning
is activated.
If the buffer is not filled up: press PROTO.IN/OUT on the
softkey menu. Live scanning is activated outside the stress
protocol.
If the buffer is filled up: press Select later in the
Continuous capture selection screen. Live scanning is
activated.
3. Perform the additional acquisition (e.g. Color flow,
Doppler). Images will be stored outside the protocol.
4. In order to resume the stress echo exam and assign loops
for the views from the Continuous capture buffer, press
PROTOCOL.
5. Press on the Continuous capture icon on the lower left
corner of the Protocol screen.
The Continuous capture selection screen is displayed.
6. Assign the cineloops to the views (see page 211).
7. Press Delete to discard the loop
OR
Press Select later if you want to reselect any loops (open
the capture again from the Protocol screen).
OR
Press Store all to keep the entire acquisition.
The normal procedure is to discard the acquisition. The
loop is very big and will take a lot of disk space.
Postponed image assignment
The assignment of the cineloops to the views can be done on a
later stage on a stored Continuous capture acquisition.
1. Perform Continuous capture as described in "Running

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Continuous capture" on page 208 (steps 1 to 11).

The continuous 2. Press Store all.
capture loop is very The entire Continuous capture acquisition is stored. The
big, and ending the examination can be ended and the image assignment,
exam may take sev-
eral minutes if stor-
analysis and scoring can be done on a later stage.
ing through a slow 3. Re-open the examination if necessary.
network or storing
4. Press PROTOCOL.
to a removable me-
dia. The Protocol screen is displayed.
5. Press on the Continuous capture thumbnail on the lower
left corner of the Protocol screen.
The Continuous capture selection screen is displayed.
6. Assign the cineloops to the views (see page 211).
7. Press Done when finished.
9. When exiting this patient a dialogue window is displayed
asking whether the remaining continuous capture images
should be deleted.
• Press Yes to delete the remaining continuous capture
images
OR
• Press No to keep the entire continuous capture
acquisition.
The normal procedure is to delete the remaining images as
they take a lot of disk space.
Restart capture from the Continuous capture selection
screen
• Press RESTART CAPTURE.
The recording in memory is deleted and the Continuous
capture is started again.
Resume Continuous capture
• Press CONTINUE CAPTURE.
Resumes Continuous capture recording (only if the
Continuous capture buffer is not full).

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Assigning and storing the loops

The cineloops captured in the buffer are assigned to the stress
protocol views and stored from the Continuous capture
selection screen (see Figure 5-6).
1. Rotate CHANGE PAGE assignable to display 4. Red bar: pause session

other pages. 5. Grey gauge: position of the highlighted loop
2. Cycle number and total number of cycles within the buffer area
3. Highlighted loop
Figure 5-6: The Continuous capture selection screen
Assigning a cineloop to a view

1. Trackball to the desired loop in order to assign it to a
particular view of the stress template.
The frame of the loop is highlighted.
2. Press SET.
A pop-up menu is displayed with the view names of the
template (see Figure 5-7).

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The views that are 3. Trackball to the required view name.

already assigned are
4. Press SET.
tick marked (see
Figure 5-7). The name of the view is displayed above the timers in the
loop window.
5. Repeat steps Figure 1 through Figure 4 to assign loops to
the other views of the level.
6. Press the assignable DONE when completed.
7. Press Delete to discard the acquisition.
Saving the entire OR
acquisition may Press Store all to keep the entire acquisition.
take a few seconds The normal procedure is to discard the acquisition. The
on the local hard
disk and several
acquisition is very big and will take a lot of disk space.
minutes on a re-
movable media.
1. Assigned loop
2. Highlighted loop
3. Views pop-up menu
4. Highlighted views
5. Already assigned view
Figure 5-7: Loop assignment in Continuous capture

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Analysis
Analysis consists of viewing previously saved loops and
assigning scores to each cardiac segment, in order to quantify
the function of the muscle, or wall motion.
Depending on the protocol configuration, the analysis stage
can be started automatically after completion of the stress test
or it can be started manually. In this case, the usual procedure
consists of sequentially opening all image groups (if defined)
and perform scoring from image to image.
The quad screen is the standard display for comparing heart
cycles (Figure 5-9). The heart cycle loops in the display are
synchronized to enable comparison. Each loop in the quad
screen can be magnified, using the "Crop Images" function
(see page 591) or the zoom control (see page 120).
Image selection for analysis

Images can be selected manually or from a pre-defined group
in the Protocol screen.
Selection of images from a group
If groups of images have been defined in the protocol template
(see page 231), the user can select a group of images for
analysis and sequentially analyze all images from all groups
from within the analysis screen (see Figure 5-9, page 215).
1. In a stress examination, press PROTOCOL.
A preview of the acquisitions is displayed.
2. Trackball to a group in the Group list.
The frame of the images belonging to the group are
highlighted.
3. Press SET to open images in the Analyze screen (see
page 216).
Note: Pressing ANALYZE (while no images are selected in
Protocol screen) automatically opens the first group of images
in the analysis screen.

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1. Select a Projection
2. Select an image
3. Select and open an Image group
Figure 5-8: Image selection from the Protocol screen
Manual selection of images in the Analysis screen

1. When currently in protocol analysis in the Stress analysis
quad screen (Figure 5-9), hold down SHIFT while performing
steps 2 to 4.
2. Trackball to the first image to select in the Template matrix.
3. Press SET.
The selected loop is displayed in the Stress analyze
screen and the next window in the quad screen is
automatically selected.
4. Repeat steps 2 and 3 to select other images.
5. Depress SHIFT.
Manual selection of images in the Protocol screen
1. In a stress examination, press PROTOCOL.
A preview of the acquisitions is displayed.
2. Trackball to the first image to select.
3. Press SET.
The frame of the selected loop is highlighted.
4. Repeat steps 2 and 3 to select other images.

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Alternative: Double 5. Press ANALYZE to open images in the Analyze screen (see
click on the last se- page 216).
lected image to open
images.
1. Selected loop (highlighted frame) 4. Change page or enter next image group
2. Highlighted segment name 5. Exit Wall motion scoring
3. Wall segment diagrams 6. displayed loops (highlighted frames)
Figure 5-9: The stress echo analysis screen (Quad screen)
Wall motion scoring

Wall motion scoring is used to evaluate wall motion in each
cardiac segment. The left ventricle myocardium is divided into
a number of segments (e.g. 16 or 18), and each segment is
assigned a score based on visual evaluation/"eye-balling". The
wall motion scoring results are linked to the stress level of the
image being evaluated. This means that for instance when
scoring a short axis projection and a long axis projection from
the same stress level, then common segments with the same
scoring value will be shown in the respective scoring diagrams.

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The wall motion scoring result is assigned to the stress level of

the image, but will not be updated if the image is moved to
CAUTION another stress level in the protocol at a later time. Images should
be correctly placed in the protocol when performing wall motion
scoring.
Note: The number of segments (WMS segment model), the

range of scoring values (WMS scoring legend) and the initial
scoring value (WMS initial scoring) may be configured in
Config/Meas Text/Advanced under the Cardiac M&A category.
Scoring acquired loops

1. After image selection (see page 213), press ANALYZE.
The Stress Echo Analysis screen is displayed (see
Figure 5-9).
To edit a score, se- 2. Trackball to a segment in one of the scoring diagrams and
lect it and choose a press SET.
new score. The Score pop-up list is displayed (see Figure 5-10).
3. Trackball to a score.
Alternative: Press 4. Press SET.
the arrow heads at The score is displayed in the relevant segment area in the
the bottom of the diagram (see Figure 5-10).
scoring diagram
(see Figure 5-9) 5. Repeat steps 1 through 3 to score relevant segments.
6. Rotate the assignable CHANGE PAGE to display next group
of images.
7. Repeat steps 1 through 3 to score relevant segments on the
new loops.

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1. Selected segment
2. Selected score
1. Scored segment
Figure 5-10: Segment scoring

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Quantitative TVI Stress echo analysis

QTVI Stress analysis is meant as a guide to wall motion scoring.
Diagnosis must not be based on results achieved by QTVI Stress
WARNING analysis only.
The Vivid S5/Vivid S6 Ultrasound unit provides a Quantitative

TVI (QTVI) Stress analysis package based on Tissue velocity
information (TVI). The TVI data is stored in a combined format
with grey scale imaging during stress examination.
When selecting a template supporting TVI data acquisition, the
ultrasound unit will automatically store TVI information,
generally for the apical views of the stress examination.
The QTVI Stress analysis option currently applies only to
Dobutamine stress-echo.
Wall Motion Scoring remains the basis for the diagnosis of CAD
in stress echocardiography. QTVI Stress may be used as a
guidance tool to check this interpretation.
QTVI Stress is based on the assessment of peak velocity at
peak Dobutamine stress (see "References" on page 224. The
normal ranges have been validated in the "average" patient
presenting for stress testing. The velocity cutoff values for the
Vpeak measurement will not work in the following cases:
Velocity measure- • Submaximal stress (<85% predicted max HR)
ments in mid and
• Patients at extremes of age (<40 or >70)
basal segments of
the myocard will • Previous myocardial infarction/revascularization
contain contribu- • Previous heart-failure / cardiomyopathy / hypertrophy /
tions from the api-
cal region of the
arrhythmia / aortic regurgitation
myocard. E.g. if The velocity cutoff values are based on placing the sample
measured value in a
mid segment is be-
volume at center of each cardiac segment at start of systole,
low the cutoff value the left ventricle myocardial segments are defined by the
for this segment American Society of Echocardiography 16 segments model.
then this might re- However, the velocity cutoff model does not cover the apical
late to a reduced segments (due to low velocities and segment orientation), (see
function in the mid
side note).
or apical region.
Tissue Doppler does not have perfect site-specificity because
of tethering by adjacent segments. Thus, although an ischemic
segment has little thickening (and therefore could be expected
to show low velocity), measured velocity may be influenced by

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local tethering, reflecting contraction in surrounding segments.

Conversely, a normal segment may have its velocity reduced
by an adjacent segment with reduced velocity. This tethering
effect may decrease the sensitivity for single vessel disease,
but nonetheless the sensitivity and specificity of the cut-offs are
approximately 80% (see "References" on page 224).
Three different analysis tools based on TVI data are available:
• "Vpeak measurement" on page 220, enables the display of
a tissue velocity trace for a selected region of a previously
scored segment through the entire heart cycle. In addition
Vpeak is color-coded on the 2D image. From the velocity
trace, the user can estimate the peak systolic velocity (see
"References" on page 224).This tool is available in views
from peak levels only and only when a segment has been
scored in one of these views.
• "Tissue Tracking" on page 223, enables visualization of the
systolic contraction of the heart by color-coding the
myocardial displacement through the systole.
• "Quantitative analysis" on page 223, enables further
quantitative analysis based on multiple tissue velocity
traces.
The quantitative analysis is described in Chapter 8,
"Quantitative Analysis" on page 375.
Accessing QTVI Stress analysis tools

The three QTVI Stress analysis tools are entered by pressing a
dedicated button on the scoring diagram (see Figure 5-11) of
the selected view. Only views with TVI data acquired will
display QTVI Stress tools buttons on the respective diagrams.

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1. Vpeak measurement (V-peak measurement is displayed in views from peak levels and only after
scoring.)
2. Tissue Tracking
3. Quantitative analysis
Figure 5-11: QTVI Stress tools buttons
Vpeak measurement
This tool enables the user to generate a tissue velocity profile
for a given wall segment through the entire heart cycle and
display color-coded Vpeak in tissue.
From the velocity trace, the user can determine whether the
systolic Vpeak is over or under a clinically determined velocity
threshold (see "References" on page 224) to confirm the wall
motion scoring.
QTVI Stress can be used only in conjunction with wall motion
scoring analysis, as a guiding tool.
CAUTION
When activating QTVI Stress, the measurement applies only to
the currently highlighted segment for the current level and
projection view.
To display a Vpeak measurement

1. Perform segment scoring as described on page 216.

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When performing scoring a view from a peak level, the

Vpeak measurement button (V) is displayed in the
corresponding diagram.
2. In the Scoring diagram, press V.
The trackball cursor is changed to sampling area and the
scored peak views are updated showing:
See page 222 for • A diagram with the current segment highlighted (scoring
further information bullet with a ring) and the segment's velocity cutoff (see
on Vpeak measure- Figure 5-12).
ment interpreta-
tion. • Color-coded velocity in tissue. The color-coding
convention is as follow:
- Green: Velocities above threshold value + 5%
- Yellow: Velocities near threshold (+/- 5% interval)
- White: Velocities below threshold value - 5%
• A result window to display tissue velocity profile, shown
when moving the sampling area in the view.
3. In the 2D sector, trackball the sampling point over the wall
area corresponding to the current segment (shown as the
highlighted segment in the diagram). A tissue velocity
profile for the actual segment is generated in the Result
window (see Figure 5-12).
4. Use SEGMENT SELECT assignable to analyze the other
segments in the peak view,
Or
Select another scoring bullet in the diagram in one of the
peak views.
To turn off the Vpeak measurement tool

1. Trackball to one of the V button in the peak view scoring
diagrams.
2. Press SET in the trackball area.

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1. Threshold for current segment (green) 4. Vpeak threshold for current segment
2. Sampling point 5. Color-coded tissue velocity
3. Current segment 6. Result window with tissue velocity profile
Color-coding (velocity thresholds and tissue):

• Green: velocities above threshold value
• Yellow: velocities near threshold (0 to -10% interval)
• White: velocities below threshold value - 10%
Figure 5-12: Vpeak QTVI Stress display
V-peak measurement interpretation

The systolic Vpeak in the tissue velocity profile is automatically
detected and highlighted by a vertical bar (see Figure 5-12).
The automatically detected Vpeak should be visually verified by
the user. In addition Vpeak thresholds are displayed as
color-coded horizontal lines (see Figure 5-12). These
thresholds represent statistical guideline values for peak
velocity at peak stress level (Dobutamine stress procedure) for
the three apical views. Only threshold values for basal and
mid-segments for each apical view are defined (see
"References" on page 224). The result is highlighted by a
color-coding of the thresholds lines, the color-coding in the 2D
image and the scoring bullet (see Figure 5-12).

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Tissue Tracking
Tissue Tracking calculates and color-codes the displacement in
tissue over a given time interval. The displacement is found as
the time integral (sum) of the tissue velocities during the given
time interval. The color-coded displacements calculated in the
myocardium are displayed as color overlay in the respective
acquisition window.
By studying the color patterns generated in the different
segments, the user can confirm the standard segmental wall
motion scoring at peak levels.
To display Tissue Tracking

1. Trackball to a loop with TVI data (usually an apical view at
peak level).
2. Press SET on the control panel.
3. Trackball to the corresponding Wall segment diagram.
4. Press T on the Wall segment diagram field (see
Figure 5-11). The Tissue Tracking color overlay is
displayed in the Acquisition window.
Figure 5-13: Tissue Tracking display
Quantitative analysis
Quantitative analysis enables further analysis based on
multiple tissue velocity traces. Quantitative analysis is
performed using the Quantitative analysis package described
in Chapter 8, "Quantitative Analysis" on page 375.

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To start quantitative analysis

1. Trackball to a loop with TVI data (usually an apical view at
peak level).
3. Trackball to the corresponding Wall segment diagram.
4. Press Q on the Wall segment diagram field to launch the
Quantitative analysis package (see Chapter 8,
References
1. Application of Tissue Doppler to Interpretation of
Dubotamine Echocardiography and Comparison With
Quantitative Coronary Angiography. Cain P, Baglin T,
Case C, Spicer D, Short L. and Marwick T H. Am. J. Cardiol.
2001; 87: 525-531

R2424458-100 Rev. 2
Stress Echo
Editing/creating a template
The stress package provides protocol templates for exercise as
well as pharmacological stress examinations. The user can
create new templates or modify existing templates to suit the
individual needs. Up to ten projections and fourteen stress
levels can be created in a template.
Templates created may be temporary, used only during the
current examination, or saved as new templates, for future use
and reference. The editions that may be performed include:
• Adding/deleting levels and projections, page 229
• Assigning new labels to levels and projections, page 230
• Defining level options, page 230
• Defining new groups, page 231
Templates are edited/created from the Template editor screen.
Entering the Template editor screen

1. Press PROTOCOL to enter the stress echo mode.
2. Press the assignable TEMPLATE.
The Template pop-up menu is displayed.
3. Trackball to Template Editor.
4. Press SET.
The Template editor screen is displayed (see Figure 5-14).

R2424458-100 Rev. 2
Stress Echo
Template editor screen overview
Figure 5-14: The Template editor screen
Template
Parameter Description
Template:
• Select a pre-defined template from the
pop-up menu. The Protocol template
preview (see below) is updated
accordingly.

R2424458-100 Rev. 2
Stress Echo
Protocol template preview
Protocol template preview:

• displays an updated preview of the
template accordingly to the settings
applied.
• To change Projection and Stress level
labels, select a pre-defined label from the
pop-up menu or press SET in the actual
label field and type a new name.
• Q Stress acquisition: enables TVI data
acquisition for QTVI Stress analysis.
Template settings
Template settings:
• Cycles: select the number of cineloop
heart cycles to store for each level from the
drop-down menu.
• Continuous capture:
: enables continuous image acquisition
throughout the level. The images acquired
are temporarily stored in the unit's storage
buffer.
• Preview of store:
: enables review and adjustment of
cineloops before storage (see page 407 for
further information).
• Show reference:
: displays a dual screen with the
reference level (first or previous level) on
the left and the live image on the right.

R2424458-100 Rev. 2
Stress Echo
Other options
Grid size:
• Enter the number of levels and projections
for the selected template.
Timers:
• : starts T1 and T2 timers automatically
Auto-start analysis:
• : displays the Stress Echo Analysis
screen when the last acquisition is
performed.
Smart Stress:
Smart Stress option is available for Vivid S6 • : stores a subset of the image acquisition
only. settings (geometry incl. zoom, gain,
compress, reject, power etc.) for each view
in the protocol. Smart Stress enables to set
image acquisition settings for each view at
baseline level and automatically get the
same image settings in the corresponding
views in the next levels.
In Continuous capture acquisition at peak
stress, the active cell must be moved
manually through the views using the arrow
buttons (or foot pedal).
Reference image:
• When Show Reference is selected (see
page 227), selects either corresponding
baseline loop or corresponding loop from
the previous level to be displayed as
reference image during acquisition.

R2424458-100 Rev. 2
Stress Echo
Pre-defined groups
Pre-defined groups:
• Shows the image groups created.
• New group: creates a new image group.
Select the desired images on the template
preview (see page 231).
• Update group: edits a selected group after
new loop selection on the template preview
(see page 231).
• Delete group: deletes selected group (see
page 231).
Editing/Creating a template
Selecting a base template to edit
1. Trackball to the Template pop-up menu on the upper left
corner of the Template editor screen.
2. Press SET on the arrow.
The Template pop-up menu is displayed.
Determine the re- 3. Trackball to the base template to edit.
quired number of
4. Press SET.
projections and lev-
els you need and se- The selected template is displayed in the Protocol
lect the most template preview field, showing the levels and projections
appropriate founda- and their labels.
tion template.
Adding/deleting levels and projections
Factory templates 1. Enter the number of levels and projections in the Grid size
cannot be changed. field (see Figure 5-14).
The new grid size is displayed in the Protocol template
preview field.
2. Press New Template to create a new template.
Or
Press Save Template to update the base template.

R2424458-100 Rev. 2
Stress Echo
The timers can also Display timer(s)

be started or
stopped at any time
• Check the box(es) to display timer(s) as specified (see
during stress exam- Figure 5-14).
ination using the
assignables T1 and Start analysis automatically
T2 on the control • Check Auto start analysis to display the Stress Echo
panel.
Analysis screen when the last acquisition is performed.
Smart stress
Check Smart stress to store a subset of the image acquisition
settings (e.g., geometry, zoom, gain, compress, reject, power,
etc.) for each view in the protocol. Smart Stress enables to set
image acquisition settings for each view at baseline level and
automatically get the same image settings in the corresponding
views in the next levels. In Continuous capture acquisition at
peak stress, the active cell must be moved manually through
the views using the arrow buttons.
Assigning new labels to levels and projections

1. In the Protocol template preview field, Trackball to the Label
field that is to be changed.
2. Select the Label pop-up menu and press SET on the desired
pre-defined label.
Or
• If the Label field is empty:
Press SET and enter the label or projection name.
• If the Label field has a name to be changed:
Press SET twice (double-click) to highlight the text to be
replaced and enter the new label or projection name.
Configuring levels
The following options can be set up for each level:
Number of cycles to be stored in the cineloop:
• Enter the desired number in the Cycles field.
Up to four cycles/cineloop can be stored.
Continuous capture
• Check Continuous capture if continuous image
acquisition throughout the level is desired.

R2424458-100 Rev. 2
Stress Echo
When Continuous capture is selected, preview of cineloop

and reference display (see below) during acquisition are
not possible.
Preview of store
• Check Preview of store if review and adjustment of
cineloops before storage is desired.
Show reference
• Check Show reference if the display of the corresponding
reference loop is desired during acquisition (dual screen
mode).
Adding a group
1. In the Protocol template preview field select the cells to be
part of the group.
2. In the Pre-defined group field, press New group.
A dialogue box is displayed asking the user to enter a
name for the new group.
3. Enter the group name.
4. Press OK.
The new group is displayed in the Pre-defined group field.
Updating an existing group

A selected group is 1. In the Pre-defined group field, select the group to edit.
highlighted by a The selected cell are highlighted in the Protocol template
yellow frame. preview field.
2. Either select (a) new cell(s) to add to the group or deselect
(an) existing cell(s) to remove from the group.
3. Press Update group in the Pre-defined group field.
The display in the Protocol template preview field is
updated accordingly.
Deleting a group
A selected group is 1. In the Pre-defined group field, select the group to delete.
highlighted by a
2. Press Delete group.
yellow frame.
The group is removed from the list in the Pre-defined
group field.

R2424458-100 Rev. 2
Stress Echo

R2424458-100 Rev. 2
Contrast Imaging
Chapter 6
Contrast Imaging
• Introduction ................................................................................... .. 234

• Cardiac imaging ....................................................................... 234
• Non-cardiac imaging ................................................................ 235
• Data acquisition ............................................................................ .. 235
• Left Ventricular Contrast Imaging ............................................. 235
• LV Contrast overview ................................................................... .. 236
• LV Contrast controls ................................................................. 236
• Using LV Contrast .................................................................... 238
• Optimizing LV Contrast ............................................................ 239
• Vascular Contrast Imaging .......................................................... .. 240
• Abdominal Contrast Imaging ....................................................... .. 241

R2424458-100 Rev. 2
Contrast Imaging
Introduction
Vivid S5/Vivid S6 supports:
• Left Ventricular Contrast imaging: Optimized for
endocardial border detection and assessment of wall
motion and wall thickening (see page 235).
• Vascular Contrast imaging: optimized to visualize
contrast in larger vessels (see page 240).
• Abdominal Contrast imaging: optimized to visualize

contrast in liver and kidney (see page 241).
Appropriate training
WARNING
Only physicians or echo technicians who have received
appropriate training can use the Contrast applications.
Always read and follow carefully the manufacturer instructions

on the contrast agent label.
WARNING
Note: This system is designed for compatibility with

commercially available contrast agents. Because the
availability of these agents is subject to government regulation
and approval, product features intended for use with these
agents may not be commercially marketed nor made available
before the contrast agent is approved for use. Advanced
contrast features are only enabled on systems for delivery in
countries or regions where the agents are approved for use or
for investigational or research use.
Cardiac imaging
The only contrast acquisition application available for cardiac
imaging is Left Ventricular Contrast imaging. The LV
Contrast (LVO) application is optimized for endocardial border
detection and assessment of wall motion and wall thickening.
This application requires the LVO Contrast option to be
enabled.

R2424458-100 Rev. 2
Contrast Imaging
Non-cardiac imaging
The following non-cardiac contrast acquisition applications are
available.
• Vascular Contrast imaging: optimized to visualize
contrast in larger vessels, e.g. carotid artery. Requires the
Vascular/Abdominal Contrast option enabled.
• Abdominal Contrast imaging: optimized to visualize
contrast in abdominal organs, e.g. liver and kidneys.
Requires the Vascular/Abdominal Contrast option enabled.
Abdominal and Vascular Contrast applications are for research

purposes only. Diagnosis must not be based on results achieved
WARNING by contrast analysis alone.
Misdiagnosis based on image artifacts
WARNING
Misdiagnosis in ultrasound contrast images may be caused by
several artifacts, most importantly:
Motion artifacts: gives rise to signals independently of contrast
presence. This may be caused by patient movement; including
respiration, or by probe movement influenced by the operator.
Regional drop outs: caused by unintentional destruction of the
contrast agent, too low concentration of contrast agent, poor
acoustic penetration due to rib/lung shadows or system failing to
detect the contrast agent due to erroneous settings induced by
the operator.
Tissue harmonics: gives contrast-like signals independently of
the presence of contrast agent.
Data acquisition
Left Ventricular Contrast Imaging
The Left Ventricular (LV) Contrast application has an optimized
system preset for Left ventricular opacification, optimal
resolution of endocardial borders delineationand for optimal
assessment of wall motion.
The LV Contrast application may help to identify LV thrombus
and evaluate wall motion.

R2424458-100 Rev. 2
Contrast Imaging
LV Contrast overview
1. Status window
2. Soft menu
Figure 6-1: The LV Contrast acquisition screen
LV Contrast controls
LV Contrast assignable controls
Width
Controls the size and angular width of the image sector. A
smaller angle generally produces a scan with a higher frame
rate.
Tilt
Frequency
Enables the adjustment of the probe's operating frequency. A
higher frequency gives better resolution. Frequency is also
used to switch between Octave (single-pulse) and CPI (Coded
Phase inversion - multi-pulse).

R2424458-100 Rev. 2
Contrast Imaging
Ultra Definition (UD) Clarity

This control reduces the unwanted effects of speckle in the
ultrasound image.
See "Ultra Definition (UD) Clarity" on page 146.
Focus Pos.
Changes the location of the focal point. A triangular marker on
the depth scale along the image sector indicates the position of
the focal point.
Two triangular markers pointing towards each other (><)
indicate that Coded Phase Inversion (CPI) is being used. CPI is
a multi-pulse technique with focus at the indicated depth.
Frame rate
Lower frame rate Controls the line density.
gives better spatial
resolution. Up/Down
Enables the 2D image to be flipped 180 degrees.
Left/Right
Enables the display of a mirrored image. When applied, the
reference marker V moves to the other side of the image.
T1/T2 (Timers)
Contrast timer: press T1 once to start the timer, press again to
stop the timer. A second timer (T2) is available from the More
menu.
B Color maps
Displays a 2D maps menu to optimized the grey scale
non-linear grey-curves or different 2D-colorized curves to be
selected.
LV Contrast Soft menu controls

Power
Controls the amount of acoustic power applied to the
transmitted pulse.
Too high Power lev- Compress
el will destroy the
contrast agent.
Controls the degree of image contrast.

R2424458-100 Rev. 2
Contrast Imaging
Reject
Controls the Echo rejection level. When increased, low level
echoes are rejected and appear darker in the 2D image.
Dynamic Range
Controls the image contrast. A high dynamic range setting
gives a softer image. Decreasing the dynamic range will
provide a more black and white image.
Tilt
Contour
Controls the image processing related to the extent of edge
enhancement applied.
The Diff control de- Diff on/off
creases the frame
rate and the number
Affects the level of reverberation in the image. The
of focal zones when reverberation in the image is reduced when Diff control is
turned on. turned on.
DDP (Data Dependant Processing)
Performs temporal processing, which reduces random noise
without affecting the motion of significant tissue structures.
Using LV Contrast
The LV Contrast application works with the 3S-RS, M4S-RS
(Vivid S6 only) 5S-RS, 6T-RS, and 6Tc-RS probes.
1. Press PROBE on the control panel.
A list of the connected probes is displayed.
The Application menu for the selected probe is listed.
2. Trackball to LV Contrast application.
3. Press SET to launch the application.
4. Perform the acquisition.
Always read and follow carefully the manufacturer instructions
on the contrast agent label.
WARNING

R2424458-100 Rev. 2
Contrast Imaging
Optimizing LV Contrast
The default setting for the LV contrast application is optimized
for contrast detection and not tissue imaging. Therefore, with
some patients it may be difficult to orient the probe before the
contrast agent arrives. In this case we recommend to stay in
the Cardiac application until the contrast agent is observed in
the right ventricle and quickly switch to the LV Contrast
application.
If a swirling pattern is observed and persists after the LV cavity
has been filled with contrast, the power should be reduced until
homogenous opacification is obtained
Too high Power setting will destroy the contrast agent in the LV
cavity.
CAUTION

R2424458-100 Rev. 2
Contrast Imaging
Vascular Contrast Imaging

Vascular Contrast is intended for visualization of ultrasound
contrast agents in large vessels (e.g. carotid artery and femoral
artery).
The Vascular Contrast application works with the 8L-RS and
9L-RS probes.
The application uses Coded Phase Inversion (CPI) (greyscale)
to maximize the contrast detection and visualization.
before the contrast agent is approved for use.
This application may not be available on your system. Contrast

agent for this application are undergoing clinical trial and
CAUTION therefore, not yet available in the United States.
Note: the Vascular Contrast application requires the


R2424458-100 Rev. 2
Contrast Imaging
Abdominal Contrast Imaging

Abdominal Contrast is intended for visualization of ultrasound
contrast agents in abdominal organs (e.g. liver or kidney).
The Abdominal Contrast application works with the 4C-RS
probe.
The application uses Coded Phase Inversion (CPI) (greyscale)
to maximize the contrast detection and visualization.
before the contrast agent is approved for use.
This application may not be available on your system. Contrast

agent for this application are undergoing clinical trial and
CAUTION therefore, not yet available in the United States.
Note: The Abdominal Contrast application requires the


R2424458-100 Rev. 2
Contrast Imaging

R2424458-100 Rev. 2
Chapter 7
• Introduction ................................................................................... .. 246

• About Measurement results display ......................................... 247
• The Assign and Measure modality .............................................. .. 248
• Starting the Assign and Measure modality ............................... 248
• Entering a study and performing measurements ..................... 249
• Measure and Assign modality ..................................................... .. 251
• Starting the Measure and Assign modality ............................... 251
• Post-measurement assignment labels ..................................... 252
• Cardiac measurements ................................................................ .. 255
• 2D Measurements .................................................................... 255
• M-Mode Measurements ........................................................... 259
• Doppler Measurements ............................................................ 262
• TSI Measurements ................................................................... 266
• Automated Function Imaging ................................................... 273
• AutoEF Measurements ............................................................ 292
• Vascular measurements ............................................................... .. 302
• B-Mode measurements ............................................................ 302
• Intima-Media Thickness ........................................................... 303
• M-Mode Measurements ........................................................... 308
• Doppler measurements ............................................................ 309
• Pediatric Calculations .................................................................. .. 314
• Overview .................................................................................. 314
• Hip Dysplasia Calculation ........................................................ 315
• Making Hip Dysplasia Measurement ........................................ 315
• Performing an OB exam ............................................................... .. 317
• Patient entry ............................................................................. 317
• Selecting probe and OB application ......................................... 321

R2424458-100 Rev. 2
• OB Measurements and calculations ........................................... ... 322

• Introduction ............................................................................... 322
• B-Mode measurements ............................................................ 323
• M-Mode measurements ............................................................ 330
• Doppler Mode Measurements .................................................. 330
• OB parameter configuration ........................................................ ... 333
• Configuring OB M&A according to geographical regions ......... 333
• Measurement package configuration ......................................... ... 338
• Measurement package configuration - example ....................... 338
• User-defined formulas ................................................................. ... 343
• User-defined formula - example ...............................................343
• About units ................................................................................ 349
• Measurement result table ............................................................ ... 351
• Minimizing the Measurement result table .................................351
• Moving the Measurement result table ....................................... 351
• Deleting measurements ............................................................ 352
• Worksheet ..................................................................................... ... 353
• Overview ................................................................................... 353
• Using Worksheet ...................................................................... 354
• OB worksheet ............................................................................... ... 356
• Patient data ............................................................................... 357
• Measurement information ......................................................... 357
• Calculation information .............................................................358
• OB graphs ..................................................................................... ... 359
• Overview ................................................................................... 359
• Fetal Growth Curve Graph ........................................................ 360
• Fetal Trending ...........................................................................364
• Fetal Growth Bar Graph ............................................................ 365
• OB-Multigestational ...................................................................... ... 366
• Multiple Fetus ...........................................................................366
• GYN Measurements ...................................................................... ... 370
• Introduction ............................................................................... 370
• To Start a Gynecology Exam .................................................... 370

R2424458-100 Rev. 2
• B-Mode Measurements ................................................................. .. 371

• Uterus length, width, and height ............................................... 371
• Ovary length, width, and height ................................................ 372
• Follicle measurements length, width, and height ..................... 373
• Endometrium thickness (Endo) ................................................ 373
• M-Mode Measurements ................................................................ .. 374
• Doppler Mode Measurements ...................................................... .. 374

R2424458-100 Rev. 2
Introduction
The Vivid S5/Vivid S6 Ultrasound unit provides functionality for
two measurement conventions:
A study is a set of • Assign and Measure (Measure Protocols): the user
related measure- selects a study consisting in a set of pre-labeled
ments, or measure- measurements related to the active scanning mode and
ments that are
logically grouped
clinical application. The user is prompted through the
together. The mea- measurements in the order of the measurement labels.
surements in a This convention is started from the MEASURE button on the
study are some- control panel. You must select desired folder, Dimension,
times used in a for- Volumes, area, etc. A set of tools is implemented to make
mula to calculate
the measurement process as fast and easy as possible for
new parameters
(e.g. biplane volume the user:
with EF, SV and • The user is guided through the study: an auto-sequence
CO). functionality automatically selects the next
measurement in a study.
• The selected measurement is highlighted in the
Measurement menu.
• The performed measurement is indicated in the
Measurement menu.
The studies and their parameters are user-configurable. The
user can create its own studies containing the relevant
measurements only (see page 598).
• Measure and Assign (Free style): the user performs a
measurement and assigns a label. This convention is
started either from MEASURE or CALIPER button on the
Control panel.
Only assigned measurements will be saved. Measurements

without assignment will be lost when scanning is resumed.
CAUTION

R2424458-100 Rev. 2
About Measurement results display

Be aware of the following:
• Measurement results display
By default the system always displays absolute values for
parameters measured in Doppler. This means that values
from above and below baseline will all be displayed as
positive results.
For Cardiac this behavior cannot be changed. For
non-Cardiac the Absolute Value setting can be turned off in
Config -> Meas/Text -> Advanced, by setting the attribute
Absolute Value to Off.
• Calculated parameters
For calculated parameters the system uses signed values
in calculation formulas, and displays the absolute value of
the result.

R2424458-100 Rev. 2
The Assign and Measure modality

In this measurement modality, the user selects a study
consisting in a set of related pre-labelled measurements.
Starting the Assign and Measure

modality
1. Press MEASURE on the control panel.
The Measurement Menu is displayed in the Parameters
window (see example Figure 7-2).
The trackball cursor is in the parameter window, ready for
measurement selection.
1. Active application
2. Study
3. Selected study
4. Opened study
5. Measurements related to the
area study for the cardiac
application
Figure 7-1: Example of a measurement study

R2424458-100 Rev. 2
Entering a study and performing

measurements
Note: When enter- 1. Press MEASURE on the front panel to enter the Assign and
ing the Measure- Measure modality.
ment mode for the The Measurement menu with a list of studies is displayed
first time, the Cali-
per tool is selected
in the Parameters window (see example Figure 7-2).
by default.
When re-entering 2. Select any required study (other than Generic study which
the Measurement is reserved for the Measure and Assign modality).
mode, the first mea-
surement in the ac- 3. Within the selected study, select the required parameter
tual study that has which you intend to measure.
not been performed 4. Perform the measurement. The parameter’s name and
is selected by de-
measured value will appear in the result window.
fault.
To perform a measurement from another study
1. Trackball to the required study.
2. Press SET on the trackball area.
The study folder is opened displaying the measurements
related to this study. Other related studies may also be
available from within the study.
3. Trackball to the measurement to perform.
4. Press SET on the trackball area to activate the
measurement tool.
The cursor is moved back to the scanning window.
5. Perform the measurement.
Completed measurements are marked with a check mark
(Figure 7-2).
When the measurement operation is completed the next
measurement on the list is automatically selected.
To skip a measurement in a study

1. Trackball to the desired measurement
2. Press SET to activate the measurement tool.

R2424458-100 Rev. 2
1. Performed measurement
2. Next measurement is
automatically selected
Figure 7-2: Display of a performed measurement (example)

R2424458-100 Rev. 2
Measure and Assign modality

In this measurement modality, the user performs a
measurement and assign a label.
Only assigned measurements will be saved.
CAUTION
Starting the Measure and Assign

modality
Alternative: Press 1. Press MEASURE on the control panel.
CALIPER on the con- The Measurement Menu is displayed in the Parameters
trol panel and select window (see example Figure 7-3).
the measurement
tool from the as- 2. Select the Generic study if not already selected, and
signables. trackball to the required measurement tool.
3. Press SET on the trackball area to activate the
measurement tool.
The cursor is moved back to the scanning window, ready
for measurement.
1. Measurement tools
Figure 7-3: The 2D Mode Measurement tools (Cardiac application)

R2424458-100 Rev. 2
Post-measurement assignment labels

Each type of measurement, within each mode, can be
associated with a set of pre-defined parameter labels.
Parameter labels can be assigned to the highlighted
measurement by the user.
To assign a parameter label to a

measurement:
1. Trackball to the actual measurement in the Measurement
result table (see Figure 7-4).
The selection of a 2. Press SET.
measurement with- A Parameter label menu is displayed.
out pre-defined la-
bels will not display 3. Trackball through the Parameter label menu to highlight the
the Parameter la- required label.
bel menu. 4. Press SET to assign the highlighted parameter label to the
measurement.
The assigned measurements may be reviewed in the
Worksheet (see page 353). Up to five assigned measurements
with the same label can be stored in the patient archive.
Only assigned measurements will be saved. Measurements
without assignment will be lost when scanning is resumed.
CAUTION

R2424458-100 Rev. 2
1. Parameter Label menu

2. Selected label
Assignment
3. Assigned measurement
Figure 7-4: Measurement assignment

R2424458-100 Rev. 2
To assign a user-defined parameter label

1. Trackball to the actual measurement in the Measurement
result table (see Figure 7-4).
2. Press SET.
A Parameter label menu is displayed.
3. Trackball to User and press SET.
The Enter new parameter window is displayed.
Figure 7-5: The Enter new parameter window
4. Type a name for the parameter label.

5. Press OK.
The user defined parameter label is assigned to the
selected measurement.

R2424458-100 Rev. 2
Cardiac measurements
2D Measurements
2D Length measurements
1. Generate the 2D image.
2. Press FREEZE to stop the cineloop.
Alternative: Press 3. Press MEASURE on the Control Panel.
CALIPER on the con-
4. Select Caliper in the Measurement Menu (see Figure 7-1).
trol panel and press
CALIPER assignable. 5. Trackball the cursor to the start point of the measurement.
6. Press SET to anchor the start point of the measurement.
See the Status bar 7. Trackball the cursor to the measurement end point.
to get the next step The current distance value is displayed in the
to perform. Measurement result table and is instantaneously updated
when moving the cursor.
The measurement 8. Press SET to anchor the end point of the measurement.
display color on the The measurement result is displayed in the Measurement
2D image changes result table.
from green to blue
after completion of 9. To assign a label to the measurement, see page 252.
the measurement. 10. Repeat steps 5 through 8 to make additional length
measurements.
The measurements 2D length measurement ratio
displayed on the 2D
image and the cor-
responding results 2. Press FREEZE to stop the cineloop.
are numbered.
3. Press MEASURE on the Control Panel.
Alternative: Press 4. Select Dist. ratio in the Measurement Menu (see
CALIPER and DIST Figure 7-1).
RATIO assignable.
5. Perform two length measurements as described in steps 5
through 8 in the above section.
The measurement results including the ratio (%) of the two
measured lengths are displayed in the Measurement result
table.

R2424458-100 Rev. 2
Editing 2D Length measurements

1. Trackball the cursor to one of the anchor points of the
measurement to modify.
2. Double-click the SET key to select the anchor point.
The selected marker turns green and is unanchored.
3. With the Trackball, reposition the marker.
4. Press SET to anchor.
2D Area measurements
CALIPER and AREA
4. Select Area (trace) in the Measurement Menu (see
assignable.
Figure 7-1).
5. Trackball the cursor to the start point of the measurement.
See the Status bar 6. Press SET to anchor the start point of the measurement.
to get the next step
7. Trace the area (planetary) with the Trackball.
to perform.
The measurement The area and circumference fields are displayed in the
display color on the Measurement result table.
2D image changes
from green to blue 8. Press SET to complete the measurement.
after completion of The current measurement results are instantly updated
the measurement. and displayed in the Measurement result table.
9. To assign a label to the measurement, see page 252.
The measurements 10. Repeat steps 5 through 8 to make additional area
displayed on the 2D measurements.
image and the cor-
responding results 2D area measurement ratio
are numbered.
2. Press FREEZEto stop the cineloop.
CALIPER, MORE as-
4. Select Area ratio in the Measurement Menu (see
signable and AREA
RATIO.
Figure 7-1).
5. Perform two area measurements as described in steps 5
through 8 in the above section.
See the Status bar The measurement results including the ratio (%) of the two
to get the next step measured areas are displayed in the Measurement result
to perform. table.

R2424458-100 Rev. 2
Editing 2D Area measurements

1. Trackball the cursor to the anchor point of the area
measurement to modify.
2. Press SET twice (Double-click) to select the anchor point.
3. With the Trackball, reposition the marker.
4. Press the SET to anchor.
2D Volume measurements
The measurements described in this section enable volume
measurement in a defined zone. The measurements tool
generates results by two methods:
For measurement • Method of Disk (displayed as Vmod in the Measurement
formulae, refer to result table), known as Simpson's method.
the Reference
Manual. • Area/Length method (displayed as Va-l in the
Measurement result table).
To perform a volume measurement:
CALIPER and
4. Select Volume in the Measurement Menu (see Figure 7-1).
VOLUME assignable.
5. Trackball the cursor to the start point where a volume is to
be measured.
See the Status bar 6. Press SET to anchor the start point of the measurement.
to get the next step
7. Trackball the cursor to draw the length. Use the trackball to
to perform.
outline the area of interest.
8. Press SET to anchor the second point. A third caliper will
appear, marking the length of the ROI.
The measurement 9. If required, drag the cursor with the Trackball to modify the
display color on the length marker.
2D image changes The current area, circumference and Area/Length Volume
from green to blue
after completion of
(Va-l) values are displayed in the Measurement result table
the measurement. (see Figure 7-1) and are instantaneously updated when
moving the cursor.
10. Press SET to complete the measurement.
The measurement results including Vmod (Simpson) are
displayed in the Measurement result table (see
Figure 7-1).

R2424458-100 Rev. 2
The measurements 11. To assign a label to the measurement, see page 252.
displayed on the 2D
12. Repeat steps 5 through 10 to make additional volume
image and the cor-
responding results measurements.
are numbered.
2D Depth measurements
The measurements described in this section enable depth
measurement from the probe to a selected point.
Note: This measurement is disabled in the factory default
configuration. See "Measurement package configuration" on
page 338 for details about on how to enable it through
configuration menu.
To perform a depth measurement:
See the Status bar 4. Press the assignable POINT to select the depth
to get the next step measurement function.
to perform.
5. Trackball the cursor to the position to measure.
The current distance from the probe is displayed in the
Measurement result table and is instantaneously updated
The measurements 6. Press SET to anchor the point.
displayed on the 2D The depth value (cm) is displayed in the Measurement
image and the cor- result table.
responding results
are numbered.

R2424458-100 Rev. 2
M-Mode Measurements
In M-Mode, the user can perform distance and time
measurements. This measurement package has also the
following pre-defined measurement studies:
• LA/Ao
• LV
• RV
M-Mode Length measurements

1. Generate the M-Mode image.
CALIPER on the con-
4. Select caliper in the Measurement Menu.
CALIPER assignable. 5. Trackball the cursor to the start point of the measurement.
See the Status bar 7. Trackball the cursor to the measurement end point.
to get the next step The current distance value is displayed in the
to perform. Measurement result table and is instantaneously updated
8. Press SET to anchor the end point of the measurement.
The measurement The measurement result is displayed in the Measurement
display color on the result table.
M-Mode changes
from green to blue 9. To assign a label to the measurement, see page 252.
after completion of 10. Repeat steps 5 through 8 to make additional length
the measurement. measurements.
The measurements Editing M-Mode Length measurements
displayed on the
M-Mode image and
1. Trackball the cursor to one of the anchor points of the
the corresponding measurement to modify.
results are num- 2. Press SET twice (double-click).
bered. The selected marker turns green and is unanchored.
3. With the Trackball, reposition the marker to a new position.
4. Press SET.

R2424458-100 Rev. 2
Ao/LA study
CALIPER on the con-
4. Select Ao/LA in the Measurement Menu.
the AO/LA assign- 5. Trackball the cursor along the time axis to the required point
able. to start measurement of Aorta root diameter.
See the Status bar 6. Press SET.
to get the next step The starting point for the measurement is anchored.
to perform.
7. Trackball to the end point of the measurement.
The current value is 8. Press SET.
updated while mov- The measurement end point is anchored and the value is
ing the cursor. displayed in the Measurement result table.
A new free-moving cursor is displayed on the image, ready
for the next measurement.
9. Repeat steps 5, through 8 to measure Left Atrium.
The LA value is displayed in the Measurement result table.
The Ao/LA ratio is displayed in the Measurement result
table.
LV study
The LV study consists of measurements in fixed-time mode in
both systole and diastole of:
• Interventricular septum thickness (IVS)
• Left ventricular internal dimension (LVID)
• Left ventricular posterior wall thickness (LVPW)
The following parameters are also calculated:
• EDV (End diastole volume)
• ESV (End systole volume)
• SV (Stroke volume)
• EF (Ejection Fraction)
• FS (Fractional Shortening)
To perform LV study

R2424458-100 Rev. 2

CALIPER on the con-
4. Select LV study in the Measurement Menu.
the LV STUDY as- 5. Trackball the cursor along the time axis to the required point
signable. to start measurement of IVSd.
6. Press SET. The starting point for the measurement is
anchored.
7. Trackball to the end point of the measurement.
8. Press SET. The IVSd measurement end point is anchored
and the value is displayed in the Measurement result table.
The end point of the IVSd is also the start point for the LVIDd.
1. Trackball to the end point of the LVIDd measurement.
2. Press SET. The LVIDd measurement end point is anchored
and the value is displayed in the Measurement result table.
The end point of the LVIDd is also the start point for the
LVPWd.
1. Trackball to the end point of the LVPWd measurement.
2. Press SET. The LVPWd measurement end point is
anchored and the value is displayed in the Measurement
result table.
3. Repeat steps 5, through 2 to measure IVS, LVID and LVPW
in systole.
RV study
The RV study consists of measurement in fixed-time mode of
Right ventricular internal dimension (RVID) in both diastole and
systole.
To perform RV study
CALIPER on the con-
4. Select RV study in the Measurement Menu.
the RV STUDY as- 5. Trackball the cursor along the time axis to the required point
signable. to start measurement of RVIDd.
6. Press SET. The starting point for the measurement is
anchored.
The current value is 7. Trackball to the end point of the measurement.
updated while mov-
ing the cursor.

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8. Press SET. The measurement end point is anchored and

the RVIDs measurement value is displayed in the
Measurement result table.
A new free-moving cursor is displayed on the image, ready
for the next measurement.
9. Repeat steps 5, through 8 to measure RVIDs.
Both the RVIDd and RVIDs values are displayed in the
Doppler Measurements
The following measurements may be calculated on Doppler
mode spectra:
For measurement • Maximum (peak) and mean velocity
formulae, refer to
• Maximum and mean pressure gradient
the Reference
Manual. • Pressure half-time (PHT)
• Velocity time integral (VTI)
• Mitral valve area (MVA), derived from PHT
Velocity and Pressure point measurements

1. Generate the spectrum to be measured.
CALIPER on the con-
4. Select Point in the Measurement Menu.
the POINT CALIPER 5. Trackball the cursor to the position to measure.
assignable. The current velocity is displayed in the Measurement result
table and is instantaneously updated when moving the
cursor.
The measurement 6. Press SET to anchor the point.
display on the spec- The velocity (m/s) and pressure (mmHg) values are
trum and the corre- displayed in the Measurement result table.
sponding results
are numbered.
Velocity and Pressure caliper measurements
CALIPER on the con-
4. Select Caliper in the Measurement Menu.
the CALIPER assign- 5. Trackball the cursor to the start point of the measurement.
able. 6. Press SET to anchor the start point of the measurement.

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7. Trackball the cursor to the measurement end point.

The current velocity and pressure values are displayed in
the Measurement result table and are instantaneously
updated when moving the cursor.
The measurement 8. Press SET to anchor the end point of the measurement.
display color on the The following measurement results are displayed in the
spectrum changes Measurement result table:
from green to red af-
ter completion of • Velocity and pressure at anchor point positions
the measurement. • Velocity (V3) and pressure (p3) differences between
anchor point position
• Time difference (dT) between anchored points position
The measurement 9. To assign a label to the measurement, see page 252.
display on the spec-
10. Repeat steps 5 through 8 to make additional
trum and the corre-
sponding result are measurements.
numbered.
Manual Doppler trace measurements
Adjust Compress 1. Generate the spectrum to be measured.
and reject controls
to optimize the
Doppler signal. 3. Press MEASURE on the Control Panel.
Alternative: Press 4. Select Trace in the Measurement Menu.
CALIPER on the con- A vertical green cursor is displayed on the spectrum.
the MANUAL TRACE 5. Trackball the cursor to the start point on the left side of the
assignable trace.
7. With the trackball, trace the Doppler envelope.
The trace can be adjusted, while tracing, by moving the
cursor backward to erase portion of the trace (or the entire
trace) and then create the trace again.
The measurement 8. Press SET to complete the trace.
display color on The following measurement results are displayed in the
spectrum changes Measurement result table:
from green to red af-
ter completion of • Maximum and mean Velocities
the measurement. • Maximum and mean pressures
• Env. Ti
9. Trackball the cursor to the start point of the next heart beat.
10. Press the SET to anchor the next heart beat starting point.
The heart rate (BPM) is displayed in the Measurement
result table.

R2424458-100 Rev. 2
Automatic Doppler trace measurements

and reject controls
to optimize the
Alternative: Press 4. Select Auto Trace in the Measurement Menu.
CALIPER on the con- A vertical green cursor is displayed on the spectrum.
the AUTO TRACE as- 5. Trackball the cursor to the starting point.
signable. 6. Press SET to anchor the start point of the measurement.
7. Trackball to the end trace position.
8. Press SET to anchor the end point of the trace.
The trace is automatically generated and the following
measurements are displayed in the Measurement result
table:
• Maximum and mean Velocities
• Maximum and mean pressures
• Env. Ti
9. Trackball the cursor to the next heart beat.
10. Press SET to anchor the next heart beat starting point.
The heart rate (BPM) is displayed in the Measurement
result table.
MV E/A ratio
and reject controls
to optimize the
Alternative: Press 4. Select MV E/A ratio in the Measurement Menu.
CALIPER on the con-
5. Trackball the cursor to the peak of the E wave.
the MV E/A RATIO as- 6. Press SET to anchor the point.
signable. 7. Drag cursor to baseline to mark dT.
8. Press SET on the trackball area to anchor the second point.
9. Trackball the cursor to the peak of A wave.
10. Press SET to anchor the point.
the velocity at peak for E and A waves and the calculated
E/A ratio are displayed in the Measurement result table.

R2424458-100 Rev. 2
Measurements on protocol images

When performing measurements on images acquired in a
protocol, the measurement results will be associated with the
protocol level of the image. Average values will be calculated
for each protocol level.
For example you may measure LVOT Diam for images
acquired outside protocol and for images on each level of an
Exercise 2x4 protocol, leading to the following results in
worksheet:
Parameter Value Method M1 M2
LVOT Diam 1.0 cm Avg. 1.1 0.9
LVOT Diam, Rest 1.1 cm Avg. 1.0 1.2
LVOT Diam, Peak 1.2 cm Avg. 1.2
Measurement results associated with a stress level will not be

updated if the image is moved to another stress level at a later
CAUTION time. Images should be correctly placed in the protocol when
performing measurements.
Event timing measurements

Event timing enables the time measurement for opening and
closure of the Aorta and Mitral valves, as referred to the
automatically detected QRS marker, which normally is on the
rising slope of the R-wave.
Event timing can be performed on a Doppler spectrum or an
M-Mode acquisition showing the corresponding valves. The
procedure is similar on both modes. In addition event timing
can be done on curved anatomical M-Mode traces in
Q Analysis. The measurements are shown as dashed lines in
the Analysis window and Anatomical M-Mode window in
Q Analysis.
4. Select Event Timing in the Measurement menu.

R2424458-100 Rev. 2
The following event timing measurements are available

(with the first measurement on the list selected):
• AVO: Aortic Valve Opening
• AVC: Aortic Valve Closure
• MVO: Mitral Valve Opening
• MVC: Mitral Valve Closure
5. Trackball the cursor to the corresponding point on the
spectrum for the selected measurement.
6. Press SET to anchor the point.
The event timing measurement (ms) is displayed in the
When an event timing measurement is performed, the
QRS markers are displayed on the ECG trace and correct
QRS marker position should be verified before the Event
Timing measurements are performed.
TSI Measurements
Each sample in the TSI image represents the time to the
maximum velocity within the chosen TSI search interval from
TSI Start to TSI End. (See page 189 on how to set the TSI
search interval.)
There are two automatic TSI time to peak measurement tools:
• Generic TSI Time to peak measurement: displays the TSI
value at the location point set by the user.
• Segment TSI Time to peak measurement: measures the
time to peak velocity in specific wall segments and gets
automatically calculated TSI indexes based on these
measurements. The measurements may be presented in a
color coded Bull's eye diagram.
Alternatively, TSI time to peak measurement can be done
in Q Analysis by manually measuring the time between the
QRS marker and the peak velocity on the velocity trace.
Generic Time to peak measurement

1. Acquire a TSI apical loop.
2. Press MEASURE.
3. In the Measurement menu, select Generic and Time to
peak (see Figure 7-6).
The TSI loop freezes at the TSI end frame.

R2424458-100 Rev. 2
4. Place a point in the middle of a basal or mid-level

myocardial segment in the TSI image.
5. The Time to peak value for the segment is displayed in the
Measurement result window.
Note: to judge the quality of your data at the measuring
point in the 2D image see the Caution text on page 272.
Figure 7-6: TSI Generic Time to peak measurement screen
Segment Time to peak measurements

1. Acquire TSI loops from all three apical views.
2. Press MEASURE and select TSI time study.
The TSI loop freezes at the TSI end frame.
The first measurement in the study is automatically
selected (see Figure 7-7).
3. Place a point in the middle of the corresponding segment in
the TSI image.
The Time to peak and the Peak velocity for the segment
are displayed in the Measurement result window.

R2424458-100 Rev. 2
4. Perform a measurement for all basal and mid-level

segments in all three apical views.
In addition to the Time to peak and the Peak velocity for
each segment, the following TSI indexes are calculated:
• Septal lateral delay: difference in Time to peak velocity
in the basal lateral wall and basal septum.
• Septal posterior delay: difference in Time to peak
velocity in the basal posterior wall and the basal
antero-septum.
• Basal max delay: difference between the maximum and
minimum time to peak measurements in the six basal
segments. Requires at least four of the six basal
segment measurements.
• Basal standard deviation: the standard deviation of the
time to peak measurements in the six basal segments.
Requires at least four of the six basal segment
measurements.
• All segments max delay: difference between the
maximum and minimum time to peak measurements in
all the measured basal and mid level segments.
Requires at least eight of the twelve segmental
measurements.
• All segments standard deviation: the standard deviation
of the time to peak measurements in all measured basal
and mid level segments. Requires at least eight of the
twelve segmental measurements.
The TSI indexes indicate degrees of asynchrony in time to
peak velocity
5. Select TSI Bull’s eye report in the Measurement menu.
The measurements are displayed in a color coded bull’s
eye diagram together with a list of the calculated TSI
indexes.

R2424458-100 Rev. 2
Figure 7-7: Segment Time to peak measurements screen
TSI trace
The TSI Time to peak measurement can be verified and
eventually manually changed from the TSI trace.
1. Double click on the measurement point.
The ROI and the corresponding TSI curve are displayed
(see Figure 7-8).
2. Press SET to anchor the ROI and trace.
3. If required, select a new peak location in the trace.
4. Click in the acquisition window to exit the TSI trace.

R2424458-100 Rev. 2
1. TSI ROI
2. TSI trace
3. TSI Time to peak marker
Figure 7-8: TSI trace
Time to peak measurement in Q Analysis

1. From a TSI apical loop, press Q Analysis.
2. Place a sample area in a myocardial segment. A velocity
trace is displayed in the Analysis window (see Figure 7-9).
3. Press MEASURE.
4. In the Measurement menu, select Generic and Time.
Note: if Time is not available in the Generic folder press
ACTIVE MODE on the Control panel.
5. In the Analysis window, measure the time from the yellow
QRS marker to the peak velocity of the velocity trace.

R2424458-100 Rev. 2
1. Time measurement tool

2. Sample area
3. QRS marker
4. Time to peak measurement
Figure 7-9: Manual TSI Time to peak measurement in Q Analysis
Note: it is possible to do a Generic or a Segment Time to peak

measurement from within Q Analysis and compare the result
with a manual Time to peak measurement. To access to the
corresponding measurement tool in Q Analysis you may have
to press ACTIVE MODE to display the relevant Measurement
menu.

R2424458-100 Rev. 2
The Time to peak measurement in Q Analysis may differ from the

Generic and Segment Time to peak measurements due to the
CAUTION following considerations:
• The Generic and Segment Time to peak measurements find the
maximum velocity only within the TSI search interval. If the
desired peak on the velocity trace is outside the TSI search
interval, the Generic and Segment Time to peak measurements
will return a different result than the manual Time to peak
measurement.
• If the maximum velocity is at one of the ends of the TSI search
interval, the Generic and Segment time to peak measurements
return the time of the end of the TSI search interval. In some
cases the falling flank of an iso-volumic contraction peak at the
time of TSI Start or the rising flank of a post-systolic
contraction peak at the time of TSI End may be detected. In a
manual measurement the time to a peak within the TSI search
interval with a lower velocity than the velocity at the end of the
interval may be measured instead.
• If there are two or more peaks of comparable velocity within the
TSI search interval, or a poor signal quality, the Generic and
Segment Time to peak measurements may return the time to a
different peak than what a manual method would do. Typically
in these situations, the TSI image will show a wide range of
colors over a small spatial region.

R2424458-100 Rev. 2
Automated Function Imaging

Automated Function Imaging (AFI) is a decision support tool for
regional assessment of the LV systolic function. AFI is a tool
derived from the 2D Strain, which tracks and calculates the
myocardial tissue deformation based on feature tracking on 2D
grey scale loops.
AFI is used to compute local and global tissue deformations in
the myocardium.
The purpose of AFI is to provide the user with a decision
support tool when reporting myocardial function.
AFI is performed on apical views in the following order: apical
long-axis, 4-chamber and 2-chamber view, following an on
screen guided workflow (Figure 7-10).
The result is presented as a Bulls-Eye display showing color
coded and numerical values for peak systolic longitudinal
strain. All values are stored to the worksheet. In addition,
Global Strain for each view, Average Global Strain for the whole
LV, and the Aortic Valve Closure time used in the analysis are
stored to the worksheet.

R2424458-100 Rev. 2
APLAX 4-Ch 2-Ch Step
Acquired views
Defining a ROI
Tracking validation
AVC timing adjustment
Parametric image result
Review screen
Trace and Bulls-Eye result
Figure 7-10: AFI workflow

R2424458-100 Rev. 2
Acquisition
1. Create an exam, connect the ECG device and make sure
to obtain a stable ECG trace.
2. Acquire 2D grey scale cineloops of an Apical long axis
(APLAX) view, an Apical 4 chamber view and an Apical 2
chamber view.
3. Store the loop (must store).
Note: It is recommended to acquire all three apical views
sequentially in order to get similar heart rate in all views.
• The frame rate should be between 37 and 80 frames per
second. A high frame rate is recommended for high heart
rate.
• The scanner should be configured to store at least 100 ms
before and after each heart cycle,
- or -
• The scanner should be configured to store 3 loops or more.
• If the stored loop contains more than one heart cycle, the
analysis will be done on the second last heart cycle.
• The entire myocardium should be visible.
• A depth range that includes the entire left ventricle should
be used.
Starting AFI
1. Open an APLAX view and press MEASURE.
2. In the Measurement menu, select AFI. The View selection
menu is displayed (Figure 7-11).

R2424458-100 Rev. 2
Figure 7-11: Measurement and View selection menus
3. Select APLAX.
The AFI application is started. A ROI can be defined.
Note: When performing AFI on all three apical views, the user
is asked to start with the APLAX view. This allows manual
adjustment of the Aortic Valve Closure (AVC) event timing that
is used in the calculation of the longitudinal systolic strain in all
apical views.
AFI on the APLAX view

Defining a ROI
When selecting the view to analyze, the system automatically
displays a frame where the endocardial border is usually
clearly visible. To use another frame, adjust SELECT FRAME.
To define a ROI, place three points at the endocardial border;
two annular points at the base and one at the apex
(Figure 7-12). Follow the indications displayed on the screen
when placing the three points.
Note: the Yo-yo function is turned on to help finding correct
location for the points. Should you wish to turn it off use the
YOYO soft button.
Note: In case the Yo-yo function is not running place the
trackball pointer in the vicinity of the contour trace to activate it.

R2424458-100 Rev. 2
Figure 7-12: Defining a ROI
After placing the apex point the ROI is displayed (Figure 7-13)
Note: Correct ROI definition is important for accurate
measurements. The system has an adaptive ROI function:
using the endocardial three points as a guide, the system will
analyze the image and automatically adapt the ROI to an
optimal position.
Figure 7-13: ROI Generation

R2424458-100 Rev. 2
You may adjust the shape of the ROI by moving the cursor over
the inner ROI border, select an anchor point (red circle), press
and hold SET button and move the red mark to a new location
(Figure 7-14). The shape of the ROI is updated accordingly.
Figure 7-14: Selected anchor point on the inner ROI border
Note: System may be configured so that data processing is

started automatically if the cursor is not moved for a few
seconds (Figure 7-15).
If the ROI needs to be adjusted make sure to make the changes
immediately after the ROI is displayed.
CAUTION
Note: The auto processing function is configurable (from

Config/Meas-Text/Advanced/AFI/AutoEF auto processing).
Figure 7-15: AFI auto processing configuration

R2424458-100 Rev. 2
Softmenu
Select Frame - Prior to the placement of the 3 points you may
select a different frame from the default one. Marked by a blue
vertical bar over the ECG trace.
YOYO - When turned ON the image will loop through some of
the neighboring frames to allow improved visualization of the
anatomy.
Left and Right Marker - Allows to correct the placement of the
yellow markers over the ECG trace and define the R-R interval
correctly.
Redraw - Allows to go back to previous screen and re-position
the three points.
ROI Width - May be adjusted to include more or less of the
myocardial tissue that needs to be assessed by AFI.
Process - Starts the speckle analysis of the tissue within the
selected ROI.
Quick Tips
Correct ROI definition is crucial to get good tracking. Refer to
the example displayed in the Tip window for correct point
placements. To display additional guidelines, select the Tip
button on the Tip window. Make sure to follow the
recommendations when placing the three points (see below).
Base Correct Wrong
1. Correct position of
the base points.
2. The ROI extends
into the aortic tract.

R2424458-100 Rev. 2
Apex Correct Wrong
the Apex point.
2. The apex point is
placed too high. The
ROI is extending
beyond the
epicardium.
Apex Correct Wrong

the Apex point.
2. The upper right
border of the ROI is
way too much into
the chamber cavity.

R2424458-100 Rev. 2
Bulges Correct Wrong

1. Correct ROI
2. ROI should not be
bulging or follow the
papillary muscle
("ROI Adjustment"
on page 284).
General Correct Wrong

The left ventricle must
be visible through the
entire cycle.
1. End systole frame:
the entire left
ventricle is
displayed.
2. End diastole frame:
the annulus is not
displayed.
Processing
After the processing has been completed, the following screen
appears.

R2424458-100 Rev. 2
1. Display Quick Tips on tracking quality assessment

2. The ROI divided in segments
3. The Scoring table
• : acceptable tracking
• : unacceptable tracking
4. Bulls-Eye icon:
• Segments with yellow border: segments being analyzed.
• Green segments: segments already analyzed.
• Black segments: segments not analyzed.
Figure 7-16: Tracking Validation screen
Softmenu
Speed - Allows to slow down the loop play-back speed.
Syst YOYO - When turned ON the image will loop over the
systolic portion of the heart cycle.
Recalc - Allows to go back to previous screen in order to
manually correct the ROI.
Approve - Press Approve once the tracking quality has been
validated.

R2424458-100 Rev. 2
The ROI is divided into segments. The tracking quality for each
segment is automatically evaluated and summarized in the
Scoring table (Figure 7-61).
Tracking Validation
The tracking for each segment must be visually controlled and
validated. Poor tracking quality could result from a variety of
causes. Select Quick tips (Figure 7-61) to get tips on the most
common causes for bad tracking. The common causes for bad
tracking are:
• Erroneous placement of the basal points when defining the
ROI. If the basal points are placed too far from the annular
region, the ROI segments at the annular base will not move
together with the underlying 2D image throughout the entire
heart beat (see example cineloops in the Quick tips).
• Erroneous placement of the apex point when defining the
ROI. The point should be placed so that the resulting ROI
covers mainly the endocardium. If the apex point is placed
too high, the ROI will mainly cover the epicardium resulting
in poor tracking (see example cineloops in the Quick tips).
• Too small ROI width. Narrowing the ROI too much will
result in poor tracking due to lack of tissue data in the ROI
(see example cineloops in the Quick tips).
• Too much clutter. Images with too much static clutter will
result in poor tracking (see example cineloops in the Quick
tips).
To validate the Tracking:
1. Inspect each segment and make sure that the center line is
moving together with the underlying 2D image.
Note: The tracking quality is automatically evaluated for
each segment and displayed in the Scoring table. The
tracking in each segment is scored as either Acceptable
( ) or unacceptable ( ).
If the tracking needs to be improved for some segments,
the user can modify the ROI ("ROI Adjustment" on
page 284). The user may override the tracking quality
evaluation done by the system by clicking on the
evaluation result in the Scoring table.
2. Once the tracking quality has been validated for all
segments, press Approve in the Scoring table, or Approve

R2424458-100 Rev. 2
softkey. The user is asked to confirm or adjust the AVC

timing setting ("Timing Validation" on page 284).
ROI Adjustment
1. Press RECALC.
2. The following adjustments can be done:
• Adjust ROI WIDTH.
• Press Redraw to re-define the ROI.
• Adjust the shape of the existing ROI: move the cursor
over the inner ROI border, select an anchor point and
move it to a new location. The shape of the ROI is
updated accordingly.
Press the Process softkey, or allow data processing to start
automatically if the cursor is not moved for a few seconds
(configurable).
The Tracking validation screen is displayed for tracking
validation.
Timing Validation
Timing information may be crucial to accurate diagnosis. The
most important event timing is the aortic valve closure (AVC),
since it is part of the definition of the peak systolic strain
parameter.
Determination of the AVC timing by the system is as follow,
depending on the situation:
• If AVC timing has been measured by the operator (through
an event timing measurement tool) prior to running AFI, the
system is using this data.
• If event timing is not available, an automatic AVC estimate
is used, determined by the temporal contraction of all LV
segments (Strain curves).
• From the APLAX view, the user can adjust the estimated
AVC timing. The adjusted AVC timing will then be used in
the other apical views when running AFI on these views.
This option is only available from the APLAX view.
AVC Timing Adjustment
Note: This procedure is available in the APLAX view only.
1. After validation of the tracking quality, the frame for the
current AVC setting (automatic or event timing

R2424458-100 Rev. 2
measurement) is displayed and highlighted on the ECG.

A message appears.
2. To keep the current AVC setting, press SET. To change the
AVC setting, use the trackball to display another frame and
press SET.
If the AVC setting was changed, a Confirmation window is
displayed. Select one of the following options:
• Manual to accept the manual AVC setting.
• Event timing to discard the manual AVC setting (if for
example the AVC setting was not possible to assess
from the APLAX view). The AVC event timing
measurement will then be used.
Note: This choice is only visible if AVC event timing
measurement has been done.
• Auto to discard the manual AVC setting and use the
automatic AVC timing.
The Parametric systolic strain APLAX view is displayed
(Figure 7-17).
Figure 7-17: Parametric systolic strain APLAX view
Note: The image will not be saved unless Store is pressed.

Press Quad softkey to display a quad screen (Figure 7-18)
showing:
• 2D image with the ROI

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• 2D image with Peak systolic strain parametric data

• Segmental curves with peak marker
• Curved M-Mode image with strain parametric data
• ECG trace and "QuickTip" help
Figure 7-18: Quad screen for the APLAX view
AFI on A4-Ch and A2-Ch views

The procedure for AFI on Apical 4-chamber and 2-chamber
views is similar to the one used in the APLAX view:
• Open the apical view from the clipboard.
• Select the corresponding view in the View selection menu
(Figure 7-11).
• Define a ROI ("Defining a ROI" on page 276).
• Tracking Validation ("Tracking Validation" on page 283).
Note: the AVC timing setting defined in the APLAX view is used
by the system when running AFI on the other apical views.

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Figure 7-19: 4-ch and 2-ch Parametric systolic strain images
Results
For the APLAX and apical 4-chamber views the following
results are available:
• Single screen (Figure 7-17) displaying a 2D image with
strain parametric data.
• Quad screen (Figure 7-18) displaying:
• 2D image with the ROI
• 2D image with Peak systolic strain parametric data
• Curved M-Mode image with strain data
• Segmental curves
• ECG trace and "QuickTip" help
If auto-AVC is used as AVC timing calculation method when

running AFI ("AVC Timing Adjustment" on page 284), the strain
CAUTION values displayed in the Quad screen for the APLAX and 4
Chamber views may differ from the strain values obtained after
the system has performed the final calculation from all three
views. The reason for this is that the Auto-AVC calculation
derived from all three views is most accurate and may be
different from the intermediate AVC calculations used for each
view. The strain values displayed in the Quad screen on APLAX
and 4 Chamber views are therefore preliminary values. Only final
strain values should be reported.
If you enter Quad screen again after all three loops have been
processed, the strain values will be correct.

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When performing AFI on all three apical views the following

results are also available:
• Review screen (Figure 7-20) displaying:
• 3 processed apical views
• Bulls-Eye with different user-selectable presentations
(see "Bulls-Eye presentation" below).
• BE+Traces screen (Figure 7-21) displaying:
• Segmental curves for each three Apical views
• Single Bulls-Eye screen (Figure 7-22) displaying:
• Global Strain (GS) values for all three apical views.
In a given view the Global Strain (GS), also called Global
Longitudinal Peak Strain (GLPS), is defined as the
percentage of maximal contraction over the whole cardiac
cycle of the entire myocardial wall relative to its end
diastolic length.
• Averaged global Peak strain value from all three apical view
data.
• AVC measurement (either automatic, event timing
measurement or manual ("AVC Timing Adjustment" on
page 284).
• APLAX heart-rate
Bulls-Eye presentation
The Bulls-Eye in the different screens displays the Peak
Systolic strain presentation. It shows the segmental Peak
systolic strain (PSS) color coding (different shades of blue-red)
with segmental Peak systolic strain values and other
calculations.
Note: The Bulls-Eye can be configured to display either 18 or
17 segments (from Config/Meas-Text/Advanced/ AFI Segment
model)(Figure 7-15).
Note: The system can be configured so that the user can also
choose to display Post systolic index (PSI) color coding and
segmental PSI values in the Bulls-Eye (from

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Config/Meas-Text/Advanced/AFI PSS/PSI Mode)

(Figure 7-15).
Getting Results
When approving the tracking in the Apical 2-chamber the
Review screen with three Apical views and Bulls-Eye is
displayed (Figure 7-20). Select Bulls-Eye only to display the
Single Bulls-Eye screen (Figure 7-22).
Figure 7-20: Review Screen
Figure 7-21: BE+Traces Screen

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Figure 7-22: Single Bulls-Eye screen
To save a snapshot, press STORE. To save the results exit AFI

and answer Yes to the prompt Do you want to store?. Once the
results are saved, the measurements are available in the
Worksheet and can be used in the report.
If the tracking quality of a segment was scored as Not
acceptable ( ), the colorimetric display on the Bulls-Eye
is greyed (Figure 7-23).
1. Segment with tracking quality scored as Not acceptable ( ).
Figure 7-23: Colorimetric display

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Peak detection
The peak systolic strain detection for each segment can be
verified and eventually manually changed.
To adjust the peak detection:
1. Press BE+Traces.
The Bulls-Eye and Traces screen is displayed
(Figure 7-21) showing:
• Trace plots for all three loops
• Bulls-Eye with Peak systolic strain values
2. To change the peak marker position on a curve:
• Press Set on the peak marker (square point) on one of
the curves, move the peak marker to a new position and
press the Set key again to fix the point.
- OR -
• Place the cursor on a segment in the Bulls-Eye. The
corresponding curve is highlighted.
3. Click on the segment to select the corresponding peak
marker and move it to a new position.
The position of the AVC marker can also be checked in the
Bulls-Eye and Traces screen. If needed, the APLAX view
should be reprocessed to change the AVC time.
About the Results
• Clinical assessments should be made based on both color
and segmental Peak systolic strain values.
• The Save As function is intended for research purposes
and should not be used to archive diagnostic data.
• To populate the worksheet the report and the review page
the Single Bulls-Eye screen must be saved.
• All results shown (curves and colors) are based on drift
compensated values. Any strain drifting is linearly
compensated throughout the cycle. If the drift
compensation in a given segment is too high, the tracking
quality is automatically set to Not acceptable ( ).
• If the tracking quality was scored as Not acceptable
( ) in more than one segment, the Global peak strain
value is not calculated.

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Figure 7-24: Worksheet results AFI
Note: Do not disable any sub-measurement of AFI using

Config. tab, as this will disable the whole set of AFI
measurements.
Reprocessing data
The data from one or several views from a saved AFI analysis
may be reprocessed. When reprocessing a AFI analysis new
result screens are created.
1. Double-click on the Bulls-Eye thumbnail.
A quad screen is displayed showing the three apical views
and the Bulls-Eye diagram.
2. Select the view to reprocess and perform the analysis
("Acquisition" on page 275).
AutoEF Measurements
Automated Ejection Fraction (AutoEF) is a semi-automatic
measurement-tool used for measurement of the global EF
(Ejection fraction). The AutoEF tool is utilized as optional
decision support tool in the system.
The AutoEF tool is derived from 2D speckle tracking algorithm,
which tracks and calculates the myocardial tissue deformation
based on feature tracking on 2D grey scale loops.

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AutoEF is performed on either one or both apical 4-chamber or

2-chamber views, in any order.
The result is presented as Ejection Fraction value for each view
and average Ejection Fraction for the whole LV are stored to
the worksheet.
Note: AutoEF tool is intended for adult cardiology and is not
intended to be used in pediatrics cardiology. AutoEF tool is
therefore only available when using the following probes:
M4S-RS (on Vivid S6 only), 3S-RS, 5S-RS.
Acquisition
1. Create an exam, connect the ECG device and make sure
to obtain a stable ECG trace.
2. Acquire 2D grey scale cineloops of an Apical 4 chamber
view and an Apical 2 chamber view.
• The frame rate should be between 35 and 100 frames
per second. A higher frame rate is recommended for
high heart rate.
• The scanner should be configured to store at least
100 ms before and after each heart cycle.
• If the acquisition has more than one heart cycle, the
analysis will be done on the second last heart cycle.
• The entire myocardium should be visible.
• A depth range that includes the entire left ventricle
should be used.
Starting AutoEF
1. Open any one of the stored views and press MEASURE.
2. In the Measurement menu, select AutoEF. The View
selection menu is displayed (Figure 7-25).

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Figure 7-25: Measurement and View selection menus
3. Select the name of the current view: 4-ch or 2-ch. A ROI

can be defined.
4. Place 3 points, 2 on the basal area and one on the apex
according to the guidance.
Tracing the endocardial border
When selecting a view to analyze, the system automatically
displays a frame where the endocardial border is usually
clearly visible. To use another frame, adjust SELECT FRAME.
To trace the endocardial border, place three points at the
endocardial border; two annular points at the base and one at
the apex. Follow the indications displayed on the screen when
placing the three points.
After placing the third point on the Apex an endocardial border
will automatically be traced (Figure 7-26).
Note: Correct border tracing is important for an accurate EF
measurement. The system has an adaptive border tracing
function: using the endocardial three points as a guide, the
system will analyze the image and automatically adapt the
border tracing to an optimal position.
Note: the Yo-yo function is turned on to help finding correct
location for the points.

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Editing the endocardial border tracing

1. If required, use the Left/Right Edge Shift softkey controls
to delineate separately the left or right portions of the
endocardial border visually as best as possible.
2. If required, move the trackball cursor over the border trace,
select an anchor point (red circle), press SET and correct
the trace by dragging the anchor point to a new location
(Figure 7-27). The shape of the border trace will update
accordingly.
3. In case you wish to start over, press Redraw and
re-position the 3 points defining the basal and apex points.
Figure 7-26: Defining a ROI

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1. Place the trackball cursor over the desired point.

2. Selected point is marked by a red circle.
3. Click over the red circle, it will turn to a square.
4. Move the square to re-align the border trace
Figure 7-27: Selected anchor point on the inner border trace
Press the Process soft-button when ready.

Note: Data processing is configured by default to start
automatically if the cursor is not moved for a few seconds. If the
trace needs to be adjusted make sure to make the changes
immediately after the ROI is displayed.

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Figure 7-28: EF Results Screen
Figure 7-29: EF Results Screen - Alternative dual screen mode
EF Results screen
When processing is complete the screen is generated
(Figure 7-28).
Note: The bi-plane results (BiP) will only appear on screen
(Figure 7-28) after measuring both 2-Ch and 4-Ch views.
The AutoEF pro- The running loop is shown on the left. A green dotted line
cessed image runs marks the inner border of the chamber. In case of poor
slower than the tracking, the system will automatically display parts of the
original loop- speed.
In order to see the
border in red.
loop in correct play- The system will automatically pick the frames with the maximal
back speed exit au-
toEF.
area (ED) and minimal area (ES) and place them on the right
area of the display.

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The End Diastolic volume (EDV) and end Systolic Volume

(ESV) is calculated and shown above each frame.
The resulting EF calculation is displayed on top of the screen.
Tracking Validation
The tracking must be visually controlled and validated. If the
tracking results are visually correct press the red Approve
button. The button turns green and is labeled Approved. The
calculated values will be stored and later appear in the
worksheet.
If tracking needs correction there are several options:
• If required, press Layout softkey to enlarge the ES and ED
frames and position them side-by-side (Figure 7-29).
• You may manually select a different ED frame or ES frame
using the ED frame or ES frame softkeys.
• You may edit any misaligned point on either ED or ES
frames. This is done by:
a. Placing the trackball cursor over the desired point.
b. Clicking over the red circle, it will turn to a square.
c. Pressing SET. The ESV, EDV and EF will be
recalculated accordingly.
d. Moving the square to re-align the border trace
(Figure 7-30) by:
Figure 7-30: Border Trace Edit
• In case these results are incorrect you may go back to the

previous step by pressing the Recalc soft-button and
editing the endocardial border ("Tracing the endocardial

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border" on page 294).

• In case editing the endocardial border is too difficult you
may start all over again by pressing Redraw and retrace
the border ("Tracing the endocardial border" on page 294).
Possible causes of poor tracking
Poor tracking quality could result from a variety of causes. The
common causes for bad tracking are:
• Erroneous placement of the basal points when defining the
border. If the basal points are placed too far from the
annular region, the border segments at the annular base
will not move together with the underlying 2D image
throughout the entire heart beat.
• Erroneous placement of the apex point when defining the
border. The point should be placed so that the resulting
border trace covers mainly the endocardium. If the apex
point is placed too high, the border trace will mainly cover
the epicardium resulting in poor tracking.
• Too much clutter. Images with too much static clutter will
result in poor tracking.
Results
For each of the views, a results screen containing the EF
calculation, appears (Figure 7-28) with a small mini-report
appearing in the results window on the right side (Figure 7-31).
Figure 7-31: Mini Report

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The results are summarized in the worksheet and in the report

(Figure 7-32 and Figure 7-33).
To exit the AutoEF package:
Press Measure to exit AutoEF.
Whenever pressing Worksheet , Patient, or 2D the system
closes the AutoEF package.
Before AutoEF closes a prompt appears: Do you want to store
the loop? Click Yes to store the loop or No to discard it.
Note: Do not disable any sub-measurement of AutoEF using
Config. tab, as this will disable the whole set of AutoEF
measurements.
Figure 7-32: Results in worksheet

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Figure 7-33: Results in the Report template

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Vascular measurements
B-Mode measurements
The following instructions assume that you first scan the patient
and press FREEZE.
% Stenosis
% Stenosis by diameter
2. Open % Stenosis in the Measurement menu.
3. Select % Sten (Diam).
4. Make a distance measurement of the inner area of the
blood vessel.
5. Make a distance measurement of the outer area of the
blood vessel.
The distance measurements and the % Stenosis are
displayed in the Measurement result table.
% Stenosis by area
2. Open % Stenosis in the Measurement menu.
3. Select % Sten (Area).
4. Make a trace measurement of the inner area of the blood
vessel.
5. Make a trace measurement of the outer area of the blood
vessel.
The area measurements and the % Stenosis are displayed
in the Measurement result table.
Volume
The volume calculation can be made from one, two or three
distance measurements.
1. Press MEASURE on the control panel, then select select
Generic.
2. Select Volume in the Measurement menu.
3. When doing volume calculation from three distance
measurements (i.e. biplane volume), the measurements
should be done in dual mode displaying a sagittal and an

R2424458-100 Rev. 2
axial view. One measurement is usually made in the sagittal

plane and two measurements in the axial plane.
When doing volume calculation from one or two distance
measurements, make one or two distance measurements
and press MENU.
The distance measurement(s) and the volume calculation
are displayed in the Measurement result table.
A/B Ratio
In B-Mode, A/B Ratio can be measured by diameter or area.
A/B Ratio by diameter
2. Open A/B Ratio in the Measurement menu.
3. Select between:
• Ratio (Diam)
• Ratio (Area)
4. Make the corresponding two measurements.
The measurements and the corresponding A/B Ratio are
Intima-Media Thickness
The Intima-Media Thickness (IMT) is calculated based on
automatic contour detection of the Intima and Media layers on
a user-defined search region along the vessel wall. Multiple
IMT measurements are made between pairs of intima and
adventitia points along the wall (Figure 7-34). IMT can be
measured both on the posterior and the anterior walls of the
vessel.
The IMT measurement is available with linear probes only.
Note: due to the physical properties of ultrasound imaging, the
posterior IMT measurement is generally more accurate than
the anterior IMT measurement.
The following parameters are calculated:
• Average IMT
• Maximum IMT
• Minimum IMT
• Standard deviation of IMT measurements
• Number of successful IMT measurements

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1. Vessel lumen 3. Lumen-Intima boundary

2. Vessel wall 4. Media-Adventitia boundary
5. Multiple IMT measurements
Figure 7-34: IMT measurement (Posterior wall)
IMT Measurement Protocol

The IMT measurement is based on the placement of an ROI
(region of interest) tool to define an area of the vessel where
the IMT will automatically be measured.
There are two methods to position the IMT ROI:
• Arbitrary: Place the ROI at an arbitrary location selected by
the user. The ROI length is also arbitrarily defined by the
user.
• Protocol defined: Place an ROI with predefined length at
a predefined distance (offset) from some vertical marker.
Both ROI offset and length are predefined by the user
according to the user's protocol.
At any time, the users may select if they wish to measure IMT
by the protocol or by the arbitrary method.
IMT Measurement procedure

The following procedure describes the posterior IMT
measurement.
1. Acquire a longitudinal scan of the carotid artery and
optimize the image.

R2424458-100 Rev. 2
2. Press FREEZE.
3. Scroll to an end-diastolic frame where the intima layer is
clearly visible.
4. Press MEASURE.
5. Select the appropriate IMT measurement. If measuring the
IMT of the posterior wall of the right common carotid select
Rt and CCA IMT Post (Figure 7-35).
Figure 7-35: IMT Measurement menu (Right Common Carotid

Posterior IMT measurement tool)
6. Turn the Protocol soft-key OFF or ON depending on your

requirement to operate the tool arbitrarily or by a fixed
protocol.
7. If Protocol is turned OFF place the cursor in the artery
closer to the posterior wall and press SET to anchor the start
of the search region (Figure 7-36, left).
8. Move the cursor parallel to the artery to define the end point
of the search region. Make sure the Intima and Media
layers are within the search region (indicated by the lower
dotted line in Figure 7-36, left).
9. In case Protocol is set to ON place the vertical cursor on
some anatomical reference point on the bifurcation.
10. Press SET. This will anchor a vertical cursor on the
anatomical reference point, and an ROI box will appear on

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the right, at a pre-defined offset distance. The length of the

ROI box is a fixed length.
11. Move the ROI box up or down to cover the posterior wall of
the carotid vessel.
Press SET to anchor the point. For the posterior wall the
contour detector searches for the leading edges of the
intima and adventitia layers. The detected contours are
drawn in the image (Figure 7-36, right).
The measurement calculations are displayed in the
Measurement result Table.
Note: if the Intima and Media layers are not within the
search region, the contour is not drawn. Select (double
click) and move the anchored points closer to the Intima
layer.
1. Measurement segment 2. IMT trace
Figure 7-36: IMT Measurement segment and traces
12. If the contour is not optimal, the following assigned control

may be adjusted to improve border detection:
• TRACE FIT: the traces are modified according to different
threshold values.
If the contour is still not optimal, try to perform the IMT
measurement on another frame, preferably close to the
end diastole.
IMT Measurement Protocol setting

When the IMT Protocol soft-button is turned ON two special
controls will appear: "Offset" and "Length", controlling the IMT
ROI with predefined length and predefined distance (offset)
from the vertical marker.

R2424458-100 Rev. 2
The user may modify the offset or length while performing the
exam, in case these are not set to optimal dimensions.
To modify Protocol defaults
1. Set the Protocol button ON or OFF.
2. In case Protocol is ON: adjust the Offset and Length
values.
3. Press the Store default soft-key to store the status of
"protocol" button ON or OFF and the current settings of
Offset and Length, to be used in the future exams.
4. The default settings may be defined differently for the CCA
and the ICA.
Note: When adjusting the offset for the ICA, the offset
values are negative, as the ROI is located to the left of the
vertical reference marker.
IMT trace approval

Since the IMT measurements are done semiautomatically, the
operator has to approve the detection by visual inspection
before storing the results in worksheet and report.
• If the traces fit both layers of the intima-media walls,
approve the measurement by selecting Transfer in the
Measurement menu.
Once transferred, the calculations can be viewed in the
worksheet and report.
Measurements that are not approved will not be saved.
CAUTION
Any image adjustments (e.g. Gain or zoom) on approved

(transferred) measurements will unassign the measurements.
CAUTION Press Transfer to approve the measurements again.

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M-Mode Measurements
and press FREEZE.
% Stenosis
2. Select % Stenosis in the Measurement menu.
3. Make a distance measurement of the inner area of the
blood vessel.
4. Make a distance measurement of the outer area of the
blood vessel.
The distance measurements and the % Stenosis are
A/B Ratio
In M-Mode, A/B Ratio can be measured by diameter, time or
velocity.
2. Open A/B Ratio in the Measurement menu.
3. Select between:
• Ratio (Diam
• Ratio (Time)
• Ratio (Velocity)
4. Make the corresponding two measurements.
The measurements and the corresponding A/B Ratio are

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Doppler measurements
The system can detect the trace automatically or the user can
draw the trace manually.
Auto vascular calculation

The system performs calculation automatically on the spectrum
trace.
The auto vascular calculation can operate in live, freeze or be
turned off (Live, Frozen and Off commands in the
Measurements menu).
From the Modify Calcs menu, the user can:
• select the calculations to be displayed in the Measurement
result table.
• set the calculations that should be default when an exam is
started (Save as default command).
• turn on the automatically detected trace to display max
and/or mean trace (Max and Mean commands).
• display forward flow, reverse flow or both flows (Above,
Below and Both commands).
Setting up auto vascular calculation
1. Press MEASURE.
The Vascular measurement menu is displayed
(Figure 7-37).
2. Press Auto and select between:
• Live: calculation displayed on the real-time image.
• Freeze: calculation displayed on the frozen image.
• Off: auto vascular calculation is turned off.
3. Press Modify Calcs.
The Modify Calcs menu is displayed (Figure 7-37).
4. Select:
• Above, Below or Both to select the spectrum to perform
the calculations on, i.e. above or below the baseline or
both.
• Max and/or Mean to display max and/or mean velocities.
5. In the Modify Calcs menu, select the measurements and
calculations to be displayed in the Measurement result
table.

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6. Press Save as default to set the selected calculations to be

default when a new study or exam is started.
1. Selected vessel 5. Trace parameters

2. Vessel location parameters 6. Selected measurements and calculation to
3. Manual/auto calculation controls appear in the Measurement result table.
4. Other vessels 7. Assign measurement and calculation
Figure 7-37: Vascular measurement menu (example)
Using Auto vascular calculation

1. Perform the scan and press FREEZE.
The system performs the calculation automatically and the
pre-defined measurements and calculation are displayed

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2. The following controls may be adjusted from the control

panel:
• CYCLE SELECT: change the selected cycle.
• TRACE SENSITIVITY: optimize the trace contour.
• CURSOR SELECT: select Peak systolic or End diastolic
marker. The selected marker can be moved to a new
location. Press SET to anchor the marker to its new
location.
Assigning auto calculations
1. In the Vascular Measurement menu (Figure 7-37), select:
• The actual vessel name
• Prox, Mid or Dist: the location of the vessel (Proximal,
Middle or Distal).
• Rt or Lt: right or left side of the patient.
2. Press Transfer to assign the measurements and
calculations.
To undo the assign- The Measurement result table is updated accordingly and
ment, press Cancel the measurements and calculations are added to the
transfer. worksheet and report.
Manual vascular calculation

When doing manual measurements, the system can detect the
trace automatically or it can be drawn by the user. This is
controlled by the Auto and Manual commands is the
Measurement menu.
and press FREEZE.
1. Adjust the vessel location parameters in the Vascular
measurement menu (Figure 7-37).
2. Select the measurement to be performed from the
Measurement menu or from the Show All menu for
additional measurements.
3. Perform the measurement as described below.
Acceleration, Acceleration time (AT)
1. Select Accel or AT.
2. Position the caliper at the start point and press SET to
anchor the caliper.

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3. Position the second caliper at the end point and press SET
to anchor the caliper and complete the measurement.
The acceleration and/or the acceleration time is displayed
Heart rate
Heart rate is calculated by selecting two identical points over
two heart cycles.
1. Select HR.
2. Position the caliper at a recognizable point in the first cycle
and press SET to anchor the caliper.
3. Position the second caliper at the identical point in the
second cycle and press SET to anchor the caliper and
complete the measurement.
The Heart rate is displayed in the Measurement result
table.
Peak systole (PS), End diastole (ED) and Mid diastole (MD)
1. Select PS, ED or MD.
2. Position the caliper at the corresponding measurement
point and press SET to complete the measurement.
The selected measurement is displayed in the
Pulsatility index (PI)
With Auto trace on
1. Select PI.
2. Position the caliper at the beginning of the wave form and
press SET to anchor the caliper.
3. Position the second caliper at end diastole and press SET.
A trace is displayed between the two calipers and PS, ED,
MD, TAMAX, PI and RI are displayed in the Measurement
result table.
With Manual trace on
1. Select PI.
2. Position the caliper at the beginning of the wave form and
3. Using the trackball, draw the trace to the end diastole and
press SET.
The trace is displayed and PS, ED, MD, TAMAX, PI and RI

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Peak systole/End diastole (PS/ED) and End diastole/Peak

systole (ED/PS) ratio
1. Select PS/ED or ED/PS.
2. Position the caliper at Peak systole or End systole and
3. Position the second caliper at End diastole or Peak systole
and press SET to anchor the caliper and complete the
measurement.
The Peak systole, End diastole and PS/ED or ED/PS ratio
Resistive index (RI)
1. Select RI.
2. Position the caliper at Peak systole and press SET to anchor
the caliper.
3. Position the second caliper at end diastole and press SET.
The Peak systole, End diastole and RI are displayed in the
TAMAX/TAMEAN/Volume Flow
With Auto trace on
1. Select TAMAX, TAMEAN or Volume Flow.
anchor the caliper.
3. Position the second caliper at the end point and press SET
to anchor the caliper and complete the measurement.
A trace is displayed between the two calipers and
corresponding measurements are displayed in the
With Manual trace on
1. Select TAMAX, TAMEAN or Volume Flow.
anchor the caliper.
3. Using the trackball, draw the trace to the end point and
press SET.
The trace is displayed and the corresponding
measurements are displayed in the Measurement result
table.

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Pediatric Calculations
Overview
Pediatrics measurements offer two different types of
measurement studies:
• Generic. The Generic Calculations study is common to all
applications. See "Starting the Assign and Measure
modality" on page 248 for more information.
• Pediatric Hip (PedHip).
This section describes Pediatrics 2D-Mode measurements.
Figure 7-38: Pediatrics B-Mode Measurement Top/Sub Menu
The following generic measurements are common to other

exam applications:
• %Stenosis
• Volume
• Angle
• A/B Ratio
See "2D Measurements" on page 255 for more information.

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Hip Dysplasia Calculation

The HIP calculation assists in assessing the development of
the infant hip. In this calculation, three straight lines are
superimposed on the image and aligned with the anatomical
features. The two angles are computed, displayed, and can be
used by the physician in making a diagnosis.
The three lines are:
1. The baseline connects the osseous acetabulum convexity
to the point where the joint capsule and the perichondrium
unite with the iliac bone.
2. The inclination line connects the osseous convexity to
labrum acetabulare.
3. The Acetabulum roof line connects the lower edge of the
osilium to the osseous convexity.
The α (Alpha) angle is the supplement of the angle between 1
and 3. It characterizes the osseous convexity. The ß (Beta)
angle is the angle between lines 1 and 2. It characterizes the
bone supplementing additional roofing by the cartilaginous
convexity.
Making Hip Dysplasia Measurement

To make a Hip Dysplasia measurement:
1. From the Top/Sub Menu, select either the right or left side
(orientation) and then select HIP. A horizontal dotted line
displays.
2. To place the baseline, move the Trackball. Position the
crosshairs edge at the osseous convexity of the ilium.
3. To rotate or change inclination, adjust the Ellipse control or
Hip Rotate.
4. To fix the baseline, press SET. The system displays a
second dotted line at an angle.
5. To place the line along the inclination line of the osseous
convexity to labrum acetabulare, move the Trackball.
Hip Rotate.
7. To fix the second measurement line, press SET. The system
displays a third dotted line at an angle.

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8. To place the caliper along the acetabular roof line, move the
Trackball.
Hip Rotate.
10. To fix the third measurement line and complete
measurement, press SET.
The system displays the hip measurements (α and ß) in
the Results window.
Alpha HIP
The Alpha HIP measurement measures the angle between the
iliac baseline and the bony roof line. To make an Alpha HIP
measurement:
(orientation) and then select Alpha HIP.
A horizontal dotted line displays.
2. To place the baseline, move the Trackball. Position the
crosshairs edge at the osseous convexity of the ilium.
Hip Rotate.
4. To fix the baseline, press SET.
The system displays a second dotted line at an angle.
5. To place the caliper along the acetabular roof line, move the
Trackball.
Hip Rotate.
7. To fix the second measurement line, press SET.
The system displays the alpha hip measurement (α) in the
Results window.
d:D Ratio Measurement

The d:D Ratio measurement measures the percentage of the
femoral head coverage under the bony roof. To make this
measurement:
(orientation) and then select d:D Ratio.
A horizontal dotted line displays.
2. Use the Trackball to place the baseline along the ilium.
Position the crosshairs edge at the osseous convexity of
the ilium.

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3. Use the Ellipse control to adjust or change inclination or

Hip Rotate.
4. Press SET to fix the baseline.
5. The system displays a circle representing the femoral head.
Use the Trackball to position the circle.
6. Use the Ellipse control to size the femoral head
circumference.
7. Press SET to fix the femoral head circumference.
The system displays the d:D ratio for the femoral head in
the Results window.
Performing an OB exam
Patient entry
1. Enter a New Patient or a New Exam for an existing patient
by following the procedure "Starting an examination" on
page 95.
Note: Use "Other ID" if relevant - For further information
see "Using other ID" on page 99.
2. When the Search/Create Patient screen appears, the
Category field should be preset to Obstetrics. Change it if
required.
3. Enter or validate the patient's Last name, First name, ID
and birth-date or age.
4. Click the Create Patient softkey
5. To add an additional patient information click Patient.
6. Select Current Patient Information.
The Patient Information screen appears (see
Figure 7-39). Use the fields in this screen to enter various
data (see Table 7-1)
7. After entering data click the Begin Exam softkey to
continue with the exam and get a scanning screen.
Alternatively, click 2D Mode to continue scanning.

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Figure 7-39: The Patient Information window
Table 7-1: Obstetric fields
Field Description
LMP Last Menstrual Period; enter the date that the

patient started her last menstrual period, in
dd/mm/yyyy format. You must enter 2 digits for
the day or the month. When you type the month
and day, the system fills in the / (slash) and the
digits 20 as the first digits of the year.
EDD by LMP Estimated Delivery Date by LMP; the system fills

in the date after you enter the LMP.
GA by LMP Gestational Age by LMP; the system fills in the

age after you enter the LMP.
EDD If you click on the EDD by LMP button it will

change into EDD. When you fill in the EDD
(Estimated Delivery Date) the system calculates
and fills in the LMP and the GA by EDD field.
GA If you click on the GA by LMP button it will

change into GA. When you fill in the GA
(Gestational Age) the system calculates and fills
in the LMP and the EDD by GA field.

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Table 7-1: Obstetric fields
Field Description
Fetus number Number of fetuses; default is 1; possible values

are 1-4.
Gravida Number of pregnancies.
Para Number of births.
AB Number of abortions.
Ectopic Number of ectopic pregnancies.
Accession # Exam number used with hospital information

system (DICOM). This is a tracking number from
the worklist.
Ref. Doc The physician who requested the exam. Choose

from the list or type the name.
Diagn. The physician who diagnoses the exam. Choose

Physician from the list or type the name.
ExamDate Defaults to today's date. May be edited by user.
Note 1: After entering the LMP, the system will automatically

calculate and display the EDD by LMP and the GA by LMP
values.
Note 2: If you prefer to enter the EDD instead of LMP, click on

the EDD button just to the left of the EDD field, and type in the
EDD. The system will automatically calculate and display the
LMP and the GA by EDD values
Note 3: If you prefer to enter the estimated GA instead of LMP,

click on the GA button just to the left of the GA field, and type in

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the GA. The system will automatically calculate and display the
LMP and the EDD by GA value.
To exit the Patient Data Entry screen and return to the Scan
screen, you can use one of the following methods:
• Press ESC on the keyboard.
• Select PATIENT or FREEZE on the control panel.
• Select 2D-MODE on the control panel.
The Scan screen appears.
Setting patient information on the image

Title-bar
In case you wish to display some OB data on the
image-header, such as LMP or GA, the system can be
configured to display this information.
1. Select CONFIG > Imaging > Global.
2. Select Title Bar Line 1 or Line 2 to select the relevant
information to appear on the screen.
Figure 7-40: Setting patient information on the image title bar

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Selecting probe and OB application

Select probe and application as described on "Starting an
examination" on page 95.
• For a first-trimester OB exam select OB1.
• For a second / third trimester OB exam select OB2/3.
The following presets are available in addition:
• OB General
• Fetal Heart
• OB/GYN Vessel
Note: The selection of the OB preset will not only optimize the
imaging but will also bring up the proper M&A package for that
particular application.
The parameter contents of each of the applications are
configurable by the operator. Following are the factory presets
for each of the applications.
OB1 application
The measurements available by default for OB1 are:
GS (Hellman)
CRL (Hadlock)
BPD (Hadlock)
FL (Hadlock)
OB2/3 application
The measurements available by default for OB2/3 are:
AC (Hadlock)
HC (Hadlock)
BPD (Hadlock)
FL (Hadlock)

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OB - general application
The measurements available by default for OB-General are:
AC (Hadlock)
HC (Hadlock)
BPD (Hadlock)
FL (Hadlock)
GS (Hellman)
CRL (Hadlock)
Figure 7-41: OB general application measurements
OB Measurements and calculations

Introduction
Comment: Measurements and calculations derived from
ultrasound images are intended to supplement other clinical
procedures available to the attending physician. The accuracy
of measurements is not only determined by the system
accuracy, but also by use of proper medical protocols by the
user. When appropriate, be sure to note any protocols

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associated with a particular measurement or calculation.

Formulas and databases used within the system software that
are associated with specific investigators are so noted. Be sure
to refer to the original article describing the investigator's
recommended clinical procedures.
Note: When you make measurements, you can select the
calculation before you make the measurement or after you
make it. If you select the calculation before you make the
measurement, the Results Window shows the estimated fetal
age as you make the measurement. If you select the
calculation after you make the measurement, the estimated
fetal age is displayed after you complete the measurement.
The measurements steps in this section tell you to select the
calculation before you make the measurement.
The following pages describe how to make OB measurements
and calculations. The measurements are organized by mode,
and within mode are listed in alphabetical order.
Out of range: If the system indicates that a measurement is
out of range (OOR), it means one of the following:
• The measurement is out of the normal range based on the
gestational age that is calculated from the LMP. The system
determines OOR from the ultrasound age compared to the
gestational age. The gestational age is calculated from the
last menstrual period or the estimated delivery date.
• The measurement is outside of the range for the data used
in the calculation. That means that the measurement is
either less than or more than the range of measurements
used to determine fetal age based on the measurement.
Note: Calculation formulas are listed in the Reference Manual.
B-Mode measurements
This section describes all B-Mode measurements that you
typically find in OB studies. Additional OB measurements follow
the typical ones.

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Single diameter parameter measurement

Table 7-2: Single diameter parameters
Parameter Full name
BPD biparietal diameter
OFD occipitofrontal diameter
TAD transverse abdominal diameter
TCD transverse cerebellar diameter
ThD thorax transverse diameter
To measure one of the Single-diameter parameters shown in

Table 7-2 above, perform one distance measurement by
completing the following procedure:
1. Press MEASURE. Use the trackball to select the required
measurement parameter on the right-hand pull-down
menu. Alternatively, use the soft-keys to select the required
measurement parameter.
2. To position the active caliper at the first point, move the
Trackball. To fix the first point, press SET.
The system fixes the first caliper and a second active
caliper becomes available.
3. To position the second active caliper at the end point, move
the Trackball. A dotted line connects the measurement
points.
4. When the second caliper is moved, the measurement-box
displays the current value of the measured parameter and
the corresponding age, in weeks +days.
5. To complete the measurement, press SET. A checkmark will
appear by the measured parameter. The second caliper is
anchored, and a third caliper is available for further
measurements.
The system displays the selected Parameter diameter in
the Results Window.
Editing 2D Length measurements
1. While the measurement is on the screen, trackball the
cursor to one of the anchor points of the measurement to
modify.

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2. Double-click the SET key to select the anchor point.

3. Reposition the marker using the Trackball.
Deleting a 2D Length measurements
1. While the measurement is on the screen, Trackball the
cursor to one of the anchor points of the measurement.
The selected marker turns green.
2. Press Delete on the alphanumeric keyboard.
Single Length parameter measurement

Table 7-3: Single length parameters
Parameter Full name
CRL crown rump length
FL femur length
Tt foot length
HL humerus length
SL spinal length
tibia tibia length
Ulna ulna length
To measure one of the Single-length parameters shown in

Table 7-3 above, follow the procedure "Single diameter
parameter measurement" on page 324.
Circumference parameter measurement

Table 7-4: Circumference parameters
Parameter Full name
AC Abdominal Circumference
HC Head Circumference
When selecting one of the Circumference parameters shown

in Table 7-4 above, the system will automatically provide an
Ellipse tool to perform the measurement.

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To measure circumference using the Ellipse tool

1. Select the Circumference parameter.
An active caliper appears.
2. To position the active caliper, move the Trackball.
3. To fix the start point, press SET.
The system fixes the first caliper and provides a second
active caliper.
4. To position the second caliper, move the Trackball.
An ellipse with an initial circle shape appears.
5. Position the second caliper so as to measure the major axis
of the elliptical measured body.
6. When ready press SET.
A third caliper will appear along the second axis of the
ellipse.
7. Use the trackball to control the length of the minor axis of
the ellipse.
8. Press SET to anchor the third caliper.
The system displays the parameter's circumference and
estimated age in the Results Window.
Editing Ellipse measurements
1. While the measurement is on the screen, trackball the
cursor to one of the anchor points of the ellipse to modify it.
2. When color changes to green, double-click the SET key to
select the anchor point.
The selected marker is unanchored and can be moved.
3. With the Trackball, reposition the caliper.
The ellipse will rotate or stretch along with the motion of
the caliper
Figure 7-42: Editing ellipse measurements

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Deleting the ellipse measurements

1. While the ellipse measurement is on the screen, Trackball
the cursor to one of the anchor points of the measurement.
The selected marker turns green.
2. Press Delete on the alphanumeric keyboard.
Gestational Sac
To calculate the gestational sac, you need to make diameter
measurements in three orthogonal directions. These may be
done either sequentially or simultaneously in two scan planes.
Measuring GS on two scan planes
To display two scan planes, press the 1/2/4 key once. Get an
image in each scan plane and press FREEZE.
1. Activate M&A and select GS (Hellman).
An active caliper appears.
• To position the active caliper at the start point, move the
Trackball.
• To fix the start point, press SET.
The system fixes the first caliper and displays a second
active caliper.
• To position the second active caliper at the end point,
move the Trackball.
A dotted line connects the measurement points.
• To complete the measurement, press SET.
The system displays the distance value in the Results
Window and displays an active caliper.
2. To make the second and third distance measurement,
repeat step 1.
After you complete the third distance measurement, the
system displays the gestational sac measurement in the
Results Window. It displays the three diameters d1, d2
and d3. In addition, it shows the average diameter GS and
the corresponding estimated age.

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Figure 7-43: Gestational sac measurement
Measuring GS sequentially
1. Scan and freeze an image of GS that you would like to
measure (use full screen).
3. Measure the two diameters of the GS (as explained above).
The measurements will display on screen as d1 and d2.
4. Scan again to produce a view of a plane which is orthogonal
to the previous plane.
6. Measure the GS diameter; this will be marked as d3.
system displays the gestational sac measurement in the
Results Window. It displays the three diameters d1, d2
and d3. In addition it shows the average diameter GS and
the corresponding estimated age.
Amniotic Fluid Index (AFI)

To calculate the amniotic fluid index, you make
measurements of the four quadrants of the uterine cavity. The
system adds these four measurements together to calculate
the Amniotic Fluid Index.
Note: The four quadrants can be measured with distance
(caliper) or circumference (circle) measurements. Press the
appropriate AFI quadrant Top/Sub Menu key to toggle between
caliper and circle.
1. Select OB-2/3, then AFI(Moore) located just under it.
The first distance measurement, AFI-Q1, is already
selected.
2. Make a standard distance measurement for the first
quadrant:
Trackball.

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active caliper.
move the Trackball.
Window.
3. When the measurement of the first quadrant is completed,
unfreeze and move to the second quadrant.
4. After you obtain the image, press FREEZE and then
MEASURE.
The system prompts you to continue with the AFI
measurements. Make sure that the next quadrant has
been selected.
5. Perform a standard distance measurement for the second,
third, and fourth quadrants (see step 2 above).
6. When all four quadrants have been measured, the system
calculates the AFI total and displays it in the Results
Window.
Note: If the fluid in a pocket is zero, set the second caliper on
top of the first one to give it a zero value.
Figure 7-44: Amniotic Fluid Index

R2424458-100 Rev. 2
Estimated Fetal Weight (EFW)

To measure estimated fetal weight, you make several OB
measurements. These measurements can vary, based on how
your system is set up. Measurements can include biparietal
diameter, fetal trunk area, femur length, antero-postero trunk
diameter and transverse trunk diameter, abdominal
circumference, head circumference and spinal length.
• Activate the Worksheet.
The calculation for EFW will appear under 2D
Calculations label as soon as the required measurements
have been made.
Note: For a description of any of the required measurements,
refer to that measurement.
M-Mode measurements
There are no special tools for OB other than the general
M-Mode measurement tools found under all applications.
Doppler Mode Measurements

You can use Doppler mode to study fetal blood flow in the
heart, umbilical cord, placenta, and middle cerebral arteries.
OB/GYN Doppler mode also allows you to study uterine and
ovarian blood flow.
The OB/GYN vessel study includes the following vessels:
• Aorta
• Desc. Aorta
• Middle Cerebral Artery (MCA) (right and left)
• Ovarian (right and left)
• Placenta
• Umbilical
• Uterine (right and left)
For each of these studies, you can make any of the following
measurements:
• Peak Systole (PS)
• End Diastole (ED)
• Minimum Diastole (MD)

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• Resistive Index (RI)

• PS/ED Ratio
• ED/PS Ratio
• Acceleration
• AT
• TAMAX
• Pulsatility Index (PI)
• Heart Rate
• Volume Flow
• TAMEAN
• PV
Figure 7-45: Doppler Mode Measurements
To select OB/GYN vessel measurements

OB/GYN Vessel measurements use the auto sequence
feature. With this feature, when you select a folder for the
vessel you want to measure, the system automatically starts

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the first measurement. It then continues with each of the other

measurements in that study.
1. Select the folder for the vessel you want to measure.
The system shows all the measurements for that vessel.
The caliper for the first measurement is automatically
displayed.
2. Make the measurement.
After you complete each measurement, the system starts
the next measurement. After the last measurement is
complete, the system returns to the first measurement.
Your system is set up to show the measurements that you
usually make for each vessel. To make a measurement that is
not shown for the selected vessel:
1. Select the folder for the vessel you want to measure.
2. Select Show All.
The system displays all possible vessel measurements.
3. Select the desired measurement.
Detailed explanations about making the different
measurements and using the different tools are provided in the
Doppler M&A section of the Vascular package (page 309).
The following pages describe the steps to make each specific
measurement in the OB/GYN Vessel study.

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OB parameter configuration
Configuring OB M&A according to
geographical regions
Different countries use different sets of OB charts. The system
supports OB charts from USA, Europe, Osaka, Tokyo, and
ASUM.
1. Press CONFIG.
2. Select MEAS/TEXT.
3. Select the Advanced tab.
4. Set the M&A category to Obstetrics.
5. Locate the parameter OB Type in the upper pane and click
on the region.
A menu opens listing the region names.
Figure 7-46: Region name menu
USA
OB-1
Folder contents

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OB-2/3
Folder contents
OB-General
Folder contents
Europe
OB-1
Folder contents

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OB-2/3
Folder contents
Osaka
Osaka
Folder contents

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Tokyo/Shinozuka
Folder contents
JSUM
Folder contents
EFW (Osaka)
Folder contents
EFW (Tokyo)
Folder contents
EFW1 (S)
Folder contents

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EFW2 (S)
Folder contents
EFW3 (S)
Folder contents
EFW (JSUM)
Folder contents
ASUM
ASUM 2001
Folder contents
ASUM
Folder contents

R2424458-100 Rev. 2
Measurement package configuration

A list of all cardiac calculations with needed measurements and
location in the Measurement package can be found in the
Reference manual.
There are many more measurements and parameters in the
measurement package than shown in the default Measurement
menu. Use the configuration system to set up the
measurements that should be available in the Measurement
menu and which parameters should be calculated.
The following example based on calculation of AV CO (Cardiac
Output by Aortic Flow) describes how to configure the
measurement package so that necessary measurements and
the resulting calculations are displayed on screen.
Measurement package configuration -

example
Calculation of Cardiac Output by Aortic Flow requires
measurement of:
• AV diameter located in the folder Dimension (2D mode)
• AV VTI located in the folder Aortic (Doppler AV Trace).
• Heart rate
If a calculated parameter (e.g. AV CO in AV Trace
measurement) requires another parameter to be calculated
(e.g. AV Diam) the user must first measure the required
parameter (e.g. AV Diam) before the dependent parameter
(e.g. AV CO in AV Trace) gets calculated.
Configuration of the Measurement menu

If the AV diameter measurement is not present in the folder
Dimension in the Measurement menu, follow the following
procedure:
1. Press CONFIG and select the category Meas/Text.
The Measurement menu sheet is displayed (see
Figure 7-47).
2. AV Diam is a 2D measurement, make sure that 2D is
checked in the Measurement sheet.
3. Select folder Dimension in the Measurement menu.

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A list of all available measurements for the selected folder

is displayed in the Measurement menu sheet.
4. Check the box in front of AV Diam.
The AV Diam measurement is displayed in the folder
Dimension in the Measurement menu.
5. For the AV VTI measurement, check Doppler in the
Measurement menu sheet and select the folder Aortic in
the Measurement menu.
6. Check the box in front of AV Trace.
The AV Trace measurement is displayed in the folder
Aortic in the Measurement menu.
1. Select the scanning mode for the measurement to add to the Measurement menu.
2. Select the folder for the measurement to add.
3. Select the measurement to add.
Figure 7-47: Configuration of the Measurement menu

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Configuration of the Measurement result table

If AV CO calculation is not displayed in the Measurement result
table, follow the following procedure:
The Measurement menu sheet is displayed.
2. The AV CO calculation is based on Doppler AV Trace
measurement in the folder Aortic, check Doppler in the
Measurement menu sheet and select the folder Aortic.
A list of all available measurements and calculations for
the selected folder is displayed in the Measurement menu
sheet.
Note: Entries in green are calculated measurements.
3. In the Measurement menu sheet, double-click on the AV
Trace measurement.
A list of all available measurements and calculations for
the AV Trace measurement is displayed in the
Measurement menu sheet.
4. Check the box in front of AV CO.
The AV CO calculation will be displayed in the
Normal values
Normal values can be defined by the user for all parameters. A
Normal value can be either a range or a threshold. Normal
values entered are grouped by measurement category (e.g.
Cardiac, Pediatry etc.)
Normal values are displayed in the report.

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To define a Normal value
1. Measurement category
2. Selected measurement
3. Parameters
4. Press to define Normal value
Figure 7-48: Adding Normal value
1. Press CONFIG and select the Config category

Measure/Text.
The Measurement menu sheet is displayed (Figure 7-48).
2. In the Measurement menu, browse to the measurement of
interest.
The parameters for the selected measurements are
displayed in the Measurement menu sheet.
Note: to change Measurement category, press the
Heading in the Measurement menu and select another
Measurement category.
3. Select in the Normal value column.
The Normal value window is displayed.

R2424458-100 Rev. 2
Figure 7-49: The Normal value window
4. In the Normal value window:

• Select the Normal value type (Range, Above or Below).
• Type in the Normal value.
• Optionally enter a reference for the Normal value.
5. Select OK.
The Normal value is displayed in the Measurement menu
sheet.
To display Normal values and references in the Report, the
Report template must be configured to show Normal values
(see page 340). Measurements outside the Normal value are
highlighted in the Report.

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User-defined formulas
User-defined formulas can be created using existing
measurements or by defining new measurements. The
following example describes the creation of a formula based on
existing measurements.
GE Medical Systems does not take any responsibility for the
correctness of the user-defined functions.
CAUTION
User-defined formula - example

The workflow for user-defined formula is:
• If the user-defined formula is based on several
measurements of different types, create a user-defined
folder in the Measurement menu so that all measurements
and the formula are grouped together. If the formula is
based on a single measurement you may select an existing
appropriate folder.
• Add the measurement(s) needed for the formula to the
user-defined (or existing) folder.
• Create the formula based on the added measurements.
The following procedure describes the creation of user-defined
LIMP formula as follow: My LIMP = (MCO-AVET)/AVET.

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Creation of a user-defined folder
1. Select the appropriate scanning mode.

2. Create a folder in the Measurement menu.
Figure 7-50: The Measurement menu sheet

2. MCO and AVET are Doppler measurements, select
Doppler in the Measurement menu sheet.
3. Select Add folder.
4. Give the folder a name (e.g. “My Folder”).
Adding measurements
1. Select the user-defined folder.

2. Press Add measurement.
1. Select the user-defined folder (e.g. “My Folder”) in the

R2424458-100 Rev. 2
Measurement menu.
2. Press Add Measurement in the Measurement menu
sheet.
The Add measure window is displayed.
Figure 7-52: The Add measure window
3. MCO and AVET are measurements that already exist on

the system, check Use copy of and select MCO from the
drop down menu.
4. Select OK to add the MCO measurement.
5. Repeat steps 2 to 4 to add the AVET measurement.
Creation of the formula
1. Select the last measurement.

2. Double click and enter the formula name.
3. Select “=” to create the formula.

R2424458-100 Rev. 2
The formula for this example is as follow:

My LIMP = (MCO-AVET)/AVET
1. In the user-defined folder (e.g. ”My folder”), select the last
measurement created (e.g. AVET).
2. Double-click (Name) in the last line in the Parameter list in
the Measurement menu sheet.
3. Enter the name for the formula (e.g. My LIMP).
4. Select .
The Edit formula window is displayed.
Figure 7-54: The Edit formula window
5. Select “(“ from the Operators drop-down menu.

6. In the Doppler drop-down list, select
MCO [My Folder, MCO].
Make sure to select the measurement located in the user
defined folder (e.g. “My Folder”).
7. Select “-“ from the Operators drop-down menu.
AVET [My Folder, AVET].
9. Select “)“ from the Operators drop-down menu.
10. Select “/“ from the Operators drop-down menu.
AVET [My Folder, AVET].
The Formula line should display: ({MCO}-{AVET})/{AVET}.
No units are necessary since the formula is a ratio (see
also "About units" on page 349).
12. Press Check to make sure that the syntax for the formula
is correct.

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User-defined measurements
Some user-defined formula may require measurements that do
not exist on the system. The following example based on a
generic distance measurement illustrates how to create
user-defined measurements.
1. Select the appropriate scanning mode.

2. Select the appropriate folder.
3. Press Add measurement.

2. In the Measurement menu sheet, select the appropriate
scanning mode for the measurement to be created (e.g.
2D).
3. Select the appropriate folder in the Measurement menu
(e.g. Dimension).
4. Press Add Measurement in the Measurement menu
sheet.
The Add measure window is displayed.
Figure 7-56: The Add measure window

R2424458-100 Rev. 2
5. Check Blank and press OK.

The Measurement menu sheet is updated.
1. Enter a name for the measurement.

2. Select the appropriate measurement tool.
3. Double click and enter the formula name.
6. In the Measurement menu sheet, enter the name for the

measurement (e.g. My Distance).
7. Select the appropriate measurement tool in the drop-down
menu, next to Tool (e.g. 2D Caliper).
8. Double-click (Name) in the appropriate parameter (e.g.
Distance) and enter a name for the parameter (e.g. My
Length).
If desired change the unit and the number of decimals for
the measurement by double clicking the values under Unit
and Precision (see also "About units" on page 349).

R2424458-100 Rev. 2
About units
• All units are calculated in SI units (see table below).
• If no unit is specified in the Edit formula window when
defining a formula, the displayed value will be in SI unit.
To define a different unit

1. When creating a formula, enter the unit to use when
displaying the formula output. E.g. if Y in the formula Y=f(x)
is to be displayed in cm, enter cm in the Unit field.
The Unit field is case sensitive, make sure to enter the
exact unit as shown in the table below (Alternative unit
column).
2. The output of a formula must always be in an SI unit (see
table below). Conversion to the specified display unit is then
done automatically.
Example: a user wants to add a regression formula for
estimating a length B from a measured length A, both in
cm.
The formula is: B = 2.4 + 1.1*A.
• As A is a measurement value the system will enter the
formula in the SI unit for length (m). The formula expects
A in cm, and to get that, A must be multiplied by 100:
B = 2.4 + 1.1*A*100
• The formula now gives B in cm. Converting the output
from cm to the SI unit (m), is done by dividing by 100:
B = (2.4 + 1.1*A*100)/100
The output is now in m, and by entering this formula into
the system the user gets the expected result. Measuring
an A of 2 cm gives:
B = (2.4 + 1.1*0.02*100)/100 = 0.046 m.
Before display of the value it is converted according to the
specified display unit (cm), and the system displays 4.6
cm. If the selected display unit was set to mm the formula
would give the exact same output, 0.046 m, but the
automatic unit conversion would now instead give a
displayed value of 46 mm.

R2424458-100 Rev. 2
Calculation SI Alternative unit
Time s
Ratio %
Frequency bpm
Angle rad
Distance m
Velocity m/s
Acceleration m/s2
Area m2
Volume m3
Volume flow m3/s
Pressure mmHg*
Pressure/time mmHg/s
Mass kg
Other
* The correct SI unit for pressure is Pa, but here mm Hg was used as base unit as it is a standard pressure unit
to use in medicine.

R2424458-100 Rev. 2
Measurement result table

The display of the Measurement result table can be minimized
and moved to prevent the table obscuring parts of the
ultrasound image.
Minimizing the Measurement result

table
1. Trackball to the symbol on the heading of the
Measurement result table (see Figure 7-58).
2. Press SET.
Repeat step 1 to en- The Measurement result table is minimized to the heading
large the Measure- bar.
ment result table.
Moving the Measurement result table
Alternative: Use 1. Trackball to the symbol on the heading of the
the Move Calc Measurement result table (see Figure 7-58).
Win softkey located
under More to 2. Press SET to grab the table.
move the Measure- 3. Trackball the Measurement result table to a new position.
ment result table
from corner to cor- 4. Press SET to anchor the table.
ner on the Acquisi-
tion window.
1. Minimize/maximize table
2. Move table
Figure 7-58: Measurement result table display tools

R2424458-100 Rev. 2
Deleting measurements
1. Trackball to the measurement to delete in the
Measurement result table and press SET.
A menu is displayed.
2. Select Delete Measurement.

R2424458-100 Rev. 2
Worksheet
The worksheet function enables the user to review, edit, delete
or print data independently of a report. All measurements and
calculations taken during the examination can be viewed at any
time using the worksheet.
Overview
1. Measurement type 4. Measured / calculated values

2. Measurement parameter 5. Value type
3. Value: Averaging, Max, Min or Last 6. Measurement type selection
Figure 7-59: The Worksheet screen (Cardiac)

R2424458-100 Rev. 2
Using Worksheet
• Press WORKSHEET on the control panel and select the
measurement type (see Figure 7-59).
To scroll through pages

• Select PAGE DOWN or PAGE UP.
To select the type of value

1. Trackball to the relevant cell in the Method column.
2. Press SET.
A pop-up menu is displayed showing the different options
available (Figure 7-60).
1. Average of the measurements taken

2. Maximum measurement
3. Minimum measurement.
4. Last measurement that was taken
Figure 7-60: The Calculation method options list.
3. Trackball to the required option.

4. Press SET.
The value is updated accordingly.
Excluding or including measurements

One or more measurement values from a set of measurements
for a parameter can be excluded when doing average
calculation.
To exclude a measurement
1. Trackball to the measurement value to exclude.
2. Press UPDATE MENU.
The Worksheet menu is displayed.
When excluded the 3. Trackball to Exclude Value.
measurement dis-
4. Press SET.
play turns grey.

R2424458-100 Rev. 2
To include a measurement
1. Trackball to the measurement value to include.
3. Trackball to Include Value.
4. Press SET.
Manually changing a value

Individual measured values can be manually changed using
the alphanumeric keyboard.
To manually change a value
1. Trackball to the value that is to be changed.
2. Press SET.
An asterisk indi- 3. Use the alphanumeric keyboard to enter the required value.
cates that the value
has been manually To restore automatic calculation
altered. The calcula- 1. Trackball to the relevant cell in the Method column.
tion type is changed
to Edit.
2. Press SET.
A pop-up menu is displayed showing the different
calculation options available (Figure 7-60).
3. Press SET.
The value is re-calculated according the method selected.
Deleting measurement parameter

1. Trackball to the measurement parameter to delete.
3. Trackball to Delete Value.
4. Press SET.

R2424458-100 Rev. 2
OB worksheet
The OB Worksheet lists patient information, and all
measurement and calculation data.
• To view the OB Worksheet press Worksheet.
1. Patient data
2. Measurement information
3. Calculation information
Figure 7-61: The OB worksheet

R2424458-100 Rev. 2
Patient data
The Patient data section, at the top of the worksheet, lists
information from the Patient Data Entry screen.
You can select the following fields:
• FetusNo - if this is a multi-gestational patient, you can
select the fetus in this field. You can also adjust the Fetus
selection to change the fetus.
• CUA/AUA - select the ultrasound age calculation method:
• Composite Ultrasound Age (CUA) - regression
calculation
• Average Ultrasound Age (AUA) - an arithmetic average
You can select the method in this field, or adjust the Select
CUA/AUA soft-key control.
You can enter information in the following fields:
• FetusPos - type information about the fetus position.
• PLAC - type information about the placenta.
Measurement information
This section lists the results of all measurements.
• CUA or AUA - If this field is checked, the system uses the
measurement to calculate the ultrasound age.
• Value - The measured value. If more than one
measurement was made for an item, the system uses the
specified method (average, maximum, minimum, or last) to
determine this value.
• m1-m3 - Up to three measurement values for each item. If
you make more than three measurements, the worksheet
uses the last three.
• Method - When there is more than one measurement for an
item, this specifies the method used to calculate the
measurement value listed in the Value column. Choices are
average, maximum, minimum, or last.
To change the method:
• Move the Trackball to the Method field.
• Press SET.
• Move the Trackball to select from the list.
• Press SET.

R2424458-100 Rev. 2
• AGE - The fetal age for this measurement.

• Range - The typical range of fetal age for this
measurement.
Calculation information
This section of the worksheet provides calculation choices and
lists calculation results.
• EFW - lists the parameters used to calculate EFW. This is
followed by the calculation result.
To change which parameters are used:
• Select this field, or press Select EFW.
• Select the desired parameters.
• EFW GP - lists the source used to calculate EFW-GP
(growth percentile). This is followed by the growth
percentile.
To change the source:
• Select this field, or press Select GP.
• Select the desired source.
The remaining calculation information shows ratios for several
measurements, and the Cephalic Index (CI).
The worksheet shows if any of the ratios are out of range
(OOR). Out of range indicates one of the following:
• The measurement is out of the normal range based on the
gestational age that is calculated from the LMP. The system
determines OOR from the ultrasound age compared to the
gestational age. The gestational age is calculated from the
last menstrual period or the estimated delivery date.
• The measurement is outside of the range for the data used
in the calculation. That means that the measurement is
either less than or more than the range of measurements
used to determine fetal age based on the measurement.
For more information about how to use the worksheet, see
"Worksheet" on page 353.

R2424458-100 Rev. 2
OB graphs
Overview
OB Graphs allow you to assess fetal growth compared to a
normal growth curve. When a patient has completed two or
more ultrasound exams, you can also use the graphs to look at
fetal trending. For multi-gestational patients you can plot all
fetuses and compare the growth on the graphs.
Vivid S5/Vivid S6 provides the following two basic types of
graphs:
• Fetal Growth Curve graphs - show one measurement per
graph. These graphs show the normal growth curve,
positive and negative standard deviations or applicable
percentiles, and ultrasound age of the fetus using the
current measurement. For multi-gestational pregnancies,
you can show curves for all fetuses. If previous exam data
is available, the graph can show fetal trending.
• Fetal Growth Bar graph - shows the ultrasound age and
the gestational age based on patient data. Plots all
measurements on one graph.
To view OB graphs
1. Press Worksheet.
2. Press the Graph soft-key button
The Fetal growth curve graph is displayed (see
Figure 7-62).

R2424458-100 Rev. 2
Figure 7-62: Fetal Growth Curve Graph
Fetal Growth Curve Graph

The horizontal axis shows the fetal age in weeks. The system
determines this age from the data entered in the Patient
Information window.
Depending on the measurement selected the vertical axis
displays measurements (mm or cm), ratios (%) or fetal weight
(g).
The Fetal Growth Curve Graph shows the following information
for the selected measurement:
• The normal growth curve
• The standard deviations or relevant percentiles
• The gestational age of the fetus, using patient data (vertical
dotted line)
• Using the current ultrasound measurement data, where the
fetus is on the growth curve
From the OB graphs screen, the user can enter relevant
information in the Fetus position and Placenta fields.
The legend at the bottom of the graph shows the symbols and
colors that indicate data for fetal trending (Past and Present)
and multiple gestation (Fetus).

R2424458-100 Rev. 2
To select the measurement

To select which measurement you want to display on the Fetal
Growth Curve Graph, do one of the following:
• To select a specific measurement:
• On the graph display, move the Trackball under the
<Measurement Type> field and press SET.
The system displays a list of measurements (see
Figure 7-63).
• Move the Trackball to select the desired measurement
and press SET.
The system displays the Fetal Growth Curve Graph for
the selected measurement.
• To scroll through all Fetal Growth Curve Graphs, adjust the
Graph Change control.
Figure 7-63: Fetal growth measurement type
To select the age to use

To plot the fetus age, the system allows you to use the
gestational age (GA) from the LMP, or to use the composite
ultrasound age (CUA). To select, adjust the Select GA control.
The information in the left column changes between CUA and
GA (EDD), and the data may change.

R2424458-100 Rev. 2
When selected, the gestational age may be changed by the

user.
1. Select the GA (LMP) value.
An editing window is displayed.
2. Enter a new value and select OK.
The GA (LMP) label is changed to GA (GA) showing the
new value entered. This information is also updated in the
Patient information window. In addition the EDD (LMP) is
updated to EDD (GA) with new calculated value.
To view a single or four graphs

You can view either a single Fetal Growth Curve Graph or you
can view four graphs at the same time. To select each view,
press Single or Quad on softkey button.
Figure 7-64: Fetal Growth Curve Graph: Quad View
The measurement values are displayed at the bottom of the

graph.

R2424458-100 Rev. 2
To change measurements in quad view

When you view four graphs simultaneously, you can select
which four you want to see. To change each graph in quad
view:
1. On the graph display, use the Trackball to move the cursor
to the small box that is upper left of each graph, then press
SET.
The system displays a list of measurements.
2. Move the Trackball to select the desired measurement and
press SET.
The system displays the Fetal Growth Curve Graph for the
To scroll through all Fetal Growth Curve Graphs, adjust the
Graph Change control.
Figure 7-65: Changing a chart in quad view
To edit patient data

When you are working with graphs, you can change or enter
the following patient data.
• GA (LMP) - this field is computed using the LMP date on
the Patient Data Entry screen. To change this field:
Note: You can only change this field on the Fetal Growth
Curve Graph in single view.
• Move the Trackball to the field, which is left of the graph.
To select the field press SET.
The system displays a window with the GA weeks and
days.
• To select each field, move the Trackball to the field and
press SET.

R2424458-100 Rev. 2
• Type the correct weeks or days.

• Select OK.
The system makes the following changes:
• GA (LMP) is now GA (GA) and shows the age you entered.
• In the Patient Data section, the GA changes.
• In the Patient Data section, the EDD (LMP) changes to
EDD (GA) and shows an updated date, using the GA you
entered. In addition, the LMP is erased.
• FetusPos - type information about the fetus position.
• PLAC - type information about the placenta.
Note: To return from a graph to the scan display press
Worksheet or Freeze.
Fetal Trending
When you have ultrasound data for more than one exam for a
patient, you can use the data to look at fetal trending on the
Fetal growth curve graphs. Fetal trending requires that a LMP
value is entered in the Patient information screen.
1. Press Worksheet.
2. Press Graphs and select the desired measurement to
display.
3. Press More and then Plot Both.
The system automatically finds the data from previous
ultrasound exams, and displays it on the graph with the
present data.
Figure 7-66: Fetal Trending

R2424458-100 Rev. 2
Fetal Growth Bar Graph

The fetal growth bar graph shows current exam measurements
and the normal growth range based on the gestational age. It
shows all measurements on one graph.
To view the Fetal Growth Bar Graph:
1. Press Worksheet.
2. Select Graph.
3. Select Bar.
Figure 7-67: Fetal Growth Bar Graph
Graph description:
• The horizontal axis shows the gestational weeks.
• The red vertical line shows the gestational age using the
patient data.
• The blue dotted vertical line shows the ultrasound age
using the current measurements.
• The yellow x shows the ultrasound age for each
measurement.
• The green rectangle shows the normal age range for the
measurement.
You cannot do fetal trending or view multiple gestation data on
the bar graph.
Note: To return to the graphs, press the Worksheet and the
Graph soft-key; or press the "More" and the Graph soft-key.

R2424458-100 Rev. 2
OB-Multigestational
Multiple Fetus
Vivid S5/Vivid S6 allows you to measure and report multiple
fetus development. The system can report a maximum of four
fetuses.
To define the number of fetuses

If more than one fetus is imaged during the exam, enter the
number of fetuses in the Patient Information Entry page.
1. Press PATIENT.
2. Select Current Patient Information.
The Patient Information window appears.
3. Type the number of fetuses into the Fetus No. field (1-4).
4. Press the Begin Exam softkey to continue with the exam
and get a scanning screen.
Note: You may also press the 2D mode button to continue
with the scanning.
To identify each fetus

For measurements, calculations, and worksheet displays, the
system labels each fetus A, B, C, or D. Each fetus is identified
by a letter and the total number of fetuses. For example, fetus
A/3 is fetus A from a total of 3.
When scanning, you can enter information about the fetus
position and placenta location. You can enter the information in
the Patient Data section of the worksheets and the graphs.
You can type up to 23 characters in the FetusPos and PLAC
fields.
Each fetus may have different description in these fields.
Figure 7-68: OB Worksheet - Patient Data section

R2424458-100 Rev. 2
To select a fetus
During measurements and calculations, to change between
fetuses, do one of the following:
• Adjust the Fetus selection.
• Move the Trackball to the Summary Window and select
the fetus.
Figure 7-69: Summary Window: Multiple fetus
You can change between fetuses at any time during the exam.
Note: After you change to the next fetus, any measurements
you make are recorded and reported to that fetus. If you have
any active measurement or calculation that is not completed
when you change the fetus, the system cancels the
measurement or calculation.
To compare multiple fetus data on a

worksheet
With multiple fetuses, you can list and compare measurements
of the fetuses on the worksheet.
• Select Worksheet Display.
• Select Fetus Compare.
The system lists the measurement results for each fetus
on the Worksheet.

R2424458-100 Rev. 2
Figure 7-70: Worksheet Display with Fetus Compare
To view multiple fetuses data on graphs

You can view multiple gestation data on fetal growth curve
graphs. After you have made measurements for each fetus,
select Graph Display.
• To view the graph for each fetus, do one of the following:
• Adjust the Fetus selection.
• In the Patient Data section, move the Trackball to
highlight the FetusNo field. Then, in the list of fetuses,
move the Trackball to select the fetus you want, and
press SET.
• To display data for multiple fetuses on the same graph,
select Fetus Compare.

R2424458-100 Rev. 2
Figure 7-71: Fetal Growth Curve Graph: Fetus Compare
The legend at the bottom of the graph shows the symbols and
colors that represent each fetus.

R2424458-100 Rev. 2
GYN Measurements
Introduction
The Gynecology exam category includes the following three
studies:
• Generic: This study is common to all exam categories, and
is part of the Measure and Assign Modality. See "Starting
the Measure and Assign modality" on page 251 for more
information.
• General Gynecology: This study includes uterine, ovarian,
ovarian follicle, and endometrium measurements.
• OB/GYN Vessel: This study includes the following vessels:
uterine, ovarian, umbilical, middle cerebral artery, aorta,
placenta, and descending aorta.
Note: The calculation formulas are listed in the Advanced
Reference Manual.
To Start a Gynecology Exam

To begin a gynecology exam, you enter patient data or, if the
patient data from a previous exam is saved in the system, find
the patient information.
For details about how to start an exam, see "Performing an OB
exam" on page 317.
After you complete the patient information, you can begin the
scan.
1. To change from the Patient Data Entry screen to the Scan
screen, do one of the following:
• On the keyboard, press Esc.
• On the Control Panel, select PATIENT or FREEZE.
• On the Control Panel, press the B-MODE key.
The system displays the Scan screen.
2. On the Control Panel, press MEASURE.
The default Gynecology study is displayed on the Top/Sub
Menu.

R2424458-100 Rev. 2
B-Mode Measurements
In B-Mode, you make the measurements in the General
Gynecology study. These measurements include:
• Uterine length, width, and height
• Ovarian length, width, and height
• Ovarian follicle
• Endometrium thickness
Uterus length, width, and height

Each of these is a standard distance measurement. Typically,
length and height are measured on the saggital plane while the
width is measured on the axial/transverse plane.
To measure uterus length, width, or height:
1. Scan the patient in the appropriate scan plane.
2. Select the UV folder, then select UV L, UV H, or UV W.
An active caliper displays.
3. Perform a standard distance measurement:
Trackball.
active caliper.
move the Trackball.
window. After the first and second measurement, the
system displays an active caliper for the next
measurement.
4. To make the second and third distance measurement,
repeat steps 2-3 above.
system displays the Ut-Vol (uterine volume) in the Results
Window, together with the three dimensions: Ut-L, Ut-H,
Ut-W.

R2424458-100 Rev. 2
Ovary length, width, and height

You can measure the length, width, and height of the left and
right ovaries. Each measurement is a typical distance
measurement made in the appropriate scan plane.
Typically, length and height are measured on the saggital plane
while the width is measured on the axial/transverse plane.
To measure ovarian length, width, or height:
1. Scan the patient's right or left ovary in the appropriate
plane.
2. Select the OV folder, then select left or right side.
3. Select length, width or height: OV L, OV W, or OV H.
4. Perform a standard distance measurement:
Trackball.
active caliper.
move the Trackball.
window. After the first and second measurement, the
system displays an active caliper for the next
measurement.
5. To make the second and third distance measurements,
repeat steps 3-4 above.
After you complete the length, width, and height
measurements, the system displays the ovarian volume in the
Results window. The results are:
• Right side: Rt Ov-L, Rt Ov-H, Rt Ov-W, Rt Ov Vol
Or:
• Left side: Lt Ov-L, Lt Ov-H, Lt Ov-W, Lt Ov Vol

R2424458-100 Rev. 2
Follicle measurements length, width,

and height
You can make left and right ovary follicle volume
measurements from three distances.
1. Select the right or left side by clicking Rt or Lt.
2. Select Follicle.
3. Measure the 3 dimensions length, width, height of the
follicle as follows:
4. Make the first distance measurement:
Trackball.
active caliper.
move the Trackball.
Window. After the first and second measurement, the
system displays an active caliper.
5. To make the second and third distance measurements,
repeat step 4 above.
The three distances will display in the Results Window.
After the third measurement, the system displays the
follicle volume calculation including previous
measurements in the Results window.
Endometrium thickness (Endo)

To measure the endometrium thickness, make one distance
measurement.
1. Select Endo.
2. To position the active caliper at the start point, move the
Trackball.
3. To fix the start point, press SET.

R2424458-100 Rev. 2

active caliper.
4. To position the second active caliper at the end point, move
the Trackball.
5. To complete the measurement, press SET.
The system displays the endometrium thickness in the
Results window.
M-Mode Measurements
M-Mode measurements for the Gynecology exam are identical
to M-Mode measurements for the Obstetrics exam. These
measurements include % stenosis, A/B ratio, and heart rate.
For details regarding these measurements, see "M-Mode
Measurements" on page 308.
Doppler Mode Measurements

Doppler measurements for the Gynecology exam are identical
to Doppler measurements for the Obstetrics exam. These
measurements include the following vessels: uterine, ovarian,
umbilical, middle cerebral artery, aorta, placenta, and
descending aorta. For each vessel, you can make any of the
following measurements: peak systole, minimum diastole, end
diastole, heart rate, TAMAX, pulsatility index, resistive index,
acceleration, PS/ED, ED/PS, and acceleration time.
For details regarding these measurements, see "Doppler
measurements" on page 309.

R2424458-100 Rev. 2
Chapter 8
• Introduction ................................................................................... .. 377

• Accessing the Quantitative analysis package ........................... .. 378
• Quantitative Analysis window ..................................................... .. 379
• Overview .................................................................................. 379
• Generation of a trace .................................................................... .. 386
• About the sample area ............................................................. 386
• To generate a trace .................................................................. 386
• Manual tracking of the sample area (dynamic anchored sample
area) ......................................................................................... 387
• Zooming in the Analysis window .............................................. 388
• Deletion of a trace ......................................................................... .. 389
• To delete all traces ................................................................... 389
• To delete one specific trace ..................................................... 389
• Saving/retrieving Quantitative analysis ...................................... .. 389
• Frame disabling ............................................................................ .. 390
• Disabling frames ...................................................................... 390
• Re-enabling all frames ............................................................. 390
• Optimizing sample area ................................................................ .. 392
• Reshaping a sample area ........................................................ 392
• Labelling a sample area ........................................................... 393
• Optimizing the trace display ........................................................ .. 394
• Optimizing the Y-axis ............................................................... 394
• Trace smoothing ...................................................................... 395
• Switching modes or traces .......................................................... .. 397
• To switch mode ........................................................................ 397
• To switch trace ......................................................................... 397
• Cine compound ............................................................................. .. 398

R2424458-100 Rev. 2
• Anatomical M-Mode ...................................................................... ... 399

• Introduction ............................................................................... 399
• Using Anatomical M-Mode ........................................................ 399

R2424458-100 Rev. 2
Introduction
The quantitative analysis software package is designed for
analysis of TVI, Tissue Tracking, Strain and Strain rate related
raw data.
The main features of these options are:
For TVI:
• Multiple Time -motion trace display from selected points in
the myocardium.
• Arbitrary Curved anatomical M-Mode
For Tissue Tracking:
• Multiple tissue displacement trace display from selected
segments in the myocardium.
For Strain Rate:
• Multiple Strain rate (Rate of deformation (s-1)) trace display
from selected segments in the myocardium.
For Strain:
• Multiple Strain (extend of tissue deformation (%)) trace
display from selected segments in the myocardium.
Note: Strain and Strain Rate modes are options available on
Vivid S6 only.

R2424458-100 Rev. 2
Accessing the Quantitative analysis package

In replay mode
1. Open an examination and recall a TVI or contrast loop.
2. Press the assignable Q ANALYSIS.
The Quantitative Analysis screen is displayed (see
Figure 8-1).
In live
1. Press FREEZE.
Note: if in 2D mode outside a contrast application, press
ALT and MORE assignable.
2. Press the assignable Q ANALYSIS.
The Quantitative Analysis screen is displayed (see
Figure 8-1).

R2424458-100 Rev. 2
Quantitative Analysis window

Overview
1. Color cineloop window 5. Time at cursor position and velocity at cursor

2. Tissue cineloop window position
3. Analysis window 6. Trackball Assignments
4. Sample Area 7. Sample area tools
Figure 8-1: The Quantitative analysis window (here with TVI data)

R2424458-100 Rev. 2
The color cineloop window
Displays TVI, Tissue Tracking, Strain, Strain

rate or Angio color-coded data.
Sample area (1):
Indicates sampling position of the velocity
1 (TVI), displacement (Tissue Tracking), percent
deformation (Strain), deformation rate (Strain
rate) or intensity (Contrast) trace. The sample
area is color-coded: the first sample area is
yellow, the second green...etc.
The cineloop windows system menu

This menu is entered by pressing UPDATE
MENU when the QA trackball cursor is within
one of the Cineloop windows.
• Delete all Sample areas: removes all traces
at once.
• Disable frameb: the current frame is
excluded from the cineloop display.
• Set Sample area Shapea: enables resizing
of a selected sample area by setting height,
width and tilt angle. The trackball marker
must be pointed at an anchored sample area.
• Label Sample area...a: set a descriptive
name to the sample area. The label is useful
for identification of the sample area when
exporting data.
a)Shown only when a sample area is • Delete anchorc: remove anchoring from a
selected (pointed at). dynamic sample area (see also page 386
b) With Contrast data only. and page 387).
c) Shown only when pointing at an
anchored sample area.
• Delete Sample areaa: removes selected

sample area from the Cineloop window and
belonging trace in the Analysis window. The
trackball marker must be pointed at an
anchored sample area.
• Cancel: exits the System menu.

R2424458-100 Rev. 2
The Tissue cineloop window
Displays 2D data
Sample area (1):
Indicates sampling position of the velocity
(TVI), displacement (Tissue Tracking), percent
1 deformation (Strain), deformation rate (Strain
rate) or intensity (Contrast) trace. The sample
area is color-coded: the first sample area is
yellow, the second green...etc.
Sample area tools:

• : creates a sample area based on
freehand drawing.
• : creates a sample area with a
pre-defined circular/elliptic shape
(configurable, see page 392)

R2424458-100 Rev. 2
The analysis window
TVI:
6
Displays velocity trace
-2.3
1. Y axis: velocity scale (cm/s)
2. X axis: Time (s)
1 3. ECG
5 4
4. Time at cursor position
5. Velocity at cursor position
6. Velocity at frame marker position
(color coded)
Tissue Tracking:
Displays tissue displacement trace
2 1. Y axis: displacement scale (mm)
2. X axis: time (s)
3 3. ECG with Tracking start and Tracking
end markers
5. Displacement at cursor position
6. Displacement at frame marker
position (color coded)
Strain rate:
Displays Strain rate trace (rate of deformation
(s-1))
1. Y axis: s-1
2. X axis: time (s)
3. ECG
5. Strain rate at cursor position
6. Strain rate at frame marker position

R2424458-100 Rev. 2
Strain:
6
Displays Strain trace (extent of tissue
deformation (%))
-2.3
1. Y axis: percent displacement

1 2. X axis: time (s)
5 4
3. ECG with Strain start and Strain end
markers
5. % deformation at cursor position
6. % deformation at frame marker
position (color coded)
2

R2424458-100 Rev. 2
The analysis window system menu:

This menu is entered by pressing UPDATE
MENU when the QA cursor is within one of the
analysis window.
• Delete all Sample areas: removes all traces
at once.
• Analysis signal: toggles trace display
between velocity, displacement, strain rate,
stain or greyscale intensity curves.
• Drift compensation: compensates drifting
of strain or Tissue Tracking curves by either
resetting the curve to zero at the tracking
start point (cycle resetting) or by linear
compensation throughout the cycle (linear
compensation)
• Horizontal scale: set horizontal unit as time
(s) or time interval (dt) between frames.
• Vertical auto-scaling: selects between full
unit range or a range according to the
maximum and minimum values of the
displayed trace(s).
• Vertical unita: toggles between logarithmic
(dB) and linear acoustical units (AU).
• Line style: selects between solid line only or
solid line with square markers at each data
a)
point.
With contrast data only.
• Smoothing: smooths the trace displayed by
b) Shown only in zoom mode. applying a filter over a defined time window.
Both the filter type and time window are
user-selectable. The type of filter available is
depending on the analysis signal displayed.
• Export traces: saves trace data in ASCII

format, readable in spreadsheet programs. If
present, trace data for physiological traces
are also exported.
• Unzoomb: restores full analysis window
display when in zoom mode.
• Cancel: exits the System menu.

R2424458-100 Rev. 2
The Trackball assignments
QA:
Pointing tool in Quantitative analysis mode.
Scroll/Speed:
• When the cineloop is stopped, enables
scrolling through the cineloop.
• When the cineloop is running, enables
control of the cine replay speed.

R2424458-100 Rev. 2
Generation of a trace
Up to eight traces can be generated.
About the sample area

The sample area can be in three different states:
• Free sample area: freely moving sample area (QA cursor)
before anchoring.
The free sample area • Static sample area: the free sample area is anchored by
disappears when the pressing SET on the Trackball area.
QA cursor is moved
over a static an- • Dynamic anchored sample area: the sample area is
chored frame. anchored in two or more frames (see Manual tracking
below). In these particular frames, the sample area is
displayed with an anchor. The sample area moves
smoothly between the anchored positions when
playing/scrolling the cineloop.
To generate a trace
Trace from a pre-defined sample area
The shape of the pre-defined sample area is configurable (see
page 392).
1. If the Trackball assignment is not on QA, press TRACKBALL
until QA is highlighted.
The trace and sam- 2. If necessary, select the sample area Shape button .
ple area are col-
3. Trackball to one of the Cineloop windows.
or-coded. First
generated trace is The trackball cursor is changed to a sample area (white
yellow, second circle).
green...etc. A preview of the trace is displayed in the Analysis window.
4. Press SET to anchor the sample area.
In this frame the sample are is marked with an anchor.
If the cineloop has more than one heart cycle a sample
area will also be anchored in the corresponding frame in
the next heart cycles.
The trace is updated accordingly in the Analysis window.
The Strain cursor
In Strain and Strain rate modes, the sample area displays a
Strain cursor showing the segment along the beam direction
that is used for Strain and Strain rate calculations. Make sure

R2424458-100 Rev. 2
that the Strain cursor is within the myocardium when anchoring

the sample area.
Trace from a freehand sample area

1. Select the Pencil button .
2. Trackball to one of the Cineloop windows.
The trackball cursor is changed to a cross.
3. Press and hold down the SET button while drawing a
sample area with the trackball.
4. Release the SET button.
The sample area is automatically closed.
The trace is updated accordingly in the Analysis window.
Manual tracking of the sample area

(dynamic anchored sample area)
The sample area can be moved within the loop to ensure that
data in the trace are generated from the same anatomical
location during the cyclic motion of the heart.
1. Place a sample area over a region of interest.
Note the anatomical location of the sample area.
2. Using the trackball, scroll to a new frame.
3. Press TRACKBALL until the QA trackball assignment is
selected.
4. Trackball to the sample area.
5. Press SET.
The sample area is unanchored.
6. Drag the sample area to the corresponding anatomical
location in the new frame.
In the original When the sample area is anchored in more than one
frame and this par- frame, linear interpolation is performed, so that the sample
ticular frame the area is smoothly moved between the anchored positions in
sample area is
marked with an an-
the selected frames when running the cineloop.
chor. 7. Press TRACKBALL until the Scroll trackball assignment is
selected.
8. Using the Trackball, scroll through the cineloop and control
that the sample area follows the moving anatomical
structure.
9. Add anchored sample areas in several frames to obtain a
more accurate displacement of the sample area.

R2424458-100 Rev. 2
To move a dynamic anchored sample area

1. Press TRACKBALL until the Scroll trackball assignment is
selected.
In these frames the 2. Using the trackball, browse through the cineloop to display
sample area is one of the frames where the sample area was anchored.
marked with an an-
chor. 3. Press TRACKBALL until the QA trackball assignment is
selected.
4. Trackball to the sample area to move, in one of the
Cineloop windows.
5. Press SET.
The sample area is unanchored.
6. Drag the sample area to a new location.
7. Press SET to anchor the sample area to the new location.
Zooming in the Analysis window

1. In the Analysis window, press and hold down the SET key
while dragging the trackball cursor to define the zooming
area.
2. Release the SET key.
The selected area is displayed in the Analysis window.
To unzoom
1. Press UPDATE MENU in the trackball area on the control
panel.
The System menu is displayed.
2. Trackball to Unzoom.
3. Press SET.

R2424458-100 Rev. 2
Deletion of a trace
The user can delete all traces at once or one at a time.
To delete all traces

1. If necessary, press TRACKBALL until the QA trackball
assignment is selected.
panel.
3. Trackball to Delete all traces.
4. Press SET.
To delete one specific trace

2. Trackball to the sample area to delete.
panel.
4. Trackball to Delete trace.
5. Press SET to perform deletion.
Saving/retrieving Quantitative analysis

1. Press IMAGE STORE to save the quantitative analysis
session.
2. To recall the Quantitative analysis session, select the icon
on the clipboard, and press the assigned key Q ANALYSIS.

R2424458-100 Rev. 2
Frame disabling
Frame disabling excludes the actual frame from the cineloop
display. Frame disabling is available only with contrast data.
Disabling frames
To re-enable a 1. Trackball to the frame marker of the frame to disable
frame: Press beneath the Analysis window (see Figure 8-2).
SELECT on the cor-
responding frame 2. Press SET to disable the frame.
marker. The frame marker turns red.
disabling successive frames at a time

To re-enable succes- 1. Press and hold down SET while dragging the cursor over the
sive frames: press frame markers of the frames to disable.
and hold down The frame markers turn red.
the SELECT key
while dragging the
ECG triggered frame disabling
cursor over the
frame markers. In a multi-cycle acquisition, the user may deselect all frames in
all heart cycles but a selected one. This function can be used
for example to select a particular systolic frame for each heart
cycle.
1. Scroll through the cineloop to identify the cardiac phase to
analyze or identify the cardiac phase on the ECG trace.
2. Trackball to the frame marker of the frame of interest in one
of the heart cycles (see Figure 8-2).
4. Trackball to ECG triggering.
5. Press SET.
All frames in all heart cycles are disabled except for the
selected and corresponding frames in the other heart
cycles.
Re-enabling all frames

1. Trackball the cursor to the Frame marker axis.
panel.
3. Trackball to Enable all frames.
4. Press SET.

R2424458-100 Rev. 2
All previously disabled frames are re-enabled.
1. Analysis window
2. Frame marker axis
3. Enabled frame (green marker)
4. Disabled frame (red marker)
5. ECG
6. Current frame
Figure 8-2: Frame disabling

R2424458-100 Rev. 2
Optimizing sample area

The sample area can be reshaped and labelled.
Reshaping a sample area

There are two ways of modifying a sample area: either from the
Update menu or by selecting the SAMPLE SHAPE assignable.
Reshaping a sample area from the Update

menu
2. Trackball to the sample area to reshape.
panel.
4. Trackball to Set Sample area shape.
5. Press SET.
A Dialogue window is displayed where the user can adjust
the height, the width and the angle of the sample area (see
Figure 8-3).
Figure 8-3: The sample area reshaping window
6. Drag the sliders to adjust the shape of the sample area as

desired.
7. Press OK to return to the Quantitative analysis window and
use the settings for the current analysis only.
OR
Press Set as default to return to the Quantitative analysis
screen and keep the settings as default.

R2424458-100 Rev. 2
Reshaping a sample area from the assignables

This procedure allows to reshape either a free sample area or a
specific anchored sample area providing that the QA cursor is
pointing at the actual sample area.
1. Press the SAMPLE SHAPE assignable.
The Sample shape assignable controls are displayed.
2. Adjust the size and angle of the sample area using the
assignable rotaries.
3. If desired press the assignable SET DEFAULT to keep the
settings as default.
Labelling a sample area

The sample area label is used to identify data associated to the
sample area when exporting to a spreadsheet program.
2. Trackball to the sample area to label.
panel.
4. Trackball to Label Sample area....
5. Press SET.
A Dialogue window with a free text field is displayed (see
Figure 8-4).
6. Type a name for the sample area.
7. Press OK to return to the Quantitative analysis screen.
1. Free text
Figure 8-4: The sample area labelling window

R2424458-100 Rev. 2
Optimizing the trace display

Optimizing the Y-axis
Auto-scaling
The system can be configured to display the full unit range or a
range according to the maximum and minimum values of the
displayed trace(s) (auto-scaling function). In addition, the
auto-scaling function can be set to be live update (updates
while the sample area is moved) or delayed (updated when the
sample area is anchored).
Setting the auto-scaling function
2. Trackball to the Analysis window.
panel.
4. Trackball to Vertical auto-scaling.
5. Press SET.
The Vertical autoscaling menu is displayed.
Figure 8-5: The Vertical Auto-scaling menu
6. Trackball to the desired option:

• Delayed: autoscaling takes place after anchoring the
sample area.
• On: autoscaling while moving the sample area.
• Off: displays full scale.
7. Press SET.

R2424458-100 Rev. 2
Vertical units
Applicable with When analyzing contrast data, the Y-axis can be set to display
contrast data only. either logarithmic scale (dB) or linear, acoustical units (AU) for
both tissue intensity (2D) or Angio intensity data.
Selecting the Y-axis unit
panel.
4. Trackball to Vertical unit.
5. Press SET.
The Vertical unit menu is displayed.
Figure 8-6: The Vertical unit menu
6. Trackball to the desired option.

7. Press SET.
Trace smoothing
The system can smooth the traces displayed by applying a filter
over a defined time window. The type of filter available is
depending on the analysis signal displayed.
Smoothing trace(s)
panel.

R2424458-100 Rev. 2
4. Select Smoothing.
The Smoothing menu is displayed.
5. Select a smoothing filter.
The trace display is updated.

R2424458-100 Rev. 2
Switching modes or traces

The user can toggle between TVI, Tissue Tracking, Strain rate
or Strain modes to access to the mode specific controls (soft
menu and assignable) or display alternative traces from within
a selected mode.
To switch mode
1. Press MORE.
2. Select the desired mode (TVI, Tissue Tracking, Strain rate
or Strain.
The Soft menu and assignables are updated accordingly.
To switch trace
panel.
4. Trackball to Analysis signal.
5. Press SET.
The Analysis signal menu is displayed.
Figure 8-7: The Analysis signal menu
6. Trackball to the desired trace.

7. Press SET.
The Analysis window is updated with the selected trace.

R2424458-100 Rev. 2
Cine compound
Cine compound calculates and displays cineloops generated
from a temporal averaging of multiple consecutive heart cycles.
The number of averaged cycles is displayed on the top left
corner.
To apply cine compound:
1. Using the Soft menu rocker, adjust the number of heart
cycles to average.
The traces are updated showing averaged data. The
number of heart cycles averaged is displayed on the top
left corner.
2. Press the assigned key CC Zoom to display the last
recorded heart cycle.
3. Press CC Zoom again to unzoom.

R2424458-100 Rev. 2
Anatomical M-Mode
Introduction
M-Mode applied to TVI, Tissue Tracking, Strain rate, Strain or
intensity data (Contrast) calculates and color/codes data
accordingly along a path drawn by the operator.
Using Anatomical M-Mode

1. Press the CAMM assignable.
2. In one of the Cineloop windows, trackball to the region from
where to start the sampling path.
3. Press SET to anchor the first point of the path.
4. Trackball to the location for the next anchoring point of the
path.
To edit a path under 5. Press SET to anchor the point.
construction, A path with two anchor points will give a straight
trackball back- anatomical M-Mode profile. By creating more than two
ward and retrace
the path.
anchor points, the user can bend the path and obtain a
curved anatomical M-Mode profile.
6. To end the trace press SET twice (double clicking).
Rotate HORIZ. The color-coded display of the corresponding data
SWEEP and scroll calculated along the path is shown in the Analysis window
through the (see Figure 8-8).
cineloop to optimize
the display to the
portion of interest.

R2424458-100 Rev. 2
1. Cineloop window 3. Path anchor point

2. Analysis window 4. Time scale
Figure 8-8: The anatomical M-Mode display (here TVI data)

R2424458-100 Rev. 2
Optimizing Anatomical M-Mode

Edition of the curve
The drawn Anatomical M-Mode path can be edited by moving
the anchor points.
To move an anchor point

1. Trackball to anchor point to move.
2. Press SET.
3. Trackball the anchor point to a new position.
4. Press SET to anchor the point to its new location.

R2424458-100 Rev. 2

R2424458-100 Rev. 2
Archiving
Chapter 9
Archiving
• Introduction ................................................................................... .. 405

• Storing images and cineloops ..................................................... .. 406
• Storing an image ...................................................................... 407
• Storing a cineloop .................................................................... 407
• Saving images and cineloops to a standard format ................. 408
• MPEGVue/eVue ....................................................................... 410
• Retrieving and editing archived information .............................. .. 413
• Locating a patient record .......................................................... 413
• Selecting a patient record and editing data in the archive ....... 418
• Deleting archived information ................................................... 422
• Moving examinations ............................................................... 424
• Review images in archive ............................................................ .. 426
• Review the images from a selected examination ..................... 426
• Select images from the Image list screen ................................ 427
• Connectivity .................................................................................. .. 431
• The dataflow concept ............................................................... 431
• Stand-alone scanner scenario ................................................. 434
• A stand-alone scanner and a stand-alone EchoPAC PC
environment .............................................................................. 435
• A scanner and EchoPAC PC in a direct connect environment 437
• A scanner and EchoPAC PC in a network environment .......... 441
• A scanner and a DICOM server in a network ........................... 443
• Export/Import patient records/examinations ............................. .. 452
• Exporting patient records/examinations ................................... 452
• Importing patient records/examinations ................................... 460

R2424458-100 Rev. 2
Archiving
• Disk Management ......................................................................... ... 464

• Configuring the Disk management function .............................. 465
• Running the Disk management function ................................... 468
• Data Backup and Restore ......................................................... 471
• DICOM spooler .............................................................................. ... 479
• Starting the DICOM spooler ......................................................479
• Database import from Vivid 3 or Vivid 4 ..................................... ... 482
• Transfer Procedure ................................................................... 482
• Installing the Vivid 3/4 Data Viewer .......................................... 485
• Using the Vivid 3/4 Data Viewer ...............................................488

R2424458-100 Rev. 2
Archiving
Introduction
During an examination, the operator stores data, images and
cineloops for immediate purposes. The Vivid S5/Vivid S6
ultrasound unit includes an integrated patient archiving system
for data and image storage.
Do not use the internal hard drive for long-term image storage.
CAUTION
The Vivid S5/Vivid S6 ultrasound unit enables also storing of

data and images to external databases (Image Vault, Magneto
Optical (MO) disk, CD-R or DVD-R). The patient and image
archives are set by the selected dataflow (see page 616 about
available dataflows and default dataflow selection).

R2424458-100 Rev. 2
Archiving
Storing images and cineloops

DICOM images are Images and cineloops that are stored during a current
stored to formatted examination are displayed as thumbnails on the clipboard (see
Magneto Optical Figure 9-1). When an image is stored, all the additional
disks separately
from patient data.
information that is displayed is saved with it (i.e. probe and
application selected, image setting, annotations or
measurements, etc.).
The image archive is set by the dataflow selected (see
page 616 about available dataflows and default dataflow
selection).
Do not use the internal hard drive for long-term image storage.
External storage media or network-based server solution is
CAUTION
recommended for image archive.
If working off-line with a dataflow pointing to a DICOM server, the

images stored during the examination will have to be manually
CAUTION resent in the DICOM spooler (page 479) when reconnecting the
unit. Resend all jobs that are failed or on hold (See page 479 for
more information on DICOM spooler.).
In addition, stored images and cineloops can be saved to a

removable media in the standard formats JPEG, AVI (cineloop),
MPEG and DICOM (see page 408).
1. Single image stored

2. Cineloop stored Scrolling tool
3. Scrolling tool
4. Serial number of image
Figure 9-1: The Clipboard on the scanning screen

R2424458-100 Rev. 2
Archiving
Storing an image
Images are displayed chronologically on the clipboard.
1. While scanning in any mode, press FREEZE.
2. Trackball to scroll through the cineloop and select the
required image.
3. Press STORE.
The image is stored and a thumbnail is displayed on the
clipboard. A serial number appears on each thumbnail,
start from “1” in chronological order (see Figure 9-1).
Storing a cineloop
A cineloop is a sequence of images recorded over a certain
time frame. The time frame can be adjusted to cover one or
more heart cycles. The stored cineloops are displayed
chronologically on the clipboard. Cineloops can be stored at
any time during the scanning session. The user can choose to
preview the cineloop before storage or save the cineloop
directly as described below.
Preview and storage of a cineloop

1. While scanning in any mode, press FREEZE.
2. Press the Assignable CINELOOP.
3. Determine the best cineloop to store using the assignables
(see page 110 for further information on cineloop
operation).
4. Press STORE.
The cineloop is stored and a thumbnail is displayed on the
clipboard. The "loop" icon appears on the thumbnail image
indicating that the image stored is a loop (see Figure 9-1).
A serial number appears on each thumbnail, starting from
“1” in chronological order.
Note: Cineloop storage can be configured to store heart cycles
with additional time before and after the R-wave (see "The
Global setup sheet" on page 590).
Direct storage of a cineloop

Depending on whether the system has been configured to
enable or disable the Preview Loop before store function

R2424458-100 Rev. 2
Archiving
(see page 590), the following procedures enable the cineloop

to be stored directly.
Storing cineloop without preview
The function Preview Loop before store is disabled (see
page 590).
• While scanning, press STORE.
The last valid cineloop is stored in the archive and a
thumbnail is displayed on the clipboard.
Scanning resumes immediately.
Storing cineloop with preview
The function Preview Loop before store is enabled (see
page 590).
1. While scanning, press STORE.
The last valid cineloop is previewed on the screen (but not
stored).
2. If desired, press CINELOOP and adjust the cineloop to be
stored using the assignables (see page 110).
3. Press STORE to save the cineloop.
A thumbnail is displayed on the clipboard.
Saving images and cineloops to a

standard format
Images and cineloops can be saved to a removable media or a
shared network folder in the following standard formats:
• Still images: JPEG, MPEG, DICOM and RawDICOM (Raw
data + DICOM), and HDF
• Cineloops: AVI, MPEG, DICOM and RawDICOM (Raw
data + DICOM), and HDF
Images can also be stored as MPEG format on a CD-R using
the Export function as described on page 410.
Procedure:
1. In live: press FREEZE.
In replay: select an image thumbnail on the clipboard.
2. Press UPDATE/MENU on the control panel.

R2424458-100 Rev. 2
Archiving
Figure 9-2: The System menu
3. Trackball to Save as.

4. Press SET.
The Save as menu is displayed.
Figure 9-3: The Save as menu
5. Select the desired removable media from the Save in

archive pull-down menu.
6. Enter a file name in the File name field.
If the image or cineloop is saved as DICOM or RawDICOM
the file name is automatically generated to follow the
DICOM standard.
7. Select between:
• Store image only: saves the image or cineloop only.
• Store secondary capture: creates a still image of the
image area and the Title bar.

R2424458-100 Rev. 2
Archiving
The secondary capture is not available when saving

images as DICOM or RawDICOM.
• Quad view: saves all images or cineloop when in quad
view.
Quad view is not available when storing RawDICOM.
8. Select the image compression type (JPEG or RIe) or no
compression.
9. Enter in the desired Image quality (between 10 and 100).
A high quality setting will give a lower compression.
10. In the Save as type field select one of the following formats:
• RawDICOM: saves the still image or cineloop in both GE
raw format and DICOM format.
• DICOM: saves the still image or cineloop in pure DICOM
format.
• JPEG: saves a still image in JPEG format.
• MPEG: saves the still image or cineloop in MPEG format
• AVI: saves the cineloop in AVI format.
• HDF: saves the image or cineloop in HDF (Hierarchical
Data Format). HDF is a portable data format for
exchange of scientific numerical and graphical data.
More information about HDF format at:
http://hdf.ncsa.uiuc.edu
A tool for viewing HDF files can be downloaded from:
http://hdf.ncsa.uiuc.edu/hdf-java-html/hdfview/
11. Press Save.
A file is saved in the selected archive.
MPEGVue/eVue
MPEGVue/eVue enables the user to export or save an exam
(images, measurements and reports) into MPEG format
readable from a regular Windows computer together with a
special MPEG viewer.
MPGEGVue Viewer is intended for secondary review and patient
consultation.
CAUTION
Note: MPEGVue is optionally available on both Vivid S5 and

Vivid S6, while eVue is available for Vivid S6 only.

R2424458-100 Rev. 2
Archiving
MPEG exams can be created using the Export function

(MPEGVue) or by using the dataflow Local Archive -
Int.HD/eVue (eVue).
The MPEGVue option is used to create MPEG exams on
finished exams. The eVue option is used to create MPEG
exams when performing the exam, upon saving the images.
Creating an MPEG exam using the Export

function (MPEGVue)
Refer to "Exporting patient records/examinations" on page 452.
Creating a MPEGVue exam usingan eVue dataflow
The dataflow must be configured before first time use as
follows:
1. Press CONFIG and log on as administrator.
2. Select the Connectivity category and Dataflow subgroup.
The Dataflow sheet is displayed.
3. Select the dataflow Local Archive - Int. HD/eVue in the
Name pull-down menu.
Make sure that the option Hidden is unchecked.
Figure 9-4: The Dataflow Sheet

R2424458-100 Rev. 2
Archiving
4. Select the eVue device in the Selected devices pane and

press Properties.
The eVue properties window is displayed.
Figure 9-5: The eVue properties window
Remote paths of 5. Select a removable media or a network volume remote path

network volumes as the destination in the Destination pull-down menu.
must be entered
once in the Remote 6. Check the options as required.
path field before 7. Select OK and press CONFIG.
they can be selected
from the Destina- To create an MPEG exam using an eVue dataflow
tion Pull-down 1. Press ARCHIVE.
menu. The Search/Create patient window is displayed.
2. Select the dataflow Local Archive - Int. HD/eVue or
Remote Archive - Remote HD/eVue.
3. Perform an exam.
When saving an image, it is stored as raw data to the local
machine, an MPEG copy is created and stored to the
destination set during the configuration of the dataflow.
Reading an MPEG exam
A MPEG exam can be read from any computer with Windows
98/2000/XP, provided that DirectX 8.1 or later and Windows
Media Player 7.1 or later are installed.
Refer to the MPEGvue User Manual for details on reading
MPEG exams on a computer.

R2424458-100 Rev. 2
Archiving
Retrieving and editing archived information

Locating a patient record
To create an opera- 1. Press PATIENT on control panel.
tor ID, see If the unit is password protected a Log In window
page 637. (Figure 9-6) will appear asking for user ID, and password.
The unit can be con- 2. Press Log on when completed.

figured to automati- The Archive entry screen is displayed (Figure 9-7).
cally generate a
patient ID (see
page 626)
Figure 9-7: Archive entry screen
3. Click the Create New Patient button.

The Search/Create patient window is displayed
(Figure 9-8).
Note: Use "Other ID" if relevant - For further information
see "Using other ID" on page 99.

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CAUTION
The automatic When default configured, the system automatically

searching tool dis- searches to see if the patient is already in the database.
playing matching The result of this search is displayed in the Patient list field.
patient information
in the Patient list 5. Trackball to the actual patient and press the Trackball SET
can be turned off key.
(see page 626) The patient record is highlighted.
6. Press SELECT PATIENT
Or
Press [+] in front of the actual patient record and select the
desired examination.
The Examination List window for the actual patient is
displayed (refer to Figure 9-10).

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Archiving
1. Press one of the headings to sort the list 4. Select the column heading border and drag to
accordingly. adjust column width
2. Select new archive and other pre-defined 5. Expended Patient record displaying belonging
services examinations
3. Extended menu
The Search/Create patient window may be slightly different depending on the Dataflow selected
Figure 9-8: The Search/Create Patient window

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Advanced search
The list of searching To restrain the search to a specific patient group, one or more
filters may vary de- filters may be applied to the search. The table below shows the
pending on the filters applicable to a patient search:
Dataflow selected
Searching filter
Echolab
Diagnostic code
Born between
Examination date between
Current date
Images: patient records with examinations with images
Stress examinations: patient records with stress echo examinations
No Report: Patient record with examination(s) without stored

reports
Category: displays only patient records for the selected category
Diagnosis Physician
Searching with filter:

The unit can be con- 1. Trackball to the More button in the Search/Create Patient
figured to display window.
the Advanced
search tool as de- 2. Press SET on the control panel.
fault (see page 626) The Search/Create Patient window is extended displaying
the searching filters (see Figure 9-9).
3. Type the information in the required searching filter field.
The matching data is displayed in the Patient list when the
automatic search function is turned on.
Note: Use "Other ID" if relevant - For further information see
"Using other ID" on page 99.
Sorting data
The search result can be sorted according to the fields
displayed in the patient list, in ascending or descending order.

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To sort data:
1. In the Patient list field, Trackball to the field header by which
the sort is to be performed (Figure 9-9, page 417).
The patient list is sorted in ascending order according to
the field selected.
3. Press SET once more.
The patient list is sorted in descending order according to
the field selected.
1. Press one of the headings to sort the list 4. Select the column heading border and drag to
accordingly. adjust column width
2. Select new archive and other pre-defined 5. Expended Patient record displaying belonging
services examinations
3. The system can be configured to display the
Advanced search tool as default (see page 626)
The Search/Create patient window may be slightly different depending on the Dataflow selected.
Figure 9-9: The extended Search/Create Patient window

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Printing the patient list

1. In the Search/Create patient window, select More to display
the additional menu.
2. Select Print Patients.
The displayed patient list is printed.
Selecting a patient record and editing

data in the archive
After locating the patient in the database (see page 413
page 417), the user must select the patient record, to be able to
review and edit archived data.
Selecting a patient record from the patient list

1. In the Search/Create patient window, trackball to the actual
patient and press the Trackball SET key.
The patient record is highlighted.
2. Press SELECT PATIENT.
The Examination List window is displayed showing
previous examinations and diagnosis information related
to the selected patient (see Figure 9-10).
1. The information displayed in the Patient list is 3. Select the column heading border and drag to
configurable (see page 626). adjust column width
2. Insert pre-defined text in the Comment field 4. Enter the diagnostic code
Figure 9-10: The Examination list window

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Editing Referral Reasons, Comments and

Diagnosis
The user can edit the actual text in the Examination List
window using the alphanumeric keyboard and by inserting
pre-defined text input.
The user is responsible for patient demographic data, diagnostic
information or any other patient related information entered in
CAUTION the database.
Text edition
1. In the Examination list window (Figure 9-10), trackball to
the required field.
2. Press SET.
Use the Arrow keys 3. Using the alphanumeric keyboard, edit the information.
to move text mark-
4. Press PATIENT on the control panel to quit the archive.
er.
Inserting pre-defined text input
1. In the Examination list window, trackball to Insert Text over
the actual field.
2. Press SET.
The Insert text window is displayed (see Figure 9-11).
The pre-defined text list is organized in a three level
hierarchy. Selecting one item in the first column displays
pre-defined text entries related to the selected text in the
second and third column.
3. Navigate through the pre-defined text list by selecting items
in the columns and double-click on the desired pre-defined
text to be inserted. If an entry in the third column is inserted,
the selected text in the second column is also inserted.
Press More>> to display the full text for the selected entry.
Figure 9-11: The Insert text window

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Creating, editing and deleting text input

These features are described in "The Comment texts sheet" on
page 613.
Diagnosis code
Entering a Diagnosis code
1. In the Examination list window, select Code (see
Figure 9-10).
The Entered Code window is displayed.
2. Select Add.
The Code list window is displayed.
3. Double-click the code to enter.
The selected code is displayed in the Examination list
window.
1. The Entered Code window

2. The Code list window
Figure 9-12: Entering Diagnosis codes
Deleting an entered Diagnosis code

Figure 9-10).
2. In the Entered Code window, select the code to delete and
press Delete.
Creating a Diagnosis code
Figure 9-10)
2. Select Add.
The Code List window is displayed.

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3. Select New.
4. Enter the new code.
5. Select Done to exit.
See also "The diagnostic codes sheet" on page 612.
Editing Demographic details

If you modify the Patient ID, Last name, First name or Date of
birth on a patient in the archive, be aware that the contents of the
WARNING archived images for that patient is not updated. If the images are
still in the buffer and not yet archived, the image files are updated
if you modify any patient information, but not if the images are
archived. So if any of these images are later on exported to
DICOM media or DICOM server, they will still contain the original
patient information, as it was before you did the modification in
the archive. The system does not alter the contents of the image
files at all when doing DICOM export.
Note: Patient ID may also refer to patient's "other ID". For further
information see "Using other ID" on page 99.
1. Press the PATIENT button on the control panel.

2. Select Patient Details.
The Patient information window is displayed.
3. Trackball to the field to edit.
5. Using the alphanumeric keyboard, edit the information.
CAUTION
Alternative: Press 6. Press the EXAM LIST assignable to go back to the

any active scanning Examination list window. OR
mode key. Press PATIENT on the control panel to quit the archive.

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Deleting archived information

Only user logged in To delete a patient record
with full operator
rights can delete pa-
1. Press PATIENT on the Front panel.
tient records (see 2. Select Patient List.
page 637 for further The Search/Create Patient window is displayed
information). (Figure 9-8, page 415).
4. Trackball to the actual patient record.
5. Press SET to highlight the patient record to delete.
6. Press Delete in the Search/Create Patient window.
A dialogue box is displayed asking for confirmation of the
deletion (Figure 9-13).
7. Trackball to OK and press SET on the control panel.
Figure 9-13: Delete patient record confirmation prompt
To delete an examination
2. Select Patient List.
The Search/Create Patient window is displayed
(Figure 9-8, page 415).
3. Type the patient Last Name, and/or ID depending on
system configuration.
4. Trackball to the actual patient record and double-click the
Trackball SET key (or press SET once and SELECT PATIENT)
to select the patient.
The Examination list window is displayed.
5. Trackball to the examination to delete.
6. Press the trackball SET key.

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7. Press More in the Examination list window (see

8. Press Del Exam to delete the examination.
A warning message is displayed asking the user to confirm
the action to perform (see Figure 9-14).
9. Trackball to OK and press SET to delete the selected
examination.
Trackball to Cancel and press SET to abort deletion.
Figure 9-14: Delete Examination prompt
To delete an image
2. Select Patient List.
The Search/Create Patient window is displayed.
4. Trackball to the required patient to highlight the record.
5. Press the trackball SET button.
The Examination list window is displayed.
6. Trackball to the actual examination in the Examination list
window.
7. Press the trackball SET button.
8. Press REVIEW.
The images for the selected examination are displayed on
the Review screen (Figure 9-17, page 427).
Repeat steps 9 and 9. Trackball to the image to delete.
10 to delete several
images.
11. Press Delete.
A pop-up dialog box is displayed asking for confirmation of
the deletion.
The image is deleted.

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Archiving
To delete an image from the clipboard

1. If in live, press FREEZE.
2. Press TRACKBALL until the Pointer tool is selected.
3. Move the pointer over and select the image to delete in the
clipboard.
4. Press the Update/Menu button.
5. Select Delete clipboard cell from the Update menu.
A pop-up dialog box is displayed asking for confirmation of
the deletion.
The image is deleted.
Moving examinations
An examination can be moved from one patient record to
another. This feature should only be used if an examination
was performed and stored to a wrong patient record.
When moving an examination, verify that the target patient
record is correct.
CAUTION
1. In the Search/Create Patient window press [+] in front of

the patient record containing the examination(s) to move
(see Figure 9-8, page 415).
2. Select the examination to move.
3. Press the More soft button in the lower, right-hand corner
of the Search/Create Patient window.
4. Press the Move Exam soft button.
The Move exam window is displayed.

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Archiving
Figure 9-15: The Move exam window
5. Search and select the target patient record.

6. Press Move Exam.
A warning message is displayed asking the user to confirm
the action to perform (see Figure 9-16).
Make sure that the patient record selected is correct.
CAUTION
Figure 9-16: Moving examination prompt
7. Trackball to OK and press SET.

An information window is displayed to confirm the
operation.
8. Press OK.

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Review images in archive

There are two ways to access to archived images:
• Review the images from a selected examination.
• Select images from the Image list screen displaying all the
images sorted by examination sessions for the actual
patient.
Review the images from a selected

examination
1. In the Examination list window (see Figure 9-10, page 418),
trackball to the actual examination.
2. Press SET on the control panel to highlight the examination.
3. Press REVIEW on the control panel.
The stored images for the selected examination are
displayed in the Review screen (see Figure 9-17).
To analyze images:
1. Press SET on the images to analyze.
2. Press ANALYZE.

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Archiving
1. Page number 3. Selection tools

2. Selected image (bold frame)
Figure 9-17: The Review screen
Select images from the Image list

screen
The procedure described below enables the analysis of images
belonging to different examinations for a selected patient
record. If images are stored on multiple removable media, they
have to be restored to the local hard drive prior to review as
described below.
1. In the Examination list window (see Figure 9-10, page 418),
press Image list.
The Image list screen is displayed (see Figure 9-20)
showing thumbnails of stored images for the actual patient
sorted by examination.

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Archiving
If the images are stored on a removable media that is not

mounted, the image thumbnail is replaced by a symbol.
2. Press SET on the images to review or press ANALYSE to
review all images.
• If all images are available the images are displayed for
review.
• If some of the images are not available locally the
Restore images window is displayed.
Figure 9-18: The Restore images window
3. Select between:
• Restore only the selected images: only selected
images that are not available locally are restored.
• Restore all images of the selected exam: all images
that are not available locally in the exams where an
image was selected are restored.
• Restore current patient: restores all images in all
examinations.
4. Press OK.
The Insert media window is displayed.

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Archiving
Figure 9-19: The Insert media window
5. Insert the required media.

6. Select between:
• OK: the images on the mounted media are restored on
the local hard drive. If not all the required images are on
the inserted media, the user is prompted to insert
another media until all required images are restored on
the hard drive.
• Skip media: the images stored on the media required
are not restored. If not all the required images are on the
inserted media, the user is prompted to insert another
media until all required images are restored on the hard
drive.
• Cancel: no images are restored.
The selected images are displayed for review.

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Archiving
1. Examination
2. Examination date and archive location
3. Selected image
4. Preview of selected image
5. Defined groups
Figure 9-20: The Image list screen

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Connectivity
This section describes the communication and connection
options for the Vivid S5/Vivid S6 ultrasound unit with other
devices in the hospital information system. This section covers
the procedures for configuration and optimal data management
from a Vivid S5/Vivid S6 in the following scenarios:
• A stand-alone Vivid S5/Vivid S6 (page 434).
• A Vivid S5/Vivid S6 and one or several EchoPAC PC
workstations in a sneaker net environment (page 435).
• A Vivid S5/Vivid S6 and an EchoPAC PC workstations in a
direct connect environment (page 437).
• A Vivid S5/Vivid S6 and a DICOM server in a network
(page 443).
• A Vivid S5/Vivid S6 and one or more PC stations in
MPEGvue or eVue environment.
The dataflow concept

Communication between the Vivid S5/Vivid S6 ultrasound unit
and other information providers on the network takes the form
of dataflows. Selecting a dataflow will automatically customize
the ultrasound unit to work according to the services
associated with this dataflow. Each dataflow defines the
location and format of patient information. Patient information
can include demographic data and images, as well as reports,
measurement and analysis data. By utilizing dataflows, the
user can configure the Vivid S5/Vivid S6 ultrasound unit to
optimally meet the connectivity needs of the facility, while
keeping the user interface unchanged. The dataflow concept
allows the flexibility of data to be obtained from various sources
and allows data to flow to various output sources.
Dataflow examples
Refer to "Dataflow" on page 616 for a complete list and
description of supported dataflows.
Stand-alone scanner
The figure below illustrates dataflow for a stand-alone scanner.

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A: LocalArchive-Int.HD dataflow:
The local database is used for
patient archiving. Images are
stored to internal hard drive.
Figure 9-21: Stand-alone scanner dataflows
Scanner in a network
The figure below illustrates two different dataflows for a
scanner connected to a network.
B: RemoteArch-Remote HD
dataflow:
A remote database (here
EchoPAC PC) is used for patient
archiving. Images are stored to a
remote archive (here
EchoPAC PC).
C: Worklist/LocalArchive-DICOM
Server/Int.HD dataflow:
Search in the DICOM Modality
Worklist, the patient found is copied
into the local database. Images are
stored to a DICOM server and to
the internal hard drive.
Figure 9-22: Scanner in a network dataflows (example)

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Dataflow selection
Select a dataflow from the Search/Create Patient window (see
"Creating a new Patient record or starting an examination from
an existing patient record" on page 95) or configure the system
with a default dataflow from the Configuration management
package as described below.
Default dataflow selection
1. Press CONFIG and log on as administrator if required.
The Dataflow sheet is displayed (see Figure 9-23).
3. Select the desired dataflow in the Name pull-down menu
and check the option Default.
4. Press CONFIG to exit the Configuration management
package.
1. Select Connectivity category

2. Select Dataflow subgroup
3. Select a dataflow
4. Default option for the selected dataflow
Figure 9-23: Default dataflow setting

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Stand-alone scanner scenario

In this scenario images will most likely be reviewed from
images stored in the internal archive. If digital images are
stored, they should be stored on the scanner’s internal hard
drive.
Figure 9-24: Stand-alone scanner with LocalArchive-Int.HD dataflow
Data management
Data acquisition
• Select the LocalArchive-Int.HD dataflow as default
dataflow.
In this configuration the local database is used for patient
archiving. Images are stored to internal hard drive.
Image review
The same dataflow is used for review on the system.

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A stand-alone scanner and a

stand-alone EchoPAC PC environment
In this scenario the EchoPAC PC (one or several) is used for
review of studies acquired on one or more Vivid S5/Vivid S6
without being connected via a private or a local area network.
Images can be stored on the scanner’s internal hard drive
(recommended), on a dedicated MOD, or on a CD/DVD.
Images stored on the internal hard drive
Vivid S5/Vivid S6: dataflow LocalArchive-IntHD

EXP: export from LocalArchive-Int.HD to Removable MOD Archive
IMP: import from Removable MOD Archive to LocalArchive-Int.HD
EchoPAC PC: dataflow LocalArchive-Int.HD
Figure 9-25: A stand alone scanner and a stand alone EchoPAC PC

environment with images stored on the scanner’s hard drive
In this configuration images are first stored on the scanner’s

hard drive and then exported from the scanner’s hard drive to a
MOD and finally imported from the MOD to the EchoPAC PC’s
internal hard drive.
Data management
Scanner’s dataflow configuration
• Select the LocalArchive-Int.HD dataflow as default
dataflow.
The local database is used for patient archiving. Images
are stored to internal hard drive.
Export from Vivid S5/Vivid S6
• Export the data (images, demographics, measurements

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and report) for the patient(s) to be reviewed on a blank

dedicated formatted MOD (or CD/DVD) as described in
"Export/Import patient records/examinations" on page 452.
Export from LocalArchive-Int.HD to Removable MOD
Archive or to CD/DVD Archive.
Make sure that the option Copy images is checked.
Import on EchoPAC PC
1. Select the LocalArchive-Int.HD dataflow on the
EchoPAC PC (can be configured as default dataflow).
The MOD dedicat- 2. Import the data from the Export/import MOD (or CD/DVD)
ed to Export/Import to EchoPAC PC internal hard drive using the Import
can be reformatted function as described in the workstation user manual.
and reused.
Import from Removable MOD Archive or CD/DVD
Archive to LocalArchive-Int.HD
Make sure that the option Copy images is checked.
3. Press Archive and select the patient to be reviewed.
Stand-alone scanner and a stand-alone DICOM workstation
In this scenario a DICOM workstation is used for review of
studies acquired on one a Vivid S5/Vivid S6 without being
connected via a private or a local area network.
Figure 9-26: A stand-alone scanner stand-alone DICOM workstation
Data management
Scanner's dataflow configuration
1. Select the LocalArchive-Int.HD dataflow as default
dataflow. The local database is used for patient archiving.
Images are stored to internal hard drive.
2. Export the data to the DICOM MOD (or CD/DVD) using the
following settings: export from LocalArchive-Int.HD to
Pure DICOM MOD or DICOM CD/DVD (see "Export/Import
patient records/examinations" on page 452).

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A scanner and EchoPAC PC in a direct

connect environment
In this scenario the data is transferred from the
Vivid S5/Vivid S6 to a dedicated EchoPAC PC workstation over
the Ethernet (either in a peer-to-peer connection with a
crossover cable, or in a network). The database from the
EchoPAC PC is used as the master and images are stored
directly to the EchoPAC PC internal hard drive. In this
configuration the scanner is just an intermediate acquisition
unit which after completion of a study, will not contain any
patient information, measurements or images.
Up to three scanners can be connected to one EchoPAC PC if
the workstation has the EchoPAC Share option enabled.
Vivid S5/Vivid S6: dataflow RemoteArch-RemoteHD

EchoPAC PC: dataflow LocalArchive-Int.HD
Figure 9-27: A scanner and EchoPAC PC in a direct connect

environment (peer to peer or network)
The acquisition can be done online or offline. Both situations

are described below.
Scanner’s connectivity configuration

If working in a peer-to-peer connection with a crossover cable
between a Vivid S5/Vivid S6 and an EchoPac PC, the default
delivery TCP/IP settings should be used.
If working in a network, follow the procedure described below to
configure the scanner.

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Scanner’s TCP/IP settings

To be able to use the network functions when connected to a
hospital network, the scanner must have a proper network
address. Typically source for this information in the network
administrator.
2. Select the Connectivity category and TCP/IP subgroup.
The TCP-IP subgroup is displayed.
1. Computer name: device’s name of type 3. Remote archive setup: remote archive IP
VIVID7-00nnnn or ECHOPAC7-00nnnn, where address and name (EchoPAC PC or Image
“nnnn” is the system’s serial number. Do not Vault)
change the computer name. 4. Save TCP/IP settings. The changes will be
2. IP settings: system IP settings effective after the system is rebooted.
Figure 9-28: TCP/IP setting
3. In the IP settings area enter:

• The IP address for the scanner
• The subnet mask for the scanner
• The IP address for the Default Gateway

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4. In the Remote archive setup area enter:

• The IP address for the remote archive
• The name of the remote archive
5. Press Save settings and reboot the system.
Direct connect with online acquisition

Data management
• Select the RemoteArch-RemoteHD dataflow as default
dataflow.
When saving the study on the scanner, the images are
transferred from the scanner’s image buffer to the hard
drive of the EchoPAC PC. Patient demographics,
measurements and reports are transferred on the fly when
entering the information on the Vivid S5/Vivid S6.
Review on the EchoPAC PC workstation
1. Select the LocalArchive-Int.HD dataflow on the
Do NOT open a study on the EchoPAC PC workstation before the
study is closed on the scanner.
CAUTION

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Archiving
Direct connect with offline acquisition

Data management
Scanner’s dataflow configuration for offline
acquisition
• When offline, select the LocalArchive-IntHD dataflow.
Export examinations done offline from the scanner to
EchoPAC PC
• When reconnected, export the data (images,
demographics, measurements and report) for the
examination(s) done offline to EchoPAC PC as describes in
Press Today to dis- Export from LocalArchive-Int.HD to
play today’s exams RemoteArch-RemoteHD.
to ease the search. Make sure that the option Copy images is checked.
The examination done offline can now be reviewed on the
workstation.

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A scanner and EchoPAC PC in a network

environment
In this scenario the Vivid S5/Vivid S6 is configured to work with
an ImageVault 4.0 or an Image Vault 7 patient demographics
and image server in a network environment. Images are first
saved on the local image buffer on the scanner and transferred
to the server when saving the examination.
The acquisition can be done online or offline. Both situations
are described below.
Network environment with online acquisition

Data management
• Select the RemoteArch-RemoteHD dataflow as default
dataflow in the sublevel Dataflow in the subgroup
Connectivity of the Configuration management package
(see page 616 and following pages).
When saving the study on the scanner, the images are
transferred from the scanner’s image buffer to the server.
Patient demographics, measurements and reports are
transferred on the fly when entering the information on the
Vivid S5/Vivid S6.
Review on the EchoPAC PC workstation
1. Select the RemoteArch-RemoteHD dataflow on the
Do NOT open a study on the EchoPAC PC workstation before the
study is closed on the scanner.
CAUTION

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Archiving
Network environment with offline acquisition

Data management
Scanner’s dataflow configuration for offline
acquisition
• When offline, select the LocalArchive-IntHD dataflow.
Export examinations done offline from the scanner to
the server
• When reconnected, export the data (images,
demographics, measurements and report) for the
examination(s) done offline to the server as described in
Press Today to dis- Export from LocalArchive-Int.HD to
play today’s exams RemoteArch-RemoteHD.
to ease the search. Make sure that the option Copy images is checked.
The examination done offline can now be reviewed on the
workstation.

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Archiving
A scanner and a DICOM server in a

network
In this scenario the Vivid S5/Vivid S6 is configured to work with
a DICOM server in a network environment. Images are first
saved on the local image buffer on the scanner. At the end of
the examination the images are sent to the DICOM server via a
DICOM spooler.
The DICOM server dataflow supported are:
• DICOM server: images are stored to a DICOM server
• Local Archive - Int HD/DICOM Server: the local archive is
used for patient archiving. Images are stored to the internal
hard drive and to a DICOM server.
• Remote Archive - Remote HD/DICOM Server: a remote
database is used for patient archiving. Images are stored to
a network image volume and to a DICOM server.
• Worklist/Local Archive - DICOM Server/Int HD: search in
a DICOM Modality Worklist, the patient found is copied into
local database. The patient information and the
examination results are stored to the local database.
Images are stored to a DICOM server and to an image
volume on the local hard drive.
• Worklist/Remote Archive - DICOM Server/Remote HD:
search in a DICOM Modality Worklist, the patient found is
copied into a remote database. The patient information and
the examination results are stored to a remote database.
Images are stored to a DICOM server and to an image
network volume as pure DICOM in both locations.
• Query/Retrieve: retrieve images from a DICOM server
based on query parameters.
This scenario requires that the scanner is configured to be
connected to the DICOM server as described below.

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Scanner’s connectivity configuration

The scanner’s TCP/IP settings must be configured as
described in "Scanner’s TCP/IP settings" on page 438.
In addition, to work against the DICOM server the following
information has to be entered in the scanner:
• The DICOM server IP address
• The DICOM server port number
• The DICOM server AE title (the server’s name)
Typically source for this information in the network
administrator.
Setup of the DICOM server in the scanner’s configuration
management package
DICOM dataflow selection
3. Select the DICOM dataflow to configure in the Name
pull-down menu (see Figure 9-29).
Figure 9-29: The Dataflow sheet

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Archiving
DICOM devices configuration

Depending on the DICOM dataflow selected, one or several
DICOM devices may have to be configured.
1. Select a DICOM device in the Selected devices pane and
press Properties (see Figure 9-30).
1. Select the DICOM device. 2. Press Properties.
Figure 9-30: Display of the DICOM device Properties window
The Properties window for the selected DICOM device is

displayed (Figure 9-31).

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Figure 9-31: DICOM worklist properties window
2. Select the DICOM server from the IP-address pull-down

menu.
Follow the steps below if the IP address settings for the
DICOM server need to be modified or created:
• Select <Modify> from the IP-address pull-down menu.
The IPs window is displayed.
• Select the DICOM server and press Modify in the IPs
window (or press Add if creating a new IP address).
The Enter name and IP window is displayed.
• Enter the name and/or IP address of the server and
press OK to return to the Properties window.

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Figure 9-32: Modifying/Creating the IP address
3. In the Properties window, enter:

• The DICOM server AE title. This entry is case sensitive
and must match exactly.
• The DICOM server port
For some DICOM servers, the default Timeout setting
may be too low.
When configuring the DICOM storage device, the following
image settings should be entered in the Properties
window:
• Check DICOM SR if required (see below).
• Keep Reopen per image unchecked.
• Keep Allow raw data unchecked.
• Set Max Frame rate to 30.
• Keep Only Black and White unchecked.
• Set Compression to JPEG.
• Set Quality to 95.
• Check Allow multiframe.
DICOM SR
DICOM Structured Reporting (SR) is a standardized format for
medical results. Vivid S5/Vivid S6 and EchoPAC PC support
the specialized form for Adult Echo Ultrasound ("Supplement
72") for M&A results.
With the DICOM SR support, M&A for an exam can be sent at
the end of the exam or when exported from local archive. The
destination can be either a server on the network (Storage

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SCP) or a removable media (DICOM Media) depending on the

DICOM dataflow selected.
"Supplement 72" does not support all M&A results from
Vivid S5/Vivid S6 and EchoPAC PC. "Supplement 72" limits the
information that is possible to send to the following:
• Publicly coded parameters, no pediatric or fetal cardiac or
unassigned measurement. Refer to the Vivid S5/Vivid S6
Reference manual for a complete list of supported
parameters.
• Basic modes: 2D, M-mode, Color Flow, PW and CW
Doppler.
• Publicly coded methods, not Modified Simpson or Bullet.
Refer to the Vivid S5/Vivid S6 Reference manual for a
complete list of supported methods.
• Basic derivations (Average, Last), no references between
the derived measurements and the ones they were made
from.
• Wall Motion Scoring: individual segment scores only
according to 16-segment model, no graded Hypokinesis
(only Hypokinesis is used).
Activating DICOM SR
DICOM SR must be activated for each DICOM device.
3. Select the DICOM dataflow to configure in the Name
pull-down menu (see Figure 9-29).
4. Select a DICOM storage device in the Selected devices
pane and press Properties.
The Properties window for the selected DICOM stogare
device is displayed.

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Figure 9-33: DICOM storage properties window
5. Check the option DICOM SR.

6. Select OK.
7. Press CONFIG.
Adjusting the Search criteria
When selecting a DICOM Worklist dataflow or Query/Retrieve,
search criteria can be set for the system to use when searching
the database.
The Dataflow sheet is displayed (see Figure 9-34).
3. Select a DICOM Worklist dataflow or the Query/Retrieve
dataflow.
4. Select the Worklist or Query/Retrieve device in the
Selected devices pane and press Properties.
The Properties window for the selected DICOM device is
displayed.
5. Press Search criteria.
The Search criteria window is displayed.
6. Select a Search criteria from the Select tag pull-down
menu.

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7. Enter a value if required or leave blank if not to be used.

This entry is case sensitive and must match exactly.
8. Press Add to list.
9. Press OK to close the Search criteria window.
1. The dataflow sheet

2. The Properties window for the Worklist device.
3. The Search criteria window
Figure 9-34: Adjusting the Search criteria

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Checking the connection to the DICOM server

1. In the Dataflow sheet, select the DICOM device to verify the
connection to.
2. Press Check.
The verification process may takes several seconds.
• A green check mark is displayed in front of the DICOM
device if the verification is successful.
• A red cross is displayed in front of the DICOM device if
the verification failed.
Data management (DICOM dataflows)
Performing a study
Online scanner
1. In the Search/Create patient window, select a DICOM
dataflow.
2. If a DICOM worklist dataflow is selected, enter a search
criteria and press QUERY. The patient list is updated.
3. Select or create a new patient and perform the examination
in a usual manner. During the examination images are
temporarily stored in the local buffer on the system.
4. At the end of the study press END EXAM on the Control
panel. The save images dialogue window is displayed.
5. Press ALL to save all images on the DICOM server or press
SELECT to display the Image review screen where to select
specific images to be saved. The images are transferred to
the server via the DICOM spooler.
6. Press F4 or ALT+S to display the DICOM spooler (see
"DICOM spooler" on page 479 for further details).
Offline scanner
When working offline the images are stored in the DICOM
spooler. Images are sent to the DICOM server when
re-connecting the system to the network.
1. If a DICOM worklist dataflow is selected, the patient list
must be queried before the system is disconnected.
2. After offline acquisition, the images stored on the DICOM
spooler are automatically sent to the DICOM server when
connecting the system. Press F4 or ALT+S to display the
DICOM spooler (see "DICOM spooler" on page 479 for
further details).

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Export/Import patient records/examinations

Patient records/examinations from the local archive on one
system (Vivid S5/Vivid S6 or EchoPAC PC) can be exported to
the local archive on another system via a removable media.
Patient records/examinations from the local archive can also be
exported directly to a remote archive (Echo server, DICOM
server or EchoPAC PC depending on the environment). In
addition patient records/examinations from a remote archive
(Echo server or EchoPAC PC depending on the environment)
can be exported to a removable media or to a DICOM server.
Database information (patient and report archives) can be
exported with or without images. No data is deleted from the
source archive when exporting data unless the command
Delete selected patient(s) after copy is checked in the Export
patient window (see Figure 9-36, page 454).
Similarly, patient records/examinations from the local archive
on one system can be imported to the local archive on another
system via a removable media. Database information can be
imported with or without images. No data is deleted from the
source archive when importing data. In addition patient records
from a removable archive can be imported to a remote archive
(Echo server).
If an examination is opened, it must be closed before performing
Export/Import of patient records/examinations to guarantee that
CAUTION all data is included in the transfer.
Exporting patient records/examinations

1. If exporting to a removable media, insert a removable
media in the drive.
2. Press PATIENT on the Front panel, then select Patient List.
3. Select the source archive in the Dataflow field:
• LocalArchive-Int.HD: exports data from the local
archive.
• RemoteArch-RemoteHD: exports data from an Echo
server.
4. Press Export in the Search/Create Patient window.

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The Export dialogue window is displayed.
Figure 9-35: The Export Dialogue window
5. Select one of the following destinations from the

Destination drop-down menu:
Note: the exact contents of this menu depends on the
options and devices contained in the system.
• MOD Archive: exports raw and DICOM (if present) data
to a removable MOD.
• Pure DICOM MOD525: export DICOM data only to a
removable MOD.
• CD/DVD Archive: exports raw and DICOM (if present)
data to a CD/DVD.
• Memstick Archive: exports raw and DICOM (if present)
data to a USB flash drive device.
• DICOM CD/DVD: export DICOM data only to a
CD/DVD-R/W.
• DICOM Memstick: export DICOM data only to a USB
flash drive device.
• Remote Import/Export Archive: exports raw and
DICOM (if present) data to an Echo server (network) or
EchoPAC PC (direct connect or network).
• DICOM Server: exports DICOM data only to a DICOM
server.
• Excel file: exports demographics, measurements and
reporting data to a spreadsheet. The export destination
must be configured (see page 459).
• DICOM Print: prints images to a DICOM printer via
DICOM spooler.
• MPEGvue: exports examinations to MPEGVue format
readable from a regular computer. Ultrasound images

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are stored as MPEG, and saved reports as CHM-files.

The export destination must be configured (see
page 458).
6. Press OK.
Figure 9-36: The Export patient window
The following situations may occur:

• The system is checking that the removable media is
inserted. If not, a dialogue window is displayed
prompting the user to insert a media.
Insert media and select Retry.
Figure 9-37: Insert media window
• The system is checking if the destination media is empty

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and needs to be formatted. If yes an Information window

is displayed asking the user whether or not to format the
media.
Figure 9-38: Media Formatting window
• If desired enter a new label and select OK.

Note: Only the following characters and signs can be
used when labelling a media: A - Z, a - z, 0 - 9, "_" and
"-". Do not use more than 11 characters or signs. Do not
use space.
• If the media is not empty, the Add files window is
displayed.
Figure 9-39: Add files window
Select Yes.
The system is preparing the media to allow addition of
new files.
Note: If Eject is selected, the user is prompted to insert
another media. If No is selected, the Export Dialogue
window is displayed (Figure 9-35), where the user can
select another destination.

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The Export patient window is displayed (see

7. Search and Select the patient records/examinations to
export in the Patient list. All searching criteria can be used
to find the patient records to export.
The following selection methods can be used:
• Press and hold down SHIFT while selecting patient
records/examinations to select several consecutive
items at a time.
• Press and hold down CTRL while selecting patient
records/examinations to select several discrete items.
• Press Select all in the Export patient window to export
all patient records.
Press More to dis- • Press Today to display today's examinations and select
play the extended the actual examinations.
Export patient
window if neces- • Fill in the Exam between field to display the patient
sary. records done during a specific time period and select the
actual records.
• Fill in the Born between field to display the patient
records of patients born during a specific time period and
select the actual records.
8. Adjust the following settings (if available) as desired:
• Delete selected patient(s) after copy
• Copy images
9. Press Copy.
If one or more patient examination is already present in the
destination archive the Export/Import conflict window is
displayed (see Figure 9-40). For each conflicting item,
select:
Keep: to keep the existing examination in the destination
archive.
Replace: to replace the existing examination with the
corresponding item in the source archive.

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Figure 9-40: The Export/Import conflict window
Press OK to resume export.

A progress indicator is displayed. When done a status
window is displayed showing the number of patient records
that have been successfully exported.
10. Press OK.
A check mark is displayed in the Copied field in the Export
patient window for each item exported.
A status message is displayed for each item exported.
Make sure that the operation was successful for each item
exported.
11. Press Done in the Export patient window to complete the
process.
Do not eject the CD 12. If exporting to a removable media, press Eject or ALT+E to
using the button on eject the disk.
the CD drive. The Eject device menu is displayed.
Figure 9-41: The Eject device menu
13. Select the relevant media.

The selected removable media is ejected.

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Export Configuration
The destination for Export of patient records to Excel and
MPEG must be configured prior to use (both are options). This
is done from the Dataflow sheet in the Configuration package.
To display the Dataflow sheet:
2. Select Connectivity category and Dataflow subgroup.
The Dataflow sheet is displayed (Figure 9-4, page 411).
3. Select the dataflow Misc Export in the Name pull-down
menu.
Figure 9-42: The Dataflow Sheet
Configuring an Excel Export

1. Select the Excel storage device in the Selected devices
pane and press Properties.
The Excel properties window is displayed.

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Figure 9-43: The Excel properties window

must be entered
once in the Remote 3. Select OK and press CONFIG.
Path field before
Export to an eVue Configuration
from the Destina- 1. Select the eVue device in the Selected devices pane and
tion pull-down press Properties.
menu. The eVue properties window is displayed (Figure 9-5,
page 412).
must be entered
once in the Remote 3. Check the options as required.
Path field before 4. Select OK and press CONFIG.
from the Destina-
tion pull-down
menu.

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Importing patient records/examinations

1. Insert the removable media of the source archive in the
corresponding drive (MO drive or CD-ROM).
2. Press PATIENT on the Front panel, then select Patient List.
3. Select destination archive in the Dataflow field:
• LocalArchive-Int.HD: imports data to the local archive.
• RemoteArch-RemoteHD: imports data to an Echo
server (network) or an EchoPAC PC (direct connect).
4. Press Import in the Search/Create Patient window.
The Import dialogue window is displayed (see
Figure 9-44).
Figure 9-44: The Import Dialogue window
5. Select one of the following source archive from the Source

drop-down menu:
• MOD Archive: imports raw and DICOM data (if present)
from a MOD.
• DICOM MOD525: imports DICOM data only from a
MOD.
• CD/DVD Archive: imports raw and DICOM data (if
present) from a CD/DVD-R.
• Memstick Archive: imports raw and DICOM (if present)
data from a USB flash drive device.
• DICOM CD/DVD: imports DICOM data only from a
CD/DVD-R/W.
• DICOM Memstick: imports DICOM data only from a
USB flash drive device.
• Remote Import/Export Archive: imports raw and

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DICOM (if present) data from an Echo server (network)

or EchoPAC PC (direct connect or network).
• Query retrieve: imports data from a DICOM server.
6. Press OK.
The Import patient window is displayed (see Figure 9-45).
Figure 9-45: The Import patient window
7. Search and select the patient records to import in the

Patient list. All searching criteria can be used to find the
patient records to import.
The following selection methods can be used:
• Press and hold down SHIFT while selecting patient
records/examinations to select several consecutive
items at a time.
• Press and hold down CTRL while selecting patient
records/examinations to select several discrete items.
• Press Select all in the Import patient window to export
all patient records.
Press More to dis- • Press Today to display today's examinations and select
play the extended the actual examinations.
Import patient
window if neces- • Fill out the Exam between field to display the patient
sary. records done during a specific time period and select the

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actual records.
• Fill out the Born between field to display the patient
records of patients born during a specific time period and
select the actual records.
8. Adjust the following settings as desired:
• Copy images
9. Press Copy.
If one or more patient examination is already present in the
destination archive the Export/Import conflict window is
displayed (see Figure 9-40). For each conflicting item,
select:
Keep: to keep the existing examination in the destination
archive.
Replace: to replace the existing examination with the
corresponding item in the source archive.
Figure 9-46: The Export/Import conflict window
Press OK to resume import.

A progress indicator is displayed. When done a status
window is displayed showing the number of patient records
that have been successfully imported.
10. Press OK.
A check mark is displayed in the Copied field in the Import
patient window for each item imported.

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A status message is displayed for each item imported.

Make sure that the operation was successful for each item
imported.
11. Press Done in the Import patient window to complete the
process.

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Disk Management
The Disk management function allows the user to manage hard
disk space while maintaining the patient database on the
system. The Disk management function can be used to move,
copy or delete images and move or copy reports from the
oldest patient records (configurable). The Disk management
function has also an auto-purge feature that automatically
deletes images that have already been copied if the local hard
disk is approaching its capacity limit.
When moving or Three different disk management scenarios are possible
copying files a copy depending on the system configuration:
of the patient ar-
chive is also created • Disk management is set to move files: the user runs the
on the media. Disk management function on a regular basis to move
images and reports from older patient records to removable
media or to a network volume. Using this setting, moved
images and reports are deleted from the local hard drive
and copied to the specified destination. This scenario
prevents the local disk to fill up and keeps images and
reports from the most recent patient records on the local
disk. Using this scenario, the user can control what should
remain on the system while keeping the disk free space at
an operational level.
• Disk management is set to copy files: the user runs the
Disk management function on a regular basis to copy
images and reports from older patient records to removable
media or to a network volume. To prevent the local disk to
fill up, the auto-purge function automatically deletes files
that were previously copied when the disk free space has
reached the minimum allowed limit. This scenario lets the
system automatically manage the disk space on the
system.
Note: When using this setting, the images location
displayed in the Examination list screen is the selected
destination for the copy operation, even if the images are
still present on the local hard drive. When reviewing the
exam, the original images is retrieved from the local hard
drive as long as they are available there. When the images
are deleted from the local hard drive by the auto-purge
function, the copied images are retrieved.

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• Disk management is set to delete files: the user runs the

Disk management function on a regular basis to delete
images and reports from older patient records.
Ensure that you have established a data management protocol
for your office/institution. The user MUST manage the
removable media used when running Disk management by
keeping a log and by creating a media filing system.
A person should be in charge of performing the process. The
Disk management system can be set up so that a reminder is
displayed at a regular time span.
Configuring the Disk management

function
Configuration of the Disk management system can only be
done by user with administration rights.
1. Press CONFIG.
If required, log on as administrator.
2. Select the Admin category.
3. In the Admin category, select the sheet Data Management.

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1. Sets the reminder time interval for running Disk management

2. Sets the files to be managed based on the examination dates
3. Sets the Disk management to copy, move or delete images
4. Sets the destination device
Figure 9-47: The Disk management sheet
Disk management schedule settings

• Next to Reminder interval, specify the number of
days/weeks you want the system to prompt you to perform
disk management. This setting should be set based on the
activity of your office/institution. If None is selected, no
reminder is displayed.

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Disk management settings

1. Select a number of days, weeks or months or a specific
date next to Manage files older than. Only files older than
the specified setting are copied or moved. If None is
selected, all files are copied or moved.
2. Next to Operation, select one of the following options:
• Copy: the images and reports from the examinations
older than the specified setting defined in step 1 are
copied to the specified destination. After using this
setting, the files exist in two locations, the local hard
drive and the media used to copy to.
• Move: the images and reports from the examinations
copied to the specified destination, verified and then
deleted from the local hard drive. After using this setting,
the files exist in one location, the media used to move
the files to. They are removed from the local hard drive.
• Delete: the images and reports from the examinations
deleted from the hard drive.
Destination device settings

• Next to Destination device, select a removable media or a
network shared folder.
Note: To be able to select a network shared folder in the
Destination device field, its path must have been entered
once in the field next to Remote path.
If using removable media, it is recommended to use dedicated
media to the Disk management process. Removable media used
CAUTION for data backup must not be used when performing Disk
management.
Do not use the same removable media on several systems.

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Running the Disk management function

The Disk management function can be run at any time. In
addition, the user may be prompted to run Disk management if
the time since the last Disk management operation performed
has reached the setting for the Reminder interval (see
page 466), or if the local hard drive is about to reach its
capacity limit.
Manual start of disk management

1. Press PATIENT on the control panel, then select Patient list.
The Search/Create patient window is displayed.
2. Press More in the Search/Create patient window to display
additional menu options and select Disk management.
The Disk management welcome screen is displayed
(Figure 9-48). The Disk management operation will either
copy, remove or delete files from the local archives
depending on the Disk management configuration (see
page 465). Make sure that the correct configuration is set.
Figure 9-48: The Disk management welcome screen
3. Press Next.
The Storage size information window is displayed
(Figure 9-49). Verify the information displayed. If using
removable media, the operation may require several

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media as specified on the screen. Make sure to gather the

necessary number of disks.
Figure 9-49: The Storage size information window
The media does not 4. Insert a removable media into the specified drive. The disk
need to be format- does not need to be formatted.
ted.
5. Press Next.
The Copying files window is displayed (Figure 9-50).
Figure 9-50: The copying files window

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The system automatically formats and labels new disks. If

the media contains backup or export data, a Warning
window is displayed.
6. Select one of the following options:
• Cancel: the Disk management process is stopped.
• Eject: the media is ejected, a new media must be
inserted to resume the Disk management process.
• OK: (Export disk only) the export data on the disk is
deleted and the Disk management process is resumed.
This choice is not available if the disk contains backup
data.
The information displayed on the Copying files window is
updated while the files are being copied.
7. If more than one media is necessary the filled media is
ejected and a dialogue window is displayed asking the user
to label the ejected disk and insert a new media. Press OK
after the new media is inserted. The operation is resumed.
When all the files are copied, the media is automatically
ejected.
8. Press Next to continue.
The Summary window is displayed (Figure 9-51), showing
a list of the disks used.
Figure 9-51: The summary window

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• Select Print summary to print the list for archiving

purpose.
• Select Detailed summary to display the list of the
patient records copied.
9. Make sure that all media are physically labeled according
to the list displayed in the Summary window. The media
label should also have an identification of the system the
Disk management was run from.
10. Press Done to complete the Disk management operation
and file the media.
Data Backup and Restore

The Backup/Restore function enables the user to:
• Copy/Restore the patient archive.
• Copy/Restore the system configuration. The Copy/Restore
system configuration feature enables the user to configure
several units with identical presets, providing that the units
have the same software version.
To minimize accidental loss of data, perform backup of the
patient archive stored on the local hard drive at least once a
week.
GE Medical Systems is not responsible for lost data if the
suggested backup procedures are not followed and will not aid
WARNING in the recovery of lost data.
There is no backup function for the images or reports (no

creation of a safety copy). For long-term storage, images and
reports should be moved to removable MOD or to a network
shared folder using the Disk management procedure (see
page 464).
DO NOT use the local hard drive for long-term image storage.
CAUTION
The backup of the patient archive on the hard drive and the
system configuration is done from the configuration
management package as described on page 472.

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Data from Backup/Restore disks may be restored to the local

hard drive using the Restore procedure as described on
page 476.
Only users with administration rights (see page 637) have
access to the backup/Restore function.
Backup procedure
1. Press PATIENT on the control panel, then select Patient list.
The Operator login window is displayed.
2. Select the operator with administration rights, enter the
password and press Log on.
3. In the Search/Create patient, select the dataflow Local
Archive - Int. HD (Figure 9-52).
Figure 9-52: Dataflow selection for backup
4. Press CONFIG.
5. Select the category Admin.
6. Select the Backup sheet (Figure 9-53).

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Figure 9-53: The Backup sheet
7. In the Backup sheet, select one of the following options:

• Patient archive: to backup the patient records.
• System configuration: to copy system settings and
user presets.
To be able to select a 8. Select a removable media or a shared network folder as
shared network destination.
folder, the path (of
type: \\serv- 9. If the backup is done to a removable media, insert a
er-name\share-na dedicated media in the drive.
me) must be entered 10. Select Start backup.
once in the Remote
The following situations may occur:
Path field.
• The system is checking that the removable media is
inserted. If not, a dialogue window is displayed
(Figure 9-54) prompting the user to insert a media.

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Figure 9-54: Insert media prompt
Insert the media and select OK.

• The system is checking if the media needs to be
formatted. If yes, a dialogue window is displayed
containing some auto-generated label, prompting the
user to enter a media label.
Figure 9-55: The Enter media label window
Type in a label for the media and select OK.

Note: Only the following characters and signs can be
used when labeling a media: A - Z, a - z, 0 - 9, "_" and
"-". Do not use more than 11 characters or signs. Do not
use space.
Note: If you select Eject you can perform the backup
using another removable media. If you select Cancel
the backup operation is stopped.
• The system is checking if there is already a backup or a
Disk management copy on the media. If the following
error message is displayed, the disk is ejected and the
user is asked to use a new media that does not contain
any backup or Disk management data.

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Figure 9-56: Replace backup prompt
• Insert a new media and select OK.

Note: to reuse a Backup media when performing a new
archive backup, the media has to be re-formatted first.
11. During backup, Progress windows are displayed
(Figure 9-57), showing the current operation being
performed.
Figure 9-57: Backup progress windows
12. At the end of the process, the media is ejected and the
Backup completed window (Figure 9-58) is displayed.
Figure 9-58: Backup completed window
Select OK.

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The Backup result is displayed on the Backup sheet

(Figure 9-59).
Figure 9-59: Backup result
13. Make sure to physically label the media. An identification of

the system should also be noted on the media and a
backup log should be kept.
File the media in a safe place.
Restore procedure
1. Press CONFIG.
3. Select the Restore sheet (Figure 9-60).

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Figure 9-60: The Restore sheet
4. In the Restore sheet, select one of the following options:

• Patient archive: to restore the patient records.
• System configuration: to restore all system settings
and user presets.
OR
• One or several System configuration items to restore
parts of the system settings and user presets (see
Figure 9-60).
5. Make sure that Restore from Source Device is selected.
6. Select the appropriate Source device.
The Restore procedure OVERWRITES the existing data on the
local hard drive. Make sure to select the correct device.
CAUTION
7. If restore is done from a backup on a removable media,

insert the media in the drive.
8. Select Restore now.

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Depending on the selection, one or two Restore

confirmation windows are displayed (Figure 9-61):
Figure 9-61: Restore confirmation windows
9. Ensure that the correct source is selected an select OK.

The selected items are copied to the systems. If items from
the system configuration are restored the system needs to
be rebooted. The Reboot system window is displayed
(Figure 9-62).
Figure 9-62: Reboot system prompt
10. Select OK to reboot the system.

If connectivity configuration settings have been restored,
make sure to save the TCP/IP settings: select
Config/Connectivity/TCPIP and select Save settings. The
system needs to be restarted again.

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DICOM spooler
DICOM spooler displays the current DICOM output jobs. The
jobs may be Storage, Print, Modality Performed Procedure
Step or Storage Commitment. The DICOM spooler is used for
checking the current job's status when a job is saved or when
the total spooler status on the right of the Archive windows
displays an error.
From the DICOM spooler the user can also:
• Delete non-active jobs
• Resend a job that has failed or is in hold
• Send a job that has failed or is in hold, to a new destination.
• Hold a job that is not active.
The job's status displayed in the DICOM spooler window can
be:
• Pending: the job is complete, waiting to be active.
• Hold: the job is complete, but suspended, waiting for a user
action.
• the job is incomplete, waiting for more images.
• Append: the job is incomplete, waiting for more images
(Direct store function).
• Active: the job is complete and connected to the
destination device.
• Failed: the job is complete but one or more images failed to
transmit to the destination device.
• Done: the job is saved to the destination device. The jobs
that are done are removed from the spooler after a while.
Starting the DICOM spooler

• On the alphanumeric keyboard, press and hold down the
ALT key and press S.
The DICOM spooler window is displayed (see
Figure 9-63).
The DICOM spooler window is automatically updated. Press
Refresh to update the information displayed at any time.

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Figure 9-63: The DICOM job spooler window
Deleting a job
Only non-active 1. Trackball to the job to delete in the DICOM job spooler
jobs can be deleted. window.
Note: Several jobs can be selected.
2. Press SET.
3. Trackball to Delete.
4. Press SET.
Resending a job
Only jobs that 1. Trackball to the job to re-send in the DICOM job spooler
failed or are in hold window.
can be resent. Note: Several jobs can be selected.
2. Press SET.
3. Trackball to Resend.
4. Press SET.

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Sending a job to a new destination

Only jobs that 1. Trackball to the job to send in the DICOM job spooler
failed or are in hold window.
can be sent to a new
destination. 2. Press SET.
3. Trackball to Send to...
4. Press SET.
A dialogue window is displayed.
5. Select the new destination from the Destination popup
menu.
6. Trackball to Send.
7. Press SET.
Holding a job
1. Trackball to the job to hold in the DICOM job spooler
window.
Note: several jobs can be selected. Only inactive jobs can
be set on hold.
2. Press SET.
3. Trackball to Hold.
4. Press SET.
To undo hold, press Resend.

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Database import from Vivid 3 or Vivid 4

The Vivid 3/Vivid 4 Database Import option provides the
capability to import data from a Vivid 3 or Vivid 4 system with
software version BT02 or higher, into the Vivid S5/Vivid S6
system.
This feature allows the user to review examinations previously
acquired on a Vivid 3 or Vivid 4 system, on the
Vivid S5/Vivid S6 in DICOM format. In addition, the user may
review all measurements made on the Vivid 3/4 , using an
Excel viewer installed on a separate PC.
Note: The following procedure is valid for Vivid 3 or 4 of version
BT02 and upwards.
Transfer Procedure
This is a one-time procedure which will normally be performed
by your GE representative, during the system's installation.
The database imported from the Vivid 3 /4 into Vivid S5/Vivid S6
should only be imported during the installation, while the
CAUTION Vivid S5/Vivid S6 archive is still empty. Importing the database at
a later stage is not possible without first erasing the whole
Vivid S5/Vivid S6 database.
Data must be imported only from the LATEST backup media. In

case you are not sure, it is advisable to perform another backup
CAUTION from the Vivid 3/4.
Attempting to import data from any backup version other than
the latest, will make the Vivid S5/Vivid S6 database incomplete,
with missing exams.
1. While in regular scanning mode, press PATIENT.

2. Log in as an Administrator.
3. Press Create New Patient/New Exam.
4. Verify that the Patient list is empty.
5. From the Dataflow drop-down menu select No Archive
(see Figure 9-64).

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Figure 9-64: Dataflow selection
6. Press ESC to close the window.

7. Press Config, then select Admin.
The Admin dialog window is displayed (see Figure 9-65).
Figure 9-65: Config menu - Vivid 3/4 DB Import
8. Select the V3\V4 DB Import tab.

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9. Insert the media (CD/DVD or MOD) containing the LATEST

database backup from the Vivid 3 or Vivid 4, into the
Vivid S5/Vivid S6 system.
10. Select the appropriate import path from the drop-down
menu (see FIG).
Figure 9-66: Config menu - Import Data from Removable Media
11. Click Import Vivid-3 Database to commence the import

process.
A progress bar is displayed. The import process may take
some time, depending on the size of the database being.
When the import process is complete, an "Import
Complete" message is displayed. The Import Vivid-3
Database button is disabled (appears grayed-out) and the
Vivid 3/Vivid 4 Database Import option is no longer
available.
12. Repeat steps 3 and 5 above for the Local Archive + Int.
HD dataflow.
Note: The user is now able to review the imported data on the
Vivid S5/Vivid S6 system. The images may be loaded at a later
stage in the normal review process, as described in this
manual.
Exporting the Excel database

It is possible to convert all of the patients' demographic data
and exam measurements to Excel format, which may be
exported to removable media and viewed on a PC. This
procedure is performed from the Admin dialog box.
1. Log in as an Administrator.
2. Press Config, then select Admin.
The Admin dialog window is displayed (see Figure 9-65).
3. Select the V3\V4 DB Import tab.
4. Insert blank media into the appropriate media drive on the
Vivid S5/Vivid S6 system.
5. Click Generate Excel Database (see Figure 9-67).

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Figure 9-67: Export Excel Data to Removable Media
A progress bar is displayed during the export process. The

measurements and demographics database is generated
and compressed into a ZIP file.
6. When done, eject the media and label it accordingly.
Installing the Vivid 3/4 Data Viewer

The Vivid 3/4 Data Viewer installation consists of two
procedures: Extraction and Formatting.
Extraction
1. Insert the media created in the section above ("Exporting
the Excel database" on page 484).
2. Browse to the media location, copy the database file
Patients.zip from the media, and paste it to a dedicated
path on the PC hard disk.
3. Right-click the Patients.zip file on the hard disk and select
Extract All... from the context menu.
The Extraction Wizard appears.
4. Click Next twice.
During the extraction process, a password prompt appears
(see Figure 9-68).
Figure 9-68: Extraction password prompt
5. Type dolphin in the password field, then click OK.

The files are extracted into a new Patients folder, located
under the dedicated path on the hard disk.
6. Proceed to the following procedure - Formatting.

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Formatting
1. Locate the file Master.xls under the Patients folder and
double click it (see Figure 9-69).
Figure 9-69: Patients folder contents
While the Excel file opens, a macro prompt appears (see

Figure 9-70).
Figure 9-70: Excel macro prompt
2. Click Enable Macros.

The Start formatting V3/4 Data Viewer window appears
(see Figure 9-71).
3. Select a language.
4. Type any password you wish to use into the password field.
This later provides privacy protection to your Vivid 3/4 Data
Viewer database.

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Figure 9-71: Start formatting V3/4 Data Viewer window
5. Click Run.
Automatic formatting begins. When finished, the Progress
field on the bottom-right shows 100% and the Stop button
is grayed-out (see Figure 9-72).
Figure 9-72: Formatting complete
Note: Depending on the database size, formatting may

take several hours. In case you need to stop the process

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before it concludes, click Stop. Then, remove the

previously generated files and repeat the entire procedure.
Note: While formatting takes place, if prompted by
AutoSave, do not save Master.xls.
6. Press Exit.
All files, including Master.xls are closed.
Using the Vivid 3/4 Data Viewer

Opening the Data Viewer
1. Locate the file Vivid 3_4 Data Viewer.xls under the
Patients folder and double click it.
2. When prompted for a password, type in the password you
defined in step 4 of the previous procedure (see
"Formatting" on page 486).
The Data Viewer database opens in Excel (see
Figure 9-73).
Figure 9-73: Vivid 3/4 Data Viewer

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Using the Data Viewer

The Data Viewer Excel database contains several useful tabs.
The main tab is Index_patient, detailing demographic data of
each exam. Each row details one exam. The left-most Patient
Index column contains internal index numbers, each unique to
an exam.
To browse exam results:
1. Use the Last name, Patient ID or Exam date tab to identify
the patient or exam of interest.
2. Click records in blue font to jump to the corresponding
exam in the Index_patient tab.
3. Identify and locate the exam of interest in the
Index_patient tab.
4. Click the corresponding Patient Index number to see all of
the relevant measurements for that particular exam.
5. Click on same Patient Index to return to the main
Index_patient tab.

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Chapter 10
Report
• Introduction ................................................................................... .. 492

• Creating a report ........................................................................... .. 493
• Working with the report function ............................................... 493
• To print a report ........................................................................ 496
• To store a report ....................................................................... 496
• Retrieving an archived report ................................................... 497
• Deleting an archived report ...................................................... 497
• Structured Findings ...................................................................... .. 498
• Prerequisite .............................................................................. 498
• Starting Structured Findings ..................................................... 499
• Structured Findings structure ................................................... 499
• Using Structured Findings ........................................................ 501
• Structured Findings configuration ............................................ 504
• Direct report .................................................................................. .. 514
• Creating comments .................................................................. 514
• Creating pre-defined text inputs ............................................... 515
• Report designer ............................................................................ .. 516
• Accessing the Report designer ................................................ 516
• Report designer overview ........................................................ 516
• Designing a report template ..................................................... 519
• Saving the report template ....................................................... 530
• To exit the Report designer ...................................................... 530
• Report templates management ................................................... .. 531
• Configuration of the Template selection menu ......................... 532
• Export/Import of Report templates ........................................... 533

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Introduction
The Vivid S5/Vivid S6 system enables the creation of patient
and examination reports containing measurements, images
and analysis that were made during the examination. The
layout of the reports is defined by generic templates delivered
with the system. Custom templates can also be made.
Saved reports are read-only. Therefore it is recommended that
the data be carefully reviewed before the report is saved. Use
the worksheet (see page 353) to facilitate the review and
adjustment of data before generating a report. The final report
can be printed on a regular laser printer.

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Creating a report
Reports summarize data obtained in the examination. They can
contain data and images.
Once generated, the report can be viewed, images can be
added, wall segment diagrams can be assigned, and text can
be entered in the free text fields. All other information must be
changed from the Patient information window and the
Worksheet screen.
Note: "Other ID" does not appear as a separate item in the
system's Report templates. The user should generate a custom
report sheet if Other ID data is required to be recorded.
Working with the report function

• Press REPORT.
The default template for the current examination, or the
template last used, is displayed (see Figure 10-1). The
information entered during the examination in
automatically filled out (e.g. demographic, Diagnosis,
Comments etc.)

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1. Assigned keys
• Print
• Store
• Retrieve
• Template
MORE menu
• Insert Text
• Save as
• Delete
• Designer
Figure 10-1: The Report screen and assigned keys

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To choose another report template

1. Press the assignable TEMPLATE.
The Template selec- The Template selection menu is displayed showing the
tion menu can be available report templates organized by application.
configured to dis-
play only the tem- 2. Do one of the following:
plates of interest • Select a template from the current application template
(see page 532). list.
• Select another application and select the desired
template from the sub-menu displayed.
Note: From a sub-menu, select Back to return to the
current application template list.
The selected template is displayed on the screen.
Note: After selecting a different report template the selected
template becomes the default template which will be selected
next time
To change patient information

1. Trackball to heading of the information to change.
The trackball marker is changed to a hand with pointing
finger .
2. Press SET on the Trackball area.
The original location of the data is displayed.
3. Change the information entered if required.
4. Press REPORT when completed.
Images in the report

• To add an image to the report, place the pointer over an
image in the clipboard and double-click the SET key.
The image is inserted into the first free image container in
the report.
• To move an image in the report, select and drag the image
to move it to a new image container.
• To replace an image in the report, select and drag an
image from the clipboard over the image to replace in the
report.
• To remove an image from the report, select and drag the
image to remove outside the report page.

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To print a report
Only members of the user group "Cardiologist" are allowed to
print a report (see page 637).
• Press PRINT.
The report is printed on the default printer. A status window
is displayed showing the printing process.
For printer configuration, see Chapter 12, "Peripherals" on
page 575.
Printing a report with the Ink-saving feature

When a report containing many images is printed it contains
many large areas with black background. When printing to an
ink-jet printer these black areas utilize a lot of ink and take
longer to print.
The report may be configured In order to eliminate these large
areas of black background while printing.
To configure the Ink-saving feature:
1. Press CONFIG and select the Report - Template tab (see
Figure 10-26).
2. Set the Ink-Save checkmark.
All reports generated from now on will be printed with
images containing white background.
To store a report
Only members of the user group “Cardiologist” are allowed to
store a report (see page 637).
1. Press STORE.
The report is stored in the Report archive.
A confirmation window is displayed when completed.
2. Press OK.
Alternative storage
Reports can also be saved in a user-defined locations in the
following formats:
• Compiled HTML (.CHM) files: readable from any web
browser.
• Portable Document Format (.PDF) files: readable with

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Adobe Acrobat reader (not available on EchoPAC PC).

1. Press MORE.
The additional controls are displayed (Figure 10-1).
2. Press SAVE AS.
The Save as dialogue window is displayed.
3. Select the destination folder from the Save in pull down
menu.
The default location is the Export folder.
The Report archive folder is selected by default.
The default name for the report is of type:
<exam DICOM UID>
4. Select PDF or CHM format from the Save as type pull down
menu.
5. Press SAVE.
Retrieving an archived report

1. Press RETRIEVE.
A list of the available reports for the actual examination is
displayed.
The default name for a report is of type:
<template type>_<store date>_<store time>
To display the current report, select Show active exam.
2. Trackball to the report to retrieve.
3. Press SET.
Deleting an archived report

Only members of the user group “Cardiologist” are allowed to
store a report (see page 637).
1. Press MORE.
The additional controls are displayed (Figure 10-1).
2. Press DELETE.
A list of the available reports for the actual examination is
displayed.
The default name for a report is of type:
<template type>_<store date>_<store time>
3. Trackball to the report to delete.
4. Press SET.

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Structured Findings
Structured Findings is a feature that enables the user to insert
pre-configured structured diagnostic statements and codes
(e.g. Billing, Accreditation) in the patient report and create a
conclusion based on the inserted statements.
Prerequisite
To be able to insert structured diagnostic statements and create
a conclusion in a patient record, the report template used must
have assigned fields for the structured findings, the codes and
the conclusion.
To create the assigned fields in a report template:
1. Press REPORT.
2. Press TEMPLATE and select the desired report template.
3. Press MORE and DESIGNER.
The Report designer screen is displayed.
4. Select the location in the report template where to insert the
Structured findings fields.
5. Select Insert and Archive Information.
The Archive information box is displayed (Figure 10-2).
6. Double-click on Select All under all three parameter fields
in the Archive information box to deselect all parameters.
7. Select Structured findings, Findings conclusion
Indication codes and Billing codes in the Exam
Information field (Figure 10-2).
8. Select OK.
9. Save the Report template and exit the Report designer.

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Figure 10-2: The Archive information box
Starting Structured Findings

1. Press REPORT.
Make sure the current template has a Structured Findings
field and a Conclusion field defined or select another
template if necessary.
2. Press MORE and FINDINGS.
The Structured Findings window is displayed
(Figure 10-5).
Structured Findings structure

The diagnostic statements are organized in tab folders (see
Figure 10-3). Each tab folder may contain:
• Underlying tab folders that contain Tab sheets.
• Tab sheets that contain diagnostic statements.

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1. Tab folder with underlying tab sheets

2. Tab sheet
Figure 10-3: Structured findings structure
There are three types of diagnostic statements (see

Figure 10-4):
• Check box statement: when selected the statement is
included in the report.
• Combo box statement: create a statement by selecting one
alternative text among several choices.
• Statement group: create several statements by selecting
multiple check box statements.

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1. Check box statement

2. Combo box statement
3. Statement group
Figure 10-4: Diagnostic statement types
Using Structured Findings

1. Start Structured Findings (see page 499).
2. Browse to the tab sheet containing the statements of
interest.
3. To insert a statement in the report (Findings field):
• Check box statement: select the statement.
• Combo box statement: select an alternative text in the
combo box next to the statement.
• Statement group: select the statements of interest within
the group.
A preview of the selected statement(s) is displayed in the
Findings preview field (see Figure 10-5). The statement
text in the preview field can be edited. This will apply only
for the current report.
Once a statement is selected an asterisk is displayed on
the tab of the current sheet and folder.
Note: select Normal to select only normal statements from
the current tab sheet (see page 508 for more information
on how to define normal statements).

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Note: select Clear to deselect all statements from the

current tab sheet.
To insert a conclusion statement in the report:
• Press the Conclusion button in front of the statement of
interest.
A preview of the selected conclusion statement is
displayed in the Conclusion preview field (see
Figure 10-5). Conclusion statements are displayed in a
numbered list. The list can be reordered: triple-click on the
conclusion statement to move in the Conclusion preview
field and use the ARROW UP or ARROW DOWN key to
move the statement up or down.
The conclusion statements can be reordered using drag
and drop procedure in the Conclusion preview field. The
conclusion text in the preview field can be edited. This will
apply only for the current report.
Note: pressing the Conclusion button in front of a
statement that was not previously selected results in
simultaneously inserting the finding statement and create
the conclusion.
4. Press OK.
The report for the current patient is displayed with the
selected findings, conclusion statement(s) and associated
codes (if any).
Note: Some diagnostic statements have measurements
values in the body text referred by a tag (e.g. the {EF} tag
refers to EF measurement). These statements require that
the actual measurement is done to display correctly in the
report.

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1. Statement inserted in the Conclusion and Findings field.

2. Statement inserted in the Findings field only.
3. Findings preview field
4. Conclusion preview field
5. Remove all selections.
6. Insert normal findings for the current tab sheet.
Figure 10-5: Structured Findings window

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Global selection of normal statements

It is possible to select all normal statements from all tab sheets.
1. Place the cursor in the Statement field, press UPDATE MENU
on the control panel and select All normal.
All statements defined as normal are selected from all the
tab sheets. An asterisk is displayed on the tab of all the tab
sheets that contain normal statements.
Note: this operation will remove any other “non-normal”
previously selected statements.
2. To remove all statements at once, place the cursor in the
Statement field, press UPDATE MENU and select Clear all.
Structured Findings configuration

Structured Findings configuration is used to:
• Create, edit or delete finding statements, conclusion
statements and codes.
• Organize the diagnostic statements in the Structured
Findings screen.
• Define the normal diagnostic statements.
Accessing the Structured Findings

configuration screen
1. Press CONFIG and select the Report category.
2. Select the Structured Findings tab.
The Structured Findings configuration screen is displayed
(Figure 10-6).
Or from within Structured Findings:
• Press UPDATE MENU on the control panel and select Config.

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1. Structured Findings structure tree:

• tab folder Combo box statement
• tab sheet Statement group
• Check box statement
2. Tab or statement label
3. Findings text
4. Conclusion text
5. Codes for the selected statement
6. Move, create or delete statement.
7. Create folder, Combo box or statement groups
8. Enter a variable in statement or conclusion text
9. Hide selected tab or statement from the Structured Finding window
10. Set the selected statement as normal
11. Rest factory default findings
12. Export/import findings.
Figure 10-6: Structured Findings configuration screen

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Creation of a tab folder

The following procedure describes how to create a new top
level tab folder.
1. Configuration window
2. Structured findings window
Figure 10-7: New tab folder
1. In the Structured Findings configuration window

(Figure 10-6), select the Structured Findings tab folder.
2. Select Add.
A new entry is created in the Structured Findings tab
folder. The new entry is by default a tab sheet ( ).
3. Select Enable one more tab level to change the new entry
to a tab folder ( ).
A warning message is displayed. Select OK.
4. With the new entry selected, follow the following steps:
• Enter a name in the Label field (tab name).
• Enter a description in the Findings text field. The
description will be displayed in the report as a heading
when selecting a statement from the underlying tab
sheets. The system is always using the Findings text
from the highest item in the structure as a heading for
the selected underlying statements.
• Enter the appropriate codes.

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Note: to enter several codes separate each code by a

space.
5. Press Up or Down to move the tab in the structure tree (or
do drag and drop).
Creation of a tab sheet

The following procedure described how to create a tab sheet in
a tab folder.
Figure 10-8: New tab sheet
1. Make sure that the tab folder is selected and press Add.
A new entry is created in the tab folder. The new entry is by
default a tab sheet ( ).
• Enter a name in the Label field (tab name).
• Enter a description in the Findings text field.
If required:
space.

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Adding statements in the tab sheet

Check box statement
The following procedure describes how to create a check box
statement.
Figure 10-9: New check box statement
1. Make sure that the tab sheet is selected and press Add.
A new entry is created in the tab sheet. The new entry is by
default a check box statement ( ).
• Enter a name in the Label field (statement name).
• Enter the full statement in the Findings text field.
• Enter a conclusion in the Conclusion text field (optional).
Note: if the Conclusion text field is left empty, the
statement text will be used as conclusion when
selected.
If required:

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space.
• Check Include findings in normal report to define the
statement as normal.
All statements within the selected tab sheet that have
this option checked will be included in the report when
Normal is selected in the Structured Findings window
(see "Using Structured Findings" on page 501).
Combo box statement
The following procedure describes how to create a combo box
statement.
Figure 10-10: New combo box statement
1. Create a new statement as described above. A check box

statement is created by default.

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2. With the new statement selected, press Add.

A new underlying entry is created and the parent
statement is changed to a Combo box statement ( ).
3. With the new underlying entry selected, follow the following
steps:
• Enter a name in the Label field.
• Enter a text in the Findings text field.
• Enter a conclusion in the Conclusion text field (optional).
4. Repeat the procedure from step 2 to create as many
underlying statements as necessary. Each underlying
statement will be a selectable entry in the combo box.
Statement group
Statement groups are created by changing a combo statement
to a statement group.
1. Create a combo box statement as described above.
2. Make sure the combo box statement is selected and
deselect the option Enable pull-downs.
The combo box statement is changed to a statement group
( ). Each underlaying entries are changed to check box
statements.
Editing a statement
Tab label, statements and statement alternative texts can be
edited.
(Figure 10-6), select the item to edit.
2. Make the required changes.

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Inserting variable parameters in a statement

Variable parameters such as patient name, institution name,
measurement values etc. can be inserted in a statement as
tagged information.
To insert variable parameters in a statement:
1. Place the cursor at the required position in the Findings text
field (or Conclusion text field).
2. Press Insert parameter.
The Insert parameter window is displayed (see
Figure 10-11).
3. Browse and select the actual parameter to insert.
Note: for measurement values, select first the scanning
mode.
4. Press OK.
The selected parameter is inserted in the statement as a
tag (e.g. the {EF} tag refers to EF measurement)
Note: to display correctly in the report, the actual
parameter value must exist, e.g. if a measurement value is
included in a statement as a variable parameter, a
measurement value must exist for the current patient,
otherwise the parameter name is displayed.
Figure 10-11: Insert parameter window

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Copy of a statement
Tab folders, tab sheets and statements can be copied from one
location to another. The word "Copied" is added to the copied
item name.
(Figure 10-6), select the item to copy.
2. Select Copy.
3. Select the item to contain the copy.
4. Select Paste.
Note: if the item to copy cannot be copied in the selected
location, the operation is ignored.
Note: copy can be done by drag-and-drop, while holding CTRL
depressed.
Deletion of a statement
Tab folders, tab sheets and statements can be deleted.
Deletion cannot be undone.
CAUTION

(Figure 10-6), select the item to delete.
2. Select Delete.
The selected item is deleted.
Factory reset
All statements can be reset back to the factory default.
Factory reset cannot be undone.
CAUTION
1. Select Reset.
The Reset statements window is displayed.
2. Select:
• Yes to reset all statement to the factory default (No
undo).
• No to cancel the operation.

R2424458-100 Rev. 2
Report
Exporting/Importing statements
Diagnostic statements can be exported from one system and
imported on another system.
Exporting statements
(Figure 10-6), select Export.
A browsing window is displayed.
2. Browse to a destination and select Save.
Importing statements
Importing statements will replace the current statements. If
necessary, backup the current statements by exporting them
CAUTION before performing import.

(Figure 10-6), select Import.
A browsing window is displayed.
2. Browse to a destination and select Open.

R2424458-100 Rev. 2
Report
Direct report
Direct report enables the user to insert comments at any time
during the examination that will be part of the final report.
Direct report provides also an overview over the measurements
completed.
Creating comments
2. Select Direct report (see Figure 10-12).
3. In the Direct report screen, select the comment type.
4. Type your comments in the Text field.
5. To add a measurement in the comment, double-click a
measurement in the Measurement overview field.
1. Open Direct report

2. Select the type of information
3. Create/insert pre-defined text
4. Text field
5. List of measurements completed
6. Exits the Direct report
Figure 10-12: The Direct report

R2424458-100 Rev. 2
Report
Inserting pre-defined text input

1. Select the insertion point in the Text field.
2. Select Insert text.
The Insert text window is displayed (see Figure 10-13).
Figure 10-13: The Insert text window
The pre-defined text list is organized in a three level

hierarchy. Selecting one item in the first column displays
pre-defined text entries related to the selected text in the
second and third column.
3. Navigate through the pre-defined text list by selecting items
in the columns and double-click on the desired pre-defined
text to be inserted. If an entry in the third column is inserted,
the selected text in the second column is also inserted.
Press More>> to display the full text for the selected entry.
Creating pre-defined text inputs

This feature is described in "The Comment texts sheet" on
page 613.

R2424458-100 Rev. 2
Report
Report designer
The Report designer software package enables the user to
create report templates that best suit its needs.
Designing a report template consists of choosing the
information to display in the report (e.g. header, footer, logo,
patient information, images, measurements etc.) and arrange it
in the report viewer.
The Report designer function is based on the information
container concept: each type of information is included within a
container with parameters that can be configured (size, color,
font properties, information to display etc.)
Accessing the Report designer

1. Press REPORT on the Control panel.
The Report screen is displayed.
2. Press DESIGNER.
The Report designer screen is displayed with the selected
template in the Report template design area (see
Figure 10-14).
Report designer overview
1. Menu bar
2. Report template design area
Figure 10-14: The Report designer screen

R2424458-100 Rev. 2
Report
The menu bar
Menu Description
File • New: start working on an new template

• Save: save the template using the same name. Factory
report templates cannot be overwritten.
• Save as: save the template using a new name.
• Page setup: define printing orientation and
header/footer for the printed report.
• Print Preview: display a print preview of the report
template.
• Exit: exit the Report designer and returns to the report
function. The user can choose whether to save the
updates or restore the original template.
Menu Description
Edit • Delete: remove the selected object from the report

template.
• Undo: restore the previous state of the report template.

R2424458-100 Rev. 2
Report
Menu Description
Insert • Page Break: insert a new page in the report template.

• Table: configure and insert a table in the report
template.
• Logo: select and insert a logo to the report template.
• Archive info: select and insert data from the following
categories:
Patient information
Exam information
Site information
• Anatomical graphics: select and insert an
anatomicalgraphic (cardiac, vascular or TEE).
• Image: create a container for the display of ultrasound
images.
• Wall motion analysis: insert a container for the display
of Stress Echo analysis results (cut planes Bull's eye
and scoring table).
• OB/GYN: insert OB graph.
• Measurements: insert a container for the display of
measurements and calculations. When creating a
measurement container, the user is prompted through a
configuration procedure enabling the selection of mode
specific measurements and/or calculations.
• Text field: insert a container where the user can write in
the report.
• Fixed text: insert a container with static text. The text
typed during the creation of the container will be
displayed in the report.
Menu Description
Preferences • Page color: sets the default background color for the
template page.

R2424458-100 Rev. 2
Report
Designing a report template

Starting template designing
1. Start the Report designer (see page 516).
2. Press File and select New to display a blank page or use
the current report template as basis template.
Setting the layout preferences

Adjusting the report page color background
1. Press Preferences and select Page Color.
The Color selection window is displayed.
2. Select the desired color.
3. Press OK.
Header and footer in the printed report
This function is described on page 528.
Inserting an information container in the

report template body
The different type of information to be included in a report are
grouped in information containers. Designing a report template
consists in inserting and configuring the different information
containers in the template page in an ordered manner.
Information containers can be inserted either:
• Directly into the report template body: this procedure does
not allow side-by-side insertion, the information container
will normally cover the width of the report template page.
• Within a table: this procedure allows side-by-side insertion
of several information containers.
Inserting a table
1. Press the Left mouse button at the desired insertion point
in the Report template design area.
2. Press Insert and select Table.
The Container properties window is displayed (see
Figure 10-15).
3. Adjust the parameters as desired.
4. Press OK.
The table is displayed in the template.

R2424458-100 Rev. 2
Report
Note: To modify an inserted table, double-click in an empty

area in the table. A selection menu is displayed where the user
can add, delete a row or a column or open the Table properties
window.
Figure 10-15: The Table properties window
Inserting a logo
1. Provide the hospital logo in JPEG or Bitmap format onto a
CD or MO disk.
2. Select the location where to insert the logo (a table cell or
directly in the report template).
3. Select Insert and Logo.
The Logo box is displayed.
Figure 10-16: The Logo box

R2424458-100 Rev. 2
Report
4. Select a logo, or if not available, select Import logo.

Browse and select the logo and select OK.
5. Specify the appearance.
6. Select OK.
Inserting fixed text

Fixed text is an entry that cannot be changed in the report (e.g.
hospital information).
1. Select the location where to insert the fixed text (a table cell
or directly in the report template).
2. Select Insert and Fixed text.
The Fixed text box is displayed.
Figure 10-17: The Fixed text box
3. Enter the text and specify the appearance.

4. Select OK.

R2424458-100 Rev. 2
Report
Inserting archive information

Archive information contains all the objects of the different
information menus (Patient, Exam, Study and Site Information).
You may display the archive information over two columns
using a table container as described below.
1. Insert a table for the archive information to the desired
location (a table cell or directly in the report template).
2. Select the first table cell.
3. Select Insert and Archive information.
The Archive information box is displayed.
Figure 10-18: The Archive information box
4. If desired, enter a heading and select a heading link from

the pull-down menu.
5. Select the Information parameters to be displayed in the
first cell.
Select Box properties to change the font, alignment,
appearance, etc.
6. Select OK.
7. Select the next table cell and repeat steps 3 to 6 to enter the
remaining archive information.

R2424458-100 Rev. 2
Report
Inserting an image container

1. Select the location where to insert the fixed text (a table cell
or directly in the report template).
2. Select Insert and Image.
The Ultrasound image box is displayed.
Figure 10-19: The Ultrasound image box
3. If desired, enter a heading, set the container size and

specify the text appearance.
4. Select OK.
Inserting measurement containers

You may display the measurements over several columns
using a table container as described below.
1. Insert a table for the measurements to the desired location.
2. Select the first table cell.
3. Select Insert and Measurements.
The Measurement box is displayed.

R2424458-100 Rev. 2
Report
Figure 10-20: The Measurements box
4. Enter a heading (e.g. 2D).

5. Using the Filter criteria, define the type of measurements to
be entered (e.g. Cardiac, 2D, measured and calculated).
Select Show normal value to display user-defined Normal
value next to the measurements in the Report (see
page 340 for more information).
Note: References for the normal values can be displayed
in the report by checking Normal value references from
Insert -> Archive Info (see page 522)
6. From the measurement list, select the measurement to
insert and press Add. Both single measurements or a folder
may be added.
7. The list of the inserted measurements is displayed in the
Selected measurement list on the right side.
8. Press OK.
9. Select the next table cell and repeat steps 3 to 8 to insert
several measurements.

R2424458-100 Rev. 2
Report
Inserting text fields

Text fields are:
• Containers for Referral reasons, Comments and Diagnosis
information.
• Containers for free text, where the user can type
information in the report.
1. Select the location where to insert the text field container (a
table cell or directly in the report template).
2. Select Insert and Text field.
The Text field box is displayed.
Figure 10-21: The Text field box
3. Enter a heading.
4. From the Display field, select one of the following options:
• Referral reasons: displays the information entered in
the Direct report (see page 514) or in the Examination
list window.
• Comments: displays the information entered in the
Direct report (see page 514) or in the Examination list
window.

R2424458-100 Rev. 2
Report
• Diagnosis: displays the information entered in the

Direct report (see page 514) or in the Examination list
window.
• Free text 1-8: creates an empty free text container.
5. If desired, adjust the font settings for the header and data.
Inserting Wall motion scoring analysis

containers
Two different containers must be inserted for the Wall motion
scoring analysis:
• A Wall motion scoring diagrams container (Cut planes or
Bull's eyes)
• A Wall motion scoring table
Inserting Wall motion scoring diagrams container
1. Select the location where to insert the free text container (a
table cell or directly in the report template).
2. Select Insert, Wall motion analysis and select between
Cut planes and Bull’s eye.
The corresponding Wall motion scoring box is displayed.
Figure 10-22: The Wall motion scoring box (Cut planes)
3. Adjust the parameters and select OK.

The scoring diagrams are inserted in the report template.

R2424458-100 Rev. 2
Report
Inserting Wall motion scoring diagrams container

1. Place the cursor right below the Wall motion scoring
diagrams container.
2. Select Insert, Wall motion analysis and select Score
table box.
The Score table box is displayed.
Figure 10-23: The Score table box
3. Adjust the layout parameters in the Score table box and

select OK.
The Score table is inserted in the report template.
Editing the information container

Resizing the information container
1. Move the Mouse cursor over the border of the container to
resize.
The mouse cursor is changed to a cross .
2. Press Left mouse button once.
The container is displayed with anchor squares on the
sides and at the corners.
3. Resize the container by dragging from the anchor points.
Editing the information container properties
Modifying the container’s specific properties
1. Move the Mouse cursor over the border of the container to
edit.
The mouse cursor is changed to a cross .
2. Double-click on the Left mouse button.
The Container box is displayed.

R2424458-100 Rev. 2
Report
3. Adjust the parameters specific to the selected container.

Note: Some information containers have additional
parameters that may be adjusted by selecting Box
properties.
Inserting a new page

1. In the template, position the Mouse cursor at the insertion
point.
2. Press the Left mouse button.
3. Press Insert and select Page Break.
Inserting header and footer

Header and footer may be defined to be displayed in the
printed report. The header and footer are not visible in the on
screen report.
To insert header and footer in the printed report:
1. Select File and Page setup.
The Page setup box is displayed.
Figure 10-24: The Page setup box
2. Adjust the printing orientation.

3. Define the header and footer for the printed report, by
typing text and entering the required variables listed in the
table below.

R2424458-100 Rev. 2
Report
Check Different on first page and create a specific

header/footer for the first page.
4. Select OK.
To check the display of the header and footer, select File
and Print preview.
Variable Description
{pid} Patient ID
{pnm} Patient name
{pdb} Patient date of birth
{exd} Examination date
{prd} Current date (printing date)
{prt} Current time (printing time)
{cp} Current page
{tp} Page count
{c} Subsequent entries are centered
{r} Subsequent entries are right aligned

R2424458-100 Rev. 2
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Saving the report template

Replace an existing template
Factory templates cannot be overwritten.
1. Press File and select Save.
A dialogue window is displayed asking for confirmation.
2. Select:
• Yes to save the report template
• No to discard the report template
• Cancel to go back to the Report designer without saving
the report template.
Save existing template with a new name

1. Press File and select Save as.
The Save as template window is displayed.
Figure 10-25: The Save as template window
2. Enter a name for the template.

3. Press OK.
The template is saved.
To exit the Report designer

1. Select File and Exit.
The Exit window is displayed.
2. In the Exit window, select one of the following:
• Yes: to save the report template and exit the application.
• No: to exit the application without saving the changes
made in the report template.
• Cancel: to return to the application.

R2424458-100 Rev. 2
Report
Report templates management

This section describes:
• Configuration of the Template selection menu.
• Deletion of user-defined report templates.
• Export/import of user-defined report templates.
The report templates management is done from the Report
templates sheet in the system configuration package.
To access to the Report templates sheet:
1. Press CONFIG and select the Report category.
The Report category sheet is displayed.
Figure 10-26: The Report template sheet

R2424458-100 Rev. 2
Report
Configuration of the Template selection

menu
The Template selection menu displays the application specific
report templates that can be selected when creating a report.
The Template selection menu can be configured to display only
the templates of interest.
Inserting a template in the Templates

selection menu
1. Press CONFIG and select Report.
The Report template sheet is displayed (Figure 10-26)
2. In the Available templates field (left field), select the
template to insert in the Template selection menu.
3. Next to Section, select the appropriate application.
4. Press the Right arrow button .
The selected template is inserted in the Template selection
menu.
Note: Double-clicking on a template in the Available
template field will also insert the template in the Template
menu.
Removing a template from the Template

selection menu
1. In the Report template menu field (right field), select the
template to remove.
2. Press the Left arrow button .
The selected template is removed from the Template
selection menu.
Note: Double-clicking on a template in the Available
template field will also insert the template in the Template
menu.
Sorting the templates in the Template

selection menu
1. In the Report template menu field, select the template to
move.
2. Press the Up or Down arrow buttons .
The selected template is moved accordingly in the
Template selection menu.

R2424458-100 Rev. 2
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Deleting a report template from the system

Only user-defined report templates can be deleted from the
system.
1. In the Available templates field (left field), select the report
to delete (Figure 10-26).
2. Press Delete.
A Confirmation window is displayed.
3. Select Yes to delete the report template.
Export/Import of Report templates

User-defined report templates can be exported to a removable
media and imported from the removable media into another
system (Vivid S5/Vivid S6 / EchoPAC PC).
Export of Report templates

1. Insert a removable media into the drive.
The Report template sheet is displayed (Figure 10-26,
page 531).
3. Select Export Templates.
The available user-defined templates are displayed in the
Export template dialogue window.
Figure 10-27: The Export template dialogue window

R2424458-100 Rev. 2
Report
4. Select the template(s) to export. Multiple selection can be

done using SHIFT or CTR key.
5. Select the desired removable media under Select target
device.
6. Press OK.
7. Press OK.
The selected template(s) are exported to the removable
media.
8. Press ALT + E and select the media to eject.
Import of Report templates

1. Insert the removable media with the report template(s) to
import.
The Report template sheet is displayed (Figure 10-26,
page 531).
3. Select Import Templates.
The Import template window is displayed.
Figure 10-28: The Import template window
4. Select the source device from the pull-down menu.

5. Press OK.
6. Press OK.
The templates are imported into the system.
7. Press ALT + E and select the media to eject.

R2424458-100 Rev. 2
Probes
Chapter 11
Probes
• Probe overview ............................................................................. .. 537

• Supported probes ..................................................................... 537
• Vivid S5 Probe/Application Overview ....................................... 542
• Vivid S6 Probe/Application Overview ....................................... 543
• Maximum probe temperature ................................................... 544
• Probe orientation ...................................................................... 545
• Probe labelling ......................................................................... 546
• Environmental Requirements ................................................... 547
• Probe Integration .......................................................................... .. 548
• Selecting probes ...................................................................... 548
• Connecting the probe ............................................................... 548
• Activating the probe ................................................................. 550
• Disconnecting the probe .......................................................... 551
• Care and Maintenance .................................................................. .. 552
• Planned maintenance .............................................................. 552
• Inspecting the probe ................................................................. 553
• Special handling instructions .................................................... 554
• Cleaning and disinfecting probes ............................................. 556
• Probe safety .................................................................................. .. 562
• Biopsy ............................................................................................ .. 563
• Precaution concerning the use of biopsy procedures .............. 563
• Preparing the Biopsy guide attachment ................................... 565
• Displaying the Guide zone ....................................................... 569
• Endocavitary Probe Biopsy Guide Assembly ........................... 571
• Biopsy needle path verification ................................................ 573
• Starting the biopsy procedure .................................................. 573
• Cleaning, disinfection and disposal .......................................... 573

R2424458-100 Rev. 2
Probes
• Surgery/Intra-operative Use ........................................................ ... 574

• Preparing for Surgery/Intra-operative Procedures .................... 574

R2424458-100 Rev. 2
Probes
Probe overview
The Vivid S5/Vivid S6 ultrasound unit supports four types of
probes:
• Phased Array Sector
• Linear Array
• Curved Array (Convex)
• Continuous Wave Doppler
Supported probes
Phased Array Sector probes
Probe Mode Intended use Technical data Image
3S-RS 2D mode Cardiology Frequency: 1.5–3.6 MHz

M-Mode Coronary Foot print: 18 x 24 mm
Color Flow Transcranial
CW Doppler Renal
PW Doppler OB
Abdomen
Fetal Heart
M4S-RS 2D mode Cardiology Frequency: 1.5-3.6 MHz

(Vivid S6 M-Mode Pediatric heart
only)
Color Flow Adult Cephalic
CW Doppler Abdomen
PW Doppler Renal
Fetal Heart

M-Mode Coronary Foot print: 18 x 24 mm
Color Flow Pediatric Heart
CW Doppler Fetal Heart
PW Doppler

R2424458-100 Rev. 2
Probes
6S-RS 2D mode Cardiology Frequency: 2.7-8.0 MHz

M-Mode Pediatric Heart
Color Flow Fetal Heart
CW Doppler Neonatal
PW Doppler cephalic

M-Mode Pediatric heart Foot print: 15 x 21 mm
Color Flow Coronary
CW Doppler Neonatal head
PW Doppler

M-Mode Pediatric heart Foot print: 10 x 14 mm
Color Flow Coronary
CW Doppler Neonatal head
PW Doppler
Linear Array probes
8L-RS 2D mode Peripheral Frequency: 4.0–13.0 MHz

M-Mode vascular Foot print: 14 x 48 mm
Color Flow Small parts
PW Doppler

PW Doppler

R2424458-100 Rev. 2
Probes

PW Doppler
Curved Array (Convex) probes
4C-RS 2D mode Abdomen Frequency: 1.8–6.0 MHz

M-Mode Fetal Heart Foot print: 17 x 65 mm
Color Flow Renal FOV: 58 degrees
PW Doppler OB
8C-RS 2D mode Pediatrics Frequency: 4.0-11.0 MHz

M-Mode Abdomen Foot print: 26 x 10 mm
Color Flow Neonatal FOV: 133 degrees
Head
PW Doppler
Cartoid
Small parts
Cardiac
e8C-RS 2D mode Endocavity Frequency: 4.0-11.0 MHz

M-Mode Fetal Heart Foot print: 23 x 10 mm
Color Flow Obstetrics FOV: 133 degrees
PW Doppler Pelvic
Doppler probes
2D-RS CW Doppler Cardiology Frequency: 2.0 MHz

(P2D)

R2424458-100 Rev. 2
Probes
6D-RS CW Doppler Vascular Frequency: 6.0 MHz

(P6D)
Multiplane Transesophageal Phased Array

probe
6T-RS 2D mode Transesophageal Frequency: 2.9–8.0 MHz

6T* M-Mode Cardiology
Color Flow
CW Doppler
PW Doppler
6Tc-RS 2D mode Transesophageal Frequency: 2.9-8.0 MHz

M-Mode Cardiology
Color Flow
CW Doppler
PW Doppler
9T-RS 2D mode Transesophageal Frequency: 4.0–10.0 MHz

9T* M-Mode Cardiology
Color Flow
CW Doppler
PW Doppler
* Applicable only for Vivid S6.

R2424458-100 Rev. 2
Probes
Intra Operative Probes
i12L-RS 2D mode Intraoperative* Frequency: 5.0-13.0 MHz

M-Mode Thoracic
Foot print: 14 x 33 mm
Color Flow Vascular and
abdominal
PW Doppler
Pediatric
Small parts
Musculo-skeletal
Musculo-skeletal
Superficial
Peripheral
vascular
* Excluding direct contact with the heart

R2424458-100 Rev. 2
Probes
Vivid S5 Probe/Application Overview
i12L-RS
e8C-RS
10S-RS
12L-RS
6Tc-RS
4C-RS
8C-RS
3S-RS
5S-RS
6S-RS
7S-RS
8L-RS
9L-RS
6T-RS
9T-RS
P2D
P6D
Application
Abdominal + + +
Aorto-Iliac +
Breast + +
Cardiac + + + + + + + + +
Carotid + + + + + + + +
Contrast + + +
Coronary + + + + + + +
Excercise + +
Fetal Heart + + + + +
HFR (High Frame Rate) +
LEA + + + +
LEV + + +
LV Contrast + + + +
LVO Stress +
Musculoskeletal +
Neo Head +
Nerves + + + + +
Obstetrics + +
Pediatric + + + + + +
Pelvic + +
Pharm Stress + +
Renal + +
Small Parts + + + +
Small Organs +
Superficial + + + +
Transcranial +
Thyroid + + +
UEA + + +
UEV + + +
Vertebral + +
Note: Some of the above applications depend on the availability of certain options

R2424458-100 Rev. 2
Probes
Vivid S6 Probe/Application Overview
M4S-RS
i12L-RS
e8C-RS
10S-RS
12L-RS
6Tc-RS
4C-RS
8C-RS
3S-RS
5S-RS
6S-RS
7S-RS
8L-RS
9L-RS
6T-RS
9T-RS
P2D
P6D
6T
9T
Application
Abdominal + + + +
Aorto-Iliac +
Breast + +
Cardiac + + + + + + + + + + +
Carotid + + + + + + + +
Contrast + + +
Coronary + + + + + + + + +
Excercise + + +
Fetal Heart + + + + + +
HFR +
LEA + + + +
LEV + + +
LV Contrast + + + + + +
LVO Stress + +
Musculoskeletal +
Neo Head +
Nerves + + + + +
Obstetrics + +
Pediatric + + + + + + + +
Pelvic + +
Pharm Stress + + +
Renal + + +
Small Parts + + + +
Small Organs +
Superficial + + + +
Transcranial + +
Thyroid + + +
UEA + + +
UEV + + +
Vertebral + +
Note: Some of the above applications depend on the availability of certain options

R2424458-100 Rev. 2
Probes
Maximum probe temperature

Probe Max Temp
3S -RS 40.5
M4S-RS 42.8
5S-RS 40.8
6S-RS 39.5
7S-RS 37.7
10S-RS 36.1
8L-RS 41.0
9L-RS 40.4
12L-RS 36.6
i12L-RS 40.5
4C-RS 37.8
8C-RS 37.3
E8C-RS 40.7
6T/6T-RS 40.8
6Tc-RS 42.3
9T/9T-RS 42.1
P2D 35.3
P6D 36.0
Notes: Lens temperature measured under following conditions

per IEC 60601-2-37 Amd. 2:
1. Thermocouple was placed at the geometric center of the
lens. Thermal phantom made with tissue-mimicking
material as referenced in IEC60601-2-37 Amd 2: Annex
BB.
2. a: Thermal phantom at 23 +/- 3 °C for all probes.
b: Temperature rise is measured and added to 33 for
External-Use probes or 37 °C for Non External-Use
probes.
3. Probe placed upright in contact with above thermal
phantom.

R2424458-100 Rev. 2
Probes
4. Auto-freeze capability is disabled.

5. Lens temperature is monitored until it reaches equilibrium
(temperature change rate of less than 0.06 °C per minute).
6. a: Measurement uncertainty for probes with temperature
sensor: 0.3 °C
b: Measurement uncertainty and probe variation for other
probes: 1.6 °C
Probe orientation
Some probes are provided with a green light (LED) orientation
marking near their head (see Figure 11-1). Probes which do not
have a LED have an indentation (notch) for orientation on the
probe housing. This LED, or notch, corresponds with the V
mark on the scanning screen. The V mark indicates the
orientation of the probe to the scan.
1. LED 3. V-mark on screen: indicates the orientation of

2. Notch the probe to the scan.
Figure 11-1: Orientation marking on probe and on screen

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Probes
Probe labelling
Each probe is labelled with the following information:
• Name of distributor and manufacturer
• Operating frequency
• Model number
• Probe serial number
• Year of manufacture
The probe name is displayed on the probe housing.
1. CE mark
2. Probe name
Figure 11-2: Probe labelling (examples)

R2424458-100 Rev. 2
Probes
Environmental Requirements
Probes should be operated, stored, or transported within
parameters outlined in Table 2-1, page 53.
Ensure that the probe face temperature does not exceed
normal operation temperature range (see table on page 544).

R2424458-100 Rev. 2
Probes
Probe Integration
This section covers:
• Connecting the probe
• Activating the probe
• Disconnecting the probe
Selecting probes
Selecting a new • Only use approved probes.
probe unfreezes the
• All imaging probes with an RS-type connector can be
image.
plugged into any of the probe RS ports.
• Always start out with a probe that provides optimum focal
depths and penetration for the patient size and exam.
• Begin the scanning session by choosing the correct
application and preset for the examination by selecting
Preset.
• Begin the scan session using the default Power Output
setting for the probe and exam.
Connecting the probe

Probes can be connected at any time, whether the unit is on or
off.
Vivid S5: 3 type RS ports Vivid S6: 3 type RS ports and one type OR
port to support TEE probes
Figure 11-3: Probe ports
Do not allow the probe head to hang freely. Impact to the probe
head may result in irreparable damage.
CAUTION

R2424458-100 Rev. 2
Probes
Fault conditions can result in electric shock hazard. Do not touch

the surface of probe connectors which are exposed when the
CAUTION probe is removed.
Do NOT touch the patient and any of the connectors on the

ultrasound unit simultaneously, including ultrasound probe
WARNING connectors.
To connect a probe (small connector - type RS)

upwards.
2. Push the connector locking handle to the right-most
position.
into place.
4. Push the connector locking handle to the left-most position.
To connect a probe (large connector - type OR)

upwards.
2. Turn the connector locking handle horizontically.
into place.
4. Rotate the locking handle to the full vertical position to lock
in place.
Take the following precautions with the probe cables:

• Keep free from the wheels.
CAUTION • Do not bend cable sharply.

R2424458-100 Rev. 2
Probes
Activating the probe

When a probe is connected to the unit it is automatically
detected.
To select a probe and an application

1. Press PROBE on the control panel. A list of the connected
probes will pop up.
2. Trackball to the desired probe.
An application menu for the desired probe is then listed.
3. Trackball to the desired application
4. Press SET to launch the application.
Make sure that the probe and application names displayed on the
screen correspond to the actual probe and application selection.
CAUTION
Check that the correct TI category is displayed (see "Thermal
Index" on page 26). TIB must be displayed when a fetal
application is selected.

R2424458-100 Rev. 2
Probes
Disconnecting the probe

Probes can be disconnected at any time. It is recommended
that the probe should not be active when being disconnected.
To disconnect a probe (small connector -

type RS)
1. Freeze the image by pressing FREEZE.
2. Press the connector locking lever towards the left to unlock
the connector.
3. Pull the probe and connector straight out of the probe port.
4. Carefully slide the probe and connector away form the
probe port and around the right side of the keyboard.
5. Ensure that the cable is free.
6. Verify that the probe head is clean before placing the probe
in its storage case.
To disconnect a probe (large connector -

type OR)
1. Rotate the lock handle counter-clockwise to the horizontal
position to unlock the connector.
2. Pull the connector straight out of the probe port.
3. Verify that the probe head is clean before placing the probe
in its storage case.

R2424458-100 Rev. 2
Probes
Care and Maintenance

This section covers:
• Planned maintenance
• Probe inspection
• Probe cleaning
• Probe disinfection
Planned maintenance
Improper handling can lead to early probe failure and electric
shock hazards.
CAUTION
DO follow the specific cleaning and disinfection procedures
provided in this chapter and the germicide manufacturers
instructions.
Failure to do so will void probe warranty.
Transesophageal and intraoperative probes require a special

handling. Refer to the user documentation enclosed with these
CAUTION probes.
It is recommended to keep a maintenance log and note all

probe malfunctions. Follow the maintenance schedule below to
ensure optimum operation and safety:
After each use

• Inspect the probe
• Clean the probe
• If required disinfect the probe
Before each use

• Inspect the probe

R2424458-100 Rev. 2
Probes
Inspecting the probe

If any damage is found, DO NOT use the probe until it has been
inspected and released for further use by a GE service
CAUTION representative.
After each use

1. Inspect the lens, the probe housing and the cable
(Figure 11-4).
2. Look for damage that might allow liquid into the probe.
Before each use

1. Inspect the lens, the probe housing and the cable
(Figure 11-4).
2. Look for damage that might allow liquid into the probe.
3. Test the functionality of the probe.
1. Housing
2. Strain relief
3. Seal
4. Lens
Figure 11-4: Probe parts

R2424458-100 Rev. 2
Probes
Special handling instructions

Using protective sheaths
Protective barriers may be required to minimize disease
transmission. Probe sheaths are available for use with all clinical
CAUTION situations where infection is a concern. Use of legally marketed,
sterile probe sheaths is strongly recommended for intra-cavitary
and intra-operative procedures. Use of legally marketed, sterile,
pyrogen free probe sheaths is REQUIRED for neurological
intra-operative procedures.
Instructions
Custom made sheaths are available for each probe. Each
probe sheath kit consists of a flexible sheath used to cover the
probe and cable and elastic bands used to secure the sheath.
Sterile probe sheaths are supplied as part of biopsy kits for
those probes intended for use in biopsy procedures. In addition
to the sheath and elastic bands, there are associated
accessories for performing a biopsy procedure which are
included in the kit. Refer to the biopsy instructions for the
specific probes in the Discussion section of this chapter for
further information.
Reordering
To reorder sheaths, please contact your local distributor or the
appropriate support resource.
Devices containing latex may cause severe allergic reaction in
latex sensitive individuals. Refer to FDA's March 29, 1991
CAUTION Medical Alert on latex products.
Do not use pre-lubricated condoms as a sheath. In some cases,

they may damage the probe. Lubricants in these condoms may
CAUTION not be compatible with probe construction.
DO NOT use an expired probe sheath. Before using probe

sheaths, verify whether the term of validity has expired.
CAUTION

R2424458-100 Rev. 2
Probes
Endocavitary Probe Handling Precautions

If the sterilization solution comes out of the endocavitary probe,
please follow the cautions below.
Sterilant Exposure to Patient (e.g., Cidex): Contact with a
sterilant to the patient's skin or mucous membrane may cause an
CAUTION inflammation. If this happens, refer to the sterilant's instruction
manual.
Sterilant Exposure from Probe Handle to Patient (e.g., Cidex): DO
NOT allow the sterilant to contact the patient. Only immerse the
probe to its specified level. Ensure that no solution has entered
the probe's handle before scanning the patient. If sterilant comes
into contact with the patient, refer to the sterilant's instruction
manual.
Sterilant Exposure from Probe Connector to Patient (e.g., Cidex):
DO NOT allow the sterilant to contact the patient. Only immerse
the probe to its specified level. Ensure that no solution has
entered the probe's connector before scanning the paitent. If
sterilant comes into contact with the patient, refer the the
sterilant's instruction manual.
Endocavitary Probe Point of Contact: Refer to the sterilant's
instruction manual.
Probe handling and infection control

This information is intended to increase user awareness of the
risks of disease transmission associated with using this
equipment and provide guidance in making decisions directly
affecting the safety of the patient as well as the equipment user.
Diagnostic ultrasound systems utilize ultrasound energy that
must be coupled to the patient by direct physical contact.
Depending on the type of examination, this contact occurs with
a variety of tissues ranging from intact skin in a routine exam to
re-circulating blood in a surgical procedure. The level of risk of
infection varies greatly with the type of contact.
One of the most effective ways to prevent transmission
between patients is with single use or disposable devices.
However, ultrasound transducers are complex and expensive
devices that must be reused between patients. It is very
important, therefore, to minimize the risk of disease

R2424458-100 Rev. 2
Probes
transmission by using barriers and through proper processing

between patients.
Risk of Infection: ALWAYS clean and disinfect the probe between
patients to the level appropriate for the type of examination and
CAUTION use FDA-cleared probe sheaths where appropriate.
Adequate cleaning and disinfection are necessary to prevent

disease transmission. It is the responsibility of the equipment
CAUTION user to verify and maintain the effectiveness of the infection
control procedures in use. Always use sterile, legally marketed
probe sheaths for intra-cavitary and intra-operative procedures.
For neurological intra-operative procedures, use of a legally
marketed, sterile, pyrogen free probe sheath is REQUIRED.
robes for neuro surgical use must not be sterilized with liquid
chemical sterilants because of the possibility of neuro toxic
residues remaining on the probe.
Cleaning and disinfecting probes

Transesophageal and intraoperative probes require a special
handling. Refer to the user documentation enclosed with these
CAUTION probes.
You MUST disconnect the probe from the Vivid S5/Vivid S6 prior
to cleaning/disinfecting the probe. Failure to do so could damage
CAUTION the system.
Cleaning probes
Cleaning procedure
1. Disconnect the probe from the unit.
2. Remove the coupling gel by wiping the probe lens with a
soft cloth.
3. Wipe the probe and cable with a soft cloth moisten in a
warm soap and water solution (<80 oF/27 oC).
4. Wipe the probe and cable with a soft cloth moisten in clean
water (<80 oF/27 oC) until all soap is removed.
5. Wipe dry with a soft towel.

R2424458-100 Rev. 2
Probes
To minimize the risk of infection from blood-borne pathogens,

you must handle the probe and all disposables which have
CAUTION contacted blood, other potentially infectious materials, mucous
membranes, and non-intact skin in accordance with infection
control procedures. You must wear protective gloves when
handling potentially infectious material. Use a face shield and
gown if there is a risk of splashing or splatter.
Disinfecting probes
In order to provide users with options in choosing a germicide,
GE Medical Systems routinely reviews new medical germicides
for compatibility with the materials used in the transducer
housing, cable and lens. Although a necessary step in
protecting patients and employees from disease transmission,
liquid chemical germicides must also be selected to minimize
potential damage to the transducer.
Refer to the Probe Care Card enclosed in the probe case or to
http://www.gehealthcare.com/usen/ultrasound/products/probe_
care.html for the latest list of compatible cleaning solutions and
disinfectants.
Low-level disinfection
• After cleaning, the probe and cable may be wiped with a
tissue sprayed with a recommended disinfectant.
Use additional precautions (e.g. gloves and gown) when
decontaminating an infected probe.

R2424458-100 Rev. 2
Probes
High-level disinfection
High-level Disinfection destroys vegetative bacteria; lipid &
non-lipid viruses, fungi and, depending highly on time of
contact, is effective on bacterial spores. This is required for
endocavity (TV, TR, and TE) probes after contact with mucosal
membrane.
High-level disinfection procedure
Follow the manu- 1. Prepare the germicide solution according to the
facturer's instruc- manufacturer's instructions.
tions for storage,
use and disposal of
the disinfection so-
lution.
Use only germicides that are listed in the Probe Care Card
enclosed with the probe. In addition, refer to the local / national
WARNING regulations.
Do not steam autoclave or subject the probe to Ethylene Oxide
(ETO).
2. Place the cleaned dried probe in contact with the germicide

for the time duration specified by the manufacturer.
Do not immerse the probe in liquid beyond the level specified for
that probe (see Figure 11-5).
WARNING
Never immerse the probe connector or probe adapters in liquid.
The probe should not be exposed to the germicide longer than
specified to achieve the desired effect.
DO NOT soak or saturate probes with solutions containing
alcohol, bleach, ammonium chloride compounds. In addition TE
probes must not be immersed in solutions containing hydrogen
peroxide.
3. Rinse the part of the probe which was in contact with the
germicide according to the germicide manufacturer's
instructions.
4. Wipe dry with a soft towel or air dry the probe.
CREUTZFELD-JACOB DISEASE
WARNING
Neurological use on patients with this disease must be avoided.
If a probe becomes contaminated, there is no adequate
disinfecting means.

R2424458-100 Rev. 2
Probes
1. Fluid level
2. Contact face with patient environment
Figure 11-5: Probe immersion levels
Table 11-1: Description of Pictogram on Care card
Pictogram Description
"ATTENTION - Consult accompanying

documents" is intended to alert the user to refer
to the operator manual or other instructions
when complete information cannot be provided
on the label.
"CAUTION - Dangerous voltage" (the lightning

flash with arrowhead) is used to indicate electric
shock hazards.
Biohazard - Patient/user infection due to

contaminated equipment. Usage:
• Cleaning and care instructions
• Sheath and glove guidelines

R2424458-100 Rev. 2
Probes
Table 11-1: Description of Pictogram on Care card
Pictogram Description
Ultrasound probes are highly sensitive medical

instruments that can easily be damaged by
improper handling. Use care when handling
and protect from damage when not in use.
Do not immerse the probe into any liquid

beyond the level specified for that probe. Refer
to the user manual of the ultrasound system.
Since there is a possibility of having negative

effects on the probe, observe the specified
immersing time by the germicide manufacturer
strictly. Do not immerse the probe in liquid
chemical germicides more than the time
prescribed in the care card.
In order for liquid chemical germicides to be effective, all visible

residue must be removed during the cleaning process.
CAUTION Thoroughly clean the probe, as described earlier before
attempting disinfection.
You MUST disconnect the probe from the Vivid S5/Vivid S6 prior
to cleaning/disinfecting the probe. Failure to do so could damage
the system.
DO NOT soak probes in liquid chemical germicide for longer than
is stated by the germicide instructions for use. Extended soaking
may cause probe damage and early failure of the enclosure,
resulting in possible electric shock hazard.
1. Prepare the germicide solution according to the
manufacturer's instructions. Be sure to follow all
precautions for storage, use and disposal.
2. Place the cleaned and dried probe in contact with the
germicide for the time specified by the germicide
manufacturer. High-level disinfection is recommended for
surface probes and is required for endocavitary and
intraoperative probes (follow the germicide manufacturer's
recommended time).

R2424458-100 Rev. 2
Probes
Probes for neuro surgical intra-operative use must NOT be

sterilized with liquid chemical sterilants because of the
CAUTION possibility of neuro toxic residues remaining on the probe.
Neurological procedures must be done with the use of legally
marketed, sterile, pyrogen free probe sheaths.
3. After removing from the germicide, rinse the probe
following the germicide manufacturer's rinsing instructions.
Flush all visible germicide residue from the probe and allow
to air dry.
Coupling gels
Do not use gels (lubricants) that are not recommended. They
may damage the probe and void the warranty.
CAUTION
In order to assure optimal transmission of energy between the

patient and probe, a conductive gel or couplant must be applied
liberally to the patient where scanning will be performed.
Do not apply gel to the eyes. If there is gel contact to the eye,
flush eye thoroughly with water.
WARNING
Coupling gels should not contain the following ingredients as

they are known to cause probe damage:
• Methanol, ethanol, isopropanol, or any other alcohol-based
product
• Mineral oil
• Iodine
• Lotions
• Lanolin
• Aloe Vera
• Olive Oil
• Methyl or Ethyl Parabens (para hydroxybenzoic acid)
• Dimethylsilicone
Returning/shipping probes and repair parts

US Department of Transportation and GE Medical Systems
policy requires that equipment returned for service MUST be
clean and free of blood and other infectious substances.

R2424458-100 Rev. 2
Probes
When you return a probe or part for service (Field Engineer or

customer), you need to clean and disinfect the probe or part
prior to packing and shipping the equipment.
Ensure that you follow probe cleaning and disinfection
instructions provided in the Basic User Manual.
This ensures that employees in the transportation industry as
well as the people who receive the package are protected from
any risk.
Probe safety
Ultrasound probes are highly sensitive medical instruments that
can easily be damaged by improper handling. Use care when
WARNING handling and protect from damage when not in use. DO NOT use
a damaged or defective probe. Failure to follow these
precautions can result in serious injury and equipment damage.
For a detailed description of the safety guidelines see "Probe
Safety" on page 32.

R2424458-100 Rev. 2
Probes
Biopsy
The Vivid S5/Vivid S6 supports biopsy capability for the 3S-RS,
M4S-RS (Vivid S6 only), 4C-RS, 8L-RS, 9L-RS, 12L-RS, and
e8C-RS probes. The biopsy option is intended for use by a duly
licensed physician who has received the appropriate training in
biopsy techniques as dictated by current relevant practices, as
well as in proper operation of the Vivid S5/Vivid S6 ultrasound
unit.
Precaution concerning the use of

biopsy procedures
Do not freeze the image during a biopsy procedure. The image
must be live to avoid a positioning error.
WARNING
Biopsy guidezones are intended to assist the user in determining

optimal probe placement and approximate the needle path.
CAUTION However, actual needle movement is likely to deviate from the
guideline. Always monitor the relative positions of the biopsy
needle and the subject mass during the procedure.
The use of biopsy devices and accessories that have not been
evaluated for use with the equipment may not be compatible and
CAUTION could result in injury.

R2424458-100 Rev. 2
Probes
The invasive nature of biopsy procedures requires proper

preparation and technique to control infection and disease
CAUTION transmission. Equipment must be cleaned as appropriate for the
procedure prior to use.
• Follow the probe cleaning and disinfection procedures and
precautions to properly prepare the probe.
• Follow the manufacturer’s instructions for the cleaning of biopsy
devices and accessories.
• Use protective barriers such as gloves and probe sheaths.
• After use, follow proper procedures for decontamination, cleaning,
and waste disposal.
Improper cleaning methods and the use of certain cleaning and
disinfecting agents can cause damage to the plastic components
that will degrade imaging performance or increase the risk of
electric shock.

R2424458-100 Rev. 2
Probes
Preparing the Biopsy guide attachment

The 3S-RS, 4C-RS, 8L-RS, 9L-RS, and 12L-RS probes have
an optional biopsy kit specific for each probe. The biopsy kit
consists of:
• One reusable non-sterile bracket
• Five disposable, single-use sterile Ultra-Pro IITM Needle
guide kits (Civco Medical Instruments Co, Inc.) consisting
of:
• Two sets with needle inserts covering gauge
size 14 through 23 (2.1 mm to 0.6 mm)
• One sterile sheath
• Two rubber bands
• Sterile gel
• One reusable needle guide
• Instructions
In addition sterile Ultra-Pro IITM Needle guide kits can be
ordered as replacement kit.
Introduction to CIVCO's Needle Guidance

Systems
CIVCO's Needle Guidance Systems utilize a two-part system
consisting of a reusable biopsy bracket and a disposable
snap-on needle guide. The disposable needle guides snap
onto the biopsy bracket, providing a fixed path for visualizing
ultrasound-guided instrument placement procedures.
Applications include tissue biopsy, fluid aspirations and
catheter placement. Single-angle brackets offer imaging
professionals a fixed angle needle path during puncture
procedures. Multi-angle brackets offer professionals different
angles for needle placement. Once the desired angle has been
selected, a stainless steel pin locks the angle securely into
position. The pin is removable from the bracket for easy
reprocessing between patients. Brackets should be cleaned
and disinfected according to your CIVCO User's Guide.
The Ultra-Pro II™ allows for accurate placement for
ultrasound-guided biopsy and drainage procedures. The
needle guide directs instruments according to on-screen
system software guidelines. The Ultra-Pro II features a

R2424458-100 Rev. 2
Probes
mechanism for quick-release detachment of the needle guide

from the transducer while maintaining secure needle
placement. The Ultra-Pro II includes disposable needle inserts
for 14 to 23 gauge instruments. 8.5 French gauge inserts also
available. Replacement kits include sterile needle guide,
transducer cover, gel packet and colored elastic bands. Biopsy
depth is indicated in centimeters.
Read the following instructions and the user's guide for the
Ultra-Pro IITM Needle Guide kit before using the biopsy
WARNING equipment.
Bracket attachment procedure

1. Identify the appropriate biopsy guide bracket as shown in
Figure 11-6.

R2424458-100 Rev. 2
Probes
Probe Bracket Probe with Bracket
3S-RS
4C-RS
8L-RS
9L-RS
12L-RS
E8c-RS
Figure 11-6: Biopsy Guide Brackets

R2424458-100 Rev. 2
Probes
2. Orient the bracket so that the needle clip attachment is on

the same side as the probe orientation mark (notch or LED),
see Figure 11-7.
1. Needle clip attachment on the bracket

2. Bracket label
3. Probe label
4. Probe orientation mark (notch or LED)
5. Lever lock
Figure 11-7: Probe/bracket alignment
3. Attach the biopsy bracket to the probe by sliding the bracket

over the end of the probe until it clicks or lock into place.
Make sure the bracket is firmly attached to the probe.
4. 3S probe: tighten the biopsy bracket to the probe by locking
the lever lock.

R2424458-100 Rev. 2
Probes
Placing the probe and bracket into the sterile

sheath
Refer to the Ultra-Pro IITM Needle Guide user manual.
Attaching the needle guide to the bracket

Refer to the Ultra-Pro IITM Needle Guide user manual.
Displaying the Guide zone

1. Select the desired probe with biopsy support.
2. Press BIOPSY on the alphanumeric keyboard.
3. If the needle multi-angle is supported, select the correct
angle from the Biopsy menu.
Figure 11-8: The Biopsy menu
The biopsy guide zone is displayed on the screen.

The biopsy guidezone represents a path of the needle. The
dots which make up the guidezones is the depth readout
where:
• Yellow represent 1 cm increments.
• Red represents 5 cm increments.
The display should be carefully monitored during a biopsy for
any needle deviation from the center line or guidezone.

R2424458-100 Rev. 2
Probes
1. Biopsy guide zone The first red mark is at 5 cm from the top of the needle
• 5 cm between the red marks guide.
• 1 cm between the large yellow marks
• 0.5 cm between two consecutive marks
Figure 11-9: Biopsy guide zone
The needle may vary from the center line or guidezone for
various reasons:
• Needle barrel to needle clearance or strength
• Bracket manufacturing tolerance
• Needle deflection due to tissue resistance
• Needle size chosen. Thinner needles may deflect more.
Failure to match the guidezone displayed to the guide may cause

the needle to track a path outside the zone.
DANGER
It is extremely important that when using the adjustable angle
biopsy guides, the angle displayed on the screen matches the
angle set on the guide, otherwise the needle will not follow the
displayed guidezone which could result in repeated biopsies or
patient injury.

R2424458-100 Rev. 2
Probes
Endocavitary Probe Biopsy Guide

Assembly
Note: The reusable biopsy guide fits with 16G needle or
thinner.
E8C Preparation
To prepare the E8C for use:
1. Remove the probe from the box and carefully examine it for
any damage.
2. If the biopsy guide is to be attached, use the filling removal
tool to clean out the attachment area on the probe head.
a. Probe Head
b. Attachement
c. Filling Removal Tool
Figure 11-10: Attachment Filling Removal
3. Clean, then disinfect the probe.

Note: Ensure that protective gloves are worn.
Installing the sheath

To install the sheath:
1. Remove the sheath from its package. Do not unroll the
sheath.
Note: Remember to rinse all sanitary probe sheaths of
powder before placing on the probe. Powder can degrade
the displayed image.
2. Place an adequate amount of ultrasound gel inside the
sheath tip (the gel is between the sheath inner surface and
the probe aperture).
Note: Ensure that only acoustic coupling gel is used for
this purpose.

R2424458-100 Rev. 2
Probes
3. Place the sheath tip over the probe aperture and then pull
the sheath end toward the probe handle.
4. Inspect the sheath for nicks, cuts or tears.
a. Probe Handle
b. Sanitary Sheath
c. Probe Body
Figure 11-11: E8C Probe with Sheath
5. Rub a finger over the tip of the probe to ensure all air
bubbles have been removed.
E8C Biopsy Guide Preparation

1. If a biopsy is to be performed, snap the plastic biopsy guide
on to the probe over the sheath.
Patient injury or repeated biopsies may result. The needle
placement will not be as intended if the needle guide is not
CAUTION properly seated and secure.
Figure 11-12: Civco Disposable Biopsy Guide (approx. 5° Angle)
2. Place an adequate amount of ultrasound gel on the

gel-filled sheath tip's outer surface.

R2424458-100 Rev. 2
Probes
3. Ensure the guide is properly seated and secure by pushing

forward on the needle insertion end of the guide until the
attachment node is firmly in place in its hole.
Biopsy needle path verification

Perform the Needle path verification once a year or whenever
there is a suspicion of malfunction.
To verify that the path of the needle is accurately indicated
within the guide zone on the system monitor, perform the
following:
1. Properly install the bracket and biopsy guide (see
page 566).
2. Scan in a container filled with a glycerol solution (6% in
water).
3. Display the biopsy guide zone on the monitor (see
page 569).
4. Ensure that the needle echo falls within the guide zone
markers.
Starting the biopsy procedure

1. Press BIOPSY.
Enabling color flow 2. Place sterile coupling gel on the scanning surface of the
would allow for vi- probe/sheath.
sualization of the
vascular structure 3. Perform the biopsy.
around the area to
be biopsied. Cleaning, disinfection and disposal
1. Refer to the Ultra-Pro IITM Needle Guide user manual for
cleaning and disinfection of the bracket.
2. Perform cleaning and disinfection of the probe as described
in page 556.
3. Dispose the sheath, bands and needle guide after use,
according to medical regulations for biohazardious waste.

R2424458-100 Rev. 2
Probes
Surgery/Intra-operative Use
Preparing for Surgery/Intra-operative
Procedures
Preparing the transducer for intra-operative use follows the
same sterile procedure as for biopsy use except that no biopsy
attachments are used. See "Preparing the Biopsy guide
attachment" on page 565 for more information.
Sterile gel is applied to the transducer face and a sterile sheath
completely covers the transducer and cable which has first
undergone a thorough cleaning and high-level disinfection.
The invasive nature of biopsy procedures requires proper
preparation and technique to control infection and disease
transmission. Equipment must be cleaned as appropriate for
the procedure prior to use.
For surgery/intra-operative procedures, a sterile environment is
required. Therefore, both the operator and probe needs to be
CAUTION sterile.
To ensure a sterile environment during the procedure, it is

recommended that this be a two-person job.
Follow your insti- 1. Perform a high level disinfection of the probe.
tutions guidelines
2. The scanner (surgeon, sonographer, etc.) should be sterile
on post surgery/in-
traoperative proce- and gloved.
dures for probe 3. Place an adequate amount of sterile coupling gel on the
cleaning and disin- face of the probe.
fection.
4. Place the proper sterile sheath over the probe and cord.
5. Depending on the type of procedure, use either sterile
water or sterile gel on the sheath cover.
Figure 11-13: Applying Sterile Sheath

R2424458-100 Rev. 2
Peripherals
Chapter 12
Peripherals
• Introduction ................................................................................... .. 576

• Printing .......................................................................................... .. 577
• To print an image ..................................................................... 577
• Specifications for peripherals ..................................................... .. 577
• DVR (Digital Video Recorder) ...................................................... .. 578
• Overview .................................................................................. 578
• Using the DVR ......................................................................... 578
• Configuring the DVR ................................................................ 581
• Reviewing the DVR Media Externally ...................................... 581

R2424458-100 Rev. 2
Peripherals
Introduction
This chapter provides information on peripherals that can
operate with the Vivid S5/Vivid S6 ultrasound unit, as follows:
• Color Thermal Video Printer
• Black & White Thermal Video Printer
• Integrated Digital video Recorder (DVR)
Use only GE Medical Systems approved internal equipment

when replacing an internal peripheral.
CAUTION
External peripheral equipment must be CE marked and in
compliance with related standards (EN 60601-1 or EN 60950).
Conformance to EN 60601-1-1 (2000) must be verified.
All devices meeting IEC60950 must be kept outside of the patient
environment, as defined in IEC60601-1-1 (2000), unless it,
according to IEC60601-1-1 (2000), is equipped with additional
protective earth or extra isolating transformer. Commercial
devices such as laser cameras, printers, VCRs and external
monitors, usually exceed allowable leakage current limits and,
when plugged into separate AC outlets, are in violation of patient
safety standards. Suitable electrical isolation of such external
AC outlets, or providing the device with extra protective earth,
will be required in order to meet UL2601-1 and IEC60601-1
standards for electrical leakage.
When using peripheral device, observe all warnings and

cautions given in peripheral operator manuals.
WARNING

R2424458-100 Rev. 2
Peripherals
Printing
The Vivid S5/Vivid S6 ultrasound unit can support a color and a
black & white thermal video printer. The printer devices are
controlled from the PRINT key on the control panel.
The PRINT key can also be configured to perform alternative
storage (i.e. storage to DICOM media or secondary capture).
See page 623 for configuration of the PRINT key.
To print an image
For details on the • Press PRINT on the Control panel.
Thermal video
The image displayed on the screen is printed on B&W or
printers operation,
consult the manu- Color printer, depending on the key assignment
facturer operator configuration (see page 623).
manual provided
with the printer.
Specifications for peripherals

Please refer to the documentation accompanying the
peripherals.

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Peripherals
DVR (Digital Video Recorder)

Overview
The DVR drive is located on the lower left side of the system. A
single drive is used for either DVD Archiving or DVR recording.
The DVR is operated from the control panel. The DVR status
displayed on the screen indicates the current DVR function, as
detailed in Figure 12-1.
1. DVD time counter 6. Pause (red while recording)

2. Title number 7. Fast Forward
3. Recording - blinking red 8. Rewind
4. Stop 9. Eject
5. Play 10. Search
Figure 12-1: The DVR status area on the Title bar
Using the DVR

Inserting the DVR media
Insert a media type DVD+RW into the drive.
1. If the media is empty, the system will take time to identify
the media, and within about 50 seconds will prompt the user
to enter a media-label, or approve the automatically
generated label.
2. About 20 seconds after entering the media label, the DVR
status icon will display a "Stop" icon, and is now ready for
recording the first chapter.

R2424458-100 Rev. 2
Peripherals
3. If the media contains some previously recorded material it

will ask the user whether recording or playback is
requested.
Note: When inserting a DVD-R or DVD+R type media, the
system will accept this as an archiving-type media and will not
allow using it for DVR recording.
Recording Titles and Chapters

Titles
The DVR media is divided into titles and chapters. There may
be up to 8 titles on each media.
A new uniquely named title is created for each recording
session or whenever a new patient is entered.
Chapters
Each title contains several chapters. There may be up to 99
chapters within each title. Every continuous recording segment
generates a chapter. Whenever recording is paused, the
current chapter is closed and when recording is continued a
new chapter begins.
Recording Time
The total recording time which is the sum of all chapters on all
titles may be as long as 70 minutes on one DVR media.
Recording
1. When DVR media is inserted and the "Stop" icon appears,
the media is ready for recording.
2. Press the Record button once. The blinking red indicator
indicates that recording has begun. The data recorded is
stored directly onto the DVR media.
3. To stop recording press Record button once again. The
recording will stop and a red "Pause" indicator will appear.
4. Press the Record button to toggle between pause and
record.
Note: When recording is resumed after pause a new chapter is
created.

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Peripherals
DVR playback on the system

1. In order to play-back any of the recordings on the current
DVR media, simply press the Playback button (F12).
2. Within about 1 minute for the media to load. The recording
of the first title will soon start to play.
3. While in Playback mode the softmenu will contain different
dedicated playback controls.
Note: Upon changing from recording to playback mode, the
system will close the current title. Any further recording will be
made on a new title.
DVR playback controls

• Chapter select rotary - Rotate the rotary to display a list of
all titles on the current media. Highlight the required title
and press rotary to select and play the desired title.
• Title select rotary - Rotate the rotary to advance to any
desired chapter. The selected chapter will begin to play as
soon as the rotary is held still.
• Play/Pause button - Press this button to toggle between
Play & Pause.
• Next /Previous Title / Chapter - Four buttons allowing to
skip chapter or title
• Cineloop - Press this button to capture the last few
seconds of playback into frame-memory and run them in
cineloop mode.
• Left & Right markers - Allows you to trim the cineloop
borders.
• Frame rotary - When cine is stopped, allows you to view the
recording frame by frame.
• Speed rotary - When cine is running, allows you to modify
the cine review speed.
• Freeze button - When playback is running, press Freeze to
stop playback. Once stopped, use the trackball to review
the last few seconds captured in the frame-memory.
• 2D Freeze button - When the Freeze button has been
pressed, use the "2D Freeze" button to run or stop looping
the last few seconds of captured playback frames.

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Peripherals
Ejecting the DVR

Press the Eject button at any time during recording or
playback. The media will eject after a short delay.
Configuring the DVR

Press Config and select the DVR configuration tab.
• PAL / NTSC
• WIDE / Narrow
Reviewing the DVR Media Externally

DVR playback on an external DVD player
You may use any good-quality commercially available DVD
player to playback the DVD. Select the desired title and then
select the desired chapter from the displayed list.
DVR playback on a separate PC

The DVR media can be played back on any PC containing the
following components:
• Windows XP OS or higher
• Installed with any commercially-available DVD player
software
• Configured with a high quality display
Be sure to adjust your screen to display the full range of
gray-levels. It may assist to record and playback a screen
test-pattern.
To generate a test pattern, use the Test pattern button available
on the LCD adjustment Soft menu Controls (see page 90).

R2424458-100 Rev. 2
Peripherals

R2424458-100 Rev. 2
Chapter 13
• Introduction ................................................................................... .. 585

• Starting the Configuration package ............................................ .. 588
• To open the Configuration package ......................................... 588
• Overview ........................................................................................ .. 589
• Imaging .......................................................................................... .. 590
• The Global setup sheet ............................................................ 590
• Application ................................................................................ 593
• Application menu ...................................................................... 596
• Measure Text ................................................................................. .. 598
• The measurement menu sheet ................................................ 598
• Configuration of the Measurement menu ................................. 601
• The Advanced sheet ..................................................................... .. 603
• Parameter configuration ........................................................... 603
• The Modify Calculations sheet .................................................... .. 604
• Parameter configuration ........................................................... 604
• The OB table sheet .................................................................. 605
• Report ............................................................................................ .. 611
• The diagnostic codes sheet ..................................................... 612
• The Comment texts sheet ........................................................ 613
• Connectivity .................................................................................. .. 616
• Dataflow ................................................................................... 616
• Additional outputs ..................................................................... 623
• Tools ........................................................................................ 625
• Formats .................................................................................... 626
• TCP-IP ..................................................................................... 632
• System ........................................................................................... .. 633
• The system settings ................................................................. 633

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• About ............................................................................................. ... 635

• Administration .............................................................................. ... 636
• Users ........................................................................................ 637
• Unlock Patient ...........................................................................640

R2424458-100 Rev. 2
Introduction
This chapter describes the configuration management package
of the Vivid S5/Vivid S6 ultrasound unit. The Vivid S5/Vivid S6
configuration package enables users to customize the global
configuration for the unit and the application-specific settings.
In addition, users with administration rights have access to the
local archive backup function, local archive restore function and
creation of users.
Note: the default factory password for the "ADM" user is
ulsadm (case sensitive).
The configuration management package consists of a Setup
dialogue window divided in different setup categories with
sublevels.
The table below summarizes the contents and access rights of
the different categories and sublevels of the Vivid S5/Vivid S6
configuration package:
Category and sublevel Description access Refer to
Imaging page 590
• Global Sets the cineloop controls and All

display.
Sets the patient information
display.
Sets the scan information
displayed on the video record.
• Application Configures the probe and All

application specific settings.
• Application menu Configures the Application All

menu.
Measure / Text page 598

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• Measurement menu Configures the Measurement All

• Advanced menu by selecting and defining
• Modify calculations the sequence of the
measurements and calculation
to perform.
Creates user-defined
measurements
Configures vascular Doppler
calculations to be performed.
• Annotation Configures the Annotation menu All

• Customize and create pre-defined
annotation.
Report page 611
• Templates • Configures the Report All

templates menu by selecting
and ordering the templates to
show in the menu.
• Diagnostic codes Create or delete pre-defined text All

input for the referral reasons and
diagnosis.
• Comment texts Create or delete pre-defined text All

input for the comments.
• Structured findings Enables the insertion of All page 498

pre-configured structured
diagnosis statements in the
patient report.
Connectivity page 616
• Dataflow Create new dataflows or Admin

configure existing dataflows.
• Additional outputs Configure the PRINT key. All
• Tools Formats removable media. All
• Formats Configures the Examination list All

window display and other
options related to the patient
management.

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• TCP-IP Sets the Transmission Admin

Protocol/Internet Protocol.
System page 633
• Settings Sets the date and time format, Admin

language and units.
• Test Enables testing of the different Admin

parts of the unit.
About Displays information about the All page 635

software, hardware and probes.
Administration page 636
• Disk management Enables the management of the All page 464

hard disk space while
maintaining the patient database
on the system.
• Backup Local archive and system Admin

configuration backup.
• Restore Restore local archive and Admin

system configuration from a
backup.
• Users Operator and referring staff Admin

registration, operator's rights
settings.
• System administration Keeps track of all the options Admin

implemented in the unit.
• Unlock patient Unlock patient records that were Admin

not properly finished.
Service This sheet is for service staff Admin

only. Deals with printer definition
and keyboard configuration.

R2424458-100 Rev. 2
Starting the Configuration package

To access the Configuration package the user has to log on as
a specific user (see page 637). This ensures user-specific and
user-defined settings and presets to be used.
The access to the entire configuration package is user
configuration dependent (see page 637).
To open the Configuration package

1. Press CONFIG on the alphanumeric keyboard.
The Log In window is displayed asking for operator ID and
password (see Figure 13-1).
2. Select Log on when completed.
The Setup dialogue window is displayed (see Figure 13-2).

2. Type password

R2424458-100 Rev. 2
Overview
The configuration management package consists of a Setup
dialogue window divided in different setup categories with
sublevels (sheets labelled with tab).
The functionality of each configuration category and associated
sublevels are described on the following pages.
Note: Whenever making any modifications of settings through
the different configuration screens and tabs, it is always
required to re-boot the system for the modifications to become
valid.
1. Sublevel tabs for the selected Setup

category.
2. Setup categories
3. Selected Setup category
Figure 13-2: The Setup dialogue window structure

R2424458-100 Rev. 2
Imaging
• Global: enables the user to configure display-related
settings.
• Application: enables configuration of the probe and
application specific settings.
• Application menu: enables configuration of the
Measurement menu.
The Global setup sheet
Figure 13-3: The Global setup sheet
Flex Button configuration

The Flex button can be configured to function as any button on
the keyboard with the exception of alphanumeric and
soft-menu sections.

R2424458-100 Rev. 2
Configuring the Flex button

Click the combo-box menu and select one of the functions on
the list. The selected function will be assigned to the Flex
button.
Configuring the Flex button while in the Global tab will assign
the selected function independent of any probe or application
selection.
Configuring the Flex button while in the Application tab will
assign the selected function only for the selected preset
application.
Cineloop store
Cineloop store:
• Time before/after heart cycle: sets the total
storage time span of the cineloop in ECG
mode.
• Time span (no ECG): sets the total storage
time span of the cineloop with no ECG.
• Preview loop before store: when selected
enable review of cineloops before storage.
Crop images
Crop images:
: In the Analysis screen, removes top and
bottom of the image when more than two
images have been selected.
Doppler
Doppler:
• Show KHz scale: when selected, displays
the KHz scale on the left side of the Doppler
spectrum (see page 164).

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Patient Info
Patient Info:
• Title bar Line 1 & 2: selects from the
pop-up menu the patient information
to display on the scanning screen's
Title bar (see page 98).
• Anonymous patient: when checked,
no patient information is displayed on
the scanning screen's Title bar.
Scan Info
Scan Info:
• selects scan information on the video
record.

R2424458-100 Rev. 2
Application
The Application category enables the configuration of
probe/application specific settings (presets). The
application-specific settings can be stored and used as default
presets with this probe.
Figure 13-4: The Application setup sheet (example)

R2424458-100 Rev. 2
The Probe/application configuration

parameters
Image Store settings:

• Single frame (live store):
: Store cineloop.
: Store single frame image only.
• Number of heart cycles:
Select the number of heart cycles to
store (Single frame must be
unchecked).
Auto freeze:
• Freeze 2D image in Doppler: the last
2D or color flow image is displayed
when entering in Doppler mode.
• Auto freeze after: sets the time after
which the system enters in freeze when
not in use.
Templates and Packages:

Defines the default stress protocol
associated to the application.
Select the default Protocol to be
associated to the selected application
from the pop-up menu.
M&A Category/Study:
Selects particular M&A categories to be
associated with a specific probe and
preset.
Auto invert on steer:

In Color flow, the color bar is inverted
when steering the color flow sector angle.

R2424458-100 Rev. 2
Create new application:

Press New to create a new Application. A
dialogue window is displayed where the
operator is asked to give a name to the
new application.
Remove current application:
Press Delete to remove the current
application. Factory Application settings
cannot be deleted.
Save image/appl. settings
Press Save to store the changes applied
to the current setting. Not applicable on
factory application settings.
Creating a new Application

The application created is probe dependant. Select the desired
probe before configuring a new application.
1. Press APPLICATION on the Control panel.
2. Highlight the probe and press SET.
3. Trackball to Presets...
A pop-up window Enter new name: appears.
4. Enter a name for the new application.
5. Press Save.
To edit an application
1. Press APPLICATION, select the probe, and select the
application to edit.
2. Adjust the imaging parameters as desired.
3. Press APPLICATION.
4. Highlight the probe and press SET.
5. Trackball to Presets...
A pop-up window Enter new name: appears, displaying the
current preset name.
6. Press Save to store the changes.
Applicable only on user-defined applications.

R2424458-100 Rev. 2
Application menu
The Application menu category enables rearrangement of the
the Application menu to best suit the user's requirements.
The Application menu is a two-levels pop-up menu. The first
level called Application, displays the most frequently used
applications in any desired order. The second level called
More... displays the less frequently used applications.
1. First menu level 3. Moving tools

2. Second menu level
Figure 13-5: The Application menu setup sheet (example)
Configuration of the Application menu

The Application menu can be configured by moving the
applications up and down inside the pop-up menu and from
one level to the other.
To move an application inside one level
1. Trackball to the application to move.

R2424458-100 Rev. 2
2. Press SET.
3. Press .
The application is moved one step up.
Press Default to 4. Press .
get factory setting. The application is moved one step down.
To move an application from one level to the other
1. Trackball to the application to move.
2. Press SET.
3. Press as many times as necessary:
• if the application to move is in the More menu
• if the application to move is in the Applications menu
till the application has moved to the other menu.
To delete an application
1. Trackball to the application to delete.
2. Press SET.
3. Press Delete.
Applicable only to user-defined applications.

R2424458-100 Rev. 2
Measure Text
The Measure/Text category deals with the following:
• Configuration of the Measurement menu (see page 601)
• Creation of user-defined measurements (see page 343)
• Configuration of Measurement tools (see page 603)
• Configuration of the vascular Doppler calculation (see
page 604)
• Configuration of the Annotation function (see page 132)
The measurement menu sheet

The Measurement sheet enables the organization of the
Factory default Measurement menu and the creation of
user-defined Measurements.
1. Configuration window (see next pages for 2. The measurement menu (displays updated
details) configuration)
Figure 13-6: The Measurement menu setup sheet

R2424458-100 Rev. 2
Add measurement:
Create or select from the pop-up list a
measurement to be added to a folder (see
page 339).
Add folder:
Enables the user to create its own folder
with the desired measurements. The
folder is displayed the Measurement
menu.
M&A Categories:
Enables selection of the measurement
categories to display in the Measurement
menu. Only checked items will be
displayed.
• Create Copy: Enables copy of a
selected measurement category
(selection is done by selecting the
category name).
• Delete: enables deletion of user-defined
measurement categories.
• Factory Default: restores factory
display.
2D, MM and Dop. radio buttons:

Enables the display of mode related
Measurement menu in the configuration
window.
Configuration tools:
Deletes selected entry (folder or
measurement) in the Measurement
menu. The factory entries cannot be
deleted.
Moves selected measurement or
folder up or down inside the
Measurement menu.

R2424458-100 Rev. 2
Folder:
Displayed when a folder is selected in the
Measurement Menu.
Shows the entire contents of a selected
folder.
• : the items is displayed in the
Measurement menu.
• : The item is hidden from the
Measurement menu.
Measurement:
Displayed when a measurement is
selected in the Measurement Menu.
Shows all the parameters related to the
• : the items is displayed in the
Measurement menu.
• : The item is hidden from the
Measurement menu.
Only checked parameters will be
displayed in the Measurement result
window, the worksheet and the report.
Auto sequence:
: Prompts the next measurement in the
folder.

R2424458-100 Rev. 2
Configuration of the Measurement

menu
There are many more measurements and parameters in the
measurement package than shown in the default Measurement
menu. Use the configuration system to set up the
measurements that should be available in the Measurement
menu and which parameters should be calculated (see also
"Measurement package configuration" on page 338).
Display of the Measurement categories

1. Press M&A categories in the Configuration window.
The M&A categories are displayed in a pop-up window
(see page 599).
2. Check the categories to be displayed.
Uncheck the categories to hide.
To copy a Measurement category

1. Press M&A categories in the Configuration window.
The M&A categories are displayed in a pop-up window
(see page 599).
2. Move the trackball marker over the M&A category name.
3. Press SET to highlight the category.
4. Press Create copy.
A copy of the selected measurement category is displayed
in the Measurement menu.
Factory Measure- To rename the Measurement category:
ment categories 1. Select the Measurement category in the Measurement
cannot be renamed. menu.
2. Enter a new name in the Measurement field.
Selection of a Measurement category

1. Trackball to the Measurement menu heading.
2. Press SET.
The measurement categories are displayed in a
sub-menu.
3. Trackball to the measurement category of interest.
4. Press SET.
The measurement category is displayed.

R2424458-100 Rev. 2
Moving an item in the Measurement menu

1. Trackball to the entry to move into the Measurement menu.
2. Press SET.
3. Press or to move the selection up or down inside the

Measurement menu.
Deleting an item in the Measurement menu

Only user created 1. Trackball to the entry to delete in the Measurement menu.
items can be delet-
2. Press SET.
ed.
3. Press to delete the item.
Display/hide a folder or a measurement in the

Measurement menu
The Measurement menu (Folders and Measurements) can be
configured to display only the entries (folders and
measurements) of interest.
To hide a folder or a measurement:
• Uncheck the actual folder or measurement in the Folder or
Measurement field in the Configuration window.
To display a hidden folder or measurement:
• Check the actual folder or measurement in the Folder or
Measurement field in the Configuration window.
Creating a user-defined folder

1. If the folder is to be inside another folder, select the actual
folder in the Measurement menu.
2. Press Add folder.
The Measurement menu is updated.
3. Select the new folder and Enter the folder name in the
Name text field.
Adding a measurement to a folder

The user can either add a pre-defined measurement or create
a new measurement with user-defined parameters to a folder
(see page 339 for more information).

R2424458-100 Rev. 2
The Advanced sheet

The Advanced sheet enables further configuration of the
Measurement function. The settings are divided into application
specific parameters and global parameters.
Figure 13-7: The Advanced sheet
Parameter configuration
1. If configuring application specific parameters, select an
application from the M&A category pull-down menu.
When pointing at a 2. Select the configuration value next to the parameter to
parameter an expla- configure.
nation label is dis- A pull-down menu is displayed (see Figure 13-7).
played.
3. Select a new value from the pull-down menu.

R2424458-100 Rev. 2
The Modify Calculations sheet

The Modify Calculations sheet is used to configure the
calculations to be performed when doing a Doppler vascular
measurements.
Figure 13-8: The Modify Calculations sheet
Parameter configuration
The following example describes how to configure the Carotid
Doppler calculations:
1. In the Modify Calculations sheet, select Vascular next to
M&A Categories.
The Vascular measurement category is displayed.
2. Select Carotid.
The available calculations are displayed.
3. Check the desired calculations to be performed.
4. Select Save.

R2424458-100 Rev. 2
The OB table sheet

The OB table sheet enables the creation and edition of
user-defined OB tables.
Figure 13-9: The OB table sheet
The following example describes how to create a fetal age

OB-2/3 table based on Bi Parietal Diameter measurements.
1. In the Measure/Text category, select the Measurement
menu sheet.
2. In the Measurement menu sheet, select 2D mode.
3. Select the OB table sheet.
4. In the Measurement menu, select the category Obstetrics
(Measurement menu heading) and the OB-2/3
measurement study.
5. In the OB table sheet, check New table.
6. Enter or select the following:
• OB Table Template: when creating a new OB table,
select Template (1 - 7) which you want to use as the
basis of the user programmable OB Table (see
page 607).

R2424458-100 Rev. 2
When editing an existing user OB table, select the

desired OB table to edit.
• Tool type: Select the type of measurement (e.g.
Distance)
• Measure Name: type the name of measurement that will
display in the Measurement menu (e.g. My BPD
Measure).
• Author Name: Type the author’s name (e.g. My Name).
• Table Type: If necessary, select the table type (e.g.
Fetal Age).
• Measure type: select the desired measurement (e.g.
BPD).
7. Select Edit table.
The OB Table spreadsheet is displayed, showing the table
template selected.
Figure 13-10: The Edit table spreadsheet
8. Enter the Min, Max and Interval values in the Parameters

field.
The system automatically fills in the MEAS column.
9. Enter the input values for the MEAN and SD columns.
10. Select Exit to save.

R2424458-100 Rev. 2
The OB table templates
Template 1 (based on Hadlock)
Fetal age format: MEAS MEAN SD
Unit: mm week week
Table range: 1 SD
Graph range: 1 SD
Measurement Value: [cm]

result
GA: [#w#d]
Min: [#w#d]
Max: [#w#d]
Fetal growth Format: AGE MEAN SD
Unit: week mm week
Others are same as above
Template 2 (based on Tokyo)
Fetal age Format: MEAS MEAN SD
Unit: mm day day
Table range: 1 SD
Graph range: 1 SD

result
GA: [#w#d]
SD: [day (+/-)]
Unit: day mm day

R2424458-100 Rev. 2
Template 3 (based on Osaka)
Unit: mm day mm
Table range: 1 SD
Graph range: 1 SD

result
GA: [#w#d]
SD: [(mv-pv)/sd]
Unit: day mm day
Template 4 (based on several European tables)
Unit: mm weekday mm
Table range: 5%–95%
Graph range: 5%–95%

result
GA: [#w#d]
GP: [%] Calculated by Fetal growth table. If Fetal

growth table is not edited, GP is not calculated.
Unit: weekday mm day

R2424458-100 Rev. 2
Unit: mm weekday mm
Table range: 1 SD

result
GA: [#w#d]

Unit: weekday mm day
Fetal age Format: MEAS MIN MEAN SD
Unit: mm weekday weekday weekday
Table 10%–90%
range:
Graph 10%–90%
range:

result
GA: [#w#d]
GP: [%] Calculated by Fetal growth table. If Fetal growth

table is not edited, GP is not calculated.
Fetal growth Format: AGE MIN MEAN SD
Unit: weekday mm mm mm

R2424458-100 Rev. 2
Unit: mm weekday mm
Table range: 1 SD

result
GA: [#w#d]

Unit: weekday mm mm

R2424458-100 Rev. 2
Report
The Report configuration category is divided in three sheets:
• Templates: enables the configuration of the Template
selection menu and the export/import of user-defined
templates. See "Report templates management" on
page 531 for more information.
• Diagnostic codes: enables the creation of pre-defined text
inputs to be used in the Diagnosis information field in the
Examination list window (see Figure 9-10, page 418).
• Comment texts: enables the creation of pre-defines text
inputs to be used in the Comment information field in the
• Structured findings: enables the insertion of
pre-configured structured diagnosis statements and
Billing/Accreditation codes in the patient report (see
"Structured Findings" on page 498).

R2424458-100 Rev. 2
The diagnostic codes sheet

This sheet enables the creation (and deletion) of text inputs
that can be used when entering diagnostic codes in the
1. List of text inputs 3. Text input display area (free text area)
2. Text input name 4. Create a text input
Figure 13-11: The Diagnostic codes sheet
Creating a diagnostic codes

1. Select New text to create a new diagnostic code (see
Figure 13-11).
2. In the Code field enter a name for the diagnostic code.
3. Trackball to the Text input display area.
4. Press SET.
5. Enter the text.
To add a diagnostic code to an examination refer to "Diagnosis
code" on page 420

R2424458-100 Rev. 2
Deleting a diagnostic code

1. In the Code list field, trackball to the diagnostic code to
delete (see Figure 13-11).
2. Press SET.
3. Trackball to Delete.
4. Press SET.
The Comment texts sheet

This sheet enables the creation (and deletion) of text inputs
that can be used when entering comments in the Examination
list window (see Figure 9-10, page 418) or in the Direct report.
Figure 13-12: The Comment texts sheet
The pre-defined text list is organized in a three level hierarchy.

Selecting one item in the first column displays pre-defined text
entries related to the selected text in the second and third
column.

R2424458-100 Rev. 2
Creating pre-defined text input

First level
1. Select the first level.
2. Press New.
The Enter new text window is displayed.
Figure 13-13: The Enter new text window
3. Enter a title in the Text field.

Enter the pre-defined text in the Full text field.
4. Press OK.
Second and third level
1. Select an item in the first column.
The pre-defined text input to be created in the second and
third column will be related to this selection only.
2. Select the second or third column.
3. Press New.
The Enter new text window is displayed (Figure 13-13).
4. Enter a title in the Text field.
Enter the pre-defined text in the Full text field.
5. Press OK.

R2424458-100 Rev. 2
Editing a pre-defined text input

1. Select the term to edit in one of the columns.
2. Press Edit.
3. The Edit text window is displayed.
Figure 13-14: The Edit text window
4. Edit the text in both the Text and Full text fields.
5. Press OK.
Deleting a pre-defined text input

1. Select the item to delete in one of the columns.
2. Press Delete.
3. A Confirmation window is displayed.
4. Press Yes.
The selected text input is deleted including the belonging
text inputs.

R2424458-100 Rev. 2
Connectivity
This configuration setup category deals with:
• Dataflow: connection and communication setup of the
ultrasound unit with other devices.
• Additional output: configuration of the PRINT and ALT keys
on the control panel.
• Tools: formatting of removable media
• Formats: configuration of the Examination list window and
other tools related to patient management.
• TCPIP: internet protocol configuration
Dataflow
Communication between the Vivid S5/Vivid S6 ultrasound unit
and other information providers on the network takes the form
of dataflows. Each dataflow defines the transfer of patient
information and images from an input source to the unit, and
from the unit to one or several output sources. Input/output
devices cannot be added/removed to/from the pre-defined
dataflows. However the settings for the devices can be
adjusted.
A dataflow is a set of pre-configured settings. Selecting a
dataflow will automatically customize the unit to work according
to the settings associated with this dataflow.
Dataflows are configured in the Dataflow sublevel sheet in the
Connectivity setup category as described below. The Dataflow
sublevel sheet is only available to users with administration
rights.

R2424458-100 Rev. 2
1. Select a dataflow to edit 5. Option for the search function. In the

Factory defined dataflows cannot be edited. Search/Create patient window select between
None, All patients and Today’s patient
2. Use selected dataflow as default
6. Input/output devices assigned to the current
3. Store data directly to archive
dataflow
4. Hide selected dataflow from the list of available
dataflow 7. Adjust the settings for the selected assigned
device
Figure 13-15: The sublevel Dataflow (example)

R2424458-100 Rev. 2
Dataflows available
A set of pre-defined dataflows is available on the unit as listed
in the table below. Input/output devices cannot be
added/removed to/from the pre-defined dataflows. However the
settings for the devices can be adjusted (see page 621).
Dataflow Description
No Archive Enables to perform an examination

without storing the data to the archive.
LocalArchive-Int.HD Local archive internal hard drive

The local database is used for patient
archiving. Images are stored to
internal hard drive. The stored image
files will consist of raw data only,
together with a single-frame DICOM
preview image (no DICOM multi-frame
is stored).
Local Archive - Int The local archive is used for patient

HD/DICOM Server archiving. Images are stored to the
internal hard drive and to a DICOM
server.
Some of the measurements are stored
if DICOM SR is turned on (see
page 447)
RemoteArch-RemoteHD Remote archive remote hard drive

A remote database (either on
EchoPAC workstation or a server) is
used for patient archiving. Images are
stored to a network image volume
(either internal HD on EchoPAC
workstation or a server).
Remote Archive - Remote A remote database is used for patient

HD/DICOM Server archiving. Images are stored to a
network image volume and to a
DICOM server.
page 447)

R2424458-100 Rev. 2
WL-LA-DServ: Worklist/LocalArchive-DI Modality Worklist local archive

the local COMServer/Int.HD DICOM server and local hard drive
database is not Search in the DICOM Modality
searched, only Worklist, the patient found is copied
the DICOM into local database. The patient
Modality information and the examination
Worklist. results are stored to the local the
database. Images are stored to a
DICOM Server and to an image
volume on the local hard drive.
page 447)
Worklist/RemoteArchive- Modality Worklist remote archive

DICOMServer/RemoteHD DICOM server and remote hard drive
Search in the DICOM Modality
Worklist, the patient found is copied
into a remote database. The patient
information and examination results
are stored to a remote database.
Images are stored to a DICOM Server
and to an image network volume as
pure DICOM in both locations.
page 447)
Worklist/Remote Archive This dataflow is used in a network

- Remote Storage environment that includes Vivid HL7
Gateway. The patient list in the
Search/Create Patient window is
coming from Vivid HL7 Gateway
through DICOM Modality Worklist. All
patient data and images are stored to
a server.

R2424458-100 Rev. 2
DICOM MOD Pure DICOM image format to/from a

DICOM Magneto Optical Disk
Read/Write images in “pure” DICOM
format from/to a DICOM formatted
5.25'' MO-disk.
page 447).
DICOM CD/DVD read DICOM CD/DVD read

Read DICOM Media from the
CD/DVD-drive.
Read-only dataflow, no data can be
stored.
DICOM Server DICOM server

Store pure DICOM images to a
DICOM device.
page 447).
DICOM Print DICOM Print

Send images to a DICOM printer.
Query Retrieve Query Retrieve

Retrieve images from a DICOM server
LocalArchive-Int.HD/ The local database is used for patient

eVue archiving. Images are stored to
internal hard drive and a MPEG exam
is created to the configured
destination.
RemoteArch-RemoteHD/ A remote database (either on

eVue EchoPAC workstation or on Image
Vault) is used for patient archiving.
Images are stored to a network image
volume (either internal HD on
EchoPAC workstation or Image Vault
volume) and a MPEG exam is created
to the configured destination.

R2424458-100 Rev. 2
To select the default dataflow

1. Select the dataflow in the Name drop-down menu. (see
Figure 13-15).
2. Check the Default box.
The dataflow will be selected by default when restarting
the unit.
3. Check the Direct Store box to have data stored
automatically to the archive (no buffer storage).
Adjusting the assigned devices

1. Select the device in the Selected devices field.
2. Press Properties.
The Properties window is displayed.
3. Adjust the device specific parameters as desired (see table
below). Not all the settings listed below apply to all devices.
General settings Definition
Name Free text: give a descriptive name for the device.
IP address Select from drop-down menu
Database Name Automatically selected according to the IP address
File destination Automatically selected according to the IP address
Removable Check the entry is the media is removable.
MPPS Modality Perform Procedure Step: send information

(typically to a HIS) that a scheduled exam has been
started, performed or interrupted.
Image settings Definition
Allow raw data : save data in both raw and DICOM format.
: save data in DICOM format only.
Raw Compression Enables compression of raw data images upon storage

and export. Raw compression is active only if the setting
Allow raw data is checked.
Max Framerate Select 25, 30 or Full from the pop-up menu. Full (original
acquisition) is default.
Compression Select compression type or no compression.

R2424458-100 Rev. 2
Image settings Definition
Quality Set picture quality from 1 to 100%. A low picture quality

level allows high data compression, while a high picture
quality restrains the compression.
Allow Multiframe : allow cineloop storage.
Connection settings Definition
Retry Set maximum number of connection tentatives, time

interval between tentatives and time-out.
DICOM settings Definition
AE Title The Application Entity Title is set during DICOM

configuration. Refer to the network specifications.
Port The Port no. is allocated during DICOM configuration.

Refer to your network specifications.
Verification Verify the connection to another DICOM application
Storage commitment Send a request to a PACS, asking it to permanently

archive image(s)
MPPS Modality Perform Procedure Step: send information

(typically to a HIS) that a scheduled exam has been
started, performed or interrupted.

R2424458-100 Rev. 2
Additional outputs
The Additional outputs sheet deals with configuration of the
PRINT and ALT keys on the control panel. Several outputs (e.g.
Video Print, Laser print, DICOM storage etc.) can be
associated to the keys (i.e. hitting PRINT can result in printing a
Color video print and storage to a DICOM media).
1. Select between P1 and P2 keys. 5. Adjust the device settings for the selected
2. Available output devices that can be assigned assigned device
to the current button. 6. Select the type of images to produce and adjust
3. Output devices assigned to the current button. image settings.
4. Add or remove selected device to/from the 7. Printer configuration (see page 577)
current button.
Figure 13-16: The sublevel Additional outputs (example)

R2424458-100 Rev. 2
P1/P2 Print key configuration

1. In Button field select Print P1 or P2.
2. Select an output device in the available outputs field and
press the Right arrow button to assign the service to the
dataflow. The Properties window is displayed
3. Adjust the device specific parameters and select OK.
Some of the settings can be changed directly in the Image
to Produce field in the sublevel Additional outputs.
4. Adjust the image specific parameters (see the table below).
Configuration parameter
Format Select between:

• Raw DICOM
• DICOM
Image compression Select compression mode from the pop-up menu.
Quality When JPEG compression is selected, adjust the picture

quality between 1 and 100%. A low picture quality level
allows high data compression, while a high picture quality
restrains the compression.
Image frames Select between:

• Single: stores single frame only
• Multiple: stores cineloop
• Secondary Capture: screen shot
Capture Area Select between:

• Video Area (1)
• Whole Screen (2)
To remove a device, select the device in the Selected devices

field and press the Left arrow button.

R2424458-100 Rev. 2
Tools
The Tools sublevel sheet deals with:
• formatting of removable media (MO disk, CD-R, DVD-R).
• Creation or re-creation of a DICOM directory on a
removable media containing DICOM images.
• Enter a remote path of a network shared folder
(\\server-name\share-name) for:
• Export traces function in Q-Analysis
• Export of system error log file
• Save as function for images
Figure 13-17: The sublevel Tools
Remote path setting

The user can define a default remote path for a network shared
folder (\\server-name\share-name). The remote path can then
be selected as a destination archive for the following
operations:
• Export traces function in Q-Analysis
• Export of system error log file

R2424458-100 Rev. 2
• Export of report templates

• Save as function for images
• Save as function for reports
To define a remote path
1. Press Utility/Config on the Touch panel and log on as
administrator if required.
2. Select the Connectivity category and Tools subgroup. The
Tool sheet is displayed.
3. Enter a remote path of a shared folder on the network.
To check the connection, press Check.
Creation of a DICOM directory

1. Insert the media in the drive.
2. Select Repair DICOM DIR.
Wait for the display of the Information window indicating
that the process is completed.
Formats
The Formats sublevel enables configuration of the Examination
list window (see Figure 9-10, page 418) and other tools related
to patient management, as described below.

R2424458-100 Rev. 2
Figure 13-18: The sublevel Formats (example)
Configuration of the Examination list window

The user can configure the examination list displayed in the
Examination list window (see Figure 9-10, page 418) by
deleting, adding columns and change the information type
displayed in each column.
Column configuration
1. Trackball to the column to edit.
To adjust column 2. Press the SET key in the trackball area.
width, select and A sub-menu is displayed (see Figure 13-19).
drag column head-
ing border. 3. Select the action to perform:
• Insert: creates a new column
• Delete: removes selected column
• select the desired information to be displayed in the
selected column.

R2424458-100 Rev. 2
1. Insert new column to the left of

the selected column
2. Delete selected column
3. Select column heading
Figure 13-19: Configuration of the Examination list window

R2424458-100 Rev. 2
Other configuration settings
Use free text addresses:

In the Patient information window (see
page 98),
: The address information (e.g. street, city
etc.) is entered in type-specific fields.
: The address information is entered in a
single field (free text).
Use Date of birth:

page 98), enter either the patient age or the
birth date:
: Enter age (Date of birth field not
available)
: Enter Date of birth, the age is calculated.
Use extended patient dialog:

page 98),
: The entire patient information data is
displayed.
: Patient information data displayed is
restricted to a minimum (e.g. name and
Patient ID). When unchecked, press More to
display the entire patient information data.
Use extended search dialog:

In the Search/Create Patient window (see
page 97, page 415 and page 417),
: All the searching filters are displayed as
default.
: The searching criteria are restricted to a
minimum. When unchecked, press More to
display all the searching filters.

R2424458-100 Rev. 2
Auto search for patient:

In the Search/Create Patient window (see
page 97, page 415 and page 417),
: The system searches automatically
through the patient archive selected while
entering patient information.
: The system searches through the patient
archive after pressing SET.
Pre-defined text directly:

In the Examination list window (see
page 418),
: the Insert text key launches pre-defined
text input.
: the Insert text key open the extended
text field.
Examination list on Archive button

When a patient is selected, pressing
ARCHIVE will:
: open the Examination list window for the
selected patient.
: open the Patient Information window for
the selected patient.
Automatic generation of patient ID:

In the Search/Create Patient window
(page 97),
: Patient ID is not required when entering a
new patient in the archive. The system
generates automatically an ID number.
: Patient ID is required when entering a
new patient in the archive.
Request acknowledge of End Exam

action:
: The user is asked to confirm action when
ending an examination.

R2424458-100 Rev. 2
Go directly to scanning from search:

: The unit goes directly to the Scanning
screen after selecting/creating patient
record.
: The unit displays the Patient information
window after selecting/creating patient
record for further information entry. The user
must press Begin Exam to enter the
Scanning screen.
Save all images on end exam:

: All images on the clipboard are
automatically saved when ending an
examination. A dialogue window is displayed
when ending an exam where the user can
select between:
• Store all images
• Select images to store
• Store no images
Exam screen/Report headings:

Enter user-defined headings for Comments,
Diagnosis and Referral reasons fields.
DICOM images:
Select between:
• No extra info
• Add visible patient info in the DICOM
images: displays patient information
(name, date of birth and ID) on DICOM
images.
• Add titlebar: adds the Titlebar to the
DICOM images.

R2424458-100 Rev. 2
TCP-IP
This configuration category enables the user with
administration rights to set the Transmission Protocol/Internet
Protocol for the system and connected remote archive.
1. Computer name: device’s name of type VIVID_S5-00nnnn or

VIVID_S6-00nnnn or ECHOPAC7-00nnnn, where “nnnn” is the system’s
serial number. Do not change the computer name.
2. IP settings: system IP settings
3. Remote archive setup: remote archive IP address and name (EchoPAC PC
or Image Vault)
4. Save TCP/IP settings. The changes will be effective after the system is
rebooted.
5. Advanced DICOM log: creates a detailed DICOM related report log. Should
be used only if DICOM issues are registered (see page 646 about report log
generation).
Figure 13-20: The sublevel TCP/IP

R2424458-100 Rev. 2
System
This configuration category is divided in two sheets:
• System Settings: enables the user to set the date and
time, choose the measurement unit and language for the
system and enter basic information about the organization,
such as the institution name and department.
• Test: enables testing of the different parts of the unit.
This sheet is accessible to users with administration rights only.
The system settings
Figure 13-21: The System settings setup sheet

R2424458-100 Rev. 2
Location
Location:
• Hospital: Enter the hospital name (up to 64
characters). This information is displayed
on the scanning screen's Title bar (up to 24
characters) and on the image properties of
all saved images.
• Department: Enter the department name
(up to 64 characters). This information is
displayed on the image properties of all
saved images.
Date and Time
Date and Time:

• Date: sets the date. Select the correct
date from the pop-up window.
• Time: sets the time. Press the arrow head
buttons to set the time (hour, min, sec).
• Time Format: select the desired format
(24 or 12 AM/PM) from the pop-up menu.
• Date Format: select the desired format
(EU or US) from the pop-up menu.
• Default Century: select the desired
format (1900, 2000 or None) from the
Changes done on the date or time format pop-up menu.
will be effective only after rebooting the 1900: the number 19 is automatically
system. displayed when entering the year in the
patient date of birth (to edit century, press
BACKSPACE twice).
2000: the number 20 is automatically
displayed when entering the year in the
patient date of birth (to edit century, press
BACKSPACE twice).
None: four digits must be typed when
entering the patient year of birth.

R2424458-100 Rev. 2
Languages
Language:
Select the desired language for the system
from the pop-up menu.
Manual language:
Select the desired language for the Online
manual. If not available the English manual
will be displayed as default.
Units
Units:
Select the desired units (Metric or US) from
the pop-up menu.
About
The About sheet gives informations about the ultrasound unit
concerning:
• software
• hardware
• Probes

R2424458-100 Rev. 2
Administration
Only users with ad- The Admin. category deals with the following:
ministration rights
• Disk management: enables the management of the hard
have access to this
setup category (see disk space while maintaining the patient database on the
page 637). system (see page 468).
• Backup: enables the backup procedures for local patient,
and report archives as well as system and user-defined
configuration (see page 472).
• Restore: enables data retrieving of patient and report
archives as well as system and user-defined configuration
(presets) from a backup (see page 476).
• Users: deals with operators registration, operator's rights
setting and registration of staff related to an examination
(e.g. referral doctors, sonographers etc.)
• System Administration: keeps track of all the options
implemented in the unit.
• Unlock patient: enables to unlock patient records that
were not properly terminated (see page 640).

R2424458-100 Rev. 2
Users
The Users sheet deals with operators registration, operator's
rights setting and registration of referring members related to
examinations (e.g. referring and diagnosing physicians).
Figure 13-22: The Users setup sheet
Users are divided in groups with different rights. There are two
types of groups:
• User groups: members of these groups (see table below)
are allowed to login on the system when selected together
with the group Operator. They have group specific rights.
• Referring groups: members of these groups (Diagnosing
physician and Referring doctor) are not allowed to login on
the system. They are registered as references that can be
associated to a patient record.

R2424458-100 Rev. 2
Table 13-1: The User groups
Right (see definition below)
Store report
Print report
Service
Create
Admin
Group
Cardiologist + + + Activated
with a
Physician + + Dongle
Sonographer + +
Fellow + +
Sys Admin + + +
Hosp admin +
GE admin + + +
The rights associated to the user groups are:
Right Definition
Create and delete • Create, update and delete a patient record

• Create, update and delete an examination
• Create, update and delete an user or a referring member
• Import/Export patient records, examinations
• Move examinations
Print report • Print a report
Store report • Store a report
Admin • System administration
Service • Access to the service platform

R2424458-100 Rev. 2
Creating a user or a referring member

1. Press New
2. Enter the user’s information.
3. Select the type of user/referring member in Member of
Group(s).
To be able to login on the system, the group Operator MUST be
selected.
CAUTION
Editing an user configuration

1. Select the actual user in the User list.
2. Make the desired changes.
3. Press CONFIG or any active scanning key to exit the
Configuration management package.
Deleting a user
1. Select the actual user in the User list.
2. Press Delete.
The user is removed from the User list.
Auto logon and auto Screenlock

Auto logon
• Select the desired logon setup from the pull down menu:
• Disabled: no default user is selected when logging on.
• Last user: the last user is selected automatically when
logging on.
• A specific user: select one of the users to be the default
user when logging on.
Auto logoff
• Set the time span (from 10 min) for the system to
automatically get locked when not in use. When the system
is locked, the current user may either log on again or the
system may be restarted by a different user.

R2424458-100 Rev. 2
Unlock Patient
If for any reason an examination is not properly finished, the
patient record is locked and cannot be opened again unless it
is unlocked.
Figure 13-23: The Unlock Patient sheet
To unlock patient records:

1. Press CONFIG.
3. In the Admin category, select the sheet Unlock patient.
4. In the Unlock patient sheet, select the patient records to
unlock
You can search for a specific patient record or a group of
patient record using the searching filters.
5. Select Unlock to unlock the selected patient record(s), or
select Unlock All to unlock all patient records.
6. Select OK.

R2424458-100 Rev. 2
User maintenance
Chapter 14
User maintenance
• System Care and Maintenance .................................................... .. 642

• Inspecting the system .............................................................. 642
• Cleaning the unit ...................................................................... 643
• Prevention of static electricity interference ............................... 645
• System self-test ............................................................................ .. 646
• System malfunction .................................................................. 646
• Using InSite ExC ........................................................................... .. 650
• InSite ExC Functionalities ........................................................ 650
• Initiating a Request for Service (RFS) ...................................... 650
• Clinical Lifeline Mode ............................................................... 653
• Exiting InSite ExC .................................................................... 654

R2424458-100 Rev. 2
User maintenance
System Care and Maintenance

Having been determined by GE Medical Systems engineers
that your Vivid S5/Vivid S6 system has no high-wearing
components likely to fail due to frequent use, no Periodic
Maintenance Inspections are mandatory. However, some
Customer Quality Assurance Programs may require additional
tasks and/or inspections to be performed at periods of
frequency different from those listed in this manual.
The user must ensure that safety inspections are performed at
least every 12 months according to the requirements of the
CAUTION patient safety standard IEC 60601-1 (1988).
Only trained persons are allowed to perform the safety
inspections mentioned above.
Technical descriptions are available on request.
To ensure that the Vivid S5/Vivid S6 unit constantly operates at

maximum efficiency we recommend that the following
procedures be observed as part of the customer’s internal
routine maintenance program.
Inspecting the system

If any defects are observed or malfunctions occur, DO NOT
operate the equipment, and inform a qualified service person.
CAUTION
Monthly
Examine the following on a monthly basis (or whenever there is
a reason to assume that any issue may have occurred):
• Connectors on cables, for any mechanical defects
• Entire length of electrical and power cables, for cuts or
abrasions
• Equipment, for loose or missing hardware
• Control panel for defects
• Brakes
To avoid electrical shock hazard, do not remove panels or

covers from the unit.
WARNING

R2424458-100 Rev. 2
User maintenance
Virus Protection
To minimize virus vulnerability Vivid S5/Vivid S6 is configured
with a minimal set of open ports and with all network services
not actively used by the system closed down. This significantly
reduces the risk of a virus attack on Vivid S5/Vivid S6. GE is
continuously judging the need for additional actions to reduce
vulnerability of equipment, this includes vulnerability scanning
of our products and evaluation of new security patches for the
third party technology used. Microsoft (and other) security
patches that addresses serious issues with Vivid S5/Vivid S6
will be made available to customers after GE verification of
those patches.
Cleaning the unit

General Cleaning
Frequent and diligent cleaning of the Vivid S5/Vivid S6
ultrasound unit reduces the risk of spreading infection from
person to person, and also helps to maintain a clean working
environment.
When performing Cleaning Procedures, to prevent the risk of
system damage, always observe the following precautions:
CAUTION • Use only recommended cleaning materials and solutions.
• Do not use any solutions or products not listed in the
Vivid S5/Vivid S6 User Manual.
• Do not spray any liquid directly onto the Vivid S5/Vivid S6 covers,
LCD Display or keyboard!
• Do not allow any liquid to drip or seep into the system.
• Prior to cleaning, turn OFF power to the system.
System Cabinet
On a weekly basis, moisten a soft, non-abrasive folded cloth or
sponge with a mild, general purpose, non-abrasive soap and
water solution. Do not use any solution containing abrasive
powder or strong chemicals such as acid or alkaline.
Squeeze excess liquid from the cloth/sponge, them wipe down
the top, front, back and both sides of the unit. Do not spray
any liquid directly onto the unit!
1. Rinse the cloth/sponge with clean running water and wipe
the unit surfaces again.

R2424458-100 Rev. 2
User maintenance
2. Use a dry, soft, lint-free cloth to dry the unit surfaces.

3. Wait for the unit surfaces to dry completely.
Note: In the event that disinfection is required or any stubborn
stains remain, remove them with a soft, dust-free cloth on
which a small quantity of isopropyl rubbing alcohol has been
absorbed, as described below for cleaning the Keyboard.
LCD Display
On a weekly basis, gently wipe the LCD Display with a dry, soft,
lint-free non-abrasive folded cloth.
Note: In the event that you see a scratch-like mark on the LCD
Display, this may be a stain transferred from the Keyboard or
Trackball when the LCD Display Cover was pressed from the
outside. Proceed as follows:
Wipe or dust the stain gently with a soft, dry cloth. If the stain
remains, moisten a soft, lint-free cloth with water or a 50-50
mixture of isopropyl alcohol and water that does not contain
impurities. Wring out as much of the liquid as possible then
wipe the LCD Display again. Do not let any liquid drip into
the computer!
Be sure to dry the LCD Display before closing the cover.
Control Panel and Keyboard

Control Panel:
On a weekly basis, moisten a soft, non-abrasive folded cloth or
sponge with a mild, general purpose, non-abrasive soap and
water solution or general purpose disinfectant. Do not use any
solution containing abrasive powder or strong chemicals
such as acid or alkaline.
Squeeze excess liquid from the cloth/sponge, them wipe down
the Control Panel.
Do not spray any liquid directly onto the Control Panel!
1. Rinse the cloth/sponge with clean running water and wipe
the Control Panel again.
2. Use a dry, soft, lint-free cloth to dry the Control Panel.
3. Wait for the Control Panel surfaces to dry completely.

R2424458-100 Rev. 2
User maintenance
Keyboard:
Clean the keyboard as described (above) for cleaning the
Control Panel.
Note: In the event that disinfection is required or any stubborn
stains remain, absorb a small quantity of isopropyl rubbing
alcohol on a soft, dust-free cloth.
Wipe the surface of the keycaps with the cloth, making sure
that no liquid drips on or between the keys. Allow to dry.
Magneto Optical Disk (MOD)

Clean the drive head and media with the vendor-supplied
cleaning kit. Advised to repeat this often, to prevent future
problems. MOD disks must be stored away from dust and
cigarette smoke. Do not use alcohol or benzene to clean the
MOD cartridge.
DVD - CD-RW Drive

Clean the drive head and media with the vendor-supplied
cleaning kit. Advise the user to repeat this often, to prevent
future problems. CDs must be stored away from dust and
cigarette smoke. Do not use alcohol or benzene to clean the
CD drive.
Peripherals
Clean the peripherals in accordance with the respective
manufacturer's directions.
Prevention of static electricity

interference
Interference from static electricity can damage electronic
components in the system. The following measures help to
reduce the likelihood of electrostatic discharge:
• Wipe the alphanumeric keyboard and monitor with lint-free
tissue or a soft cloth dampened with anti-static spray on a
monthly basis.
• Spray carpets with anti-static spray because constant
walking on carpets in or near the scanning room may be a
source of static electricity.

R2424458-100 Rev. 2
User maintenance
System self-test
The Vivid S5/Vivid S6 ultrasound unit is designed for reliable
operation and consistent, high-quality performance. Automatic
self-testing facilities are provided to monitor system operation
and to detect malfunction as soon as possible, thereby
eliminating unnecessary downtime. The detection of any
serious malfunction may result in immediate interruption of
scanner operation.
System malfunction
In the event of error or system malfunction the user may
generate and export a log file to a removable media as
described below and contact authorized service personnel.
Adding bookmarks
When a problem occurs during regular use of the system, press
ALT - B. This inserts a "bookmark" into the system failure logs,
and a confirmation message appears on a prompt line (see
Figure 14-1). Bookmarks serve as time-stamps, indicating
where particular problems have occurred, while allowing the
user to continue working with minimum interruption. The
bookmark logfile assists service engineers in troubleshooting.
Figure 14-1: Bookmark message
Adding Problem description

1. Press ALT - D on the alphanumeric keyboard.
The Problem description dialogue window is displayed
(see Figure 14-2).
2. Type in a description of the problem. Notes should be made
regarding the selected probe, the imaging mode and the
application that was being used at the time of malfunction.
If applicable, try to describe the button or key pushing
sequence that immediately preceded the problem.
Check the mention System lockup if applicable.
3. Click Save to create a logfile.

R2424458-100 Rev. 2
User maintenance
Figure 14-2: The Problem description dialogue window
Using advanced features

Extensive logging
In some cases you may be asked to activate the Extensive
Logging feature. This allows the system to record logging data
in a more detailed format.
To activate, click Extensive Logging (see Figure 14-2) and
select the categories which require detailed analysis (see
Figure 14-3).
This generates a larger, more detailed log-file.
Note: extensive logfiles can grow considerably over time.
When the feature is not needed, turn it off in order to conserve
the size of the logfiles.

R2424458-100 Rev. 2
User maintenance
Figure 14-3: Extensive Logging dialog
Advanced Options
Click Options (see Figure 14-2) to open the Advanced
Options dialog (see Figure 14-4). This dialog allows you to:
• Control the size of logfiles
• Specify some optional attachments to be added to the
logfiles
Setting Logfile ranges
By default, the logfiles may be very large as they are not limited
by time. In case you wish to limit the logfiles:
1. Select Export Logs Using (see Figure 14-4).
2. Select Time Range.
3. Define the time range using the From and To fields.
Alternatively, select Bookmarks. This generates logfiles which
are limited to one hour before through one hour after the
selected bookmark.

R2424458-100 Rev. 2
User maintenance
Figure 14-4: Advanced Options dialog
Setting Logfile attachments

On the lower area of the Advanced Options dialog (see
Figure 14-4) you can select different items that you wish to
attach to logfiles.
Exporting the logfile

1. Press ALT - D on the alphanumeric keyboard to display the
Problem description dialogue window again.
2. Select the destination where to export the logfile (MOD or
CD-R).
3. Press Save and Export.
A Zip file (named “logfile_<date>_<time>.zip”) is copied on
to the selected removable media.

R2424458-100 Rev. 2
User maintenance
Using InSite ExC

InSite ExC is your direct link with a GE Online Service
Engineer, or Applications Support Engineer, or a Request for
Service. The system enables you to get online assistance
promptly, and monitor and follow up the status of your requests.
A Request for Service (RFS) can also be initiated by GE
service personnel.
You access Insite ExC via the InSite ExC link located at
the bottom left corner of the screen.
InSite ExC Functionalities

• Service Desktop: Utilities intended for service personnel
• Request for Service: Opens a service call with GE Service
• Connect to GE: Sets up a quick link with GE Technical
Support
• Connect Clinical Lifeline: Gives GE service full access to
your system and enables Technical Support to establish a
remote control link with your system
• Cancel
Initiating a Request for Service (RFS)

This option opens a service call with GE Service.
1. Click the icon at the bottom left corner of your screen.

The Insite-2 dialog box opens (Figure 14-5).
Figure 14-5: Insite-2 dialog box
2. Select Request for Service. The Contact Information

dialog box opens - (Figure 14-6 and Figure 14-7).

R2424458-100 Rev. 2
User maintenance
The items marked with a red asterisk are required fields

and the requested information must be typed in the
relevant fields.
Figure 14-6: Contact Information dialog box
Figure 14-7: Contact Problem Description

R2424458-100 Rev. 2
User maintenance
Note: Before clicking the "Send" button, verify that

"Checked Out" is displayed at the bottom left corner of the
screen. This indicates that the communications link is
active.
3. After you have completed filling in all the required
information, press Send to initiate the Request for Service.
The following request confirmation appears (Figure 14-8).
Figure 14-8: Request confirmation
4. Select the Queue tab (see Figure 14-9) to check the status
of your request.
Figure 14-9: Screen showing status of requests in queue
5. To identify which users have sent service requests, click the

Users tab (see Figure 14-10).

R2424458-100 Rev. 2
User maintenance
Figure 14-10: Users tab
Clinical Lifeline Mode

Using the Clinical Lifeline functionality is similar to the Request
for Service procedure:
1. Click the InSite ExC icon at the bottom left corner of

the screen. The Insite 2 dialog box displays.
2. Select Connect Clinical Lifeline.
After a few moments the InSite ExC icon changes to a red
icon indicating that you have authorized Service to

establish a remote control link with your system.
Note: In addition to contacting a technical / clinical support
person, selecting this mode also changes the service response
time from 10 minutes to 15 seconds so that your call can be
answered as quickly as possible, as well as enabling Disruptive
mode (where Technical Support can establish a remote control
link with your system).

R2424458-100 Rev. 2
User maintenance
Exiting InSite ExC

1. Click at top right corner of the screen to exit InSite ExC.
2. After you have finished using InSite ExC, reboot the
system.

R2424458-100 Rev. 2
Index
Index
Numerics
2D Soft menu controls............................................................................ 145
2D-Mode.......................................................................................... 140–150
Controls............................................................................................. 142
Optimizing ......................................................................................... 148
Overview ........................................................................................... 140
Using................................................................................................. 148
A
Active mode gain
Optimizing Color Mode ..................................................................... 163
Optimizing CW Doppler .................................................................... 168
Optimizing PW Doppler..................................................................... 168
adding malfunction description............................................................... 646
Advanced sheet............................................................................... 603, 604
AFI.......................................................................................................... 328
Alpha HIP ............................................................................................... 316
Amniotic Fluid Index ............................................................................... 328
Angle correction
CW Doppler ...................................................................................... 166
PW Doppler....................................................................................... 166
Annotations ..................................................................................... 128–135
Configure .......................................................................................... 132
Editing ............................................................................................... 131
Erasing.............................................................................................. 131
Inserting ............................................................................................ 128
Application
selecting............................................................................................ 100
Assignable keys ..................................................................................... 103
Audio Volume
PW/CW Doppler................................................................................ 165
AutoEF ................................................................................................... 292
AVI.......................................................................................................... 408

R2424458-100 Rev. 2
Index
B
B Color maps
2D Mode ............................................................................................ 143
Baseline
Color Mode ........................................................................................ 159
CW Doppler ....................................................................................... 165
Optimizing Color Mode ...................................................................... 163
PW Doppler ....................................................................................... 165
TVI ..................................................................................................... 170
battery, internal ......................................................................................... 57
BFI .......................................................................................................... 195
B-Flow..................................................................................................... 195
Biopsy ..................................................................................................... 563
needle path........................................................................................ 573
Blood flow imaging..................................................................................195
B-Mode measurements....................................................................323, 371
Bodymark................................................................................................134
bookmark ................................................................................................646
C
Care and Maintenance.....................................................................642–645
Cine Compound
Strain ................................................................................................. 186
Strain rate .......................................................................................... 181
Tissue Tracking ..........................................................................176, 190
Cineloop........................................................................................... 110–113
Controls ............................................................................................. 111
Overview............................................................................................ 110
Saving as AVI .................................................................................... 408
Using ................................................................................................. 112
Circumference parameter ....................................................................... 325
CIVCO..................................................................................................... 565
Cleaning
Ultrasound unit ..................................................................................643
Color 2D
Using ................................................................................................. 162
Color maps
Color Mode ........................................................................................ 160
CW Doppler ....................................................................................... 166

R2424458-100 Rev. 2
Index
M-Mode............................................................................................. 152
Strain................................................................................................. 184
Strain rate ......................................................................................... 179
Tissue Synchronization Imaging ....................................................... 189
Tissue tracking.................................................................................. 175
TVI .................................................................................................... 171
Color M-Mode
Overview ........................................................................................... 158
Using................................................................................................. 162
Color Mode...................................................................................... 157–163
Controls............................................................................................. 159
Optimizing ......................................................................................... 163
Overview ........................................................................................... 157
using ................................................................................................. 162
Comments .............................................................................................. 419
Compound....................................................................................... 143, 194
Compress
2D ..................................................................................................... 145
CW Doppler ...................................................................................... 166
LV Contrast ....................................................................................... 237
M-Mode............................................................................................. 152
Optimizing M-Mode........................................................................... 155
PW Doppler....................................................................................... 166
Strain rate ......................................................................................... 180
TVI .................................................................................................... 171
Compund......................................................................................... 143, 194
Configurable Remote Path ......................................................................118
Configuration see System setup
Connecting peripherals ............................................................................ 58
Connecting the unit .................................................................................. 54
Connectivity
Buttons.............................................................................................. 623
Dataflow ............................................................................................ 616
Overview ........................................................................................... 616
Continuous capture ................................................................................ 205
Contour
2D ..................................................................................................... 146
LV Contrast ....................................................................................... 238

R2424458-100 Rev. 2
Index
M-Mode ............................................................................................. 153

Optimizing M-Mode ...........................................................................155
Contrast Imaging..............................................................................233–241
Abdominal Contrast Imaging .............................................................241
LV Contrast Imaging.......................................................................... 235
Vascular Contrast Imaging ................................................................ 240
Control panel........................................................................................71–82
Coupling gels .......................................................................................... 561
CW Doppler .....................................................................................164–168
Controls ............................................................................................. 165
Optimizing.......................................................................................... 168
Overview............................................................................................ 164
Using ................................................................................................. 167
D
D Color maps
PW Doppler ....................................................................................... 166
d-D Ratio................................................................................................. 316
DDP
2D ...................................................................................................... 146
LV Contrast........................................................................................ 238
Optimizing 2D .................................................................................... 149
Delete
Examination....................................................................................... 422
Image................................................................................................. 423
Patient record .................................................................................... 422
Depth
2D ...................................................................................................... 144
Optimizing 2D .................................................................................... 148
Diagnosis code ....................................................................................... 420
Diagnosis information ............................................................................. 419
DICOM spooler ....................................................................................... 479
DICOM verification..................................................................................625
Diff On/Off
2D ...................................................................................................... 146
Diff on/off
LV Contrast........................................................................................ 238
Digital Video Recorder ............................................................................ 578
Direct report ............................................................................................ 514

R2424458-100 Rev. 2
Index
Disk Backup ........................................................................................... 471

Disk Management .................................................................................. 464
configuring ........................................................................................ 465
destination device ............................................................................. 467
manual start ...................................................................................... 468
running .............................................................................................. 468
schedule............................................................................................ 466
settings.............................................................................................. 467
Disk Restore........................................................................................... 471
Doppler measurements .......................................................................... 330
Doppler see PW or CW Doppler
Dual focus
2D ..................................................................................................... 143
DVR........................................................................................................ 578
playback controls .............................................................................. 580
Titles and Chapters........................................................................... 579
Dynamic Range
LV Contrast ....................................................................................... 238
Dynamic range
2D ..................................................................................................... 145
M-Mode............................................................................................. 153
Dysplasia................................................................................................ 315
E
ECG
Adjusting trace .................................................................................. 126
Connecting........................................................................................ 122
Controls............................................................................................. 126
Edge Enhance, M-Mode......................................................................... 153
EFW ....................................................................................................... 330
Ejection Fraction, automated.................................................................. 292
Emission declaration ................................................................................ 44
Estimated Fetal Weight .......................................................................... 330
Event timing............................................................................................ 265
eVue ....................................................................................................... 410
Examination
Starting................................................................................................ 95
Export

R2424458-100 Rev. 2
Index
Patient records ..................................................................................452

extensive logging .................................................................................... 647
F
Fetal growth
bar graph ........................................................................................... 365
Fetal growth curve graph ........................................................................ 360
File Management .................................................................................... 464
Focus
2D ...................................................................................................... 142
LV Contrast........................................................................................ 237
M-Mode ............................................................................................. 152
Optimizing 2D .................................................................................... 149
Follicle measurements ............................................................................ 373
footswitch ..................................................................................................87
Formatting
Removable media.............................................................................. 625
Frame rate
2D ...................................................................................................... 142
Optimizing CW Doppler ..................................................................... 168
Optimizing PW Doppler ..................................................................... 168
Strain ................................................................................................. 184
Strain rate .......................................................................................... 179
Tissue Synchronization Imaging........................................................ 189
Tissue Tracking ................................................................................. 174
TVI ..................................................................................................... 170
Frequency
2D ...................................................................................................... 143
Color Mode ........................................................................................ 160
CW Doppler ....................................................................................... 167
LV Contrast........................................................................................ 236
M-Mode ............................................................................................. 151
PW Doppler ....................................................................................... 167

R2424458-100 Rev. 2
Index
Strain................................................................................................. 185
Strain rate ......................................................................................... 180
Tissue Tracking................................................................................. 175
TVI .................................................................................................... 171
G
Gain
2D ..................................................................................................... 144
Optimizing 2D ................................................................................... 148
Gel.......................................................................................................... 561
Gestational Sac ...................................................................................... 327
GS .......................................................................................................... 327
GYN measurements............................................................................... 370
H
Hazard symbols........................................................................................ 16
Hip Dysplasia ......................................................................................... 315
Horizontal sweep
Color M-Mode ................................................................................... 159
CW Doppler ...................................................................................... 165
M-Mode............................................................................................. 151
PW Doppler....................................................................................... 165
I
Images
Saving as JPEG................................................................................ 408
Import
Patient records.................................................................................. 460
Intima-Media Thickness ......................................................................... 303
Invert
2D ..................................................................................................... 143
Color Mode ....................................................................................... 159
CW Doppler ...................................................................................... 165

R2424458-100 Rev. 2
Index

PW Doppler ....................................................................................... 165
Strain rate .......................................................................................... 179
Tissue Tracking ................................................................................. 174
TVI ..................................................................................................... 170
J
JPEG.......................................................................................................408
L
Language
Online manual ................................................................................... 635
System............................................................................................... 635
Lateral Averaging
Color Mode ........................................................................................ 161
Strain ................................................................................................. 186
Strain rate .......................................................................................... 180
Tissue Tracking ................................................................................. 175
TVI ..................................................................................................... 172
LCD monitor safety ................................................................................... 37
logfile.......................................................................................................648
exporting............................................................................................ 649
LogiqView ............................................................................................... 193
Low Velocity Reject see LVR
LPRF.......................................................................................................166
LVR
Color Mode ........................................................................................ 159
CW Doppler ....................................................................................... 165
M
M&A ........................................................................................................ 333
Magneto Optical Disk
Formatting .........................................................................................625
Measurements

R2424458-100 Rev. 2
Index
Configuration..................................................................................... 338
User-defined formulas....................................................................... 343
Measurements (Cardiac)................................................................. 243–351
2D ..................................................................................................... 255
Doppler ............................................................................................. 262
M-Mode............................................................................................. 259
TSI .................................................................................................... 266
Measurements (Vascular)
B-Mode ............................................................................................. 302
Doppler ............................................................................................. 309
M-Mode............................................................................................. 308
M-Mode ........................................................................................... 150–156
Anatomical M-Mode .......................................................................... 154
Controls............................................................................................. 151
Conventional M-Mode................................................................ 153, 154
Curved Anatomical M-Mode ............................................................. 155
Optimizing ......................................................................................... 155
Overview ........................................................................................... 150
Using................................................................................................. 153
Monitor
adjusting image................................................................................... 90
adjusting position ................................................................................ 92
Moving the unit ......................................................................................... 64
moving the unit ......................................................................................... 64
MPEG exams ......................................................................................... 410
MPEGVue/eVue ..................................................................................... 410
multiple fetus .......................................................................................... 366
N
Needle Guidance Systems..................................................................... 565
normal values ......................................................................................... 340
O
OB application ........................................................................................ 321
OB exam ................................................................................................ 317
OB graphs .............................................................................................. 359
OB measurements ................................................................................. 322
OB Multigestational ................................................................................ 366
OB parameter configuration ................................................................... 333

R2424458-100 Rev. 2
Index
OB table sheet ........................................................................................ 605

OB worksheet .........................................................................................356
On/Off ....................................................................................................... 61
Operation principles .................................................................................... 2
Ovary measurements.............................................................................. 372
P
Patient
Entering information ............................................................................ 95
Pediatric Calculations ............................................................................. 314
Phono
Adjusting trace................................................................................... 126
Controls ............................................................................................. 126
Physiological traces .........................................................................122–127
Power
2D ...................................................................................................... 146
Color Mode ........................................................................................ 161
CW Doppler ....................................................................................... 167
LV Contrast........................................................................................ 237
M-Mode ............................................................................................. 153
PW Doppler ....................................................................................... 167
Strain rate .......................................................................................... 181
Tissue Synchronization Imaging.................................................186, 190
Tissue Tracking ................................................................................. 176
Probe-Application Overview
Vivid S5 ............................................................................................. 542
Vivid S6 ............................................................................................. 543
Probes
Activating ........................................................................................... 550
Care and Maintenance ...................................................................... 552
Cleaning ............................................................................................ 556
Connecting ...................................................................................87, 548
Disconnecting .................................................................................... 551
Disconnecting and connecting............................................................. 87
Disinfecting ........................................................................................ 558
Intra-operative use............................................................................. 574
Labelling ............................................................................................ 546
Orientation markers ...........................................................................545

R2424458-100 Rev. 2
Index
returning............................................................................................ 561
Safety................................................................................................ 562
Selecting ........................................................................................... 100
shipping............................................................................................. 561
special handling ................................................................................ 554
surgery use ....................................................................................... 574
Types ................................................................................................ 537
probes, selecting .................................................................................... 548
protective sheaths .................................................................................. 554
Pulse Pressure
Adjusting trace .................................................................................. 126
Pulse Pressure transducer
Controls............................................................................................. 126
PW Doppler ..................................................................................... 164–168
Controls............................................................................................. 165
Optimizing ......................................................................................... 168
Overview ........................................................................................... 164
Using................................................................................................. 167
Q
Quantitative Analysis.............................................................................. 375
Anatomical M-Mode .......................................................................... 399
Deletion of a trace............................................................................. 389
Frame disabling ................................................................................ 390
Labelling a sample area.................................................................... 393
Manual tracking................................................................................. 387
Optimizing Anatomical M-Mode ........................................................ 401
Optimizing sample area .................................................................... 392
Optimizing the trace display.............................................................. 394
Overview ........................................................................................... 379
Sample area...................................................................................... 386
Strain cursor...................................................................................... 386
To generate a trace........................................................................... 386
Trace smoothing ............................................................................... 395
R
Radial Averaging
Color Mode ....................................................................................... 161

R2424458-100 Rev. 2
Index
Strain ................................................................................................. 186

Strain rate .......................................................................................... 180
Tissue Tracking ................................................................................. 176
TVI ..................................................................................................... 172
Referral reasons ..................................................................................... 419
Regulatory requirements............................................................................. 6
Reject
2D ...................................................................................................... 145
LV Contrast........................................................................................ 238
M-Mode ............................................................................................. 152
Optimizing 2D .................................................................................... 149
Strain ................................................................................................. 185
Strain rate .......................................................................................... 180
Remote Path ........................................................................................... 118
Removable media
Ejecting.............................................................................................. 119
Flash Card ......................................................................................... 115
Formatting .........................................................................................625
Report ..............................................................................................491–534
Configuration of the Template selection menu .................................. 532
Creating ............................................................................................. 493
Deleting ............................................................................................. 497
Direct report....................................................................................... 514
Export/Import templates ....................................................................533
managing report images....................................................................495
Print ................................................................................................... 496
Retrieving .......................................................................................... 497
Save .................................................................................................. 496
Report designer ...................................................................................... 516
Designing a template......................................................................... 519
ROI size
Color Mode ........................................................................................ 161
S
Safety...................................................................................................13–50
Biological hazard ................................................................................. 36
Electrical hazard .................................................................................. 35
Equipment safety................................................................................. 35

R2424458-100 Rev. 2
Index
Explosion hazard ................................................................................ 35

Mechanical hazard.............................................................................. 32
Pacemaker hazard.............................................................................. 36
Patient safety ...................................................................................... 31
Personnel safety ................................................................................. 35
Sample volume
Color Mode ....................................................................................... 160
CW Doppler ...................................................................................... 166
PW Doppler....................................................................................... 166
save as PDF to network ..........................................................................118
Scale
Color Mode ....................................................................................... 159
CW Doppler ...................................................................................... 165
PW Doppler....................................................................................... 165
Strain................................................................................................. 184
TVI .................................................................................................... 170
Scanning
Screen layout ...................................................................................... 84
starting .............................................................................................. 100
Simultaneous
Strain................................................................................................. 184
Strain rate ......................................................................................... 179
Tissue tracking.................................................................................. 174
TVI .................................................................................................... 170
Single length parameter ......................................................................... 325
Site requirements ..................................................................................... 53
Soft Menu Rocker................................................................................... 103
using ................................................................................................. 107
Strain ...................................................................................................... 183
Controls............................................................................................. 184
Optimizing ......................................................................................... 186
Overview ........................................................................................... 183
Using................................................................................................. 186
Strain cursor ........................................................................................... 386
Strain rate............................................................................................... 178
Controls............................................................................................. 179

R2424458-100 Rev. 2
Index
Optimizing.......................................................................................... 181
Overview............................................................................................ 178
Using ................................................................................................. 181
Stress Echo......................................................................................197–231
Acquisition .........................................................................................200
Analysis ............................................................................................. 213
Configuring levels .............................................................................. 230
Creating an image group ................................................................... 231
Deleting a group ................................................................................ 231
Editing template................................................................................. 225
Labelling a level................................................................................. 230 Y
Labelling a projection......................................................................... 230
Scoring .............................................................................................. 216
Selecting a template .......................................................................... R 199
Timers.........................................................................................204, 230
System
Controls affecting acoustic output ....................................................... 27
A
Switching On/Off.................................................................................. 61
System documentation ...............................................................................3
System setup ...................................................................................583–640
Application .........................................................................................593
N
Connectivity ................................................................................616 –632
Examination list window ....................................................................626
I
Examination signoff ...........................................................................626
Imaging setup .................................................................................... 590
Language........................................................................................... 633
M&A................................................................................................... 598
Patient ID...........................................................................................
M 626
Patient information............................................................................. 592
I
Scan information................................................................................ 592
Starting system setup ........................................................................ 588
Units .................................................................................................. 633
Unlock Patient ...................................................................................
L 640
User configuration ............................................................................. 637
T E
TCP-IP .................................................................................................... 632
TGC see Time Gain Compensation........................................................ 144
Threshold
R
668P Vivid S5/Vivid S6 User Manual

R2424458-100 Rev. 2
Index
Strain................................................................................................. 185
Strain rate ......................................................................................... 180
Tissue Tracking................................................................................. 175
TVI .................................................................................................... 171
Tilt
2D ..................................................................................................... 142
LV Contrast ................................................................................ 236, 238
Time Gain Compensation (TGC)
2D ..................................................................................................... 144
Optimizing 2D ................................................................................... 148
Tissue priority
Color Mode ....................................................................................... 160
Tissue Synchronization Imaging ............................................................ 188
Controls............................................................................................. 189
Optimizing ......................................................................................... 192
Overview ........................................................................................... 188
Using................................................................................................. 191
Tissue Tracking ...................................................................................... 173
Controls............................................................................................. 174
Optimizing ......................................................................................... 176
Overview ........................................................................................... 173
Using................................................................................................. 176
Tissue Velocity Imaging see TVI
Trackball
Operation .......................................................................................... 108
Transparency
Strain................................................................................................. 185
Strain rate ......................................................................................... 180
Tissue Tracking................................................................................. 175
TVI .................................................................................................... 171
TSI................................................................................................... 170, 174
TSI, see Tissue Synchronization Imaging
TVI.......................................................................................................... 169
Controls............................................................................................. 170
Optimizing ......................................................................................... 172
Overview ........................................................................................... 169

R2424458-100 Rev. 2
Index
Using ................................................................................................. 172
U
UD....................................................................................................146, 237
Ultra Definition Clarity ......................................................................146, 237
Uterus measurements............................................................................. 371
V
Variance
Color Mode ........................................................................................ 159
Velocity range
Virtual Convex.........................................................................................196
W
wheels....................................................................................................... 64
Width
2D ...................................................................................................... 142
LV Contrast........................................................................................ 236
Worksheet............................................................................................... 353

R2424458-100 Rev. 2

Vivid s5 s6 User Manual

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GE Medical Systems

This manual is a reference for the Vivid S5 and Vivid S6. It

GE Medical Systems Information Technologies GmbH,

Vivid S5/Vivid S6 User Manual i

Label Icon Description......................................................... 23

ii Vivid S5/Vivid S6 User Manual

Peripheral Update for EC countries .................................... 46

Vivid S5/Vivid S6 User Manual iii

iv Vivid S5/Vivid S6 User Manual

Vivid S5/Vivid S6 User Manual v

Tissue Synchronization Imaging (TSI) ..................................... 188

vi Vivid S5/Vivid S6 User Manual

Data acquisition......................................................................... 235

Vivid S5/Vivid S6 User Manual vii

Selecting probe and OB application .................................. 321

viii Vivid S5/Vivid S6 User Manual

Endometrium thickness (Endo)......................................... 373

Vivid S5/Vivid S6 User Manual ix

Using Anatomical M-Mode ................................................ 399

x Vivid S5/Vivid S6 User Manual

Database import from Vivid 3 or Vivid 4.................................. 482

Vivid S5/Vivid S6 User Manual xi

xii Vivid S5/Vivid S6 User Manual

Vivid S5/Vivid S6 User Manual xiii

Additional outputs.............................................................. 623

xiv Vivid S5/Vivid S6 User Manual

Revision Date Reason for Change

1 19 July 2009 Initial release

2 07 February 2010 Updates and additions

List of effective pages

Revision Effective Pages

Vivid S5/Vivid S6 User Manual xv

xvi Vivid S5/Vivid S6 User Manual

Vivid S5/Vivid S6 User Manual 1

Devices not to be used near this equipment:

2 Vivid S5/Vivid S6 User Manual

Medical staff in charge of the unit are required to instruct

Indications for use

This machine should be used in compliance with law. Some

The Vivid S5/Vivid S6 ultrasound unit is not intended for

Vivid S5/Vivid S6 User Manual 3

probes, and user care and maintenance.

4 Vivid S5/Vivid S6 User Manual

Conventions used in this manual

Indicates that the relevant feature exists in the standard configuration

Indicates that the relevant feature exists as an option of the Vivid S6

Indicates that the relevant feature exists as an option on both Vivid S6

Indicates that the relevant feature exists in the standard configuration

Indicates that the relevant feature exists in the standard configuration

Vivid S5/Vivid S6 User Manual 5

Indicates that a specific hazard is known to exist which through

Indicates that a specific hazard is known to exist which through

Indicates that a potential hazard may exist which through

6 Vivid S5/Vivid S6 User Manual

Accessories Catalog Requests

Vivid S5/Vivid S6 User Manual 7

Latin and South America

8 Vivid S5/Vivid S6 User Manual

Vivid S5/Vivid S6 User Manual 9

Luxembourg Tel: 0800 2603 toll free

10 Vivid S5/Vivid S6 User Manual

Other countries NO TOLL FREE

Vivid S5/Vivid S6 User Manual 11

12 Vivid S5/Vivid S6 User Manual